Archive for grief

Death the Avoided Topic: How to work with Loss

During the past year, I have experienced two close deaths (ok, one was a pet). It’s taken time to fully appreciate the impact this has had on me. I’ve learned some fundamental lessons throughout this process, and how some of my narratives about death have been informed by my background, and society’s expectations of the expression of death. Most importantly, it has allowed me to see that everyone’s experience of death is different, and there is not a right or wrong way to express grief. 

Working with recently bereaved clients has sometimes been a challenge for me as a therapist. Of course, I feel their pain, the pain that loss brings, and I hope I have been sensitive and compassionate. But, the truth is, my personal experience with death has been limited. 

It was only when my young cat died last summer followed by my mother in September that I started to fully appreciate the expression of grief. It is a complicated process, often confusing and sometimes very messy with no right or wrong way to express emotions and feelings.

It’s hard to write this, but my experience at the time was I felt more upset over my cat’s death than my mother’s. It’s not because I didn’t have a good relationship with my mother, in fact, we had an excellent relationship: I adored her, and she adored me. Was there something wrong with me? No. She was 93 years old, and she died; I accepted this fact and was grateful that she died quickly without any prolonged illness. 

Obviously, I felt sad and missed not seeing and speaking to her, but that’s it. That’s all I felt, and it holds true to this day. I mention this because after her death I had letters and conversations with friends saying how sorry they were and how upset and devastated “I must be”. This caught me off guard because it wasn’t how I felt, and I began to feel as if I was experiencing death ‘in the wrong way’. It was only when I was able to take accept my feelings that I was able to say “actually I don’t feel that way, I felt this way”, and this felt far more aligned to how I was feeling. 

This has undoubtedly helped inform me to think differently when working with individuals and couples. It reminds me to stop assuming anything and allows me to create more space with clients to encourage them to say what’s in their hearts or the unsayable. It has also taught me to know when it’s better to steer away from and when to gently push forward more difficult conversations. Most importantly, it’s taught me to honour one’s own process and never to judge or think there is a right or wrong way to get through grief.

Useful things to say/do after someone has died:

  • Be physically present, unless you are specifically told: “I don’t want you here”. 
  • Be attuned, be there to take care of the tedious things like cooking, cleaning, helping in what’s needed. 
  • Don’t ask for instructions (that takes energy); see what is needed and do it.
  • If you’re unable (for any reason) not to be supportive or present, address it with the person.  It’s never too late to talk about it and to heal painful and complicated feelings between friends or relatives. 
  • Talk about the person who has died. Tell amusing or meaning stories that you remember. Also, don’t compare your own experience with death but do say what was helpful to you at that time. 

As time passes, help bring them slowly back into life. Invite them out and understand if they need to cancel but always continue to ask. Do not expect them to be ok until they are ready to be ok. No judgement, just acceptance to, however that person needs to be.

Shirlee Kay

Can you stay friendly with your ex?

Looking at the royal family for an overview it would appear that there are two hugely differing outcomes of a separation. We can all see Sarah Ferguson and Prince Andrew’s rumoured enduring and affectionate connection and we have also seen the apparent face of far less harmonious royal divorces played out in a sadly public manner.

A passionate love affair will not easily reform quickly into a fond friendship.

All that strong feeling can’t dissipate overnight. We need time to elapse in order to create a new relationship without the heat and intensity that used to bind us. This is when it may be worth taking a while to decide exactly why we actually want to stay friends with an ex lover

If they ended the relationship then perhaps it mitigates feelings of rejection. See? We aren’t unloveable after all, they don’t want to completely let go of us, and maybe a small bit of the cake is better than total deprivation.

If we ended it, well keeping in touch shows that we aren’t that cruel after all. And someone who loves us is still in our life, most of us do like to be adored.
The reality is that uncoupling is usually a painful process. So a lot of people swerve a brutal ending by not ending at all. This avoids the pain of grief, but it’s worth considering if this mateyness is a way of soothing this pain rather than the healthier option of enduring it which allows for reflection and acceptance and a capacity to experience change and to understand that this will always also bring loss.

The finish of a love affair is similar to a bereavement and can involve the same incredibly sad and hurtful stages.  But for some, there’s the added pain of knowing the other is now significant to somebody new.  In the age of social media, a clean ending is almost impossible. It can be agonising to see happy snaps of a beloved ex cosying up to their new love and moving on without you. It may be necessary to disconnect from media sites that bring pain, and even to avoid old haunts for a while.

These are the tricky bits, but let’s also look at the positive reasons that can help twosomes maintain good contact

Some couples can live comfortably like housemates without sex or passion. If they truly are friends, there may come a time that sex does become important and a new love can bring feelings that don’t totally diminish the bond between them. Real friends should be capable of unselfish pleasure and be able to see and enjoy renewed happiness for each other.

Time can settle old scores and bring a fresh perspective to a relationship. Empassioned feelings can fade, and once an ending has been mourned and accepted, then people can begin to see the good in what they once had, and want to preserve that affection. If a person has been truly important in our lives, it’s worth remembering the good times and not allowing those happy experiences to melt away or be completely eclipsed by the pain of the end.

Do both partners agree to a new way? If so, clarifying fresh boundaries will be important.This will be another, new kind of couple. Talk about how often you both feel it’s appropriate to talk or connect. Maybe daytime meetings are best in the initial period, and away from anywhere that holds memories.

How might you cope with seeing each other in new relationships?    Is this truly an equal agreement and are you really sure that neither of you might possibly be hanging on in the hope of repair?

Of course the biggest and most powerful reason to stay friends with an ex is if you have children together.

You are co-parents for life, so it’s imperative to look at your relationship in the most positive way that you can muster.  As relationship counsellors who have witnessed many of these couple breakdowns we are familiar with a scenario in which, initially, the ending will be harder for one half of the couple.  It takes sensitive thought and great care to see that the main focus has to be on safeguarding children from any unnecessary fall-out.

Whatever unresolved or negative feelings may surface, especially at the outset of what may be a traumatic time, the connection between parents has to be seen to be restrained and polite in order to maintain security and stability for the new arrangements that their children will have to experience.

In time many couples can forge friendships  as they are compelled to stay connected through the family links.  If we keep anger and grievances within us, this will only block our capacity for the best outcome with new partners.  It takes time and kindness to come out of our previous relationship and to allow both people the freedom to enjoy a future that won’t be blocked by negative feelings.

So, here’s to conscious decoupling and shaping some new horizons of a different kind of love.

Christina Fraser

We’ve got to go through it….

There’s a wonderful children’s picture book by Michael Rosen, ‘We’re Going On A Bear Hunt’, that I think has a message for us all.

We wake every morning preparing to face the stresses of the day. We take a real or metaphorical deep breath, look for the positives, remember our skills and abilities, and search for resilience. We can even understand life as an adventure.

‘We’re going on a bear hunt. We’re going to catch a big one. What a beautiful day! We’re not scared.’
We can all feel the thrill and excitement of risk. There can be an adrenaline rush that comes with sport or travel. Stepping outside our comfort zone can be exhilarating.

But then, of course, the unexpected can happen. Life throws a curve ball and we feel shaken by the challenge of unexpected adversity.

The children in the book, buoyantly setting off on a country walk, are suddenly faced with a number of ‘Uh-uh!’ obstacles that stop them in their tracks. A river, deep mud, long grass, a big dark forest means they have to make a decision as to what to do next.

If they are not to abandon the walk they realise that, ‘We can’t go over it. We can’t go under it. Oh, no. We’ve got to go through it.’

And that is true for us all too. We have to endure and find a way of surviving unexpected and overwhelming events. The ending of a relationship that breaks our heart. Redundancy and sudden financial insecurity that hits like a sledgehammer. Facing gruelling treatment after a frightening medical diagnosis. The loss of a loved one that feels unbearable.

The wonderful illustrations by Helen Oxenbury show the children looking more daunted and worn down by each obstacle. Their energy levels lower as they stumble in the thick forest and struggle through the snow storm. They draw closer and cling on as they try to help each other get through.

Then the children discover that, unlike the fantasy, the reality of an actual bear is terrifying. They race back to the sanctuary of home and leap together into the bed and under the duvet.

When we are facing a devastating situation, or the sheer number of difficult incidents has worn us down and we are peering into the abyss, we all need a sense of a safe haven. At the very time we feel we are free floating, with nothing to ground us, we need to reach out and clutch on. No one can take away the pain, but we need support until we find the resources to manage and cope.

In Jerusalem’s trauma centre, when there has been a catastrophic occurrence, they have found it is essential for the victim’s recovery that close family and friends are immediately brought to the bedside.

We will all have different ways of coping and managing the turmoil. In her book ‘H is for Hawk’ Helen Macdonald describes training a hawk when overcome with grief at the death of her father.

http://www.telegraph.co.uk/culture/books/10989164/H-is-for-Hawk-Helen-Macdonalds-intense-relationship-with-her-goshawk-Mabel.html

Sometimes it can be the counselling room which offers the safe place to begin to let out the pent up agony and find a way to breathe again.

Kathy Rees

Coping with Grief and Loss

‘I hold it true, whate’er befall;
I feel it when I sorry most;
‘Tis better to have loved and lost
Than never to have loved at all.’

Alfred Lord Tennyson wrote these words in response to the sudden death of his friend Arthur Hallam. But it does not need a death to trigger grief – the break up of a relationship; unrequited love; missed opportunities; the abuse of trust – each in their own way results in grief and loss. At Coupleworks helping our clients to begin to process these feelings is part of our work.

Almost 50 years ago Elizabeth Kubler Ross frustrated by the lack of studies on grief, and inspired by her work with terminally ill patients, described the 5 stages of grief: denial, anger, bargaining, depression and acceptance. She was also concerned to underline that not everyone who is grieving will go through all the stages and the stages may not be in that order. Everyone’s grief is his or her own and there is no right way of experiencing it, nor can you predict how intense it will be. However they remain a useful tool to help people see that what they are experiencing is normal and natural and accepting this can be very helpful.

The 5 stages of grief:

Denial: in this stage the individual is trying to deny their loss, they can’t believe it is happening to them, they feel as if it is a mistake. If the loss is sudden and unexpected then sometimes there may be numbness like waiting to wake up from a bad dream – all will be better tomorrow but it isn’t.

Anger: The intense reality of the pain can feel too much as the denial stage wears off, but a way of avoiding that pain is for the individual to look for someone to blame. It can be themselves for not doing something or being there or directing it to others.

Bargaining: Here the characteristic phrase is ‘If only….’ I had done this or been there then it might not have happened. This is a normal reaction to feelings of helplessness and vulnerability, to feel as though despite what has happened we still have some control.

Depression: what is the point of going on? I can’t be bothered any more…. The feeling of sadness and pain just seems so overwhelming, and ordinary things that we enjoyed previously feel mundane.

Acceptance: this is the final stage and not everyone reaches it. It is the point of beginning to come through the grief – a gradual reinvesting of energy into life. There is an adjustment and acceptance that life can go on even without our loved one or those lost hopes.

Sometimes it can feel like the pain is never ending but time can heal and things may eventually become more bearable. We can find ways of living with the loss.

A few tips to help you cope and keep going….

1. Allow yourself to feel sad and express and release your feelings. Don’t be afraid to cry – it is better than bottling up your feelings.
2. Look after yourself – don’t forget to take exercise even if that is going for a walk.
3. Sleep if you can and have a regular bedtime.
4. Avoid drink and drugs that temporarily dull the pain – you will only feel worse afterwards.
5. Plan ahead for grief triggers such as anniversaries or special reminders.
6. Find support and don’t be afraid to talk to family and friends
7. Counselling can be helpful to talk your feelings through and have a space to share the pain.

And perhaps hold on to those words of Tennyson, however difficult it may be to believe them – still less to feel them. ‘Tis better to have loved and lost, than never to have loved at all’

Sarah Fletcher

The Use of Antidepressants and Therapy

My views on antidepressants have changed over the years. Where I was once not in favour of their use, I now see their benefits with clients. The problem is that most antidepressants are too freely given out without thought or proper assessment and there is rarely follow up with clients to reassess their progress.

It is important to say that feeling low at times is part of the human experience and allows us the opportunity to know ourselves better and helps us to manage these feelings as they come and go.

Anti-depressants need to be prescribed by a Psychiatrist who is knowledgeable with psychopharmacology drugs. Because there are so many anti-depressants available, without a comprehensive assessment it’s difficult to pinpoint which drug will be best for which individual. An assessment will also help to differentiate whether the person is going through normal loss and grief or going through depression. This is a crucial distinction.

Antidepressants allow people to work through their issues with a therapist because it lifts the depression enough for the person to feel more hopeful and therefore allow them to begin to have another perspective on an issue.  I often use the analogy of a person standing in water up to their eyes; they can’t breath or do anything except try and survive.  If the water level is lowered (with antidepressants) it allows the person to see things differently.

Our brain’s neuropathways can change the way we think and experience things. If we have long periods of depression and our thought process is negative it impacts the way we see others and ourselves.  With antidepressants, we are able to bypass the depression and different parts of our self begin to emerge. With consistent and regular positive thoughts, our brain chemistry alters and our perspective can change.

My experience tells me that clients who are very depressed do not utilise the process therapy offers at that time.  The ideal combination is therapy with antidepressants. This can offer an opportunity for clients to understand the origin of their depression and work through and learn to manage their depression.

A new protocol is needed to look after clients from beginning to end to ensure they are on the correct dosage of medication and progressing. Psychiatrists/GP’s would do better to work together with psychotherapists/ counsellors in order to best serve their clients.

Shirlee Kay