Beyond the Cancer Diagnosis: Dialogue with Sue Morris, by Adrian Pogacian

In this edition of “Beyond the Cancer Diagnosis”, Adrian Pogacian interviews clinical psychologist Sue Morris on coping with grief and loss. Morris shares insights into the emotional waves of grief, practical coping strategies, and the importance of a “toolbox” approach, including routines, self-care, and social support. She also discusses the role of E-health tools in navigating bereavement, highlighting that coping is a deeply personal journey.

Sue Morris, PsyD, is a Senior Psychologist and Director of Bereavement Services at Dana-Farber Cancer Institute in Boston. She is also a member of Robert’s Program on Sudden Unexpected Death in Pediatrics at Boston Children’s Hospital. Dr. Morris studied Clinical Psychology specializing in adult mental health and cognitive behavior therapy.

She has worked in bereavement for the past 25 years in both Sydney and Boston and is the author of Overcoming Grief and An Introduction to Coping with Grief, published in London by Robinson.

Dr. Morris also lectures on the topic of bereavement for the Harvard Medical School Center for Palliative Care continuing medical education courses and teaches medical students, residents and fellows about grief and loss. She currently holds the position of Assistant Professor in Psychiatry at Harvard Medical School.

Adrian Pogacian, MS Psychology, clinical psychologist with executive education in Psycho-oncology, holding a degree in Global Health Diplomacy from Geneva Graduate Institute. Currently, researcher and associate lecturer with focus on Impact of Cancer Diagnosis on Couples and Families, Communication in Cancer Care and Posttraumatic Growth. His expertise is on Coping with Cancer and managing Fear of Recurrence.

Additionally, Founder of INCKA Psycho-oncology Center, Host of Beyond the Cancer Diagnosis Interview Series as well as Writer and Host Content in Psycho-oncology at OncoDaily.com, co-author of the first Romanian Multimodal Care Guideline in Pediatric Onco-hematology, active contributor to the International Psycho-oncology Society, presently IPOS Fear of Cancer Recurrence SIG member and IPOS Early Career Professionals in Psycho-Oncology Committee founder member.

Coping with Grief

Adrian Pogacian: Dr. Sue Morris, for the beginning of our discussion, I would like to ask you: what is coping?

Sue Morris: I consider the word ‘coping’ to refer to the way in which we manage or tackle the difficulties that arise in life given the specific circumstances we are facing, such as being diagnosed with cancer or following the death of a loved one. From a psychological perspective, ‘coping’ typically includes both cognitive and behavioral strategies to help manage these demands. It can be helpful to think of a ‘toolbox’ approach where you use different ‘tools’ or strategies to cope with the issues at hand, which may change over time. With respect to coping with grief, ‘coping’ usually involves navigating the many changes that arise following the death of a loved one.

Adrian Pogacian: Grief is a natural reaction to loss and a very personal feeling, but also a process. What are the stages when somebody is grieving?

Sue Morris: Grief is typically an extremely painful yet normal response to loss. Many people wrongly assume that grief will be linear – that each day they will get ‘better and better’, or that grief follows set stages, including denial, anger and depression. Both models are inaccurate and can set unrealistic expectations about progress.

Instead, grief tends to follow a wave-like pattern, where the waves are characterized by intense sadness and a yearning or longing to be with the deceased person again. For most people, the intensity and frequency of the waves ease over time, even though larger waves can hit at different times, sometimes ‘out of the blue’, months or even years later.

Adrian Pogacian: Therefore, I would like to ask you what is a person’s emotional reaction to grief?

Sue Morris: There can be many different emotional reactions to the death of a loved one, including yearning or longing, intense or profound sadness, shock, disbelief, guilt, worry, anxiety, anger and feelings of emptiness. Yearning tends to be the emotional reaction that characterizes grief. When someone significant in your life dies, you long to see or be with them again. Yearning or longing is a very painful reaction and is something we can’t just switch off. Over time it tends to ease as people adjust to the physical absence of their loved one.

Adrian Pogacian: Consequently, could you share for our audience the main practical coping strategies in dealing with loss?

Sue Morris: In the early months of bereavement, the main practical coping strategies tend to fall into three categories – the 3 S’s as I call them. 1. Structure and routine; 2. Self-care, and 3. Social connections.

Structure and routine

If someone you love has recently died, try to establish a simple daily routine early on. Start by aiming to get out of bed at the same time each day, take a shower and have breakfast. Having a routine provides structure to your day. Even though you might not feel like doing anything, starting with these three steps can help get you get on track for the day. You can add more things to your daily routine as you go, which in turn can help you feel a little more in control.

Self-care

Given how stressful grief can be, it is essential to pay attention to your self-care, especially in the early weeks and months of your bereavement. Some ideas include making an appointment with your local doctor, catching up on medical appointments, spending time outdoors, exercising, having a massage or practicing meditation. I encourage people to also make time for their hobbies that previously they enjoyed.

Social connections

Grief is often a very isolating experience so connecting with people whose company you normally enjoy, is important when grief is new. I encourage people to accept invitations from their family and friends, even if you only stay for a short time. A good rule of thumb is to start with small groups of people and build up slowly.

Adrian Pogacian: In addition, what is your advice for dealing with, so called, ”the first anniversary”?

Sue Morris: The ‘first anniversary’ of a loved one’s death can be a very difficult day and tends to correspond with larger waves on the ‘wave of grief’. Most people tend to anticipate the day in the weeks and months prior, and can be worried about how they will cope.

I always encourage my bereaved clients to make a plan for the day – how would they like to acknowledge the day? Where might they want to go? Who might they want to be with? Is there something special they can do to honor their loved one?  Finding ways to reminisce with others about their loved one can also be very helpful.

Adrian Pogacian: There is nothing worse than when you lose someone. Hence, what are the factors that influence the way a person cope after the death of loved one?

Sue Morris: Everyone grieves in their own way and how someone copes following the death of a loved one depends on their personality, the circumstances of the death, whether they have a past history of a mental health disorder, such as depression or substance use, and how they tend to manage other difficulties in their life. It’s important to be aware of these factors and seek help and support from others, especially if you feel lonely and are isolated.

Adrian Pogacian: As for the last question, what is your opinion about the utilization of E-health instruments when dealing with grief and loss?

Sue Morris: I think recently bereaved individuals should seek help from a range of options – a ‘toolbox’ of different strategies. E-health instruments or apps can be part of this toolbox. Typically, support can be found in many places and might include family, friends, a local doctor, a counselor, bereavement support groups, a faith or religious community, self-help books, and E—health apps or online support. In a way, E-health apps are a modern-day version of a self-help book.

That said, I would encourage people to read reviews so they have a good sense of what to expect before they subscribe and consider whether the apps are offered by clinicians or lay people. If, however, you are really struggling following the death of a loved one, seek professional help by making an appointment with your doctor or counselor.

Previous editions of “Beyond The Cancer Diagnosis”

Edition 1: Beyond The Cancer Diagnosis: Psycho-Oncological Aspects Of Kate Middleton’s Diagnosis

Edition 2: Beyond The Cancer Diagnosis with Sonia Amin Thomas – Survivorship

Edition 3: Beyond The Cancer Diagnosis: Dialogue with Wendy Lam, Hosted By Adrian Pogacian

Edition 4: Beyond The Cancer Diagnosis: Dialogue with Camille Moses, Hosted By Adrian Pogacian

Edition 5: Beyond The Cancer Diagnosis: Dialogue with Tihana Gašpert, Hosted By Adrian Pogacian

Edition 6: Beyond The Cancer Diagnosis: Dialogue with Amanda Balakirsky, Hosted By Adrian Pogacian

Edition 7: Beyond The Cancer Diagnosis: Dialogue with Dr. William Breitbart, Hosted By Adrian Pogacian

Edition 8: Beyond The Cancer Diagnosis: Dialogue with Dr. Alberto Costa, Hosted by Adrian Pogacian

Edition 9: Beyond the Cancer Diagnosis: Dialogue with Prof. Sophie Lebel, Hosted by Adrian Pogacian

Edition 10: Beyond the Cancer Diagnosis: Dialogue with Darren Haywood, hosted by Adrian Pogacian

Edition 11: Beyond the Cancer Diagnosis: Dialogue with Sarah, Hosted by Adrian Pogacian

Edition 12: Beyond the Cancer Diagnosis: Dialogue with Taryn Greene, Hosted by Adrian Pogacian

Edition 13: Beyond the Cancer Diagnosis: Dialogue with Maryam Lustberg, by Adrian Pogacian

Edition 14: Beyond the Cancer Diagnosis: Dialogue with Carmen Uscatu, by Adrian Pogacian

Edition 15: Beyond the Cancer Diagnosis: Dialogue with Alique Topalian, Hosted by Adrian Pogacian