Grief Psychologist: The Truth About Loss That No One Teaches You! - Dr Erin Hope

0:00Alberto Zandi: Grief is not a mental health condition, it is a human experience.

0:03Dr Erin Hope: Why do you think we're not very good at grieving?

0:05Alberto Zandi: As soon as you talk about death, you are acknowledging that you are going to die, and there's a real desire to not even engage in that level of thought. Which is so fascinating, because it is the one guarantee. If you look at the sympathy cards, it's all black and white and vanilla, and not representative of some of the language people might be holding. It's one of the reasons at the Lost Foundation we created our own sympathy cards that say things like, fuck, this is really shit. Dr. Erin Hope Thompson is a world-renowned clinical psychologist and founder of The Loss Foundation, a bereavement charity dedicated to supporting people through grief and loss.

0:41Alberto Zandi: In 2022, Erin received an MBE in recognition of her commitment to supporting bereaved families through her clinical psychology practice and her leadership in the field of grief and loss.

0:50Dr Erin Hope: If I'm losing someone and you lose someone, are we going to grieve in the same way? You don't get a choice.

0:57Alberto Zandi: It's not like something happens and you choose, this is how I'm going to respond. Avoidance is a wonderful short-term strategy. If I was to always avoid that emotion, emotion's still in there, right? If we think of ourselves like hydraulic systems, that pressure is just building in the pipes. And if I don't turn that tap on and make room for emotion somewhere at some point, that pipe's going to burst somewhere else.

1:19Dr Erin Hope: What is one message that you want a grieving person to hear today?

1:30Dr.

1:31Dr Erin Hope: Erin, who are you and what is it that you do for a living?

1:35Alberto Zandi: So I am a clinical psychologist and I work in the NHS, the private sector and charity sector. And I am the founder and CEO of the Loss Foundation, which is a national cancer bereavement charity. And so although I work across a range of mental health, bereavement is very much one of the areas I specialize and enjoy kind of working in and supporting.

1:58Dr Erin Hope: Why bereavement?

2:00Alberto Zandi: Bereavement shows me, you know, like most people who set up charities, it came from a personal experience. And my dad died from cancer when I was 22 years old. And he had great support during his journey with cancer. But it was kind of shocking to see how little support was there for those left behind when he died. And about a year after he passed away, you know, my stepmom was struggling. She had therapy and she had family and friends. But she was saying to me, you know, where do I go to speak to somebody else who's lost their soulmate? I need to know how to get out of bed. You know, I need to speak to somebody else who's been through something similar.

2:35Alberto Zandi: And I was starting my career in psychology. And I said, well, I'll find the place and, you know, give you the info. And the obvious long story cut short is that there wasn't any organization directly supporting cancer loss. and that was the starting point of me sort of venturing into that and developing it over time.

2:52Dr Erin Hope: And what did you study? What did you work on that equipped you to become a subject matter expert in the field?

2:59Alberto Zandi: A lot of expertise comes from experience, you know. So, you know, I'm trained as a clinical psychologist, which means I'm trained in lots of different psychological approaches to all mental health disorders or conditions or difficulties. But grief is not a mental health condition. It is a human experience. And so much of what I have learned about grief is through running the Loss Foundation and supporting people grieving over the last 15 years. You know, we've been able to see what's really common in grief, what's really normal, and also what's needed in helping people manage it, survive it, look after themselves, you know, whilst they're navigating it.

3:35Dr Erin Hope: In very, very simple terms, imagine I'm a 10-year-old. What is grieving? What is grief?

3:42Alberto Zandi: So grief is a response to losing something that you are attached to. You know, sometimes that is a person, but it can be other things, you know, the end of a relationship or losing a job or losing part of your identity. Grief is a response to that loss. And most people, when you think about grief, most people are going to think of the word sadness. It's sort of the number one thing that comes to people's mind. And that would be fair, but it's incredibly broad. Grief typically comes with a whole range of different emotions and even physical experiences in your body, different behaviors, different ways of living.

4:18Alberto Zandi: So typically when someone's grieving, they would find it consumes most areas of their life for a period of time.

4:25Dr Erin Hope: Do we grieve in the same way for the same reasons? As in, if I'm losing someone and you lose someone, are we going to grieve in the same way?

4:35Alberto Zandi: No, no, it's incredibly rare. Even when I support families who've lost the same person, inevitably every single member of that family is going to grieve differently because we're different individuals. You know, we're made up of our own personalities, our histories, our experiences, our social circles. And all of these things mould how somebody responds to grief. And so it's incredibly unusual that people would respond in exactly the same way. And I think people get confused about that because sometimes there's the expectation that it'll look the same or, you know, why are they responding differently to me?

5:13Alberto Zandi: And it can create, you know, complex or conflicting family dynamics, but it's very rare that it would ever be the same because we're all different people.

5:20Dr Erin Hope: Yeah, I've recently lost a very close family member and it was very interesting for me to see how within my family, every single family member was grieving in a totally different way, but completely different. And for me, that was fascinating. And I just wasn't sure who was doing it right. And when I mean right, in a healthy way.

5:43Alberto Zandi: Right.

5:44Dr Erin Hope: Is there a right way of grieving?

5:46Alberto Zandi: again I would say no there's some caveats to that you know important for anyone listening having any kind of grief response you know you're not doing it wrong you don't get a choice it's not like something happens and you choose this is how I'm going to respond often that is a reflex that is not something you choose and often that's a survival mechanism you know some people need to go straight into denial or shock or something that prevents them from being up close with the sadness or the emotion. But that's not necessarily a choice. That's just your body and brain's reaction to an absolutely life-changing, potentially traumatic situation.

6:28Alberto Zandi: But somebody else might not get shock and might feel themselves, you know, absolutely bulldozed by emotion immediately and being able to access that. Neither of those are right or wrong. They are just different human responses. The one thing we sometimes keep an eye out for is avoidance over the long term. Avoidance is a wonderful short-term strategy. If that feels really painful, I'm going to try and not think about that or dwell on it or look at it because that's what helps me survive of my day. It makes perfect sense. However, if I was to always avoid that emotion, sometimes we use the analogy, the emotion's still in there, right?

7:10Alberto Zandi: If we think of ourselves like hydraulic systems, that pressure is just building in the pipes. And if I don't turn that tap on and make room for emotion somewhere at some point, that pipe's going to burst somewhere else. And so sometimes we see that. If I haven't made room for this, it's going to show itself somewhere. So I would be mindful of avoidance of grief in the long term but how you respond in acute moment is

7:33Dr Erin Hope: often not your choice but what is the purpose of grief in our lives is it to stop feeling the pain

7:40Alberto Zandi: is it to grow as a person great question it's the point of grief is to to process you know something that is life-changing you know it is the strength of your grief is really the strength of your love, it means something. The reason it hurts so much is probably because of how much this thing or person meant to you. And it is a human experience. And what we're invited to do as humans is have expression. And so grief is inviting you to express your thoughts, your feelings, your experiences, not necessarily to not have it anymore, but to be able to live a life that's worth living whilst I'm still carrying my loss.

8:24Alberto Zandi: So grief doesn't have an end point. It's not like I can get that done and tick it off. But there are things that we can do to help us navigate such a challenging psychological, emotional situation so that we can still live life and have joy whilst carrying grief with us.

8:42Dr Erin Hope: Is there a totally wrong way of doing it? Because I feel like if for me grieving is a process and if you don't go through the process which there are some very bad moments in that process you you will feel very bad at some point in the future without knowing where this is coming from it's almost like you're patching a wheel that is broken rather than fixing the whole wheel or changing it all together how should we process this?

9:14Alberto Zandi: Think about grief as well. What I'm thinking about whilst you ask that is there are so many different types of grief and often it's not just the loss of someone that someone's processing. Probably that's the point they're processing all the things that happened prior if it was a long illness, you know, like cancer or Alzheimer's. You know, while you're going through something like that with someone, there's no time to process that. Often you're in survival mode, let's be positive, let's follow the, you know, medicine routine or whatever it is. But what we often see then when grief hits, if that person dies, that is likely the point that you're also processing so much more.

9:53So grief isn't just about someone not being there, it's likely incorporating

9:57Alberto Zandi: a whole butterfly effect of losses, including, you know, well, how am I a daughter if, you know, my dad's not there, am I still a daughter? Do I still have a dad? You know, impacts identity. And And so there is so much to processing grief, which will be impacted by the type of loss. And, you know, there's something about making room for that. But not everyone does that immediately. Some people do. We sometimes have people come to the Lost Foundation 10 years down the line. And they might say something like, I had young kids. I had to look after my kids. I couldn't make room for this. But now I need to.

10:35So we try not to put a time point on it, but recognize it'll look different for everyone.

10:40Alberto Zandi: When we say wrong or unhealthy, the only thing I'd be really mindful of is sometimes when it's incredibly painful, people turn to relying on drugs or alcohol or behaviors that ultimately will only make them feel worse. And of course, the recommendation is to try and limit and avoid and reduce any behaviors that are keeping you really unwell or stuck in avoidance or, you know risking your own health and safety i think there are different i completely agree

11:06Dr Erin Hope: with you there are different forms of avoidance and if we take the loss of a of a partner not due to death but splitting in the partnership i've seen a good friend of mine splitting from a very long-term relationship which he loved he adored his his partner and he in my opinion avoided confronting the grieving stage, the grieving process by going out and meeting multiple new short-term partners in a very short amount of time. Is that the wrong way to go about it? Because I think there's another school of thought that says you need to sit in with your feelings, with your emotions, let them run inside of you.

11:49Dr Erin Hope: And then at some point you will make sense of them rather than avoiding them, pushing them down and and sort of occupy your mind with other things in the case of my friend going out meeting other girls yeah i'd be mindful of using the right or wrong terminology it's a little bit

12:05Alberto Zandi: too black and white again because it almost ignores individual factors you know it one theory would be actually you know sit and be with this before trying to put the plaster on right um but actually again that might not be something somebody's able to do maybe actually there's a seeking of pleasure. Because I feel so awful, I'm going to seek things that make me feel good because this is too much to handle right now. Is it wrong if someone needs to try and find some joy somewhere? Or is that a survival mechanism? Again, I think it becomes a bigger issue when it's avoidance in the long term. I never look at this and I'm always just seeking pleasure and avoiding pain.

12:45Alberto Zandi: Because I would argue if you avoid difficult feelings, I'm not sure how possible it is to reach positive feelings in their fullness because a life fully lived means we have to experience both ends of that spectrum fully if we just try and seek the positive but we don't ever look at all those difficult things we carry i'd argue those are the things that are keeping you quite stuck and making it hard to fully experience the other side yeah we can't experience a good day or define what it's a good day if we didn't have a bad day yeah i think this point

13:17Dr Erin Hope: that you're making is very important for everyone to understand including myself because when someone is grieving whether it's in the case of my different family members the loss of this case it was my uncle the brother of my mom the only brother my mom had we've seen each and every single family member grieving in a completely different way and some family members like sort of behind each other's back they were like not judging but commenting not in the most positive way the way this other family member is grieving and they're and they say things like they're not grieving in the right way they are ignoring it and and then vice versa the other family member would feel the same and i think this happens quite often also my friends when they saw this other friend that i've just mentioned that he was in a very long-term relationship grieving in his way going out and so on there was a group of friends that were like you know secretly judging him like you shouldn't do that you are avoiding it like you're not being strong enough to confront your feelings But what you're saying is there's not a right or wrong way of doing it.

14:22Dr Erin Hope: It's how each of us individually want to process it.

14:27Alberto Zandi: Yeah. And, you know, what each of us of individuals have the capacity to go towards in any one moment. You know, somebody might have the ability to go towards difficult feelings, whereas for somebody else, that just feels too hard to do right now. I don't feel like I've got the resilience right now to do that. And I could push myself, but actually I just don't feel like I can right now. You know, one way we sometimes invite people to look at grief, and this is relevant for all types of loss, is through the lens of something called the dual process model. It's quite a simple model, but I think it's really helpful, which is inviting people to recognize that when we're grieving, we're oscillating between being with loss, so processing like we're talking about now, or we're in a space called restoration, where I'm trying to live my life.

15:14Alberto Zandi: I'm trying to engage in things that bring me joy. Now, what's interesting about this theory is that you're invited to make room for both of these things. If I was to just sit in processing all the time and just think about grief and dwell in it all the time, I'd probably be really depressed and it'd be hard to get out of bed. But equally, if I was to sit in restoration and avoid all of that loss and never sit with that, again, we'd see it showing itself somewhere else. So the invitation is kind of to make room for both, but people oscillate in different ways, much like within your family. People doing it differently, and the risk there is the narrative of, oh, why are they still crying?

15:55Alberto Zandi: Why are they still this? People oscillate differently, and I don't think that's the issue. The issue is when we don't respect that people do it differently. And if actually even within families we were to recognize it's normal to do it differently, we can encourage making room for both. but it is okay to be different then we could soften some of the dynamics rather than you're doing it wrong

16:23Dr Erin Hope: I'd like I'd like your take on a different example that I have so another friend of mine she split from a long-term relationship from a person that she thought she would marry and she would have a life with and kids and the whole thing and I think the way that she put herself together was by embracing spirituality and i've seen that also happen in other people when they suffered the loss of someone in the form of death and they embrace a different religion that they were just never religious but they embrace religion it's a way of giving them purpose

17:01Alberto Zandi: do you think this is healthy i think anything that helps you navigate grief process find peace find connection to your loved one is healthy and it's you know religion is one of the things that does that for people or spirituality either because there's a belief that that person is at peace or we will meet again or i can connect to them through prayer or spiritual or religious practice. And when people have that, I'm always really pleased. What a beautiful thing to hold and think about and connect to. And for some people, they find religion or spirituality after a loss. For some people, they lose it.

17:42You know, I believed in God, but then this happened.

17:45Alberto Zandi: How could this happen? You know, how could God let this happen? And so, you know, that existential kind of crisis can happen or, you know, a deeper connection to religion or spirituality. anything that helps you in that sense connect to your feelings and connect to your your lost person wonderful you know I absolutely don't want to take that from anybody and then sometimes we don't know

18:10Dr Erin Hope: that we're grieving and we just can't determine it yeah but then we have maybe mood swings or yeah mood swings or we're just low in energy but we don't know that that's due to grieving not because maybe that grieving is not an obvious one like a death what are the physical or mental

18:29Alberto Zandi: symptoms of grieving yeah so that can show you know grief can show itself in lots of different ways cognitively you know physiologically so most commonly people will describe you know a foggy head i can't think straight trouble concentrating trouble remembering things you know even if you used to be fantastic at that. Cognitively, you can have a real confusion. Physiologically, you know, anxiety is typically the thing that shows itself. I'm getting heart palpitations, I'm getting sweaty, fast hearts, you know, dodgy tummy feeling, you know, because grief and anxiety actually go very closely hand in hand.

19:10I might be worried about the safety of other people or

19:13Alberto Zandi: other bad things happening. And so sometimes it creates a bit of a hypervigilance or being hyper aroused or alert. And then the other thing that we have is memories, right? So if you have seen someone die or being unwell, or even if a relationship has ended and that was a really traumatic conversation, one of the most common experiences in grief is flashbacks and intrusive memories. I'm not choosing to think about it, but it's just punching me in the face. and I can't get that out of my head. It's one of the most common symptoms of traumatic bereavement especially, but it's one that you don't often hear about, right?

19:51Alberto Zandi: And if you look up grief on the internet, you're not gonna see that symptom, but it's one of the most common ones. And so one thing we hear a lot is people feel like I'm going crazy. I'm just not myself. I just don't feel like myself. I don't feel well. I've not got an appetite. I'm not remembering things. They might not know that's grief. They might recognize it is, But sometimes people just think they're going mad or having a mental breakdown. Whereas all the things I've just described, very, very normal in grief.

20:23Dr Erin Hope: Does grieving have a particular duration? Is there a lifetime to grief? And then are there different stages to grieving?

20:32Alberto Zandi: So, you know, grief's going to last a lifetime. That's the honest answer. But it doesn't mean it will always feel the same. You know, the concept of grief being a finished process doesn't do it justice because it is a representation of how much you loved or love or how much something meant to you. So sometimes I prefer to use the phrase, you know, grief will always stay as meaningful to you. But again, doesn't mean it always stays the same. And I try not to generalize because it's so individual. But if I was to generalize, I recognize that over time, most people describe that raw acute feeling going down and being able to function and feel like your normal or new normal self.

21:21Alberto Zandi: There is a bit of research that is out there that comes under that mental health kind of umbrella where, you know, there's this phrase prolonged grief. yeah right prolonged grief is where actually we recognize that people are getting stuck in that raw acute feeling of grief for a prolonged period of time a sort of normal adaptive response to grief we would see that acute feeling go down in the following months but some people get stuck there for various reasons um there are some risk factors for that and so the research kind of indicates if you've been feeling like you're stuck in that acute space for for a year that you might be invited to get some more, you know, individual support with that.

22:06Alberto Zandi: But that's talking about a year in an acute kind of space. I try not to put timelines on it myself because it's different for everybody. And it will also come in peaks. Maybe I feel better for a while, but then an anniversary comes and, or a reminder and I get that punch of grief again. You know, grief's going to show itself over life, but doesn't mean you'll feel it in exactly the same way. It'll change

22:31Dr Erin Hope: shape over time but but it's going to stay i also think that sometimes and some people when they're grieving what they're trying to do is to feel themselves again feel like normal is that even possible should we should we be seeking to feel as we used to feel before that loss or we should accept that we are changed forever i think that depends on the loss and you know your relationship

22:58Alberto Zandi: with the person or the thing. But most experiences continue to shape us. You know, we're not the same person now that we were two years ago, whether you've grieved or not, because our life experiences continue to shape who we become. We see that as people evolve through life. You know, some of your friends follow you through life, but some we've evolved out of that friendship and I've made new ones. And that's just because of the way life works and the way we live. And so there's an evolution kind of over time, sometimes people use the phrase new normal, because there's a recognition that you're never going to be exactly the same again.

23:36Alberto Zandi: And I don't know if you can be, because typically grief really has a big impact on people. So the idea of being exactly the same is probably an unlikely tall order. Sometimes I think about it as, if you think about us having lots of different traits or resources, all in their different measure. Maybe I'm really high in positivity and, you know, low in resilience, and then I get a grief or a big life experience, that's going to impact all my resources. Maybe I come down in positivity, but I've come up massively in resilience as a response to what's happened. Life experiences are going to shape who you are and your traits and your beliefs.

24:18Alberto Zandi: That happens with grief and, you know, everything outside of grief, life shapes who we are and who we become.

24:24Dr Erin Hope: And at what point should we seek professional help?

24:27Alberto Zandi: Great question. So there's different forms of help. You know, going through grief is a very human thing. I would absolutely recommend some kind of level of peer support. That's not professional therapy, but because, you know, grief is such an isolating experience, you know, in Western cultures, people don't speak about it much at all. Typically you'll have, you know someone dies a funeral lots of support cliff drop you know very quickly we see people go quiet on grief but the grieving person being full of the need to talk still having lots of thoughts and feelings and so peer support is often really good for that speaking to others who've been through something similar that might be within your social circle or you know organizations that specialize in that such as ours we specialize in bringing people together through cancer loss but there are other equivalents charities that support suicide loss baby loss they are great for feeling connected understood and giving space to talk openly without judgment for those who find that they're really struggling to kind of function over time you know I just really am struggling to get those memories out my head or even get out of bed or I can't go back to work you know we're looking at that function word if they're struggling to function that's likely indicative that someone one-to-one support would be helpful.

25:51Alberto Zandi: And I want to normalize that as well. That doesn't mean you're doing badly. That would be a very normal, appropriate thing to do. And lots of people do that.

25:58Dr Erin Hope: Why do you think we're not very good at grieving?

26:01Alberto Zandi: Grief is very societally informed. There are countries that are a lot more open about speaking about grief. In the UK, we're not. In lots of Western cultures, we're not. You know, I can speak to the UK culture, being a British person, There's been generations of stiff upper lip and it not being encouraged to be with emotion or to express it. And that has filtered down into how we speak to each other and to children. And I think that has informed this belief that showing emotion is a weakness. What a terrible belief to encourage as it is so the opposite that is true. But that has massively impacted how openly people speak about grief or ask about it.

26:46Alberto Zandi: and there's a real sadness in that because all it does is sort of isolate that grieving person and you know kind of leave them to do it on their own and what we know about that is that puts them at risk of lots of other things depression anxiety suicidal ideation sometimes but but i think it's all about sort of culture over time um there are countries that do it significantly better than us

27:11Dr Erin Hope: do you think we should also talk more about death not necessarily grief which is already the consequence of death but to be more open to talk about death in general i think that would be

27:21Alberto Zandi: good i think that is tough because what happens is as soon as you talk about death you are acknowledging that you are going to die but also that people you love are going to die and for most people that makes them feel incredibly vulnerable and there's a real desire to not even engage in that level of thought which is so fascinating because it is the one guarantee you know that unfortunately that will happen all going well it's after long healthy lives but I think that the discomfort in talking about it means the conversations don't happen and impacts that whole grief experience when it does do you talk about death with your family I do I do talk about death with my family I think working in grief has been one of my biggest perspective givers.

28:12Alberto Zandi: You know, I am constantly hearing stories of people's loved ones dying after long illnesses, you know, immediately without any notice and people of all ages, babies through to old age. And so it is staring me in the face all the time, death actually, such a big part of my life. The outcome of that is that I tell people I love them all the time, maybe too much um I am very aware that life can change in a moment and so I try really hard to be grateful for it although I'm human and life gets busy and in the way a lot um but I do talk about um death and even with my you know six-year-old he's aware that my dad his grandpa died and he'll sometimes ask about that and I try to be very open with him about it there's no reason not to be I just need to be age appropriate but I'm keen that it's not a conversation we have to have all the time it's absolutely not a topic we we can't talk about and when should we introduce

29:15Dr Erin Hope: that topic to our kids at home because at school they don't teach us what death means and how to process it so at what age should parents do it at home and how should they do it

29:29Alberto Zandi: so I think if there is a bereavement you know that is an obvious time point where you kind of have to talk about it or if someone's ill in the family that might come up. You know in the absence of that most people don't talk to their kids about death until they ask about it either because it happens in a tv show or a movie or it's in a book and that's okay you don't have to introduce it necessarily earlier than that and sometimes they'll come home from school and ask because they've learned something about it somehow and the thing about that is you know typically what we encourage is using quite concrete language with kids.

30:05Alberto Zandi: Sometimes parents are so keen to prevent the child from experiencing any discomfort or pain that they soften it. But often that creates a bit of ambiguity. For example, you know, they're in the clouds now or they're sleeping. How confusing for a little thing who then might be scared about going to sleep or be confused when they look at the clouds. So as hard as it can be, the encouragement is actually to use concrete language you know they were quite unwell um and their body you know their body came to die um they're not suffering now they're not they're not in any pain um and they live in our memories and we can talk about them you know that's quite concrete you have to be mindful of their age and you know there's lots of different activities you can do with kids to help them also process and express sometimes drawing sometimes memory boxes there are wonderful kids books actually on on death.

30:59Alberto Zandi: The invisible string is one of them. Just to help them try and start to understand the concept. We wouldn't expect them to fully understand it. But I'm all for having open conversations with kids in an age-appropriate way.

31:13Dr Erin Hope: Many of my friends are parents now and they are watching many of the Disney movies that Once Upon a Time we all watched, like Bambi, for example. Many of them, they do talk about, at least they show death. Do you think that's a good moment while they're watching that movie and that character dies for the parents to talk about death?

31:32Alberto Zandi: I think it can be acknowledged. You know, that doesn't mean because we've watched Bambi, which is incredibly sad that we have to then sit the kid down and tell them, listen, mommy, daddy's going to die one day. Don't have to do that. But, you know, if the child is really upset, you know, we can respond, you know, say, you know, that's what happened to Bambi. But, you know, mommy and daddy are healthy and, you know, you've got nothing to worry about right now you know I wouldn't lie to kids but you don't have to open up this big can of worms if it's not needed in that moment you know a lot of what kids need is reassurance and to help get some help not worrying right and if there's no reason to worry then we don't need to worry them but we can acknowledge that it happens there are some people that they they talk about death in a

32:15Dr Erin Hope: very humoristic way like for example you just did it right now and I think in my opinion it's totally fine but I'd like to take your your opinion on it do you think that that's something

32:26Alberto Zandi: we should do to normalize the notion of death yeah I mean yeah if you if you if you look up grief on the internet you're going to get a really you know generic website that talks about sadness and has pictures of people in a hospice bed and it's all very sad and depressing but also not realistic of what all people's experiences are you know I'm not suggesting we go around and tell you know jokes every time we're met with grief but you know even if you look at the sympathy cards that people get sent it's you know my condolences it's all it's it's all very um black and white and vanilla and not representative of some of the language people might be holding you know it's one of the reasons at the Lost Foundation we created our own sympathy cards that say things like, fuck, you know, this is really shit, you know, excuse my language, but using the language that people will use or, you know, trying to make fun of some of the, what's it called, the sort of phrases that people use times a healer or, you know, sometimes it's okay to make jokes about things that people might be able to connect to, but it wouldn't mean that we're turning up to meet grief with humor.

33:38Alberto Zandi: But if you know someone and what might, you know, land well with them, it's okay to not have to be so serious.

33:50Dr Erin Hope: I'd like to talk a little bit about the solutions of grieving. What are some things that we can do within the first few days when we're grieving someone's loss?

34:03Alberto Zandi: I mean, the first few days of any loss is survival. You know, actually our encouragement there is to stick with your basics. And when I say basics, try and eat some food, try and get some sleep, try and get some time outdoors in the fresh air. As simplistic as this sounds, these are our basic needs to keep our body running. And these are often the things that people neglect or struggle to engage with early in grief. And so the first tip is to survive. Try and look after your body, go with any emotion that is coming up and try and speak to somebody try not to be alone

34:38Dr Erin Hope: as a psychologist would you recommend sleeping pills during those early days if you need them

34:44Alberto Zandi: sure you know trouble sleeping is one of the most common experiences in grief because what happens when we go to bed at night that's exactly the moment i can't avoid anymore and in comes all my thoughts or my memories and so typically people would struggle to go off to sleep um you know in the early days of grief and sometimes for many months after, your body needs sleep to physically recover and restore, but also to emotionally process. That's what dreaming is, right? And so we need to get you some sleep if you are getting, you know, a very small number of hours over a prolonged period of time.

35:20Alberto Zandi: You know, there's other risks there. And so if you need some sleeping pills, it's something to speak to your GP about. And it's okay if you need that. That's not a weakness that's a helping my body manage and survive what about alcohol no alcohol during those first days you know from a health perspective we would encourage no alcohol alcohol sometimes helps people go to sleep but it's full of sugar and so it's going to wake you up and you're not going to have a deep restorative sleep so on the surface it looks like it's helping because i've fallen asleep but probably will make people feel worse um so the encouragement is not to.

35:56Alberto Zandi: Sometimes people struggle with that because they rely on it as a bit of a vice. So we'd be looking for a reduction and not really relying on it to get to sleep where possible. So yeah, from a health perspective, it wouldn't be encouraged.

36:10Dr Erin Hope: And in those, again, early days, some people binge eat. Is that something that we should avoid?

36:15Alberto Zandi: Most people go the other way, where actually they have no appetite. That's quite a common symptom of being low in mood or you know being anxious that actually my appetite is impacted so more typically we would see people reducing eating or not eating at all um you know it's rare that people would binge eat in that scenario unless they already have a history with binge eating and that might be one of their responses you know really i'm thinking that the main thing we need to do in the early days is give

36:41Dr Erin Hope: your body some calories and nourishment yeah anything too much or too little we should be mindful of and for someone that is listening to this today who's also grieving today what is one thing that you would recommend them to do today so it can help them one thing that

36:58Alberto Zandi: you can do today it's tough to think of one because there's a few angles but one obvious invitation is to go with whatever's there today so if emotion is really there try not to push it down if today's a better day go with that and the invitation would be not to judge where you are today where you are today is where you are today but knowing you're not alone is one of the most important things i could pass on there is support out there you know be it with ourselves at the loss foundation or other wonderful organizations they exist to help you with where you are today whatever that is and so reaching out for support is always number one recommendation i've recently come across a model called the jar model are you familiar with it for my audience

37:49Dr Erin Hope: who probably some of them are not familiar with it. Can you describe it to them in a very simple way?

37:55Alberto Zandi: Sure. So the jar model of grief is this visual. If you imagine this sort of glass jar, and then the invitation is to think about how much of that jar is taken up by grief. So if this jar represents your life, how much of that jar in your life is taken up by grief? And then what you'll typically see is this big black ball taking up most of the jar, i.e. grief consumes my life. And that's a really typical experience where actually I haven't got room for anything else in this jar. This is all I'm thinking about, all I'm engaging with. Now what we see over time is that grief will remain in the jar.

38:34Alberto Zandi: It will remain in your life, that big black ball, but that actually over time that might change in size. So maybe actually it still stays there because grief is as meaningful to me, but I got a bit more room in the jar over time. And so really what happens is we see this visual of the sort of black ball shrinking in the jar and there being more space. What we're trying to sort of represent with that imagery is that grief will stay a meaningful part of your life, but over time with the right support, that there's room to build a life around grief. So what else can I put in that jar to help me engage in a life that's worth living?

39:14Alberto Zandi: You know, talking with people, engaging in hobbies that I enjoy and bring me pleasure relationships maybe my work you know what else can I fit in the jar over time that helps me have a meaningful life but recognizing that grief will always be part

39:30Dr Erin Hope: of that jar and how often should we think through the lens of the jar model should we do this every morning once a week

39:40Alberto Zandi: I think if you were looking at that visual and wanting to work with it directly probably a weekly kind of journaling experience would be really good you know what else is in my jar at the moment and that might change week by week it might change day by day but journaling that and I'm all for writing and grief and journaling to to help us recognize what helps us be the best version of ourselves but doing that over time will help you see what are the common things in this jar that I keep writing down that are really helping me be who I want to be

40:10Dr Erin Hope: my mother when she went to therapy when when she was grieving her brother she was taught a different technique it was sort of i'm trying to explain it in the correct way but it was sort of like compartmentalizing her feelings in a little box in a mental box so her therapist told her that she should not be thinking about her brother the whole day she should choose a moment during the day, an hour, half an hour, in which that moment is to think about her brother and to let all the feelings run. And then after that half an hour or that hour, she would close that box mentally and then move on with her day.

40:52Dr Erin Hope: What do you think of this?

40:54Alberto Zandi: I'm on the fence. Because typically we use that model in psychology for when people are really struggling with worry. You know, they can't stop worrying. It's all they do all day long. Sometimes there's a technique we call worry time, where actually, this is your time. You've got one hour in the day, that's where we're going to worry, right? Yeah. And then actually, we're going to try and invite you to come outside of that time. And that's given, you know, sometimes successfully for people, sometimes not, where we're trying to help them detach from the habits of worrying and trying to help them recognize the process of it and separate from it.

41:30Alberto Zandi: For grief, I'd be mindful of that, because there's a risk here that we're saying, don't have your grief feelings outside of this moment and I don't know how helpful that is or how humanly possible that is you know I get the theory I'm not sure it's the best fit for grief

41:50Dr Erin Hope: now there's a completely different use case which I think it's also applicable for our conversation so some people are yes grieving right now or they've experienced it so everything that we've just discussed may be familiar to them to an extent but then there's another group of people and i also include myself in that basket in which they haven't grieved personally as much because the loss of a person wasn't that close to them but we are around people that are suffering a first degree loss if that can be put in that way like for example my mom or my grandparents losing their son and sometimes we just don't know how to help them we see them suffering but we don't know how to help is there a right way of helping through different stages so let me put this into three stages stage number one in the funeral what do we say in the funeral because that's such a hard thing to do I believe number two what should we say or what can we do the weeks after the funeral and then number three months after the funeral how can we still support this person that we love.

42:57Alberto Zandi: So supporting someone at a funeral is such a unique moment in itself because that day is going to be a whirlwind for them. I don't know if they'll even remember what you say on the day. And that doesn't mean we shouldn't say anything. But in that moment, we are really passing on our condolences or how much we feel about what happened and letting them know, I'm going to check in with you. Now, don't say that if you can't commit to it, you know, but letting someone know you're not alone, you know, I'm going to be here for you is a wonderful gesture. But again, you've got to follow through. Because, you know, in that moment, someone has, you know, got so many people around them, they're still in the acute phase of grieving this person, you know, knowing that people are going to check in might be helpful.

43:44Alberto Zandi: But beyond that, they're not going to be able to take much in. They again, just need to sort of survive the day and get from it what they need. But I'm going to put stage two and stage three together because I think the same response can be used in the weeks, months, I'll argue years down the line. And this is helpful for those in the periphery because actually this simplifies it. One of the things that people want the most when they're grieving is acknowledgement that grief still exists. So what typically happens is again, lots of people go quiet on grief, stop asking altogether. a simple way to do this is to say how are you doing today or how are you coping because that's a more direct way of acknowledging there's something to cope with what most people do is say how are you now as we all know how are you has one response fine you know it's it's not a real question how are you today acknowledges change over time how have you been if you haven't checked in in weeks or months i haven't checked in with you but i've been thinking about you how have you been coping?

44:46Alberto Zandi: How's it been? Because it's a direct open invitation to acknowledge what has happened and ask them how they are. They don't have to take it. If it feels too hard to answer, that's okay. But I would be consistent with that approach, whether they answer or not, because the message there is I care, I'm acknowledging, and I'm checking in. and what most people tell us is that 99 % of people don't do that when someone does or someone is direct they never forget it you know we'll hear it you know my cousin or my friend they just every week they called or every month they just asked how I'd been so directly and they never forget the person who went out their way to to have an open conversation so my invitation would be be the person they never forget be the person who asked and should we mention the deceased person sure you know again often we'll hear people say you know no one ever says the name anymore yeah you know how you feeling about bill how's it been you know that person was still a real person and they they they probably thought about you know the majority of the time by the person who's grieving so to acknowledge their name to check in about them maybe even to share memories talk about them that could bring lots of joy this doesn't have to be a depressing conversation I would argue that asking about it is a way to connect with this person and make them feel you know really bonded to you rather than oh why are they asking this would you advise the same thing to someone that has lost someone from a relationship point of view.

46:27Alberto Zandi: Yeah, you know, maybe we're not having to sort of directly speak about the person so much, but hey, how's that been? You know, I know you were hit really hard. How have you been coping? We're just looking to give an avenue and to acknowledge that we know that this is something that is really important to you. Again, it doesn't matter if they take the opportunity or not. They will remember you gave it. and there's a there's a subtext there of we can talk about this and us as the external person

46:57Dr Erin Hope: trying to offer help how can we do that while also preserving our mental health anytime we go towards a conversation that is asking about difficult you know content or

47:10Alberto Zandi: topic matter or what have you there's a risk that we see someone very upset or we hear upsetting things. And sometimes that can be traumatic in itself. Maybe someone shares a memory or they're just so incredibly distressed. And, you know, as humans, when we see someone distressed, we want to stop the feeling. We want to make it better. What's being invited in grief is to sit with it. Don't fix it. Just witness it. The cost of that will be that you may well feel distressed, upset, heavy and the invitation there would be to respond to that in whatever way is normal for you to help you come back to your baseline you know engage in your activities or traditions that help balance you and anchor you back to who you are that's such an interesting point you made

47:59Dr Erin Hope: sits with the feelings because i go back to the example of my mom every time i see her sad but unfortunately I've been seeing her sad for quite a long time now since her brother died. I'm a very logical person, so I try to give her logical reasons why she can move on, giving her examples of people that are alive and how good her life is right now, but also maybe giving examples of how good of a life her brother had and that maybe he's in a better place. It's almost like I'm trying to give her tools and reasons to be happy to cut that pain. It's almost like I'm trying to cut that negative feeling.

48:40Dr Erin Hope: But what you're saying is I shouldn't do that. I should sit with her and let her feel it because maybe what she needs is to cry and that's it. Rather than me trying to stop the cry through all these logical arguments.

48:51Alberto Zandi: This is such an important point. And the way you have responded to your mother is a very typical response. You are hurting, so I want to help reduce that feeling and I want to help you have positive things to hold. The thing that people need most when they are grieving is to be met exactly where they are, rather than I'm going to help take the feeling away. So what we're looking for is again witnessing, not fixing. Sitting with, making room for. That is incredibly cathartic experience. You're not going to make it worse because you sit with it. I will argue you will do a very helpful thing and we'll get a catharsis.

49:31Alberto Zandi: We'll get a release rather than the subtext that a grieving person hears, which is you shouldn't be so sad. Because look, these people are well and, you know, that is a subtext there, which is you shouldn't feel this way. They feel that way. They do, right?

49:51Dr Erin Hope: Let's talk about the workplace. what should myself as an employer if I have an employee coming back to the workforce and they are still obviously they're grieving is there something that the company should do or something that we should not do to make the process easier and healthier this is a great question because

50:12Alberto Zandi: you know it helps the grieving person and the employee but it's also it's worth us thinking about from a business point of view because it is a very good business model to support people well don't support them well in their grief or difficult experiences absenteeism presenteeism leave your company right and so we look after people well they feel valued they want to stay in my business and they're going to work well as well when they feel up to it so it makes sense from a personal and a business point of view this question um now most organizations have some kind of policy about how much leave they might give and you know that varies very much but unfortunately it does require a bit of an individual case-by-case basis, which is checking in with the person.

50:58Alberto Zandi: And again, we're acknowledging what happened, we're checking in, and we're seeing how they feel about what time off they need or how they want to come back, when they want to come back. In an initial point, there would be just an acknowledgement and asking people to take their time. And then we'd be thinking about a phased return. Phased return is often really helpful rather than people going from, I'm sort of with my acute grief and I'm not at work, and then I jump into full-time, you know. And that really varies. Maybe people come back part-time or different hours. And I would encourage employers to check in with people, you know, a few weeks down the line.

51:38Alberto Zandi: How's it feeling? You know, are you getting everything that you need? Is there anything more we could do to support you whilst you're at work? So really all we're talking about is a dialogue and an open conversation. But we're seeing at the Lost Foundation, we provide training to corporates and organizations and we're getting more and more inquiries with companies asking this question, which is great. Because again, look after people well and they'll stay and they'll work well and feel valued by the organization. organization.

52:08Dr Erin Hope: And in terms of workload, I feel like sometimes people, and I include myself in that basket, I would like to be busier with work. If I'm grieving, it's like I would throw myself at work, but maybe that doesn't work for everyone. So is there a right or wrong way of doing it with an employee?

52:27Alberto Zandi: Sometimes people feel better when they are productive. I've achieved this, I've ticked this off, and so it makes me feel good. And so we know that sometimes coming back to work for some people will be one of the most helpful things. I got a routine, structure, responsibilities, I'm getting things done. And maybe there's a bit of an avoidance there. I don't think about that because I'm at work. But that will be very different for people on a case by case. For some people, that's what they need. For others, it won't be. And so that's why an individual checking in with people, rather than you have to be off for this time, or you have to come back in this specific date.

53:05A little bit of flexibility whilst also trying to run a business and you know being

53:09Alberto Zandi: mindful of that but even giving people a little bit of flexibility goes a really long way in people feeling supported so some will want to come back earlier and some might need a couple a couple bit more time off.

53:22Dr Erin Hope: Let's talk about kids as parents if our child is grieving what should we do and what should we avoid?

53:32Alberto Zandi: So as kids develop, you know, there'll be a point where they learn about the concept of death. You know, even in the absence of a bereavement, they learn about it, again, either on television or books. And it's a very, you know, it's a huge adult, you know, thing for them to understand. And most young kids obviously don't get it in its fullness. But how kids respond depends on their age, right, and their understanding. But, you know, being able to respond to any worries that a child has about grief or death is really important. So being able to have a conversation rather than we don't talk about this.

54:14Alberto Zandi: You know, if a young child is grieving or worried about anything like that, then we'd be talking, maybe even doing some drawings, depending on the age. In fact, at the Loss Foundation, we have resource worksheets for different age groups that come with different exercises and different things that kids can do to engage in the topic because it does really depend on the age of the child, but we'd be looking to engage and acknowledge not to avoid.

54:40Dr Erin Hope: Can you give me some examples of those exercises?

54:42Alberto Zandi: Yeah. So, you know, if we're thinking about children sort of seven and under, they do lots of drawing, right, you know, and things like that. So we'd be thinking of that age group drawing their feelings. You know, how are you feeling today? What face here would you be feeling today? And can we draw that person? And can you draw, you know, anything related or drawing how you're feeling or what we've done today or the things that make you feel good? Because all of these things relate to emotion, right? And connecting to it and understanding which one they feel and where do you feel that in your body?

55:15Alberto Zandi: And can you point to that? So very visual with young kids, right? as they get older they'll be more able to write some of the equivalent down and then you know it is helpful to show them some pictures even the jar model we spoke about for older age groups they'll be able to visualize that and understand it and we can draw on that sheet what's in my jar right so what we're looking to do is give them a little bit of education about feelings that can come with grief to normalize it and give them appropriate ways to express it what is one message

55:47Dr Erin Hope: that you want a grieving person to hear today if you were only to pick one?

55:53Alberto Zandi: You're not alone. Grief is so isolating and it may be that everyone around you has stopped asking, but you don't have to do this alone. There is support that exists, the Lost Foundation and equivalent organizations who are there to see you through.

56:11Dr Erin Hope: Dr. Erin, if you had to compress all your knowledge into one essential piece of advice that we must implement in our daily lives, what would it be?

56:24Alberto Zandi: My recommendation as psychologists and human beings would be to go with whatever emotion is there at the time. Sometimes we are struggling and sitting with some really difficult stuff and sometimes there are better days. The invitation is to be with what's there because a life fully lived means being able to be with that full spectrum of emotions and experiences. Thank you. I'm really, really glad that I got the chance to have this conversation with you

56:56Dr Erin Hope: and also my audience, because I think there are very few things in life that are a common denominator across everyone. And this is one of them, death or the loss of something or someone. and I don't recall any institution whether it's educational or any other sort of institution that teaches us this and I do believe that we need to normalize it and I believe that we need to be able to speak about it in with much more comfort and security and confidence and I believe that people like yourself and your work are getting us closer to that. So I thank you for helping me, you've given me a lot to think about and I hope that you've done the same for my audience.

57:44Dr Erin Hope: So thank you very much.

57:45Alberto Zandi: Thank you for having me and for giving me a platform to talk about a topic that impacts us all. It's been a pleasure.