Book Review: Mindfulness for Prolonged Grief; a guide to healing after loss when depression, anxiety, and anger won't go away

Mindfulness for prolonged grief

What was called Complicated Grief, has now been termed Prolonged Grief. For when you are still grieving, months after a loss, incapable of living your best life, it is time to get some help. It makes so much sense to me. While my mother died 6 weeks after I moved to care for her, the trauma I experienced caring for my late father led to many symptoms of PTSD. Seriously. I've seen many families speaking to this on Canadian Virtual Hospice. They cannot forgive themselves, or cannot get over their grief. For me, I spent hours wondering if I did enough, made the right decisions.

This is an excellent book! It incorporates a lot of the techniques I've come across during my own recovery process, as well as those I've used in my teaching practice, in order to relax my students, and focus their minds (Meditation, relaxation, belly breathing, etc.).

How do you know what treatments you need? 

See you healthcare professional. Try treatments. If they do not work, stop. I've found that long-term antidepressants work for me. I've also found that therapists help, too. It is my belief that we need to know what is normal, and what is not and, therefore, when to get help. If we are in the depths of mental health issues, reaching out may be impossible, and it is up to family and/or friends to be able to determine when to intervene.

We all experience loss

This is an excellent self-help book for those who seek to improve their mental health, as well as their physical health. It came at just the right time for me. The loss of my ex-husband brought back a lot of old issues. My 2nd husband's surgery, and my work as caregiver, brought back issues and some of my anxiety symptoms, as well as new ones, while fretting over hubby's care. I was having chest pains, triggered by anxiety, and talk of wills, legal issues, and my divorce decree. Directly related! (But I did go to hospital to have it checked out.)

We know that bereavement (the state of having lost a loved one), grief (your feelings)  and mourning (the rituals of bereavement) are separate things. There is a complex grief and grieving process. I must say that after my father died, I experienced a number of these symptoms. I mentally revisited the sights, sounds, smells of his long-term care room with horror, triggered by other smells. I now realize that I needed to give myself permission to heal after caring for my mother and father. It wasn't just one event, but months of worrying about what I needed to do, being afraid of not doing enough, or doing the wrong thing. I was unable to concentrate at work, to make decisions about curriculum, or interact with my principal. She didn't understand my issues, and I ended up taking leave. Then, the bank decided my father was dead, he wasn't, mom was, and closed his bank account. It was a difficult time.

Excellent charts

Kumar says, One of the most consistent experiences people share in grief are the “supernatural” ones. This is very different from depression criteria. People do very often have visions, sensations, and experiences they struggle to explain, and often attribute them to their deceased loved one or loved ones. 

I can identify with this. You need to know that this is normal and can be comforting, rather than frightening.

We know that a combination of CBT and drugs work best (Cuijpers et al. 2009). It takes discipline, and mindfulness. The book is truly a way of doing your own Cognitive Behavioural Therapy, if you cannot afford, or do not have access to professionals. I used my Employee Assistance Program (EAP) each time and found that talking to professionals helped.

Your healthcare professional is the person to talk to, but if you can ameliorate some symptoms using CBT, Mindfulness meditation, traditional or Complimentary Therapies (i.e., massage, Reiki) , this book is for you. These solutions (Mindfulness) work well in conjunction with medication. Sometimes it is about immediate Mental Pain relief, rather than Physical Pain Assessment and management.

The well of grief

Excellent chapters:

1. Identifying your grief - important noting your symptoms (create a medical journal)
2. Mindfulness meditation – I've tried meditation and it didn't take! Deep breathing exercises may be for you. (Meditation, relaxation, belly breathing, living in the present moment.)
3. Mindfulness of the body – (Grief is stressful; fight or flight leads to hormonal responses)
4. Sleeping mindfully – good points on sleep hygiene; Sleep Induction, Sleep Hygiene, Dreaming, Journalling.
5. Mindfulness in motion – I prefer walking meditations, but included are Body Scan Techniques and Progressive Muscle Relaxation. 
6. Mindful sustenance – Eat well, eat mindfully, healthy food choices.
7. Mindful cleaning and decluttering – Sweeping, vacuuming, decluttering mindfully.
8. Transforming pain – Compassion, Random Acts of Kindness, reaching out, forgiving. 
9. Creative action – Spiral Staircase of Grief (essentially around death dates, some call it being in the well of grief. Celebrate their day of birth, not mourning on the day of their death.
10. Mindful resilience – Take charge, set goals, track your progress, draw, listen to music, celebrate your life.

The book fixates on the US healthcare model, whereby people only get insurance plan funding if their mental or physical issues can be properly labelled according to the DSM ( DSM-V –Medicalisation of Grief).  In Canada know that we can access healthcare no matter what. We need not pay up front, then fight to have our insurance reimburse us. (You can read more by Dr. Kumar here: removal of the bereavement exclusion). Or in a blog post following the release of the updated DSM-V, “Grief Over New Depression Diagnosis.”  Others worry that physicians will refuse to prescribe medication, even if it is perhaps necessary.

The DSM, since they are looking for labels and a diagnosis, may frighten those with the symptoms of Prolonged Grief (see Identifying Your Grief). Illumination, shedding light on mental health issues, helps us all. (Cancer in your family). It is crucial to get the right help.

Sameet Kumar, PhD, is a psychologist at the Memorial Healthcare System Cancer Institute in south Broward Florida, who specializes in working with end-of-life care and bereavement. He is a skilled writer who blogs regularly about his work applying mindfulness with the dying, and the author of the best-selling Grieving Mindfully: A Compassionate and Spiritual Guide to Coping with Loss, and the newly released Mindfulness for Prolonged Grief: A Guide for Healing After Loss when Depression, Anxiety, and Anger Won’t Go Away.

My late mother's celebration

Lots of good research out there:

Cuijpers P, van Straten A, Warmerdam L, Andersson G. (2009). Psychotherapy versus the combination of psychotherapy and pharmacotherapy in the treatment of depression: a meta-analysis. Depression and Anxiety 26(3):279-88. (Full record)

Cuijpers P, Donker T, van Straten A, Li J, et al. (2010). Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies.Psychological Medicine 40(12):1943-57. (Full record)

Book Review: The Brain Bible: stay vital, productive, happy, healthy

Cats know how to sleep!
So does hubby!

I have been sent a book for review. I'm dubious about such things such as, "How to prevent

Healthy eating!

dementia."  It's much more than simply doing brain exercises to prevent a biological symptom of various diseases. However, this book includes strategies for living that will improve your life, keep you healthy and active, both mentally and physically, if not preventing death!

  One of today's leading experts on brain health, Dr. John Arden tells it straight: there is no single remedy for maintaining “sharpmindedness” into old age. Nor can we prevent dementia, but we can learn how to interact and live our best lives no matter our situation.

Neuroplasticity of our brains

He has done his research, for we know that our brains can be changed, if we change our behaviours. Just as we know that stopping smoking, for example, allows our lungs to heal and overcome the toxins smokers inhale. We know how complex our brains are, and that while toxins can cause cancer cells to grow, remember that some develop cancer through no discernible factors at all.

brain function
Frontal lobe, robbed of oxygen,
cannot function.

Truthfully, this isn't so much a brain book, as a bible for healthy living. There are many myths about body and brain, and people who are jumping on the self-help band wagon, but it does boil down to healthy eating, exercise, living and loving well, and sleep hygiene.

What I find comforting, in reading this book, is that as we shift from middle age into old age, is that we need to keep sharp in different ways than when we were employed, and to keep active in different ways.

ISBN: 9780071826549

Price: $27.95 CDN

This is why I continue to read and write, and blog about life, love and joyfulness. We know that in 1950 we could expect to live to live in the USA until about age 68, and in 2002 life expectancy was around 77 years of age. What are we going to do with these additional years? Life and living in our later years must be meaningful, in a different way.

If you are interested, as am I, in understanding our bodies, this is a good book for you. It explains the biochemical reactions in our brains as we age. It breaks down the research, and writes of the neurochemical changes that age brings. We can expect that our bodies wear out in certain ways, and we cannot necessarily prevent disorders, but we can do everything in our power to keep sharp by being active, volunteering, and paying attention to issues like cholesterol and diabetes. 

Brain research

The aging brain does change, despite all these ideal habits. Neurotransmitters and the neurochemistry of aging brains means that there are more mutations, neurons shrink, we lose myelin, and synapses. In our teenage years, we are creating synapses, and learning how to learn, forming neural pathways, which are later pruned in adulthood. In our later years, we develop and strengthen these old pathways. For example the brain uses some of the same pathways to process music as we do math. This is something I learned whilst doing action research for my classroom curriculum. In older age, we may not be able to prevent senile plaques and neurofibrillary tangles (which prevent blood from getting to the part of the brain which processes abstract thought). Be rest assured that healthy, active older adults develop issues, which cannot be prevented, but we can play our cards right by healthy living. 

PET scan shows brain function.
New information.

When my students would ask why we were learning algebra, for example, I'd tell them we were building dendrites to make all learning faster, better and easier. For those who eschewed math, or for those who complain about what we teach in elementary school, remember you are building better brains for old age. 

Activities for healthy living

Dendrites connect the brain cells, allow us to 'think.'
They cannot function if they are blocked by plaques.

Dr. Arden has broken down the vast amount of confusing and sometimes conflicting brain data into the five crucial “Brain Bible” factors to be mindful of:

• Education - Read and keep your brain active
• Diet - What you eat and drink directly affects your brain health
• Exercise - Starting a fitness routine is simpler than you think
• Relationships - The love of friends and family has a strong healing power
• Sleep - Get enough, but not too much, sleep

A few samples of Dr. Arden's tips for improving brain health include:

• Drink water even when you're not thirsty
• Take the stairs instead of the elevator
• Laugh a lot
• Don't drink alcohol before going to bed
• Eat fish at least twice a week

homemade meatloaf

About the Author

Dr. John Arden is the director of mental health training for the Kaiser Permanente Medical Centers and oversees one of the largest mental health training programs in the world, operating in 24 different medical centers throughout Northern California. He also practices part-time at Kaiser Permanente in Petaluma, CA and San Rafael, CA and for several years has been the chief psychologist at Kaiser Vallejo. He has written several successful books, including the bestselling Rewire Your Brain, as well as Brain-Based Therapy for Adults and Brain-Based Therapy for Children and Adolescents. For more information, visit drjohnarden.com.