The Brain Processes Facial Expressions- But what if they are fake?

Source: Pricelessparenting.com

How are you feeling?

I love this How are you feeling tool by pricelessparenting.com (it's a free printable chart!)  Several other mood assessment charts exist and are so helpful when children and others cannot put their feelings into words. 

But what happens when a child or adult learns how to fake an expression, to hide feelings? 

The Condolence Coach poses this question after reading a report about a study published in the April 19 issue of the Journal of Neuroscience by Ohio State University researchers. Seeking to locate the brain area where we translate and label someone else's facial expressions, test subjects were shown a thousand photographs of human facial expressions.

Study author, Aleix Martinez, a cognitive scientist and professor of electrical and computer engineering at Ohio State reported that:

 "Our brains decode facial expressions by adding up sets of key muscle movements in the face of the person we are looking at." He continued, "Humans use a very large number of facial expressions to convey emotion, other non-verbal communication signals and language." [Source: cbsnews.com April 20, 2016]

Learning to fake it

Heart Keys, acrylic on canvas,
 Suzy St. John

In my post What's the Big Hurry? Stop Pushing the Bereaved grieving men, women and teens reported feeling naked when baring emotions; they find the expectations of others, draining. The pressure to 'move on' is tremendous; in fact, deep grief six months after a death is considered to be a sign of mental illness! No wonder a grieving person quickly learns to mask feelings. An arsenal of euphemisms come out in response to that well-intentioned question:  "How are you?"

Faking it can include flat emotion that passes as disinterest. The Condolence Coach urges friends, family, and coworkers to assume pain continues.  Your "posterior superior temporal sulcus (pSTS)" [Source: cbsnews.com April 20, 2016] may be firing normally, but we're talking about a psycho-cultural cleverness rooted in basic human survival:  it will always win over a machine (the pSTS.) 

Filter the fake

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The simmer of ache, anger, anxiety, loneliness and emptiness continues in a grieving person, no matter what their face tells you. Here are some ideas on how to filter through the fake and deliver real care and comfort:

• It is not up to you to heal the grief.  But your note will be a balm and help in ways you may not know. Acknowledge that you cannot imagine what this loss feels like, but you recognize courage when you see it. There are documented health benefits to feeling cared about; a condolence note delivers comfort and often, hope, because it can be re-read in any hour of need. 

• Forget what you think you know about grief, including what you believe an expression is telling you. There are many myths about grief and rather than give advice, your friend or co-worker just needs you to listen.

• It is never too late to write a condolence note. Once while waiting for an oil change, I struck up a conversation with another customer and discovered she was related to a former employer. She informed me that one of his adult children had died the previous year. I found an address and sent him and his wife a note. There is a 'higher reason' this information reached you now. Use it!

• Anniversary notes are deeply appreciated. As I explained in my post When Little Birds Chirp, writing to the bereaved on the occasion of their loved one's birthday or death anniversary is not a painful reminder. 

• These principles apply to pet loss, too! Acknowledge the wonderful friendship but do not discuss a 'replacement pet'. 

    Thank you for caring!

The Long Goodbye, Part 2: The Empty Sigh After Alzheimer's Disease

This is the second in a series of posts about what it is like to live with Alzheimer's Disease, what comes after the death, and how to compassionately support a family during this journey.


In Part 1. The Long Goodbye, Alive Though Different: Anticipatory Grief During Alzheimer's Disease, we followed the story of Richard Taylor, Ph.D., the remarkable author and psychologist, who lucidly lectured to sensitize others about living with the disease. Among his films, "Be With Me Today" stresses: There's is a person in there!" 
Richard died July 25, 2015.

Part 2. The Adjustment After Death

What is left of the grief process after Alzheimer's Disease finally takes your loved one?

"Caregivers' depression often improves following the loss, but not always," says Co-Director of the Center for Research on End-of-Life, Holly G. Prigerson, PhD.
"The emphasis is often on the great relief that occurs following the death, once the caregiving and agonizing is over. They think it should be downhill after that, but it's not as easy as that. These people typically have been caregivers for about 10 years -- that has been their identity and mission -- and it can be very difficult for them to regain their life." [Source]

Some bereavement comments on the alzconnected.org message boards included:

"My father died almost 4 months ago from Dementia/AzD [Alzheimer's Disease], but really, the goodbye process began last spring when we placed him into assisted living.  It was a year long good bye that was harder some days than others."

"What I miss is her company. But it was quiet around here for so long that a lot has not changed in my routine. I don't have to worry about her any more. I am surprised that I have not felt a surge of grief but I think it had just lasted so long that I am grieved out."

"It's been over six months since I sat with mom as she took her last breaths. There was a sense of relief as well as the sorrow. My emotional side goes up and down but I'm dealing with life and have moved forward."

In Time...Healing

Source: Diane Zilliox

I was struck by two of the healing factors identified by Dr. Prigerson, in a presentation on Meaning-Centered Grief Therapy:

• The survivor must reconnect to sources of meaning for their life: creative, experiential and attitudinal.
• The survivor must reframe their arduous caregiving experience as an important part of their life story (and the life story of their loved one.) 

These steps--though they will take time--remove the "log jam" that may have dammed up the vitality and fulfillment enjoyed before caregiving. The natural flow of life is gradually re-established, and the legacy of the deceased is now heartwarming rather than gut-wrenching.

One message board contributor wrote:
"Mostly now, I remember her as she was. Full of life and always having a positive word for everyone."

Your Compassionate Response

[Source]

Your compassionate response to the Long Goodbye begins as a listener. In various settings, I have found myself listening to a caregiver pour out weariness and frustration. Give someone five minutes of your time; let them vent. It helps.

If you are able to provide some support during the caregiving phase:  a respite visit, chores, a nourishing treat--it helps.

After death, being a good listener will be an important compassionate response, and avoid impatience! A long goodbye can be followed by an equally long recovery. Be attentive to cues that the surviving family/caregiver(s) is ready to:

• Receive gratification from new experiences
• You may be able to encourage or lead the way to a subscription, a hobby, a concert, a vacation. 
• Teaming up in a volunteering project can create a bridging experience after caregiving, for feeling useful and gratified. The direction of volunteering may not be linked to the deceased's disease. Follow your friend's lead.
• Gather the fruits of legacy
• You may be able to encourage or lead the way for the family's special use for mementos (such as donating a wedding dress)
• A legacy is often comprised of memories and kernels of wisdom. Help a friend celebrate simple links in the chain of legacy by speaking and writing of them. 
• A survivor may want to participate in fashioning legacy by embarking on the completion of the loved one's Bucket List. 

The Coach reminds you to be heart-centric:  do not assign projects or set agendas. Listen, be encouraging and "brainstorm" with your friend as topics arise.

Finally, mark the date of death on your calendar, and remember the family with an anniversary note. It will be a great comfort.

Thank you for caring!

From MIA to RIP: A One Year Anniversary Reflection

One of my most frequently read posts continues to be the riveting story, Missing In Action! A Soldier's Sister Keeps Vigil.
After 44 years, in May, 2014, Sue Scott's dear brother began his Final Journey Home.  With the anniversary approaching, I asked Sue to share her reflections.

Doug’s Return, One Year Later

"It has been a year since Captain Douglas Ferguson, USAF, MIA December 30, 1969, was identified and made his Final Journey Home..."

Author Image

There is satisfaction and peace that Doug is home and at rest, and that Linda (his widow) has a place to visit Doug, as do others.  One day I too will be able to visit and know in my heart that all has been done and that his marker reflects who he was and how he was cherished!

In this last year, I have allowed myself to feel the pain of losing someone so dear.  I have listened and continue to listen to ‘50s Hits on XM that take me back to our youth and the sweet sorrow of knowing that, even on his 70th birthday, he will never be older than the handsome Air Force pilot who I said goodbye to as he stepped aboard the plane at Lambert-St.Louis Airport in July, 1969.

Though he met our two oldest sons as infants, he never knew them as the wonderful, successful human beings they have become.  He never met our youngest son who was born three years after he was shot down over Laos.  He never met any of their wives or any of his great-nephews and nieces. We never got to know his children that might have been.

He never had to see the pain of our father’s broken heart at his son, of whom he was so proud; or the dementia that ravished our mother’s mind when she could no longer stand the pain of not knowing the fate of her beloved son.

One of the last things I said to her as she passed from this earth was, “Now you are going to be with Doug!”  She seemed at peace!  Or maybe he did know!  It would have been one of his biggest regrets that he might have been the cause.

Even bigger than the pain his plight caused our parents would have been the pain his loss brought to the love of his life, Linda and the years of being together, of which they were robbed.

We cannot dwell in the “House of What If’s”, but we do need to know that we can travel through our grief and find the precious memories that will sustain us the rest of our lives.  Though this has not been the journey I would have chosen, I am proud to say I have kept the commitment, I made in early February, 1970, and that was to bring Doug home.  On that journey I have done things and gone places beyond my wildest dreams.  It was an opportunity to rise from a devastating loss and make a life far “richer” than I ever could have imagined.

Now a year since Doug’s return, I know my journey is not yet complete because too many with whom I have travelled, do not yet have answers, including Captain Wes Featherstone, USAF, the front seater in Doug’s F-4D aircraft.  It is because I know the joy and peace that can be the Final Gift, I still have work to do……to help sustain others so they can continue their search, their quest for the return of their loved ones…..to fulfill the Promise our country made to their loved ones when they left family and friends to serve and to possibly make the ultimate sacrifice for our Freedom.

What great gifts I have been given!  Why me?

I don’t know for sure, but this is what I believe: God has great gifts for each of us!  Our job is to be open to his abundance! That in itself is a life-time journey to learn to trust God for all things!  To know that though I may choose my own way, it is not always God’s way. I may not be ready at a given moment in time, to accept God’s gifts…….think of Moses and his people wandering in the wilderness for 40 years.  They didn't seem to be ready to hear God’s message.  I know I am not always ready to hear and trust in God’s messages either, but for Doug, I am grateful that I was able to listen, trust and therefore find enormous peace.

God Bless You Doug!  And, God Bless each One of You!"

Read treasured memories and tributes, and browse photos of Doug's life and Final Journey Home, on the Forever Missed memorial site.

Sue's strength is remarkable but she has "paid her dues" on that path through grief. The Condolence Coach reminds readers that anniversary notes are a very special comfort. For suggestions on how to compose this note, read: When Little Birds Chirp: Anniversary Notes.

Thank you for caring!

What's the Big Hurry? Stop pushing the bereaved

"Lola copes"  - Author photo

In a 2013 survey by the online magazine, Slate, 8,000 men, women and late teens grieving the loss of someone close, were asked about numerous factors related to their experience.  93% of survey respondents noted:

"interacting with others is generally awkward at best, and painful and isolating at worst." 

It's akin to feeling naked in public or, a teen angst I can relate to--being seen during a really bad acne outbreak. Grief can be so raw, painful, and unpredictable in when it will flare up feverishly. Trying to fulfill "normal" responsibilities and the expectations of others is draining to the point of sometimes feeling hopeless or unhinged.

In journals on bereavement, in support groups and online forums, the grieving are distressed by the push to get over it. Slate survey respondents commented:

• "They would get tired of my sad mood and need to talk about it, and say I was 'wallowing' or I should move on." 
• "People are very supportive for the first couple of weeks, but then they move on. … It makes you feel guilty to continue to mourn when others are tired of dealing with it."

No wonder it's a lonely road 

Author image

After a few encounters with friends, family, and co-workers' boredom, impatience, and jovial coaching, it feels safer to stay home, alone. Many people--but not all--find relief in peer support settings specific to their loss such as The Compassionate Friends, TAPS, for military families, or AfterGiving for grieving caregivers.

 In their analysis of the Slate survey findings, Dr. Leeat Granek, a critical health psychologist and grief researcher, and journalist/editor Meghan O'Rourke, returned to the medical branding of a grief journey that doesn't hurry up and press the Reset button on life:

"perhaps the most important finding in the data had to do with recovery from grief. Here, the answers suggested that loss takes longer to recover from than we typically imagine. More than one-quarter of our respondents reported that they never went back to feeling like themselves after their loss. Another quarter said they felt normal only "one to two years" after the loss."

Is grief a disease?

"This is of particular note since the fifth edition of the DSM (or Diagnostic and Statistical Manual of Mental Disorders) [which was due for 2013 release]...may propose that a mourner can be diagnosed with "complicated, pathological, or prolonged" grief if he or she is still grieving intensely six months after a loss.  from "What is grief really like?"

Granek and O'Rourke highlighted an important human variable: "What our respondents suggested (which rang true for us) was that for many mourners, recovering from a death of a loved one can take a year or several years. For others, "recovery" may never happen at all."

Thankfully, this label was squashed by public and professional outcry, but the waters are still muddy, and doctors remain on alert for 'disease' in their assessments of grieving individuals. In his editorial for PsycheCentral.com, "How the DSM-5 Got Grief, Bereavement Right," Dr.Ronald Pies defended,

"Clinical judgment may warrant deferring the diagnosis [of major depressive disorder, MDD] for a few weeks, in order to see whether the bereaved patient “bounces back” or worsens. Some patients will improve spontaneously, while others will need only a brief period of supportive counseling — not medication."

Can we please stop pushing the bereaved? 

The Condolence Coach reminds readers:

'Heart Keys' acrylic on canvas
 Suzy St. John 

• It is not up to you to heal the grief.  But your note will be a balm and help in ways you may not know. There are documented health benefits to feeling cared about; a condolence note delivers comfort and often, hope, because it can be re-read in any hour of need. 
• Forget what you think you know about grief. There are many myths about grief and rather than give advice, your friend or co-worker just needs you to listen.
• It is never too late to write a condolence note. Last month, waiting for an oil change, I struck up a conversation with another customer and discovered she was related to a former employer. She informed me that one of his adult children had died the previous year. I found an address and sent him and his wife a note. There is a 'higher reason' this information reached you now. Use it!
• Anniversary notes are deeply appreciated. As I explained in my post When Little Birds Chirp, writing to the bereaved on the occasion of their loved one's birthday or death anniversary is not a painful reminder. 
• These principles apply to pet loss, too! Acknowledge the wonderful friendship but do not discuss a 'replacement pet'. 

    Thank you for caring!

The 5-Step Good Life: Make Condolence Notes a Habit

American psychologist, Martin Seligman, coached that there are 5 components of a "good life." 

Using the acronym, PERMA    [Source]  he theorized that we can  control our sense of well being with the following habits:

Positive emotion — every night before sleep, write down 3 things that went well, and why

Engagement — rather than taking shortcuts, apply your best skills, ("highest strengths") to any task

Relationships — connect with people--the levels of intimacy will vary, but avoid isolation

Meaning — find where you belong, to serve something bigger than your own agenda

Achievement — determination is the key to any endeavor

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The best part of this theory is the discovery about habits. Seligman laughingly gives the example of the pleasure in eating ice cream-- before you know it, it's gone, and another carton soon winds up in your freezer!

Because positive emotions feel so good, their origins can easily become habits. 

The general idea of "habit" can be daunting or delightful.

Your morning coffee enticed you out of a warm bed, but knowing you must "put in your time" on the treadmill elicits a groan.Writing condolence notes will always take some time. They require an investment of heartfelt focus.

These are the sources of positive emotions by regularly writing notes:

• Perhaps you had a conversation with the bereaved during the illness that resulted in death, or at the funeral service. Listening is an act of kindness, a comforting acknowledgement of your friend and their concerns. This connection adds value to the note you will write.
• Your note is like a gift that arrives unexpectedly in the mail. Its recipient can sit down for a few minutes to read, and feel bathed in a aura of caring. 
• More times than I can count, I am eventually told how much my note was appreciated. People use expressions like, "I'll keep it forever," "I've read it so many times," "I showed it to my mother." 

THE COACH DISCUSSES THIS THEME IN THESE POSTS:

Why Is Sympathy Sweet?

Ithaca College President Reaches Out

You Can't Erase Death's Shadow, Sorrow

Why I Write Condolence Notes

Share these thoughts with a friend, and thanks for caring!

When Grandparents Grieve

[Source: Heather, Openphoto]

Sometimes, grandparents are blindsided by the death of a grandchild. 

In The Grief of Grandparents, a brochure produced by The Compassionate Friends, it is dubbed:

A double loss.

Deeply saddened, often angry and frustrated by the circumstances of the death, a grandparent must also helplessly endure their child's mourning. 

[Source]

Whether the grandchild is 2, 12 or 22, the death is a shock.

When Little Birds Chirp: Anniversary Notes

Every year as March approaches, a little bird chirps in my thoughts:  send D. an anniversary note. 

I go to my stationery box and select a simple card-- I favor small note cards, and set it out. In a few days, I'll sit down with it. I know it has been a long time-- over 10 years now, since her daughter was the victim of a drunk driver. I don't really keep count of the years, though I commented with surprise when I checked, and it was the 10-year anniversary. I remember writing:

My how the world has changed in the 10 years since A's death! What do you think she would say about it?"

Isn't an anniversary note a painful reminder?

It is easy to assume that you are "pouring salt in a wound," but you are not. The feedback I get from my own notes, and from discussing anniversary notes with others who receive them is appreciative:

"Thank you so much for remembering my A."

"That person [the note writer] is gold." 

 "My husband will always be in my heart, why wouldn't I want someone else to remember him, too?"

 I already said 'I'm sorry', so what do I write a year later?

If you want to say you are sorry, again, go ahead. An anniversary note should not be a philosophical overview of what happened, a one-year wrap up, a dismissal, or a newsy season's greetings letter!

1. Have you wondered how the person you are writing to is weathering life-- perhaps you know of specific goals or challenges. Ask the question.
2. Have you been reminded of the deceased while doing a task, reading a book, cooking a meal?  Share that moment.
3. Have you felt sad or mad, inspired or delighted during the year, while thinking of the deceased? Declare your emotion.

Has this post reminded you of an upcoming anniversary? 

Begin your note, today, and thank you for caring!

Condolence During Holidays

In the 1934 romantic movie, Death Takes A Holiday, the character,“Death”, takes a break from duties to spend 3 days as a mortal man, where he falls in love. In reality, death never takes a holiday. 

The end of life can come on any day.

Festive plans are cancelled and happy occasions are seemingly scarred. A dear local matriarch is profiled in the newspaper, celebrating her 100^th birthday and, two months later, takes her last breath on New Year’s Day … My husband’s family remembers their grandfather had a fatal heart attack after his shift ended at the Dodge Plant on Christmas Eve, 1947:  “without a word, we just started taking ornaments off the tree.” For them, a busy, joy-filled season was exchanged for a black wreath on the door and a blustery graveside burial.

How can sympathy be commingled with seasonal greetings during holidays and other special days? It can’t.

Should traditional messages be set aside? Yes.

Here are my top 4 suggestions for writing condolence notes during a holiday season:

1. The best approach is to honor the life of the deceased and express your own feelings.  “When I heard that Jeremy died on Thanksgiving Day, my first thought was how grateful I was for his friendship.”

2. Do not write a sympathy note on the goofy Christmas card you planned to send to everyone on your list. Peaceful winter scene: YES. Standard imprint: NO.  Buy a blank card or a sympathy card.

Stay on task:  you are writing a condolence note. Period.

3. Grieving during a holiday season can be extremely challenging. If you have personal experience with a loss during a holiday or special occasion, share briefly, but do not give advice. The only good advice are gentle encouragements like, “Do what is comfortable,” or “Be easy on yourself.”  Instead of a clichéd “let’s get together soon” try:  “can you join me next Wednesday for breakfast at the coffee shop—@ 8:30?” Over coffee, just be a good listener.

4. Finally, mark your calendar and, next year, compose a one-year anniversary note. This might be the time to mention a special Christmas ornament, a memorial tree or tulips planted and now thriving, or a sweet memory about sweet potatoes.

“There is nothing sweeter than to be sympathized with.” George Santayana, The Life of Reason, 1905

Read more about grief and sympathy during the holiday seasons: Nan Zastrow's 8 steps to tame the holiday blues