I’m sure you just read that title and replied in your head “Of course it does!” Why would I even think about writing a blog for therapists presupposing that they did not know that core piece of the therapeutic relationship?
When you run a practice based largely on grief and loss, you get to hear about other therapists. Not that we don’t with all of our clients, and I get that. Many of them have stories to tell. Some make us laugh, some make us embarrassed for our profession. A few, unfortunately, will make us give brochures to clients about reporting.
That’s not what I am referencing here. As a grief therapist who deal with bereavement issues all day, and online, I am talking about the extraordinary number of stories I hear form my clients when they are interviewing me before they will even set an appointment. The ones who will sit on the edge of their seat, refusing to relax even a little bit until they have had questions answered and can trust that my approach will not be what they have heard somewhere else.
I am absolutely not claiming to know all or be extraordinary as a therapist. We all do the best we can, using the skills we have available. But as a grief specialist, I hear the stuff that is said because a therapist has had no training in grief and does not know what to say. I hear about the fall-back to old paradigms that do not work, but we learned somewhere along the way and pull out when we are out of our element.
When someone is grieving, and they are searching for someone to absorb their pain and listen to them, saying the wrong thing will break the therapeutic relationship before it even happens. It may also sour the potential client, who finally had the courage to call and ask for help, to decide that they were right- therapy will not work for their grief.
I’ve had several of those folks in the last 2 weeks sitting in my office. They want to know how I think they can be helped. They want to make sure I do not think their grief is the same as someone else’s, but they also want to be sure not to assume their pain is as intense as the next person’s. It’s a tough place for them to be.
What do I do?
- I sit with them and allow them to tell me their story, without interruption.
- I reaffirm that if their last experience was a negative one, the therapist was not a good fit for them at that moment.
- I make sure they hear me say that all losses hurt, and losses cannot be compared. Pain can’t be compared. Everyone feels their pain at 100%.
- I emphasize that grief and bereavement are not pathology or a mental health diagnosis. They are a normal response to a huge and abrupt change- even if the loss was expected. (I do explain that if the criteria fits, that “adjustment Disorder” can be used for insurance, but that grief is not a disorder).
- I normalize the physical and cognitive impact of grief. The response is, universally, “you mean I’m not crazy?”
- I allow them to set the schedule for appointments- their world has shifted, and they may have many new and unexpected responsibilities. They do not need me to stress them.
- I give them self-care homework to give them hope for change.
- I do not discuss stages or time frames. I use recovery and completion instead.
That approach works. It meets the client where they are, because it can be adjusted to what is occurring for them. It holds no judgments, no need for finding a reason for the loss, and does not shut them down when telling their story. Normalizing makes all of us feel better, doesn’t it? You go to the doctor and they tell you that you really do have strep throat- there’s a reason you feel awful and your throat hurts. Doesn’t that make you feel better- even though you feel like crawling under a rock with a blankie and popsicle?
Let’s be the best therapists that we can for our clients facing bereavement. It takes a lot of strength to call for an appointment, and we need to be ready.
