Follow

Translate

NYC Psychotherapist Blog

power by WikipediaMindmap

Monday, December 2, 2024

The Many Layers of Grief

There is no right or wrong way to grieve. Everyone grieves in their own way and in their own time (see my article:  Common Reactions to the Loss of a Loved One).

The Many Layers of Grief

The 5 Stages of Grief
The idea that there are stages of grief was developed by Swiss-American psychiatrist Dr. Elizabeth Kubler-Ross in the late 1960s. 

According to Kubler-Ross, these stages are:
  • Denial
  • Anger
  • Bargaining
  • Depression 
  • Acceptance
Although these stages are usually thought to be linear, they often occur in no particular order and they're often reoccurring. 

For instance, if someone experiences anger first, they might experience denial, depression and bargaining and a certain level of acceptance

But over time this same person will probably re-experience these stages in no particular order on certain anniversaries (e.g, birthdays, anniversaries of their loved one's death and holidays).

In addition, acceptance has many layers to it. There is the initial acceptance that the death has occurred, but over time acceptance can deepen as the meaning of this loss also deepens.

The Many Layers of Grief
In addition to the 5 Stages of Grief, people often experience grief in waves and in layers.

Anyone who has ever grieved for the loss of a loved one is aware that grief comes in waves. Weeks, months and years after the loss you might experience a wave of grief come over you for no apparent reason that you're aware of at the time.

The Many Layers of Grief

The concept that there can be layers of grief over time isn't commonly recognized.  The layers, which often go with the stages, are usually experienced from surface to depth.  

In other words, even if you go through all five stages several times and in a different order or in a combination of stages each time, you might go through these stages in more profound ways each time from surface to depth.

Although this is understandable when the loss is close, people are often surprised to go through many layers of grief even when they were estranged from the person who died or the death was of a relative they never knew (see my article: (see my article: Mourning the Death of a Father You Have Never Known).

Clinical Vignette
The following clinical vignette illustrates how grief can come in layers over time for an estranged family member:

Sara
When Sara received the phone call from the police that her estranged older sister, June, was found dead from an overdose of heroin hundreds of miles away, she was shocked at first. She and her sister had estranged for over 20 years (see my article: Family Estrangements: Understanding the Barriers to Reconciliation).

Growing up Sara wasn't close to June. By the time Sara was five years old, her older sister had already quit high school to move in with a boyfriend that no one in the family liked, so Sara never saw her sister again.

As friends and family members heard about the June's death, they reached out to Sara to express their condolences (see my article: Expressing Condolences in a Caring and Tactful Way).

In response to their concern, Sara told them that she didn't have a sense of loss because she and June weren't close. She said she was just glad that June wasn't suffering anymore.

After Sara and her husband arranged for June's burial, they resumed their daily activities as if nothing had happened. But over time June's feelings changed. She noticed that her level of acceptance of June's death evolved over time.

As time passed and she went through what was left of June's personal belongings, Sara felt waves of sadness to be missing the sister she had never really known. 

Going through one of June's picture albums, Sara was surprised to discover that June kept pictures of her when she was a baby. It was at that point that Sara realized, even though June was someone she never really knew, she was important to June in ways she had never known.

The Many Layers of Grief

After discovering the pictures of herself, Sara made an effort to find out more about her sister. 

With much effort, she was able to find people in the area where June lived who knew her. She discovered that, before her life took a precipitous decline, June liked to draw portraits, including portraits of Sara when she was a baby.

She also discovered that up until June began abusing heroin, she loved to cook and she often invited friends and neighbors to her home for a meal, including people who were much less fortunate than her.

No one who knew June in the past was sure why her life took such a turn for the worse because she isolated herself in her final years. 

But some former friends believed her life got worse after she began a relationship with a man who introduced her to heroin. They surmised that after he left June, she kept to herself and her heroin use got worse until the day she overdosed.

As she discovered more about her sister, Sara was surprised to feel a depth of grief for June she would have never anticipated. 

Soon after that, she began therapy to deal with her loss.

People who are estranged from family members for a long time and people who have never known certain relatives are often surprised by the many layers of grief they feel.

Grieving in Your Own Way
We're hardwired for attachment in order to survive as babies. We're not hardwired for grief.

Grief is a topic that makes many people feel uncomfortable. In fact, many people try to avoid feeling emotions related to grief. 

The Many Layers of Grief

Those who aren't grieving often express surprise when people who have experienced a loss are continuing to grieve. 

Many make unkind remarks like, "You're still sad about your loss? How can this be when it's been over a year?" or "You just need to get out there and meet someone new."

As I mentioned at the beginning of this article, there's no one right or wrong way to grieve so if you're grieving, you'll go through it in your own time and in your own way, but it's important to make room for all your feelings.  

Certain rituals in various cultures are meant to help those who are grieving to acknowledge their feelings and come together with other people for emotional support (see my article: The Power of Creating Rituals).

The Many Layers of Grief

But after everyone has gone home and returned to their lives, you'll probably realize your life has changed in unanticipated ways after your loss.  

You might return to work and other routines but, just like any other profound experience, grief can change you.

Aside from experiencing the loss, you might also discover that, over time, grief can give you a new appreciation for love and life.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

I work with individual adults and couples and I have helped many clients to work through grief in their own way.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.































Sunday, December 1, 2024

What is the Relationship Between Anxiety and Depression?

Although anxiety and depression often look different, they're more closely connected than most people think (see my article: What is the Difference Between Fear and Anxiety?)

The Relationship Between Anxiety and Depression

While anxiety is usually considered a high energy state, depression is usually perceived as a low energy state. 

Even though they appear to be different, it's not unusual for a person with depression to also experience anxiety, including panic attacks, and vice versa.

How Are Anxiety and Depression Connected?
Anxiety is more than just common worry and nervousness. 

Anxiety can cause debilitating fear beyond what most people might experience.  

People who experience debilitating anxiety usually know that many of their anxious thoughts aren't rational, but they might not be able to stop these thoughts. 

Over time, this constant sense of dread can lead to depression.

What is the Cycle Between Anxiety and Depression?
When people feel highly anxious and they're unable to overcome or control their anxious thoughts, they often feel they have failed, which can lead to depression (see my article: Looking Happy on the Outside But Feeling Broken on the Inside).

The typical cycle between anxiety and depression can include one or more of the following:
  • The chance of becoming depressed is much higher if you're already grappling with anxiety. About 50% of people who suffer with major depression also suffer from debilitating anxiety.
  • Anxiety and depression can trigger each other.
The Relationship Between Anxiety and Depression

  • People who have unresolved trauma including PTSD (posttraumatic stress disorder) are prone to depression.
  • Many people have a genetic predisposition for anxiety and depression so that, without therapy, these conditions are passed on from one generation to the next. This includes intergenerational trauma.
What Are the Signs of a Combination of Anxiety and Depression?
Symptoms of anxiety and depression include (but are not limited to):
  • Persistent irrational fears and worries
  • Feeling helpless or powerless
  • Feeling hopeless
  • Difficulty falling and staying asleep
  • Feeling tired and irritable
The Relationship Between Anxiety and Depression
  • Changes in eating habits including overeating or eating too little
  • Memory problems
  • Difficulty making decisions
  • Problems concentrating
  • Loss of interest in former activities or hobbies
  • Problems relaxing
  • Problems with being in the moment
  • Suffering with panic attacks
Getting Help in Therapy to Overcome Anxiety and Depression
There are many different types of therapy to overcome anxiety and depression.

If your anxiety and depression are rooted in unresolved trauma, Experiential Therapy is safer and more effective than regular talk therapy (see my article: Why is Experiential Therapy More Effective Than Talk Therapy to Overcome Trauma).

Getting Help in Therapy For Anxiety and Depression

Experiential Therapy includes therapy modalities that work due to the mind-body connection (see my article: Experiential Therapy and the Mind-Body Connection: The Body Offers a Window Into the Unconscious Mind).

Experiential therapy includes the following types of therapy:
  • EMDR (Eye Movement Desensitization and Reprocessing) Therapy
  • AEDP (Accelerated Experiential Dynamic Psychotherapy)
  • Parts Work including IFS (Internal Family Systems) and Ego States Therapy
Instead of struggling on your own, seek help from a licensed mental health professional who can help you overcome anxiety and depression so you can lead a more fulfilling life.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

I work with individual adults and couples.

I have helped many clients to overcome anxiety and depression, including problems related to unresolved trauma (see my article: What is a Trauma Therapist?).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.