This article is from the source 'nytimes' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.
You can find the current article at its original source at https://www.nytimes.com/2020/03/23/well/family/coronavirus-grief-loss.html
The article has changed 29 times. There is an RSS feed of changes available.
Previous version
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Next version
| Version 13 | Version 14 |
|---|---|
| Grieving the Losses of Coronavirus | Grieving the Losses of Coronavirus |
| (about 1 hour later) | |
| When it comes to the coronavirus outbreak, what’s the word related to mental health that you hear most? If you said “anxiety,” you’re not alone. But if you were to sit (virtually, of course) in a therapist’s office like mine or any of my colleagues’, what you might hear just as often is the word “loss.” | When it comes to the coronavirus outbreak, what’s the word related to mental health that you hear most? If you said “anxiety,” you’re not alone. But if you were to sit (virtually, of course) in a therapist’s office like mine or any of my colleagues’, what you might hear just as often is the word “loss.” |
| This may seem obvious, because many people are experiencing tremendous loss as a result of this pandemic: loss of life, loss of loved ones, loss of health, loss of jobs and income. For those who are losing loved ones at this time, there is also the loss of the normal rituals of funerals and communities gathering to grieve together. | This may seem obvious, because many people are experiencing tremendous loss as a result of this pandemic: loss of life, loss of loved ones, loss of health, loss of jobs and income. For those who are losing loved ones at this time, there is also the loss of the normal rituals of funerals and communities gathering to grieve together. |
| But what might be less obvious are the smaller losses that also affect our emotional health. | But what might be less obvious are the smaller losses that also affect our emotional health. |
| As a therapist, I always say that there’s no hierarchy of pain — pain is pain. Suffering shouldn’t be ranked, because pain is not a contest. I believe, too, that there’s no hierarchy of grief. When we rank our losses, when we validate some and minimize others, many people are left alone to grieve what then become their silent losses. The thinking often goes: You had a miscarriage, but you didn’t lose a baby. You had a breakup, but you didn’t lose a spouse. It’s hard to talk about these silent losses because we fear that other people will find them insignificant and either dismiss them or expect us to “get over them” relatively quickly. | As a therapist, I always say that there’s no hierarchy of pain — pain is pain. Suffering shouldn’t be ranked, because pain is not a contest. I believe, too, that there’s no hierarchy of grief. When we rank our losses, when we validate some and minimize others, many people are left alone to grieve what then become their silent losses. The thinking often goes: You had a miscarriage, but you didn’t lose a baby. You had a breakup, but you didn’t lose a spouse. It’s hard to talk about these silent losses because we fear that other people will find them insignificant and either dismiss them or expect us to “get over them” relatively quickly. |
| Right now, in addition to the tragic losses of life and health and jobs are the losses experienced by people of all ages: missed graduations and proms, canceled sports seasons and performances, postponed weddings and vacations, separation from family and friends when we need them most. We have also lost the predictability that we take for granted in daily life: that there will be eggs and toilet paper on supermarket shelves, that we can safely touch a door knob with our bare hands, that we can get a haircut and our teeth cleaned or spend a Saturday afternoon at the movies. | Right now, in addition to the tragic losses of life and health and jobs are the losses experienced by people of all ages: missed graduations and proms, canceled sports seasons and performances, postponed weddings and vacations, separation from family and friends when we need them most. We have also lost the predictability that we take for granted in daily life: that there will be eggs and toilet paper on supermarket shelves, that we can safely touch a door knob with our bare hands, that we can get a haircut and our teeth cleaned or spend a Saturday afternoon at the movies. |
| So, yes, there is collective anxiety surrounding Covid-19, but there’s also collective loss. Here are some ways to help navigate through our losses. | So, yes, there is collective anxiety surrounding Covid-19, but there’s also collective loss. Here are some ways to help navigate through our losses. |
| Although anxiety is unpleasant, it can be easier to acknowledge anxiety than to acknowledge grief. That’s because there are two kinds of anxiety: productive anxiety and unproductive anxiety. We can turn our anxiety into something productive (using our worry to take actions such as hand-washing, social distancing, sending meals to elderly relatives, or calling a neighbor who lives alone) or unproductive (spending all day clicking on the latest coronavirus headlines). Either way, anxiety tends to be active. | Although anxiety is unpleasant, it can be easier to acknowledge anxiety than to acknowledge grief. That’s because there are two kinds of anxiety: productive anxiety and unproductive anxiety. We can turn our anxiety into something productive (using our worry to take actions such as hand-washing, social distancing, sending meals to elderly relatives, or calling a neighbor who lives alone) or unproductive (spending all day clicking on the latest coronavirus headlines). Either way, anxiety tends to be active. |
| Grieving, on the other hand, is a much quieter process. It requires us to sit with our pain, to feel a kind of sadness that makes many of us so uncomfortable that we try to get rid of it. Even under normal circumstances, we do this to ourselves and our children. A child might say, “I’m sad” and the parent says, “Oh, don’t be sad. Hey, let’s go get some ice cream!” In the age of coronavirus, a child might say: “I’m so sad that I’m missing seeing my friends every day” and the parent, trying to lessen the child’s pain, might say: “But honey, we’re so lucky that we’re not sick and you’ll get to see your friends soon!” A more helpful response might be: “I know how sad you are about this. You miss being with your friends so much. It’s a big loss not to have that.” | Grieving, on the other hand, is a much quieter process. It requires us to sit with our pain, to feel a kind of sadness that makes many of us so uncomfortable that we try to get rid of it. Even under normal circumstances, we do this to ourselves and our children. A child might say, “I’m sad” and the parent says, “Oh, don’t be sad. Hey, let’s go get some ice cream!” In the age of coronavirus, a child might say: “I’m so sad that I’m missing seeing my friends every day” and the parent, trying to lessen the child’s pain, might say: “But honey, we’re so lucky that we’re not sick and you’ll get to see your friends soon!” A more helpful response might be: “I know how sad you are about this. You miss being with your friends so much. It’s a big loss not to have that.” |
| Just as our kids need to have their grief acknowledged, we need to acknowledge our own. We tend to mistake feeling less for feeling better, but it helps to remember that the feelings are still there — they’ll just come out in other ways: in an inability to sit still, in being short-tempered (which is especially problematic in close quarters), in a lack of appetite or a struggle to control one’s appetite, in an inability to concentrate or sleep. | Just as our kids need to have their grief acknowledged, we need to acknowledge our own. We tend to mistake feeling less for feeling better, but it helps to remember that the feelings are still there — they’ll just come out in other ways: in an inability to sit still, in being short-tempered (which is especially problematic in close quarters), in a lack of appetite or a struggle to control one’s appetite, in an inability to concentrate or sleep. |
| The more we can say to ourselves and the people around us, “Yes, these are meaningful losses,” the more seen and soothed we will feel. | The more we can say to ourselves and the people around us, “Yes, these are meaningful losses,” the more seen and soothed we will feel. |
| There’s a term to describe the kind of loss many of us are experiencing: ambiguous grief. In ambiguous grief, there’s a murkiness to the loss. A typical example could be a person whose spouse has dementia: you’re still married but your spouse no longer recognizes you. (Your partner is alive but “not there.”) Another might be the inability to get pregnant. (You’re grieving the loss of a child you haven’t yet had.) | There’s a term to describe the kind of loss many of us are experiencing: ambiguous grief. In ambiguous grief, there’s a murkiness to the loss. A typical example could be a person whose spouse has dementia: you’re still married but your spouse no longer recognizes you. (Your partner is alive but “not there.”) Another might be the inability to get pregnant. (You’re grieving the loss of a child you haven’t yet had.) |
| With Covid-19, on top of the tangible losses, there’s the uncertainty about how long this will last and what will happen next that leaves us mourning our current losses as well as ones we haven’t experienced yet. (No Easter, no prom, and what if this means we can’t go on summer vacation?) | With Covid-19, on top of the tangible losses, there’s the uncertainty about how long this will last and what will happen next that leaves us mourning our current losses as well as ones we haven’t experienced yet. (No Easter, no prom, and what if this means we can’t go on summer vacation?) |
| Updated June 22, 2020 | |
| A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| Ambiguous grief can leave us in a state of ongoing mourning, so it’s important for us to stay grounded in the present. Instead of futurizing or catastrophizing — ruminating about losses that haven’t actually happened yet (and may never happen) — we can focus on the present by adopting a concept I call “both/and.” Both/and means that we can feel loss in the present and also feel safe exactly where we are — snuggled up with a good book, eating lunch with our kids who are home from school, taking a walk with a family member, and even celebrating a birthday via FaceTime. | |
| We may have lost our sense of normalcy, but we can still stay present for the ordinary right in front of us. | |
| Although loss is universal, the ways in which we grieve are deeply personal. For instance, one college student who’s grieving the loss of a missed spring quarter might want to isolate in her bedroom, while another who’s grieving the same loss might need a lot of family time. Similarly, one person in a couple might deal with loss by staying hyper-informed and discussing the latest news updates over dinner, while the other might want to binge-watch “Love Is Blind” and not talk about what’s going on at all. For some, the loss of stability leads to a reckoning with mortality, while for others, it leads to a rehaul of one’s closet or stress-baking. | Although loss is universal, the ways in which we grieve are deeply personal. For instance, one college student who’s grieving the loss of a missed spring quarter might want to isolate in her bedroom, while another who’s grieving the same loss might need a lot of family time. Similarly, one person in a couple might deal with loss by staying hyper-informed and discussing the latest news updates over dinner, while the other might want to binge-watch “Love Is Blind” and not talk about what’s going on at all. For some, the loss of stability leads to a reckoning with mortality, while for others, it leads to a rehaul of one’s closet or stress-baking. |
| In other words, there’s no one-size-fits-all for grief. Even Elisabeth Kübler-Ross’s familiar stages of grieving — denial, anger, bargaining, depression, acceptance — aren’t meant to be linear. Everyone moves through loss in a unique way, so it’s important to let people do their grieving in whatever way works for them without diminishing their losses or pressuring them to grieve the way you are. A good rule of thumb: you do you (and let others do them). | In other words, there’s no one-size-fits-all for grief. Even Elisabeth Kübler-Ross’s familiar stages of grieving — denial, anger, bargaining, depression, acceptance — aren’t meant to be linear. Everyone moves through loss in a unique way, so it’s important to let people do their grieving in whatever way works for them without diminishing their losses or pressuring them to grieve the way you are. A good rule of thumb: you do you (and let others do them). |
| Lori Gottlieb is a therapist and the author of “Maybe You Should Talk to Someone.” | Lori Gottlieb is a therapist and the author of “Maybe You Should Talk to Someone.” |