Working with Imerman Angels

Zen Caregiving Project is working with the non-profit organization Imerman Angels. Imerman Angels provides comfort and understanding to those experiencing cancer by matching them with a Mentor Angel, a cancer survivor or caregiver who has faced the same type of cancer.  ZCP delivered a four-part training to staff on self-compassion and ran a session on grief and loss for the wider Imerman Community on Grief Awareness Day. ZCP will be working with Imerman Angels on future resources around grief for Imerman Angels’ Mentors and Mentees. 

We spoke with Executive Director Stephanie Lieber and asked why a focus on grief was so important for her staff and community. 

ZCP: Why did you feel it was important to bring in training around grief for your staff and community?

Stephanie: The idea actually didn’t come from me, it emerged from our mentors. Our mentors were coming to us and sharing that they didn’t feel adequately equipped to support their mentees going through grief and loss. They wanted resources to give to their mentees to support them through a range of losses, including loss of confidence in the body, loss of a limb, or loss of a partner. They also often struggled to address the feelings of loss that were triggered for them when supporting their mentees. We needed to equip our community with tools and approaches to support them and to help them support each other.

Hearing this from our Mentors, our Staff team dug in and thought about their own feelings towards loss and grief, along with how we serve our community.  In our staff team alone, four staff members have lost loved ones to cancer in addition to others who have survived cancer themselves, or have relatives and friends that they have supported through cancer. It was as part of this focus on grief and loss we reached out to Zen Caregiving Project to work with us on this sensitive and incredibly important topic.

It’s a much bigger conversation than just us at Imerman Angels – people simply aren’t talking about loss and grief openly in society. They may be talking about it in small groups, but they aren’t standing up and saying “I’m grieving“, “I’m still grieving” or “Grieving is hard“. It’s just not a topic and discussion that is culturally and societally welcome. 

What is the biggest learning you took away from the Staff Training that ZCP delivered?

For me, the biggest takeaway was that our job is not to fix people’s grief. Grief is not something that is meant to be fixed – it’s meant to be experienced. As a support organization, our job is to sit with those who are grieving and be there with them, being with whatever they are feeling at that moment. Roy Remer, who led the training, shared that when supporting others through grief “it’s not what you say, it is how you show up”. You need to show up and just be present for someone, and drop your own agenda of wanting to change things or change how the other person is feeling. 

What did you find out about your community from the open session you ran with ZCP for your community on grief and loss?

It was clear from the high attendance and the session feedback we got that we need to be doing more sessions like this. We need to be providing opportunities for open and candid conversations and making these conversations accessible and frequent. 

In the session itself, I was surprised and touched by what I witnessed happening in the Zoom Chat. People started sharing about their losses via chat and others in the group responded, built each other up, and said “that sucks, I’m here and I’m listening, your feelings are normal, it takes time to heal”. Right there on the chat was a community of grievers that showed up and listened. That’s what our community is. 

On a personal note, my dad died in February of this year and in the two months after his death I would call and apologize to friends who had previously lost a parent as I realized I hadn’t showed up in the way that they needed and would have been most helpful to them. Yes, I drove hours to attend funerals and delivered food, and checked in on them to see they were OK, but I wasn’t just there for them to just be as they were. I didn’t spend time just acknowledging how they felt and being a supportive witness to that.  That’s what the people in the chat function did at the session – they showed up. 

What elements of ZCP’s approach to loss and grief did you appreciate the most?

I really appreciated Roy’s unique approach to loss and grief. The way that he carefully and thoughtfully wove mindfulness into his explanations and how the approach is geared towards offering people useful tools to use, rather than trying to help or solve their grief.  

And along with this idea of “showing up” I also appreciated the emphasis on compassion, and that compassion involves feelings and action. But also learning that an action doesn’t have to be big and loud, sometimes an action is as simple as being present and not saying something. 

What are the next steps for Imerman Angels to integrate grief awareness and training into your program?

We never thought of this as a self-contained project. All of what we have learned, and the ideas that have sprung from it, has to be integrated into everything we are doing. We have, for example, run journaling sessions, or yoga classes in the past but in the feedback from the Grief and Loss Session people were suggesting that we run a Grief and Yoga class, or Grief and Journaling class. And of course, that makes sense because essentially everything we do is about loss – not about death – but a huge part of living with and managing cancer is about experiencing loss. 

There is no end to this conversation, it has to be an ongoing dialogue with our community to support them and help them open up the conversation to others, even outside of the Imerman Angels community. Because grief is not specific to a particular audience – we all experience loss on a daily basis and are all going to experience grief at some stage in our lives.

For more information on this project or our custom training course and sessions, please contact Sarah at sarah@zencaregiving.org.

If you like what you read, please join us and enroll in one of our courses, share our work with someone you think will benefit from it, or support us through a donation.

Coping with loss, sharing our approach with Curry Senior Center staff

Curry Senior Center is a non-profit in San Francisco dedicated to helping vulnerable, low-income, and homeless seniors through a holistic and integrated care approach. The organization runs a Peer Outreach Program in which Peer Outreach and Drop-in Center Specialists help connect isolated older adults to services and social activities.

Working with a vulnerable older population, the Outreach Specialists often witness their clients experiencing multiple losses, for example, loss of mobility, loss of social connections and loss of their own living spaces as they move to assisted housing. During the pandemic, however, the losses experienced by the staff and clients intensified, with a number of clients passing, and the Curry team also losing a member of staff to COVID-19.

To support their staff with such losses, and to prevent burnout and overwhelm that can accompany such experiences, Curry Senior Center approached Zen Caregiving Project (ZCP) to run two online, interactive sessions on managing loss and grief. 

The sessions

Working with loss and grief is a core part of Zen Caregiving Project’s approach to caregiving. When the organization was first established as Zen Hospice Project over thirty years ago, it served people approaching the end of their lives, and provided hospice care. Offering on-going support for persons at the end of life, the organization advanced a Buddhist-inspired approach to working with loss and grief, allowing individuals to both feel the emotions that loss brings, and also build the capacity to sit with the loss and reduce overwhelm. 

The sessions for the Outreach Specialists were based on this approach and were taught by Roy Remer, the organization’s Executive Director. Across the sessions he introduced five ways to working mindfully with loss:

1. Loss is universal

It can be comforting to remember that loss is a natural part of being human. While the particular circumstances of loss may differ from person to person, we all experience loss. It is unavoidable. If nothing else, the shared experience of loss is what reminds us that we are connected to everyone else. 

2. Understand the value of exploring our feelings on loss

It is important to be aware of how we respond to our own losses, especially as caregivers. When we don’t work on how to process our own losses, it can be difficult to fully support the person receiving our care. Others’ experience and reactions to loss may be triggering for us, and it is hard to untangle the pain and emotion of their loss from the pain and emotion of our own losses. 

3. Introducing mindfulness to work with grief and loss

Often our first response to grief is to deny it or turn away from this. Mindfulness techniques can be used to turn toward grief, allowing us to see what sensations and emotions are felt, and what thoughts we are having. Being with the emotions of grief allows for their processing. We can build our capacity to be with strong emotions and over time the emotions will begin to quiet. The sadness of loss may not go away, however, we may begin to find it is not as disrupting  or overwhelming. We begin to integrate the loss into the normal rhythms of our life. 

4. Building compassion in the face of frequent loss

Caregivers may confront a lot of barriers to expressing compassion – these barriers can sometimes be exhaustion, hunger or frustration, and sometimes it can feel like what we are doing doesn’t make a difference. A deeper understanding of the dynamics of compassion and the ways it can be used enable us to more readily recognize and overcome barriers when they arise.  Practicing compassion means also including oneself.  Self-compassion is essential for caregivers to build resilience and avoid burnout: “you can’t pour from an empty cup.” (see our free webinar on compassion for caregivers)

5. Inviting conversations about loss with those we are care for

Conversations with care recipients about loss can feel awkward, but there are ways of approaching these conversations that help the other person open up, and feel supported. It is helpful to remember, in the face of loss we are all equals as no one can avoid personal loss and grief. In this regard, we are all alike. This thought naturally brings feelings of empathy and compassion for the person we care for. It is also helpful to notice if you are attached to a particular outcome for a conversation and perhaps let go,  trying to meet others where they are at. Maybe the person you care for isn’t yet ready for a big conversation on loss but providing an opportunity, may support them to get more comfortable with it over time. 

For a more detailed explanation of these five approaches please see our blog on approaches to loss.

The impact of the sessions

The sessions were deeply moving for all involved, with Curry staff sharing and connecting over common experiences and recognizing their own unique relationship with loss. The feedback we received from the session was very positive and it is our hope that the training will continue to support these staff persons in the important work they are doing in the community, as well as in their own personal wellbeing.

We would like to thank the Curry Senior Center for its holistic and compassionate approach to supporting its staff. For any enquiries on running sessions in your organization please contact us via our enquiry form.

Five approaches for caregivers to work with loss and grief

We all experience loss and grief throughout our lives, but as caregivers loss can be very prominent in our day-to-day experience. Caregivers experience our own loss and also witness the losses experienced by the person we care for, e.g. loss of physical or mental health, loss of work, loss of social role. 

In the 30+ years since our founding, we at Zen Caregiving Project have learned a lot about loss and grief while caring for others through our work supporting people living with a chronic and terminal illness. We have developed a Buddhist-inspired approach to facing inevitable loss which we believe can support caregivers to more easily withstand the strong emotions that loss can bring.

Five approaches to exploring and working with loss and grief

1. Remembering that loss is universal

It can be comforting to remember that loss is a natural part of being human. While the particular circumstances of loss may differ from person to person, we all experience loss. It is unavoidable. If nothing else, the shared experience of loss is what reminds us that we are connected to everyone else. 

2. Understanding the value of exploring our feelings on loss

We may not like the idea of looking into our own feelings of loss and grief but as a caregiver it is important. Why? Well, exploring our own emotional response to loss will help us to tell the difference between our own suffering and the suffering of the person we care for. By untangling our emotions from the emotions of our care recipient it makes it easier to decide what is best for the person we are caring for. 

For example, a caregiver is caring for her father who is experiencing memory loss. She experiences strong emotions around her father no longer remembering who she is or remembering who he has been for so much of his life. This caregiver’s relationship with her father is shifting into completely new territory, so such feelings are natural. When she is able to step back and look at the situation, she sees that her father is in fact not distressed. Since he is not very aware of what is happening, he is not upset by it. Actually, he seems confused when she tries to comfort him about his memory loss. She is able to see that perhaps comforting her father is more about her strong feelings than his. 

3. Using mindfulness in processing loss and grief

Experiencing loss and grief is not easy and can bring up powerful and unpleasant emotions. It is normal to want to avoid these feelings, push them away or pretend they are not there. 

A mindful approach to loss attempts to meet grief directly. We can learn to simply observe our natural response to loss, at that moment, without judgment.  We can become curious: where do we feel emotions in our body? What color are they? What texture are they? In this moment, what is the nature of our emotional landscape? When opening to our emotions in a given  moment we may feel sadness, resistance, anger, vulnerability. Over time, we can accept that such emotions are natural and okay, and welcome them all in. None of the feelings associated with loss are “wrong,” nor should they be excluded. 

Being with the emotions of grief allows for their processing. We can build our capacity to be with strong emotions and over time the emotions can begin to quiet. The sadness of loss may not go away. However, we may begin to find it is not as disrupting or overwhelming as before. We begin to integrate the loss into the normal rhythms of our life. (See our free webinar on Working Mindfully with Grief)

4. Building compassion in the face of frequent loss

Compassion is an essential part of caring for others, but there can be times when it is difficult to express compassion to the person you care for. Caregivers commonly confront a lot of barriers to expressing compassion, including exhaustion, hunger, frustration, and feeling like what we are doing is not making a difference. 

Cultivating self-awareness through mindfulness gives us the mental space and clarity to identify when we come up against one of the common barriers to compassion. In recognizing these barriers (e.g. hunger), we can more easily overcome them (e.g. prioritize getting some food). It can be helpful to remember that we are not alone in facing barriers to compassion; all caregivers will experience some version of these barriers from time to time. Struggling to maintain compassion is a common part of caregiving, yet compassion is like a muscle, the more we work with it, the stronger it becomes. 

 Practicing compassion means also including oneself. For many, it is easier to experience compassion for others than it is for oneself. However, self-compassion is essential for caregivers to build resilience and avoid burnout (see our free webinar on Deepening compassion in challenging times). 

“If your compassion does not include yourself, it is incomplete.“
– Jack Kornfield

5. Inviting a conversation with those we are serving

Conversations with care recipients about loss can feel awkward, but there are ways of approaching these conversations that support openness and care. We suggest approaching the conversation as a peer; another human being who experiences loss and grief. In this regard, we are all alike. Being aware of this common experience naturally brings increased empathy and compassion for the person we care for and can also make us feel more comfortable talking about loss with them. 

It is also helpful to notice if there is attachment to a particular outcome for a conversation and if so, try to let go of any goals and follow their lead. This will make it easier to meet others where they are. If the person we care for isn’t quite ready for a big conversation on loss, we can start by talking about change. This can provide an opening for a bigger conversation on change and loss in the future, if that’s where the care recipient wants to go as they get more comfortable with the topic.  

On a more practical level, we can set an intention to listen generously. This includes giving our full attention, using open-ended questions, allowing for silence, and checking our eagerness to express our own thoughts. 
We at Zen Caregiving Project hope that these approaches to working with loss help in your caregiving journey. We have more free resources on mindfulness and loss on our Resources pages, and our Mindful Caregiving Education courses also explore this important topic in a group setting.

Webinar on Loss and Grief as Initiation

Loss and the natural grief that accompanies it can be one of life’s primary transformational experiences.  In this session, Roy Remer explores how the pain and poignancy of loss can also teach us lessons which may be of benefit to others in our community. The session includes short meditations, opportunities for inner reflection, and guided exercises. 

This session was run on May 23, 2020, as part of Reimagine: Life, Loss, & Love, a Worldwide Virtual Festival on embracing life, facing death, and loving fully, during COVID-19.