My Interest and Experience in Grief Counseling
I have a great heartfelt interest and ability to support
people through this difficult time in their lives, and feel a calling for this
type of work and support. Our life
experiences are regulated by patterns of grief related to any kind of
transition that we may be going through, and our lives are constantly filled
with change and transition. Grief can be a brief experience between everyday
life transitions, or it can be a long difficult process such as happens
following the death of a loved one. For the
purpose of this page, I will be discussing grief as it relates to the bereavement
one experiences following the death of a loved one and anticipatory grief that
occurs during terminal illness.
For anyone, going through the loss of a loved one is a
difficult time and requires support from someone who is knowledgeable about
bereavement and the grieving process. I
have education and experience in working with people who are experiencing a
typical grieving process, anticipatory grief (grief experienced in anticipation
of death while a loved one is experiencing a terminal illness) and complicated
grief (grief that follows a pattern that is not typical or is not “resolved” in
a typical manner or period of time). My
method of grief counseling follows J. William Worden’s flexible model of
grieving “tasks” which I will address later on this webpage.
When a person is grieving the loss of a loved one, there are
some typical symptoms or experiences that they are likely to experience during
this difficult time. Some of the
experiences of acute grief include actual physical symptoms related to
depression and loss (headaches, fatigue, aches and pains), preoccupation with
the deceased, and many different feelings
including intense sadness, anxiety, loneliness, helplessness, shock, yearning,
guilt, anger and numbness. A grieving person may experience feelings of
disbelief and confusion, preoccupation with the loved one, and sometimes a
sense of the loved one’s presence or experiences seeing or being “visited” by
the loved one in dreams or in waking. Sometimes
a loved one can develop depression (which would be considered under the
category of “complicated” grief) following the death of a loved one (see
information on this site about depression).
A grieving person may also experience certain behaviors such
as crying spells, irritability, depressed mood and also a temporary inability
to function as they did prior to the loss of the loved one. More typical behaviors that a person
experiencing grief may experience include sleep disturbance, changes in
appetite, absent-mindedness, social withdrawal or isolation, dreams of the
deceased, preoccupation with or avoidance of things that remind them of the
deceased, restlessness, and more. Although I refer to “typical” grief, no one
experiences grief the same way as another.
It is a personal process that is unique to each individual.
Worden’s tasks of
the grieving process
The “tasks” that one must go through during the grieving
process include (1) Accepting the reality of the loss which can be very
difficult for some people especially if they are experiencing shock following
the loss of a loved one, or have experienced multiple losses all at once. Acceptance is something that must happen both
intellectually and emotionally which can be a challenging process.
The next task is (2) working though the pain of the grieving
process. This is often the longest and
most difficult phase of bereavement.
Some people want to avoid the pain, and have difficulty going through
this process. It is not uncommon to see
avoidant behaviors (such as alcohol abuse, or keeping busy with work)during this phase of healing as people do not like to
experience the pain of their loss. It is
also common for social support to cease or decline once a person has entered
this phase. Time has passed and friends
and loved ones may no longer be immediately available or may not know what to
do to support a loved one through this inevitable time. This period can last several months, and it is
important for the bereaved to receive support during this time from a support
group or counseling professional familiar with the grieving process.
The third task (3) that one must accomplish in the grieving
process is adjusting to an environment in which the deceased is missing. Worden discusses external adjustments
(getting used to the loved one not being
present in your everyday life), internal
(how the death affects one’s sense of self) and spiritual adjustments
(how the death
affects one’s beliefs, values and assumptions in the world). Many people
question their personal spiritual values and beliefs following the death of a
A task that is unique to Worden’s tasks of bereavement is
the fourth (4) task in which the bereaved faces the reality of emotionally
“relocating” the deceased and moving on with life. Emotional relocation involves finding a new
way to related to the deceased. Instead
of merely accepting them as “gone” the bereaved person may want to find a new
way to relate to them and continue their bond to the deceased person. An ongoing relationship is developed with the
thoughts and memories of the deceased in a way that allows the survivor to
continue with their own lives following the loss. The bereaved releases the old
attachment to the deceased and forms a new bond that is different but
and Grief Therapy
Worden distinguishes a difference between grief counseling
and grief therapy based on one’s ability to move through the above tasks in a
therapeutic and timely manner. Grief “counseling” helps the individual to
maneuver the tasks of the grieving process and grief “therapy” is initiated
when there is a complicated reaction to the loss. Different variables that may
affect this process include levels of ongoing social support, levels of stress,
personality factors and coping skills of the survivor, and one’s ability to
find meaning in the loss. Grief therapy may be needed if an individual is
struggling with the tasks involved in coping with their loss, or if there are
extenuating circumstances related to the loss.
One may also have a “delayed” grief reaction if they experienced a great
deal of shock at the time of the death.
This is very common where multiple and / or unexpected deaths are involved. Grief therapy is also called for if an
individual is experiencing clinical depression, anxiety, extreme physical
symptoms, substance abuse, post traumatic stress disorder or other psychiatric
problems related to their loss.
Some ways to know if you are experiencing “complicated” grief include the
- Time has passed, and you are unable to talk
about the deceased without feeling the freshness of the grief as if it has just
- Minor events that remind you of your loved one trigger
an unusually strong grief reaction.
- You have experienced multiple losses, and can’t
seem to cope with your current loss
- Time has passed and you are unable to move the
material possessions belonging to the deceased.
- You have developed physical symptoms similar to
those of the deceased prior to their death.
- You are isolating socially, or have totally
changed who you spend time with (for example: avoiding friends of the deceased).
- You have a history of clinical depression and
are experiencing current symptoms of
- You have self-destructive or suicidal impulses.
- You are experiencing guilt regarding the death
of your loved one
- You over-identify with the deceased by copying
their behaviors and habits.
- You experience extreme sadness around the anniversary of your loved one’s death.
- You have developed a phobia related to the
manner in which the deceased died.
- You strongly avoid talking about the deceased or
visiting their grave site because it is too difficult.
Anticipatory grief is a unique experience that one may go
through while anticipating the death of a loved one while they are suffering
from a terminal illness. It is difficult
to witness the loved one suffering, and one may feel a sense of relief once the
suffering is over and the love one has passed. The bereaved may hear things
from friends or loved ones like, “He is in a better place now.” Or “At least
she is not suffering any more.” To some
this may bring comfort, to others it may bring confusion or resentment that the
loved ones don’t understand the pain that the bereaved person is
suffering. Despite the length of
illness, or circumstances leading up to the “expected” death of the loved one, the grief process following the death is no
easier or different from what I have discussed above
. It is helpful to have
a hospice team involved during this time, and to receive counseling prior to,
and following the death of your loved one.
Whether your grief follows a “typical” pattern or is
“complicated” in some way, it can be extremely helpful to receive professional
support through this difficult time to help you move through the grieving
process. It is important that you seek a
professional who is familiar with issues related to grief, and prepared to help
support you through the difficult emotions that are often a part of the healing
process. If there is any way I can
assist you with this process, please don’t hesitate to contact me.