Coping with a medical diagnosis often means coping with loss. The initial diagnosis presents a loss of what we thought the future would be like. Other losses may follow, some related to the chronic condition. What I have learned as a mental health professional over the years is that any kind of loss leads to a need to grieve. Grief is a healthy reaction to loss. I have also learned that grief is often accompanied by a need for closure.
I spend a lot of time talking with clients about closure. Here are a few examples:
A parent learns that her child has a chronic condition after having been rushed to the emergency room. She describes this experience as a “parent’s worst nightmare” and begins the road ahead, learning to monitor symptoms and adhering to medication and self-care routines. “I had a vision for his future and now that vision has changed. I am grieving for the life I thought we would have. Why him?”
A man learns he has been laid off from his job after five hears. His is living with a chronic condition and has had to take frequent days off from work over the last year. Now, he has been laid off. He has repeatedly emailed his boss and asked if they can talk about what happened, and his boss doesn’t respond. “I lost my job! He at least owes me some answers on what happened to my job.”
A couple has a daughter with a chronic condition and have been working with the same physician for years. Last week, they received a letter from her doctor’s practice informing her that her physician has left the practice and providing her with the name of the doctor her case has been transferred to. “I was totally unprepared to lose our doctor. I thought she would say good-bye and tell us how to say in touch if we had questions down the road.”
The individuals in each of these examples are facing a loss of some kind and they are grieving their loss. Their loss has led them to a need for closure.
What is closure? I think of closure in this way. As humans, we don’t like like leaving loose ends in conversations. We want to be understood. We want answers. Questions that may be unanswerable.
It is only human nature to want closure when we experience any kind of loss. Hearing about a life-changing medical diagnosis, with the feeling that life, your body, your hopes and dreams, have suddenly betrayed you. Losing a relationship, romantic, career, or professional. And of course, other losses in life, including death. Humans want to know! Why?
How? When? Along with, often, whether the situation can somehow be fixed, if not made to go away. Is this all a mistake or a bad dream? Or, Can I find a silver lining here somewhere?
Lack of closure leaves us feeling helpless. We have a loss. We grieve. We seek closure.
I’m Hurting. What Can Take This Pain Away?
It is really hard to sit with deep emotional pain. The pain around a chronic condition can feel like a dark cloud hanging over you, as I described in the examples I provided. The pain can feel overwhelming, accompanied by feelings like disappointment, anger, fear, resentment, and other emotions. Even physical.
And when we feel intense pain, it is only human to want the pain to go away. We hope that finding closure may be the key.
Looking for closure to help you to cope with a loss? Here’s help:
Define for yourself what closure means. Closure is a relatively general term. Are you looking for an explanation of what happened? An answer to why life has suddenly dropped this bomb on you or a loved one? An answer to why the other person made the decision they made? Are you looking to receive an apology? Do you just want to hear that you were important to that person and that you will be missed? Reassurance that life will indeed get better? Taking the time to sit down with yourself and define exactly what closure means in this situation will help you to come to terms with why you are feeling such difficult emotions. It may also be the first installment on purchasing your ticket to freedom. We’ll get to that.
Consider if closure is realistic the way you have defined it. People can only do what they can do. Everybody has limitations. Life happens around us, and to us, and we may never have answers to the question of why. Sometimes we make decisions that we can’t explain, this happens in love. Or we are constrained by rules and guidelines, like in the workplace. Or professional boundaries may guide what is appropriate or allowable. And let’s face it. People can just be plain old limited, whether we like it or not, and avoid a conversation that may be uncomfortable for them. If you’re expecting something from someone that they can’t or won’t deliver, then you are, like my mom used to say, trying to get blood out of a turnip. It’s a lose-lose, and you’re only hurting yourself.
Weigh the risks of further exposure to the situation or the person. Are you sure your closure meeting might make you feel worse instead of better? And lead to more feelings of unfinished business and lack of closure? Don’t let this turn into an endless cycle leading nowhere. And the risk to you? Further misery. Demanding answers to unanswerable questions leaves you stuck, when you could be putting all of that energy into controlling what you can control. Beware of setting yourself up for disempowerment.
Get support. Talk it out. The need for closure, as my examples illustrated, is often about coping with a loss of some kind. And when we experience loss, we go through a grieving process. When you’re grieving, it’s really important to tell the story, even if you end up telling it over and over. Talk. Feel your emotions. Each time you do, something clicks into place. So find supportive people who are willing to listen to you as process the loss, and your need for closure. Let them know you don’t need answers or “fixing,” you just need listening. Through support, you may find your own way to closure. Consider reaching out to a mental health professional to help you sort this out.
Move Forward With Power!
You don’t have to stay stuck while you wait to find closure. Here’s how to get moving forward:
Embrace gratitude. Be grateful that you are a multi-faceted human being, resilient and resourceful. Remind yourself of this every day, multiple times a day if you need to. Stay grateful for all the good things in your life. Make a list if you need to. Review it often.
Choose to move on. When I have a client stuck in their demands for closure, in a very kind way, I say something to the effect of, “Do you think you might be kind of having a temper tantrum right now?” A question, not a judgment. We can’t change the random and mysterious way that life works, including changes in our health status. We can’t change how another person chooses to think, feel, or behave. Trying to do otherwise only leads to frustration, sadness, and disappointment.
In a perfect world, we would all have the closure we need. Answers to the why question. Understanding. Forgiveness. But the world sure isn’t perfect.
You have a choice. Choose to accept life on life’s terms. Focus on doing the best you can for yourself and the people you love.
Here’s the bottom line on closure. Sometimes the only closure is to accept that there is no closure. Move on with your life. Eyes forward. Head held high. That’s empowerment!
Gary McClain, PhD, is a therapist, patient advocate, and educator, specializing in helping clients deal with the emotional impact of chronic and life-threatening health conditions, as well as their families and professional caregivers. He works with them to understand and cope with their emotions, to learn about their lifestyle and treatment options, to maintain compliance with medical regimens, to communicate effectively with each other and healthcare professionals, and to listen to their own inner voice as they make decisions about the future. His book, The Power of Closure: Why We Need It, How to Get It, and When to Walk Away, was published by TarcherPerigee in 2024. His website is: JustGotDiagnosed.com.