• Anxiety and Grief: A Conversation Between Alethea Black and Claire Bidwell-Smith

    Alethea Black lost her father at the age of 26. Claire Bidwell-Smith lost hers at 25. Now, both write publicly about grief and recovery. Bidwell-Smith is a practicing grief therapist and the author of three books of non-fiction, most recently Anxiety: The Missing Stage of Grief (Da Capo, 2018). Alethea Black’s memoir, You’ve Been So Lucky Already, was published earlier this month by Little A Books. She also blogs about health and wellness at WelcomeToHeaven.com. In September 2018, the two corresponded by email.


    CLAIRE BIDWELL-SMITH: I’ve long believed that we hold grief within our bodies. And that unprocessed sadness and unresolved relationship issues with our loved ones can manifest in all kinds of physical symptoms. Can you tell me what you believe about the connection between your grief and your illness?

    ALETHEA BLACK: My grief made me feel vulnerable to emotional pain, and I think that sense of loss of control over what happens to us later amplified my experience of physical pain. On the one hand, there was the pain itself; on the other, the fear of the pain, which gave the pain a bullhorn.

    To be honest, I think my father’s life affected my illness more than his death. He was very much an iconoclast, an unfailingly independent thinker, and growing up under his influence emboldened me to push back when various doctors suggested, subtly or not so subtly, that what I was feeling was “all in my head.” By the time I got sick, I was forty; I’d already begun to make the shift from locating authority outside the self to locating it inside the self. And a funny thing happens when you locate your authority inside the self: you locate your power there, as well. I’m sure some of the doctors I saw would have loved to Band-Aid my symptoms with a psychotropic drug. But my body was talking to me, and I listened. When they tried to tell me my nervous system and my digestive system weren’t working because I was anxious, I looked them in the eye and said: No. I’m anxious because my nervous system and my digestive system aren’t working. If I hadn’t done that, I would never have turned to Functional Medicine, and gotten to the real root of the problem.

    Why do you think illness in women is frequently attributed to mental health issues even when there is a real physical illness that the woman is suffering from? And where does the shift need to occur — within the medical community? With men? With women themselves?

    I think physical problems are being misdiagnosed as mental problems in both sexes. But women tend to be more emotionally expressive than men, so if we’re conflating physiological issues with emotional issues, it’s women in whom that conflation might be more readily apparent.

    This may sound strange, but I think the shift that needs to take place is not in the minds of women or men or the medical community, but in consciousness itself. We — we the collective — have not yet solved the core etiology of our diseases because what happened to me is happening across the board. Rather than search for the root cause — and, surprisingly, there is one — we just put a Band-Aid on our symptoms. We’ve boxed ourselves into a system that insists that advancements in medical research be ratified by randomized, double-blind, placebo-controlled clinical trials, but the randomized, double-blind, placebo-controlled clinical trials are funded by drug companies, so whenever we ask a question about our health, the answer that comes back is invariably (surprise, surprise): a drug.

    The solution isn’t to vilify the pharmaceutical industry — or men, or women, or doctors. This is the system we ourselves designed, doing the best we could, with the information we had at the time. But that time is ending, and the system is about to change.

    Talk to me about writing and grief. Just as I believe we hold grief within our bodies, I also believe that writing is a powerful way to work through and release grief. Did you find that your understanding of loss and of your own particular grief changed as you wrote about your experiences?

    Writing has always been healing for me. Even with my book of short stories (I Knew You’d Be Lovely, Broadway Books, 2011), there was something about putting truth into language — using just the right word in just the right way — that was not only satisfying, but therapeutic. With a memoir — and not only that, but a memoir about illness and loss — the effect was even more profound. I seem to like to write about characters who deepen their understanding of self and world through the crazy experiences life throws at them. Only this time, the character was myself. It’s always meaningful to transmute pain into something else — a kind of strength. But more than strength, I wanted to find the humor in it. I knew there was a crack in everything, and I needed to find the light. Now, when I see that a reader has said: “I laughed at least once a page,” or “To the author: Your father would be so proud of you!” I sometimes think, Maybe this whole thing had to happen this way. Really, the book could be expressed in six words: Turned my struggle into my song.

    It’s so funny. You lost your dad when you were 25, and I lost my dad when I was 26. I wrote a whole memoir about the joy of having him and the pain losing him, and all the scary-sad-funny experiences I had after he was gone. But it wasn’t until reading your book that I realized there might be a relationship between the two! Why is it that we are so slow to recognize anxiety as a manifestation of grief?

    I believe the reticence around grief-related anxiety is two-fold. To begin with, it’s about the silence around grief. As Maria Shriver puts it, “We are a grief-illiterate nation,” and I really believe this to be true. As a culture we haven’t always done a great job at making space for grief or understanding how to talk about it, so grief comes with its own natural silence and awkwardness. Couple that with the secretiveness of anxiety and you’ve got a lot of people failing to connect the dots. 

    Anxiety is a complex creature. It often manifests in such real physical symptoms that we usually have a hard time correlating the experience to our emotional state. Anxiety is also quite hidden. Someone can be struggling with it and you wouldn’t necessarily know. People keep quiet about it out of shame and…well, anxiety. You can actually have anxiety about your anxiety. Like I said, it’s a complex issue. 

    This is precisely why I wrote this book — to help bring anxiety and particularly, anxiety as it relates to grief, out of the closet. We can’t heal until we understand what’s going on inside. 

    I typically start to feel a little anxious when reading about anxiety. But your book had a very calming, healing effect on me — almost like the embrace of a knowing friend. I couldn’t tell if this was because you have experienced so much loss in your own personal life, or because the authorial voice of the book is so warm yet knowledgeable. When you work in these intimate fields of grief counseling and writing, what is the boundary between your personal life and your professional life? Is there one?

    I’m so glad to hear that it was calming. I thought a lot about all the clients I’ve worked with over the years while writing this book and I really tried to adopt the same calm, reassuring tone I use in my office. When it comes to grief counseling there is a personal connection that’s very important between the therapist and client so I tend to share a lot more of my personal experience than I would in a general therapy relationship. 

    Most of my clients come to me after having read one of my books anyway so they already tend to know a lot about me. But truthfully I don’t think anyone would want a grief therapist who wasn’t personally familiar with grief. Going through a big loss is such a singular experience. It can feel so lonely and isolating to be in the throes of grief that I think it’s really important for the therapist to be able to understand and relate. 

    I cried my way through your final chapter — happy tears — because it resonated so strongly for me. You speak so beautifully of how we can honor our stories of loss, and remind us that death is not the end of love. What are some ways in which we can allow our love for a deceased person to continue to evolve even after they’re gone? Have you ever had any validation, albeit soft or subtle, that your parents are in some sense still with you?

    These days I feel my parents with me all the time. But it took many years for me to get to this place. In order to open up to a greater sense of connection with them I really had to work through a lot of my deep grief. I had to forgive myself for a lot of things I felt guilty about, particularly around not being there when my mother died. And I also had to really examine my ideas and beliefs about the afterlife. I had to let down some walls and I needed to find some self-compassion for my experience. 

    Once I’d moved through those things, I was able to really let myself open up to the idea that I’m still connected to my parents in many ways that aren’t always so concrete. I think doing this work is really the final piece of moving through grief. The truth is that our relationships do not end when someone dies. We continue to have an internal relationship with our loved ones even after they are gone. Remembering that, and continuing to honor it, will serve to heal our broken hearts.