Overview:

Grief scrambles memory and concentration, at a time when life already feels out of control. Here's how I've mitigated those effects.

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During my days as a therapist for combat vets with PTSD, my patients would routinely tell me, “Doc, I’ve got CRS.”

As in Can’t Remember Shit.

Since my son Josh died, I’ve had a rip-roaring case of it myself. I stand motionless in the kitchen, puzzling over what I was planning to do next. I blank out when balancing the checkbook. I’ve run a couple of stop signs.

Sustaining my attention while reading for pleasure is a 50/50 proposition. Learning something new on the job—say, how to navigate the latest user-unfriendly electronic health record—feels overwhelming. During an otherwise delightful and engaging conversation with my fellow OnlySky writer, Jonathan MS Pearce, I had to ask him to repeat one of his questions (and truth be told, I probably could’ve done so a couple more times).

At least I’m in good company. Other survivors of traumatic loss tell similar stories. My wife Jessica compares her cognitive difficulties to a post-concussive state. As a speech-language pathologist working with patients in recovery from traumatic brain injuries, she doesn’t make the comparison lightly.

Regrettably, this aspect of grief is scarcely discussed in the professional literature. Empirical research has barely begun on grief and cognition, largely limited to elderly populations. Studies have also used the problematic differentiation between “normal” grief and Prolonged Grief Disorder, a concern I’ve written about previously. Using the standard medical search engines (Medline and PubMed), I didn’t find a single article assessing cognitive function after traumatic loss.

This deficit underscores how much we have yet to examine empirically in the realm of psychology. It leaves us mourners to discover our limitations for ourselves.

As with all facets of traumatic grief, I need to be kind to myself. I haven’t willed myself into la-la land.

So, why do the bereaved, like combat veterans, complain of CRS? I suspect there are several factors in play. First, suicide survivors are contending with post-traumatic stress (though not necessarily the full syndrome of PTSD). Concentration difficulties are a common aftereffect of trauma. When you’re in a “fight or flight” state of high adrenaline, it can be hard to focus on a single point.

Next, grief in many ways overlaps with depression, enough that one of Sigmund Freud’s classic, still-helpful essays is entitled Mourning and Melancholia. It’s long been recognized that trouble concentrating and forgetfulness are typical depression symptoms, so it shouldn’t astonish us to see them in the grieving state, too.

But let’s get more personal. Losing my beautiful son to suicide is the biggest shock I’ve ever suffered. I’ve been yanked into a hellish alternate reality, one that should not exist. It’s a jarringly wrong, fatally flawed world that doesn’t include my boy.

Instead of a present- and future-orientation, the temptation is to escape into the past, where I interacted daily with my uniquely humorous, generous, and exasperating kid. It’s too easy to enter the rabbit hole of wishful thinking and “what if” fantasies.

Is it therefore any surprise my head frequently resides in a swirling, gauzy, disconnected state? Mental health professionals call this dissociation, where a person feels out-of-body (depersonalization) or in a state of unreality (derealization). These are common responses to trauma and impair your ability to stay grounded in the present.

At the milder end of the dissociation spectrum is emotional numbing. So often numb and detached, it’s no wonder I struggle to focus.

What’s a sorrowful space cadet to do? I’ve found some useful strategies for navigating this mental territory.

First, as with all facets of traumatic grief, I need to be kind to myself. I haven’t willed myself into la-la land. This is wholly unintended. Getting frustrated with myself only compounds my anxiety, which then worsens my concentration further.

Next, it’s essential to slow down. I’ve reduced my work hours, because mental fatigue is best buddies with impaired concentration. I’ve given up multitasking, since my marbles are scattered enough as it is.

In addition, I employ more memory aids. My monthly bills are almost totally on autopay. I keep more to-do lists. As I provide patient care, I don’t double-check my orders. I triple- or quadruple-check. I also lean on my medical director and my virtual trips to the psychiatrist’s office to ensure I’m still performing better than adequately on the job.

(On this note, I’m so grateful for the gift of compartmentalization. Concentration and memory lags haven’t been consistent across all settings. Like many survivors of terrible loss, I can suppress my feelings of devastation and submerge myself in work for a few hours. Thinking back to my years at the veterans’ hospital, I’m sure this is why so many combat vets seek our services after retirement, when PTSD symptoms can no longer be squelched.)

It’s also beneficial to get outside of my head more frequently. Taking breaks, brewing a pot of tea, playing Best Fiends on my phone, stepping outdoors: these activities recharge my batteries.

Lastly, I remind myself it gets better. Already I’m noticing my cognitive storehouses have greater capacity. When so much of my existence is unambiguously divided into zones of “when Josh was alive” and “now that Josh is gone”—and not in a good way—this offers me a welcome infusion of hope.

For those who know survivors of traumatic loss—as coworkers, friends, partners—be patient when we’re not all there. Pay heed to the lyrics of that lovely Hamilton tune, “It’s Quiet Uptown.” Have pity. We are going through the unimaginable.

If you are having suicidal thoughts, please reach out to someone you trust, establish care with a therapist, call the National Suicide Prevention Lifeline (800-273-8255), or go to your nearest emergency room. Please stick around. We need you. 

This column is Part 17 of the Secular Suicide Survivor series. Here’s how it began.

Stuff they don’t tell you about grieving: The “Space Cadet” stage | Closeup of Josh at the beach, smiling, with front tooth missing
On the Outer Banks with Josh. Photo by author.
Lincoln Andrews

Lincoln Andrews

Life seemed as good as it gets in early 2021, with a happy family, a job I loved, and a long-desired move out of the Bible Belt to the Pacific Northwest. My world split open on September 12th, when...