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, Vermont
Author of Mindful Happiness
“technologize” is not a popularly accepted word, but it is a sad reality. We live in a time when texting while driving may become the new addiction-based cause for many, many deaths. This addiction is so strong people do it in situations that could case their injury or death, or the injury or death of others. Sound familiar! It should. Cellphone “abuse” is not so different from the plans of cigarette producers to “hook” us on something we will pay for during many years. So here is a partial list of what people tend to do when faced with severe stressors.
– 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.
cognition, emotion, behavior and sensory contact with all phenomena are fully engaged in evaluation of everything: did I get what I wanted and avoid suffering for now or not? This is the hedonic treadmill of lived attachment and avoidance. Cognitive-Behavioral analytics ends up in the same place over and over again: short-term pleasure (getting what I want for now) and longer-term suffering (fear of losing it or being involved in more emotional pain). This state of constant seeking (how many “likes” do I have?) tricks us into thinking that this time, it will work. We seek safety, security, and various forms of wealth; we expect to achieve these goals and to avoid as much suffering as possible. This is impossible, since the seeking and attaching itself eventually causes more personal suffering. We humans have very short memories when it comes to the realities of pleasure and pain, happiness and suffering. Our emotional striving to be perfect and get ahead often leave us with just more desire. The sad fact is that no matter how successful we are in accumulating all the goodies, we tend to continue our suffering sometimes in different forms.
self. It does not change even when the content of experience does change. Become your observing self in a state of pure awareness without judging or evaluating. In the evolutionary process, clinging is one of the most primal actions. The “vapor of thoughts” along with strong attachment clinging causes our norms to be related to our false self – with its entitlement, feeling special as a defense, greed, anger, even hatred. Just STOP all of this process as much as you can; focus on who/what you are at the deepest most spiritual levels. Who am I is the eternal and most important question. As you meditate and do yoga, concentrate on radically accepting everything that has happened to you and may still be happening to you. This does not mean stand by and allow yourself to be abused by cruel people; however, it does mean to pay very acute attention to what experiences trigger your ego-defenses and negative reactions in thoughts, emotions, and behaviors. How much control over your emotions are you willing to give up to other people? Radically accept as a norm, do your asanas, meditate often, allow your true self to “let go” of the false self”s ego and superego demands. Pursue spiritual practices, be compassionate and generous, and live the life your true self desires for you. This is a life of more inner peace, even tranquility, more happiness, less competition, more love, and DOING good for others. This path is difficult in our materialistic world. The fruits of your efforts will be gratifying! If you practice, you will discover the truth about being a happier, more lovable person.
and there is nothing you can do about it; this is pure suffering, and it is painful. However what you decide to have your mind, body and emotions do with the first arrow of suffering is called the second arrow. This very sharply pointed arrow can lead to long-term, even life-long suffering about something you failed to radically accept and let go. Become an expert in perceiving the initial activity of your second arrows, and STOP as soon as possible. At this point you may apply RAIN – recognize what if happening; accept it; investigate causation; and, apply no-self or if less skilled “its not about me attitudes.” These follow-up practices should be very helpful to you in your effort to become a more calm and more happy person.
