Let's Be Real

We have problems with what is real. There are good things and times of life that don’t get the respect of being fully real. And there are parts of life that seem too real, and we avoid and turn away. So, for just a few minutes and a few paragraphs, let’s see if we can get a little more clear about and comfortable with what is "real."

When I was in college, a common commentary was that we college students lived in a “bubble.” This was said by those outside of our college world as well as by us college students. Living on or near the campus, spending our time in class, studying, writing papers, avoiding studying and writing papers, trying to balance work and play in new ways, trying on early adulthood, etc. was not the “real world.”

Something about that critique — telling someone else, or even oneself, that the life they’re living isn’t “real” felt and feels somewhat cynical. An underlying assumption seems to be that being “real” requires experiencing stress and pain. Experiencing friendships, joy, fun, and kindness — these were seen as less “real” than the weights of responsibilities and suffering. Another underlying assumption seems to be that if something exists only for a time in our life, then it’s not real. Why were the positive, temporary, parts of life seen as less real than the painful and lingering parts?

This devaluing of the joyful parts of life seems present, too, in how we who are older sometimes minimize and invalidate the experiences of those who are younger. With the perspective of greater years and more experience, the older can look on the distress felt by children, teens, or even young adults and say that what is causing them stress is not that big of a deal. We can unhelpfully tell them to “just wait” and they’ll understand that they don’t have it so bad. Think it’s hard now, well just wait until you’re out of high school. Or just wait until the baby comes or when there’s more than one child or when they’re in elementary (or middle school or high school) or when they’re gone. Just wait until you hit 40, or 50, or 60 (or 70, or 80) and on and on. If you think it’s bad now, or if it feels pretty good now, just wait. Not sure how this “just wait” advice is ever very helpful.

What is it about us that sees more reality in hard or painful things than in kind, caring, enjoyable things? Why do stressful experiences get to be more “real?”

Perhaps it’s partially a failure of language. Maybe when we say that life during a less stressful, possibly more innocent time, is not “real,” we’re acknowledging that what we’re living is a narrow slice of how big life can be. It’s real, but it’s certainly not all there is. Sadly, annoyingly, or tragically, there is more to life than this. And if life feels good, safe, and comfortable, then there’s part of us that may benefit from being reminded that this is not the whole of life’s experience. Maybe we overcompensate to make that point and end up undercutting the nurturing and supportive parts of our lives in the process.

We may also put more “reality” on the more stressful and painful experiences of life to protect ourselves. Don’t forget to be careful. Don’t assume that all people and circumstances are safe. Expect that there will be hard things in life and make some plans to be prepared. Managing expectations and having contingency plans make good sense and help to keep our lives and hearts protected.

Yet, here is our paradox. While we minimize the realness of the joys of life in order to remind ourselves that stress, pain, and suffering are unavoidable and critical parts of life, we often avoid talking about these darker realities of life. In many situations, we kill the conversation by bringing up loss, grief, pain, or death. Talking about these realities of our mortality can be taboo. Perhaps they feel too “real” for us. And this leaves us in a strange limbo between joy, comfort, and kindness (not real enough) and death, grief, and loss (too real).

We struggle to find the right balance—experience the joys of life (but don’t hold too tightly or expect them to last) and recognize that life is full of burdens and loss (but it’s depressing to talk much about it). This reality bind is what is more depressing, however, and its costs are too high. Its haunting keeps us from fully affirming and enjoying the temporary blessings of life—temporary because our lives and everything in them are temporary, of course. When we are suffering, it sends our friends to the other side of the grocery store, street, or room because they don’t know how to act or what to say. It keeps doctors from telling us the whole truth as the full realness of our conditions is found too intimidating.

So, a few real-life suggestions before we end these few minutes and few paragraphs. Let’s avoid telling people to “just wait” until they’re in the real world. Let’s work at being at least a little more open with each other (and ourselves) about talking about the realities of being temporary like aging, illness, grief, and death. Let’s practice fully seeing and being real.

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Greg Adams, LCSW, ACSW, FT
Program Coordinator
Center for Good Mourning
[email protected]

Other Voices 

"Miranda Featherstone had a brother, Jody, born before her that she never knew. Jody had a serious illness at birth which significantly impacted his development, and he lived only to the age of nine. Miranda was born two years later. Her mother wrote a book about the family’s experience called A Difference in the Family: Living with a Disabled Child. In this essay, Miranda offers frank and sensitive reflections on her experiences as a child, adult, and mother—living with “ghosts in my nursery.” (Adult language) Continue Reading...


In the Spotlight

One of the innovative programs of HealGrief.org is Let’s Talk Death. This web-based show is a hybrid between a podcast and a webinar. Every month brings a 15-20-minute pre-recorded episode that lets you listen in to a casual conversation with guests and show hosts. Let’s Talk Death episodes cover topics such as end of life issues, pre-planning, and grief as seen by researchers, authors, bereavement support professionals, bereaved individuals, and community members. They’ve even interviewed a grief/loss newsletter editor from Arkansas. Check it Out


Particularly for Parents

Kate Bowler, author of Everything Happens for a Reason and Other Lies I Have Loved hosts an insightful and compassionate podcast entitled Everything Happens.

In this episode, she talks with her guests about what they’ve learned from leading a widowed parent support group for fathers. At the link, you can listen to the podcast and also read the interview transcript.  Listen Now

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Living All the Way

Katy Butler’s father died with dementia, and that experience inspired her to be very clear with what she would want and not want if she developed dementia:
“I believe that ‘comfort care’ is what I want if I develop dementia. I have written the following letter - couched in plain, common-sense language, rather than medicalese or legalese - as an amendment to my advance directive. I’ve sent it to everyone who may act as my guardian, caregiver or medical advocate when I can no longer make my own decisions. I want to free them from the burden of future guilt, and that is more important to me than whether or not my letter is legally binding on health care professionals." Read More

For Your Library

The Conversation: A Revolutionary Plan for End-of-Life Care by Angelo E. Volandes, MD. Bloomsbury, 2015.  

A number of years ago, I attended a conference where I heard a presentation from a palliative care team who worked with adults. The comment that has stayed with me from that presentation went something like this: “Our major intervention is not a treatment or test or medicine. Our major intervention is a conversation.”

I was reminded of that presentation when reading the compelling stories of patients and families found in Dr. Angelo Volandes' book, The Conversation: A Revolutionary Plan for End-of-Life Care. Dr. Volandes is a skilled storyteller, and the stories he shares of patients and their decision-makers at the end of life illustrate the challenges that many face in understanding their situation and their options. Too often the major obstacle has been the lack of an honest and clear conversation about the realities of the medical situation and the choices available. While advocating clearly for more and improved communication, Dr. Volandes acknowledges the challenges of confronting dying as he shares poignantly about his own father’s illness and death.

The need for more and better communication around end-of-life planning is a worthy topic but not a unique one. Many have also written persuasively on the issue. What sets this book apart is the description of the development of videos as a tool for helping patients and families understand their choices. Dr. Volandes talks about three primary approaches a patient and family can consider for end of life: a priority of prolonging life at all costs, a priority of comfort, and somewhere in-between. To help some of his patients understand what it meant to prolong life at all costs, Dr. Volandes would give them and their support persons a tour of the intensive care unit. Seeing patients on ventilators or dialysis with multiple IVs for medication and fluids and sometimes tubes for nutrition made an impact on patients and families in ways that just talking about them could not. After seeing aggressive life-prolonging approaches in action, patients and families better understood what choices were right for them.

The intensive care staff eventually put a stop to Dr. Volandes tours, so Dr. Volandes developed the first of many videos to better explain the three basic treatment approaches available for patients and families. The videos were shown by anecdotal experiences and clinical research to have significant impact on decision-making for patients and families. This effort led to the founding of Advance Care Planning Decisions, a nonprofit organization devoted to encouraging “The Conversation” through the use of videos.

Patients and families facing dying and death are extremely vulnerable and are in need of supportive and clear information and conversations. The writing of this book and the development of a series of videos (in multiple languages) are significant contributions toward the kind of healthcare needed at the end of life.
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Taking Questions

Dear Dr. Neimeyer,

"My question is regarding my mother.   We lost my father very unexpectedly this past summer, and she is having a very hard time with his loss, as we all are.  My question is this: Is it good for her to have her bedroom looking like a shrine to him, so that whenever she looks anywhere in the room, she is reminded of him and starts crying?  I don’t know what’s best at this point."

“What is best at this point” could have less to do with the number of months that have passed since your father’s death, than with where your mother is in the course of her grieving.  It sounds as if she is both striving to maintain his possessions just as they were after many months, and also experiencing great pain rather than a sense of consolation and closeness to him when in their presence.  If so, then it could be that she is reaching for some way to restore a sense of secure connection or attachment to him… but that “freezing” his room is not meeting this need.  In this case it could help to consider what steps could be taken to reduce the discrepancy between her inner and outer world, psychologically and practically.


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