GRIEF THERAPY

BEREAVEMENT COUNSELLING


Grief therapy and biological, psychological effects on feelings in bereavement counselling


Grief therapy, statistically, there appears to be a growing demand for, and bereavement counselling. Officially admittedly training is poor in bereavement counselling. So are counselling education on effects in grief therapy.


Grief, mourning, bereavement; words synonymous to lay persons seeking grief therapy, bereavement counselling.


Grief therapy is mostly sought as bereavement counselling. It often involves loss of someone dear which is  so painful, that it has found its way to lay dream interpretations as symbolising predicted sorrow, of the type sought as bereavement counselling in grief therapy.


Grief therapy seekers' pain, especially in bereavement counselling, is death. Death's pain has always moved the lay person and the specialist alike -literarily as well as academically and  professionally.  The lay person, varying from culture to culture, has his traditions; the specialist his researches, theories ~places are named after the dead, investigations carried into of out-of-body experiences -whether death is considered sad or joyous, physical or spiritual.. the interest continues, grows -whether the bond is broken with the dead or not those left behind are seriously affected by a need to adjust to the changes caused. Grief management involves more than knowledge of grief process. In managing grief it must not be forgotten that the feelings differ of clients of grief therapy and more so in bereavement counselling.


Grief therapy in bereavement counselling, deals with  what is of utmost importance in death loss and grief recovery. "If we go to the root of it,"  said Dag Hammerskjold, "it is our concept of death that decides our answers to all the questions which life poses."  Jung agrees that "when a human life comes to an end before our eyes.. the question of the meaning and worth of life never becomes more urgent." It makes bereavement counselling and guidance the ultimate in grief therapy.


Grief therapy training in bereavement counselling has ignored what adds Jung:  "...or agonising..." It is; the composer, the poet, the story-teller  agrees, as does the scientist and the monk. Laing only hints at the effect: "You'll cry, when I die; you'll yawn, when I'm gone; you'll be bored, unadored" -and the reasons why are sought grief therapy, especially bereavement counselling.


Grief therapy clients, the bereaved seeking bereavement counselling, are not necessarily fully functioning persons. Death ~intentional -suicide, abortion; unintentional ~sudden or expected -accidental or violent, or with stigma and shame...  Loss ~something/someone precious taken away -perhaps with little or no memories of to cherish.. bereavement ~the experience of the loss -the vacuum felt and necessity for struggle (to re-organise personally and socially -chores and bills, cultural expectations and friends avoiding not to upset).. grief ~the emotional response to bereavement -sadness, guilt, rejection, fear, anger, self-worth, hopelessness..  mourning ~coming to terms with grief -through its stages (numbness -shock, searching -'why me!?', depression -loneliness, low mood, and recovery -acceptance, adjustment)...  Painful enough for the fuller functioning person! More so for most seeking grief counselling, the client in bereavement counselling.


Bereavement counselling client, the bereaved in grief therapy, include those whose 'organismic valuing process' has not developed enough to manage the 'tasks of mourning'; their grief is not 'typical'. It may be delayed, not yet experienced (perhaps a child, a teen-ager); chronic (necessitating medical attention); inhibited (can't grieve properly, perhaps married and lost a lover and needs exercising  treatment); abnormal, years later still setting the table also for the lost loved-one... To such the pain of the anxiety and distress is unmanageable. Training is without education in these of bereavement counselling and generally in grief therapy.


Grief therapy may be needed only, or bereavement counselling may need to be coupled with medical help. When one realises uncontrollable behaviour, be it identifiable such as moodiness or as 'something wrong' affecting adversely personally and/or sociably there are neglected considerations: "Even in a simple organism such as a sea-snail's, learning changes the structure of the cells within the nervous system" says Agras, director of behavioural medicine at Stanford university; within the brain cell learning and biological processes are joined -biology influences behaviour, but behaviour affects biology. Such education is not coupled with grief therapy training specific to bereavement counselling.


Bereavement counselling, and grief therapy training lack education. Even in the case of pathological depression the bereaved client can be helped. David Burns, founder of Behavioural Sciences Research Institute says that "The medical model implies purely medical, or biochemical solutions, but the interactionist model implies that the therapist can break into the mind-body loop at several points: physical symptoms, behaviour, thoughts" -thoughts being based on feelings, on emotions. Bereavement counselling this is important to; yet, training is without such education in grief therapy.   


Grief therapy, including bereavement counselling, and counselling generally, assume that some clients cannot be helped. A client seeking counselling can be; not only if he is defensively seeking to reject his grief and to attribute his problem to something else, but even if he is seeking to displace his grief onto other persons or one counselling. Frijda tells us "Most human emotional behaviour consists of intentional behaviour in the restricted voluntary sense.  It is behaviour prompted by outcome expectations and, to a large extent, by conscious anticipation of those outcomes" and that "Emotional action tendencies (...) are states of readiness to achieve or maintain a given kind of relationship with the environment."  The client has sought help, is ready to be helped in grief therapy by bereavement counselling. 


Grief therapy client, the bereaved seeking bereavement counseling, can be helped: "All needs evoke corresponding drives toward their satisfaction," writes Assagioli, "Therefore every need arouses, sooner or later, a corresponding will."  The client having exercised that will.. in Glanwill's words, "the will therein lieth, which dieth not - who knoweth the mysteries of the will, with its vigour?".. if the grief therapy counsellor uses her skills with such knowledge in bereavement counselling.


Clients differ in grief therapy, also if bereavement counselling. Not all affected by grief seek specifically grief therapy, not all affected by bereavement seek bereavement counselling unaware of grief as the underlying cause; some seek counselling without consciousness of grief -e.g., delayed grief.  Frijda tells us that sometimes no emotion of fear is conscious of as having to do with grief: "They may lead to tears and to despair, but in between, life is filled with other things; actions to feel the emptiness or seek contact with the lost person by arranging flowers before her portrait or dusting his clothes in the closet. Evidently the absence is continually present and reacted to; there is no continuos grief, but in some other sense an action-readiness change." Only the counsellor's educated skills can discover grief as the underlying cause of the problem of a client who is seeking neither bereavement counselling specifically nor unspecified grief therapy.


Grief therapy, bereavement counselling, as other counselling, also vary in approach, e.g. person centered. "It's All about Loving" say Mearns and Thorne, "Jean looks very attentive -as though she's really trying to understand as fully as she can..  she  reaches out, holds Jim's hand.. he cries.. Jean shivers..."  ~she does not seek to interpret, nor to impose her or the society's values on him, for she is a 'companion' -congruent, non-judgemental, empathic.. 'loving'... But  'Jean' counselling with tearful eyes!? Does that help in counselling, in grief therapy, to a client seeking bereavement counselling?!


Whether grief therapy generally or bereavement counselling, 'Jean' is human -her training has not,  cannot,  make her less capable of feeling, emotion.  The Bozarth, Thamner, Brodley Prepositions consider the optimum in relation to the creation of the core conditions of congruence, positive regard, and empathy, and say that the client must be the primary reference point. It is much advocated, most popularly in the person centered approach, that the counsellor must grow herself to be able to deal with her own feelings first, so that she can better understand the feelings and emotions of her client. It is recognised that "The anguish of another touches, on the whole personality of the individual called upon to help," and the counsellor's training does not seek to make her inhuman and incapable of feeling and emotion. But she knows, at first consciously and later habitually, also to protect herself from harmful or self-injurious non-discrimination between sympathy and empathy, in seeking to understand 'Jim'... This matters even more in grief therapy, especially in bereavement counselling.


To a terminally ill client, not a grief therapy client seeking bereavement counselling, asks Carl Rogers: "Is that a hurt you think nobody could understand?" and "A client needs," he explains, "to be understood". But the client needs also, in Egan's problem-solving way, to be helped to understand himself. Indeed in the Gestalt way to be shocked into that, and even in the way of Ellis his economic wellbeing to be concerned with, in grief therapy, especially if bereavement counselling.


Grief therapy, and more so in bereavement counselling, calls for more than the way counselling of one or of another. Grieving over a loved one is a natural and necessary process, says Worden, that most people are able to experience, and emerge from in a healthy manner.   'Sorry to hear that...' helps quickly create opportunity for the client to talk about it, to feel less bad about it, although some may react differently which is also fine, and  the counsellor works not with the facts but the feelings. Yet, do not include basic education on feelings grief therapy training, bereavement counselling.


In Grief therapy, more so if bereavement counselling, the feelings the counsellor works with must be those of the grieving or bereaved client himself. This may necessitate the counsellor's also teaching the client how to express his feelings of grief or bereavement. "We need," writes Marco deVries, "to let go of our feelings of impotence in the face of death, whether we are aware of them or not -feelings that make us see death as the only thing we cannot rule, which therefore inflicts an unavoidable defeat on us."  This emphasises the client's own feelings. On the first afternoon of a session, say Rijke deVries and Rudy Rijke "none of the participants used the word 'I', but, instead, they talked in terms of 'my husband says...' and 'my children want...' and 'my doctor thinks..'; but by the end of the second afternoon, by simply talking about some basic ideas, the participants developed, in their own respective ways, a 'relative I', to take responsibility for themselves, making choices that were realistic and meaningful (to themselves)." The person centered approach stops where Sartre does, "hell is other people!" The client is capable of learning to express his own feelings, if the counsellor helps this essential, in grief therapy or 'work of mourning' in bereavement counselling.


In grief therapy, especially in bereavement counselling, the client's perceptions have to do with his feelings. There are generally recognised stages to the process of mourning; but, even on the basis of gender, men and women grieve differently. Special attention may require a client whose pain is coupled with stigma or shame -to do with crime or an unsociable disease, or whose pregnancy is coupled with miss-carriage or still-birth; also, if there are no memories to cherish, or when the client is children with no adult perception of death. In grief therapy for the terminally ill apply  Jung's words: "Dying, therefore, has it's onset long before actual death.  Moreover, this often shows itself in peculiar changes of personality which may precede death by quite a long time." Therefore the client's feelings can constantly change in grief therapy, also in bereavement counselling.


Grief therapy training, not only in bereavement counselling but in counselling generally, lacks basic education on perception -not many counsellors have even heard of the Ames room, even among those preferring the related system of counselling. Insight into perception enhances the ability to deal with feelings that are based on the client's perception in counselling for grief, especially when counselling on bereavement.


The counselling trainee, be it grief therapy with or without specialisation in bereavement counselling, or generally counselling, need not be enabled to argue the differences in psychology of, e.g., Freud, Jung, Adler -nor even of counselling systems of Gestalt, Egan, Ellis, and Rogers. But while many, e.g., person centered counselling trainees, may know of Lao Tsu, many counsellors forget, e.g., that Carl Rogers's reason for not becoming a minister is said to be that he did not favour the idea of maintaining a rigid set of beliefs, and on a training-video he reveals what he describes as being hurt and fear itself as illness, almost worse than the illness itself, by the question "...because you didn't dare express the person that you really were...?" Yet, rigidly excludes, does not attach importance grief therapy training to educating on feelings to better help the client express his feelings in, e.g., bereavement counselling.


In bereavement counselling, especially grief therapy, in its interpretation that "the self-concept is unalterable" but that attitudes or behaviour can be modified or transformed, in its task "to create new conditions of relationship where the 'growth-process' can be encouraged and the stunting or warping can be remedied", the person centered approach, and other approaches to counselling, demand the consideration that "everyone experiences grief in his own way." In his own way should grief therapy enable, with education on feelings, the client seeking bereavement counselling to express his experience of grief. 


In Bereavement therapy, generally in grief counselling,  the client is depressed. "Depression is tied in, to a great extend with loss" suggest experts. Depression rates highest, 100, on the Holmes and Rahe Social Readjustment Scales in the case of the death of a spouse, and as high as 5th in the case of the death of a close family member; and "Talking is very important, especially if there is genuine interest on the part of the person encouraging the conversation -the important thing is for the depressed person to be sure of your concern." This concern cannot be shown without the person giving grief therapy having basic education on feelings, especially in  bereavement counselling.


No less in grief therapy, nor in bereavement counselling, it applies that the client "needs to be understood in the darkest corners of his experience" as says Carl Rogers. He needs to talk and grieve, and he must be made to feel safe, he must be empowered to do so, encouraged to perform or complete what Worden calls 'the tasks of mourning' -accepting the reality of the loss, experiencing the pain of grief, adjusting to the new environment, looking ahead and investing in the future. Without basic psychology education specific to feelings grief therapy is disadvantaged, and where constantly changes the client's feelings more so is bereavement counselling.


The effectiveness of grief therapy and bereavement counselling depend also on the availability and the effectiveness of the training of the grief therapists and the bereavement counsellors. Expert research conclusion and recommendation is that "there is need by training support" in the medical profession for doctors and nurses responsible for breaking bad news and the "confusion which lies in the terminology between bereavement and professional grief counseling." This is more alarming in counselling for grief, bereavement therapy.


The departed do ‘know’ this: "Since to mourn and remember us there is someone,” (verse by Orhan Seyfi Ari) “That's what counts -we can assume our duty to've done."


On grief, bereavement, "I am I and you are you," wrote Henry Scott Holland, "whatever we are to each other, that we are still. (...)  Play, smile, think of me, pray for me.  Let my name be ever the household word that it always was.  Let it be spoken without effect." -of grief in bereavement.


So it can be for clients of grief therapy, bereavement counselling -with a little more concern on the part of  trainers in grief therapy and bereavement counselling.


May interest -with empathy did he empower…          TEACHER OF TEACHERS


Bibliography


Anxiety -Carol Travis ~Science Digest, Feb. 1986


How is it  That We Live After Death an What is the Meaning of Life

-Dr. Richard Steinpach ~Stiftung Gralsbotschaft.


Do You Love Me? (= Do You Really Love Me?) -R. D. Laing ~Penguin Books, 1976


The Act of Will -Roberto Assagioli, MD ~Turnstone Press, 2nd impression, 1985


Ordinary People With Ordinary Illnesses

J. Rijke de Vries, MD, Rudy Rijke, PhD, MD ~Institute of Psychosynthesis -reprint article.


Life and Death -Professor Marco de Vries, MD, PhD

Institute of Psychosynthesis Yearbook Vol. IV, 1984.


The Soul and Death -C. G. Jung ~Collected Works, Vol. 8.1  The Structure and Dynamics

of the Psyche -reprint,  Psychology & the Occult, Princerton University Press, 1977


The Emotions -Professor Nico H. Frijda ~Cambridge University Press, 1986


Carl Rogers -training video (Counselling a terminally ill client)


Person-Centered Counselling in Action -Mearns & Thorne~ 2nd ed., Sage, 1999


Orhan Seyfi Arı –(translated) Canım Kardeşim Namık Kemal Yeşilada’ya ~internet sites


Henry Scott Holland -To the Loved One Who is Bereaved ~various

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