For the last few years I have volunteered with an organization that provides prevention, intervention, and treatment for adolescents who struggle with addiction and their families.  I recently found myself thinking that for grieving parents suffering the loss of a child, there are really a lot of similarities that parallel that of struggles with addiction and recovery.  That may seem unbelievable to you at first thought, but bear with me and let’s walk through it a little…..

Immediately after the loss, we may go through the denial in various forms – “No, (s)he is going to be just fine” (upon being told in no uncertain terms that no hope is left), “I’m fine” – virtually ignoring the fact that the child is gone and going through your days as though nothing has changed.

If we had time with our child, there may be times of withdrawal. All you think about, ALL the time, is your child.  If they had been at home, you may camp out in their room, snuggle with their clothes or favorite stuffed animal just to smell them again.  You may watch old videos, or continuously look through old photo albums, just staring at the face you will not see again in life. Many these reactions are part of normal grief, but some people get stuck here. Sometimes they remain stuck here for a very long time. More so, many of us start exhibiting addiction-like behaviors, such as not meeting obligations and work responsibilities, engaging in highly risky behaviors, losing interest in activities or doing things you wouldn’t normally do in attempts to deal with or process their grief.

“But isn’t that depression?” you may ask. Good call. I am not a medical professional, and there is way too much complexity in such things so I’m not even going to go there. My point is not to argue that the lost child is an addiction to some bereaved parents. Rather, my point is these behaviors can be similarly viewed with those of addiction and that because of this, looking at people’s challenges and steps in terms of a path of recovery can be useful in understanding their journey and potentially helping them.

First, I want to share a very important aspect about my personal view of recovery, and perhaps challenge yours…..

In volunteering for the organization I mentioned earlier, I have learned that there is a big push to redefine recovery (for the outsider’s perspective as well as the insider’s) as something to be PROUD of and shared openly, to learn from. You see, there has been a long-standing stigma associated with recovery and the programs that help others on their road towards kicking their substance of choice. Think about it: Secret meetings where you don’t talk to anyone else about what happens there (a bit like Fight Club, eh?)  You don’t disclose who may or may not be in their with you, you show up and keep the anonymity out of respect for traditional beginnings. You may feel shame in admitting that you’ve lost control of yourself, and in the things you have done because of that addiction. Addictions have been viewed by the outside world as something to feel guilty about, something we should be able to conquer our own, and when we can’t we are inadequate.  But much like the stigma attached to talking about dead children and our grief for them (no matter how much time has passed), because it makes others uncomfortable, this view must be changed.

A new view

Spearheaded by a ever-growing movement called Faces & Voices of Recovery (http://www.facesandvoicesofrecovery.org/) , the move now towards being open and brutally honest about being in recovery from addiction to substances hopes to provide not only a sense of solidarity with countless others in the same boat, but also the opportunity to share and learn.  We have learned much more from this movement about addiction itself. It’s helped us to be more recognizing of the inner struggles and signs of abuse/addiction, it’s shown us that there are people who are able to function nearly perfectly in public while still privately battling addiction, but still struggle to keep it at bay when they are alone, and it has shown time and time over that it’s not something that’s “cured” once the twelve steps are done, but rather an ONGOING struggle.

But what is recovery exactly? 

A paper published by the Journal of Substance Abuse Treatment in 2007 noted a special section about “Defining and Measuring Recovery” had a definition that made the most sense to me. It noted a working definition of recovery from substance dependence as “a voluntarily maintained lifestyle characterized by sobriety, personal health, and citizenship.”

Obviously the part about sobriety here may not apply, though it depends on how someone is handing the grief. I am not trying to discount the importance of sobriety with respect to substance abuse, surely substances may be a crutch in times of grief – but for my purposes, I’m looking more at the personal health and citizenship aspects.

In recovery, one should be maintaining personal health (it should also be noted here that personal health encompasses physical, psychological, and spiritual health as well as independence).In recovery, one should strive towards citizenship, meaning living with regard and respect for those around you.  I will view it here as when one chooses to re-enter their world as a functioning human person. Returning to work, taking care of things at home, acknowledging and caring for any other surviving children, social obligations, taking part in community events, and even volunteerism.

So what does this mean in terms of how we interact with and recognize recovery for bereaved parents?

This paper further notes the following things defining recovery that stuck out in particular to me:

1) Recovery is not simply sobriety. – Recovery is multi-faceted, and as mentioned earlier, its important to look at the health and social aspects not just the presence or absence of one single item.

2) Recovery is a personal condition, not a specific method.  There is no static measurement of recovery. Its highly subjective, because people all operate differently, and figuring out what recovery looks like for an individual who is already adjusting to a new normal further complicates that.  One should recognize that there is no single checklist to fit the bill.

So thinking about that…. let’s take a look at some of the varying programs for recovery that are out there and what we can incorporate into helping the bereaved parent

Acknowledgement

In some of the “Anonymous” groups for example, members get a chip for mile-markers of sobriety.  Every bereaved parent has those markers in their head.  Wouldn’t it be nice to recognize significant dates and milestones along with them? Not a “congratulations you’ve made it a year”, but more acknowledging the dates of importance.  Most bereaved parents are touched deeply when others remember their lost children (especially the more time passes) because we are afraid they’ve been forgotten by others except themselves.

Forgiveness

In the step-programs, making amends with those you’ve “wronged” is one of the significant steps.  An example would be the feeling of having wronged friends of family members by having innate anger or jealousy toward those with healthy children or those who become pregnant while the bereaved parent was mourning. Or they may have ditched their best friend’s baby shower or stopped hanging out with friends for those reasons. They may feel like they did them wrong by being unsupportive when they did nothing wrong, or just knew they couldn’t handle it at that time.

I think for bereaved parents, this is two-fold.  First, for the guilt they may feel for wronging their child in some way as their parent, even if they did not have any particular fault in their death. Parents instinctively have the protective response, so when their protection isn’t enough, when love isn’t enough, or when a mother’s body starts to work against her and her unborn child, the guilt sets in. Writing an open letter to their own child telling expressing their feelings, and asking for their forgiveness if they feel they need it may be a helpful practice. Secondly, bereaved parents should be encouraged to take time and focus on forgiving themselves, over and over as many times as it takes until they truly believe and feel it, and practicing self-compassion. None of these feelings are wrong in any way.  They are natural, and they are part of the grieving process.

“It takes a village” (kind of)

Many programs have both a group and mentor type support system, and many times it is a combination. Both have their pros and cons, but I generally advocate for bereaved parents to surround themselves with as many people as possible who, together, fulfill as many of their perceived voids. To clarify, I mean this as a sum of parts, not a team that is in contact with each other about the bereaved parent. The twelve step programs strive for members to recognize and admit that they are powerless against the addiction, that it is out of their control.  I believe that this particular acknowledgement is essential in a vast majority of experiences. Embracing that is essential for the self-compassion and forgiveness mentioned earlier.

The amount of support gained from each of these methods are dependent on the person.  Some may not get as much out of group-based support as they will from individualized mentoring and professional counseling for example.  What one may get out of their group (being in a place which provides tangible evidence that they are not alone in their struggles) could be the singular takeaway if they don’t want to share themselves, but still vital to their healing. Having a “sponsor” whom the person feels they can trust and turn to for help in times of need, would likely be beneficial. This person does not have to have a labeled role, but should be someone who has had at least some kind of similar experience to provide a peer-based support. Added to this team may be trusted health-care professionals, such as a social worker, psychologist, psychiatrist, therapist, significant others, family members, spiritual support persons, or others depending on life situation. It could be as simple as someone providing resources to the parent.

When they are stronger than they realize

Another recovery program, called SMART Recovery (smartrecovery.org) is embracing teaching self-empowerment and self-reliance. This program also teaches how to manage thoughts and behaviors, which may be of value to one who is struggling. This is completely opposite of the foundation the step programs were built on, but equally as important when focusing on recovery in the loss of a child. For as valuable as supporting players are, only the bereaved parents themselves can truly understand how their world will exist now that their child is gone and how to continue living in it.  Teaching them the tools to put the power back in their own hands is vital.

Giving the tools

Some recovery programs teach the importance of identifying and recognizing triggers and learning relaxation techniques. These are everyday life skills that everyone can benefit from, but are especially useful in helping those who have experienced a traumatic loss, who may also suffer from anxiety.  Loss sets off a ton of triggers, from the obvious (upcoming milestones, someone else’s baby announcement, etc.) to the hidden, like some random day a bereaved parent is walking down the street sees a child that doesn’t look anything like theirs (or what they envisioned he would look like), but is about the same age that their child would have been had they been here. Or a red bow, just like the one that was bought for their baby, an old picture they happen across when spring cleaning, or some stranger asking them how many kids they have, etc.  Helping teach bereaved parents to cope with the triggers and manage their preparedness for the obvious and not-so-obvious will do them a great service.

Conclusion

Bereaved parents are often “in recovery” for life. At the end of the day, there is no substance stand-in they can kick from habit.  But the process in recovery and some of the takeaways are useful. I encourage you to think about the models that recovery programs have provided us. I encourage you to challenge the stigma by teaching the bereaved that there a place for recovery, and it’s not just at a group meeting.  It is HERE. It is NOW. with anyone who will support them and give them the tools. It is those of us who will be there when they “fall off the wagon”, which really isn’t falling off at all, merely tripping on the road of recovery. No parent is every “cured” from their loss, they never completely move on, only forward, because the remnants from that loss will always be with them. It may be a fleeting thought, or a hard holiday every now and then. It is not always constant, but it is always there lingering, just like that urge of an addict to use.

***  Reference Note: The article I have been referencing here about defining recovery and such can be found here: http://www.naadac.org/assets/1959/betty_ford_recovery_definition.pdf