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Anthony Quintiliani, Ph.D, LADC

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January 22, 2021 By Admin

Loss, Grief and Suffering in America

Loss, Grief and Suffering in America

By Anthony R. Quintiliani, Ph.D., LADC

Other than our nation’s suffering during The Civil War, The Great Depression, and World War II this past year has been one of the most stress-filled, fear-filled times in our history. Here is a list of the reasons behind it all: the COVID-19 pandemic, racial injustice, legal reactivity, massive unemployment, loss of housing, quarantines, closed schools and colleges, powerful political demonstrations, and a “president” who betrayed his trust and incited riotous violence against the Capital of the United States. Also a “president” who has been impeached not once but twice by The U.S. House of Representatives. What a year!

Types of Loss, Grief and Suffering

Along with the above, we have witnessed increased anxiety, depression, fear, anger and traumatic stress. Although death (loss of a loved one) is by far one of the most severe stressors, we also suffer from the virus, separation/divorce, developmental stress, incarceration, and the loss of the way of life in pre-COVID-19. Americans are suffering from various bio-psycho-social-spiritual dimensions of stress, loss and grief. Perhaps the correct words to use are “complicated grief.” Our current experiences with loss and grief go far beyond the stage-based versions of E. Kubler Ross; our current complex grief does not follow neat linear progressions, and includes more serious symptoms. For those who also experienced childhood trauma of various forms or developmental regressions the current experience is more exasperating and dangerous. When loss is catastrophic reactions may include nightmares, shame, guilt, regret, hopelessness and suicide. Cultural differences also play roles in loss and grief as well as its treatment. Therapists must also be aware of the influence of race, gender, sexual orientation, and age.

Treatments for Loss and Complex Grief

Treatments for loss and complex grief are many, but with varying levels of success. Matching treatments to client characteristics, and developing a powerful clinical alliance are important for therapeutic success. Below, I list (only) various treatments, most supported by empirical research and practice. I will leave it you the reader to look more deeply into treatments or interventions they may prefer. Here is the list: Trauma-Informed Cognitive-Behavioral Therapy, Mindfulness-Based therapies/practices (breath work, meditation, yoga, tai chi, qi-gong and MBSR or ACT), Continued Bonds Theory – the changed internal relationship with the lost person, and Attachment-Informed Grief Therapy – utilizing attachment styles of secure, insecure, anxious or avoidant.

Many therapeutic interventions may be helpful: social-emotional support, recovery journaling, music, exercise, imagery, play therapy, and sand tray work. Generally especially strong empathy is required. Self-care of the therapist is a must. Using Maslow’s Hierarchy of Needs may be helpful.  Other active interventions include empty-chair work (sitting in the “worry chair” or the lost person chair), self-talk or out-loud talk using stimulus words like relax, breathe, not me, etc. Social networking with new people in groups is often helpful. Improving client self-care and participating in activities associated with joy or satisfaction moves the mind to other things.

In the end, if so many various interventions fail to meet needs, people should consider joining a formal, therapeutic bereavement group. Loss is emotionally tough, and recovery requires complete emotional activation.

For more information refer to: comments of A. Bodner, Ph.D. in The New England Psychologist, p. 2 (Winter, 2021). Hanlon, P. (2021). The Many Faces of Complicated Grief. The New England Psychologist, pp. 1 & 4 (Winter, 2021). Cormier, S. The Transformative Power of Loss. Psychotherapy Networker,  pp. 17-18 (January-February, 2021). Cacciatore, J. (2020). Grieving is Loving: Compassionate Words for Bearing the Unbearable. Boston, Wisdom Publications, pp. 1-8.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

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New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Coping, Covid-19, E.Kubler-Ross, Featured, Grief, Happiness, Healing, Human Needs, Inner Peace, Joy and Suffering, Personal Suffering, Practices, Relational Suffering, Self Care, Suffering, Tools, Treatment Tagged With: AMERICA, COPING, COVID19, E. KUBLER-ROSS, EMOTIONAL, GRIEF, HOPE, JOURNALING, JOY, LOSS, LOVING, MINDFUL, MINDFUL HAPPINESS, MINDFULNESS, PRACTICES, SELF, SOCIAL, SUFFERING, THERAPISTS, TREATEMENTS, TREATMENT

October 22, 2020 By Admin

COVID-19 Means Higher Stress and Emotion Dysregulation

COVID-19 Brings Higher Stress and Emotion Dysregulation

The Book of Job notes “Man is born unto troubles as the sparks fly upward.”

Current stress surveys indicate Americans are stressed out due to COVID-19 concerns, work stress (money needs), imbalance in life-work experience, and lack of support (social, emotional, financial).  The 2020 American Psychological Association national survey of stress in America indicates similar finding. Stress is getting the best of us! Of special concern are the physical, emotional (psychological), and behavioral implication of such high levels of stress reactivity. Higher stress reactivity is particularly recorded in families; stress is also related to educational concerns, basic needs, health care services, and missing out on major developmental milestones of children and youth. In 2019 Americans were experiencing stress levels noted at the 4.9 level; in 2020 that number rose to 5.9.  Now 74% of respondent noted their stress dealt with fears and concerns about coronavirus; this same number had concerns about how the government was responding to this mega-crisis.  Additionally, 71% of respondents noted that managing their child’s education was a major source of increased stress. The concerns and stress do not appear to be highly related to political party affiliations: 63% of Republicans, 67% of Independents, and 73% of Democrats were worried/stressed about coronavirus concerns. Stress appears to be impacting more so on people of color. Hispanic adults noted stress levels between 8 and 10 regarding the virus. When one compares the levels of stress for people of color with whites, there is no doubt people of color are suffering more – having higher levels of stress reactivity: fear of getting the virus 71% vs. 59%; meeting basic needs 61% vs, 47%; and, access to health care services 59% vs. 46%.  For more information Stress in America 2020 may be found at www.apa.org.

Another important reality is COVID-19 fatigue. Johns Hopkins Medicine has published a helpful article about dealing with this reality. The federal government, state governments, hospitals, healthcare workers,  patients, and the general public may be suffering from COVID-19 fatigue. This condition is similar to burnout under high stress conditions.  Important outcomes may be habituation to death, emotional exhaustion, strong fears, auto-pilot routines, reduced energy of health care providers, and increased errors in care. This pandemic is surely one of the most serious challenges this nation (and the world) have faced. It does not appear that the crisis will end soon.

If you are experiencing serious stress reactivity, you might want to practice the following self-care strategies. Eat well, sleep well, and exercise well as much as is possible for you.  Staying connected to loved ones and friends is also highly important. Use mindfulness skills to be in the present moment; realize it will change due to impermanence. Note it will change either for the better or worse. It may also be helpful to make formal plans to DO positive activities, no matter how small. Get out into nature; if you cannot do this regarding forests and mountains, at least spend more time outdoors. Regular daily walking is a good idea.  Doing good things to help others is also a way to feel better about yourself; in hard times, it is not easy to feel good about yourself. Learn and practice various tried-and-true breathing techniques (usually from meditation, yoga, athletics, etc.). If you are in fact doing some of these self-care practices, but you still feel overwhelmed, defeated, anxious, depressed – it may be best to see professional for psychological help. Before you decide to work with a mental health provider, do a search about them, their practice, and their ethics.

For more information refer to Hanlon, P. (Summer, 2020). COVID-19 means different approach to stress in American surveys. New England Psychologist (Fall, 2020). pp. 4 and 7.

https://psych.ly/covidfatigue.

Anthony R. Quintiliani, PhD., LADC  

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

Filed Under: Coping, Covid-19, Emotion Dysregulation, Emotions, Featured, Human Needs, Johns Hopkins Medicine, MIndfulness, Stress Tagged With: COVID-19, EMOTION DYSREGULATION, JOHNS HOPKINS MEDICINE, STRESS

December 24, 2019 By Admin

Journaling and Grief Process

Journaling and Grief Process

Regular brief journaling may be helpful in your grief and horror regarding significant personal losses of self and/or others. Here are the various ways it may be helpful to you.

  1. Writing and reading about your personal loss experience may help you to make sense of the process, and at the same time guide you gently on that path.
  2. Journaling may open up past and present realities – both positive and negative – about your loss experience.
  3. At times anger, resentments, and regrets will come up. These realities open you up to the depth of the grief experience. Do not linger too long there!
  4. S. Kierkegard reminded us that our lived experiences are processed forwardly, but better understood if observed backwards. Journaling helps to focus us on the present but never lets go fully of the past.
  5. It may be important to you to make your personal journal more balanced with both negative and positive experiences. For example, it may be helpful to list all simple pleasures you experienced in any given day. It may also be a good idea not to linger emotionally too long when such experiences trigger negative states.
  6. I have always found it helpful to list my personal gratitudes, even in the midst of painful loss and suffering. It is not uncommon for the most valued experiences to be linked with the lost love-object and your shared life.
  7. If fear and trepidation occur as you move through the grief process, I suggest that you break down the scary moments into smaller, more manageable periods of time, space, and emotions.
  8. Pay attention to and write about both helpful and unhelpful thoughts, emotions, behaviors, and sensations related to your grief process. Be aware keenly of small improvements in all.
  9. You may notice that as you slowly heal you spend less time journaling. This is natural.
  10. You may wish to do “grave worship” practices, or simply write many good things about the lost person.
  11. V. Frankl noted that when we cannot change the reality of a situation, we may have to change ourself.
  12. When you find yourself crying over your loss, that is a very good time to contemplate and do journaling.
  13. Reading related poetry or writing your own may help you.
  14. If and when you experience the emptiness of the void inside, do your best to find words for the experience. And, work to fill that void by re-engaging with your life as it is now.
  15. It is always a good idea to develop and practice personal rituals about your healing. Write about this in your journal.
  16. S. Becket reminded us that we must go on! As painful as it may be, we cannot stop the process.
  17. As P. Chodron noted, we must allow it all to fall apart before we can find the resilience to face what comes next. In most situations, what comes next is slow improvement in your emotional condition.
  18. Rest in peace with your breath, and do more meditation or yoga if that suits you well.
  19. You may wish to visit optionb.org or other sites that support grief work.

Refer to Sandberg, S. and Grant, A. (2017). Option B: Facing Adversity, Building Resilience, and Finding Joy. New York: A. A. Knopf, pp. 58-76.

Anthony R. Quintiliani, PhD., LADC  

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon

Filed Under: Activities, ANTHONY QUINTILIANI, Calming, Coping, Crisis Resilience Skills, Emotions, Featured, Gratitude Meditation, Grief, Holiday Coping, Inner Peace, Journal Writing, Learning, Letting Go, Meditation, MIndfulness, MIndfulness Activities, Mourning, Natural Healing, Self Care, Spiriuality, Stress Reduction Tagged With: ANTHONY QUINTILIANI, GRATITUDES, GRIEF PROCESS, JOURNALING, MINDFUL HAPPINESS, RESILIENCE

December 18, 2019 By Admin

How to Offer Personal Tribute to Those Who Have Died

How to Offer Personal Tribute to Those Who Have Died

The Four Noble Truths tell us sobering news. There is suffering, and impermanence of all things including us and our loved ones. Below I have listed several thing you can do to HONOR a person you have lost.  Here is the list.

  1. Recall a special time before or at the time of death, and consider it a sacred place in space and time. Honor it and the person with the complete softness of your loving heart.  Do this now if you wish to.
  2. Pray for the person you have lost – and the goodness in that lost relationship.  You can do this if you are agnostic, even atheist. The prayer is to honor the loved person not to one of many gods.
  3. Go to your soft, suffering heart and fill it with joyous remembrances of your time with the person. Yes, the person has moved beyond; however, your internal and emotional memories are quite vibrant. They have made a special place for them self in your soul.
  4. You can carry this to a deeper level by seeing and touching special objects that belonged to the deceased.  Or, you can set up a small shrine in your home to pay respect and honor whenever you wish to do so.
  5. Know that the deceased person would want you to recall your joy, so light up your senses and recall in mild meditative state the pleasant and happy experiences you both shared.  If something happened with them that made you laugh, go there! This is what they wish for you.
  6. Listen to the music the lost person enjoyed, or read something inspirational.
  7. Think carefully of all the ways you could say goodbye again. Do it now if you wish to.
  8. Recall the smile on their face, and smile back. You may be surprised at how powerful this experience may be.
  9. Dedicate meritorious behavior to them. If you wish, set up some special program or fund to champion causes they cared about. The financial level is far less important than the emotional level of actually doing something.
  10. Write a special tribute about them in a journal. Write often, and read what your have written again and again.
  11. Lastly, work carefully to discover some ways to celebrate that person’s life and your relationship. Celebrate often and be calm within the warmth of your love.

For more information refer to Reoch, R. (1997). To Die Well: A Holistic Approach for the Dying and Their Caregivers. New York: Harper. See also Holecek, A. (2013). Preparing to Die: Practical Advice and Spiritual Wisdom from the Tibetan Buddhist Tradition. Boston: Snow Lion, pp. 312-314.

Anthony R. Quintiliani, PhD., LADC  

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon

Filed Under: ANTHONY QUINTILIANI, Compassion, Coping, Death, Deep Mindfulness, Featured, Gratitude Meditation, Grief, Letting Go, Meditation, Mourning, Rituals, Self Care, Spiriuality, Tributes Tagged With: HONOR, LOVING, OFFERINGS, PRAYER, TRIBUTES

August 15, 2019 By Admin

Advanced Practice in Tara Brach’s RAIN Protocol

Advanced Practice in Tara Brach’s RAIN Protocol

So often we humans find ourselves in a state of limbic disarray, with ego defenses stimulating our need to protect ourselves from others – even from ourselves. We feel something is very wrong in this moment, and we allow separateness to pull us into a frenzied effort to escape pain and suffering. At such times our most deeply hidden negative self-views strengthen and dominate. We will do almost anything to escape the aloneness and self-alienation. Endless impulses to seek what is wrong and forget what is right take over our emotional lives. It is at such times of strong emotional challenge that we need to take refuge in the Buddha, the Dharma, and the Sangha. Tara Brach’s creation of the RAIN process is a huge leap in a sane direction. According to Brach, RAIN helps us overcome tendencies to activate the “second arrow” of suffering; our second arrows are caused by unhelpful thoughts, feelings, emotions, body sensations, and behaviors related to the “first arrow.” The first arrow is the original event or experience that caused our pain and suffering. Often our reactivity to it makes matters worse – we suffer more in our own minds and bodies. Below I will review the RAIN process and make additional comments on its usefulness and versatility in ongoing self-care and emotional self-regulation. The practice of RAIN skills is appropriate for all people – helpers and helpees.

  1. The first step of RAIN is recognition of what we are experiencing in this moment. What is happening now and how am I experiencing it in mind, body, heart and soul? This focus is on our inner emotional experience, and the causes and conditions creating them. Strong attention is necessary here. Recognition requires a cognitive shift from the auto-pilot of fear, pain, and desire to escape into a mental state of mindful attention in the now. We recognize our thoughts, emotions, sensations, behaviors, and habitual action urges.  This momentary shift into control helps our prefrontal executive brain to take action, and reduces limbic dominance in unpleasant experiences. For now, we are no longer at the mercy of negative emotional events and experiences. In fact we are at the starting point of liberation. We are participating in the experience and our responses to it. Like in DBT, we may find ourselves describing what we have now recognized. Tell yourself what you are experiencing and remain strong, emotionally. We may notice that anxiety, fear, depression, addiction – even some aspects of trauma – begin to transform slightly via the relatively simple cognitive act of recognition.
  2. The second step of RAIN is radical acceptance of the experience of pain and suffering in this present moment. This means that we allow whatever pain and suffering we are experiencing in this moment. With self-kindness we may place our hand over our heart (Thich Nhat Hanh) and breathe into the accepted experience of suffering. We learn to hold ourselves in loving self-presence within the limited space and time of the negative experience. We may experience self-compassion in this process. The act of allowing implies a strong “yes” to whatever is happening now, and it also implies an intention to become capable of handling the experience. This is similar but not exactly what D. W. Winnicott described in how humans are “going on being.” With self-compassion and self-acknowledgement, we allow ourselves to be in this unpleasant experience of suffering. This process, obviously, takes some courage to do. If the suffering involves other people, Winnicott’s view of “intersubjective space” and Kohut’s view of “experience-near empathy” may apply. We have moved from fear and suffering to recognition and now emotional oneness with the experience. Now it is time to add more cognitive control to the process, thus expanding emotional regulation.
  3. The third step  of RAIN is to investigate why now. This is a more cognitive intervention of analysis, analysis of our environment, belief, needs, and strengths. This shift enables us to stop negatively judging ourselves and others; this shift bring a more true presence into the emotional feeling state. Again, the cognitive intervention brings more stability to mind and body in the experience of suffering. Investigating enhances the meditative stance of the observing mind: I am not this experience (anxiety, fear, depression, anger, small-self, marginalization, etc.) , but I am experiencing this! At times this one realization can bring relief from negative emotional triggers embedded in our lives. We may experience pain and suffering in the process, but we are doing so with great mindful discernment. We are NOT the experience, but we are in the experience. It is not us, but it is happening to us. When we investigate, we may ask: Why now? Why me? With self-kindness and mindful strength we reduce reactivity and tendencies to escape or self-medicate. The strong large self is taking charge.
  4. The last step of RAIN non-identification with the experience as self, and more realization that the experience is happening to me and is not me (no-self). Here we practice BEING the true-self, the larger self, the expansive self. We slowly and gently open up a calm, secure space in our hearts. We realize we are not fused with the negative experience or its causes and conditions; we dis-identify with the small escaping self, and over-identify with the stronger, defused, more capable self. With a little luck and skill, we may even experience spiritual transcendence and/or feeling of liberation. We may realize that the self experiencing the suffering is a temporary, small piece of being in this life; the self that is recognizing, accepting, investigating, and not over-identifying is stronger and expanding into the emptiness of ultimate reality. Time and space may be altered. We may become our spiritual experience. We are ready for our next steps.

For more information refer to Brach, T. (2013). True Refuge: Finding Peace and Freedom in Your Own Awkward Heart. New York: Bantam Books. See also Tara Brach’s other works – Radical Self-Acceptance: A Buddhist Guide to Freeing Yourself from Shame.  See also Meditations for Emotional Healing: Finding Freedom in the Face of Difficulty.

Anthony R. Quintiliani, PhD., LADC  

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

 

Filed Under: ANTHONY QUINTILIANI, Buddhism, Coping, Emotions, Featured, Healing, Healing, Inner Peace, Meditation, Mental Health, MIndfulness, RAIN Skills, Self Care, Tara Brach, Training, Well Being Tagged With: ANTHONY QUINTILIANI, MINDFUL HAPPINESS, RAIN SKILLS, TARA BRACH

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