Why am I so Tired? an article

https://parasolwellness.com/why-am-i-so-tired/?

Caring Community on CASC website

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Grief is the Response to loss of something meaningful - from the Centre for Complicated Grief

From the following article:
https://complicatedgrief.columbia.edu/professionals/complicated-grief-professionals/overview/

"Grief is the response to loss of something meaningful Grief is the natural response to losing a loved one. Most people don’t need grief therapists, even when the loss is sudden and unexpected and very, very sad. People have natural ways of adapting to attachment loss, usually with the support of friends and relatives, and everyone does it in their own way. You can think of healing after loss as analogous to healing after a physical wound. The loss, like the injury, triggers a pain response which can be very strong. Injuries also activate a healing process. Loss does too. However, a wound complication, like an infection, can interfere with healing. So, too, maladaptive thoughts, dysfunctional behaviors or inadequate emotion regulation can interfere with adaptation to loss.

CG is not less likely after loss of a rewarding relationship Mental health training does not usually include learning about the syndrome of complicated grief. However, trainees often are taught that grief is complicated if there was an ambivalent relationship to the person who died. This is a misconception. Adapting to a loss is more difficult if a person can imagine how things could have been different. People might do this because the relationship was conflictual. However, this is uncommon. Most people with complicated grief have had an especially strong and rewarding relationship to the person who died.

Key definitions
 Grief is the response to loss that contains thoughts, behaviors, emotions and physiological changed; if the loss is permanent, so too is the grief, but its form evolves and changes as a person adapts to the loss

Acute grief occurs in the early period after a loss and often dominates the life of a bereaved person; strong feelings of yearning, longing and sorrow are typical as are insistent thoughts and memories of the person who died. Other painful emotions, including anxiety, anger, remorse, guilt or shame are also common. Activities are often focused on doing or not doing things to try to deal with the loss.

Integrated grief is the lasting form of grief in which loss-related thoughts, feelings and behaviors are integrated into a bereaved person’s ongoing functioning; grief has a place in the person’s life without dominating.

Complicated grief is a persistent form of intense grief in which maladaptive thoughts and dysfunctional behaviors are present along with continued yearning, longing and sadness and/or preoccupation with thoughts and memories of the person who died. Grief continues to dominate life and the future seems bleak and empty. Irrational thoughts that the deceased person might reappear are common and the bereaved person feels lost and alone.

Adapting to loss entails accepting the reality of the death, including its finality, consequences and changed relationship to the person who died; adapting means seeing the future as holding possibilities for a life with purpose and meaning, joy and satisfaction.

 Examples of Grief “Complications”

Maladaptive thoughts are typically counterfactual, grief-focused or catastrophizing; its natural to second guess a loved one’s death, especially if it was sudden, unexpected or untimely; most people worry about whether they are grieving in “the right way” and many dread the future in a world without their deceased loved one. People with complicated grief ruminate over these kinds of thoughts.

Dysfunctional behaviors are typically related to avoiding reminders of the loss and/or escaping from the painful reality. A bereaved person may try to feel close to the person who died through sensory stimulation and day dreaming about being with them – looking at pictures, listening to their voice, smelling their clothes, trying to recall what it was like to be together. Bereaved people are often inclined to avoid places, people or activities that hold reminders of the person who died. These behaviors are problematic when they become the only way of managing painful emotions.

Inadequate emotion regulation is another common problem for people with complicated grief. Acute grief is typically highly emotional. Most people have a range of ways to regulate these emotions. They balance the pain with periods of respite, giving themselves permission to set the grief aside for a time. People with complicated grief have trouble doing this; instead, they often focus on things that increase emotional activation. Regular routines including adequate sleep, nourishing meals, adequate exercise and social contacts may be disrupted, making emotions more difficult to manage."

https://complicatedgrief.columbia.edu/professionals/complicated-grief-professionals/overview/

Ethical Framework in a time of pandemic

https://www.professionalchaplains.org/Files/resources/An%20ethical%20framework%20for%20pandemic%20-%20for%20Chaplains.pdf

Sample Script- Supporting Healthcare Workers during COVID19

I cut all of this information out of the patient script and have copied it into its own script ideas for use when supporting healthcare workers either by phone or in-person:


Specific Responses to Specific Concerns During COVID19:

(Adapted from the resource found at file:///C:/Users/Dell%20User/Documents/Spiritual%20Care%20Education/Telehealth%20Chaplaincy/VitalTalk-COVID19.html /  It is a free resource that can be downloaded and you may wish to review the whole document.)

When coping needs a boost, or emotions are running high

What they say	What you say
I’m scared.	This is such a tough situation. I think anyone would be scared. Could you share more with me?
I need some hope.	Tell me about the things you are hoping for? I want to understand more.
Nobody cares about us. You people are incompetent!	I can see why you are not happy with things. I am willing to do what is in my power to improve things for you. What could I do that would help?
I want to talk to your boss.	I can see you are frustrated. I will ask my boss to come by as soon as they can. Please realize that they are juggling many things right now.
Do I need to say my goodbyes?	I’m hoping that’s not the case. And I worry time could indeed be short. What is most pressing on your mind?

Anticipating

When you’re worrying about what might happen (or when you’re supporting a healthcare provider who is worried about something that might happen)

What you fear	What you can do
That patient’s son is going to be very angry.	Before you go in the room, take a moment for one deep breath. What’s the anger about? Love, responsibility, fear?
I don’t know how to help this family understand why their loved one isn’t being transferred to the ICU like they want/expect.	Remember what you can do: you can hear what she’s concerned about, you can explain what’s happening, you can help her prepare, you can be present. These are gifts.
I am afraid of burnout, and of losing my heart.	Can you look for moments every day where you connect with someone, share something, enjoy something? It is possible to find little pockets of peace even in the middle of a maelstrom.
I’m worried that I will be overwhelmed and that I won’t be able to do what is really the best for my patients.	Check your own state of being, even if you only have a moment. If one extreme is “wiped out,” and the other is “feeling strong,” where am I now? Remember that whatever your own state, that these feelings are inextricable to our human condition. Can you accept them, not try to push them away, and then decide what you need

Grieving

Supporting Healthcare Workers Who are Grieving Over the Limitations Imposed on Them by COVID19

What they are saying or thinking	What you can do
I should have been able to do more to support that person.	Notice: am I talking to myself the way I would talk to a good friend? Could I step back and just feel? Maybe it’s sadness, or frustration, or just fatigue. Those feelings are normal. And these times are distinctly abnormal.
OMG I cannot believe we don’t have the right equipment / how mean that person was to me / how everything I do seems like its blowing up	Notice:  am I letting everything get to me? Is all this analyzing really about something else? Like how sad this is, how powerless I feel, how puny our efforts look? Under these conditions, such thoughts are to be expected. But we don’t have to let them suck us under. Can we notice them, and feel them, maybe share them? And then ask ourselves: can I step into a less reactive, more balanced place even as I move into the next thing?

4-Square Breathing

Box breathing, also known as four-square breathing, involves exhaling to a count of four, holding your lungs empty for a four-count, inhaling at the same pace, and holding air in your lungs for a count of four before exhaling and beginning the pattern anew.

"Hope, Gratitude and Solidarity: A Message to Canadians from Religious Leaders in Canada in Response to the COVID-19 Pandemic"

"Canadians are experiencing the devastating impact of COVID-19 in what has become a rapidly evolving crisis. Understandably,this crisis has brought about feelings of anxiety, apprehension and fear. Critical elements of our daily lives are being thrown into uncertainty: health, employment, financial security, recreational activities, as well as our ability to gather as worshiping communities. In view of these difficulties, we as religious leaders wish to bring forward a message of hope, gratitude and solidarity to all people who call Canada home.

A Message of Hope We draw hope from a variety of sources: from our religious beliefs, the love of our families, the rela- tionships with friends and the work we do. Each of these, and others as well, provides rays of hope to our daily lives. Likewise, hope provides cour- age to face the burdens we bear and the ability to look onwards toward the dawning of a new day. In spite of present sufferings, which can seem overwhelming at times, the flames of hope cannot be extinguished. Love, which gives life its fullest meaning, continues to seek out the common good in spite of individual difficulties. Acts of kindness can bring us closer in spirit, despite the require- ments of physical distancing. Let us witness hope to each other and so become beacons of light dur- ing these uncertain times. Canada has gone through several difficult and painful experiences in its history. When current and former generations have responded to these challenges, many were empowered by unwaver- ing hope as well as human and spiritual resilience. For religious believers, this hope takes on a special We draw hope from a variety of sources: from our religious beliefs, the love of our families, the relationships with friends and the work we do. Each of these, and others as well, provides rays of hope to our daily lives. and unique dimension. It assures us of the caring embrace of the Creator, a sacred relationship sus- tained by prayer, and which flows into our human relationships whereby we care for one another and bear each other’s burden. Yet, hope brings for everyone a promise of renewal, even in the midst of human suffering. Hope assures us that this affliction too shall pass.

A Message of Gratitude During this time of crisis, we as religious leaders wish to offer words of appreciation and grati- tude. Health care professionals are providing unfailing and dedicated service under stressful and difficult circumstances. They provide for us a powerful witness of care, expertise and service in the midst of the COVID-19 pandemic. There is also the increased risk of exposure to infec- tion along with other hardships being experi- enced by so many others. For instance, while the rest of society rightly heeds the precautions of physical distancing, many remain at work in grocery stores, pharmacies and factories. Students, the middle-aged, and those close to retirement are fulfilling a variety of essential front-line jobs in the supply chain, ensuring that stores remain open, shelves remain stocked, and goods are delivered so that others can have food, medicines and other essentials for their families and communities. We express a deep appreciation and gratitude for these workers. As religious leaders, we raise our collective voices to highlight the necessity for greater attention to the needs of the homeless, the incarcerated, the elderly and those already suffering from social isolation. Governments across Canada as well as religious leaders are bearing particularly heavy burdens in steering our communities through this calamity. It is comforting to see that in such demanding times, political differences are being set aside to serve the common good. This too is a witness of hope for Canadians. For all these acts of generos- ity and dedication, let us add our expressions of gratitude for the important work of the diverse leaders of our country. A Message of Solidarity We urge all people in Canada to listen and follow attentively the directions of our public health officials and government leaders. We, as religious leaders, pledge to lead by example. We all must act together in confronting this virus. While everyone is vulnerable during this crisis, let us not forget those in our society who, prior to COVID-19, were already vulnerable to health and social ailments. As religious leaders, we raise our collective voices to highlight the necessity for greater attention to the needs of

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Hope, Gratitude
and Solidarity

the homeless, the incarcerated, the elderly and those already suffering from social isolation.
We remember too those people, especially women and children who face abuse and violence, who are not safe at home and may suffer additional abuse and violence as stress increases. We must never overlook or exclude these groups from our plan- ning, preparedness and response to this pandemic. We are particularly mindful of First Nations,
Métis and Inuit communities, including isolated Northern communities, who were already facing pre-existing challenges and for whom the COVID- 19 outbreak could prove singularly devastating. Likewise, we need to remember the needs and vulnerabilities of the many refugees and migrant workers who have come to Canada seeking safety and security.
Charitable organizations in Canada will face greater challenges during this time of crisis and will need greater assistance from governments so as to continue their vital work. This is a time for human solidarity. We all need to pull together. It is essential to carry out the practical requirements to limit the spread of this virus. It is also important to maintain a posture of attentive caring towards our

This is a time for human solidarity.
We all need to pull together.
neighbour. This includes care and solidarity for the global community who face this crisis with far fewer resources than those accessible to Canada. This is a time for us to draw closer to God.
Religion and spirituality can indeed contribute to building people up, to providing a sense of meaning, inner strength, new horizons and openness of hearts. As religious leaders, we wish to emphasize, especially in times like these, the power and importance of prayer. We earnestly pray for healing, for the continued efforts to relieve human suffering, and for perseverance throughout these challenging times. As history records these moments for our country’s future,

let us pray that, in the face of COVID-19, we respond with an abundance of hope, gratitude and solidarity, trusting in the loving and ever merciful God, the source of all hope. 

Let us pray that, in the face of COVID-19, we respond with an abundance of hope, gratitude and solidarity, trusting in the loving and ever merciful
God, the source of all hope"

Signed, Religious Leaders Rev. Kenesha Blake-Newell Rev. Kenesha Blake-Newell Itinerant Elder (Grant AME) African Methodist Episcopal Church Farhan Iqbal Farhan Iqbal Missionary Ahmadiyya Muslim Jama’at Canada Rev. Shane B. Janzen Rev. Shane B. Janzen Archbishop The Anglican Catholic Church of Canada The Most Rev. Linda Nicholls The Most Rev. Linda Nicholls Archbishop and Primate The Anglican Church of Canada Rev. Fr. John Benjamin Vic Paradero, OMHS Rev. Fr. Jose Mark John Jamili, OMHS Kevin Schular Kevin Schular Executive Director Baptist General Conference of Canada Charles Mashinter Charles Mashinter Executive Director Be In Christ Church – Canada Lee Nicholas-Pattillo Lee Nicholas-Pattillo President Canadian Association for Baptist Freedoms MGen Guy J.J. Chapdelaine, OMM, CD, QHC MGen Guy J.J. Chapdelaine, OMM, CD, QHC Chaplain General Canadian Armed Forces Rev. Dr. Terry G. Smith Rev. Dr. Terry G. Smith Executive Director Canadian Baptist Ministries Dr. Peter Reid Dr. Peter Reid Executive Minister Canadian Baptists of Atlantic Canada Rev. Tim McCoy Rev. Tim McCoy Executive Minister Canadian Baptists of Ontario and Quebec Rev. Rob Ogilvie Rev. Rob Ogilvie Executive Minister Canadian Baptists of Western Canada Rev. Fr. John Benjamin Vic Paradero, OMHS Rev. Fr. Jose Mark John Jamili, OMHS Apostolic Catholic Church of Canada Rev. Wesley E. Mills Rev. Wesley E. Mills President Apostolic Church of Pentecost of Canada, Inc. His Grace Bishop Abgar Hovakimyan His Grace Bishop Abgar Hovakimyan Primate Armenian Holy Apostolic Church Diocese of Canada Mobeen Khaja, O Ont. Mobeen Khaja, O Ont. President Association of Progressive Muslims of Canada

Religious Leaders (continued) Dr. Adriana Bara Dr. Adriana Bara Executive Director Canadian Centre for Ecumenism +Richard Gagnon +Richard Gagnon Archbishop of Winnipeg, President Canadian Conference of Catholic Bishops Elton Da Silva Elton Da Silva Zul Kassamali Aileen Van Ginkel Zul Kassamali, Co-chair Aileen Van Ginkel, Co-chair Canadian Interfaith Conversation Rabbi Reuven Poupko Rabbi Baruch Friedman-Kohl Rabbi Debra Landsberg Rabbi Jonathan Infeld Rabbi Reuven Poupko Rabbi Baruch Friedman-Kohl Rabbi Debra Landsberg Rabbi Jonathan Infeld Co-chairs Canadian Rabbinic Caucus, an affiliate of the Centre for Israel and Jewish Affairs Beverly Shepard Beverly Shepard Presiding Clerk Canadian Yearly Meeting of the Religious Society of Friends (Quakers) Rev. Dr. David Hearn Rev. Dr. David Hearn President The Christian and Missionary Alliance in Canada Rev. Ann Stainton Rev. Ann Stainton Moderator Christian Church (Disciples of Christ) in Canada The Rev Dr. Darren Roorda The Rev Dr. Darren Roorda Canadian Ministries Director Christian Reformed Church in North America National Director Canadian Conference of Mennonite Brethren Churches Rev. Stephen Kendall, Pastor Peter Noteboom Rev. Stephen Kendall, President Pastor Peter Noteboom, General Secretary The Canadian Council of Churches Imam Mohamed Refaat Abo Onar Imam Mohamed Refaat Abo Onar President Canadian Council of Imams Nina Karachi-Khaled Nina Karachi-Khaled President of the National Board Canadian Council of Muslim Women Rev. David McGrew Rev. David McGrew National Director Canadian Fellowship of Churches and Ministers Pandit Roopnauth Sharma Pandit Roopnauth Sharma President Canadian Multifaith Federation

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Religious Leaders (continued) Michel J. Carter John N. Craig James E. Evanson Michael R. Murray Elder Michel J. Carter Elder John N. Craig Elder James E. Evanson Elder Michael R. Murray Area Seventies The Church of Jesus Christ of Latter-day Saints Rev. Dr. Ian Fitzpatrick Rev. Dr. Ian Fitzpatrick National Director Church of the Nazarene Canada Kerry Richards Kerry Richards President, Canada East Community of Christ Rabbi Reuven P. Bulka, CM, Ph.D Rabbi Reuven P. Bulka, CM, Ph.D Rabbi Emeritus and spiritual leader Congregation Machzikei Hadas, Ottawa Rev. Dr. David Schrader Rev. Dr. David Schrader National Pastor Congregational Christian Churches in Canada Netta Phillet Netta Phillet Coordinator Edmonton Interfaith Centre for Education & Action H.G. Anba Mina H.G. Anba Makar HG Abba Boulos H.G. Anba Mina Bishop Mississauga, Vancouver and Western Canada H.G. Anba Makar Bishop of Goshen, Egypt; Papal Vicar in the Archdiocese of Toronto H.G Abba Boulos Bishop of Ottawa, Montreal, and Eastern Canada The Coptic Orthodox Church in Canada L.K. (Rev. Fr.) Messale Engeda L.K. (Rev. Fr.) Messale Engeda Head priest and Administrator Ethiopian Orthodox Tewahedo Church of Canada Dr. David P. Lavigne Dr. David P. Lavigne Bishop The Evangelical Christian Church in Canada Bruce J. Clemenger Bruce J. Clemenger President The Evangelical Fellowship of Canada Dr. William Taylor Dr. William Taylor Executive Director Evangelical Free Church of Canada The Rev. Susan C. Johnson The Rev. Susan C. Johnson National Bishop Evangelical Lutheran Church in Canada

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Religious Leaders (continued) Tim Dyck Tim Dyck Executive Director Evangelical Mennonite Conference Rev. Steven F. Jones Rev. Steven F. Jones National President The Fellowship of Evangelical Baptist Churches in Canada Steve Falkiner Steve Falkiner President Foursquare Gospel Church of Canada Bill Hall Bill Hall President Grace Communion International Canada Philip Bryant Philip Bryant Executive Director Grace Fellowship Canada His Eminence Archbishop Sotirios His Eminence Archbishop Sotirios Greek Orthodox Archdiocese of Canada Pandit Roopnauth Sharma Pandit Roopnauth Sharma President Hindu Federation of Canada Rev. Paul McPhail Rev. Paul McPhail General Secretary Independent Assemblies of God International Canada Dr. Ronald A. Kuipers Dr. Ronald A. Kuipers President Institute for Christian Studies Halil Yurtsever Halil Yurtsever Intercultural Dialogue Institute Brian A. Hawes Brian A. Hawes President Interfaith Committee on Chaplaincy in the Correctional Service of Canada Imam Ilyas Sidyot Imam Ilyas Sidyot Grand Mosque of Saskatoon Islamic Association of Saskatchewan (Saskatoon) Inc. Jennifer Henry Jennifer Henry Executive Director KAIROS: Canadian Ecumenical Justice Initiatives Naj Mankal Naj Mankal President Islamic Centre of Southwest Ontario Imam Zubair Sidyot Imam Zubair Sidyot Lethbridge Muslim Association (Alberta) Belle Jarniewski Belle Jarniewski President Manitoba Multifaith Council

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Religious Leaders (continued) Rev. Dr. Isaac Mar Philoxenos Episcopa Rev. Dr. Isaac Mar Philoxenos Episcopa Bishop, Diocese of North America And Europe Mar Thoma Syrian Church Doug Klassen Doug Klassen Executive Minister Mennonite Church Canada Zul Kassamali Zul Kassamali President National Alliance for the Advancement of Pluralistic Society Muneeb Nasir Muneeb Nasir Co-Chair National Muslim Christian Liaison Committee His Eminence, Archbishop Irénée His Eminence, Archbishop Irénée Archbishop of Ottawa and Canada and the Archdiocese of Canada Orthodox Church in America Rev. Dr. David R. Wells Rev. Dr. David R. Wells General Superintendent The Pentecostal Assemblies of Canada Rev. Terry W. Snow Rev. Terry W. Snow Imam Irshad Unia Imam Irshad Unia Prince Albert Muslim Association (Saskatchewan) The Rev. Marijke Strong The Rev. Marijke Strong Executive Secretary Regional Synod of Canada Reformed Church in America Pascale Frémond Pascale Frémond President Religions for Peace Canada Commissioner Floyd J. Tidd Commissioner Floyd J. Tidd Territorial Commander The Salvation Army Canada and Bermuda Territory The Most Rev.Zenji Nio The Most Rev. Zenji Nio Abbot, Samurai Buddhist Temple & Museum Tokyo, Japan & Bay Street Corridor, Toronto Rabbi David Seed Rabbi David Seed President Toronto Board of Rabbis The Most Reverend Lawrence Huculak, O.S.B.M. The Most Reverend Lawrence Huculak, O.S.B.M. Metropolitan Archbishop of Winnipeg for Ukrainian Catholics in Canada General Superintendent Pentecostal Assemblies of Newfoundland & Labrador The Rev. Amanda Currie The Rev. Amanda Currie Moderator The Presbyterian Church in Canada

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Religious Leaders (continued) His Eminence, The Most Rev. Metropolitan Yurij (Kalistchuk) His Eminence, The Most Rev. Metropolitan Yurij (Kalistchuk) Archbishop of Winnipeg and the Central Eparchy Primate of the Ukrainian Orthodox Church of Canada Rev. David Rowley Rev. David Rowley General Secretary The Union of French Baptist Churches in Canada Rev. Brian K. Magnus Rev. Brian K. Magnus Bishop The United Brethren Church in Canada The Right Rev. Richard Bott Nora Sanders The Right Rev. Richard Bott, Moderator Nora Sanders, General Secretary The United Church of Canada David Ruis David Ruis National Director Vineyard Canada Pastor Mike Stone Pastor Mike Stone Executive Director Vision Ministries Canada Rev. Dr. Eric R. Hallett Rev. Dr. Eric R. Hallett District Superintendent, Central Canada District The Wesleyan Church Venerable Dr. Bhante Saranapala Venerable Dr. Bhante Saranapala West End Buddhist Temple and Meditation Centre Jaskaran Singh Sandhu Jaskaran Singh Sandhu Executive Director World Sikh Organization of Canada Code: 185-140 Legal Deposit: Library and Archives Canada, Ottawa Creative Commons License: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ISBN: 978-0-88997-874-4

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