One of the perks of being a family doctor isthat I get to listen to the fascinating, real-lifestories of patients. Their stories are betterthan the ones you'll read in any best-sellingbook—you can't make this stuff up. Take JoeSnow, for example. He's a single male, aged 60, whorecently came in for his routine hypertension followupvisit. As I usually do, I asked him what was new inhis life. This question gives patients a chance to tell metheir real concerns, which are often far removed fromany medical concerns.
Joe replied, "Well, I have two problems. The firstis that my 24-year-old exgirlfriend wants to moveback in with me." I thought, "Wow, that's interesting.A 24-year-old girlfriend." Then I said, "That can be aproblem, can't it?"
"But I'm not going to let her. She has loving parentsand she needs to reach out to them, not me," Joereplied. That's certainly a mature attitude. I asked,"So what's the other problem?"
"The big problem is that I lost a bundle of moneyin the stock market when it crashed, and I know Ihave to get back into the market now, but I'm afraid.And I know I must, or my retirement plans will bedashed," Joe said.
As I carefully watched Joe's facial expressionswhile he talked, I knew I had seen that look before. Itwas the same look I've seen on patients who aremourning the loss of a parent or spouse. Joe was, infact, grieving over the loss of his money. What?Grieving over your money? Can that happen?
On Death and Dying
I shouldn't have been surprised. Ever sinceElisabeth Kubler-Ross wrote (Scribner; 1997) in 1969, psychologists have beentelling us that any loss of something we treasure—ajob, car, piece of jewelry, or especially a loved one—isfollowed by a series of mental states that we mustwork through to reach a position of psychologicalequilibrium that was upset by the loss. These statesare made up of the following:
• Denial—This is an unreal feeling. The consequencesof the loss are so catastrophic that our minds seem to shutdown. We think, "This can't be happening."
Are you in denial? Do you still have problems believinghow much you lost? Do you avoid looking at yourfinancial statements because it might not be so bad if youdon't know about it? Did you prefer to view the crash asjust another dip, a buying opportunity rather than awarning to limit your exposure to failing companies? Doyou refuse to dump your losers because then you'd haveto accept the fact that you lost money on them?
• Anger—We grow frustrated knowing thattragedies such as this simply should not happen. If theydo, something or someone went wrong. The anger canbe directed at either an action or a person, simplybecause of who they are. You or I, as the closest availablephysician, may catch some of that anger. We simplyhappen to be present when the person gets into an angrymood, and the mood gets directed toward us.
Are you mad at the CEOs of the companies youinvested in? Are you mad at them simply because of whothey are, or because of what they specifically did? Insome cases, you may be angry simply because the CEOrepresents the company. I suspect all the show trials ofcorporate executives are surrogates for expressing ourpersonal and collective anger. This may have some rolein mourning, but a fixation on anger can impede ourability to work through our grief. And it can lead to badpublic policy if it results in inappropriate governmentregulations that hamstring American businesses.
• Bargaining—After exhausting our anger, we moveon toward the bargaining stage. Say our house hasburned down or we have lost our job. Often, we ask forhelp from a higher power. If you give me back my job ormy house, I promise to go to church every Sunday. Insome cases, we ask for a miracle.
Have you taken a flyer on risky stocks in a futileeffort to make up for your losses? I suspect that tradersare looking for a quick and easy way to recoup their lossessome day, so that they don't have to work through thepain of the grieving process. That probably won't work,and they often end up with even greater losses to mourn.If you have lost money and still feel that somehow youstill have it, or are entitled to it, and that you just have tofigure out a technique or angle to get it back, you areexhibiting a form of bargaining.
• Acceptance—In this stage, we are over the loss. Westop assigning blame, bargaining, and denying. We saythings such as, "I decided to move on."
Have you reached the state of acceptance of yourloss? Sure, you miss the money, the early retirementoptions, and the security that the money represented. Butyou'll not deny that it is gone forever. You'll stop blamingyourself or others for mistakes that were made. You'llnot waste your time hoping and praying that somehowyour money will come back to you. If so, you've acceptedthe fact that today is the first day of the rest of yourfinancial life, and you'll make financial decisions basedon what you know in the real world of today.
Unfortunately, all too many of us get stuck in one orthe other of these stages. We become paralyzed andunable to put the loss in perspective. My patient was stillgrieving for the money he lost in the market. And thatmourning was interfering with his ability to accept loveand make plans for his financial future. At that point, Iexplained to him that he was in a state of mourning, andthat he would have to work toward acceptance of theloss before he could move on with his financial plans. Ipatted him on the shoulder and proceeded to the medicalportion of his visit.
Death of Mourning
Now, there is a crucial difference between mourningthat occurs with of the loss of a loved one andmourning that occurs because of the loss of money.The loved one is gone forever. The mourning processruns it course and eventually is over. But, in the caseof your money and your investments, the loss willrecur. The very nature of money and investing guaranteesthat this will happen. Therefore, if my patientsuccessfully traverses the grieving process and is ableto get back into the market, he will certainly be put ina similar position in the future.
We know that those who have a close brush withdeath, such as soldiers in times of war, often go on toachieve great success in life. Perhaps their secret is thatthey've already mourned for their lives when they werecertain that they would die, and that mourning strengthenedthem so that nothing could frighten them in theirpostwar lives. Similarly, if my patient has adequatelymourned his losses, he may very well be able to carrythat attitude with him in the future.
Louis L. Constan, a family practice physician in
Saginaw, Mich, is the editor of the Saginaw County
Medical Society Bulletin and Michigan Family
Practice. He welcomes questions or comments at
3350 Shattuck Road, Saginaw, MI 48603; 989-792-1899; or firstname.lastname@example.org.