Dear Dr, Neimeyer,
It’s been around two years now since I lost my husband and my dad a few weeks apart. The grief is still so debilitating I can hardly get up in the morning. I see a therapist but it doesn’t feel like it’s helping very much. I attempted to take my life earlier this year, spent some time in the hospital but now am back to work and expected to function as a supervisor again. I live in a pretty small town and am unable to find any grief support groups. I don’t know what else to do to get out of this dark place. Can you suggest some books or material I can read to help begin to move forward, please?
Though we all wish it were otherwise, the sad truth is that time alone does little to heal the wounds of grief; it is more a question of what we do with the time that matters. And from your brief letter, it is clear that you have tried to do much to surmount the pain of your double loss, from your desperate attempt to end your life to your determined attempt to return to work, and your interest in reaching out to groups and for readings that might provide support and compassionate counsel. I want to join you in these latter, more constructive efforts.
Of course, your first priority needs to be safety; if you do not survive, then there is no life on which to build. This clearly needs to be a central focus of your therapy with your current provider or another, to help address the psychic pain, despair, or aloneness that has driven you toward suicide. Beyond reducing risk through limiting access to means of self harm (safely removing firearms from the home, entrusting potentially lethal medicine to a friend or relative), it will be critical to identify what, for you, can begin even by small degrees to restore hope. Perhaps this might be as small as learning some new skills for combatting the escalation of overwhelming negative emotion through mindfulness or moderate exercise, or taking steps to complete one or two of the tasks on a neglected and similarly overwhelming to-do list. Likewise, anything that enhances reasons for living—such as strengthening important relationships, grounding in a faith tradition or personal philosophy, or undertaking meaningful projects—can help you both defend against despairing impulses and rebuild a life of meaning.
Second, it is clear that you need to work on your grief per se, not only generically on depression or engaging your work (though this also is important). In this, your impulse to find mutual support from others like yourself could be a relevant step, even if this means planning a weekly visit to a nearby community that offers support that yours does not. There are even weekend or week-long grief retreats that could be specifically healing, for a tiny fraction the cost of psychiatric hospitalization. Alternatively or additionally, I would encourage you to search on the internet for online support forums for people with similar losses, which should be abundant. Increasingly therapists and counselors also offer consultation and therapy in online environments such as in videoconferencing, which can be as effective as face-to-face sessions. Importantly, this would let you find and work with a truly expert provider specializing in complicated grief, just as you would consult a medical specialist rather than a general practice family physician if you were facing an equally life-threatening medical condition. Your profound and prolonged grief needs to be taken no less seriously.
Finally, hold a magnifying lens over the grief itself. What feelings and needs, specifically, do you find threaded through the fabric of your bereavement? If loneliness, you need to find not only activity companions, but also good listeners. If hopelessness, you need to connect to people and stories that can speak of moving through similar darkness toward the light. If spiritual struggle, you need to read books in your faith tradition that ask and answer the hard questions of where God is in your suffering. If self-criticism, you need resources that help you view your self-talk in a more self-distancing perspective, and find ways of moving toward less hard self-judgments. And if resolution of unfinished relational issues with your husband or father, you need to find ways of addressing them with the help of a therapist skilled in facilitating symbolic conversations with the deceased, or helping you find a secure base in your continuing bonds with these figures (with AfterTalk conversations playing a potentially useful role here) or with others in your lives. In other words, whether you examine your grief with a group, with a therapist, or through the lens of self-help books or grief memoirs you can find on sites like Amazon or Open to Hope, the crucial thing is for you to safely examine what your grief tells you about what you need to find or change to not only manage your pain with self compassion, but also to reach toward a changed but meaningful life in the future.