Grief and trauma work are time-consuming and complex processes for sure, but they can also be incredibly rewarding given the arduous labor involved. When some degree of healing is achieved, a major transformation generally starts to occur.
The world seems to be reeling from one crisis to another. We’ve experienced a global pandemic, economic uncertainty, political and social turmoil. Then there are personal traumas that people are dealing with, such as the loss of a loved one, health issues, unemployment, divorce or the loss of a job.
Coping with change can be traumatic as it often affects every part of our lives.
How do you deal with loss or change in your life? What coping strategies can you use? Do you ignore them and just push through, or do you use specific techniques?
In this series called “5 Things You Need To Heal After a Dramatic Loss Or Life Change” we are interviewing successful people who were able to heal after a difficult life change such as the loss of a loved one, loss of a job, or other personal hardships. We are also talking to Wellness experts, Therapists, and Mental Health Professionals who can share lessons from their experience and research.
As a part of this interview series, I had the pleasure of interviewing Joey Miller, MSW.
Joey Miller, MSW, LCSW, has over 20 years’ experience in women’s mental health, particularly in the areas of reproductive psychology, and loss and trauma. She is in private practice at Wellsprings Health Associates in Chicago. Joey formerly served as the Perinatal Loss Coordinator at Prentice Women’s Hospital of Northwestern Memorial Hospital, as well as a faculty member at Northwestern Feinberg School of Medicine.
Thank you so much for doing this with us! Before we start, our readers would love to “get to know you” a bit better. Can you tell us a bit about your childhood backstory?
When I was in middle school, one of my classmates committed suicide. Death by gunshot. I remember feeling shocked when I learned the details, helpless, and then awkward when his twin brother, Mike, returned to school a few days later and took his seat at the desk next to mine. I had no idea what to say, so I said nothing. Not even, “I’m sorry.” I never saw anyone else say anything to him either — not even a teacher. I remember he looked so normal, even though I knew nothing was normal. I think a part of me was afraid to talk to him because I didn’t want to say or do anything that would disrupt that. Perhaps we all collectively yet silently agreed if we didn’t talk about it, we could all pretend it didn’t happen. But it did. It wasn’t until much later I realized while on some level I probably was trying to protect his normal, I was actually more focused on protecting mine.
The following year, another classmate died in a terrible motorcycle accident. His family was well known to the community, and on the day of his funeral, it seemed the whole town showed up at the church to grieve and express their support to the family. While I knew this boy and was saddened by his death, Mike was the one I thought about — wishing there was a way I could have evened things out a bit and have him feel some of that support instead of the silence I had witnessed.
Throughout my childhood and early adulthood, I experienced more and more losses even closer to me. I continued to witness others’ reactions to death and trauma, and I reflected on my own. I saw and understood why people felt uncomfortable and withdrew, and I grew more and more impressed and inspired by those who found ways to overcome their discomforts to engage the grieving individual compassionately and thoughtfully.
When I first began my master’s level training in social work, my clinical focus was emergency medicine and adult trauma. While my exposure to loss and trauma had started during adolescence, I still had much to learn. And learn I did.
I learned many of the things that were helpful (and unhelpful) to people following a life-changing tragedy or trauma. I learned how to initiate sensitive conversation and then actively listen to the aching and raw emotions others expressed. I learned how to help others sort through them, process, and understand them. I learned how to help people find ways to cope and pace themselves through the exhausting and grueling process of grief. Through my years of education, field training, and thousands and thousands of interactions with patients, I also learned ways to help people regain a sense of control over their lives and find meaning and fulfillment again.
While I never had the chance to do things differently with Mike, I vowed I would break the silence going forward. And I continue to, to this very day.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“The obstacles in our path are the path.” — Rolf Gates
Professionally, much of my work focuses on counseling patients who have experienced profound loss, trauma, or tragedy in various situations and circumstances. These include but are not limited to: birth and delivery trauma, congenital conditions and diseases, accidents/injuries, suicide, chronic and acute illness, and medical- and violence-related trauma. I’m highly invested in the education, advocacy, and empowerment of my patients, helping them work to regain a sense of control over their lives and find meaning and fulfillment again. Even though the path in front of them isn’t the path they had expected, I help them see there is still a path. As impossible as it may seem initially, there is life after loss. The goal is not to “get over” the loss but to learn to live with the loss.
My personal path has also included significant challenges. Most recently, when the COVID pandemic first hit, my life as a working mother changed dramatically when my four school-age children transitioned to remote learning. I had to singlehandedly oversee, support, and help supplement academic content for four children on top of my professional work. These responsibilities grew to include friends, family members, and even professional colleagues, who also struggled under the increased stress and strain from the pandemic, and were looking to connect. I suddenly found myself working with my children and treating patients during the day and informally counseling family/friends/colleagues after hours. As I feel great responsibility for my family and patients, that left little to no time for self-care. Fortunately, I’d been well-educated and trained on ways to avoid compassion fatigue. I tapped into reserves I wasn’t always confident I had and rose to the occasion for everyone who needed me. I also prioritized and set limits to remain emotionally resilient and maintain my mental stamina. Although it has been a year of extraordinary obstacles, it has also been one of extraordinary growth.
You have been blessed with much success. In your opinion, what are the top three qualities that you possess that have helped you accomplish so much? If you can, please share a story or example for each.
- I work to maintain my priorities and perspective. My professional work involves regular conversations about loss, trauma, and tragedy, so I am reminded daily how short life is. I know all too well each day is a gift, and we must spend this time wisely, focused on the things and people most important in this world. When those things are in focus, it’s easier to set down everything else. For me, my deep faith, my children/family, and our health (physical and mental/emotional) come first. I am also deeply committed to my work and ensuring the health of my patients. That work is beyond meaningful and provides me with incredible inspiration when I see what my patients are capable of following loss and trauma.
- I am emotionally resilient. I work to differentiate what I can control from that which I cannot. (And, my children unknowingly, but constantly, help me practice this lesson!) I acknowledge and accept that what I cannot control is of more extensive range and scope. The more you chase control, the more elusive it becomes. The more you focus on the things you actually can control (and release yourself from the things you cannot), the more balanced and grounded you will feel.
- I practice gratitude daily. There is much to be thankful for, even if we have to search for it. This is one of the lessons learned from the pandemic. Many have learned to live more intentionally and simply, finding contentment and even happiness in small moments.
Let’s now shift to the main part of our discussion about ‘Healing after Loss’. Based on your experiences and knowledge, what advice would you give others to help them get through a difficult life challenge? What are your “5 Things You Need To Heal After a Dramatic Loss Or Life Change? Please share a story or example for each.
- Pivot Your Perspective. It is not uncommon following a loss/trauma/tragedy for your identity to take a big hit and to feel insecure, of little worth/value, etc. It’s important to recognize and remember: you are not wrong, rather, something very wrong happened to you. Adding the weights of self-blame or guilt about your circumstance will only make your existing burden heavier and create more layers for you to work through.
- Practice Regular Self Care. Grief/trauma work is exhausting. Be gentle and extend yourself as many graces and as much kindness as you can. Nourish your body, mind, and soul in healthy ways that feel comforting and nurturing.
- Don’t Go it Alone. The experience of loss/grief/trauma can be lonely. Find a great therapist and create a strong support network. This network should consist of people who add value — not those who dispense unsolicited advice, judgment, or pressure. Be honest with yourself about your needs and selective as to who makes the cut.
- Learn How to Say No. You will quickly realize many things are unhelpful following a loss. Resist the need to yield to social pressure. Only you can determine which events, activities, and relationships are worth the energy right now. Your main focus needs to be healing you.
- Create/Recreate Meaning.You were a multi-dimensional person with many interests before your loss/trauma. Those remain even though you may currently feel defined exclusively by your present circumstances. Revisit previous interests and explore new ones as you continue to put the pieces back together.
Let’s discuss this in more specific terms. After the dust settles, what coping mechanisms would you suggest to deal with the pain of the loss or change?
The work of healing is an ongoing process and involves many steps. Initially, it’s important to start with the basics:
- Establish safety. When it comes to loss or trauma, it is not “What is the worst thing that could happen to you?” Rather, it’s that the worst thing did happen. Initially, many people feel an extraordinary sense of insecurity, vulnerability, hypersensitivity, and emotional reactivity, believing if something bad happened once, it can (and will) happen again. The entire world can feel like an unsafe place where each subsequent step involves dodging a potential landmine. Determine what (and who) you may need to feel physically safe and request additional emotional support and reassurances from trusted others as needed.
- Acknowledge the fact that a loss or trauma occurred. There can be a tendency to minimize, avoid, or deny horrific details and painful memories to self-protect, but those coping strategies don’t work indefinitely. Healing involves finding a way (e.g., with therapy) to better tolerate and accept the full truth of a situation that was completely and entirely outside your control to predict, prevent, direct, or change.
- Take care of your body. Continue to take good care of yourself. That includes what you do with your body and what you put into it. Remain active and exercise regularly because a healthy body will provide you with a stronger base from which to handle the emotional challenges. Get plenty of rest (even if you can’t sleep) so that you have enough energy to get through the day. Stay well hydrated and nourish yourself with healthy and nutritious foods.
- Get professional mental health support. The aftermath of a loss or trauma can lead to shock, numbness, disbelief, denial, anger, depression, panic/anxiety (especially in the context of an unknown future), flashbacks, insomnia, nightmares, intrusive thoughts, a sense of detachment, confusion, avoidance, withdrawal, guilt, feelings of helplessness/hopelessness, and even suicidal thoughts. There can also be an increase in substance use/abuse to numb or escape the pain. Licensed mental health providers can be very effective in addressing and treating all the above through individual therapy, medication management, or a combination of the two. Cognitive behavioral therapy (CBT) in particular, is an effective treatment that can help control or change thoughts, which can improve feelings and behavior. CBT is one of many different types of clinical approaches for individual therapy that can be highly effective in regulating emotions, managing anxiety and depression, and improving self-esteem and confidence — all of which may be severely damaged after loss. Most importantly, therapy can help in identifying, returning to, and then continuing the path forward.
- Tell the truth. Share your whole experience. Full disclosure affords you the greatest benefit in therapy. Specifically, share all your worries, fears, thoughts, behaviors, and coping strategies (including those impulsive, unhealthy, or risky) with a licensed professional for support and treatment. Even though you may feel embarrassed or ashamed, this is the path to help (and eventual healing).
How can one learn to to heal and “let go” of the negative aspects of that event?
Letting go of negative aspects of a traumatic event can be a challenge. The way forward can be to:
- (Eventually) Re-tell your story. This can be done privately through writing, in person with a therapist or a trusted confidant, or even publicly. We cannot rewrite the past, so the reality is some negative aspects of the trauma/tragedy will always remain. However, reviewing the upsetting thoughts and feelings again after the event (and from a different vantage point that affords greater safety, distance, and thus control) can help create a different perspective and overall feeling about the experience. Even though the plot is the same, being the narrator is different than being the story.
- Confirm you’ve been heard.Don’t underestimate the power of this step. Just as it can be very difficult for the victim, survivor, or grieving individual to re-tell their story, it’s sometimes difficult for others to listen. Just because someone can’t or doesn’t listen, doesn’t mean no one will. Obtaining validation of your experience, reactions, and responses is a powerful tool and avoids grief becoming disenfranchised.
Aside from letting go, what can one do to create an internal, emotional shift to feel better?
The path to feeling better is not always a linear one as loss and trauma work are complicated and layered. It’s common for people to feel frustrated and discouraged when they take one step forward, and then two steps back at times. Forward movement to eventual healing is possible, but you must find ways to stay the course. To feel better, it’s important to:
- Take your time. Society’s understanding and tolerance of loss and trauma are limited since the depth and duration of an individual’s experience greatly outweighs and outlasts others’ sympathies. Well-intentioned others may sincerely believe that time heals all wounds, but in reality, their patience, tolerance, and comfort level with loss or trauma is finite, resulting in a mixed message to “hurry up and grieve.” In the case of loss and trauma, time cannot heal all wounds, but time undoubtedly can help. Free yourself from the unrealistic pressure of having to “get over it” at some point. Take the time you need. Grief/trauma reactions can remain intense, but they can also become more familiar. And as you become more aware, you can better anticipate your triggers and respond more effectively.
- Focus on integration. Initially, loss and trauma are blinding, all-consuming, and sometimes believed to be all-defining. People struggle to see beyond the acute event. While again, some negative aspects of the trauma or tragedy will always remain, there is more to your life story than one episode or chapter. Instead of the loss or trauma becoming your life, it can become a part of your life. The goal here is integration, as the traumatic aspects can come to co-exist with some of the positives that also happened in the past, that are occurring in the present, and that are expected in the future. Healing involves learning to take back some control and find ways to create more balance within your entire life story instead of allowing one event to control you.
- Be patient with yourself. Grief and trauma work are undeniably difficult. But the investment in yourself can prove invaluable in helping you find ways to not only survive but thrive.
How can one eventually reframe the consequences and turn it into a positive situation?
When people are assisted and supported in effectively dealing with their trauma and grief head-on, and with eyes wide open, in time and with dedicated hard work, healing is possible.
For example, strategies can be employed to calm and transform extreme anxiety and emotional reactivity into more adaptive and positive responses (such as improved caution, assertion, diligence, or vigilance) even though fear and uncertainty may still linger.
People can avoid becoming trapped in their grief when they are taught how to confront their fears and not be paralyzed by them. In time, many are even able to overcome some of their fears.
Grief and trauma work are time-consuming and complex processes for sure, but they can also be incredibly rewarding given the arduous labor involved. When some degree of healing is achieved, a major transformation generally starts to occur. The deep hollow created from pain can eventually become replenished over time with a renewed sense of identity, greater confidence, deepened understanding, patience, empathy, gratitude, and love. People can and do become empowered to resume their path and find ways to embrace their new life (and themselves) after loss.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be?
Over the past year, I have seen the following three phenomena during the pandemic in my practice:
- An explosion in the number of people seeking mental health treatment as our nation experienced unprecedented levels of stress, anxiety, depression, etc.
- Improved access (initially) for persons seeking such services as more clinicians offered telehealth appointments, and as the historic stigma surrounding mental health treatment eroded rapidly.
- And, more recently, increased barriers to care as the mental health system remains overloaded and clinicians’ practices are maxed out or have long wait lists. Additionally, many people are unable to prioritize mental health treatment given severely limited financial resources due to decreased income, lost jobs, and lost health insurance.
As providers, we MUST continue to push progress and create solutions. The residual mental and emotional trauma from the pandemic will exist longer than the pandemic itself does.
Hands down, reform and improvements are desperately needed in the area of mental health, and now. We must create greater ease of access to all who need mental health treatment, and then ensure it is affordable for as long as indicated. We must also work to encourage interested and capable persons into this rewarding profession, and then make ourselves available to offer supervision and support to the next generation of clinicians. It is heartbreaking to see the need and demand rising, and far too little being done to address the existing gaps in service. This is simply not acceptable nor sustainable.
We are very blessed that some very prominent names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them. 🙂
I would like to connect with Chrissy Teigen, who suffered the very public loss of her son, Jack, at approximately 20 weeks’ gestation back in October 2020. Her very courageous disclosures in pictures and words broke the barrier on the taboo of talking about these types of losses for bereaved women everywhere. Further, her candor sparked the long-overdue conversation surrounding pregnancy and infant loss. By sharing everything as she did, she connected with a silent community and gave brave and empowered voices to millions of women’s similar experiences. These connections likely made her — and everyone else she touched — feel a little less alone and a lot more understood.
Since that time, she has kept the conversation going, not only about her grief process but also about infertility. Recently, she launched the Fertility Out Loud campaign with the organization RESOLVE, which aims to help those struggling to conceive — something she understands on a very personal level. Her struggle with fertility makes her loss story even more poignant and her resilience more admirable. I remain so sorry for her loss but simultaneously deeply appreciative of the impact her sharing her story has had on the loss and mental health communities.
How can our readers further follow your work online?
Thank you so much for sharing these important insights. We wish you continued success and good health!