The Good that Comes from Grief- Not Drowning but Waving

Bird in Space (1923) - Constantin Brancusi

Over the last six years since Ruby died my grief clarified previously opaque aspects of my personality. My grief has been the ultimate prioritiser, stripping away extraneous chaff and forgettable nonsense, enabling me to focus my energy on more important decisions about the directions I was to take- need I become more exclusive or inclusive, what and who matters to me, how do I feel about my job, what sort of father do I want to be, how much anger and love do I want in my life and so on.
Bereavement has been a unique teacher, presenting me with predetermined lessons about which I have no say but also offering a breadth of options, mostly baffling (as has been written before, there is no way around grief, you have to through it- the key skill is the ability to navigate). Grief is about newness and disorientation, about a seemingly unfathomable depth of loss coupled with a revelatory introspection, about open weeping and quiet contemplation.
I have learned a lot. The arduous psychic work has been more challenging than the previous 39 years of my life combined but where there is endeavour, there is usually reward and this is no less true than of grief. I have gained and learned so much from Ruby's death and I use that knowledge to buoy myself when I am drowning a little. I thank her for not only teaching me so much when she was alive but also after she was alive.
Good can come from grief. But it has taken time- many years, really- to distance myself into an occasional objectivity without disconnecting from my bereavement. One of the many lessons I learnt being a patient in  psychotherapy is that I need not fear being without the pain of grief- painlessness won't sever me from my love of Ruby which means I can then become closer to her, to our relationship, to my love of her and the memories of her.

Here are some good things that have come from Ruby's death in my life:

-I let go. Friendships that were hard work, ones that I nostalgically held onto in case they returned to the early days of carefree fun and excitement, were set free. Ones that mattered less, dissolved. Other friendships remained.
-I love more and respect more. It isn't necessary to display affection for all my clients, patients, friends, family members or strangers but to know they are all part of the same humanity as me with a similar complexity of emotions and drives as me has become a default. How can I now judge someone's decisions when I don't know the choices they had?
-I trust more. My old social worker friend Mary used to say "you don't know if you can trust someone until you trust them". It took Ruby's death for me to fully appreciate the profundity of this statement.
-Image is nothing. I should always be honest (but I need not always be open- some things are private)
-I think about how I want to live and then I live like that. Grief has forced me into a colossal introspective review of myself and my life. And if I am reassessing everything that matters to me- or doesn't- then I have to address some deep basics of what makes me me. Do I want to live in fear, playfully, in connection with others, thinking "what if"? Shall I remain as a Nurse or should I nurse some other way and have a new career? How do feel about my wife and my son? Do I think I am a good person? What type of impact to I want to have in the world- none? Some? What do I care about?
This introspective review has been, and continues to be, deeply valuable to me and affecting to those around me. Actively weighing and considering previously recondite attributes and behaviours is a great effort but is worthwhile and important.
-Most time away from Claire and Tom is wasted time. But some isn't.
-If something is neither beautiful nor useful, get rid of it (as per the ideals of William Morris, designer and social activist)
-Culture is more deeply important to me than I had ever realised and it gives me joy and hope and a humanist bond to the living. Art, literally, saved me. There were paintings and sculptures that threw me a tentative lifeline at the worst times of my grief, that proved I can feel and live and breathe again. And now, six years along, there is art that I understand in a way I was simply unable to before.
For years I loved Michelangelo's sculpture Pieta (Jesus in Mary's arms after crucifixion), for example, but dismissed it as over-religious and disconnected from any experience I could understand as an atheist. Now, though, I see Jesus' emaciated body in death and the almost imperceptible depiction of Mary's acceptance of his death and the strength she may gain from it. She knows it was inevitable and she knows his death is not the end but is, in fact, the beginning of something else. He is weightless not because he is emaciated but because she needs to hold him up (in her eyes and in ours). There are techniques used to maximise the emotiveness (eg. Mary is much larger than Jesus so she can cradle him, their body positions in relation to drapes and seating, Mary is too young, etc) but it is the ability to express these ideas in carved stone that tells me more about Michelangelo's probable lived experiences than his skills as an artist. He understood loss and longing and he knew the importance of iconography and of actions, not empty words.
Similarly I always loved Brancusi's sculptures, particularly his "Bird in Space" created in the 1920's and which I saw many years ago at the Tate Modern in London. It is an imposing 200cm tall majestic, vertical swirl of white marble representing, I used to think, a wingless, featureless bird-like creature flying upwards. It is simple and colourless and beautiful. Shortly after Ruby died I looked at it again, I got lost in its curves for many minutes and I cried with the attachment to humanness it afforded me. I realised what I think Brancusi actually meant by "Bird in Space"- the shape was a representation of the potential movement of a bird, it was meant to convey an abstract idea of a bird or a bird-like thing. It wasn't a sculpture of a bird, it was a sculpture that presented me with questions about potential and kinesis, about volume and space and about my relationship within those limits. Art, literally, saved me.
-I think I am a better nurse. I feel a new sensitivity and a new patience in dealing with particular needs of clients. It should be unsaid that nurses should reflect on their skills of empathy (it is a skill to be honed- it is not true that one either has this quality or one does not) but I have found a new appreciation of the effects of grief or heartache or trauma that I can now understand, as opposed to simply "appreciate" or "empathise with". I don't need to imaginatively place myself in my clients' position to begin to appreciate their loss, I know how my loss feels and can therefore extrapolate to a more nuanced but sophisticated starting point- how do they feel in their position?
-I am less damaging to myself, to others and to the world around me because I think I am less of an arsehole to be around and I don't eat meat or drink alcohol anymore. I am much more environmentally aware, I run, I cycle, I look at trees like friends, I love being in the woods- Ruby's death may have added years to my life.
-One of things I take most seriously is to not be serious. I laugh a lot more and I am sillier. Most things are insignificant, they just don't need to be important, they're just not worth it. Most things are just not worth the stress or effort you think they are.

Pieta (1499) - Michelangelo

Being Present

It is early December and I am getting a little nervous about Christmas. It's a time of year I find quite difficult. Christmas has always made me squirm because its' conspicuous consumerism squares up to my anti-capitalist leanings. But this time of year is also about children's joy and for six Christmases  Ruby has not been here with me to enjoy it. It is my son Tom's birthday early December- he was nine years old last week- which can add to the mix of emotions too. Coupled with a nasty bug I have had for a few days which has stopped me exercising- very unfortunate for runner and cyclist like me- I have been pretty flat in my mood and a little fragile in my coping abilities.
Being as active as I try to be meant that I couldn't simply take time off to rest (I get too fidgety for that) but instead I had to use exercise as therapy somehow. A sore throat and blocked sinuses meant that a jog would be impossible. A lack of motivation meant cycling any worthy distance at any speed was unobtainable. The only type of movement that I knew I was capable of and which was likely to be rewarding enough for a positive effect was something short and tough. There are two options- I could go for a brief and intense mountain bike ride, preferably as muddy as I can get, or a short but mountainous walk.
I decided to walk over Belfast 's Cave Hill- short enough at only 7 km, and intense enough due to the vertical climbs. I could bring my DSLR camera as the sun was out and the views would be beautiful. I packed a sandwich, boots on, camera charged, drove to the car park nearest the summit and walked 2 hours up and down.
I had been feeling mentally untethered recently partly due to a sinus infection that made me feel disconnected from my surroundings and also because of my emotional state in proximity to Christmas. My walk made a huge difference- stretching my legs, heart pumping, fresh oxygen coursing my brain.
But there was more to it than the base somatic experience. It is empirically true that to experience movement and visual pleasure is rewarding, of course, but there was an immersiveness in my environment today that seemed to enable a connection between the ground and myself- an earthing. It helped exclude negative thoughts crowding my mind. It linked me with a sense of immediacy to the ground, to the trees, to the biting wind and the sub-zero air temperatures and by association brought me away from thoughts that were troubling me, that were encouraging me to drift and float away. I was, quite literally, grounded.
I perform the same action- deliberate consideration of my environment- for the same purpose when I wake from a nightmare. To open my eyes fully, to sit up, to reinforce where I am at this precise moment, rooting myself in the here and now. If I remind myself where and when I am I become disconnected from the grasp of the dream world. The same action for the same purpose is performed by a patient of mine who experiences flashbacks due to his Post Traumatic Stress Disorder- when he feels himself beginning to disconnect from his surroundings and his anxiety rise to a panic he eats the most sour, most strong and disgusting sweet he can buy (he has a particular dislike of lemons) and which he always has in his pocket for this exact reason. He is jolted into reality again and pulled away from his imaginary enemy because his sensory experience- the intense flavour- connects him to the present.
It is for this reason why going for a run in extreme weather can sometimes have such a rewarding effect and why sometimes I seek out the strongest wind, the heaviest rain on the darkest night, the tallest trees to run through. During those admittedly questionable endeavours I have little choice but to focus on the path directly in front of me- to not do this would be folly- and as a consequence I observe every detail, I cool with the wind flowing over my head and through my naked toes, I wince at the rain drops stabbing my cheeks, I hear the branches creek and the leaves rustle. I am not just in the run, I am within it.

It is a myth that humans can multi-task. We cannot perform more than one activity at a time that needs our attention (sometimes we can perform one that is automatic alongside, or in rapid succession to, one that is not automatic but this is not the same as multi-tasking). We are evolutionarily hardwired to focus but we rarely use this skill to its full potential. I would do well to recognise the importance of connecting to the present, to concentrate in that very particular way, and use that as a tool of adventure in my internal world and to define the border of what I am. Maybe I could explore thoughts I may not yet know how to think.
I can find ardent depth and profound connectedness from immersing myself in the present. The present wills me to take note of myself, to define the boundaries of my subjective experience and to recognise the relationship I have with my surroundings- the objective world. It reminds me who I am, who I could be and what I am capable of. Immersing myself in the present can provide me a victorious sense of enoughness.
And when I need to be tethered it saves me.

Not Quite Suicidal

Mental ill-health affects around a quarter of the worlds population- one in four of us can be diagnosed, at some time in our lives, with a clinical psychiatric illness.This does not count even more frequent experiences like grief or trauma that the majority of us will go through. Most of those clinical diagnoses are of depression, the most common of all mental illnesses, which is experienced by around one in five humans. We should all be aware of what can be done to help ourselves and others. More frequently felt, though, are the emotions and thoughts that can occur prior to the development of, or instead of, depression- the prodromal ideas. As a mental health professional I come into regular contact with people who experience clear ideas about ending their own lives. But what is more frequently experienced are the thoughts written below- ideas that explore non-existence, the “what if” ideas, the “will it be painful” thoughts and so on- and these are thoughts that are rarely recognised as being risky. They ARE risky, they are worthy of note, they should set alarm bells ringing. These thoughts can be the pre-cursor to suicidal actions and should be actively addressed as soon as they occur. Consider:

Just because you are not depressed it doesn’t mean you are not at risk of taking your own life- it is a myth that only depressed people do this.

You may not be actively considering to take your life but you may wonder what it might be like for others if you are not around any more.

You might be thinking about the least painful ways of doing it and you may have formulated a plan- how, where and when, how to get your finances and domestic issues in order beforehand, whether to write letters.

You may not be thinking straight- are you weighing it up while drinking, smoking a joint, after a bad day at work, after an arguement? It may be hard to see things in anything other than black and white terms but real life, unencumbered by such sadnesses, has many shades of many colours. If you only see black and white or all-or-nothing, an alarm bell should ring in the back of your mind.

Ultimatum words (“I always fail” or “no-one is ever kind to me”) should sound alarm bells.

You feel unworthy of kindness or love, you feel you don’t deserve it. This is more about how you see yourself and not how others see you.

Feeling lonely is not the same as being unwanted.

Your everyday life may not be seriously affected by your thoughts but this doesn’t mean there isn’t a problem that needs addressing. Don’t wait until your job suffers or until you can’t have fun anymore or a rift is growing between you and your chidren.

Distancing yourself from friends and loved ones isn’t always “getting older” or “just being middle-aged”.

Maybe you don’t have an overwhelming sadness but maybe you are more irritated or agitated or anxious than usual.

You may feel bad about yourself- how you look, say, or how you interact- but is this really true or just your perception? Get an honest opinion from someone else.

Do you have evidence that ending your life is the right thing to do? It is easy to jump to conclusions without proof. Remember this phrase as a mantra- don't confuse thoughts with facts.

You may feel there is no alternative way of looking at your life and personal situation. How might you feel on a different day, week or month?

Asking yourself metaphorical questions is rarely useful and usually provides no pragmatic answers.

Does suicide hold potential as a real, tangible answer? Reconsider your position if suicide appears valid.

Unattainable perfection and blaming yourself for something that is not your fault are common reasons to find it hard to see a way through. Be honest with yourself and your relationships.

Maybe taking your life feels as if you would be back in control again? Reality is different- it is empowering to let go of things that are out of your control and it is empowering to be in control of your life, not your death. Start small, it all helps.

Are there things happening in your life that are so unbearable that suicide appears the best way out? There are always other ways. Always.

Are you stuck? Are you grieving? Are you traumatised? This is not an end- this is inertia, this is grief, this is trauma. These are normal reactions to common human experiences. It is distressing, of course, but survivable and is treatable and is something that you can go through and come out the other side.

If any of the above is familiar this is what you can do:

• Tell someone, anyone. You will immediately feel at least a little better.
• You do not have to act on these thoughts. With time they will pass.
• Make an agreement with someone that you will contact them, day or night, if things become unbearable.
• Distance yourself from means of suicide. Ask someone to look after those tablets for a while, to look after your car keys and your whisky.
• Formal support is near- your GP, the local Community Mental Health Team (CMHT), the CMHT in Casualty at your nearest hospital, counselling services, the Samaritans/ telephone support services, etc.
• Avoid doing things you find difficult until you are feeling a little better.
• Develop a temporary routine for a brief period- a written schedule to stick to no matter what happens (always include movement, fresh food and at least 30 minutes of enjoyable activity).
• Reduce or stop taking alcohol or drugs (these massively increase the risk of suicidal actions).
• Deep breathing exercises, visualising a safe space, meditation, calming activities.
• Always know that a positive end is in sight, free from distress, and is acheivable.
• You will always get through adversity.
• Look for helpers, there are always there (even if it doesn’t feel like it).
• Be as kind to yourself as you would be to someone else. Be as kind to yourself as you would want someone to be to you.
• Allow yourself to be at peace. You have earned the right.
• Know that everything passes.

Rebuilding Myself

Six years ago, shortly after Ruby died, I told a friend that I felt shattered. I had come apart from inside, whole sections of me had disconnected from each other and the constituent parts that used to be me were disparate. I was frightened I would never be whole again. My friend's empathy and passion for philosophy provoked an answer for me, of sorts- "you need rebuilding, in time, so who will you be?". Thereafter the question I asked myself, again and again, wasn't "how will I survive?" but "who will I become?"
In the first numb-yet-intense months I knew I was in shock and that I couldn't engage in any meaningful way with helping myself and I knew I shouldn't hope for any progress (although looking back I now know that "surviving" is progressive behaviour and should be applauded as the extremely courageous act it is). I needed to put something in place- a model, a framework, scaffolding- upon which I could build myself (this is a curiously odd but not rare human behaviour- the extreme calm that sometimes goes hand in hand with extreme emotion. I have experienced many occasions of total clarity of thought unencumbered by heightened emotions at times of emergency or drama, for example a patient overdosing or experiencing a cardiac arrest. Paramedics have told me they know this feeling and most people trained in emergency first aid, who use it, also feel this. It is not the same as being "in shock", which makes you feel disassociated, but is instead a sense of insightful reflection on the matter come in hand. You feel more, not less, focused. More "fight" than "flight").
I looked at various "self-help" books, books about therapy, about grief, about depression, but none connected with me. After a warm and valuable email exchange with Dr A. C. Grayling (Professor of Philosophy at University of London, humanist and all-round lovely gentleman) I received three books about humanism he kindly sent me and immediately devoured them. Here was the answer I needed. Humanism was the cultural ethos I need as a skeleton to help me rebuild myself, alongside an emerging and flourishing love of art. These two things- the love and warmth in humanism and the essential beauty of being human in the art I searched for- arrived just in time. Within months grief consumed me. And as the shock of Ruby's death quickly subsided and I realised it was all real, I started navigating my new path.

I have written about humanism before (link here) and, as with all new truths, I am regularly surprised by its depth of use and wide-reaching effects. Humanism has taught me what is valuable about being human and it has suggested to me how to live well- with love, self-direction and silliness, to empower others, to be creative and active, to use reason and cynicism well, consideration and balance, to simplify and reinforce what's left.
But art helped me reconnect. I spent hours staring at paintings and sculptures online, unable to attend real galleries, and immersed myself in their form. Aesthetic experiences, of all kinds, helped me reconnect to my emotions. When I looked at the Brancusi or Hepworth sculptures I felt something. When I read Andrew Motion's war poetry ("But today nothing that happens next happens according to plan") I felt something. When I tied to memorise all 36 Hokusai "Fuji" paintings I felt something. It didn't really matter what appropriate emotions I would feel seeing these things when I wasn't grieving, the point was that I felt something akin to being human at that moment. And feeling kind-of human helped me reconnect with being whole. It helped me realise what I was to become and encouraged me to reconsider my foundations. I could be human again.

I recently finished attending cognitive behavioural therapy (CBT) to help come to terms with the traumatic grief of losing Ruby and coming to terms with other complicating factors hindering my progress. It helped enormously. It helped in a way that anti-depressant medication helps someone who is depressed- they are not "happy pills" that make you elated but instead target the symptoms of depression such as broken sleep, low appetite, high anxiety or dangerously self-destructive thoughts so that your mood has the psychic space to improve naturally. CBT, similarly, doesn't make the depressed person "happy", it provides the mental space to recover as well as your brain is able. CBT achieved two major goals for me- it opened a bottleneck in my mind that helped it become free to reprocess a foggy mess of trauma and, secondly, it aided a reduction of social anxiety.
A number of events happened recently that have clarified my new path of progress. These events are also a positive influence for Tom, letting him know we can be safely away from each other, that mum and dad can have happiness and that, when I am away, I come back. They are objectively small incidences that, in truth, have a deeply personal and profound resonance for me:

-I drove six hours into rural County Clare on the other side of Ireland to stay overnight with my oldest and closest friend Andy (we met on the first day training as nurses 24 years ago and have been friends since, we sometimes go for months without contact, we needn't speak regularly and we will be friends until we die). It is always hard for me to be away from home, whether alone or with Claire and Tom. Other than at Mum's funeral two years ago I haven't been away from Claire and Tom more than one night and, even then, only one hour drive away in the caravan. To stay with Andy and his lovely family was a momentous move- a long way to drive, a great distance to be separated from my family, meeting his 11 year old son for the first time, to see his house for the first time in a decade, to hug his wife for the first time since Ruby died (who has her own connection to Ruby and also to her own experiences of complex grief). To visit him was a deeply emotional and emotive experience juxtaposed, as is often the way, with a lot of fun and silliness too.
-I attended three social events in two days. On a recent Friday I met a work colleague for catch up and a coffee. Pretty innocuous for most people but, for me, impossibly difficult in the past, less so now. The next morning I met a good friend, John, at his new house for lunch and a walk in the beautiful surrounding woods in the Sperrin Mountains here in the north of Ireland. In the evening Claire and I met with her oldest and dearest friends (and partners) for a long evening of catching up and laughs. I drank a lot of tea, the only sober one there, and I enjoyed the conversation with everyone. 18 years ago Ruby was the first child in our group of friends and was surrounded by their love for her entire 11 years. We all miss her.
-I continue to plan my professional move away from nursing.
-I remain alcohol-free from May.
-A disadvantage of being a nurse is that, rarely, you get threatened. This has happened to me recently, more than once, but I have been surprised at my resilience and my new ability to be able to recover from this type of adversity, quicker. Being this buoyant is a new quality of mine.
-I have chosen to not ruminate.
-I have chosen to be happy, some days.

World Suicide Prevention Day 2019

It was World Suicide Prevention Day 2019 on Tuesday 10^th September. The theme for this year is “Working Together to Prevent Suicide”. How do we do this?

We all need to look out for those who are not coping. Individuals in distress are often not looking for specific advice- the key to preventing a tragedy is empathy, compassion, genuine concern, knowledge of resources and a desire to help. Warning signs of suicide include: hopelessness, uncontrolled anger, seeking revenge, engaging in risky activities, feeling like there’s no way out, increased alcohol or drug use, withdrawing from friends, family & society, anxiety, agitation, unable to sleep or sleeping all the time and dramatic mood changes. In short, the main warning sign is that there are changes to someone’s behaviour.

So what can we do?

The listening ear of someone with compassion, empathy and a lack of judgement can help restore hope. We can check in with them, ask them how they are doing and encourage them to tell their story. This small gesture goes a long way.

You don’t have to be a clinician- just ask “are you OK?” This is often enough to start a conversation, one that may be life-saving. You should ask someone directly if they have thoughts about taking their own life and then listen, really listen, to them. Reflect, with them, their reasons for life, their reasons against death, any supports they have and their ideas for their future. Be tender and be kind- it will be detected by the person you are talking to. Reassure them that they are not alone, that everything passes, that you, and others, care about them.

Pragmatically we can assist with medical intervention (a phone call or escort to their GP or to Casualty), removing any means of suicide from them (asking if you can keep their medication, etc.), do not be anxious about calling 112 for an ambulance as it may be a medical emergency. Be with them- don’t just say that they are not alone, prove it. 

Keep in touch- an email, a text, a phone call, a card, a spontaneous visit. 

Some contacts:

Lifeline (24 hours a day, 7 days a week)- 0800 808 8000

Samaritans- 116 123 (UK and Rep. of Ireland)

Aware-ni.org and Aware.ie (depression support for UK and Rep. of Ireland)

Yourmentalhealth.ie and https://www.nhs.uk/conditions/suicide/ (HSE and NHS websites for support about suicide)

https://www.iasp.info/wspd2019/ for information about World Suicide Prevention Day 2019

After Therapy

Cognitive Behavioural Therapy (CBT) is a type of talking therapy that examines the connection between what we think and how we feel. It is based on decades of evidence and it continues to develop and grow in its breadth like an umbrella slowly unfolding, shielding as many people as possible from the rain. It focuses on the way we think about things (cognition) and the way we do things (behaviour) to help break destructive cyclical ideas. For example, someone may feel themselves to be unworthy of love or of friendship which in turn affects how they socialise or chat to others which in turn can bring their mood down. This would then affect how they feel about themselves, that they may be unworthy of friendship, and so on and on in a negative cycle. CBT examines all this and cracks through the barriers that have been created. It is an extremely successful form of talking therapy and can positively address many different mental health issues from depression to phobias to psychosis. And it is used very successfully for people experiencing trauma and grief.
I recently said goodbye to my CBT therapist after four intense months of successful treatment focussing on the trauma of my grief and on my social anxiety (a decades-old problem). Psychologically I have felt stuck for two and a half years, since my mum died. I hadn't grieved for her (there is no such thing as normal grief- any old fashioned models of "stages of grief" having been superseded by new knowledge) but, most worrying for me and most affecting of my mood, was that I had not changed or progressed in my grieving for Ruby. My feelings about Ruby were no different now, in 2019, than they were when my mum died in early 2017. This was distinct from the first four years after Ruby's death (Ruby died in May 2013) when change, though not always linear, was consistent each week, each month, each year. It took me two years to realise I was now in a sedentary prison, I was stagnant, and I needed to move.
CBT hasn't made my grief vanish or done away with any of my experiences, it hasn't reduced any value of my love for Ruby or made me forget anything. CBT has reduced the sharpness of the trauma, the intensity of pain has diminished, I can cope more adequately. And this also means I can remember Ruby with greater clarity and with less distress. I hope, in time, to be able to think about Ruby without pangs of loss, without those little stabs that demand my attention in place of the joyous memories that should be my focus.

Undergoing CBT taught me many things which may be useful for other people to read. Here are some things I now know:

-Mum's death created a bottleneck in my mind. Trying to cope with my intense grief for Ruby, even four years after she died, and then coping with mum's death (and shortly after that the death of my aunt- her sister- and the near death of my sister from sepsis and coma) was too much to bear. I was incapable of processing that weight of work and so I stalled and came to halt. This can happen to anyone who may have been through one traumatic or difficult event and then has to undergo another one or more. CBT released that strain and let things flow, it let my brain do what it does best, naturally.
-CBT helped me come to terms with the way I grieve. I hadn't grieved too deeply for Mum since she died (about which I felt guilty and embarrassed) for one very good reason that took months of discussion to identify- I had already grieved for her. My mum was chronically ill all her life and all of mine too. Since I was young I had thought that she may die at anytime (or "leave me" are more accurate words, hence a great deal of separation anxiety as a child). I had 43 years of preparation of her death. When she died in 2017 it was the "natural order"of life and death, it was something I had mentally prepared for through my childhood and now, two years later when that bottleneck was opened and I had space to process her death, I am learning to allow myself to not be too affected or traumatised by it. There are as many ways to grieve as there are people on Earth and if we don't feel too badly affected or traumatised by death, this doesn't always mean it is "buried" or "latent" or that it will disable us later in life- sometimes it just means we have already done the work and that we deserve to be free from distress.
-My brain, all our brains, are extraordinarily complex and powerful machines. It can do amazing things and, most of the time, it works smoothly and elegantly. But when we experience trauma our brains don't always use the most appropriate section to process information. CBT, and some other forms of therapy, help our brains reprocess that difficult and traumatic information and so we become less negatively affected by it over time. The trauma becomes duller, more "ordinary", boring even. It becomes easier to think about and to cope with.
-I have to respect my brain and allow it the space it needs to work properly. For me this entails being alcohol-free which allows me to sleep deeper and to dream well which is extremely important to the subconscious processing of difficult information (I stopped drinking alcohol the day I started therapy for this exact purpose, I have no plans to start drinking again). To sleep well is more important than I had ever realised. I am now slightly obsessed with drinking huge amounts of white tea, partly to help me signify "nighttime" but also because the process of making it is as enjoyable as making the gin and tonic I used to drink.
-I needn't feel pain as a legacy to Ruby. I have earned the right to be free from this (in therapy, men are particularly prone to self-flagellation). No-one needs to deliberately increase their own suffering, it does no good, it is a waste of psychic space and has no value.
-I don't pointlessly and painfully ruminate anymore. I stop this process after it has barely started (I have distressing memories of the early days after Ruby died of ruminating for hours at a time over obsessive thoughts of boulders and fissures in cliffs and other overpowering immensities).
-I now reflect on her whole life, not only those last traumatic hours and days.
-Regarding my social anxiety, I now know that I am enough. I need not prepare for all social interactions as I used to do, my irrational anxiety has no use here, I am not the witless dullard I had thought, it suits me to be more spontaneous. I need practice but it is a process I am willing to adapt to.
-Thoughts are not facts. This is deeply and intensely important. It underpins much of CBT practice.
-I will make a deliberate decision to think about Ruby when and how I want to. Distress is a choice and I don't choose it.
-There exists vulnerability zones that I need to prepare for. This includes obvious times such as anniversaries but, almost ironically, also includes happier days when on holiday or when out running in the hills or cycling in the sunshine. I would think, as I am sure many people who are also grieving think, "do I deserve this" and of course the answer is "yes, I do" but it took time to realise this, it took time to allow myself to be happy again.
-I am enough. I am enough. I am enough.
-I can allow myself happiness again, I give myself permission. On some days I can decide that I will be happy for at least that full single day.
-I need creativity. I need movement. I need to be non-sedentary. I need non-routine.
-I can change the way I feel.

Sixth Anniversary: unexpected friendships and the lessons of grief

Six years have passed since Ruby died and life flows relentlessly on. The path of grief needs continual navigation but over time there are fewer surprises, fewer hard turns or stony trails.  As a runner would say, my path is less "technical"- fewer roots, rocks and climbs to test my body and mind.
The sixth anniversary of Ruby's death was only a few weeks ago. Each year I feel more confident in my predictions, to expect the unexpected, I know the weeks leading up to the day itself are the most upsetting and that the actual anniversary itself is a strange type of relief, a release of a pressure valve. I know I need to have a plan of distraction, I know I need to organise my day-job so that I can fulfil tasks expected of me prior to the build up of tension, I know I need a few days off work as a break from the psychic effort that is necessary to be at least a half-decent support worker (I am a nurse helping homeless people with severe mental health problems and addiction issues). I know I need to deliberately increase my sensitivity to Tom and Claire's needs prior to Ruby's anniversary as I can be emotionally numb in the preceding days.  I have had six years practise, I am a pro.

But if there's one thing grief has taught me it is that life's new route is not straightforward. I achieved only half of my predicted actions for this year because the unexpected, it turns out, is always more unpredictable than I'd remembered. The result was that I was very anxious and very sad even though I had prepared well. I did prepare well but I had prepared for the wrong thing.
I have learnt something new this year- no matter how much effort I put into preparation for each new anniversary of Ruby' death there will be an unavoidable sadness at this time, about which nothing can be done. I have learnt that, although my preparation cushions my landing, I must allow myself to fall. I have often written about the importance of freeing myself from the tyrannical grip of things that are out of my control and this appears to be something I need to periodically remind myself. This time I misidentified the issues in my control. I have tried, year after year, to control my emotions at the time of Ruby's anniversary but this has been a wild miscalculation. From now on I will let those feelings flow and will instead focus on the acceptance and consequences of those feelings- I will prepare as best I can, I will remember that it will be maddeningly sad and acutely painful but I will roll with those punches, I will be gentle to myself and I will focus on sharing love with other people as a type of selfish mental health first-aid.

Three months ago I met with two close friends for dinner. Year after year we are busy with work and the usual commitments of everyday life getting in the way of friendships so we get together once a season. I told them I had my first appointment for cognitive behavioural therapy with a psychotherapist the following week to address my grief and related trauma. I had been feeling inert and in desperate need of change for the last two years since my mum died and I had been unable to process this new grief on top of the old grief. I was stuck. I had been looking at new jobs, new careers, new interests, but had realised that the change I needed was internal not external. (How many therapists does it take to change a lightbulb? Only one but the lightbulb has to want to change).
Neither friend has spoken to me since. No text, no phone call, no arranging to meet again (I have seen the therapist each week since then and it has been extremely beneficial). This is another surprise about grief that I had forgotten- the unusual friendship. When Ruby died, and since then, I have lost friends. My recent experience with these two friends have shown that, even if someone's heart is there, they may be unskilled or unconfident about what to say. There are a hundred reasons why those two friends might not have been in touch- maybe they continue to not know what to say, maybe they haven't thought about it again, maybe they're waiting for me, as usual, to suggest another night out as it's now been a few months since we last met, maybe they have their own distractions and that life just goes on- but it's an interesting point to note that even though some friendships carry on just as normal before one's bereavement, others can change in dramatic and unexpected ways.
After Ruby died, other people became new friends. Some people stepped forwards not back, became new supportive partners helping me grieve and helping me reconnect to others again. I now have, for example, two new friends (I had know them both for some years prior to this but was never close)- G was one of the first people to see me after Ruby died and although he obviously had no idea what to say at the time (who does?) he stayed with me because he felt it was the right thing to do. This may sound odd to someone who may not have been bereaved but this seemingly innocuous act of just being with someone even if you are silent, even if you don't know what to say, can be immeasurably valuable. He had also become a role-model by then, helping me become fit and healthy, running and cycling, he has unwittingly extended my life by many years and he has greatly improved my health and my happiness.  The other friendship, JJ,  has also grown over the years. He is gentle and loving and kind and I am proud to know him. He is a vegetarian humanist, modest and life-changing in his work, he is loyal to his small group of close friends and to his awesome wife- a therapist who eases the burden of others' mental distress every day. These are good people to know and to be around.

An over-confident, experienced griever like me suddenly forgot the important basics of how to grieve "properly". I would do well to revisit those foundations to review my baseline every now and then- principles of bereavement such as flexibility, honesty about my emotions, considering how I want to live, being loving and kind, creating and contributing, knowing that everything passes.
It was the sixth anniversary of Ruby's death that prompted me to consider these two very important reflections- the deep effect of these new friendships (their positive influence, their kindnesses, their emancipatory powers) and the importance of identifying my emotions (and preparing myself for their effects not for their elimination). I will continue to learn forever.

What Of The Eternally Young?

Youth isn't wasted on the young,
They are the only ones who can cope with the heartbreak of it all.
Adults are the
expressionless wreckage after childhood's wake,
Smug and snug in their deep yearns,
arch surrender permitting their amelioration.
Any vestige of the child left,
becomes a detached valediction, an excuse and a reason.
At childhood's end,
We create new benchmarks using then losing youth.

And we tell the young
To love being young, to love for the love of it,
To do it, do it,
be proud of it, don't deprecate the doing of it,
Let fly the looseness, the loucheness,
be indiscreetly joyous of it,
celebrate the being,
and the moving,
and the unsedentariness,
with tender furiousness.

But youth and age get levelled,
And both can die of broken hearts, of worn aortas or loss,
And the eternally young
Leave the old to cope with the heartbreak of it all.

And Here We Are

And I remain here in our world of blood-red tomatoes and earthy spices,
Willing for change and new routine and otherness,
I can be a sentinel for others' attraction
and a beacon of rest for the grieving faction.
But I know what I am not
and who I have not.
Everyone else remains here in our world of barking dogs and carrier bags,
Scuttling, targeting, oblivious to who they have lost,
Maybe wilful ignorance helps navigate
the risks of daily comfort.
Maybe they do not want
what they have not got.
The children that know lived through homework and after-school clubs,
Their fortitude bolstered by potential and by childish romance,
Maybe distance has dulled the sharpness
and youth is resilience.
They can survive painlessly
wanting what they don't have.
But she doesn't remain in our world of red tomatoes and earthy spices,
Of barking dogs and homework and after-school clubs.
Of sentinels and beacons and places of rest
Of daily comfort from those who give peace.
There she is,
and here we are.

Anniversaries

There are a handful of anniversaries to navigate now that Ruby is not with us any more. Each has its' own identity. The anniversary of her death (May 8th, the day before my wedding anniversary) has a blanket sadness that is utterly unavoidable, there is nothing that can be done that day to reduce its effects, no distractions, no positive discussions. It is, without fuss or negotiation, the worst day of my life. I feel terrible rage at the unfairness of it all, I feel my body collapse and implode, I feel fate has assaulted me with a disability for life, I feel so much and also so little.
Our birthdays, as close relatives, have their own identity in connection to grief- we make them as fun as we can but the gap of loss is unavoidably present. There is no other day of the year like a birthday for someone who forever grieves. There are presents, laughs, cake, going out for dinner, seeing friends and all the usual shared celebrations. But the edges of the precipice are crisper than ever. On birthdays Ruby is barely mentioned, if at all. It is supposed to be day of celebration after all so sad stuff is not supposed to be brought up but of course it barely needs to be brought up, its always there.
The emotions experienced on Ruby's birthday vary every year depending on her age. Three months ago she would have been seventeen years old (when I last saw her she was eleven). The run-up to this anniversary is the longest of the year and usually takes many weeks. In public during this period I can only see young women of about her age and I am distracted by ideas of lost potential- would Ruby be in education, training, still have the same friends, would she be happy in our family, what about her relationship with her brother Tom, would she have liked a birthday party or a quiet night in with close friends?
Christmas grief has its own identity, one influenced by a monthly build-up to a holiday of family time, expected jollity, excess and conspicuous consumerism. I can experience social anxiety any time but there is a pressure on me like no other time of year to be around other people and there is an expectation to be celebratory, which I never feel. As an atheist adult, Christmas meant very little for me from the time I stopped believing in Santa Claus up until I had children of my own. Then there were eleven Christmases of childlike wonder and excitement but now that has gone. Tom enjoys it, of course, but everything is different now.
In the last five years Christmas has barely evolved from what it has always been around here- getting together with extended family, eating and drinking. This year I spent much of my time in a quiet corner online, connecting with strangers and trying to make things a little less lonely for us all on a Twitter group designed just for that purpose. That is my Christmas identity- loneliness. Feeling alone, even in company, has been the unique identity of my Christmas for the last five years. I do what is expected of me, as a relative, but there is no other day of my year that has that same quality of displacement as Christmas, of disconnectedness from my surroundings (it is for this reason that I can easily empathise, and can create good connections with, lonely people online and I try to use some of my day to ease our burdens). I am always pleased to see the end of this day. This year my dad was over from London for a week which was lovely too but he and Claire and Tom were all ill with bugs so my two weeks time off from nursing over Christmas was a busman's holiday. I had prepared myself a little for the unhealthiness of the time by losing a little weight in December (reducing bread and pasta for a few weeks and adding on a few more runs than usual which also contributed to helping me feel a little more in control of my emotions).
I spent midnight New Years Eve at home. Claire and Tom were asleep, snotty, coughing, with a high temperature, and I considered my resolutions for 2019 but came up with nothing. I think all I wanted was a return to some sort of routine combined with an escape to the forest. Maybe this is all I ever really want.
I want to get through the new year without totally fucking up. Anything else is a bonus.

This my favourite tree in the world- an oak in Castlewellan Forest Park in Northern Ireland, taken today 2nd January 2019.