June 28, 2007 Dealing With Grief and Loss - Dr. Kenneth J. Doka

HEALING THE GRIEVING HEART
Dealing with Grief and Loss
Hosts:  Dr. Gloria Horsley and Dr. Heidi Horsley
With guest:  Dr. Kenneth J. Doka
June 28, 2007
G: Hello.  I’m Dr. Gloria Horsley
H: and I’m Dr. Heidi Horsley.
G: Each week Heidi and I welcome you to Healing the Grieving Heart, a show of hope and conversation with those who’ve suffered the loss of a loved one and for health care professionals who work in this most difficult field.  As always the message is others have been there before you and made it.  So can you.  You do not walk alone.  If you are listening to our Thursday show, we’re doing a pre-record so you won’t be able to call in today.  But remember, these shows are archived on our blog, www.thegriefblog.com, as well as www.compassionatefriends.org websites and all shows can be downloaded on Itunes and we also have transcripts on our website.  Good morning, Heidi.
H: Hi, mom.
G: It’s good to talk to you.  We’re coming up with the Fourth of July holiday next week, and I just wanted to say something quickly before we get to our guest about the holidays and the difficulty.  It can be a hard time.  The Fourth of July obviously isn’t a giant holiday for a lot of people but for some people, it may be, don’t you think?
H: Well, yes, and I think one of the issues is sometimes when after you’ve had someone die in your family, you feel guilty for celebrating and maybe guilty for participating in a holiday so that’s always an issue that can come up.
G: Yeah, and so you might want to think about what you do this holiday if it has been a big one for you or sometimes if it’s in the first year, you may feel kind of down but your kids are still looking forward to celebrating it, so we do have to think about the siblings, don’t we, Heidi?
H: Yeah, I was going to say, for people who have other children, that have surviving children, you really do need to think about celebrating the Fourth of July and having fun and kind of keeping that tradition and for people that don’t have surviving children, maybe you want to do something else this year that’s different.
G: Yup, and I must say, Heidi, we do have an international audience so we probably should say that the Fourth of July is certainly an American celebration, right?
H: Absolutely.  Yeah.
G: So let’s go on and introduce our guest today, Heidi.  We’ve got a really very prominent guest in the field of grief and loss and we’re very excited about having him on the show.
H: Yes.  He’s wonderful and he’s worked in many many areas and I’m sure that he will give us a lot of really important information today.  Our guest today is Dr. Kenneth Doka and our topic is Dealing with Grief and Loss.  Dr. Kenneth J. Doka is a Professor of Gerontology at the Graduate School of The College of New Rochelle and Senior Consultant to the Hospice Foundation of America.  Dr. Doka is a prolific author whose books include:  Men Don’t Cry, Women Do: Transcending Gender Stereotypes of Grief; Children Mourning, Mourning Children; Death and Spirituality; Living with Grief: Who We Are, How We Grieve; and Living with Grief: Children, Adolescents and Loss.  Dr. Doka has also published over 60 articles and book chapters.  He is editor of both “Omega” and “Journeys: A Newsletter for the Bereaved.”  Welcome to the show, Ken.
K: It’s good to be here Gloria.
G: and Heidi, that was
K: And Heidi.
G: It’s great to have you on the show, Ken, and I wanted to ask you, I noticed from your – you’ve got a great website.  They can go to your name, google your name, Dr. Kenneth Doka, D-O-K-A, and find out a lot of things about you and look at all these books.  Wow.  You’ve spent a lot of time writing or editing.
H: And I’m very interested in the fact that you aren’t just an expert in one area.  I mean you know about children’s grief, adolescent grief, elderly grief, adult grief, which I find fascinating.
K: Well The Hospice Foundation has given me remarkable opportunities to learn a lot and to grow a lot and as I’ve helped them produce teleconferences and the books that go along with those teleconferences, it has certainly broadened my knowledge given the opportunity to talk to a lot of people who are grieving a lot of losses.
G: Yeah, before we get to the nitty gritty of grief and loss, tell us a little bit so we don’t lose that about your teleconferences.  They’re pretty interesting.  Every year groups of people get together and
K: Every year in over 2,000 sites throughout the country, The Hospice Foundation of America has an annual teleconference.  Compassionate Friends is usually one of our sponsors or co-sponsors and the teleconference gives us an opportunity to offer training and to offer insights to professionals but many times people in the audience come from a wide range of varieties and a variety of situations including of course many of the people who are involved in Compassionate Friends.
G: Well, your topic this year is certainly a hit for us because Heidi and I just had finished a book that will be out at the end of the month on grief relief for parents parenting teens about a loss so that’s going to be an interesting teleconference you’ll have.  Well, I wanted to ask you.  I noticed from your resume that you have in the past been a minister.
K: I’m still an ordained Lutheran minister.  I’m basically retired from that now but I still occasionally preach and I’m involved in the church, of course.
G: Yeah, is that how you got in the field of grief and loss?
K: It was a combination, really.  At the same time I was going for my ministry degree, I was going for a degree in sociology and as part of my ministerial training, I had to work in what’s called a CP, Clinical Pastoral education, and I ended up really by a series of almost accidents, ending up working in Sloan Kettering with dying children and adolescents and then for my sociology degree, I decided to do a thesis on the organization of terminal care in two pediatric hospitals and it sort of set me in the field.  That was some 36 years ago actually, so I’ve been in the field for a long time.
G: Now did you work with Grace Christ then?  Wasn’t that where she is, Heidi?
K: Remember that was 36 years ago.
H: Okay.  I think she came after you.  She’s my supervisor now.
G: Yeah, Heidi works with the 9/11 families in New York.  So really you came to it from a more academic health care point of view minister.
K: Well, it was always a combination because remember my original work was with dying children and their family and I think the first thing I learned was that I spent about a third of my time with children, about a third of my time with staff, and about a third of my time with parents, all of whom were struggling with that loss.
G: Well, maybe that’s a good thing to start with now for our listeners out there who are newly bereaved.  What is “normal” grief?
K: Well, you know, I think sometimes it’s important to recognize that probably in the first couple of months, with the exception of a couple of things I’m going to mention, self-destructive behaviors, real impairment in one’s roles, it’s very hard to typify what is normal grief.  This is a horrendous loss.  It’s a terrible loss and it affects us in lots of different ways.  I think some things we can say about us is it affects us on all kinds of levels.  It affects us physically.  It affects us emotionally.  It affects the ways we think, the ways we behave.  It affects us spiritually and I think for a lot of people, as I’ve experienced grief in my life and I’ve talked with many of the people who’ve experienced their own losses, they often use a metaphor like a roller coaster to describe it.  Ups and downs and highs and lows and times that you think you’re doing better and times that you really feel much worse.
G: Yeah, it is very discouraging I know for a lot of our listeners.  They’ll let us know that they’ve had a setback, right, Heidi?
K: And I wouldn’t look at it as a setback.  I look at it as part of, you know, if you take a metaphor like a roller coaster, in many ways it’s a very healing metaphor because it reminds you that ups and downs are going to be part of the process.  If you think of grief as sort of this straight line where you’re going to go from feeling bad to feeling better, that’s not going to happen.  You’re going to have this kind of uneven journey.  Just the low points really.  Not as setbacks.
H: Well, that’s a good point, Ken, and like you said not to look at it as a setback, it’s part of your healing process. 
K: Yeah, it’s part of your grieving process.
H: Absolutely.
K: Because the other point I’d want to stress, too, for people, cause sometimes people say to me well I’m just not feeling and then they’ll talk about just thinking about their child, well you experience grief in all kinds of ways and all of us do that very differently.
H: Well, what about the idea of going through stages of grief and people feeling like okay, I’m in this stage and now I’m in another stage which is a previous stage, maybe I’m going backwards?
K: See that’s the problem with stage theory.  Most people today choose not to typify the process of grief in stages.  It’s just for most people not a kind of helpful way of looking at the grieving process.  If you think about it, here we are.  We’re very individual people.  Even the three of us.  We have different spiritualities.  We come from different generations.  To think we’re going to experience a loss and react to it in the same predictable set of ways is probably when you think about it not particularly likely.
G: And we have different genders, which I know you’ve talked about.
K: Yeah, different genders.
G: Would you mention that a little bit because I know that’s been something for folks out there.
K: Yeah.  So I think it’s important to really kind of realize there is not going to be this set series of predictable stages.  We moved away from this notion of universal stages to really individual pathways of grief.
H: Oh, I like that.
G: Yeah, I like that.  And the end one with the Kubler-Ross model was acceptance and we’ve gone on to think about different ways.
K: Yeah, I like to use the term amelioration and what I mean by that is that for most people who are grieving, over time they say it’s less painful now than it was over time.  They usually are able to function as well as they function before the loss.  But there’s still moments and there’s still periods in which one still experiences, even years later, these sort of surges of grief, you know.  It may be that your child dies at four years old and then this June you realize that some of his classmates or some of her classmates are graduating from high school.  And that was 13 years ago.
H: I was going to say, anniversary dates often will bring us into another place.
K: Yeah, or events, or just all kinds of things.
H: So it sounds like what you’re saying, one of the ways grief has changed over time in the field is that we’ve gone from universal stages to individual pathways.
K: Yeah, very much so.
H: I like that.
G: Now what about gender differences?
K: In a sense, we’ve done some work, Terry Morton and I, on gender differences, but what we really like to emphasize are grieving styles that are influenced by gender but not determined by it so we talk about – and really look at them as a continuum.  And so we say some people who grieve really experience grief on a very very feeling level.  They really experience grief on a very very feeling level and then other people who experience grief experience their much more cognitive level and they find doing things, building a memorial, running a scholarship for their child is very very helpful.  And again, all of these are normal and natural ways of handling grief.  The problem becomes when people, particularly couples, start saying well, he’s not reacting like I’m reacting.  What’s wrong with him or what’s wrong with me?
G: Now, I like that.  Let’s pick that up when we come back from break talking a little bit about expectations of couples.  We’re coming up on break, and I’m your host Dr. Gloria Horsley with my co-host Dr. Heidi Horsley.  Please stay tuned to hear more about dealing in grief and loss with our guest, Dr. Ken Doka.  You cannot join our show today because it’s a pre-record, but we’d like to have you get in touch with us through our blog, www.thegriefblog.com.  All shows are archived on our blog as well as www.compassionatefriends.org website.  Please stay tuned for more.
Well, Ken, when we went to break, we were talking a little bit, we just had gotten on to.  You talked about grief and how the stage theory has kind of gone out in terms of looking at people’s individual ways of coping, and we were talking a little bit.  You had started into talking about couples a little bit and expectations.  Could you talk a little bit about that because I know a lot of our folks out there are saying my husband doesn’t grieve this way or my wife is too distant or, you know, that kind of thing.
K: Yeah, well, I think it’s important to recognize that again each of us deal with grief in our own very very individual way and certainly that helps with couples, and certainly that’s true for couples.  And sometimes what happens is couples impose their way of grieving on the other person, and I always like what Jane Nichols used to say.  She was a bereaved parent as well and one of the things that she used to say is the differences – she used to talk about all the factors that affect how we grieve differently and say they have little to do with love.  It’s different attachment styles, different relationships, different expectations, and the point she was making by that was saying just because somebody grieves differently doesn’t mean they had less love for the person who died or anything of that nature.  It just means that they grieve differently.  Sometimes when I’m working with couples, I talk about what attracted them to the other person and very often, the very thing that attracted them is what’s causing them problems now.  So they’ll say, you know, well, a woman might say for instance, you know, I liked him because he was so strong and whenever I got upset, he could be the very calming influence on me, and whenever I was dealing with a crisis, he was the steady hand.  And then you’ll say well, what’s wrong now?  Well, he’s the steady hand.  He’s not emotional.  And it brings them back to the fact well, this is nothing new.  This is the way that this person reacts.  This is part of the way we couple together, and so it’s important to just recognize that and understand.
G: Right, it reminds me a little bit of Pat Loder who was on our one of our very first shows in 05.  It’s archived on our website.  She had been talking about how her husband Wayne had always been the quiet steady hand and after her two children were killed, she was very angry with him because he wasn’t there for her and she kept saying, you know, Wayne you’re supposed to be there for me and supporting me, and Wayne finally looked at her and he said, how can I send you a life raft when I’m drowning myself?
K: Yeah, yeah.  And that’s the thing.  And we recognize sometimes that even what’s helpful to one person is not helpful to the other.
G: Yeah, and I think groups are kind of in there because some people think everyone should go to group or some people think that nobody should go to group.
K: It’s just recognizing and supporting each other and recognizing that in this period of time, it’s important to keep the lines of communication between people open and to keep the lines of respect open.
H: So, Ken, you talked about how people grieve differently and how some people are feeling versus some people grieve in a cognitive way and they’re more active in their grief.  They build memorials, etc., and that’s how they work through their grief process.  I wonder for the feeling people, how are they working through their grief process?  I always thought everybody was moving towards active grieving.  But it sounds like that’s not.
K: Moving toward what?
H: Active grieving like building memorials, being more active with their grief.
K: Well, no.  I think sometimes people.  You know, again, I think the important question is always the question, how have you coped with these kinds of losses in the past?  And I think very very often what happens for people is that as they’ve dealt with these losses in the past, they can see patterns.  But I guess the answer would be that often people who are very feeling will talk about expressing their feelings and maybe shouting and crying.  And often they’ll find that ways to help them explore and develop their feelings, like a support group in some cases, or maybe like something else can be very very useful and very important.
G: How about men getting together?
K: Yeah, talking to a confidante.  Talking to a counselor.  Writing in a journal.  But again the important point to remember is that it helps if I were a counselor, I’d help people be cognizant of and recognizing how it is they work through their grief and what helps them and recognizing and respecting the differences in their different approaches.  It also counts for siblings in the family.
G: How about that first year of shock?  The very beginning, when you’re around someone who has just lost a child.  We’ve got some folks that maybe are only two weeks out there?
H: I actually just ran into a woman that just lost her child two weeks ago and it was a small child from cancer and she said I don’t know how I’m going to survive.  I’m at that point, I’m not sure how I’m going to survive this.
K: Yeah, I think at that point in time, you’re doing first aid.  You’re just recognizing this is a shocking period.  You’re just trying to give support.  You’re recognizing this is.  And we live in a society in which the loss of children is totally unexpected and we expect our children to outlive us.
G: Yeah, you were saying something about siblings.  What about the siblings of this kid who died just two weeks ago?
K: We also have to understand that siblings are going to grieve differently.  They’re going to grieve differently because of their own grieving styles, where they are in development, too, and so sometimes we can do the same thing to siblings that we do to couples.  We expect everyone to grieve in the same way.
G: Right, and sometimes siblings don’t get much attention do they, Heidi?
H: Siblings can feel very unacknowledged and like their grief is overlooked oftentimes and also I’m always telling parents when kids are not grieving in front of you, sometimes they’re trying to be good kids.  Sometimes they don’t want to cause you any more pain so they might not be grieving in front of their parents because they feel like their parents have been through so much already.  Especially with teenagers. 
G: So tell me.  You’re involved in the hospice work and I know California’s been doing some initiatives.  What’s going on in hospice if a child is sick in hospice and then they want to go back to the hospital and that kind of thing.  What’s happening in that area?  Do you know what I’m talking about?
K: Not exactly, no.
G: Are we able to carry continuity of care for these children who are dying?
K: I think in most cases very definitely yes.
G: That’s working out.  What about a child who dies?  Are these families being taken care of after or is there aftercare now?
K: Well, I think one of the valuable things about hospice is that hospice has always had as part of its philosophy that the unit of care was always the family and therefore the death of the patient doesn’t end the need for care so I think hospice has been a pioneer in providing services for the family whether the patient is a child or an adult that extend way beyond the patient’s death.
H: So they are providing follow-up for the family? 
K: Oh yeah.  That’s part of their mandate.  That’s part of their responsibility.  That’s part of their mission.
H: That’s wonderful.  Ken, you know what the biggest question I get when working with bereaved parents is my teenagers are not communicating about the death of their sibling.  How do I get them to communicate more?  What information would you have for those parents?
K: Well, I think, recognize that often for lots of reasons, it’s probably a complaint that many parents make about their teenagers generally.  I think the thing I would try to say is do you see any indication of problems?  Is there acting out behavior?  Is there substance abuse?  Is there difficulty beyond the kind of normal teenage trauma.  And then I think to help teenagers identify sources that they can do both within and outside of the family.  But as I said, adolescence is a tough area and adolescents don’t want to appear different than their peers.  They don’t want to be identified very often as the kid who’s lost his brother.  They want to be accepted on their own.  So I think it’s important to again keep lines of communication open.  To respect where they are at development.  And just look for danger signs and help them find.
G: What kind of signs would danger signs be?
K: Well, I think, for instance, if there’s radical changes in grades or behavior.  I think if there’s certainly delinquent behavior.  If there’s acting out behavior including maybe sexual acting out.  If there’s substance abuse.  All of these would be signs that I would.  Suicidal self-destructive behavior.  Behavior destructive of others.  All of those would be important, you know, just not functioning.
G: Someone sent us an email when they heard that you were going to be on the show and it’s from John in Wisconsin, and he said:
My wife doesn’t want to be intimate with me.  My child died three months ago.  Do you have any suggestions?
K: Well, again, I think probably the best suggestion I would make.  First of all, I would say, yeah, these things happen.  And again, part of the ways that we grieve is that men often look at sexual acts as a way of intimacy and support and people vary on how they look at that.  For many women, that may be associated with child raising and their child or their own grieving style that may not be appropriate to them so I think the question is just to bring lines open and really talk about it.
G: Yeah, that’s a good point.
K: For John, I would say be very attentive, too.  There’s other ways to establish intimacy.
G: You might just go to dinner.
K: Yeah, have a quiet dinner together.  But I think it’s important to talk these things through.
G: Right.  Sometimes it’s pretty difficult to talk right after.  I remember when our son was killed, sometimes I’d be wanting to have a great day and my husband would be in a bad mood and that would annoy me where he would be feeling up that day.
K: Or you’re at different points in the roller coaster and that’s also a complicating factor.
G: Yeah, good point.  Well, we’re coming up for break now and I’m your host Dr. Gloria Horsley with my co-host Dr. Heidi Horsley.  Please stay tuned about dealing with grief and loss with our guest Ken Doka.  You cannot call in to our show today because it’s a pre-record, but if you’d like to email us about this show or upcoming shows, you can do it through our blog, www.thegriefblog.com.
Well, Ken, this is going to be your last segment on the show with us and I want to talk a little bit about all the things that you’re doing because you have this journal, “Omega,” and then a newsletter, “Journeys.”  Would that be something our bereaved folks might be interested in? 
K: They probably would be less interested in “Omega” simply because it’s a professional journal and it’s aimed at people who do research on death and dying.  So certainly some of the articles may interest them but I doubt enough for a subscription.  But “Journeys” they probably would be very interested in.  Journeys is written for bereaved people.  It’s published through the Hospice Foundation of America.  It comes out monthly, and it often has articles that I think will both validate and provide good coping advice.  It’s written by experts in the field.  Most of the articles are about a couple of pages.  They’re not particularly long and they’re really just good solid information for people in the midst of grief.
G: Now how would our folks get a hold of that?
K: I think if they call Hospice Foundation of America at 202-638-5419 or just go on the web page, www.hospicefoundation.org, they can find information about “Journeys.”
G: That’s great.  And you’ve done so many books.  Do you have any special, out of your books, that you feel are more for the public in general or all of them for the public in general?
K: Well, I think probably any of the books that Hospice Foundation has done are aimed for a wide audience and therefore I think can be helpful but none of them are truly aimed for people who are right in the midst of grief.  I think there you may want to look at Terry Rando’s book, How To Go On Living When Someone You Love Dies.
G: That’s great.  I wanted to ask you also how does a family qualify for hospice in the United States now if they do have a child who’s dying or a sick child?
K: Well, I think what they should do is they should call the local hospice and have an assessment made.  There’s all different kinds of, and again my work with Hospice Foundation of America is not so much on policy but on providing support for grieving families so I wouldn’t consider myself an expert on that but what I would consider and what I would strongly suggest to people is that they recognize that hospice provides exceptional palliative care and I think when they reach that point where they realize the goal is to keep their child as comfortable as possible to contact hospice and talk with them about what that may involve.
G: Now we have some folks listening to the show that are down the road a ways and if what if they wanted to volunteer?  Are there opportunities there?
K: Yeah, again I would contact the local hospice.  They’re always looking for good volunteers and many of the volunteers in hospice are often people who have come to hospice through the death of a family member.
G: Now, you know, that’s great to know because in the old days back there when I started out in the therapy business, they were saying well you shouldn’t work in an area where you’ve had a loss or whatever and now we’re really open to having people help out, aren’t we?
K: Yeah, and I think if we said to everybody you shouldn’t work in an area in which you’ve had a loss, then just about everyone’s not going to work anywhere.
H: That’s a good point.  So Ken, in your work with grieving families, you said that you offer support, what have you felt that they’ve needed the most?
K: I think sometimes they need a couple of things.  I think they need a good sense of understanding how to use the resources around them.  A good sense of what resources are available, including their own personal resources.  When I work with families, I often have them make a list of their friends and support network, and then I have them label who’s good for doing things and who’s good for listening and who’s good just to have a good time with, and that’s important, too.  Just to have time off from your grief because it is such hard work.
G: Yeah, you should remember that there are people that will help you and they are out there.  They just don’t know what to do.
K: They don’t know what to do and sometimes we don’t always ask them to do what they’re good at doing.
G: Um hm.  Good point.
K: And then I think the other thing that they need is just information that comes out of programs like yours that just says, hey, if it’s six months and everyone’s telling you to get over it and you’re still feeling bad, hey, you’re the one who’s understanding what grief is about.
G: And it’s your experience.  How about grief in the workplace?  People getting back to work.  Do you have any thoughts on that?
K: Well, again, I would think whenever you’re dealing with grief and other people, the key always is to establish open communication and to keep connections.  You have to realize when you go back to work if you’ve had a horrendous and major loss, you’re not going to be as effective as you might have been before then.  And sometimes it’s good to really talk about what you’re experiencing and how work has been with hopefully supervisors who can understand. 
G: So be proactive.  And we do sometimes have to educate people a bit.
K: And unfortunately that’s an additional burden but it is a burden we have to do.
G: Yeah, and one of the things people also tell us is that some of the friends or co-workers that they were friends with before can’t handle it.  They’re not there for them but new people appear.
K: Yeah, I always talk when I talk with grieving families, I always ask them about the surprises.  And what I mean by the surprises that the people you really thought, not just at work but all over who you could count on and you found out you couldn’t, but then there are other surprises, too.  People who you never really knew well or thought you could count on who were really there for you in ways that you never expected.
G: And we find that with teenagers, right, Heidi?  They really are disappointed in some of their friends.
K: Yeah, yeah.
H: Absolutely.  And you know I think we also need to educate people about time frames because I feel that a lot of people I work with and myself included, we feel that people feel like we should get over it and move on quickly than we’re ready to.
K: Yeah.
H: Grieving takes a lot of time and when you think that your brother.  Like when I thought that my brother was going to be with me for a lifetime, it takes a long time to work through my grief.
K: Yeah, and chances are you’re still going to have moments where you still struggle with that.
G: Yeah, as you said, some things are only once in a lifetime, like a marriage or a wedding or, you know, where you’d like your loved one to be there with you.  Well, Ken, I want to thank you so much for being on the show and just all the work that you do in this field.  It’s absolutely amazing.
H: It is, Ken.  Thank you very much.
K: Well, thank you, Gloria.  It’s been a real pleasure and I’d love to do this again.
G: And all these books that you’ve written.  I hope people will.  We’ll put some on our website and we hope people will look through those and even the titles, I must say, piques some interest.  So they’re very interesting.  And all the work and teaching that you’re doing.  You’re teaching how many classes?
K: Um, during the normal year, I teach about three different classes dealing with different elements of loss and grief.
G: Now you do presentations.  Do you do anything for the public?
K: Occasionally when an organization brings me, they’ll have me do a public lecture and I always enjoy those opportunities to really be with people and to dialogue with people.  I learn so much from people. 
G: Now if people wanted to see where you’ll be presenting, they can go to your website?
K: Yeah, I hope so.  I’m not always that current in updating it.
G: I hope that Heidi and I get to meet you sometime.  I wanted to ask you, can you advertise in “Omega?”
K: Uh, yes you can.
G: Oh, maybe Heidi and I will put an ad for the radio show and our new book in there.  It would be great.  Well, thank you so much for being on the show.
H: Thanks, Ken.
K: Thank you.
G: Well, have a great day, and keep up the good work. 
K: Thank you very much.
G: Okay, bye-bye.  Well, that was very interesting having Dr. Doka on the show wasn’t it, Heidi?
H: It was, given most people are not experts on so many different areas of grief and loss.
G: Yeah, it’s just kind of amazing how he’s covered the whole waterfront and the national hospice conversation and all that.  Very very interesting.  Well, we’re coming up on break now, and I’m your host Dr. Gloria Horsley and please stay tuned as Heidi and I recap our show with Ken Doka and talk to you about our very very special guest we are going to have on next week.  You can’t call in today because this is a pre-record, but we would like to have you email us through our blog, www.thegriefblog.com, and we’ve also had a lot of interest, Heidi, on the blog recently, because we’ve had people blogging in about some of the past shows.  I had someone recently call me about it and say one of our past shows had been very influential in their lives so we’re happy that people are going to the blog and we hope that you’ll come in there, blog in, give us some stories and comments.  Please stay tuned for more.
H: Welcome back to Healing the Grieving Heart.  For those of you just joining us, I’m Dr. Heidi and I’m here today with my mom and host, Dr. Gloria, and we were talking today with Dr. Kenneth Doka about dealing with grief and loss and how we’re going to spend the last segment is recapping on what we’ve learned from Dr. Doka today, and my mom and I will talk about certain points and things that we’ve learned.  Welcome back to the show mom.
G: Thanks, Heid.  Well, very interesting guest.  Those many years he’s been in the field is pretty amazing, everything he covered.
H: What did he say 37, 38 years?
G: Yeah.
H: I know in 1973 he got his master’s degree.  So that was a while ago.  He knows a lot and I liked that he’s been in the field so long because he’s been able to see the changes and transformations that have taken place in their field and I love that he said we have gone from universal stages to individual pathways.
G: Yeah, can you talk a little bit about what that means?
H: What I think it means from what he was saying is that most people that are in the field of grief and loss and all of us who have experienced a death know that you don’t grieve in nice neat stages any more.  Everyone has their own individual way of grieving and their own path that they take and like he said, we have waves of grief that come over us at certain times.  Maybe certain anniversary dates.  There’s not a certain order that everybody goes through.
G: Yeah and that order really was wonderful groundbreaking work from Elisabeth Kubler-Ross and we’ve talked about it before how people didn’t even recognize it and I think in the late 60s she was at St. Christopher’s Hospital in London and people didn’t even recognize dying people and they were just kind of, they didn’t talk about dying people and they had wards where they’d put em off and wouldn’t tell people they were dying or whatever and she came, started talking about dying and that people were dying and they started acknowledging about it.  The whole hospice movement started.  That she had these stages.  Anger, denial, depression, acceptance.  And like you would go through em one at a time and it was a good way to start wasn’t it?
H: Yeah, and the thing is, we do experience all those emotions but we can experience them along our grief path at any point.  We can be years down the road and experience all those emotions.  Something can trigger it.  An anniversary date or whatever.
G: Yeah, as Dr. Doka was saying, you know, a wedding.
H: Exactly.
G: Can be very dramatic.
H: Yeah, I though that was a really really good point and we’re all individuals and we’re all doing it at our own path in our own pace in our own way and that was very refreshing to hear.  He really normalized it.  For some people, they move through it a little quicker.  I think one thing also that Kubler-Ross did and the whole talk about grief and loss is people used to not realize what people were going through that had had a death and that they were going through a very painful, very significant event.
G: Right.  And as he said, we aren’t expected to have our kids die nowadays.  At the turn of the century, like 50% of children died.
H: That’s a good point.  Now it’s a non-normative event right now and, you know, I do something in my grief and loss classes at Columbia where we get in a circle and there’s 26 people, and I’ll step in and say everybody that’s experienced a death of a sibling step in the circle, and I’m usually the only person in there.  So losing a sibling or losing a child nowadays is something that most people have not experienced.
G: That’s right.  I like the way you say it’s a non-normative event now.
H: Because sometimes you can feel alone and like I’m the only one that’s been there and it’s really good to know that other people have been there and made it through it and you’re not alone.
G: Absolutely.  Well, I thought his gender differences thoughts, too, were interesting.  One of the things that we always find out with academics, Heidi, I think, is that you can’t pin em down because they’ve seen so many differences and studied so many different things so there’s no cookie cutter is there?
H: Absolutely not.  I agree with you.  One thing he did that I liked is when he said that he asks people to make a list of their friends and the support people in their lives.  Even people that they can be around where they can take time away from their grief. 
G: Yup.  I liked that too.  Yeah, I hadn’t thought of that.  My get-away-from-the-grief group.
H: I didn’t either.  I think that’s such a good idea to make a list of support people in your life and then a list of people.  Okay, I’m going to go have fun with Johnny.  He’s a fun guy.  He’ll give me a break from the grief.  He’ll want to play basketball, whatever.  I think that’s important and it’s like I said with the family fun time.  It’s important to take a break from our grief.  Sometimes we feel guilty about doing it.  It’s really important to do it.
G: Absolutely, it is.  Well, I wanted to talk a little bit also about next week’s show, Heidi, because we’re going to have on next week’s show someone else who’s been involved with the hospice movement, right?  Dr. Betty Davies.
H: Yes, and Ken and Betty have worked together before.  They know each other.
G: Yeah, she’s a published author on grief and loss also like Dr. Doka is and she’s won a lot of awards.  But she comes from a nursing background, doesn’t she, Heidi?
H: She does and I co-authored an article on continuing bonds with her and I was honored to do that because when I wrote my doctoral dissertation on sibling loss, I cited her many times.  She is the most published author, I think in the world on sibling loss.  She has published many many articles and books on it as well so she’ll have so much information for us on the death of a sibling.
G: Yeah, that’s great.  So that will be interesting to have her come on the show.
H: And like you said, she’s a nurse and she works out of UCSF, University of California, San Francisco hospital.  That’s her background.
G: One of the things that I think is also.  I meant to ask Dr. Doka about working with funeral homes.  I thought that was interesting that he works with funeral homes and funeral directors and is with the hospice and gets involved with those kinds of things.  Very interesting.  I thought it was interesting that he felt that there was so much after care.  I have a feeling my audience out there or our audience out there aren’t sure about that.
H: About after care.
G: After the death of a child.
H: You know, I’ve heard that a lot like you said, mom, where people said that there were so many people around when their child was dying or their sibling was dying as far as from an illness and then the minute they were dead, everybody disappeared.
G: Yeah, I’ve even heard that in hospice so it’s interesting that he’s working on that after care and for our audience out there, if you didn’t have that kind of after care, give us an email, shoot us an email, or put something on the blog because I think this would be an interesting point of discussion.
H: And Grace Christ set up a program at Sloan Kettering where they did follow up.  They did follow up after care after the death of a parent and they went out and did home visits and saw families over time.  And to my knowledge, in fact, I’m almost positive, that was the first time they had ever done that at Sloan Kettering under her leadership.
G: So I think one of the things we’re working on a little bit in the grief field and should be is after care.  I know after Scott was killed in the automobile accident, we didn’t ever see anybody.
H: Right.
G: So even though I was in the field so I saw a lot of people because I was working in the field.
H: Well even with a sudden death, too, because you don’t have the support before.  It was a sudden death, and then afterwards usually you just have the support of family and friends but not the medical community.
G: Yeah, so I thought that was interesting that he sees that there’s so much support going on in that area.
H: Right, yeah, which maybe he does.  Maybe where he is there’s more going on.
G: I have a feeling wherever he is as a person, there’s more going on, because I think that’s one of his passions it sounds like.
H: Absolutely.  I also thought it was interesting when he talked about adolescence.  I know that all of our listeners out there are concerned about their teenagers.  Teenagers is a hard time even in the best of situations and when he said look for danger signs.  If you’re worried about your teen, look for the danger signs.  Acting out, substance abuse.  That’s the kind of things you need to look for.
G: Yeah, absolutely.  Well, it’s time to close our show today, Heidi, and Ken Doka was a great guest wasn’t he? 
H: He was.
G: And I think that people will want to get this newsletter he was talking about.
H: I know.  I would love to get it.  “Journey: A Newsletter for the Bereaved.”  I’ve actually never read it.  It sounds really good.
G: And it looked like the National Hospice Foundation is where you can get it.  I’ll try to put something on the blog about that so you’ll be able to get that newsletter.  So next week our topic’s going to be Sibling Bereavement in Childhood as Heidi and I talked about.  We’re going to have as our guest Betty Davies, Professor of the University of California San Francisco and Dr. Davies is one of the world’s leading experts on bereavement and she’s a published author and has won numerous honors and awards for her groundbreaking work especially with her work on siblings and she’s on the advisory board of Super Sibs! a non-profit organization for siblings of children with cancer.  So this show is archived on our blog, www.thegriefblog.com, as well as www.compassionatefriends.org website.  And we certainly hope that you’ll go to the grief blog and take the opportunity.  We love to get your stories, your poems.  We’ve even got a place for recipes.  You can download all of our shows and look at our past shows or whatever you want to do on the blog.  Have you got any thoughts about the blog, Heidi?
H: Any thoughts about the blog?
G: Um hm.  Anything you’d like to see people do more with it or
H: I like to get comments and feedback about our shows.  If you want to see more of a certain topic, please let us know and we’ll get somebody on.  Those kind of things are interesting to me.  Like what kind of things would you like to see that we haven’t had as far as guests.
G: Absolutely, because we had Dr. Jed Black talk about sleep and we wondered if you want more health kind of things.  So if you do, please let us know.  So please stay tuned again next Thursday at 9:00 Pacific Standard Time, 12:00 Eastern, for more of Healing the Grieving Heart, a show of hope and renewal and support.  And we also want to remind you before I totally close the show that Heidi and I will be at the National Compassionate Friends Conference and we will be speaking and do you know what the date is, Heidi?  The end of July, second weekend in July, and it’s in Oklahoma City.
H: Yeah, on the 22nd.  I don’t know the exact date.
G: Yeah, around the 22nd so we hope that you’ll be able to come to that.  Healing the Grieving Heart, a show of hope and renewal and support.  Heidi and I want you to know that others have been there before you and made it.  You can, too.  You need not walk alone.  So thanks for listening.  I’m your host, Dr. Gloria Horsley, with my co-host
H: Dr. Heidi Horsley, and Dr. Kenneth Doka, thank you for all the work that you do for people that are grieving.  Have a good week.