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Dr. Saltzman:

I recently experienced the loss of my mother. She was ill for a long time, but the living will didn't quite cover the situation we were in and I'm not certain she would have wished to stop all sustenance at that time. Worse, when her body was shutting down, a physician mentioned that he could have given her a medication that would have helped, but it was now too late. I felt (and feel) a lot of guilt along with my sadness.

My question, however, has to do with how I now sometimes find that I am splitting my emotions from actions, or feel like I'm acting "outside" of myself. At times I find myself crying deeply, but experiencing it in slow motion. For example, a memory might hit me while I'm walking the dog. Tears begin pouring from my eyes and my emotions seem to overcome me, and yet if the dog pulls the leash, I immediately respond correctly, speaking to her in a completely calm, normal, day-to-day cheerful voice and telling her to come or sit or whatever. It almost feels like I've momentarily split in two and the crying, grieving self is watching (in an auditory sense - not visually) - in slow motion - while the normal, cheerful self is handling the situation rationally. A few minutes later I am usually more-or-less ok, although I feel depleted.

Do you know what is going on? I'm hoping it's just temporary but I'd like to know if that's a pretty normal reaction to grief. I am taking 10 mg Lexapro (and have been for several years) and I'm wondering if this is causing the "splitting" sensation.

Thank you so much for your help and your time. I really appreciate any insights you can share.


Dear Linda--

I do not think that the Lexapro has much to do with this. Actually, what you experience as being split in two seems to me to be a rather healthy reaction to life's ups and downs. In other words, having an internal "watcher" which is not emotionally involved to the same extent as the rest of the ordinary personality probably indicates that you not completely wrapped up in your emotions, and, in my opinion, is a sign of strength, not a problem. In fact, being the watcher, a simple witness to what is happening, without judging it, resisting it, or trying to change it, often is recommended as a beginning spiritual practice, as I have discussed in reply to another ask the psychologist letter.

Now I imagine that something in you feels slightly guilty about not grieving totally and continuously, and perhaps that guilt just compounds the guilt which you already feel for having signed off on the final stages of your mother's departure. But in my view all of that guilt, while understandable, is not justified by events. You did nothing wrong, in my view, in trying to allow your mother to have as graceful an exit as possible under the circumstances, and your grief, I am sure, is real enough. But real grief does not mean that one grieves continuously. Feelings change from second to second, and that is perfectly OK. By the way, the physician who told you that he could have done something to help, but that now it was too, late should be ashamed of himself. What a cruel and useless remark!

As time passes, your grief, now so difficult to bear, will change into something valuable. It will not disappear entirely, but it will change, eventually becoming a deeper understanding of life--an appreciation both of the brevity of it, and of the opportunity that being alive provides us to participate, to learn, and to love.

Be well.

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page last modified May 5, 2007

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