The Somatic Experiencing® training shifted not only how I view my personal history and how I work with clients in my psychotherapy practice but it has proven invaluable in my work at the DC Medical Examiner's Office. There my role is to accompany families as they identify a loved one's body. I'll never forget the moment SE® changed the lens through which I view that work. I was sitting in a beginning year training module for SE and heard trauma defined as “too much too soon.” I learned our bodies have automatic responses which calm us down. It was like a kaleidoscope that came into crisp focus and when it did, a moment at the DC morgue that took place years before came flooding into my mind.
“Ma'am, I don't think you are getting enough sleep at night.”
I looked up and saw a smile on the security guard's face as I walked by his desk. I had just said goodbye to a family who earlier that morning identified their 35-year-old son who died of an apparent overdose.
“The bags under my eyes are that obvious?” I replied half joking but a little self-conscious.
“No, you look great; but every time you reach for the door knob to open that door you yawn. It's like clockwork.”
I had no idea what the guard was referring to. Sure I knew I yawned occasionally and chalked it up to being tired. Once he pointed it out, damn if he wasn't spot on. I started to think something was wrong with me. Whenever a yawn arose, as hard as I tried to stifle it, for the life of me I just couldn't. I'd reach for the doorknob, pause, yawn, and then open the door to walk in so I could be with the family.
SE helped me to understand that in entering that room I was nearing a potentially overwhelming situation. Sitting with a family who just learned of an unexpected tragic death— and who I will assist in identifying the body— can be overwhelming. That's when I understood that my automatic yawning was my body's attempt to regulate my system to a calmer state. I wasn't tired. I was simply activated.
Editor's note: Jen was kind enough to share with us the full story of her experience, originally published in the Summer 2013 volume of Voices: The Art and Science of Psychotherapy (journal of the American Academy of Psychotherapists). If you're intrigued with her intro above, we know you'll love the insights she shares in the longer tale that follows. PLEASE READ ON!
During the Spring and Summer months after my mother died I continued to work at the city morgue. Colleagues and friends asked if I was ready to go back, concerned that surrounding myself with others' grief and loss might exacerbate my own. I understood their questions and concerns. It was unrealistic to think my work at the morgue accompanying families through the body identification would not be affected by my mother's death.
Six or seven months passed without incident. I did not fall apart and begin to sob during an identification of a deceased person. I did not suddenly get up and walk out of the room, unable to tolerate the overwhelming sadness, longing or desperation, feelings which often encompass the entire room as families confirm their loved one's identity. I seemed fine. It was not until November that I sensed something had changed. I began to feel bored with the work and noticed I felt nothing, numb. My interactions with families seemed flat, rigid and predictable and it seemed like all I was doing was helping them fill out paperwork. I seldom welled up with tears, a reaction that had been common for me, and I struggled to genuinely express heart-felt condolences. It felt disrespectful of each loved one and their family; and dismissive of the meaning of their lives and the loss to say such words with little or no emotional sincerity.
The more I became aware of feeling numb and emotionally distant, the more I began to question what was happening. Had I burned out? An understandable reaction given that I had accompanied hundreds of individuals and families, heard tragic, horrific and wrenching stories, looked at gruesome scene photos and viewed hundreds of dead people. Maybe it was burn-out. Or maybe my mother's death really was impacting my work at the morgue.
One day a colleague observed, “You don't seem nearly as connected to the work as you have been in the past.” Her observation stayed with me for several days and bothered me. I treasured the opportunity to support families during those very difficult moments in their lives and decided to pray a silent prayer each Tuesday morning as I walked through the door into the Medical Examiner's Office, “Let me be present.”
Be careful what you pray for.
This mid-December day at the Medical Examiner's Office was not particularly hectic compared to some days when several families arrive at the same time or one immediately after the other. The pace of this day was steady. Unlike other days, there was no pressure to get to the next family in the waiting room. This allowed more time for answering questions, addressing concerns, and even allowed some time for asking a few questions about the family member who died— something I'd often loved best about the work.
When the security guard informed me a family had arrived to identify someone, I went to the Communications Office to read through the decedent's chart. “White male … mid-twenties … motor vehicle accident … blunt impact trauma … died at the scene.” My stomach squirmed when I read “blunt impact trauma” because it meant the fatal injuries he'd suffered might be visible in the identification picture. But since it only read “blunt impact trauma” and not “massive head trauma” it felt easier to reach into the envelope and pull out the picture.
When I first looked at the photograph I saw a decedent— a dead man. I felt little feeling. But the moment I read his date of birth, May 4th, 1975, a breeze of sadness brushed gently past me. His birthday was one day before mine. When I looked again I no longer saw a dead “white male decedent” but a young, handsome, clean-shaven man with short blonde hair whose eyes were closed. He came alive in my mind: a twenty-five-year-old guy, a son, a brother, a boyfriend. I glanced at the chart: Billy was his name.
Billy had been driving home from work when a car traveling in the opposite direction crossed the yellow line and slammed head-on into his car. My stomach clenched from the sudden intrusion, as if those words had slammed into me. I immediately jerked my head to the side and shoved Billy's chart across the desk. “God, I hope he didn't see it coming.” A tinge of guilt flared within me because I knew I had the choice to turn my head and push away the pain— a choice Billy hadn't. That survivor's guilt lingered just long enough to create an opening for those ever-hovering questions that reside dormant within me to awaken and whisper: “Why him? Why now? Why not me?”
Billy's family was sitting in the waiting room. I needed them to identify him and they wanted to claim him. As I walked toward them I felt four sets of eyes starring at me: eyes full of sadness, longing. The looks on their faces were familiar, filled with urgency and quiet desperation, with questions they were eager to ask while dreading the possible answers.
“You are here to identify Billy?” I asked as I eased into their huddled semi-circle. A young woman stood up. Her shoulder-length, dirty-blonde hair was disheveled; her blue eyes teary and puffy from an apparent fitful attempt at sleep. Clutching a small travel-size pack of Kleenex in her right hand she nervously switched it to her left as she reached out to greet me. Her hand was clammy, her grip sturdy, her gaze on me intense.
“Yes. Billy, my younger brother … This is our mother Betty, our younger sister Sheila and his girlfriend Sue … I am Barbara, his older sister.” I tried to make eye contact with each person, but she broke in: “He's here, right? The police told us to come here …”
“Yes, Billy is here.” I gently replied as his mother began to silently cry, her head shaking side to side, her eyes stuck in a glazed stare toward the floor. Billy's mother had short, wavy dark blonde hair which lay softly along her scalp, the wide curls layered neatly over her ears. She dabbed her eyes with the balled up, mascara-smudged Kleenex she pulled from the side pocket of her navy cardigan. Before I could locate the office Kleenex box barely visible behind a fake potted plant (the morgue's effort to add at least the appearance of life), Barbara had slipped into her mother's hand a fresh, dry replacement from the travel pack still scrunched in her hand.
“Thank you, Honey,” Billy's mother replied without shifting her gaze from the floor. “This can not be happening!” she mumbled softly, as she slowly lifted her head. I could feel her eyes focused on me, looking to me, hoping that I might confirm that none of it was actually happening.
Billy's family followed me through the entrance into the family ID room. They stepped across the threshold over which so many others have crossed, then crossed again in departing— their lives forever changed. Billy's family entered hesitant, yet also eager. Barbara guided her mother gently and protectively to a chair in the middle of the room while her sister and Billy's girlfriend sat on a small couch to her right. Barbara chose to sit on the end table next to her mom, leaving me the only remaining seat, directly across from Billy's mother, closest to the door.
In my short walk to that chair I started to feel really nervous and fought hard to hold back an anxious yawn, reminding myself of the gentle prayer of presence. Despite the prayer, the moment I sat down I found myself staring vacantly at the forms on the clipboard. Rather than explaining to Billy's family the next steps in filling out paperwork I sat still and silently directed myself: “Look up, look at Billy's family!” I began to feel as if an invisible glass dome was descending down around me, encapsulating me and keeping me isolated and safe from something some part of me did not want to approach.
By rote, I started talking. I reintroduced myself, explained the identification process, and provided information about community grief services. Speaking helped but not enough. I still felt distant and not quite in the room. “Eye contact … make eye contact,” I told myself. I knew I couldn't look at Billy's mom seated directly across from me, just three feet away. Something about her felt too much. I could look at Barbara, though, and when I did her eyes grabbed me: wanting answers, an explanation, some kind of direction.
“We've never done this before … never come to the morgue before,” she said, a thread of sadness and panic quivering in her voice. The emotion in her words drew me, welling up from that place deep within each of us that is so basically human, that yearns to understand, to feel safe and secure.
“This is a very difficult thing,” I said as I watched Barbara's eyes well up. While I feared I had spoken too directly, I saw her head begin to nod slightly, slowly, up and down.
“Yes, too hard.” she said. She shifted in her seat and began to rub her mom's back slowly in small but deliberate circles. Her hand looked strong, assuring. There was something very genuine about this woman. I liked her. Though afraid and grief-struck herself, she was somehow still attuned to her mother.
“What you all are experiencing is really difficult and really painful.” I replied, hoping to also make contact with Billy's younger sister and his girlfriend. They both seemed to appreciate my gesture, nodding their heads, but nonetheless remained silent.
I returned to the Communications Office to let the staff know the family was ready to view the picture, pausing a quick moment to glance again at Billy. I was relieved to see he had just a few scratches on his face. I suppose my thought— that a family may somehow feel less pain if they see their loved one's face unscathed— serves to protect me more than it eases them. It fools me into thinking they won't fall apart if the family member doesn't look hurt.
The identification itself was not as difficult as I had expected. Each person cried but no one fell, screamed, or ran out of the room. Billy's mom signed the back of the picture and then sat back in her chair, quiet and still. The room fell silent as she cupped her son's picture on her lap, like a precious egg. She was no longer crying, but seemed lost in a private moment where what was said, thought, and felt would be known only by her and Billy. Certain I had no idea of the depth of her feeling. I sat quietly as she sat with him. I tried to imagine her 25 years earlier, holding her infant son facing her in her lap, his tiny peach-fuzz head cupped in the palm of her hands, his small, warm, living body nestled near her breast. I imagined her clear blue eyes gazing into his, delighting in the new life she'd brought into this world. After a few minutes, she exhaled a deep, heavy sigh and handed me the picture, her face wrought with a reluctant acceptance, her fingertips pinching its corner, hesitant to let go.
The identification was complete, and my work was basically done, but Billy's family did not seem ready to leave. When I asked if they had any additional questions or concerns, they replied “no.” But no one stood up. No one signaled with eye contact that they wanted to leave. No one even shifted in their seat.
Some family members want to exit the building immediately after the identification is complete. They don't like the idea of the morgue: its stench, the emotional pain permeating and surrounding the place. Other people want to talk, either to me or amongst themselves. Once in a while there will be a long silence, and— although it can be awkward— most of the time I am fine with it. This time the silence felt uncomfortable. I felt nervous and hesitant to engage them and I didn't know why. My mind was debating: “Should I ask a question about Billy, about the family's thoughts and feelings, or should I let them know they are free to go and excuse myself?”
My heart joined the debate: “Do I risk engaging with this family, and being affected by them, or do I say goodbye, physically distance myself, emotionally protect myself, and continue to remain unaffected and numb?” It didn't seem like my questions were about whether the family's identification process was complete, but rather about whether or not I was able to stay with them, be present to them.
“Can you tell me a little bit about Billy?” I pushed though my lips. Barbara looked up from the floor, leaned forward, smiled.
“My little brother Billy was such a good guy … He lived with me … just moved in a few months ago … he was growing up, turning into a real nice guy, had a nice girl … don't get me wrong, we had our share of fights as kids for sure … didn't we Ma?”
Billy's mom looked at Barbara, straightened up her back, widened her shoulders, and chuckled. “The two of you were a handful, arguing one minute, best of friends the next, fighting one second, protecting each other the next … No telling what Billy'd do if someone messed with Barbara … Such a good boy he is … was … sorry … don't know if I can get used to saying was.”
Billy's mom continued to look at me but now her expression changed, from a soft, worn sadness to a hard, disbelieving anger. Her eyes pierced mine, demanded my attention. Then her torso began to subtly rock back and forth as she hit her left thigh with her palm. “This ain't how it's supposed to be … just ain't how I thought it was gonna be … He was too young … My boy was not supposed to die before me … mamas don't bury their children … children are supposed to bury their mamas … it just ain't right!”
Barbara reached for another tissue, gave it to her mother and then took her mother's hand. “I am so sorry Ma … This has been such a hard year for you … Pop died a year ago and now Billy … This is too much … and Ma … your diagnosis.” Barbara turned to me, “Ma was just diagnosed with lung cancer.”
The words, “Ma … diagnosed … lung cancer,” reverberated through my body. I couldn't think and I became intensely aware of my proximity to the door. I felt a strong urge to get up and leave the room; I wanted to run out the door, to flee, to escape. But I sat frozen like a deer in headlights, staring into Barbara's eyes. I knew I needed to, at least, look at Billy's mom and acknowledge what I heard. But I couldn't. My head wouldn't turn.
Although I sat immobilized I suddenly understood why this identification with Billy's family felt hard, and why I felt so anxious. “Mom … diagnosed … lung cancer” were words I had heard many times during the preceding year. My mother had died of lung cancer eight months earlier.
No wonder it was so hard to maintain eye contact with Billy's mother. It wasn't that she was “too much.” It was just that it was all so very close. I honestly don't recall how long it took me to respond to Barbara's words, but somehow I was able to turn to Billy's mother and look at her. I could feel my eyes well up and managed to assemble some words along the lines of “Having to cope with one death or life threatening illness is hard enough, but the death of your husband, your son, and your …”
Even though I could not for the life of me finish that sentence, something shifted within me and it was as if that encapsulating dome I sought protection within had begun to dissipate. The urge to flee began to subside. While I now had the freedom to physically leave Billy's family, I knew I had to stay. There was something in his mother's face— a depth that was palpable— and I didn't want to leave it. It was if with her eyes she was inviting me to come toward her, to be near. She was giving me permission, allowing me access to her private, internal world.
A vivid image popped into my mind of my mother lying in her hospital bed, on her right side, holding a paperback book. It was the same position I'd so often seen her in during my childhood, when she'd spend hours on the family room couch reading a book or doing the New York Times crossword puzzle. I was always amazed at how much she read, mostly mystery and love stories, and frequently wished I could slow down enough to read half as much. I had recalled that thought as I sat next to her as she lay in her hospital bed, four days before she died. I was amazed she could even focus enough to read, given the fact that she had just learned her prognosis was not good and her treatment options were few.
As I sat with Billy's mom, my eyes began to fill with tears and sadness swept through me. It occurred to me that my mom probably was not reading the contents of that paperback book at all but was instead feeling terribly sad and scared, isolated and alone. And yet there I'd sat, just three feet away, emotionally distanced, not allowed and unable to bridge the barrier of that small paperback.
My mother was an intensely private person who never talked about how she felt. She denied access to that tender place deep within her that day after day, year after year, she worked hard to protect and keep buried with alcohol. Many times I imagined my mother's death and her last months, weeks, days, or hours, thinking we'd have long, in-depth conversations about our hopes, fears, proud accomplishments, and disappointments. Reality was different. During those last few days of her life Mom didn't talk about how she was feeling or what she was thinking— about her life or her imminent death. The few times I broached a personal topic my mom responded with short answers that clearly conveyed “don't go there” or “I can't go there.”
Billy's mom could. Through a steady stream of tears flowing down her cheeks, a quivering voice delivered muffled words saturated in grief. It was if she wanted to tell me— and she knew I wanted, needed, to listen.
“It's hard being left behind … when my husband Buddy died ten months ago … I was lost … felt like I had to learn everything all over again. It was hard on the kids, still is, but at least I'm here to comfort them and reassure them. That's what mamas do, comfort their kids.” Stroking Barbara's thigh with the palm of her hand she continued, “I can't say I'm afraid to die. I don't want to die but if the Lord says it's my time, then it's my time. I got faith God will take care of me … But who's gonna take care of my kids when I'm gone? Who's gonna hold them at my funeral? Hard enough when your kids are hurting but when you're not around to make their hurt go away …”
I sat mesmerized listening to Billy's mother and began to feel that glass dome descending again, but this time it encapsulated Billy's mom and me there together. It was as if anyone and anything in the surroundings began to fade far into the background, and all that existed was a mother, Billy's mother, sitting across from me. Her voice settled me, comforted me; her teary gaze reassured me. Over the next few moments it all became very personal and I knew this was my chance. Nothing felt too much even though it was all so very close.
Her words became treasures, her emotions heart-felt, and her invitation into her world of motherhood, diagnosis, and imminent death gratefully accepted. Soon enough, all that was held vague in the background became real in the foreground. What felt briefly about me became again about Billy and his family.
A grief counselor supporting a grieving family. A grieving and dying mother sitting across from a still-mourning daughter. Each providing the other a few moments of healing in a quiet room at the DC morgue.
Author Jen Hackler, LCSW-C is a psychotherapist and Somatic Experiencing Practitioner (SEP) in Silver Spring, MD. In her private psychotherapy practice she works with individuals and couples struggling with issues related to substance abuse, grief and loss, attachment, trauma, and emotional dysregulation. Her work as a grief counselor at the District of Columbia's Office of the Chief Medical Examiner is through the William Wendt Center for Loss and Healing. The Wendt Center's Recover Program began in 1999 as a collaboration with the DC morgue where 365 days a year a licensed clinician provides immediate and on-going emotional and educational support to individuals, families, and children affected by the sudden or traumatic death of a loved one.