Competing Adaptations and Grieving

Patty's dog died, hit by a van while she watched. The van didn't stop; Patty's 9 year old mind angrily concluded that "they didn't care." She helped wrap the bleeding animal in a blanket, carried it to the vet's and voted along with Dad to let it die.

Mom called me ahead of our scheduled session to let me know that her daughter was "a total wreck."

I listened to Patty recount the tale of loss, pain, and indignation until she started to repeat herself. There were related issues of Patty's own fear of death and of her mother's mortality. There was a choice at this moment; to let her repeat herself until fatigue and habituation calmed her or to intervene more actively.

I used some language from Richard Dawkins, (The Selfish Gene, Oxford) phrased so that Patty could understand it and so that her mother would be comfortable with both the philosophy and treatment recommendations. 1) I told her about my black duck, Sassy, who died by my neglect but whose quarrelsome disposition and peculiar gait and postures reappeared 6 months later in a gray daughter of Sassy's sister, Millie. In a very real sense, all of Sassy was still living but in a different pattern and in different members of the flock. 2) Likewise, there are parts of Patty's dog still alive but in other dogs, again in a different pattern. 3) Finally, Patty's mother is a mix of her own mother and father and, in turn of their parents. Parts of her mother have been around for some 12 million years. (Mom interjected, "Thanks a lot!" but in a teasing manner.) 4) Patty herself is a mosaic of her mother and father. Her looks as well as her talents, disposition, and even some of her habits are a brickwork, not a blend of her parents and, especially, her grandparents. 5) Patty will likely have children who will be like her own mother. Patty will thus know parts of her mother again but as a younger child.

Patty seemed considerably relieved and remarked that she understood what I was saying. Mom was also relieved to see that her daughter was by no means, "a total wreck." But, what to do after the session? I suggested to mom and Patty that they choose a brief time each week or each month to "remember" the dog but to distract Patty into other tasks if she started to cry at other times. The teacher offered to have Patty write an essay about the positive traits of her dog.(1,2)

NOTE:

1) Patty has been fine at our later sessions. The choice to relive a loss or to pick a time to remember is an old dilemma. We generally opt for a selective manipulation of competing activities and thoughts for most of our time. We also choose limited times and places for remembrance, respect, and dedication perhaps so that we can attend to other, survival tasks. This focus is the perhaps adaptive basis for funerals and anniversaries. As the prophet noted, "There is a time for ..."

2) PTSD can be crippling and often difficult to treat. I've had some luck with recommending "put it away." The nightmares about seeing the underside of tombstones ended, mood improved, and appetite returned. There are hints of similar outcomes in clinic reports. It could also be that standard treatments may actually reinforce the symptoms as was possible in a report from the VA clinic in West Haven. The gist was that participation in the program was negatively correlated with improvement. More research on deliberate suppression of sensitive memories could be warranted.

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