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Breathing Again

You must go on,
I can’t go on,
I’ll go on.
—SAMUEL BECKETT

ABOUT A YEAR AFTER Dave died, I was at work when my cell phone buzzed. An old friend was calling, and since nobody calls anyone anymore, I figured it must be important. It was. My friend had horrible news about a young woman she mentors. A few days earlier, the young woman had gone to a birthday party, and as she was leaving she noticed that a coworker needed a ride home. Since he lived nearby, she offered to drop him off. When they arrived, he pulled out a weapon, forced her inside, and raped her.

The young woman went to the hospital for a rape kit exam and then reported the attack to the police. Now my friend was looking for ways to provide comfort and knew I’d met this young woman, so she asked if I would talk with her and offer support. As I dialed her number, I felt nervous about whether I’d be able to help someone recover from something so violent. But as I listened to her, I realized some of what I’d learned about overcoming grief might resonate with her too.

We plant the seeds of resilience in the ways we process negative events. After spending decades studying how people deal with setbacks, psychologist Martin Seligman found that three P’s can stunt recovery: (1) personalization—the belief that we are at fault; (2) pervasiveness—the belief that an event will affect all areas of our life; and (3) permanence—the belief that the aftershocks of the event will last forever. The three P’s play like the flip side of the pop song “Everything Is Awesome”—“everything is awful.” The loop in your head repeats, “It’s my fault this is awful. My whole life is awful. And it’s always going to be awful.”

Hundreds of studies have shown that children and adults recover more quickly when they realize that hardships aren’t entirely their fault, don’t affect every aspect of their lives, and won’t follow them everywhere forever. Recognizing that negative events aren’t personal, pervasive, or permanent makes people less likely to get depressed and better able to cope. Not falling into the trap of the three P’s helped teachers in urban and rural schools: they were more effective in the classroom and their students did better academically. It helped college varsity swimmers who underperformed in a race: their heart rates spiked less and they went on to improve their times. And it helped insurance salespeople in difficult jobs: when they didn’t take rejections personally and remembered that they could approach new prospects tomorrow, they sold more than twice as much and stayed in the job twice as long as their colleagues.

On my call with the young woman, at first I just listened as she described how she felt violated, betrayed, angry, and scared. Then she starting blaming herself, saying it was her fault for giving her colleague a ride home. I encouraged her to stop personalizing the attack. Rape is never the victim’s fault and offering a coworker a ride was a completely reasonable thing to do. I stressed that not everything that happens to us happens because of us. Then I brought up the two other P’s: pervasiveness and permanence. We talked about all the good in other areas of her life and I encouraged her to think about how the despair would feel less acute with time.

Recovering from rape is an incredibly difficult and complicated process that differs for everyone. Evidence suggests that it’s common for rape victims to blame themselves and feel hopeless about the future. Those who can break this pattern are at lower risk of depression and post-traumatic stress. A few weeks later, the young woman called to tell me that with her cooperation, the state was moving forward with prosecuting the rapist. She said she thought about the three P’s every day and the advice had made her feel better. It had made me feel better too.

I’d fallen into these three traps myself, starting with personalization. I immediately blamed myself for Dave’s death. The first medical report claimed that Dave had died of head trauma from falling off an exercise machine, so I worried incessantly that I could have saved him by finding him sooner. My brother David, a neurosurgeon, insisted that this was not true: falling from the height of a workout machine might break Dave’s arm, but it wouldn’t kill him. Something had happened to make Dave fall in the first place. The autopsy proved my brother right: Dave had died in a matter of seconds from a cardiac arrhythmia caused by coronary artery disease.

Even once I knew Dave had not died from neglect on a gym floor, I still found other reasons to blame myself. Dave’s coronary artery disease was never diagnosed. I spent weeks with his doctors and the doctors in my family poring over his autopsy and medical records. I worried that he had complained of chest pain but we had missed it. I thought endlessly about his diet and if I should have pushed him to make more improvements. His doctors told me that no single lifestyle change would definitely have saved him. And it helped when Dave’s family reminded me that his eating habits were much healthier whenever he was with me.

I also blamed myself for the disruption his death caused to everyone around me. Before this tragedy, I was the older sister, the doer, the planner, the leaner inner. But when Dave died, I was incapable of doing much of anything. Others jumped in to help. My boss Mark Zuckerberg, my brother-in-law Marc, and Marne planned the funeral. My father and sister-in-law Amy made the burial arrangements. When people came to pay their respects at our house, Amy nudged me to get up and thank them for coming. My father reminded me to eat and then sat next to me to make sure I actually did.

Over the next few months, the thing I found myself saying most often was, “I’m sorry.” I apologized constantly to everyone. To my mom, who put her life on hold to stay with me for the first month. To my friends who dropped everything to travel to the funeral. To my clients for missing appointments. To my colleagues for losing focus when emotion overwhelmed me. I’d start a meeting thinking, I can do this, only to have tears well up, forcing a quick exit with a hasty “I’m so sorry.” Not exactly the kind of disruption Silicon Valley is looking for.

Adam finally convinced me that I needed to banish the word “sorry.” He also vetoed “I apologize,” “I regret that,” or any attempt to weasel my way past the ban. Adam explained that by blaming myself I was delaying my recovery, which also meant I was delaying my kids’ recovery. That snapped me out of it. I realized that Dave’s doctors had not prevented his death, so it was irrational for me to believe that I could have. I hadn’t interrupted everyone’s lives; tragedy had. No one thought I should apologize for crying. Once I tried to stop saying “sorry,” I found myself biting my tongue over and over and started letting go of personalization.

As I blamed myself less, I started to notice that not everything was terrible. My son and daughter were sleeping through the night, crying less, and playing more. We had access to grief counselors and therapists. I could afford child care and support at home. I had loving family, friends, and colleagues; I marveled at how they were carrying me and my children—quite literally at times. I felt closer to them than I ever would have thought possible.

Going back to work helped with pervasiveness too. In the Jewish tradition, there is a seven-day intense mourning period known as shiva, after which most regular activities are supposed to resume. Child psychologists and grief experts counseled me to get my son and daughter back to their normal routines as soon as possible. So ten days after Dave passed away, they went back to school and I started going to work during school hours.

My first days back in the office were a complete haze. I had worked as the chief operating officer of Facebook for more than seven years but now everything felt unfamiliar. In my first meeting, all I could think was, What is everyone talking about and why on earth does this even matter? Then at one point I was drawn into the discussion and for a second—maybe half a second—I forgot. I forgot about death. I forgot the image of Dave lying on the gym floor. I forgot watching his casket being lowered into the ground. In my third meeting of the day, I actually fell asleep for a few minutes. As embarrassed as I was to find my head bobbing, I also felt grateful—and not just because I wasn’t snoring. For the first time, I had relaxed. As the days turned into weeks and then months, I was able to concentrate for longer. Work gave me a place to feel more like myself, and the kindness of my colleagues showed me that not all aspects of my life were terrible.

I have long believed that people need to feel supported and understood at work. I now know that this is even more important after tragedy. And sadly, it’s far less common than it should be. After the death of a loved one, only 60 percent of private sector workers get paid time off—and usually just a few days. When they return to work, grief can interfere with their job performance. The economic stress that frequently follows bereavement is like a one-two punch. In the United States alone, grief-related losses in productivity may cost companies as much as $75 billion annually. These losses could be decreased and the load could be lightened for people who are grieving if employers provided time off, flexible and reduced hours, and financial assistance. Companies that offer comprehensive health care, retirement, and family and medical leave benefits find that their long-term investment in employees pays off in a more loyal and productive workforce. Providing support is both the compassionate and the wise thing to do. I was grateful that Facebook offered generous bereavement leave, and after Dave died, I worked with our team to extend our policies even further.

The hardest of the three P’s for me to process was permanence. For months, no matter what I did, I felt like the debilitating anguish would always be there. Most of the people I knew who had lived through tragedy said that over time the sadness subsides. They assured me that one day I would think of Dave and smile. I didn’t believe them. When my children cried, I would flash forward to their entire lives without a father. Dave wasn’t just going to miss a soccer game…but all the soccer games. All the debate tournaments. All the holidays. All the graduations. He would not walk our daughter down the aisle at her wedding. The fear of forever without Dave was paralyzing.

My dire projections put me in good company. When we’re suffering, we tend to project it out indefinitely. Studies of “affective forecasting”—our predictions of how we’ll feel in the future—reveal that we tend to overestimate how long negative events will affect us. Some students were asked to imagine their current romantic relationship ending and predict how unhappy they’d feel two months later. Other students were asked to report their own happiness two months after an actual breakup. Those who experienced a real split were far happier than expected. People also overestimate the negative impact of other stressful events. Assistant professors thought being denied university tenure would leave them despondent for the next five years. It didn’t. College students believed they would be miserable if they got stuck in an undesirable dorm. They weren’t. As someone who was assigned to the least desirable dorm in my college—twice—this study rings especially true.

Just as the body has a physiological immune system, the brain has a psychological immune system. When something goes wrong, we instinctively marshal defense mechanisms. We see silver linings in clouds. We add sugar and water to lemons. We start clinging to clichés. But after losing Dave, I wasn’t able to do any of this. Every time I tried to tell myself things would get better, a louder voice inside my head insisted that they would not. It seemed clear that my children and I would never have another moment of pure joy again. Never.

Seligman found that words like “never” and “always” are signs of permanence. Just as I had to banish “sorry” from my vocabulary, I tried to eliminate “never” and “always” and replace them with “sometimes” and “lately.” “I will always feel this awful” became “I will sometimes feel this awful.” Not the most cheerful thought, but still an improvement. I noticed that there were moments when the pain temporarily eased up, like a splitting headache that briefly dulls. As I had more reprieves, I was able to recall them when I sank back into deeper grief. I started to learn that no matter how sad I felt, another break would eventually come. It helped me regain a sense of control.

I also tried a cognitive behavioral therapy technique where you write down a belief that’s causing you anguish and then follow it with proof that the belief is false. I started with my biggest fear: “My children will never have a happy childhood.” Staring at that sentence on paper made my stomach turn but also made me realize that I had spoken with many people who had lost parents at a young age and went on to prove that prediction wrong. Another time I wrote, “I will never feel okay again.” Seeing those words forced me to realize that just that morning, someone had told a joke and I had laughed. If only for one minute, I’d already proven that sentence false.

A psychiatrist friend explained to me that humans are evolutionarily wired for both connection and grief: we naturally have the tools to recover from loss and trauma. That helped me believe that I could get through this. If we had evolved to handle suffering, the deep grief would not kill me. I thought about how humans had faced love and loss for centuries, and I felt connected to something much larger than myself—connected to a universal human experience. I reached out to one of my favorite professors, Reverend Scotty McLennan, who had kindly counseled me in my twenties when my first husband and I divorced. Now Scotty explained that in his forty years of helping people through loss, he has seen that “turning to God gives people a sense of being enveloped in loving arms that are eternal and ultimately strong. People need to know that they are not alone.”

Thinking about these connections helped, yet I couldn’t shake the overpowering sense of dread. Memories and images of Dave were everywhere. In those first few months, I’d wake up every morning and experience the sickening realization that he was still gone. At night, I’d walk into the kitchen expecting to see him, and when he wasn’t there the pain hit hard. Mark Zuckerberg and his wife Priscilla Chan thought it might be comforting to take me and my kids to a place where we had no memories of Dave, so they invited us to join them on a beach we’d never seen. Yet when I sat on a bench overlooking the ocean, I glanced into the big open sky…and saw Dave’s face looking down on me from the clouds. I was sitting between Mark and Priscilla and I could feel their arms around me, but somehow Dave managed to be there too.

There was no escape. My grief felt like a deep, thick fog that constantly surrounded me. My friend Kim Jabal, who had lost her brother, described it as a lead blanket covering her face and body. Dave’s brother Rob said it felt like there was a boot pushing down on his chest that made it nearly impossible to get air into his lungs, one pressing even harder than when their father had died sixteen years before. I had trouble filling my lungs too. My mom taught me how to breathe through the waves of anxiety: breathe in for a count of six, hold my breath for a count of six, then exhale for a count of six. My goddaughter Elise, in a touching reversal of our relationship, held my hand and counted aloud with me until the panic subsided.

Rabbi Nat Ezray, who led Dave’s funeral, told me to “lean in to the suck”—to expect it to be awful. Not exactly what I meant when I said “lean in,” but for me it was good advice. Years earlier, I’d noticed that when I got sad or anxious, often the second derivative of those feelings made them doubly upsetting. When I felt down, I also felt down that I was down. When I felt anxious, I felt anxious that I was anxious. “Part of every misery,” C. S. Lewis wrote, is “misery’s shadow…the fact that you don’t merely suffer but have to keep on thinking about the fact that you suffer.”

Following Dave’s death, I had stronger second-derivative negative feelings than ever before. I wasn’t just grief-stricken; I was grief-stricken that I was grief-stricken. I wasn’t just anxious; I was meta-anxious. Small things that never really concerned me before, like the possibility of my kids getting injured riding their bikes to school, worried me incessantly. Then I worried that I was overworrying. Taking my rabbi’s advice and accepting that this completely sucked helped a great deal. Instead of being surprised by the negative feelings, I expected them.

A friend told me I had just learned something Buddhists have known since the fifth century BC. The first noble truth of Buddhism is that all life involves suffering. Aging, sickness, and loss are inevitable. And while life includes some joyful moments, despite our attempts to make them last, they too will dissolve. Buddhist teacher Pema Chödrön, who broke the Zen ceiling as the first American woman to become fully ordained in the Tibetan tradition, writes that when we accept this noble truth, it actually lessens our pain because we end up “making friends with our own demons.” I wasn’t going out for a drink with my demons, but as I accepted them, they did haunt me less.

A few days after Dave’s funeral, my son and daughter and I made a list of our new “family rules” and hung it over the cubbies where they put their backpacks so we’d see it every day. Rule number one was “Respect our feelings.” We discussed how the sadness might come over them at awkward times, like during school, and that when it did, they could take a break from whatever they were doing. Their cry breaks were frequent and their teachers kindly arranged for them to go outside with a friend or to the guidance counselor so they could let their feelings out.

I gave this advice to my kids but also had to take it myself. Leaning in to the suck meant admitting that I could not control when the sadness would come over me. I needed cry breaks too. I took them on the side of the road in my car…at work…at board meetings. Sometimes I went to the women’s room to sob and sometimes I just cried at my desk. When I stopped fighting those moments, they passed more quickly.

After a few months, I started to notice that the fog of intense pain lifted now and then, and when it rolled back in, I recovered faster. It occurred to me that dealing with grief was like building physical stamina: the more you exercise, the faster your heart rate recovers after it is elevated. And sometimes during especially vigorous physical activity, you discover strength you didn’t know you had.

Shockingly, one of the things that helped me the most was focusing on worst-case scenarios. Predicting a bad situation was usually easy for me; it’s a fine old Jewish tradition, like rejecting the first table offered in a restaurant. But during the early days of despair, my instinct was to try to find positive thoughts. Adam told me the opposite: that it was a good idea to think about how much worse things could be. “Worse?” I asked him. “Are you kidding? How could this be worse?” His answer cut through me: “Dave could have had that same cardiac arrhythmia driving your children.” Wow. The thought that I could have lost all three of them had never occurred to me. I instantly felt overwhelmingly grateful that my children were alive and healthy—and that gratitude overtook some of the grief.

Dave and I had a family ritual at dinner where we’d go around the table with our daughter and son and take turns stating our best and worst moments of the day. When it became just three of us, I added a third category. Now we each share something for which we are grateful. We also added a prayer before our meal. Holding hands and thanking God for the food we are about to eat helps remind us of our daily blessings.

Acknowledging blessings can be a blessing in and of itself. Psychologists asked a group of people to make a weekly list of five things for which they were grateful. Another group wrote about hassles and a third listed ordinary events. Nine weeks later, the gratitude group felt significantly happier and reported fewer health problems. People who enter the workforce during an economic recession end up being more satisfied with their jobs decades later because they are acutely aware of how hard it can be to find work. Counting blessings can actually increase happiness and health by reminding us of the good things in life. Each night, no matter how sad I felt, I would find something or someone to be grateful for.

I also deeply appreciated our financial security. Both my daughter and my son asked me if we were going to have to move out of our house. I knew how lucky we were that the answer was no. For many, an unexpected event like a single hospital visit or a car repair can undo financial stability overnight. Sixty percent of Americans have faced an event that threatened their ability to make ends meet and a third have no savings, which leaves them constantly vulnerable. The death of a partner often brings severe financial consequences—especially for women, who frequently earn less than men and have less access to retirement benefits. In addition to the devastation of losing a beloved partner, widows are often left without money for basic needs. In too many cases, they lose their homes or can’t make rent payments. Widows of all backgrounds are more than twice as likely to live in poverty as married women. And that number is even higher for black and Latina widows due to the inequalities they experience throughout their lives. This is one of the many reasons why it’s important to erase the wage gap for all women and especially women of color.

We need to embrace all families regardless of the different forms they take and provide the help they need to get through the hardships they face. Cohabiting and same-sex couples usually don’t have the same legal protections and employment benefits as married couples. We need stronger social insurance policies and more family-friendly business practices to prevent tragedy from leading to more hardship. Single parents and widows deserve more support, and leaders, coworkers, families, and neighbors can commit to providing it.

Even being aware of all my blessings, I was still consumed by the pain. Four months and two days after I found Dave on the floor, I attended my kids’ Back to School Night. For the first time, I drove there alone. Parents gathered in the gym and then headed into their children’s individual classrooms. Dave and I had always split up to cover our son’s and daughter’s classes and compared notes later. Man-to-man defense. Not anymore.

I’d been dreading choosing a classroom all week, and when that moment came a wave of sadness engulfed me. I was walking toward the rooms, holding my friend Kim’s hand while trying to decide, when my phone rang. It was my doctor. He said that he wanted to reach me right away because a routine mammogram had revealed a suspicious spot. My heart raced. He told me that there was no need to worry yet—very helpful—but that I should come in the next day for an ultrasound.

My sadness turned to panic. Rather than go to either classroom, I got in my car and fled home. Since losing their father, my children had been understandably obsessed with death. At dinner a few weeks earlier, my daughter needed a cry break and I followed her into her room. I curled up beside her on the bed and she reached for my necklace, which had dangling charms of our family’s four initials. She said with determination, “I’m going to pick one.” I asked her why. She said she wouldn’t tell me because I’d get upset. I told her she could say anything. In a whisper, she explained, “The one I pick will die next.” I felt the breath escape from my lungs. Somehow, I held it together and said, “Then let me pick.” I selected the “S” and said, “I will be the next to die—and I think it will be in forty years when I am over ninety.” I didn’t know if that was the right thing to say (and my math was wrong) but I wanted to comfort her.

As I drove home from Back to School Night, I felt her hand as if it were tugging on my necklace. How could I ever tell her and my son that I had cancer? And what if—what if—they lost me too? And how was it possible that a few minutes ago I was so stressed over which classroom to choose?

That evening, I was shaking and sobbing too much to put my kids to bed. I didn’t want to upset them, so my mother tucked them in. My sister came over and the three of us held hands and prayed. I couldn’t think of anything else to do. My mom said a few words in prayer and I asked her to repeat them again and again and again.

The next seventeen hours crawled by. I couldn’t sleep, eat, or carry on a coherent conversation. I just watched the clock, waiting for my one p.m. appointment.

The ultrasound showed that the mammogram result had been a false positive. The gratitude that flooded my entire body was as overwhelming as the grief I had felt over the past four endless months. In one fell swoop, I felt more appreciation for my health and what was good in my life than I ever had before.

Looking back, I wish I had known about the three P’s earlier. There were so many times they would have helped, even with daily challenges. On the first day of my first job out of college, my boss asked me to enter data into Lotus 1-2-3—a popular spreadsheet in the 1990s. I had to admit that I didn’t know how. His mouth dropped open and he said, “I can’t believe you got this job without knowing that.” Then he walked out of the room. I went home convinced that I was going to be fired. I thought I was terrible at everything, but it turns out I was only terrible at spreadsheets. Understanding pervasiveness would have saved me a lot of anxiety that week. And I wish somebody had told me about permanence when I broke up with boyfriends. I could have avoided a lot of angst if I’d known that the heartache was not going to last forever—and if I was really being honest with myself, neither were any of those relationships. I also wish I had known about personalization when boyfriends broke up with me. (Sometimes it’s not you—it really is them.)

All three P’s ganged up on me in my twenties after my first marriage ended in divorce. I thought at the time that no matter what I accomplished, I would always be a massive failure. Looking back, it was that failed marriage that led me to leave D.C. and move across the country to Los Angeles, where I barely knew anyone. Fortunately, one of my friends invited me to join him and his buddy for dinner and a movie. That night, the three of us went to a deli, then saw Courage Under Fire, where I fell asleep on Dave’s shoulder for the first time.

We all deal with loss: jobs lost, loves lost, lives lost. The question is not whether these things will happen. They will, and we will have to face them.

Resilience comes from deep within us and from support outside us. It comes from gratitude for what’s good in our lives and from leaning in to the suck. It comes from analyzing how we process grief and from simply accepting that grief. Sometimes we have less control than we think. Other times we have more.

I learned that when life pulls you under, you can kick against the bottom, break the surface, and breathe again.