Grief counselling

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The loss of a family member due to a chronic illness.

 

Being ostracized from a faith community because of an incident resulted in spiritual loss. 

 

The loss of a longstanding career because of health issues.

 

The loss of a friend due to the friend dying by suicide.

 

Learning that a family member was killed in a random act of violence. 

 

Experiencing a miscarriage. 

 

 

Grief comes in various forms. 

 

There is no right or wrong way to grieve unless the grief hurts yourself or someone else. Grief is always complicated. From a clinical lens, grief may be complicated or uncomplicated. Some think mourning and grieving are the same. Mourning is the external manifestation of grief. It shows others in our lives that we have lost something or someone. 

 

Grief is the internal dynamics that occur within a person when they experience a loss that affects them. It is important to understand that grief counselling is when a therapist, psychologist, or social worker walks with someone through uncomplicated grief. Grief counselling, on the other hand, is when specialized therapy is utilized for complicated grief and when trauma is involved.

 

A person’s attachment style will influence how they grieve. If someone has an avoidant attachment style, they may try to suppress the emotions involved with a loss. Someone with a preoccupied attachment style may find difficulty coping healthily due to overwhelming anxiety. The hope for us all is to grieve within a secure attachment style. This means we can move back and forth between what we need to feel and function in a healthy, productive manner. 

 

A person may experience complicated grief with its symptoms. A person may ask what constitutes complicated grief since it is a term that the population doesn’t often understand or know about. First, one thing complicated grief is not: a form of depression. When it comes to grief, depression may or may not be present. Grief often brings about a longing or yearning for a person or thing that depression does not necessarily include.

 

Complicated grief, based on one definition, is seen as the following: “Characterized by severe separation distress, dysfunctional thoughts, feelings or behaviors related to the loss that complicate the grieving process and prevent the griever from adapting to the loss, acknowledge the reality of the loss, reconnecting with others, and moving forward with aspirational goals.”

 

Two of the warning signs for complicated grief are having anger and bitterness that is challenging to release and difficulty laying to rest the “if only” thoughts about alternative scenarios that could have happened. It’s important to understand that the two examples of complicated grief are ordinary responses to a loss, especially at the beginning of the grieving journey. However, if the symptoms do not relent, then complicated grief could be the result. 

 

If only I had been a better brother…

 

If only I had been there the night before…

 

Assessments are available to ascertain if complicated grief is a concern. Culture has to be taken into account when speaking with someone about grief. A therapist needs to be competent in talking with others about their religious or spiritual beliefs. Not only do professional helpers need competence, but they also need to be willing to do so as well. 

 

There are many directions to take when it comes to interventions with grief. Below are a few of them.

 

1. Narrative reconstruction therapy for complicated grief

2. Integrative Cognitive Behavioural Treatment for complicated grief

3. Restorative retelling

4. Systematic desensitization

5. Journaling

6. Guilt, regret, and shame interventions

7. Interventions for self-forgiveness

8. Interventions for forgiving others

9. Correspondence with the deceased through photographs/photo albums, memory boxes, linking objects, life imprints, photo narratives, rituals, and music interventions.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Help is available to support you on your grieving journey. As I heard once from a presenter who specializes in grief, Christina Zampitella, Psy. D, FT: “Joy shared is joy doubled, and grief shared is grief halved.” Please reach out if you would like support. 

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References

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Neimeyer, R. (2016). Techniques of grief therapy: Assessment and intervention. Routledge

 

McLeod, S. (2021). Systematic desensitization as a counter-conditioning process.

https://www.simplypsychology.org/Systematic-Desensitisation.html

 

Peri, T., Hasson-Ohayon, I., Garber, S., Tuval-Mashiach, R., Boelen, P. (2016). Narrative reconstruction therapy for prolonged grief disorder: Rationale and case study. European Journal of Psychotraumatology, 7(1), 1-11.

 

Prigerson, H. G., Horowitz, M. J., Jacobs, S. C., Parkes, C. M., Aslan, M., Goodkin, K., ... & Maciejewski, P. K. (2009). Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS medicine, 6(8), e1000121.

 

Shear, K., Simon, N., Wall, M., Zisook, S., Neimeyer, R., Duan, N., Reynolds, C., Lebowitz, B., Sung, S., Ghesquiere, A., Gorscak, B., Clayton, P., Ito, M., Nakajima, S., Konishi, T., Melhem, N. Meert, K., Schiff, M., O’Conner, M….Keshaviah, A. (2011). Complicated grief and related bereavement issues for DSM-5. Depression and Anxiety, 28, 103-117.

 

Shear, K. (2020). HEALING milestones: What grievers can expect. Grief white papers series. New York: Columbia University.

 

Zisook, S., Simon, N. M., Reynolds III, C. F., Pies, R., Lebowitz, B., Young, I. T., ... & Shear, M. K. (2010). Bereavement, complicated grief, and DSM, part 2: complicated grief. The Journal of clinical psychiatry, 71(8), 1869.

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