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A Life & Death Conversation with Dr. Bob Uslander


Jul 9, 2018

Lydia Lombardi Good is a licensed clinical social worker. She shares the importance of self-compassion, what it is, and how to get comfortable with it and how it helps the grieving process. Note: A Life and Death Conversation is produced for the ear. The optimal experience will come from listening to it. We provide the transcript as a way to easily navigate to a particular section and for those who would like to follow along using the text. We strongly encourage you to listen to the audio which allows you to hear the full emotional impact of the show. A combination of speech recognition software and human transcribers generates transcripts which may contain errors. The corresponding audio should be checked before quoting in print. Contact Lydia Lombardi Good, Pier View Counseling Transcript

How Self-Compassion Helps The Grieving Process

Dr. Bob: Yeah. That's my pleasure. This is a Life and Death Conversation, and we talk about things that we can do to enhance life and bring more joy and peace to life, and of course, we talk about death. We don't shy away from the topic of death. We always explore a bit about how our guests feel about the whole end of life, death and dying, what experiences they've had, how the awareness of death seems to show up in your life. For people who come on and have these conversations, most of the time they're pretty comfortable speaking about death and sharing their experiences and thoughts about it. I'm just going to open it up and let you share a little bit. I know that you do a lot of work in grief and loss, and you've been in hospice, and have a lot of experience. So share a little bit about what the idea of death and dying means to you, and how it shows up in your life. Lydia Lombardi Good: What I learned from my experience with death and dying, working with clients, having my own personal experience losing close loved ones, is the more we think about death and understand that it is inevitable, and we are all dying a little bit every day, I think the richer a life we are able to live, and we are more mindful of the choices we make, and the people we choose to surround ourselves with, and the life we want to live, knowing that nothing is permanent. Everything is impermanent. And if we live a life without regrets and can be more present to our lives instead of staying maybe stuck in the past, or focused too much on the future, we can look back and say, "You know, I fully experienced all that. I don't wish to be back there again. I wish to be right here, right now, to live my life fully," knowing that we really only have one shot at that. So that's how it's changed me a lot in terms of my own choices, the way I live my life, the way I try to stay compassionate. A lot of it's talked today, and what I really am passionate about is teaching people to embody self-compassion and treat yourself kindly, the way you would treat a close friend. And the more we can do that, the better life we can have. The more chances we take, the more we can just fix up things as they are, instead of always wishing things to be another way, or for us to be another way. And when we do that, we're missing what's happening right now. Dr. Bob: Yeah. That's beautiful. And I think it's pretty common to hear people share that when they contemplate death, when they recognize, like you say, the impermanence of everything, it really allows us to stay more focused on what's happening right now, and feel gratitude, and just feel very present. I want to talk about the mindfulness, the self-compassion, and the mindfulness, because mindfulness meditation, self-compassion have figured prominently in my life and I've done my work there, I've gone through courses in mindfulness. And it's so interesting what you said, to treat yourself the way that you would treat a close friend. Do we do that? I mean, do we really do that? The stuff that we lay on ourselves, and the way that we diss ourselves, which is so common. Like, if we were doing that to a friend, would they stick around? Would we still- Lydia Lombardi Good: We wouldn't have any. Dr. Bob: We wouldn't have any friends. Share a little bit more about that, about how you came to that, what your journey has been to become a teacher of self-compassion and mindfulness. Lydia Lombardi Good: Yes. Yeah. So, I was working in hospice since about 2007, 2008. Right out of graduate school I started this work, and I think I understood it to the best of my knowledge. I'd had a lot of loss in my past, and a lot of trauma that I thought I had worked through and had done a lot of healing around and was in this work. And I think I had as much compassion for the experiences of my clients and patients as I could have at the time, for that point I was in my life where I was at and what experiences I had been a part of at that point. And then it was 2012; I lost my dad to cancer. He died of prostate cancer and endocrine cancer. So the three years prior to that, we were taking care of him, and it was a real aggressive form, so it was a really difficult dying process. So that following year I was in charge of settling what I call closing out someone's life. That process of closing up his home, preparing it for the next chapter, getting his belongings and setting up beneficiaries, that kind of thing, and doing my grief as best as I could, as much as I knew how at that time. And then, shortly before the one year anniversary, I got a call from the medical examiner's office that my uncle, who was one of my father's primary caregivers aside from myself, had taken his life. So then I embarked on that next journey. I was his only family here, so helping to then close out another person's life. And then two months later, I get a call. My husband's out of state at a bachelor party. And I get a call that he's had an accident and I need to fly out immediately to Arizona and be with him because he's had a traumatic brain injury. So I fly out there and spend 10 days in ICU with him until we were basically told that we need to consider letting him go because he was not going to recover at that point. So my real journey I think began there. I could make sense that my dad was in his late 70's, although for some that is still young, but he had lived a really full life. My uncle, I wasn't as close with. It was a different type of grief, but losing my own husband was a total ... knocked me off my feet. It was a total life-changer. So basically, learning about self-compassion and mindfulness started the year before, when my dad was going through his dying process, but really kicked into high gear after I lost my husband, simply for just survival. I was in survival mode- Dr. Bob: Yeah, self-preservation. Lydia Lombardi Good: ... trying to figure out, yeah, how do I survive all this. Three in a row, I'm totally alone, feeling like I'm totally alone. How do I keep going? How do I keep going? How do I make sense of ... if this can happen to my 32-year-old husband, what's going to happen to me? This feeling of just total lack of safety and security and anything that I once knew. So that's when things really, really kicked into high gear for me. And a couple of years later I ended up leaving hospice. I was working out as a bereavement manager, and I decided to start my own practice, focusing on grief and trauma. A lot of it because of all the work I did with amazing clinicians, and spiritual healers, and energy healers, and the amazing, amazing people that supported me through my past, inspired me so much that I felt I really needed to do this myself and work with individuals again, and step away from the program planning and go back to pure clinical work. And it's been amazing. Dr. Bob: I bet. Wow. And like many people, your journey has taken you someplace because of your own personal experience. I mean, you have the training, you have the structure of having worked in a company, but once you had your own personal experience and were down in the depths, and then figured out what you needed to do to survive, and then I'm assuming beyond surviving, starting to thrive again, you recognized that you needed to be in a position to share that on a deeper level. Lydia Lombardi Good: Yeah. It's been tremendously healing, although I didn't jump into it necessarily to do it for my own healing. I wanted to make sure that was taken care of on its own, so I wasn't coming to work with clients doing my own work. But feeling complete and on a really steady path with my own healing empowered me to know the tools that work for people, and to empower others to consider some of these healing modalities. And mindfulness and self-compassion were right up there. They were the primary methods for me in terms of my healing. A lot of people as what does that mean. When I heard, "Self-compassion," I frankly, four, five, or six years ago I never knew what that even meant. It's not a term a lot of people in western culture understand or use. So really learning what that meant, and practicing it for myself, so I could know how to show others to do that. Dr. Bob: So why don't you try to explain it and let people know, because there's probably a lot of people here who ... you know, the self-compassionate conjures up some images and some thoughts, but I think you could probably do a really good job of helping people see what it really is to learn self-compassion. Lydia Lombardi Good: Yeah. So, self-compassion defined more is bringing yourself to the same attitude and understanding that you would do for others, or a beloved friend. So asking, how can I care for and comfort myself at this moment, instead of judging and criticizing. How can I bring kindness and understanding, and patience, when I'm confronted with a personal feeling or loss, instead of beating myself up. And then honoring and accepting your humanness. And with grief, I think where I see a lot of people, and I did this myself, we put ourselves in a timeline immediately. I was talking to a woman the other day, and she said to me she just lost her fiance a week ago. And she said, "I'm trying to be happy. I know I need to be happy, so I'm just going to be happy, and I cry when I need to, but I just want to be happy." And I said, "You know, why do you have to be happy? You just lost your fiance. Can you just honor what's really happening with you? You're sad, you're angry, you're all these feelings ..." that she was telling me before she said she felt she had to be happy. We try to pressure ourselves to move faster than we actually it's reasonable for our healing. And this is actually what stuns our healing when we try to pretend it's another way. We try to pretend that ... you know, you'll hear people saying, "In a year you should be better. Just give yourself that year." Well, for some people a year it's just begun. The trauma is just starting to settle, and now all of the sudden there is space for grief. Or the realization or the beginnings of acceptance begin to occur after a year, for some people longer. None of that's wrong; it's just is. But with self-compassion, we can give ourselves that space to say, "Whatever's happening is just right for me. As long as I'm not hurting myself or I'm hurting another person, this is what I need to do in order to move forward and to heal, step by step." Dr. Bob: So how does that happen? How does somebody learn self-compassion? How do you go from having the normal chatter, the typical berating and judging that most people have ... has become sort of their pattern, to having this self-compassion, and what's the process? Lydia Lombardi: I think the first part is learning you're being able to become aware of the voice inside you and what it's saying, so really listening to that. So if you start to notice your pattern of self-deprecation, or being really hard and punitive with yourself in difficult times, starting to become an observer of those thoughts instead of allowing yourself to become hooked to them. The problem is, a lot of us, me included again, we get so used to those thoughts, they just become ... we get on autopilot with them, which becomes kind of a way of being. But by practicing things like mindfulness, or meditation, we allow ourselves to slow down a little bit, take a breath in between thoughts, and start to notice the thoughts instead of getting hooked. For example, I used to notice I would get really frustrated with myself when I would get really, really down. Like, a year or two after my husband had died, I would all of a sudden have a really bad day, a really bad grief day, and I used to think to myself, "Gosh, where is this coming from? What's going on? Why am I feeling this? Gosh, I've done all this healing, and I've done all this work. Why am I sobbing now? Something must be wrong with me. Maybe I'm just not doing enough work to heal." And all these questions, instead of just catching the thought and saying, "You know what? There I go again. Can I just have the feeling that I'm feeling and let it rise and fall naturally, instead of resisting?" Because we find, when we push against it, and we create this resistance, we actually create more suffering for ourselves. And this is a real Buddhist concept as well, that pain is inevitable, but pain with resistance equals the suffering. When we can just settle into the pain and just feel it, it's like when we have a good cry. When you're stuffing it down, and it's that nod in your throat, it hurts so bad, it's so uncomfortable, but then when we just let ourselves ball, all of a sudden you notice you come out of it and it's like, wow, I feel so much better. Why didn't I just let myself do that before? Dr. Bob: It's a catharsis, yeah. Lydia Lombardi Good: Yeah. Dr. Bob: I think we need to allow for more of that. So, a big thing that's coming up for me as you're describing this process is awareness, self-awareness. That's the first step, right? Because if you're not aware, if you don't have an awareness of what's truly taking place, there's no way that you can influence it, or impact it. Lydia Lombardi Good: Exactly. Dr. Bob: And again, going back to this, sort of the analogy of treating yourself like you would treat a friend, imagine if you were with somebody and they said something just kind of off the cuff, and your response was, "Well, you're an idiot. Like, what a stupid thing to say." Or, "There you go again, making a fool of yourself," those kinds of things that people are so comfortable saying to themselves, thinking to themselves, that if they were being said out loud to a friend, they would never tolerate that. Lydia Lombardi Good: That's right. That's right. That's exactly right. Why is that okay to do to ourselves? Dr. Bob: Yeah. It's not, but we do it, and we keep doing it. And I think we just believe that this is the way that it is. People become so accustomed, and I think it deflates you just like if you have a teacher who's always telling you how stupid you are, or a parent who's always telling you how disobedient you are, or sloppy, or whatever. That has an impact, and it will keep us from really feeling the depth of I guess the beauty and the magic of life. Lydia Lombardi Good: Yes. And it holds you back from that experience that you deserve to grief. And sometimes that sounds really strange when I say that to people, the love you had for that person needs to be expressed through your grieving process. Someone told me years ago grief is the twin of love. You can't have one without the other. So, why are we suppressing this grief expression if it's simply an expression of our love? And whatever that grief presentation looks like. For some it's crying, for some it's sharing stories with family, or memories, or whatever that looks like, memorializing, ritualizing the person. But you're entitled to that experience. That's how we're able to move forward. But when you don't allow that experience to yourself, it's still there; it's still going to be there. A lot of people will say time heals everything. It's actually time and attention. Time alone doesn't do a thing if we're not giving it the attention that it needs to do the healing that we deserve. Dr. Bob: Time can actually just cause more festering and the wounds to deepen. Lydia Lombardi Good: Right. Dr. Bob: Yeah, if you think about it kind of like an infection in your system, yes, there are some self-limited infections that will get better over time, but there are some that if they're not addressed, if you're not aware of them, and deal with them, they'll eventually cause incredible suffering and ultimately kill you. Lydia Lombardi Good: Exactly. Exactly. I use that wound example a lot. Dr. Bob: Yeah. Interesting. And one of the other things that came up, and I'm sure that this is something that's very much in your awareness and in some of what you teach, is the concept of the gap, the space, that most people just remain unaware of. So we go back to awareness. And I think it was Victor Frankl who originally made this quote. I actually saw it in one of Steven Covey's books, but it's a quote about between stimulus and response, there is a gap, there's a space. And it's within that space that our freedom and our power come from. And the fact that we have that space to choose what to do with, how to respond, if we're going to respond, what to do with that stimulus, that feeling that came, the words that someone spoke, if we recognize that we have this power, everybody has this power to take a space, take some time, and choose what to do with it, it is too incredibly empowering. Most of us are just reacting all the time without giving any honor to that space. Lydia Lombardi Good: You're right, you're right, and that space is where all the magic happens ... Dr. Bob: That's where all the magic happens. Lydia Lombardi Good: ... where physiologically we can settle our nervous system, we can move into a more parasympathetic nervous system and really think critically, shift those thoughts to a different part of the brain and be more skillful in our actions, exactly. Dr. Bob: Yeah. Lydia Lombardi Good: And maybe that just means that we still don't know what to do, and maybe skillful means stepping away and just taking a break and thinking more about what to do next, instead of jumping right in and just making a reactionary decision that could actually lead to more harm. Dr. Bob: Right. Yeah. That awareness, and it's something that I've tried to teach with my children, with others, and of course I forget. I still at times react ... Lydia Lombardi Good: Sure. Dr. Bob: ... and then when I realize that I've given up my power, I'm giving up my power to choose a response, then I actually exaggerate it, where I start ... I'll give it a full two or three seconds, when somebody says something, rather than having an immediate response prepared and going right into it, I will exaggerate the space. And sometimes it can almost be a little awkward. People wonder what you're doing and why you're not answering, but it just kind of reminds me and allows me to feel empowered and to feel a sense of peace and control again. That's a really great exercise. Lydia Lombardi Good: Absolutely. Absolutely. We're not used to that in our culture. You're very right. We always feel like we need to fill the space. And I think that's a big part of the problem too; even when we're consoling a person who's grieving, we have a hard time just sitting with their raw emotion or the feeling, or just saying nothing and just being present to their experience. We have a hard time with that. We feel like we have to say the right thing, or jump in and fix it, or push the tissue box to them real quick, to make sure their tears don't get out of control. We can be messy and just sit with snout rolling down our face. Just say it's okay. This is what's happening right now; it's okay. We don't have to fix it; we don't have to talk over it and make it pretty, put a bow on it. Dr. Bob: That's one of the things that's been such a gift for me, working with people, especially at end of life, people who are approaching the last days or weeks of life, is I get to visit them in their homes and spend time with the patient, the family, the person. And sometimes I will just be there. The conversation will stop, and as you say, so many people want just to fill the... it's uncomfortable, so they just want to fill it and find something to say, and think that that's going to make it better. But what I'm recognizing is, people will want to know that you're comfortable just being present, and just holding that space, maybe holding their hand, having a head on the shoulder, or just being in that space so you can feel what it is that's happening, and maybe reflect back just some concerns, some love and support. As an ER doc, for the 20+ years, I was an ER doc, you don't have much time to do that. But now being in people's own home, it has been such a gift. And it's a gift for me, and I think it's a gift for them to know that there's a certain comfort with just being present. Lydia Lombardi Good: Yeah. Yeah. Absolutely. And it's so humbling for you as the individual, to just allow yourself that humility to know that you don't have the right answer. And people really respect that I find. They can tell when you're just trying to fill the space, or trying to fix it. But when you have enough humility just to say, "You know what? God, I don't have the answer to this. Maybe there isn't an answer to this." Dr. Bob: Right. So let's just be together for a moment. Lydia Lombardi Good: I'll just be here. Dr. Bob: Yeah. Let's just be. Lydia Lombardi Good: Yeah. Dr. Bob: Yeah. That's powerful. Lydia Lombardi Good: Yeah. I'll tell you just a quick story. My husband died in November, and a month after I was [inaudible 00:25:17] mother and it was Christmas night. And my neighbor comes. This is a neighbor who I grew up on that street with for my whole life, and he had a son who had died. I think five years prior, in a really tragic accident. And he showed up at the door, and I open the door, and I said, "Paul, what are you doing here?" And he opens his arms, and he said, "There are no words. There are no words." He says, "I just came here to give you a hug." And every time I tell this story I get teary-eyed again because I just think, I'll never forget that. I'll never forget that. Tons of people told me all sorts of stuff, but that simple act of just, listen, I'm just here to give you a hug and to hold you. I don't have answers; I don't have anything to tell you what to do or not to do. I just want to be here, was so profound and I'll never forget that. I try to remember that very clearly, to remember of my own action, how to be with others, how important that was. We forget. We forget the importance of that simplicity, that human connection. We're looking for the next intervention. Dr. Bob: Yeah. And that goes back to a little bit of that self-talk. It's like, "I don't know enough words. I can't be consoling or comforting. My presence isn't ... that's just not enough." So it's complex, and I think it takes time for someone to learn this too. It's not innate. For some people maybe it is, but for most of us, it's learned over time. And sometimes it's through those personal experiences as well. Lydia Lombardi Good: Right. Right. And what we do know is that actually the more we practice it, it actually can restructure parts of our limbic system in our brain and help us ... it's like building a muscle. The more we practice, the better we get at it. Or we're making new neural connections, and over time it becomes easier to tap into. But you're right. It takes time. It's a skill. It's a skill. Dr. Bob: It's an interesting thing. I was just realizing that some of what has changed for me, some of the learning that I've had through being with people in this state, in this condition, it spills over into other parts of your life, where I now feel more comfortable in other relationships with silence, with just being present and not always thinking that I have to fill the space with my wife, or with my children, that there's a deeper connection that can exist just by sharing a space together, which is interesting because a lot of time I'm someone who has kind of felt like if we're together, we should be talking. Like, we should be communicating about something in some way, and if not, then it's because we don't have anything to say. Lydia Lombardi Good: Right. Right. Dr. Bob: So I'd become much more comfortable, which is nice. Lydia Lombardi Good: Yes. Yeah. It's so beautiful that when we get better at this in our work, it does spill over and makes all of our relationships and experiences, as I said in the beginning, so much richer. Yeah. Dr. Bob: So you're in San Diego, right? Or in San Diego County. Do you have an office where people come to see you? Or do you go- Lydia Lombardi: Yes. Dr. Bob: ... see people at home? How does your practice work? Lydia Lombardi Good: I have a practice in Vista, North County San Diego, Pier View Counseling. Pier like the pier in the ocean. And I specialize in supporting people who are experiencing grief, trauma. And my subspecialty is really working with partner loss. But all ages. I actually have a group as well in Vista, at Vista Library, the second Saturday of every month. It's a grief support group. Anyone's welcome to come. We've been going on for about almost three years now, and people come and go and use the space as needed, and it's a really nice complement to some of the individual work I do, where people either who just aren't interested in individual work right now, or just looking for others who are going through a same life transition they are and are just, again, wanting to tap into that common humanity, which is part of that self-compassion piece, knowing others are experiencing what you're experiencing too, although it looks a little different, we're all going through something. So yes. People come to me at my practice. And I do some Saturday hours at another office in Oceanside, but mostly Vista. Dr. Bob: All right. Great. And I'm assuming that you have some resources for people on your website, that can help them get a little more information about you, and a little bit about some of the topics that we've been covering? Lydia Lombardi Good: Yes. PierViewCounseling.com. Dr. Bob: We'll have links for that on the podcast as well, integratedmdcare.com. So there are lots of ways for people to find you, which is wonderful. Lydia Lombardi Good: Great. Dr. Bob: I have a feeling, now that we've had a chance to connect, for me to learn more about your background and how you approach things, I certainly feel that there will be opportunities for us to collaborate with some of the patients and families that we're supporting as well. Lydia Lombardi Good: Well, I'd be honored. Dr. Bob: Yeah. I look forward to that. I really, really appreciate you taking the time and sharing some of your experience and your wisdom with our listeners, and I'm hopeful that maybe there will be another opportunity to bring you back on and revisit some of this in the future. Lydia Lombardi: Thank you. And thank you for everything you do. So important. I could say that from working in the field, but then when you actually have it, when my dad was dying, having that experience in our home, it changed everything. I saw it from a whole another light, how critical that support is when a family member is dying. So thank you for what you do. Dr. Bob: It's my honor, and I imagine having you there for your father who was an incredible gift for him. So he was very fortunate in that. Lydia Lombardi Good: Yeah. Grateful. Dr. Bob: Yeah. Thanks, everybody for tuning in, and we'll talk with you very soon. Have a great day.