Episode 3: Piling On: How to Deal with Compound Grief

Tom: 

My guest today is Helen Keeling-Neal. She is a licensed mental health counselor, a licensed Marriage and Family Therapist, and a nationally certified counselor with private practice Kingfisher counseling. Prior to her work in mental health, Helen was a Creative, serving as an adjunct professor at UCF, University of Central Florida, in Radio Television Production. 

She was the director of My Art Studio, which is a children’s art studio and program. And she was also president of multimedia agency Emerged Media. Helen also has personal experience with grief and loss as a widow, her husband passing away when her children were, gosh, only four and six years old. 

We’re here to discuss a mental health topic that has I’m sure had a big impact on many of us over the past two years with COVID. And I’m so grateful for Helen, being able to put a name on this for the first time and shape it. So we can expand our understanding and address the issue. Because before I talked to Helen about this, I had no idea what to call what we were experiencing with grief and loss of our spouse and our loved one along with grief and loss through COVID. And through recession and everything else that we’re facing. 

So, Helen, welcome. Thank you for being here.

Helen:

So good to be here.

Tom:

It’s so awesome to have you here, to talk about this important issue. So many of us, as I said, haven’t just lost our spouse, we’ve been faced with several other challenges all at once. And you referred to this and it was the first time I had ever heard of this called compound grief. What is compound grief?

Helen: 

Yeah, so it’s the layering on top of incidents and experiences when the underlying grief has not been released or processed. So there’s been no chance to really get current. And what you end up with just packed down feelings packed down last pack down to the extent where it can really affect someone’s life negatively. And then of course, you know, we have that and we see that in someone that matter lost a parent, and then years later lost a spouse. But recently, we’re seeing it just compounded by the number of losses, this global loss that we’re experiencing, not just to people but safety … a feeling of safety and well-being. 

There are definitely widowers in our group. Chris is one example who lost his wife and then immediately had to deal with COVID. He was the president of a university and he had to come back from burying his wife in where their hometown was, come back here to Florida, and start to make some serious COVID decisions for the university and dealing with his own family health issues and safety and other things like that. And he admits, you know, he had a hard time because he didn’t process the grief before, and now all of a sudden there was this kind of piling on.

Helen: 

Yeah, he’s in a crisis after crisis. It’s just really difficult for him. 

Tom: 

So what I want to understand is, hearing Chris’s story and knowing that his story is not one that’s isolated, that many of us were dealing with this same issue of losing a loved one, and then all of a sudden having COVID and other health issues and maybe losing other loved ones through that or at least worrying about our jobs or family a change in lifestyle. 

I was on the road constantly. And now I was home all the time. So major changes in lifestyle, no longer having the office to go to and then many of us are suffering now from inflation, recession, whatever else it might be. It’s piling on as you indicate what happens yeah. Let’s talk about what happens to our mind and in our body as well when we experience this compound grief?

Helen: 

Yeah, well, what can happen is now there is a layered series of losses … An example being maybe someone’s lost a spouse to cancer, and then lost a parent to cancer, or some kind of illness. So, you know, just the fact of being around someone who’s not well can be a trigger, and can activate the amygdala holes, the memories, holes, the sources of what you’ve been through, the amygdala will then send out a 911. 

My gosh, you know, if I was to put into words, in that case, it might be somebody’s going to be somebody’s gonna die. Oh, my gosh, somebody’s gonna die. It’s more of a “insert curse word here”, because it’s that big of a response. So send out an emergency signal, the frontal cortex / the frontal lobes go offline, but think things through and be like, No, it’s okay. You know, that’s not what’s happening right now, that goes away. 

The limbic system that holds all the emotions and the feelings takes over. So instead of a thinking response, it’s an emotional response. 

And then the reptilian brain, the brainstem, back here goes into the physiological response, somebody might have a panic attack, they might suddenly just tense up and get really angry and flare at someone. Or, you know, we see road rage is a great example of this. It’s just like “get out of my way, you idiots”. So it’s a a trauma response.

Tom: 

Yeah, and so fight flight or freeze. Is that kind of a response right that occurs so the three F’s

Helen: 

Yes, but we can add to that it’s not just Fight Flight and Freeze, we have Fawn, Submit and Collapse. So there are actually more to that now you know, the Freeze, the deer in the headlights, that’s a trauma response. That’s a limbic system response for a deer. 

And a lot of people will Freeze and become inactive and you will see a lot of that deep-seeded depression, at the bottom of the Freeze. So people will go hypo effect, sort of below the line, think numb, think shutting down, not motivated, or hyper effect. Very, very big overt feelings, the both intense feelings just differently responded to in the limbic system. So the submit the freeze, and the foreigner down here, the fight, flight, flee, or up here.

Tom: 

Yeah, that’s a great way to explain it. And I think everyone heard of the kind of Fight or Flight but they forget that this kind of submissive, kind of hypo reactions are also something that many experience, and I would say probably more so than the hyper, right?

Helen: Yes, yes. And can experience more than one, it can be in a sort of an arc, you can go from type to type.

Tom: 

I was definitely in that… I would have the times of pulling inside and just not wanting to face the world. 

And then I remember an incident where someone drove by my house too fast. And I was in bare feet, a friend of mine was with me, and actually started chasing after the person. Look, I am Italian, and I do have a little bit of a temper, but that was a little bit overboard. 

And I was throwing every curse word I possibly could remember, including some in Italian at this person, as they were driving by, and my friend was like, wow, that was interesting. 

And luckily, he recognized that it wasn’t a reaction to that person driving fast, but I was feeling some of these compound grief feelings, having lost my dad and then losing my wife, Judy, some six months later. It was definitely a response to those feelings.

Helen, you didn’t know you were gonna be going to be pulling up the couch for me today as a mental health counselor.

Helen: 

I didn’t know but let’s go for it. Let’s get in there.

Tom: 

So you were saying how you tend to react. Tell me about that.

Helen:

 Yeah, I’m very similar to you going into Fight. I’m a lot better about it now because I have enough information to be able to get a good clue as to what the intense feeling means. You’ve been hijacked and sometimes the feeling is not happy, mad, sad, whatever. 

It’s, I think the word is anguish … anguish is such a good word. That feeling of anguish of loss is so much better describing the feeling of that intense loss, compared with “angry”.

So I go in to fight, or I go into curled up in a sobbing ball on the couch. So they’re both hyper aspects. And I go into a lot in response to any kind of traumatic thing. 

Wee were burglarized, once the kids and I.  We just moved. It was about a year after David’s death. And we came home and there was someone burglarizing our house. 

Now, move forward three months. I hear a car alarm go off. It wakes me up at five in the morning. What should I do? I’m you… I’m running down the street, with my phone, and I’m not sure what I’m gonna do with just the phone, but somebody’s going down. I was in my 40s. This was not a rational response. My frontal lobe was not on. 

Tom: 

Yeah, and the primitive kind of takes over. So we need to give ourselves grace with that. Right? We are smart people, We know about this stuff. We know the signs. We know the mental health impacts, and yet, it still takes over. 

I think this is super important. Grace and understanding. It’s not that I wanted to react that way. It’s just that it’s subconscious in a lot of ways. And like you said, your prefrontal lobes, your neocortex kind of shuts down, right? Which has a couple of impacts. Right. So first is what happens when we try to make decisions when we’re under this compound grief when we’re under this anxiety, the emotions, the stress?

Helen: 

So with an activated limbic system, it colors everything, it changes everything, the decisions or the thoughts or even the process would be different if our frontal cortex was engaged.

My thought: if I use that as an example, I’m running down the road, because I’m gonna get someone. My irrational thought, or if there’s any thought at all, is I’m gonna get these “MFers”, and somebody’s gonna get hurt. Because nobody is gonna go through being burglarized. 

Okay, knowing that, for me looking back, that was a compounded feeling response to not having my protector around anymore, not having my guy in the House who would have handled anything like that. 

Yeah, here’s me on my own now with my kids. So I this is how I reacted. So we’re looking through a filter of emotion and decision making. When in that colored place that emotionally colored place, or even communication from within that emotionally colored place, rarely gets us what we need, or want. 

We think it’s going to, if I yell at someone, it’s going to get me that response that I want, or I’m looking for that need met, but it just doesn’t work that way, it really doesn’t. So what we have to do is bring the frontal cortex back online, it’s the noticing brain, it’s the noticing part of the brain, so that I can then calm the limbic system, soothe the brainstem, calm the amygdala down, it’s okay, it’s not a crisis, not emergency. And then think it through.

Tom: 

So, what are some of the tools that we can use to transcend and overcome the impacts of compound grief and these reactions? You’re saying: calm the limbic system, calm the primitive brain so we can kind of get out of Fight Flight or Freeze. But how do you do that? You know, when you’re triggered, it’s not that easy sometimes.

Helen: 

Right. Yeah. So it’s a process to learn how to do that. And there’s a few things you can do.

I know one of the techniques I’ll use, especially in working with a veteran who lost a lot of people. And of course, that’s a particular grief and loss situation, right? And so when the amygdala sounds that 911, what I have my clients do is, I have them create a character to represent what your amygdala looks like. 

This particular guy, a war veteran, decided it was going to be somebody sitting in a tank with a head exploding like a cartoon head exploding. This was going to represent what his amygdala firing looks like. And so he would just practice whenever he got those intense feelings. Seeing this guy in the tank, this cartoon character with his head exploding… and then we developed for him to represent his frontal cortex coming back online. It was, I can’t remember what kind of army rank it was. But the neocortex character would come in and go, sir, yes, sir. False alarm, sir. And he’d have an envelope in his hand. So the image of this military person coming in and giving to the guy in the tank, this envelope that says, Sir, okay to stand down, sir. It’s a false alarm, sir. 

And this would be the way he would get his frontal cortex back online. And then he’d be able to look at the situation. No, my child has a cold, they’re not going to die. It’s just a cold or no, that loud noise was not a gunshot.

Tom:

So that’s one of the ways to sort of create these characters, and then work within that imagery that represents and those characters, represent the pieces of your brain that are overreacting over and that you want to be your general, your governor, you want to take over from the amygdala and the explosion of emotions.

Helen:

Right, rSo for me, if you’ve ever seen the movie Inside Out, it was a Pixar movie, and it had this character Joy, who represented happiness, and it had Anger and the Sadness.  The whole premise of the movie is that the character Joy thinks there’s no place for Anger and Sadness and those kind of things, right? 

So the Anger character, and that is this little red guy just gets so angry. That’s who I have for my amygdala, this little red angry guy. And then for my frontal cortex, as I bring in this very soothing sort of calm, sparkly, pale blue light that comes in, you know, wraps it around, and it says it’s okay.

Tom: 

Yeah, I have not used that technique. So I absolutely love that you’re communicating this? And I’ll definitely have to write about it and make sure I include it in my Amygdala Hijack article.

Helen: 

Yes, And it’s really good. Because the whole idea is to bring on that you can notice that you’re in a reaction.And so you can bring it back on and transcend the feeling, which is taken over Y

I use a lot of EMDR with clients. EMDR is eye movement desensitization reprocessing, I don’t know if you’re familiar with that. It’s a protocol that’s used for trauma. Originally, it was developed for trauma, but you can use it for anxiety, for grief, or loss. It’s just a wonderful technique. But you do need to go see a trained therapist for that. 

Tom: 

Can you explain what EMDR is for those who might not know what it what it’s all about with the lateral eye movements? 

Helen:

Yes, exactly. And so you may see it on some of  the police shows, nowadays, we’ll see a light bar, and somebody is looking at the light bar, and they’re just tracking with their eyes, back and forth. Or you might have seen the interview with Prince Harry, he talked about using EMDR. And he showed the tapping in the interview. And so it works similar to REM sleep in that it’s bilateral. So when we’re in REM, our eyes go back and forth.  

But what happens when you have trauma or all those intense stored feelings from a loss, we store the feelings in a belief, a negative belief or a cognitive belief or distorted belief. So one might be “I’m always going to be alone or everybody dies, or “I should have done more”. All these kinds of things. So what we do is we go in and we access the bi-laterals using this identified belief, negative belief and creating a positive belief to think about instead. 

As we go in and process the feelings in connection with that negative belief, and then install the positive belief. It’s really amazing. It’s the trauma of loss that is so difficult. 

So working with someone recently who has had a at a loss after a long period of grueling care for their loved one, and that journey is so painful, it’s so difficult and so overwhelming and, and then people end up being so hard on themselves because they’re angry or frustrated with a loved one because it is so incredibly stressful that readonly months or years of flooded cortisol stress. And so after that will come these intense feelings, guilt combined with relief, or a visual, 

One of the things I had with my husband was a visual. He died in hospice, and at the very end, there was one particularly awful moment. And I’m not going to describe it in detail, because it’s not necessary and I don’t need to trigger anybody here. But this image of him, and it was a medical piece, stuck with me for so long. And it was just awful. 

So when I would think of him, that’s the image that I went to. And I had to clear that image with EMDR. And it was so helpful, and it cleared it for me.

So we use it to clear that negative visual and thoughts and replace it with a positive visualization and statement. You can use taps, we have these little vibrating buzzes we call tappers or a light bar, I’ve got a light bar over there,

Excellent, and any more challenging times create more tension, because identifying the feeling is a key, right. So if you know, for instance, that you’re feeling agitated, you’re maybe not necessarily able to connect it to the grief, but you’re just feeling agitated in your body and restless and go to a batting cage. Whack the heck out of the ball, go play tennis against a wall … walking are always good, it’s bilateral. So that’s what EMDR is: bilateral. So it’s processing. Hugely important. 

Go to a group, your group, wonderful, amazing… connecting with others who’ve experienced this loss. So so important so that someone’s not sitting alone with the way that they feel and feeling isolated from because one of the big things this is a change in your social life, this change in your social position, going from a couple to a single, big deal socially.

Tom: 

And then breathing is a technique to leverage, right? Yoga breath, Box breath, even a simple snort two breaths in through the nose and one out through the mouth. If you don’t want to get into a more complex box breath can be really, really effective at calming.

Helen:

Yeah, definitely that is right. Breathing raises the alpha waves. When I’m triggered, and I want to kind of quickly try to address it, that to me is always a go to. 

If that song comes on, and those feelings well up, and I know I’m gonna burst into tears, I, try to do some quick breaths to kind of bring it back down and start thinking through it, you know, and processing, depending on where you are and what you want. 

Because if that song comes on, and you’re in a place where you can let those tears fly, let them rip. And if you’re in a place where you can add a sound to it, add even more expression, then do so. You know, in some countries, you have paid mourners to wail as you walk through the streets and in other countries you would wail aloud yourself. And we don’t wail in this culture. 

We’re so repressed on that, to keep it small. Oh, well, they’re in a better place. And oh, well, this man had a good life.. Well, you know, honestly, fuck that. It’s not how it works, because that’s not how it works. It just teaches everybody to shut it down. 

I was working with a couple of kids. Their Mom had left to go somewhere and didn’t come back. Because she was murdered. Right now, these kids were left by themselves and when they came to me, they just didn’t want anything to do with anybody, and one of them was Stan and he was my first one out of the siblings. And literally in that session, he sat on the floor and wailed.

Now we’re taught to be calm, that we should shut our emotions down? Well, this boy needed to show his emotions, and I just sat at a distance because he wasn’t even, you know, this is our first session. He didn’t even want to be there. And I just sat, like a couple of feet away. And I just was like, Yep, that sounds exactly right.

It’s really important for men to hear this, I think, because a lot of us do repress.

Tom:

Right. So we’re talking about ways to get control of your feelings and emotions. So you can think again, and that is important. But there are other times where you just need to let it go. And that’s all right. And in fact, it’s healthy. Yet big boys don’t cry. That is what we’ve heard growing up, you know, get up and brush it off.

Helen:

Yes, and honestly, this culture does a disservice to both genders, because, you know, men are taught that they are not allowed to be sad, but they are allowed to get angry. To a certain level, right? Women are taught that they’re not allowed to get angry, but they are allowed to be sad, to a certain level. 

And so, I think this is why it’s so wonderful that you have your group. There is nothing better than a man embracing that sadness and letting it out. That is really being a man, to be able to be that vulnerable. 

And to express, that is the greatest role modeling you can do for your child. It’s the greatest example of being a man or a human being, of processing the feelings hugely important. And likewise, with anger done in a safe way, all of it done in a safe way. Right.

Tom:

Yeah, I totally agree. And Helen, I think one of the mistakes I made early on was trying to be way too stoic, particularly with my children. I did not show the emotion, I was like, I’m going to be the rock, I’m going to be the rock for everyone around me. And I think it took a while for them to understand that I was grieving and that I was feeling these deep feelings and how, really, truly, I was sad, because I wasn’t showing it, you know. And so I think there’s definitely a beauty in being able to do it. And, you know, and express yourself and make sure that that full range of feelings is expressed and not just hide it or push it down. Because it will come back up in ways that we don’t expect it to at the wrong time.

Helen:

Yes, pushing it down can have an impact, health issues like a heart attack. 

Tom:

Many men suppress feelings, for  long enough, for as deeply as many of us do. It is just not healthy.

Tell us, what’s your one piece of advice you’d like to leave our our widowers and our growth warriors with today?

Helen:

Your path is your path. And your journey through grief is yours. And don’t let anybody tell you differently. 

You can do this in the way that is right for you. And don’t forget, it’s nonlinear. 

You may be the kind of person like me where you want to be two weeks from today. I’m going to be through this and off we go. That’s it. Let me settle in on my calendar. And, it doesn’t work like that. It’s nonlinear. 

And it’s gonna pop up when you least expect it. And when it pops up, if you can’t open the door. Don’t push it back down.

Tom:

I love that. Helen, thank you so much!