When Grief Comes in Waves: 20 Years Guiding People Through Multiple Losses at Once

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Amy Segerstrom spent almost twenty years sitting with people in the worst moments of their lives, guiding them through death, divorce, and job loss as coordinator of the Healing Place at Sacred Heart Hospital. She was also living it herself: her father's thirteen-year decline with Alzheimer's, then her brother's sudden death from a hospital-acquired infection just as he'd finally retired. On this episode of the Practitioners Rise Podcast, host Hailey Krajewski talks with Amy about what it means when grief comes in waves, one loss layered on another, and what carried her through.

Why Does Grief Come in Waves When You're Facing Multiple Losses?

For Amy Segerstrom, living through her father's thirteen-year decline with Alzheimer's and then her brother's sudden death taught her that grief rarely arrives once and settles. It comes in waves, layered on top of whatever loss came before, which is part of why she stopped treating her own grief as separate from the grief she witnessed professionally.

For almost 20 years, Amy served as coordinator of the Healing Place at Sacred Heart Hospital, helping families navigate death, divorce, and the transitions that "crack a life open." But she never positioned herself as an expert in anyone else's grief. "I never considered myself to be an expert in grief. I really think people are their own experts in their own experience," she says. Her own losses proved it to her firsthand.

Her father's death came in two parts. Alzheimer's took him gradually, and when he finally passed, Amy found what she calls a second death, the physical loss layered on top of a loss that had already been unfolding in slow motion for years. "Sometimes people mistakenly believe that if people have gone through a lengthy illness such as Alzheimer's, that by the time the loved one passes away, they really don't have much grief," she says. "I would say that's not true. I would say that it just is a different sort of grief."

Her brother's death, three years ago, was the opposite kind of loss. He'd just retired, had a son in medical school and nephews finishing their own degrees, when COVID led to cellulitis and then a cascade of hospital-acquired infections. There was no time to prepare. "We have this sense of justice around death," Amy says. "We don't believe it should happen in certain ways to certain people." Grieving a life cut short carries a different weight than grieving one that had already been fading for years, and both losses pushed her further into the spiritual direction training and mindfulness work that now shapes everything she teaches.

"I never considered myself to be an expert in grief. I really think people are their own experts in their own experience."

What Does Mindfulness Actually Look Like When You're Grieving?

For Amy, mindfulness during grief means paying attention with intention, and recognizing that grief is only one layer of a fuller present moment, not the whole of it.

She leans on an image she used constantly with clients: an empty Kleenex box. When someone is grieving, she explains, the loss can feel like the entire box, every layer, when really it's one layer in a box that still holds everything else in a person's life. "It was grief and my four children in the other room. It was grief, and somebody sent me some flowers," she says. "We don't ever want to leave grief alone as this one little layer. We always want it held by all the other layers."

Breath is part of that practice. Amy points to a pattern she saw constantly in grief work: people who are grieving tend to breathe shallowly and high in the chest. She notes that diaphragmatic breathing can increase the oxygen reaching the body by roughly 30 percent, and that something as simple as breathing lower and slower is often the piece people forget in the middle of a loss.

She also talks about listening to the body's wisdom beyond the brain, referencing mindfulness researcher Dr. Richard Davidson's term "cortical snobbery" — our cultural habit of treating the brain as the only intelligence worth trusting. Amy points to research suggesting the heart holds far more neurons than most people realize, which is part of why she treats every emotion that surfaces in grief, even anger, as a messenger worth listening to rather than a problem to fix.

"My definition of mindfulness is to pay attention with intention."

Where Do You Even Start With Journaling, Art, or Poetry When You're Grieving?

Amy suggests starting small: a short gratitude list, a few unstructured minutes with a pen or paintbrush, or a single line of poetry that catches you off guard.

Gratitude, she's careful to say, is a practice, not a feeling you have to manufacture. "You may or may not feel grateful, but to have a practice around gratitude, that means naming those small things that we notice that make up our present moment," she says. She encourages people to build a running "list poem," naming even the smallest thing daily, and points to research on gratitude practices reducing inflammation in the body over time, alongside the emotional benefits.

For people who freeze up at a blank page, Amy recommends lowering the stakes entirely. She spent years using messy, non-precious art with grieving clients and with emotionally disturbed children she once worked with, including finger-painting with shaving cream on mirrors laid flat as a table. The point was never the finished product. "This is just for us," she says. "It hopefully feels very good, as long as we don't let our ego get involved and think we need to come up with something in particular."

Poetry works the same way. Amy writes without knowing where a poem will land, and often finds the real subject only after she starts. "It really is a process of discovery," she says. "We have no idea what's going to come up." She calls the moment of realization the revelation, and the way that insight changes you afterward the revolution.

"Even though you don't feel the gratefulness, you may have habits around gratefulness, and what happens for most people over time is you will start to feel gratefulness at some point."

What Should You Actually Say (and Not Say) to Someone Who's Grieving?

Amy's guidance is blunt: when in doubt, say less. Grieving people are regularly hurt by advice that was meant to help.

She's heard the well-meaning-but-damaging comments plenty of times herself — the "you should" statements, the questions about wedding rings, the suggestions to move on. "When in doubt, zip the lip," she says. "We are so much more comfortable as fixers than healers." The problem isn't intention; it's timing. Comments that might land fine on an ordinary day can scratch at an open wound when someone is in the rawest part of loss.

Her advice to grieving people themselves is to "circle the wagons," keeping close only the people who can simply witness the story without trying to fix it. Family, in her definition, has nothing to do with biology. "Family for me is anybody who can hold your heart safely," she says.

Amy also points to a bigger cultural problem: there's no real time built in for grief. "We do not allow the bereaved very much time," she says, noting that three days off for a funeral is standard for most people, grief or no grief. Her own practical fix is small and consistent. She and her husband deliver homemade sourdough bread and jam to people who've had a loss, not to fix anything, but so they don't have to think about a meal that week. "It isn't going to fix it, it isn't going to change it," she says, "but it's the little things really that matter the most."

"Family for me is anybody who can hold your heart safely."

What Is Stretch Marks, Amy Segerstrom's Upcoming Poetry Collection, About?

Stretch Marks is Amy's upcoming poetry collection, built from poems she wrote almost daily starting during COVID, organized into four sections: family, nature, grief and the opening of the heart, and social justice.

The collection's title came late, inspired by a painting Amy saw by local artist Mindy Huntress, of a cartoonish giraffe with its feet on Earth and its neck stretching toward the sky. "I thought, stretch marks — this giraffe is stretching, and that's what I wanted to do, to create stretch marks around the heart," she says.

The four sections she pulled together reflect the different directions her own heart had been stretched: poems about family, poems about nature that she calls "rooted to ripened," poems about grief and loss written after her brother's death and while caregiving for her 95-year-old mother, and a closing section called Indra's Net, inspired by a Hindu concept of interconnected jewels, about becoming aware of our impact on the wider world. "I'd like to think if people read those poems, their heart will stretch beyond their own world, their own communities, into becoming a citizen of the planet," she says.

"I thought, stretch marks. This giraffe is stretching, and that's what my poetry is; that’s what I wanted to do is to create stretch marks around the heart."

This episode touches on grief, loss, and personal mental health experiences. It's shared for educational and inspirational purposes and isn't a substitute for individualized grief counseling or medical or mental health care.

About Amy Segerstrom

Amy Segerstrom spent almost 20 years as coordinator of the Healing Place at Sacred Heart Hospital, walking alongside families through death, divorce, job loss, and other major life transitions. After the death of her father, she trained as a spiritual director through the Franciscan Spirituality Center in La Crosse and became a mindfulness teacher alongside her grief counseling work. She lost her father to Alzheimer's and her brother to complications from COVID, and is currently the caregiver for her 95-year-old mother. She is a published poet currently completing her first collection, Stretch Marks.

Connect with Amy on Instagram, Substack, or reach her directly at amysegerstrom@gmail.com.

Quick Answers

What's the best thing to say to someone who is grieving?
Say less than you think you should. Simple acknowledgment, a hug, or "I don't know what to say, but I'm thinking of you" does more than advice or trying to fix the situation.

Is grief different when someone dies suddenly versus after a long illness?
Yes. Amy describes a long illness like Alzheimer's as creating a "second death" that layers new grief on top of grief already in progress, while a sudden death carries its own weight tied to a sense of injustice and unfinished plans.

How do you start a mindfulness practice if you've never done one before?
Start with just a few minutes a day paying attention to your senses and your breath, without judgment. Amy calls this "paying attention with intention."

What is a gratitude "list poem"?
A running daily list of small, specific things you're grateful for, added to over time. Amy says the practice can build genuine feelings of gratitude even when you don't start out feeling grateful.

How can I support a friend who's grieving without saying the wrong thing?
Keep it simple and low-pressure: a text saying you're thinking of them, a meal, or just being present without needing to talk. Let them set the pace for what they need.

Ready to dive deeper into Amy's world?

Follow her on Instagram or Substack, and keep an eye out for the release of Stretch Marks.

If this episode moved you, share it with someone who needs permission to grieve in their own way.