Monday, August 24, 2020

Pet Loss: PTSD Following Euthanasia Decision?

Dogs' lives are too short. Their only fault, really.  ~ Agnes Sligh Turnbull

A reader writes: After agonizing over this decision, I decided my beloved 16-year-old dog was no longer able to live without suffering, and I had him euthanized at home. This of course was the beginning of absolute anguish for me. Since then I have read alot, gone to grief counseling groups, conferred with a counselor, joined the APLB chatrooms (they suggested I contact your website when I told them that the chatrooms were too upsetting and intensified my pain), written copious diary entries as well as love letters to my dog, and finally, have started reading, responding and communicating with others on your website.
Last night, again I had a severe emotionsl reaction to a discusssion about euthanasia, and now realize, as I had slowly been starting to do, that I am walking a very fine line emotionally when it comes to discussing anything about this ordeal. I feel so emotionally fragile and vulnerable at the drop of a hat, and never know what is going to trigger an extreme reaction from me. I need to talk about this experience, and am the sort of person who derives conmfort and satisfaction in empathizing and comforting others, and of course it helps me. (I am an art therapist and have worked in the helping professions for about thirty years) 

I am beginning to wonder if I might be experiencing post traumatic stress disorder, and if so, how should I proceed?  I don't want to cut myself off from others as I have very little support and live alone. I am very strong but don't feel as though isolating myself even more is the answer, either. I just can't afford these really extreme reactions where I relive the awful details of my experience. I never quite know, either, when I will be set off. I know I will probably never be comfortable with this business of euthanasia except in really obvious cases of extreme suffering. My dog had not yet arrived at that point, and that was what I was trying to prevent. It seemed that this was an imminent inevitably, and he was very very uncomfortable for ten days before I took this step. I keep thinking I have put all of the self torturing aspects of this decision behind me, and try to practice mental discipline in order not to replay the excruciating events, but I just never know when they are going to resurface and grab me by the throat. 

I would be most grateful for any advice. I hope I haven't taken up too much of your time already. I really feel as though I can't afford to sink too much lower and am determined not to let this ruin the quality of my life forever, so just want to know if there is anything else I might do to help and PROTECT myself. Thank you very much for reading this and I hope all is well in your world. 

My response: I'm so sorry to learn of the difficulties you’re having in the aftermath of your dog’s euthanasia, and I know that, despite your very high expectations of yourself and despite all your professional training, education and background, right now you are experiencing the very raw and powerful feelings of loss. Grief is like that ~ it can knock you flat and leave you feeling crazy, isolated and vulnerable. Let me see if I can offer you some useful information, comfort and support.

You say that as an art therapist, you’ve worked in the helping professions for 30 years. So often we in the helping professions believe that we "should" know what to do in every crisis situation, not only for our clients and patients but for ourselves as well. We hold such unrealistically high expectations of ourselves, don’t we?  I am reminded of something I read in a book by Nina Bennett, a healthcare professional whose granddaughter was stillborn. On page 55 she shares the content of an email she received from one of her dearest friends, a hospice social worker, whose words brought her great comfort:
Just remember that although you’re strong, you are also human. And just because you’re strong, it doesn’t give you supernatural powers to avoid very real, very human feelings. You are allowed to feel this way. It doesn’t mean that you are weak. It means that you are feeling the feelings of a grandmother who just suffered one of the most terrible things that a grandparent can go through. So allow yourself to be okay with feeling this way. Because these feelings are tough enough, without beating yourself up on top of it. [in Forgotten Tears: A Grandmother’s Journey through Grief, © 2005 by Nina Bennett] 
You say that although you’ve tried many different methods of coping, you haven’t found any of them to be particularly helpful, you’re still feeling emotionally fragile, and you’re wondering if the trauma of euthanizing your dog is producing symptoms of PTSD. You might consider asking your counselor for a referral to someone who specializes in PTSD, where treatment includes simple tools (relaxation, breathwork, meditation and guided imagery) to help you master and calm the troublesome symptoms you are experiencing now. At the very least, I strongly encourage you to do some reading about PTSD so you will be better informed about it. There are some wonderful and informative resources on the Internet (see Coping with Traumatic Loss: Suggested Resources) ~ but I also want to recommend an outstanding book, Invisible Heroes: Survivors of Trauma and How They Heal, by Belleruth Naparstek, a psychotherapist, guided imagery pioneer and noted expert in PTSD. If you click on the title, you’ll go to Amazon’s description and reviews of the book. I cannot recommend this book highly enough, because it explains PTSD so thoroughly and it also contains some very simple, practical tools that you can begin using right now. Among other things, the author points out that,
All of these people . . . were helped, in differing ways, by strategic doses of applied imagination. In each instance, what got them through was imagery, sometimes guided by a therapist, sometimes by an audio program, and at other times spontaneously generated from within . . . These imagery-based solutions use the right hemisphere of the brain – perception, sensation, emotion, and movement – rather than the left side’s standard cognitive functions of thinking, analyzing, verbalizing, and synthesizing. And that’s why they work. Trauma produces changes in the brain that impede a person’s ability to think and talk about the event[s] but that actually accentuate their capacity for imaging and emotional-sensory experiencing around it. Imagery uses what’s most accessible in the traumatized brain to help with the healing . . . But too few survivors know this and, sadly, too few professionals as well. So people are not only baffled and alarmed by their symptoms; they are more often than not seeking – and getting – the wrong kind of help from people accustomed to using discussion, thinking, and language – help that often misfires. It’s not that talk therapy is bad. The emotional support of a sympathetic listener is as critically important as it ever was. It’s just that it’s not enough by itself . . . [pp. 12-13]
You can learn more about this author and her work at Health Journeys.

That said, I want to emphasize to you that making the euthanasia decision for our cherished companion animals is one of the most difficult things we ever have to do, and I'm sure this must have been terribly hard for you. Usually when we decide with our veterinarian to choose euthanasia for our animals, it is with the loving and unselfish intention of relieving our animal's suffering by creating a dignified and painless death. It is an act of compassion and mercy, not one of malice and selfishness. Nevertheless, we're still left with overwhelming feelings of guilt and remorse. Guilt is a natural component of grief — it's only human to look back at what you did or did not do, to agonize over what could have been done differently and to second-guess the decision you were forced to make. Sometimes, though, there simply isn't anything you could've or should've done differently — and I suspect that, under the circumstances, you made the right decision for your dog. If you could have done something differently, surely you would have.

You say that your dog was “very, very uncomfortable for ten days before I took this step.”  Would it have been more humane to put your beloved companion through yet another day of suffering, just to give him one more day of life on this earth? I'm sure your precious companion knew how much you loved him, and I have a feeling that he would have understood that this was your final act of love for him. It may be quite helpful for you to make an appointment to talk this over with your vet, who is the only one who can reassure you that you did, indeed, "do the right thing," and that your dog did not suffer in any way during this procedure.

It may also help you to know that the relationship, the bond you have with your dog will last as long as you decide to keep his memory alive in your heart. What you will learn to do over time is to let go of the pain of losing him, but never must you feel as if you have to let go of your relationship with him and the love you have for him. Find a way to memorialize him, whether that is by planting a shrub or tree, putting together an album or photo collage, donating a book on pet loss to your local library or making a donation in his honor to an animal shelter ~ whatever you choose to do is up to you. You say you’ve written copious diary entries as well as love letters to your dog. You might also try writing a letter of apology or explanation to his spirit and say all you need to say to him ~ get all your thoughts and feelings out of your head and onto a piece of paper ~ then go to a special place of remembrance you've created and burn the letter as a way of symbolically releasing all that guilt you've been carrying around with you.

You say you're having trouble putting “all the self torturing aspects of this decision” behind you, but I can assure you that the guilt, pain and sorrow that you are experiencing in the aftermath of your dog's euthanasia is normal. Grief is a natural response to losing someone we love. It is also very hard work, and it shouldn't be done alone. I understand that you’ve tried attending a grief support group and conferred with a counselor, but you don’t say whether that group was specifically aimed at pet loss, or whether the counselor specialized in pet loss.  Unfortunately, not all counselors are experienced and trained in this particular aspect of grief, which requires an understanding of the human-animal bond and the special attachment you had to your dog. 

I’m pleased to know that you’ve joined our Grief Healing Discussion Group sister site, which gives you an opportunity to communicate with others who may be experiencing a situation similar to your own. Oftentimes just reading many of the messages posted by others gives reassurance that what you're feeling is normal and the hope that, if others can survive such devastating losses, somehow you will find a way to survive yours, too.

You might also find solace in reading these wonderful articles by other authors, which I think are quite comforting: Euthanasia: The Merciful Release by Rita Reynolds, in Blessing the Bridge: What Animals Teach Us About Death, Dying and Beyond and The Fourth Day by Martin Scott Kosins, in Maya's First Rose

I hope some or all of this information proves useful to you, my dear. Please know that you are not alone in all of this, as I am thinking of you and holding you in my heart. 

Afterword: Dear Marty, I just wanted to let you know how I appreciate your comforting and informative response. Thank you so much for giving me so many suggestions and resources to follow up on, which I intend to do, post haste! As I wrote to someone in the discussion group on your website, I think that the greatest trauma, aside from being the one responsible for causing the demise of my most beloved dog, is seeing him without life. The contrast of the living body and spirit in such a beautiful form vs. that of a lifeless body, in just seconds. It's really incomprehensible, and so mysterious, and so unbearable. I am trying to come up with creative solutions for dealing with my grief and very interested in those things you mentioned about right brain and left brain function in relation to trauma...Thank you so very much, Marty, I am very grateful for your time and effort in trying to assist me in this unbelievable journey of grief. Best wishes to you.

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