3 Therapy Apps

Photo: Birxi

Individual therapy can be a really helpful tool during the grief process. Having an objective and professional point of view can provide perspective while sorting through all the different feelings that come along with grief. Thanks to advances in technology, therapy is a lot more accessible these days, so if you can’t get to an in-person therapist or if you prefer connecting with one remotely, there are options. We’ve rounded up a few of the top therapy apps and their costs below. If you’ve tried any of the apps or if you have other favorites, feel free to respond in the comments.

Please note that therapists are generally not able to diagnose or prescribe over the platform.

Talkspace
Talkspace has a variety of different plans available based on the type of therapy you’re looking for. There are options for live video therapy, text messaging with your therapist, and audio. You get to choose your therapist from a hand-narrowed list, all with the highest clinical license in their state of practice, plus 3+ years of clinical experience. The cost ranges from $65-$99 a week, billed monthly (depending on the plan you choose). Talkspace is in network through EAP and health insurers, so be sure to check with your insurance company to see if you’re covered or if your employer offers the platform as an employee benefit.

BetterHelp
On BetterHelp, users are matched with an experienced therapist (3+ years) after taking a questionnaire, and you can do live video sessions, phone sessions, texting, or live chats with the assigned counselor. Users can choose to remain anonymous if they prefer to preserve their privacy. BetterHelp does not work with insurance companies or employers, but there are flexible cost packages ranging from $40-$70 billed weekly, and you can cancel your payment at any time.

Larkr
Larkr offers video talk therapy. The app matches you with a therapist based on the info you provide, but you can choose whichever time zone works best for your schedule. In between video sessions you can contact your therapist in the app, and there are also other individual tools for mood tracking and journaling. The cost is $85 a session, no subscription or commitment. For cooperating insurance, you can submit to your insurance company for reimbursement.

Anxiety, another stage of grief

Photo: @thetonik_co

People are generally familiar with the idea that grief brings about sadness, sometimes anger. Anxiety has often been referred to as the other stage of grief because it’s not part of “the big five” but it’s not uncommon for loss to bring up this feeling. Claire Bidwell even wrote a book on it. For some, because anxiety isn’t always talked about alongside grief, experiencing it for the first time feels unexpected and confusing.

There are many reasons why people might feel anxious after a loss—financial strain, changes in relationships and living arrangements, the added stress of having to handle someone’s affairs or estate. Loss also shines a light on the impermanence of life, and that can turn into fear.

Here are a few ways to deal with anxiety, if you find yourself in this position.

Familiarize yourself

Sometimes being unable to label or understand a feeling, especially one like anxiety, can intensify it. Read about anxiety and panic attacks and learn about the physiological and mental symptoms so you can recognize when it’s happening. Learn about what anxiety feels like in your body and mind so that when you experience it, you can name it.

Notice triggers

Once you’re able to start identifying the anxiety, pay attention to when you’re feeling it more often. See if there are patterns. Do you start to feel more panicked when you’re behind the wheel? About to go to sleep? If you can identify times of day or situations where your anxiety peaks, this can help you prepare for it.

Breathe

The number one way to help manage anxiety is to breathe. Taking deep breaths, especially all the way into the diaphragm (known as deep belly breathing) can relax your parasympathetic nervous system and let your body and brain know that you’re not in danger. Read more about deep belly breathing in this post.

Think of your feet

Another way to manage anxiety in the moment is to ask yourself where your feet are. This technique helps you become present in the moment and can help take your mind off of the fear and panic. Anxiety can sometimes be a feeling in the mind, like a runaway train. Reminding yourself where your feet are can bring you back into your body and ground you in the now.

Talk to a professional

You don’t have to suffer alone. If you’re experiencing anxiety in your life, talk to a professional — a therapist, doctor, or psychiatrist. There’s no shame in getting help. Talk therapy is a great way to verbalize and understanding your feelings and what’s contributing to them. Medication can also be a helpful step and may not need to be a permanent solution. Talk to your personal doctor to get more information on whether this is the right approach for you. [Grief Collective is not recommending one particular health treatment and is not a substitution for professional advice]

How to: deep belly breathing

Photo: Fabian Moller

You’ve probably heard the advice “take a deep breath” a hundred times. And it’s true—deep breathing is a simple and effective tool to manage stress, anxiety, and depression. But what you may not know is how to actually breathe deeply.

Let’s try this: take a moment, get comfortable, and take a deep breath. You probably felt your lungs fill up, your chest rise and fall. Maybe you feel a bit more relaxed. This is all great, but according to breath experts (yes, it’s a thing), we can do better.

Most of us breathe from our chests rather than fully engaging our diaphragm, which is just next to our bellies. Breathing all the way into the diaphragm—really filling up on the inhale all the way to the bottom of our stomachs—produces a different physiological response than chest breathing. It can reduce blood pressure, increase the amount of oxygen in your blood, and reduce heart rate, to name a few benefits (of many). Some holistic practitioners also say that this breathing helps root into your core, allowing you to feel more grounded and clear.

Deep belly breathing (also called diaphragmatic breathing) can be a helpful tool in navigating the stress and anxiety associated with loss.

How to do deep belly breathing

Here’s how you can learn to do deep belly breathing on your own (adapted from this tutorial). It may feel a little unnatural at first if you’re like many people who breathe through their chests, but over time you can make it a routine practice. Aim for 3 good breaths in a row.

Disclaimer: If you have a lung condition like COPD or asthma, speak with your healthcare provider before trying any type of breathing exercise. If you feel lightheaded at any time, discontinue the breathing exercise.

Step 1: Get comfortable
You’ll want to start in a comfortable position, sitting or lying down on your back. Your posture should feel relaxed but not slouched.

Step 2: Place a hand on your upper chest
This will help you observe where your breath is really coming from. If you're engaging your diaphragm (deep belly breaths) properly, this hand should remain relatively still as you breathe in and out.

Step 3: Place the other hand below your ribcage
The other hand should rest on your belly, just above your navel. This will allow you to feel your diaphragm move as you breathe.

Step 4: Breathe in through your nose
The air going into your nose should move downward so that you feel your stomach rise with your other hand. It’s important not to force your abdominal muscles in the movement, just let your belly fill and expand without straining. The movement (and the airflow) should be smooth. Remember that the hand resting on your chest should remain relatively still. 

5. Breathe out through your mouth
Exhale slowly through slightly open lips, letting your belly relax. You should feel the hand that's over it fall inward as you exhale. Again, don't force the muscles around your stomach inward by squeezing or clenching. The hand on your chest should continue to remain relatively still.

I hope that deep belly breathing can be a useful tool for you to take with you as you navigate the current global situation and any feelings that arise during stressful times associated with grief, loss, anxiety, and depression. Comment below on how it goes for you.

How meditation can provide support in grief

Photo: JD Mason

“Mindfulness not only makes it possible to survey our internal landscape with compassion and curiosity but can also actively steer us in the right direction for self-care.”

— Bessel A. Van der Kolk

When I first learned about meditation, it was introduced by my college grief counselor. We had spent several sessions talking about my fears and anxieties after losing my dad and how I was having trouble falling asleep, so she emailed me an audio file, and she encouraged me to listen to it as I was getting ready for bed. That night I plugged my headphones into my iPod mini, laid down on my bed, and listened to the 10-minute clip in the darkness.

It started with a woman’s voice speaking slowly and calmly. She instructed me to take three deep breaths. After a few moments of silence, she asked me to draw my attention to my toes and focus on relaxing the muscles while continuing to breathe. After a few moments of focus on my toes, she asked me to draw my attention to my ankles and repeat the same exercise. The voice continued to direct my attention to various parts of my body, all the way up to my head, encouraging deep breaths throughout. By the end of the audio file, I felt more relaxed in my body and my mind, and I was able to fall asleep easily that night.

Meditation comes in many forms. It can be guided or unguided, it can be done walking or seated or lying down, it can be done in a group or on your own. No one approach is better than another—it’s more based on personal preference—but the benefits, especially in grief, are major. This Mayo Clinic article has lots of additional details on the general benefits and different types of meditation, but when it comes to dealing with grief and loss, these are my top reasons:

Help with sleep
A lot of the anxiety I dealt with after my dad’s death peaked when I was getting ready to fall asleep. Suddenly, right as my head hit the pillow, I’d find my thoughts and worries running rampant. Doing meditation right before bed can help your nervous system and brain go into rest mode to better prepare you for sleep. And practicing meditation on a consistent basis can help train your body and brain to access that calm state more easily and frequently throughout the day, which can help prevent the sudden surge of thoughts at night.

Health
I rarely got so much as a cold growing up, but the year after my dad died it seemed like I was sick every other week. Stress can take a toll on your immune system, which can leave you more susceptible to illness. And with grief, especially with anxiety, the stress on your body and nervous system is constant. Your parasympathetic nervous system (rest-and-digest), activated by meditation as well as breathing and other grounding activities, can combat the body’s natural reaction to stress and restore you to a calmer state. Meditation, especially when you’re more prone to stress in a time of loss, can help keep your nervous system from operating in fight-or-flight mode, which wears on the health of your mind and body over time.

The brain-body connection
When we’re stressed, we tend to store tension in our bodies in different ways. Some people are jaw-clenchers, some are shoulder-tensing, a lot of us even store emotion in our hips (it’s a common belief that, dating back to the fetal position, this is our first bodily reaction to stress). Meditation is a great tool to manage the physical symptoms that come along with grief, such as muscle tension, headaches, stomach discomfort, and anxiety-related chest tightness. For me, the guided meditation that focused on areas of the body illuminated where I was storing tension, and it helped me relax and bring more awareness to how I held stress throughout the day.

Existing in the present
When I was in the early days of grief, as I suspect many people can relate to, I spent most of my time thinking about the past, holding onto old memories, wishing I could change things. And when I wasn’t longing for the past, I was worrying about what the future held. Meditation is about focusing on the present moment—what’s here and now. That’s why practices encourage you to focus on your breath or have a mantra you repeat or, in my case with the audio file, focus on relaxing different parts of your body. These methods are meant to bring your attention to things that are tangible with the goal of anchoring you. As hard as it is to acknowledge, we only ever have control over the present moment. This isn’t to say that you shouldn’t think about the past or the future, but meditation helps re-center you when you feel yourself getting swept up.

These are just some of my thoughts around where meditation can be useful in a grieving process. What other benefits have you seen with meditation and grief? I’d love to hear.

How to find a therapist

Talk therapy can be an incredibly helpful experience when navigating grief. A trained professional can listen to your thoughts and feelings, and they can help provide context for your experience as well as advise you on what to do next. Therapists can help with many different areas, from terminal illness to grief and loss to anxiety. Many therapists now offer remote options as well as in-person. We did a whole post on therapy apps as well, which you can check out here.

Here are steps to consider when looking for a therapist:

Determine your budget

If you are like most people who live in the US, there are cost implications to be aware of when considering therapy. Costs can range based on several factors including location, frequency, and insurance coverage. The good news is that many insurance providers cover therapy if it’s in-network or charge a co-pay cost, which could be minimal depending on your insurance. Most of this information can be determined by contacting your insurance company or looking at your benefits website—some even include a search for in-network providers. If you don’t have insurance or prefer not to use it, you can also pay out-of-pocket. It’s not uncommon for out-of-pocket therapy costs to be $100+ per session. If weekly isn’t in your budget, consider working with your therapist to find a schedule that will.

Also note that some therapists offer a sliding scale for payment - this is something to ask about in preliminary conversations. And if these options are all cost prohibitive, therapy apps can be another option (some accept insurance) as well as free or reduced-cost therapy through HRSA.

Search for therapists

The next step is to actually find a few options for therapists to contact. A great starting point is Psychology Today’s therapist finder, where you can search by location and filter or search by specialty. You’ll want to look for someone with grief experience to get the most relevant training. If you’re starting with a search through an insurance provider, specialties and experience are usually listed, but you may have to go to the therapist’s website to learn more. Most of these search engines will also show whether the therapist is taking new clients.

Learn as much as you can about your potential options to help narrow it down. Read bios and review credentials to get a better sense of their experience and approach. Once you’ve found a few that resonate with you, you can reach out using their contact information. Let them know you’re interested in therapy as a new patient, and they should be able to take it from there.

Assess if they're a good fit for you

A good thing to know going in is that not every therapist will be a good fit. This is why it’s also helpful to have a few options narrowed down before contacting—in case one just doesn’t feel right. The relationship you have with your therapist will be an important one, where you should feel a sense of trust, openness, and non-judgment. Many therapists recommend a preliminary phone call or session to get a sense of whether it’s a fit for you both before committing to a longer arrangement, but this is also something you can request (note that this may have an associated cost). Feel free to ask them questions about their approach, what they look for in clients, their views on any topics that are important to you (e.g. religion, medication, etc.). Take note of how you feel talking to them. You may be nervous if it’s your first time, but do you feel respected? Heard? As much as you can, try to go with your gut.

get on a schedule

Once you’ve found a therapist and confirmed their fit, the typical next step is scheduling. You can work with the therapist to determine frequency, day and time, and iron out other details. There may be some paperwork involved and if you’re using an insurance provider you will need to provide your insurance information. Also take note of their policies so you’re aware (information-sharing, cancellation fees, holidays). Once you’ve started seeing your therapist regularly, you’ll get a better feel for their style. The first few sessions may feel awkward. You’ll often be asked to provide lots of background information early on so they can better understand how to support you. You can decide how much you want to share. The therapist may or may not take notes, and they may ask some follow-up questions as you go along.

evaluate over time

After you’ve been seeing your therapist regularly, you’ll have a better idea of fit and how much therapy is helping you overall. It’s not uncommon for it to take multiple sessions for therapy to feel more comfortable and helpful, and it’s good to have realistic expectations going in. Your therapist won’t be able to solve all of your problems, but they should be able to help you feel less alone, provide strategies for coping with the big emotions, and offer perspective on your thoughts in a way that helps you process.

As time goes on, you will have a better sense of your therapy needs. You may find that you want to increase or decrease the frequency of sessions. You may want to see if your therapist offers longer sessions. You may even get to a point where you feel okay without therapy — or where it’s not the right fit for your life anymore. On the other hand, you may find that things aren’t flowing well and sessions aren’t feeling as helpful. In any of these situations, it’s best to speak with your therapist and let them know what you’re thinking. At the end of the day, therapy should be a helpful tool for you - and if you find that isn’t the case for whatever reason, it’s okay to change things up.

5 Books on Grief

Photo: MJ Franklin / Mashable

Reading can be a helpful way to process grief, whether it’s through narratives of others who’ve gone through something similar or how-to’s that unpack all the big feelings of grief.

Here are five books that may help in your grief. What books have helped you process? Let me know in the comments below.

1. Tiny Beautiful Things

By Cheryl Strayed, On Amazon

I’ve mentioned this one before in my Personal Story post, but this book has by far had the greatest impact on my understanding of grief. It’s a collection of advice columns written by Cheryl Strayed who, at the time, went by the alias Sugar. Her advice is poignant, at times even poetic. She’s firm without being harsh, each response crafted with empathy and wisdom from her years of experience dealing with grief and trauma. Just know that not every column is about grief, but the ones that are have incredible insight. I recommend starting with The Black Arc of It, The Obliterated Place, and Tiny Beautiful Things.

2. Modern Loss

By Rebecca Soffer and Gabrielle Birkner, On Amazon

I had the privilege of hearing these two wonderful authors speak at an event in Seattle years back. Each of them had lost parents, and the experiences they shared were sad and beautiful and at times even funny. This book, as filled with personality as the authors themselves, features little illustrations and hard truths and written contributions from guests to show a wide array of experiences. Consider this your beginner’s guide to grief.

3. It’s Okay to Laugh (Crying is Cool Too)

By Nora McInerny Purmort, On Amazon

The book description puts it best when it says “This book is for people who have been through some shit.” In her book, Nora (who is from my hometown) talks about her experience losing her husband Aaron to brain cancer after only having a few years together, and how they found joy even in the depths of their grief. Aaron was a well-known designer in the Minneapolis community and was only 35 when he died, leaving behind a memorable obituary that was a testament to his personality, as well as a legacy that Nora carries on to this day. Her book is honest and raw, but it’s also funny and conversational. A must for young widows.

4. Radical Compassion

By Tara Brach, On Amazon

Tara Brach is a clinical psychologist and mindfulness meditation teacher whose work I was first introduced to on a meditation retreat. Her book “Radical Acceptance” is a great read for anyone interested in learning about mindfulness and self-acceptance, and her long awaited follow-up, Radical Compassion, applies some of the same concepts to working through grief and trauma. She features her own stories and stories from her meditation students, and her writing (like her meditation audio recordings) is a mixture of calm, insightful, and loving.

5. Wild

By Cheryl Strayed, On Amazon

Okay, not to be a total fangirl here, but Wild is another wonderful book written by Cheryl Strayed. This one is an autobiographical novel about her trek on the Pacific Crest Trail in the wake of her mother’s death. It deals with themes of loss, forgiveness, and self-discovery in the midst of pain. It’s a beautiful testament to our strength and resilience, as well as the power of nature. Fair warning: it may make you want to hike the PCT.