Grief

Grief is emotional suffering or bereavement at the death of a loved one. There is no right or wrong way to grieve. There is no timetable for grieving. It is a process we navigate in our own way, at our own pace. Yes, it’s alright to cry. In fact, crying seems to release some of the heaviness of sorrow.

Grieving is an intensely personal emotion that may be colored by guilt, regret, anger, sadness. Some people withdraw, become helpless, disengage from the business of living, while others cannot sit still, and express their grief in activity.

No matter the presentation, we need patience, courage and strength, as we go through the stages of the grieving process. Elisabeth Kubler-Ross outlines 5 stages in the grieving process:

  • Denial, the initial response, is protective and serves to keep us from being overwhelmed by the loss. This stage may last a few minutes, hours, or days.
  • Anger, a tool we use to make sense of, and cope with, the reality of the loss. We may feel anger at ourselves, at God, at the deceased, at life in general for the injustice of the loss, especially if it is unexpected, as in the case of the death of one’s child.
  • Bargaining, in which we promise to do something in exchange for having the lost person returned to us: “If I devote my life to helping others, can I wake up to find this was all a bad dream?”
  • Depression, often the most painful stage, comes when we realize the finality of the loss, that there is no turning back.
  • Acceptance comes from coming to terms with the fact that our loved one has gone, and beginning to reorganize our lives around this new reality.

Others have delineated 7 stages of grief. These are shock, anger, guilt, anxiety, physical, behavioral and cognitive symptoms, suffering, and recovery.

  • Shock or numbness, the initial reaction, protects us from being overwhelmed by the loss.
  • Anger, a normal part of grieving, as explained above.
  • Guilt is a common reaction to failing to do something before the loss or perhaps doing negative things before the loss; for example, not saying “I love you,” being unkind, not apologizing for causing hurt, or any action not taken that we perceive may have prevented the loss;  
  • Anxiety, either mild insecurity or panic attacks, about our ability to take care of ourselves, and about the well-being of other loved ones;
  • Physical, behavioral and cognitive symptoms occur. We may become fatigued, may experience loss of motivation, changes in eating and sleeping patterns, may no longer enjoy activities that used to be pleasurable, may become confused, preoccupied, be unable to concentrate;
  • Suffering, often the most painful stage, is the long period of grief during which we come to terms with the loss. Suffering includes sadness (the most common aspect of grief), and may be experienced as emptiness and despair. It is expected that the physical and emotional symptoms will stabilize and diminish over time as we move through the grieving process. If they do not, professional help is recommended.
  • Recovery is the goal of grieving. True, we continue to experience feelings of loss, and the occasional wave of sorrow that hits us like a bolt out of the blue. However, as we reorganize our lives, we are better able to accept the loss, integrate it as one important aspect of life. As we do, we are enabled to resume living.

The loss of a loved one is a painful experience. It requires us to be gentle with ourselves, to accept support, and to go on sharing our lives and memories of our deceased loved ones with family and friends.

Don’t be afraid to seek support during this difficult time, whether this is through your family, friends, hospice, or a licensed therapist. We can help you through this; you don’t have to suffer alone.

 

Written by Pansy Lindo-Moulds, LMHC

Stress

I believe that the most important word in the phrase “mental health” is “health.” There was a time when people felt a stigma associated with seeing a psychologist, psychiatrist, or counselor. Admittedly, until recent years, mental health was not always portrayed in a positive light in the media or in our communities. If someone had not experienced positive interactions with a mental health provider either directly or through family members, then there may have been a reluctance to try the unknown.

The concept of health is really a mind and body comprehensive approach. The reality is that our mind is a part of our body, and impacts our physical and emotional well being. Think about the concept of stress. Let’s take a tangible object like a paper towel. Stretch it out and keep pulling. The stress from pulling it, even gently, will begin to tear the paper towel. Add something else from the environment such as water to the paper towel and it will fall apart more quickly. Add something heavy on top of it, and we are certain to see it fall apart.

Now, let’s take the physical body. Add some stress. Pull at it with the loss of a loved one, sudden illness or injury, change of life, coping with chronic illness, work-related stress, financial stress, relationship stress, time management of life with many responsibilities, etc….. During those times, we often hear of people experiencing sore shoulders, headaches, stomach aches and digestive problems, weight gain or loss, increased blood pressure, insomnia, anxiety, and depression. What came first? Truthfully, it could be either. Sometimes physical problems contribute to emotional distress and sometimes the emotional distress can lead to physical problems.

Certainly, there are a variety of avenues of support for well-being, to include self-help books, community support groups, exercise, healthy diet, and social activities to name a few.

Why see a mental health professional? If you are struggling with managing symptoms and overall health, the question really is, why not? Regardless of which came first, quality, competent mental health treatment may alleviate or reduce both psychological and physical symptoms. A mental health provider can provide skills, support, and collaboration with your medical or psychiatric health care provider to provide a comprehensive approach to your overall health and well-being.

 

Written by Michelle Zalenski, PsyD

Group Therapy

Group therapy is a powerful tool. Effective group therapy provides psycho-education, gives members permission to talk about their fears, and to receive feedback and support from others who are in the same boat, so to speak!  As early as 1895, the French social psychologist, Gustav LeBon referred to the “group mind.” At about the time, William MacDougall, an Englishman, also saw that groups can affect individual behavior.

Effective group therapy takes place when an environment of trust has been established, which facilitates group members’ ability to share issues of concern in the here-and-now, and to be supported. That is, to allow people who are struggling with the same or a similar issue talk about how they manage symptoms on a day-to-day basis, about the tools they find effective in coping with such feelings (anger, guilt, helplessness, hopelessness, or other issues), and that help to improve their quality of life. The role of the therapist is to facilitate the process and to encourage members to apply lessons learned in group to everyday living.

As with any organism, the group goes through a developmental process:      

1) Form, at the beginning                                                                                

2) Storm, when members vie for power and control                                          

3) Norm, when members develop group rules or norms, leadership becomes shared by group participants, and the facilitator can assume more of a peripheral and less active role.                                                                       

4) Perform, when differentiation of members is respected, open feedback is expressed and shared, and members work together.                                      

5) Adjourn, when the group terminates.

As a prerequisite, group members are required to sign an Informed Consent for Group Therapy. While confidentiality cannot be guaranteed, it is understood that whatever happens in the group stays in the group so that participants will feel safe enough to talk about what they perceive as their most uncomfortable issues, and to respectfully challenge any therapeutic intervention that does not resonate with them. In the same way, the therapist does not take personally members’ disagreements, but welcomes questions and perspectives as valuable resources for promoting group cohesiveness and social learning.

 Seven qualities of successful group therapy have been identified (Yalom, I & Leszcz, M. (2005). The theory and practice of group psychotherapy. New York: Basic Books):

1) Installation of hope – if group members expect help, a positive therapy outcome is more likely.

2) Universality – hearing others’ stories and sharing their own promotes group members’ understanding that they are part of a community with the same or similar issues, so that members don’t feel so alone.

3) Imparting information – the therapist gives factual information on issues of concern, and members share advice in an environment of mutual support and respect.

4) Altruism – a “must have” component: giving and receiving help is intrinsic to the healing process: people need to feel they are needed.

5) Corrective Recapitulation of Primary Family Group – the therapist and group members help participants become unstuck from early traumas, and assist them to reframe early family conflicts correctively. For example, the member is helped to process, from an adult perspective, childhood or other trauma that disrupted the developmental process, and to adaptively realign the process.

6) Development of Socializing Techniques – group members learn basic social skills, and gain an understanding of the vast difference between their intentions and their actual impact on others.

7) Imitative Behavior – group members imitate and learn from each other, identify with more senior members of the group or with the therapist, find out what they are not, and also what they are.

Participating in group therapy can appear intimidating, but the group can be a wonderful support network as well as resource for ideas for dealing with a particular life situation or challenge.

Group therapy is, indeed, a powerful healing tool which all participants can access, and influence, and in which all participants are equal stakeholders!

 

Written by Pansy Lindo-Moulds, LMHC