GRIEF & UNATTENDED GRIEF

The death of a loved one, a break-up or loss of trust, the loss of a job, of a home, or other something fundamental to our well-being can shatter our sense of security and leave us questioning our most basic assumptions. Grief is a multi-dimensional and sacred process that seeks healing from such a loss. It is painful, disorienting and overwhelming for all, but shows up differently for different people and is different for the same person at different times. There is no correct way to grieve or to heal from a loss, but the grieving process is to be deeply respected.

Does grief go away with time?

In my work with grieving clients, I’ve seen that the deep, sharp pain of loss tends to diminish over time. While we learn to adjust to our loss as time passes, the sense of loss never completely disappears. For healing to occur, grief requires our attention and our respect. Because it can be very painful, it makes sense that we turn away, even though that does not serve us well in the long run. The modern world also contributes, with its busy fast pace, to our neglect of the presence of grief.

What is unattended grief?

When we push our grief away, it seems to go underground and can affect our lives in many unpredictable ways. Stephen Levine, the well-known author on death and dying, wrote, “Unresolved grief is like a low-grade fever. It narrows the path of our lives. When we turn away from sorrow, we intensify our pain and close off parts of ourselves.” Unattended grief can show up in physical ways such as fatigue, headaches, back pain, muscle aches, and a general malaise. It can also manifest in emotional ways such as lethargy, isolation, depression, a general pessimism, unexpected sadness, and underlying anger.

Is there a statute of limitation on unattended grief?

No. I have worked with a couple of clients who experienced the death of a loved one when they were children, and still feel the effects of unattended grief. Grief can stay tucked inside you for a very long time. 

What is an example of unattended grief?

Here are some examples of how Unattended Grief can present itself:

• Rachel was never close to her father, and yet was his caretaker for several months during his decline with cancer. After his death, she put all her energies and focus on her children. A couple of years later she found herself suddenly feeling listless and depressed, seemingly without explanation. She sought counseling when her husband pointed out that she was uncharacteristically isolating herself from him, their children, and friends. Through counseling, she came to see that she had always hoped she would finally be close to her father.  Accepting that would never happen now was difficult for her. 

• Grief can be the result of loss other than death. Jason broke up with his fiancée of four years right after graduating from college. Although he was the one who ended the relationship, soon afterward he missed her so profoundly and felt he had made a critical mistake. He has never been able to truly accept the finality of the breakup and finds that he is unable to open up to a new relationship. He says he also has trouble with friendships. Jason came to therapy after he learned that his ex-fiancée was getting married. 

  How do you work with clients struggling with unattended grief?

  In my practice, I see clients who are struggling with grief due to a wide range of losses. I have helped them to work through the pain of a loss which took place many years ago but is still limiting their lives and diminishing their vitality. I work with both individuals and groups, gently helping my clients open their hearts to grief, using various approaches, including talk therapy and EMDR (eye movement desensitization and reprocessing). Art therapy can also be particularly useful, in that it helps clients to connect with deep underlying feelings. Going to the dark places and opening to our grief can be healing, creating a space to begin to live fully again. Many clients have said to me: “It was time to do this.”

  Are there therapies other than psychotherapy recommended for unattended grief?

  There are many practices which are good for your mental health in general which would be healing for unattended grief. If you find going to church or temple a balancing activity, then by all means continue or begin attendance. If you enjoy yoga, pilates, hiking, getting out into nature, art, listening to or playing music, exercise, or other activities, all are good for your mental health. Friends who will just hear you out can be very healing as well. Grief support groups can offer great solace. An excellent resource for grief support in Los Angeles is Our House (http://www.ourhouse-grief.org), where I was trained and led groups as a volunteer.  

  How Long Does it Take to Work Through Unattended Grief?

  That is difficult to answer because everyone has his or her own process. But if you’ve read this far into the blog, it’s a good sign that you’re ready to start focusing on your grief. Feel free to contact me via phone or email to talk.

Shadowmap SESSION

Seven Questions to Ask When Seeking a Psychotherapist

1. How long have you been in practice and what are your specialties?

There are obvious benefits to therapists who have been in practice many years. Over the decades, they have dealt with a variety of clients and a multitude of issues. With years of experience, they have honed their craft and may see issues that they have dealt with before more often than newer therapists. On the other hand, a therapist who has been through graduate school more recently may be more up-to-date on psychological theories and approaches. And you may prefer a therapist for whom this is a second career, who has worked and/or owned a business, or been a lawyer, or an employee in a large company. Life experience goes a long way in the art of psychotherapy. 

2. Is your approach highly interactive or do you mostly let me, the client, lead the therapy while you make occasional comments?

Some clients prefer a more traditional therapist who sits back and allows the client to lead the session, interjecting the occasional question. Others may prefer a therapist who is more interactive and asks more leading questions. Either approach can be very effective, however, it's worth considering the approach that would be best for you.

3. Do you think you have a good approach to dealing with my main issue?

If you are going into therapy with a particular issue, it could serve you well if the therapist has worked in your area of need. If you were grieving the death of a partner, you would want a therapist who specializes in death and loss. If you identify as LGBT, it's not necessary that your therapist be LGBT as well, but it's paramount that he be comfortable working with you and is affirmative in his approach to non-heterosexual relationships. Don't assume that because you're speaking to a therapist that he or she is comfortable or well acquainted with particular issues.

4. How often would we meet and what is the cost of a session?

Make sure that your scheduling and financial exceptions (expectations?) match those of the therapist. If your time and budget constraints prohibit you from coming every other week, verify that a more infrequent schedule would work for the therapist as well. Would the therapist be willing to meet every other week for a session and a half, and would he feel that would be productive. If you are experiencing financial difficulties, ask if he would offer you therapy on a sliding scale. If you find he is too expensive, ask if he can refer you to another therapist or clinic that is more affordable.

5. Are you easy to reach after hours and on weekends?

Some therapists are available after hours and on weekends, while others are not. Some therapists are willing to call you back within a few hours. If you feel you are in crisis and need a therapist who can respond to you in a couple hours, then it is imperative that you understand the availability of the therapist right from the start.

6. Do you feel like you could help me?

This is an open-ended question that allows the potential therapist to let you know if he feels comfortable working with you and confident he can help you.

7. Can you make me a referral to a therapist who you think would work well for me?

After asking the initial questions, if you find that the therapist is not right for you, share your thoughts with him and seek out a referral if possible. The conversation could go somewhat like, "After discussing my situation with you, I realize that it's important for me to see a therapist who has worked more with grief, since I lost my father last month. Do you have a referral for a therapist who has that kind of experience in this general area?"  

A Question to Ask Yourself When Seeking A Therapist

Do I feel comfortable with this therapist and do I feel that they can help me?

Choosing a therapist is not like selecting a good dentist or medical specialist. You may spend only a few hours with your dentist on an annual basis, and even less time with a medical specialist, but you are going to be spending many hours interacting with your psychotherapist. Your relationship with your therapist is central to the growth and healing process. In fact, there are a multitude of studies that have shown the effectiveness of therapy is much more closely correlated with the strength of the "therapeutic alliance"--which is how well client and therapist relate--than to any particular approach to therapy.

It's not necessary that your therapist be someone you might want as a friend, because it is not that kind of a relationship. However, it's important that you feel that they can relate to your issue and that they have the strength to challenge you when necessary. You are the expert on what will work for you. Trust your intuition. It is important that you have a sense that this therapist can help you. If not, keep shopping.

Good luck finding the right therapist for your needs!