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From Loss to Love

The pain of loss is unavoidable, yet millions harm themselves trying to escape it. But loss has a sweet side, and when you open yourself to the pain, you open yourself to joy.

Composite of Kyle Thomson's "Falling Man" and Jim Wehtje's "Tulip" by Ed Levine

Think of the most psychologically painful thing that you have ever experienced. Actually take a moment and do it.

As you do that, realize that all it took for you to revisit it was a dozen written words from a person you've likely never met.

That's how close to your life that pain you just felt still is—and always will be.

Loss is painful. That's the trouble.

Acute pain is a signal to stop and change directions so as to avoid harm—just what your hand does automatically when you accidentally touch a hot pan. Even before you're fully aware of what you're feeling, your hand dramatically changes direction. If the reaction is fast enough, it may partially reduce the tissue damage that even a few more milliseconds would certainly produce.

If any cues reliably predict acute pain, they too will readily lead you to stop and change direction. Learning to avoid events merely associated with pain is an ancient process.

Every organism that evolved since the Cambrian period (and none that evolved before) shows it. That's half a billion years of practice. We're pretty good at learning how to avoid.

But some forms—many forms—of psychological pain cannot be removed or diminished by a change in direction. They cannot be addressed by flinching, running, or hiding. They are permanent and ever present.

Take the loss of someone you love. The sense of having lost someone or something, without any hope of recovering it, requires a profoundly different approach than jerking back from a hot pan. But the challenge it presents is clearer and more undeniable: It's not exceptional. You will go to your grave just a few words away from virtually any notable pain or loss you have ever experienced. Anytime, anywhere, human cognition can bring it back. Mental relations and memory are like that.

When a loved one dies, the loss follows you from room to room, moment to moment. It is both permanent and ever present. Although we know that loss is not going away, there are those eons of human practice in trying to avoid pain. We foolishly engage that inheritance even with the loss of those we love.

We may try not to think of the death or distract ourselves with other tasks— hoping against hope that thinking of something else will diminish the pain. We may directly try to suppress a sense of sadness. We avoid thinking of sweet moments with the loved one, lured into suppression of our memory by the deceptively soothing short-term effect. We may pretend the loss did not occur or deny its implications—refusing to ever alter a loved one's bedroom, as if she or he will return to reclaim it.

Suppression and avoidance come at a high cost—they diminish our ability to do much of anything else. The effort to suppress and run away is exhausting and eventually fails. Always, the painful reality of the loss returns. Pain does not really disappear when suppressed or avoided; it is right there, under the surface. Avoidance doesn't make sadness less of a problem; it makes it more of a problem because you have to keep working harder and harder to suppress it.

The pain of loss is important, not just because it challenges us in ways that go far beyond a hot stove. It has huge lessons to teach us, and avoidance keeps us from a significant source of wisdom. Pain is really an instructor about caring. It tells us we're vulnerable. We care where we hurt—and we hurt where we care. The gift of pain is a message about what is important in life. It not only tells us how to love; it also provides us with an opportunity to discover sources of strength and flexibility within us that help us prosper. Looking inside the pain expands us, encouraging us to become larger than we are and to live a life of meaning. To open your heart to pain is to open your heart to joy.

Photo by Isaim Lozano

The Ubiquity of Loss

My mother died a few years ago at age 92. My sister texted me that her pneumonia had suddenly worsened. A frantic plane trip had me arriving just in time to witness her last few hours of life. I knew this scene had played out countless times over the millennia, but it felt profoundly special, and it filled me with reverence for the fragility of life. It was awe-full and awe-inspiring—profoundly painful, yet profoundly precious.

My sister and I heard her breaths space further and further apart. "It won't be long now," a nurse said quietly. And then came that exhale that was not followed by an inhale. She was forever lost to me, except in my memory.

The word grief comes from the Old French gréve, meaning "a heavy burden." When you grieve for a loss, you have to carry a heavy burden. If you tell yourself that the loss isn't that heavy, or that you should be over it by now, you deny your own pain. You deny your wound and thus hinder it from healing.

There is wisdom about pain in some of our oldest rituals of death. People gather together, typically telling stories about the sweet, silly, or loving things the person did. We honor their courage, perseverance, and contributions to our lives at the same time we weep over the knowledge that we will never see them again. The rituals teach us that the pain of loss is rich and varied and reflects our caring and connection. We honor what loved ones stood for and promise to carry that forward. We acknowledge their flaws and resolve not to repeat them. We find in their lives instructions for what to appreciate and value. We laugh and we cry, extracting the array of thoughts and feelings that accompany the loss of anything important.

Loss serves up a rich and bittersweet stew of love and wisdom about what matters. Right inside the pain is the opportunity to see all of our present moments in a way that helps us live life more purposefully and more fully. But we can't learn the lessons that loss contains while fighting or running from it.

The sheer futility of the attempt is exposed by the frequency of loss in everyday life. If we fail to learn how to deal with the pain of loss in a kind and self-compassionate way, the pull to escape and avoid can dominate our moments.

For example, among the common losses that thread through our lives is loss of trust in one's own body or mind, whether due to a life-threatening illness, a panic attack, or a spell of depression. Yes, you may get better, but there is no delete button in human cognition. After a distressing illness, you cannot unknow that your body or mind is not as trustworthy as it was before.

Another common experience is loss of trust in others due to betrayal or victimization. Everyone has felt betrayed in love and very likely had the thought, I will never be hurt like that again. Only the little promise not to be so vulnerable the next time (vuln is an Old Norse word for "wound") is a promise never again to be so close, since by definition others can wound you only if they are inside your defenses. If you manage to put on the protective shield your mind desires, the cost will be yet another form of loss—loss of the ability to connect and to love.

Life may also inflict on us loss of a sense of safety, due to the capricious nature of direct trauma or even media exposure to violence. Can anyone say "twin towers" without a slight shudder? When your local news reports on a violent crime in your neighborhood, do you lock your doors before going to sleep? Glance outside your windows? You can add things to your environment to try to regain a sense of safety—gates on your community drive or a camera on your front porch—but human cognition means the innocence that was there before you knew what could happen is gone, never to be returned to you.

Simply growing older may bring loss of comfort and function due to the onset of chronic pain or increasing frailty. Some functions may come back, and some pains may subside, but some likely never will.

Anytime, anywhere, any loss can revisit you, because human cognition is like that: It contains the capacity to remember. What is there to do about that?

Loss is a reminder of the impermanence of life, and sadness signals that you cared: What was taken away mattered to you. If you look inside the pain, with gentleness, making room for discomfort, you can discover what mattered. Turn toward the pain? Who in their right mind would do that?

Pain Mishandled: The Feedback Loop from Hell

The modern world is now so rigidly committed to avoidance that it has not made room for what we all know deep down: Love and loss come as a single package. Psychological vitality and openness to hurt are two sides of the same coin. If you are unable to risk loss, you are unable to live a vital life. It you are unwilling to be hurt, you are unable to love.

Contemporary culture leaves little or no room for recognizing and caring for an experience of loss—or virtually any other experience of difficulty. Take, for example, the newest version of the psychiatric bible, the fifth edition of the Diagnostic and Statistical Manual, or DSM-5. It allows for two weeks of bereavement—anything longer is grounds for diagnosis and, likely, medication. Two weeks! You may have been married for 40 years, but 14 days of grieving for a deceased spouse and time's up!

You don't need a copy of the DSM-5 to understand an entire culture is denying the pain of loss. Television commercials relentlessly suggest that we can and should be able to manipulate our emotions with the right beer, the newest video game, the perfect vacation spot, the latest car. The real product people are buying is the promised avoidance of difficult emotions. Research shows that using material goods as a way to avoid discomfort and to self-soothe any that exists actually worsens anxiety, depression, negative self-assessment, and low life satisfaction.

Rather than acknowledging loss as an uncomfortable, inevitable, and profoundly meaningful part of life, we treat it as a disease. We see pain as a problem to be solved, instead of engaging with it and learning how to live with it as part of our life course. That gives pain an unhealthy power to control our lives—and ironically actually tends to increase our pain, creating the feedback loop from hell.

I learned this lesson personally nearly 40 years ago, when I developed a panic disorder: As soon as anxiety became something I was not supposed to feel, anxiety became something to be anxious about. Notice, amplify, react. Notice, amplify, react.

It was only when I found a way to turn toward the anxiety—with curiosity and self-compassion—that I had the chance to understand what my own feelings had to teach me. Long-suppressed memories of the sadness and fear I felt from the domestic violence I witnessed as a child came into view. Far from being a burden, my anxiety helped explain what I wanted to do with my life—it was rooted in a yearning that little boy had to help his parents.

The feedback loop of pain mishandled is on display not just in our individual struggles. It is evident in global health statistics. Around the world, chronic pain and disability are skyrocketing. Shockingly, disability is running rampant in countries with comprehensive health-care systems and excellent worker-protection laws. Sweden, Norway, and The Netherlands spend about 4 percent of their Gross Domestic Product on disability, the majority of it linked to chronic pain.

In the United States the same feedback loop from hell shows up in the opioid crisis. In 2015 the world consumed 61 "morphine milligram equivalents" per person. Americans used 11 times that amount. More than 46 people died every day last year from an overdose, primarily from prescription opioids.

The pain being treated often starts out as acute pain. But treating pain per se as something to focus on and run from, through powerful medications, risks turning acute pain chronic. Chronic back pain is something that 40 percent of people feel. Approaching it with addictive drugs may not be the wisest course. The vast research on psychological flexibility suggests that if we mishandle pain, pain will mishandle us.

Artwork by Brian Oldham

Mental Flexibility: The Path to Healing

Over the last 35 years, my colleagues and I have developed a small set of skills (see "How to Deal with the Pain of Loss" at the end of this article) that help people thrive. Most of the skills are hinted at in the social rituals honed over time to help us deal with the death of a loved one.

In more than 1,000 studies, we have found that the presence or absence of these skills predicts who is going to develop anxiety, depression, trauma, or substance abuse, and how severe or long-lasting the problem will be. If someone has one of those problems, the lack of those skills predicts who will later have two. The absence of the skills helps explain the opioid crisis and the rise of anxiety and depression among our youth. And it helps explain the paradox of the modern world: Even amidst plenty we suffer.

This set of skills, built around acceptance of emotions and affirmation of the values hidden within them, is designed to confer psychological flexibility—the ability to feel and think with openness, without defenses, just as our healthy burial rituals ask us to cry and laugh and honor and appreciate. It means being able to attend to what is present inside and out, flexibly, fluidly, and voluntarily. We learn from our own emotions instead of making them the enemy.

With psychological flexibility, people can turn toward unavoidable pain, learn the lessons it contains, and then use the lessons to create a rich and meaningful life. Inside the weeping from loss you will find the dignity and honor of a life that stood for something. Mental flexibility allows you to shift your attention from the pain to ways you can build those qualities in yourself.

There are those who fear that turning toward the pain and opening to it will only drown them in a flood of feeling, that they will be overwhelmed by the pain—as if the pain is bigger than they are. If I don't go there, it can't threaten me. But that's merely an illusion. The pain is already there.

If, instead, you approach it with kindness and compassion, you can gradually reflect on what hurts and what you miss. Sadness does not mean something is broken that needs to be fixed. It means something important to you has been lost. You have to take the time to look and identify what it is.

We can learn to be present with our pain without altering it in any way or form. We can learn to acknowledge and accept our loss and its emotional impact without pushing it away. And inside that very process we become better able to focus our attention on what makes life rich and meaningful, learning how to live lives connected to our deepest values and yearnings. By learning the lessons of loss, we learn how to open up and live. Loss becomes a stimulus for growth.

Handling a Death vs Honoring a Life

Recently, when conducting a workshop on Acceptance and Commitment Therapy, a method my colleagues and I developed to foster psychological flexibility, I asked for a volunteer to work with me. A woman came up on stage wanting to talk about the death of her sister some months earlier. Her sister had spiraled into an opiate addiction due to chronic pain and was found dead in her home of unknown causes. My volunteer was still feeling grief, she said, and guilt kept pulling her toward the idea that the death could have been averted if she had called or visited her sister.

I wasn't interested in chasing grief and guilt. I was more interested in the vital source of that pain: the love she felt for her sister.

When I asked what she loved about her sister, she immediately became animated. Her eyes sparkled as she talked of her sister's creativity, energy, and inner strength, qualities she admired in her. Yes, she admitted, others saw her as an increasingly reclusive and neurotic person addicted to opiates. Then she began to cry as she said what she really wanted: for her sister to be seen and appreciated as the whole person she really was.

In the conversation, it became clear what the volunteer wanted and needed to do. She wanted to let her sister's life shine—by allowing herself to carry her sister's best qualities forward. Right before my eyes, and the eyes of hundreds of workshop attendees, she was transforming the pain of loss into the energy and growth that love alone can provide.

The woman sought me out later in the day to share her thoughts. "When I volunteered," she said, "I thought I needed help about how to handle my sister's death." She paused and, with a sweet smile and more tears, added "Now I know my real task is how to learn from her life."

How to Deal With the Pain of Loss

There is no typical response to loss; every experience is unique. Nor is there a "right" way to grieve, although there are unhelpful ways of coping with loss. Healing takes time; it can't be hurried or forced. Some people start feeling better after weeks; others need years. In the meantime, here are steps you can take to move forward. It will not always be comfortable or easy, but it will help you to get your life back.

1: Acknowledge loss.

Before any healing can happen, there must be acknowledgement that there's a wound that needs healing. Acknowledge that you have lost someone or something, and it hurts. You are in pain, and it's uncomfortable, sometimes unbearable. To know about a loss, you have to know what was there before the loss. Start with a remembrance of some of the positive experiences that cannot now be repeated.

2: Embrace feelings of loss.

Pain is uncomfortable by definition. Often, we want to push it away, distract ourselves from it with food, alcohol, television, drugs, work—the list is endless. But numbing ourselves from pain numbs our entire existence. We focus all our attention and energy on controlling the pain. But sooner or later, the pain will surface again, and we have to numb it even more. Instead, try something radically different: Embrace the feelings of loss. You may feel hurt, sad, shocked, angry, guilty, anxious, bitter, hopeless, depressed, or all of the above. Open your arms to these emotions. It may help to make a list of them and see if over time you are better able to touch the range of feelings.

3: Expand your scope of vision.

As you open yourself up, look for what else might be there in the form of emotion, thought, or memory, especially things that are unexpected. Include reactions that superficially "do not belong" because they seem positive or confident—feelings of freedom, relief, laughter, pride. Those are normal, too.

4: Prepare to be overwhelmed.

At times, like a surging wave, your emotions will run high, crash down, knock you over, and seem to carry you away. That's normal and natural, especially in the early stages of grief. Sometimes you will feel completely numb, other times irritated by everyone. Your emotions might sway back and forth, but they won't harm you. Measure progress over days and weeks, not a single difficult hour or day.

5: Watch out for unhelpful thoughts.

I should be over it by now. Things will never be the same. Life is unfair. If only I'd done something different. It's all my fault. I'll never get over this. Such thoughts are part of the normal grieving process, but it's important to notice them with a healthy sense of distance. Most often, these thoughts won't appear as "thoughts" but as factual truths about the world that you have to obey. Instead of treating them as truths, practice looking at them as reactions to be noticed, not dictates to be followed. If you catch that you've been hooked, you can unhook: Try singing such thoughts or saying them very slowly. Recognize that they are there without letting them take control over your actions.

6: Connect with what matters.

Despite what your mind may tell you, there's still meaning in your life. There are still people and activities that are important to you. Your pain, in fact, is proof that you're still alive. Recognize that your feelings of loss identify what is close to your heart. Determine what that is so you can identify what is important to you. Use that information to become the type of person you want to be. Your loss can be an opportunity to carry what is most meaningful toward a life worth living. Decide on actionable, concrete steps you can take to put the qualities into action.

7: Take committed action.

After having identified what is truly close to your heart, act on it, so your behavior is guided by your goals and values. It might mean reaching out to other people. It might mean going back to work, or maybe volunteering at a local animal shelter. You get to define what is important to you. And while you are acting on your values, be sure to treat yourself with kindness and compassion.

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