What Abi Taught Us (5 page)

Beware of the grief ‘ambush'

In their book,
I Wasn't Ready to Say Goodbye: Surviving, coping and healing after the sudden death of a loved one
, Brook Noel and Pamela Blair introduce the notion of the grief ‘ambush'.
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I found myself ambushed by grief again only very recently, when visiting our new supermarket. It had been destroyed in the quakes, and was at last being reopened after almost five years. Our whole community had been eagerly awaiting the official opening, all laughing about how ridiculous it was to be so excited about a new supermarket. But five years is a long time and we live a fair distance from the city centre, on a peninsula with only one road in, one road out. Opening day finally came, and I raced into the car park, bright eyed, bushy tailed, thrilled to have some decent groceries on our doorstep at long last. I parked the car—and, as I was getting out, grief overwhelmed me. Suddenly and unexpectedly filled with memories of all the times I'd visited the supermarket with Abi, first as a toddler and then as a school girl, the tears began to flow. And there was no stopping them. The whole journey round the supermarket was the same: I could not stop myself crying, acutely aware of how much our lives had changed since 2011 when I had last stood on the same spot. Abi was just eight years old then, so never far from my side. As a little girl we'd buy her ham from the deli counter and eat it as we pushed the trolley around. Now, here I was living such a different life, looking back to a time when her death would have been unimaginable. Thankfully, I saw one of Abi's friends and her dad, had a quick cry on them in the Coke aisle, and then powered on, taking refuge behind my sunglasses once more.
Grief ambushes are a normal part of bereavement but, arriving unannounced, they sure can make you feel silly.

No one strategy will prepare you for these moments, but having a name for them helps us understand what's happening, and so they derail us less. Knowing there will be times when you are blindsided with grief—that misery will overwhelm you at the most unexpected and often inappropriate moments and places—puts you in a better position to weather the grief ambush when it next happens.

Re-establish routines

In Christchurch's post-quake environment, I learned of the importance of re-establishing routines to counteract the negative effects of trauma. The need to re-establish normal routines as quickly as is humanly and physically possible is recognised by disaster researchers as an important initial step towards recovery. Authorities talk about establishing ‘normalisation'—that is, getting kids back to schools, parents back to work, enabling social lives, churches, clubs, leisure facilities and communities to resume functioning. They acknowledge the importance of regarding this as the ‘new normal'.

Re-establishing routines tells our brains that we are safe, that the crisis period is over, and it's okay to disarm the red-alert functioning that is our bodies' reaction to traumatic events. The predictability of routines helps us feel safer, and minimises stress, anxiety and hopelessness.

Studies show that family resilience really matters: keeping the family together after a disaster, resuming routines and ordinary functioning as best you can, helps the children cope. Returning
to the childcare centre, going back to school, to family meals, bedtime stories, sports clubs and opportunities to socialise all give us a feeling that the chaos is over and life is (gradually) adopting a new normal. These repetitive actions are reassuring not only to children but also to adults around them.

With 16 and 14-year-old boys in the house, I was aware that they needed to experience as much normality as possible to help their brains recover from the trauma and to carry on without Abi around. That's not to say we didn't grieve openly at home. We did, we still do. But getting them back to school gave us structure to work with. I was surprised how much they wanted to do this, and how quickly. Within a fortnight, they were both back at school and happier for it.

It took Trevor and me longer to get ourselves back to work. In those first few weeks after Abi's death we stumbled around, struggling to pay attention to anything for very long, with wandering focus and only sporadic and minimal interest in the activities that usually filled our lives. Looking back, I have mental pictures of us occupying our days, always starting with a long walk with the dog, sometimes crying for the majority of it, sometimes numb and silent, at other times chewing our feelings over and over, trying to work it out, as if there was a solution to be found if we could only think it through hard enough, talk it over long enough. But while we couldn't get ourselves back to work, re-establishing meal times, and the regular routine of
exercise, dog walk, coffee, breakfast, chores, lunch, chores, nap, dinner, TV and bed helped. At around the six weeks mark, we went back to work. Trevor returned to his building company, which his crew had valiantly continued to operate without him. I was desperate to resume my research and adamant that I wasn't going to let my current PhD projects go. I talked to my colleagues, and we agreed I'd start with an hour or two and see how it went. Oddly, it was a tremendous relief to focus my mind elsewhere and I was encouraged by how much my poor smashed-up brain could manage. With exceedingly low expectations, the pressure was minimal and gradually my hours picked up. Work has been a welcome distraction and provided me with a lifeline of routine ever since.

I recently met with another woman, Anna, who had just lost her twin sister in a plane crash. I was full of admiration on the morning I met up with her —just three weeks after her sister's death—as she battled to hold back her tears, get the kids out the door and head off to work. Getting back into the classroom where she works as a teaching assistant helps, she said. Being absorbed by the children's activities gives her a much-needed rest from grieving, at least for that part of the day. Seeing the kids carry on as normal tells her brain that normal still exists, that life carries on, that the immediate threat is over. More than anything, short bouts of work provide us with a welcome rest and temporary refuge from grieving.

Chapter 3

What can resilience psychology teach us about grieving?

WHILE THE FIELD OF
psychology has traditionally focused on risk factors (predictors of undesirable life outcomes), I am one of a growing breed of academic researchers focused on protective factors that have been shown to promote wellbeing and assist with recovery among people facing trauma, stress and adversity. Bereavement research remains primarily focused on unpacking the complexities of the bereavement experience (identifying the different stages we go through) and on the alleviation of grief 's negative emotional consequences—anxiety and depression. So when we lost Abi, and my reading on bereavement began, I was struck by how little these two fields of research had crossed over. While resilience psychologists
have unearthed all sorts of findings about how to assist people in bouncing back from trauma, bereavement research (and the corresponding literature handed out to people like you and me) featured few of these strategies. I had lived through trauma—the series of earthquakes that rocked my city from 2010–2012—and previously grieved my mother, so it struck me that the tools we advocate for promoting resilience might well be useful during bereavement. The American Psychological Association defines resilience as ‘the process of adapting well in the face of adversity, trauma, tragedy [and] threats'.
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It seems to me there's sufficient trauma and tragedy in grief to make this body of research relevant.

For instance, resilience research highlights the immensely positive difference that close family ties, social support, family routines, parenting quality, thinking and coping styles (such as optimism and positive emotions), physical activity, and cultural and spiritual beliefs can have on human reaction to adversity. There's no doubt individual personality differences also play a big role in how people react; some people cope well with stress, some are more stress reactive. But, by studying those who have displayed resilience in the face of extreme adversity, researchers have demonstrated that something of a blueprint for resilience does exist. Their findings make for fascinating reading.

For example, having studied the genetic, psychological, biological, social and spiritual factors behind the resilience of prisoners of war, Special Forces instructors, and ordinary men and women who have endured harrowing traumas and gone on to thrive, Steven Southwick (Professor of Psychiatry, Post-traumatic Stress Disorder and Resilience at Yale Medical School) and his colleague Dr Dennis Charney (Professor of
Psychiatry and Neuroscience at the Mount Sinai School of Medicine) were astonished to discover that while genes do play a role in individual levels of resilience, they are only part of the story. ‘When we began our study, we assumed that resilience was rare and resilient people were somehow special, perhaps genetically gifted. It turns out, we were wrong. Resilience is common and can be witnessed all around us. Even better, we learned that everyone can learn and train to be more resilient. The key involves knowing how to harness stress and use it to our advantage.'
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For one of their studies, Southwick and Charney interviewed 30 former prisoners of war from the infamous Hanoi Hilton camp in Vietnam, selecting those who had coped with six to eight years of imprisonment and gone on to lead successful and meaningful lives. ‘We were particularly interested to discover how they handled the trauma and stress of being a prisoner of war 8000 miles away from home and come out the other end and be a strong person,' Charney explained in a subsequent interview.
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They found that, despite being held in solitary confinement for years and physically tortured, several common factors emerged as critical for survival. One was continued support from other prisoners. By developing what the prisoners referred to as a ‘tap code', neighbouring men were able to maintain communications with one another by tapping their way through the alphabet; they were never totally isolated and could still support each other. ‘Everybody needs a tap code to get through tough times, very few can go it alone,' says Charney, explaining how friendships support us.

Among these prisoners, other common ways of coping were humour, faith and spirituality, the presence of role models,
a willingness to help others and an optimistic outlook. The POWs also worked hard to maintain physical fitness, despite the limitations of their cells. This, said the researchers, boosted their self-esteem and mental toughness.

I'd first come across Charney's work and the notion and practice of resilience training at the University of Pennsylvania, where our lead instructor on the topic was Karen Reivich. Co-director of the Penn Resiliency Project, Reivich had several years of experience developing resilience training programmes for schools and corporate organisations, and had been awarded the contract to train the entire US Army in the psychological skills of resilience, making them as psychologically fit as they were physically fit. She taught me three fundamental truths about resilience: 1) most people are resilient; 2) resilience requires very ordinary processes; and 3) these processes can be taught and learned.

Later, after Abi died, she wrote to me: ‘So many of the interventions I teach are not exactly rocket science . . . More a matter of making it your intention to put your attention here rather than there.'
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Her words gave me hope. I reckoned I could choose to put my attention on the good things I still had in life, on nurturing the relationships with those close to me, on accepting what I could change and what I could not, on using my strengths to assist with recovery.

This book therefore looks at the types of personal assets and resources (promotive and protective factors in psychological terms) that have been shown to predict good outcomes in resilience studies, and examines their usefulness in a new context—that of grieving. It also asks a number of questions. What helps people cope during bereavement? Do some people manage to recover faster than others? Which ways of acting
and thinking help us get through the loss of a loved one, and which hold us back? How long does grief have to last: is there a fixed time frame? Is it possible to grieve too quickly and is that a sign of denial? Does it all come down to individual differences, or might some of these strategies prove helpful for numerous people going through grief ?

I must confess that when I first started writing this book I was sceptical (even within myself) about the notion of resilient grieving—was it really possible to expedite the grief process by employing certain cognitive and behavioural strategies? Were the evidence-based tools we use in resilience training useful in the context of bereavement? Or was I deluded, heading for a fall? Was I, in fact, just demonstrating one of Kübler-Ross's famous five stages of grief—that of denial? I hesitated and pondered, but my understanding of humans' extraordinary capacity to bounce back from a wide range of traumas (natural disasters, war, imprisonment) convinced me to try. Who was to say that the same resilience skills and recovery strategies cannot be applied to life after loss?

Then I found George Bonanno and a new breed of research academics, all of whom are starting to explore what resilience looks like in the context of bereavement. Similarly, Thomas Attig assured me that while our initial reactions to grief are passive
and somewhat beyond our control, we are not entirely helpless in grief: grieving is in fact filled with choice.
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These researchers' findings, gathered via structured interviews, and cross-sectional and longitudinal survey data, were compelling.