Grief Therapy & counseling is a form of psychotherapy that aims to help people cope with the physical, emotional, social, spiritual, and cognitive responses to loss. These stages of grief experiences are commonly thought to be brought on by a loved person’s death, but may more broadly be understood as shaped by any significant life-altering loss (e.g., divorce, home foreclosure, or job loss).
Grief counseling becomes necessary when a person is so disabled by their grief; and, so overwhelmed by their loss that their normal coping processes are disabled or shut down. Grief counseling facilitates expression of emotion and thought about the loss, including their feeling sad, anxious, angry, lonely, guilty, relieved, isolated, confused, or numb.
Stages of Grief
Denial is the first of the five stages of grief. It helps us to survive the loss. In this stage, the world becomes meaningless and overwhelming. Life makes no sense. We are in a state of shock and denial. We go numb. We wonder how we can go on, if we can go on, why we should go on. We try to find a way to simply get through each day. Denial and shock help us to cope and make survival possible. Denial helps us to pace our feelings of grief.
Before a loss, it seems like you will do anything if only your loved one would be spared. “Please God,” you bargain, “I will never be angry at my wife again if you’ll just let her live.” After a loss, bargaining may take the form of a temporary truce.
“What if I devote the rest of my life to helping others? Then can I wake up and realize this has all been a bad dream?” We become lost in a maze of “If only…” or “What if…” statements.
We want life returned to what is was; we want our loved one restored. We want to go back in time: find the tumor sooner, recognize the illness more quickly, stop the accident from happening…if only, if only, if only. Guilt is often bargaining’s companion. They forget that the stages are responses to feelings that can last for minutes or hours as we flip in and out of one and then another. We do not enter and leave each individual stage in a linear fashion. We may feel one, then another and back again to the first one.
After bargaining, our attention moves squarely into the present. Empty feelings present themselves, and grief enters our lives on a deeper level, deeper than we ever imagined. This depressive stage feels as though it will last forever. It’s important to understand that this depression is not a sign of mental illness.
Depressionafter a loss is too often seen as unnatural: a state to be fixed, something to snap out of. The first question to ask yourself is whether or not the situation you’re in is actually depressing. The loss of a loved one is a very depressing situation, and depression is a normal and appropriate response.
Anger is a necessary stage of the healing process. Be willing to feel your anger, even though it may seem endless. The more you truly feel it, the more it will begin to dissipate and the more you will heal. There are many other emotions under the anger and you will get to them in time, but anger is the emotion we are most used to managing.
The truth is that anger has no limits. It can extend not only to your friends, the doctors, your family, yourself and your loved one who died, but also to God. You may ask, “Where is God in this? Underneath anger is pain, your pain. It is natural to feel deserted and abandoned, but we live in a society that fears anger. Anger is strength and it can be an anchor, giving temporary structure to the nothingness of loss.
Acceptance is often confused stages of grief with the notion of being “all right” or “OK” with what has happened. This is not the case. Most people don’t ever feel OK or all right about the loss of a loved one. This stage is about accepting the reality that our loved one is physically gone and recognizing that this new reality is the permanent reality.
We will never like this reality or make it OK, but eventually we accept it. We learn to live with it. It is the new norm with which we must learn to live. We must try to live now in a world where our loved one is missing. In resisting this new norm, at first many people want to maintain life as it was before a loved one died. In time, through bits and pieces of acceptance, however, we see that we cannot maintain the past intact.
Participate in community support groups as well as within individual sessions.
Practice active listening and provide individualized attention.
Introduce clients to coping mechanisms.
Organize and moderate a group sessions bringing together clients experiencing different stages of grief.
The immense grief experienced after losing a spouse, partner, parent or child can be devastating. Bereavement is often the term used to describe the time we spend adjusting to loss.
Counselors in grief work understand that grieving and bereavement is different for every individual. Variations in time to cope and adapt depend upon a number of factors, including relationship to loss, significance of said relationship, previous coping skills employed, and emotional stability. Grief can manifest as sadness, anger, denial and even delusion.
Work of a Grief Counselor
Grief counseling professionals specialize in work with clients who are coping with profound loss — whether this is the death of a loved one, a debilitating injury, terminal illness, divorce, or other significant personal bereavements. In establishing a counselor-client relationship, the practitioner must first determine what type of grief reaction their client is exhibiting.
Every individual grieves in their own way, some experience depression, anxiety, or extreme stress while others may experience a feeling of relief, happiness, or confusion.
A grief counselor helps clients to accept their loss and adjust to their changed life. The most important role is to ensure that extended grief doesn’t turn to lasting depression, and if it does, that the client receives a referral to a psychotherapist or psychiatrist.
How does Grief Counseling work?
The services of grief counselors are highly sought by those in need, often indirectly through the referral of a primary care practitioner, health facility or government agency. The latter is often the case following a national disaster such as Hurricane Katrina or a mass tragedy like the Sandy Hook shootings.
Professional counselors in grief work may be in private practice or employed by a community mental health facility. Their services may be needed at hospice facilities, funeral homes, rehabilitation and long-term care facilities, social service agencies, and a variety of public and private settings depending on circumstances.
Difference between Grief Counseling and Grief Therapy
There is a distinction between grief counseling and grief therapy.
Grief Counseling involves helping people move through uncomplicated, or normal, grief to health and resolution. Grief therapy involves the use of clinical tools for traumatic or complicated grief reactions. This could occur where the grief reaction is prolonged or manifests itself through some bodily or behavioral symptom, or by a grief response outside the range of cultural or psychiatrically defined normality.
Grief therapy is a kind of psychotherapy used to treat severe or complicated traumatic grief reactions, which are usually brought on by the loss of a close person (by separation or death) or by community disaster. The goal of grief therapy is to identify and solve the psychological and emotional problems which appeared as a consequence.
They may appear as behavioral or physical changes, psychosomatic disturbances, delayed or extreme mourning, conflictual problems or sudden and unexpected mourning). Grief therapy may be available as individual or group therapy. A common area where grief therapy has been extensively applied is with the parents of cancer patients.
Goals of Grief Counselling and Therapy
Professionals believe that there are diverse frameworks and approaches to goals and outcomes of the grief counseling and therapy process. Robert Neimeyer believes, “The stages of grief acts as a fellow traveler [with the bereaved] rather than consultant, sharing the uncertainties of the journey, and walking alongside, rather than leading the grieving individual along the unpredictable road toward a new adaptation” (Neimeyer 1998, p. 200).
Janice Winchester Nadeau clearly reminds grief counselors and grief therapists that it is not only individuals who are grieving, but entire family systems. A person is not only grieving independently within the family system, but the interdependence within the family also affects one’s actions and reactions.