Since COVID-19 was declared a global pandemic, Toronto’s Andrea Kwan, Registered Social Worker, Psychotherapist, has been working out of her home office, with her partner and 16-month-old daughter also under the same roof. Andrea specializes in grief counselling, supporting adults who have experienced all different kinds of loss – including (primarily) deaths, estrangements and loss of relationships.
“I’ve tried to keep my days similar to what they were before and I’ve tried to keep my boundaries – like my part-time hours, to care for my daughter,” she said.
“Through this experience, I’ve really noticed that the physical separation between home and work isn’t there, and providing counsel over the phone or on video does change the dynamics. I’ve also realized that my work office isn’t only a safe space for my clients, but it’s also one for me, too. It’s a special place for me to be able to do the work that I do, and it’s a secure, warm place my clients can come to.”
Like Andrea, many of us have had to take – and keep – our work lives home for the last few months. I’ve always loved working from home – and I still do. I get my work done quicker, I do more in a day than I ever could at the office and I like not having to wait for the streetcar in bad weather, while wearing my backpack, and holding a lunch bag with now empty, still heavy, glass containers.
Being inside my home, though, I sometimes feel a lack of structure or schedule, not only with work, but with all the other important things on a never-ending hiatus, dipped in a soury coat of uncertainty, around me; milestones, special moments, exciting transitions and goals. Poof. Gone. Leaving me with disappointment.
In late April, I caught myself feeling heartbroken. Like, on my bed, in my nightgown, crying, while somehow simultaneously getting chocolate on my bedspread. (I had made chocolate chip banana muffins the day before, as you do).
My throat felt heavy – as if a potato chip got wedged in there somehow – and it was like my brain was processing tragedy, trauma and trigger all at the same time. I hadn’t lost someone I love and I hadn’t lost a physical item weighted in memory, so I felt (and feel) guilty about being sad and overcome by this anxiety, as if the pain I have is lesser, and therefore intangible and undeserving of time or space. I also spent too much time on Twitter one night, and ended up in a black hole of, “STOP WHINING,” thread replies and, “YOU’RE SO VAIN,” remarks. It’s not a good feeling, and I must not be the only one feeling it…right?
I wanted to explore the process between guilt and grief, and the relationship between mourning and COVID-19 a little deeper, to attempt to understand the layers and levels in all this. While, truthfully, it’s been tough to read or write anything substantial since the pandemic struck, I woke up on May 11 with a little twinkle of inspiration, and sent a note to Andrea with a request to chat. After work one mid-spring evening, a night somehow still burdened with a frost warning (c’mon, 2020), Andrea and I spoke on Google Meet.
Our interview is below, edited for flow and length.
1. Have you noticed a transition in the trauma and triggers your patients are talking to you about?
A lot of people have said to me that having to be inside their homes, not really knowing what’s happening day to day, makes them feel like things are out of control – because we don’t have control over this pandemic situation. This feeling of loss of control mirrors what we see in acute grief, when we first lose someone, so lots of people are being triggered into feeling grief from older losses. For other clients, we’re talking more about general COVID-19 anxiety and coping, than the usual grief stuff, because that’s what’s on the surface and is the most pressing and immediate.
2. Many of us may be experiencing different types of grief, right now. What are some common losses folks may be grieving?
There’s the loss of having a sense of the future, the loss of plans that you had; all these things you were looking forward to, the things we were excited to do. There’s grief about just losing day to day structure and predictability. There’s also what we call Vicarious Grief – what we experience when we’re impacted by witnessing someone else experience loss. For example, if you have a friend who has lost a parent, you may be feeling Vicarious Grief for her, as you watch her mourn. You are touched by her grief and feel empathy for her.
With COVID-19, because it’s global, we’re always reading about other countries where death tolls are higher [like in Italy or the United States], where cities are overwhelmed with death, and some of us now know people who know people who have died. Even if it isn’t our loved ones who have died, knowing someone who has lost someone has an affect on us. Most of us brush off this Vicarious Grief, but on a human level, we do truly care about those things and have empathy for people. We can feel the pain of others.
Anticipatory Grief is another one for those of us worried about how the disease may affect our lives, or lives of loved ones. We experience Anticipatory Grief when we start grieving an impending loss, before it has actually happened. In the context of COVID-19, some people may be sick with it and wondering, “Am I going to die?” Or, “My grandmother is in long-term care. Is she going to die?”
Some are also feeling grief about losing the world they once knew, because it no longer exists. We all have an internal structure and beliefs about how the world works and our place in it, and something like a pandemic can totally shift our perspective. Many of us have been living with the belief that by being a good person, going to work and paying our bills, we’ll be safe. COVID-19 is proving that we may not be as safe as we thought, and that we don’t have control over anything. That illusion of control has been broken.
Others may be feeling Disenfranchised Grief when their grief is not socially validated by their friends or family. Hearing that someone is doing so great can feel weird and strange, especially when what you see might not validate your own experience.
Some people may be having a really hard time, feel very sad and disoriented, and are grieving the losses of their plans and future. If they don’t see this experience mirrored in people around them, or worse, are being told they shouldn’t feel how they feel, they are maybe questioning, “Is my grief valid?” When someone’s grief isn’t socially acknowledged or validated, they experience Disenfranchised Grief.
3. Anxiety and fear about losing a loved one to COVID-19 are also on the rise, which we already briefly touched on. Perhaps someone we love is on the front-lines, immunocompromised or making choices different than what the Centre for Disease Control (CDC) or the Public Health Agency of Canada recommends. Is this fear valid? Or are we (read: me) spiraling?
I think this fear is normal. We don’t know what will happen. There is so much about this disease we don’t understand, and it’s hard to know from day to day or week to week. One day we hear, “Don’t wear a mask,” and the next day we hear, “Wear a mask.” It’s valid to have fear about not knowing who will be affected and how it will be transmitted. It’s normal to feel scared that people you love could get it.
It’s easier to spiral into these thoughts when we feel we don’t have control. That said, we also have to pay attention to a shift from normal worry to catastrophizing and debilitating anxiety, which can lead to things like lack of sleep, lack of daily functioning, etc. While it’s normal to be worried and fearful, we want to pay attention to these thoughts and if we start to have a hard time functioning, get support.
4. Does it feel harder for some of us to manage this mourning now, under the lens of COVID-19? Or is that just me?
Most people are finding this hard, whether or not they admit it. The feeling of not knowing when or how things will end has been dysregulating for all of us. Also, because it’s forcing us to do or not do certain things, we don’t have access to the usual routines that help us feel safe.
We’re creatures of habit and our daily structures really matter to us, so not having the things we usually do to maintain our health is really hard for people. It’s one thing to choose to stay home and never go outside, but this is something many of us would never choose. It’s also nearly impossible to not be affected by the stories we hear about how COVID-19 is impacting communities around the world.
5. What coping patterns have you suggested that may bring security to people who are experiencing loss and heartbreak, while in isolation?
We all benefit from some structure and routine. Some of us need every detail planned out and others may be more relaxed. If you are able to maintain regular sleeping hours and eating patterns, and if you allow yourself to go outside on walks, I would suggest doing these things at the same time every day, so you have a sense of a daily rhythm.
COVID-19 doesn’t mean throwing out every routine or boundary. For example, just because you may be able to sleep in until noon every day and go to bed at 2:00 a.m. every night doesn’t mean you should.
For me, my structure is built around my daughter’s life, especially her feeding schedule. For someone else, it may be having that one routine to help keep track of the day, like having your morning coffee everyday at your window while looking outside.
A huge part is also letting yourself feel whatever you feel. We can be grateful for what we have, but we can still have our grief; one doesn’t cancel out the other. Allow yourself the time and space to feel crappy if that is how you feel.
Social connections are really important to maintain but also to have boundaries around. Everyone has a different idea of what this means. Many of us don’t want to get on another video call, but maybe it’s a safe, physically distanced visit or a quick check in over the phone.
People isolating themselves – entirely solo – need to find connections with others in ways that feel good for them. People who are in a space inundated with other people may try to find pockets of time for themselves, so they can have some alone time.
6. In Canada, nearly 6,000 people have died of COVID-19 so far in 2020. We hear a lot about the number of people, and not so much about who they are. While we can’t have a traditional funeral or celebration of life right now, what can we do to keep memories alive?
It depends on the individual person and what they need. Lots of people have been doing virtual gatherings; it’s not a funeral per se, but they read some passages, share pictures, discuss memories — it’s important to try and get a sense of community and gather in ways that you can.
It might also be beneficial to have a virtual space, that’s not a video call, to post stories, pictures and messages so the bereaved can read and feel connected to family and friends.
Since many of us can’t gather in person, in addition to a virtual ceremony now, it may help to plan a memorial, funeral or celebration of life for a time when we can be together. There is nothing that can replace having a physical community in the room supporting you. It’s a missed opportunity if we don’t end up holding space for a real life memorial, funeral or celebration of life.
7. What can we do to support someone who is mourning the loss of a loved one, after something so tragic and complex?
People who are grieving often appreciate it when others are around for them to do something with. The companionship is what can be so helpful. Maybe they don’t want to talk, but maybe they want to go on a walk with a friend or watch something silly on TV. Under COVID-19, these things are limited.
With video calls as an option, it’s still possible to create some sense of companionship, like watching a movie together over Zoom, or folding laundry together over the phone.
Dropping off food is a good option, because people who are grieving may not have the capacity to cook for themselves. Sending care packages, if financially feasible, or sending a card – people love getting snail mail – are usually well-received.
Still, it’s always better to offer concrete suggestions of how you can help them. “Call me if you need anything,” or, “What can I do to help?” are well intended, but the person who is grieving may not have the capacity to think about or share what they need. Give concrete suggestions, so people can say yes or no. It can be helpful to say, “On Friday, can I send over dinner? Here is a choice of three restaurants. Tell me which one you feel like.”
For people with kids, maybe we offer to have a video call with their children, if they’re older, so the adult(s) can have time for themselves. Maybe it’s just ordering groceries for the family, and helping them to do things that need more mental capacity than they currently have.
8. Sometimes support can feel overbearing and claustrophobic – even if we’re in different houses, or six feet apart. How can we check in on people we love, with respect, while following physical distancing and not spending tons of money on a care basket?
We can offer solutions with a caveat – I want to do this for you, but if it’s too much or you don’t want it, let me know. Give the person an out, so they can take it. This can help them feel okay saying no, and help reduce any further guilt or sadness. Both parties have to do what feels right.
As much as presents, flowers and gift baskets are nice – they can cost a lot. Material items are definitely not the only tactics. Being willing to be in the awkwardness of it all, and to listen without trying to fix things – because you can’t fix anything – goes a long way.
9. Speaking of the cost of a care basket, financial loss is a grief category all on its own. How can we make sure we remain mindful about varying financial situations, when virtually connecting with people in our circles, to help prevent unintended harm or further anxiety?
Awareness. We all have different financial realities and the truth is, there are a lot of people who are and will suffer terribly. We’re not all in the same boat – there are some people who have lost their jobs, some people who may not have homes, some people who may not be able to make rent.
You can’t change another person’s perspective, but it’s important to highlight other experiences and stories to help make people aware of the varying degrees of situations we’re all in. And, if you make a mistake, recognize that and apologize. We all say things that hurt other people, without intending to cause harm. Own up to it and be gracious.
With all that said, I do think the financial, emotional and mental effects of all this are going to be long-lasting.
10. Virtually connecting and using video conferencing platforms is great, but is it rude or insensitive if I decline an invite? I feel like I can’t say no, because, well, I’m at home…
Yeah! It’s really important to maintain your own personal boundaries about what you need. You can just not feel like doing something, and that’s reason enough. It can feel easier to say no when we have an excuse that we can give.
Now that we’re home, especially if we’re alone, the person who wants to set up a chat knows you have nowhere else to be and no one else to be with. If you don’t want to talk but you feel forced into it, and you don’t enjoy it, you might feel like you just wasted an hour of your time, and could develop feelings of resentment.
Sometimes though, when we “make” ourselves do something we don’t want to, we end up enjoying it. So we can make those calls for ourselves.
11. I have so much to be happy about, and still, I blame COVID-19 for everything I’ll have to put on hold this year, even those still in the “unknown” category. Shouldn’t I be taking some responsibility for the path ahead, even though it feels like I can’t do much to be proactive and productive?
Productivity is overrated. We live in a world that prioritizes productivity and focuses on doing, doing, doing. Now that we’re being forced to not do what we normally do, for a lot of us, it feels uncomfortable and like we’re failing. But we need to reflect on our expectations about productivity and recognize the limitations are a result of the situation, not because of us.
I’m glad we’re re-evaluating, “How much of my life was me actually doing what I needed to do? How much of my life was me doing things that I just was being told to do/felt like I had to?”
12. I live in a small apartment and have no kids. But for people with children, they’re navigating waters completely unfamiliar to me. What are some common fears parents may have about their kids’ understanding of COVID-19?
Depending on a child’s age, they have different capacities and capabilities of understanding what’s happening. Kids are grieving what they know – access to their friends, their routines, their teachers, their grandparents. As well, parents are worried about whether their kids will fall behind in school, as distance learning isn’t the same as being in class or going to daycare. A lot of parents are worried about whether this will affect their kids’ overall development.
My child is quite young and she doesn’t have friends per se, but before COVID-19, we went to drop ins, and we went to meet up with other moms and kids. I often wonder whether physical distancing will affect her development because she is just around us all the time, and no other kids her age.
13. What advice would you give to parents who are struggling to understand the impacts the pandemic will have on their children long-term, while also not fully comprehending how COVID-19 will impact them, the adults, in the years to come?
It’s hard to talk to kids about this, because there is so much uncertainty, similar to what it’s like talking about death. When talking to kids about these complex and difficult subjects, often parents want to protect their kids, so they either won’t talk about it or they do it in a way that isn’t very clear, they brush over it.
Kids know when something’s up; they see when their daily life has been upended. As hard as it is, it’s best to be honest with kids and explain in simple, but truthful, language. Explain what’s happening but you also don’t want to scare them so I wouldn’t share stats and tell them extreme COVID-19 stories.
Explain there is a disease and it’s new, so we don’t know a lot about it. Say a person can have it and not know they have it, so we all have to be really careful because we could give it to someone else and make them sick. Share that if someone gets COVID-19, and they’re older in age or already sick, the disease can make their lungs very ill and they could die from it. Always remind kids that we’re doing everything we can to protect ourselves and the people we love.
When we talk about these big “adult” problems with our children, we want to give enough information so they feel informed, but we don’t want to make the kids feel like they’re responsible for solving it. We of course can’t say that none of us will get COVID-19, because we don’t want to give false promises, but we don’t want their little brains worried about trying to solve a problem. Be sure to also give kids some agency; tell them how they can help too.
14. What would you tell a parent who’s experiencing Vicarious Grief, grief on behalf of a child who is no longer seeing their friends, and doesn’t understand why their neighbours aren’t coming out to play?
Just like with adults, encourage the child to make space for those feelings, and name those feelings – sadness, anger, missing someone, etc. Kids may not have the skills to name and identify certain feelings and it’s always helpful to build their emotional literacy.
Often, we want to protect our kids and not have them feel bad, but it’s important to let them build those skills to deal with their feelings, so when they’re adults, they can be with and navigate difficult feelings.
Help the kids draw out their feelings of sadness, or punch a pillow. Be with the feeling and model how to be with feelings.
Because we parents are very stressed, as we’re working non-stop and taking care of kids non-stop, patience is slim, and our impatience might make us say, “Stop whining.” But when we can, make space for their feelings, and remember that just because they are kids, doesn’t mean they don’t feel things as we do.
And if it’s possible to help them connect with the friends and family they miss in safe ways, do so. Create opportunities for connection – walk by Jimmy’s and say hi from the street, or plan a virtual play date.
15. Many of us have shifted into a work-from-home environment, which like all of this experience, is entirely unique for every household. Some people reading this may have been on leave before COVID-19 struck, and/or are unsure of what the future holds for their career or industry. While safety comes first, some days may trigger us to feel purposeless and aimless, especially if we can’t focus on career development or fulfilling aspects of a job. When this guilt and grief come our way, how can we acknowledge and manage it all? How can we redefine self-worth?
The world as we knew it has shifted and, as a result, our identity may also be changing. We may be thinking, “What does this mean for me? Where do I go from here? Who am I now?” There’s no easy answer for these questions – it takes time to figure out what’s next, but it’s important to remember that none of us are only one thing.
When we lose our sense of self and parts of our identity, we need time to identify the other parts of us that are left, and if there are other interests and goals that we can put our energy into.
If it’s possible, figure out ways to refocus your energy. It’s important for people to feel competent and like they’re contributing – when we lose that, it’s hard on our egos. However, before we can figure out what’s next, we have to take time to grieve what we’ve lost.
16. Is there a pathway between feeling guilty about grief, and actually grieving that loss? What can it look like?
Your feelings are your feelings, and they’re totally valid. There is often a lot of judgment about what other people feel, especially grief because of a false sense of scarcity of empathy.
In Megan Devine’s book, It’s Okay That You’re Not Okay,” she talks a lot about how people compare pain, or essentially this thought: “Your problem isn’t a real problem, other people have worse problems.” I see this all the time, even with people who are bereaved, saying, “Why am I sad? It could be so much worse.” It’s true, it could always be so much worse! But that’s not the point. The point is that there is enough empathy to go around.
Empathy is an infinite resource – I can feel empathetic about my issues, and your issues, too. If we operate under the fact that empathy is a scarce resource, then of course we have a limited amount to give out, and we’d have a hierarchy of pain, but I think we have enough compassion to give everyone’s issues time and space.
17. I’m always looking for an affirmation to give myself to help stay motivated and calm. Do you have one that you use?
I have several, “take it a day at a time” and “this too shall pass.” Sometimes it’s even just getting from moment to moment. What do I need to do to get through today? In harder moments, it’s more, what’s going to get me through the next five minutes?
I also remind myself that nothing lasts forever. When we’re in a state of sadness or depression, it feels like the episode will last forever, and that’s not the case. No feeling, mood or emotion lasts forever. When I have those bad moments, I tell myself that this too will pass and that eventually, my energy will shift.
18. Some days though, this affirmation won’t work. Is it okay to not be okay? Is it okay to feel sad, uninspired and bored, but also not productive or proactive?
It’s okay to feel like it’s not working. Sometimes the affirmation just doesn’t work and we have to find other ways to get through, and this is where a support system is important. As much as we need internal resources, sometimes that’s not enough, and we just don’t believe what we’re trying to convince ourselves of.
This is where connecting with people we trust is really important. Sometimes you really don’t have hope or don’t think things will work out, and you need someone in your life who can hold onto that hope for you and say, “You might not believe this but I do, and I can be the one who holds this for you.”
19. What reassures you, despite all this wacky COVID-19 business?
I try to focus on nature, because she’s just doing her thing, she’s just continuing. Of course, sometimes, on days when the weather is really crappy, this focus doesn’t help. Still, even though we’re in the midst of this uncontrollable thing, the buds are still on the trees, the flowers are still blooming and the weather is slowly (slowly!) getting nicer. There is a deeper, bigger thing at work here.
I also find comfort in my daughter because she is happy and it made her day the other day just to pick a dandelion. I try hard to appreciate the little things and the small moments, but sometimes it doesn’t work and I’m crabby or in a mood. I try to savour those small moments, when I can, though, because that’s all I have. I can’t control the outside world; none of us can.
If you, or someone you love, is interested in exploring the benefits of psychotherapy and grief counselling, please visit AndreaKwan.com to learn more about the services Andrea provides. For every potential new client, Andrea hosts a free 20-minute phone consultation to learn more about the patient, and so the patient can see if Andrea is the best fit for them. If unavailable at the time of inquiry, Andrea will lean on her network of therapists, to pass on any potential clients. Due to COVID-19, Andrea is hosting telephone and video sessions only.
For more information about taking care of your mental health during the COVID-19 pandemic, and resources provided by the government to support the well-being of Canadians, please visit the Coronavirus Disease (COVID-19) and Outbreak Update pages on Canada.ca.
The feature photo is by Davide Burzotta.