National Grief Awareness Day: Honoring Families, Memorializing Loved Ones
August 30th marks National Grief Awareness Day in the U.S., a poignant reminder that grief is a difficult and complex experience for every individual. While many associate grief with the death of a loved one, the process of coping with grief is a critical part of facing life-altering events, including the relentless grip of addiction. Stephanie Reed, a CleanSlate counselor, spearheads support groups for families grappling with the profound loss and grief issuing from their loved one’s addiction.
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What inspired your interest in addiction treatment?
Stephanie: I’ve been a social worker for over 20 years. Prior to CleanSlate, I worked in hospice care, which gave me a lot of experience with grief work. It’s not everyone’s idea of fun, but I found grief work so rewarding. Sometimes there aren’t a lot of conversations around end-of-life and death. So it was nice to be a part of that, and share information and support during one of the most trying times in people’s lives.
What does it mean to be a mental health clinician working with families in addiction treatment?
Stephanie: It’s multilayered. You have the patient and the family, all of whom are affected in some way by substance use. Everyone has experienced loss in their lives, whether it be relationship loss or financial loss. Working with grief and loss is not just a patient-centered approach—it’s a family-centered approach. The family as a whole is able to discuss their emotions, worries and concerns.
How do grief and addiction intersect in the families you work with?
Stephanie: Patients come to CleanSlate for MAT (medication-assisted treatment) to treat their substance use disorder. But as I work with them and get to know them better, I’ve often found that they began their substance use because of some loss and grief in their history or that their substance use has caused loss and grief.
How might a family’s experience with addiction differ from other families who are dealing with grief from other causes or life events?
Stephanie: When addiction comes into play, many people have a lot of guilt and shame that are added to the equation. Whereas with traditional grief, many may not have that guilt and shame. Survivors who have lost loved ones to addiction often feel as though they should’ve worked harder to make sure their family member wasn’t using or that they should have seen the warning signs more clearly. Feelings of embarrassment complicate this as well, with families not wanting it to be known that their loved one died of an overdose. So there’s a lot of complicated grief associated with addiction.
What are some common misconceptions people have about grief in families dealing with addiction?
Stephanie: Many people will come into my grief group after losing a loved one to addiction, and describe another family member saying to them something like, “Sorry for your loss, but he was doing drugs.” This gives the message that he had it coming, which can sting a lot more than traditional grief. As we just discussed, there are persistent feelings of guilt, shame and a sense of not having done enough.
What are the first steps you recommend to families dealing with grief and loss as a result of a loved one’s addiction?
Stephanie: Definitely building some kind of support network. When you’re grieving and especially if you’re feeling depressed, it can feel debilitating and discourage you from reaching out. But I help people fight against that initial feeling of resistance, because the reward is so great when they do connect with a support group or see a therapist. Many people feel isolated at this stage of grief. So to meet people who have struggled with a similar experience, and to talk to someone who understands what you’re going through, is one of the best first steps.
When people have been struggling with grief for a long period of time, it can seriously affect their mental health. Having an evaluation for clinical depression and anxiety is something I recommend as well. Sometimes people will go on an antidepressant for a short time, so that they can function and work through the grief.
How do you support a family in navigating both their grief and the complexities of addiction?
Stephanie: More than anything else I personally do, the group setting is so beneficial for the patients. Just being around other people who have had a similar experience is so healing.
Specifically, it’s discussing the feelings and emotions that the group members are experiencing. In one sense, it is a matter of dealing with the difficult emotions and developing ways to cope going forward. And in another sense it is to process or work through them, because they can’t just be pushed aside.
We honor the person that was lost and share memories of them. And there are a lot of different activities that we do within the group to help foster that feeling of inclusiveness and healing.
Can you suggest any other coping strategies or practices that families might find beneficial?
Stephanie: Talking to a family therapist to address certain family dynamics that get in the way of processing grief, like resentment or disconnection.
I also provide homework to my patients, which they can do on their own and share with others in their lives. This deals both with shaping their mindset and behavior, but also involves a lot of memorializing. Remembering and honoring their lost loved one can be very cathartic.
Beyond the group, it’s important that they can talk about their grief with others to get additional support and let people know what they’re working on.
Are there specific challenges children in these families face, and how do you address them?
Stephanie: I actually have a couple of group members come in with their grandchildren. One of my members lost her son who was the father of her granddaughter. So they’re both processing the loss. From working at hospice, I have a lot of materials for working with loss in children. It’s definitely prevalent when it comes to addiction—loss of parents, grandparents, aunts, uncles, etc.
How has the approach to treating families in addiction evolved over the years, and where do you see it going in the future?
Stephanie: The good news is that since I started 20 years ago, the topic of addiction has become much less taboo. Unfortunately, with the prevalence of the opioid crisis, I don’t think that there’s really been anyone who hasn’t been touched by it. Going forward, I think addiction will become even more approachable as a topic, the stigma will continue to decrease, and people who are struggling themselves or have a loved one who struggles will not hesitate to reach out for help.
Are there any books, films, or other resources you’d recommend for someone looking to understand more about this topic?
Stephanie: There are several really helpful books. For families I’d recommend Please Be Patient I’m Grieving by Gary Roe and Good Grief by Granger E. Westberg. For children I’d recommend Hugs from the Sky by Christie Reed, Lost in the Clouds by Tom Tinn-Disbury and When Someone Dies by Andrea Dorn.
How do you find hope and resilience in amid the challenging stories you encounter?
Stephanie: At times it can be challenging. The issue itself is pretty grim. I don’t think grief is something that you ever just lose. It ebbs and flows, wanes sometimes, but is never completely gone. When you miss someone, you’re always going to miss them. The aim is to be able to move forward and not to let it take over your life. That’s the goal. Helping people reach that place is very rewarding. That’s what keeps me going. And that’s what keeps people coming back. They reach a point in their own recovery where they think, “This really hurts, but I can get through it.” Often they find relief in volunteering and helping others. It’s nice to see people evolve to the point where they can help other people, even as they are going through their own struggles.
Can you share a story or example (without revealing private details) of how a family overcame challenges related to grief and addiction?
Stephanie: I have a patient in the grief group who lost her son and her husband. Her son was suffering from addiction, stealing to support his using, and doing other things to the family. So his family got him sectioned, which could have been a good thing. But a couple days before he was supposed to go to treatment, he ended up going to prison, where he committed suicide. He was a young guy and just had a child. Shortly after, her husband, who was struggling with so much guilt and grief, had a heart attack and died. Then my patient started having her own struggles with addiction. She began using opiates and alcohol, and spent some time in jail herself for a DUI.
Now she’s in our program for MAT and our grief group too. She’s raising her granddaughter by herself, and dealing with her granddaughter’s grief as well as her own. It’s been very challenging. But she’s been going to work and reports being able to get out of her head a lot of the time. She also volunteers and helps people in other ways. She still feels grief but she’s able to take care of her granddaughter and do what she needs to do in life. Soon she’s going on a trip with some friends. She’s made remarkable progress.
What’s one thing you wish every family dealing with addiction knew?
Stephanie: There’s a lot of support out there. I know how you can feel alone, that you’re dealing with this all by yourself. CleanSlate Care Coordinators can connect you to counseling and support groups. Isolating and trying to carry the burden on your own is not the best way to handle grief. Although you might not feel like it, push to become connected. That’s the first step to healing, just as it is with addiction.
Do you have any final thoughts you’d like to share on our general topic of grief and families in the context of addiction treatment?
Stephanie: I can’t stress enough to take care of yourself. You might find yourself downplaying what you’re going through, but the grief is going to come out. Be proactive and realize that a major dramatic thing has happened to you and there’s nothing wrong with reaching out for help. It’s really going to help your mental health and your relationships in the long run.
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