The 5 Chairs of Grief

“Should you shield the valleys from the windstorms, you would never see the beauty of their canyons.” ~ Elisabeth Kübler-Ross

No matter where you live, how old you are, what color your skin is, or your career choice, you will experience loss and grief at some point in your life. It is universal. Maybe it will be from the death of a loved one, the loss of a job, the end of a relationship, the diagnosis of a terminal illness, or a life-altering change. In hopes that I can help someone out there, I wish to share what one of my friends is experiencing in relation to the stages of grief.

A dear friend of hers recently passed away. She was young; she had a husband who adored her, an active one year-old daughter, a lively dog, a new apartment, a flourishing photography business, and an entire life ahead of her. Though she had experienced some fairly serious health issues during her short time on earth, no one thought the common cold would be what would ultimately take her while she slept. Her death shook the community, her family, friends, and many loved ones. She is deeply, deeply missed. In dealing with her loss, my friend has had to confront the five stages of grief in a very real, very personal way. 

The five stages of grief was introduced by a Swiss-American psychiatrist named Elisabeth Kübler-Ross. She did research with terminally ill patients, and published a well-known book called On Death and Dying. Through her work, she identified five common stages of grief her patients all experienced–denial/isolation, anger, bargaining, depression and acceptance: 

  1. Denial and isolation: This can’t be happening… Denial is a common defense mechanism that buffers the immediate shock of the loss, and numbs your emotions. You hide from the facts. Denial is the brain’s way of making sure you do not get too high a dose of grief before you are ready. 
  2. Anger: Where is God in this…? Reality and its pain emerge. You likely do not feel ready. The intense emotions are deflected from your vulnerable core, redirected and expressed instead as anger. The anger may be aimed at inanimate objects, complete strangers, friends or family, or even yourself.
  3. Bargaining: If only we had gotten medical attention sooner… This is the need to regain control through a series of “If only” statements. Guilt often accompanies bargaining. You start to believe there was something you could have done differently to have helped save your loved one. You spend time reviewing how different scenarios would have played out, but it does not change your reality.
  4. Depression: She won’t even get the chance to see her kids grow up…Once bargaining no longer feels like an option, you face reality and are hit squarely with an intense sadness. You withdraw from life, left in a fog of intense sadness, wondering if there is any point in going on. When loss fully settles in your soul, the realization that your entire life will be different is understandably depressing.
  5. Acceptance: This is my new reality and I need to learn to live with it… Reaching this stage of grieving is a gift not afforded to everyone. Although most people never stop missing their departed loved ones, the painful emotions they feel shortly after the death nearly always soften with time. This phase is marked by withdrawal and calm. It does not mean you are okay with the loss or that everything is “alright”; this stage is about accepting your new reality without your loved one. You learn to live with it. You accept that life has been forever changed and that you must readjust. You reorganize roles, re-assign them to others or take them on yourself. Finding acceptance may be just having more good days than bad ones. 


The only issue with these stages–what my friend has had to re-learn and what I witness in clients–is that we perceive them to be linear steps. First, you deny it. Then you feel anger. After that you bargain, and so on and so forth until we magically “accept” the loss and all is well in the world. But what happens when you find that you seemed to have digressed back to the first so-called “step” and am in denial again? In her grieving process, she found that she was not progressing neatly from one step to the other. This has helped her see and remember, in a very personal way, that these steps are more like symptoms–they come and go, worsen and lessen with time. And that is okay! 

I like to think of these stages of grief as five chairs. Shortly after loss, you may sit for a solid hour in the denial chair. Then you may get up and move in any direction and sit for any amount of time. Maybe you move from the “denial” chair to sit in “acceptance,” but then you might go back to the denial one for a minute–or anger, or any of the other chairs.  You might feel like you have worked through the anger of losing someone or something valuable, and feel surprised to be feeling anger again. You might think, Wait, I thought I worked through anger. Why is it back all this time later? It is okay. You simply moved chairs. That is normal and you are healing just the way your soul needs to. In your bereavement, you will spend different lengths of time working through each step and express each stage with different levels of intensity. Contrary to popular belief, the five stages of loss do not necessarily occur in any specific order. You will likely play musical chairs and move between stages before achieving a more peaceful acceptance of death. 

If you are experiencing grief, be gentle with yourself. Remember, grief is not a simple process with clean steps that you will complete before moving towards acceptance; rather it is often messy and tangled, with setbacks and delays. People who are grieving do not go through the stages in the same order and may not even experience all of them. So take your time; sit in whatever chair you need to as you work through your loss and know that it is just what you need. As always, please do not hesitate to contact me and schedule a session should you need additional assistance while coping with loss. 

Note: Kubler-Ross herself said that grief does not proceed in a linear and predictable fashion. She regretted that her stages had been misunderstood as steps. The five stages of grief were originally developed to explain what patients go through as they come to terms with their own terminal illnesses; only later were they applied to individuals grieving the loss of someone or something else.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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When Stealing Is a Compulsion, Not a Choice

“A kleptomaniac is a person who helps himself because he can’t help himself.” ~ Henry Morgan

Although kleptomania is a relatively rare mental illness–affecting 6 in 1000 or 1.2 million Americans–you have likely heard someone referred to as a “klepto.”  An example of a public figure, who is thought to struggle with kleptomania, is Winona Ryder, one of the lead actresses from Stranger Things. She was caught stealing over $5,000 worth of designer clothes from Saks Fifth Avenue in 2001.

Kleptomania is a mental health disorder summarized as the recurrent inability to resist urges to steal. Very rarely do kleptomaniacs steal items of great worth; more often than not, they steal items that they do not need, that they could afford to buy, and that have little to no monetary value…like a keychain.  People affected by kleptomania do not compulsively steal for personal gain, on a dare, for revenge or out of rebellion; they steal simply because the urge is so powerful that they cannot resist it. Such episodes nearly always occur spontaneously, with little to no premeditation or forethought. Kleptomaniacs tend to steal from public places like stores and supermarkets. Some may even steal from friends or acquaintances. The stolen items are either stashed away, never to be used, or potentially donated, given away to family or friends, or even secretly returned to the place from which they were stolen. Kleptomania can cause much emotional pain to you and your loved ones if not treated.

Kleptomania vs. Stealing

Kleptomania is different from flat-out stealing. Ordinary theft (regardless of whether it is planned or impulsive) is deliberate and motivated by the usefulness of an object or its monetary worth. Kleptomania, on the other hand, is the recurring impulse to steal items even though said items are not needed for personal use or monetary value. Often a sense of entitlement comes with stealing, a feeling of “I deserve this”. Stealing is driven by need or want; kleptomania is a compulsion. 

Causes

The causes of kleptomania are unknown. Some scientists believe that kleptomania is part of an alcohol or substance addiction. Some think it is due to an imbalance of the brain chemical, serotonin–which helps regulate mood and emotions (low levels of serotonin are common in people prone to impulsive behaviors). Others consider it to be a deviation of an impulse control disorder like eating disorders or obsessive-compulsive disorder.  Although, in theory, anyone can have kleptomania, it seems its onset generally occurs in late adolescence or early adulthood among women. 

Symptoms

Signs of kleptomania are commonly misdiagnosed as everyday theft, but there are a few telltale symptoms and signs that accompany clinical kleptomania, such as the following:

  • Stress
  • Thoughts of intrusion
  • Powerful urges to steal items not needed
  • Inability to resist the compulsion to steal
  • Feeling pleasure, relief or gratification while stealing
  • Release of pressure following the theft
  • Feeling terrible guilt, remorse, self-loathing, shame or fear of arrest after the theft
  • Return of the urges and a repetition of the kleptomania cycle

Effects

Aside from the emotional turmoil that would accompany dealing with the previously listed symptoms, the physical and social effects can include arrest, incarceration, being labeled a thief, developing substance abuse problems, being ostracised from loved ones, losing a job, having poor self-image, and even incurring a criminal record. Additionally, if left untreated, kleptomania can lead to other impulse-control disorders, alcohol/substance abuse, eating disorders, depression, anxiety, and even suicidal thoughts.

Kleptomania comes with a great deal of shame and guilt, as well as the potential for serious legal consequences. Uncontrollable stealing can prevent anyone battling kleptomania from living a productive life. This mood disorder is destructive to both the kleptomaniac and their loved ones, but the good news is that help is available. Although it cannot be cured, kleptomania can be managed with a combination of pharmaceutical and behavioral treatments. I am available to offer professional support to help you or your loved one live a fulfilling life, free from the grips of kleptomania. Please do not hesitate to contact me to today. Help is one click or call away!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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When Someone Else Alters Your Reality: Gaslighting

Gaslighting:  The attempt of one person to overwrite another person’s reality.

In 1938, Patrick Hamilton wrote a mystery thriller play called Gas Light, where a husband manipulates his adoring, trusting wife into believing she can no longer trust her own perceptions of reality. He does this by dimming the gas-powered lights in their home, and then denying that the light changed when his wife points it out. From this the term “gaslighting” was born.

In the last few years, there has been attention around this term. Awareness has been heightened about gaslighting in the media, in politics, and in relationships. Also known as “crazy-making,” gaslighting leaves its victims questioning their very perception of reality.  I frequently see gaslighting in relationships where one of the partners battles an addiction; the supporting partner may suspect a relapse or regression, but the using partner may use gaslighting tactics to protect themselves by convincing the other that their instincts are wrong. My hope is to delve a little deeper into the specifics of gaslighting so my readers are better able to spot it and be armed against it. 

The phrase “to gaslight” refers to the act of undermining another person’s reality by denying facts, the environment around them, or their feelings. Gaslighting can occur in personal relationships, at the workplace, or over an entire society. Targets of gaslighting are manipulated into turning against their cognition, their emotions, and who they fundamentally are. It is an extremely effective form of emotional abuse that causes a victim to question their own feelings, instincts, and sanity, which gives the gaslighter a lot of power. Obtaining power and control is at the heart of gaslighting. 

In relationships, gaslighting typically happens very gradually; in fact, the abusive partner’s actions may seem harmless at first. Over time, however, these abusive patterns continue and a victim can become confused, anxious, isolated, and depressed, and they can lose all sense of what is truly happening. Then they start relying on the abusive partner more and more to define reality, which creates a very difficult situation to escape.

Gaslighting has several faces. The first is withholding–where the gaslighter pretends not to understand or refuses to listen. Second is countering–where the gaslighter questions the victim’s memory of events, even when the victim remembers them accurately. The third is blocking or diverting–where the gaslighter changes the subject and/or questions the victim’s thoughts. The fourth is trivializing–when the gaslighter makes the victim’s needs or feelings seem unimportant. And the final is forgetting or denial–when the gaslighter pretends to have forgotten what actually occurred or denies things like promises made to the victim. 

People are not born gaslighters like some are born introverts or extroverts. A gaslighter is a student of social learning, or nurture. They witness it, feel the effects of it, or happen upon it and see that it is a potent, effective tool. Although some individuals gaslight intentionally–like my previous example of an individual trying to cover up a relapse or slip, in their addiction, from a partner–others may not even know they are being manipulative. I have seen some people unknowingly gaslight because they lack self-awareness and/or simply think they are expressing themselves directly and saying it “like it is.” Whether intentional or unintentional, gaslighting leaves its victims discouraged, resigned, pessimistic, fearful, debilitated, and self-doubting. They also question their own perception, identity, and reality; thus, the gaslighter gains control.

The following are common signs that you may be a victim of gaslighting:

  • You constantly second-guess yourself.
  • You ask yourself, “Am I too sensitive?” multiple times a day.
  • You often feel confused and even crazy.
  • You frequently apologize to your partner.
  • You cannot understand why–with so many apparently good things in your life–you aren’t happier.
  • You frequently make excuses for your partner’s behavior to friends and family.
  • You find yourself withholding information from friends and family so you don’t have to explain or make excuses.
  • You know something is terribly wrong, but you can never quite express what it is–even to yourself.
  • You start lying to avoid the put downs and reality twists.
  • You have trouble making simple decisions.
  • You have the sense that you used to be a very different person–more confident, more fun-loving, more relaxed.
  • You feel hopeless and joyless.
  • You feel as though you cannot do anything right.
  • You wonder if you are a “good enough” partner.

At its extreme, the ultimate objective of a gaslighter is to control, dominate, and take advantage of another individual or a group. But, as I always say, this is not a life sentence. If you have been or are a victim of gaslighting or believe that you have used gaslighting in relationships, you do not have to continue that pattern. Get help. Learn how to break the cycle and create healthy relationships. I am a trained, licensed therapist, and I am here to help. My door is always open! 

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Clear and Present Danger: Teens and Vaping

“We see clear signs that youth use of electronic cigarettes has reached an epidemic proportion, and we must adjust certain aspects of our comprehensive strategy to stem this clear and present danger.” ~ FDA, September, 2018

There’s a new cool kid on the block according to statistics published by Child Mind Institute. Smoking cigarettes has taken a backseat to the accessible and underestimated–yet still highly addictive–e-cigarette. E-cigarettes are now the most frequently used tobacco product among adolescents; some 2.1 million middle and high school students used e-cigarettes in 2017! This is far surpassing traditional combustible cigarettes. What is the e-cigarette? How does it work? Is it harmful? Because so many individuals are using these devices, it is important to be educated on this new behavior, especially popular amongst teens and young adults.

What is vaping?

Vaping devices include e-cigarettes, vape pens and advanced personal vaporizers (also known as ‘MODS’). When the device is used, the battery heats up the heating component, which turns the contents of the e-liquid into an aerosol that is inhaled into the lungs and then exhaled. Vaping is the act of inhaling and exhaling the aerosol, commonly referred to as vapor, which is produced by an e-cigarette. The difference between traditional tobacco cigarettes and e-cigarettes is that e-cigs do not contain nor produce tobacco smoke, but rather an aerosol. The vapor created by e-cigarettes consists of many fine particles which contain varying amounts of toxic chemicals that have been linked to cancer, as well as respiratory and heart disease.

E-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, and other everyday items. E-cigarettes have many names, including e-cigs, JUUL (JUUL Labs, Inc. is the name of the leading electronic-cigarette company), ENDS (electronic nicotine delivery systems), e-hookah, and so much more. JUUL, the newest and most popular vape device, is sleek and tiny (reminiscent of a flash drive), and can be charged in a USB port. It comes in several enticing flavors like crème brûlée, mango and fruit medley. Every JUUL product contains a dose of nicotine, with one pod or flavor cartridge containing about the same amount of nicotine as a whole pack of cigarettes. The JUUL’s subtle design makes it easy to hide, which certainly explains why it has become so popular among middle and high school students. It now accounts for about 72 percent of the market share of vaping products in the United States and more than half of the e-cigarette market. E-cigarette company, JUUL Labs, Inc. recently exceeded a $10 billion valuation faster than any company…including Facebook! 

Is vaping bad for you?

Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic. Though it is speculated that e-cigarettes expose the user to fewer toxic chemicals than traditional cigarettes, nicotine is the primary agent in both and it is highly addictive. Nicotine causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving. Nicotine raises your blood pressure and spikes your adrenaline, which increases your heart rate and the likelihood of having a heart attack.  Additionally, many e-cigarette users get even more nicotine than they would from a tobacco product because you can buy extra-strength cartridges (a higher concentration of nicotine) or you can increase the e-cigarette voltage to get a greater hit of the substance.

Although e-cigarettes have been marketed as an aid to help you quit smoking, they have not been approved by the Food and Drug Administration (FDA) as a smoking cessation device. In fact, a recent study found that most people who intended to use e-cigarettes to kick the nicotine habit ended up continuing to smoke both traditional and e-cigarettes!

Why does vaping appeal to teens?

There are several reasons why e-cigarettes are grabbing the attention of the young people: First, many teens believe that vaping is less harmful than smoking (the packaging does little to convey the risks; it says 5% nicotine, which sounds like nothing, so teens think 95% is water weight or vapor). Second, e-cigarettes have a lower per-use cost than traditional cigarettes. Finally, vape cartridges are often formulated with flavorings such as apple pie and watermelon that appeal and seem less harmful to younger users.

What are the effects of vaping?

Vaping drugs affects how someone thinks, acts, and feels. Some may argue that vaping does not include nicotine, but most do. Even those without nicotine still have chemicals in them that irritate and damage the lungs and other internal organs. Vaping also slows brain development and affects memory, concentration, learning, self-control, attention, and mood. It serves as a gateway drug and increases the risk of other types of addiction later in life. Because this drug was only introduced to the public in 2007, there is limited research on the long-term effects.

If you are vaping, or participating in other addictive behaviors, and want to quit, there is hope! You CAN do it–you can kick this addictive habit and behavior. Start by deciding why you want to quit; own your reason and stick by it. Then, pick a day to quit. Get rid of your vaping supplies.  Avoid your triggers. Tap into available resources like apps, family members, friends, support groups, a therapist, and healthy hobbies. Get the help you need and deserve. I am your cheerleader; please do not hesitate to contact me today to schedule a session! 

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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