Techniques of Grief Therapy: Assessment and
Intervention
The Book Brigade talks to psychotherapist Robert A. Neimeyer.
Posted Sep 03, 2015
Source: Robert A. Neimeyer, used with permission of the author.
Everyone experiences loss of some kind. ItÕs often the
hidden element behind the way we cope with relationships and transitions all
our lives. Throw out the idea that youÕre destined to experience specific
stages of grief. New research suggests there are many ways we experience grief,
and many sources of wisdom on the subject.
What was your
main purpose in working on this book?
Ever since the work of Elizabeth Kbler-Ross on the
"stages of grief" in the late 1960s, many clinicians have taken it
for granted that bereaved clients need three things, all of them fairly vaguely
defined: support, a chance to express their feelings, and a
"normalizing" of their experience. Contemporary theory and research
seriously challenge the adequacy of a stage model of grieving and offer in its
place much more solid and nuanced models for understanding mourning: as a process of
reconstructing a world of meaning challenged by loss, reworking the nature of attachment to the deceased, realigning family roles, engaging
the realities of a changed social sphere, and more.
Significantly, these new models also imply new methods
for working with grief, suggesting a great range of increasingly
research-informed procedures for helping clients to deal with the profound
psychological, social, and sometimes spiritual issues that the death of a loved
one can raise, especially when that death is premature or traumatic. One goal of the book was to make these new ideas and
methods much more readily available to practicing clinicians.
Another was in some sense the opposite: to share
the clinical wisdom of therapists "in the trenches" not only with one
another, but also with researchers who are rarely privy to the actual practices
of grief therapy in field settings. In the dozens of
workshops I conduct annually with literally thousands of therapists around the
world, I am constantly struck not only by the compassion and commitment of my
clinical colleagues but also by their creativity. By offering a book packed with 66
short chapters conveying specific techniques in clear detail and illustrating
them in a brief case study, I hope to convey these practices in the voices of
their originators. The result is a cornucopia of clinical tools that can assist
therapists dealing with trauma and loss of many kinds, and also invite the
attention of clinical researchers to a great range of promising procedures that
deserve greater documentation.
Who would most
benefit by reading it?
Well, I'm tempted to say that Techniques of Grief
Therapy: Assessment and Intervention belongs on the shelf of both
experienced clinicians and those just beginning to delve into the field of
grief therapy. But I'll leave that ambitious statement for the back cover!
Perhaps it is enough here to say that it is most relevant to therapists who
find that their clients are presenting with themes related to profound loss,
either imminently, as they face the looming death of a loved one, or as they
continue to deal with the complicated implications of a loss for their ongoing
lives, maybe many months or years after the death itself. The therapeutic goals the book addresses include assessing bereavement, attending to the body, working with emotion,
reconstructing the self, re-storying narratives of loss, reorganizing the
continuing bond, mobilizing systems, and facilitating group work. In other
words, therapists interested in any of these aims in therapy should find the
book a good companion.
Why is it so
important to integrate various viewpoints and experiences—from theorists
and researchers to hospital workers and other care professionals?
Taking an integrative view of grief therapy is
important because loss, in its many forms, is a pervasive dimension of human
life. When we pause to think about it, every person, every place, every
project, and every possession that we love, we will lose, at least in an
earthly sense. By the time they arrive in our offices, most of our clients have
already lost many and much, whether these losses feature as the presenting
problems they bring us or the yet-to-be-discovered backstory that has shaped
how they have coped with relationships and transitions for a lifetime. Given
the ubiquity of loss, it is not surprising that it is a focal issue in many
clinical contexts, ranging from hospital settings to children's bereavement
centers, and from faith-based grief support groups to
psychotherapists' private practices. It only makes sense, then, to harvest the
contributions of thoughtful and innovative practitioners in all of these
settings.
Could you
describe one or more of the contributors to whom you turned first to provide
his or her perspective?
With 75 contributors, most of whom I am privileged to
call friends, I'm hard pressed to single out a handful as representative.
But I'll play rather than pass. Clinical scholars like Kathy Shear,
Camille Wortman, Simon Rubin, and Laurie Ann Pearlman are among the several
prominent theorists and researchers who are pushing the boundaries of grief therapy
by deeply mining the implications of attachment theory, experiential therapies,
and traumatology to offer novel insights and procedures to guide therapists
working with prolonged, complicated grief. Equally, creative clinicians like
Lara Krawchuck, Gail Noppe-Brandon, Anthony Papa, and Yasmine Iliya offer
original and in some cases research-vetted techniques for facilitating client resilience, self-discovery, resolution of ambivalence, behavioral
activation, and strengthening of bonds with the loved one, while embracing the
necessity to change. Basically, I used the "wow" factor to guide my
choices of who to approach: If someone was doing something that wowed me, as a
seasoned therapist who has practiced for 35 years, I invited them to join the
party.
You wrote or co-wrote several of the bookÕs chapters.
Can you tell us a bit about some of these and what you hope readers will
take away from them?
Sure. In the
opening chapter, I joined my colleague Joanne Cacciatore in pushing my work in
meaning reconstruction in new directions by positing a model of grief as a
developmental challenge in adult life. We traced the trajectory of adaptation
after a profound loss from the early weeks of "reacting" to the
questions posed by the death through the subsequent months of
"reconstructing" a viable connection with the loved one and
ultimately to the years of "reorienting" to the new sense of self and
world that life transitions often entail. At each point, we conceptualized a
characteristic "crisis" faced by the bereaved (e.g., connection vs.
isolation, meaning vs. meaninglessness) and attempted to spell out the
existential questions with which mourners wrestle, as well as their associated
psychosocial needs and illustrative therapeutic techniques of relevance to each
crisis. Our intent was to help other practitioners grasp a given client's need
and readiness more clearly, and have a sharper intuition about how this might focus subsequent therapy.
In other
chapters I joined colleagues like Laurie Burke, Jane Milman, and James Gillies
in describing different scales for assessing client's struggles with meaning in
both secular and spiritual spheres, offering these validated scales and scoring
instructions freely for the use of both practitioners and researchers.
Elsewhere, writing on my own or with Diana
Sands, I described my preferred procedures for helping clients disentangle
multiple losses suffered in a short period, leaving them in a fog of
bereavement overload, or for helping support groups contain the sometimes
re-traumatizing stories of a loved one's violent death that can otherwise
overwhelm other group members. Like the dozens of other contributors offering
specific tools for addressing specific problems, I found these chapters
especially satisfying in providing "news you can use" in the concrete
context of clinical practice.
Is there any
topic or set of topics that you think grief therapists and researchers have
misconceptions about?
Actually, I think that grief therapists are a pretty
savvy group: They've typically stood close to the existential void of tragic
loss with countless clients, and developed a sense of presence, process, and procedure
that helps clients integrate profoundly unwelcome life transitions. Researchers
I'm not so sure about! All kidding aside, there are plenty of intelligent developments in the academic study of bereavement as
well, but also some shared blind spots. All of us, clinicians and
researchers, can fall prey to thinking of grief as simply a negative emotion to
be expressed or regulated, rather than deeply explored, valued, and used to
prompt a deeper sense of compassion for ourselves and others, or a clearer
sense of what has meaning in life. One of the things I value about many of the
chapters in the book is their affirmative approach to grieving as something
that is not only painful but also potentially productive.
What do you
hope readers will gain from the book as a whole, relative to other (or older)
works on grief therapy?
I hope readers will become wiser, more incisive, and
more effective therapists to clients struggling with life-vitiating loss.
Period.
What is the
most surprising or profound thing you discovered in working on the book?
The most surprising thing was not so much a discovery
as a rediscovery: the recognition that as human beings we are wired for
attachment in a world of impermanence. What became clear to me in
compiling this book was that this same recognition animates countless
clinicians to reach deeply into their preferred theories, personal intuitions
and accidental innovations to craft creative responses to our universal
encounter with anguishing loss. Ultimately, I hope that sharing these
practices with readers will enrich their engagement with loss and grief, as it
has my own.
About THE AUTHOR SPEAKS: Selected authors, in their
own words, reveal the story behind the story. Authors are featured thanks to
promotional placement by their publishing houses.
To purchase this book, visit:
Techniques of Grief Therapy: Creative Practices for Counseling the Bereaved
For more information on Robert A. Neimeyer's teaching, training, research and practice, check out his website
Source: Courtesy of Routledge