Kelly Hill, M.A.  Psychotherapist - 303-834-0394        lifeempowermentcenter1@gmail.com.com
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 adjustments (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 loved one. 
 
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 meaningful. 
 
Grief Counseling 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 following:
 
  • Time has passed, and you are unable to talk about the deceased without feeling the freshness of the grief as if it has just happened.
  • 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 depression.
  • 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
 
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.
 
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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.
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