Clients told me that asking for help was challenging, partly because they didn't know if they were 'bad enough' or maybe 'beyond help' but mostly because they didn't know anything about counselling. So I decided to put together a jargon free framework for interested clients and write this blog.
Here are some things that someone considering counselling, after a big loss, might find helpful to know about bereavement therapy. My framework is at the end end. The framework gives an idea of the things I might cover with my clients, as a specialist bereavement therapist.
Loss is the absence of something we were once attached to. Grief is the rope burn left behind, when that which is held is pulled beyond our grasp. Nothing is more natural than grief, no emotion more common to our daily experience. It’s an innate response to loss in a world where everything is impermanent.
Stephen Levine Unattended Sorrow, Rodale Books, 2005
Helping the client to understand the Grief Process
Grief is a painful but universal response to loss. You're not alone. The impact of loss and bereavement manifests in common ways but is, at the same time, very unique to you.
If you're feeling the impact of a significant loss, even some time after the loss, this is 'normal'. Grief has been described as the cost of love and as the sadness when love has nowhere to go. So if you have loved deeply, it's very likely you will have deep grief to process. If you feel emotionally and physically overwhelmed, this is also normal. It takes our brains and body and emotions time to regulate and adjust. It's the way our human bodies are....
Dealing with loss is also not linear or tidy or predictable. There is no standard timescale or intensity score that should be held up as 'acceptable'. There is certainly no "right" way to grieve, despite most people feeling shame about their grief story.
Some people may even experience 'prolonged' or 'complicated' grief which many find stressful and shameful but this can impact around 10% of those experiencing a significant bereavement. Anyone who feels their symptoms are not lessening at all, after 6 months post bereavement, may wish to seek out professional support, as this can be very helpful in cases where grief is more complex.
After the sudden loss of her husband in a car accident, Sarah found herself experiencing a rollercoaster of emotions - some days she felt numb and disconnected, while other days she was overwhelmed with intense sadness and anger. She found herself preoccupied with replaying events leading up to the death. She felt guilt and shame about things she felt she could have done differently. She came to counselling.
Bereavement counselling helped Sarah to understand that the feelings were a normal part of the grieving process . Weekly sessions provided the support she needed to work through her complex emotions, especially the shame of just seemingly being unable to move on with her intense feelings. She particularly wanted to know more about grief itself to normalise her experience.
Managing difficult emotions and the Importance of Self-Care
Strong, uncontrollable feelings of overwhelming sadness, grief, guilt, anger, regret, anxiety and depression are common during the grieving process and they can be exhausting. As humans there are ways to manage this phase.
Talking about things and expressing difficult emotions is a vital and key part of the healing process. Yet, sometimes clients do not have anyone they feel they can talk to with honesty for fear of judgement, which can make things feel even worse. If there is no outlet to talk, we can feel like a pressure cooker at risk of exploding or blowing out pent up emotion, at all the wrong times.
Counselling provides a safe, confidential and non-judgemental space to let these things surface safely and come out. The feelings can be talked about and in so doing processed and bereaved clients can say what they feel and feel heard.
Counsellors with specialisms of working with anxiety and bereavement can also teach tools to manage the intense symptoms of anxiety and depression which are often present with significant life events, in order to prevent them from becoming debilitating longer-term.
Eliza had been caring for her elderly mother for years before her mum died. When Eliza's mother died, Eliza was already isolated, exhausted, anxious and unwell herself. Months on, Eliza could still not face starting on the 'sad-min' (admin) tasks of selling the family home or starting to rebuild her social life. Eliza was overwhelmed and starting to suffer poor sleep and panic attacks. She sought out bereavement counselling.
Through weekly counselling sessions, she started to learn breathing and was able to learn mindfulness/EFT techniques to calm her anxiety which helped her to get more sleep. Eliza wanted practical ideas to get through. I suggested journaling, and after signposting to a befriending service, with the help of a befriending volunteer, Eliza got her own wellness back on track. She only then was able to start the grieving process and sort out the practicalities out and process the psychological impact of the loss of her mum. Towards the end of her therapy, she decided to honour her mum by becoming a befriending volunteer herself.
Navigating Life Changes
The death of a loved one can lead to significant life changes, such as changes in financial or living circumstances and relationships, because clients may withdraw or struggle to communicate their needs.
A specialist bereavement counsellor can help cope with, accept and adjust to these changes and to find a new sense of stability and purpose to reconnect with self, others and life.
After the death of his best friend and partner, it felt to Paul as if life was empty. He had no-one to talk to as his relationship had been hidden from his family for years. Counselling helped Paul to not only process the devastating 'secret' loss but also after several sessions he even decided to change careers, as this was something his partner always encouraged him to do, so he could be happier and live life even more fully. In counselling he was able to explore his own identity and who he was as well as his loss.
Honouring the Relationship
Maintaining a connection after a bereavement, with a loved one, can be an important part of the grieving process. This might be through music, photos, special places, belongings, prayer, celebrations, memorials and so on. Counselling can help individuals find healthy ways to honour their relationship and create a lasting legacy.
After the death of his father, Thomas found comfort in keeping his father's favourite hat and visiting the park where they used to walk together. After his pet died, shortly after, Tom felt this was too difficult. Some of the grief counselling sessions were dedicated to helping Thomas find new and different ways to honour his father's memory, such as writing him letters or creating a memorial garden and to incorporate the dog's memory into everyday life. It helped him to mark the difficult 'first' events such as Christmas, birthday and anniversary of death as he knew he could have space to talk about his Dad without 'burdening' those around him, who he felt just didn't want to talk about death.
Grief is a lifelong process, and there is no "end" to the experience. It is therefore never 'too late' or 'too long ago' to seek someone professional to talk to. As a bereavement counsellor I am trained to help you to find ways to live with the pain while also helping you to know and begin to experience some moments of fulfilment and maybe even joy as you comes to terms with the loss.
There are charities that offer online or phone bereavement support for free though there is usually a waiting list. Private counsellors can also offer support. Please do get in touch if you would like to talk to me and make an appointment. I work from Malvern face to face, or online or by phone if you prefer.
I have developed a framework to explain the grief counselling work that I do and how I approach it. You can download the full framework below.
In sessions people often want to talk about the person who has died, about how the death is affecting them now and how to cope without being so overwhelmed. They often want to support as 'first' events happen and to just know someone will listen without judging them. A bereavement counsellor can help you to manage your feelings in the months post loss and help you to begin to adapt to life without the person who has died. Usually 8-12 sessions are what most people need, some less and some more in cases of very complex or prolonged grief. Stephen Levine talks of the ‘braille method’ – feeling our way, moment by moment, through the pain of our days post loss, until we begin to adjust to a life different from the one we had planned. If you want support to do that, please call, text, email or complete the contact form on my website.
I volunteer as a specialist bereavement volunteer counsellor, with Cruse. I have completed specialist training and qualifications to work specifically with grief, loss and bereavement.
Here is a link from Mary Curie of ideas to help.
Here is a link if you want to know how to support others.
Here is a link to Cruse with a variety of information booklets
Here is a link to At A Loss signposting and information
I would like to finish by adding that there is not a time when you ever 'get your life back' to how it was, though this is a deep yearning that is often present. The pain is always there and yet life can still grow around that pain, with time. To want life to be unchanging in this sense, is normal and the common experience of humans facing loss. It is not something we need to feel guilty or ashamed or shamed by others about. Speaking to someone who will not judge you, is very helpful.
This poem illustrates how I feel about the death of my beautiful friend, Katy, which inspired me to specialise working with grief and to volunteer for Cruse. I hope that if you are bereaved that this little blog and the poem, may help you in some small way.
Please call if you would like to make an appointment. 07843544009
Adrift by Mark Nepo
Everything is beautiful and I am so sad. This is how the heart makes
A duet of wonder and grief.
The light spraying through the lace of the fern is
As delicate As the fibers of memory forming their web Around the knot in my throat.
The breeze makes the birds move from branch to branch as this ache makes me look for those I’ve lost in the next room, in the next song,
in the laugh of the next stranger.
In the very center, under it all,
What we have that no one can take away
And
All that we’ve lost
Face each other.
It is there that I’m adrift,
Feeling punctured
By a holiness that exists inside everything.
I am so sad and everything is beautiful.
With love and kindness to anyone who has lost something or someone precious.
Please feel free to get in touch if you feel that I could help you.
References:
Boelen, P. A., & Prigerson, H. G. (2007). The influence of symptoms of prolonged grief disorder, depression, and anxiety on quality of life among bereaved adults: A prospective study. European Archives of Psychiatry and Clinical Neuroscience, 257(8).
Klass, D., Silverman, P. R., & Nickman, S. L. (1996). Continuing bonds: New understandings of grief. Taylor & Francis.
Kübler-Ross, E., & Kessler, D. (2005). On grief and grieving: Finding the meaning of grief through the five stages of loss. Simon and Schuster.
Neimeyer, R. A. (2016). Techniques of grief therapy: Assessment and intervention. Routledge.
Shear, M. K. (2015). Complicated grief. New England Journal of Medicine, 372(2), 153-160.
Shear, M. K., Simon, N., Wall, M., Zisook, S., Neimeyer, R., Duan, N., ... & Keshaviah, A. (2011). Complicated grief and related bereavement issues for DSM‐5. Depression and Anxiety, 28(2), 103-117.
Stroebe, M., & Schut, H. (1999). The dual process model of coping with bereavement: Rationale and description. Death studies, 23(3), 197-224.
Worden, J. W. (2018). Grief counseling and grief therapy: A handbook for the mental health practitioner. Springer Publishing Company.
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