Chronic Illness Archives - Andrea Tackore

The long view of grief

September 25, 2025 by Andrea

Ever wondered what grief looks like a decade later?

Do you wish you had a window into the future after a major loss?

Fourteen years since the worst day of my life. Fourteen years since the fourteenth of October. I’ve often had folks marvel at how I made it through. How have you built the life you have now? I can’t say I have that figured out (besides the grace of God), but I can share some principles:

My daughter, Christina was born with Cystic Fibrosis. Under my careful adherence to medical protocol, she thrived. She did everything any little girl could do – played soccer, danced ballet, jazz and modern, played with her friends, attended school (until we decided to homeschool) and participated in Girl Scouts. Her illness was undetectable to outsiders and her lungs never declined. Her only hospital visits were for sinus surgeries. Then, she moved into her teens and my careful adherence was no longer possible. I had to let her be her own person and she was a person uninterested in the multiple nebulizer treatments, chest physical therapy, and handful of enzyme capsules with every meal or snack. The stress of a difficult marriage between her parents, and the reality of her health brought mood disorders and other mental health struggles throughout high school. I could write a whole book on the challenge of parenting in those years. In fact, that season inspired my dissertation research on the psychosocial needs of adolescents with Cystic Fibrosis. That book sits in the Regent University library and on my shelf today…

Things were looking up as she vowed to turn over a new leaf with her entry to college. I treasure so many amazing times with the woman she was becoming, despite the heartbreaking moments in between, but it all fell apart swiftly. In the space of 10 days, at the age of 22, she departed and I was left stunned and devastated.

I always say that our culture has a terrible time with grief. Most folks struggle to know what to say, how to support others and those who are grieving are made to feel that they need to be “over it” within 3-7 business days. I haven’t seen much conversation on the long term journey of grief so I decided to share a bit of my story. My hope is that it can light the way for others in their journey of grief.

I remember leaving the hospital at 1am..without my daughter. It was a small band of us who had been there for the multiple code blues and the final goodbye. I remember sending a few texts. We started driving home from Miami back to West Palm but realized about halfway that we needed to stop. We found a motel by the highway and got a couple of rooms. After a few hours of “rest”, I got up, posted the news on social media (which had been our prayer wall) and called our pastor’s wife. She arranged for the care pastor to meet us so we drove straight from the motel to the church. Arrangements were completed that day. The funeral service took place four days later. Five days after that, I returned to work.

It was all so surreal. I don’t think we’re ever prepared for the day to day reality of loss. All the little ways in which the missing presence is felt. I remember when she was alive, I was leaving work and knew I needed to stop at Wal Mart on my way home. I was talking to her on the phone as I left my office, debating whether to come get her first and then go to the store, and I whined about how someday, she would be married and have her own life and I wouldn’t have her to go with me to Wal Mart any more. There was this long silence….then she dryly said, “mom, I’m not even dating anyone”. We laughed about that story so many times and the first time I had to go to Wal Mart after she died, I sobbed. Who would have thought that simple errand would undo me? She had also been my primary confidante for the abundant drama going on at work. Crazy things had been happening. She knew all the characters and all the details. No one else needed no explanation. Just two examples of the many ways her absence was felt.

Another aspect of grief that we don’t often discuss is the loss of identity. I remember the laissez faire that developed in me after her death. I had submitted the final draft of my dissertation mere weeks before she died. My chair had sent her response during Christina’s time in the medical intensive care unit. It remained unopened. The bizarre dynamics at work that would have activated my response in the past – I could barely muster a care. I realized after the fact that the boss I had at the time was so incredibly inept at dealing with my grief and the collective grief of my entire staff who had their own personal relationships with Christina. I blamed it all on grief but I eventually realized that the career drive and success I had always attributed to ambition was actually rooted in my role as mother. I was the primary breadwinner for most of the marriage to her dad and so the responsibility fell on my shoulders to ensure that we had access to good health insurance. My blazing trail up the ladder at every organization I ever worked for was simply a part of my responsibility as mom. Without that motivation, I couldn’t care less. Who was I besides Christina’s mom?

The pain of her loss was relentless and searing. So many tears were shed in my car – a place we had spent much time together. I battled the ‘shoulda/woulda/coulda’ game. What if I had driven her to Miami myself instead of waiting for transport to be approved? What if I had made different choices in her adolescence that would have prevented some of the damage she did to her body? Recognizing that I was flirting with the idea that I had the God-level power of life and death in my hands, gave me a harsh reality check that (mostly) snapped me out of that cruel game. I eventually imagined her stern little face chastising me: “mom, you better finish that degree you started…you didn’t come this far to let it all go!” I opened the email. I made the final changes. I paid the book editor. Before I knew it, I was applying for graduation and also applying for a job my friend encouraged me to pursue. Driving home from my graduation in Virginia, I stopped in Orlando for the job interview. Ten months after her death, I was moving three hours north to start a whole new chapter of switching from student development to teaching. I think all of this offered things to focus on in the midst of the pain. I wrote. I cried. I leaned on the friends who had walked the path with me. I would not have made it without them!

As the first anniversary of her death approached, I had a jarring realization: I was surrounded by people (in my new city and job) who had never met Christina. My students had no idea what significant date was appearing on my horizon. It was so disorienting and I had a fresh wave of reckoning with the reality of her absence. This is the thing about grief. You think it’s done, that you’ve moved on but that’s not how it works. I suppose you can choose to fill the space your loved one occupied with other things, places, and/or people. I can’t say how effective that is. I chose not to. I left the hole there…empty and visible. I talked about her all the time and it touched my heart so much when one of my new work colleagues shared how she felt like she had known her because of how I shared.

Slowly, I threw myself into my new role. I tackled the very challenging dynamics in my new workplace resulting from a significant trauma they had all faced prior to my arrival. Funny how I ended up in a group where we were all grieving and recovering from trauma. It was a hot mess but we worked through it. I drove regularly back to our home in Palm Beach County as my husband worked to renovate the place. We got renters and he joined me in Orlando 16 months later. Months before her death, Christina had confronted me about the marriage – challenging my presence in a situation she found unacceptable. I wanted to model commitment, covenant and perseverance but sadly, I came to realize what I modeled for her was enabling and acceptance of toxicity. It didn’t take long for those pending dynamics to resurface once we were living under the same roof again. My body served me notice that it had ENOUGH, my health tanked and I restarted the therapy process I had promised Christina I would engage. Months of therapy, prayer, fasting, surgery and self care later…I asked for a separation. Two and a half years later, I finally filed for divorce. Another loss. Another wound.

Despite the pain and anxiety of those two and a half years, I had space to discover my true self and aspects of God that I had never engaged. It was bittersweet to find that Christina was far more like me than I had realized. It was just that life and its responsibilities had forced me to bury much of what she had been free to exude. As I formed new relationships and pursued my faith in expanded ways, I built my identity from the ground up. As new information surfaced from my biological family, I missed processing with her. As the world took wild turns, I started to feel more and more gratitude that she wasn’t here to suffer through it. I found myself honoring her memory by embracing and cultivating the characteristics she got from me that I had buried for so long – the creativity, the free spiritedness, the acceptance, the love.

While my life became an ode to the qualities we shared and, I continued to tell her stories freely, the passing years put more and more distance between me and her physical presence. I can no longer conjure up the sound of her voice in my head. I forget what it feels like to squeeze her tiny body in the bear hugs she would roll her eyes over. A new type of grief emerges as I lose these tangible aspects of her. My life is a 180 degree existence from where she left me. Whether I want to accept it or not, letting go of my role as Christina’s mom allowed me to discover who Andrea was truly created to be. Couldn’t that have happened without losing her? That’s my beef with God and rest assured, we WILL discuss it when I get there. That said, I trust His process and I cannot deny that she got a good deal. She’s not missing much down here and I would never bring her back if I had the chance. She no longer has to deal with the challenges of Cystic Fibrosis, nor the erosion of communal responsibility that she would have needed to survive here. I love her too much to wish that on her, just so I could enjoy her presence. And so…I’ve built a whole new life with its own joys and love. The hole is still there but love has grown up around it. There is a beautiful, flowering hedge that encircles it, to the point that I rarely see it anymore. I know it’s there though and sometimes it either catches me by surprise or, I choose to sit with it. That will never change and that’s OK. I don’t have to abandon it in order to have the life God has blessed me to build. Grief is a both/and – it honors who we loved AND exists alongside the new life we can have if we are willing to risk loving and trying again.

Filed Under: Emotional Health Tagged With: Chronic Illness, Grief, Hope, Identity, Life Seasons, Loss, Rebirth, Transformation

Living with chronic illness

January 9, 2017 by Andrea

It’s like having an uninvited house guest who contributes nothing, eats everything in the kitchen, occasionally damages the furniture and won’t leave despite all attempts to kick him out. Eventually, resignation sets in and you begin trying to figure out how you’re going to work around this vermin over the long-term.

A chronic illness diagnosis (cancer, diabetes, arthritis, to name a few examples) changes everything and what makes it a special kind of challenge is the complexity of the effects. Everything is connected to everything else and so it seems no matter how much time goes by, you continue to discover another area that is impacted by the diagnosis. Let’s break down the major categories:

Obviously, there are physical changes which come with the diagnosis. Those vary according to the specific illness. The consistent theme however, is the idea of limitation. Physically, your body just doesn’t perform in the way you are used to. Changes may be immediate or insidiously appear over time. Energy level is often greatly affected and thus motivation to accomplish what was normal for you in the past, wanes significantly. All of this leads to some form of identity crisis as our culture has so trained us to associate identity/worth with production. If I cannot function/produce at the level to which I am accustomed, what does that say about me? What makes me worthwhile?

Mentally – most chronic illnesses do impact brain functioning. At best, we may experience some mental ‘fogginess’. At worst, there may be physiological changes to the brain that result in difficulties with long and/or short-term memory or even personality change. Processing speed often declines and things like executive functioning may be challenged. It is difficult to determine which of these changes result from the illness itself and which are side effects of long-term medications.

Emotionally – the self-worth battle is a significant issue. As we lose major aspects of how we defined ourselves, we struggle to redefine and focus on what now makes us who we are. If we have always struggled with self-care, the idea of prioritizing self and doing what it takes to pursue health is a foreign concept. We may face spiritual crisis as we wrestle with the idea of a higher power that would allow this to happen. This current battle filters through the lens of all we have experienced. The meanings we have made of our childhood then, determine how we integrate this latest development. If those meanings are dysfunctional – managing a chronic illness becomes nearly impossible. One of my areas of special interest is the reciprocal nature of this domain. So many chronic illnesses have a correlation with unresolved emotional challenges. It is becoming clear from medical research that emotional trauma increases the rates of chronic illness. Thus, it makes sense that addressing emotional trauma would be a key component of preventing/treating chronic illness and that is one of my passions!

Socially – our loved ones struggle to adjust to the implications of our diagnosis. As we sort out the lifestyle changes needed to care for our condition, the aforementioned limitations; as we deal with our own changing self concept, we relate to everyone differently. If we are not aware of this, then we are not even able to help others figure out what is happening and thus, we collectively exist in a state of confusion and frustration. In the end, everyone is experiencing their own grieving process of the way things used to be and the envisioned future that now will not manifest as planned. Grieving is complicated (denial, bargaining, anger, depression, acceptance). Imagine a system of individuals all working through that process at their own unique speeds in the context of their own functional and dysfunctional coping skills and core meanings. Is it any wonder that it gets messy?! Suffice it to say, relationships are absolutely impacted, yet very little attention is given to this area.

Unfortunately, most medical teams do not take the time to inform, much less address these complex issues. Too many patients muddle through their diagnosis, unaware of the developmental impact and what are very normal implications. Our default is to always seek status quo (remember learning about homeostasis in biology class?) and so the aftermath of a diagnosis often looks like a constant battle to return to our “normal” with increasing frustration at the inability to do so. The scary part is that all of this then exacerbates our illness, making our physical condition worse and creating a vicious cycle of decline.

My hope is that this information helps someone realize that they are not the problem. That the struggles they have been having are perfectly normal in the reality of a chronic illness and that there is hope! Knowledge is power and once we understand what we are dealing with, we can create and execute a plan of attack. Just as the doctor delivers information, prompts options in need of research, creates the physical treatment plan and monitors progress – so too can the counselor educate on the developmental impact of chronic illness, highlight areas for exploration, as well as create the emotional, mental and social treatment plan. Carefully working on self-worth and relationships within the context of physical limitations is key. Constantly monitoring self-care: sleep, nutrition and movement is a requirement. Completing the tasks of grieving is necessary for transitioning into a new normal: taking inventory and accepting the reality of your losses, working through the pain of loss, adjusting to the new environment created by the current reality and integrating the old self with the new self. The best part is that this work improves physical outcomes so despite the difficulty of the process, it is definitely worth it!

Filed Under: Uncategorized Tagged With: Chronic Illness, Coping Skills, Grief, Holistic health, Identity, Mind Body Connection, Psychotherapy, Relationships, Self Care, Self Love, Somatic

When talking isn’t enough

November 10, 2016 by Andrea

“Expressive therapies”. Maybe you’ve heard the term – it has certainly appeared in Phenix content before. However, you may not have clarity on what that means. So what is it exactly? It is the use of creative arts as a form of therapy. This can include art, music, dance, drama, etc. Unlike the formal practice of art however, expressive therapy focuses on the process of creativity versus a final product. This form of therapy has gained popularity due to the fact that clients often have very well developed defense systems in place to protect them from cognitively/verbally facing their pain. Even clients who enter therapy with full intention to deal with what needs to be tackled can find themselves struggling to access their history and its attendant feelings. Enter expressive therapies which utilize non-verbal forms of communication. Drawing, painting, writing, dancing – these activities access a completely different part of the brain than talking does. Thus, the results are often quite different. Since most of us are not accustomed to communicating in this manner, we have not developed the complex systems of defenses we have mastered verbally. As we awkwardly fumble through expressive assignments, we’re just trying to figure out how to follow the instructions, leaving us often unaware of the emotions and stories unfolding through our expression. This provides a valuable window into our subconscious, undefended world.

What we produce in expressive therapy can be very enlightening: a poem or song composed, a picture painted – these pieces capture our often unknown world and together, the therapist and client step back and analyze what has been created. It is a wonderful way to pursue the knowing of self that has been referred to on this blog before. However, as we have discussed, this can be wonderfully fun and terrifying at the same time. We are generally not used to the clarity of self that expressive therapy brings so facing the realities uncovered can bring difficulty. We discover hidden strengths, but also carefully avoided shadows. Though it is the product that is being analyzed, the process of discovery that this analysis entails is the true focus of the therapist.

Overall, process is the key to expressive therapy. What the client feels and thinks during the activity matters. What is happening physically is observed by the therapist. All of this provides key insight into the emotions, history and meanings underneath client experiences. These insights are what allow understanding to emerge regarding destructive patterns and provide the empowerment needed to change them. It’s all about process which is a stark contrast to the product-focused society we live in. Participating in this form of therapy often brings an entirely new dimension into the client’s life. When its power is observed in therapy, there is a natural move to incorporate a process focus into the rest of one’s life as well. What we have here is a win-win result!

An important aspect of expressive therapy has to do with information that we are just beginning to learn in the field of neuropsychology. New information about the workings of the brain comes out every single day and while this is an exciting age, I often caution my students to maintain a humility with this exploding field…based on the fact that there is still so much we do NOT know. That said, what we are finding so far is that trauma experiences affect the physiological tissue and workings of the brain. This impact has been shown to correlate with physical illnesses as well as behavioral and cognitive patterns. The race is on to develop a system of categorizing these brain changes and creating brain-based interventions that will address this physiological root of client struggles. In the meantime, expressive therapies have shown early signs of healing effects upon the limbic system – parts of the brain responsible for emotions, survival instincts, and memory. Traditional talk therapy does not seem to have the same power in this area of the brain!

Overall, expressive therapy provides a valuable tool in the therapist’s kit for accessing aspects of trauma impact that other modalities fall short with. The same logic applies to brain-based modalities like EMDR, ACT or EFT. My personal approach however is holistic which means I do not ascribe to a one-modality approach. It is my firm belief that deep and long lasting healing requires a complex process that attends to the many facets of human functioning: verbal/non verbal expression and exploration of meaning, brain based interventions, as well as physical health – sleep, nutrition and movement. I also firmly believe that all of this must take place within the confines of a healthy and connected therapeutic relationship because it is this connection that opens up the brain and heart to true transformation. Stay tuned next week for a look at a related form of therapy that Phenix will be expanding into soon!

Filed Under: Uncategorized Tagged With: Chronic Illness, Expressive Art, Expressive Therapy, Foundations, Psychotherapy, Rebirth, Transformation, Trauma