Stroke Survivor Bootcamp with Dr. Phil: "Grief, what is it and how to deal with it"

In this episode of "Stroke Survivor Bootcamp", Dr. Philip Lamoreaux, OTD, OTR/L, CPT, talks about the different types of grief that may be felt following a stroke.

NOTE: Be sure to check out some of the helpful worksheets that can be accessed by clicking here, or by going to www.StrokeSurvivorBootcamp.com.

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Hosted by Dr. Philip Lamoreaux, OTD, OTR/L, CPT, Stroke Survivor Bootcamp is a practical, hope-forward podcast for stroke survivors and caregivers, built to help you understand what’s happening, ask the right questions, and take back control one step at a time. Each episode blends real-world hospital and rehab guidance with clear, compassionate coaching so you can turn fear into a plan and progress into momentum.

For more information on signing up for a one-on-one Stroke Survivor Bootcamp session with Dr. Phil, just go to www.StrokeSurvivorBootcamp.com

Created & Produced by Christopher Ewing
Hang On to the Dream Foundation

Written by Dr. Philip Lamoreaux, OTD, OTR/L, CPT

Listen each week to the Stroke Survivor Bootcamp podcast with Dr. Phil, the OT Professor, where he will share with you practical tools, real stories, and the mindset to keep moving forward on your road to recovery! 

If you are a stroke survivor, sign up for one of Dr. Phil's Stroke Survivor Bootcamp sessions.  These sessions are proven to help stroke survivors regain more mobility following a stroke.  Just go to www.strokesurvivorbootcamp.com for more information.

Transcript

SPEAKER_05 1:25

The comments expressed in this program are the personal opinions of the participants and not meant to diagnose or treat any medical condition that you may have. Please consult your doctor or healthcare professional before making any changes to your current medical routine. Welcome back to Stroke Survivor Bootcamp. I'm Dr. Pill, a licensed occupational therapist and a certified personal trainer with over 10 years of experience working with stroke survivors. I spent a majority of my career working in the inpatient rehab setting, specifically with neuroclients. And I have since then spent a majority of my time teaching at UNLV and starting my own business where I go around the country working with stroke survivors doing what I call boot camps, where I use the evidence-based intervention of what we call high-intensity training. And I help survivors re learn and help them figure out how to get it so that their brain can adapt and make new connections and find out what their actual capacity is and be able to participate in life way more than they were before the boot camp. And I have done so many of these and have continued to experience really good positive outcomes. And this podcast is just one way that I am trying to bring value into the world and bring value into the uh stroke community. Um, because one of the things that I've always felt is that the stroke community is uh one of the the most forgotten about communities. And so it's it's been one of my life missions to make it so that the stroke community has at least somebody, someone out there that can help them find hope. Because let me tell you, when I have worked with stroke survivors, and as many of you have reached out to me and connected with me, the consistent theme that I hear is that therapists have continued to uh help have continued to make it so that you don't feel hope. And if there's one thing in this life that I genuinely do not ever want people to feel, it's that loss of hope. I felt it in my life, not because I've had a stroke, but because of other reasons. And if you go back two episodes, you'll be able to hear more about that story and why I do what I do. And so I won't spend time doing it here. But I am coming to you uh currently from Nevada, um where I am doing just a little RR where I was able to go hiking and just spend some time enjoying being being out in nature. Um and man, that has that has felt so good. And uh am almost ready to go back to my family. I'll be going back tonight. And I cannot wait, I cannot wait to see them. Um but before I can do that, I need to introduce what today's topic is going to be around. Now, I've thought a lot about what I wanted to what I wanted to talk about this week, and the thing that uh I actually taught or create you know created the lecture for in my uh doctoral program class is on the concept of grief. Now, there is a particular kind of grief that almost nobody warns you about. And it's not a grief of a funeral because nobody died. There's no casket, no service, no casserole left on the porch by a neighbor who heard the news. It's the grief of waking up in a body that does not move the way it used to, of looking at your own hand and asking it to do something simple, something you never once had to think about, and watching it refuse. It's the grief of a care partner standing in the kitchen at 2 a.m. realizing that the person they married or raised or grew up aside is still here, still breathing, still loved, and also in some quiet and complicated way gone. Didn't think I was gonna turn up from that, but if any of that landed in your chest just now, this episode is for you, so stay with me. Now, most weeks we talk about the body walking speed, intensity, getting stronger, getting your life back. And like I said, today we're gonna talk about something that lives underneath all of that. Something that I've watched slow down recovery and impact more survivors' hope and consistent motivation than anything else, and that's grief. And I want to be clear about who I'm actually talking to today. I am talking to two different types of people. I'm of course talking to the survivor, the person who had the stroke, and uh is in the process of grieving the life and the body that they had before. And I'm talking to the care partner, who is the spouse, could be the daughter, the son, the friend, who is also in grief and experiencing that as well. And usually for the care partner, it's silent. And often while being told that you need to stay strong and how amazing you are. Now, both of you are carrying something that is real, it's tangible. Both of you are allowed to. So here is the journey that I want to take you on today. First, we're going to name what you are feeling, and we're going to give it permission to exist. Then we are going to really understand it. Like, what what is grief? How does it move? How does it show up? Why it shows up, and how to know if it has gotten stuck. And once you understand it, then and only then we are going to talk about what you can actually do with all of it. So name it, understand it, then use it. That is the path that we're going to walk together today. So let me start by giving this thing its name. Because naming it matters more than you might actually think. What you are feeling has a name in the research world where some call it like ambiguous loss, some call it non-finite grief. Now, the plain language version of this is that you're actually grieving a loss that did not come with much permission to actually grieve. So when someone dies, it's interesting, the world organizes itself around your grief. Uh, especially in the Western, in the Western world. People bring you food, they send you cards, they say, take all the time you need. Oftentimes there's a ritual, and the ritual is designed to tell everyone that you are grieving and it's okay, and that you should be doing it right now. But when someone has a stroke, that doesn't come with it. The stroke actually comes with the opposite message. Everyone is so relieved you survived. They say you're lucky. They say at least it wasn't worse. And now those things may even be true, but that relief, as kind as it is, can quietly close the door on your grief before you have even walked through it. And essentially it can begin to feel ignored. So here is the first thing that I need you to hear. And I'm gonna say it slowly. You are allowed to be grateful you survived, and feel devastated by what you lost. Both of them at the same time and in the same breath. Now these two things are not in competition. Gratitude does not cancel grief, and grief does not make you ungrateful. Anyone who has told you otherwise, uh, even with love, I believe is wrong. If any of you have seen the movie Inside Out, it's an animated Pixar movie. I love it, my kids love it. I believe that it does a really, really good job of showing how we can have all these emotions inside our head and try to suppress an emotion. And by trying to suppress that emotion, that emotion can somehow become worse. And it's not until we accept that that emotion can be a part of it and should have a seat at the table, it's not until that happens that we actually get to the point where we can feel at peace. Now, I'm going to be talking more about that, but if you wanted to pause and go on to YouTube and look up Inside Out for just a minute and and watch just a little clip of Inside Out and how it shows the different emotions as little animated characters, I think that would be a fantastic thing to pause and do right now so that you can see what it is that I am actually talking about. And care partners, I haven't forgotten about you. Your grief is probably a little bit more invisible because the whole world isn't really focused on you. The world is focused on the survivor and what's happened to the survivor. And a lot of the time, let's be real, so are you. You are grieving the partnership that you had, the division of labor in your home, the conversations that used to flow easily, the version of the future you had both planned. And you are doing that actual grieving while being the scheduler, the manager, managing medications, managing appointments, fighting with insurance, being told constantly how strong you are. And sometimes being called strong can feel like being handed one more job. Now, just remember your grief that you're experiencing is real. Experiencing grief is not selfish, and it's not an actual betrayal of the person you are caring for. Now we are going to come back to you specifically, so just stay with me. Okay. But first thing, we need to actually label what exactly is grief. Because I think when you really understand what grief is, it stops feeling like something that is wrong with you and starts feeling like something that is deeply, almost beautifully what I what I would say human. Now, if you open a dictionary, grief is defined as deep sorrow, especially the sorrow caused by someone's death. And notice that word, especially. Especially caused by death. Not only caused by death, the definition itself leaves the door open. And grief is the deep sorrow that comes from loss. And like what we've discussed, I mean, the most recognized version is when a person dies, but the definition of grief itself is not limited to just that. And look at the words that live in the same family as grief. Sorrow, misery, sadness, anguish, pain, distress, suffering, heartbreak. Let's sit with that list for a second. Because every one of those is a word people use after a stroke. The survivor feels anguish at their body that their bot at what their body can no longer do. The care partner feels heartbreak watching it. Guys, that that is a version of grief. We just don't always call it by its name because in a way it's almost like we think because nobody died that we have not earned the ability to use that word. But here is the truth. Grief is actually triggered by loss. And a stroke is one of the most profound losses a human being can experience while still being fully alive to feel every bit of it. Now there is a writer named Allison Knoll who put it this way. She said, You never really stop missing someone. You just learn to live around the huge gaping hole of their absence. She was writing about death at this time, but I want you to hear that line through the lens of stroke because it fits almost too well. She said, You never really stop missing someone. You just learn to live around the huge gaping hole of their absence. Now, survivor, there's a version of you that is gone, the you from before, and you miss that person. You are allowed to miss yourself. That is one of the strangest, loneliest parts of all of this. That you can grieve a person who is still standing in the mirror. And you're not crazy for that. You're grieving an absence that happens to live inside your own life. And care partner, you miss them too. The them from before. You feel guilty about it because they are right there. And how dare you grieve someone who survived? But you're not grieving their survival. That you're very happy about. What you are grieving is the absence inside the presence, the absence inside the survival. And both of those can be true. We learn, as that writer said, to live around the whole, not to fill it in and pretend it was never there, but to live around it. So grief is the response to that loss. Now, here's the next thing to understand about it. Loss is universal. Every human culture in every era across all history has known loss. There has never been a people who did not grieve. But this is the important part. How grief is understood and expressed is not universal at all. There is a line from two researchers, Breenan and O'Connor, that I love. They said, grief is a unique experience that occurs within a historical, social, cultural, and political context. So let me just kind of translate that out of research language. What it means is that the way you think grief is supposed to look was taught to you. It was taught to you by your family, by your culture, by the movies you've watched, and also funerals you've attended and the things people said to you when you were young and someone was lost. Now you did not invent your idea of how to grieve. And that matters because a lot of people are suffering not just from their loss, but from the gap between how they actually feel and then how they were taught they were supposed to feel. So if your grief does not look like someone else's, just realize that you're not doing it wrong. There is no universal correct shape for this. The person who cries every day and the person who has not cried once, they're both still grieving. The survivor who gets angry and the survivor who goes quiet, they're both grieving. Even the survivor who is joyful and pushing through is still grieving. And just realize that your grief is allowed to look like you. Now, this brings me to one of the most quietly harmful ideas out there. And it comes straight out of our, at least the culture that I am a part of, and it's the idea of normal grief. So in a lot of Western thinking, there's an unspoken script. Grief is allowed, but only temporarily. You get kind of like a window. You have a few weeks, maybe a couple of months, and then there's this expectation that you should be getting back to it. Back to work, back to productive, back to normal. The clock starts ticking, and if you are still visibly grieving after society's invisible timer goes off, people start to worry. Or worse, they start to judge. And I want to say something directly to that idea. After a stroke, there is no timer. Guys, there can't be. Because loss is not a single event that happened and is now over. Loss is ongoing. Every single morning. I'm just thinking about so many conversations I've had with survivors where they've said every single morning they wake up into a changed body, into a life that they don't want. And um every morning the care partner breaks back into the changed life that they don't want. And it's not that it's something that you're grieving just once, it's something that you're grieving that is still happening. So please, please let go of any sense that you are running behind on some schedule because I'm here to tell you there is no schedule, and there never was a schedule. So if there is no time limit and no single correct shape, then what does grief actually do? How does it move? Let me take you let me take apart one of the most damaging ideas about grief that exists, and it is an idea almost that all of us absorbed, most likely without ever choosing to. And most people have heard of the five stages of grief: denial, anger, bargaining, depression, and acceptance. Have you heard of that? I'm sure you have. And the framework came from a researcher named Elizabeth Kubler-Ross back in 1969. And here's something that most people don't know. She developed those stages by studying people who were dying, not people who were grieving a loss. And later in her life, she said plainly that she regretted how the stages were understood. She never meant them as a checklist. She never meant them to be neat or orderly or one after another. But for some reason, that is exactly how the world has taken them. And so people end up believing that grief is kind of like a staircase that you climb out of. You climb out of denial, and then you pass through anger, and then you move into bargaining, and you sink into pre into depression, and then eventually you arrive at a place. Called acceptance, where you're done. And I'm here to tell you that is not how it works. And that has never been how it works. So if you have been beating yourself up because you thought you reached acceptance six months ago, and then last Tuesday you fell apart in the grocery store parking lot, I need you to let go of that guilt. And you did not, you know, quote unquote relapse. You did go backwards. You did fail at grieving. Essentially, you literally just grieved. And you grieved the way that grief actually happens in waves, in loops. And the one that I dislike the most is in ambushes. So let me give you a more honest picture. Two researchers, uh Strobe and Shute, described grief as moving back and forth between two kinds of days. Some days are what they call loss-oriented. Now, these are the days you feel the loss directly. You miss who you were. You look at old photos, old videos of yourself walking, talking, doing it, and it aches. These are the days for feeling it. And then other days you are feeling more restoration-oriented. And these are the days you're building the new life. Learning the new way to button a shirt, figuring out the new routine, trying something and having it actually work. Doing consistent effort. These are the days for doing. And here's the part that takes the pressure off, guys. Healthy grieving is not picking one of those and just staying there. Healthy grieving is what we call oscillating, it's bouncing between them. A heavy morning and a productive afternoon. A good week and then a hard phone call that knocks you flat. That back and forth is not just being unstable, guys. That back and forth is the actual uh what we would call mechanism of healing. It's very similar to what I do in my boot camps, where I do back and forth between making mistake to not making mistake, making mistake, not making mistake, and letting the brain heal, letting it adapt. So when you swing, guys, you're not broken. You are working. Hold on to the idea of bouncing back and forth because the next thing I'm gonna give you is a picture that is gonna make things kind of unforgettable and also hit home. And what I want to do is give you a picture that you can carry with you because when grief gets too big for words, sometimes a picture is just the thing that helps. This one comes from a woman named Lauren Herschel. Uh, she actually got it from her physician, but she posted it on X. And I've watched it land uh for person after person, including myself. And it's called The Ball and the Box. So picture a box in your mind. Inside that box is a ball, and also inside the box on one wall is a button. And that button is a pain button. And every single time the ball touches the button, you feel the full force of the loss. The wave hits, the tears come, or the anger, or that hollow feeling in your stomach. It comes with full force. Now, in the beginning, right after the stroke, the ball is massive and it fills the entire box. It is pressed up against that pain button constantly, and you cannot move, you can't turn, you can't breathe without the ball hitting the button. And that is the way, that is sorry, and that is why the early days feel relentless. Everything, every reminder, every task you used to do easily sets it off. Guys, that's not a weakness. That is just a very large ball in a very small box. Now, here's the part everyone gets wrong. The part that brings people the most relief when I think they finally understand it doesn't take away the grief pain, but it takes away the relief of at least understanding what's going on. Over time, the ball gets smaller. But the button does not. Let me repeat that. Over time the ball gets smaller and the button does not. The ball shrinks slowly, and it's so slowly shrinking that you often can't feel it happening. And as it shrinks, it stops touching the button all the time. Sometimes you get hours, then sometimes whole days, where the ball is just sitting quietly in the box and the button is not going off because it's not getting hit. You may go back to work, you laugh at something, and you feel for a moment somewhat like yourself, oftentimes it's based, you know, it happens and it depends on who you're with. But the ball is still in there, and every so often it bounces, and it is that button. And here's the crucial thing. When it does, guess what? It hurts just as much as it did on day one. The pain has not gotten weaker, the button never weakened. What changed actually is how often it gets hit. And guys, this is why grief can ambush you years later. Or at random moments. Could be a song, a smell, an anniversary. The ball bounces and it finds a button. And for a moment, you're right back in it at full strength. And that does not mean you have made no progress. Guys, it means you are a human being who loved a life. And that ball never fully disappears, guys. It just gets smaller. And your life just grows bigger around it. Oh, Survivor, I'm gonna talk to you. This is permission to stop expecting the pain itself to shrink. I want to give you that permission. It's the frequency that's gonna change and not the intensity, and that is normal. Now, care partner, this is how you can understand the day your person seems fine at breakfast and shattered by dinner, and also how you can seem fine at breakfast and shattered by dinner. The ball bounced, and it found the button. Nothing went wrong, you did not do anything wrong, the ball just moved. Now, here's the next piece of understanding what grief is. And it's one almost nobody actually connects to grief. It's a thing that I get asked about constantly without people realizing what they're actually describing. Now, grief is not just an emotion, because grief is physical. It can live in the body. And when people are grieving, they report like a very consistent set of physical symptoms. And I'm gonna list some of them because I think a few of you are about to feel very seen. A hollow, empty feeling in the stomach, stomach and bowel trouble, headaches, poor sleep, or sleep that never feels like rest, bone deep exhaustion that no amount of sleep touches, a tightness in the chest, sometimes even difficulty breathing, loss of appetite or food, really just losing its taste. And those are all physical symptoms that could be tied to grief. Now, here's why it matters so much, especially for stroke families specifically, because both the survivor and the care partner are already exhausted, already not sleeping well, already running on empty, and so when grief adds its physical weight on top of it, it can almost feel impossible to tell where the stroke recovery ends and the grief begins. Now, people come into my world convinced their body is failing them in some new way, and a real part of what they are feeling, I believe, is grief that's just showing up as a physical event. So I want you to give this a reframe. If you are like bone tired, and if your stomach is in knots or you cannot sleep, you cannot eat, and your chest feels tight, it actually may not be that something new is wrong with your body. It may be that your grief is being felt by your body. And as an OT, this is honestly squarely in my lane, because all of those physical symptoms hit your daily life and they wreck your sleep. You're eating your energy for the very therapy that helps you recover. Which means tending to grief is not separate from stroke recovery, guys. It is part of it. And when we help the grief, we often help the sleep, the appetite, the energy, and the recovery all at once. Mind and body are not two separate projects. That is, they never work. They're just one. For more information or to sign up for a boot camp, just go to Strokesurvivorbootcamp.com. I'm Dr. Phil and I'll have more web. Hey, this is Dr. Phil. If you're a Stroke Survivor and you want to regain motor function, improve mobility, and build real confidence in your recovery, then I want you to check out one of my Stroke Survivor Bootcamp training sessions. These are intensive, hands-on experiences designed to push performance, improve function, and help you get back to doing more of what matters in your life. Go to www.stroke survivorbootcamp.com and let's get you back on track one step at a time. Now there's one more piece of understanding that I want to give you before we talk about getting help and taking action, because I think it does real harm when people actually get it wrong, and the newer thinking has moved past it. For a longer, uh you know, for a long time, the message about grief that I heard and that I've I've personally shared before is that the goal is to let it go, to move on, to get closure and get over it, leave it behind. And guys, so many of you carry guilt because you can't do that and you don't even want to. And it turned that old idea on its head. The research behind it, they um, including a man named Class, the last name of Class, argued that healthy grieving is not about severing your connection to what you lost, it's about transforming that connection so that you can carry it forward into your ongoing life. So instead of letting go, you integrate. The bond changes shape, but it doesn't have to end. And it can't end. That's kind of the point. So let me make that concrete. What this means is that you don't have to amputate the person you were before, the former version of you, the athlete, the professional, the hairdresser, the um the manager, the person with the steady hands. They still get to come with you. Not as a ghost that you're chasing, but as a part of your story. The person who ran marathons is still part of who you are, even if your running days like you did are behind you. And you are allowed to honor them and keep moving. You carry them, you don't abandon them. And one of the things I've found, you know, the most healing ways people keep these bonds alive is honestly just by talking about it, telling the stories. Survivors who talk openly about their before life and care partners who reminisce together about how things used to be, they're not being sucked back into a morbid or you know negative situation, and they're not refusing to accept reality, even though sometimes they may be. So talk about it. Talk about who you were, what you missed, what was good. That is that that isn't wallowing if it's not perseverating. Sharing who you were is integration. So now what do we do when what do we do when grief gets stuck? Because it happens. And you hold on to it and you it it festers. I want to talk about the one thing that people are often most afraid to ask. And that's how do I know if my grief is too much? And how do I know if something is actually wrong? Because sometimes grief can get stuck in a way that deserves some extra support, guys. And knowing the difference is not about judging yourself, it's about knowing when to reach for a hand. Clinicians have a name for grief that gets stuck. Um, it's it's a current term that's called prolonged grief disorder. And I kind of want to demystify it. Uh, you may you likely have never heard of this um this disorder, because um it's not necessarily something that is probably checked. But the basic idea is that grief persists so deeply and far beyond what is typical for your particular culture and your situation, to the point where it is seriously interfering with your ability to function. And usually it's marked by an intense yearning and a kind of preoccupation that you literally can't move through. In plain words, the grieving process gets stuck in one place and stops moving at all. And notice this is not about how much you hurt. That's always going to be big, but it's whether or not the grief is moving. So remember the back and forth we talked about earlier, like between feeling the loss and rebuilding the life? Stuck grief is when that oscillating stops. It's when the person can only feel the loss day after day, month after month, year after year, and never even gets brief windows of what I defined as restoration days. The clinical guideposts for this uh even mention a rough time frame, something in the order of those feelings dominating nearly every day, many months out, even a year or more with no movement at all. So, if that sounds like you, go to your physician and talk to him about it. And it may be something that you just need some extra help and guidance to make make it through to get and move and help that grief that you're experiencing start to move. Um, guys, that's not a weakness and it's not failure, it's honestly a signal that something is heavy, and that any one person should never carry that heaviness alone. And the right kind of help can genuinely help you begin to move. So I would go to your physician, your primary care physician, and ask for ask for a referral. Now, let me pull all of this understanding together. Because before we turn to what you can do, you know, we have to realize we've covered a lot. And I want you to walk away with the big picture, not just the pieces that I talked about. So we started by naming grief and giving it permission. We learned that grief is the response to loss, not only to death, and that it is universal, but that its shape is actually personal. So there's no correct way to do it, and there's no timer on it. We learned that it does not move in a straight line. It oscillates, it fluctuates, it goes from one thing to the other, and it does it in waves and it ambushes. And we gave that a picture. If you guys remember the ball in the box, where the ball shrinks over time, but the button never does. So the feeling still is just as intense. And we learned that grief lives in the body and not just the mind, and that you don't have to let it go. You actually integrate it and carry it forward. We learn how to recognize when grief has gotten stuck in these extra hands. And when you stand back and actually look at all that together, guys, there's a single picture that begins to emerge. And for a long time, um, I actually thought grief was understood as like a psychological event, something happening in your mind, in individual emotions that you were supposed to actually process privately and then be done with. But the understanding has actually grown over time, and it's grown in a deck in a direction that I find very deeply hopeful, not just for stroke survivors, care partners, but for myself. And we now understand grief as a whole person, and it's an embodied experience. It encompasses your emotions, but also your physical self, your relationships, your community, and the way you fold what you lost into your life, you are actually still living. It's not a problem to be solved and filed away. It's an experience to be lived through with your whole self in the company of other people that may not understand what it is that you're going through. And that means the old picture of grief, the lonely person processing privately in a timeline until they are fixed, is just wrong. Grief is meant to be carried in community, felt in the body, and woven into a continuing life. Guys, you were never supposed to do this alone in your head against a clock. You're supposed to do that with others. So if you're doing it alone, reach out and find others who are also going through it because they can help you and help you process it. So, what can you actually do? I am going to give you five tools that you can do about grief. And um of these are going to be for the care partner, and some are for the survivor, and some are for both. I'll let you know. Um take what fits, leave what doesn't. Guys, there's no wrong way to do this. Some of these may not even do a dang thing for you, but some may. So, first tool is name the loss out loud. This one comes straight from where we started by naming it. Grief that stays unspoken tends to harden. The more you hide it, the more you bury it, the louder it gets inside your head. You remember me talking about inside out and those those emotions. During the movie, the emotions get louder and certain ones take over. And it's not until they learn that they can be together and work together and that they have to. It's not until that happens that peace actually starts to come in. But say out loud to someone safe or on paper, writing it down could be really good, and try this sentence. I am grieving. And then what I want you to do is finish it honestly. I'm grieving the runner I used to be. I'm grieving the conversations my husband and I used to have. I'm grieving that I used to be a hairdresser. And I used to be so good. I used to not have fear. I used to be confident. And I'm not naming the specific loss does something that vague heaviness can't. It gives the grief edges. It is a thing, and you know, really a thing with edges is a thing you can begin to actually hold. So here's tool two. This one grows out of that, if you remember me telling you, the continuing bonds approach. Continuing bonds theory. And that's carrying the connection forward instead of letting it go. This one can be so powerful. So please be gentle with yourself if you actually try it. Write yourself a short letter. One page. And do it from the perspective of the life the life that you actually lost, or the body you had. And it's written to you now. Let it say what it would want you to know. People are often surprised by what comes out. It is frequently not bitter, and it is frequently kind. I've done this myself. With my own grief. Let me tell you, this is powerful. It is also very heavy. So if it feels too heavy, skip it. But the door needs to stay open and you can come back to it anytime. Tool three. Remember the ball and the box image that I that I shared with you? And remember here's the thing. The ball does not shrink because you force it to, it shrinks as your life grows around it. So this is this is this is the one that you do for when it's a doing day, when it's a restoration-oriented day. Add one new thing to the box. One new routine, one new small role, one activity that is meaningful to who you are now, not who you were. As an occupational therapist, this is the heart of guys, my whole field. We're not just rebuilding the arm, or we're we're rebuilding the life around it. Every meaningful thing you put back into your days is another shape in that box. And it leaves the ball a little less room to bounce and find the button. Now here's the fourth tool. This one comes from learning that grief lives in the body and will collect what you do and not tend to do. So, care partners, your grief gets postponed because there's always something more urgent. So I'm gonna ask you to do something that sounds cold, but it is actually an act of survival and helps with grief. Put your own grief in on the calendar. Fifteen minutes. Make it daily. A walk where you let yourself feel it. A phone call to a friend where you are allowed to fall apart and not be the strong one. If you do not give your grief a scheduled door, it will let itself in through even worst possible windows. Usually it's exhaustion, resentment, um, or a body that feels like it's just breaking down. Attend to yourself on purpose. You cannot pour from an empty cup. You know, it's the whole thing that they say on airplanes, right? When the oxygen masks come down, don't put it on your kid first. Put it on you and then your child. But if you know that it's coming and scheduling it, that can bring a lot of value. And finally, tool five. This last one comes from everything we've said about grief being a whole person experience, guys. It's big enough to hold opposite things at once. There's a line from the writer, uh, Pima Children, that I come back to uh constantly. She said, the healing comes from letting there be room. Room for grief, room for relief, room for misery, and room for joy. All of it in the same room on the same day. This one is just like the movie Inside Out. Guys, you're gonna have a moment where you laugh hard at something, and I mean really laugh, and then a real stab of guilt. Like joy is a betrayal of everything you have lost. It is not. Guys, joy and grief are not enemies. They're roommates. And they're going to live in the same house, sometimes in the same hour for a very long time. And letting both of them have a room is not you failing to grieve, it's actually you healing. So let me bring this home. If you're a survivor, I want you to hear this. The grief you feel for the life you had is not a sign that you are failing to recover. It's a sign of how much that life actually meant to you. And you are allowed to mourn it and rebuild at the same time. Both hands are allowed to be full. If you're a care partner, I want you to hear this. Your grief counts. You do not have to earn it by suffering more, and you do not have to hide it to be strong. The most sustainable care actually comes from someone who's letting themselves be human, not someone running on empty and pretending. And to both of you, remember the ball in the box. The ball never vanishes. But it can get smaller. And your life, your one precious continuing life, it can grow bigger around the ball, which means the heads come less often. And the room gets wider. And when that happens, there's space. And when there's space, joy can move back yet. Remember, you are doing the best you can with the resources you have right now, guys. And that is not a consolation prize. That is actually the whole game. And you are not doing it alone. Guys, my name is Dr. Phil. And this episode, I hope it's reached someone. I hope it's I hope it's opened up the uh the way it's opened up for me. And the more that you can understand how grief is showing up in your life and how you can actually impact your life because of grief, and how you can bring it with you, man. When you understand that, there ends up being room for both. And yes, it sucks, but there's also joy. I appreciate you all. Thank you for listening. Thank you for being a part of this journey with me. And as always, what matters and what you need to remember is that all it takes is just taking one step at a time. I'm Dr. Phil, and this is Stroke Survivor Boot County. Breathe in.

SPEAKER_02 52:31

Count it out. Every scar is around. Every stomach still step you.

SPEAKER_01 52:50

Sweat on your face means you can see the eye.