When most of us think of grief, we think of losing a loved one or the end of a relationship. Does it make sense to have a sense of grief in the coronavirus crisis, even if you haven’t lost anyone?
On Isolation and Grief With Psychiatrist Swapna Vaidya
According to psychiatrist Dr. Swapna Vaidya, yes. Grief is caused by loss, and many of us have lost at the very least a sense of security and our predictable routines. Others may have lost jobs, opportunities, and of course, loved ones.
But we’re all in this together, and the potential for unity and for providing one another with support, globally, has never been greater.
In this podcast, Dr. Swapna Vaidya speaks with Gennev Director of Health Coaching Stasi Kasianchuk about the nature and course of grief and how to be kinder to everyone going through grief and isolation “ including yourself.
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Dr. Swapna Vaidya is a psychiatrist and Executive Medical Director in the MultiCare Health System.
Stasi Kasianchuk is a Sports Dietitian, Exercise Physiologist and Gennev Director of Health Coaching.
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TRANSCRIPT
Coach Stasi Kasianchuk
So welcome everyone to our wellness webinar. This is a really great one today on a great topic that’s pretty relevant right now”the topic of grief. So I am Stasi Kasianchuk. I am a registered dietitian, nutritionist and the director of health coaching here at Gennev. So, Swapna, I’d love for you to give your background, introduce yourself to our audience. And yeah, let us know who you are.
Dr. Swapna Vaidya
Oh, okay. I’m Swapna Vaidya. I’m a psychiatrist. I currently work at Multi-Care Hospital. But I have had an extensive background in consultation psychiatry. So what that means is that I have had a background dealing with psychiatric issues with patients, who are going through medical problems or are going through trauma. And I was in New York actually during the 911 time and so I have personal experience working on the ground for disaster psychiatry. So this is where my background is and here I am today trying to sort of connect with all of you to share some of the experiences that helped us back then and to talk a little bit about grief.
Coach Stasi Kasianchuk
Yeah, absolutely. Yeah. Thank you so much for joining us. And I’m interested too because we do hear a lot about some comparisons from what we’re experiencing now with the COVID 19 pandemic to 911. So your experience, your insights from that experience to now will be really great and during this this webinar. You mentioned that topic of grief and we’ve seen more some more publications on grief right now and there’s some, you know, just this feeling that even when I’m talking with my clients through Gennev of, of just there’s something different, there’s something in almost in the air, but individuals are trying to work through this. Can you give us a brief description of what is grief from your from your background and what do you see or how is it maybe playing out for people right now in this situation?
Dr. Swapna Vaidya
Yeah, thank you. You know, Stasi, because this is really an important issue to discuss right now and you nailed it. Like a lot of people are trying to draw comparisons between what happened in 911. And you know, I’ve a lot of friends back in New York who are psychiatrists and they are all just saying that this sense of loss, this sense of grief is even much more than what they experienced when 911 happened because of the fatalities, you know, which are being just immense. So that being said, you know, what is grief? Grief is a sense of loss and that’s actually the best way I can describe it. And you know, normally when we look at grief, we say, okay, this is connected to bereavement, that you lost somebody. But right now what everyone is experiencing is a big sense of loss, missing the way life was.
Missing what was the normal. Missing the fact that you could just pop up and go to a restaurant and have dinner. That’s grief. So grief is a normal human response. To any kind of loss. So I’m going to get a little technical and I’ll talk about the stages of grief and how it’s pertaining to this pandemic, if I may.
So, yeah, so you know, Dr Elizabeth Kubler Ross, she was the pioneer who did a lot of research on grief and she talked about stages of grief. So the first stage is denial. And then we connect this to the pandemic right now that are personal levels of grief, local levels, and then on a national level of denial. So on a personal level, you know, I mean, I’m sure a lot of people who are this, Oh, I’m never going to get this virus or that I’m young, this is not going to happen to me or not to my family.
So that’s a personal level. On a local level, the denial is that, Oh, well you’re not gonna follow social distancing, that doesn’t really apply to me. And then on a national level, we’ve seen various forms of denial as to how we first denied it and then we accepted it and now we know what it is. Then we look at anger. So the next day just anger. Now, once we deny it and we know, okay, this is really happening, then we get mad. You’re really angry. And how do we express the anger? Towards the people who we are living with. And that is why I’m really concerned a little bit about on the other side is the rise of domestic violence and anger towards children. So this is a huge important issue. How we need to deviate from anger and go towards acceptance. And the other issue of anger is the social media. I mean I’m sure you’ve seen the rantings and the ravings and you’re right and I’m wrong.
So this is a way people are trying to clutch onto any sense of control. Then the third stage is bargaining. Then we are trying to bargain with each other. They’re saying, okay, maybe if I do social distancing for a week or maybe if I just stop it, you know, perhaps for I wouldn’t go to this place or that place and then this would be, this would be done. Or I can see X, Y, Z friends because guess what? I’ve been seeing them so they will not be infected. So this is bargaining and then sadness. Finally we are sad, we are demoralized, we are depressed. And then acceptance. Then we say, and that is the stage we have to arrive at. But you know what? Everybody takes time to arrive at that stage. So in a way, what I’m trying to say is that it’s okay, these are the feelings you’re feeling, but the ultimate stage that you want to come to is acceptance. You know, there’s that serenity prayer. We can change things, but some things we got to accept, you know, and this is one of those hard life lessons. So this is a what I would suggest in terms of grief as well as how it’s pertaining personally and locally with us.
Coach Stasi Kasianchuk
Yeah, you brought up a lot of good points there, Swapna. Several things come to mind. The first one that I had, you mentioned these layers, the personal layer, the local layer, the national layer. We might even, I don’t know if we can add a global layer on to that. From your perspective, do those layers “¦ Does that add add more grief or does that make it heavier for the individual knowing that it’s not just in their personal bubble? There’s layers upon that. Do you see that effect with people?
Dr. Swapna Vaidya
Yeah, it actually can be dual, you know, in a way how human being how we are social creatures. So when we know that we are not alone in this, then knowing that it’s a global pandemic somehow helps. But then on the other hand it can become a very worrisome thing. So this is how we have to set our acceptance and set what we can do and how we can control things that are in our control. So for instance, ruminating about it and worrying about it to a certain extent is just going to be destructive, but understanding that we are not in this together, we are not in this alone and there is all this rush of vaccines being studied and antibodies being studied and all that, gives us hope. So I would tend to go on the side of hope to say that we are all in this together and hence we are all connected on a personal level, local level, national level. And then as you explained, Stasi, even the whole world, pandemic.
Coach Stasi Kasianchuk
Yeah, no, that’s such a good point of finding ways to, to shift the thought process to shift from a maybe a more pessimistic thought to a more to a more optimistic thoughts to be supportive of what we’re going through. The, another question that I thought of too when going, you talked about this process being normal, so is it, is it normal to go through these stages in order, or do people tend to go to one stage, skip, come back? Is there a what, what do you usually see or what is considered normal?
Dr. Swapna Vaidya
You said such a good point. Yes. There are no ways that, you know, one person reacts well situation. It’s not such a sort of like a single mold will fit everybody. So there are some people who would probably go towards acceptance, you know, maybe because they’ve been traumatized before. A lot of the folks that I’ve seen, you know, the psychiatrist or my friends or colleagues that I’ve talked to in New York have said that, that they reach the stage of acceptance pretty quickly because they had gone through it before. So they had already experienced it before. And when they knew that what happened then they couldn’t control what happened. And what’s happening now is not something they can control. But on the other hand, perhaps people who have never experienced this in lifetime, like, you know, the young kids, teenagers, maybe the millennials, they have never seen this.
And this might be a very, very difficult time. And that’s why I talked about the local level. I talked about the denial there. A lot of young people were saying, Oh, this can’t affect me. But we are now seeing like a huge demographic of young people with no preexisting health issues also getting sick by this virus. So that’s something that the mind frame had to shift to understand that this is actually happening to everybody. Maybe our older and our elderly population are more susceptible and they may have a very devastating course of the illness, but that doesn’t spare even the younger, the middle aged folks that we have. And hence I think that it depends on where at the stage. If you been if you’ve had experience before, if you had some amount of training in trauma and acceptance or understanding that can actually help how you can switch. So something to see.
Coach Stasi Kasianchuk
Yeah. You know, silver lining, I guess to having have gone through something similar to this that perhaps you’re more resilient, resiliency or experienced is built. Would you agree with that?
Dr. Swapna Vaidya
I agree. And actually, you know, I was going to talk about resilience. I came across a very good article about resilience and you know, I was reading about Sheryl Sandberg and her Option B and I think she’s going to come up with much more material about it. But there was some things which really stuck with me from that article. She talks about resilience, but she talks about three Ps, the three Ps, the letter P that are bad for you. So may I? So number one, she says, number one is personalizing it. Number two, saying this is a permanent thing, you know, and number three saying it’s pervasive, meaning it’s affecting everything that I do. So these three Ps are destructive. So how would you personalize this? You personalize this by saying, Hey, you know what? I did something wrong. Oh, I got this virus and I gave it to my mom or I gave it to my, you know, things are not in your control.
So self-compassion is something you should practice. You shouldn’t blame yourself. Second thing is permanence. The thing that, Oh, this is uncertain, I am never going to go back to normal. This is forever. But we know things are not forever. We know this too shall end. The thought and the last important thing that she talked about was pervasiveness. It doesn’t mean that every aspect of our life is affected. We still have some silver linings, as you said, you have a time to call your friends, your childhood friends. I mean, I hadn’t connected with them for God knows 25 years and now we have like this WhatsApp group when people are sharing things and it’s really nice to listen to, you know, your childhood friends and what they are going through and how connected the world has become. You know, so we cannot say that everything about this is horrific and horrible. Try to find some silver lining, whatever that may be.
Coach Stasi Kasianchuk
Yeah, I like that. I had not been familiar with those three Ps, but I think that gives, to add another one, gives perspective on just how, where you’re and allows that reflection, that mindfulness to piece to reflect on how am I internalizing this and what am I doing with the information and how can I change the story a little bit or reframe to be able to support to support myself.
Dr. Swapna Vaidya
Right. I think reframing that, that aspect. You talked about cognition, you know I’m so sorry. I just got caught up cause I was on my phone so that one was fine to call me. Another thing, I’m, I’m still on call in the hospitals, so I’m sorry if there are like, you know”¦
Coach Stasi Kasianchuk
Oh, thank you for doing, for being on the front lines right now.
Dr. Swapna Vaidya
Exactly. And I really thank my doctors and my healthcare workers. And that’s such an important thing too, you know, sort of like connect with right now, this is where I say that when you talk about how can you help in the stand and make like people feel helpless, but there is a way “ you can work as a community, you can work in your home, you can take care of your elders, your children, and at the same time you can actually try to do something good for the community such as health care workers. Our essential workers were going and putting their lives at stake. You know like some doctors are getting meals for the patients, for their staff, for their nurses, for their healthcare workers. And, and that way some doctors are actually cleaning the rooms in the ICU so that the cleaning lady doesn’t have to go in. I mean, I thought that was tremendous. I mean, I’ve reading been reading about these things on a Facebook and I think that’s such a, humanity is in, in its best best way. So resilience doesn’t really mean that you have to reject your unpleasant emotions. You absolutely accept them. You accept them, you feel them, you go through them, but you don’t let them control you. That’s the key. And that’s the hard, hard part. You know,
Coach Stasi Kasianchuk
I think, I like that you, you made that distinction of being able to experience your feelings but also not letting them then sweep you away. I’ve been talking a lot with clients about giving permission, having them give themselves permission to most of it’s around more on self care, giving permission to take a nap if you’re feeling tired, giving permission to giving permission to, you know, maybe take a little bit more time for yourself. So whether it’s a little separating, finding space in your house where you can have some time alone and being okay with taking that time, it can be a hard thing to, to feel emotions, to give permission. Do you have recommendations for people on how to best, how to best feel emotions if that’s not something they’re comfortable with?
Dr. Swapna Vaidya
You know? Exactly. And again, everybody’s going to be different, right? Everybody’s emotions and reactions are going to be different. But what I would recommend, I like what you said about how you give yourself permission. So I will give you my example, I have a five year old, right? And I want to kind of sometimes get away. I tell my husband, you know, like, listen, I’m going to be in the terrace or something, you know, just doing, I need 20 minutes. I just need some time to focus on myself because there is so much going on work-wise, so much going on community wise, you know? And then with his needs, I want to be the best version of myself, the best way I can. But you know what, there are times that I am the thing that my emotions are somewhat on the show. You know, like being very shocked and bored sometimes and I have to collect that, not be accepting own it, you know, but I, I don’t need to be pervasive and permanent about it.
You know, I don’t need to think that this is the way I am always going to be. So what if I falter? I have another chance, you know, and my boy is going to grow with me and he’s growing up also understanding this, he himself is adapting. So we have to kind of carve out a new normal, I think the best advice I can give you or give anybody is to be kind to yourself. Self criticism. I mean, to certain extent is good, but try to forgive yourself. Forgiveness is the key. But then you’re forgiving your spouse or your you know, friends or you know, your son. That sensitivity factor has become such a huge issue. And I feel like, especially now since we were all confined and we are becoming, you know, kind of like, what is this? When can we get out? And that’s the time to recognize, let’s try to be compassionate and kind first.
Coach Stasi Kasianchuk
Yeah. That and that comes with perhaps try to when we have those feelings of anger or frustration, you have to turn those down a little bit and try to make that kindness and compassion forefront, which can isn’t always instinctual when we’re in these situations dealing with grief.
Dr. Swapna Vaidya
You know, I mean, when I was sort of like preparing for this talk, I think a lot of the things that I read resonated with me. So it’s, it’s just important to realize that even though maybe I’m a psychiatrist and I can, I’ve studied this, but to adapt to this as a person, as a human who’s going through this, it’s equally hard. So this is this. I think I would tell everybody that once you get this knowledge or you’d read about it, you know, it’s okay to go back and then sort of ruminate and say, Oh, maybe this didn’t work for me. Maybe I’ll try something different. You know, for instance, when I say to people, “meditation,” they’re like, Oh, come on, I’m so anxious. I’m not going to meditate. But even anxiety can be meditation. Why? Because you’re actually feeling that anxiety, processing it and understanding it.
One good thing about that would be to maintain a journal. Write down, write down those anxious thoughts. Why are they coming? Are they rational, you feel? Are they irrational? Can you do something about it? And even then, let’s say you acted in a certain way, you’re not proud of yourself, then write down about that and say, okay, what could I have done different? If I have another opportunity, can I do something different? Apologize. You know, forgiveness, as I said, is, you know, I think it’s going to be a much needed, much needed gift that we all can give each other because we all have to say, I’m sorry. You know, I may have acted out of anger and I, you will see the other person absolutely identifies and says, you know what, even me, I’m also going through this. And then you move on and that’s the best you know sort of like advice that I can think of for people.
Coach Stasi Kasianchuk
Yeah, taking that step and having the courage to call those feelings out I think is so important. Can be hard. But like you said, oftentimes when you are saying you realize that the other person’s also feeling the same. So then there’s, there’s a moment of bonding and that over anger.
Dr. Swapna Vaidya
That’s the thing, you know, when you resonate and when you say, we’re in this together, you know, this is affecting me in XYZ way, this is affecting you in another way. But guess what? It’s affecting all of us. Not a single person that we can talk to today would say, Oh, this is all great and you know, I have found my way out of it, not a single person. And so then knowing that gives you hope because you know that, you know, you’re not the only one struggling. Yes, you are struggling, but there are others many more. And then it gives you that appreciation of how, what can I do to be productive and help them.
Coach Stasi Kasianchuk
Yeah. And that’s the doing things a lot of times when we feel this place of grief or helplessness, doing something can help maybe move us through the stages. You recommended helping healthcare workers or contributing to your community in certain ways. Anything else that you can think of? You know, even what about for that the individual themselves? What can they do themselves?
Dr. Swapna Vaidya
Absolutely simple things, you know, try to sort of find out that recipe that, let’s say you miss going to the restaurant sites. So try to Google the recipe that you actually actually miss and see if you can make it. It may not turn out great, but at least you tried. That would be one thing. Find out what your interests are, you know, like, do you like to garden or do you like to paint maybe or play games? Maybe, you know, like you could have people are doing Facebook games, you know, sort of like FaceTime or, you know having interactive games with each other. What can you do? You can have a virtual happy hour with somebody. Just be careful with how much you’re drinking because that’s a rather slippery slope. So, you know, things such as that. And you will find that you have developed these hobbies or that you had neglected these hobbies because you didn’t have time.
Reach out to that old friend of yours that you always meant to call, but never had the time. You know, and if you have kids, I mean, try to kind of, you know, be at their level and try to learn at their level and help them out and, you know sort of try to see yourself in a different light than just that you’re in this pandemic. But there are many ways to self-soothe, heal oneself you know, like give yourself a mini spa at home, you know, put a face mask on, watch your favorite movie, right? I mean there are many perks of working from home also in that sense, cause you don’t have to travel. So you at least have the time that you can save yourself and say, okay, let me do something to make my spirit lift up.
Whether it’s for 20 minutes or something, go for a stroll. You know the weather’s getting better. Go for a walk, maintain social distancing and soak in the sun. And then always have this attitude, that this too shall pass. They will be sometime there is going to be time. This is not an easy fix. I think you mentioned at one state, it’s like running a marathon, not a sprint. So you did like, so I am using that exactly what you said. And I would say that that’s what you can do one step at a time, one moment at a time, one breath at a time and knowing that this too shall pass and you’re going to appreciate how we’re spending our present because our present is important. You know, we don’t have to wait in the past and we don’t have to project the future.
We can still enjoy things right now. Maybe a limited wat, but there are ways to appreciate what’s right and good for us. You know, I was reading about this and I, I found out like in London, some people actually having parties of their driveways, dance parties. So they’re maintaining social distancing, they’re blaring music and they’re all dancing. And then in New York, my friend when I had connected with her, said she was having, these healthcare workers were, you know, walking and there was applause from people. So you know, I was on the phone with her and she actually made me hear it and it was amazing. So some of those things.
Coach Stasi Kasianchuk
That gives me chills just thinking about that. And I’ve, I’ve seen in some other countries too where at certain times of day everyone comes out and applauds or plays music for their healthcare workers. And it’s just, I mean, that type of unification is something we wouldn’t experience otherwise. So there’s definitely power in that.
Dr. Swapna Vaidya
Well, yeah, I heard it. I mean, even though like, you know, she had the phone close to a window and it was just amazing. Even though I wasn’t there, I felt like, wow, this is such a great appreciation and the whole world, the city is coming together.
Coach Stasi Kasianchuk
Yup. Exactly. Yeah. That unification piece. Well we have a question that came in from one of our viewers and it says what if you need to be the cheerleader or positive force for others? Can you be honest about how worried or down you feel? This person feels fear of pulling them down when they’re, when I feel fear pulling them down when they’re leaning on me for leadership or security. So how do people balance that?
Dr. Swapna Vaidya
You know, that’s such a great question. You know, how do you balance when you are supposedly this leader, but even leaders can experience insecurity and fear. You know what’s worked for me, transparency, always be transparent about your emotions. You know, say that, you know, I’m having a hard time right now. What can I do? You know, like lean on others. Sometimes it’s okay to lean on others, even for the leader or even for this most optimistic person because you want to do that. If that makes any sense.
Coach Stasi Kasianchuk
Yeah. No it does. And, and I think again, it comes back to we’re all in this together and we need to support each other. So, and that give and take where we all may be going through these ebbs and flows or flowing through the stages of grief. When I am feeling like I need support, I need to be able to lean on someone to say I need support right now. And then when you need support, come to me, there’s strength in that.
Dr. Swapna Vaidya
It’s going to be reciprocal. So leadership can be at local level, family level and community level. Again, national level. And I go back to these levels because it’s important to know that none of us are going to find the right answers. There will be times we fall, totally stumble, we are doing our best. Recognizing that and having self compassion. You know, often cheerleaders, they kind of have this whole burden on their shoulders thinking that this is really my thing and I have to own it. No, this is a collective thing. Let’s all own it together.
Coach Stasi Kasianchuk
Yeah. And then here’s another question that’s something else that I see is and I’ve actually been reading about, and I’d love to get your take, is this comparative grief where people might say, I feel they feel guilty complaining about their situation when others have it so much worse. What are your thoughts on that when we say, well, you know, your, you have a family member in the hospital, I’m, I shouldn’t feel bad for not being able to leave my house. What are your thoughts on that?
Dr. Swapna Vaidya
So remember when I went back to resilience and I talked about those three bad Ps, the first P was personalization. This is falling exactly there because you are not allowed to, you know, feel guilty. Everybody’s circumstances are different. Granted that, you know, on a level, you might see that this is much more catastrophic than what you’re going through. But that doesn’t diminish your grief. That doesn’t diminish your feelings of loss in any which way. And I think it’s important to own that, to say that you can’t feel guilty about the way you’re feeling because then you will not practice self-compassion. And if you don’t practice self-compassion, you’re not going to be helpful to others. Because again, I think I have mentioned it before, but it’s like going in that aircraft and you don’t put that oxygen mask on yourself. You’re not going to be good to anybody. So please I think that is a fine line. I think between being selfish, it’s not being selfish, it’s actually being compassionate towards yourself. And that’s okay. Right? So then when people compare and say, Hey, you got it better than me, or I go to see this happens everywhere. But that doesn’t mean you need to personalize it and express it as like, this is my problem or this is my guilt. So that, that we personalize. Let’s take that away.
Coach Stasi Kasianchuk
That’s such a good point. And you’re right, that it gets in, gets in the way of that compassion and, and even, you know, the feeling of guilt. You know, working with clients even before this, guilt, oftentimes it would come up, especially with working moms, you know, balancing work and family and guilt would sometimes come up and it can be a feeling that’s, that weighs people down. And it’s almost like it, it creates a knot or it creates this rock in people. So having them really turn that guilt into compassion or eliminating the guilt and transitioning more to that compassion can open up possibilities.
Dr. Swapna Vaidya
Oh, absolutely. Because you know, the more you’re self destructive and thinking you have done so many wrongs in your life, you’re not going to be able to come up to a level that you can be useful, let alone to yourself, to others. So that’s a very important thing to talk about.
Coach Stasi Kasianchuk
Great. Yeah, no, thanks for sharing that and say, we have another question here that said I have started to enjoy the slowness of sheltering in place. In some ways we’re developing good and new habits. I worry about losing things when things do get back to normal. How do we hang onto the good changes that are happening right now?
Dr. Swapna Vaidya
You know, such a good point because you know, I myself am experiencing that and I feel like what do I do now that I recognize that slowing down a bit was so good for me? So I think that registering that and making sure that once we step back to this new other