Grief is complicated . . .

so i'm at the UCLA 12th Annual Review of Psychiatry and Psychopharmacology for two days. it's only day one. and i'm doing pretty well until lunch time. guess what the luncheon speaker's topic is? "Understanding Complicated Grief."

this is interesting. it seems there is non-complicated grief and complicated grief. and the differences seems to have to do with how long the grief is going on, how intense your yearning is for the loved one, if you are avoiding reminders, and if life has become meaningless. dr. o'connor does a good talk, comparing CG to MD (major depression) and to PTSD (posttraumatic stress disorder). but then she gets into the neurobiological differences. and grief doesn't bode well for folk. she puts up pictures of the brain showing increased activity in the nucleus accumbens in the non-CG subjects. i get lost about here. but i do hear her mentioning that cortisol, a nasty substance we create more of when we are grieving in a complicated manner, is found in higher levels in folks with CG than with non-CG, and--here's the part i really understand--cortisol is related to increased morbidity and mortality.

take home message (the message I am taking home): i better get out of the grief thing soon.

better take home message: "Most bereaved individuals are psychologically resilient" (Bonanno et al., 2002).

i'm hanging in pretty well until there are a couple of questions. i've started to take a bite of the dessert, brownie. someone asks about parents' loss of a child, and of course the answer is: they don't do so good. i'm sobering at this point.

then my friend and the long time Chief of Social Work comes up behind me and grabs my shoulders, whispering that i am the most resilient person she knows, and i'm going to be fine, and--with that vote of confidence--i lose it. she goes back to her table and quietly i mop up tears with my extra large luncheon napkin, drink a bunch of water in order to avoid eye contact with my table mates--who have no idea what's happening since we are strangers--and pull myself together. but i sure can't finish the brownie.

one thing i remember dr. connor mentioning is that different societies have different ways of supporting grief. in some cultures, she mentioned, you have to wear black. it's expected. for a year. when sallie lived in Greece and nursed rhea's grandparents through their terminal illnesses, she was expected to wear black. the first thought you might have about this is "how gruesome" and yet, as sallie has said, at least in Greece people can identify you as a grieving person. no one is going to come bounding up with a big smile, saying "how ARE you?" you are not going to have to disappoint and sadden (and possibly embarrass) them with the awful news that one of your children has died. if you are dressed in black, they already know someone is gone from your life. they can approach with caution.

the talk was okay, though. i'd been so busy i had barely been thinking about kyle--well that's a lie, isn't it? but so busy that i hadn't "gone there" to the "ohmygod it's true" place for a few days. the taxes, then the project absolutely due Monday at dawn, and the late night work followed by the Red Sox games (bless them!) have kept me propped upright and plodding through.

so i made it through okay. and proceeded to my next seminar: Suicidality in BiPolar Patients. oh jeez . . .