Grief often feels pervasive, consuming, and taxing. Sometimes, grief is so immense, it is impossible to see outside of it or through it. It clouds our vision to the point of opaqueness. Thus, we are left feeling despondent, defeated, and hopeless.  
 
Grief is not only reserved for the death of a loved one. In fact, there is a type of grief that is commonplace and more universally experienced. Ambiguous grief is the grief we experience when a death has not occurred; rather we have lost something that either isn’t tangible, such as a hope or a dream, or we have lost a person in our lives but they are still living. And yet, despite how universal ambiguous grief is, we struggle to address it.
 
Even grief related to the death of a loved one is challenging to process. Much of this is due to larger cultural practices around grief. We are not a culture that provides the time necessary to process grief. If your loved one dies, you get three days to attend the funeral. But what if you have a miscarriage? Or you are going through a divorce? Or you are living in a global pandemic? How many days, hours, or even minutes, are we allowed to take off?
 
The answer is not enough.
 
Grief is uncomfortable. Oftentimes, we feel it is easier to ignore it, set it aside, or numb the pain. But in doing so, our grief is left unprocessed, which can lead to confusion of feelings, difficulty making decisions, increased conflict with family and friends, and emotional dysregulation. Unprocessed grief can make everyday tasks seem impossible to complete, meaningful relationships challenging to maintain, and our most treasured hobbies rendered seemingly meaningless.
 
Ambiguous grief could be used to describe how one feels after a divorce: you’re not only losing your spouse, but losing the dream you had laid out for your future. We experience ambiguous grief when someone we love is diagnosed with dementia, severe mental illness, or addiction. They as a human being are still physically present, but their psychological presence has changed dramatically, if not entirely. Thus you have essentially lost the person you came to know and love.
 
When one has a pregnancy loss, one grieves the loss of an unborn child. While the expectant mother never actually met the child, she is grieving the loss of her dream of who her child would become, the loss of life, the loss of what she thought her family might be. In that fetus, she says goodbye to a promised life. And, depending on how far along she was, the baby might already have a name, a due date, a nursery color picked out.
 
We even experience ambiguous loss for things that are not as tangible, such as a dream, a hope, or a vision for our future. We can grieve the loss of a dream job, or not being accepted to our top-choice college. And, we can especially experience grief as we witness our world struggling with illness, systemic racism and poverty, and political divisiveness.
 
 
How to Support Ourselves
 
Our culture does not respond well to grief. But we, as families and individuals, can start practicing ways to respond differently to our grief. We can identify ways that are more supportive. This can be challenging, because grief is uncomfortable and unpleasant. Asking ourselves to sit in discomfort is hard. As human beings, we naturally avoid pain as a means of survival. By asking us to sit in this pain actually goes against our natural survival methods! And yet, this is how we allow ourselves to move through our grief. It is important to process grief effectively.
 
Here are some ways we can start to process ambiguous grief.

1. Don’t “get over it.” Rather, integrate grief. I don’t believe we ever “get over” our grief. For one, I find it disrespectful to the event, the experience, or the person who is no longer in our lives (deceased or otherwise). By integrating grief, it becomes a part of our story, our lived experience. This allows us to increase connection with others who may also be experiencing the same thing. This doesn’t mean make the feeling bigger than it is. It simply means allowing yourself to feel what you are feeling, no more or no less. It gives you permission to feel, which in turn allows you to move forward.
2. Name it! When you experience grief, say you are experiencing it, whether to yourself, or a close friend or family member. Everyone experiences grief differently, and as a result, our grief can play out in very different ways. Some get angry, some stay in bed all day. Some overeat, some skip meals. But being able to recognize the behavior as a result of the grief you’re feeling is an enormous, mindful step.
3. Memorialize the grief. In “normal” grief, we often have a funeral or a memorial service, a formalized way to say our goodbyes. This is much harder with ambiguous grief. Yet, not having the space for this can often lead to us feeling stuck or trapped in our grief and unable to process it. Find a way to formally grieve, memorialize, and find a sense of closure. For example, when I was in my third pregnancy, my husband bought me a silicone ring for later in pregnancy to replace my wedding band. The ring was aquamarine, the future baby’s birthstone. I now wear the ring on my right hand as a way to remember our child. There are many ways to honor and celebrate that which we’ve lost.
4. Find a therapist or a support group! There are many out there, and they are not only wonderful resources, they can be essential to our process.
5. Make meaning. According to David Kessler, making meaning is an important step to how we process our grief. While this can be a hard step, and it certainly takes time to get there, making meaning allows us to integrate our grief and connect with others. By making meaning, we aren’t invalidating our pain. Rather, we are honoring our loss in a meaningful way, and weaving it into the story of our lives.

 
Processing our grief can feel challenging, overwhelming, and sad. Yet, in processing it, we are able to integrate it, and create peace within the difficult

​Now more than ever, it is important that we connect with those around us in a safe way. One of the ways in which we do that is by practicing our own self-compassion.
 
Merriam-Webster defines compassion as a “consciousness of others’ distress with a desire to alleviate it.” Compassion is, by definition, relational. Thus, self-compassion would also be relational.
 
According to Kristin Neff, a leading expert and researcher in self-compassion, one of the key components to practicing self-compassion is common humanity. Common humanity is the understanding that unpleasant feelings are part of the human experience, that suffering is universal. We are connected not only by the joys in our lives, but in our struggles, heartaches, and fears.
 
How, then, do we respond to our unwanted feelings when they arise?
 
Common humanity is a key component in what connects us. When we fail to recognize that we are not alone in our struggles, we increase our feelings isolation and self-pity. This leads to a hyper-focus on the self, creating a tunnel-visioned mindset, which only deepens our feelings of isolation and disconnection. Therefore, by improving our self-compassion, we enhance our ability to feel compassion for others. Compassion for others, in turn, increases our sense of connection, thereby decreasing feelings of sadness, depression, and anxiety. We also become less judgmental of our feelings and behaviors.
 
During the pandemic, it is important to remember we are all struggling. Common humanity can link us together while we are apart. It also allows us to support those who are struggling in very different ways from us.
 
The pandemic is universal for all of us: we all are having a response to it. We all are having shifts in our lives because of it. Our circumstances, however, are very different. In understanding our common humanity, let us not downplay or invalidate those individuals who have a different level of suffering than we do, who’s circumstances are different from our own.
 
We are not in the same boat, but we are in the same storm.
 
For more information on self-compassion and common humanity, visit Kristin Neff’s website: www.self-compassion.org.

There are countless resources available to us in our wellness, mental health journey. Here is a list of some of the books that have shaped my therapeutic practice, both personally and professionally.
 
The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Bessel van der Kolk, M.D.
 
This book is a wonderful exploration of trauma, and a resource for ways in which all of us carry trauma, anxiety, and depression physically around with us. Dr. van der Kolk is the founder and medical director of the Trauma Center in Brookline, MA, as well as a professor of psychiatry at Boston University. His work explores war veterans, children of alcoholics, and survivors of domestic and physical violence. Trauma impacts our ability to experience pleasure and engagement. This book is a resource for navigating healing trauma, and understanding the mind/body connection.
 
The Gifts of Imperfection. Brené Brown.
 
Granted, all of Brené Brown’s books are incredible reads! What I love about The Gifts of Imperfection is the step-by-step process she outlines for us to challenge our self-identified perfectionism, and find ways to truly and fully live into who we are and become our true selves.  This book celebrates being you!
 
Deeper Dating. Ken Page
 
Right now, dating apps are encouraging their users to connect with potential dates remotely. These apps are taking a very active stance in following the shelter-in-place guidelines. Your dating life does not have to come to a complete end! Ken Page, a fellow New York City psychotherapist, has developed a wonderful guide to dating in the modern era. Unlike other dating books, Page encourages the reader to first identify their “core gifts” or their values. It allows for wonderful reflection and self-identification, that strengthens our future connections with potential dates.
 
 
Self-Compassion. Kristin Neff
 
We use a lot of terms in this work, oftentimes without ever really explaining them! Trust, integrity, empathy, values, and self-compassion. I love Kristin Neff’s work because she clearly defines what self-compassion is. A researcher and associate professor at the University of Texas at Austin, Neff has defined and revolutionized the ways in which we speak to ourselves, soothe ourselves, and show ourselves the love we all deserve. She has created a Self-Compassion Scale, an evaluative tool that is available on her website (www.self-compassion.org). This scale allows you to identify specific areas to target improving your self-compassion. She also defines three core components to self-compassion: mindfulness, self-kindness, and common humanity. Mindfulness is the act of being present. Self-kindness is speaking kindly and gently to ourselves, as well as doing kind acts of service for ourselves. Common humanity is the understanding that we are all in this together: suffering is a universal experience. Her book, as well as a companion workbook and activities on her website, provide us with hands-on ways to practice self-compassion every day. Her work is so relevant that mental health professionals in various differing disciplines site her work. A must read!

Right now, many of us are feeling powerless. We might feel stuck, limited in our choices as we sit in our homes navigating a situation that ultimately feels unmanageable. As a result, we often feel unsure about what would help make our situation easier, lighter.
 
Dialectical Behavior Therapy (DBT) is an evidence-based practice to support us when we are feeling emotionally dysregulated. DBT skills help us tolerate distressing moments in our lives, by validating the distress while actively engaging in activities to ease it.  
 
One of the skills DBT prescribes is ACCEPTS. ACCEPTS is an acronym for active things we can do to support ourselves through these times.
 
A: Activities. Simply put, do something to get busy. Exercise, clean the house, engage in a hobby. Get moving! Do something that requires enough of your attention to distract you from your unpleasant feeling. In doing so, you’ll also feel productive!
 
C: Contributing. By giving our time and energy to others, we feel connected to our friends, family and community. This helps us build our positive emotions! In this pandemic, you may feel limited in what you can do. It’s important to remember that any little bit helps: shopping locally, tipping our delivery people well, video chatting with a friend who may be quarantined alone, sending a Venmo tip to our musician and comedian friends continuing to put their work out in the world. Now more than ever is a great time to contribute to others in any way we can. 
 
C: Comparisons. This skill is a tricky one. On one hand, comparing ourselves to others can lead to negative self-image. We can feel scarce, rather than abundant in what we have. Comparison can also be problematic when we use it to compare suffering. All suffering is valid and warrants validation. Comparison, however, can be helpful when expressed from a place of gratitude. It can also be helpful when we compare ourselves to our previous selves, and recognizing the progress we have made. 
 
E: Opposite Emotions. Actively do the opposite of what you are feeling. If you are feeling sad, watch a funny movie. If you feel anxious, do something that calms you down, such as meditation or gentle yoga. If you are feeling like you want to pull away from someone you love and trust out of embarrassment, fear, or shame, reach out to them.
 
P: Pushing Away. We do not have control over the first thought we have. Many of our thoughts are automatic. We do, however, have control over what follows our automatic thoughts. Our brain is incredibly powerful and can be used to reframe thoughts and use visualization to reduce unwanted thoughts and replace them with wanted thoughts.
 
T: Thoughts. Distract yourself with a positive thought. Say a prayer, count to 10, count your breaths, think about someone you love. Making a list ahead of time of our positive thoughts can also be helpful.
 
S: Sensations. Use a physical sensation to provide you with a distraction. This is helpful when we are feeling more dysregulated than usual; times when we feel we’ve tried everything in our bag of tricks, and nothing seems to be helping. Intense sensations, such as splashing cold water on your face, calms the brain for a brief period of time, giving us space to implement other calming tools. Other sensations can be taking a hot or cold shower, listening to loud music, or even listening to soothing sounds, such as rain falling or a meditation bell.
 

​We are a culture of insatiability. We are inadvertently taught that we can never have enough. As a result, we live our lives from a place of scarcity: we believe we are falling short, that we are in short supply. We are constantly striving, buying, building.
 
As someone in the mental health field, I love personal development and growth! But, we rarely stop and say “I am enough. I have enough.”
 
In my home this past week, we’ve been practicing gratitude to recognize our abundance. We are trying to not live lives of scarcity. We have started to notice every tiny thing we have that is bringing us comfort, joy, and sustainability. Every little thing has taken on new meaning. We’ve limited our consuming behaviors and practiced appreciating.
 
I will never say that the COVID-19 pandemic was a good thing: I don’t believe inflicting pain and trauma on a mass numbers of individuals is necessary. And at the same time, within our own homes or communities, I have felt the practice of abundance and gratitude immensely. Yes, I can feel pain and gratitude at the same time.
 
We have enough. We are enough. We don’t need one more thing in order to maintain our happiness. And while we have heard repetitive adages throughout our lives (“money can’t buy you happiness”, or “the best things in life are free”), I can’t say I’ve ever allowed myself to feel the true sentiment of those statements before this past month.
 
In New York City, resources are definitely stretched thin. Even getting groceries at this time is hard. It’s scary to see no available timeslots for delivery on Instacart, Fresh Direct, and Amazon Fresh. And yet, we have enough in our refrigerator and pantry (albeit, it’s might require a bit of creativity in the coming weeks!). It is in fact this mindset that then allows us to give back to those who do not have what we have. When we recognize our own abundance, we can donate food, clothing, money, resources, time, energy, to others. This is one thing I personally have gained from the pandemic that I hope does stay with me once we are back to our daily lives.
 
For our final day, shift your mindset from one of scarcity to one of abundance. Look at your clothing, your food, the books on your shelf, your streaming services. I am living a life of abundance!

On Day 1, we spoke about validation. Validation is the affirmation that what you are feeling has merit. In the midst of a global pandemic, in a time of uncertainty, any feeling you are feeling is valid: grief, anger, apathy, resentment, depression, anxiety. Sometimes you might feel numb because the feeling is so overwhelming that attempting to feel it would be excruciating, exhausting. Sometimes you may even feel content that you get a break from going to work every day! It’s all valid.
 
Despite this, we are pros at invalidating our feelings constantly. Invalidation is believing that our feelings are not accurate. A good rule of thumb: any sentence that starts with “at least” is likely to be an invalidating sentiment. These are examples of things we don’t want to say to ourselves.
 
I’m really upset that my job postponed my raise indefinitely.
At least you have a job.
 
I’m sad and miss my mom during this quarantine.
At least you have a mom to miss.
 
My husband and I have started arguing since we are in the house together all day.
At least you have a husband. At least you have a house.
 
Yes, all of these statements are factual. But they ignore the underlying feelings of frustration, grief, loneliness, and irritability.
 
What if we reframed each of these sentiments?
 
I’m really upset that I’m not getting my raise. I am, however, grateful that my job has been able to continue paying me during this time.
 
I really miss my mom. I’m grateful I have FaceTime to connect with her every day.
 
I’m feeling so irritated with my husband right now. I’m grateful that I can go into the bedroom for some quiet time apart. We’ve been arguing so much less!
 
Very different sentiment!
 
This is gratitude. Gratitude by nature cannot be invalidating. Gratitude is not berating yourself, telling you to get over it, or pull up your bootstraps.  Feelings pass naturally and in time: you will move through your feeling, you will “get over it.”  But for the moment, it’s present, it’s there. And gratitude is the way in which we move through it.  
 
For today, practice validating your feelings. I promise you won’t get lost in them! The feeling will naturally rise and fall. It will pass. Why not give yourself a bit of loving kindness to help it along?
 

​An important component to practicing gratitude is not just knowing how to practice it, but when to practice it. Today’s gratitude practice will identify one of those times.
 
Foreboding Joy
 
Work is going great. The kids are happy and healthy. My parents are healthy. My partner and I are happier than ever. Our bank accounts are in good order. I feel great!
 
Something bad is bound to happen soon. This can’t last.
 
How many times have we all felt this?
 
Joy is the most vulnerable feeling we feel. When we experience joy, we open ourselves up to potential heartbreak, hurt, suffering, and pain. By putting barriers on our joy, thinking when will the other shoe drop, we protect ourselves from vulnerability. Unfortunately, this also prohibits us from fully leaning into our happiness.
 
This is called foreboding joy: we are terrified that joy will be taken away from us that we push it away. We beat pain to the punch. As a result, we don’t fully experience joy and all that it has to offer. We limit our joy.
 
Gratitude as the Antidote
 
Oprah interviewed Dr. Brené Brown on “Super Soul Sunday” in 2013. In the interview, Brené said, “I have never interviewed a single person who talks about the capacity to really experience and soften into joy who does not actively practice gratitude.”
 
When we become aware that foreboding joy has taken over, we can practice gratitude. Gratitude centers us in the present-moment, whereas foreboding joy is future-oriented. A future-oriented mindset is anxiety-producing: we have no way of predicting when the other shoe is going to drop. We can, however, express gratitude for the joy we are experiencing in the present moment.
 

​Yesterday, we addressed two ways in which we can practice gratitude: the first was to create a daily gratitude list; the second was to identify things we are grateful for in the moment to help reframe unwanted emotions and thoughts. Both of these practices are internal practices – gratitude practices that allow us to turn inward and reflect.
 
A third way we can practice gratitude is by sharing it outwardly, externally, and with others. In fact, the act of expressing and sharing gratitude engenders further gratitude: we are more likely to express it if someone has expressed it first.
 
During this pandemic, our local establishments have had to close their doors. I’ve been sad watching shops drop their security gates and post signs thanking us for our business, and providing hope that we would all see each other again soon. Recently, I made a purchase from one of our local businesses, Brooklyn General Store, a yarn and fabric shop. I was ecstatic that they were able to continue fulfilling online orders while they were closed so I could continue my knitting. When I received my package, I thanked the shop owner for her service to our community and for continuing to remain open virtually. The shop owner, in turn, thanked me! She stated she was grateful for those of us who are continuing to support their shop as she was continuing to pay her staff while they were home. Gratitude opens the door for more gratitude, creating a mutual symbiotic relationship. We both benefit from the other in our mutual caring for one another. Thus, we care, and we are cared for.
 
Several research studies have shown that expressing gratitude and giving thanks has marked improvement on our moods, relationships, and physical health. It also increases our resiliency to unwanted situations. Studies from the University of Pennsylvania compared practicing gratitude to other positive psychology interventions. The study found that those individuals who personally delivered a letter of gratitude to someone exhibited an increase in happiness scores, and the scores continued to remain elevated for a month![1] Simply put, if we express gratitude for and to another person, we are going to remain happier for a longer period of time. 
 
Today, call up a friend or loved one and share your gratitude for them. Pull out a piece of paper, or print off a piece of stationary, get out your favorite pen, and write a note to deliver. If you can’t leave your house today to deliver it (social distancing comes first!), set it aside and deliver it at a later date.
 
I, for one, am grateful for all of you! I am grateful for the work you all continue to do during this challenging time. And I’m grateful to be a part of all of your lives.

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[1] Seligman, M.E.P. (2012). Flourish: A visionary new understanding of happiness and well-being. Freepress: New York.
Link to the book: https://www.amazon.com/exec/obidos/ASIN/1439190763/braipick-20
 

​Validation and mindfulness are primary tools we use to support our emotional wellbeing. They are the doors that help us recognize when we are suffering, allowing us to identify what we need to do in order to soothe and support ourselves.
 
What are validation and mindfulness?
 
Validation is an integral component to our wellbeing. Validation is the recognition and affirmation that our feelings are valid. Depression, anxiety, grief, irritability, anger, numbness, are not only normal, but completely valid in various situations. It is not until we validate our feelings that we are able to challenge them. Challenge without validation will only lead to negative self-talk, lack of motivation, and a decrease in self-compassion: “I shouldn’t be feeling this. I just need to get over it.” And yet, you’re not getting over it.
 
Mindfulness is the act of simply being present. Mindfulness allows us to identity whether we are happy, sad, anxious, or hurting. It makes us aware of our thoughts, “I am not enough,” or “I’m really proud of myself!” Mindfulness allows us to feel that tightness in our chest, or the lifting heaviness after taking deep breaths.
 
These two components together build our inner strength necessary for challenging our behaviors and thoughts. These two components allow us to make lasting change.
 
Now What?
 
How many times have we all implemented these tools, only to find ourselves asking, “Now what?” What do we do to support ourselves once we become aware? What is the action step to feel better?
 
Gratitude is a widely practiced skill that helps us regulate our emotions. Research has repeatedly indicated that gratitude greatly improves our emotional wellbeing. By practicing gratitude, we are able to shine light on that which lifts us up and empowers us, without minimizing our hurts or our struggles. A key component to gratitude, however, is finding the type of practice that works for you.
 
Some people start or end their day with a gratitude list. Others practice gratitude in the face of unwanted feelings. For example, Remy, my French Bulldog, snores very loudly! There have been several nights that I become aware of the rising frustration (mindfulness), and even though I want to yell out in frustration to get him to stop snoring (validation), I instead say, “I am grateful, Remy, that you’re sleeping and breathing.”  
 
Building a Daily Gratitude Practice
 
In the face of the COVID-19 pandemic, gratitude is one of the many practices that can support us during this time. All of us are feeling a range of emotions: grief, anger, sadness, anxiety, uncertainty. As we face this time together, I will be providing various practices we can use to support ourselves during this time.
 
The focus this week is on gratitude and how you can integrate it into your daily routine – a routine that presently is being upended and rewritten with every passing moment. Every day this week, I will provide you with another way to practice gratitude mindfully and intentionally. By the end of this week, my hope is that you will have practiced several gratitude practices, and have found yourself one step closer to finding a way to integrate it into your life in an effective and mindful manner.
 
Until tomorrow, please stay safe and healthy! I am thinking of you all.