Written by: Eleanor Silverberg, Executive Contributor
Executive Contributors at Brainz Magazine are handpicked and invited to contribute because of their knowledge and valuable insight within their area of expertise.
Grief is complex and not just about death. We need to look no further than the Russian invasion of Ukraine that has brought grief to a population who are forced to flee from their homeland. The grief is widespread, being vicariously felt all over the globe. This grief can easily not get acknowledged if you only associate grief with death. Another instance where grief can be disenfranchised, not recognized is in reaction to providing care for a family member who has Alzheimer's or other ongoing serious conditions. In my book "Keeping It Together: How to Cope as a Family Caregiver without Losing Your Sanity", the grief does get acknowledged including many highlighted family caregiver accounts. It features the 3-A Coping Framework, a means of transforming grief through self-monitoring with self-awareness using 3 action words Acknowledge, Assess, Assist.
The assumptions in applying the 3-A action words Acknowledge, Assess, Assist are:
(i) Wherever there is adversity, there is situational loss. Situational loss is the loss of a person, thing or quality, resulting from alteration of a life situation, including changes related to – in addition to death – illness, body image and environment (The Mosby’s Medical Dictionary 8th ed. 2009)
(ii) Grief is a reaction to situational loss and is unique to the individual.
(iii) There are potential benefits including peace and resolution in processing your grief.
The benefit for caregivers to process their grief was reinforced in my book by quoting from the article Use Grief over Alzheimer’s Loss to Transform Yourself. written by Angela Lunde who was the Mayo Clinic's health education outreach coordinator. In the following passage, she relayed the message of her teacher and mentor Lyn Prashant, Ph.D: “Grief is the most powerful untapped resource for human transformation.”
"Each of us has the opportunity to transform our grief, yet the transformation does not come without anger, pain, loneliness, and sometimes terror. I see this transformation unfolding when caregivers begin to work on what they can change and begin accepting what they can’t. I observe a shift in caregivers from “saving” their loved one to finding hope and meaning in other ways. This may be in discovering creative ways to offer the best care they can to be fully present with their loved one, and finding joy in everyday happenings. Others discover qualities about themselves they didn’t know they had, including patience, resilience and even humor in the most challenging of situations. Some caregivers find ways to help others who are experiencing similar pain or advocate for laws that support persons with Alzheimer’s disease and their families...The key I believe is to avoid feeling helpless. With incredible tenacity, many caregivers transform a heartbreaking situation into one of hope and meaning."
This perspective shines a light on the positives that can come out of grief processing. Here we are focusing on the caregiving experience but there are several other circumstances where this can be applied such as a marital breakup or job layoff. It can be a challenge though while you are in the thick of the situational loss as the Ukrainian people are experiencing. It is a process that can eventually bring you to a transformative state of comfort, peace, truth and/or resolution. Acknowledge, Assess, Assist form the framework in processing the loss and grief:
Acknowledge the situational loss(es) that accompany adverse circumstances. For instance, in the family caregiving role involving chronic illness/disability, there is the loss of your family member's health and there are associated subsequent losses such as loss of finances, the roles that your family member played in your life, control, and/or freedom. At the same time, there are other losses not associated to your family member's illness. There could be multiple losses which involve other losses occurring that are not related to your family member's illness such as in addition to having a mother with Alzheimer's, your spouse gets laid off from work.
Assess the impact that the losses currently have on you. Just as you can be impacted as a family caregiver to the demands of care, you also can be impacted with grief from the losses experienced. Self-monitoring with self-awareness can inform you. Is the impact that your mood is down, feeling hopeless, frustrated, unmotivated and/or overwhelmed with a myriad of emotions. The more specific you are with your reaction, the better you can target appropriate assisting strategies... For instance, strategically coping with guilt will get treated differently than coping with loneliness.
Assist by taking the first step of assessing your conscious intention to cope. With conscious intention to cope, you are equipped positively to assist yourself with assist strategies. Although grief is not a pleasant experience to process, the processing can lead to peace, resolve, comfort, truth ‒ leading to personal growth, another assumption of the 3-A Coping Framework. The action word of assist allows for various assisting methods such as reframing and mindfulness in addition to grief strategies to be utilized ‒ operating under the principle of whatever works for the presenting challenge.
Although 'acknowledge' is positioned first in a sequence, it is not to be considered the first step or phase or stage of the 3-A Framework. Each of the action words can operate alone as well as be interdependent of one another. A healthcare professional is 'assisting' by 'assessing' if the family member is 'acknowledging' the loss and how the reaction to the loss is manifesting. For self-care and self-development, family caregivers can 'assist' themselves through 'acknowledging' their losses and 'assessing' for themselves how the reaction to the losses are manifesting.. Pain is part of the process. 'Acknowledge' on its own can bring relief similar to the relief of receiving a diagnosis for puzzling symptoms. I have observed a sense of relief from family members when I shared with them my 'assessment' that they were grieving, 'assisting' them to identify and work through their experience. It made sense to them.
Addressing the grief can serve as a powerful transformative resource as described in Keeping It Together: How to Cope as a Family Caregiver without Losing Your Sanity: By consciously using Acknowledge, Assess, Assist, you are consciously self-monitoring with self-awareness and empowering yourself to transform, strengthening resiliency as you navigate through and beyond the pain of grief.
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Eleanor Silverberg, Executive Contributor Brainz Magazine Eleanor Silverberg, founder of Jade Self Development Coaching, is a social worker, author, speaker and grief specialist whose intention is to help adults move forward stronger through diverse life-altering situational losses, applying the innovative 3-A Coping Framework she developed. Her specialty is assisting family caregivers of the chronically ill to cope and prevent burnout. Her mode of practice stands out as she combines existing grief models with conventional and practical strategies, featuring them in her books “Caregiving with Strength” and “Keeping It Together”. She has also created a modified mindfulness program in her book “Mindfulness Exercises for Dementia”. Eleanor holds a BA in Psychology, Master of Social Work, Certification in Bereavement Education, extensive training and practice in Mindfulness and over 20 years of Independent Grief Studies.
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