Cambridge Grief Doctor: 6 Things You Must Do To Heal From Grief And Loss | Dr Chloe Paidoussis

0:00People can't think their way through grief. They have to feel their way through grief. Pretending you're okay when you're not okay. Grief is hugely individual because your inner being and my inner being and your families, every person in your family will have a different internal world. Dr. Chloe Paidoussis Mitchell is a world-renowned psychologist specializing in trauma, grief, and resilience. Author of The Lost Prescription, she brings over 25 years of clinical experience to her work alongside teaching counseling psychology and running a private practice in London. What's happening in our brains and in our bodies when we're grieving?

0:36Okay, so grief isn't just about emotional pain. It's also about a mental recalibration that the brain goes into absolute overwhelm. It literally says, no, no, no, that can't be where I've got to go and find them. If you deny it, what you're doing is you're pressing it down. it will build as tension in your body and it will dysregulate your nervous system and it will harm you in the long term. Are there any other tips that you will give people? The strategy is first regulate the body. If you need to rest, rest. Get support, ask for help. So some practical things and really importantly eat to support your grief.

1:15What's the worst thing that can happen to us if we do all the wrong things, sugar, alcohol, full-on denial for a long period of time. I think that's a very important topic you're raising. I'm taking a moment because actually...

1:36Dr. Chloe, who are you and what is it that you do for a living? Yeah, I'm a counselling psychologist and the author of The Lost Prescription. And I've been in this field for more than 20 years. helping people cope with loss and grief but I see grief as a much bigger topic so grief through trauma grief through bereavement but also other types of losses that maybe we don't name as such like a relational loss if you go through a divorce you might lose a really big part of your identity or your role coping with physical illness or chronic illness the kind of loss that that creates in you, cultural loss, all sorts of different losses that people don't really have rituals and don't have named kind of obvious support.

2:24So I tend to work with people from all walks of life, from all over the world that are feeling a little bit lost, a little bit overwhelmed or a lot overwhelmed and searching for a way through, searching for a way to make sense of who they want to be how they want to be what being actually means for them personally so yeah I think that's who I am why why have you chosen this I have lots of reasons one is my own personal lived experience seeing what a traumatic loss can do to really wonderful special people the other is it sort of chose me so in my younger years I used to work in organizational development I worked for BBC News and really got immersed in understanding trauma and the impact of trauma from working a hostile environment on professionals and I loved it and I'd already had a psychology degree and I kind of had an interest in people wanted to sort of do something that felt like I was making a little bit of a difference it's just sort of made sense to me on a soul level and the more I did that the more I remembered that actually I'd love to be a deep deeply immersed clinical person and I went off in my mid-20s late 20s finished my PhD and did traumatic loss but during my training in the NHS I was working with anyone who'd be referred to psychological services so it could have been an addiction problem alcohol problem a depression and anxiety, all sorts of stuff, you know, you can imagine.

4:00And what everyone, almost everyone had in their story somewhere in their life was a loss, was a grief that they thought they had dealt with or they'd compartmentalized it or they just got on with it. They hadn't really had the space to honor it and to reflect on how it's impacted their internal world. And it had leaked out, it leaked out as a sort of mental health problem. So the recovery was less about the psychological disturbance and more about the underlying experience of what it was like for them to be them and what it was like to carry such a grief and that that's how I ended up working in it because I thought there's a there's a lot more to this than we're taught and grief is very very much medicalized I trained in existential psychology so I kind of have an interest in the human potential to thrive through crisis, to keep creating something meaningful no matter what.

4:58I really believe in that and it kind of resonates with me on every level. So seeing that actually there is another way to look at grief that isn't medicalised, it isn't pathology, it's human and we all have it as a shared humanity. Who hasn't been impacted by a loss of some kind? I don't think there's a family throughout time in any culture that hasn't had to live with the absence of somebody precious or that hasn't had the crisis of a really big life change that actually they didn't really want to sign up for that but they had to live with it they had to endure it so it kind of it kind of chose me it's not like I thought right that's what I'm gonna do it came to me I completely agree with you I think this is one of those topics in which we can all relate to in one way or another yeah yeah yeah but nobody's teaching us what grief is or how to grieve like so let's start from those fundamentals in very simple terms yeah what is grief it's it's the mind the body the heart the spirit learning to live with the absence of someone or something that really mattered.

6:12Learning to live life with pain. Does that make sense? It does make sense. But then, as I was sharing with you earlier, my family has just been through an unfortunate loss. And I'm seeing firsthand different family members grieving in a different way. And they all believe they are grieving in the right way. is there a right way of grieving no no i mean yes and no so that might be a bit of a strange answer now i really think that um grief is living with the absence and finding a way to make sense of who you're going to be and how you're going to be but when a family loses a cherished loved one they're not all losing the same relationship they're not all losing the the same bond everybody goes through grief in their own unique way because how you're going to grieve and how i'm going to grieve is shaped by so many different factors like your relationship with yourself your relationship with your life with how you feel you get to be the person you want to be amidst this loss what and who you've lost represents for you, what that bond actually means, what other losses you've suffered, what's happening in your physical health, in your mental health, how you treat yourself, whether you tune into your inner world or you don't, you're a doer, you're not really into sort of processing your emotions.

7:45So there's so much that shapes how each and every one of us grieves that there is no wrong. The only thing that I'd say is fundamentally wrong is pretending you're okay when you're not okay it's being performative being transactional with yourself about it so grief is hugely individual there are there are phases of grief that i would expect us all to go through but how we integrate that how we assimilate that what we make of our internal world is personal because your inner being and my inner being and your family's every person in your family will have a different internal world very personal and if someone is not accepting the loss does that mean that this person is on denial and being on denial is very wrong i think sometimes sometimes um the loss is so uh devastating you're so unprepared for it it's come completely outside the natural order of things as you see them it's unexpected you couldn't have stopped it from happening and you're left with that shocking kind of shattering of your world so you we all live in this sort of forgetful state forgetful in inverted commas of feeling that the world is a safe place it's predictable I'm going to meet the reality I meet every day I know how to cope I kind of you know nothing bad's going to happen to me and that's fine I get that we need that in order to kind of be in a state of equilibrium but when something shocking happens it's very very uh normal to go into a kind of shutdown and into an initial phase of this can't be real this can't be real this can't be real this isn't happening i i can't believe this and actually loads and loads of people describe that to me because the brain takes time to actually keep up with reality and i can explain why that is but um denial initially is okay during the acute stress phase of grief which could last weeks but if you're denying it six months later then we're in trouble because the tension in your body the heartbreak because grief isn't just about emotional pain it's also about a mental recalibration that needs to happen and a physical recovery that needs to happen and a spiritual reconstruction that needs to happen so it's a really big thing it impacts every part of you the whole person and that's what I write about that's how I've created my book like let's look at how it impacts all of us not just our not just our heart and our emotions and um if you deny it what you're doing is you're pressing it down you're pressing it down and pushing it down and it will it will build as tension in your body and it will dysregulate your nervous system and it will harm you in the long term so yeah denial and compartmentalizing too much is not good.

10:47And how do we know if we are on denial? That's a good question. I would say the basic definition of denial is not accepting that this happened, but perhaps another form of denial is occupying your brain with other things. So you don't have to deal with that. Yeah, look, loads of people need to do that to survive. They've got responsibilities. They want to hold on to the scaffolds of their life that feels secure and familiar. And I would never judge that. but if you are in a state of I can't talk about this person I don't want to look at pictures of them I don't want to share cherished memories I'm not going to visit their resting place I'm just going to carry on as though they haven't they haven't died then you're you're in trouble and there is such a thing as a delayed grief where if you keep postponing it it will come out whether you like it or not, at some unexpected time, probably when you're on holiday or when you're feeling run down and tired and start getting physically ill.

11:49Why in those moments? Because I think it would be helpful to explain how grief impacts us physically so that I can answer that question. Would that be okay? So I'll start with how I always start actually. So everything and everyone that we incorporate into the fabric of our life, so it's people, places, routines, responsibilities, just everything, the whole thing, is materially mapped onto the neural network of our brain. So we have billions of neurons. They hold data about important aspects of our reality. So if I ask you to think of your best friend, you can pretty much make a good guess of where they are on the planet, how far away that is from you, and how to make direct contact with them, right?

12:40You'll know. I'll send a text. They'll get back to me in an hour or so. So that information is the 3D map that we have in the network of our brain. And that's the information the brain actually relies on to predict reality. so we wake up every day feeling that the world is in order because the map that i've got in my mind is the map that i'm going to meet in reality nothing unexpected is going to happen so we live in an assumptive world where we just assume that everything's going to be as we expect it to be and we all know that feeling and our brain relies on that for psychological safety so when we've got that all our hormones all our chemicals are like yeah everything's everything fine yeah i'm just having a normal day and we we survive like that because it's an evolutionary thing if the brain had to keep mapping reality every moment then it can never guarantee anything so when a big event happens whether you're prepared for it or not when you're not prepared for it's a lot it's a lot harder it's a lot worse the brain goes into absolute overwhelm when suddenly a really important piece of your scaffold fabric of your reality is not there it wants to locate it in physical time and space it literally says no no no that can't be right i've got to go and find them i've got to go and find bring them back i need to replace this this this reality is intolerable i can't secure myself in this and in those moments you have no choice none at all It doesn't matter how brilliant you are, how supported you are, how intelligent you are, how successful you are.

14:20You have no choice but just to go into survival mode. So reality is not as I expect it to be. Not only am I devastated, I'm also in this visceral, physical state where my brain, literally your nervous system, takes the threat as existential to you. It doesn't assess that the threat was to somebody else. All change like that is colossally threatening. And it floods you with cortisol. So it's that fight or flight, but it's a really, really extensive kind of paralyzing flooding of stress hormones. And you can't stop it. So your logical brain shuts down. Doesn't matter how clever you are. that part of your brain is offline and you find yourself i don't know if you experienced this with what happened in your family but i certainly have you you cannot think straight there is a whole load of physical symptoms that come with a flooding and it is flooding of cortisol adrenaline and noradrenaline and from a psychological perspective we we call that the traumatic response to a sudden loss which is completely normal is completely normal and it will eventually kind of calm down but it can take a quite a long time depending on what stress levels people have how they understand this physicality and the the reality of grief is that it's intensely physical like intensely physical and i'd be really happy to share the symptoms of this flooding if it would be helpful for your listeners.

16:04Before I have a question so yeah if if we are suffering physically mentally due to our assumptions being broken so something happens and it's an unforeseeable event for us and that's really what's you know cutting us by surprise is there any way of reducing this impact or mitigating it to an extent through a preventive measure so maybe shaping our our assumptions of how life it's going to be? It's a really good question. You can't prevent the trauma of losing somebody that you really care about. You can't say, well, I'm so prepared for it. I'm not going to. I'm not going to have this visceral reaction.

16:49It's more about recognizing that the reaction you're having and however it materializes, somatizes in your body is your way of dealing with it, that it's okay, and to have permission, to give yourself permission to go back to basics. And there are two things that people can do to reduce the release of cortisol whilst they're in that acute stress. You can't do therapy. You can't do any processing of anything. You're just going to be in a shutdown mode. so in those instances what I always always recommend to my to my clients and friends and family who go through through horrible losses is drop the breathing it might feel a little bit difficult to do at first I'm not talking about a 20 minute meditation I'm talking about a really back to basics three minutes maximum of intentionally breathing a little bit slower and a little bit deeper than you would normally because that forces you to slow your heart rate and that sends a message through the vagus nerve to your unconscious brain that the threat is dissipating.

18:01And whilst you're doing that, it's also really good. And when I trained in helping PTSD and debriefing people in horrible traumatic situations, what we teach them is try and visualize a symbolic safe space for you so it can be anything you want it to be it can be a magical place it can be a real place for a lot of people it seems to be a somewhere in nature you know sitting by a lake walking on a beach lying in a field you know whatever it is but the idea being that when you slow your breathing down and you visualize as best you can a symbolic safe space for you not happy place safe space what you're doing is you're recalibrating the chemistry in your brain to say okay because the brain doesn't question the messages it gets if it gets a threatening reality it's under survival and under threat if it gets a safe message it says oh all right okay okay i'm gonna calm down a bit so you're not going to get rid of the visceral reaction but you will start diminishing the cortisol and of course simple simple simple things like moving the body gently not going to the gym and you know doing a big weight lifting it's just going on a long walk or or um making sure that you eat like really simply but these are quite big things to do when you're in that state because everything in your system will be slowing down.

19:44So the kind of symptoms that people experience when they're in this is noise intolerant, feeling that they want to make the world a very small place. What does that mean? I don't want to engage. I don't want to go to work. I don't want to go to that family event. I don't want to go to the cinema. I don't want to do anything. I want the world to become a very, very small place. I want to retreat somewhere where I can just survive this. And that can be, you know, quite extreme in some cases where somebody just wants to stay in bed. You know. Is it helpful to talk about the physical symptoms? Yes, of course.

20:24Yeah? So empty pit in your stomach, a hollow feeling, feeling sick, being sick, feeling nauseous all the time, all the time. having digestive issues, finding that you can't sleep, impossible to sleep, finding that your energy levels are just all over the place, not your usual way, not being able to concentrate on anything. So even weeks later, not being able to follow a conversational thread, not being able to do what you would do to relax. so I can't have a bath I'm not gonna watch a Netflix show I can't read but I can't do anything I'm in a complete state of just need to get through this ordeal so many symptoms so many parts of grief that are physical that people don't know about because as you said we're not taught how to live with loss we're just not we're only taught about how to succeed how to achieve even perform and you can't be in a performative state when your body is in so much pain and it is physical pain and you might get aches and pains if you have autoimmune like I do you might find that you have flare-ups might have IBS you might get ill might suddenly find that you have a cold you know all all that stuff and it's incredibly taxing on the on the body and a lot of people will have five days compassionate leave and they need to go back to work and they can feel really panicked that they're not going to be able to keep it together that they're going to feel overwhelmed that somebody's going to put them on the spot and they're going to start kind of crying or there'll be some reminder or that they have lost their talent because they're not able to apply their usual kind of capacity so there's lots shaping what grief is like for people and the in answer to your question of why when you go on holiday because for a lot of people you have to dig really really deep to try and cope with all of that you might have short-term memory loss you might find that you're really irritable you can't process your emotions so in order to get through normal life getting the kids to school dealing with your partners you know all that stuff you're living on adrenaline absolute adrenaline and the moment you stop the real grief starts to happen so it's it's really hard on people and do these symptoms come in at different stages are there different stages of grieving yeah i don't like that word stages because what happens is people think oh i'm going to go through the five stages of grief and then i'm going to be all right what are those five stages well it's the it's the well i don't agree with them okay they don't exist so when elizabeth kubler ross did this research she was interviewing dying people and she used the word stages but she didn't actually mean stages she meant phases and she has published a lot of work since then to say can you stop thinking that it's going to be five stages and you're going to go through your anger your denial your depression and then you're going to be in acceptance it doesn't actually work like that so the if it's a traumatic loss it's very normal to go through the first stage which is the physical which is the acute stress phase of grief and when your body has kind of learned to recalibrate that trauma and sort of has come back to a restorative place then you can start doing your grieving like you can't do bereavement counseling or grief therapy you know two weeks into a traumatic event you have to regulate the body first the mind and the body then you process the the heartfelt experience what's the difference in between stages and phases is it that stages are one after the other they're not no they're not so so the suggestion is that well people have interpreted it because you're desperate for something recognizable that's going to stabilize you and you think okay i'm gonna i'm gonna be all right i'll get through this so people assume that stages mean i'll go through my denial and my anger and my guilt and my depression and i'm gonna be all right but actually it doesn't work like that so you could be feeling all of it in one day so you could start the day thinking okay I'm feeling a little bit better today I'm a bit more available to to my life and to myself and later feel really angry then feel really guilty then feel relieved that you can go home and have a glass of wine you know it's it's a constant what am I trying to say it's a it's a constant recalibration and rebuilding of how you're going to be you now and there are there's no such thing as stages what i can say for your listeners particularly those who are coping with a difficult grief right now is that with the right approach with with the right um opportunity that allows you to it's like allow your emotions to travel through you allow them to be valid they are there because you really care because you love so deeply so allow that to be authentically expressed and witnessed and understood particularly by you in a state of real kind of coherence and compassion and what will happen is you keep feeling these feelings but one what happens you go from one feeling to the next and eventually you will be able to think of your loved one without it being so viscerally painful and there is a transition that needs to happen for everybody for a kind of healthy recovery where you're more immersed in honoring them cherishing them tuning into what they mean and how you continue including them in your life in some way without it being so devastating that you can't you can't bear it you can't cope.

26:26That day does come, it does soften, but it takes time, takes a lot of time. And not all grief is the same. It's not the same thing to lose a child as it is to lose a grandparent, is it? It's not the same thing to, you know, go through a grief when you're also going through a cancer treatment. And the way to deal with those different losses, if we're losing a grandparent or we're losing a child, we're grieving. But as you mentioned, you're grieving in a different way. Does that mean that our solution should be different, the process to grieving healthy? I don't think it's different. I think it's about, I'm taking a moment because actually when something unthinkable happens that you just cannot bear it, it's too shattering.

27:16It's just the world is not a place you want to be in. The impact of that is a profound collapse into a state of fear, into profound meaninglessness, into rage, into absurdity, into kind of like, what is this human condition and why am I here? There's no point. So the crisis is huge. It's really huge. It's very human to find yourself in complete darkness and to want to follow your loved one or to feel like nothing makes sense anymore. You don't really know what's the point. So that is not, there's no solution to that other than to allow yourself to be valid with that, to be human in that and to be witnessed in that.

28:06Something very interesting happens, which is why good therapy works, is when we allow ourselves to be supported and witnessed in that, devastating crisis what happens is we start to see the potential in humanity something happens where we feel held we feel acknowledged and we feel like okay we're not as alone as we might feel and we have got support of one or two really good people and maybe life is a privilege maybe life is a gift doesn't happen for everyone obviously but if you can reach that turning point you can still create meaning out of a horrifically painful situation i see that happen all the time every day every day um but it's recovery is about i mean it's interesting i've written a whole book about it and i still find it quite difficult to put it in one sentence it's about embracing life meaningfully no matter what and that meaning is personal It seems to me from what you're saying that there are no preventive measures to grieving.

29:18We can't help our future selves. Yeah, how is that for you? How does that sound to you? I'm quite a pragmatic and logical person, so I'd like to solve a problem before it happens. I'd like to be proactive rather than reactive. Well, actually, having said that, sorry, I didn't mean to interrupt you. Yeah, of course. But I do think, well, I wouldn't use the word preventative, But I think we can face endings, even unexpected endings, if we feel like we've lived really with a heartfelt coherence and presence and we've made the most of the opportunities that life has given us and the people that are in our life.

29:56I think then you can maybe kind of live with the loss and kind of a little bit more comfort and cherishing what you had. it's when things have gone wrong you know when things are left unsaid relationships end in a sort of toxic way or anything that's unresolved becomes really kind of really big in grief because it comes calling and you're left holding it on your own so yeah there is a little bit of a preventative measure that we can take is to be authentic to be anchored in who who we want to be and how we want to operate in our life and make decisions that actually feel coherent.

30:47And from a reactive point of view, you've mentioned that what you would recommend anyone to do is to validate, to accept their feelings. As well as if you are in a panic mode and you can't cope, you've mentioned that you would regulate your nervous system by slowing down your breath. Are there any other tips or advices that you would give people? There are lots of things that... Can you walk me through some of them? Yeah, yeah, yeah, yeah, I will. So the strategy, if you like, which is how I've structured my book, is first regulate the body. So you've got to really think about how you're treating your body.

31:28So whatever symptoms it's got, don't turn against it. be in a state of appreciation for this body that's actually trying to get through an ordeal so if you need to rest rest don't rush back to work I see so many people rushing back to work speak to your occupational health speak to your HR speak to your managers give yourself room lots and lots of room to you know recover physically get support don't try and be super human which is what a lot of really successful people do i need to be tough here i need to get keep it together ask for help and don't assume that people are going to know what help you want ask for it so if you need somebody to bring you some food let them if you want your kids to be picked up from school let them so some practical things and really importantly eat to support your grief so when we're in that state our serotonin levels drop which is our kind of happiness and joy hormone because the system's gone into shutdown 95 % of your serotonin is produced in the gut not in the brain so you need to eat to support with tryptophan kind of food that's going to help you stabilize from a physical point of view move your body gently get out go go for a walk even if you really don't want to force yourself to go out for a walk it's it's really important just to kind of keep all your systems kind of oxygenated and there is something psychological about just walking through like i encourage people just go out in nature and walk um if you really are in a bad way simple things like um uh put your hands in freezing cold water i know that sounds really weird but it does help activate the parasympathetic nervous system have a cold shower um anything like that and really really i know i feel a bit virtuous saying this but it's not virtue signaling it's just be careful of alcohol and sugar okay when you're in that state because it amplifies all the all the stress physical symptoms so of course people will want to to drink will want to sort of seek some comfort i get it but if you do it too much it becomes a it becomes problematic and it actually delays your recovery um notice your breathing there'll be a lot of shallow breathing that's probably normal but you know remind yourself as often as you can that you need to slow down the system to to change the brain chemistry and do anything that crosses the left right so if you need to do endless housework do it it's fine it's your body needing to kind of regulate itself um for some people that will be uh ironing cleaning hoovering you know stuff like that doing in the garden, anything.

34:39For others, it will be something creative, like painting, crafting, molding. That can be a bit of an outlet. So really back to basics. And overall, it's about giving yourself permission to be in this state of grief. I want to pick on this superhuman aspect that you've mentioned. Being valiant and being strong and tough. I have a different example that I think some people can relate to. So when someone suffers a family loss, you're not the only person that has suffered that loss. So in the case of my family, as I mentioned to you before we started recording, my uncle, the only brother to my mom, passed away not so long ago.

35:25And my brother and I, my twin brother and I always wanted to, or we try to put on an imaginary armor and look serene and strong in front of her and also in front of my grandparents because they've lost their son. Is this the right way of going about it? Because we are grieving too, but in my mind I'm thinking, well, maybe my grief is not as important as theirs because they lost me in the case of my mom a brother and in the case of my grandparents a son. so I'm putting their grief first is that healthy is that the right way to do it I'm gonna throw that back at you what what does your instinct tell you I'll be very very honest because they live in Spain and I live in London yeah I do that when my uncle passed away I was going there quite often two to four times a month but if if I were to leave there and do it consistently for a long period of time I think it would impact my mental health but I got to compartmentalize that role when I was in Spain and then I would come back to London and then feel myself again and then maybe be able to deal with my grief yeah yeah yeah maybe if someone is living in the same city with their family would be different yeah I think that's really wise of you and I agree it's such a it's such a is that the right way in principle I'd say no but in practice I totally understand the intention is to be protective of your elderly grandparents who are going through a horrific trauma later in life so I understand but the the point you make is my grief less than somebody else's and therefore do I need to kind of moderate it it's it's there are too many personal factors to be too prescriptive about it but my understanding is that my experience is that when a family can share grief what it actually does is it deepens the bonds you know and to be in grief together is a profoundly uh regulating thing but i don't know your grandparents and maybe they didn't have the bandwidth to watch your grief i don't i don't judge that but i do think that if somebody is constantly editing their own grief because that's what they feel they need to do to protect their loved ones and eventually that causes them harm there's something about sharing it that is part of the process of healing and then there's another thing that I've experienced from an outsider and I think this is quite useful for people to understand when they're trying to help someone else that is grieving a loved one so in my case every time I see my mom crying or my grandparents crying I would try to convince them with logic about the beautiful things that they have in their life so it's almost like I wanted for them to see the light for them to see positivity yeah am I doing it right there no okay and I don't mean that in a judgmental way but people can't think their way through grief it it's impossible they have to feel their way through grief and to find yourself in the state of crisis and meaninglessness and rage and guilt and all those negative things is actually part of the process of being in grief it's like you have to go into the darkness to find what's going to be the light for you how you're going to keep existing in a world that actually doesn't make sense and isn't what you want it to be you have no control over it so the attitude that actually really helps people heal is to have to meet that fear to meet that crisis with compassion not with logic so we jump on that train so if my mom is feeling anger i jump on the anger train and i mimic that anger no no no no it's not about mimicking it and it's not about jumping on it it's about being present with it without trying to fix it without trying to instruct it or without trying to manage it what does that look like in real life so it's it's really about kind of allowing it to be a valid emotion anger is often very present in grief and it it it has a protective factor to it so if you try if you have the compulsion to fix it which is well intended because you don't want to see your mother suffering you want her to see the good you wanted to kind of get get onto the onto living life without being in a state of crisis and grief but she can't think her way into it so the only way she'll get there is if she can feel like it's okay for her to be angry it's not about becoming angry yourself it's just about being present with it being empathic and allowing your empathy to to create the shared humanity I often explain to people that empathy it comes in three levels have you come across that before so I think it can be helpful for your listeners so notice where you are with your loved ones who are going through a grief and how you show up what being present actually looks like so the first level is your cognitive empathy I get what you're going through I see I'm connecting the dots I understand your lived experience and I'm just going to let you know that I see it it's okay I understand it you don't need to do anything about it you don't need to reassure me with it I'm here with you tell me what's it like so there's a kind of willingness to just be alongside them you can't rescue them which is what a lot of us struggle with second level of empathy is I see it and you know what, my heart's activated and I'm resonating.

41:31So I'm feeling sad. I'm feeling anger. So sometimes it is about mirroring that emotional, heartfelt experience, which creates that sort of like we're really connected. We're sharing something each on our own journey with it, but relating to one another on it. And that level of empathy is really powerful really powerful and bonds are deepened when we can be vulnerable with our people it's not when we're perfect and logical and strong it's actually when we can let our guard down and say look i'm feeling a bit of a mess today and that for that to be okay and the third level of empathy is compassionate empathy or behavioral empathy so i see it i'm resonating with you I'm empathizing with you I'm not leaping in to fix you I'm just with you and I'm going to be with you for as long as you need me to be with you and I'm compelled to do something about it so I'm going to sit here in silence with you or I'm going to hold your hand or I'm going to you know put my arms around you I'm going to let you cry and you can cry all day if you want you know it's that kind Kind of like, I'm just going to be with you.

42:43Grief really impacts our state, our internal state. And it's all about how we be with it, not how we do it. Should we avoid talking about the deceased, naming the person? No, no, no. I think one of the big, big tasks of grief, which I've spoken a lot about in my book, is learning to reconstruct the bond and the relationship you're going to have with a person that's died. So that might be in the way that you love, in the way that you honor their legacy. Maybe you represent their values, the gift of what they taught you in life, what they offered you in life. So there's loads of ways of bringing them in and feeling like, okay, they're not here.

43:29I haven't got them in my life every day and I miss them, but I cherish them and I've got them in my heart. And the thing that I hear almost all the time is that people don't feel okay to talk about their loved ones that have gone. And they want to. They want to, you know, name them and talk about them and enjoy them and laugh about them or talk about what nightmare they were or, you know, whatever it is. But somehow in naming them and talking about them, we're not disenfranchising the experience of having to live without them. We're normalizing it. We're normalizing it, yeah. We're normalizing it.

44:09And in the very first days, if I lose someone within the first 48 hours, 72 hours, what should I do? What should I focus on? There is no way of going through that without it being painful. It's impossible. And what will help the brain assimilate, you know, that kind of alarm, like, oh, the world doesn't actually make sense. well that really big piece of my scaffold has suddenly disappeared and i'm not prepared for it um in the first 48 hours actually exposing your brain to the reality of what's happened helps it literally from a sort of processing so the the rituals we have of sitting if we can sitting with the dead hugely hugely hugely important if you can just to and see the action Yeah, I know that's something like we never talk about.

45:02It's like... So you do recommend people to see the dead body? Obviously, yes. Obviously, if it's appropriate, you know, if there's serious injury or distressing, then maybe not. But every individual is a different case. But yeah, sitting with the dead, talking to the dead, saying goodbye to the dead, if you can do it as a collective with your special people, with your friends, with your partner, with your family, really important. Like we've sanitised death. We hide it. We don't allow it to happen in the home, really. Happens in hospitals. We don't allow our children to see it. We have pretended that we're okay with it when actually we're not.

45:52The rituals that we have, think of it sort of from a tribal point of view, actually helps the brain assimilate it. So the more you can sit in that sort of wakeful state with somebody who's gone, the better for the neural network to start. It's hard. I mean, it's heartbreaking. There's no way of doing it without it being devastating. The rituals of planning funerals is a big deal.

46:26perhaps if you can't bear to see see the body just hearing yourself say it it helps something happens when we hear our it's horrible very very painful but it helps the nervous system and in the medium to long term what what is a daily ritual or a daily thing that we should do that will help us? To check in. With ourselves. Yeah, check in every day. I do that every day. And I'll actually journal every day, but I know that's not everybody's cup of tea. Before you've answered an email, before you've kind of got the show on the road, check in, where am I at today? So I really, really, really think it's very important as part of the recovery, which we haven't spoken a lot about today, is to activate that heart coherence space where because we're in a state of fear with all the kind of low frequency and vibration that comes with that, to heal we need to kind of transition from fear to love.

47:33That's the opposite. It's not hate. It's not dismissing what we're going through. It's learning to be loving to our inner world, to all of us. Even the darker parts of us that are maybe not dealing with this very well, that are acting out, that are, you know, really angry or whatever. All of it to be met with compassion. So when I say checking in, I mean, do what you can to appreciate yourself. And I have a really, really simple way of doing it that the people from the HeartMath Institute have written a lot about. It's taking a moment to check in, slow your breathing down, drop into this area.

48:18Maybe put your hand on your heart like that, maybe like that, maybe like that. If you don't want to do that, do that. Or that. Or that. Whatever works for you. I always do this. Drop your breathing and allow your breath to travel through your heart, in and out, in and out. And as you do that, ask your heart to activate a feeling of appreciation for the human being that you are that is going through a really devastating time. And be permissive. What do you need? What does your heart whisper to you? What do you need today? Because every day will be different. Some days you might have a bit more bandwidth.

48:57You might have traveled a little bit. You might think, okay, I've got a little bit of room today. And other days, you're like, okay, today's going to be one of those days. I need to look after myself. I need to slow down, I need to talk to so-and-so, I need to have a good walk, whatever it is. But I think that's one of the most important things we can do.

49:22I'd like to talk about the neurological and physiological aspects of grieving. Where would you like to start? Where would it be best? I don't mind. so we've briefly covered it but maybe we can we can discuss it through a deeper lens so what's happening in our brains and in our bodies when we're grieving okay so it's what we were talking about earlier so when uh the the remapping is happening so your reality isn't the reality you've got in your brain is not the reality you're actually in um which explains why a lot of people will think i think i feel like i just saw them i think i just saw them and you know crossing the road or i picked up the phone to call them you know the the that's because the brain is on automatic pilot and your neural networks are kind of activating exactly as they always do and meeting a kind of profound absence and it goes into panic mode so that goes on for weeks and weeks and weeks and weeks and weeks and what that means is that your everything else goes into slow mode so you won't be producing as much dopamine you won't be producing as much serotonin you're probably not going to be producing that much oxytocin which is that kind of love bonding hormone so everything is stretched and you will be flooded with adrenaline noradrenaline and cortisol um you can't help that you can't you can't help that that is just a normal embodied the the body reacts to grief in that way and it takes a long time for that to slow down so that's the new the very simple kind of explanation for the neuro physiology of grief and we used to think that there was a lot of data traveling from the brain down to the gut but actually there's more data traveling upwards does this come in waves yeah why um because living with the absence of what once was is is cyclical and you um it's like you go through a cycle of it and then the body recalibrates and you kind of adapt it and then you have to go through it again and then you have to go through it again and as you're doing that you're recalibrating your identity your roles maybe you're recalibrating your relationship with what it means to live with what you believe in with what your relationship is with god with what you make of your relationships now your social realm is impacted your relationship with your health how you look after yourself so you see there are so many aspects to grieving that it it it just comes in waves what you i don't really know why that happens it's just how we how we're designed i suppose to survive if you're in a flat line where actually you're disengaged you're spending all your money you're drinking you're walking out of your relationship you're being really promiscuous being reckless you know anything that is a sort of acting out which can happen to a lot of people um if that goes on for more than 14 days you're in trouble so you don't want to fall into that state of such a profound dysregulation that actually you're gonna you're going to explode your own own life um so it's it's just about having awareness being able to observe yourself with that and asking for support like speak to specialists get get professionals who understand it that can help you anchor yourself and stabilize there's no shame in that when when should we seek professional help it depends on the situation because grief doesn't happen in a neat life does it you know often people are already stressed they're already i mean i don't know about you but i think the world is more stressed now than it feels like it was five or six years ago yeah um the pandemic happened and it had a huge impact and i don't think we're back to normal at all so in my experience everybody's stretched massively so you've already got a tense stressed out nervous system where people are dealing with economic stress financial stress which is actually the biggest predictor of deteriorating mental health you're dealing with relationship stress there's a lot of a lot of families that have gone their separate ways and you know you're dealing with wars you're it's it's not a it's not an easy world to be in there's a lot of illness around a lot um you know one in two people in this country have cancer for example so i say that because grief dysregulates us so much when we're already quite a lot of us are in survival mode you know there's one in five people that's diagnosed with depression and one in six with anxiety so does this mean that then grieving will take us, the grieving process to feel better will take longer because of the world that we live in.

54:42We're so stressed for all these different factors. I think what it does is it's disconnected us and it's isolated us because everybody's in survival mode. And the world, I don't know, maybe this is too much of my own stuff, but I think a lot of people don't have the tribal support that they need, either because they're living abroad. Like I'm away from my family, I'm from Athens. you're away from your family you know um what's the network around our friends really there um everybody's really stressed really really pushed um so it might take longer if you don't access the right support in my experience when you trust yourself to process and allow grief to it is a traveling through you and learning to be with it and be safe with it you'll be all right You'll be all right.

55:37And I've seen it. I couldn't do my job if I thought people don't heal because they do. Even in the most traumatic of circumstances, they find a way through it. The human spirit can do that, but it can't do it in isolation. And it can't do it in a state of judgment and fear. We have to kind of be coherent and compassionate to ourselves. When you say they heal, does that mean that grieving is an illness? No. or the brain no i don't think it's an illness i mean it can be this is a really big discussion in in my world like there are psychiatrists uh the dsm you know the the diagnostic manual um just say that there is such a thing as prolonged grief disorder or complicated traumatic grief and i suppose there are some people whose nervous system is so dysregulated that actually it becomes like quite a quite a challenging mental illness but i wouldn't say that grief is an illness not at not at all i think it's a human state and what's the worst thing that can happen to us if we do all the wrong things that you've just mentioned so sugar alcohol full-on denial for a long period of time a crash what what does that So a mental health collapse.

57:00So it could be a physical illness or a mental health illness. Like it could become an addiction. It could become an OCD. It could become a personality issue. It could become an anxiety. It could become a general anxiety, become a major depression. It can become all sorts of stuff. Now, mental illness and physical illness are connected. connected and when we have our mental health really what we're talking about is we've got our subjective measure of well-being well-being is happiness and I can be happy if certain conditions in my life are met so I can cope with what life's throwing at me if we if we pretend we're okay when we're not okay I don't have that inner certainty that actually I'm okay I can cope with life actually the self I take to bed every night is one that says I'm not coping at all well so that that's a pillar if you like that needs to be stabilized and recalibrated I get to be the person I want to be that's another really important pillar of our mental health well if you're if you're doing everything wrong with your grief you're not going to be feeling inside privately in yourself that you are who you want to be you're going to be carrying a very harsh people are very good at criticizing themselves um version of yourself so you're not going to be feeling happy you're going to be thinking i'm not okay really the world thinks i'm okay but i'm not um the other is feeling like you're making a meaningful contribution to your community whatever that is it could be your your friends it could be your work be your family could be your religious group whatever if you feel like you're okay with what you're contributing and creating that bolsters that's another pillar of your well-being your mental health again if you're not looking after yourself if you're not contributing something that you feel positive and right behind it then you can't really feel good um so there are there are there are other things but i won't go on about it because i think i might be talking a lot but if you the worst thing that can happen is you derail your own potential you don't allow yourself to rebuild you do have to rebuild physically mentally socially spiritually emotionally it's a big thing it's a big thing so we've just discussed about a type of loss or or grieving which is bereavement which for those that don't know what that is is basically grieving someone from death but there are different ways of losing someone oh my goodness yeah you can lose a a great relationship it could be in the form of a romantic relationship or perhaps you stop having a relationship with a parent and you're also grieving yeah yeah how would you advise us to grieve in those circumstances?

1:00:09Yeah, I think that's a very important topic you're raising. And relationships end for all sorts of different reasons. Disagreements, different commitments, fallings out, feeling like you've been in an abusive situation. You know, there's loads of reasons. Being let down, betrayals, you know. So the most important, what would I advise, again, to recognize that whatever grief is bringing up for you is your valid response to it. and if you can be kind to yourself about it and tune in to what it's teaching you, what the gift in this experience is, how you're growing yourself through this, what you're making room for.

1:01:04Because when something ends, what we're left with is a space, a space to create something different, something to welcome something maybe more fulfilling or more aligned or more exciting or whatever. So it's about honoring that, but being true to yourself. A lot of people carry a very negative story about themselves. They don't really think about their relationship with themselves and their inner world, and that's where it goes wrong. Does that answer your question? It does. I was thinking that all of these losses have the power of changing our personalities. And when we lose someone, whether it's from death or we just stop having a relationship with another person, we unconsciously, I think, try to go back to the original baseline.

1:01:58So my definition of feeling fine is feeling how I used to feel before. Is that wrong? You like thinking in right and wrong, don't you, Will? You're not going to go back to being the version of yourself that you were. If you've invested a lot in a relationship and they've let you down and you find that you can't find safety in that relationship and you need to end it, or they've decided they want to end it because they don't love you anymore, you can't go back to being the version of yourself that you were. It's like you have to take that little bit of you and see what it's allowing you to develop in your personality.

1:02:36Like, is it teaching you to be more compassionate to yourself? Is it teaching you to be more aware? is it teaching you to take greater responsibility what is it so it's not wrong but it's just unachievable you can't be the person you were before something really profound impacts you it's like you you i see it as a kind of you you're just adding adding to yourself so your personality evolves i think we get wiser do you agree yeah that's i mean i try to think that i'm a very optimistic person so I was thinking of two different circumstances so on one hand bereavement loss from the death of my uncle and the benefits that that brought to my life and my family and then the loss of my relationship with my living father so for the last 12 years I don't have a relationship with him for very complicated reasons but I found that both losses empowered me or helped me become a better version of myself.

1:03:37So in the case of, for example, my uncle's loss, which I loved and adored my uncle, and naturally I suffered from his loss, from this loss, but also by seeing how my grandparents, my mom and my cousins and my aunt suffered this loss. But through all that pain, my brain was able to see something quite positive that happened to our family, which is that in the past when my uncle was alive, we used to meet a few times a year all together. The family would gather and we would share surface level updates of our lives. So how's work going? Or in the case of my cousins, how's university going? Do you have a new boyfriend, girlfriend, whatever?

1:04:18But now when we gather, A, we gather more frequently and then B, the topics that we open up about are much deeper. So we ask questions like, how do you feel? Are you happy in general? or are you happy with these or that? Which I found that it just connected much more the family. And as you were mentioning earlier, having that tribe feeling, I feel like my tribe is stronger now, unfortunately, through an immense expense. And then in the case of my father, I'm quite young now, but when I lost him, I was actually very young. And what that, I would like to think, made me become is a very strong man and resilient and hardworking and not rely on anything that is not created by myself, which I think those are good attitudes or attributes in my opinion.

1:05:13But again, that was at the expense of a lot of pain and not understanding because obviously, as you can imagine, a father figure or a parent's figure is something that we unconsciously think when we're born that is given for granted and it's going to be with us for such a long time. And then I've learned that at a very young age that that may not always be the case and that not everything is for granted. But that taught me so much that I think it helped me become a better version of myself. So, yeah, I do think that there are tremendously positive things that can come from loss if we allow them.

1:05:47Exactly. I totally agree. And actually, I write quite a lot about that. And when I did my PhD many years ago in my 20s, I'm now 51, so I'm quite a bit older than you. What I expected to find is not what I found. I researched the psychological experience of traumatic loss. And I interviewed lots of people and expected to find a really kind of catastrophic experience. Of course, it was devastatingly painful. But what everybody talked about is that. that through that through that horrendous um loss they had found deeper connections they'd gained wisdom that they never thought would be for them they deepened um their compassion they felt like they were a better version of themselves than they were so they were everybody was able to find the gift in it in some way and that's what I think we don't teach people enough that yes it's going to be painful yeah you're going to suffer but actually if you navigate it's an it's a navigation uh kind of with presence and with kindness and with openness and you get support if you feel like you're totally overwhelmed by it you're going to be you're going to arrive at a point where actually you're going to feel bigger in yourself and better in yourself and in your and in your group it's lovely to hear you say that about your family it's really important i think this is a very good moment to a good way to conclude our our conversation but yeah my last and final question to you is a question that i always ask uh doctor scientists, professors, and it's my favorite question for so many reasons.

1:07:39So I'm looking forward to your answer. So, Dr. Chloe, if you had to compress all your knowledge and all your experience into one essential piece of advice that we must implement in our daily lives, what would it be? Permission. It's just one word. Permission. Permission to be present. permission to be kind to yourself permission to give yourself the to author the story you want for yourself in this life because you can to really tune into what attitude you want to embrace to help you reach your potential to help you be the person you want to be no matter what thank you thank you so much i mean before we finish i'd like to to mention the book that you've written and perhaps I think you know no one better than you to briefly explain it to our audience but thanks yeah so the loss prescription it is written for anyone coping with any loss whether that is loss of health loss of a relationship loss of community loss of a loved one and the way I've done it is I've I take my readers through a process with lots and lots of prescriptions but they're really suggestions that you can pick which ones resonate with you to help you kind of calm the mind the body process what's in your heart and kind of recalibrate and rebuild your spiritual self as well so um it's it's a roadmap to help people just go through grief because a lot of people arrive saying i don't i don't really know how to do this i don't really know what to expect um i thought i'd gone through the stages of grief and actually i haven't and I want to reassure people that if you're going through a loss, a really profound one, the first two years are still really early days.

1:09:34So get rid of the idea that you should be over it by now because it's been a year. And the book, actually the audiobook is doing really well, which is narrated by me, so I'm really, really pleased about that. So sometimes you can't read, but you might be able to listen to it. Just go on a walk and tap into bits of the book that you really need. you can dip in and out of it as often as you like. So, yeah, thanks. What I really enjoy about your book is that it's really a great intersection in between plain English and science. Because you are a psychologist that teaches in Cambridge, so naturally if we think of a book that is written by someone like yourself, we may think that the book is very complex.

1:10:15But your book is actually very simple to read, and for people that are actually, they don't need to have any expertise whatsoever in reading you're just feeling it you're just going through it and and this actually helps you because it's written as i mentioned in plain english but always with an intersection and supporting everything that you're saying with science yes um which i found uh very very useful so thank you thank you so much for coming and i i believe as i'm as we were discussing earlier that this is one of the very very few topics in which everyone will relate to it at some point in their lives.

1:10:49If you haven't related to it yet, you will. Because death is as much part of life as life itself. And this is a topic that we don't talk about, particularly in the Western world. We don't talk about death. We only talk about life. Unfortunately, I envy other cultures like the Mexican culture in which they do talk about the death and they celebrate death because there's no life without death. and I'm very happy that we got to have this conversation because you allowed me and our audience to see death, loss, grieving, bereavement through a different lens which I think is beyond helpful for many people including obviously myself.

1:11:34Thank you. Well, it's an honour. Thank you so much for inviting me.

1:11:44you