Liese Groot-Alberts is a keynote speaker at this year’s Australian Palliative Care Conference in Adelaide. She became a therapist after the sudden death of her young daughter. While worked with internationally renowned psychiatrist, Elisabeth Kubler-Ross, Liese learned that after a big loss, you can decide to make life a school or a prison.

About two months ago, New Zealand based grief therapist Liese Groot-Alberts received a simple request from her 97-year-old aunt in the Netherlands.

“Are you going to visit me, before I die?” asked Aunt Janny.

Liese said she would love to. Her Aunt asked when.

“Spring would be a good time,” Liese suggested, thinking maybe after September.

Aunt Janny said June would be better. June was “the time”. Liese needed to come then.

“She has been very clear about it,” Liese tells Palliative Matters over Skype, from her Aunt’s home in Friesland.

“And I really respect that. I often say you can never come too early, but it is very easy to come too late.”

Already, Liese has enjoyed many conversations with Aunt Janny, who sits content in her favourite chair with a blanket around her shoulder, nodding off every once in a while.

“When I talk with her, she is really clear that this is the last time that we can sit together here. She is very matter of fact about it.

“She is incredibly frail in her body but in her spirit and mind she is as bright as anything. We are spending the most gorgeous time together; some good memories. So I am feeling so grateful and fortunate.”

In Friesland, bodies are commonly kept at home, rather than being sent to a funeral home, so that visitors can say their farewells in person and comfort one another. Traditionally people are buried, rather than cremated, and the coffin is carried around the grave three times to ward off bad spirits. People are also buried with their feet at the headstone, so they can push off into the next life.

Aunt Janny wants none of that. She has specified that she wants to be cremated and at her funeral there is to be no discussion of WWII.

Liese speaks with an accent that reveals her Nordic roots and gestures with expressive hands. One finger is tattooed with a large, elaborate design; a forever wedding ring. It’s a public statement of commitment with symbolism that remains private, as Liese and her husband near their 50^th wedding anniversary.

Early in their relationship, the couple lived near Amsterdam. They had a daughter, Nana.

Nana was nearly three years old when she died, just two days after the birth of her brother.

“When we look back on it, my husband and I, that is a time when we could have split apart,” says Liese.

“We have different ways of grieving, but it has brought us together. It was really significant in the deepening of our relationships and I am grateful for that.”

Liese said it was a time of hope and despair, joy and sorrow – polar emotions she believes to be closely connected; “If you move away from one, often we can’t experience the other”.

Discussion of death was tucked away in hospitals and old people’s homes. Friends and acquaintances didn’t know how to respond, and so stayed away. Liese says she understands why and would have done the same. She didn’t know how to respond either.

“How do you present a new baby, when your daughter has just died?” she says.

The experience triggered her to take action and become a “super duper therapist”, as she hoped this would make her feel better inside herself and take the pain away.

“It doesn’t work that way. I needed to be with my pain and, bit by bit, find a place for it and heal that.

“You never get over it. You get over the measles or the flu. But these really significant life events, to ask people to get over it is crazy. It loses a lot of the essence and potency and connection with their person when there is a sense you have to get over them.

“My connection with my daughter is not gone. Death ends a life. It doesn’t end a relationship. She is close and I feel, every once and a while, she gives me a prod. I get the courage to do things I find scary out of thinking of her.”

The couple had another daughter. When asked about their offspring, they say that they have three. “We have three children always. We don’t have two.”

Liese says that she is not a grief expert. Rather, she is an expert in her own grief.

“I don’t know yours. Although for many years I’ve walked alongside people who are grieving, it does not mean that I know what grief is like for you.”

“The longer I do this work, the more I realise I need to really listen in order to understand. I can be curious about how you grieve and explore your resilience. People who are in grief, have survived up to now. It is about exploring how they have survived in those other times of loss, and found strength.”

One of the great challenges of her work is accepting the feelings of helplessness and powerless that stem from not being able to fix things.

“When someone is dying, we want everything to be peaceful and beautiful and harmonious like we do in our lives too, but sometimes if feels like families and people die in a big piece of mud and you can’t clear it up,” she says.

“The key for me is then, how do I not walk away then or disconnect, but stay really present, when it is difficult for me to feel powerless. It usually is for most of us as human beings.”

Early in her career, Liese had the good fortune to work with Elisabeth Kubler-Ross, an eminent psychiatrist who taught acceptance of death.

“Her workshops always say that you can decide after a big loss to make life a school, or a prison,” says Liese.

Delivering Kubler-Ross’s workshops at a hospice in Zimbabwe, Africa, Liese she developed a passion for harnessing a different culture’s local wisdom, knowledge and creativity, rather than projecting views and values from the West. She has a focus on working collaboratively, in a way that is grounded in local tradition and custom, and has worked as a grief therapist and palliative care educator in Indonesia, the Philippines, Malaysia and Samoa.

She says a cultural contrast is evident even between the US and New Zealand. Workshops designed in the US catered for emotional expression that was “extroverted, outward and big”; the dominant behaviours for people attending. “People wail or cry or get furious,” says Liese.

In contrast, New Zealanders were more likely to be “very still and quiet, and really very deeply inside themselves”, highlighting the need to respect that a lot of feeling and emotion may not be visible.

“There are so many ways of grieving,” says Liese. “I also see it in families, where one member of the family might grieve in solitude and not speak and maybe find other ways of expressing it – walking it out or being in a quiet space – while other members of the family might be wailing and crying and talking a lot about it.”

She says in order to support someone who is grieving, she needs to tune into their way of “being with pain” and be mindful of her own natural responses.

“The more I am awake to my dominant belief system, and my way of being with death and dying, I do not have to then project it on to you. I keep that as my truth and then I have the space and the attention to be curious about your way of grieving,” she says.

“The more tolerant we are in our community of difference in the ways of mourning and grieving, the more there is the space between us where healing can happen.”

Register now to hear Liese Groot-Alberts speak at the Australian Palliative Care Conference in Adelaide (6-8 September 2017). Liese will discuss mourning, grieving, healing and hope.

Before the conference, (3 September) Liese will also be speaking at a public forum in Adelaide, hosted by Palliative Care South Australia. To attend, register here.

Liese is also presenting at the 12th Asia Pacific Hospice Conference in Singapore (26-29 July). She will speak about processing loss and building resilience in professional caregivers