The Forgotten Ones: The Grief Experience of Adult Siblings of World Trade Center Victims
Hosts:? Dr. Gloria Horsley and Dr. Heidi Horsley
With guest:? David Flomenhaft
September 13, 2007
G:? ?Hello.? I?m Dr. Gloria Horsley with my co-host
H:? ?Dr. Heidi Horsley.
G:? ?Each week Heidi and I welcome you to Healing the Grieving Heart, a show of hope and conversation with those who?ve suffered the loss of a loved one and for health care professionals who work in this most difficult field.? And always the message is others have been there before you and made it, you can, too.? You need not walk alone.? Our show today is pre-recorded so you will not be able to call in.? These shows are archived on our blog, www.thegriefblog.com as well as www.thecompassionatefriends.org websites.? All the shows can be downloaded on Itunes and transcripts can be accessed on www.thegriefblog.com.? If you want to comment on the show this week, please email us and give us your name and where you?re from, and we?ll discuss it on the show the next week or we?ll email you about it.? Well, Heidi, I wanted to apologize a little bit.? I?m not sure about last week?s show with Dianne Kane.
H:? ?Oh, yes, because we?re not sure if everybody was able to hear it live.? However, I know that Dianne said a few people that she knows contacted her and said they could hear it live but there were some problems at the station getting the show, right?
G:?Yeah.? We had some technical difficulties and it was on the Internet at large and some people didn?t come in at the top of the show and apparently some people came in later, but I just want to encourage you all if you weren?t able to hear the show, if you want to hear it again, to go on our archives at www.thegriefblog.com because we have that show on and Dr. Dianne Kane, we discussed the widows of 9/11, where are they now, and I thought maybe we could just give you a quick capsule of what the show was.? Heidi, can you talk about where the widows are?? You work with them.
H:?Um, yes.? I think, you know, it depends.? I think they?re all in very different places.? As we all know, grief is a very individual process.? People have their own journeys and their own timeline and they are all doing different things.? However, I?ve got to say that for the most part, the widows, although they still very much love their spouses that died and mourn them, they have found very unique and wonderful ways to keep their memory alive and to incorporate them into their lives by doing memorial runs and raising money and keeping their memories alive by talking to their kids about who their fathers were, and they?ve come a long way.?
G:?I thought it was interesting.? One of the things that Dianne said was that a fair amount of them haven?t remarried which is kind of interesting because I think it says that everybody has their own trip and own journey and, you know, you can do well without remarrying or you can do well remarrying, or, you know, it?s just a whole.
H:?Absolutely.? Like Dianne said on the show, she made such a good point, mom, and you?re bringing that up, and that is being remarried is not an indicator of how well one is doing.? You can do very well and be doing incredibly well and be a single parent still.
G:?Absolutely.
H:?And that?s okay.
G:?Well, we are ? 9/11 has passed when we do this show, right, Heidi?
H:?This show is going to be aired on September 13th so it will be two days after the eleventh.
G:?So we want to say to all you folks that have lived through this and that lived through these events and as we always say to you, these reminders are difficult and we understand that they are for all of you, and we have got another great show today involved with the 9/11 and I?m looking forward to it.? It?s about the siblings.? So, Heidi, do you want to introduce our guest?
H:?Yes, I do, and before I introduce him, I just want to say that I am ? David did his doctoral dissertation on the siblings of 9/11 and I had the opportunity to meet him because I was so excited that somebody actually took in the interest in hearing about surviving siblings and their experience and giving them a voice.? So let me introduce him.
G:?Well, let me say, because as you yourself are a surviving sibling, right, Heidi?
H:?Absolutely, so, yeah, I very much
G:?didn?t feel like you got that much attention.
H:?I very much appreciate that someone felt like the siblings needed to be heard and acknowledged and validated because that?s what all siblings want.? That?s we all want after we?ve had the death of a brother or sister.? So our guest today is Dr. David Flomenhaft, and our topic is ?The Forgotten Ones: The Grief Experience of Adult Siblings of World Trade Center Victims.?? Dr. David Flomenhaft has practiced in behavioral health for over twenty years.? He is the director of a large mental health clinic in Nassau County, New York.? He is also a private practitioner in psychotherapy.? David recently completed a doctoral research study examining the grief experience of adult siblings who lost a brother or sister in the World Trade Center attacks.? This study stems from his clinical experience with the 9/11 family community as well as critical incident response work with trauma victims.? David was raised in a family of social workers.? His parents and his younger sister all have advanced degrees in the field.? Welcome to the show, David.
D:?Thank you.? I?m glad to be here.
G:?Hi, David.? Welcome to the show.?
D:?Hi, Gloria.
G:?Well, very interesting show and sounds like an interesting study that you did.? What made you decide to work with adult siblings?
D:?Well, I had a chance to hear Dianne Kane talk last week on the show so.
G:?Oh, good, you did hear her.? Great.? We weren?t sure.
H:?Good to know you were able to access it.
D:?So I want to validate that experience.? In a similar situation, I was director of a mental health counseling center that responded to critical incidents that happened in our community.? The plane crashes, shooting at the Long Island railroad.? So when this event happened in September 2001, it became another event although on a massive scale that we responded to as disaster mental health workers.? I responded to New York City?s need.? We went to the pier where they were ? where the police department was receiving DNA remains from family members so they could help with the body identification.
G:?Oh, that must have been traumatic.
D:?Oh, it was traumatic.? Interestingly, not only were we working with the families, we were working with the detectives that were receiving the remains.? They had rarely been in a position of accepting fragments from shavers and hair from combs and toothbrushes.? And then we began to work with the families.
G:?You know, when you?re talking about that, David, I?m just thinking about, this has got to bring up something for our listeners out there who remember doing the toothbrush and the hair and all that kind of thing.
D:?It kind of set the stage in many ways for the delay in the grief process that the absence of bodily remains has.? That?s a topic I would hope we can get to.
G:?Yeah, I would like to get to that because I know that?s an issue for our listeners also.
D:?The agency I work for quickly opened by the end of September 2001 a family base center to take care of family and children.? We work in an area where 75 to 100 families within the five mile radius were affected by 9/11 very directly and on the weekend, Saturday and Sunday over the course of September and October, began to take in families.? Kids would come for our therapy projects, and who were bringing them were their aunts and uncles because the moms for the most part needed a break.? Before our center opened for a full seven-day-a-week service, we had kids engaged with art projects and recreational activities to begin to process some of the grief experience put words to their feelings, and the aunts and uncles were sitting on the couches that we got donated from the local furniture store and I saw that they didn?t have anything to take care of them, so five members were identified in a first support group we began in October 2001.? By April of the following year, 2002, we had 80 members.
H:?So these were siblings that ? David, these were siblings
D:?Eighty adult siblings.? Brothers and sisters who lost their brothers and sisters in the 9/11 catastrophe met.? Eventually that group grew to every week a Tuesday night event, and it was from that group that I decided that I gotta find out more about this.? The research surveys that I did showed me that there was very little written.? Most of sibling loss was talked about in the research about children.?
H:?You?re right.
D:?Kids that had lost brothers and sisters to cancer.? The AIDS crisis also left some research for brothers and sisters that lost their siblings to the HIV-AIDS.? However, there was very little written about ? especially in traumatic loss.? So it gave me an impetus to finish that old doctoral dissertation and study this population.
G:?You know, what occurs to me when you say this.? What a fortunate group of siblings they were to be able to find some resource like this.
H:?Well, mom, it?s interesting because they weren’t even looking.? They were taking there nieces and nephews to therapy and they were sitting in the waiting room.
G:?Yeah.? Isn?t that amazing that oftentimes, I think Heidi?s talked about the fact that siblings don?t even feel like they have the right to services and mourn and they somewhat protecting their parents or feeling like they?re other people especially adult siblings.
D:?As one of your earlier guests, Ken Doka, talked about the disenfranchisement.? This is a population that the research identified themselves as the forgotten ones and so did my population in their meetings.? They were the ones who when queried by family and friends in how were they doing, it wasn?t how are they doing, how are their parents doing?? So their loss was not recognized.? They were not seen by the community, by the media, by their own family friends as primary mourners.? So this recognition that we were able to provide was very affirming and what we ended up doing is creating a group for brothers and sisters to find community again from brothers and sisters who knew directly about the loss experience.
G:?Um hm.? What were some of the major issues that you found with them?? You?re going to talk about the body remains.? What are some of the other issues?
D:?They were angry.? They were overlooked, unacknowledged.? They didn?t have access legally to information.? From the early days on, the public health information that was available from the hospitals, and everyone felt that the hospitals were going to be flooded with individuals who would get care.? In the initial days, siblings didn?t have access to that information and then even later on from the Medical Examiner’s office where we?re looking at remains, they also could not get information.? Later on, there were issues as the legal cases began to roll out and financial settlements were made.? The siblings also were not entitled to any of the financial settlements that came from the government.? Those settlements went, of course, to the spouse, some to the parents, and there were social strata differences that began to be identified as their sisters-in-law moved away, went into a different social bracket.? Siblings also were as you might expect preoccupied with caring for their own parents.? Their grieving mothers and fathers retreated and isolated and they felt that the siblings couldn?t attend to their own grief while they saw their parents were paralyzed with grief.
G:?You know, it?s really interesting because when we?re talking about these adult siblings, I would guess.? I don?t know what percent of them actually their sibling was married and had other children or something.? Would that be a lot of cases or?
H:?Yeah, were most of the people that died married?
D:?In my population ? you know I talked to and did in-depth interviewing with 13 respondents and 7 of them were married so more than half were married.? The population of the deceased or of the surviving siblings are you asking about?
G:?The surviving siblings.? Yeah, I mean, no, no.? The deceased.? I was just thinking if their siblings were married.? You?ve got the parents.? It?s been my experience that the parents are also disenfranchised because the spouse is the one that?s able to decide what happens with the body.? It decides on the funeral.
H:?Right, and that?s what David was saying that the widows ? they got all the information.? They got the memorabilia.? They got all that stuff.? Isn?t that correct?? The widows did?
D:?That?s right.
G:?Was it all widows that you worked with?? I mean was it all, uh, were they siblings, males?
D:?Adult siblings.? It was only by siblings.? No, I had 10 females and 3 males in my study, and one brother and sister pair, which really gave insight into how siblings process grief differently.
G:?Yeah, and let?s talk about that.? It?s time for us to go to break now, but when we come back from break, let?s talk about how siblings do process grief.? I?m your host, Dr. Gloria Horsley, with my co-host, Dr. Heidi Horsley.? Our show today is pre-recorded so you?ll not be able to call in but please feel free to email us through our blog, www.thegriefblog.com, and these shows are all archived on our website, www.thecompassionatefriends.org website.? They can be downloaded on Itunes and transcripts can be accessed through www.thegriefblog.com.? Please stay tuned to hear more on the topic of ?The Forgotten Ones: The Grief Experience of Adult Siblings of World Trade Center Victims? with David Flomenhaft.
One of the things I wanted to make clear with our listeners, because Heidi does work with the firemen families and this was just families from 9/11 from any walk of life, right? siblings?
D:?That?s right.
H:?They weren?t firefighters.? They were in all different kinds of work, isn?t that correct?
D:?That?s right.? The deceased males, three were in the uniform services, the other ten were in the financial field.
G:?And that might be something kind of interesting.? Did you see any difference between the people who had siblings that were in uniform services like the police department or the fire department?? Was there any difference between those siblings who had siblings that worked in financial services?
D:?I?m glad you asked the question because I had ? among uniform services, I had a representative of the police department, fire department, and the port authority police which is the police that?s in the World Trade Center building and all the bridges and tunnels.? Their siblings and those families had a very different grief experience.? Number one.? There was a tremendous outpouring of community support.? There?s a brotherhood in each of those uniform services so in the immediate aftermath, there were lots of colleagues that came to the home.? People said the food was continually delivered.? If appliances went out or lawns needed to be mowed, things were taken care of.? And at the funerals, ceremony took place.? There was a protocol.? The grief experience of those in the financial industry was very different.? There was no uniform protocol to the service.? There were less people that came by.? However, they both had a similar experience three and six months later because the community support began to wane away.? Thanksgiving, people were there.? Christmas, there was still some support, but after Christmas, most of the siblings said that there wasn?t as much involvement from the community.? And perhaps in terms of most people?s grief trajectory, that was okay.? But they did have a lot? also, their brothers in the uniform services were accorded hero status even though everybody just went to work that day that was killed down at the World Trade Center.? Hero status was not accorded to the financial services.
G:?So you would think that they were victim status as opposed to hero status sort of.
D:?Yes.
H:?And does that change the way people go through the grief process, do you think, David?? Did you see that?
D:?It did change.? One family I talked to, the brother was a young lawyer but also a volunteer fireman on the side.? He went back up.? He escorted people down and went back up into the towers and brought down other members of his company.? He in effect was a hero.? A private investigating firm determined later on that he did this so there was confirmation of just the story about this.? Yet he wasn?t accorded the hero status.? So there was a lot of resentment among the population that identified that the financial services people, that the non-uniform people did not get the same kind of community recognition.
G:?That?s very interesting for those folks out there who have family members who have just died suddenly in an accident or whatever and the idea that if you are with the fire department or the police department, they?re a little more prepared for this.? I was wondering in a sibling point of view, I was kind of thinking of that brotherhood.? Do you think they were able to also bring siblings in more initially?? The fire department.? The police department.? Would they recognize whole families in a better way or no?
D:?Did the uniform services?? They tried.? I worked with Dianne Kane and they set up brother-seeking-brother support groups so they had much more success with the fire department.? The police department didn?t.? Policemen tended not to come forward for counseling services because they generally work alone.? They don?t work in a unit the way the fire department does.? Same thing with the Port Authority Police.?
G:?Oh, that?s interesting.? Well, what are some of the major issues that you saw with the siblings?? I know you mentioned anger.
D:?Just more generally.? The loss of family due to terrorism is sudden loss.? It appeared to lead to protracted grief.
G:?Protracted means
D:?Protracted in elongated kind of grief.? It was just so unexpected.? So over the top.? The exposure to media, because people couldn?t turn off their TV sets.? They didn?t know what happened to their loved ones for several days after the event.?
H:?It?s interesting, David, talking to people about September 11th and when you do, they say, you know what, our loved one to our knowledge?it wasn?t September 11th where it was hard for us because we actually held onto the hope that they were still alive on September 11th.? Like you said, it took awhile to realize that no one had survived.
D:?One participant in my study actually left his job working on the commuter railroad and went down to the site.? He had a whole different experience because he was around Ground Zero as the buildings were coming down.? He was the only one that really recognized that there was no likelihood that his brother was going to be coming home any time soon.? Others had this, you know, this brief hope that they would come back, but the absence of remains.? There was no body for more than half of the people that I spoke with.? That also protracted the grief.? They didn?t have anything to put in the ground.? You didn?t have a center to the ceremony that would allow sort of an unfolding of the grief process so that made it that much harder.
G:?Now I know, I?ve heard a lot about family members have talked to us about the fact that not having a body, having maybe somebody die overseas, or in another kind of accident, or whatever, that there sometimes is a feeling, an anger or a bitterness or whatever, and I know initially that it does impact the grieving process.? What did you find out?? Just that, what, developing awareness, I think they call it, that early on it may kind of make the reality come a little sooner, but what do you find out down the road a bit?? Did you find out it made that much difference?
D:?I find it made a big difference.? I believe that it drew on some level of creativity in developing a ceremony to memorialize someone?s passing without a body.? There were other families that got delayed return of remains and one family in particular got incremental return of remains.? There were four deliveries of body remains over a four-year period and that led to a challenge in their religious community about how to bury these remains.? They ended up having the foresight to dig a deeper grave so that they could ? they didn?t have to open a new grave.? They just buried on top.
G:?I know Heidi and I went down to ? actually the World Trade Center area where they had the remains and we were talking to the director there and she was saying that some families didn?t want to be told.? They didn?t want to see them, and they wouldn?t see them, and then sometimes they would see them after the third time that they called them.? So it was really very individual how people respond to it.
H:?It was, but, you know what, because I just spoke to someone today that said, you know, I always wished even today, six years later, that I had had some proof that my loved one really did die in the World Trade Center.? Even though I know he did, I never found it.? They never had any remains and a part of me still for some reason feels like, wow, what if he really didn?t die?
D:?That?s a common sentiment and I heard that from others because there was no physical remains.? You also mention going down to Ground Zero.? For those that without remains, Ground Zero symbolically became a very important place to pay homage to.? That sentiment has dissipated over time and some of the families don?t go down there any longer.? They?ll go to local memorials or they?ve developed their own ceremony or ritual around the grief process.? They?ll go to the beach or they?ll go to a park.? Ground Zero was very very important initially.
H:?Yeah, and this will be the last year.? I know we?ve already passed September 11th by the time this airs, but this will be the last year that people will actually be able to go down into Ground Zero even though they?re going to have a memorial at the park next door, people will be able to go down for the last time this year.
G:?Yeah, and I know, Heidi and I were talking about an article in the New York Times about grief fatigue, and they were talking in this article about not reading all the names and then other people were coming up and saying yes, we need to keep reading the names, and those kinds of things.? Are you continuing to follow these families, or have you ended your study?
D:?I ended my study and the rules around it were that I couldn?t contact them again, but my plan is to assist in another research study that will follow up with other siblings.? I?d like to see how they?re doing.
G:?So you can see how they?re doing.? And how long did you follow them?? Did you just give them a once look at or did you follow them?
D:?There was a single interview that went on between March and June of 2005.?
G:?Oh, okay, so it?s been awhile.? So how did you see them doing with their anger because for those folks out there who are feeling anger, do you have any thoughts about that?
D:?You know you might expect that anger would be a very prominent symptom of grief.? You have to remember, I interviewed them four years after the event.? Anger was very prominent early on.? Anger towards the government, anger towards the President for the government?s inability to protect them from terrorism.? The lack of responsibility that the government acknowledged.? Anger took the form of writing letters or going to meetings.? Sending letters into the newspaper.? But it was really only endorsed by two participants.? So that wasn?t as prominent.? There was also some anger at God.? God didn?t protect.? God didn?t protect the innocent, but again that was a small, small percentage.
G:?So the siblings weren’t feeling that angry.? Were they confused about their parents? level of anxiety or mourning or grieving when you interviewed them?? Were they concerned about their parents not moving on or was there any of that?
D:?Absolutely.? They were bewildered by that the parents would overwhelm in grief.? Some of the parents didn?t leave the house for several weeks and months at a time.? One described her mother curled up in a fetal position and she didn?t know how to reach her.? Grief was paralyzing for many of the parents, and the siblings in turn also didn?t know how to manage their own personal responsibility for ? caring for their children for some of the female participants in my study was a tremendous undertaking.
G:?Let?s talk a little bit about that, but it?s time for us to go out on break now because I know we?ve got siblings there who are concerned about their parents right now, and let?s talk a little bit about their grief and their responsibility to their parents.? We?re coming up on break and I?m your host, Dr. Gloria Horsley, and please stay tuned to hear more from David Flomenhaft about the experience of adult siblings of the World Trade Center.? I?m your host, Dr. Gloria Horsley, and you can get us through www.thegriefblog.com as well as www.thecompassionatefriends.org website.? We?re archived on those sites.? Please stay tuned to hear more.
Well, David, when we went to break, I wanted to ask you about, for one thing, I wanted to ask you, have you got any kind of your synopsis of your dissertation or anything that you ? that our listeners could get a hold of, or maybe you could write a little something up for the www.thegriefblog.com?
D:?Sure, I have the abstract.? I?d be happy to post that on the blog.
G:?That?d be great.? Would you send it to us and we?ll put it up on www.thegriefblog.com for people to take a look at.
D:?Sure.
G:?That?d be great.? Well, when we went to break, we?ve been talking about the siblings of 9/11 and I was asking you about how the siblings are dealing with their parents? grief, because it?s been my experience that the siblings do kind of put their grief on hold a little bit to help take care of their parents but this has been how many years since you interviewed them?? I mean, how many?? They were four years after the 9/11.
D:?That?s right.
G:?And I think that, it?s been my experience as a bereaved parent that parents really take a lot longer to, what would you call it, Heidi, reinvest?
H:?Reinvest in life.? I think parents do take longer and I think four years ? at four years parents are still in a very painful place and I think as siblings, we are still taking care of you, our parents, and worrying about our parents at four years after the death.? What do you think, David?
D:?I would agree.? The research showed that women 40-50 years old, so those women that might have young children at home and parents involved in their lives tend to be the most at risk following sudden death or community-wide trauma.? And this population was three-quarters of the people that I looked at so that they had their parents on the one end who were far from recovered, their dependent children, and most interestingly, their spouses who were really not available to attend to their needs.? Men and the women that I spoke to didn?t know how to talk to them about their grief, how to support them, and how to provide a supportive environment at home so that the women felt cared for and acknowledged around their grief.
G:?That?s very interesting, yeah.? It?s interesting because maybe the spouse of the bereaved sibling is a group that we should be working with, too.
D:?Well, my impression is that when we have loss we need to attend to the whole family and the success of the center that I worked at rested largely on it being family based.? That we had different brooms basically to attend to different age groups and that even if it just meant that we were serving food to people waiting for other people to pick up their kids, there was a grief counselor that could just talk with them, and that the only way that we could get to the male, especially the male siblings or the male spouses was to talk to their wives.? So we had to engage them in a community style center that was really family based.
G:?And now were you able to get the spouses in?? Male spouses?
D:?You had to go through their wives.
G:?And the wives would get them to come in?
D:?Yeah.? Well, at least for an informational meeting.? One of the male siblings in my study I obtained through his sister and it was only the prodding of a sister that got him to participate and it was the only kind of mental health involvement that he had was participating in a study about his loss.
H:?I really liked that you looked at adult sibling loss because I think even among siblings and sibling loss there is a hierarchy of grief and I think adult siblings.? I was 20 when my brother died, and I think that adult siblings, our loss is even more overlooked than a sibling that is living at home with the sibling that has died.? For some reason, people think well, you?re an adult now and you weren?t living with that sibling, so therefore your loss must not even be significant.
G:?Um hm.? And also if you?re off at college or off married or whatever and you?re not living by them people just like, I mean how many times have I said or other of us have said, oh, I?m sorry to hear your brother died, you know, as an adult, and you really don?t say, generally say, you know, how is it for you, how are you doing with this?
H:?And like David said and I think even the research is showing that people are looking at sibling loss in children but not in adults.? There?s not a lot of research out there.?
D:?That?s right.
H:?Which is why I?m glad that David has undertaken this for his study.
G:?Absolutely.
D:?One of the most interesting aspects of the loss of the sibling was that there was this lost opportunity to kind of grow old with that sibling.? You know Betty Davies, who you also had on your show, talked about siblings as life?s longest relationship.? So the inability to kind of raise your kids and see your nieces and nephews and hang out with your brother over the course of your life for many was just kind of a tremendous loss.? Lot of melancholy around that.
G:?Yeah, and it is a huge loss, I mean, my husband just had back surgery and my sister is waiting.? She?s three years older than I am, and she?s waiting to get on the plane when I call her when he?s going to be released and she?s going to come and spend two weeks with me helping to take care of him.
H:?Right.? We spend 80 to 100 percent of our lives with our siblings ? that?s what we?re supposed to spend ? versus 40 to 60 percent of our lives with our parents, and to have a sibling death is so huge because, like David said, we are parallel travelers through life.? We?re supposed to grow old together.
D:?That?s right.? It would change the life script.? A lot of the research around grief talks about this narrative that you have to rewrite and if your siblings, who?s somebody that you grew up and learned to speak and play with, he?s part of your identity, so it?s a tremendous undertaking.
G:?Now how do you suggest our folks out there who are now really embracing the fact that they have lost a sibling and what do you suggest to them?? How do they deal with this?
D:?Well, I believe that active remembrance is perhaps the healthiest way to cope with loss.? That if you engage with others, that you begin to rewrite some of that script by participating in an active engagement with others that creates that new life script.? Engage in activities also that help you memorialize your lost sibling.? A number of the people that I worked with got involved in political advocacy.? 9/11 was a charged event that left a lot of things to be questioned and challenged so there was opportunity there.? Find some way to give to others.? So one of the gentlemen I work with became a volunteer fireman to memorialize his brother?s loss.? That gave him another community of helpers to be involved with it.? Others have gone back to school.? Some felt energized and went through this transformation of process and they were fearful before but now they could travel and take trips independently so they were kind of emboldened by the loss and most interestingly one said and others repeated that they were less concerned with the petty concerns of non-family members.? They didn?t get involved in the BS as much any more.
H:?I love that David.? So active remembrance that creates a new life script.
G:?Yeah, I think that?s great.? I think one of the things that is wonderful is when they pass on stories about their sibling to their nephews and nieces.
D:?Yes, the assembling of photo albums.? Wearing the memorial bracelets.? Collecting news clippings.? That?s an important part of telling the story because that?s in many ways telling your own story, and many of the people that I talked to got out the photo albums and shared those stories with me.? One even had a tape of his brother?s recorded music that gave her a lot of solace so keeping that a part and telling other family members keeps that person alive in their lives.
G:?Now are there any special tips that you have for siblings about dealing with their parents in helping them if they feel like they?re grieving?? In fact, I think we have an email that kind of connects up with that.? We had an email from Justin from Provo, Utah, and he said that his brother was killed in the World Trade Center and that he and his wife and baby were living in New York and they?d moved back to Provo, Utah, after his brother?s death and he is concerned because his parents have not got the relationship with their daughter-in-law that they think they should have and he wondered if you had any suggestions so he could help his parents deal with that.? Apparently, she?s moved on a bit.
D:?Okay, lost her husband.
G:?Yeah, she lost her husband.? The sibling is wondering what about he and his parents with the daughter-in-law.? With the ex.? Do you see people moving on?
D:?Most of the stories of the ex did not work out very well.? There were some unique stories where the ex who got the financial settlements.? They were newly married three months before 9/11, got the financial settlement, and she split it with her former mother-in-law and her siblings who participated in my study.
G:?Oh, my goodness.
D:?That was one of those great events.
H:?I heard a story like that, too, David, just one, and it was a really positive experience and the guy that told me, the sibling that told me, has embraced the widow as a sister, that?s kind of like one of a sister now, and they?re very very close, and she was very generous and helped the family like that.
D:?If only more of these stories went like that.? Usually, there was a disconnect between the sister-in-law because she retreated into her own family for support and understanding.? The siblings that I met with had difficulty finding a balance between attending to their parents? needs, taking care of their own, being present for their children, and attending to their spouse.
H:?That?s a lot to juggle, all those things.
D:?It?s a lot to juggle, so I think getting support.? I would always advocate at least a support group, sibling support group, if you can find it.? Compassionate Friends is a great resource.? Getting therapy.? Most of the people delayed therapy, and if you find you can?t get back on your feet after a reasonable period of time, I?ll let you be the judge of that, and get some support.? Give somebody the opportunity to give you a context to understand your loss.
G:?Could you talk a little bit about what it would look like if you needed support?? I mean what kind of behaviors would you say to somebody that?s a flag that you really, you know, ought to reach out and get some support?
D:?You?ve got to take a look at your functioning.? If there?s an impairment in your ability to attend to the usual things that you do, simple biological things.? If your sleep is interrupted.? If your appetite is interrupted.? If your ability to attend to work, to family.? The ability to even find pleasure in any way that you previously found pleasure.? Then there?s an interference in your functioning and if it goes on longer than a couple of weeks to a couple of months, I mean, grief.? Nobody says that there?s a beginning and end of grief but there ought to be a time when somebody gives you the feedback if you can?t do it for yourself and say it?s time to reach out for help.? You know, there are criteria around what makes a diagnosis of depression, but a bereavement is not an illness.? It?s a life process.
H:?I like that.
D:?But if it interferes with the ability to cope and manage your needs, then you got to get some help.
G:?I like that comment, too, Heidi.
H:?Not an illness but a life process.
G:?Yeah.? Bereavement.? Great.? Well, one of the things I think people ought to take a little thought about is how were they prior to the death because there?s some people who suffer a certain amount of depression or sleep problems or that kind of thing.
H:?How were they functioning before the death?
D:?It?s a very good point.? I had an opportunity to talk to the gentleman that took over running the support group for siblings that I started now five, six years ago, and the people that still participate in that group and the new people that have come forward had a history of pre-existing depression, social isolation.? So those people that are still disengaged in focusing on bereavement at this point really have to also attend to the pre-existing difficulties that they were encountering.? It?s more than the loss.? The loss just compounded what they were already challenged with.
G:?And if, you know, there are some people who say that you should take anti-depressants or you shouldn’t or whatever and there are some people who are taking them prior to a loss and they get into this idea that they?re a bad thing or something, that grief?s a normal process, and maybe for some people, they need more support, wouldn?t you say?
D:?I agree.? Anti-depressants play a role in helping function.? I?m not a great fan of them either because they have their side effects that we have to be mindful of.? I?d say the most important thing is support and education.? Support and education also of the spouses to understand what their loved one is going through.? One of the other findings, at least for the mental health community is understand the impact of traumatic grief which is a whole new diagnostic category that we have to understand sort of this area between major depression and post-traumatic stress.? Some of the individuals that I met with seemed to satisfy this very complex form of grief.?
G:?Now the post-traumatic stress area?
D:?Yeah.
G:?Yeah.? Well, I know you?re a behaviorist and it?s time for us to come up on break now and it?s our last break and I want to ask you after the, you know, when we come back on the show again if there?s something you want to finish up with but I would also like quickly to talk a little bit about behavior modification that you do and I believe that?s right, right?? You?re a behaviorist?
D:?I?m really a family therapist.
G:?I am, too, so anyway, when we come back from break, let?s talk a little bit about some of the things that might be recommended to folks.? We?re coming up on break and I?m your host, Dr. Gloria Horsley, and please stay tuned to hear more.? Our show is pre-recorded today so you won?t be able to call in.
Well, David, when we went to break, I was talking a little bit about I wanted to get some recommendations that you might have for siblings who have, are bereaved.? So do you have some?
D:?I do.? I think that it?s important to understand that adult siblings are very instrumental in supporting their extended families.? These are people that have to multi-task to take care of their own family, their children, their spouse, especially for the female adult siblings, and that they need support and education.? They also need to set some reasonable limits about how much care taking they can do of their adult parents because they, too, have to learn and get support of their own.? I think we need to also for those that lose loved ones in very public events, they need to shield themselves from all the media exposure.? They can overdo it and it tends to prolong and worsen the grief process by continually being exposed to the media, to doing the interviews, to watching an excessive amount of TV.? A number of the families that I spoke with, their children had a degree of post-traumatic stress because of all the TV that they watched after 9/11.
G:?That?s incredible.? Yeah.? However, we had a lady from the Midwest who said that there was so much grief fatigue around 9/11 that nobody wants to hear about it any more, right, Heidi?
H:?Um, yes, but was ? she was somebody that directly lost somebody in the World Trade Center?
G:?Yes, her brother.
H:?Oh, okay.? But she wanted to hear about it.? She felt that other people didn?t want to outside.
G:?Yeah, they didn?t want to talk to her about it anymore, but of course that doesn?t mean that the media won?t overwhelm her, but it sounds like for her, she needs to do as David said, get out there, find a group, set some limits.
H:?Right.? Get some support and get with a therapist that understands, like David said, the traumatic loss and the impact of September 11th. This is not.? This is a very unique loss.? There?s a lot of reminders.? It takes a long time to heal after something this traumatic.
D:?Heidi, you?re right on.? Most of the people that I spoke with who tried therapy wound up with a therapist who, number one, didn?t understand bereavement and loss and didn?t have a clue about how to address the 9/11 aspects of it.? So they shopped around.? Many of them got frustrated.? So you have to get a good referral to a good grief therapist when you go through this.? 9/11 is, though, a unique event.? We?re still engaged in a war that followed this event so this loss has daily reminders, and I think because of that, because it?s an event that?s named after a date, it has an unusually long residence.? I don?t think this is going to go away as quickly as any of the previous mass trauma.? People need to
G:?Very interesting.? Well, Heidi, as a bereaved sibling, what would you say to the siblings out there?
H:?What would I say to the siblings?? I would just piggyback onto what David is saying.? This is going to take a long time and don?t compare where you are or your loss to where somebody else is.? It?s a very individual experience and you?re not alone and know that there are others out there, and if you feel isolated, go to counseling or a support group with someone that understands trauma and understands grief and loss.
G:?Absolutely.? Well, David, I want to thank you so much for being on the show today.? And we would love to get an abstract of your research that you?ve done, and keep up the good work, and we will be interested to follow this when you pick up some more families.? This is such important work that you?re doing.
D:?Thank you for the opportunity to talk about this.
H:?Thank you so much, David.
D:?Thank you, Gloria.? Thank you, Heidi.
G:?Well, it?s time to close our show today, and I?m your host, Dr. Gloria Horsley.? Please stay tuned again next week when our topic will be ?Opening Your Heart with Yoga,? and our guest will be Jason Wendroff-Rawnicki.? He?s a bereaved sibling and a registered yoga teacher.? This show is archived on our blog, www.thegriefblog.com, as well as www.thecompassionatefriends.org website.? Please stay tuned again next Thursday at 9:00 Pacific Standard Time, 12:00 Eastern, for more of Healing the Grieving Heart, a show of hope, renewal and support.? Remember, others have been there before you and made it.? You can, too.? You need not walk alone.? Thanks for listening.? I?m your host, Dr. Gloria Horsley, with my co-host
H:? ?Dr. Heidi Horsley.? David, those that died on September 11th are gone but will never be forgotten.? Thank you for remembering the forgotten ones and giving the surviving siblings a voice.

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