Rick Nizzardini, LCSW

ADDRESS:

533A Castro Street
San Francisco, California 94114

PHONE:

415-706-5716

Thursday
Jan052012

Grief and Loss

Grief is an emotional reaction that follows the loss of someone or something of great value.  It is a spiral of feelings and reactions rather than a line with a beginning and an end.  In a sense, grief doesn’t know the concept of time.  Sometimes it can feel like the loss happened yesterday although it may have happened awhile ago. 

Most people think of grief connected to the death of a loved one, but there are actually many life changes that can lead to feelings of grief and loss.  Some examples include:

  • Relationship changes, such as the ending of a friendship, dating relationship, or a break in a family relationship.  This can include parents divorcing or separating, as well as changes in a friendship in your life. 
  • School or job-related changes, such as graduation, moving to a new place, losing out on a new career opportunity or internship.
  • Health changes, such as an injury or illness that is chronic and not easily resolved, or changes in a family member’s health.
  • Life changes, that include the death of a friend, partner, or family member.

Research has identified certain stages of grief reactions that many people experience.  It is important to know, however, that these stages occur differently for each person.  They may not occur in sequential order, but the emotions that are linked to the stages are common emotions that people experience at some point in the grieving process. 

When a loss occurs, it is important to recognize that this loss has happened.  However, many people initially experience shock or disbelief which can last for days or weeks.  It is almost as if people are in a state of denial about the loss or as if they are acting on “auto pilot” and restricted from feeling the full impact of the loss.  People can also feel angry, numb, confused about what happened, or even guilty.

At some point after recognizing that a loss has occurred, a person can begin to feel more intense emotions, including tearfulness and crying; feeling anxious and overwhelmed; preoccupation with the loss or memories of the lost person or situation; feeling restless or having difficulty sleeping; feeling anguish, agony, despair; and physical symptoms including headaches, fatigue, or upset stomach.  All of these reactions are common, as the reality of the loss settles in.

Healing from a loss takes time, and it varies for each person.  Signs that someone is moving towards the end of the grief process include feeling more energized; experiencing bursts of energy and building an interest in life again; and beginning to make plans for the future.

It is important to know that some of the feelings described above can reoccur during anniversaries of the date of the loss, birthdays or other significant events that can happen annually or throughout a year that remind you of the loss, or other triggering situations or events.  Preparing ahead of time before these anniversaries occur can be very helpful.  You can make sure to be with someone to talk about the loss before or on an anniversary, or do something significant to honor the loss at that time.  Whatever you do, remembering not to deny that these feelings may come up due to memories of the loss is critical.

In terms of coping with grief, different strategies can be helpful in accepting the reality of the loss, working through the denial of the loss to the feelings of pain and grief, adjusting to life with an acknowledgment of the loss, and reinvesting in a future after the loss.  Here are some things that can assist with all of those tasks:

  • Talk about the loss with friends or relatives.  Getting their support can be invaluable.  Sometimes, meeting with a counselor can be helpful if you cannot identify someone you feel comfortable talking to or if you feel you reaction is interfering too much with your daily living.    
  • Create a ritual to honor the loss.  This can be a funeral in the case of a death, or it can be creating a photograph memory book.  It can also be planting a tree, doing something artistic or creative, or writing a letter to the deceased person or the person with whom you have broken up, without feeling the letter has to be mailed or given to the person.      
  • Start a journal and write down your feelings about the loss.   
  • Pray or meet with someone important from your spiritual or religious practice.   
  • Attend a support group for people who have lost someone to help you feel that you are not alone in this process through which you are going.     
  • Take care of yourself, including eating regularly, getting enough sleep each night, exercising if you can, and any other self-soothing activities that you know are helpful to you.   

Above all else, remind yourself that loss and feelings of grief are unavoidable and common aspects of living.  With time, patience, and support, you can move through the grieving process and come to a place in your life with new understandings about you, others in your life, your spirituality, and life overall.

Tuesday
Dec212010

Managing Conflict

Conflict is happening every day in our lives.  Put simply, it is unavoidable.  The real question is how do we manage through conflict?  Or if we are managers or supervisors, how do we assist others in managing conflict?

The starting point is knowing exactly what conflict is, and what it is not.  Conflict is a disagreement through which the parties involved perceive a threat to their needs, interests or concerns.  It occurs when the goals or values between individuals are incompatible.  This results in attempts to control each other with antagonistic feelings towards each other.

Conflict is not a mere disagreement.  It is a situation in which people perceive a threat (physical, emotional, power, or status) to their well being.  As such, it is a meaningful experience in people’s lives, not to be thought of as something that will just pass with time.

Above all else, we need to recognize that where there is a conflict, there is a problem.

Once we identify that a conflict is occurring, it’s helpful to know the sources of conflict.  If we know the sources, then we might be able to address them and release the tension around the conflict.

A primary source of conflict is stress.  Stress is the fuel for anger, which can result in conflict.  If we can recognize that we, or others around us, are under stress and we can help alleviate that stress, conflict is less likely to hang around. 

Another source of conflict is miscommunication.  When miscommunication is occurring, clarifying where the goals and values of those involved in the conflict overlap can reduce the tension around the conflict. 

Conflict can also arise from differences in individuals’ beliefs, values or ideologies of the ways of life.  This can come up particularly with people who are different from one another in terms of ethnic, family, religious, and sexual orientation backgrounds.  These can be some of the more difficult conflicts to resolve, because there are strong differences in values or styles that improved communication may not be able to address.

What are some other ways to resolve conflict, particularly if you have to engage in a conflict management discussion? 

  1. Be clear what you and the other person (or those you manage) are trying to achieve.  Focus on each person’s interests, concerns and goals and not his or her motives. 
  2. Assess the situation and clearly define the problem.  Define the problem in a way that does not place blame.  Separate the problem from the people involved so that solutions can be generated.  Also be aware that if the problem requires some specialized help (from a higher level manager, human resources employee, or perhaps a therapist), make sure to arrange for that person to assist or manage the conflict.
  3. Problem solve!  Brainstorm to create new options that might resolve the disagreement.
  4. Implement a strategy and a time (several days or weeks later) to check-in to see how effective the strategy has been in addressing the problem and reducing the conflict.
  5. If you are a manager or supervisor facilitating a conflict management discussion, reconcile both sides; do not take one side or the other.  Encourage each side to demonstrate empathy and mutual understanding when possible.  Make sure everyone gets to speak.  If someone is quieter than the other, make sure you create a safe space for them to voice their feelings.  Encourage the use of “I” statements rather than “you” statements like “you need to…” or “you have to…”  Discourage interruptions when someone is speaking.  Discourage any personal criticisms or name calling.  Above all else:  make sure that everyone involved and present at the conflict management meeting agrees to work through the conflict to arrive at a solution.  A conflict cannot be managed if those involved do not want to work through it.

Remember, conflicts are going to happen.  It’s when we are able to step back and walk through some of the suggestions described above that we can reduce the conflict before it festers and continues to affect us, and those around us, over time.

Monday
Dec142009

Managing Stress

Stress is so much a part of our lives.  And it can lead to emotional and relationship upheaval for us every day.  So what do we do?  Understanding stress is a critical first step.

First, it's important to realize that all stress is not the same.  The reasons and sources of stress can come from different places such as relationship conflict at work, home, or with family or roommates; financial instability; illness or health problems; problems at work, or even a sudden death in the family. 

Another significant source of stress are traumatic events that happened while growing up or as an adult.  Research is finding out more and more that there are a wide range of these types of traumatic events that can lead to what is called traumatic stress.  These events can be things like growing up in a home with ongoing conflict; growing up feeling isolated and alone in one's family; being bullied and feeling inadequate while growing up; being on the receiving end of taunting/teasing/ongoing criticism on a regular basis while growing up; repeated physical punishment or violence from parents, siblings or peers; and sexual situations that felt unwanted and forced upon someone growing up.

All of these sources of stress can lead to emotional difficulties (irritability, anxiety, depression, withdrawal, panic attacks, worrying constantly, rapid swings in mood, difficulty concentrating, feeling cynical, feeling helpless, lack of self confidence, guilt, or constant anger).  Physical problems can also result from stress (tightness in the chest, chronic fatigue, out of breath often, nausea, muscle twitching, fainting, sweating, insomnia, muscle tension, persistent headaches, migraines, and indigestion or stomach aches).  Often behavioral problems can result from stress (changes in eating, easily startled, unable to make decisions, increased absenteeism at work or school, poor work performance, teeth grinding, nightmares, or increased alcohol or drug use). 

So what can we do to manage stress?  It's so important to start off by thinking about the things that you know have helped you in the past.  If those stress management strategies worked in the past and did not have negative consequences on your overall well-being, yet you have stopped doing them, then re-start them as soon as you can.  Second, be open to trying some new strategies that work for your personality style, such as writing or journaling, something to do with nature or the outdoors, being creative/musical/artistic, or going to a place of workship or doing something spiritual.  Since stress is a physiological phenomenon, a physical activity often can help reduce stress (walking, exercise, yoga, playing a sport, or hikes).  Also remember that some basic in-the-moment stress management techniques can be helpful such as deep breathing, muscle relaxation and stretching, or visualization. 

Finally, therapy can be helpful as well.  Sometimes the stress is due to stressors that require professional guidance to figure out how to move through them and  the feelings they can lead to in order to lessen the stress over time.  This is true particularly if the stress is due to the types of traumatic events described above.  Sometimes to address the stress, we need to have a sense of safety and trust that comes in a therapeutic relationship to begin to move beyond the constant stress we're experiencing. 

Whatever strategy you think will work best, remember to give it a fair shake.  If it doesn't work immediately, don't give up right away.  Sometimes it can take awhile before we get connected to a strategy that works.  Best of luck!

 

 

Saturday
Oct312009

Hello!

Hello and welcome to the blog section of my website.  My hope is to post my thoughts and ideas on different topics related to our emotional and mental well being.  Information and education is an important part of taking care of our mental health.  Hopefully my blog can provide some guidance or tips on how to take care of yourself.  If you would like to talk to me about whether therapy could also be helpful for you, feel free to give me a call.  Thanks for checking things out.