Grief Series - Episode 2

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Transcript

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You're listening to Vital Signs, a podcast for Sentara providers. Welcome to episode 2 of the grief series.

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In today's episode, we're joined by Tommy Bateman, director of clinical Practice Management,

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and Peggy Hames, licensed clinical mental health counselor. Before we turn things over to the team,

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here are a few important CME announcements. This episode is accredited for AMA PRA Category 1 credits.

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For full accreditation, designation, and disclosure information, please refer to the show notes.

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And now, here are Tommy and Peggy. Hello. Welcome to Vital Signs, a podcast for Sentara providers.

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I'm your host, Tommy Bateman, and we're continuing our talk on grief in the second session with Peggy Hames.

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Thank you again, Peggy, for coming back.

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I'm glad to be here. And so at the end of the last session, we talked about,

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um, you know, what grief is.

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How to recognize that the difference between normal grief and complicated grief. Uh,

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uh, and at the very end, we started talking about what it looks like, how it manifests emotionally in your families,

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uh, relationally, and then we kind of hinted at the end what it looks like in a doctor's office, uh,

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how it manifests, you know, lack of sleep, uh, higher blood pressure, even, you know, all, all those other things that,

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that, um, you know, mimic real, uh, and they are real medical issues. So let's talk about that,

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but I think What we want to hit at first is sometimes when, uh, um,

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it's hard to recognize or deal with.

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You, you know, I could speak for myself, my client's issues when I still have some unresolved stuff or unrecognized stuff within myself.

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So let's talk about that for a little bit. Um, as a practitioner, medical, behavioral chaplain,

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whatever, how do you recognize grief within yourself so that way we can be there fully present for those that we're helping.

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So when I do, ah, like weekend grief seminars.

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Uh, one of the questions I always start with is, what was your first experience of loss?

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Because a lot of our expectations around grief, a lot of what we think about grief are formed by

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those early experiences, and your family may have said,

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You know, when your cat died, well, it was just an animal. Don't be sad,

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we'll get another one. He says, don't grieve. Um, you may have been sheltered away from the

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experience of grieving and nobody ever talked about it.

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Or shamed for crying, um, sometimes that's a religious shaming.

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They're in a better place. Why are you sad?

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So spend a little bit of time, uh, thinking about your first experience and even doing a timeline of,

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of what have been my significant losses, and, and sometimes they're professional losses.

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Uh, if you wanted to go in one direction and really loved it and for some reason, you had to go in a different direction.

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Mhm.

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Um, or, or the grief over, OK, I said yes to this profession that I love,

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but that is also very demanding, and that yes has meant I've had to say no to some other things that I

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grieve.

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Um,

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I, I wanna get back to one other thing with the assessments. Sure. Um,

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If if I may.

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And that is.

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The grief over loss of abilities.

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Mhm.

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So, uh, my dad had pulmonary fibrosis, and he told my brother one of the saddest days of his life

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was when he had to clean out his golf locker. Oh, because he loves to play golf, but he also loved the community of men that he played with every

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single week. Mhm.

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So that's a picture of the layers of grief. So if you're talking with someone about a limiting diagnosis.

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Ask how that's going to affect them. What are they going to have to give up? Mhm.

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Because that's a loss.

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Also ask if they have pets. Mhm.

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Because they can be a great comfort.

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But also, again, the loss of a pet is the loss of a family member, right?

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So

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One of the things uh I, I, I'm thinking of right now.

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Is, uh,

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again, how our own internal grief challenges us to see the grief in others or at least effectively help others,

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um.

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You know, you, you mentioned doing a, um, doing a, uh, an inventory for yourself.

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If let's say you're dealing with.

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Unresolved grief

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And

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Um, you know, you're in the helping profession, really any profession.

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How would you at least recognize it within yourself because I know me, like I could put my nose to the grindstone and ignore every single one of my issues,

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you know, I ask my wife, right, um, and, and, uh, it comes out eventually when I'm agitated with the kids because they're making too much.

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Noise or something like that.

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How does someone that doesn't quite know the full picture of what's going on at least may be able to clue themselves in that,

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hey, I may be dealing with some grief here. I need to address this first before maybe I can start really helping others the way I would like to.

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Yeah, it's a great question. Um, you know, as a therapist, I always have that kind of internal assessment going on

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of what's happening with me as I'm with this client.

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So to pay attention to, you know, if, if there are people that.

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You kind of dread seeing, or if you find yourself getting impatient with them. Uh-huh,

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um.

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If you want to kind of rush through it.

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Or if you have that internal feeling of, oh,

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why are they making such a big deal out of this?

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Uh, Virginia Satear is a great therapist, uh, used, um, curiosity.

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So to be curious about what's going on with that patient, but also what's going on in you.

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Um,

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What, what is this, what does this feeling remind you of? Mhm. When did I have this feeling before?

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And sometimes the circumstances look so completely different.

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But it's the feeling that you're connecting with.

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Um, what patient just really drained you? Mhm.

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Pay attention to all of those kinds of internal reactions and then ask where,

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where might I have had a loss.

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Yeah, feelings aren't, yeah, feelings aren't necessarily. Indicators of the truth, but they're certainly alarm bells that we need to take a look at something,

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right? Well, I, I use the images. They're like the, the lights on the dashboard, right.

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It just says something needs to be paid attention to. OK, very good. So doctors,

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nurses, everybody.

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Listen to your bodies. Listen to everybody. Listen to them. So, um.

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Let's say, OK,

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I've worked on myself, or I am working on myself. Hey, it's a lifelong process.

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And you know, I've recognized my grief or anything like that in me,

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and now I have a patient in front of me that I'm getting the inkling.

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There's some, there's some other things going on in this person's life beyond high blood pressure. What type of questions do you ask to explore?

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Is there a grief issue going on here?

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Uh, is there anything different in your life?

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Uh, have you been having to deal with, uh,

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Any kind of losses or any kind of caregiving.

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You know, caregiving is a stress all on its own, but there's also

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There's a lot of grief involved too, like when you have to start taking care of a parent or if you're a spouse with uh.

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Uh, a loved one who has dementia, there, there are losses that come along throughout that process.

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So,

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um, a lot of times people won't name things as grief.

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No. So to just don't say, are you grieving, because, oh no, I'm fine. Have you,

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have you had any kinds of losses, like any big changes in your life?

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Mhm. And then a gift that doctors can give is to normalize and name that as grief.

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I think you may be grieving, and then to be able to make a referral. Here's,

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here's a list of, of counselors we refer people to.

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This would be a good thing. Mhm. And I find, I find, you know, having been in practice myself that adding another assessment or another

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tool within my EMR on my laptop to fill out while I'm trying to sit there with a mem a client or a patient,

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um, is just absolutely maddening. Do you think, uh, in, in this case, uh, Uh, and just what's your opinion on having a formal assessment like a,

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uh, you know, we have the GAD for anxiety. Uh, do we need a formal assessment for grief or just asking some questions and build a connection,

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um, um, adequate, I mean, for lack of a better way of putting it.

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Yeah, I, I, I really think it's asking the questions and paying attention to their stories and paying

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attention to how they tell their stories.

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You know, if they're telling you, oh, I'm just fine, it was just a dog, it didn't matter, but tears are coming to their eyes

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or their voice is catching.

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Um, and again, I think.

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If you have a formal assessment.

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I'm not gonna say people lie on it, right, right, but, uh, they really may not recognize it.

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They'll say, oh, you know, I'm fine.

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This, this has nothing to do with anything, or

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I've done my grieving, you know, like somebody tell me one time, oh, we went through the funeral. Now I'm done with my grieving.

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Grieving is such a heart connected thing too. Yeah.

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And when people feel that heart connection, then it opens up space where they can be real

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about where their hearts are. If they see it as a clinical thing, right.

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A lot of times they're they're not, they're not going to open that up to you. So, and you said.

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Um, the best gift for a medical professional or anybody can give to that person in that moment is to name it as grief.

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Can you give me an example or or or how, how would you do that in a compassionate way that

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would really connect with a person. I just said, build that heart connection and give them space to, to, to feel it or to,

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I don't know about agree, but move through the stages of change motivationally to go from, I don't even recognize this as grief,

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oh, it is grief and I do have a problem, let's move towards resolving this or working with somebody to do it,

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how do and making a plan. How, how do I do that?

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So let's use the example of uh an older adult who's moving into community of care.

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Um,

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You talk to realize they've been in their house for 50 years, raised their family there. They're having to rehome a pet in order to move in.

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And to say, gosh, you know, I know you're really excited about this, but there are a lot of losses here too,

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and sometimes our bodies carry our losses, our bodies carry our grief.

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It's really normal to feel grief, even if you're excited about something,

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you can still grieve the thing you're leaving.

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So It can really help just to talk with somebody about grief and allow your space to.

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To tell your stories and to heal.

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And to allow your body not to have to carry all of that stuff.

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And I think that is a proper place to stop this session because fortunately,

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guess what we're gonna do guys in the next session, we're gonna be talking about our communication strategies and how to move that person from uh

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From recognition and uh to moving towards, towards healing. So thank you again,

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Peggy and we'll come back here in just a moment.

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Thank you for joining us. Be sure to keep an eye out for episode 3 of the Grief series.

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You've been listening to Sentara Vital Signs, a podcast created for Sentara providers.

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As a reminder, please check today's show notes for details on how to claim your continuing education credits.

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That's it for now, but we'll be back soon with another episode of Vital Signs, the podcast that delivers evidence-based education for physicians

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and healthcare providers on the go.