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Making Room for Grief During COVID-19

April 03, 2020

By Andrew Penn, RN, MS, NP, CNS, APRN-BC
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The opinions expressed by Psychiatry & Behavioral Health Learning Network bloggers and those providing comments are theirs alone and are not meant to reflect the opinions of the publication.

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 Find opportunities for gratitude. There is much loss and sorrow in the world. Each day, we are reminded of the fragility of life. While fear of loss is an understandable response, we also have the opportunity for noticing, for appreciating, and for savoring. The grief we are feeling is a form of praise that reminds us of how important that which we are without has been to us.

 Show compassion and patience. Make compassion for and patience with others a practice. Being cooped up with our loved ones can quickly get irritating. The habits of our household, once easily ignored, become a proverbial rock in our shoe. When we find frustration rising, take a breath or two, remember we’re all stuck in this together, and maybe find another part of the house to go to, or take that walk that you said you were going to take today. It’s worth remembering that we’re all trying to get through this as best as we can.

 Practice self-compassion. No one is self-quarantining perfectly, and that is fine. Lists like these can feel dictatorial and burdensome, fuel for that self-critical part of ourselves to say, “See, other people are making good use of this time, why can’t I?” I welcome you to take what works for you from this list, whenever you feel the need, and to leave the rest behind, without guilt. Let’s go easy on ourselves and each other. These are difficult times that call on us to sustain ourselves and each other for the long road ahead.

 Learn from others who have gone through this before. While media has been a helpful escape of late and there is great value in an amusing distraction (I recently saw a meme about reaching the end of Netflix), there is also the opportunity to learn from the wisdom of others who have faced similar circumstances. John Keats spent 10 days quarantined in the Bay of Naples during a typhus epidemic. Albert Camus’ The Plague and Viktor Frankl’s Man’s Search for Meaning have been helpful companions for me in recent weeks.

 Consider death. The ever-present, ubiquitous subtext of this entire pandemic is that we, or someone close to us, could die. Consider this reality as difficult as it may be. It’s worth making sure your advance directive for health care and your will or estate are in order. Talk to your loved ones about your preferences. Practical considerations aside, it’s worth meditating on the impermanence of life in the quiet moments of our day. While I first balked at this thought, the more I have practiced it, the less frightening, and sometimes, dare I say, comforting, it has become.

We are called to make space for our grief, in whatever form that takes. There will be times when we want none of this, when our hearts are heavy with all that we have lost, and times that the suggestions on this list just feel like another opportunity for failure. There are times when we will want to weep and times when we will want to sit and stare plaintively out the window. If that is what your soul is asking for in that moment, allow it that, too.

T.S. Elliot ended his poem with the haunting line “These fragments I have shored against my ruins.” This time will undoubtedly leave us both brokenhearted and greater of spirit. There is room for it all if we can allow it.

Andrew Penn, RN, MS, NP, CNS, APRN-BC was trained as an adult nurse practitioner and psychiatric clinical nurse specialist at the University of California, San Francisco. He is board certified as an adult nurse practitioner and psychiatric nurse practitioner by the American Nurses Credentialing Center. He has completed extensive training in Psychedelic Assisted Psychotherapy at the California Institute for Integral Studies and recently published a book chapter on this modality in The Casebook of Positive Psychiatry, published by American Psychiatric Association Press. Currently, he serves as an Associate Clinical Professor at the University of California-San Francisco School of Nursing, where he teaches psychopharmacology, and is an Attending Nurse Practitioner at the San Francisco Veterans Administration. He has expertise in psychopharmacological treatment for adult patients and specializes in the treatment of affective disorders and PTSD. As a steering committee member for Psych Congress, he has been invited to present internationally on improving medication adherence, cannabis pharmacology, psychedelic assisted psychotherapy, grief psychotherapy, treatment-resistant depression, diagnosis and treatment of bipolar disorder, and the art and science of psychopharmacologic practice.

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