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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

November 26, 2020 By Admin

Personal Happiness in the Age of COVID-19

Personal Happiness in the Age of COVID-19

We are all in this together!  However, wealth and employment status do play important roles. RTI International and the Consortium for Implementation Science have serious concerns about the links between racial equity, social justice, and personal responses to COVID-19. Neuroscience notes that personal happiness in a brain-mind-body thing. Its formula is hard-wired in our brain. In difficult times, it is even more important to figure out your personal formula (without self-medication) to satisfactory levels of joy and happiness. Because happiness is physical, psychological, emotional, and spiritual (in ways) we need to focus more now on experiencing it. We cannot be happy if we focus more on fear, anxiety, and depression; we need to make happiness a personal priority. According to a poll by the American Psychiatric Association, over one-third of Americans noted that the pandemic has impacted their mental health in negative ways. According to the American Psychological Association, two-thirds of adults experience better well-being in post-traumatic growth. Here are some things you can do to improve/expand your personal happiness in these times.

  1. Do your best to find positive and helpful interpretations of your experience.
  2. Maintaining a hopeful attitude is important.
  3. Hold on to empathy for yourself and for others.
  4. Spend some time relaxing with your favorite music.
  5. Watch lots of comedy.
  6. Happiness is an inside job, so end the blame game. This is not to say unfairness does not exist.
  7. Do your best to eat well, sleep well, exercise and use proven stress coping skills daily.
  8. Connect with other you care about – and who care about you.
  9. Move your body!
  10. Practice proven breathing techniques that calm us – and or excite us.
  11. Follow Thich Nhat Hanh’s advice and savor anything you can – do not rush it.
  12. Keep in mind that Buddhism implies impermanence is primary – nothing stays the same over time.
  13. Get qualified/licensed professional help when you need it – do not delay.

Since the list of courses for this information is plentiful, I will not list them.  Google the topic if you wish.

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: Activities, Buddhism, Covid-19, Featured, Happiness, MIndfulness, Self Care, Spiritual Energy, Thich Nhat Hanh Tagged With: COVID-19, MINDFULHAPPINESS, PERSONAL HAPPINESS

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

October 8, 2020 By Admin

Clinical Practice in Times of Uncertainty

In Times of Uncertainty; Clinical Practice

H. Colodro and J. Oliver provide sound advice in their new book, A Guide to Self-Care for Practitioners in Times of Uncertainty. This 2020 New Harbinger publication is loaded with helpful suggestions on surviving, even thriving, in our time of struggle. Their core questions include: What do my clients need most now? Am I able to provide what is needed and do so effectively? What might I do regarding my own uncertainty and struggles? Here are some of their suggestions.

  1. Spend some time daily practicing self-compassion.
  2. Know what you are facing, and if you are in a position (emotionally) to provide what is needed.
  3. Recognize the effects of chronic stress on yourself and your clients. Make adjustments as needed.
  4. Work smart! Work with only what you have some control over and not what is beyond your control.
  5. Be sure to take good care of yourself: sleeping, eating, attending, worrying, being aware, obtaining social-emotional support, meditating/doing yoga, and holding onto a strong sense of consciousness.
  6. Check in with yourself. Ask: How am I doing right now? Why did I react emotionally to that? etc.
  7. Release yourself from a “fix-it” mentality. Rather focus on emotion regulation, stability, and safety.
  8. Be there with your own, personal losses, sadness and fear. Deal with these and seek help when needed.
  9. If appropriate, include happiness-enhancing activities and skills in your therapy.
  10. Recognize the reality of impermanence in all things, including current problems and yourself.
  11. Settle into a more self-caring flexible outlook. If possible, work less. Take breaks! Do not over-extend.
  12. If you experience psychological exhaustion or failure in behavioral activation, seek support and consider doing more telehealth rather than live, person-to-person therapy. Cut back if necessary.
  13. Follow all guidelines regarding masks, gloves, social distancing, disinfecting, etc.
  14. Consider using “good enough” standards in your work in these times. See D.W. Winnicott for details.
  15. Remain safe, calm, competent, and helpful in your work.
  16. Consider using the same breathing training techniques you teach to your clients on yourself.
  17. When you feel stuck or sucked-into the craziness of the times, use CBT-M (CBT with mindfulness) on yourself.
  18. If you feel overwhelmed, hopeless, etc. seek your own clinical help.

Refer to Colodro, H. and Oliver, J. (2020). A Guide to Self-Care for Practitioners in Times of Uncertainty. Oakland, CA: New Harbinger Publications.

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: Covid-19, Featured, Helena Colodro, Joe Oliver, Self Care Tagged With: CLINICAL PRACTIVE, CORONA VIRUS, COVID-19, MINDFUL HAPPINESS, PANDEMIC, SELF CARE

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