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Liz Unruh (Host): Hello, listeners, and thanks for tuning in to the Well Within Reach podcast brought to you by Riverside Healthcare. I'm your host, Liz Unruh. And joining me today is Roger Hartline, who works in Pathways, which is our outpatient mental health program here at Riverside. Thanks for joining us today, Roger.

Roger Hartline: Hi. Thank you for having me.

Host: Can you tell us a little bit about yourself?

Roger Hartline: Like you said, I work at Pathways Program at Riverside, which is our outpatient behavioral health program, where we do group therapy programming. I mean, children starting at age six up to, like, we'd love to say over a hundred if needed. We've had clients come into us in the past that have been of the older generation. And we are just happy to provide therapy and stuff for those in the community.

Host: Yeah, that's great. So today, we're talking about something maybe in those older folks, but it touches every generation. We're talking about some conversations on grief and growth. And to start this off, I'm going to start with the most simple thing. Grief can manifest differently for everybody. It's going to be different. Can you share some insights on to the diverse ways that people express and cope with grief and how we can better understand how each individual processes that?

Roger Hartline: Sure. I think that's really the hardest idea that we have in our society, is like understanding that everyone is going to deal with grief in a different way. We've all kind of been taught those age-old stages of grief. You're done with one, now we're on to two, especially how it's depicted in media. But I think we start to understand and see that different people deal with grief in different ways. And it's a hard journey to try to figure out how do I deal with grief in a way that honors myself and honors other people. And that can be hard, especially when, you know, you're dealing with some of the issues like other people really struggle with the idea of, "Well, you're not grieving in the way that I grieve," you know what I mean? How do I deal with that?

So, I think the best thing to do, especially when it comes to respecting individual processes, is just allowing self to feel how we feel in the moment and then allowing our family and friends to feel how they're feeling in the moment too.

Host: Yeah, I think that's definitely some really good tips. I know even in my own life, there's been times where I'm like, "Well, I feel this so deeply, why don't you?" But it's because how things affect each person individually.

Roger Hartline: Absolutely.

Host: Yeah. Are there any common misconceptions about grief that you encounter in your work? And when you go to understand those misconceptions, is that going to help aid in the healing process?

Roger Hartline: One million percent. Yeah. I think, you know, we're taught so much bad stuff around grief. Folks are like, "Well, grief needs to be crying. Grief needs to be, you know, loud. Grief needs to be mad." And a lot of that comes from our own personal experiences with our family. That's where we learn the majority of myths and misconceptions regarding grief is from those who have, you know, kind of taught us how to grieve, and sometimes we have to unlearn some of those things in order to move forward and grieve in a, you know, healthier way.

Host: Oh yeah, for sure. I can think of so many examples where people are crying and I'm sitting there laughing, because you remember the happy things versus the sad things. I think that's a really, really big misconception, is that you have to only do it in one way.

Roger Hartline: Right.

Host: Are there certain therapeutic approaches or counseling techniques that you find particularly effective when helping individuals cope with grief and loss?

Roger Hartline: Sure. So at Pathways, we do a lot of psychoeducation with our clients. That's one thing that's super important to our programming because we want to set people up with success when they leave our program. And grief is definitely one of those topics that we dedicate like a day to. But honestly, it comes up a lot in processing. Grief is one of those things that tends to just bury under our skin a little bit, you know what I mean? And we have to sometimes unpack that and kind of figure out what that means to us, you know, how it impacts us.

And I think trying to move away from the idea that stages of grief are like that's how this happens and trying to move towards understanding that there's like acute grief or like right when it happens. And then, when we keep moving forward with that and it's not going away as much as we'd want, that's when it becomes that complicated grief where it's kind of impacting some of our daily routines maybe, or maybe if we're thinking about it every day, it can be really hard. And then, trying to move towards that experience of integrated grief, where we are able to start moving through it, like leaving the idea of, "I've got to get over grief." that's not going to happen, you know, and trying to learn about how do I move through it, move through life with it, with me, you know?

Host: Yeah. It's definitely something you're going to carry with you. And knowing that not everyone experiences the same stages of grief and recognizing that people do experience them in different orders and ways.

Roger Hartline: One-hundred percent. People jump around.

Host: Yeah. So, how would individuals recognize and navigate the different stages of the grief after experiencing that loss? How would you start off down that road with them?

Roger Hartline: One thing we say a lot in therapy is don't practice coping skills when you need them. Practice them when you feel good. You know what I mean? Because then when you do feel bad, it's going to set you up for success, that you know how to use them already. And I think that's one of the main things. You know, continuing to be mindful of yourself fully, thinking about like, "What are my thoughts? How are they right now? How am I expressing my emotions? What am I feeling?" Even checking with ourselves regularly and asking some of those questions are really going to help us in the future if we experience something related to grief, because then we need to do something about that when we don't feel good, you know?

Host: Yes, for sure. I know another thing that impacts how we deal with grief and loss is society and the cultural norms within the culture that we live in. Are there certain things that influence how individuals experience or express grief? Can you touch on anything that you've experienced, like cultural considerations that should be taken into account.

Roger Hartline: Our society, we tend to try to push those who are sick, those who are disabled, or those who have died or growing old away. You know what I mean? Like, how do we get them out of the public view? We push them, for some reason, to the fringes, which It tends to be how we treat death and dying as well. And I think that really sets the tone with how we grieve, right? If we're pushing away our conscious from these things, then when it does happen, we're going to want to push that away too. So, I think that is impacted a lot by our society and how we grieve, especially like social media and stuff like that. So often, I'll have clients who talk to me and are like, "This is how I'm experiencing grief. But I see online or on Instagram and Facebook, people will share anniversaries and things like that and they seem like that's helping them, but that does not help me." It's like, well, that's the thing about society, is that no one can dictate how we do things,.

And when you think about the cultural aspects of it, different cultures experience and have grief routines that are very different than us. I think about like Native American folks and like how they cut their hair, or they cut their hair in order to honor someone who may have passed or different cultures wear white to a funeral, different things like that, where that white is meant to celebrate the person and it's part of like the rebirth. You know what I mean? And I think that's just interesting to think about how when we are working with clients, even in Kankakee, we are such a multicultural population here that we need to be very conscious that Black Americans, you know, Mexican Americans, Latino folks, people from different backgrounds, 100%, are going to have cultural parts to how they grieve as well.

Host: Yeah, I think those are all really great points, we're going to take a quick break to talk about finding a primary care provider.

Riverside knows that health, especially your mental health, is your greatest asset and that your primary care provider is your partner in health. If you're starting out on your mental health journey, a great first step would be talking to your primary care provider. If you don't have a primary care provider, Riverside can help. Find a primary care provider that fits your needs at riversidehealthcare.org/primarycare.

And we're back! So, Roger, grief doesn't always follow a linear path, right? So, what advice do you have for individuals who might feel stuck or overwhelmed in their grief journey to find the support or resources to start that forward movement?

Roger Hartline: Sure. I think the biggest thing with like the idea of stages or just in general feeling like you want to move forward through your grief and feeling stuck in that is normal, so normal, in any kind of mental health related thing. And I think, number one, ask for help is like the biggest thing. If you're struggling, reaching out to somebody who maybe you experienced the loss with, or somebody who also may have experienced loss may really help.

The biggest resource in our community for grief and death and dying is definitely UpliftedCare in Bourbonnais. They have that grief community center or the community grief center on Career Center Road in Bourbonnais. And the resources there are so expansive and can help people dealing with grief of like loss of a pet, loss of a family member, loss in such a different definition that we've been taught to deal with. We can grieve things that we never even thought we could grieve. And I think, if for some reason, you're still finding yourself stuck, there are resources, for instance, Riverside Center for Emotional Well-Being. We have the Pathways Program. We have, like I said, programsa for children, adolescents, and adults too. And 100%, grief is a reason why someone could pursue some form of treatment in our program, if they just can't get through those everyday routine functions that they used to, and they are having trouble moving forward.

Host: Something that you touched on there didn't even really dawn on me, we grieve all types of things, it's not just the loss of a loved one. Loss of pets, loss of maybe a relationship or a...

Roger Hartline: A job or even like level of functioning. I mean, if you look at a lot of my experience has been working with like older adults or adults with disabilities. And when you look at loss of functioning and loss of abilities to do our daily activities of life, you know, like it's hard for people, you know, and it hurts. And losing some of that autonomy, there can really be intense grief.

Host: Yeah, that's definitely a really good point to bring up and it didn't even dawn on me until you started talking about it. I know something that we talked about just a little while ago was talking about like anniversaries or special occasions that had to do with the loss of, in this instance, a loved one. But coping with those anniversaries or special occasions sometimes are challenging. Are there certain strategies you would recommend for managing those difficult moments?

Roger Hartline: Yes. Yes. You know, a lot of folks I work with tend to ignore that the day is coming, or they don't want to think about it, and they don't want to deal with it. But I think finding some kind of ritual surrounding the situation is a really good idea. It goes along with some of those tasks of mourning, like, if you find a day to be especially hard because it's like an anniversary coming up, figuring out a way to celebrate that day and celebrate that other person, or the loss that you've experienced may make it a little easier to cope with that day. And also, just kind of know yourself and know that that day may be hard for you, so that's not the day to have the most important business meeting, you know what I mean? , So, schedule around some of that loss and lack of ability to regulate those emotions on those days because it might come up.

One of my counterpart clinicians at Pathways, Robin Motes, talks about grief in a way that I just really appreciate. And she talks about like grief attacks. And that's the first time I've ever heard it like that. Because I, back in the day, used to be one of those people as well that kind of felt like, "Oh, I'm past grieving," but that doesn't really happen. What Robin says is sometimes we have to think of those grief attacks and take them as they come and do our best to cope with them in ways that is going to help our mental health, and kind of know that you may never be over it, and that's okay, you know what I mean? And moving forward with it and learning how to live your life with it with you is the best case scenario,

Host: Oh, yeah, for sure. I could definitely see that. I know now in the age of social media how does the online environment impact the grieving process and obviously what kind of things would you suggest for people as they're navigating grief in the digital era?

Roger Hartline: It's really hard for people to sometimes see online how others grieve when they are also grieving. Because like anything online, you see the very popular celebrity on the yacht, and you're like, "Why don't I have a yacht?" You know what I mean? "When do I get my yacht?" And I think the same thing might come from grief where you'll see someone say, you know, "Remembering my father who passed away three years ago today. I love you, dad." And that for some people can be so triggering and lead to those grief attacks and issues like that.

Host: Oh, I can definitely see that in my mind. And maybe it's one of those things for you to cope on that day. Like we said, maybe you just avoid social media that day.

Roger Hartline: One-hundred percent. And I think that it goes back to that idea that everyone grieves in a different way, and not everything you see online is going to be real or someone's real experience, so just remember to always stay true to yourself and grieve in the best way that's going to honor you, you know.

Host: So, we touched on this just a little bit earlier and understanding how you and yourself deal with grief, but what role does self-care play in coping with grief and are there specific self-care practices that maybe someone could try?

Roger Hartline: Well, I think self-care really can be like such a subjective experience. When you look at the more basic side of self-care, and you think about some of those routines and such, we can fall off our routine, and that's okay. When we are dealing with acute grief, someone just has passed, or we just experienced a loss, it's okay to not be 100% on your routines. But I think try to keep yourself moving towards getting back in those routines as it feels appropriate to you in your life. And I think maybe centering some of those self-care routines around giving yourself a break would be a big help as well.

Host: Yeah, for sure. That definitely would. I know routines are a big help when it comes to mental health and kind of getting back on track and being able to cope.

Roger Hartline: And don't hold yourself to this, like, "I have to get back on the horse. I have to get back to work." Give yourself time to just deal with it. And if you're someone who maybe doesn't need all the time in the world, don't be mean to yourself. Don't dog yourself over feeling ready earlier than you think you should be. Listen to yourself. Listen to your full self, all aspects of yourself, and then decide how to move forward.

Host: Yeah, I know we've talked a lot about if you're the person experiencing the grief. But if you are a friend or a family member of someone who is grieving, is there something that you could possibly do without overstepping boundaries or adding additional stress to kind of help help the person?

Roger Hartline: The number one thing is thinking of communication, which I think comes down to a lot of our relationships in our lives. It's super important to communicate with other people. If someone you know is experiencing some kind of grief, it is such a touchy experience for people. And everybody, like we said several times, does it at their own pace and in their own way. So, the easiest thing to do is talk to someone and say, "Hey, Liz, like, how are you doing with this loss? Is it okay that I ask you this question? How can I best be there for you?" Asking questions and trying to figure out like, "Hey, how can I best support you through this," I think, is going to be the best thing. And this is true of pretty much most circumstances, if you feel like you don't know how, if you're overstepping someone's boundaries, or if you're worried that's a possibility, ask the other person, "Is this overstepping your boundaries?" I know that seems silly, but we should have that in our common vernacular to ask that question in general. And I think in the grieving sense, it could really help that other person feel like that door's open to say, "You're actually overstepping my boundaries a little, and I need time."

Host: Yeah. I think a lot of people have trouble setting boundaries and saying, "Actually, I would prefer not to talk about that." So, I think that's an interesting thing that you bring up. Just asking the other person, "Am I overstepping? Just tell me, I'll back it up. It's okay."

Roger Hartline: "I can talk to you later." Yeah, absolutely. Give people the opportunity to speak up when they need space.

Host: Yeah, I feel like we've gone through a lot of really, really great things here. Is there anything else that you would add to the conversation?

Roger Hartline: I think my last thing is just that, like I had mentioned earlier, there's resources. There, like I said, is the Community Grief Center on Career Center Road with UpliftedCare. We have our intensive outpatient program and partial hospitalization programs through Riverside's Behavioral Medicine Program. Use some of these resources that are available to try to fine tune your grieving process. Because most of these programs that are at play, maybe all of them together, maybe only a few bits from each one, can help meet your grieving plan and what's going to get you through your next step.

Host: Yeah. Well, thank you so much for joining us today, Roger.

Roger Hartline: Thank you.

Host: Yeah, and thank you for tuning in to the Well Within Reach podcast with Roger Hartline with the Riverside Behavioral Medicine Outpatient Program and your host, Liz Unruh. To lLearn more about the services that Roger mentioned today that are provided by Riverside Behavioral Medicine, visit our website at riversidehealthcare.org or call our Central Intake Department at 844-442-2551.