Dear Therapist Writes to Herself in Her Grief

Dear Therapist,

I know that everyone is going through loss during the coronavirus pandemic, but in the midst of all this, my beloved father died two weeks ago, and I’m reeling.

He was 85 years old and in great pain from complications due to congestive heart failure. After years of invasive procedures and frequent hospitalizations, he decided to go into home hospice to live out the rest of his life surrounded by family. We didn’t know whether it would be weeks or months, but we expected his death, and had prepared for it in the time leading up to it. We had the conversations we wanted to have, and the day he died, I was there to kiss his cheeks and massage his forehead, to hold his hand and say goodbye. I was at his bedside when he took his last breath.

And yet, nothing prepared me for this loss. Can you help me understand my grief?

Lori
Los Angeles, Calif.

Dear Readers,

This week, I decided to submit my own “Dear Therapist” letter following my father’s death. As a therapist, I’m no stranger to grief, and I’ve written about its varied manifestations in this column many times.

Even so, I wanted to write about the grief I’m now experiencing personally, because I know this is something that affects everyone. You can’t get through life without experiencing loss. The question is, how do we live with loss?

In the months before my father died, I asked him a version of that question: How will I live without you? If this sounds strange—asking a person you love to give you tips on how to grieve his death—let me offer some context.

My dad was a phenomenal father, grandfather, husband, and loyal friend to many. He had a dry sense of humor, a hearty laugh, boundless compassion, an uncanny ability to fix anything around the house, and a deep knowledge of the world (he was my Siri before there was a Siri). Mostly, though, he was known for his emotional generosity. He cared deeply about others; when we returned to my mom’s house after his burial, we were greeted by a gigantic box of paper towels on her doorstep, ordered by my father the day before he died so that she wouldn’t have to worry about going out during the pandemic.

His greatest act of emotional generosity, though, was talking me through my grief. He said many comforting things in recent months—how I’ll carry him inside me, how my memories of him will live forever, how he believes in my resilience. A few years earlier, he had taken me aside after one of my son’s basketball games and said that he’d just been to a friend’s funeral, told the friend’s adult daughter how proud her father had been of her, and was heartbroken when she said her father had never said that to her.

“So,” my father said outside the gym, “I want to make sure that I’ve told you how proud of you I am. I want to make sure you know.” It was the first time we’d had a conversation like that, and the subtext was clear: I’m going to die sooner rather than later. We stood there, the two of us, hugging and crying as people passing by tried not to stare, because we both knew that this was the beginning of my father’s goodbye.

But of all the ways my father tried to prepare me for his loss, what has stayed with me most was when he talked about what he learned from grieving his own parents’ deaths: that grief was unavoidable, and that I would grieve this loss forever.

“I can’t make this less painful for you,” he said one night when I started crying over the idea—still so theoretical to me—of his death. “But when you feel the pain, remember that it comes from a place of having loved and been loved deeply.” Then, almost as an afterthought, he added, “Beyond that—you’re the therapist. Think about how you’ve helped other people with their grief.”

So I have. Five days before he died, I developed a cough that would wake me from sleep. I didn’t have the other symptoms of COVID-19—fever, fatigue—but still, I thought: I’d better not go near Dad. I spoke with him every day, as usual, except for Saturday, when time got away from me. I called the next day—the day when suddenly he could barely talk and all we could say was “I love you” to each other before he lost consciousness. He never said another word; our family sat vigil until he died the next afternoon.

Afterward, I was racked with guilt. While I’d told myself that I hadn’t seen him in his last days because of my cough, and that I hadn’t called Saturday because of the upheaval of getting supplies for the lockdown, maybe I wasn’t there and didn’t call because I was in denial—I couldn’t tolerate the idea of him dying, so I found a way to avoid confronting it.

Soon this became all I thought about—how I wished I’d gone over with my cough and a mask; how I wished I’d called on Saturday when he was still cogent—until I remembered something I wrote in this column to a woman who felt guilty about the way she had treated her dying husband in his last week. “One way to deal with intense grief is to focus the pain elsewhere,” I had written then. “It might be easier to distract yourself from the pain of missing your husband by turning the pain inward and beating yourself up over what you did or didn’t do for him.”

Like my father, her husband had suffered for a long time, and like her, I felt I had failed him in his final days.

I wrote to her:

Grief doesn’t begin the day a person dies. We experience the loss while the person is alive, and because our energy is focused on doctor appointments and tests and treatments—and because the person is still here—we might not be aware that we’ve already begun grieving the loss of someone we love … So what happens to their feelings of helplessness, sadness, fear, or rage? It’s not uncommon for people with a terminally ill partner to push their partner away in order to protect themselves from the pain of the loss they’re already experiencing and the bigger one they’re about to endure. They might pick fights with their partner. They might avoid their partner, and busy themselves with other interests or people. They might not be as helpful as they had imagined they would be, not only because of the exhaustion that sets in during these situations, but also because of the resentment: How dare you show me so much love, even in your suffering, and then leave me.

Another “Dear Therapist” letter came to mind this week, this one from a man grieving the loss of his wife of 47 years. He wanted to know how long this would go on. I replied:

Many people don’t know that Elisabeth Kübler-Ross’s well-known stages of grieving—denial, anger, bargaining, depression, and acceptance—were conceived in the context of terminally ill patients coming to terms with their own deaths. It’s one thing to “accept” the end of your own life. But for those who keep on living, the idea that they should reach “acceptance” might make them feel worse (“I should be past this by now”; “I don’t know why I still cry at random times, all these years later”). The grief psychologist William Worden looks at grieving in this light, replacing “stages” with “tasks” of mourning. In the fourth of his tasks, the goal is to integrate the loss into our lives and create an ongoing connection with the person who died—while also finding a way to continue living.

Just like my father suggested, these columns helped. And so did my own therapist, the person I called Wendell in my recent book, Maybe You Should Talk to Someone. He sat with me (from a coronavirus-safe distance, of course) as I tried to minimize my grief—look at all of these relatively young people dying from the coronavirus when my father got to live to 85; look at the all the people who weren’t lucky enough to have a father like mine—and he reminded me that I always tell others that there’s no hierarchy of pain, that pain is pain and not a contest.

And so I stopped apologizing for my pain and shared it with Wendell. I told him how, after my father died and we were waiting for his body to be taken to the mortuary, I kissed my father’s cheek, knowing that it would be the last time I would ever kiss him, and I noticed how soft and warm his cheek still was, and I tried to remember what he felt like, because I knew I would never feel my father’s skin again. I told Wendell how I stared at my father’s face and tried to memorize every detail, knowing it would be the last time I’d ever see the face I’d looked at my entire life. I told him how gutted I was by the physical markers that jolted me out of denial and made this goodbye so horribly real—seeing my father’s lifeless body being wrapped in a sheet and placed in a van (Wait, where are you taking my dad? I silently screamed), carrying the casket to the hearse, shoveling dirt into his grave, watching the shiva candle melt for seven days until the flame was jarringly gone. Mostly, though, I cried, deep and guttural, the way my patients do when they’re in the throes of grief.

Since leaving Wendell’s office, I have cried and also laughed. I’ve felt pain and joy; I’ve felt numb and alive. I’ve lost track of the days, and found purpose in helping people through our global pandemic. I’ve hugged my son, also reeling from the loss of his grandfather, tighter than usual, and let him share his pain with me. I’ve spent some days FaceTiming with friends and family, and other days choosing not to engage.

But the thing that has helped me the most is what my father did for me and also what Wendell did for me. They couldn’t take away my pain, but they sat with me in my loss in a way that said: I see you, I hear you, I’m with you. This is exactly what we need in grief, and what we can do for one another—now more than ever.

Related Podcast

Listen to Lori Gottlieb share her advice on dealing with grief and answer listener questions on Social Distance, The Atlantic’s new podcast about living through a pandemic:

Subscribe to Social Distance on Apple Podcasts or Spotify (How to Listen)

Dear Therapist is for informational purposes only, does not constitute medical advice, and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, mental-health professional, or other qualified health provider with any questions you may have regarding a medical condition. By submitting a letter, you are agreeing to let The Atlantic use it—in part or in full—and we may edit it for length and/or clarity.