Grief and Types of Grief

Grief is a deep sense of loss produced by terrible events such as death. It has also been linked to a feeling that grabs people when they have experienced tremendous hardship, such as the destruction of their cherished belongings due to natural or man-made calamities. Grief is a natural experience for everyone, but it can lead to more pain if not managed properly. Counseling is useful as a therapy for dealing with sorrow, and when handled by a competent professional, the affected individuals enjoy healing and well-being. The death of a loved one can have devastating consequences to an individual if not supported well. People have different ways of responding to grief based on their personality traits. The intensity of grief also depends on the relationship individuals have with the departed. It is easier to grieve a casual friend or an acquaintance than it is with a close family member as a parent. In this respect, it is vital to examine the various types of grief

Types of Grief

Abbreviated grief is the kind of notion which is short-lived. It does not mean that it is not genuine; the affected individual may receive sufficient help so as to deal with the consequences of the grief (Walter and McCoyd 2015, p. 35). An example may be a man who loses his wife; the grief may last until he finds comfort by marrying a second wife. There is the absent grief that is depicted in a person who seems not to be affected by sorrow at all which is considered a normal phase of grief in the initial stages but it begins to raise eyebrows if it goes on for an extended period of time. Men commonly put aside their sorrow so as to act strong before the family. A mother may also postpone her grieving so as to concentrate on taking care of her children.

There is also the ambiguous grief which is usually not accepted by the individuals who are expected to supply comfort. The grief is usually unseen by the others and therefore not considered as valid. A person, who loses a favorite pet, may be grieved in the ways the others may not understand (Boss and Yeats 2014, p. 50). They may even belittle the loss which aggravates the grief on the affected persons. Anticipatory sorrow happens when one is living with the anticipation of impending grief. If a person has a terminally sick relative, they may suffer from bereavement of anticipating the loss; it is worsened if the sickness persists for a long time.

People also commonly suffer from chronic bereavement when their sense of loss persists over a long period of time. The feelings remain as fresh as the incident happened. People who had close dependence on the deceased were more likely to experience this type of grief which also happens when death occurs after a tragic happening as an accident. Complicated grief happens when the bereavement fails to heal with time and instead, it worsens. Affected people may show symptoms of the type of grief by avoiding reminders, maintaining solitude, and displaying denial. Unless such people receive timely therapy, they can sink into mental illness. People experience delayed grief when they do not immediately get the opportunity to go through the emotion that comes with loss. The delay may either be deliberate or it may be occasioned by pre-occupation with other aspects related to the grief. Persons who witness violent deaths may develop a feeling of numbness and may avoid even to attend the funeral of the killed person. In that manner, they do not get closure and the grieving is postponed.

Disenfranchised grief happens when societal rules prohibit certain forms of expression. Mothers may experience this grief when they lose their unborn children, it can be the same experience for a mother after procuring an abortion. In suicide cases, someone may fear retribution for inappropriate actions or words and may bottle in their feelings (Boss and Yeats 2014, p. 133). Closely related to this is the inhibited grieving where a person exhibits less than the expected signs of mourning. This is usually seen among people who consider expressions of grief as a sign of weakness. Such people tend to withdraw emotionally as they deal with inhibited grief.

Case of Bereavement

Handling grief of a loved one is a delicate case because we cannot predict how the bereaved will respond. Sigmund Freud was of the view that the bereaved persons should “let go” of the feelings of loss and put it behind them. Freud prescribed a formula through which a bereaved person can achieve a detachment from the deceased; understanding and accepting the loss, withdrawing one’s attachment to and identification with the deceased and resuming one’s emotional life and establishing new relationships (Nardi 2016, p. 100). The formula acknowledges that the deceased person has already left and should be placed in the past where he/she belongs. Grieving people may consider this to be a radical approach especially if they enjoyed a close relationship with the deceased. Such mourners will still maintain an attachment with the deceased through placing their portraits in their living rooms and holding annual commemoration days in their honor.

A unique case of bereavement is the death of a parent especially when the bereaved has seen them undergo painful suffering for a long period of time which may be caused by a terminal sickness that continually robs them their functionality. The bereaved person in this case usually goes through great emotional turmoil when they see their parent in a helpless state. By the time the death is happening, they may not depict the symptoms commonly associated with grief and people may not understand them. To casual observers, the bereaved may look uncaring for the deceased. The emotional baggage they may have carried throughout the elongated period of sickness may have in a way have prepared them for the loss. However, it must not be mistaken to mean that such a person has already dealt with the bereavement, it is a temporary stage and the actual bereavement may be delayed.

Stages of Bereavement

Kubler-Ross understood the emotions when postulated the five stages of loss. The first stage is denial where the bereaved responds through “not me” responses. The stage is closely followed by anger when the person gets through a “why me” process before getting to bargaining. In response to bargaining, the bereaved gets through the “yes me, but…” motions. He then goes through depression and finally arrives at the acceptance stage. The stages resonate with individuals especially in cultural settings where funeral rites linger on for many days. Traditional communities have structures through which they support families that have suffered loss of their loved ones. Such rites may extend to weeks and even months. By surrounding the family from the day of bereavement, such communities acknowledge that dealing with grief is a long process. However, clinicians and researchers have not bought into Kubler-Ross’ theory because it has not been supported by research (Smaldone and Uzzo 2013, p. 450).

Jean Piaget developed the theory of cognitive development where he outlined the stages that children went through from infancy through to adolescence. They begin to interact with the environment as helpless creatures during their formative stages where they learn to crawl and then to walk. From age two to seven, children go through the preoperational stage that includes the growth of vocabulary and the adoption of abstract thinking and ability to reason. Seven to twelve is the operational stage where children where the abstract thinking capacity is matured and they begin to be logical on concrete things. From age twelve to eighteen the children enter into the formal operational stage and adopt sophisticated abstract thinking (Stroebe, Schut, and Boerner 2017, p. 120). Adults can prepare children for the loss of a loved one by talking to them about the stages of life. If children are well prepared, they will understand that death is an inevitable stage of life which every human being has to go through. By preparing children in this manner, their burden of grief will be lighter; they will not have to deal with confusing questions when it happens to a loved one.

. Lawrence Kohlberg developed on Piaget’s work by coming up with stages of moral development: the pre-conventional, conventional, and post-conventional stages which are further divided into two sub-stages each bringing the total to six. Kohlberg observed that the sense of morality of a child was externally controlled during the pre-conventional stage. A child’s protectors as parents, teachers and others inform the rules which a child accepts at this stage (Mulder et al. 2017, p. 250). During the conventional stage however, the sense of morality of an individual in tethered to societal relationships. As much as children continue to take instructions from authority figures, they do it in realization that it is necessary to achieve positive relationships and to ensure societal order. Kohlberg continues to say that a person’s sense of morality is informed more by abstract values and principles during the post-conventional period. At this stage, people believe that some laws are not just and should either be changed or be eliminated.

Kohlberg’s theory may be used by Clinicians and other professionals to segment their therapy based on the age of the bereaved person. This theory has however been seen to be inconsistent because it tasks the therapists to ensure that their sense of judgment is perfect regarding the perceived stage of their clients which is a hard task because the development of an individual is dependent upon various factors including environment, culture, and gender. It is also likely that a therapist will be biased against clients from different races and cultural settings (Loewenthal 2015, p. 218).

Sigmund Freud examines grief from the perspective of mourning and melancholy. Mourning, according to him, means the loss of either a loved one or some abstraction like fatherhood or an ideal. He considers it to be a normal reaction, and it should not be considered as an illness. He describes melancholy as a phenomenon that is more radical and injurious which manifests itself in negative expressions. A person undergoing melancholy therefore will display loss of interest in the outside world, diminished self-esteem and self-hatred and inability to love among other traits. Melancholy can be confused for mourning because it exhibits the same characteristics apart from the low self-esteem. Counselors of persons undergoing grief need to ensure that they distinguish between these two aspects clearly. Whereas the person should be allowed to go through mourning, the harmful effects of grief should be checked so that the individual reverts back to normal activity (Hayes 2013, p. 330).

Counseling

Counseling is the process of providing assistance and guidance in order to resolve personal, social or psychological difficulties especially by a professional. Life has a myriad challenges which require individuals to seek psycho-social support from various corners. Trained counselors assist such people to face situations in their lives with confidence (Anderson and Collins 2015, p. 360) Counseling requires plenty of time to listen and to allow the client vent out whatever is bothering them. In this regard, counseling requires a high level of trust. Apart from professional counselors, various persons can offer counseling services to people that commonly approach them. Friends provide a kind of counseling when people are faced with serious challenges because they are the first to contact before professional services are sought, if that happens at all. It is however important to note that counseling is not giving advice or passing a judgment. Counselors must go beyond advising their clients to empowering them to take charge of situations that confront them (Mcleod 2013, p. 90). Counselors should never try to solve problem for the client. They should also desist from any form of emotional engagement with the person seeking their services. This service must remain strictly professional.

A good counselor is usually well-armed with listening skills which allows the client to talk more, and the person is keen to note the tone used by the client when speaking as well as the omissions made by the customer. Consequently, the counselor will need to seek clarification, engage the client in reflection and practice effective questioning skills (Mcleod 2013, p. 120). As much as counselors are ethically proscribed from getting emotionally involved with their clients, they need to make an effort and build a healthy level of rapport with them. In addition, they need to practice empathy and to ask proper questions which will allow the client to obtain positive conclusions.

Counseling mostly involves talking and thus a counselor needs to perfect their communication skills in order to effectively engage a client. First and foremost the counselor needs to use a language which the client can understand (Hodgson et al. 2014, p. 118). It restricts itself to the lingua franca of the client. Furthermore, the language must be customized to the age and social standing of the client (Midwinter and Dickson 2015, p. 14). A youthful client might be conversant with slang but elderly people will prefer being addressed in clear conventional language. Improper language might cause a person to form a negative attitude about the therapist and thereby mentally blocking them from the exercise; this is a disaster in the counseling journey. The therapist must also show genuine interest in the client (Kwong 2014, p. 54). Basically, they should remember their name and the names of the places that are of importance to the client. Such places may have been mentioned in previous sessions. Most importantly, the therapist should remember the cause of the problem that the individual has shared. It shows a bad signal when the counselor has to keep referring to the client’s file to confirm names.

A good counselor gives sufficient time to the person to express themselves, however in doing so; the professional should not remain a passive observer in the process. He can display his engagement in the process by using encouraging statements. The statements should not interfere with the flow of what the client is narrating, and they should also not be mechanical (Nelson-Jones 2015, p. 131). A skilled counselor will make the client comfortable to share their experiences openly thereby allowing them internal relief. Counselors must also give information and ensure that they supply the client with the requisite data that will help them make informed decisions. Therapists should never give into the temptation of advising the client; the individual has the responsibility of summoning energies within themselves to confront their problems (Mearms et al., 2013). The therapist’s task is to help the client to galvanize these energies.

In grief situations, tension is likely to build up thus subjecting the parties to some awkward scenarios. To defuse these tensions, a good counselor can employ a sense of humor (Kopp 2013, p. 70). The humor must be innocent so that the client doesn’t read sarcasm. The counselor could veer the conversation off to some unrelated topic that breeds laughter. The two can then laugh together before the counselor carefully drives the conversation back on course. Counselors should take caution to speak slowly, softly and clearly. They should avoid scenarios where the client continuously seeks clarification about something they have not said clearly. Clarity of speech is a sign of confidence and the professional must strive to display this quality to the client.

Types of Psychotherapy

Psychotherapy is a roadmap that guides psychologists as they walk with their clients through the journey of seeking solutions to their problems. Psychotherapy approaches are divided into five areas.

The first category is psychoanalysis and psychodynamic therapies. It aims at altering problematic behaviors, thoughts, and feelings through discovery of their underlying motivations and meanings. Through the approach, a close working relationship between the professional and the patient is established. Clients explore their interactions in the relationship and learn about themselves (Mulder et al. 2017, p. 45). The therapy is mostly identified with Sigmund Freud but has been applied by other scholars including Ivan Pavlov who has enriched behavioral therapy through his discovery of classical conditioning. Through the famous experiment involving dogs, Pavlov discovered the aspect of associative learning (Labrenz et al. 2015, p. 220). Human beings have been seen to display such predictability when subjected to certain stimuli. When people are given the right incentive, they easily adopt new forms of behavior.

Cognitive therapy is an approach that emphasizes what people think as opposed to what they do. Therapists that follow this approach believe that it is dysfunctional thinking that leads to emotions that are dysfunctional and then dysfunctional behaviors arise. They focus on changing the behaviors of people by changing the way they think. This therapy agrees subtly with the way certain forms of education are administered to people; they are geared more to influencing the way people think. Religious education, to a large extent, follows this route so as to direct people towards favorable thoughts and deeds. Leading scholars in cognitive therapy include Albert Ellis and Aaron Beck. Cognitive therapy is mostly short-term and deals with issues ranging from fear, panic and eating disorders to marital problems and depression. It focus on how a person thinks, behaves and communicates

The humanistic therapy lays emphasis on the capacity of people to make rational choices and grow to their maximum potential (Rubin 2016, p. 85). Leading philosophers in the approach such as Jean-Paul Satre and Martin Buber believe in respect and concern for the others. Under the approach, there is the client centered therapy that goes against the thinking that therapists should be the authority on their clients’ inner feelings. They rather assist the client to change by stressing on their concern, interest and care (Waterman 2013, p. 23). The other theme is the Gestalt therapy which lays emphasis on “Organismic holism”. It is the philosophy of being aware here and now and accepting responsibility for one self. Lastly under this therapy is the existential therapy that approaches the patient from a premise of free will, self-determination and the pursuit for meaning.

The integrative or holistic therapy is a blend of the various approaches. Therapists do not bind themselves to one approach. In doing this, they customize their treatment to specific clients (Ramsay and Rostain 2014, p. 56). It gives them the freedom to alter their strategies as they observe the client.

Narrative Therapy and Bereavement

Narrative therapy is a technique used in counseling where the professional attempts to distinguish the person from the problem they are facing (Elderton et al. 2014, p. 102). With this technique, the problem is dealt with separately without connecting it to the personality of the client. They guide the client to activate skill within them so that they can handle the situations that confront them instead of sinking into depression thinking that there is something wrong with them (Roe et al. 2014, p. 43). When it comes to bereavement, it is comfortable to learn that grief is an occurrence that has happened to people, and they do not have to internalize it (Lopes et al. 2014, p. 320). It means that they see it as an occurrence common to all the people regardless of their personality orientation or other factors in their individual nature. Grief can weigh heavily down on an individual and they may begin to think that they have contributed to the state of things. Parents who had been bereaved of their children many blame themselves if the child died of a sickness that they thought was preventable (Hayes 2013, p. 54). They might begin to imagine that if they had they taken extra care, the death could not have occurred. Narrative therapy externalizes these feelings and the healing process is expedited (Beilin and Pufall 2003, p. 25).

Given the weight that grief puts on an individual, the role of a counselor will have to go beyond the counseling room; he must develop a professional personal contact with the grieving person (Jordan 2014, p. 88). For the personal applications to be effective there are several guidelines that need to be followed.

The therapist must develop a collaborative stance with the client. This means that he must be willing to be flexible regarding the homework he gives based on the client’s feedback. The professional must be alive to the client’s unique circumstance. The therapist must bring to bear his/her creativity to allow taking into account the needs and the resources of the client (Lopes et al. 2014, p. 412). The client’s resistance to a particular suggestion by a therapist must also be respected. The counselor remains an outsider in this relationship and should recognize that the client’s refusal to undertake a particular homework might be for their good. In fact, such resistance could end up being the topic for further discussion that may bring out invaluable insights into the extent of the client’s loss (Klass, Silverman, and Nickman 2014, p. 45).

The client’s privacy must also be respected so that the therapist doesn’t unnecessarily prod into details he/she is hesitant to share. At the beginning of a counseling journey, a client may reserve certain reactions (Hara et al. 2015, p. 43). It should be taken in the right perspective by the professional. With time after the client has gained sufficient confidence, they are able to share the experiences and reactions with others in a free environment. The therapist should also integrate the counseling process with homework (Tanner 2016, p. 77). It can happen seamlessly when the person asks the client about the homework when they meet for the next session. The customers can, in creative ways, be asked to share relevant portions of the exercises with the counselor (Trower et al. 2015, p. 38). When it is done at the client’s pace, a sense of confidence ultimately arises, and the therapist achieves the requisite rapport for direct client sharing in later sessions.

The therapist must also acknowledge that grieving takes time and as such, they should never rush the process with activities that the client must do (Rahman 2016, p. 43). The emphasis should be on ‘being’ as opposed to ‘doing.’ As the process progresses, the client may not even be given exercises to do (Mearns, Thorne, and McLeod 2008, p. 34).

Grieving people tend to go through varied emotions having lost someone or something (Stets et al. 2014, p. 70). Such people yearn to have back what they have lost although they know that it is impossible. The narrative therapy is supportive in helping people to move away from the thinking that grief is private and not a societal problem (Adelufosi et al. 2017, p. 117). We all have the duty to assist the grieving person to resume normalcy. Because not all grieving persons do have the privilege of sitting with a counselor; society can be sensitized to develop structures for narrative counseling (Neimeyer, Klass, and Dennis 2014, p. 44). By staying often with the bereaved and engaging them in common talk, they can begin to slowly regain their emotional space in society. It can be very refreshing if close friends and relatives stay with the bereaved person and engage them in conversation that they are accustomed to (Kentish-Bernes and Prigerson 2016, p. 120). They can manage to do away with the ‘professional’ tag and naturally weave the grieving person back to ordinary life. However, close acquaintances that are not trained may aggravate the grief more if they are not sensitive of the various stages of grief (Joyce and Sills 2014, p. 23). For example, they may keep the person in continuous conversations and not be sensitive when they leave the individual alone (Lewis and L’Engle 2017, p. 45).

When dealing with a professional counselor, the ‘stranger’ tag may be beneficial for a client. This is because the counselor may have very few details about the previous life of the client. The only information they will gain is the one the client volunteers to give (Dyregrov, Dyregrov, and Idsoe 2013, p. 54). It sets the client at peace and prevents any form of prejudice on the part of the counselor. They are likely to engage the counselor even in details that they consider embarrassing in their lives and this may be the key to their recovery (Khan et al. 2015, p. 65). On the flipside, the counselor in the above-mentioned case solely depends upon his/her professional training to navigate into the feelings and emotions of the client (Freedman and Combs 2016, p. 210). However, a counselor can involve an intimate friend or relative of the grieving person with time. Although not professional, such a close person will have the advantage of having mastered the attitudes and dispositions of the grieving person. Thus, they can easily guide and caution them by virtue of familiarity (Nicoll and Hawes 2013, p. 90).

Narrative therapy has been questioned on the basis of ethics (Baldwin 2015, p. 39). In their quest to engaging the client and integrate them to the life before the grief, therapists stand on the border line of infringing privacy rights (Baugham et al. 2014, p. 74). It may be seen when documents which have previously been private like certificates and permits are brought to the fore as friends and relatives come together to share their experiences with the client in therapy. Given that privacy is one of the solemn principles of narrative therapy, counselors must ensure that they protect their clients from public exposure (Kwapong et al. 2014, p. 50).

Conclusion

Bereavement through loss of a loved one can be a devastating experience which may alter the course of a person’s life completely. Depending on the relationship they enjoyed with the deceased person and the personality of the bereaved, one could easily give into depressing thoughts and lose functionality of their senses. Good counseling services ensure that such secondary suffering is minimized, and individuals are helped to regain their place in the family and society at large after bidding farewell to their loved one which promotes healing of the grieving individual.



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