Misconceptions About Grief

People hold certain misconceptions about grieving, which can make the process even harder. The idea that grief is a linear process with a definite endpoint can create anxiety for people who worry that they are not grieving “correctly,” says Kailey Roberts, PhD, in conversation with Jonathan M. DePierro, PhD.

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Transcript

[00:00:00] Stephen Calabria: From the Mount Sinai Health System in New York City, this is Road to Resilience, a podcast about facing adversity. I'm your host, Stephen Calabria, Mount Sinai's Director of Podcasting.

[00:00:15] On this episode, we have a special edition of Road to Resilience with guest host Jonathan DePierro, PhD. Dr. DePierro is an Associate Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai and the Associate Director of the Mount Sinai Health System's Center for Stress, Resilience and Personal Growth.

[00:00:33] Dr. DePierro interviews his friend and colleague, Dr. Kailey Roberts, on a subject we all unfortunately must someday come to terms with, the subject of grief.

[00:00:43] It turns out there are many misconceptions surrounding grief, among them that grieving is a linear process with a definite endpoint. Addressing misunderstandings around grief is important in managing grieving folks' expectations, and in correcting decades of thinking around the grieving process.

[00:01:00] We're honored to welcome Drs. Jonathan DePierro and Kailey Roberts to the show.

[00:01:05] Jon Depierro: Welcome to the Road to Resilience podcast. My name is Dr. Jonathan Depierro. I'm an associate professor of psychiatry here at the Icahn School of Medicine and Associate Director of Mount Sinai Center for Stress, Resilience and Personal Growth. With me today in the studio is Dr. Kailey Roberts, and we'll be talking a little bit about grief.

[00:01:24] Dr. Kailey Roberts is an Assistant Professor of Clinical Psychology at Yeshiva Universities for KA graduate school of psychology and a consultant faculty member at Memorial Sloan Kettering Cancer Center. She specializes in bereavement and palliative psychology. 

[00:01:39] Dr. Roberts has invested her career as a researcher and therapist in bringing attention to under-recognized grief experiences and improving supports for grievers.

[00:01:47] Additionally, Dr. Roberts is an dedicated educator facilitating workshops on grief and bereavement and meaning centered psychotherapy for various institutions as well as mentoring students. 

[00:01:58] Like many who choose to focus their work in grief and bereavement, she comes with her own history of loss that inevitably informs her life and work. So Dr. Roberts, welcome to the studio. Welcome to Road to Resilience. 

[00:02:11] Kailey Roberts: Thank you so much for having me. 

[00:02:13] Jon Depierro: So could you tell me a little bit about grief? So people use this term all the time. What is grief? 

[00:02:22] Kailey Roberts: It's an interesting question because in many ways, grief. Is an emotion, but it also includes so many other facets.

[00:02:31] There are cognitive facets. I know for myself when I've been in an acute grieving state, I've often felt like my concentration was off, that I couldn't even remember things that had happened. It can also be really physical for a lot of people. 

[00:02:46] People talk about that gut punch or that ache that you feel in your stomach or in your chest. So it's a complex emotion that can manifest in so many different ways for each person. 

[00:02:57] Jon Depierro: So there's something really individual about grief that's important to keep in mind as we're talking more about today. 

[00:03:03] Kailey Roberts: Absolutely.

[00:03:04] Jon Depierro: There's also been a lot of research on how people grieve, different patterns to grief, different problems people encounter along the way as they're grieving. And we'll get into that a little bit today, but I want people to keep in mind that grief is really a personal experience. 

[00:03:18] There's no right or wrong way to grieve. One of the things that people often talk about with grief are the stages of grief. And if you asked any or person off the street, they'd be able to say that there are certain stages of grief.

[00:03:32] And that's maybe about all they know. Maybe we could talk about these stages of grief. They have been around in our understanding about grief since about the sixties, and there's five of them. Denial, anger, bargaining, depression, and acceptance. 

[00:03:49] Kaleigh, can you tell us a little bit more about these stages? Are they really stages or are they a set of different experiences and how we understand grief? 

[00:03:59] Kailey Roberts: This is probably one of the most common questions that I get, from my students, from clients that I'm working with, and even from other mental health professionals. Because it really is something that is so pervasive in our society.

[00:04:13] And while my initial response is to say no without thinking, I think that's important to pause there because there is a reason that the stages of grief are so embedded in how we think about it. Many people understandably seek something to ground into to help them to feel like there's a roadmap for grief, because it's so confusing and disorienting.

[00:04:38] So I think this is one of the reasons why the stages have become so pervasive in our thinking. But the reality is that for most people, grief isn't linear, and that's challenging for people to experience, and sometimes people even want there to be stages. 

[00:04:54] On the flip side, I've heard many people that have said, "how could you possibly say that my grief is linear and in stages. It's a complete mess." "I experience really intense pain one minute, and the next minute I'm like laughing hysterically and I don't know why."

[00:05:10] So what I tend to tell clients and even the students that I train, is that some of the elements that go into those stages can certainly be aspects that people experience in their grief. But sometimes they might be experienced all at once. 

[00:05:24] Sometimes, you might feel a sense of acceptance about some aspect of your loss, but not about other aspects. And from a research standpoint, the research is a bit mixed, but mostly what pans out is that grief is not linear.

[00:05:40] We like to characterize it more as something that comes in waves, with intensity increasing at times, decreasing at times, and that kind of valence going back and forth. 

[00:05:51] Jon Depierro: So when you say grief isn't linear, or the research says that grief isn't linear, by that you mean that people don't necessarily go from denial to anger, then to bargaining, then to depression and acceptance.

[00:06:04] Kailey Roberts: Absolutely. And sometimes you can experience all of that at one time. And I think the other concerning aspect of the stages of grief is that there is the implication that there is a done point, and that should be the goal. 

[00:06:20] And what I hear so often from people is shoulds, should I be grieving differently? Am I in the right stage? Why am I not in this stage? Or why am I not grieving in this way? Or why am I not quote unquote farther along? And it still has that kind of idea of that there's this end point. 

[00:06:40] But really, for many people, especially if you've experienced a significant loss, there may not be an absolute endpoint to your grief, and many people will experience that actually as invalidating. 

[00:06:51] Some of the populations that I work with include parents who have lost a child, and what we hear again and again is that they understandably take offense to being told that they should move on from their grief. 

[00:07:04] So what we tend to talk about, and I'll bring up the term that was coined by my mentor, Dr. Wendy Lichtenthal, is the idea of coexisting with our grief. So, learning how to reengage in life, but not saying we're gonna get rid of that grief because that grief is valid. 

[00:07:20] Jon Depierro: That was something that was on my mind. I was wondering, and listeners might be wondering too, is it something that's ever done? Are you ever done grieving? And you sort of just answered that question. 

[00:07:30] You're saying that it's a process, something that evolves over time that you learn to coexist with but you're never finished with. 

[00:07:39] Kailey Roberts: Yes. And that I, I really like this term coexisting because it implies that we are still existing. We need to live. But grief is often so linked to what's most important to us, the person that was most important to us, if we're talking about death loss. 

[00:07:55] And so, part of that process is also integrating that person into your life in a new way. And it doesn't necessarily mean that you are leaving that grief behind.

[00:08:05] One thing that I did wanna bring up though is that this can be not only challenging on an individual level, but the reality is our society is not set up to help people to coexist with their grief. We have three day bereavement leave policies at most workplaces, if that. 

[00:08:23] We have people that might have shift work jobs and work multiple jobs. And how are they to have the time to just kind of learn to coexist with their grief? So there are a lot of barriers that people face. 

[00:08:33] And this is also, I think, what contributes to this desire to, to find a solution in order to cope. But perhaps if we had a more grief informed society, if we had communities that were oriented towards supporting grievers, we wouldn't feel this need to kind of get rid of it and that something was wrong with us because we're grieving. 

[00:08:53] Jon Depierro: Or get over it. 

[00:08:54] Kailey Roberts: Yeah. 

[00:08:55] Jon Depierro: Get over it and get back to work or get on of our lives. 

[00:08:57] Kailey Roberts: Facilitate capitalism.

[00:08:59] Jon Depierro: It sort of got me thinking about misconceptions or myths around grief. And you alluded to a couple, which is that a misconception around grief might be that it has certain stages and denial for two weeks, and then you move on to your two weeks of anger and then your two weeks of bargaining and in a month and a half you're all wrapped up in a neat bow and done grieving.

[00:09:22] Maybe that's one misconception. What are some other misconceptions or myths that people might have about grief? 

[00:09:27] Kailey Roberts: I think kind of going off of what we were talking about earlier is the idea that it's universal. Certainly we're all going to experience losses, many types of losses, both death losses as well as non-death losses.

[00:09:42] But everybody's circumstances are going to be different. People come from different cultural backgrounds. They come from different points of access to support different types of communities that deal with grief differently. 

[00:09:54] So the kind of general experience is universal, but it will look very different for each person. And one of the things that comes to my mind is thinking back to the height of the Covid pandemic and how people experiencing losses during that time had limits placed on them in terms of how they would engage in cultural or religious rituals. 

[00:10:15] And we are seeing now in research panning out from that time, that did have an impact on people's grief processes. They didn't have that opportunity to connect to meaningful sources of community and sources of how they see the world and cope with death. 

[00:10:31] So in that sense, we want to think about how, yes, we can all have shared experiences, but also we wanna recognize the unique experiences people have.

[00:10:41] Jon Depierro: So an example from the pandemic might be that, due to restrictions, family members might not have been at the bedside, able to hold their loved ones hand or speak to them in person at the end of life, and there might not have been a wake or a funeral or other kinds of rituals where people were coming together, and making meaning.

[00:10:59] Are those the kinds of things you're thinking about? 

[00:11:02] Kailey Roberts: Another, maybe not so much a myth, but perhaps a bias that I did wanna raise around grief is the idea that it is only something that we experience around death. Certainly that is a pervading way that we experience grief, but we also, most of us experience many losses across our lifetime.

[00:11:19] Whether it's loss of a job, of a relationship, loss of a sense of security in how the world works. And I have to say that today, doing this interview, what's on my mind is the idea of non death loss in the context of what's going on in LA and the fires. 

[00:11:39] And certainly there have been death losses in that as well, but there are so many people that are going through all of these other types of loss, and it's important to make space for grief about non-death loss as well.

[00:11:52] One of the elements of kind of the rhetoric that I've been hearing coming out about the fires is I think attempts to be encouraging and saying, you will rebuild, you'll regain your life and what you had. 

[00:12:06] And I think in many cases this is well-meaning people wanna try to instill hope in others. But I think even as we have these encouraging statements, it's also important to hold space for the very real pain that people are experiencing.

[00:12:20] You can certainly rebuild a home, but you can't replace everything that was in there that was meaningful. And I think about this in the context of other kinds of losses too, that we wanna, as a supporter of grievers, balance being that kind of hopeful, encouraging person with also tolerating that grief just sucks.

[00:12:40] It's hard and we need to just be in that space with other people who are grieving. 

[00:12:46] Jon Depierro: Yeah, I think there's a natural human instinct, and I certainly have this instinct as a therapist. It's my profession to jump in with solutions. Oh, try this or do this, or, why don't you think about it this way? And really, what the person might really need is validation.

[00:13:05] That they're heard, that you're holding those emotions with them, that you're present with me. You might not even need to say anything, but just sitting alongside them, as they're going through something, is deeply meaningful. Probably even more meaningful in that moment than offering a suggestion.

[00:13:20] Kailey Roberts: And the ability to sit with that and tolerate the pain is not necessarily something that people are always comfortable with, and so part of the work that I'm involved in as well as my mentor, who I will continue to reference because she has informed so much of my work, Dr. Lichtenthal, is the idea of building more grief informed communities, helping people to have resources so that they could feel more comfortable supporting people who are grieving, because of course, most people don't know what to say and also sometimes there isn't a right thing to say. And everybody's not a therapist.

[00:13:55] And even I will say some therapists have a trouble sitting with grief. So just putting out that message that tolerating the pain, being there for somebody consistently, unconditionally is really the most important thing that somebody can do to support a griever. 

[00:14:10] Jon Depierro: I think one of the disorienting things about sitting with grief is that it reminds you of your own mortality. It reminds you of life's limitations and that's a very scary thing to be thinking about. 

[00:14:22] Kailey Roberts: Certainly. And people who are grieving them also are often feeling that mortality salience too. They're missing the person, but they're also reminded that life is short if, especially if it was a loss they experience that's not necessarily in the expected timeline of what we would think about in life. 

[00:14:42] So they're holding both their own existential dilemmas as well as the missing and so many aspects of pain that can come into what they end up presenting with when you're there trying to support them. 

[00:14:54] Jon Depierro: You had mentioned this phrase loss that wasn't on an expected timeline. Can you give an example of that? 

[00:15:00] Kailey Roberts: So there are numerous examples of this, and it also depends on the individual's own expectations, but examples that come to mind are certainly, losing a young child, a young spouse who is also coping with parenting, who loses their partner. 

[00:15:16] And for some people, even though it might be expected as somebody ages for them to ultimately die, depending upon their life circumstances, this can also feel off time. For example, I do work with a number of people who were approaching retirement and then experience a loss of a partner or a close friend. 

[00:15:37] And all of those plans that they had in mind of how they thought those next two decades of their life would look, go out the window. And so they're again, not only missing that person, but trying to figure out what does my life look like now when this timeline is totally thrown off. 

[00:15:52] Jon Depierro: One of the things that we can get into a bit more, and you might see on social media is almost a kind of artificial trauma comparison of, oh, this loss is worse than this loss. Or, I shouldn't be grieving this in this circumstance because this other person had a more significant loss.

[00:16:09] This, putting yourself in relation to other people and either downplaying your own loss or arguing that one loss is greater than another. What do you say? What do you think about that? 

[00:16:21] Kailey Roberts: I think it's complicated. I don't believe in making hierarchies of loss, and we do know that there are certain things that can make it particularly hard. Being socially isolated, for instance. Losing your main person and then not having anybody else can make it harder for some people. 

[00:16:38] And I think it's important to kind of, especially when I'm running groups, for instance, to hold both spaces that everybody's loss is valid and everybody's loss is different, and might have different levels of significance.

[00:16:52] And this can be challenging in groups. I would say though that most of the time people have a kindness towards others and kind of lean on more the minimizing side. And feel like, oh, my loss can't possibly be as bad as so and so's. 

[00:17:07] So the goal is to kind of see how we might all have challenges and we might all have ways in which we are kinda buffering against the challenges. 

[00:17:17] Jon Depierro: Although you might have different kinds of losses that people are experiencing, you're all in the same boat of messy emotions and figuring out who you are now without that person.

[00:17:28] Kailey Roberts: And I will also say that in terms of people who are seeking support, it may not always be the appropriate fit to be in a group of congenital any kind of loss. Some people really do want to speak to others who have experienced very similar losses. 

[00:17:43] For example, I do hear this a lot from bereaved parents, especially parents who have lost a younger child or even a child at, at any age, frankly. Most bereaved parents often wanna connect with other bereaved parents. 

[00:17:56] And similarly, I've heard this, thinking about other kinds of experiences that we might have. For example, groups that support bereaved spouses or partners are not necessarily always L-G-B-T-Q friendly.

[00:18:09] And so sometimes people might feel it's more appropriate for them to go into a specific group where people can understand what those unique needs might be. 

[00:18:18] Jon Depierro: So we spoke about the stages of grief and how it can be helpful and also how it, there are some limitations to it. What are some ways of explaining grief or models of grief that you use when explaining this to patients or when speaking to patients about grief?

[00:18:36] Kailey Roberts: So one of the first frames that comes to mind that I find helpful to understand grief and why we can have such intense reactions is that grief is often related to attachment and it is the people will describe it as going hand in hand with love, or we can think about it as going hand in hand with connectedness and there could be differing views on this, but at least from a psychological perspective, we are attachment-seeking, connection-seeking beings.

[00:19:06] I would argue other animals are too, but let's just stick with humans for now, and we want these relationships, this closeness. And so when we lose somebody that is so significant to us, we can think about grief as kind of a separation protest or separation distress. 

[00:19:24] So, again, Dr. Lichtenthal often draws on this image in some of the talks that she and I have been involved in, of a crying toddler looking so distressed. And we can think about how when a toddler is taken away from their primary carer, they feel completely at sea. 

[00:19:41] They don't know what to do. And when we lose somebody significant, it can kick up those feelings of losing that, that deep connection. And so sometimes, the goal then can be how do we figure out how to retain that connection?

[00:19:57] How do we transform it when somebody's not physically here, but still have that connection? Now that might look different if the person had a conflicted relationship. And then it's partly kind of giving space to talking about that complicated connection and the attachment challenges that brings up for somebody. 

[00:20:16] Jon Depierro: I know in the literature there's something called the dual process model of grief. Maybe you could tell us a little bit about that. 

[00:20:22] Kailey Roberts: So this is definitely another model that I find helpful, both in educating clinicians and coping with my own grief and working with clients. The idea behind this is, it looks different than the stages of grief because it's not stages. 

[00:20:36] It's basically two buckets, to, for lack of a better word. And the idea is that we have two ways that we are bouncing back and forth between of coping with grief. One is loss-orientation, which I'll explain what that means in a second.

[00:20:53] And the other is restoration-orientation. Loss oriented coping is what I think of as the deep icky pain of grief that we're really feeling it, we're feeling it in our bodies emotionally. It's the missing the yearning for that person. 

[00:21:08] The restoration-oriented coping is more the moments where we are trying to reengage in our lives, seeking out new activities, new relationships.

[00:21:17] And sometimes even distracting from that pain. For many people, what happens is they oscillate between these two ways of coping, and I think that it can be very helpful to recognize which area that somebody is in, because what I do hear from clients sometimes is worry that if they're engaging in new activities, that means that they're doing something wrong by distracting themselves from their grief, that they should be focusing on their grief or vice versa. 

[00:21:48] People will feel stuck. I just feel the pain all the time. And so we talk about what are ways that you actually may be bouncing back and forth in this process.

[00:22:00] Jon Depierro: I can imagine that's kind of exhausting for people to bounce back and forth so much. 

[00:22:05] Kailey Roberts: It can be disorienting. And, I think this is also what we've touched on already, the idea that people often have a sense of "should" when they're grieving, that I should be doing something or feeling something different.

[00:22:19] So much of grief work or even just supporting a grief or not as a therapist, is just validating, normalizing that yes, it, it looks messy, it's complicated, but there isn't necessarily a right way that you should be grieving.

[00:22:36] Jon Depierro: One thing I was thinking about as I was planning the interview was about red flags. So as an individual, as a therapist, friend, family member, what are some things that would be warning signs that someone's really struggling with navigating this process? 

[00:22:55] I know there's no right or wrong way to grieve, but what are some problems that people typically or might encounter or typically encounter along the way?

[00:23:06] Kailey Roberts: So there are certain elements that can come together to make some bereavement experiences more challenging than others. Some are more of these systems level-issues. Being isolated, not having access to supports. Having your grief be judged. We refer to a term called disenfranchised grief.

[00:23:28] And this is the concept that somebody's expression of grief or how they're feeling the grief, or even who they are grieving is deemed as not societally acceptable somehow. And to have that disenfranchisement can result in somebody struggling more in their grief. 

[00:23:49] Other factors that we might consider are especially if the circumstances of the death were particularly traumatic, as perceived by the griever.

[00:23:59] And this can certainly include sudden or violent deaths, but also for some people this can include medical deaths witnessing, distressing experiences, witnessing their loved ones suffering can result in a traumatic experience for some.

[00:24:15] What we want to look for is, how does somebody engage in this process of coexisting with their grief over time? It's not about do they stop grieving, it's about are they also engaging in the things that are meaningful to them in parallel?

[00:24:32] Are they engaging in activities that they need to do? Are they personally extremely distressed by how they're experiencing their grief? In my work, I try to center somebody's perception of their own coping as much as possible versus applying an expert opinion necessarily.

[00:24:53] And people will report that they feel stuck, that they don't know how they can continue to cope, that they don't know how to live without the person. And those are the times where we might want to step in a little bit more and provide more support.

[00:25:09] Jon Depierro: Maybe we could transition a little bit. We had mentioned up top that your professional experiences have dovetailed with some of the experiences you've had in your personal life of losses that you've had in your own life. Maybe you could speak a little bit about that.

[00:25:24] Kailey Roberts: So I came into the grief professional world already having early loss experiences, and interestingly, I didn't necessarily have insight into the fact that was informing some of my decisions. 

[00:25:39] I had some but not fully and amidst my training, I did experience a significant loss in my life as well as a significant caregiving experience. And I will just say that one of the things that helped through that process was supporters, which included you. 

[00:26:00] So it is meaningful to be here having this conversation, in particular with you. I think in addition to that, it was complicated to be in the field talking about grief all the time, engaging in that world.

[00:26:14] And I think it also did give me a benefit because I was surrounded with other people who were talking about grief already. 

[00:26:21] My mentor, who I've mentioned multiple times, other mentors who have personally experienced grief, who also work with clients experiencing grief, all gave me the opportunity to talk about what was, what I was experiencing and to feel like it was okay to talk about it.

[00:26:39] This, I think could have been more challenging had I not had those supports because the particular loss that I experienced was what some might consider off time. So a lot of my peers had not experienced this kind of loss outside of the grief world. So talking about it at times could be challenging.

[00:27:00] Really emphasizing the importance of social support and people who get it, or at the very least want to try to get it is so important. I think on a bigger level though, what I learned through my own loss experiences is how our systems are really not set up to support people who are grieving. 

[00:27:22] And even as somebody who is, was in the system, still is, it's a struggle to access that kind of support to even have the larger systems be supportive of say, bereavement leave, for example. 

[00:27:37] And so it has fueled my passion and goals to not only work on the individual level, but to think about how we can improve grief supports from more of a public health standpoint and a systems level standpoint.

[00:27:52] Jon Depierro: What would some of those systems look like? What would be a trauma-informed community in the ideal world? 

[00:28:00] Kailey Roberts: Well, to the point of trauma-informed, we've talked about the idea of being grief informed or bereavement conscious care. 

[00:28:07] So the idea is that, especially if we're talking about, say, a cancer setting, or a dementia care setting, for all of the providers involved to at least have some nugget in mind, that whatever is going on medically is going to also inform somebody's grief experience down the line. 

[00:28:27] So for example, having conversations about treatment-related decisions. It doesn't mean that every physician has to be ready to have a deep conversation about grief, but to be aware that whatever is being talked about will come up, most likely, down the line for somebody.

[00:28:44] People remember what providers have said, and I would say that one of the biggest things people remember is whether providers communicate that their person matters. 

[00:28:54] That they're not just another patient. So a very simple but challenging systemically thing that providers can do is to provide condolence calls.

[00:29:04] Now, some of the work that I'm involved in is examining just that simple act and what makes it hard, and it's easy enough to say, well, of course doctors should follow up with their patient's families, but we also don't have a system that supports that. 

[00:29:21] As you well know in your work, we have burnt out clinicians all over the place and adding another thing to their plate is incredibly challenging and not really feasible in how things are set up right now.

[00:29:34] So some of the work is thinking about how can we get into the system, how can we incentivize administrators to better prioritize grief care?

[00:29:45] Jon Depierro: To carve out that time for those meaningful conversations, to invest resources into those conversations as well. 

[00:29:51] Kailey Roberts: One important area that we're looking at is the fact that it is part of the core elements of palliative care to provide bereavement support, but so many palliative teams don't have somebody who has dedicated time to actually be the bereavement support person.

[00:30:08] This is, again, going to larger issues, in terms of resource allocation, but it also is, I think it speaks to what health systems tend to prioritize and understandably, many health systems prioritize treatment and active care..\  

[00:30:25] But we also wanna think about how can health systems prioritize preventative care, supportive care, and follow up care for families.

[00:30:34] Jon Depierro: We had talked about this a little bit earlier. What is the role of ritual in supporting people's grieving ? 

[00:30:42] Kailey Roberts: For many people and across cultures, rituals that are unique to each culture or each religious tradition can be incredibly powerful. And they're powerful on multiple levels, I would say. 

[00:30:56] They can be powerful spiritually and in the intangibles. They can also facilitate community, and therefore social support. 

[00:31:05] For many, some of these rituals can also provide that sort of grounding or that idea of a roadmap that we were talking about earlier to feel like there's something to guide them in grief. 

[00:31:16] One of my students actually is doing an incredible project examining the role of Orthodox Jewish bereavement rituals in young adults who lost a parent.

[00:31:26] And what we are writing about is how, interestingly, these rituals and that at least for when one loses a parent go on for at least a year, they follow this idea of the oscillating between loss and restoration. 

[00:31:41] You are saying prayers that are really putting you into that space of feeling the pain and thinking about the person, but you're also engaging in activities with others and going back and forth.

[00:31:52] Even the idea of Shiva, being culturally positioned to sit there, not do anything, to have people coming and talking to you, but you are not having to engage in daily activities, is facilitating that being in the pain and having others tolerate your pain and also facilitating connectedness.

[00:32:14] So that's just one example that comes to mind. But there are so many other traditions and, cultures that have these rituals and it does help to build community. 

[00:32:26] There can be challenges for some people that I also wanna raise, which is that, for some, significant losses can shake up their worldview.

[00:32:35] And some people may feel disconnected from their spiritual, religious background. They may not feel like their community necessarily understands their loss. 

[00:32:44] And I've certainly heard this from people in our research as well as people that I've worked with. And in that case it's a process of, how do you rebuild a sense of meaning in life?

[00:32:54] For some people, it's trying to find ways to reconnect with that tradition, and for others it's discovering new ways to connect to meaning or, for some people, spirituality? 

[00:33:06] Jon Depierro: It makes me think of the concept of what we've called negative religious coping, which is that in general, spiritual traditions, religious practices can be very helpful to people as they're going through difficult times. 

[00:33:21] However, if you think that your God is punishing you for things that you've done or not done, or that you're really angry at your God, for example, then it actually is not so.

[00:33:35] Like, the spirituality is less helpful and actually can even be problematic for you in bringing up that distress over and over again, continuing to engage with the anger and questioning the religious traditions rather than engaging with them more proactively or adaptively. 

[00:33:52] Kailey Roberts: And the question that I would explore with somebody who's experiencing that is thinking about what did they find meaningful about that?

[00:34:00] Spiritual view. And again, are there ways that they wanna continue to connect with it or to continue to connect with that aspect of themselves and giving space for what can often be a very real and valid feeling of anger and a struggle to make sense of something that seems entirely senseless.

[00:34:20] Jon Depierro: Are humans the only creature in the animal kingdom that grieve? 

[00:34:25] Kailey Roberts: Well, I continually have a fantasy that someday I will go and study grief in elephants. And interestingly, other people in the grief research world do too.

[00:34:37] So no, we actually do see e evidence with elephants, for instance, that they build memorials, that they'll return to where their dead's bones are. So I think it is something that also is a reminder for us to have humility. 

[00:34:54] Not only thinking about other types of animals, but even then applying that to ourselves as human beings to recognize that everybody probably grieves, but again, what it looks like might be very different.

[00:35:06] But it is something that seems to connect all creatures who have attachments to their loved ones. And what love looks like, that's for different podcasts. In, in animals. But, I've also certainly seen grief in pets, where another pet has died. 

[00:35:22] You can see them kind of looking around for the other pet, they were their friends. And they certainly experienced absence.

[00:35:29] And I have experienced from clients that I've worked with them describing their pets, looking for the human that had died as well, which can be both painful to watch as somebody's also grieving, but also a form of connection to see that the pet is also grieving.

[00:35:48] Jon Depierro: Yeah. It's sort of what ties us all together. At some point in our lives, this is an emotion that we'll feel.

[00:35:54] One of the things I was thinking about as we're wrapping up is, this podcast is called Road to Resilience, and I think from our conversation today, it makes me think about grief. 

[00:36:04] Grief is a, a road, a journey, not a destination. We didn't call it Destination resilience. We called it Road to Resilience, because it's something that takes effort. 

[00:36:15] It's helpful to maybe have a navigator or a roadmap, but often that's not the case. Often we figure it out as we go along through leaning on other people. 

[00:36:25] Kailey Roberts: So we're coming up toward the end of time. I often ask our guests if they have any questions for me. 

[00:36:32] I am curious about what it was like for you to witness grief in me. More broadly though, if it doesn't have to be about me, but for you to be on the end of being a supporter.

[00:36:46] Jon Depierro: Yeah. I sitting here, thinking back to years ago when you lost your loved one and I was, really in the thick of it with you. It was for me, really meaningful to accompany you through that process, to be present, to be practically helpful.

[00:37:09] Even just sitting, talking late night phone calls, talking over a manuscript. We were working on a project we were working on. To be that support for you was really meaningful. 

[00:37:21] I think to your point, I really hadn't had losses of that kind before in my own life. So at times, I think other people would experience this too, it was hard to know sometimes what you needed. 

[00:37:35] And I think one lesson from this is rather than guess what the person might need, it's much better to ask the person what they might need. 

[00:37:46] They might not know how to answer that question, but it can be really important to ask what kind of support would be most helpful to them right now.

[00:37:54] Do they want to reminisce about memories? Do they want to have a laugh? Do they want to a shoulder to cry on? Do they need some practical help with certain life tasks? 

[00:38:05] So I learned how to navigate that process a little bit through supporting you. I think for me professionally, it's one of the toughest things that I do as a therapist, sitting with someone who's lost a loved one.

[00:38:19] I used to work with nine 11 first responders, and that was no warning. These police officers, firefighters went to work one day and 80% of their buddies died. 

[00:38:32] Their whole support system, professional support system, almost gone entirely. No warning, and there's no context for that. 

[00:38:39] No, nothing to relate that to it all and that was some of the toughest grief to sit with and creating space for that kind of grief and the loss of a parent or child. 

[00:38:54] And even pets who are dear family members and friends and companions, that's so heavy.

[00:39:01] And, I think grief and sitting of grief has given me really, I think necessary and helpful practice just being in the room of difficult emotions, being in the room of sadness, accompanying someone through it. 

[00:39:18] Not feeling as if I'm not doing anything by not saying anything. Just being present with that is, is deeply meaningful. I don't need to say, let's think about that another way, or why don't you schedule some time with friends. 

[00:39:33] Just being with someone while they're reminiscing or sad or trying to make sense of it while they're being a mess is what they'll remember. 

[00:39:43] Not what suggestion you had, but just the fact that you were present. So, thank you Kailey, for coming on the podcast and I really enjoyed our conversation about grief today. I hope our listeners do too. 

[00:39:56] Kailey Roberts: Thank you so much for having me.  

[00:40:00] Stephen Calabria: Thanks again to Drs. Jonathan DePierro and Kailey Roberts for their time. That's all for this episode of Road to Resilience. If you enjoyed it, please rate review and subscribe to our podcast on your favorite podcast platform.  

[00:40:14] Want to get in touch with the show or suggest an idea for a future episode? Email us at podcasts@mountsinai.org. 

[00:40:21] Road to Resilience is a production of the Mount Sinai Health System. It's produced by me, Stephen Calabria, and our Executive Producer Lucia Lee. This episode was inspired by and dedicated to the memory of Denise Calabria, my Mom, who passed away recently and was a fan of this show.

[00:40:37] From all of us here at Mount Sinai, thanks for listening, and we'll catch you next time.