Maybe You Should Talk to Someon - Lori Gottlieb Page 0,48

comment over and over in my mind: I don’t know that this is the end of the story.

I think about how, riding up to my office in the elevator, I actually laughed when I remembered the old pun Denial is not a river in Egypt—and how even so, I went right back into denial: Maybe he’ll change his mind, I thought. Maybe this is all a big misunderstanding.

Of course it wasn’t all a big misunderstanding because here I am, crying in front of Wendell and telling him again how lame I am to be doing this, to still be such a wreck.

“Let’s make a deal,” Wendell says. “How about we agree that you’ll be kind to yourself while you’re in here? You can go ahead and beat yourself up all you want as soon as you leave, okay?”

Be kind to myself. This hadn’t occurred to me.

“But it’s just a breakup,” I say, immediately forgetting to be kind to myself.

“Or I could just leave a pair of boxing gloves at the door so you could hit yourself with them all session. Would that be easier?” Wendell smiles, and I feel myself take in some air, let it out, relax into the kindness. I flash on a thought I often have when seeing my own self-flagellating patients: You are not the best person to talk to you about you right now. There is a difference, I point out to them, between self-blame and self-responsibility, which is a corollary to something Jack Kornfield said: “A second quality of mature spirituality is kindness. It is based on a fundamental notion of self-acceptance.” In therapy we aim for self-compassion (Am I human?) versus self-esteem (a judgment: Am I good or bad?).

“Maybe not the boxing gloves,” I say. “It’s just that I was doing better and now I can’t stop crying again. I feel like I’m going backward, like I’m back where I was the week of the breakup.”

Wendell tilts his head. “Let me ask you something,” he says, and, assuming it’s going to be about my relationship, I wipe my eyes and wait expectantly.

“In your work as a therapist,” he begins, “have you ever sat with somebody who’s grieving?”

His question stops me cold.

I have sat with people dealing with all kinds of grief—the loss of a child, the loss of a parent, the loss of a spouse, the loss of a sibling, the loss of a marriage, the loss of a dog, the loss of a job, the loss of an identity, the loss of a dream, the loss of a body part, the loss of youth. I’ve sat with people whose faces close in on themselves, whose eyes become slits, whose open mouths resemble the image in Munch’s The Scream. I’ve sat with patients who describe their grief as “monstrous” and “unbearable”; one patient, quoting something she had heard, said it made her feel “alternately numb and in excruciating pain.”

I’ve also seen grief from afar, like the time in medical school when I was transporting blood samples in the emergency room and heard a sound so startling that I almost dropped the tubes. It was a wail, more animal-like than human, so piercing and primal that it took me a minute to find its source. Out in the hallway was a mother whose three-year-old had drowned after running out the back door and falling in the swimming pool during the two minutes in which the mother had gone upstairs with her infant to change his diaper. As I listened to the wail, I saw her husband arrive and receive the news, heard his shock erupting into shrieks as if in chorus with his wife’s roar-moan. It was my first time hearing this particular music of sorrow and anguish, but I have heard it countless times since.

Grief, not surprisingly, can resemble depression, and for this reason, until a few years ago, there was something termed the bereavement exclusion in our profession’s diagnostic manual. If a person experienced the symptoms of depression in the first two months after a loss, the diagnosis was bereavement. But if those symptoms persisted past two months, the diagnosis became depression. This bereavement exclusion no longer exists, partly because of the timeline: Are people really supposed to be done grieving after two months? Can’t grief last six months or a year or, in some form or another, an entire lifetime?

Then there’s the fact that losses tend to be multilayered. There’s the actual loss (in my case, of Boyfriend), and the underlying