News Today: Public Urged To Learn These Grief Counseling Skills

Sept. 3, 2011 - PRLog -- HEALING PAINFUL EMOTIONS

The first and fundamental goal in the process of healing grief is to identify and express the range and intensity of painful feelings that make up grief. Healing involves identifying these painful emotions and expressing the pain of grief: fear, anger, guilt, sadness, emptiness, low self-worth, and despair.

To Register for the online course Grief Counseling Theory and Skills, visit http://www.counseling-skills.com

UNHEALTHY BEHAVIOR DECISIONS

The second goal is to identify unhealthy behavior decisions related to the loss. This goal is very important in cases of complicated loss, that occurs when the painful emotions have not been expressed in a healthy way. Instead of being expressed and supported, the pain of grief has been defended against and protected, resulting in unhealthy behaviors that undermine relationships. When these behaviors continue, then the result may be a complicated grief experience.

"Decisions" is an interesting word because the behavior choices, or ways of coping with the pain, are often done unconsciously, but they are decisions nonetheless. A person can re-decide and make healthy decisions about the pain and how to cope, getting close to others, welcoming life's challenges.  

UNFINISHED BUSINESS

The third goal of grief counseling is to complete unfinished business, and to say goodbye in order to say hello. It's difficult to say hello to new life experiences until one says goodbye to old painful ones. Saying goodbye, letting go, and learning acceptance, which is a commonly used term, all mean the same thing.

Saying goodbye really encompasses all three objectives of grief counseling. A person hasn't completely grieved, or said goodbye, or let go, until he has worked through the pain, identified and changed the behavior decisions, and finished the unfinished business.

Losses may include deaths of loved ones, break-up of relationships, family breakdown, loss of parental caring in childhood, loss of health, loss of roles in life, property and financial loss.

The first goal of grief counseling is to identify and express, ideally in spoken words, the range and intensity of painful feelings.

FEAR

The grieving person may fear the pain. The fear may be about falling apart or losing control. When working with the very blocked, resistant person, invite him to say just a little  about the fear. once he feels supported with that, then he can go on to another painful emotion.

A gradual approach to the feared object is fundamental to working with fear. Remember that whenever there is fear, there is resistance and defenses. So it is important to go slowly, invite the person to say what the fear is about and after he has disclosed, ask him what it was like to talk about that. Then invite him to say a little more.

Whenever, there is disclosure of a difficult, painful experience, be sure to process the process by saying, "What was it like talking about that? Is it OK?" This allows the person to control the pace and amount of disclosure and to validate the process and to maintain his sense of safety.

ANGER

Sometimes a grieving person finds it easier to feel the anger than the sadness. Anger may be used to defend against the sadness. One feels strong with anger but weak and vulnerable with sadness. Generally the person who finds it easier to feel anger in grief, has an aggressive personality. This person may be generally outspoken, direct, and opinionated. In helping the very angry grieving person, the anger can be validated and supported for as long as necessary before reaching for the sadness underneath.

For the person afraid of anger, the helper can say, "I wonder if you feel a little cheated? Your husband has died, you expected you'd be able to retire together, you were looking forward to that. And now he's gone. I wonder if you feel just a little bit cheated about that?" And sometimes if the helper can minimize a feeling and use the word cheated with that individual, he or she will maximize and say, "Yes, I feel really cheated," and then, "Go on and say more about feeling cheated." In fact, she is talking about her anger, but she is just not using that word.

If it was a child who died, the person may ask why a child died instead of an older person. Why not someone who lived a full life? Why a child? Anger is behind that question. It's about the outrage, the sense of injustice, the unfairness. Sometimes the grieving person will use the word anger. The helper can invite him to say more about the anger, then validate and support it: "It's Ok to feel that."

Another approach is to say, "Talk about the lost hopes and dreams." Lost hopes and dreams are about feeling cheated because those hopes and dreams can't be fulfilled now that this loss has occurred.

The helper can design a 'why' question or a blaming statement. For example in the case of an abusive parent, in working with loss of parental caring and closeness, one may suggest the statement directed to the parent, "You didn't care about anyone but yourself. You didn't care about me. All you cared about was the bottle." The helper may say it without any emotion in the voice to make it less frightening for the person to repeat or try on.

SADNESS

To bring out sadness, the helper can say, "I wonder if you're using anger to cover another feeling," or "I wonder if that anger is easier than the sadness." Or if a client identifies both anger and sadness one can say, "Which of those two feelings is easier for you to express?"

Other ways to get to sadness is to say things like:
"Say his name." The name of the loved one may be loaded with sadness and remains unspoken until you invite it.
"Talk about a happy memory." The happy memory brings up a sense of loss and sadness.
"Talk about the last time you saw him." The last memory may be of the death or of regrets and sadness about that.
"What do you see as you talk? It's as if you are looking at something." Tapping into mental images may be associated with sadness because the past is being re-lived in the present.
"You will never see his face again." The realization about the finality of the death is often very sad but true.
"Have you said good-bye to him?" This brings up sadness about the finality of the loss and can be a key to letting go.

GUILT

Guilt is one of the primary reasons that people develop very unhealthy behaviors. A person who feels very guilty doesn't believe that he deserves happiness, and so what does he think he deserves? Punishment goes with guilt and so the helper may want to explore with the person how much guilt he feels. Maybe a little bit, a lot? This is the same technique one may use exploring any feeling such as, "How much anger do you feel?"

If the grieving person feels a lot of guilt or identifies a degree of guilt, the helper may say, "I wonder if you're aware of how you may be punishing yourself."

Say something like, "Sometimes when people feel guilty they won't let themselves be happy, they'll be depressed, they'll be stuck in life. They won't let themselves get on with their life. They won't let themselves experience enjoyment, they won't let themselves be close to people, they won't let themselves really welcome the challenges and opportunities that life has to offer. And I wonder if you're aware of how you may be punishing yourself in some small way?"

When the person has talked about ways of self-punishing, the helper can say, "I wonder if you will give yourself a life sentence." This helps the grieving person move away from self-punishment. Another effective statement is: "I wonder what your (loved one: mother, son, etc.) would say they want for you if they could speak to you right now." This can lead to a healthy decision to move forward in life.  

For the full report see Grief Counseling Skills in "Effective Counseling Skills" by Daniel Keeran, MSW, in digital and hard copy at http://www.amazon.com/Effective-Counseling-Skills-therape...

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