Episode Transcript
[Speaker 1]
Hello and welcome to the Somerset emotional well being. Podcast. My name is Dr Andrew Tree sitter. And joining me this week is Dr Peter Back. Saw to discuss loss and grief. Pizza.
[Speaker 2]
Thank you, Andrew on Dime Peter Back show on the GPS. Some said on I'm also the clinical commissioning group. Mental health leads. So it's something that certainly interested me for many years. Thank
[Speaker 1]
you. And I've been interested in physician health and the health of the health of everybody. Really. But on the health of health professionals, particularly because, you know, Peter, if you ask 100 people how they are, what do they say?
[Speaker 2]
Well, generalised, I'm fine, thank you. Don't mean it, of course.
[Speaker 1]
Absolutely certain fine stands. Fearful, insecure, neurotic and emotionally imbalance.
[Speaker 2]
GPS. There's a danger that if you ask them, they actually tell you what they want. They leave, but how? They just excited the surgery.
[Speaker 1]
But But most of us use denial. If you ask 100 health professionals or mothers or care is or or others how they are, they very often can't answer is so they used in island. So as as health professionals as as carers has as mothers and as many others in life. We actually start by not looking after our own health because we're too, too busy looking after other vehicle
[Speaker 2]
on. That picks up very well to a conversation I was having yesterday with our mental healthy, where we're talking about the mental health of staff on psychiatric wards. And they said, Well, no, they're find they all say We're not going to get it It's fine his patients to get It's not stuff. So denial absolutely runs right.
[Speaker 1]
Interesting, and we have that professionally. But today we're talking about loss and grief, which is sadly, always topical. For many people in life and particularly at this moment, is appears very topical. And I would certainly say my heart goes out to anyone on whose suffering with distress in the moment, because it's it's difficult times,
[Speaker 2]
absolutely. It is always difficult, and you and I both dealt with a very great deal of grief and bereavement over the years. But these seem exceptional times because people are able to use the normal mechanisms that we do to cope with grief. So being unable to see people with great real dying being unable to market in a public way is is makes the already difficult task even harder, I think, don't you?
[Speaker 1]
Absolutely. Is there any way that way we can navigate ourselves through what often seems a sort of a morass of emotions that we we get waves of emotions when something when someone that were attached to has we've lost them all? When something has gone wrong? Is there any sort of regular way of understanding this sort of thing? In your experience,
[Speaker 2]
I think the a way that weakens, divided into different clusters of emotions, could be helpful in making sense of what often seems a a chaotic, conned, never ending process. So you've done a lot of work on this, Andrew, haven't you? So do you want to say a bit about the are recognizing loss, preventing most recurring lost, letting go loss phases. Thank
[Speaker 1]
you. Thank you very much. And I would pay tribute Teoh, Dr Trevor Griffiths from South Devon for for developing something called emotional logic. And you've just given us the four phases that we go through before anything happens where we're in normal phase. And nothing yet has happened on this. These phases, Peter, are not just about losing something that means something a great deal to us, but also about success, because every new change in life, every new birth, every house, move, every new job, every moving on actually starts with lots. So these faith deserve loss, a common to to every every part of life for us and
[Speaker 2]
absolutely sorry. Could I just enter up? Because I certainly heard people say that living is coming to terms with loss. So it's not just the loss of loved ones. It's lots of childhood, loss of youthful, also sometimes health, lots of dark hand. It is absolutely won't through our life is there? It
[Speaker 1]
is in the anything that they say they, the anything was inevitable, really, is that change is always there. So if we understand these phases of change, then it gives us a handle on what's happening. You mentioned four, so the 1st 1 is recognizing that most is actually happening. But of course, what can happen in that point is that we experience the emotions attached to those which are shock and denial on. We all know that rabbits caught in headlights will freeze on. That's a mammalian response to shock refreeze onder. We can't manage to do anything else. So that's the first response that we have.
[Speaker 2]
I think we've always seen that in the current pandemic. Where to begin with way. All for a while. This is something happened a long way away. Won't affect us. Um, let me go. Well, maybe it'll affect some of us, but, uh, this this denial is absolutely a possible Everybody does. I think, Smith,
[Speaker 1]
you're quite right. And as we move through these phases off of motion states, which Trevor actually says these air phases of growth, these are stepping stones to growth. We then try to prevent the loss. We try to prevent the loss of something dear to us Onda Classic emotions. We feel our anger on guilt.
[Speaker 2]
I be interested in your views on those emotions because there's something that we're Selkoe professional. See Onda although there understandable and I've certainly experienced it myself. Um, when people close to me have passed away and I I thought particularly guilty because this doctor I I haven't been able to start their day, but they seem the very negative emotions and and I'd be interested to hear your views on what purpose they serve on how we can get stopped getting stuck in this destructive stage.
[Speaker 1]
Um, thank you. Pizza. Well, interesting. You should ask that question because every emotion actually has a meaning. Andi, it has a purpose. So the meaning just back tracking of shock is I don't know how to cope. I'm doubting my resources. The purpose is, well, stop trying to do everything, find a safe place to review your resources. And if we think about denial in that recognition of the lost phase, denial means, as you were just saying, I can carry on regardless. If I ignore it, it'll go away on the purposes. Just wait for now, keep going for what's important, but moving to those two really important emotions as we start to recognize loss and we want to try and prevent it. Anger is what we've experienced when we want to prevent the loss of something that's important to us on the useful purposes that creative energy, we can actually be used to make changes outside the world, outside, in the world and ourselves and anger transformed is actually creativity. And very often we see that in life, if you can transform that anger than it becomes a positive, useful force, whereas if it remains as a negative, frustrated and, um, emotion. Actually, it corrodes us on the inside. Unfortunately,
[Speaker 2]
yes. And of course, funneling Europe energies into preventing this potential loss can actually stop it happening. In some cases we're talking about. Or even so, by definition, we're talking about situations where that hasn't happened. But we all know a circumstances where people show enormous resolve and courage on anger that gets them through. Otherwise, basically, situations don't pay. Andi, particularly thinking back to some of the wartime stories that come out as this is coincided, would be the day celebrations or memory commemoration, I should say, rather in celebration.
[Speaker 1]
Absolutely. The other strong emotion that we feel that the time is is guilt. And that's an internal emotion of asking. I just did something I do cause it, and we all feel guilty about funny little things in life that have happened in childhood or other times that nothing to do with us. But we ask ourselves that on the purpose is what else can I learn that I could do in future to prevent it happening? And now The interesting thing about human beings is that we have thes these fascinating grains with prefrontal cortex sees, which could conceptualized we can. We can imagine the future. We can remember the past, and we could live in the present. But that human brain is on top of the mammalian brain of emotional and social emotions on the reptilian brain of of fear. And sometimes we default to those aspects of the brain. So at the time, well, every moment of our life, we're asking ourselves little questions. What if that happens? If only really serves? That happens. What if this doctor trusted a stops droning on? Then I could go and have whatever else I need to dio what someone said at the time of high emotion. Peter, what can happen is these little fort get emotion attached to them on day start to circle. And so the little thoughts like, Well, if only I had stayed in London and not moved to Somerset, mortified. What if we lived in Lancashire? If only I'd stopped smoking 20 years ago? What if I had taken one sugar lesson, my tea? If only I had done a bit more exercise what if I visited my mother more frequently. If only the doctors such and such What if What if the medicines that they've bean that they had available? What if they do? So should such an accident set of others Quite interesting at a time of high emotion, these little questions, which normally we just dismiss. They get anger or guilt to touch, at which point they start to circle and they cycle, and they can pester and festive and turn to poison. Which point we either hold this in his guilt or we casting actors. Blame, neither of which is on is a tall first ever. If I used to say in chance of my patients that if anybody if ever you meet. But what if so, the bonus? You've got my full commission to just ask them to go away and give yourself peace of mind because very often this is an emotional phase we're working through. Not a Russian question.
[Speaker 2]
Absolutely. That's a really interesting insight and something we see not just with today's topic, but in ah lot of mental health issues that things like guilt are incredibly important in keeping us safe. Um, people who don't feel any guilt at all, Uh, cause a lot of grief to themselves and others. But it seems that these normal emotions, which are there to be protected if they are taken to extremes, they then become damaging, much like also immune reactions in physical health, where the body is fighting off invaders. But if it gets caught up with it, so you get into this vicious cycle because you describe Onda. We see so many people who get stuff in this hamster wheel of ports that they just can't get out off
[Speaker 1]
on. Our thoughts go after them because it's such a difficult place to bay. So how would we help people be still in themselves? And how would we help them at times? And that sort of a nation,
[Speaker 2]
I think, just by accepting. But what they are experiencing is real. On distressing to them, Uh, you mentioned that Gilles is often about going over things that happened. Onda worry is off today are worrying about things that are yet to happen. So the basic of mindfulness techniques of trying to focus on the here and now live in the moment rather than be living a past that we can't change, I think could be powerful. Do you have other techniques that you find useful?
[Speaker 1]
Emma. I think that's a very good one you've met from lifeless. Should we just do one together a minute piece suit for for anybody who's listening. So as long as you're not actually driving a vehicle, if you're listening or using heavy machinery, we invite you to put both feet flat on the floor to allow your spines to be comfortable and suggest using. Maybe using your nose may be used in math, but using your tummy muscles to take three slow regular rhythmic branch in times and in that process, what we're doing is changing the settings of the bodies engine management system away from the alert and danger setting to the calm rest and digest away from sympathetic drive to parasympathetic dry. I'm just focusing on that breathing could bring us back into the because at a time of distress shock, we catch our breath. Don't wait and we take a sharp intake of breath on Retract that emotion on. It's very interesting that when we get something off our chests weaken, get it off by sorry or laughing Ha! ha ha and the muscles that we use to get something off our chest. Whether we're sobbing, laughing, nothing are actually the same. Now I'm I'm pleased. I'm not making fun of everybody. But inappropriate humor at a time of tension is something that the emergency services and the armed forces and others know very well that works. So it's very curious how we get suffer for Chest.
[Speaker 2]
I think it's medical students. We all develop this rather black humored in bay as we, uh, came face to face with the difficult realities. And it's fascinating what you say about this interplay to visit. Come on emotion. So I absolutely would encourage people to try these exercises. It's it's no area, very New Age nonsense, and they're they're actually, they've shown the changes in brain waves when people meditate or chance for practice mind for this seven day, so their actual real physical things happen inside the brain.
[Speaker 1]
Absolutely. The interaction between mind and body is far more powerful than we know, and just changing our breathing and slowing ourselves down can actually allow ourselves to feel safer. Andi in the face is that we just discussed shock means that we need to find a safe place. Now. A safe place is either a frame of mind on by stealing our breathing, and and you may be using headspace, apple or some mindfulness technique on, we can feel safe. We can feel safe in a relationship with with a lot one with with family or friends or with others all we can feel safe in a particular place. So it's worth remembering, which are worth trying to remember which you're safe. Places are either a physical place, a relationship or a frame of mind. Trying to work on each of those seven you can always find somewhere safe to presence likes challenges.
[Speaker 2]
I think that's really helpful. Would it be useful to look at the next stage of recovery loss? Because again, the bargaining and depression that we experience are really just an exaggeration off normal, day to day emotions, aren't they?
[Speaker 1]
They are, and thank you for asking. So with bargaining on the meaning of bargaining is I must try to do something to get back. What has been lost on the useful purpose is that it gives the energy to take risk to deal with the situation in new ways. Onda. As we know there are three types of bargaining. There's aggressive bargaining, which means I know what I want and I'm just going to take it. There's passive aggressive bargaining, which is a sort of a manipulative way of achieving the same end. And then there's there's a fair bargaining. There's assertive bargaining, which says, Look, Peter, this isn't good for you and this is what I'm going through. How could we work it out together so that we both come out of this as best as possible, actually, minimize our losses on if we are able to us if we're able to state our own needs. And here the other personal him situation, no state there needs, then we can work together, moving forwards. The other admission that we often feel that the the recovering of lost stays it is his depression, and I don't mean clinical depression for clinical depression. Police. Do you see your doctor? It's really important that depression should be treated, but but a flat state of no energy when we just sort of we're oh, what's the use? I haven't got the energy to deal with this and allows us to realize that we may seem empty and powerless, but actually it's important to see what all live it's are so that we don't strive for the impossible. Um, and then when we've worked through the recovery of loss, we can reach that point of of letting go on acceptance. We can recognize that we can't change what's happened. We're powerless over that loss. But actually there are other areas of the human race on. There are other areas of life where Aiken discover my creative talents and where I'm valued where other people value. And the purpose, of course, is then toe rejoin the human race, using energy again to explore life.
[Speaker 2]
And again, it's interesting that you choose bargaining, for instance, that is absolutely something that you do in day to day life. But we're in a situation, unfortunately, where we're facing mortality, there's not much to bargain. When I reminded of didn't if it's depart for Queen Elizabeth as my kingdom for a moment of time. Ah, hey, on depression again, that that's been shown to have some benefits. It feels like completely negative thing, but it does conserve your energy. Onda allow you as you say, that space to reenter life. So although we're maybe looking on these emotions as negative things and things we should move through, do you agree that it's important to acknowledge that they are inevitable stages in going through coming to terms with grief on something that we shouldn't rush to to get out, over or to reject?
[Speaker 1]
I completely agree, Peter Trevor Griffiths says that these are the stepping stones to growth. One of the biggest challenges Teoh not trying to rush it, to be patient with ourselves, to be kind of ourselves. One of the very interesting things that we're seeing at the moment is is how so many people are exhibiting gratitude and kindness in ways that is unexpected. And that's just so lovely to see that the most difficult person to be kind to for many of us as humans is actually ourselves on bond. Whenever there's been a bereavement or or a big event, we always say that we have to forgive it, but we have to forgive three ways. We have two favorite forget, for instance, in the death, we have to forgive the event, the death we have to forgive the other person for going on leaving us, and we have to figure of our cells for feeling the way we do. That final step of forgiving ourselves is actually really quite a a tough one because we'll beat ourselves up. We, whether we should have a stiff up, a little boy's own cry or it's not appropriate to show emotions. Or there are all sorts of cultural issues that that inhibit us on from working through the process.
[Speaker 2]
And I think it's healthcare. Professionals were particularly hard on ourselves only on we have external bodies that are quite hard on this as well, unfortunately, But there is very much this this macho culture on the several doctors have described that that they are very hard to deal with so when they had tried to be kind to themselves and give him some space. Sadly, if you have found, uh, like Adam K, that colleagues would be quite unsympathetic,
[Speaker 1]
it's really so what positive things can help support us. Do you think in, in in re adjusting to life and getting over our losses? What are the important things? Anything.
[Speaker 2]
I think you've mentioned quite a few of them, so being kind of ourselves, incredibly important, giving ourselves time and space to go through these feelings, accepting them rather than beating ourselves up, that were not able to just carry on as normal. I think all of these are very important. Obviously, if we're not able to think that with our own resources, there are lots of organizations I bear. But if you want to go through specifics, but there's a lot of people who help with grief on gloss.
[Speaker 1]
It would be very helpful to mention some of them, if you would, please.
[Speaker 2]
Well, we're setting up a specific breathing service, but I think the easiest thing to remember is that we have to sunset mind line, which is in the current way of social distancing off port of call for anyone suffering any sort of men help the stress. So if you just search, I'm being careful not to advertise particular Search engines here search online for Somerset Mind Line. They're available 24 7 and they indirectly to specific greed counseling services. If that's appropriate,
[Speaker 1]
Thank you and crews do great work. And of course, we for distress. The Samaritans and I am going to Rio advertise here 116123 is a number that everybody should have engraved on their hearts in case of desperation, to be able to wring Thea other things and help us. Of course, coming back to our own resources are excuse me, are finding somebody else to talk to and contacting other people. We've talked about professions, but we get great support from our own friends and also our physical bodies do me to move. So exercise of any sort can help us had process stuff, particularly if we're lucky enough to be able to walk in round a ransom. Nice streets order. There's a nice countrysides somewhere, but time in nature could be very helpful as well as pastimes or hobbies. Any faithful practice that honors our spirituality or anything that connects us to something outside ourselves because when we when we turn in on ourselves, we tell not so. To resolve things so easily is when we when we allow support to come towards us,
[Speaker 2]
I think the other thing about what you said which absolute indoors is the often we have to go through the motions off those things. I see lots of people who used to enjoy same walking take no pleasure in this results at all. Do it anyway, and it feels as though doing the action. Sometimes the feelings Capulet. So it's really important to carry on being acted world, isn't it?
[Speaker 1]
Yes, on that in a calmness, a time of personal turmoil. If we can have some techniques that bring us in a con, then we release any fears and worries and health improves. And maybe in time, happiness could return.
[Speaker 2]
Which takes us onto our last acceptance letting girls loss, which doesn't come here everybody. Andi, a patient, described it to me as not like getting over flu. It's like getting over losing an arm or a leg. The loss is always there, but you learn to live with it. I don't know. That's your experience, Andrew.
[Speaker 1]
Yes, there's a new normal. That's not a phrase I wish it would be using, really. But life is not the same, but it's different. I remember, and my father dropped dead when I was 21. On its takes a while to adjustments, one gets to a point where one lives life as others would wish you to live on a different on, obviously with regrets. But but we move on on where our himself again. If we can keep calm and stay grounded. Life does return since stability.
[Speaker 2]
Obviously it's very much the four in the current crisis. But laws Riemann grief is part of the human condition, isn't there? It is the price we pay for caring as quickly, but so
[Speaker 1]
is the price. We can't pay for caring. And there's Trevor Griffiths would say You can only grieve if you have loved, so we have toe. We have to accept that the price of love is that we will have loss at some level. But far better to have had the love of the experiences.
[Speaker 2]
Absolutely. I think we'd all endorse that it's better to have loved and lost in minutes with love before. It's a price with pain for being humans in it.
[Speaker 1]
Thank you very much, Peter. That's a really exciting conversation.
[Speaker 2]
Thank you very much. Thank you.
[Speaker 1]
Thank you. You've been listening to the Somerset's emotional well being. Podcast posted by Dr Andrew Tree sitter on Dr Peter Bagshaw Show was produced by Rob Huns Music on behalf of the NHS Somerset Clinical Commissioning Group
