The Grief WorkshopWritten By: Tian Dayton, Ph.D., TEP Date: October 16th, 2012. Topic: Behavioral Health.
By Dr. Tian Dayton
Grieving Old Losses
Losses that have gone underground for years, that have remained open wounds deep within the self, may benefit greatly from grieving out in the open with the support and understanding of others. We experience a loss of self when we relegate emotional wounds into a sort of psychic silence. Losses that become buried in the unconscious, that go unspoken and unfelt, are the losses that rise up and catch in the throat and body and block personal creativity and spontaneity. They can make us fearful of deep attachment. They are losses that become complicated over time, interwoven with other losses. Oftentimes in cases of addiction and divorce, family aren’t able to acknowledge the depth of their pain around loss of, for example, a sober parent or the family unit. In the case of addiction, loss is literally all over the map. There is the loss of one parent to addiction, the other parent to their complicated response to living with addiction.
A surprisingly large number of life events go ungrieved and, thus, they become disenfranchised. Some examples of these losses are:
- The effects of divorce on spouses, children and the family unit.
- Dysfunction in the home, loss of family life.
- Addiction, loss of periods of one’s life to using and abusing.
- Loss of an addictive substance or behavior.
- Loss of a parent, spouse or child to the diseases of addiction or mental illness.
- Loss of job, health, youth, children in the home, retirement, life transitions.
Unlike a loss to death, there is no funeral to acknowledge and honor disenfranchised losses, no grave to visit, no covered dishes dropped at the door, nor sitting in the company of fellow mourners and supporting each other through the tears. These losses live in unmarked graves that sit within people and families who often avoid discussing them. Thus the pain becomes covert rather than overt.
Addiction and Grief
Many addicts have relied on a substance to manage emotional pain. In sobriety, they may have complicated issues of grief. They may need to grieve:
- The life they have lost through addiction (lost time, lost years that they could have devoted to getting their lives in order).
- The painful issues that they were self-medicating with drugs, alcohol, food, sex, gambling.
- The pain that they have caused those they love.
To make matters tougher still, they will be grieving these issues with a weakened set of psychological and emotional tools. This is why it is often advisable to make sure sobriety is solid before we deal with early trauma, so that it doesn’t lead to relapse. Although ignoring these issues for years and years in sobriety is no answer either. They may then become the pain pump that fuels relapse because they are the pain we were medicating in the first place.
The ACOA or spouse of an addict also has mourning to do that can be hard to get to in recovery. For example, they may feel they have no right to mourn the loss of a problematic relationship, be it a parent, spouse, addict or abusive person, because they are “better off without him.” They may have conflicting feelings of love and hate, guilt and relief that complicate their mourning process. But painful and complicated relationships can be very hard to let go of, because there is so much unfinished business connected with them. Millions of dollars are often spent trying to locate the bodies of lost loved ones so that we can mourn them. This need to concretize the object of loss seems to be a deep, psychic need, without which the mind and heart search and yearn without settling. This is why I find psychodrama so very useful in helping clients to grieve. Through role play we can concretize the lost person, object or period of life and talk directly to it. We can create a ritual, in a sense, through which mourning can happen.
Divorce and Grief
Divorce seems to occur between two people. This is an illusion. Divorce is a family affair. We lose not only one person, we lose access to all of the relationships in the network that belong to that person. If we don’t lose them completely, they certainly change.
For the child of divorce, losses are multiple and substantial. They lose easy access to one parent. Along with this, they may lose easy access to the network of that parent as well. They may also lose the comfort and security of knowing just where they belong; all of this is thrown into serious question during divorce. They lose the security of coming from parents who are able to work out their differences and live comfortably together and sometimes the anger and resentment that divorcing partners carry for one another is the stuff of novels and detective stories. All of these losses need to be acknowledged, understood and grieved. The problem is, generally both parents are in so much pain themselves, the pain of their child overwhelms them.
Children may also experience divorce as fragmenting on a psychic level. The limbic bonds that have been literally woven into the fabric of their beings can become disrupted or even torn through divorce. The experience can feel shattering both to spouses and children. All of this needs to be recognized so that the pain, resentment and sense of disconnection that is incumbent upon any divorce doesn’t do long lasting damage.
All this being said, a good divorce can be better than living in an unbearable circumstance. If handled well, it can show all concerned that life can be renewed and relationships can work. All of us take a huge risk when we marry.
When to Let Nature Take Its Course
In cases of loss to death, there is a growing body of research suggesting that intervention is not necessarily beneficial in all situations. Feeling grief is a natural occurrence when we lose some one we care about; it is a testimony to our ability to become meaningfully attached and is not pathological or unnatural. A major new study entitled “Report on Bereavement and Grief Research’” prepared by the Center for the Advancement of Health concluded:
”A growing body of evidence indicates that interventions with adults who are not experiencing complicated grief cannot be regarded as beneficial in terms of diminishing grief-related symptoms… In fact, the studies indicate grief counseling may sometimes make matters worse for those who lost people they loved, regardless of whether the death was traumatic or occurred after a long illness, according to Dr. John Jordan, director of the Family Loss Project in the Boston area. Such people may include the only man in a group of women, a young person in a group of older people, or someone recently bereaved in a group that includes a person still suffering intensely a year or more after the loved one’s death.
Further, the research suggests, bereavement counseling is least needed in the immediate aftermath of a loss. Yet it is then that most grieving people are invited to take part in the offered services. A more appropriate time is six to 18 months later, if the person is still suffering intensely.
The care and comfort offered by friends and relatives was found to be the most beneficial to the person suffering loss. Unless the loss is complicated, most people can work through their loss, even though it is painful and difficult. And men and women tend to grieve differently, which can also influence how they experience grief counseling. For example, most bereavement groups focus on emotional issues, which seem to be most helpful to women. But men are more likely to benefit from an approach that focuses on their processes of thinking.”
- Releases the pain surrounding an event or situation so that it will not be held within the psyche, the emotional and physical self.
- Allows the wound to heal. If we do not grieve, we build walls around the ungrieved wound in order to protect it. When a wound is not healed, it hurts. It is tender to the touch; so we push away any experience that might touch it, press on it or produce pain.
- Makes it easier not to retreat from deep experience when it presents itself again in our lives. We reduce the fear that we will not be able to handle the potential pain that could be associated with deep feeling and caring.
- Is necessary in order to release the anger that arises as part of the grieving process at feeling helpless and out of control, or at losing something or someone important, so that we can risk loving or becoming attached again in life.
- Allows us to integrate emotions and/or split-off parts of self that may have been denied, repressed or split out of consciousness. This helps us to become or remain more whole.
- Can lead to a spiritual awakening.
Warning Signs of Unresolved Grief
- Excessive guilt
- Excessive anger/sudden, angry outbursts
- Recurring or long-lasting depression
- Caretaking behavior
- Emotional numbness or constriction
Possible Grief Triggers
Sometimes we feel off but don’t know why. Following is a list of life situations that sometimes trigger old grief and may be beneath the level of our conscious awareness.
- Anniversary reactions: Anniversary reactions are common on or around the anniversary of a loss or death. One may feel a vague or even an overwhelming sense of pain related to a loss that feels as if it is coming out of nowhere. This reaction may also be experienced around previous significant dates such as hospitalization, sickness, sobriety, relapse or divorce.
- Holiday reactions: Holidays often stimulate pain from previous losses. Because they are traditional ritual gatherings, they heighten our awareness about what is missing or what has changed.
- Age-correspondence reactions: This reaction occurs when, for example, a person reaches the age at which there was a loss by someone he or she identified with. A daughter whose mother divorced around age 45, for example, may find herself thinking about or even considering divorce when she reaches that approximate age.
- Seasonal reactions: Change of seasons can stimulate grief or be unconsciously associated with a loss, thus causing a type of depression during a particular season.
- Music-stimulated grief: Music can act as a doorway to the unconscious. It activates the right brain, drawing out associations and feelings that get stimulated by a particular song or piece of music.
- Ritual-stimulated grief: Important, shared rituals can stimulate grief when there has been a loss. For example, family dinners or Sunday brunch can be a sad time for family members who have experienced divorce or death.
- Smells or returning to a particular location: Smell is associated with the oldest part of the brain and stimulates memories associated with it. Visiting a place that was previously shared with a loved one, now lost, can bring painful recollections – and eventually mastery if feelings are confronted honestly and directly.
Inadequate Attempts at Dealing with Grief
Following are some attempts to deal with or manage grief that do not necessarily lead to satisfactory resolution and integration:
- Premature resolution: This is when people try to force themselves to resolve grief without allowing themselves to move through the full cycle of mourning. In these cases, the unresolved feelings tend to come out sideways in the form of projections, transferences, bursts of anger, simmering resentments, excessive criticism, bouts of depression and so on.
- Pseudo-resolution: Pseudo-resolution is a false resolution that occurs when a person fools himself or herself into feeling that grief has been resolved, when it actually has not run its course.
- Replacement: This is when we replace the lost person or circumstance without mourning the previous loss first. For example, the divorced person who immediately marries again may feel he or she has solved the pain of loss when, in fact, the loss has not been processed and learned from. In the case of divorce, the same issues that led to one loss tend to reappear in the next relationship.
- Displacement: This occurs when mourners cannot connect their pain to what is actually causing it and instead displace their anger and sadness onto something or someone else – displacing the pain, or putting it where it does not belong. It becomes difficult to resolve pain in this case, because it is projected onto and experienced around the wrong subject. It needs to be consciously linked back to what is actually causing it.
The Stages of the Natural Grieving Process
The stages that one can expect to pass through in the grieving process are laid out below. Loss here is defined as loss of a person, a part of the self, a period of life or life circumstance. I have adapted John Bowlby’s first four stages on loss of primary attachment figures and added a fifth stage that I have seen clients pass through when they can allow themselves to surrender to the process of grieving. Particularly when the grieving is of disenfranchised losses related to addiction, we can feel a new lease on life when we move through the stages of loss.
It is important to note that people’s feelings do not necessarily follow an exact course, but the stages offer an overall map of the emotional terrain covered during the process of grieving loss. The stages are:
- Emotional numbness and shutdown. In this stage, we may go through a period of feeling emotionally numb. We know something happened, but our feelings are shut down and out of reach.
- Yearning and searching. A yearning for the lost object (person, situation) and searching for it in other people, places and things mark this stage. Ghosting, or the sense of a continuing presence of the lost object, or even feeling one is seeing them may be experienced. There is deep yearning for what was lost, be it a stage of life, a part of the self, or a person, followed by searching for a way to replace the lost experience.
- Disruption, anger and despair. In this stage, clients may experience anger, despair, sadness and disappointment that comes and goes and is overwhelming at times. Life feels disrupted. Many losses that have anger and resentment attached to them can get confusing at this point. For example, it may be easier for some ACOAs to feel the anger rather than the sadness beneath it. Or there may be ambivalent feelings like longing and relief, or rage and yearning.
- Reorganization and integration. In this stage we are able to articulate and experience either the natural, numbed or split-off emotion connected with the loss and integrate it into the self-system. This is a stage of acceptance and letting go.
- Reinvestment, spiritual growth and renewed commitment to life. In this stage, we come to believe in life’s intrinsic ability to repair and rebuild itself. We experience firsthand that we can heal by reaching out and letting in love and care from willing people.
One of the most important functions a recovery support network can provide is a safe and supportive container that can help the recovering person to “hold” feelings that may, at times, overwhelm them.
The beauty of grief is that it frees up our energy. We become “unstuck” and we find we have choices about how and where we want to invest our energy and time that may previously have been unavailable to us.
Experiential Exercises for Working through Grief
The exercises below are from RTR Relationship Trauma Repair: A Multi-Sensory Model for Working With Relationship Trauma and PTSD Related Issues (available through unrivaledbooks.com).
Grief Graph/Spectrogram: How Much/How Little am I Feeling?
Notes to Therapist: The purpose of the Grief Spectrogram is 1) to educate clients about grief symptoms; 2) help them to self-identify as to how much of any one symptom they may be experiencing; and then 3) connect them to each other through identification and sharing. The exercise places the locus of control within each group member in terms of self-identifying where they are on the continuum in relationship to each symptom. Both trauma and grief are on a continuum; individuals will vary considerably as to how they experience even the same trauma depending on previously identified factors. Consequently, their level of grief, sadness, anger, disruption and so on will depend upon the individual. The spectrogram allows clients to assess themselves. Clients may move around if they change their minds as to where they belong as sharing progresses.
- To discern “levels of emotional intensity” so that clients can understand how much or how little of any particular emotion they may be experiencing.
- To work with the pain, sadness and anger that can drive depression, anxiety and relapse.
- To make unconscious material conscious by experiencing the frozen feelings that block real emotion.
- To allow group members to identify with and connect with each other.
- Draw an imaginary line dividing the room down the middle, showing group members where it is as you do so.
- Explain to the participants that each end of the room represents an extreme and that 50% is the mid-point: for example, one end of the room is 0% and the other 100%.
- Now choose some of the questions from the list below that feel are relevant to your particular group and ask participants to stand at whatever point along the continuum that feels right for them in response.
- How much yearning do you feel?
- How much sadness do you feel?
- How much anger do you feel?
- How much unresolved emotion do you feel surrounding this loss?
- How blocked are you from getting in touch with your genuine feelings involved in this issue?
- How disrupted in your daily routines do you feel?
- How much fear of the future do you feel?
- How much trouble are you having organizing yourself?
- How uninterested in your life do you feel?
- How much do you feel your grief has contributed to your becoming a deeper person?
- How much old, unresolved grief is being activated and remembered as a result of this current issue?
- How tired do you feel?
- How much hope do you feel about your life and the future?
- How much regret do you feel?
- How much self-recrimination do you feel?
- How much shame or embarrassment do you feel?
- How much depression do you feel?
- After each question, allow people to spontaneously share feelings that come up for them while doing this exercise, either with the group at large or, if the group is large, in subgroups with those who are next to them on the spectrogram. You can do a mixture of forms of sharing; that is, on one question you can let the group share in the large group and on another they can share in subgroups with those who are standing near them along the spectrogram. I generally allow the group to choose however they would like to share by simply asking, “Would you like to share in the large group or subgroups on this one?”
- Repeat this process for as many questions as can be absorbed, generally three or four will be plenty, but you can do more if the group wishes.
- Next, invite group members to go to their Personal Journals to “write a letter.” Write a letter beginning with Dear_____ and ending with an appropriate closing.
Note: Letters can be shared in group, subgroups or read to an empty chair or role-player.
JOURNALING: Letter Writing
- Write a letter to someone to whom you wish to say goodbye.
- Write a letter to yourself at a particular time of life that you may be letting go of.
- Write a letter to a substance or behavior that you’re giving up.
- Write a letter to a role or part of yourself (e.g. the role of the addict) that you’re saying goodbye to.
- Other: This can allow for personal adaptation of letters, “Write what you need to write to bring closure and relief.”
Empty Chair/Vignettes/Letter Writing: Making It Real: Making It Relational
- To say goodbye fully to someone who has left one’s life.
- To release that person, place, relationship, part of life or part of self and move on in one’s life.
- To say goodbye to a substance or behavior
- To say goodbye to a part of the self or a period in one’s life.
- Invite the protagonist to share briefly a sentence or two about the person, behavior, substance or part of herself, etc., that she wishes to say goodbye to.
- Invite her to choose a person or to use an empty chair to represent the person, substance of, part of self, etc.
- Invite the protagonist to fully say goodbye. Encourage the protagonist to be specific, saying goodbye, in detail, to all that she will miss.
- If it seems appropriate or helpful, allow her to say what she will not miss.
- The protagonist can reverse roles with the person, substance, or part of self whenever appropriate.
- Ask the protagonist to finish the goodbye in any way she wishes.
- Allow plenty of time for sharing in the group.
Variations: If the protagonist is saying goodbye to a lost person or even a part of the self, setting the scene can also be part of the role-play. The protagonist may wish to be in any type of setting, either real or imagined.
Notes to Therapist: This exercise allows pain to be shared, personalized and placed into context. It is amazing to witness how much feeling can arise when talking to an “empty chair” that is, of course, not empty at all but filled with the felt presence of another person from the client’s life. It is a testimony to the power of the introject, or carried presence within us of another person, and how real they become through this exercise. There will be significant grief, along with the relief, when giving up a substance or compulsive behavior. Protagonists may benefit from talking to the substance or behavior, embodying it, speaking as it so that they can pass through that feared boundary between becoming it and never getting out again. Protagonists may also want to talk to a part of themselves that they are letting go of: the “fun drunk”, the “life of the party”, the “bad person”, etc.
Use doubling (see The Living Stage, pages 36-38) to allow the protagonist to give words to what may be too difficult to say from his or her own role and role reversal so that: 1) the protagonist can experience actually “standing in the shoes” of the other person; and 2) so that the protagonist can have the opportunity, if they wish it, to say something “as” that other person that they may long to hear (Note: This should not be expected, but it can happen and it can be very healing if it does).