“When those you love have passed away…” is how my mom begins her last goodbyes to us on her “Remembrance” memorial message. She’s not near death yet, just preparing.

For her, death is simply a door opening into a glorious reunion with her God and loved ones who have gone before. Oh, if only it could be so jubilant for the rest of us — we often have difficulty with goodbye.

Goodbye comes in many forms: death, disease, divorce, family fallouts, moves, unrequited love, “ghosting,” natural endings, maturation, and violence, to name a few.

Rehab facilities and prisons are filled with those who have been left behind. Alcohol, drugs, sex, eating, gambling, technology addictions and the like temporarily soothe and distract us from such pain.

Disenfranchised youth join gangs seeking safety and security. Gregory Boyle, a Jesuit priest and founder of Homeboy Industries, details case after case in “Tattoos on the Heart.” Loss and grief need to be addressed.

In my end-of-life work over the years, I’ve seen people disengage in different ways.

My 41-year-old best friend with end-stage cancer was admitted to the inpatient care center at hospice needing to be palliative sedated because her physical symptoms were so out-of-control. Once she became unconscious, her husband left, never to return, stating, “She’s already gone.” Fortunately, family and friends held vigil at her side for days until she peacefully died.

In another case, an elderly husband could no longer bring himself to touch his wife of nearly half a century as she was dying. His son came cross country to sit with his mother and hold her hand. His father stayed, though, standing at the foot of her bed, watching.

Lori Gottlieb, psychotherapist and author, describes how discombobulating it can feel to be unilaterally disconnected in “Dear Therapist: My Friend Is Dying and Has Asked Me Not to Contact Her.” She exquisitely explains what happens as the terminally ill begin untethering from life.

Regardless of how or why the separation occurs, to paraphrase a Buddhist saying, “All suffering is the same.” So, how might we more healthfully deal with the difficulty of goodbye?

In her spot-on article, “How Do You Say Goodbye?” journalist and minister Ellen Debenport addresses this dilemma. She proposes that with mindfulness and gratitude we may more quickly and completely gain closure.

Here are a few more ways:

Feelings

It’s important to feel our feelings, whatever they are. For me, only now sadness is surfacing from an upsetting series of separations that happened months ago. Tapping into my Nonviolent Communication training, I know that underneath my anger lies sadness, hurt and fear. Accessing and acknowledging our true feelings is a means to moving on.

Cognitive Strategies

There are so many ways to shapeshift our thinking. Reflecting on both the positives and the negatives of the relationship may help in regaining perspective.

Before she died, I asked my aforementioned friend how she wanted me to remember her. She described in depth an earlier, happier time we spent together including exactly what she was wearing. I’ve hung onto this image to this day in celebration of all that we shared.

Self-Care

The shock, surrealness and sadness that often comes with a goodbye requires us to double down in our efforts to nurture and nourish ourselves. Take that bath, that nap — whatever helps you heal. This is not the time to be making big decisions about anything.

Support

Friends, family, neighbors, coworkers, colleagues — depending on your situation any of these folks may be available and appropriate to lean on. Hospice provides bereavement groups and resources to the community at large as well as for the patient’s survivors. So do places of worship, town centers, even libraries. Use them.

Eventually (it takes as long as it takes), a shift occurs. You’ve heard the saying, “When one door closes another one opens.” Endings become beginnings. Goodbyes become hellos — like my mother says.

"We must be willing to get rid of the life we've planned, so as to have the life that is waiting for us. The old skin has to be shed before the new one can come." — Joseph Campbell