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Maggie McKay (Host): Getting through grief  is one of the hardest things we have to deal with. But today, we're going to find out some helpful ways to cope. Welcome to Conversations like No Other presented by Valley Health System in Ridgewood, New Jersey. Our podcast goes beyond broad, everyday health topics to discuss very real and very specific subjects impacting men, women, and children. We think you'll enjoy our fresh take. Thanks for listening.

Today, we have Carley Anne Tsaglos with us. She is Coordinator of Bereavement Services at Valley Home Care. Thank you so much for being here today, Carley.

Carley Anne Tsaglos: Thanks so much for having me, Maggie. 

Host: So, this is a big topic that affects everyone at some point in our lives. So, let's just start with what's helpful for people to hear after suffering a loss? Because you never want to say the wrong thing.

Carley Anne Tsaglos: Yeah. Grief is just so overwhelming and disorienting, Maggie. It impacts us emotionally, physically, and spiritually. Two of the most common questions that I'm asked on a daily basis by grievers is, "Am I normal? Am I grieving in the right way?" I think grievers can find great comfort in hearing that everyone grieves in their own way. There is not a right or wrong way to grieve, and there's certainly not one way to grieve. Each person's journey will be completely unique.

At one point in time, I think grief was thought to be this neat and tidy process that ended in completion. We now know that grief is quite the opposite. There are certain feelings, certainly then experiences that are common in grief, but there are not feelings that everyone will feel, and it's definitely not a linear process. So in grief education, we still do reference certain tasks and stages. This is not in any way to infer that people should grieve in a certain way or in a certain order, but it does help normalize certain experiences, which goes back to that question, "Am I normal?" Hearing that what you're going through is common can bring the griever a great deal of comfort. It can also make grief a bit less scary because it is such an unpredictable process. I often remind people that they've never been here before. Despite the past losses or experiences, they've never been right here, right now before, so they're not expected to know exactly how to cope or to have all the answers.

Grief is a process that takes time, and so much of it is trial and error to figure out what might be helpful to them. So, I think the most impactful reminder we can offer someone who is grieving is to give themselves the space, the grace, and the time to grieve in their own way and at their own pace, and that they don't have to do it alone. 

Host: And we're not just talking about death, we're talking about like all the people who lost their homes in the fires, the loss of a job, right? We're just talking about grief in general.

Carley Anne Tsaglos: So, loss is a part of everyone's life in so many different ways.

Host: Right. So when you're talking to someone who's grieving, what should you avoid saying to them?

Carley Anne Tsaglos: I think people so often don't know what to say. Let's be honest, Maggie, death is not a very comfortable discussion for many. So, sometimes people will just avoid it altogether, which can really leave the griever feeling unseen and alone in their experience. I think it's so important for us to remember there are no magic words that can take away someone's pain. It's really just about being present, acknowledging their loss and letting them know they're not alone.

Platitudes, such as they're in a better place or giving unsolicited advice might come easy, but they can be hurtful and I think it can leave one feeling that their pain is diminished, as can saying to someone, "I know how you feel." Because the truth is no one truly knows what someone else is feeling or how one's life has been impacted by this profound loss. This is one of the things that makes grief such a lonely journey, although grief is universal, it is such a personal experience. 

Host: And I read an article once about how to talk to grieving people and it said, "The best thing you can do is listen."

Carley Anne Tsaglos: Yeah, right. It's not even about words at all. It's really just about being present.

Host: You know, from experience when you've been grieving, like you don't want to hear all those platitudes, like you said. It's just, like, just be there. So, what is anticipatory grief?

Carley Anne Tsaglos: So, anticipatory grief is the normal grief process that one may experience before an anticipated loss. When your loved one is ill, you begin to grieve that person in parts as they change and decline. People will often share after a long illness that they felt they lost their loved one, one piece at a time. And they grieved each piece as it happened. This can include feelings like anger, sadness, anxiety, fatigue, and much more.

Host: How does that affect a person after an actual loss? 

Carley Anne Tsaglos: I think some people really do feel that this process of anticipatory grief help them be more prepared for the actual death themselves and possibly even more accepting. I think for others, anticipatory grief can leave someone feeling that because they were grieving over time, that they should be more prepared or coping better. And this can lead to pressure for the griever feeling inadequate in their grieving process.

So, I think it's important to acknowledge that the grief that one may experience prior to the death is certainly an important part of their story. But I think it's equally as important to acknowledge that nothing, including anticipatory grief, can fully prepare you to say a permanent goodbye to someone that you love. When someone is alive, even if they are very ill, we can see them, we can smell them, we can touch them, we can be with them. Once they are gone from this earth, none of that is possible and it's a completely different experience.

Host: Earlier you mentioned that people feel so alone, understandably. What are some common feelings one feels when grieving? So, people find this out and don't feel so alone.

Carley Anne Tsaglos: Facing our feelings in grief is really just so hard and overwhelming, and I think there's a real temptation to push away these feelings and push them in some obscure box. However, when we do this, our feelings don't disappear. Eventually, they'll bubble up and we'll have to deal with them, and sometimes when we least expect it, and that relief that we feel is only temporary.

My corny little saying is that you have to feel to heal. But it's so true with grief, there just is no way around it, just going right through it. So, people experience such a wide range of emotions when they're grieving. It can be scary to not know what emotion will be next or how they'll handle it. Sometimes one can experience two conflicting feelings at the same time, leaving one feeling completely confused and out of control. When a profound person in your life dies, your equilibrium is completely out of whack, right? So, that homeostasis that was your life no longer exists, even the things that have stayed the same may look completely different without this person alive in this world. One may question their identity. "Who am I without this person? Am I still a mother? Am I still a wife, a son, a sister, a husband? What is my purpose? How do I spend my time now? Should I be coping better? Should I be healing faster?" The griever is just left with so many questions.

It can truly be a rollercoaster of emotions. One could experience sadness, numbness, denial, anger, relief, acceptance, guilt, shock, loneliness, and so much more. Sometimes things make sense to us intellectually, but we may feel completely different emotionally. For example, a caregiver who took such good care of their loved one 24/7 and did the best that they could, may still feel that they could have done more. Intellectually, they may know that they did the best they could, but emotionally they feel something very different. That's one of the confusing things about grief is that the intellectual and the emotional are not always congruent.

I think that it's also important to remember that feelings are factual that they just are, even the ones we don't want or don't like or can't understand. And I think reminding grievers of this can really help in terms of giving themselves permission to feel whatever it is that's coming up for them without judgment, and to give themselves that space and the grace to process the wide range of emotions that people grieve as they grieve their past, their present, and the future with this person. Because we do grieve things that have not yet happened, things that we thought would happen, that we wanted to happen, that we planned for. And at the same time, there's also a whole other dual process that's going on. The person who is grieving is actually grieving parts of themselves, who they were before the illness, before the death, the person who woke up and all was right in the world. And this is a major secondary loss that people face. 

Host: Carley, is there a time when someone should be concerned, like after they've been grieving a long time? 

Carley Anne Tsaglos: So, there is no timeline with grief. So, this gets a little bit tricky. But for some, grief does not lessen or change even after a long time. There may be persistent feelings of sadness or despair, and these feelings may significantly interfere with daily functioning. So, some may need individual therapy, medication, a support group, a combination of all three. I think the most important thing is for people to remember that support is available and they do not need to do this alone. 

Host: And how can a support group benefit a grieving person? 

Carley Anne Tsaglos: Oh, there's so many ways. But I would say one of the greatest benefits of a support group is the sacred space that's created by people who are all grieving and adjusting to life without someone that they love. In this space, they can share thoughts, feelings, and experiences without the fear of being judged or being vulnerable that they may experience in the outside world.

In their outside lives, they may feel they need to keep it all together to appear strong or to portray that they're coping better than how they really are. This is maybe because how they want to be perceived, but also maybe because the pressure of those around them. The group environment really encourages one to take off that mask and to be their true self. We encourage people to come as they are, not how they think they should be. Immediately following a death, people may have a lot of support and they may be asked regularly how are they are doing, and have lots of opportunity to talk about it. People are calling and making plans and maybe bringing casseroles to their doorstep. But this changes with time and people get busy and go back to the normalness of their lives.

For the griever, there is not a normal to return to. And they may still have the same need to talk to process, but they may no longer have the audience and the sounding boards that they once did. So, the group environment provides a place for them to share their story, their experiences. This storytelling and the sharing of their experience is such an important aspect of the grieving and healing process. For many, when there's an illness, and an eventual death, they have been in fight or flight mode. They have not had a minute to process anything from diagnosis, what their loved one has gone through, what they've endured until after the death. So, the telling of your story and examining the different parts of your journey in this collective space really allows for people to begin to wrap their mind around all that they have gone through.

I think one of the nicest things to witness is that this support network often goes beyond the four walls of the group. Group members connect and make their own plans and go on to develop friendships because there truly is nothing like being with people who can relate and understand because they're also grieving. Coming to a group is such a special gift one can give to themselves, but also a special gift that they give to all their other group members by holding this collective sacred space. And it really is just something such a beautiful process to witness and I feel blessed and honored to do that work each day.

Host: I bet. And it's invaluable to them, for sure. Carley, thank you so much for sharing this invaluable information that affects us all, as we mentioned earlier. It was really informative and we appreciate it.

Carley Anne Tsaglos: Oh, thanks so much for having me, Maggie. It was my pleasure.

Host: Of course. Again, that's Carley Tsaglos. For more information about bereavement services at Valley, please visit valleyhealth.com/bereavementservices. Thanks for listening to Conversations Like No Other, presented by Valley Health System in Ridgewood, New Jersey. And again, for more information on today's topic or to be connected with today's guest, please call 201-291-6090 or email valleypodcast@valleyhealth.com.