Spring 2014

PacificConnections

Newsletter for Past Clients and Friends

Long-Term Recovery and Preventing RelapseLorraine Wood, Co-Founder, South Pacific Private

continued...

IN THIS ISSUE

www.southpacificprivate.com.au

FEATURE ARTICLE

Long-Term Recovery and Preventing Relapse

12 STEP PROGRAM UPDATE

The Role of 12 Step Programs & Improved Outcomes

RECOVERY SUPPORT

Your Key to Recovery

WEBINAR UPDATE

An Introduction / Refresher - The Twelve Steps

BIPOLAR DISORDER UPDATE

Book Review - Art from Adversity Bipolar Disorder Q & A

DAY PROGRAM UPDATE

Supporting your Recovery

HEALING AND GRIEVING

Good Grief - Is there such a thing?

READING SUGGESTIONS

Lorraine’s Favourite Recovery Books

Addiction is an incurable disease that if left untreated may eventually take all we have including our freedom, our mind and eventually, our life. The average life span of pop band members is 40 years, think Michael Hutchence, Amy Whitehouse, just to mention two of the many who have died well before their allotted span of three score years and ten.

In Recovery we can arrest this disease and lead a life “beyond our wildest dreams” as 12 Step programs suggest, if we are willing to live by the principles they suggest.

The dangerous times for relapse are the first three years. The first year is about getting our minds straight, the second year is about physical Recovery and it is only in the third year that we start developing our spirituality, and that is when the miracles happen! Never underestimate the value of counselling throughout these years. Making this a life time priority can save so much pain, angst and getting “stuck”.

Once we work our way through the first three years, many seem to settle into a routine and Recovery becomes a way of life. Our friends are people we connect with at meetings, the slogans become our philosophy of life and, as we experience more miracles, we can start taking Recovery for granted. I believe we can be at risk again between 17 and 25 years.

If we start slipping up on meetings the warning signs may emerge. Signs to be aware of include; distorted thinking, pity parties, low grade depression, isolation and, above all, resentments. Many say the “dry drunk syndrome” is worse than using.

Even if we keep meetings on our radar, there are many stories of people with 20 or more years of sobriety who have a relapse and do not recover. Robin Williams and Phillip Seymour Hoffman are two that come to mind. There of course many reasons for this, one being the progressive nature of the disease.

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FEATURE ARTICLE

However as we gain long-term Recovery, the road becomes narrower, and I believe we are at an even greater risk of relapse if we don’t keep working the Steps. Everything that is not of love will manifest itself and to thrive we need to continually be taking the dead fruit off the tree. This is called cleaning house. Shed not a tear for the fallen fruit as this makes way for growth which allows us to move forward towards health and happiness. It is vital that being healthy is who you are.

Resiliency is one of the important things that we develop, also known as the art of bouncing back. This is something we can’t learn but need to experience and it is the base of spirituality which gives us confidence and allows for transformation. Transformation is adjusting to the new normal. Life events are our teachers and we all learn from adversity. We can hit a bump in the road or come to a crossroads which leads to transformative events as we try something else. The choices we make at times such as these are so important and yet we often don’t see that until long afterwards.

It is good to be a seeker but I don’t think we ever get well until we give it away which is the core of 12 Step Programs.

Being in touch with our feelings is vital as they are never wrong, you can embellish, deny or project them

but if not owned they will sabotage our Recovery. Our feelings are held in the body and the body is always right.

Constant vigilance is a healthy habit to cultivate and keeping company with healthy positive people is another. I have no place for negativity in my life as it saddens my spirit and can make me ill.

A behaviour which can keep us stuck is rage. Rage is an action or behaviour that we use to numb our

feelings. “I feel lonely, I’ll rage/eat or whatever and then I don’t feel lonely!” A raging person may not rage in the overt ways they did but can utilise more covert actions. Impatience is a pretty word for being frustrated or angry. Withholding is another word for rage and paying back. It is not a clean, clear and healthy way of acting. Stay with your anger and express it in healthy ways, journaling, exercise etc.

Anger not addressed can lead to depression, exhaustion and a feeling of depletion. Expressed, we gain energy, intimacy and serenity.

Finally, in Recovery authenticity is one of the wonderful qualities that we learn for as they say in meetings: “Be Yourself, because everyone else is taken.”

My final message is this; always put your recovery first and never, ever, take it for granted. It is a gift from god to be treasured every day.

“Be Yourself, because

everyone else is taken.”

Like our recovery page on Like us on Facebook and keep up to date with SPP news, updates and information on upcoming programs.

Find us at: www.facebook.com/PacificRecovery

Giving the Gift of Recovery Ashleigh Woolridge was a former Clinical Manager for SPP and is currently going through a course of chemotherapy. Two of her close friends have set up a support fund, to help with all her expenses in her long recovery. The chemo will last for six months, and she won’t be able to work in that time. If you would like to support her in her treatment and recovery please donate here:

www.mycause.com.au/page/ashleighsupportteam

South Pacific Private has donated $5000 to support Ashleigh and we know your support will be gratefully received.

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12 STEP PROGRAM UPDATE

At South Pacific Private, we support the 12 Step philosophy that addiction is a disease with emotional, physical and psychosocial components, and that this disease can be arrested, but not cured, through abstinence. Wherever it is appropriate for clients, we actively encourage them to engage in 12 Step programs and we do as much as we can to facilitate their entry into this world.

But why do we do this?Well, at SPP we have known for a long time that this holds the key to successful recovery – and offers our client’s the best chance of a healthy future. We’ve known this through the personal experience of the founders and owners (Bill and Lorraine Wood) and other staff, as well as though seeing the results for our clients with our own eyes. More than that though, ongoing research into the efficacy of 12 step programs provides a growing body of evidence that supports this belief.

We recently undertook to review some of the most relevant research into this area in order to confirm our commitment to these programs, and we’d like to share this with you here.

We should point out that this is not to examine the value of abstinence as a treatment goal, but rather to look at pathways to achieving this if it is the goal.

Do 12 step programs work?Firstly, it is worth a brief look at what the journey to recovery looks like. Research suggest that it takes an average of 8 years from the point of seeking treatment for addiction, to the being able to maintain a year of continuous abstinence. This 8 year timeframe is beset with periods of relapse, and ongoing support is required.

By their very nature, 12 step organisations are the most widely, and freely available means of support imaginable. The barriers to entry are very low, making them extremely accessible, and they welcome back people who are locked in the ongoing struggle with relapse.

The Cochrane study (2006) showed that engagement with 12 step programs is as effective as other treatments (CBT and Motivational Enhancement). The Match study also showed no difference in outcomes between 12 step / CBT / Motivational Enhancement at 1 or 3 year mark (so 12 step programs were at least as effective) – and showed that 12 step programs showed much better outcomes for continuous abstinence. Mertons (2012) supports this by showing that attending fewer 12 step meetings was associated with higher odds of relapse

The longest known cohort study followed adolescents /emerging adults for 60 years and found that for individuals with alcohol use disorder, one of the

strongest predictors of abstinence was AA attendance (Vallant 2003).

The Cochrane study further suggested that individuals seeking treatment for addiction who are in 12 step programs incur on average $8,000 (US) less per year in healthcare costs than those who are not. Fascinatingly, further analysis shows that they actually incur on average $145 (US) less per year, per meeting attended! This means that, not only do 12 step programs provide the best chance of achieving long term abstinence, but that they make for much healthier individuals too.

If we accept the idea that addiction is a chronic disease, then we must manage it as such and accept that the treatment pathways are long term. 12 step programs, by nature, are best positioned to afford this ongoing, long term support.

Why do 12 step programs work?There are now hundreds of studies that support the common notion that participating in recovery-supportive social organisations, like AA and other mutual-help organizations, predict current and long-term remission and recovery. But these effects have now been explained.

12 step fellowships provide a supportive community. Consistently, it has been found that engagement within a peer support community is associated with a lower risk of relapse (Boisvert, Martin, Grosek, & Clarie, 2008).

Participation tends to help people find new social contacts and friends that can facilitate new sober activities which lower exposure to high risk cues and triggers and boosts individual’s confidence in their ability to cope with high risk relapse contexts (Emrick, Tonigan, Montgomery, & Little, 1993; Ferri, Amato, & Davoli, 2006; Litt, Kadden, Kabela-Cormier, & Petry, 2009; Longabaugh, Wirtz, Zweben, & Stout, 1998; Walitzer, Dermen, & Barrick, 2009).

Simply put, 12 step fellowships provide people with a number of sober friends, a level of social support, and a level of spiritual support. Participation builds (or changes) social networks, builds confidence and hope, facilitates stress management, instils hope (by hearing from others) and a sense of belonging…all top reasons that people give for successful recovery

This also explains why participation in organizations such as AA and NA also help reduce depression symptoms and increase psychological and emotional well-being which boost the chances for continued recovery.

If research into this, or other areas of Recovery interests you, we recommend the Harvard Medical School – Recovery Research Institute website - Recoveryanswers.org

The Role of 12 Step Programs in Improved Treatment OutcomesThe Research Speaks

By Claire Barber, General Manager, South Pacific Private

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RECOVERY SUPPORT UPDATE

Hold onto Your Key to RecoverySteve Stokes, Program Director, South Pacific Private

On the weekend I bought a South Sydney Rabbitohs jacket.

My inner teenager wanted a jersey, but my functional adult knows I’m more likely to wear a hoodie, so a hoodie it was. I have followed the Rabbitohs since I was six, when I saw a Rabbit on my Grandfathers key ring, but this purchase was not just for me. It for my friend Sid. He died. He was a Rabbitohs supporter. He was in Recovery & relapsed.

I had known him for over 25 years, not as a close friend, but as a member of the “Firm”, Narcotics Anonymous. I would see Sid at conventions, and some big milestone birthday meetings. We were not close, but I liked him, he liked me, we were members of “The Firm”. Plus, we both loved the Rabbitohs.

I saw many friends in the meetings like this. Friends that when I got clean, I had not met yet. I was promised this would happen if I just had faith. I did, and I made them, friends I have had for over 28 years now in some cases. They were friends through thick and thin, early recovery, relationship issues, dealing with childhood trauma, depression, anxiety and other addictions as they arose.

Getting clean or sober is rarely an end for a person; it’s actually only a beginning.

Sure, arresting an addiction provides an immediate relief because the current crisis is arrested. This means that the unmanageability for the moment is also arrested and there is some initial relief. Fairly quickly, however, the acute withdrawal symptoms emerge; irritability, mood swings, sleep disorders, anxiety to name but a few. However, compared with the drama and distress of the end of a progressive illness, it’s still a relief. The initial phase of withdrawal can last up to six weeks, then the post-acute withdrawal symptoms kick in and these alone can last up to 18 months.

What does this mean in layman’s terms? It means that, on any given day, when you have worked a strong recovery program, you can still feel terrible. These are the days we pray for a stronger back, not a lighter load. These are the days that we learn that an addict alone is in bad company and that the best way to get “out of yourself” is to do service for another. It is the greatest spiritual accomplishment of the 12 step fellowships that the most self-centred narcissistic individuals learn that “to keep what you have, you have to give it away”.

When you stay clean for a long time, people stop thinking that you might relapse. When you work in treatment, sometimes people think you “can’t relapse”.

I know I can. I have seen it.

Relapse is a strange thing, yet it is part of the Recovery journey. Our most recent statistics indicate that when a person’s Recovery journey begins, they will have - on average - an 8 year period of attempting recovery. This will be peppered with periods of abstinence, and with up to four major inpatient stays. I knew a man once who relapsed after six years clean and sober, returned to heroin for a few weeks, re-entered a methadone clinic and then stayed on the methadone for 16 years! It’s these stories that frighten me as a recovering person; that possibility of return to the insanity of active addiction.

Yet, there are still some of us that got clean from the first meeting. We let the others relapse for us, and learnt from their mistakes. That’s what balances that statistic out. One thing is for sure though, just because you can get clean, and make it through the early years of recovery; you never can give up the vigilance of a recovery plan.

Rarely do we see a person appear for treatment with only one addiction, but regularly we see people being prepared to only deal with one addiction stating

that the other addiction isn’t that bad. They attend their Narcotics Anonymous or Alcoholics anonymous program, and can have long term clean time, but they never actually deal with their food/ sex/money/ gambling or relationship addiction.

Its these circumstances that create the perfect storm and that can impact someone in long term and lead them

back to relapsing in their original addiction.

When you have had a lot continuous time in recovery, and you then relapse, it is very difficult to deal with the pain and shame that goes with that terrain.

One’s personal expectations combined with the fears of what peers and family members might be experiencing when we relapse is very challenging. If, after years of continuous recovery from one addiction, you have a another addiction develop into a major crisis, the despair that goes with this can be unbearable.

Recently we lost one of the worlds most loved entertainers, a man that bought great joy to so many. He had been in recovery, long term. The media took full advantage to reveal all these details about his life, but without the context.

I didn’t know Robin Williams. I did not know his recovery plan, his relapse prevention plan, or the complexities of his mental health issues or family situation. I cannot pretend to know his dilemma.

Getting Clean or Sober is rarely an end for a person; it ’s

actually only a beginning.

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WEBINAR UPDATE

I did, however, know Sid.

Whatever led to the crisis and unmanageability resulting in Robin choosing to take his own life, well that is his business. I wish his family and children have an opportunity to grieve in privacy. I felt the same when Phillip Seymour Hoffman died.

Sadly, for us in treatment and recovery, it is not a new occurrence. It is an all too familiar sight. This is the complex cunning baffling and powerful nature of addiction.

Vigilance in Recovery is essential.

We must ever be vigilant. We need a plan that is flexible, and that allows for the emergence of trauma issues, mental health issues and the challenge of honestly addressing all our addictions. We need to treat them all as seriously as the first addiction we are in Recovery from.

We know that giving up all addictions at once gives a client a better chance of getting well. We also know that unless we deal with the impact of the underlying

developmental trauma, the relationships we form will always be a reflection of it.

To Sid, I say farewell. Your recovery journey was inspiring, and along the way you helped many with your story and your support. As for Robin, rest in peace.

May we learn that we are never out of the woods completely, that the key to recovery is an ongoing plan which we are vigilant about and that a plan only works if we work it.

Mindfulness is the practice of purposely focusing your attention on the present moment—and accepting it without judgment.

It’s a busy world and in the rush to accomplish necessary tasks, you may find yourself losing your connection with the present moment—missing out on what you’re doing and how you’re feeling.

Join us for this webinar introduction to mindfulness and meditation. Chris Mordue will share insights as to how these techniques and tools can support your ongoing Recovery and can help bring balance into your day; helping you to be present.

This webinar will show you how practicing mindfulness improves both mental and physical health. Chris will show you how to deliberately pay attention to thoughts and sensations without judgment.

What Next in our webinar series - South

Pacific Private will introduce how to use mindfulness and meditation to support

your recovery.

WhereAt your laptop / on your

tablet or computer

WhenWednesday 5th November 7.30 - 8.15pm (NSW)

Please register by emailing registrations@southpacificprivate.com.au and we will send you all the necessary details.

NB: Please be aware webinar content is educational not therapeutic

Webinar Series: Mindfulness and Meditation in the Real World

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INTERVIEW WITH ANNE NAYLOR

Bipolar Disorder Q & A with Anne Naylor - Author Art from Adversity

What stay-well strategies can you advise readers on specifically as regards bipolar disorder?I am very proactive about finding ways to stay well. Medication is fundamental to my well being, as is good psychiatric care. Psychological therapies are important too. Diet and exercise play a part and I have found vitamins and antioxidants to be extremely helpful as an adjunct to medication.

Having access to information is very important to me and I like reading about the latest research into bipolar disorder. I have also found that creative outlets provide a positive counterweight to fluctuations in my mood.

Last year I published a book called Art From Adversity: A Life With Bipolar and in it I wrote about my stay well strategies:

“I do everything I can to prevent relapse. I anticipate my triggers and intervene early. I force myself to go to bed at a reasonable time as I know that sleep is crucial.

I exercise and eat a diet of vegetables, fruit, meat, fish and whole grains. I don’t eat all the nice things in life such as chocolate, biscuits, junk food, meat pies, processed meats, pizza, chips, hamburgers, white bread, sugar or soft drink. I take fish oil and vitamin supplements. I don’t smoke or drink and manage stress to the best of my ability.

I do all of these things religiously. Except, of course, when I don’t.” (Art From Adversity: A Life With Bipolar, pp.98, 99)

Out of Your Mind, Acrylic on Canvas, 300 x 400mm

Art from Adversity by Anne Therese Naylor

Art from Adversity is a very personal story, told honestly and passionately. It feels very natural. It is filled with metaphor and also with gorgeous examples of the author’s art – a literal and visual treat.

This “bug’s eye” view of life with bipolar is fascinating, frightening and also heartening. Anne presents it all – the good, the bad and the ugly. Her account of the inspiration and drive that she found during her periods of mania, and how this led her to creating visual art is told with the bittersweet tinge of experience that knows of the fall that inevitably follows.

We were also struck by the real-life moments of discrimination that the author faced. How could you not cringe when reading of a teacher’s response to the request to accommodate an acknowledged disability? It’s a stark reminder of the stigma that persists around mental illness – and to a general ignorance in our society around what it means to have a mental illness, and how to treat people who do.

At SPP we know that about one third of Australians will experience a mental health difficulty at some stage, with the figure rising close to half when disorders related to drugs or alcohol are included. However, fewer than half of these seek help from a health service. This highlights the issue of stigma and it being one of the biggest barriers to treatment.

Anne makes a clear point about treatment in her book. She emphasises the importance of seeking treatment, seeking it early – and then maintaining treatment even (and especially in the case of bipolar) when you are feeling good. We wholeheartedly agree.

The book concludes with a section of very useful resources and ways to access help.

South Pacific Private recently spoke with Anne about her personal experience with bipolar disorder as well as her art, writing, advice and her thoughts regarding stigma about the disorder.

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INTERVIEW WITH ANNE NAYLOR

What does living successfully with bipolar mean to you?To me, living successfully with bipolar is being able to have a relatively ‘normal’ life, that is, to function well in all areas: with family, at home, at work, with friends and so on. It also means having a balanced and positive sense of self. None of it is easy, but then, juggling all of these things can be hard at times for most people.

I know that I am living successfully with bipolar when I am not thinking about it too much and just getting on with life.

Living successfully with bipolar also means not being embarrassed or ashamed.

This is what I say to myself, “It can happen to anyone and it has happened to you. Don’t be ashamed of who you are, celebrate your unique sense of style. You only have one life so don’t squander your talents, use them to help others where you can. Embrace your uniqueness, your essence and your individuality. Be authentic. Stop wanting everything to be perfect and celebrate your strengths.

That’s what living successfully with bipolar means to me.

Landscape of the Mind, Acrylic on Canvas, 700 x 1000 mm

Can you tell us a little of your journey since being diagnosed as having bipolar and where has it taken you?My journey with bipolar has taken me to places I didn’t know existed. It has introduced me to people I would not otherwise have met. It has led me to an appreciation of the mundane and the magnificent. It has allowed me to experience things that others will never know. It has given me the best days of my life, and the worst. It is impossible to describe my journey in just a few words and that is why I wrote a book about it.

“[Mental illness] can’t be explained easily. It’s a bit like childbirth. You read everything you can get your hands on, talk to everyone you meet, go to classes, prepare as much as you can and think you have a handle on it. But when it happens, it blows you out of the water, and you realise that you had understood very little of what it would be like to give birth, or to have a baby.

Your whole world is irrevocably transformed, for better and for worse. The conundrum, of course, is that it’s almost impossible to explain what is like to anyone who hasn’t been through it themselves. Mental illness is a bit like that, except you don’t get a baby at the end. Well … not unless you’ve been manic, and slept with someone without taking precautions …

There are multiple facets to mental illness. Just like childbirth and parenthood, there are many perspectives and points of view. It’s not all good and it’s not all bad. There are endings and beginnings, and beginnings and endings. One thing is certain, after you experience it, your life will never be the same again.” (Art From Adversity: A Life With Bipolar, pp.119, 120)

You’re Not Alone, Acrylic on Canvas, 700 x 1000mm

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INTERVIEW WITH ANNE NAYLOR

You are both an advocate and an artist who works hard to raise awareness – what challenges do you see daily as regards to awareness and what do you believe the solutions are?The biggest problem for people with mental illness is stigma. For no matter how many advances have been made in the area of mental health, and there have been many, the fact remains that mental illness is still stigmatised and stigmatising.

What is stigma? It is the sense of shame, disgrace and dishonor than emanates from those around us, but also from within. To some extent we all internalise the stereotypes we grew up with and those prevalent in society today. People with bipolar disorder are seen to be sick, abnormal, different, odd, dangerous, unstable, unreliable, unpredictable and violent.

So why would I want to talk about it? Why would I want to publish a book ‘outing’ myself as a person who has a mental illness? Why should others do the same?

This is why: To help people. To stand tall and proud and say this is who I am and this is what has happened to me. To say I have done nothing wrong and I will not be shamed. To raise awareness, to inform and to educate. To improve attitudes towards those of us who live with, and struggle with, and triumph over, bipolar disorder, depression or any type of mental illness. To challenge stereotypes and to fight stigma. To show that recovery is possible and to convey hope. To speak for those who do not have a voice.

It’s easier said than done. Community perceptions and attitudes are changing for the better and that’s great, but we still have a long, long way to go. Unfortunately, ignorance, stigma, stereotyping, discrimination and prejudice abound.

It’s scary to have a mental illness and even more scary to tell people about it, but if no one speaks out, and no one comes out, how do things ever change?

The Light - Acrylic on Canvas, 300 x 400mm

How can we work to break down barriers to understanding and acceptance?I believe that education is the key to breaking down barriers to acceptance. It is important to understand that bipolar is an equal opportunity disorder. It is not the result of flawed character or personality. It occurs in all societies at the same rate regardless of class, colour, religion or culture. Mental disorders affect both men and women from different age groups. One in five Australians will experience a mental illness within a 12-month period and almost half (45%) of all Australians will experience a mental disorder at some point in their lifetime. One way to break down barriers is by educating people about these things, and this is happening, albeit very slowly.

Looking into the future, I believe that research will transform the way bipolar disorder is diagnosed and treated. When a blood test is available that can give an unequivocal diagnosis of bipolar, and when treatment is better, attitudes will change.

“What is the future for people with bipolar disorder? In many ways, life for people living with mental illness now is much better than it has ever been in the past, but in other ways we are still in the dark ages. The scientific literature tells us that much progress is being made, and it is and I believe that most strongly. There are continual and exciting advances in treatments, drugs and other therapies. Regarding stigma and discrimination I am not so sure that progress is happening at the same rate. As for the future, who knows? I have high hopes.” (Art From Adversity: A Life With Bipolar, p.98)

Oranges and Lemons, Oil on Canvas, 700 x 1000mm

‘Art From Adversity: A Life With Bipolar’ is available fromAnne’s Website: www.atnaylor.com • Blog: www.becauseofbipolar.com.au • Email: anne@atnaylor.com

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DAY PROGRAM UPDATE

10

HEALING AND GRIEVING

Recently, my family suffered the tragic loss of my mother in law, who sadly fell down some stairs at my Husband’s 50th birthday party. She was a fit and energetic lady, who sadly never regained consciousness after the fall. This has been a shocking time; a period of grief that was so raw and painful, words cannot convey.

The mixed emotions, the “what ifs” and “if only” scenarios, the anger, the deep sadness, the shock, the need to restore family balance and the still ever present demands of everyday life and work life create such a huge drain on you and how to function. What I have learnt through this period is that there can be such a generosity of spirit around you at this time by so many and a loss does bring out so much humanity and kindness.

I studied a psychology degree at the University of Sydney and upon reflection I am gobsmacked that we never studied the process of grief and the stages that you will naturally step through. I find this also quite shocking, as we know that so much dysfunctional human behaviour and addictions are the result of unresolved grief. Why is this not included in studies also in schools today?

An article in J Psychosoc Nursing Mental Health Service 1992 by Bateman, Broderick, Gleason, Kardon, Flaherty and Anderson states that “Dysfunctional grieving represents a failure to follow the predictable course of normal grieving to resolution. When the process deviates from the norm, the individual becomes overwhelmed and may resort to maladaptive coping” such as displaced anger and a change in pathological behaviours.

Grief can be experienced in so many forms - not just the loss of someone. It can be moving location, moving jobs, leaving schools, divorce; facing menopause; facing demotion; redundancy; job loss; loss in health; facing retirement.

A definition of grief is: the mental suffering or distress over affliction or loss; sharp sorrow or painful regret (Collins English Dictionary). This definition makes us realise that many people are suffering grief at any one time and in the workplace we should be mindful and aware of this. Later in this article I have gathered some thoughts on helpful hints to be there for someone grieving and to be thoughtful and insightful as a friend, partner, employer or colleague.

We live in a western world that is lacking for ceremony, openness and vulnerability. Aussies like to exude a “stiff upper lip” and “Get on with it”. Bravado pervades emotional bruising. This macho culture of the “great aussie battler/ survivor” does not support people grieving with emotional, spiritual and social intelligence.

There are now many articles on the stages of grief and it appears that there is a tendency to encounter 5 stages of the grieving process: denial, anger, bargaining, depression and acceptance.

Elisabeth Kübler-Ross and David Kessler talk more deeply about these stages:

Denial, Anger, Bargaining, Depression and Acceptance.

DenialThis first stage of grieving helps us to survive the loss. In this stage, the world becomes meaningless and overwhelming. Life makes no sense. We are in a state of shock and denial. We go numb. We wonder how we can go on, if we can go on, why we should go on. We try to find a way to simply get through each day. Denial and shock help us to cope and make survival possible. Denial helps us to pace our feelings of grief. There is a grace in denial. It is nature’s way of letting in only as much as we can handle. As you accept the reality of the loss and start to ask yourself questions, you are unknowingly beginning the healing process. You are becoming stronger, and the denial is beginning to fade. But as you proceed, all the feelings you were denying begin to surface.

AngerAnger is a necessary stage of the healing process. Be willing to feel your anger, even though it may seem endless. The more you truly feel it, the more it will begin to dissipate and the more you will heal.

Underneath anger is pain, your pain. It is natural to feel deserted and abandoned, but we live in a society that fears anger. Anger is strength and it can be an anchor, giving temporary structure to the nothingness of loss. At first grief feels like being lost at sea: no connection to anything. Then you get angry at someone, maybe a person who didn’t attend the funeral, maybe a person who isn’t around, maybe a person who is different now that your loved one has died. Suddenly you have a structure – your anger toward them. The anger becomes a bridge over the open sea, a connection from you to them. It is something to hold onto; and a connection made from the strength of anger feels better than nothing. We usually know more about suppressing anger than feeling it. The anger is just another indication of the intensity of your love.

BargainingBefore a loss, it seems like you will do anything if only your loved one would be spared. “Please God” you bargain, “I will never be angry at my wife again if you’ll just let her live.” After a loss, bargaining may take the form of a temporary truce. “What if I devote the rest of my life to helping others? Then can I wake up and realise this has all been a bad dream?”

We become lost in a maze of “If only…” or “What if…” statements. We want life returned to what is was; we want our loved one restored. We want to go back in time: find the tumour sooner, recognise the illness more quickly, stop the accident from happening…if only, if only, if only. Guilt is often bargaining’s companion. The “if onlys” cause us to find fault in ourselves and what we “think” we could have done

Good Grief - Is there such a thing?By Simone Allan Member of South Pacific Private’s Consumer and Carer Advisory Committee.

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HEALING AND GRIEVING

differently. We may even bargain with the pain. We will do anything not to feel the pain of this loss. We remain in the past, trying to negotiate our way out of the hurt. We do not enter and leave each individual stage in a linear fashion. We may feel one, then another and back again to the first one.

DepressionAfter bargaining, our attention moves squarely into the present. Empty feelings present themselves, and grief enters our lives on a deeper level, deeper than we ever imagined. This depressive stage feels as though it will last forever. It’s important to understand that this depression is not a sign of mental illness. It is the appropriate response to a great loss. We withdraw from life, left in a fog of intense sadness, wondering, perhaps, if there is any point in going on alone? Why go on at all?

When a loss fully settles in your soul, the realisation that your loved one is not coming back or your life will never be the same is understandably depressing. If grief is a process of healing, then depression is one of the many necessary steps along the way.

A wonderful definition of depression that I read in the Manly Daily by a counsellor, Martin Hunter Jones is that depression can be described as a simple mathematical equation: ( D= Fx EE - depression equals fear times emotional exhaustion) - at this time of grieving you are extremely fearful about the future and what is ahead and emotionally exhausted - so it is no wonder you will feel depressed.

AcceptanceAcceptance is often confused with the notion of being “all right” or “OK” with what has happened. This is not the case. Most people don’t ever feel OK or all right about the loss of a loved one. This stage is about accepting the reality that our loved one is physically gone or that life will never resume back the same way and recognizing that this new reality is the permanent reality. We will never like this reality or make it OK, but eventually we accept it. We learn to live with it. It is the new norm with which we must learn to live. In resisting this new norm, at first many people want to maintain life as it was before. In time, through bits and pieces of acceptance, however, we see that we cannot maintain the past intact. It has been forever changed and we must readjust.

Finding acceptance may be just having more good days than bad ones. As we begin to live again and enjoy our life, we often feel that in doing so, we are betraying our loved one. We can never replace what has been lost, but we can make new connections, new meaningful relationships, and new inter-dependencies. Instead of denying our feelings, we listen to our needs; we move, we change, we grow, we evolve. We may start to reach out to others and become involved in their lives. We invest in our friendships and in our relationship with ourselves. We begin to live again, but we cannot do so until we have given grief its time.

At times, people in grief will often report more stages. Just remember your grief is an unique as you are. You will be triggered at times in the strangest moments and reminded of your grief. Tears may come to your

eyes in the oddest situations - allow yourself the tears - they will only make your stronger.

In my recent experience of this grieving process I have gained some helpful insights into what can help someone in their time of grief. These ideas are all based upon my own experience and some friends that I respect and have observed in their deep grieving experiences. Obviously some of these notes will depend upon the type of grief. These are also random hints - they are not a process or in any order.

A) Acknowledge the loss: Be present (send some written words) not necessarily a visit - but let the person know you are there for them. Let them know you are holding them in your thoughts.

P) Practical help: When someone is going through the first stage of grief and shock sets in - the every day ways to operate and function go out the window - meal times get forgotten and family schedules get missed. If you can provide a humble and practical way to help, such as a meal; setting the dinner table: doing a shop for essentials, helping with kids and weekly activities; putting out the rubbish; cleaning; watering the flowers - any practical help - this is such a loving and practical way to ease the noise and machinations of the moment. Even allowing a spontaneous ceremony to reflect, such as bringing the favourite flower of the loved on and leaving it at their door; sending respectful memories of good times. Small ceremonies can be so therapeutic. My nephews and nieces lined up little paper boats with tea lights and dropped them into the river we were all staying at - this was so therapeutic and respectful for our healing in the immediate days thereafter.

E) Express Less: One thing that I have heard from so many is how so often unwittingly words of “intended consolation” had been so unhelpful and hurtful. Meanderings of others grief experiences. Such as ‘I understand how you are feeling” “time will heal” “you will get over this” can be so destructive. Funerals often allow people to truly feel and experience their own withheld grief and feel that they need to share. In this situation less words truly is more! Say less and just be there in your warmth and spirit.

In conclusion - there is no such thing as good grief but there is healthy and unhealthy grieving. Healthy grieving allows freedom to openly move through the stages of grief and have open expression. Healthy grieving can be supported by friends who can openly show acknowledgement, practical support and few words. There are so many forms of grief and unresolved grief that can lead to dysfunctional behaviour. Be mindful of those around you who may be experiencing grief and know that the pain may get less but the gap in their hearts that grief causes may never go away.

Editor’s Note

By Simone Allan Member of South Pacific Private’s Consumer and Carer Advisory Committee.

It’s wonderful to see such a powerful article on grief. South Pacific Private works with Pia Mellody’s Model of Developmental Immaturity and through this we learn about the importance of our grief as attached to developmental trauma. We also learn the significance of grieving the childhood we didn’t have. Therefore, once we identify with the model we understand the grieving is one of the first key processes in our Recovery.

SOUTH PACIFIC PRIVATE EDITORIAL

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