### Podcast Transcript
Amanda Dinsmore (00:01.367)
Hey guys, welcome back to the podcast. I am Amanda.
Laura Cazier (00:05.586)
I'm Laura.
Kendra Morrison (00:07.291)
And I'm Kendra.
Amanda Dinsmore (00:08.919)
And today we welcome Krista St. Germain to the show. As physicians, we are on the front lines of our patients' very worst days on earth, but we are not always, shockingly so, prepared to help them with their grief, let alone their families, or even our own grief. Krista is a widow, a master certified life coach, a post-traumatic growth and grief expert, and host of the Widowed Moms podcast. Krista has been featured in so many fabulous places, including Psychology Today, Medium, Thrive Global, Bustle, Psych Central, Parents Magazine, and multiple podcasts. Today, she's gonna help us better understand grief, the myth of the grief stages, as well as how to be supportive of our patients when they are grieving the loss of a loved one. Thank you so much for joining us, Krista. We are incredibly honored to have you on the show.
Krista St-Germain (01:02.352)
Thanks for having me. I always love when people want to talk about grief because I don't think we talk about it enough. So thanks for being willing.
Kendra Morrison (01:10.971)
Absolutely. Thank you for helping to normalize the conversation. I think people are fearful of bringing that up because then that brings up the whole gamut of emotions, no matter where in the stage of grief you are. So thank you for bringing it to a normal conversation and being brave enough to talk about it publicly and internationally. So thank you. Tell us about you and what led you to become a grief expert.
Krista St-Germain (01:34.896)
Sure. I say it's selfish because I know that if I had gone into my own grief experience, which I'll tell you about, but if I had gone into my own grief experience with more information, I would have suffered less. And so it's selfish for me to have these conversations because it's like helping the former version of me and then helping all the "me's" that are out there and coming. But I never intended to be a grief coach. I did not set out to do grief work or even life coaching, but I found myself in a place when I was 40 where I had recently gotten remarried. My first marriage, which resulted in two beautiful children, kind of went down in flames. It was not what everyone hopes their marriage will be. But I had found this redemption story in my second marriage. I was on a real high in my life. Everything was going right. I firmly believed my best days were in front of me. It was all looking up. And it was like, finally. And we were coming back from a trip together, we had driven separately. I had a flat tire and I pulled over on the side of the interstate and we were so close to being home. But he pulled up behind me. He did not want to wait on AAA to change the tire. He was like, "Baby, you know, I can do it. It won't take me that long." And so he got out and was trying to get in my trunk to get the tire out of my trunk. I was standing on the side of the road texting my daughter. She was 12 at the time she'd been on the trip with us, but she had ridden the bus home. And I was telling her that I would be late. At that moment, a driver who we didn't know at the time, but later found out had meth in his system and alcohol in his system. 5:30 on a Sunday, daylight, right? His life obviously was not going so well, but he didn't see us. And he crashed in the back of Hugo's Durango and trapped him in between his car and mine. And so very quickly, what I felt like was a high in life went to an absolute low. And even though I really did have great friends and family, and a wonderful therapist who I went back to very quickly, I had all of those things around me, but I quickly figured out that what I thought I knew about grief was actually not accurate. It was not helping me. And when I finally got to a better place, having done a lot of that work on my own, I decided, you know, I don't want other people to struggle this much because we do live in such a grief-illiterate society. We need to have more of these conversations and this is what I want to do. So that's what led me here. It was really just, you know, some unexpected grief of my own.
Kendra Morrison (04:21.723)
Incredible way to make that test in your life just truly a testimony and then to reach out and use it as your passion for the future. That's certainly something very honorable. So in med school, we learned the popular five stages of grief. Tell us where this popular theory comes from and why we shouldn't try to fit everything into the grief theory box.
Krista St-Germain (04:44.976)
I can do sometimes to hear the phrase five stages of grief and not want to like throat punch someone. It's so frustrating to me, but I get it. So the five stages of grief is, do you want to guess what decade? Anybody?
Kendra Morrison (05:00.507)
1950. 50 seems like everything. Right, right.
Amanda Dinsmore (05:00.567)
Yeah, fifties seemed right.
Krista St-Germain (05:02.576)
Close, yeah, 69. 69, you're close, right, everything. We didn't evolve after that, we just, we stopped in the 50s. So 1969, I don't want to, even though I am not a fan of how we use the five stages of grief presently, and even though there are many more grief theories and models that I think are more valuable, I don't want to discount the work that Elizabeth Kubler-Ross did with the five stages of grief at that time. Nobody was having those conversations, and so for her to come along and study what was happening to people who were coming to terms with the terminal diagnosis was important. And that's what it was, right? It was an anecdotal study of, I noticed that people, when they're coming to terms with their own mortality, tend to go through this phase of denial, and then they tend to bargain, and then they get depressed, right? I forgot anger. Denial, anger, bargaining, depression, acceptance, right? Ultimately landing in acceptance. And so she wrote the book on death and dying first, and then later took that five stages idea and brought it into the grief space and wrote on grief and grieving with David Kessler. And so really important in its time, however, we have taken it and we have gone wild with it, right? She never meant it to be formulaic. And later in life, she wrote about that and really regretted that people had used her work and made it formulaic and prescriptive and used it against themselves, right? Instead of using it as a way to normalize what can happen during grief, we took it and made it mean this is what should happen during grief, and that's not the intention at all. So grief is extremely unique. It varies highly from person to person, and I see a lot of us really creating more suffering for ourselves because the only thing we've heard is the five stages, and we just keep perpetuating it over and over and over. Even Taylor Swift did it lately. And I love Taylor Swift. But she even made a Spotify playlist right before her latest album came out. And she classified all of her breakup songs in the five stages of grief. Right? It's everywhere. It's everywhere. But it does not reflect what most of us experience when we are grieving.
Kendra Morrison (07:21.659)
Funny. Even pop culture wants to fit everything in the box. What do we need to know as physicians about people going through grief?
Krista St-Germain (07:26.96)
Yeah, I mean, I think if we can kind of zoom out and first of all, just broaden our definition of grief, that will help. So in, you know, what I do is I'm primarily working with people in terms of bereavement, right? Where a person has died. And that is a type of grief, but there are many others, right? So I like thinking about grief as the natural human response to a perceived loss. And when we think about it with that generous definition, we start to see it in so many other places. We thought something was gonna go one way and it went another and to us that feels like loss. And so we don't wanna just think about it as bereavement, right? We wanna understand that probably everybody has some grief that they're experiencing to some extent and that it's just always happening. So broaden up the definition, remind ourselves that it is not, even though there is the diagnosis of prolonged grief disorder, right? Even though there is some language that we use around it that implies it's a problem, it really is a natural thing that humans are designed to go through. It is not just like feelings aren't problems to solve, grief isn't anything to solve either. And then I also like to think about it instead of an emotion. Sometimes people tend to think of grief as a feeling. It can be a feeling for sure, but I like to think about it as all the thoughts and feelings that we have about this loss that we perceived, right? All the things that we do in response to that. And so when we can use a generous definition and we can think about it being inclusive of
all the thoughts and feelings instead of just one, then we can also help people understand that, you know, there's no end of it. Because a lot of us are coming from the lens of five stages and we're thinking about acceptance being the quote unquote final stage, then we tend to relate to the idea of acceptance as though it's like a place that we reach like, or some ultimate choice that we make and when we make that choice or reach that place, then we're done, you know, or, I don't know, we get a medal or a gold star or something. But obviously it's not the way it works, right? Acceptance isn't, it's not a thing that we do one time. It's not a place that we reach. And unless we can go back and change time and undo the loss, a person's always gonna have a response to it. So the grief never ends.
Amanda Dinsmore (09:54.631)
Right.
Krista St-Germain (09:56.016)
There is no such thing as it ending. It's really more of, can we go through a process of integration? Can we go through a process of choosing consciously how we wanna think about the role that that loss is gonna play in our lives and what we wanna make of it and who we wanna be in the face of it. So those are some of the things that I find to be helpful.
Amanda Dinsmore (10:12.791)
I've heard people say, and I don't know if this is helpful or not, but that's why I'm running it by you, but that grief is almost a proxy of the love that you shared with the person that you lost. You know, you don't grieve somebody who you didn't care for deeply.
Krista St-Germain (10:29.392)
Yeah, typically, sometimes for some people, given there's a lot of unique circumstances, that can feel kind of complicated when maybe if we are talking about a person, maybe the relationship that you had might have been abusive, or there might have been some things that just make it a little bit less clean than just it being the price of love. But I do think that as humans, that kind of is the price that we pay. If we want to have connections with people that are meaningful and valuable to us, then the price of those valuable relationships is that we could lose them. And that is a part of grief, for sure.
Laura Cazier (11:08.85)
Yeah. So I'm still trying to catch my breath after hearing your story. And it is perfect because the question that we are asking next is how do we support patients and families who are grieving and not say the wrong thing? Because when you hear something like that, there's just so...
Krista St-Germain (11:37.234)
So many thoughts run through our brains and our brains try to make sense of things for us and try to make sense of things for you and that can lead people to say things that might cause more harm than comfort. How do we avoid that?
Krista St-Germain (11:55.056)
Yeah, I so get that. I think the first thing we do is we extend grace. We aren't going to always say it the way that we later wish we had. And I can count many times since even becoming a coach and studying grief and doing what I do where I have said things where I'm like, well, that's not what I really, really wanted to say or that didn't go over as I had hoped. So if we can extend some grace and give ourselves permission to know that we aren't going to screw it up and we can still be kind to ourselves afterwards, I think that will help. And then really, I think the next best thing is to then get in touch with our motivation for why we want to say something in the first place. Like, you know, I don't know if you've ever been on the receiving end of a comment that felt minimizing to you, but you know, when you were experiencing a lot of pain and someone tried to talk you out of that pain, or they tried to get you to look on the bright side or count your blessings or, you know, tell you that, well, you know, that everything happens for a reason or they're in a better place. All those cliches and platitudes tend to come from a well-meaning place, but a place where we're believing that how that other person is feeling is a problem. Right? It's a problem. I am not comfortable with this level of discomfort that I perceive in them. And so the things that come out of my mouth are trying to make them feel better, which ultimately also makes me feel better. And the times when you feel the most validated are when people are just with you in your pain, right? They're not trying to change it and they're not trying to talk you out of it. They're just with you. And so if you can give that kind of a gift to someone, right? If you can increase your ability to feel comfortable, and I don't mean like you're like happy that they are in pain, but you develop a tolerance for it and ability to stay present with them and yourself as they are having the experience that they're having and not relating to it as something that's problematic that you need to fix or solve. That helps tremendously. And then it's like, this is so hard.
Laura Cazier (14:07.57)
Yeah.
I'm reminded of that. Brene Brown has a little short where I think it's a giraffe or something. She's showing the difference between sympathy and empathy. And someone's down in a hole and that giraffe just sticks their head down there and says, mm, it's bad. You want a sandwich? And then for sympathy, they go down in the hole with them and just sit.
Krista St-Germain (14:36.368)
Yeah. Yeah. And I think that's, we all have gone through something. You can't be human on this planet and not know pain. And it may not be the same pain that that person is experiencing, but there is a part of you that understands what it is like to lose something or someone that you care about and experience pain. And so it's like, can that part of you see that part of the other person without needing to try to change it or fix it? It's not broken. Yeah.
Laura Cazier (15:05.042)
Yes, it's so interesting because we think that it's healing. We might think it's healing to have someone try to get someone to see the bright side, but what's healing is feeling heard and that sitting with them is what is ultimately going to be more healing.
Krista St-Germain (15:23.12)
Yeah. That's what I find. And it seems like it's kind of surprising sometimes when you realize how many people just don't have the stomach for it or the experience of doing it. But it's like a muscle. We can learn to do it.
Laura Cazier (15:35.73)
Yeah. Absolutely. So what about when we are the person experiencing grief as doctors? Many of us default to just keeping our head down, numbing out, powering through, continue to work like feelings. A lot of doctors are very uncomfortable with feelings. So any tips for us?
Krista St-Germain (15:59.408)
Yeah. Well, it seems like in many ways, you've kind of been taught that, right? Like you have to not pay attention to what your body needs because you're taking care of another body. And like, you know, not to say that I'm advising that by any means, but it makes sense how someone in that profession would arrive at that conclusion. I think you kind of want to be bought into the value of letting yourself feel feelings first because if you're not bought into the value or you don't see how maybe not being in touch with what you feel is creating something you don't want, you probably wouldn't have the incentive to start baby stepping your way into being more in touch with what you're feeling. So it's good to look back and say, okay, is this costing me something that I don't want to be paying for anymore? You know? And if so, what is it? And like, what's in it for me if I actually learn and give myself the option of not overworking so much, not distracting, not doing those things that have kept me from feeling. Is that something I really want? Because I don't think it's morally superior to feel.
Laura Cazier (17:12.754)
Yeah, it's certainly, I think a lot of us feel like it's adaptive to not feel, especially, you know, we might declare someone dead and then have to go into the next room and see someone's sprained ankle. And it definitely feels more adaptive sometimes to compartmentalize, but those of us who have been doing this a long time, many of us realize the toll that that can take on us, not just emotionally, but physically. Our bodies do not love it when we keep shoving the, keep packing all these feelings down into the basement for us to deal with later, so.
Krista St-Germain (17:52.24)
Yeah, that makes so much sense. I can also see how it could turn into a should that someone would use against themselves, right? And those never really tend to be too helpful.
Laura Cazier (18:08.786)
Yeah.
Krista St-Germain (18:13.68)
In my experience. So that's why I say, can we really think about, is this something I want to learn? Instead of letting it be a should, or instead of thinking that I'm somehow better if I do, is it something I actually want to and why? And then if I want to, okay, I can start kind of baby stepping my way into it, like titrating a little bit, right? Because we don't want to go from, I never feel any of my feelings because I can always distract myself with X, Y, or Z to some sort
of binary extreme of now I have to feel all of them because that sounds terrifying. So how can I spend, right? Like, can I do it for five seconds and see what a feeling is like in my body and then give myself permission to quit and then maybe come back to it? Can I do it when I'm not at work and I do feel like I'm in a safe environment or with somebody who actually knows what they're doing that could help me?
Laura Cazier (18:50.93)
Yes!
Krista St-Germain (19:06.064)
You know, and then we can, yeah, start developing the muscle.
Laura Cazier (19:06.61)
Yes. Yes, I love that.
Amanda Dinsmore (19:10.135)
I was gonna mention, I don't know if you've heard of Jill Bolte Taylor, but one thing that has helped me is her work on that, the neurochemical cascade of an emotion lasts about 90 seconds unless you revisit it. Like I can give myself 90 seconds. And certainly for myself, the numbing out which I was pretty much an expert at was coming at the cost of like,
Krista St-Germain (19:38.8)
Yeah.
Amanda Dinsmore (19:40.663)
Almost my soul, you know, like I wasn't the tender-hearted person that I was when I started working in medicine and I didn't like that. And so, but I can give myself 90 seconds to at least process some of it. And that's a place to start, I guess, for some people.
Krista St-Germain (19:54.928)
I love that. Yeah. I also think, there's another theory of grief that I really love. It's called the dual process model. And what I, I never want people to hear that feeling your feelings is the best and always the best thing to do and somehow superior, right? Dual process model just quickly divides all the activities up into two buckets. It says there are loss-oriented activities. So things related to the loss, thinking about it, feeling it, logistical dealing with it, loss-related things. Then there are restorative things, things that are unrelated to the loss, hobbies, time in nature, laughing, Netflix binges, distractions. And dual process model proposes that healing is found in the intentional oscillation, the back and forth. And if we have swung too far to the other extreme where we think that we must do the work of grief all the time and we must feel all of our feelings all the time, then we don't get the Netflix binges and the breaks, right? Which are actually quite beneficial. So if we can give ourselves permission to have both, yes, I will learn to feel feelings if I feel like that is where I wanna go. And also, breaks are good. Breaks are healthy. I can give myself a distraction. I can do things that are restorative in nature. And it doesn't become another should.
Laura Cazier (21:10.738)
Yeah. that's awesome. That's great. See now, A, you're going to go back to Real Housewives now, huh?
Amanda Dinsmore (21:20.023)
Is it bad that I absolutely was thinking about that? Like, Ooh, excellent. Put that back on the docket.
Krista St-Germain (21:24.24)
I was like, what am I missing?
Krista St-Germain (21:28.976)
I love it.
Laura Cazier (21:28.978)
So you're an expert in post-traumatic growth. I am so intrigued. Tell us what that is.
Krista St-Germain (21:37.872)
I always love it when people are like post-traumatic growth, just because I remember hearing it for the first time myself and just was one of those moments where you just go, wait, what did they say? Post-traumatic what? Because everybody knows post-traumatic stress disorder, but then you say post-traumatic growth and most people look at you kind of funny. So post-traumatic growth has actually been around since the mid-90s. Just apparently nobody was talking about it to me anyway until somewhere in the, we won't talk about when, but much later. But post-traumatic growth is the idea that we can create a positive psychological change following something traumatic. So the researchers that came up with the idea and coined the phrase had prior to their work thought that there would be something traumatic that would happen to someone. And at the time, they were using a very objective definition of trauma, right? It was the, like, this is the list of things that are traumatic, and if any of these things happen, whereas now we know that trauma is much more subjective. So, but anyway, they were noticing or thought that there would be this level of wellness or life satisfaction that someone would have before something traumatic happened to them. And then after that thing that was traumatic happened to them, they would experience a dip in that level of wellness or life satisfaction. And then the best we could hope for was to get back to where they were before. Like that was the goal. And so they started noticing that there was, there's actually people who were experiencing this level and then dipping and then never recovering. There was a group that would experience that level of wellness dip and then bounce back. And then there was a third group who would experience the dip, but not just bounce back, they would bounce forward. And not in spite of what had happened, but literally because of it, literally because of what they chose to do after it had happened. So I like to think about it like a tornado because I live in Kansas and we have tornadoes here, which is simply that, you know, if you lived in a house and a tornado came and knocked down your house, you're going to need to rebuild the house, right? You could just rebuild what you had. Do as close as you could to that. Go find a builder and give them the exact plans that you had before and that will be fine. Also, if you lived there for any given amount of time and because the tornado came, you might make some changes. You might want more light. You might want a bigger kitchen. You might want a storm shelter. There are some things that you might want to change because a tornado came and you now have the chance. And so if you choose to do that, it doesn't mean you ask for the tornado to come. It doesn't mean that you're grateful that the tornado came. It just means that you're the one that gets to choose, right? So post-traumatic growth is primarily about five areas. So it's relating to others, new opportunities, personal strength, spiritual change, and appreciation for life. So for me, it was in large part a wake-up call to decide to check in with myself and decide, am I doing what I wanna do with my life? Like here I am, making money, in a job. Is this really, if life is this short and precarious, is this what I wanna be doing with mine? And ultimately the answer was no. Does that mean I'm a better person because I changed my career and did something else with my life? No, right? But did it help me create a life that's more aligned with what I value? Yes, that's post-traumatic growth.
Laura Cazier (25:12.306)
Love that so much.
Amanda Dinsmore (25:12.599)
Well, I always appreciate a tornado reference. Kendra and I are originally from Oklahoma, so we're now in Missouri, so we're still your neighbors. Yes, spoke directly to my heart. So tell me, so this is absolutely amazing and thank you so much again. Tell us about who your clients are. Who has the opportunity to work with you and how does that work?
Krista St-Germain (25:40.176)
Yeah, so I work specifically with widows, but that doesn't mean that someone can't, if they're interested in learning more about grief and post-traumatic growth, by all means go and listen to my podcast. It's called The Widowed Mom Podcast, which I realize is very niche in terms of its name, but really, truly it's about grief and who we want to be after something like that happens to us. So for sure, anybody is welcome to learn from that. But in terms of my coaching, I specifically work with women who were where I was, right? And found themselves still not done living, but...
Amanda Dinsmore (26:12.631)
I just appreciate that because now when I have a patient who is in that scenario, I have you as a reference. Like there is help out there. And that's, that is what I've loved about becoming a coach too, is realizing there are people in these arenas that I had no idea about. I can't tell you how many people I have said, start listening to Corinne's podcast. You know, we can say start listening to Krista's podcast. Like there are people who have been exactly where you are.
Krista St-Germain (26:37.744)
Yeah.
Amanda Dinsmore (26:44.375)
And that is probably my favorite, one of my favorite things other than people feeling tremendously better. But like, being with somebody who's been through what you've been through, I can't even imagine how cathartic that would be for them.
Krista St-Germain (26:47.408)
Yeah.
Krista St-Germain (26:58.32)
Yeah, I absolutely love it. I have a woman who's still in my program. Once you come into my world, like a lot of people, they just fall in love with the community and the coaching and they just never leave. And she's an ER doc and she lost her husband and has just been through it, right? I know that that is one thing that she absolutely loves doing is being able to hand people resources, right
? When a widow comes and she's got to give somebody bad news, is to then follow that up with hey this podcast might help you. Yeah.
Amanda Dinsmore (27:31.735)
So we'll have a link to the podcast and we'll also have a link to your social media and everything. Is there a best way to get in touch with you or what's your recommendation?
Krista St-Germain (27:42.704)
CoachingwithKrista.com has all of my information on it, including email. And if anybody ever just needs to be pointed in the right direction, don't hesitate. Reach out, send me an email. If I don't have a resource, I know a lot of people that do what I do, and I can probably find somebody that can help. I also love just helping educate people on grief. And sometimes I'll go into organizations and work with them after maybe they've lost an employee, or maybe they want help understanding grief so that they're better prepared. So I just love being a resource and helping people in whatever ways helps them be more able to support themselves and others when things like this happen because this is what happens as humans, right? We know this.
Amanda Dinsmore (28:27.255)
Okay, well I have loved this. Are there any closing thoughts before we end the podcast?
Krista St-Germain (28:32.624)
No, just kudos to you again for wanting to talk about grief and helping further the conversation. That's how we change the experience of people who are gonna go through it. So thank you.
Laura Cazier (28:44.626)
Yeah, thanks so much.
Kendra Morrison (28:47.579)
Yeah, what a great conversation today and thank you, Krista, so much for taking time out to share your work. I know there's, you know, some old adages there, but there's, you know, we go through pain, but kind of what you mentioned before, there's always purpose in the pain and you've made such a beautiful purpose out of some painful things that have gone through your life. So I know it's going to inspire so many to just realize that, you know, sometimes just like you said, that we go through stuff and that there's growth on the other side and maybe a purpose that you found that was greater than anything else you could have imagined. You know, even if you still have that same life, I mean, just really being introspective and doing something about it. So thank you very much for your work and being available and so personable and lovely. So thank you very much.
Krista St-Germain (29:34.832)
100% my pleasure. Thank you.
Kendra Morrison (29:39.963)
And if you want to find more information about Wellness 911, go to our website, www.thewholephysician.com to get more information. We take demoralized doctors from fried to fantastic with our easy and evidence-based Wellness 911 program. So until next time, you are whole, you are a gift to medicine, and the work you do matters.
