By Joseph Gaccione (UNLV School of Nursing Associate Director of Communications)
There is no one way to grieve, to process your emotions and thoughts through tragedy and loss. But there are many ways to find support to guide your through dark days.
This year, UNLV School of Nursing partnered with local non-profit Adam’s Place for a series of virtual support groups for grieving adults. Spearheaded by UNLV Nursing Professor Paul Thomas Clements (who also moderates alongside fellow expert Theresa Fay-Hillier from Drexel University), the sessions take place once a month. Clements and Fay-Hillier both specialize in grief and bereavement therapy, among other health-related foci.
These meetings are not therapy sessions. They’re support groups designed to listen, learn, and express one’s grief while looking for ways to cope. While moderators will introduce the monthly topic, the participants drive the meetings with their stories. From heartbreak to hope, they bare their souls, not to let go of the pain but to find a way back to life.
Checking In or an Extended Stay
The virtual grief sessions began in January 2022, a product of a partnership established between UNLV Nursing and Adam’s Place in Fall 2021. Since then, Clements is encouraged by an increased number of participants alongside a more comfortable set of people interacting with each other. “It’s getting more cohesive because people are starting to come back, which is what you want," he says. "Some people just need to stop in now and then for a tune-up. It's good when you can have others coming back and they start to build a culture within the group.” He also says with more people gelling, they can take over a session without moderator help. “The level of respect in this group has been profound," Clements says. "Sometimes, [Theresa and I] don't have to do much except coach and give suggestions because they challenge each other. You should see how some of the grieving people that are further down the road jump in, offering ideas to other people and say, ‘Maybe you should try this.’”
Although Clements was not part of virtual grief groups prior to these Adam’s Place sessions, he’s been a full-time virtual academician for more than 20 years, so he has extensive experience with online platforms. He explains the sessions are broken up into seasonal and holiday-themed meetings based on his experience of different kinds of grief associated with notable annual events. He says, “My experience has been the seasons have different things that go with them; people tend to get very depressed, especially around the holidays.”
Group session titles are based off these themes, such as “The Garden of Grief: What’s In Your Toolbox?” or “Summertime is Here! Is it OK to Take a Vacation from Grief?”. Not every topic is supposed to be serious. Clements says on certain occasions, he’ll ask participants to focus just on positive memories of a lost loved one, to recount funny stories to show that humor is acceptable to keep. “It could be the baby spit up on them or laughing at their big toothless smile,” he explains. “It's all relative to who the person was to try to move them out of the horrible ending part, where they had to say good-bye, to celebrating something that was funny.”
Through a Student's Eyes
Recent UNLV Nursing graduate Andrea Blaskan participated in these grief sessions as a student leader during the spring semester. She helped gather information and resources for group participants while sitting in each meeting, observing and offering strategies. Resources range from suggestions on how to create new traditions to lists of activities and group memberships and coping mechanisms.
Blaskan says while listening to participants’ stories was difficult, it was somewhat rewarding to see strangers opening up to each other. “It's nothing like I've experienced before,” she says. “I think it was a great experience. As a nurse, you're going to run into these situations where you have to tackle grief and loss.” She adds as a nurse apprentice, she recently used what she’s learned from the sessions into practice, talking with patients about their grief, learning the best ways to approach these conversations. This was the biggest lesson Blaskan learned. “You really do not know what anyone is going through,” she says. “Just taking the time to ask something as simple as, ‘How are you doing?’ or ‘How are you feeling?’ can set off this chain reaction of your patient being able to open up and get things off their chest that they may not have told anybody yet.”
Even though Blaskan graduated from UNLV in May 2022, she’s still plans to be a counselor for the Adam's Place Camp Cope, a fall camp that teaches grieving children how to handle death and loss in a healthy way.
The Therapy That Works For You
Clements cites virtual grief supports are not common, even in pandemic times, but though they’re not the norm, they can still be effective. “A lot of people don't necessarily think you can do what I think you can do," he says. "To me, virtual is better than nothing.” But remote settings provide advantages for people coping with grief that in-person may not provide. For starters, being virtual allows for privacy opportunities for participants. “I think it's actually safer for some people because if they fall apart, they can turn their camera off momentarily,” Clements says. “I reinforce constantly that crying or if your hair is messed up shouldn't have an impact about whether you come to group.”
Blaskan concurs the virtual option isn’t just for aesthetics; it can truly aid someone whose emotions have taken a physical toll. “How do you get someone who can't get out of bed to go to a grief meeting in person?”, she asks. “I think rolling over, going on your laptop and listening to other people’s experiences and chime in when you have something to say is good for them.”
Sara Jordan is a professor and program director for the Couple and Family Therapy department through the Kirk Kerkorian School of Medicine at UNLV. She’s versed in both traditional and non-traditional support systems. While she sees the benefit of virtual support, Jordan says it’s important for in-person groups to remain an option, especially for people wanting that human contact coming out of the COVID-19 pandemic. “Because so many things were virtual, a lot of people missed the chance to grieve," she explains. "People who had loved ones dying during COVID couldn't have a funeral service, couldn't be at the bedside when the person died. I think they might benefit more from in-person grief groups than maybe the general public, because of their experience. People were distant, and they want people around physically.” But Jordan stresses preference falls on the individual. "I think whatever fits best for them, whatever's most comfortable for them," she says. "For some people, virtual might be better if distant or travel is an issue, if they have some social anxieties about being in a group, if they perhaps are more comfortable at home.”
Regardless of the format, she says community support is beneficial. “We like to send our people to groups even if they're coming to individual therapy," Jordan says, "because sometimes they need different things that we can't just give on the week-to-week basis for grieving, just kind of a check-in peer support group that is different than what we do in therapy.” She adds, “I think if there are others there who have experienced these losses, it can be easier for them to share.”
Potentially Prohibited Grief
One major obstacle to conveying grief or supporting someone who’s grieving, virtually or not, is simply talking about it. Certain topics, for instance, are considered taboo. “People don't like to talk about suicide, people don't like to talk about baby or infant or child death,” Jordan states. "Those are things that make people very uncomfortable, and it becomes difficult to find grief groups [where] people can open up about these things.”
Moreover, she says even the language itself, the syntax can muddle the conversation. Certain words or phrases can dance around grief or even mislead others on what happened. One example Jordan gives is saying someone “died by suicide” as opposed to “committed suicide”. Jordan explains, “The reason we don't say ‘committed suicide’ is because people commit crimes and it turns that into a very pathologizing crime. I think being honest and open about using the term, ‘they died’, using death, versus trying to hide it or make a euphemism up." The same honesty applies to discussing grief with children. “A lot of times adults will want to protect children, [saying] ‘Kids can't handle it.’ Kids are actually very resilient and usually handle it better than adults," she says. "You say, ‘So-and-So died. Do you have any questions?’ Ask them to ask you questions, and then that will let you know developmentally what they can handle, where they're at with the thought processes, and you can answer those questions directly.”
Clements contends that despite the option to increase one’s privacy, the virtual component allows people to express themselves more intensely. “I've been running grief groups in-person for a long time, and at least in my opinion, after all these years, they’re much more raw online," he admits. "A lot of people in live groups, I think, were more hesitant. You had to pull that out because you could see other people get uncomfortable when you were talking about it, so you felt ashamed and uncomfortable yourself, and you didn't want to put people through that.” But he doesn’t see the rawness as a deterrent for new people joining the virtual group. “They’ll see it's safe to do that," Clements says. "Frankly, the more raw you can get right from the start, you're going to work through much better, to know that ‘die’, ‘death’, ‘murder’, ‘suicide’, ‘homicide’, ‘motor vehicle accident’, these aren't bad words. They're just descriptors of what happened.”
Finding the Way Back
At the end of the day, any way to talk about grief is positive, and new health guidelines on the topic add more weight to support group relevancy. “Prolonged Grief Disorder has been added to the Diagnostic Statistical Manual,” Clements says. “It actually is now a mental health disorder with the new DSM-5. Now we're finally getting people to understand that grief is not only emotional and spiritual, like your spirit’s broken - but it's also biological. It takes a toll when your brain is firing all the time with this. Add to that, you may have a pre-existing condition such as depression or bipolar disorder.”
Clements stresses group support like this isn’t to make people totally forget the grief, but to remember they can live even with these painful memories. “People with grief tend to lose their full range of affect,” he says. “They tend to get stuck in sadness and anger, but it is okay to enjoy yourself. The very first thing the research shows that people who are grieving do is lose their social life and activities. The research also shows that's the absolute worst thing that can happen, because that's when you become isolated and you lose connectivity to humanity, to humanness.”
“Moving forward with your grief, your memories and things that you've learned from that person's experiences you've had together, they're always going to be with you in that sense,” Blaskan says. “Just because they may not be here physically does not mean they can't be there either spiritually - if anyone is spiritual - or just in everything that you do because you can take everything that you learned from these individuals and put it into practice in your life as you move forward.”