It’s mind-boggling. That’s what it is.

Jackie settled down just minutes earlier. In her last year of residency, she’s often on the go. She throws her sweatshirt over her shoulders, stuffing her folded lab coat into her over-filled back pack.

That was a long day, gosh. And although I’m tired, my mind is racing. But get this, there’s absolutely no reason for my mind to race.

I actually flipped through the psychiatric conditions and my anxiety isn’t related to anything. Some days I’m ok and other days I feel like a cushion slowly unraveling at its seams.

Jackie is a smart, intelligent woman. She’s put herself through medical school and has been leaning on her strengths which have gotten her far.

In this moment, though, her shoulders carry an exhaustion paired with a yearning. A seeking. An emptiness in her eyes that are asking for something.

At our initial meeting Jackie presented with a confidence and “together-ness” as she eloquently shared, “My life has been working out but I’m not as happy as I should be”.

We’ve been getting to know what that feeling is about. As we settle in to the session, I inquire about any subtle shifts at home or work.

Nothing changed much, aside my placement at the hospital.

Her voice gets quieter and her eyes look as though she’s staring at something in the distance. “Jackie, I’m still here, I say, and I wonder how much of you is here right in this moment”. She glances up and smirks.

You know I’m here.

“Oh of course you are, but if I were to ask you what percentage of you is fully here and what percentage of you is somewhere else, what would that be?”

Oh. Well, not very much of me is here.

She breaths a deep sigh. We take a few more breaths together, paying attention to “gathering” more of her presence into the room and noticing what’s happening as we do that.

I’ll tell you what I’m noticing. When you asked if anything changed, I said no. But then I realize Ive been working on the gyno unit for the past two weeks. I am fascinated by the human body and parenthood, I truly am. But then there’s a sadness there. It doesn’t make sense to me though. Anyway, that’s where I went when I was spacing out,

Was her anxiety related to inhibited grief?

As her therapist, the pieces are starting to take form, and there’s an edge of possible clarity. I’m curiously holding some of what she had shared and looking at its relativity to the current anxiety. Six months ago, Phil, Jackie’s ex-boyfriend broke up with her.

When sharing this, Jackie laughed at the break-up, saying he was an idiot, and how school should be her priority anyway. Beneath the laugh there was more than a tinge of disappointment. Yes, Phil was immature and had growing up to do, but they had really connected and Jackie had invested a lot of her future goals in imagining life with him.

Next to becoming a doctor, Jackie's life dream was to become a mom someday. Jackie’s mom had been ill for much of Jackie’s childhood, which propelled her commitment to give back to the medical community. She wanted to do that while being there to nurture a child of her own in a way her mom couldn't.

Her eyes lit up and her soul had a special spark when she discussed her dreams of future parenthood.

It was obvious that those plans invigorated her mind, energized her body and brought vibrance to her spirit. And now, her mind + brain + body were struggling with accepting and aligning with the life in front of her.

Our session continued as Jackie engaged in the exploration and gentle work of what was going on, on more levels than consciousness had shown to her.

What Jackie is experiencing is anxiety related to grief.

Grief of a life she hoped for, a reality she expected, a love life she had built and lost, and an image of her soon-to-be future that is no longer. She’s grieving the acceptance of reality with the losses, worries and possibilities of rebuilding her dreams. She’s also grieving the promises she’s made to her inner child, as there is an unknown she’s facing.

To be clear, grief does not mean sitting with broken hopes and getting trapped in mourning.

Grief actually is more about holding space for the “feels” of what is, and there can still be lots of space for hopes, dreams and possibilities. The two do not contradict. It’s more about needing to re-adjust, re-route and re-structure life in ways that were previously not explored.

Grief is a word often used regarding death or significant loss; what many people forget is that we all grieve.

As we start unpacking the anxiety that’s related to grief, Jackie’s energy calm down and her focus cleared up. When the body calms down and the mind slowly clears it’s often sign that were headed to the unconscious area that’s needing some healing.

I didn’t realize how working with moms and babies would trigger me. But of course, I see happy couples, families building and it’s like a kick to my gut. Jackie lets a heavy tear roll down her cheek. There’s more where this came from y’know. I guess it’s normal that I’m feeling like this even though it’s been a while. Huh?

What is grief?

According to the Merriam Webster dictionary, grief if defined as: a deep sadness caused especially by someone’s death, a cause of deep sadness, a trouble or annoyance.

Let’s open the interpretation of grief to invite healing for all forms of griefs that are in need of gentle healing.

The process of healing grief is often understood in the context of death and dying, however, grief encompasses any form of loss, sadness, pains and hurts. A swiss psychiatrist. Dr Kubler-Ross is known for her impactful work in grief. She describes healing griefs in five steps; Denial, Anger, Bargaining, Depression and Acceptance.

What's important to note is that grief is individualistic. There may be common emotions and experiences, but you will have different emotions, triggers, sensations and feelings as you ride the waves of your losses and changes in life.

 

Why is this relevant to you?

If you're struggling with anxiety, and have been navigating a big change, a loss or a hurt, it may be grief.

The anxious symptoms may be a communication of grief you’re moving through.

The thing about healing pains and grief is:

You don’t simply walk upward five steps of healing and then tuck it away in a box with a nice pink ribbon.

Elisabeth Kubler-Ross actually writes about this in her book called “On Grief and Grieving”. She says,

“ The (5) stages (of grief)…were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss, as there is no typical loss. Our grief is as individual as our lives. Not everyone goes through all of them or goes in a prescribed order.”

Counseling is often one of the first platforms to explore healing, emotions and transformation. As Jackie shared;

It’s just all foreign language to me, Jackie says one afternoon. My family doesn’t use feeling words. You just work hard because thats what we did. I’m the first one to go to medical school so no one was able to relate to my struggles. But I realize it’s also because I didn’t even realize what I was struggling with until I started therapy.

Here Jackie is grieving, and as she grieves + heals, her anxiety lessens. Demystifying symptoms helps better identify trigger points, plan for better self care and work within the context of what life is presenting with today.

Grief is hard, but living stuck and trapped in unacknowledged grief is worse.

If you’ve been one who has been struggling with anxiety and you’re sensing it may be related to grief, please be gentle with yourself. Give yourself the space to heal, process and prioritize your healing. Grieving softens the platform of exploring new possibilities and expanding horizons, when ready.

The big, small and medium pains are all valid. Here are some other griefs that may be causing anxiety that’s holding sadness and pains.

You have permission to grieve.

  • The life you thought you’d have, yet you’re slowly building the life you currently have

  • The children you hoped for but are currently facing a different reality than expected

  • the ease you hoped for but are struggling to keep up in university or at work

  • the health you envisioned for your body yet are struggling with symptoms that leave an impact

  • the love you sought in your family but did not receive

  • the parents you wished you’d had

  • the breaking apart of your friend group from your childhood

  • the holidays that bring up feelings of confusion, loss and isolation

  • the loss of freedom that came along with parenthoo

  • the expectations you’ve had to release due to limitations of life and/or self

  • the realization that your loved one may never fully understand a part of you

  • the awareness that your social group is shifting

  • the loss of a leadership role at work

  • the shifts in your financial earnings

  • the loss of safety in a others when you’ve been betrayed or hurt

  • the diminished confidence in yourself as you navigate a new, scary phase of life

  • the changes in your relationship with god and your beliefs

  • the ending of a relationship and the pains it comes with (even if you chose it)

  • the mental health and illness that runs in the family and the pains it causes

  • the siblings you didn’t get to have

  • the brains you wished you had

  • the creativity that just doesn’t flow naturally for you

  • the changes in identity as you mature

  • the loss of naivety as you are exposed to the world

  • the thick skin and aggression you’ve had to use in frightening situations.

  • the difficult associations you have with intimacy, sex and love

  • the years of the past where you were disconnected from yourself, others and life

  • the difficulties you have in cultivating healthy relationships

 

You have permission to grieve other forms of losses as well. If you’ve been touched by death, my heart feels for yours. The loss of a loved one, a pet, a parent or siblings is devastating. And those griefs can bring new griefs as you move through phases of life.

We’ve all been through ups and downs, as life has a way of leaving an imprint on those traveling on their journey. The better you are at owning your story, the joys, the griefs and the pains, the less weighted you’ll feel.

When you give grief a platform, the bubbling anxiety can slowly reduce its intensity and gradually dissipate.

Own your journey and take your next step to healing. Need tips to helping you heal through grief? Read this for 6 tips to support yourself while grieving.

Seeking additional support? Reach out to a local skilled therapist who can join you as you heal the pains and anxieties related to grief.

 

Esther Goldstein LCSW is psychotherapist and trauma specialist who runs a private practice called Integrative Psychotherapist in Cedarhurst, NY. At Integrative Psychotherapy we are passionate about helping adults reduce anxiety and find a richer way of living, loving and "being" that promotes joy and connection. Our therapists use science based methods and modalities such as psychodynamic psychotherapy, Eye Movement Desensitization Reprocessing (EMDR) Sensorimotor Psychotherapy (somatic), Expressive Arts and Parts work (Ego State Work) to help clients feel relief that last way beyond their time on the therapy couch.

Specialties include treating anxiety, trauma survivors, relationships issues, family-of-origin work, Inner-Child work, Attachment focused Therapies, Healing for Complex PTSD And Dissociative Disorder Treatment.

We also offer Trauma Informed Consultation To Therapists Committed To Improving Their Trauma-Informed Practice And Attachment Focused EMDR Consultation To Therapist Attaining Hours Towards EMDRIA Certification.

Website: Integrativepsych.Co