How Do You Cope with Complicated Grief? An Interview with Daniel Clifford, Part One

Counselor Daniel Clifford talks about what complicated grief is and how yoga helps his clients heal

In part one of a two-part interview, SevenPonds speaks with marriage and family therapist Daniel Clifford. Through his work as a counselor and yoga instructor, Daniel has expertise in coping with complicated grief mentally and physically. He began his work as a counselor in 2010 and has since operated his family counseling office in San Francisco. He works with adults and children to heal after significant losses. 

Daniel Clifford, family counselor

Credit: Daniel Clifford

Marissa: What got you interested in the counseling world?

Daniel: It was a calling that I had. I was going through lots of what I’ll call grief in some ways about not having a fulfilling life and always wondering why. I started in my mid- to late 20s, and over the course of time I got really involved in reading about psyche, and I actually started seeing a therapist myself and started studying aspects of Plato and Aristotle with regard to the soul. I found myself eventually looking for graduate schools. That journey started about 10 years ago.

Marissa: Since then, you’ve focused a lot of your work on complicated grief. What exactly is complicated grief? 

Daniel: I feel it’s really sort of a subjective thing. Particularly there’s a lot of conversation about including it in the recent release of the next DSM 5. They’ve tabled it to be in consideration for the next volume because it’s really a subjective construct. What my experience has been in working with the bereaved and those in grief, we culturally at this point do not give a whole lot of permission to be sad or depressed. The reality is it is an emotional state. And so what we do is do everything we can to push people into happiness and joy through various aspects, including medications, and never getting into that space and suggesting that’s a bad place to be.

And what’s complicated about it is that there’s a mixed bag of emotion…

My experience has been that people never actually go there to grieve and actually feel the loss, that broken heart of someone passing, whether that’s a grandparent or a sibling or even a spouse. You get into a place in midlife or later in life never having to actually grieve your losses. So when you get into a complicated grief state, you’re grieving — typically I see a client who is grieving for one specific loss, and the next thing you know it unravels to every person that they lost in their life. And what’s complicated about it is that there’s a mixed bag of emotion, and it usually runs the whole gamut of emotions teetering back and forth between anger and sadness and depression and loss, and you’re not quite sure at what point who you’re grieving and why. This feels uncomfortable because you think, “I shouldn’t feel angry toward my spouse,” but you might actually feel an anger toward your parents, or whatever it may be, and then all of the sudden that gets repressed again. From my experience, it’s been an unraveling of a lifespan of grief that occurs in a complicated way.

Marissa: What’s the difference between someone experiencing a complicated grief compared to someone who experiences a simpler grief? 

Daniel: If it’s not a “complicated grief scenario,” working with one specific loss is fairly simple on paper. I don’t want to make it sound like grief and working with bereavement is simple in any way. It’s simple on paper because you can reconstruct that relationship: What was good; what was uncomfortable. From that, how do you honor the loved one that has passed? When you get into a complicated state, there are several traits that you have incorporated into your life over time from the many losses that you’ve had. To actually focus in on one, like I said, is an unraveling, and really a taking apart of every single relationship you’ve ever had in your life. And for someone who has not really processed or grieved and felt that experience emotionally, it’s a scary, scary place.

You find that you end up doing a lot of trauma work with them.

What you end up doing and end up finding is that it gets into a trauma place. You find that you end up doing a lot of trauma work with them. This moves directly into the somatic work and whatnot, which is with the yoga stuff that I’ve been doing. How do you experience your body in those states and know where you feel it, and what sort of emotion speaks to you if you work with that pain in your back, or shoulder, or arm or chest?

Yoga Therapy

Credit: Jean Henrique Wichinoski

Marissa: Do you incorporate a lot of yoga into your counseling? 

Daniel: I suggest to people in a very broad way and work with them in the room to experience their body. It starts out with mindfulness, usually doing some breath work, and really focusing on where your body’s at and understanding where your breath is. Is it short? Is it long? Is it shallow? Is it deep? Is it quick breath or long breath? Really what your breath is trying to do is balance out your system. Your body is designed to bring balance into life, and understanding where your body’s at at any given moment is a huge step moving forward with understanding your emotional body. In that space and in that understanding of your emotional body, then you can say, “OK, I’m feeling a pain in my shoulder, or my hip, or my leg. Let’s see if we can stretch it out.”

And that’s where the yoga starts to come into play. If that happened and the client is feeling safe in the room to move their body, that’s great and it works out pretty well. I would suggest to them maybe starting some yoga classes or starting to do some physical exercise to really work with some of this stuff. And all of that being based in a mindful way, not necessarily a “go for a run” type thing.

Marissa: How do you overcome complicated grief?

Daniel: Slowing down. It’s very easy to say, and really, really hard to do. We are, in my opinion, designed educationally to sit at a desk and push a button. In pushing things, we never really release anything. We never really think for ourselves, and we get caught up in this whirlwind of very fast-paced living. Whether it’s driving in a car for six hours a day at your commute, meanwhile being in front of your computer 12 hours per day, you’re never really processing anything. To get someone to sit in their own space without anything in front of them, even with their eyes closed, takes a good deal of time for the average person. It’s being able to slow down and hear yourself and understand what you’re feeling, where you’re feeling it and why.

The three step process I go through with my client is: Where am I feeling it? Why am I being triggered at this point? What do I want to do with that information?

The three step process I go through with my client is: Where am I feeling it? Why am I being triggered at this point? What do I want to do with that information? The first step is pretty easy and most people can get to. The second step takes some good time to slow down. It might take anywhere from half a year to even a year for some folks to understand what their trigger is and why. And then the third step is a transitional space into a new way of living. Now that I understand this information, and I have this power of emotion within me, what do I want to use with my power, and how do I want to shape my life with it? Rather than ignoring that it exists and taking some medication for it.

Marissa: Do you think this process is better than taking medication for grief?

Daniel: Medication works in one context from my experience. It works in the immediacy. And medication without counseling is a recipe for failure. Medication, from my experience, for most of them has a six month lifespan. Your body will essentially get used to anything you inject into it or eat. If you eat carrots for six months, your body is going to be able to process carrots like it’s never been before. If you start ingesting something, your body will find a way to balance itself out again.

Medication and Therapy

Credit: TheOpenMind.com

So you’ve got about a six-month span for most medications. If you’re not continually experiencing those emotions and working with them, you’re gonna need to constantly change medications. What you have now is a pharmaceutical industry that suggests, “Here are six different ways to cure anxiety. Pick one and we’ll put you on another, then another, then another until you’re all better, which doesn’t necessarily happen.”

To bring it back to a grief space, I know lots of clients who come in, and they’re on sleeping pills because they can’t sleep at night since they’re so upset with this. And that’s great. Sleep is a huge thing, and I would encourage people in a grief state to sleep as much as their body will want or allow. There’s been lots of different studies that sleep cures just about anything. Up to 16 or 20 hours a day sometimes cures large complicated emotions, and even injuries physically, whether it’s muscle or bone.

We’ve trained ourselves culturally that we only need six to seven hours of sleep a night. Anything more than that and we’re in some sort of psychotic or mental state that is not productive or successful. One of the remedies I would suggest in any regard to grief or even emotional discomfort is to allow your body to slow down and begin to process. When it’s at its slowest is when we’re asleep.

Marissa: What would you say to someone experiencing any type of grief?

Daniel: The human experience is like a heartbeat. If you hooked up your heartbeat to an EKG machine, it goes up and down in that circadian rhythm. To be alive, you experience the highs and the lows. If you’re flatlining, that means you’re dead. In order to experience life and have a human experience, you need to be comfortable in both of those, the high and the low. That’s the best way I would suggest anyone to come at any emotional experience if they need a process. Both the high and the low are good experiences. Neither of them is bad and neither of them is going to end your life in any way.

To be continued in part two next week.

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Our Weekly Tip: Using Social Media as a Touching Memorial

Give your loved ones a space to remember your life the way you want on Facebook
Facebook symbol

Credit: MKH Marketing

Our Tip of the Week: Many of us spend hours every day online. What happens to our social media accounts after we die? What you might not know is that you get to choose. Popular websites such as Facebook, Twitter and YouTube let their users control what happens to their accounts posthumously, according to the O’Grady Law Group. You can select someone to take over your account to keep your online legacy alive, or you can make your profile into a memorial page for your friends and family to share happy memories. All of this is at the click of a button, and you can do it right now.

How-to Suggestion: To choose what happens to your Facebook page in the event of your death, go to “settings” on your profile. Select the “security” tab, then click on “legacy contact.” From there, you can decide to delete your account automatically after you die if you don’t want your online presence to continue on without you. If you want to keep your profile alive, choose one of your Facebook friends to take over your page in the event of your death. Make sure this person is someone you can trust with your online life. Give this person contact instructions about what you want him or her to post on your wall after you die, and tell your contact how you want your online persona to live on. The more specific you are, the better your memorial profile will be. Your friends and family will treasure having a space online to come together in your memory.

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“The living are just the dead on holiday.”

- Maurice Maeterlinck
On Holiday

Credit: Wikipedia

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Book Review: Death Warmed Over: Funeral Food, Rituals, and Customs from Around the World by Lisa Rogak

One woman’s idea for a cookbook is more like a glimpse into the customs that various cultures partake in surrounding food during funerals
Death Warmed Over

Credit: Amazon.com

One evening, as I was trying to research the Internet for a topic for my Cultural Perspectives article, I stumbled upon a book called Death Warmed Over: Funeral Food, Rituals, and Customs from Around the World. The concept intrigued me that it was part cookbook, part history book all surrounding the food consumed and the rituals and customs observed for funeral services among a wide variety of cultures. As a self-proclaimed “history buff,” I knew this had to be the next book I’d review for SevenPonds.

I liked that Lisa Rogak provided variety in her cultures and counted religions as actual cultures rather than just those from certain countries.

When I cracked open a copy that I retrieved at my local library, the initial influx of information I learned about the customs of around 75 cultures — such as Amish, Ethiopiana and Mongolian among many others — greatly intrigued me. I liked that Lisa Rogak provided variety in her cultures and counted religions as actual cultures rather than just those from certain countries. She also included sections like “Olde England” and “Colonial America.”

Lisa Rogak author of Death Warmed Over

Lisa Rogak
(Credit: Amazon.com)

To be honest, I pretty much ignored the recipes provided, especially after I learned in the introduction that Rogak just made up some of dishes she thought the cultures would have consumed when in actuality she couldn’t find information for those particular cultures. After having written about the New Orleans Jazz Funeral over a year ago, I mostly skimmed Rogak’s section on it because it didn’t offer much of anything new to me.

Some of Rogak’s choices on what to cover left me either scratching my head or struggling to not snore, especially those moments she mentioned in her blurbs that she couldn’t find any actual food-related facts.

While Rogak’s Death Warmed Over: Funeral Food, Rituals, and Customs from Around the World provides sporadic snippets of humorous jokes, takes on epitaphs, and fascinating historical facts that she gathered during her research along with her page-long blurbs about each culture she chose to write about, I found the book an overall disappointment mostly because I personally would have preferred more than just one page each about the historical facts on the cultures and their funeral customs. Some of Rogak’s choices on what to cover left me either scratching my head or struggling to not snore, especially those moments she mentioned in her blurbs that she couldn’t find any actual food-related facts. In my opinion, she should have just omitted those cultures rather than fantasizing about what might have been the appropriate funeral foods. In some ways, I felt like I would have been better off reading up on the cultures I was most interested in myself.

Overall, Lisa Rogak’s Death Warmed Over: Funeral Food, Rituals, and Customs from Around the World reminded me of a sweet treat you have long been craving for — only for it to leave a lingering unpleasant aftertaste with your craving not fully satisfied.

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Beautiful Offerings to a Loved One

Taking inspiration from Japan's memorial celebration ritual of beautiful floating "boats"

Getting inspired by other cultural practices can be a wonderful way to gather ideas for a memorial ceremony you may be creating on your own. When you lose someone you loved beyond words, putting an event together worthy of who they were can be a healing, meaningful part of the process. We look to Japan’s beautiful offerings to add to a loved one’s memorial celebration.

Offerings to a Loved One

Offerings of flowers, food, candles & gifts placed in a wooden “boat”
(Credit: japanvisitor.com)

As more people choose cremation as their contemporary choice, it’s appropriate to look at Japan for inspiration given they have the highest cremation rate in the world, just short of 100%. They have so many beautiful ideas to share from their traditional memorial ceremony. It surprisingly begins with the family bringing the body of their loved one home to place on a futon for a night. A white cloth is laid upon the body, including a separate one on the face. Family members then sit with the body and comfortably talk and engage them. We see a similar practice gaining acceptance here in the US called home funerals.

Offerings to a Loved One

Japanese “boats’ are set out to float as an offering to someone lost
(Credit: japanvisitor.com)

In the morning, their loved one is moved to where the service will take place with a quiet procession. A two-day wake follows — filled with a sequence of beautiful prescribed step-by-step observances made most special with flowers, incense, lights and sculptures. Once the cremation is over and the ashes with bone fragments put to rest, the true beginning begins with memorial ceremonies taking place every seven days until the forty-ninth day arrives. The custom is to have another memorial on the hundredth day as well as an annual ceremony until the fiftieth anniversary. This annual ceremony in Japan is called the Obon during which offerings are made in memory of a loved one.

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A beautiful food offering on an altar during the Obon
(Credit: shinnyoen.org)

During the Obon, families visit a loved one’s grave to clean it and bring the spirit home with them. The Japanese also offer food and incense on an altar to the spirit of the person gone. On the final day of the Obon, they float “boats” or trays of gift offerings. This can be food, candles, flowers, or special paper memories set out to sea or on a river. This lovely custom has been outlawed yet continues on. It’s no surprise, given how beautiful it is.

You can make this idea your own to incorporate into an annual memorial event or as part of the service you’re creating.  One need not be Japanese to borrow ideas from their traditions — amazingly beautiful traditions that can be directly implemented or altered to fit the uniqueness of the ceremony you’re creating.

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Oliver Sacks Says Terminal Cancer Has Never Made Him Feel More Alive

Neurologist Oliver Sacks wrote an op-ed for the New York Times about embracing life in the face of death
Oliver Sacks

Credit: oliversacks.com

A lot can change in a month, as Oliver Sacks found out recently. The 81-year-old writer and neurology professor went from swimming a mile every day to learning he had terminal, inoperable cancer. He says he’ll be lucky to have a few more months alive.

We often think of news like this as a punch in the gut. It should take the wind out of us, leaving us crumpled on the floor in pain and confusion. Yet Sacks takes a different approach to the news of his impending death: He is grateful.

In his op-ed in The New York Times, Sacks quotes philosopher David Hume (who took his own death at 65 in stride). Hume wrote that his illness didn’t cause him suffering, and that he continued to embrace life to the fullest.

Awakenings-2-1-194x300

Credit: oliversacks.com

Like Hume before him, Sacks says he wants to enjoy life’s pleasures while he still can.

Sacks makes a salient point in his article when he says:

Over the last few days, I have been able to see my life as from a great altitude, as a sort of landscape, and with a deepening sense of the connection of all its parts. This does not mean I am finished with life.

Although doctors have given him a death sentence, Sacks says he has never felt more alive than he does in this moment. When we strip away the idea that death is a far-off moment in the timeline of life, we revel in every second. Similarly, when our fear of death melts away, we give ourselves permission to experience all that life has to offer without worrying about the long-term consequences.

For some of us, that might mean parachuting out of a plane. For others, it could mean finishing that 500-page novel we’ve always wanted to write, but we’re afraid no one will want to read. Both carry a different risk, but fear prevents many of us from experiencing either of them.

Oliver Sacks says he has always been a man of passion in every regard. Now that he knows death is at his doorstep, he wants to embrace these experiences even more deeply.

What we can learn from Sacks is that death is a fact of life, but it doesn’t need to consume our lives.

Read more about Oliver Sacks and his works, including his book, Awakenings, here.

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