by: Dr. Lila Z. Hakim, C.Psych.

The period prior to and during birth can create significant distress for women. Women can experience high degrees of anxiety in the period just prior to the birth of a child, whether or not a low- or high-risk pregnancy is anticipated. Learning how to cope with the distressing thoughts and emotional reactions associated with anxiety may alleviate some of these symptoms. 

During the birthing experience, some women will have frightening experiences (e.g., surgical complications, neglect or ill-treatment during or after delivery, or physical trauma as a result of a difficult delivery). Women experiencing traumatic births may feel isolated and dismissed when sharing their fearful or painful experiences. They can feel hopeless about finding others to connect to regarding what has transpired. These types of experiences can result in post-traumatic stress in the form of recurring images, flashbacks, and painful emotional memories of what transpired during their delivery. These reactions to the event need to be processed fully in order to heal.

Finally, the emotional impact of loss of a child during birth can have a devastating impact on both partners. These effects are further complicated by the post-partum physical status of the woman. Dealing with intense grief associated with the loss of a child is a difficult process for both partners. A partner’s view of him/herself, the relationship, and the future may be altered. The loss can also have an impact on emotional and physical closeness and result in relationship deterioration.

Psychologists and clinicians at CFIR are skilled in addressing the post-traumatic stress associated with painful or difficult birthing experiences. We support individuals and couples in coping with the grief associated with the loss of a child. We assist individuals and couples to deal with tragic loss through education, emotional support, and processing of such traumatic experiences. We help you find a way forward during this difficult time.

Read more about our Fertility Counselling Treatment Service.

Dr. Lila Z. Hakim, C.Psych.

Pregnancy loss can be associated with a significant amount of emotional distress for a woman and her partner. Individuals may feel alone, frightened, angry, sad, grief-stricken, guilty, and shameful as a result of such an experience. The physical recovery process may occur more quickly than the time it takes to heal emotionally from a miscarriage. The loss can further negatively affect communication and intimacy in your relationship. Sexual issues may emerge due to complex feelings about the possibility of conceiving again. Working through these challenging feelings is important for healing and moving forward.

Supporting couple partners to comfort and support each other during this time is essential to emotional recovery and sustaining a strong relationship in the aftermath of loss. Moments of loss activate a deep need within us to have close emotional and physical proximity to our loved ones. We promote partners to develop closer relationships to journey through these difficult emotional experiences together. 

Psychologists and clinicians at CFIR provide a compassionate and caring therapeutic relationship to support women, men, and couples to come to terms with the inner emotional reactions and meanings that can emerge during these moments of loss.

Read more about our Fertility Counselling Treatment Service.

by: Dr. Dino Zuccarini, C.Psych.

Life can be a symphony of losses. Many of us struggle to cope with unresolved losses from either the past or present day. We can experience loss as we transition through various life stages (i.e., childhood onward toward the end of life). Some individuals will experience loss as a result of unmet needs, separation, divorce, or death of loved ones, or unfulfilled goals and potentials. Some of us will experience a deep sense of loss as we inevitably experience changes in our physical and mental abilities, health status, and roles and identity. The emotional residue and grief associated with these losses, when left unaddressed and unprocessed, can evolve into anxiety and depression.

In terms of overcoming your grief, we help you to understand the meanings of your losses, and to process the unresolved or complicated emotional residue from these losses. Unprocessed grief and loss can affect our emotional well-being, our functioning in everyday life, and our interpersonal relationships. We support you throughout your grieving process so that you may move forward with your life with a renewed sense of meaning, purpose, and hope. Psychologists and clinicians at CFIR employ psychodynamic and experiential approaches to support you through the process of dealing with past and present-day losses.

Read more about our Depression, Mood & Grief Treatment Service.

by: Dr. Dino Zuccarini and Tatijana Busic

Do you find yourself struggling to cope with the intense feelings and emotions associated with depression?

In this second post of our four-part series about depression, we’ll provide you with a few of many psychological views of how unprocessed feelings and emotions might lead to depressed feelings. In the following post, we’ll provide you with various strategies you can use to deal with depression on your own, or in your relationships with others.

Feelings and Emotions Associated with Depression

Depression involves different types of difficult emotional experiences, including chronic negative feelings and emotions (e.g., fear, sadness, anger, worthlessness, guilt, shame, irritability, restlessness or lethargy, detachment and numbing). Depression is, of course, a broader mental health diagnosis that consists of many different features, as outlined in this series’ first post in which we addressed what is depression. Depression is different than normal grief in which we feel sadness for a prolonged period of time in the aftermath of the loss of a loved one (i.e., loss of a parent, child, sibling or friend).

Unprocessed Feelings and Emotions as Signals of Need in Depression

Our feelings and emotions provide us with important information about our self, others and the world around us. Depression is a signal to us—a calling for us to listen to our feelings, emotions, desires, and needs.

Some of us are unable to clearly identify, label or express our feelings and assert our needs. Being able to figure out our feelings, emotions, and needs is, however, critically important. It is important because our feelings and emotions guide us by providing us with a sense of what is significant to us in our environment both at home and work. Emotions signal to us that we have concerns, goals, and needs and that some type of action may be required by us to deal with these concerns, goals, and needs in our environment. When we do not attend to our feelings, emotions, and needs, we can create a world that feels false to us. We can become disconnected from what’s really important to us and in our relationships, which can result in hopelessness, anger, or detachment and withdrawn feelings.

In our relationships, it’s important to process our feelings, emotions, wants, and needs. Depressed individuals may have difficulties managing their emotions and figuring out what they need from others. If we can’t figure out our feelings, emotions, wants and needs, we won’t be able to approach our friends, family members, partners, or even employers with our concerns or needs. Some individuals become out of touch with how others can sometimes provide us with responses that can be valuable to us—-only if we actually know what it is that we need from others, feel entitled to ask for support, and risk expressing our vulnerabilities and needs to others (i.e., to listen to us, help us sort out our feelings, verbal reassurance or physical reassurance through a hug etc.) can we realize how others can be a source of contact-comfort, and soothing to assuage the distress in our everyday world.
When we can’t sort out our feelings, emotions, and needs, we can’t get in touch with ourselves and how others might be able to respond to us in ways that can make life better for us. Depression sets in as hopelessness grows—with depression, it becomes more and more difficult to reach for support and increasingly we withdraw, detach, or are irritable and angry, which pushes people further away from us.

Loss and Grief, Meaninglessness and Purposelessness

Life can be a symphony of losses. Many of us struggle to cope with unresolved losses that are accompanied by grief, and possibly a sense of meaninglessness and purposelessness. We can experience loss in many ways—loss of loved ones in our close relationships (i.e., death, separation), and the loss of self and identity as we transition through various life stages or as a result of unexpected changes to our mental or physical health.

We may experience the loss of a parent, partner, child or friend through death, separation or divorce—and experience normal grief. Some individuals will grieve these types of losses and eventually return to feeling better—albeit life is never the same with the loss of a loved one. Some individuals, however, will not recover as well. The loss may create a deep sense of loss and grief about the relationship with the loved one—this loss may also remind you of various other past losses in life in which your emotional needs were unmet—increasing a sense of loneliness, pain, guilt, shame, and isolation. When we have not appropriately grieved our losses, the pain and sadness of previous losses can accumulate and surface unexpectedly—prolonging your recovery time.

Loss of a loved one might also leave you with a shattered sense of your self, identity, and future—if so many of your life plans were associated with the lost loved one. Re-discovering who you are separate from your lost one can take time. Hopeless despair, sadness, and anger can also emerge when it is difficult to reconnect with others, and re-create a renewed sense of meaning and purpose after these types of losses.

We also experience loss and grief as a result of changes caused by normal lifespan changes (i.e., change in roles and identity), changes in our physical and mental abilities, and health status. When these changes occur, some individuals have to face loss related to unmet expectations and unachieved goals—the lost hopes of what we thought our lives would be. Changes in our life circumstances (i.e., children leaving home, loss of employment etc.), health status (i.e., mental and physical changes associated with illness or aging), alter our capacities and possibilities of functioning in ‘old’ ways. When we experience loss or a lot of change, we can lose our bearings and struggle to find meaning and purpose in life again. Over time, we can begin to feel hopeless about ourselves. You can lose a sense of vitality as you try to re-define what’s of importance to you in the aftermath of all of these changes.

How Psychotherapists at CFIR Can Help

Psychotherapists at CFIR can support you to deal with your emotions, including helping you to get to know your feelings and emotions, label them and figure out what they might mean to you. Some of us of have strong emotions that need to be dimmed somewhat but still understood. Sometimes strong emotional reactions come from unprocessed feelings, emotions and needs from our past relationships, and losses, or from losses in present-day life. Psychologists at CFIR provide cognitive-behaviors, existential-humanistic, emotionally-focused and psychodynamic therapy strategies to support you to deal with your emotions, understand what these important signals mean to you, and to help you to take action in the world that will promote self-growth and recovery from your losses.

In the next blog post of the series, we will be providing you with strategies on how to deal with your feelings of depression. We’ll be outlining strategies for ‘yourself’ and strategies for ‘your relationships’. Aside from seeking psychological services to help you with your symptoms, there are many things you can do to feel better on your own.

Read more additional posts from the ‘Depression’ series:

• Depression: How Your Thinking Can Lead to the ‘Blues’ (Part One)
• Combatting Depression: Strategies for Your Self (Part Three)
• Combatting Depression: Strategies for Your Relationships (Part Four)

Learn more about our Depression, Mood & Grief Treatment Service.

by: Dr. Dino Zuccarini, C.Psych.

Parent’s Grief Process in the Aftermath of Loss of a Child

Parents vary in terms of how they deal with loss—most parents will cycle through a wide range of emotional reactions. 

All parents face profound painful feelings and absorbing experiences of grief when a child dies. There can also be intense shock, confusion, and even denial about the loss. There is no loss more devastating than the loss of a child. This loss leaves parents disoriented and disorganized. Hopeless despair can immobilize parents from dealing with the tasks of everyday life, connecting to each other or other children. In hopeless, despair states, parents can experience existential distress—finding life to be meaningless and purposeless.

Parents will also vary in terms of how long the grieving process takes. Some parents will move toward sadness and grieving the loss, trying to make sense of the loss and what life will be like with the loss of their beloved one. They will reach out and connect to others (i.e., their partner, support systems), memorialize the loss of the loved one (e.g., scrapbook, rituals), and re-organize themselves and create a new sense of family identity with the remaining children—although the loss will continue to be felt, the intensity of the emotions will lift. Some parents, on the other hand, will hold onto grief for longer than others—remaining disoriented and disorganized in the aftermath of the loss—not being able to make sense of the loss in the present and the meaning of the loss in terms of the future. Some parents will be over-consumed by guilt and self-blame–feeling that they didn’t do enough to protect or care for their child, and even possibly feel shame and a sense of inadequacy and failure. Many parents will have an increased sense of fear about the surviving children, and a deep sense of isolation and loneliness in feeling disconnected from others who they feel may not understand their experience.

Others may experience intense anger at themselves, their spouse, hospital staff or whomever as a reaction to the loss of a loved one, and even resentment toward those who have children—while experiencing deep sadness and deep fears underneath. Some will enter into a state of numbing, withdrawal to escape the pain, and even turn to other maladaptive soothing behaviours, such as increased alcohol or substance use. Being stuck in guilt, shame, anger and resentment, or numbing withdrawal can prolong the grieving process and block a parent, couple and family from re-building a renewed sense of hope for the future and reshaping a new family identity in the aftermath of the loss of a beloved child.

Parents might express and deal with emotions differently—which will affect the grief process and how parents will journey through this difficult period. Parents who are able to express themselves and journey through this painful experience together can help assuage each other’s distress, make sense of the loss together, deal with the changes to the family, and re-build a sense of hope and future for themselves and remaining family members. A renewed sense of family identity can be created while holding onto the loving memories of the lost child.  Parents must re-define their family identity together. Parents who are emotionally isolated or withdrawn block the necessary engagement to deal with emotional distress and to engage in this meaning-making process that allows the couple and family to re-organize their sense of family identity and future in the aftermath of a loss.

The hardest part is when partners are in different places emotionally and cannot be present for each other (e.g., one is disorganized and the other sad). It is important to be able to reach out to other family members at this time as well for emotional and practical support in dealing with everyday tasks.

Strategies to cope with the loss of a child

1.  Express your emotions and needs to supporting, caring others. It is important to authentically express the wide range of emotions and reactions that are experienced in the aftermath of loss to maintain an emotional connection. It is important that parents take turns expressing their feelings, acknowledging each other’s emotional reactions and listening to what each parent might need. For example, Sara might be feeling hopeless, despair. It is important that she express her needs to her partner, Paul. She may need contact-comfort (e.g., a hug) or verbal reassurance from him (i.e., that the family and the rest of the children will be okay and that they will get through this together). Expressing needs for support and care when distressed is important in sustaining the connection and taking care and soothing each other’s emotional distress.

2.  Reach out for support and care. Isolation increases emotional distress. Ask loving family members and caring friends for practical support for tasks (e.g., helping with other children, home tasks etc.). This allows parents to deal with their emotions and other tasks related to the loss.

3.  Prepare yourself to deal with questions about the loss. Telling the outside world about the loss of a child can bring up emotions. Find a way to tell your story in a way that is comfortable for you (i.e., the amount of details that you feel comfortable sharing). If you feel others are asking too many questions, it is okay to let them know your limits (i.e., I only feel comfortable sharing this amount of information). 

4.  Healing takes time. Expect strong emotional responses for a sustained period of time and accept differences in how you are reacting to the loss. It is important to acknowledge emotions and accept that the intensity of these emotions will diminish over time. In the midst of painful emotions associated with loss, parents might benefit from reminding themselves that these emotions shall pass over time. It is important to accept that there will be moments in which you are both experiencing different reactions and will differ in your grieving process. Talk about your child and use his or her name—avoiding names does not allow you to come in touch with your feelings. Eventually, parents will be able to talk about their child with less of a reaction.

5. Ensure all family members emotional needs are addressed, including other children. If there are other children in the home, it is important to ask them about their sadness and help them along with their grief. Children can feel a wide range of emotions and have several needs at this time for contact-comfort, reassurance and physical affection.

6. Don’t make any big decisions in the immediate future (i.e., doing anything with clothing or toys of your loss child, returning to work, moving, making big changes to family routine and structure). During the initial phases of grief, the disorganization and disorientation may lead parents to make decisions that may not be beneficial for themselves or their family in the long run. Take time to deal with your child’s personal items. 

Some parents will want to return to work soon to restore some sense of normalcy in their lives, while some will return too early without having  healed enough and completed their grieving process—with dire consequences on their family and work life. Making big changes creates further disruption and emotional distress that may block the grieving process from unfolding. Other children will require structure and routine to hold them emotionally through the turmoil of loss—routine and structure allows for a sense of normalcy and provides children with a sense of safety and security.

7.  Rituals and honouring memories of the child. It is important to make sense of the loss and to create a narrative about the beloved child—the meaning of the child to the family and the positive experiences of love, joy, and connection that were experienced in the relationship with the child. Creating a scrapbook or ritual to construct this narrative will allow parents to hold onto the positive and loving memories of the child. Involve children, if appropriate developmentally, in this process. Also, plan on how you are going to deal with birthdays and the anniversary of your child’s death. Planning ahead of time can minimize distress. Creating a ritual around these dates can be helpful to deal with the emotions associated with the loss and remind parents and other children of the positive joy and loving memories of their beloved one.

8. Join a support group. Isolation makes emotional distress harder. Being able to share your feelings, and learn from others who have experienced the loss of a child can make the healing journey less isolated.

9. Consult a psychologist.  Psychologists can support you to understand your own, your partner’s and other family members’ emotional reactions to loss. Some parents, couples, and children will need extra support to move through a grieving process. Couple and family problems can emerge when the residue of unprocessed grief persists. 

What types of programs does the Centre provide to parents who have experienced the death of a child?

CFIR has several services that can support parents in dealing with the impact of loss of a child on the individual parent, the couple relationship and the family (i.e., other children and family relationships).

The Grief and Loss Service offers psychotherapy services to individual parents to support them through the devastating and intense emotional experiences in the aftermath of significant losses of loved ones, such as the loss of a child. Psychologists who are part of this service are experienced in supporting individual parents to deal with the different, and sometime complex, emotional reactions experienced in association with the loss of a child (see grief process below). Individual parents will vary in how they will deal with their own emotional reactions and how they will respond to their spouses or other children’s emotional reactions to the loss. Over time, and as the grieving process unfolds, most parents can expect that their emotional distress will lighten—although the loss of a child can continue to trigger emotional reactions upon reminder of the loss in future years. Loss of a child can be extremely disorienting, especially since a parent’s sense of self and family identity was so closely tied to the child who has died. For some parents, the emotional reactions and distress will seriously affect their ability to return to work and affect their sense of connection to their partner and/or other children. Some parents will have complex grief reactions that will be accompanied by symptoms of traumatic stress, depression and anxiety that are unremitting over time and that affect their capacity to function in their relationships at home or at work. One’s sense of self and the future can be shattered when the hopes and wishes held for a child and one’s sense of self and family identity is altered as a result of the death of a child. Psychologists at CFIR accompany individuals through their grieving process and support them to cope with losses and minimize the devastating impact of loss of a child on emotional well-being, relationships and occupational functioning. 

Psychologists in the Child and Family Psychology Service can support parents to address the emotional needs of other children in the family to adapt to these circumstances. Children grieve deeply as adults do—and sometimes they are blocked by their inability to put words to their complex emotional experiences. Helping children make sense of loss is a challenge to parents undergoing their own grief process, yet other children in the family will need more support than ever to make sense of the loss of a sibling. Losses of a sibling can create deep sadness and fears about future losses, create a sense of unpredictability, and increase insecurities that require increased parental emotional attention to their children. Psychologists in this service support children through their own grief process and support parents to deal with their children’s emotions and the impact of the loss on the entire family system. Children will deal with grief in developmentally appropriate ways—a psychologist can help you to understand how your child’s grief process varies depending on their stage of development and the types of strategies that should be used for connecting to them emotionally. Sustaining a healthy emotional connection with a partner and other children is important in supporting all members to grieve, make sense of the loss, and re-build a new sense of family identity and future in the aftermath of the loss of one member of the family.

The Relationship Service provides services to individuals and couples who are experiencing relationship difficulties. The loss of a child can have an impact on a couple’s emotional connection with each other. For some couples, each parent will be able to express their grief and respond to the other with nurturance, warmth, care and support that will decrease the emotional distress of loss. A parent’s connection to the other parent and their other children can be an antidote against the painful emotional distress associated with loss.  Connecting with a partner and children at a time of loss can buffer us from the distress of these painful emotions. The loving responsiveness and the accessibility of partners to each other’s emotions and the deeper meanings associated with the loss of a child helps each partner cope better with the intense emotional experiences in the aftermath of loss. When one partner shuts down, or withdraws by numbing and emotionally withdrawing to deal with their painful emotions, the other partner can feel rejected and abandoned during a critical moment of need for connection, support and care. Emotional distancing can create relationship distress and have a negative impact on the couples attachment bond. Psychologists at CFIR support couples to deal with loss together in a manner that deepens each partner’s capacity to express their emotions and needs to each other in the aftermath of loss, and to enhance each partner’s responsiveness to the other’s emotional reactions during this painful experience of loss.  

Read more about CFIR’s Depression, Mood & Grief Treatment Service.