Call to Action - What can womb twin survivors do to help make this diagnostic code a reality - this validation would open the doors for our cause and its treatment:
http://www.scientificamerican.com/article.cfm?id=shades-of-grief
Home » Scientific American Magazine » June 2011
The Science of Health | Mind & Brain
See Inside Shades of Grief: When Does Mourning Become a Mental Illness?
The new edition of a psychiatric manual called DSM-5 tackles what to do when mourning becomes complicated or leads to depression
By Virginia Hughes | June 7, 2011 | 3
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MORTAL TOLL: For most people, extreme grief subsides with time. For some, however, it may continue unabated or lead to depression.
Image: Michael Blann Getty Images
Sooner or later most of us suffer deep grief over the death of someone we love. The experience often causes people to question their sanity—as when they momentarily think they have caught sight of their loved one on a crowded street. Many mourners ponder, even if only abstractedly, their reason for living. But when are these disturbing thoughts and emotions normal—that is to say, they become less consuming and intense with the passage of time—and when do they cross the line to pathology, requiring ongoing treatment with powerful antidepressants or psychotherapy, or both?
Two proposed changes in the “bible” of psychiatric disorders—the Diagnostic and Statistical Manual of Mental Disorders (DSM)—aim to answer that question when the book’s fifth edition comes out in 2013. One change expected to appear in the DSM-5 reflects a growing consensus in the mental health field; the other has provoked great controversy.
In the less controversial change, the manual would add a new category: Complicated Grief Disorder, also known as traumatic or prolonged grief. The new diagnosis refers to a situation in which many of grief’s common symptoms—such as powerful pining for the deceased, great difficulty moving on, a sense that life is meaningless, and bitterness or anger about the loss—last longer than six months. The controversial change focuses on the other end of the time spectrum: it allows medical treatment for depression in the first few weeks after a death. Currently the DSM specifically bars a bereaved person from being diagnosed with full-blown depression until at least two months have elapsed from the start of mourning.
Those changes matter to patients and mental health professionals because the manual’s definitions of mental illness determine how people are treated and, in many cases, whether the therapy is paid for by insurance. The logic behind the proposed revisions, therefore, merits a further look.
Abnormal Grief
The concept of pathological mourning has been around since Sigmund Freud, but it began receiving formal attention more recently. In several studies of widows with severe, long-lasting grief in the 1980s and 1990s, researchers noticed that antidepressant medications relieved such depressive feelings as sadness and worthlessness but did nothing for other aspects of grief, such as pining and intrusive thoughts about the deceased. The finding suggested that complicated grief and depression arise from different circuits in the brain, but the work was not far enough along to make it into the current, fourth edition of the DSM, published in 1994. In the 886-page book, bereavement is relegated to just one paragraph and is described as a symptom that “may be a focus of clinical attention.” Complicated grief is not mentioned.
Over the next few years other studies revealed that persistent, consuming grief may, in and of itself, increase the risk of other illnesses, such as heart problems, high blood pressure and cancer. Holly G. Prigerson, one of the pioneers of grief research, organized a meeting of loss experts in Pittsburgh in 1997 to hash out preliminary criteria for what she and her colleagues saw as an emerging condition, which they termed traumatic grief. Their view of its defining features: an intense daily yearning and preoccupation with the deceased. In essence, it is the inability to adjust to life without that person, notes Mardi J. Horowitz, professor of psychiatry at the University of California, San Francisco, and another early researcher of the condition. Prigerson, then an assistant professor at the Western Psychiatric Institute and Clinic in Pittsburgh, hoped the meeting would begin the process of finding enough evidence to support changing the DSM. “We knew that grief predicted a lot of bad outcomes—over and above depression and anxiety—and thought it was worthy of clinical attention in its own right,” says Prigerson, now a professor of psychiatry at Harvard Medical School.
Monica
A blog for womb twin survivors around the world
June 16, 2011
June 12, 2011
Amalia Rodrigues - Cansaço (Tiredness)
Por trás do espelho quem está Who is that, behind the mirror,~
De olhos fixados no meus? With eyes fixed on mine?
Alguém que passou por cá Someone that came by
E seguiu ao Deus dará And followed her own God given way
Deixando os olhos nos meus. Leaving her eyes on mine.
Quem dorme na minha cama Who is sleeping in my bed,
E tenta sonhar meus sonhos? Trying to dream my dreams?
Alguém morreu nesta cama Someone died in this bed
E lá de longe me chama And is calling me from far away
Misturado nos meus sonhos. Mixed in my dreams.
Tudo o que faço ou não faço Everything I do or don't do
Outros fizeram assim Others have done
Daí este meu cansaço Hence this my tiredness
De sentir que quanto faço That I feel that whatever I do
Não é feito só por mim. Is not done just by myself.
Author: Luis de Macedo
April 28, 2011
Part 2 - Interview with a well-adjusted Womb Twin Survivor - they do exist!
As a follow up to Part 1 of this interview (posted below on April 7), here concludes this very special interview with a womb twin survivor who lost his female twin at birth, and is quite fine with it. He is convinced he was spared traumatic affect due to his mother's early acknowledgment and constant communication about the loss of his twin.
Consider what he shares - about a subject never spoken about with people other than his mom - an early Mother's Day tribute to the incredible instincts his mother had not to repress the loss. Let this also be a tribute to the current & future mother's of womb twins to overcome their apprehension and fears and learn to talk about it with their children. When you handle it well, your child will too. Ignoring it doesn't make it go away, it makes it much worse.
What advice would you give parents of womb twin survivors on how to handle this well for their children?
I wouldn’t evade it or negate it, I’d definitely talk about it. It’s something that did happen.
How early would you bring it up?
I would talk about it from when you brought the baby home. I remember it was a pretty early memory that I was a twin and my mother was talking to me about it, by doing that she comforted me and that’s what you want to do.
Do you feel that if she told you later in life that it would’ve been shocking rather than always growing up with that knowledge?
Sure because you set a tone with a child in exposing it to any kind of information or knowledge. If you do it later, it could be more of a shock and less embraceable. You might have difficulties developing that knowledge.
Whereas if you get it earlier, it’s just integrated into who you are?
Yes and then you have more of a possibility of developing that knowledge and nurturing it into a positive manifestation.
For instance, my mother was a great artist and she chose not to teach me that when I was very young. She taught me when I was 9 or 10 and it was hard for me to assimilate that information and I was kind of upset because I wish she did teach me earlier. To use an example, prodigies like Mozart who are taught & exposed to information at a young age can assimilate that information much easier, you don’t have to think about it too much. You’re just doing it. It’s like walking and reading and talking.
How would you suggest the subject be brought up?
Just talk. There’s no right way or wrong way…but the wrong way is not doing anything about it all. If parents are fearful and apprehensive… look, a child only wants to share with you and other people, the more sharing and conversing is done, the more adulation and love is created. And the more love and adulation, the more intelligence is developed and the greater the perception. And that’s all that beings want is that comeraderie, all species, that is the first act of communication. Just going through the motions of eating and getting up in the morning, they emulate those things. So when you start talking about things, they’re going to emulate those things.
When you do it while their young, as a parent to a child, you’re going to do it in a positive way for the most part because you’re enamored by this new being. You make it up as you go, there are no instructions on how to rear children even though there should be, but you know there are right ways and wrong ways of doing things and anything that is done in a positive, loving manner can’t be bad.
If you don’t know what you’re doing and you think you’re doing it wrong, it still can’t be bad because you figure it out as you go. And not only do you figure it out, the child figures it out, you help each other. It goes back & forth. It’s a given that the teacher learns more or just as much from the student. The master really learns from the student if he’s a good teacher. And that is a very high acknowledgment in a very sagely manner, it’s not easy to do and people who are masters and have acquired that sagely manner are aware of that. That’s what you want to manifest in and it can take a lifetime to learn to do that.
Or you can just do it…as your biological being tells you to do. And if you follow those things, sometimes you can learn a lot more than you knew you could.
Did your mother ever tell you things about your twin that you didn’t like hearing - did she ever vent or say anything that wasn’t as palatable to you but served her more? Anything negative? Or was it all positive sharing?
Pretty much, I was fortunate that she didn’t - but she did vent about her mother. Even that wasn’t accusatory, just venting issues. I remember she would say things like “there’s no such thing as better, there are just different applications or different ways of looking at things.” It instilled in me not to be judgmental.
Do you think you and your mother shared the same level of grief for your twin? Did you feel on par or that there were different intensities?
I guess the grief that she was dealing with, she dealt with by acknowledging it and speaking to me about it. So I was aware of it and I could acknowledge it and in doing so, that was dealing with the grief. Now, when I got older and dealt with grief with the passing of relatives, I learned a lot about grief. You have to confront grief. You have to deal with grief. If you don’t, it manifests into disease and creates illness and ill manners and ill ways. Dis-ease.
I think that by her talking to me about it, she was dealing with her grief and I was acknowledging this information but I didn’t necessarily grieve. That’s why I brought up the family grief, it’s a different type of grief…
So was that a delayed channeling of the grief of your twin to these other later outlets?
No I don’t think so, it’s just different.
Then, would you say that you grieved at the time your mother shared knowledge of your twin’s death and it was just taken care of then? As you went along?
Right, exactly. That’s why I said I didn’t grieve. I think the initiation of this knowledge and the fact that this individual was no longer with us but we were discussing it – this is the acknowledgement of this information but also the embracing of the grief. Dealing with it and diminishing it at the same time. Working in tandem.
To make an analogy, a relative got sick and almost died but didn’t and it was so traumatic that I grieved a real sense of loss. So later, when this person eventually died, it wasn’t as hard as it would’ve been if I hadn’t dealt with that grief earlier. I think of you deal with loss, at that time, in the moment - it creates less of a dramatic situation later, no matter what.
Right, if a parent handles it well, the child can handle it well, no matter what it is.
You don’t even have to handle it all that well but dealing with it is much better than not dealing with it.
Even if it gets messy?
Even if it gets messy because then you’ll deal with it again and it will get easier. You’re still dealing with it as opposed to not dealing with it, because you never get over the death of someone very important to you. Time is kind of irrelevant about that, it could’ve happened yesterday or twenty years ago but depending on how great that individual was in your life, you’re still going to feel that hurt and sense of loss and emotional trauma. But that’s all grief is, it’s like oh we ‘memorialize this person’ but it’s not for them it’s all for us and how we deal with these things emotionally. It’s not for the people who passed. They are wherever they go, we’re still here and it’s us that are emotionally struck by these things and a lot of times these things are not dealt with. That’s why we recreate all these stories about being haunted, we create all these things in our psyche because they’re not dealt with, all this emotional baggage turns into all these diseases whether they’re physical or psychic or psychological, they’re very real and they become very real things. They can become very psychotic, either individually or communally.
So no – it just needs to be dealt with. It doesn’t matter how, it doesn’t matter if it’s the right approach or not. There’s no right way or wrong of way of dealing with this, as long as it is dealt with.
This question may not be appropriate, since you haven’t been aware of Womb Twin Syndrome, but answer it if you like: What advice would you give others who lost a twin around birth to cope?
Other twins who lost twins themselves? It’s an odd question since I never really even knew this was an issue…
Now that I know that it is an issue, and I never knew about it personally myself, I think the best thing to do is to speak about it with other people who have gone through these experiences and to share with one another and talk about it. If you didn’t have that chance when you were a child or baby, I don’t think it’s ever too late to actually try to deal with these things. But do it with people of like mind and maybe you’ll acquire a rest in the trauma and maybe a bit of understanding on how to deal with that and try to heal. What more could you ask for? That’s what I would try to do.
Consider what he shares - about a subject never spoken about with people other than his mom - an early Mother's Day tribute to the incredible instincts his mother had not to repress the loss. Let this also be a tribute to the current & future mother's of womb twins to overcome their apprehension and fears and learn to talk about it with their children. When you handle it well, your child will too. Ignoring it doesn't make it go away, it makes it much worse.
What advice would you give parents of womb twin survivors on how to handle this well for their children?
I wouldn’t evade it or negate it, I’d definitely talk about it. It’s something that did happen.
How early would you bring it up?
I would talk about it from when you brought the baby home. I remember it was a pretty early memory that I was a twin and my mother was talking to me about it, by doing that she comforted me and that’s what you want to do.
Do you feel that if she told you later in life that it would’ve been shocking rather than always growing up with that knowledge?
Sure because you set a tone with a child in exposing it to any kind of information or knowledge. If you do it later, it could be more of a shock and less embraceable. You might have difficulties developing that knowledge.
Whereas if you get it earlier, it’s just integrated into who you are?
Yes and then you have more of a possibility of developing that knowledge and nurturing it into a positive manifestation.
For instance, my mother was a great artist and she chose not to teach me that when I was very young. She taught me when I was 9 or 10 and it was hard for me to assimilate that information and I was kind of upset because I wish she did teach me earlier. To use an example, prodigies like Mozart who are taught & exposed to information at a young age can assimilate that information much easier, you don’t have to think about it too much. You’re just doing it. It’s like walking and reading and talking.
How would you suggest the subject be brought up?
Just talk. There’s no right way or wrong way…but the wrong way is not doing anything about it all. If parents are fearful and apprehensive… look, a child only wants to share with you and other people, the more sharing and conversing is done, the more adulation and love is created. And the more love and adulation, the more intelligence is developed and the greater the perception. And that’s all that beings want is that comeraderie, all species, that is the first act of communication. Just going through the motions of eating and getting up in the morning, they emulate those things. So when you start talking about things, they’re going to emulate those things.
When you do it while their young, as a parent to a child, you’re going to do it in a positive way for the most part because you’re enamored by this new being. You make it up as you go, there are no instructions on how to rear children even though there should be, but you know there are right ways and wrong ways of doing things and anything that is done in a positive, loving manner can’t be bad.
If you don’t know what you’re doing and you think you’re doing it wrong, it still can’t be bad because you figure it out as you go. And not only do you figure it out, the child figures it out, you help each other. It goes back & forth. It’s a given that the teacher learns more or just as much from the student. The master really learns from the student if he’s a good teacher. And that is a very high acknowledgment in a very sagely manner, it’s not easy to do and people who are masters and have acquired that sagely manner are aware of that. That’s what you want to manifest in and it can take a lifetime to learn to do that.
Or you can just do it…as your biological being tells you to do. And if you follow those things, sometimes you can learn a lot more than you knew you could.
Did your mother ever tell you things about your twin that you didn’t like hearing - did she ever vent or say anything that wasn’t as palatable to you but served her more? Anything negative? Or was it all positive sharing?
Pretty much, I was fortunate that she didn’t - but she did vent about her mother. Even that wasn’t accusatory, just venting issues. I remember she would say things like “there’s no such thing as better, there are just different applications or different ways of looking at things.” It instilled in me not to be judgmental.
Do you think you and your mother shared the same level of grief for your twin? Did you feel on par or that there were different intensities?
I guess the grief that she was dealing with, she dealt with by acknowledging it and speaking to me about it. So I was aware of it and I could acknowledge it and in doing so, that was dealing with the grief. Now, when I got older and dealt with grief with the passing of relatives, I learned a lot about grief. You have to confront grief. You have to deal with grief. If you don’t, it manifests into disease and creates illness and ill manners and ill ways. Dis-ease.
I think that by her talking to me about it, she was dealing with her grief and I was acknowledging this information but I didn’t necessarily grieve. That’s why I brought up the family grief, it’s a different type of grief…
So was that a delayed channeling of the grief of your twin to these other later outlets?
No I don’t think so, it’s just different.
Then, would you say that you grieved at the time your mother shared knowledge of your twin’s death and it was just taken care of then? As you went along?
Right, exactly. That’s why I said I didn’t grieve. I think the initiation of this knowledge and the fact that this individual was no longer with us but we were discussing it – this is the acknowledgement of this information but also the embracing of the grief. Dealing with it and diminishing it at the same time. Working in tandem.
To make an analogy, a relative got sick and almost died but didn’t and it was so traumatic that I grieved a real sense of loss. So later, when this person eventually died, it wasn’t as hard as it would’ve been if I hadn’t dealt with that grief earlier. I think of you deal with loss, at that time, in the moment - it creates less of a dramatic situation later, no matter what.
Right, if a parent handles it well, the child can handle it well, no matter what it is.
You don’t even have to handle it all that well but dealing with it is much better than not dealing with it.
Even if it gets messy?
Even if it gets messy because then you’ll deal with it again and it will get easier. You’re still dealing with it as opposed to not dealing with it, because you never get over the death of someone very important to you. Time is kind of irrelevant about that, it could’ve happened yesterday or twenty years ago but depending on how great that individual was in your life, you’re still going to feel that hurt and sense of loss and emotional trauma. But that’s all grief is, it’s like oh we ‘memorialize this person’ but it’s not for them it’s all for us and how we deal with these things emotionally. It’s not for the people who passed. They are wherever they go, we’re still here and it’s us that are emotionally struck by these things and a lot of times these things are not dealt with. That’s why we recreate all these stories about being haunted, we create all these things in our psyche because they’re not dealt with, all this emotional baggage turns into all these diseases whether they’re physical or psychic or psychological, they’re very real and they become very real things. They can become very psychotic, either individually or communally.
So no – it just needs to be dealt with. It doesn’t matter how, it doesn’t matter if it’s the right approach or not. There’s no right way or wrong of way of dealing with this, as long as it is dealt with.
This question may not be appropriate, since you haven’t been aware of Womb Twin Syndrome, but answer it if you like: What advice would you give others who lost a twin around birth to cope?
Other twins who lost twins themselves? It’s an odd question since I never really even knew this was an issue…
Now that I know that it is an issue, and I never knew about it personally myself, I think the best thing to do is to speak about it with other people who have gone through these experiences and to share with one another and talk about it. If you didn’t have that chance when you were a child or baby, I don’t think it’s ever too late to actually try to deal with these things. But do it with people of like mind and maybe you’ll acquire a rest in the trauma and maybe a bit of understanding on how to deal with that and try to heal. What more could you ask for? That’s what I would try to do.
April 21, 2011
Mourning
O let me weep, for ever weep,
My Eyes no more shall welcome Sleep;
I'll hide me from the sight of Day,
And sigh, and sigh my Soul away.
She's gone, she's gone, her loss deplore;
And I shall never see her more.
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