3 vital pointers for helping clients with grief

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How to lead your clients safely through the agony of bereavement - by Mark Tyrrell

"Sorrow makes us all children again - destroys all differences of intellect. The wisest know nothing." Ralph Waldo Emerson

People say that there are different stages to grief, from numbness and disbelief and denial, shock and intense sadness, through anger, guilt and acceptance. Of course, different people deal with grief in different ways and no one has to respond in all these ways or experience them in any particular set order.

We live in a society where ageing, sickness and even simple bad luck are somewhat taboo. Just when the grieving client may need support and understanding and listening ears, they may find people avoiding them out of embarrassment and awkwardness.

Grieving the death of a loved one is of course entirely natural and not pathological in any way. It should only become a concern if it doesn't start to diminish after some months and the grief stricken person starts to believe that they cannot possibly have any meaningful existence without their deceased loved one.

There are many ways of comforting and supporting a grieving person and of course this succour is best provided by relatives and friends. But as therapists we may need to help grieving clients eventually learn how to stop grief from continually burdening their lives.

Here are three pointers for how to help people deal with grief.

1. Let them talk about the one who has gone

People often feel awkward about discussing a deceased person with someone who is bereaved, and won't even mention their name. This is hard for the one who is grieving, as they often need and want to talk about their lost partner, friend or relative.

If you are reasonably sure it won't unnecessarily upset your client, don't be afraid to ask about the dead person and encourage the client to talk about them.

Let them talk about past times and describe what the person they have lost was like, their foibles, their likes and dislikes, even their weaknesses if this subject comes up. Ask them how this person would have wanted them to be living now and even what advice or comfort this person may give right now.

This may be the first time they have properly been able to pay tribute in words, and have it accepted.

2. Distinguish grief from trauma

While someone is still experiencing flashbacks to the time they heard about the death of their loved one, or found them dead, or saw them dying, the natural processes of grief don't really get a chance to start, let alone run their course.

You may hear clients say things like: "I just can't think about them without that horrible image of them lying in the hospital!" or "All I see when I think of them is the way they looked when they were dead!"

One client had the awful experience of discovering her husband hanging in the garage and needed help to deal with the trauma of that experience before she could feel 'free' to grieve properly for him.

Of course, their corpse isn't really the person, or who they were, just as the way someone died is not their life.

I often reassure people through analogy, by talking about how

...the 'full stop' at the end of the story isn't the book itself - it's just the way it ends...

and how

...you have all those different chapters, full of events and adventures and maybe illustrations, and they are the real book, not the last full stop, and when we think of a book we take it as a whole, not just its final full stop...

People tend to get the message more easily when we communicate metaphorically in this way.

But if someone is traumatized by the memory of and manner in which someone died, we need to help them by de-traumatizing those memories. The best way I've found to do this is through the Rewind technique.

3. Deal with guilt and help them organize the grief

Guilt can be a real problem in grieving. People will often feel guilty about stuff they did or didn't do or say, or feel bad about the fact that they are starting to grieve less intensely and are not always thinking about the person they have lost.

I worked with a couple who had lost their 20-year-old daughter to cancer nine months before they came to see me. I suggested that the best way to really honour someone's life is to properly and fully live, yourself.

I also suggested that an important part of doing anything well is resting from it. An athlete needs to train hard and eat properly, but in order to get better at what they do, they also have to not exercise sometimes, and simply rest. So they could grieve even better and in a sense more 'purely' if they started having breaks from it, allowing themselves to forget their daughter "for a while" so that they could actually remember her better at other times.

For some people we might suggest a 'grieving day' once a month (eventually to be once or twice a year). They can spend the whole day or a pre-determined portion of it thinking about their loved one, maybe looking at pictures of them and honouring their life in whatever way seems appropriate.

This approach helps stop grief from continually intruding by providing an organized outlet and regular ritual.

And finally, eventually, help your client begin to look to a productive and - dare we suggest - fulfilling future. Because, as writer Jan Glidewell so eloquently said: "You can clutch the past so tightly to your chest that it leaves your arms too full to embrace the present."

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