Our world today appears locked in the iron grip of what many refer to as generational trauma. I wonder if a more apt and descriptive term might be unprocessed and unintegrated loss. A psychoanalyst colleague often said, “All emotional suffering is about loss, and all healing is about mourning.”  The Muslim Sufi poet Rumi expressed a similar sentiment in the aphorism “The cure for the pain is the pain.”

As I write this my 100-year-old mother is dying of terminal cancer. A product of this intergenerational phenomenon— whatever we choose to call it—she has always maintained a stance that “everything is fine.” She steadfastly insists that her yellow skin and loss of appetite are “nothing to worry about” but adds at the end a question “Right?” At my father’s funeral this past summer I spoke of my apprehension as it became clear that his life was coming to an end. I shared with the audience of family and friends, “The Meiningers don’t do grief.”

My mother’s resistance to processing loss left her shrouded in mystery- warm and loving with friends but emotionally distant from her closest family. In part she was able to remain hidden due to the drama of my father’s story as a Holocaust survivor. Both of them subscribed to the same adage; to “live life forward” and not talk about the past.

In the last few years, my mother has shared bits and pieces that help me to begin to make sense of her. Her parents escaped the violent attacks on Jews of the Russian pogroms of the late 19th century. Her mother, my grandmother Helen, arrived in America from Kiev ( at the time part of Russia) when she was 11 years old. Helen’s parents brought with them a living reminder of the horrors in “Baby Ida,” the infant daughter of neighbors. Ida’s entire family was murdered. She grew up with my grandmother as an adopted sibling.

My mother shared one other story of her family. When she was a young child, my grandfather David returned to Odessa (also then part of Russia) to search for his family. He suffered a massive heart attack on the trip; he experienced debilitating poor health for the rest of his life. My mother claims to have no memory of him beyond his invalid status. Even when she had her full mental faculties, she could not even say if I had met him, or he died before I was born. The multiple losses that form the underpinnings of my mother’s childhood created in her a profound fear of loss that engendered a deeply entrenched self-reliance.

My mother’s cancer diagnosis in a strange twist of fate occurred on the eve of my planned speaking tour of Australia at the invitation of the Australian Association for Infant Mental Health. When her doctor predicted a likely rapid decline in her health in the coming weeks, as her only living close relative, my only choice was to cancel the trip.

Now, for the first time I can recall, she acknowledges her need for me. Over and over, she thanks me for not going away. She admits that while she had accepted that I was going, she approached the date of my departure with a deep sense of dread. As we sit together in quiet peacefulness on what will likely be the last weeks of her life, we have the chance to repair the rift created by her dogged insistence that she needs nothing from me.

For years, her apparent inability to recognize the family bonds that connected us produced in me a feeling of anger—a deep rage at not being seen. “It’s normal for family members to need each other,” I tried yet failed to explain. In what felt like gaslighting but has been explained to me as projective identification, she accused me of rejecting her. Now I understand that the generations of loss that had never been spoken of—much less mourned—created meanings for her of danger in intimacy. It’s not that she did not want to be close with me. She needed to protect herself from the possibility of loss by denying any reliance me, her only child.

My life’s work is about listening to parents so they can better hear their children. The core theme of my practice, writing, and teaching is what I name “playing in the uncertainty;” approaching another person’s story without an agenda and with a tolerance for the discomfort that goes with not knowing exactly where we are headed. This process almost always leads to stories of unintegrated loss and blocked mourning.

The missed opportunity to share ideas while learning from colleagues across an entire continent halfway around the world is itself a wrenching loss. This past Saturday I was neither in Australia nor in my role as faculty for the UMass Chan Medical School Early Relational Health Fellowship that occurred the same weekend. Rather I met with the hospice intake nurse to tell her about my mother. We thought together about how to explain the services without frightening her. I then sat by my mother’s side as she graciously accepted this new person’s gentle care. It was exactly where I needed to be.

As I move through and past disappointment, my focus narrows to my own family which is —as I suspect it is for many of my colleagues in early relational health— the inspiration for the professional work., I see how my mother’s fear of loss still lives strongly in me. I tend to fall back on my intellect to guard against the intensity of emotion. I’m filled with gratitude for the many new relationships over my adult life that have taught me to embrace the messiness of grief. Navigating my father’s brave and peaceful death showed me that I can do it.

This next chapter calls on me to slow down; to just be where I am. I respect for my mother’s fears by using the words “visiting nurse” rather than “hospice” and offering reassurance that for now she is “fine.” For decades she has shown an unfathomable resistance to discussing the possibility of the end of life. But as the cancer takes hold, I hear subtle communications that she does in fact know she is dying. I hope we both have the courage to play in the uncertainty of the unfolding process as together we face this final loss.