By the time most of us reach mid-life, we understand life as a strange mixture of joy and sorrow. We realize that we can experience exhilarating moments that leave us almost breathless with pure ecstacy. But we can also feel such intense pain that it seems as if our hearts are ripping apart, sometimes to such a degree that we plead with God to take us to heaven to avoid dealing with this unbearable life.
When we are feeling this pain and sorrow, loss is undoubtedly a significant part of that hurt. Loss can take many different forms: a broken relationship, the estrangement of a child, the loss of a valued job, dealing with a life altering or potentially terminal illness, or experiencing the death of a loved one. All of these hurt horribly, but differently depending on a wide variety of individual factors because each person’s grief experience is unique. Grief experiences also differ because of the nature of the relationship that has been lost. Many people are hurt when comparisons are made which imply a judgment on someone’s part about the extent to which a person should be sad or should be getting back to “normal.” Actually with any loss, the “old normal” doesn’t exist anymore. A significant change has occurred through the removal of that situation or person, and the bereaved individual needs to adapt by constructing a “new normal,” to determine how he/she is going to make healthy choices about their life now, which are both realistic and possible. A large percentage of counseling or therapy deals with the issue of some loss as a root contributor to the symptomatology of depression and anxiety. As therapists, we know how to deal with many of the causes of loss and the resulting grief. In this article we are primarily dealing with the loss through death of a loved one and the grief that follows. Since the time when we both experienced the deaths of our first spouses and wrote a book about spousal loss, we have increasingly realized that the general public holds to a number of misperceptions of grieving. These myths are often perpetuated as one generation models to another. We are disturbed to hear cliches such as, “give it time and your pain will heal,” “you’re being so strong,” Christian (as if that were a good thing) or “you’ll never really get over the death of your loved one.” What is even more troubling is that some people in helping professions also may have some distorted beliefs about grief—distortions that detract from working effectively with those who are bereaved. Constructs for Grief Therapy We use four basic constructs in our work with grieving people. These may reinforce what you already believe and are using in your own practice, or these constructs may provide you an alternative perspective on grief and bereavement.
1. The first construct is the use of “journey” as an analogy for grief—a journey from despair filled with pain to the eventual absence of pain when remembering the deceased. The journey is not a straight road. Rather, the journey vacillates between times of anguish and times of hope. We often use another analogy —that of waves rushing in and sweeping over the bereaved only to recede into relative calm. Grief comes naturally as a result of both having loved and having attached to the life lived with the deceased. Grief is not something that someone chooses. With death the attachment is broken, and therefore pain results. However, as a counselor, we think it is important for you to let your clients know how they can best navigate this journey. One of the natural tendencies of bereaved persons is to distract themselves, avoid tough situations, or capitulate to the pressure of others urging them to reenter their usual life and get busy again. The result of this, however, is that it diverts them from the goals of the journey and may prolong the process of grief or divert grief into some other more damaging physical or emotional manifestations contributing to “delayed” or “complicated” grief. Trying to return to the pre-death “normal” life is not healthy. Returning automatically to the old patterns of life often prevents a bereaved person from experiencing and dealing with all the emotions of grief.
2. A second helpful construct in bereavement counseling is to encourage your client to develop a healthy and renewed sense of self-esteem. Depending on the nature of the relationship and the roles played by both the bereaved and the deceased, some emphasis may be needed in therapy to assist the client in determining who he/she is now without that loved one in their life. With the therapist’s help, the client should identify the specific components lost through the death of a spouse, parent, child, sibling or friend because these all differ from each other, while still being very painful in their own way. Specific questions need to be explored, such as, “who was I in my life with the deceased?” and “what are the changes now that I am without that special loved one?” and “how has my identity changed and for what role losses do I now need to grieve?” Exploration of these issues is essential to a healthy grief journey. In a very real sense, grieving is an individual and solitary process that has a self-focusing element necessitating that the bereaved person learns to be congruent with him/herself. To know how one’s thoughts, feelings and behaviors flow in an integral unity is an important aspect of the therapy process. In order to plan a healthy journey through grief, your client needs to know him/herself more fully, learn to be congruent with thoughts, feelings and behaviors, and then develop a series of specific actions that can help that person move through the process of grieving.
3. Although there is a sense in which grief “just happens,” a third basic grief construct is that grieving also needs to be an intentional, deliberate, and active process. The bereaved person needs to realize there are many things necessary for a healthy journey through grief to get to the other side. Grief work consists of a task framework with many suggested behaviors that help a person journey through the grief process. Notice that we emphasize going “through” versus “over” or “around” grief. These behaviors involve a lot of hard work. Many of the components and symptoms that manifest themselves on an emotional, physical, behavioral, spiritual, and cognitive basis need to be acknowledged and dealt with. Grieving is very painful, and we as a society have been primed to take the easy way, to not wait but find the way of least resistance now. Yet, the Bible is filled with the word wait. But biblical “waiting” is not passive. The biblical words for waiting are much more in line with “attending to” or “serving” than with passively sitting along the sidelines doing nothing. In this case, a “waiter” is more analogous to the person serving your table at a restaurant than someone sitting in a surgical waiting room. While we wait on the Lord in our grief, we also “attend to” the pain of the loss. We “attend to” our memories of the deceased person and all the things that now can no longer be. We “attend to” our acceptance of the fact that this person is never coming back. Grieving people are helped when they hear about the numerous things they can do on their grief journey —things like sorting through memo- rabilia and belongings, revisiting favorite places, looking at sympathy cards as well as the cards and letters sent by the deceased, visiting the scene of the accident or place where the loved one died, looking at pictures, and going out alone to social events without the deceased loved one. By doing these, and many other tasks, the bereaved person moves a little further down the path of the grief journey toward healing from the pain of loss. Even the language we use as counselors is critical. How often to do we allow a bereaved person to use euphemisms such as “he’s lost,” “passed away,” or “in a better place” rather than use the direct language of died or dead? Using words that speak to the reality of the situation is an important part of the process in recognizing both cognitively and emotionally that the death is really permanent. Accepting the reality of the death frequently takes several months because of the numbness and shock that often protects the person from facing initially more than they can bear. God does promise that He will not permit more to come into our lives than what we can handle, even though for grieving individuals it sometimes seems as though they are pushing the edge of being able to manage. While in the wilderness the Israelites received only enough manna for daily use—none in advance for the next day. They received just enough sufficient for the day. If the bereaved looks too far into the future, the grief process may appear overwhelming. Taking it minute-by-minute or day-by-day is the healthiest way to deal with grief. Grieving is definitely work, but grief also needs time. We think that grieving needs at least a year for the bereaved to deal with all the tasks, and it can take two or three years as the pain slowly decreases in intensity and frequency. As you know, the majority of people who experience the death of a loved one never seek out counseling. Many people probably believe grieving is something you have to “wait out,” followed by an attempt to get back to normal as soon as possible. But we believe that many grieving people can benefit from therapy intervention. We also hope you will promote in your practice and in your contact with churches and other civic groups the concept of an active grief journey defined by specific tasks of grief.
4. As the title of our first book suggests—Getting to the Other Side of Grief—we believe that the fourth and final construct in grief therapy is that the majority of grieving individuals can find healthy resolution to their grief. We define resolution as the bereaved no longer experiencing the pain associated with their loss, while still able to remember the pain and recollect at will all the cherished memories of the deceased loved one. However, the former relationship with the loved one who died must be put on a lifeline and moved into the past. Those memories can be retrieved and revisited as one wishes. Also comforting for the bereaved is the realization that the deceased person in some ways has most likely become a part of them through particular behaviors, interests, or attitudes they have adopted because of their relationship with the deceased. The other facet of this “resolution” is that resolution is not a static thing. We firmly believe that the client can be “done for now” with grief. There may be subsequent moments of sadness which they did not, or could not, anticipate. Times will come in the bereaved person’s life when the bereaved will pause, perhaps with a few tears, and want to have the deceased person with him/her. Graduation days, a birth of a child or grandchild, a marriage, another death, or new job may trigger momentary sadness or pain. But these are generally “momentary” and “sad” rather than a longer process of revisiting grief and intense pain. A positive sign of healing and resolution of grief is when the bereaved is able to acknowledge that he/she is faced with the tasks of grief and is ready to move on with their life. We also think it is important for the bereaved person to share this milestone with his/her loved ones. This is an important signal to oneself and others of the fact that, while the deceased person was very important in the life of the bereaved person, the bereaved and other people who have surrounded the bereaved have equal value and importance. This will hopefully also reinforce the reality that the role the bereaved played in the deceased person’s life may have been an important one, but that was not the only significant role for the surviving individual. When a bereaved person gets to the other side of the journey, he/she also embraces a new sense of God’s purpose for his/her life and is able to more fully invest in that purpose again. We as humans definitely grieve because we have loved, but the bereaved need to remember that this is not the end of life for them. Eventually, the grieving person needs to look around and observe who else in their life cares about them and wants to have a relationship with them, as well as to explore the new directions their life may encompass.
Completing the Journey
While many grieving people do not seek professional counseling to help manage their grief, we firmly believe that bereaved persons can learn much through a counseling relationship regarding how grief is truly a journey. They can understand that grief entails an active process, consisting of intentional activities and experiences. The process involves a re-definition of oneself because of the changes brought through the death of a loved one. They can also be assured that with time and work, they will be able to get to the other side of grief. We are so hopeful that with a multitude of mental health and spiritual leaders promoting a healthy understanding of grief constructs, an increased number of bereaved will be able to work through their grief in a healthy manner and re-enter a life that is filled with renewed purpose in becoming all that God intended them to be.
Susan J. Zonnebelt-Smeenge, R.N., Ed.D. is a Registered Nurse and a Licensed Clinical Psychologist employed by Pine Rest Christian Mental Health Services in Grand Rapids, MI. Robert C. De Vries, D.Min., Ph.D. is an ordained minister and a Professor of Church Education at Calvin Theological Seminary, Grand Rapids, MI. Susan and Bob have both experienced the death of their previous spouses. They are now married to each other and have four adult children in their blended family. They collaborated on writing Getting to the Other Side of Grief: Overcoming the Loss of a Spouse (Baker Book House, 1998). Their second book is entitled The Empty Chair.
