All of us suffer losses in our lives, ranging from the minor to the catastrophic. Some losses we are able to move through on our own with the help of family members and friends.  Some losses overwhelm us to the point that we cannot move through the grief without assistance. Psychotherapist, Dr. Firestein offers grief counseling with the compassion, experience, and psychological knowledge necessary to help individuals, couples and families move through significant losses and complicated grieving processes.  She also helps with releasing the trauma associated with stressful events that result in a loss, such as car accidents, deaths by suicide or violence, and  life-threatening health issues.

As a leading psychologist, Dr. Firestein wrote a monthly Q & A column for the Healthline magazine called Uncommon Sense for seven years.  Below are excerpts from previous columns.

Question: My mother is in her early 60s and she has been diagnosed with a terminal illness. She is in treatment but the odds are really not in her favor and she could well die in the next year. I am in my late 30s. In my teens and early 20s my mother and I butted heads a lot.  Things have gradually improved between us and although we are not extremely close, I care about her and want to do the right thing by her in this time of her life. What can I do?

Answer: There are quite a few books and web sites now that help people deal with a loved one who has a terminal illness. Many offer practical suggestions and deal with issues around grief and preparing for the likelihood that your family member may die in the near future.  What I can contribute are some things to consider from a psychological and relational point of view as you relate to her in the last few months or years of her life.

Most family relationships are complicated.  Even the most emotionally healthy parent-child relationships can have not-so-pretty histories, ragged edges, and quirky elements alongside a great deal of love.  You are probably in the same boat as most adult children with a terminally ill parent. Most of the adults I talk to in this situation primarily want two things: 1) to help their parent die in peace, feeling loved and cared about by their family, and 2) to be at peace themselves about the relationship at the time of her or his parent’s death, both at the time of the death and in the very long future they will live without their parent.

There is no perfect way to go about helping a loved one die but there are more and less graceful ways to go about it.  You and your mother have come a long way in your relationship and have healed a lot, but are not extremely close. Here are a few suggestions:

1)      While you may wish to do more healing work with your mother and try to become closer to her before she dies,  as the illness progresses, there is a time to stop trying and just do your best to be with her as a loving and accepting presence in her life;

2)      Mutual acceptance, kindness of spirit and small loving actions convey love and create healing in ways that verbal communication may no longer be able to do;

3)      This is the time to let go of resentments. No matter how justified they may seem to you, they are irrelevant to what is happening in the ill person’s life and irrelevant to healing your relationship with that person. Let them go and you will be more at peace after she passes away.

4)      If you can create new, positive memories with you Mom even during this period of deterioration in her condition, you will have those memories the rest of your life. Such memories may include organizing an album of family photos together, asking her to share stories about her life and the life of the family she grew up in, or just sharing a cup of tea in front of the television. Simple things count the most.

There are parents, adult children, sometimes younger children, and sometimes even grandparents involved in the situation of the ill family member. There may be spouses or ex-spouses. Each person will have their own unique relationship with their ill family member. While you can gently encourage estranged family members to work on healing their relationships with your mother, you have absolutely no power over whether they do so.  This is a time to focus on your own relationship with your mother and allow others to do,  or not do, whatever they choose in regard to their own relationship with her.  I wish the two of you peace and further emotional healing in the last days, week,s or months of your togetherness.

Question:  I have a brother that committed suicide 3 years ago around this time of year. Ever since then, the holidays have been awful. Everyone around me seems to be enjoying the season, but I just get sad, depressed and feel more left out when everyone around me seems to be celebrating.  I don’t know how to deal with these feelings and I wonder if they will ever get better.

Answer: Suicide is one of those “unspeakable” topics and the suicide of a family member can haunt us for years or decades, whether the death occurred during the holiday season or at some other time of year.  Certainly, holidays, birthdays and anniversaries are times when grief can come to the surface strongly, evoking memories, feelings and regrets.  Three years is not a long time when it comes to dealing with the death of a family member, and deaths involving suicide are especially difficult.

For most people suffering this kind of loss, the first year of the person’s death is the hardest and the first year after their death is just about equally as hard.  Often the intensity of the emotional pain decreases in small increments as the years pass. You are still relatively close to the loss. I do believe the feelings will get better, though the holidays may always evoke some sadness for you and your family that others might not have to feel.  There are a couple of ways to help get ourselves through those first tough years.

You might consider a yearly tradition of honoring your brother. You can do this in more than one way.  For example, you might deliberately organize a part of the holiday as a time to remember and talk about your brother, reflecting on what he brought into the lives of family and friends. This may be a somber time of grieving or a time of joyful remembering, but often it is both. Some people choose to create a memory area in the family room during the holidays with photos of their loved one or a couple of their favorite items sitting out, creating a “place” for your brother even though he is no longer physically present.

You can also remember your brother by giving a special gift of your time or money to a cause he believed in as a way of honoring him and his values.  Making foods he loved or watching a favorite holiday film are other ways of including him in the thoughts and actions of the family. You need not to dwell in the sadness, but neither is it necessary to “forget” your brother in order to enjoy the holidays. There is enough room in our hearts for both sorrow and joy at this time of year….and every time of year.  May you have a holiday filled with peace and gentleness.

Question: A month and a half ago I was laid off from a job I’d had for 11 years. Since that time I’ve applied for a bunch of jobs, but I haven’t gotten an interview much less a response on any of them. It is the most frustrating thing I’ve ever been through. What can I do keep an upbeat frame of mind and not get down on myself? 

Answer: Beating the unemployment blues is definitely a challenge. I talk to people every day from every walk of life who present the same frustrations around replacing a lost job.  You have enough work experience to know that you are competent and you can perform well in a job setting so it sounds like confidence is not the primary issue.  Still, loss of confidence can become an issue after an extended period of frustration.

At this point, I think you are asking the best possible question:  how do I keep an upbeat attitude in the face of a complete lack of positive affirmation from potential employers? Here are a few ideas that may be helpful:

1)      Doing things we enjoy and are passionate about keeps our attitude about life in tip-top condition.  Treat your job search like a part-time job. Do the work part of each day but then go skydiving, sunbathe at the local pool, or go for a mountain bike ride. Sitting in your backyard and petting your pet iguana counts too.

2)      Don’t slip into expecting the worst, but don’t put your heart and soul into every resume you send out either.  Think of each resume sent as a seed you have planted. You don’t know which ones will come up and produce but it is important to plant as many seeds as you can.

3)      Working and feeling productive are an important part of self-esteem for most of us. During this time, it is really important to shift the emphasis of our sense of self-worth. You can derive self-esteem from donating time to causes and organizations you value, accomplishing personal projects (like finally cleaning out your basement!) and from being a good friend, a good partner and a good parent.

Life is always throwing wrenches into our plans as well as opening doors to new adventures. Sometimes both happen simultaneously, like when we are laid off from a job. Continue your efforts but keep nourishing your soul. Your job search and your attitude will be better for doing so.