Joseph Nowinski, Ph.D. is an internationally recognized clinical psychologist and co-author of Saying Goodbye: A Guide to Coping with a Loved One’s Terminal Illness.
When someone you love receives a terminal diagnosis, the whole family is suddenly faced with a prolonged crisis. While medical advances have given us the gift of extending life, meaning that a loved one could survive months or even years before dying, it has also changed the way we grieve.
As co-author of the award winning book Saying Goodbye: A Guide to Coping with a Loved One’s Terminal Illness, why did you choose this critical topic about grieving and terminal illness?
My co-author, Barbara Okun and I had both had the experience of dealing with a loved one receiving a life-threatening diagnosis. In my case the loved one survived and is in remission, but Barbara lost her loved one. In both cases the crisis lasted for years. And in both cases we came to realize that there was little in the way of guidance available or people like us. Moreover, as we spoke to friends and colleagues we found that a surprising number of them had undergone similar experiences and also found themselves “adrift” with little in the way of guidance.
Earlier books on grief, including Elisabeth Kubler-Ross’ groundbreaking work, address the process of coping with acute grief. However, thanks largely to advances in medicine, grief today tends to be a protracted process that only begins with a diagnosis but then can proceed through a lengthy process of treatment, possible, remission, and possible relapse, that involves not only the patient but the entire family. So Barbara and I made the decision to see if we could come up with a book that would be more relevant to what we (and others) are likely to experience at some point in our lives.
How did you go about gathering the input for your book?
We were fortunate to be able to interview volunteers who either had undergone the experience of having to cope with a terminal illness in the family, or were in the midst of it. We sought insights into what their experiences were like and what if any “lessons” or advice they would want to share with others.
Can you tell us about the 5 stages of grieving and the key take-away from each one?
After pouring over a great deal of interview material we were able to sort things out, looking for common threads in the stories we heard. That led in time to the five stages we describe in the book, beginning with the “crisis” stage when the patient and family first receive the life-threatening diagnosis. It would take too long to go into each of the stages in depth here, but suffice it to say they flow into one another, with a sharp line separating one stage from another. As this prolonged process extends over time, both personal issues (for the primary caretakers) as well as family issues are likely to emerge.
We advise families to expect these and not to feel guilty or shameful about them, but rather to accept them and address them. Along the way we offer what you could call a “blueprint” that describes the process along with concrete, practical advice as to how to address these issues. Much of that blueprint and advice reflects the wisdom we learned from those who were going through the process of saying goodbye or had been through it.
How has the grieving process changed over the years culturally and its impact on caregivers, friends and family?
Medical science has made incredible strides over the past several decades. Whereas sudden (or relative sudden) death was once commonplace, it is increasingly rare today. In its place is this prolonged process that ensnares whole families and which many describe as “a roller-coaster that never seems to end.”
Dr. Nowinski, what are 3 key messages from your book?
I would say they are these:
- Be prepared to have to experience the process we describe in our book at some point in your life.
- Think ahead and follow some of the advice in advance of having to do so in a state of emergency.
- Keep in mind that as traumatic as this process can be for families, families can also emerge stronger, more connected, and more resilient at the end of it.
Visit Dr. Joseph Nowinski’s website.