What does grief counseling look like?

Principle One: Help The SurvivorRealizeThe Reality Of The Loss

When one has a significant loss of any kind, there is often a fleeting sense that the event did not happen. The first item on the counseling agenda will usually be to lead the client to the verbalization that the loss actually did occur. This can range from “Tell me about your relationship with ____, leading up to the time of their death — all the way to homework to bring mementos of that life and death to the next session. What circumstances led up to _____’s death?

Principle Two: Help The Survivor To Identify And Express Feelings

Some feelings that are most problematic to survivors are anger, guilt, anxiety, and helplessness. Anger may be turned outward and be accusatory or turned inward and be seen in depression. Guilt is a common reaction for survivors. Survivors can experience guilt because they did not provide better medical care, should not have allowed an operation, did not consult a doctor sooner or should have chosen a different hospital. There IS such a thing as real guilt, and this makes recovery more difficult. Anxiety often comes to people left behind after a death. Much of this stems from feelings of helplessness and an increased personal death awareness. Sadness and the expression of such often needs to be encouraged by the counselor. Crying alone may be useful but crying with someone as the griever realizes the meaning of the tears may be even more so.

Principle Three: Assist The Survivor In Living Without The Deceased

To do this, the counselor may use a problem-solving approach — that is, list the problems the survivor faces and how can they be solved. That first part is a typical homework assignment, and the last part is a good starting point for the next session. (This may be a good place to remind us as counselees that a therapeutic hour typically lasts 50-55 minutes. Thus far these principles we are looking at seem to require two sessions each and J. William Worden in his book Grief Counseling & Grief Therapy lists nine principles. So do the math. Therapy CAN be brief, but it may not be.)

Principle Four: Facilitate Emotional Relocation Of The Deceased

Survivors must make peace with the fact that their loved one is gone and is not coming back. In order to survive and thrive, the survivor will need to learn to move on and form new relationships. Some people are hesitant to form new relationships, believing that this will dishonor the memory of their departed spouse. There are also those who (rather than hesitating) seem to jump quickly into a new relationship and the counselor can act as an impartial third party in exploring how appropriate this is. For a new relationship to work, the new person in a relationship must be recognized and appreciated for himself or herself and NOT as a replacement partner for the bereaved. 

Next time we will conclude our discussion of facilitating Uncomplicated Grief. In the meanwhile — remember that you don’t HAVE to grieve alone!