Sharing different experiences working with clients who have complex or unresolved grief. Stages of grief and overview of therapy with grieving clients.
Grief and Loss:
Grief is the emotional response to loss, which includes a wide range of feelings, thoughts, and behaviors. While grief is most frequently connected with the death of a loved one, it can occur in response to a variety of losses. It is a very personal and frequently non-linear process that affects people differently based on their circumstances, personality, and support asystems.
Grief is more than just sadness; it can also express as anger, shame, uncertainty, or even relief, depending on the nature of the loss. It tests a person’s sense of identity, stability, and purpose, frequently putting them in emotional turmoil as they struggle to accept their new reality.
To heal from grief, it’s important to acknowledge the pain rather than avoiding it. Setting your purpose to heal might help you accept pain and preserve optimism for the future. While embracing your sadness and committing to recovery, it’s important to realize that grief healing takes time and requires patience. It’s important to recognize that the perception of “doing well” throughout grieving is incorrect. To cope with loss effectively, it’s important to mourn freely and honestly, rather than being strong and silent.
Is grief a disease?
George Engel (1961) posed an intriguing subject in a thought-provoking essay published in Psychosomatic Medicine. According to Engel’s argument, losing a loved one can be as psychologically devastating as being seriously injured or burned. He contends that grief is a departure from a state of health and well-being, and that, just as healing is required in the physiological realm to restore the body to homeostatic balance, a period of time is also required to restore the mourner to a similar state of psychological equilibrium. Therefore, Engel sees the process of sorrow as similar to the process of healing. complete function, or nearly complete function, can be recovered, but there are also cases of compromised function and insufficient recovery. The phrases “healthy” and “pathological” refer to the various stages of the physiological healing process.
Grief is a universal human experience that can feel solitary and totally personal. For some, the process of grieving becomes complicated or unresolved, resulting in a lengthy battle that has a significant influence on their emotional, psychological, and even physical well-being. Working with clients who are experiencing complex or unresolved grief is both a tremendous responsibility and a chance to help them heal and accept.
GOALS OF GRIEF THERAPY:
Helping the survivor cope with the death of a loved one and find a new world without them is the main objective of grief counseling.
The four mourning tasks are accompanied by specific objectives:
(1)Increasing the reality of loss; (2) assisting the counselee in coping with the emotional and behavioral pain; (3) assisting the counselee in overcoming various obstacles to readjustment following the loss; and (4) assisting the counselee in finding a means of preserving a relationship with the deceased while feeling at ease reinvesting in life.
Grief Beyond Death: The Many Faces of Loss.
While the death of a loved one is a well-known cause of grief, other forms of losses can also elicit strong emotions of mourning. These losses may not receive the same level of public recognition, resulting in disenfranchised grief—grief that goes unnoticed or is dismissed by others. Below, we look at some of these lesser-known but as devastating sources of grief.
- Loss of self-esteem.
Failure, criticism, and personal setbacks are common causes of low self-esteem. It can be quite upsetting because it undermines one’s sense of self-worth and identity.
Why it causes grief:
Self-esteem is inextricably linked to our sense of competence, value, and belonging. When it is undermined, people may mourn the confident, capable version of themselves that they believe they have “lost.”
This type of sorrow may include feelings of guilt, inadequacy, or hopelessness.
For example, a student who fails a major exam may suffer grief due to the loss of their self-image as accomplished and capable.
The social comparison and fear of missing out makes him feel unworthy and neglect his abilities; there may be a possibility of him not being able to study due to health issues and other causes, but the pain of failure is so great that he feels guilty and performs suicide.
- Loss of dreams or aspirations.
The loss of aspirations or future plans can be distressing, especially if those dreams were important to one’s identity or life mission. This sort of grieving is frequently associated with significant life transitions, health problems, or unexpected changes.
Why it causes grief:
Dreams and goals provide guidance and meaning. Losing them might cause feelings of emptiness and bewilderment.
This loss may cause existential distress as people question their purpose and value.
For instance, a woman may need to take a work pause to care for her children, notwithstanding her desire to be successful.
3. Loss of job or career
Losing a job is more than simply a financial setback; it may also be a significant emotional and psychological blow. A job frequently offers structure, purpose, social ties, and a sense of accomplishment.
Why it causes grief:
The loss might shake a person’s sense of security and self-worth.
It may cause feelings of rejection, failure, and anxiety about the future.
Employees who are laid off during a firm downsizing may struggle with their identity as a professional and contributor, in addition to their job position. Losing money in business, not finding a job, being fired from a job, and a variety of other factors can all create significant stress and anguish. It was noticed that during covid 19 hundreds of individuals lost their jobs and sources of money, which led to many psychological difficulties and disrupted the lives and lifestyle.
- Loss of Relationship
Breakup, divorce, or alienation can all result in severe grief. Relationships are fundamentally linked to emotional safety, companionship, and identity.
Why it causes grief:
The loss of shared memories, future ambitions, and a sense of belonging can be like losing a piece of oneself.
Even bad partnerships can cause individuals to regret the loss of familiarity or disappointed expectations.
For instance, a person who ends a long-term partnership may grieve not only the relationship itself, but also the picture of their future together. The attachment to the individual, Missing them can make it tough to go on and accept that they are no longer part of your life.
- Loss of Health or Physical Ability.
Chronic sickness, disability, or aging can cause grief due to the loss of physical capacities, independence, or the life that was previously envisioned.
Why it causes grief:
Health is frequently taken for granted until it is threatened, resulting in emotions of fragility and constraint.
This sort of grieving may include lamenting the loss of the “old self.”
A person with a degenerative condition may experience grief due to the loss of their active lifestyle and autonomy. a 39-year-old man diagnosed with cancer, experiencing extreme terror and distress about the illness and death and thinking about his family.
Understanding Grief's Stages
The emotional anguish of grieving is frequently summarized by Elisabeth Kübler-Ross’s five stages of grief concept, which includes
- Denial: Shock or disbelief at the loss.
- Anger : It is defined as feelings of irritation and resentment, which can be directed at others or at oneself.
- Bargaining It is the attempt to negotiate or “undo” the reality of a loss.
- Depression: Deep sadness and retreat when the truth of the loss dawns.
- Acceptance: Coming to grips with the loss and beginning to move on.
It’s important to notice that these stages aren’t linear. Clients may experience them in a non-sequential order or alternate between stages. For some, the mourning process goes beyond these stages to complex or unresolved grief.
Complex or unresolved grief: Beyond the norm
Complex grieving, also known as prolonged grief disorder (PGD), arises when people suffer acute and persistent symptoms over a longer period of time, usually more than six months or a year. Unlike “normal” sadness, which eventually decreases, complex grief is strong and interferes with daily functioning.
Common Features of Complex Grief:
- Persistent yearning or preoccupation with the deceased.
- Difficulty accepting the death.
- Avoidance of reminders of the loss.
- Intense feelings of guilt, self-blame, or anger.
- A sense of meaninglessness or loss of identity.
- Physical symptoms, such as fatigue or insomnia.
- Clients may become “stuck” in their grief, unable to process or move forward, often due to sudden or traumatic losses, unresolved relationships, or other complicating factors.
Grief & Depression
It may appear that many of the normal grieving behaviors are signs of depression. In order to clarify this, let’s examine the discussion surrounding the parallels and discrepancies between depression and grieving.
The primary differences between depression and grief are that, although both conditions can cause the classic symptoms of intense sadness, disturbed appetite, and disturbed sleep, a grief reaction does not include the loss of self-esteem that characterizes the majority of clinical depressions. That is, those who have lost a loved one do not, or usually do not, regard themselves less as a result of the loss, or only temporarily. Furthermore, if the deceased’s survivors feel guilty, it’s typically in relation to a particular component of the loss rather than a generic sense of responsibility.
According to Freud, when people are grieving, the world appears desolate and empty. A person who is depressed feels empty and impoverished. Beck and colleagues have identified these variations in cognitive style.
According to (1979) and other cognitive therapists, people who are depressed have unfavorable opinions of themselves, the outside environment, and the future. Even though the bereaved may have such unfavorable opinions, they are typically more fleeting.
During grieving therapy, a therapist can help you set your purpose to heal and make a positive commitment to your journey. You can choose to be a “passive witness” or a “active participant” in your grieving.
Grief therapy's advantages
- Complex emotions can be expressed and validated in a secure environment by utilizing emotional processing.
- Sense of Connection: Promotes empathy and a common understanding, which lessens isolation.
- Building resilience gives people the skills they need to handle obstacles in the future.
- Better Functioning: Assists clients in readjusting to everyday life with a fresh sense of purpose.
- The psychological, emotional, and existential effects of sorrow are addressed via holistic healing.
Grieving allows us to heal, to remember with love rather than pain. It is a sorting process. One by one you let go of things that are gone and you mourn for them. One by one you take hold of the things that have become a part of who you are and build again.
—Rachael Naomi Remen
