Sober Synthesis

“Grief can be the garden of compassion. If you keep your heart open through everything, your pain can become your greatest ally in your life’s search for love and wisdom.” — Rumi 

How does Grief Impact Addiction and Recovery?

• Grief is a common trigger for substance use and relapse, especially for people with additional trauma histories.
• In particular, prolonged regret and guilt (what ifs), inflame unhealthy shame interfering with healthy grief for ongoing recovery and wellness.
• In addition to the grief of losing a person, pet, and/or relationship, people often experience grief with the loss of the relationship with the substance of abuse.

What is the Neurobiology of Grief and Guidelines for Healthy Grief?

• The human brain is hardwired to form deep attachments, tracking relationships across dimensions of space, time, and emotional closeness. When a significant attachment is lost, implicit (unconscious) memory of the bond persists.
  • In response, we undergo a rewiring process involving repeated experiences and mental rehearsal to integrate the reality of the loss.  
• Grief is similar to a phantom limb, the common experience of feeling pain and/or sensation of an amputated limb. 
  • Grief often includes the strong emotions of pain/sadness/anger and a strong need/craving/desire/longing for something or someone that is now “out of reach”. 
• Healthy/healing grief is a process of remapping (reframing) our relationship of the loss (person, pet, relationship) from the past to establish our ongoing memory/relationship in the present.
• Although challenging, minimizing “what ifs”/regrets is essential for a healthy grieving process. A “what if” mindset, like an anchor, interferes with transitioning our past attachment to our present and future  attachment. 
• Often quoted stages of grief (denial, anger, bargaining, depression, acceptance) are stages that may not occur in order and people may not experience all stages.
  • Grief is not a linear process and may re-emerge after periods of respite.

What are Other Types of Grief?

• Ambiguous Grief: Dr. Pauline Boss coined the term ambiguous loss to describe the feelings of grief, confusion, and uncertainty that can occur when someone is mourning the loss of a loved one who is still alive but fundamentally not the same person they used to be. 
  • Mental illness
  • Alzheimer’s disease or dementia
  • Brain injury
• Anticipatory Grief

• Terminal illness: If a loved one has been diagnosed with a poor prognosis, their family and friends may begin to experience anticipatory grief as they prepare for the eventual loss.
• Aging and declining health: As a person gets older and their health begins to decline, family members and caregivers may start to experience anticipatory grief as they come to terms with their loved one’s limited time.

• Grief From a Major Life Change
  • Abstinence from longstanding substance of abuse.
  • Estrangement or cutting off communication with a family member or close friend.
  • Divorce or separation
• Grieving an estranged loved one, especially a parent, 
  • Often involves conflicting emotions like sadness, relief, guilt, and anger, and requires processinging both the loss and the relationship that never fully existed.
• Grieving the loss of a substance of abuse.

What is Complicated Grief?

• Approximately 1 in 10 people experience complicated (prolonged grief) due to a variety of factors including neurochemical and hormonal differences. Professional help may be best to support complicated grief.

What Activities Support a Healing Grieving Process?

• Create and/or participate in a ritual/memorial.
  • Rituals are actions that symbolically connect us to something meaningful. They can be comforting, express feelings, bring about a sense of closure, or keep an important part of the past alive.
• Set aside time to deeply feel your attachment while actively decreasing “what if” thinking and memories. Hold your grief in the present, connected to your immediate physical environment.
  • Connecting our attachment with our senses (touch, vision, smell, taste, sound) reinforces our present relationship.
• Talk about the loss of your loved one or loved experience with friends or colleagues. Joining a grief group may be helpful.
• Eating healthy foods, exercising and getting plenty of sleep can help your physical and emotional health. The grieving process takes a toll on one’s body.  
• Tool to move through grief from loss of addictive substance
  • Set aside time to deeply feel your attachment to how you are feeling physically, emotionally, spiritually in the present without your substance of abuse.

  Proposed Questions for Thought/Sharing:

1. Have you grieved the loss of a loved one, pet, or relationship (including addictive substance) in a manner that supported your recovery/health and wellness? How?
2. Are you currently experiencing grief from the loss of a loved one, pet, relationship (including addictive substance)? How are you supporting and/or struggling with a healthy grieving process?

Disclaimer

This summary is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed.