One of our recommended books is After Effects by Andrea Gilats


A Memoir of Complicated Grief

An intensely moving and revelatory memoir of enduring and emerging from exceptional grief.

To grieve after a profound loss is perfectly natural and healthy. To be debilitated by grief for more than a decade, as Andrea Gilats was, is something else. In her candid, deeply moving, and ultimately helpful memoir of breaking free of death’s relentless grip on her life, Gilats tells her story of living with prolonged, or “complicated,” grief and offers insight, hope, and guidance to others who suffer as she did.

Thomas Dayton, Andrea Gilats’s husband of twenty years, died at 52 after a five-month battle with cancer.

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An intensely moving and revelatory memoir of enduring and emerging from exceptional grief.

To grieve after a profound loss is perfectly natural and healthy. To be debilitated by grief for more than a decade, as Andrea Gilats was, is something else. In her candid, deeply moving, and ultimately helpful memoir of breaking free of death’s relentless grip on her life, Gilats tells her story of living with prolonged, or “complicated,” grief and offers insight, hope, and guidance to others who suffer as she did.

Thomas Dayton, Andrea Gilats’s husband of twenty years, died at 52 after a five-month battle with cancer. In After Effects Gilats describes the desolation that followed and the slow and torturous twenty-year journey that brought her back to life. In the two years immediately following his death, Gilats wrote Tom daily letters, desperately trying to maintain the twenty-year conversation of their marriage. Excerpts from these letters reveal the depth of her despair but also the glimmer of an awakening as they also trace a different, more typical course of the grief experienced by one of Gilats’s colleagues, also widowed. Gilats’s struggle to rescue herself takes her through the temptation of suicide, the threat of deadly illness, the overwhelming challenges of work, and the rigor of learning and eventually teaching yoga, to a moment of reckoning and, finally, reconciliation to a life without her beloved partner. Her story is informed by the lessons she learned about complicated grief as a disorder that, while intensely personal, can be defined, grappled with, and overcome.

Though complicated grief affects as many as one in seven of those stricken by the loss of a close loved one, it is little known outside professional circles. After Effects points toward a path of recuperation and provides solace along the way—a service and a comfort that is all the more timely and necessary in our pandemic-ravaged world of loss and isolation.

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  • University of Minnesota Press
  • Paperback
  • February 2022
  • 200 Pages
  • 9781517912185

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About Andrea Gilats

Andrea Gilats is the author of After EffectsAndrea Gilats is a writer, educator, artist, and former yoga teacher who was the cofounder and longtime director of the University of Minnesota’s legendary Split Rock Arts Program, a nationally renowned series of residential workshops in visual art and creative writing, as well as Split Rock Online Mentoring for Writers. She is author of Restoring Flexibility: A Gentle Yoga-Based Practice to Increase Mobility at Any Age and has written many articles about aging.

Author Website


“I am enormously grateful that the world is finally welcoming a deeper and more complex understanding about grief and grieving. Andrea Gilats makes a vital contribution with this honest account of her husband’s death and her long journey through complicated grief to arrive at her hard-won ‘fringes of happiness.’” —Judith Barrington, bestselling author of Writing the Memoir: From Truth to Art

“Andrea Gilats has given us a beautifully written story of the heartbreaking problem of complicated grief that is now officially called prolonged grief disorder. Her detailed, honest account of almost two decades of intense suffering after the loss of her beloved life partner will help others understand that there is no shame in grieving in this way—that grief is a form of love. Importantly, though, there are ways to gently guide people like Andrea much sooner in the process to find ways to honor the deceased as well as the life of the bereaved they leave behind.” —M. Katherine Shear, M.D., founder and director, Columbia University Center for Prolonged Grief

Discussion Questions

1. How has reading After Effects affected your sense of empathy? Has Andrea’s story changed your feelings for people who have survived the death of a close loved one from Covid-19? What about people who have lost loved ones unexpectedly in a mass tragedy or a war? What about family members and friends who have suffered a significant loss?

2. How long should “normal” grief last? What factors might contribute to prolonged or complicated grief? Have you ever experienced emotions that somehow went beyond normal? Can you imagine yourself ever suffering from prolonged grief disorder?

3. After Tom died, Andrea lost the ability to take pleasure in activities she had always enjoyed. This can also be a sign of depression. From your personal perspective, do you feel that there are differences between grief and depression?

4. After Tom died, Andrea’s health worsened. What part, if any, do you feel grief played in that? Do you feel that there is a connection between grief and health? How might acute grief affect our ability to function each day?

5. Do you feel that it is possible for people to recover their former state of “wholeness” after a significant loss? Why or why not?

6. In After Effects, Andrea writes that grief never fully fades into the past but instead becomes “a fixed part of character.” Do you agree with this statement? Why or why not?

7. Do you feel that Jewish mourning customs and remembrance practices affected Andrea’s experience of grief? If so, how? How might your cultural or religious heritage affect the ways you express grief? Do you feel that our deceased loved ones remain with us forever?

8. How did Andrea’s grief influence her reactions to important events in the world, such as the death of Senator Paul Wellstone and the election of President Barack Obama? Had she not lost Tom, do you think these events would have affected her in the same ways?

9. How did finding purposeful creative activities, such as painting, teaching yoga, and creating new kinds of lifelong learning programs affect Andrea’s ability to heal? From which parts of yourself do you draw strength?


Experts tell us that yearning for the deceased, missing the deceased, emotional pain and numbness, and loneliness are the four most common “affective experiences” associated with complicated grief.

For at least seven years after his death, I yearned for Tom without abatement, and I missed him passionately and constantly. Though I could have never parsed these emotions so closely then, I have now come to learn that there is not only a clinical difference between yearning for someone and missing someone; there is also a defining difference by which complicated grief earns its name. Yearning, according to psychologist Mary-Frances O’Connor, is “an unsatisfied, intense, and future-oriented appetitive desire. It is not merely missing something from the past (i.e. being aware of its absence), but rather entails actively desiring something in the future.”

In the early months and extending on for perhaps two years, I heard Tom at night in our small home, walking to the bathroom, opening or closing the refrigerator, rustling the sheets as he got into or out of bed, opening the back door so he could have a midnight smoke on our back steps. Sometimes a dream would follow his noises; other times I would lie alert in bed, waiting for him to come back. I heard him in the daytime, too, loading his work clothes into the washing machine, plopping an ice cube into his milk, creaking his chair as he ruffled through the newspaper on the front porch. After a long while, I no longer associated the ordinary sounds emanating from an aging house with him. Instead, my yearning settled into a self-contained ache, acute in its intensity but chronic in its duration. Like an inflamed sciatic nerve, it often hurt to the edge of insanity.

Call it craving. Call it yearning. No matter what you call it, the massive heartache that kept me steeped in misery year after year also kept me fiercely, if insidiously, connected to Tom. Could it have been the yearning itself that kept me grieving? What would have happened if I had somehow been able to quiet that longing? Would it have meant that Tom and I were no longer bonded? Would it have meant that I no longer loved him? I wonder now if that insatiable yearning was a perverted way of proving to myself that I still loved him. It is possible. I had lived so close to my grief for so long that it had become a suffocating sedative. Gradually, my inability to imagine life without Tom had become an inability to imagine life without grief.

There was my insistent yearning, and there was also my desire to die in order to be with him, which for nearly four years kept me from feeling a preference for life. Though I would now characterize my death wish as half-hearted, I felt it strongly enough at the time so that it killed my desire to survive. A will to live, a self-preservation instinct: both had disappeared. Before Tom died, a friend told me to save his drugs. “Don’t let hospice take them back,” she advised. “You never know.” I bagged up his liquid morphine, oxycontin, and codeine. There was also Ativan, but I appropriated that for my own use so that I could sleep at night. I counted the oxycontin and codeine tablets, and reckoned that there were more than enough to do the job without resorting to the almost-full bottle of morphine. I kept the bag in our linen closet, and every time I opened the door to grab a towel or put away the freshly laundered bedsheets, I gazed at the bag. But somehow the moment was never quite right. After all my consideration and contemplation, not once did I come close to suicide by overdose. I was simply too afraid. Gradually, my preference for death was replaced by apathy. If I lived, I lived. If I died, I died.

It seems like an unbelievable paradox even to me, but at the same time as I endured constant, unbearable yearning for Tom and a deeply serious, if ambivalent, wish to join him in death, I could not bear to remember him. I now know that this insidious disability was one more expression of complicated grief, the one that experts characterize as “inappropriately intense reactions to memories of the person who has died.” It was a true dichotomy: at the same time as I yearned for him, I could not bear to bring him to mind. It was simply too painful. The trouble was that, at least in the first few years of widowhood, I was haunted by recollections of his physical decline as his disease worsened and plagued by memories of him as he was when he was mortally ill.

Chemotherapy that his doctors surely knew would never cure him served only to give him false hope. He might wake up one morning in unusually good spirits, having noticed that a softball-sized malignant lymph node in his neck seemed to have shrunk a little after a chemo treatment, only to wake up the following morning to see that another node in his neck, which just the day before had been the size of a walnut, had grown overnight to the size of an egg. Within a few weeks after he started treatment, his thick, wavy hair (except for his runt of a ponytail, which I cut off before it was too late) was gone, as were his eyebrows. His lung capacity was so diminished that he had to pause to catch his breath after walking from the bathroom to the kitchen, and I can still see him leaning over the counter, panting as he whispered, “I just want to do what I used to do.” Two weeks before he died, his dental bridge, which had been part of him since he lost a front tooth in a Navy training exercise, fell out. He had lost so much weight that it no longer fit.

These, along with countless similar others, were the memories that day after day, week after week, month after month, and year after year I worked with all my might to shut off the moment they flooded my consciousness. To help drive them from my mind, I tried to force myself to think of Tom as he was when he was well, but even those memories were too painful to bear. I was tormented: not only had my beloved—the object of my yearning—become physically inaccessible to me, but I could not even bear to hold him in my own mind.

How are we affected when there are people and experiences in our pasts that are too painful to remember but too essential to forget? How are we affected when memories of them, including the feelings they evoke, persist for years on end, simmering just below our consciousness and coming up for air when we least expect it? To carry on living, we work hard to stifle these memories, but even as we do so, we know that if, in a selective amnesia, we were able to completely and irretrievably forget what is too painful to remember, we would lose integral parts of ourselves, leaving us irreparably broken for the rest of our lives.

How can the inability to remember one’s lost loved one exist alongside the refusal to believe that one’s lost loved one is really gone forever? In dreams. While we cannot censor our sleeping dreams, we forget most of them upon waking, which amounts to the same thing. Over the past two decades, I have had dozens of dreams in which Tom either came back from the dead or never died in the first place. Still, in a contradiction to what scientists have observed in people suffering from complicated grief, I am convinced that one reason my grief was so acute and persistent was that I did believe he was gone forever. The unreality lay in my inability to accept that fact: My husband is gone forever. He will never come back. Now my job is to carry on living without him.

As the years passed, it became obvious even to me that I was carrying on without him. Still, I continue to ask: Are our lost loved ones really gone forever? Are they obliterated except in memory? Yesterday I wrote the preceding paragraph, and coincidentally or not, last night as I slept, I dreamed that Tom had never left. Coincidentally or not, when I awoke this morning, I remembered the dream. I was walking with my sister Resa at an outdoor gathering, perhaps the Minnesota State Fair, and without our noticing, afternoon had turned to evening. To be exact, it was 6:15 p.m. It was dark save for the lighted streets. We had stopped to discuss whether to leave the gathering, and as we were talking, I happened to turn my head. There was Tom walking toward us, hale and vigorous, his backpack on his back. As he grew closer, I held out my arms to welcome him, but instead of embracing me, he hung his head, hunched his shoulders, and crumpled to the ground like an exhausted marathon runner who has just crossed the finish line. I came to the ground and sat next to him, resting my head against his bent knee as he told us a story about where he had been. I cannot remember his words.


Twenty-two years after losing my husband, I learned that yearning is the single most common feeling experienced by those of us who have suffered or still suffer from complicated grief.

Missing someone means that you’re aware, often sadly so, that someone you loved, someone who brought you joy or enhanced your everyday well-being, is no longer part of your earthly life. Yearning, on the other hand, is a potent form of desire. Dead or not, you want your loved one back so that you can feel like yourself again. Missing someone can feel wistful, even calming, but yearning aches. It stabs. It can be unbearably painful, especially when it refuses to subside. Missing your loved one feels real and natural; it has a place in your life. Yearning, on the other hand, can disconnect you from reality. It prevents you from feeling fully present in your life, and it keeps you from reentering the land of living after your loved one has died. That’s why it so perfectly defines complicated grief.

When yearning for what is no longer possible begins to loosen its grip on our minds, we can begin a healing journey into the more livable state of missing someone. After enough time has passed, we may even reach a point where thinking about our loved one begins to feel pleasant. We can come, eventually, to a place where we can finally begin to replace self-inflicted pain and self-pity with profound, undying gratitude for having had our loved one in our life.

After twenty-two years, I think I’ve finally gotten there. I only realized this last year, shortly after I finished writing most of After Effects. During one of my frequent online journeys, I found an article by psychologist Mary-Frances O’Connor and her colleagues about yearning as a central characteristic of complicated grief. In it, she shares a diagnostic tool called the Yearning in Situations of Loss (YSL) Scale.* The Scale lists twenty-one statements describing how we might feel after losing a loved one and asks us to react to each statement by indicating how often we feel that way. We are given a scale of five choices ranging from never to always.

I confess that I’m drawn to quizzes, especially those that are supposed to help you know yourself better, so when I encountered the YSL Scale, I was genuinely curious. I wanted to try it. I told myself that I was ready to take the chance, but at the same time, I was afraid. I had avoided looking into the mirror of my grief for two decades, and now, through a simple questionnaire, I was finally about to do so. As I scanned the twenty-one statements, I could feel a familiar tightening in my chest, an icy, constricted feeling I had experienced so often during my years of complicated grief. I took a breath. Would the YSL Scale reopen wounds that, even after two decades, were still tender? Would it derail my precarious healing path?

Temperate and gentle, the statements seemed safe enough, so I chose a few that felt most relevant to my situation and answered each one twice, the first time based on how I felt during my years of hardest grieving, and the second time based on how I feel now. I called my plan Then and Now.

I find myself wishing that things could be the way they were when I was with Tom.

Then: always. Now: rarely.

So much in my life has changed over these two long, hard decades. I have settled into a different home, I am no longer employed, and, amazingly, I am so many years older than Tom. It feels surreal to think of simply picking up where we left off, yet my love for him remains constant. My survival has enabled me to learn firsthand that no matter how much time passes, love never dies.

The feeling of wanting Tom back is so strong that it is indescribable.

Then: always. Now: never.

Not only was my yearning indescribable, it was unbearable. To lack the words to comfort yourself is a tragic form of suffering, but the inability to bear life is worse. Then, I never thought about my survival. I had no insight into my emotional state and no words through which to try to understand what was happening to me. At the same time, I couldn’t bear my own company. It was as though my “self” had disappeared. Now, after so many years of feeling only partially alive, I am finally able to recognize myself again. I now know that ongoing inner dialogue is the key to self-awareness, and that self-awareness inevitably leads to self-understanding, which inevitably leads us toward peace of mind.

It’s hard for me to be happy without Tom.

Then: always. Now: rarely.

When circumstances leave us traveling alone through life, we must create our own happiness. Is that a curse or a blessing? When we find ourselves alone in perpetuity, should we assume that the door to happiness has permanently closed behind us? Or are we given an unexpected opportunity to light our own way? Then, I felt permanently locked in grief. Happiness, I was sure, was for other people, not for me. Now, I’m not so sure. Recently, I read a tiny tale about a European cobbler who worked long into the night even as the light from his single candle dwindled and flickered. When a concerned friend asked him how he could continue to work in such darkness, he sagely replied, “As long as there is light, repairs can be made.”

I miss Tom as much or more than I have missed any other person.

Then: always. Now: always.

Then, I felt bereft, unmoored, at sea. Now, I am able to peacefully miss him, and that allows me to cherish him as my eternal companion. Professionals in helping fields use the term “anticipatory grief” to describe how we might feel as we accompany a loved one through a terminal illness. Witnessing our loved one’s decline, including their suffering, is thought to prepare us for the grief that is to come, thereby lessening our pain after our loved one leaves us. I had spent five months as Tom’s only caregiver, so I hoped, as did everyone around me, that my bereavement would be relatively mild and last only a short while.

Unfortunately, so-called anticipatory grief encourages us to suppress our grief when it actually arrives. Why bother to grieve again when we’ve already put in our time? We should be grateful that we are finally relieved of caregiving and that our loved one is now in a better place. Besides, we knew it would happen, didn’t we? When Tom entered home hospice care four weeks before he died, I was introduced to anticipatory grief by the intake nurse, who assured me that while I would grieve after his death, it would almost certainly be mild, and I would continue to feel better as I recovered my strength after the stresses of caregiving. How could this be true? The intake nurse knew nothing about Tom or me outside of Tom’s illness. How dare she speculate about how I would feel in bereavement? Still, she was kind and knowledgeable, and at such a vulnerable time, I welcomed her counsel. I was genuinely grateful to her until my grief failed to unfold as she predicted.

Grief, I have come to believe, is as unpredictable as it is natural. On one hand, there is the grief I felt for so long after losing Tom, and on the other, there is the grief I felt after the deaths of my parents, who died at ages eight-four and ninety-three. After they died, I missed them terribly and still do, but I never yearned for them. I was able to accept that their earthly lives were over and continue my own life with little disruption.

Respected researchers tell us that grief that is extraordinarily intense and prolonged—the condition that is now officially called prolonged grief disorder but is widely known as complicated grief—is much more likely to affect people whose loved one died in the prime of life. It is even more likely to affect people who lose their life partner, their most significant other, the one person to whom they were inextricably connected. And it is very likely to affect people who lose a child or who lose a close loved one to suicide or murder.

That well-meaning hospice nurse wasn’t aware of how closely I fit the profile of a person whose dearest friend, lover, and life partner would soon die in the prime of his life. It was, after all, the quality of my relationship with Tom that paved the hard road I would travel in grief. Pioneering grief researcher M. Katherine Shear tells us that grief is the form love takes after your loved one has died. She says that there is no shame in grieving long and hard, but that there is now trustworthy professional help if you seek it. I hope that the story I tell in After Effects will bring a beam of light to its readers, whether or not they have suffered the harsh losses that temper our lives.