Loss and Bereavement (Emotional therapy views)

This is another from the reports I write for my course, it’s also a topic that was very hard for me to write about at the time so it’s a little bit awkward in points. Regardless, I hope whoever reads it finds it interesting!

large (1)Loss is something that will unavoidably affect us throughout our lives, for it comes in many different ways. Death is of course the first thing we think of when it comes to loss and bereavement but loss does not have to refer solely to the loss of a loved one; whether it be the loss of a job, a limb, health, innocence, home, or happiness (or many of the other things that can be lost throughout our lives), each loss—no matter how small—can be difficult and require a period of adjustment, or ‘mourning’ if you will.

Loss is not exclusive to death, whereas bereavement only deals with loss through a death, and both words are not interchangeable but do share a core meaning which is that the person suffering from loss or who is bereaved has lost something that was, in any capacity, important to them. Both do elicit a wide variety of feelings that might depend on the person lost, the person suffering from the loss, or the situation surrounding the occurrence of the loss. Where a sudden, unexpected loss has as higher chance of leaving someone feeling angry or numb, a loss that takes place over a long period of time, that someone can see coming is just as likely to give way to exhaustion and hopelessness. But even those examples are vast generalisation and it is impossible to predict what losses and bereavement will leave people feeling. Far more often than not, it is the tangle of numerous emotions that form the process of mourning, if one can only traverse it to the other side.

Grieving people will often be afraid of ‘being left behind’, not just by the deceased but by those around them, because grief may make them less social then they were. With this loneliness and fear of isolation they might start to fear how they will be able to cope with the intensity of their feelings, as well as the day to day life that still requires their attention. Having to look after others if they too were affected by the death might be extremely difficult and make some people put their own emotions on the back burner whilst they try to help others. This may cause them to turn to drinking/drugs to help coping with the situation. Some may lose themselves to religion or work as an attempt to keep themselves busy (more of this when I talk about denial). The over-empathic reaction of friends and families, as well as overwhelming subjective advice and the social pressures surrounding the bereaved are all things that can add up to make grief an even more complicated process than it already is.

The framework for some of the effects of loss reflects the general categories of emotions that come into play and I shall be using it as a guide to go through some of the stages of loss and large (3)bereavement in more detail. Grief itself is often preceded by shock. Any loss, even those we might have expected, comes with a measure of shock. Grief and the sadness/tears that represent it more commonly tend to show themselves only once the shock has receded and allowed for the reality of the situation to register. Below grief and in the centre of the framework sits denial: the refusal to believe that the loss is real, maybe accompanied with the belief that ‘things will sort themselves out’ (if we’re not talking about someone’s death). Denial can manifest in many ways, from people acting as though the other person is still around (talking about them in present tense, not mentioning their death at all), to small actions that reveal that our mind has not yet registered the loss fully (turning around to address someone we used to live with, picking up a phone to call someone who is deceased). Similarly, some people can go in denial over the loss of a relationship, stubbornly believing that they can get back with the other person even if that isn’t going to happen.

From there the framework goes in three different directions. Now not all people will go through all of those paths, and the order might be different for everyone, but they do offer a clear image of grouped reactions. On the right sits the concepts of ‘minimising’ and ‘idealising’. The first word refers to the process of trying to make the loss seem lesser than it is. This might be mostly seen in losses of jobs, home, health, or similar situations where it would be easier for the person to pretend that the loss and changes did not affect them a lot, even if they do. Idealising for its part, is when a person might put on a pedestal the one that has died, or looks back upon what has been lost through rose-tinted glasses. It is a fact that people ‘do not speak ill of the dead’, which is one of the primary causes of idealisation as only the ‘good’ sides of that person are ever talked about and whatever else they were is lost to memory. Similarly people might look back on a job or relationship, remembering how wonderful it all was before whilst completely disregarding all the issues/stress that it came with.

On the opposite side of the framework we see another three concepts: avoidance, depression, and withdrawal. Avoidance is self-explanatory and occurs when the person suffering the loss tries to avoid anything that is related to it, including but not limited to thinking about it and facing up to the consequences of it. Depression is to an extent a separate problem all together, although it can be triggered by the occurrence of the loss of bereavement.  Finally, withdrawal is used here to mean the departure of the person who has suffered the loss from their usual circles of society, with a possible nuance that they are pushing people away. This can be done for different reasons, whether it is that the person is private in their mourning process, or that they are distancing themselves from others as a way to avoid further pain, protect others from their own pain, or something entirely different.

Finally, the last segment of the framework goes down from guilt to anger. Anger is a totally normal feeling when facing loss. Anger at the situation, its possible unfairness, anger at our helplessness or the injustice of the world: it is rare that loss does not at some point elicit some form of anger. Anger in turn can give way to guilt. Be it guilt over being angry in the first place, or over events that happened prior to the loss that the anger may have been masking before it dissipated. That anger and guilt cannot be felt at the same time does not prevent one from masking the other, and it is often the case that we may be angry at something as a way to disguise how we may feel guilty about it (whether there is an actual reason for guilt and not just a perceived one). After this comes bargaining, although as discussed during the study day, this is almost a stage that could happen before the actual loss. This can be seen in people who pray and may bargain with their god(s), promising to do certain things if the loss is avoided, if the person is saved. Also outside of that, people do it in their daily lives ‘if this doesn’t/does happen, I will/won’t do this’ is a very common thing.

large (2)After that, one starts to move in the stages where one can learn to deal with the loss and grief more effectively. First comes the adjustment period, often particularly relevant for people who have had a particularly strong phase of denial or have carried through habits that are no longer relevant/healthy now that the loss has occurred. Adjustment can take many shapes, depending what the loss was. In the case of career, it could be finding a new path to walk down, when it comes to health or an ability to be self-dependent, it would be taking the correct steps to ensure that all needs are met. In the case of bereavement, it could mean moving house, putting away the belongings of a partner that are no longer needed, or anything else that would allow the person to start moving on with their lives. At last, the final step of acceptance can happen. This does not necessarily means being ‘over’ the loss, but being capable of acknowledging it and the effects it has had on our lives, as well as being capable to handle the emotions still attached to it.

Talking about grief and loss is one of the most difficult things for people to do: we live in a culture where the ‘get over it’ mentality is unfortunately dominant and forces people to bury how they truly feel about what is happening in their lives. Alongside this there is the awkwardness that comes with talking about loss: it is an uncomfortable, often difficult topic, and those that are going through it might be afraid of hurting others by bringing up their own issues. Similarly, they might be afraid of other people’s reactions: will the people around them try to appropriate the grief onto themselves (even if they were not as close to the deceased), might they only respond by bringing up their own experiences in loss? People will also be afraid of their own reactions when talking about this: they might not be wanting to show their more vulnerable side for fear of being judged (especially true for men who are told from a very young age that ‘boys don’t cry’ and other such fabricated societal ideas).

This is where the job of the counsellor is particularly important as we offer a safe place for people to work through the stages of loss and bereavement. As with every other client it is important that we respect the boundaries of what they can and cannot handle, which means we must never rush, patronise, pity or make promises. What we can offer however is an attentive ear, someone who is capable of empathising with them. It is important to allow the person to cry if tears come during the session, although it is perfectly okay to give physical and verbal expressions of concern and understanding. We are here to guide the person through what is a process that everyone who suffers loss goes through (and even those that bury it all away will eventually need to go through it or it will come back to them after the fact), we are here as someone who offers a safe, supportive environment that they may not have access to anywhere else, especially as we are totally separate from the situation. With the counsellor that person can safely start to actualise the loss and allow themselves to feel the pain of grief, and the time we give the client who is grieving is entirely theirs: there are no children, friends or family who require their attention during that time. It is also important to remember to have non-emotional (and obviously non-judgemental) reactions to whatever it is that our client is telling us. Where empathy and validation are important, if the client see that the counsellor themselves are upset by the topic they might close off and not speak as openly.

As counsellor we must, however, also be aware of our limitations. It might be that a particular client is in a situation that hits too close to home for ourselves, or that we have just largeundergone a loss of our own and cannot take on the task to help someone else through grief. When such situations arise it is good to know how, and when, to refer someone to a colleague, or doctor, or anyone who will be able to offer better care to them.

Advertisements

Fear seen as an Emotional Therapist

This is another report I have written for the course I am currently on. As with the last one it’s very blog-post like, so I hope it’ll make for an interesting read!

largeFear is one of our primal emotions, alongside love, one of the first things that, as a new born, we are able to feel. Fear has a lot of negative connotations, but it is, in its most basic representation, something that allows for the triggering of the flight or fight instinct which can be intrinsic to our survival. But what happens when fear stops triggering that reaction and instead freezes us on the spot, trapping us in a pattern, situation, or cycle that we simply cannot move from? That is when fear becomes an obstacle to our daily lives, and it is also when we begin to fear the fear itself, therefore creating a loop in which we simply cannot face the original fear that has us frozen in place.

Fear is one of the most common underlying feelings that a client might demonstrate, and it more likely than not that they will be unaware that fear is the root of their problem, let alone a fear of what. Because the fear is often rooted in one or more events of childhood, it is likely that the specifics of it have all been buried away by the adult as a coping mechanism. Similarly the fear may also have been displaced.

There are many physical, mental, and emotional signs that can tell us, as counsellors that fear is an underlying problem for the client even if they do not realise it. Physical signs can range from sweaty palms to shaking, to clinging onto specific items and high levels of restlessness. Mentally and emotionally, clients who are afraid are more likely to talk themselves in circle as they are too afraid to give voice to what the actual problem is. They are also likely to report high levels of anxiety in their daily lives as well as suffer from panic attacks. Addictions are also a good sign that there may be fear masked by the client’s actions. And those are only a small selection of examples on how fear manifest itself: lack of sleep, untargeted anger, and a chaotic lifestyle with no capacity to adapt are also some of the red flags surrounding fear in a client.

Anxiety, as is mentioned above, is unfocussed fear that the client has detached from what created it in the first place and it has become spread over everything that is part of the client’s life. Phobia, on the contrary, is a focussed fear, wherein a particular object, situation, or creature, becomes the target of an intense, uncontrollable fear. It is likely that phobias are displaced and targeted fears the origin of which clients can neither face nor recognise.

As therapists what we offer client is not to diminish their face, but it is to develop love large (1)(and self-love) to balance out the fear and make it more manageable. We cannot rid people of their fear, but what we can do is help the wounds caused by the events that created the fear, heal, and become just a scar. Triggering events will always make the scar feel sensitive but, with self-love and the proper healing having happened, a person can know what it is that is causing the feelings and why it is doing so and therefore be able to tackle how they feel both on a mental and emotional level.

When handling people who are afraid it is important for the therapist to be aware that they might need to approach the person and their issues in ways that are tailored to that person as each individual will handle their fear differently. One thing that can be said in most cases is to remind the person that they are being brave, and showing courage in coming to therapy. Courage can only exist in the face of fear, and by coming to therapy people are willing to tackle the fear that is hindering their lives, therefore demonstrating courage. This alone can help some people feel emboldened and more in control when it comes to the difficult process of therapy.

Most important is not to frighten the person away, not to give them another thing to be afraid of. It is necessary to be reassuring with frightened clients, perhaps to employ a particularly soft tone of voice to help them feel at ease. Exercises such as creative expression and dreamwork could prove beneficial to such clients: the former as a way to express the fear in a safe environment and in whichever way is more suited to them and the latter potentially as a way to uncover hints towards what is causing the fear. Visualization can be used to help calm the person if the session has taken them to somewhere which has caused them distress, whereas working with the stones might be a way to find out whether the fear is linked to one individual, or a group of individuals in particular.

What is important above all, and if not done will render any attempt to help the person useless, is the building of trust. Without trust, the client will not be able to open to their fear in front of the therapist, who will most likely become feared in turn.

large (2)It is important to help the client also understand that the fear they feel is not simply their own, but that of the inner child who has been holding onto that fear potentially for years now. It is very important to comfort the inner child and to teach the client to do the same, and not to belittle whatever it is that their inner child is feeling. Ways to get the client in touch with the inner child could involve the use of photographs from childhood (or old diaries), non-dominant hand writing, or the good parent visualization. It could be helpful to ask the client what would have helped them when they were in that situation and do behave that way towards the inner child where possible.

The therapist could ask questions along the line of ‘Can you remember a time when you felt afraid/safe/anxious?’ as a way to start creating a timeline of when the fear was created. Although this might be difficult for customers who have little to no memories of their childhood. Client willing, there are ways to help them try and retrieve these memories, but it is never guaranteed and there is always the risk of the client going to very dark and uncomfortable, often frightening, places. Again the use of old photos can help jog specific memories, and if the client has any, they could use object or toys from their past to build memories outwards from what they remember regarding the object/toy. Talking to old friends and family can also help.

It is also possible that the fear will prevent the recovery of memories, or that they have simply been lost and as such the therapist will need to work more with the present life of the client instead of trying to heal the wounds of the past. It is also possible that the fear has been created in a more recent past and not in the childhood, and therefore will likely need to be tackled differently. Either way, it is important to help people realise that fear is False Evidence Affecting Reality and that the proper support and love, it can be overcome in most cases.

Book review: The Drama of Being a Child (The Search for the True Self) – Alice Miller

This is actually a book report I had to write for my course, so it might be less of a traditional book review and more of a summary/general impressions I had of the book. Either way it seemed enlightening enough for those who might be wondering whether to read this to post it here. I don’t usually review books that aren’t genre fiction so this feels very odd, and somewhat personal too, but I do hope it will interest those who are intrigued by this field of study and self-discovery!

 

41046HJX0YL._SY344_BO1,204,203,200_Miller offers through her book a fascinating tale of the effects of childhood, not solely on the child as these events take place, but more so on the adult. These events from childhood that have become the invisible strings that guide us through our lives are, more often than not, simply accepted by the adult person as a fact that had little to no consequences on their lives. It is only when as an adult we can look back to our childhood days and not only understand but truly feel what affected us as children, that we can begin to unravel the tangle of fears, habits, and issues that has followed us everywhere we went during our adult life.

Much like emotional therapeutic counselling, Miller recognises the importance of the hurt and lonely child we all carry within us. She emphasises that it is that child’s emotions that make us often react as we do to the world around our adult selves. Because that child is made of so many repressed emotions, so he seeks to either take revenge upon the world, or hide away everything even more. The dialogue with this Inner Child is, to Miller, as intrinsic a part of healing, as it is for emotional therapeutic counselling.

Miller also mentions the importance of confronting those who have caused the hurt during childhood, whether face to face or, if the former is impossible for one reason or another, through a mental dialogue wherein the adult can finally unload the Inner Child’s actual feelings onto the person who has caused them and have a discussion with them. Similarly to emotional therapeutic counselling, Miller does not believe that we can be free of the hurt of our childhood until we have truly felt the emotions that our child-self repressed.

Another element in the book that reminded me strongly of what we had done in the course was Miller’s regular mention of her patients’ dreams and their importance in their therapy. She takes dreams as the subconscious’ way of talking to us, or trying to point where or what the issues might be. She points out in one of her examples how it can be an easy way to track therapy progress as the patient’s dreams change and evolve.

I personally found this read enlightening, especially following what I had already learnt about myself during the course and it shed a fascinating light on some elements of my childhood that has just seemed that they had left me unaffected up to that point. Stories of which I have little to no recollection but have been told about seemed to come back with stark clarity as the emotions I had felt were accessed. It emphasised that it was ok for my adult self to revisit those emotions, to let them happen and face the feelings of my childhood without fear of any consequences. It has allowed me to understand my reactions to certain things that happen around me, as well as turn the emotions elicited towards their true target instead of the situation at hand.

5/5

Like a phoenix rising from its ashes

dusty-room-800-600Hello? Anyone around?

It’s gotten a bit dusty around here, hasn’t it?

I guess that’s what happens after such a long time, dust piles up and then there’s lots of cleaning to do before we can move forward. To be honest I’m surprised this little corner of the Internet didn’t collapse out of existence after being ignored for so long. But I’m really glad it didn’t!

I had all these wonderful ideas of what I could do and what I could post and how I would do it all. Studying psychology at the OU felt like such an amazing thing and I was ready to take on the world, one blog post at the time. This was supposed to be the place where I could express my thoughts, all my ideas and insights born from what I was studying.

This was all created and thought up with the naivety of one who still believes that traditional education is there to teach us how to /think/. I think I had already forgotten my previous stint at university and the painful realization that I was not so much expected to think as I was expected to fit into a mold.

I don’t do molds. The more I am forced into one, the more I push against it. But also the more miserable I become. So not only was I heartbroken that what I was studying was nothing of square_peg_in_round_hole_2what I had wanted, but it contributed (alongside what feels like a million things that life was throwing at me) to me sinking very low into depression.

For a year, maybe more but it all feels like a timeless blur now, I fought and lost against depression. Simple things became hard and the stress only piled on as I fell behind on my studies. Ridiculously to say I was studying a course about psychology, I received little help from my tutors and the course people. So I crashed somewhere at the bottom of a very dark pit, and for a while, I thought I would stay there.

Maybe one day I’ll talk about it, but for now suffice to say that what saved me is the fact that I don’t know how to give up. It’s something I learnt in childhood, but not so much from my parents as from the anime I used to watch. But that’s a topic for another day.

6304953359400960So somewhere along the line I managed to start crawling back up out of the hole. I had withdrawn from the OU and felt very hopeless about my desire to become a counsellor. That was until I stumbled upon this http://www.emotionaltherapeuticcounselling.co.uk/. This is the Foundation for Emotional Therapeutic Counselling. But I didn’t go to them for counselling, I saw instead that they offered training to those willing to learn. So I signed up. Everything about it sounded like what I wanted to learn and become, and so I took a leap and hoped it would work out better than university.

I still remember being very shaky on the phone interview I had to do before being allowed on the course, but I like to think I rocked it, and that my already increased understanding of our emotions/thoughts/psychology stuff really helped!

Let’s add a little bit of context to this though, shall we?

Around the same time I signed up for the course, I got the news that a sister-like-friend was terminally ill with cancer. She had been fighting it for years already, but this time the fight wassydney-grief-counselling-how-to-deal-with-the-loss-of-a-partner going to be over, and she wouldn’t be the victor left on the field. I don’t think there is an age that makes getting this kind of news easier, but being young can make it more difficult. There is nothing in the way we are raised that prepares us to watch someone we love, someone who is around our age, die the slow death my friend was going to go through.

I crumbled all over again, crashed back down at the bottom of the pit, and shattered. I felt hopeless, like nothing would be bright or be the same again.

My brother, Final Fantasy XIV, and kpop, literally saved my life. They were my anchors to reality, my weapons against the darkness of depression. I didn’t think we could win but, somehow, we did.

So a year down the line nearly from the day we got that news, my friend is gone. She died recently, passed away in her sleep to a better place, or a new, hopefully better, existence depending on what you believe. For months already I had lost her as she wasn’t able to live her life anymore, the cancer so debilitating. So the news didn’t come as a shock, but it didn’t make it any harder: having lost her was now official. There would be no miracle to save her anymore.

But she lives on in mine, and her friends and family’s hearts.

weight-loss-plateauAnd for the living, things carry on. Soon I will be working towards my diploma in Emotional Therapeutic Counselling so I can begin practicing. I am more motivated than ever to finish all the many stories I have started writing and I have a gazillion projects I can’t wait to get started.

Somehow, despite everything, I made it back to the top of the pit, and all the hardships on the way up only made me stronger, made me want to take on the world.

So alongside with starting posting here, and expressing the thousands of opinions I have about our inner workings, I am also going to start doing the #100happydays photo project both here and on Twitter/FB page (which will be created especially for this blog!). Why? Because no matter how dark things get, there are always small things to be happy about. I learnt that over the last years, and now I want to celebrate those small things (or sometimes big things) that make me smile every day.

So yes, Ladies and Gentlemen, the Psych Engine is open once again, and this time it is more than ever ready to deliver!