538. Loss is inevitable, but grief is our emotional response to what is gone. In this episode, Dr. Monica Johnson and psychotherapist Hilary Bucell look at the differences between grief and depression and discuss various forms of loss, including ambiguous loss (like dementia or divorce) and disenfranchised grief (loss that society doesn't acknowledge).
538. Loss is inevitable, but grief is our emotional response to what is gone. In this episode, Dr. Monica Johnson and psychotherapist Hilary Bucell look at the differences between grief and depression and discuss various forms of loss, including ambiguous loss (like dementia or divorce) and disenfranchised grief (loss that society doesn't acknowledge).
Learn more about Hilary Bucell at her practice, integrativepsychwellness.com.
Find a transcript here.
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Dr. Monica Johnson: There’s a lot to grieve in the world, and that’s not simply limited to the present-day nature of our reality. Grief is an inescapable aspect of the lived experience. Which is why I’m so happy for the guest we have on the show today. She will explain what constitutes as loss and grief, whether that be death, job loss, or identity related. And tips on how to find meaning on our journey. Stay tuned until the end for an important announcement.
Welcome back to Savvy Psychologist. I’m your host Dr. Monica Johnson. Every week on this show I will help you face life’s challenges with evidence-based approaches, a sympathetic ear, and zero judgement.
I am so pleased to have Hilary with us today to talk about grief. But before we get into that topic, please, please Hilary, introduce yourself to the audience. We are so gracious to have your presence today.
Hilary Bucell: Thank you so much, Monica. I am Hilary Bucell. I'm a licensed clinical social worker and psychotherapist. So I have a private practice where I work with young adults, adults, and couples. And then I'm also a lecturer at the Columbia University School of Social Work.
Yeah. And I
Dr. Monica Johnson: And I know, you know, I plugged you today to get you in kind of
to kind of talk about grief. I know I know that there's a lot of grief experiences happening in the world right now, so as a starter, I I know that grief and loss are related. Um, but can you give us a working definition of loss and grief like as a foundational kind of start to this conversation? Absolutely. So loss is simply something that's gone, right? That's it. The loss is what is gone, what's not here anymore. And grief is our emotional response to that loss. So pretty simple. Grief is what we're doing with the thing that's gone. Yeah. Yeah.
And I know something that often comes up is people are sometimes confused on kind of what kind of counts loss. Can Can you talk about the different types of loss that a person can experience?
Hilary Bucell: Yeah. I think this is a really important one. So probably the most universal truth or loss that we know of is death, right?
Um, when somebody is physically no longer here with us on the planet, on Earth. But there are so many other types of loss, and often these types of losses go unrecognized. And so we could call them ambiguous loss. And so a form of ambiguous loss could simply be, um, they can either be physical or mental.
So you can have, let's say a family member has dementia, right? So that family member is physically present with us, but mentally, they're no longer here. Right? So that would be an ambiguous loss. And another ambiguous loss could be a relationship ending, right? Yeah, absolutely. It could be your children going off to college, right?
There's that, there's no longer that, um, experience of them in your home. A divorce is another type of loss. Um, so there's so many types of loss, a pet being gone, right? The death of a pet, um, that often go unrecognized or unappreciated by society. Yeah. And that we don't give ourselves, like, the experience to grieve? Yeah.
Dr. Monica Johnson: Oh, oh, for sure. I know that I've had some patients who have who have dealt with job loss. There's been there's been a lot of grief around losing their job, but also an impact on their identity as well in a lot of these situations.
Hilary Bucell: Absolutely. There's so much tied into what we do, who we surround ourselves with, even kind of how we physically look or move through the world. And when one of those things is no longer present, um, there can be a really intense emotional response to that.
Dr. Monica Johnson: What are some common signs of a person that's grieving?
Hilary Bucell: Hmm. Great question. So common signs of grief can be a lack of interest in the things going on in our lives. It could be this emotional response, like a physical emotional response such as crying or even like feeling of an upset stomach.
Um, it can be things that also we typically relate to anxiety, right? So like butterflies in the stomach or a tightness in the chest, right? There's the saying, right? Heartache. Right, and it's real grief is physically felt in the body. Yeah. Yep.
Dr. Monica Johnson: When you are, you know, helping a person kind of decide is it grief or not, you know, you know, grief and depression can definitely have a lot of overlap and be interrelated.
Are there certain things that you would be looking for or would suggest people to notice, to kind of maybe understand the differences between the two?
Hilary Bucell: Yeah, absolutely. So depression can be seen, we can kind of think of it like an umbrella. So it's, it's this like pervasive sense of not enoughness or kind of this lack of, um, interest in kind of anything going on that continues for a prolonged period of time.
Whereas grief is more of the, um, it's like a yearning, right? For that thing that's no longer here and they're very similar, but, um, it's not that you're no longer interested in your life like depression. It's more of the longing for this thing that's no longer here is coloring the way that you're looking at the world. Yeah.
Dr. Monica Johnson: The way that you're talking about grief, it it sounds like grief is a very normal process that like probably all of us are gonna grieve multiple things throughout the course of our lives.
Hilary Bucell: Yeah, I'd say grief is like the universal human experience. None of us are going to go through life without loss, without having this experience of loss.
Dr. Monica Johnson: Absolutely. Yes. I just I just wanna say out loud, I don't like it. I I don't want to feel bad. And I'm sure other people feel that way too, But but knowing that there are, you know, obviously parts of grief that can lead to kind of experiences that we're not gonna choose on our own.
How can I tell the difference between like, is this kind of like the normal healthy process of grief versus something that may be outside of that?
Hilary Bucell: Yeah. I think, you know, the thing with grief, and I wanna emphasize, is that there really is no normal way to grieve. There's no specific way to grieve, which I think, um, we often think that there is. Um, Elizabeth Kubler-Ross came out with these stages of grief, but it's important to note that those were actually created as, um, stages of dying.
She was working with terminally ill patients when she created this, and so it wasn't initially intended for grief. And even before her own death, she came out saying, "Hey, you know what? These stages aren't linear," so that's a really important one, and not everyone will experience them. So I think that's the first thing to keep in mind.
And so we don't want to pathologize the way that we're grieving, and in answer to your question, uh, I think when our experience of grief gets in the way for like a prolonged period of time of us actually engaging in our life, right? So doing our job, showing up for people on the things that we need to, um, even taking care of like our physical health, right?
Like getting dressed, getting up in the morning, right? For, for an extended period of time. Then that's a point where we'd want to seek professional help, right? So after a really significant loss, I'd say, yeah, there's going to be a period of time where you are feeling that yearning, right? You're feeling really blue.
That intensity of feeling is with you, and that's very normal. Okay? But after, you know, we actually have a disorder called Prolonged Grief Disorder that takes actually about a year post, at least a year post the death of someone. Um, that's when we start to go, "Hey, if we're not engaging in our life in the way that we want to, then this might be something that we want to address." Yeah.
Dr. Monica Johnson: I know that when I work with patients around grief, there's also a lot of judgment that comes up. Sometimes it's judgment about the amount of grief we are experiencing over that particular type of loss. That can go in both directions. Sometimes we feel like we're doing too much. Sometimes we question, "Am I grieving enough?" Um, do you have any sort of insight or tips on how to work through some of those judgments?
Hilary Bucell: Yeah. You know, judgments are values-based assessments, right? Like what's good, bad, right, or wrong. And that's going to differ from person to person based on their values. So what I would invite in is that maybe your grief is showing up in a way that's unpreferred, but it doesn't necessarily mean that it's bad or wrong.
It's there. And, kind of like you mentioned, you're like, "I don't like it. I don't want to be with it." Right, of course. Grief is a really uncomfortable experience. Very uncomfortable. And the thing with grief, too, is it often doesn't completely go away. Right? I like to say that we learn to walk with grief.
It's not something that we can box up and put on the UPS truck. It's something that we take for a walk daily. So this idea of how do we learn to adapt to the grief, to the waves of how it shows up in our life, and really hold that tenderly and compassionately. If we're having
an experience of grief, again, that's showing up in ways that are really unpreferred again and again, then that could be a time to take note and say, "Hey, you know what? Maybe I do want to seek help to learn how to meet this differently or meet with my friends or try something new." But if the loss is initial or it's showing up occasionally, then I might invite in, "Hey, how do we learn to walk with this grief?" Like, adapt with it, move, um, create new meaning with it in our life now. Yeah.
Dr. Monica Johnson: The next question might be a little bit complicated. However, I know that I work with a very diverse population of people, and I myself hold a lot of different diversity variables. Sometimes I work with patients who have a lot of grief around various identity experiences, whether that relates to race, religion, sexuality, or gender, and this grief of, you know, these identities represent who I am. Society puts certain oppressive forces against those identities, and there is a grief response or a sense of loss in a lot of these situations. I'm wondering what your thoughts are on that. Are there different ways to perceive these things or to find pathways toward coping, resilience, community, or any of those sorts of things?
Hilary Bucell: Yeah, absolutely. Um, so the first thing I'd want to say is that experience of loss—kind of alluded to it in the beginning, spoke about it in the beginning—is this idea of an ambiguous loss or a type of loss that society really doesn't recognize. And so, you know, that loss of, "Oh, I am not part of the dominant culture," right?
Or my experience isn't recognized—like that is a loss in and of itself. When we have a loss that goes unrecognized like that, it can move towards what we call disenfranchised grief or unrecognized grief, right? So our ambiguous loss moves toward disenfranchised grief. Oftentimes in that space, it can feel really stuck.
I'm imagining that's something that your clients are coming in with. It's something that my clients come in with—this idea of just feeling stuck. What do I do with this? Am I allowed to grieve this? Society says I can't grieve this. The first thing that both science and, you know, I think community tell us is to label it, to really validate your experience and say, "Yes, this is a loss.
This is something that you are experiencing and many others experience, and yet we don't always name it." But it's really important to. So the first thing is naming it, validating our experience. And then when we really see something, that's when we can move toward problem-solving, right? So that problem-solving might simply be, "How do I hold this more tenderly?
How do I validate my experience? How do I make meaning out of this?" Sometimes that's really challenging to do. Or it could be, "How do I find community with this?" You know, there are so many varied experiences that you're talking about, but in this simple act of labeling it, acknowledging that it's here, we can effectively move forward in a way that's appropriate. Right. Aligned with your values. Yeah.
Dr. Monica Johnson: You know, particularly when it comes to this idea of disenfranchised grief, is there any sort of journaling or reflection or any sort of things that you would suggest in terms of helping a person? Because, you know, it's great to name it, but sometimes we need that step before that of just really noting what is coming up for me before we can make sense of it and find a label. I know for me, at least related to race, when I was like 12 or 13 is when I fully or at least initially had the realization of what it meant for me to be a Black woman.
Like I wrote a poem, and there was a journal entry that was all about the fact that probably for the entirety of my life, I would have to face certain forms of oppression and discrimination. And then, you know, feeling the sadness over that, like crying.
I remember writing in my journal,I had a moment where I was crying, I looked at my hands, and then in my brain I went, "I'm Black." And I smiled because I was also able to tap into the energy of what my family had taught me about being a Black person or what I knew of my ancestors—that this was a part of our calling or our burden or whatever it is. You know, the meaning that we can assign to it. Right?
And so, you know, especially in a time where there's a lot of that, how do we reflect? How do we ground ourselves, I guess, within our identity, our ancestry, and find community? Whether that be people who represent our same kind of demographics or our allies or whatever.
I also know this is a complicated conversation or question. But when we talk about disenfranchised grief, I don't think we can talk about it without acknowledging that it's nuanced.
Hilary Bucell: Totally. It's a very nuanced thing, and I’m glad you're bringing these questions of depth in. I have several things kind of percolating in my mind right now, so I'll try to be clear with them.
I think the first thing that you asked about is this actionable step of how do I even recognize I'm grieving, and I think that's so important. I too have had clients come into my practice where they're very anxious and actually feeling sensations of panic, and we later learn, "Oh, that intensity of feeling is grief." You mentioned journaling. Yes, journaling can be a really lovely thing to do, like having a grief log or we could even say a mood log of, "Hey, this is how I felt, and these were the thoughts and emotions that showed up." Eventually, we can look back at the patterns and go, "Hey, what are we actually thinking about?"
Or what occurred that day? You know, maybe you're grieving. You spoke of your identity with race, right? So it could be that you saw something—maybe you saw an advertisement, right? You're a young kid and you saw an advertisement of someone doing a job you wanted to, and they didn't look like you.
Then you just noticed you felt really angry. We can notice those moments and then make patterns, and that can really help us recognize, "Oh, actually, maybe this anger underneath it is some sadness, and maybe there's grief there." So that's a really actionable step that we can do. We can have conversations with friends, right?
That validate that experience, like, "Oh, I was grieving—that was real for me." In terms of this meaning-making, one thing we can do is, like narrative work. Like, "Who am I with this loss? What does that look like? What does this loss mean to me?" That can also be a really lovely writing prompt or conversation to have—"What does my life look like now that this thing isn't there anymore?"
So even, um, another disenfranchised, uh, loss is often, um, a relationship or a lack of, right, one that you didn't have. You could even be in a relationship and feel like, oh, it doesn't look like the one I wanted. And so we can really do some narrative work on the thing that was lost and we desired and what our life looks like now.
And then, you know, in terms of, uh, these identities, um, we can do ritual, right? And that can be a really lovely way of connecting with ancestry, as you're saying. And, um, making meaning out of struggle or making meaning out of our experience that isn't honored by society. And so that ritual can also be really joyful.
So it can be this both-and, right? So I think you, you know, you mentioned smiling in the mirror; you can acknowledge, wow, this is such a painful experience that I'm having, right? As like a young Black child not being acknowledged, and yet also, wow, like I really love myself. I'm so fond of myself. Or there's some beauty in this, and both things can be true, right?
We can acknowledge the sorrow and sadness in those really difficult experiences of our identity and also recognize, wow, there is also beauty in this too. Um, so those are just a few ways that we can move through experiences like these, which are so nuanced. And I'm so grateful, you know, you're bringing them up because we don't talk about them nearly enough. Yeah.
Dr. Monica Johnson: One thing I wanted to ask about too was kind of the anger piece. I know we've kind of touched on judgment, guilt, shame, but whether it's disenfranchised grief or, you know, loss of a loved one, anger is often a piece that comes through at some point or another. Do you have any specific tips or ideas about anger?
Hilary Bucell: Totally, yeah. Anger and sadness. I call them like cousins. I think, uh, maybe a lot of clinicians do, and it's this idea that both anger and sadness often tell us that a goal is blocked. So anger says, "This thing that I really wanted, I'm not getting it. Something's in my way; it's preventing me from getting it." And sadness can say, "Oh wow, like something was taken from me, right? It's no longer here." Those are very similar experiences, yet they have really different action urges. Um, 'cause anger wants us to propel towards something, right?
And that can often be like an urge that is easier to access; society almost condones that more, right? Whereas sadness, we want to retreat. And so there's an invitation; if you notice intensity of anger arising frequently, we don't want to judge that anger.
It's a very normal part of grief. We want to recognize it. And if we're moving through our anger skillfully, that's great, but if we notice that our anger is actually impacting our relationships or our performance at work or getting us into trouble, right? Then that's something we might want to look at and pause, right?
And that could be a really lovely time to do some journaling prompts or even just distract for a bit, like purposefully, right? Saying, "Hey, I am going to go and watch this movie or go for a walk or do a puzzle and then come back." And then that can be a moment where we can check in and go, "Right, like, am I really angry or is there something else here?"
Um, but it takes a lot of bravery too. Sadness can be a very difficult emotion for people to access. There's a fear, like if I'm sad, I'll never actually get out of it. So, um, yeah, it's a really brief thing to move from our anger into allowing the sadness to be there, and if we allow that to be there, then we can actually kind of move forward from it.
Yeah.
Dr. Monica Johnson: A big part of what I'm hearing you say is if we kind of move with the experience versus moving against it, we have a much easier and deeper experience.
Hilary Bucell: Yes. Yeah, a hundred percent. Yeah. It's like that analogy, right? If you're caught in like a riptide, you actually want to move with.
The current is going to take you to shore. It might take you further downshore than you want to be, right? But if you actually don't fight it, you're going to come to land. And the same thing happens with our grief. And you know, grief does come in waves. So again, it's not this linear experience.
I really want to emphasize that. And sometimes it shows up in the most unexpected of places, right? You might be on the subway in New York, and there's an ad that shows up and it reminds you, you know, of your pet that you had, you know, 10 years ago, and you're just struck with this intensity of feeling.
And so this idea of exactly like you said, moving with it, labeling it, right? Rather than fighting it. Like, "Oh my gosh, I can't, this can't be here, right? I can't cry; I can't feel this." Oh, it's here. You can even let that little bit of tear, you know, well up in your eye like, "Oh yeah, I'm feeling grief right now."
And amazingly enough, I think, um, I've seen it in the people I work with, even in my own experience. Then that grief subsides; it goes away, right? It's like, "Oh, I'm seen. The message is heard," and then you're able to kind of go back to the present. Yeah.
Dr. Monica Johnson: Part of what we're talking about in terms of this anger, because as you're talking, my brain is percolating, so questions are coming. Love it as you're talking. Yeah. So
part of what I'm also thinking about in terms of like anger and some of the not problematic emotions, but emotions moving out of the space of being outside of normal limits, you know, for the grief situation, you know, things that I worry about sometimes is like social comparison, right? Particularly when we have, I mean, it can come up in disenfranchised grief, um, you know, in a lot of different ways. Comparing ourselves to someone who maybe is in a different socioeconomic status than us or has a different body type than us, or, I mean, because there's just so many things that you can grieve.
I've even had, you know, obviously many of the people who listen to the show probably struggle with mental illness or thinking differences. Um, I've had a lot of people reach out to me who have chronic illnesses, like chronic physical conditions that put a lot of limitations on their lives. And all of these things bring about a grief reaction.
And then, you know, sometimes there's the social media comparison that just sometimes triggers like anger reactions, grief reactions, intense sadness, or things like that because we're constantly viewing people who, you know, maybe have what we wish that we could have.
Hilary Bucell: Yeah. And so then, and I guess, you know, if someone's finding that, like, you know, these types of actions or behaviors are making their experience worse, is the answer just like, "Girl, get off social media"? Like, you know, like, is that the answer? Are there certain things that we can do to be more conscious consumers, I guess?
Well, I do think, you know, that could be an answer, right? Some of those things that are staring at us, right? If social media is really prompting this comparison, right?
Which is then prompting this anger and intense grief, absolutely. Taking a break is really skillful. Kind of removing yourself from those, uh, you know, prompters is really skillful. Another thing that can help kind of soothe that experience, though, is this idea of compassion or compassion for yourself in that moment, even if you're having intensity, like intense anger, right?
And so compassion, literally like the definition literally means like to suffer with, and it gets this bad rap. It doesn't mean like condoning; it doesn't mean liking, but it's this idea of like saying, "Hey, I can be with my really difficult experience, and I don't need to push it away." And so it's this idea of saying, "Oh, I can feel this.
This can be here without me needing to engage in kind of all of these behaviors that are really ineffective." So, that's one way, right? Because maybe it is something that's prompting us, and we can't just remove ourselves from the situation. And that can also be a really lovely way to start validating ourselves and honoring our disenfranchised
grief, like those identity experiences, right? You really spoke to that. Um, that's such an important thing for us to do when society isn't going to do that for ourselves. Like actually saying, "Hey, yeah. This is really painful. This is something I don't have. This is something that society's not giving me. It's not honoring; it's not respecting my experience."
Um, yeah. So practically, yes. Like you said, remove yourself from social media. Get off, close it out. You don't need to be posting on Reddit anymore. You don't need to be liking those photos. Like, yes, get off, right? If that's prompting you, don't watch the TV show. Don't listen to the podcast.
You know, if there's somebody in your life while you're initially having a grief response, that's really prompting, you know, you can say to them, "Hey, like I am having a difficult time right now with something. I'm just going to take a step back for a bit," right? Like, we don't want to ghost people; we don't want to give them a loss too.
Right. But we can certainly take care of ourselves, and something more internally that we can work on is this idea of just allowing our experiences to be there. Right? This, again, this idea of moving through it without needing to fix it, immediately validating it and holding it—like the space.
The space. There's the word I was looking for. Yeah. Yeah.
Dr. Monica Johnson: Are there any general tips that you would give for someone who's trying to rebuild following a loss?
Hilary Bucell: Hmm. Yeah. First, I think it's this idea of not trying to force ourselves to be anywhere in our grief journey that we're not, right? It's really hard to build. Right? We can use this analogy: it's really hard to build a house with the foundation if that cement isn't actually dry yet, right? Yeah. So that's the first thing that I'd really bring in—again, this non-judgment that we're bringing into this experience to say, "Hey, like there is really no definitive timeline," right?
Like, when do I feel ready? Or, you know, noticing when am I ready enough? That's probably a more skillful way to put it. When am I ready enough? And then when we feel ready enough, what is the narrative we want to claim about the loss? Right? And that's our choice. So how do I want to integrate this into my life now?
How do I want to view it? How do I want to see it? And am I capable of seeing the places that the loss has maybe ineffectively colored my view of the world, right? It's actually making me see the world in a way that isn't skillful, maybe isn't true, maybe isn't aligned with my values, and can I challenge that?
And in that challenging, like creating that narrative we want to, and then being really, you know, that balance of both-and. We can be gentle with ourselves and push ourselves beyond, right? Kind of our boundaries—that both-and. Because whatever's new is uncomfortable, and it's going to be new because that thing we had before is no longer there.
And so we're kind of going to be fumbling our way around in the dark for a bit. So again, that both-and, yeah.
Dr. Monica Johnson: I want to say thank you so much for the information. I can feel your compassion coming through the screen. If any of the listeners wanted to integrate a little bit more of you into their lives, where could they find you, you know, for content or if they wanted to potentially utilize you to help them through their grief journey?
Hilary Bucell: Absolutely. So, my psychotherapy practice is Integrative Psychotherapy and Wellness, and you can find us online at integrativepsychwellness.com. That's where you can find me. It's where I hang out. Yeah.
Dr. Monica Johnson: Yeah, I just want to say thank you so much again for this lovely conversation, and I hope that the listeners take your wisdom and use it to help them on their journey. Thank you so much.
Hilary Bucell: Thanks for having me.