What lessons from trauma therapy can teach us about grief

(CNN) — Back-to-back celebrations with family and friends this December and into January — typically considered “the most wonderful time of the year,” as the classic song goes — can bring acute reminders of who’s missing from our holiday tables.

As a trauma therapist in Washington, DC, specializing in grief and loss, Meghan Riordan Jarvis counsels clients on how to get through what can be a trying time full of painful triggers. She brings to her work not only decades of training and clinical experience but also personal perspective from her own struggles with complex post-traumatic stress disorder following her mother’s sudden death.

In her new book, “End of the Hour: A Therapist’s Memoir,” which she calls “a love-letter to my clients,” Jarvis tells the story of checking herself into the same inpatient treatment center where she’d previously referred clients, sharing insights and practices gleaned from her own embodied grief experience along with interventions that have helped people she treats. In this conversation, Jarvis explains how paying attention to your body’s responses provides critical insights for helping you recover from loss — during the holidays and beyond.

This conversation has been edited and condensed for clarity.

CNN: What makes the holidays such a difficult time for people who are grieving?

Meghan Riordan Jarvis: The gap between our expectations and reality plays a big role. Instead of being the “most wonderful time of the year,” the holidays are stressful and grief-laden for a lot of people. Often my clients will devise avoidance strategies. They’ll shop online to escape the endless holiday music, double-book themselves to shorten time spent at uncomfortable gatherings, or even plan a trip to Aruba to sidestep facing the missing stocking hanging over the hearth. But trying to skirt around grief triggers doesn’t work. There is no outrunning a feeling.

CNN: What do you mean by “triggers”? And why can’t we evade them?

Jarvis: We are built of memories. A trigger means that some stimulus from the present moment pulls you back into a memory. To keep us safe, our brains are constantly coding information as either a threat or not a threat. If it sees a familiar piece of data that’s coded as harmful to our well-being, the brain will, instinctively, pull us into a threat response to try and keep us safe. This is true even if that “data” is simply John Lennon’s “this is Christmas,” [a line from his song “Happy Xmas (War Is Over,)”] that slays me because it reminds me of my mom. This is an automatic process of the nervous system. Our attempts at avoidance will never be better than our built-in systems to remember.

CNN: What do grievers struggle with most at this time of year?

Jarvis: Anticipation can be the worst part. People always ask me, “How am I going to get through this day?” What they really mean is “… with the least amount of pain possible.” What generally causes the most pain is the misbelief that you can avoid the pain. I tell my clients, “You will get through the day. The day will be what it is. Show up for all of it without judgment.” I also remind people that they will never have to do this day again. I reassure them, “How you feel about the holidays will not be the same 365 days from now.”

When people say, “I can’t bear the pain,” I remind them, “You already did.” It’s important to remember that we already survived the worst. So, if during the holidays you hear a song and it’s triggering, remind yourself, “This is just a memory.” Also remember that it is not only a memory of the pain but also of the love.

CNN: What specific coping strategies do you recommend?

Jarvis: Because everyone is different, it takes some “Sherlock Holmes-ing” to figure out what will work best for you. Feeling less alone is incredibly important. I usually push people to find at least two folks to be your “sad holiday buddies”— people you can text or call when waves of grief hit. We can taper down the overwhelm when we share it with people who care. If you don’t have a friend available, be your own friend. First write down the story, then turn the page and respond to it as if it was written by someone you cared about. Having compassion for ourselves while we are experiencing loss is so important.

CNN: What have you discovered about the physical symptoms of grief?

Jarvis: I was really struck by the intensity of my own physical symptoms after I lost my mother. For 20 years, clients had described them, but I learned that’s a bit like a friend telling you what it’s like to live in France. And then you go to France, and you’re like, “Oh, this is what he meant about salted butter!” My sleep became completely disrupted, brain fog led me to mistakenly throw away my credit card four different times, a condition called exostosis led my body to grow tiny bones across my ear canal, and my back went out so suddenly and dramatically that it brought me to my knees and confined me to living on the floor for days. We filter all our experiences in the world through our bodies. The stress of grief can lead our bodies to throw up flares.

I had a client whose hair started to fall out. She kept saying, “I’m really stressed” but couldn’t say why. Once she came to understand this as a grief reaction, it totally pivoted how she showed up for herself, helping her realize that she wasn’t failing at managing her life but instead was responding to the seismic shift in her reality that came from losing a loved one. The hair loss helped her realize she needed to pause to grieve.

CNN: What advice do you have for people to become more attuned to the physical experience of their emotions?

Jarvis: I use this practice with my clients to help getting to know how their system is wired: Set a timer for seven minutes. Then close your eyes and take deep breaths as you imagine a can of magnetic paint slowly being poured over your head. As it rolls down your body, the paint will only attach to places where your body is holding energy. When the timer goes off, take note of where the paint collected. That shows you where the energy is stored. Then we get curious about the energy. How big is it? What’s it made of? Does it change its shape? How long has it been there? What does it usually drive me to do? What does it need from me? With practice, people can skip imagining paint and instead just do what’s called a body scan.

CNN: How can grievers best manage the physiological effects of loss?

Jarvis: Tuning in to your body’s responses provides critical insights into which coping strategies can help re-regulate the nervous system. Understanding the progressive nature of the body’s threat responses — from fight to flight to freeze to collapse — is key. Different practices will help depending on which state you’re in.

Fight mode when you’re grieving might look like overproducing the holidays — telling yourself you are going to make this the most amazing first year without your dad ever. Unfortunately, we know this effort to fight against sadness is not going to work. The body’s ability to remind you of hard things is stronger than your ability to stage-manage with holly and mistletoe.

The fleeing griever might say, “Let’s go to Barbados and pretend Christmas isn’t happening.” There’s nothing wrong with breaking routines, of course, but acknowledge the fact that, even in Barbados, Christmas Day will come and you’re still not going to have your dad. Feelings will doubtless arise.

Freeze might look like not even thinking about the holidays — being shocked to discover it’s Christmas Eve or that you missed the first four days of Hanukkah.

Collapse could lead people to hide under the covers, avoiding everyone and everything. They might try and dissociate, using drinking, drugs, gambling or excessive shopping to distract themselves from difficult emotions. Healthier versions of disassociation might include scrolling TikTok, cleaning or bingeing on Netflix.

Freeze and collapse are the most perilous states. When we feel helpless, the brain very quickly makes meaning out of the feeling, telling us we actually are helpless. Disrupting that process is critical.

CNN: What does disruption entail?

Jarvis: We must meet our nervous system where it is. Our brains work under two different systems, the activation side and the soothing and cooling side. In hypo-arousal, where you’re sleeping too much, lacking energy, suffering from brain fog or migraines, and disassociating, a lavender bath is not going to make you better. Instead, try adding movement into your day — maybe building in a small, manageable commitment that will help push you into action. Try cross boxing, jumping jacks or taking a brisk walk. All of these provide bilateral stimulation.

When someone is feeling anxious or agitated — aka hyper-aroused — it’s important to find a way to come to stillness. Just like running a puppy or a toddler, your body might need you to burn off some energy before you can settle. So, go for a 30-minute run, followed by a hot shower or bath, which can bring on a soothing state. Yin yoga or other slow practices that focus on stretching and bilateral stimulation can help, too.

Sometimes, to calm my jacked-up nervous system, I hold five or six ice cubes in each hand and three or four in my mouth. The discomfort grounds me by drawing all my attention to the sensation of cold.

I often have my clients do a mindfulness exercise called “54321.” First, name five things that you can see. Then, four things you can hear, three you can touch, two you can taste, and one you can smell. In therapy, if I see a client start to dissociate, I tell them to look around the room and tell me one thing they can see that’s green or two things that are made of glass.

CNN: How do these practices function?

Jarvis: When we’re dysregulated, a brain structure called the amygdala enlarges, blocking out messaging to other parts of the brain, including the prefrontal cortex, which is where we do our critical thinking. Central nervous system reset practices like these calm the limbic system from its highly activated state and invite other parts of the brain back online.

In all my training, I had never heard an expert directly address the physical symptoms of grief. Since my own treatment experiences, I’ve been determined to help inform people about the embodied aspects of grief and how to heal. In the same way that we teach middle schoolers about puberty, we need to teach people about how our bodies experience grief so that they are prepared for loss — an inevitable, universal human experience.

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