The Grief You Know
By Gabriel Quaglia, Guest Contributor
To call my relationship with grief complicated is an understatement. The road to get where I am today was quite a twisty one. I lost a close friend as a teen to a car accident and shortly thereafter lost my first close friend to an overdose before I was 19.
Over the years, as I struggled with substance issues, many folks I loved dearly were taken by overdose, suicide, and other deaths of despair. Even when I attempted abstinence and straightened out my relationship with substances, those losses didn't get any easier. While mutual aid programs such as 12 Steps and Recovery Dharma brought many beautiful people into my life, I lost many of these new friends to the fentanyl epidemic and others who struggled with prohibited substances. The dissatisfaction with seeing people taken so quickly from me led me from a desire to work in addiction counseling to harm reduction. The pragmatic solutions I saw to the overdoses and other deaths of despair came from the harm-reduction community. I started volunteering at a syringe service program and ended up the Post Overdose Engagement Coordinator at my current employer.
I worried that the loss and grief would be hard to deal with in approaching these jobs, but I slowly found out I was wrong. The fact that I had lost so many coupled with my work in recovery programs, therapy, and my practice of Buddhism (with its focus on impermanence) made me feel better equipped to deal with loss.
As I predicted, I could see normal grief coming, and I could deal with that, but another kind of grief I wasn't aware of began to bother me. In my work as a counselor, I get to know many people, and some are the most marginalized in our society. These people might be chronically homeless, jobless, have no family or contact with their family, or carry any identification. Providing these people with low-barrier access to whatever services I can offer and doing whatever I can to facilitate or even insist on access to other services for them brings me great joy.
The issue is that sometimes people just disappear. People I saw daily would stop coming around, and other staff and participants would notice and start asking questions even if I didn't.
The idea that grief was not just about a known death really began to crystallize for me when one of my co-workers found a person who had died while on outreach during the winter several years back. The police asked us some questions but we are an anonymous program and did not divulge any details. We couldn’t even provide much information about most people we work with, even if we wanted to.
When the police mentioned another body that had been found elsewhere recently, that made me realize that people were likely passing away, and I just didn't know. There was nothing in the news about either of those people who had been found dead. I don't know if their families had been told or not, but my brain began to assume the worst if I didn't see someone for a while. My inclination now was to assume everyone I hadn't seen in a while had died alone, found somewhere, and buried with no one marking their death other than a few bureaucrats. There was now just a hole and an ache in the community that might never be recognized.
Being cognizant of what was going on with this grief at least allowed me to discuss it and deal with it. I realized grief isn't just about death; it can be the loss of something tangible or intangible, and the most intense grief can sometimes be over the intangibles. An example of this is a young woman I once worked with -- young enough to be my daughter. She seemed particularly withdrawn one day, but I didn't broach the subject as it seemed like she wasn't in the mood to talk about anything. She told me she didn’t want any alcohol pads or hand sanitizer that day. Making sure people have what they need to prevent life-threatening infection is one of the most important parts of our jobs. As a matter of course, I asked if she just had a lot going on at home. She gave me a very dejected look and said, “No. I just don’t give a shit anymore.”
I felt like I had been punched in the stomach. My breathing stopped, and my fight-or-flight response began to rise. I became aware that my body needed to DO SOMETHING, but I didn't have to give in to that need. To be honest, knowing that didn't make me feel any better; I still felt that compulsion. I told her that I did care about her well-being, but I could respect how she felt and try to understand it a little. I told her I was always there if she wanted to talk about anything and tried to leave it at that. We got through the rest of the encounter. Later I realized that my reaction was grief. I was grieving the loss of her will to take care of herself and was facing the fact that my impulse to “fix” things was likely to be unproductive. I believe that the fixing impulse would have quite likely backfired and hurt our relationship. It could have made her doubt my agency's ability to treat people expressing their complicated feelings with respect and fear that any attempt at opening up would be met with a response of paternalistic control. That would only meet my needs, not hers. I am happy to say her mood improved over the following days, but I have no idea where she is today. Similar situations continue to emerge in my work, and I struggle to recognize and address them, but now, at least, I am aware of them.
While my personal workaround impermanence and loss undoubtedly helped, there was so much more to grief than people dying. I grieved people’s loss of will to live, the co-worker who moved to a new job, relationships that went from cordial to cold. Or even the loss of something as simple as a breakroom.
My message here is to encourage others who work in harm reduction (and beyond) to open up their awareness around this. My workaround death-related loss served me well in the simplest term; I was quite unprepared to deal with these complicated and even simple unconventional losses. Having a better understanding of grieving all losses, both visible and invisible, is a critical tool that is helpful to me in my work and the people I work with and for.
Note: This is a link to a text that has helped me recognize and deal with these issues around grief: When Grief Comes To Work