Cumulative Grief

"There are years that ask questions, and years that answer."  —Zora Neale Hurston


I first heard the term cumulative grief while working at a Bay Area Hospice, as a Volunteer coordinator, after my partner William passed away. I had gone out on family leave from my former employ, to address some of my own health issues. I was diagnosed as having severe depression and anxiety disorder. While I was addressing those issues is when William was diagnosed as having Stage 4 appendiceal cancer. Not the most common of cancers but we joked that he had to go get a cancer that not many others had—just to be different.

I was fortunate to spend the last year of his life with him, taking him to his chemo infusions and endless doctor's appointments. He was put in hospice and this is the hospice that I was now working for. I started volunteering there while I figured out what to do with my life next. They offered me a job and I happily took the position. When we lose someone, we lose so much more than just that person. We lose ourselves, if we have been a caregiver. We also lose the life we once had, our direction, sometimes our homes, because we can no longer afford to live there. I just went through this myself in December 2015. It has a rippling effect. It is also different for everyone. I will continue to share my experiences and observations.

As a requirement of the position, I had to attend weekly meetings to discuss patients as they are followed through the last phases of their lives. Hospice is essentially a team of people that includes  the doctor, case manager nurse, assigned nurses, nursing assistant or aid, social worker, chaplain, volunteer coordinator, and sometimes a therapist. I will address the workings of hospice at a later date because it is helpful to understand how it all works before you have to deal with it.

It is during these meetings that the subject of cumulative grief came up quite a bit. This is basically when someone has experienced many losses and has not had sufficient enough time to work through them. At some point it all catches up to them and can have devastating effects. The other important note here is that grief is not just about losing loved ones, spouses, family or friends. It is also about losing pets, jobs,homes, cars and other things in our lives that turn our world upside down when they are gone.

These are tumultuous times, in which we live and yet our culture and society do not allow for the time and self-care that is really needed to properly address and grieve these losses. If you are lucky, you get a week. Uh, not enough time....  Instead it's “move on,” “get over it,” "throw yourself into your job,""you gotta be strong," etc. etc. etc.  

As I sat and listened to these discussions on a weekly basis and looked back over my life, a lot of this rang true for me. I considered myself very fortunate and grateful to be able to sit in and be a part of these conversations. I also have to say that this was truly an amazing group of clinicians and big-hearted folk. I have much admiration and respect for all of them (more hospice shout-outs to come at a later date). This cumulative grief conversation fascinated me and I was able to get some clarity on how this took form in my own life. I was also very lucky to share my office with the department head who oversaw all the chaplains. She was one of my favorite people there and we had such incredibly deep, moving, open and honest conversations about all of the most difficult subjects in life—not just grief. We shared a lot of healing laughter and spiritual discussion, as well—she was also a rabbi.  I am grateful to still call her a friend. I have so much admiration and respect for her.  I asked about cumulative grief and she explained how if we do not deal with the losses one at a time as they come up, people can have "breakdowns" and become incapacitated in their lives. I had to ask myself—could this be the cause of the recent severe depression diagnosis and anxiety attacks I had been experiencing?

This was an eye-opener for me.

If we stop and take a moment to write down all of the losses in our lives in say the last ten years, what would that look like? What did we do about them? What actions did we take to address them, if any? How do we practice self-care during these times?  Or do we? Do we listen to everyone telling us to hurry up back to our jobs and busy lives because that will fix it?

I enjoyed doing art and music therapy groups with my rabbi friend and watched the healing that went on with people. It was so beautiful and honest—I felt so privileged and honored to be on this journey with them. It also helped me heal. It was probably inevitable that everyone would come in saying "I'm not an artist." Yet they were able to tap into some very deep emotions and feelings that they had been unable to express in words. I suspect many of these people were experiencing cumulative grief and I would think many people in our communities are as well. Sometimes words just aren't enough and fall short of total expression.

I can't say enough about the support that you get in a grief support group. Of course no one wants to go—it's not fun. It's work. But you are worth the work that you put into it.  One cannot put a price tag on the value of finding someone going through the same difficult challenges at the same time that you are. Or finding someone who never tires of hearing you speak your loved one's name once again, even when you are starting to.


i feel you brush my shoulder
disguised as a frosty breeze
i smell your musky scent
as I step upon the autumn leaves
i see your brilliant beauty in the winter berries
i mouth a simple
thank you
for letting yourself be known

copyright TClare 2016