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May 6
2021

Growing Through Grief: You Will Never Feel the Same Again… But You May Become Better

Losing a loved one may shatter your life. You may feel numb. You may feel that you can’t think straight. Every heartbreak that you have suffered previously may hit you full force, simultaneously. At times, the pain can almost paralyze you.

Be patient with yourself. Healing from grief is a slow process. It moves, not at the tempo of technology, but at the tempo of agriculture, as slowly as plants grow. But as you heal, you may discover in yourself new strengths that were not there previously.

In my case, my mother’s death forced me to re-examine my identity and my purpose in life. This exploration eventually led me to seek a master’s in social work. I discovered that my interests include caring for older adults, persons who are nearing death, and persons who are grieving.

Each experience of grief is unique, as unique as you are, and as unique as your relationship with the person you lost. But there are some patterns that humans share. It helps to learn these patterns, as they will help you understand yourself and other persons.

Elisabeth Kubler-Ross’s 5 Stages of Grief

This was the first research model of grief, and it is still used. People do not go through the stages in a neat, sequential way. But they usually experience all 5 emotions, and move in a gradual, bumpy way from shock toward healing.

Denial (shock)—This is the emotional equivalent of an airbag in a car. It protects you from feeling the impact all at once, which could be overwhelming.
Anger—You may protest and feel, “This is terrible! This shouldn’t have happened!”
Bargaining—You may think, “I’m trying to regain some control of my life, when I feel so out of control. If I change my life in such-and-such a way, then I should feel less bad.” A religious person may make deals with God, such as, “Dear Lord, if I start teaching Sunday school, You should make me feel less awful.”
Depression—This stage is not well-named. It’s not depression, but it can look that way. There is a general withdrawing from activities and social life, a conserving of energy. The person may feel powerless, but not hopeless. They are starting to come to terms with the loss.
Acceptance—At this point, you may feel, “This situation stinks. I don’t want it this way. But it’s reality, and I am going to acknowledge it and deal with it as best as I can.”

William Worden’s 4 Tasks of Grief

Again, people don’t go through these tasks in a neat, sequential way. There may be setbacks and cycling. But there is a gradual movement toward healing.

Acknowledge the reality of the loss. State that the person is dead. Describe how it happened, how you learned, and what you saw.
Experience the pain. Face it. Don’t try to pretend that it doesn’t hurt much. It does. Don’t try to dull it out with alcohol.
Adjust to an environment without the person there. The longer that people are in relationship, and the more closely their lives are intertwined, the more adjusting needs to be done.
Withdraw some emotional energy from that relationship and invest it in another relationship. Be careful! You can’t replace one person with another. (We all know a grieving widow or widower who remarried out of loneliness, but chose altogether the wrong person.) Some marriages and other relationships aren’t happy. In this case there may not be much emotional pain after the death. Or there may be intense pain, as the person grieves for a relationship they craved, but never had. Sometimes a loss leads to a new project. A mother whose child was killed by a drunk driver started MADD (Mothers Against Drunk Driving), to try to prevent this tragedy from happening to others.

Corr & Doka’s 5 dimensions of grief

Emotional
Physical—You may feel cold. (When we feel threatened, blood flow goes to our inner organs, and we feel cold.) You may get sick, since grief weakens the immune system.
Spiritual—Grief may impact your belief system.
Social—It may be hard to socialize, as some people may misunderstand you, or say clumsy things.
Cognitive—You may have poor attention, poor concentration, or difficulty learning new material. Some children who are grieving are diagnosed incorrectly as having ADHD. When these children heal from grief, they do not show ADHD behavior. (This research study was my professor Dr. Helen Harris’s doctoral dissertation.) Some older adults who are grieving fear that they have dementia; but when they heal from grief, they can think just as well as they did before the loss.

Alan Keith-Lucas’s study of children’s resilience after a loss

Shock and denial: After a significant loss, every child experiences shock and denial. Then there are 2 different paths:

Protest: If the child is allowed to have and express the feelings, “No! This is unfair! This can’t be!” then the child can achieve “mastery,” becoming stronger than before the loss. The key is for the child to learn to express their feeling of anger in a way that doesn’t hurt themself or anyone else.
Despair and Detachment: If the child is not allowed to protest, the child falls into despair and detachment. These children are not troublesome. However, as adults, they may not function very well. They struggle to keep a job or stay in a relationship.

Books—Some of my favorite books about grief are:

Doka, Grief is a Journey
Neeld, Seven Choices: Finding daylight after loss shatters your world
O’Brien, The New Day Journal
Wings of Change Publications, The Nature of Grief: Honoring and Healing the Seasons of Loss.

Are you currently grieving?

We experience grief not only when a loved one dies, but also when we lose anything that is important to us, such as our health, a job, or a treasured relationship. If you are grieving, it would be my honor to share your journey with you. Grief is too hard a journey to travel alone.

[I wish to thank Dr. Helen Harris and Dr. Richard D. Grant, Jr., for teaching me the above material.]

*Written by:* *Catherine C. Stansbury,* LMSW, supervised by Melissa L. Gould, LCSW-S. Catherine is a therapist here at Austin Family Counseling. She is an EMDR Trained Therapist specializing in trauma therapy for adults. She has a Master of Social Work from Baylor University, where one of her internships was in a hospice agency. She is a PAC Certified Independent Consultant, trained by the *Positive Approach to Care organization; a Certified Practitioner of the MBTI, trained by* *The Myers & Briggs Foundation; and an associate member of the* *Aging Life Care Association*.

Apr 22
2021

4 Things Parents Should Know About Child Therapy

As a therapist who has worked primarily with children for the past two years, a common theme I have noticed with parents and caregivers is their misconceptions and misunderstandings of what the therapy process can look like for children. Therapy for children and therapy for adults is completely different and understanding these differences can not only clear any mistaken beliefs that parents may have about child therapy, but also set realistic expectations for how the therapeutic process may develop.

1. Communication

Children cannot always communicate clearly and/or effectively about how they are feeling or what they are thinking in the way verbal adults can. Using words is not the only way that children need or have to communicate in the therapy room. Play therapy is one of the most commonly used modalities when working with children because it relies on play, a child’s natural way of communicating. Play encompasses a wide range of activities, a few being: imaginative play, board games, nature explorations, creative visualizations, storytelling, legos, dancing, and role playing.

2. Trust and Safety

One of the main duties of a therapist is to establish and maintain safety. Creating a space that is judgment free and accepting is one of the ways therapists strive to create a sense of safety in the therapy room. This can be especially challenging with children because it relies on them to purposefully take down their guard and trust the therapist, which is why therapists spend most of their time focusing on building strong rapport with their younger clients. When a strong therapeutic relationship is created between the client and therapist, it allows for more trust and communication.

3. Privacy

It goes without saying that children under the age of 18 are considered minors and because of that their parents are entitled to know anything and everything that happens in session. However, barring any danger or physical harm to the client or to others, some therapists may ask parents to agree to the therapist’s confidentiality rules before they will treat the client. In doing so, therapists are increasing cooperation in therapy, protecting their clients from the risk of abuse, and maintaining a sense of safety and trust in the therapeutic relationship. Some parents may feel concerned about their child’s therapist not telling them everything that transpires in session and that is a valid concern to have. When therapists preserve their clients’ confidentiality and privacy, their intention is not to create a one-sided relationship between client and therapist, but rather to encourage communication and trust in the counseling room, which can then progress to relationships outside of it.

4. Trusting the process

It is not always easy for parents to trust in the therapeutic process. Parents are paying for their child to get help and when change does not happen as quickly or acutely as they would like it can be disheartening. Additionally, the idea of not always being able to know what is happening in their child’s therapy can create feelings of separation and disconnection. Ultimately, when parents understand that therapists share the mutual goal of providing help and healing for their child then any concerns or apprehensions about the process can dissolve.

It is unreasonable for parents to expect their children to openly discuss everything that occurs in session. Children in therapy need to know that what they say or do in therapy will be upheld by confidentiality. If a child knows that what they share in their sessions will be shared with their parents then they would be less willing to attend therapy and get the needed help. Trusting their child’s therapist to share important and general information about the happenings in the therapeutic process is a vital part of the child’s healing and effectiveness of therapy. When an open line of communication is created between parents and therapists, therapists can listen to any concerns that parents have and offer appropriate suggestions which can aid in the healing process.

Written by: Geetha Pokala LPC-Associate Supervised by Kirby Schroeder LPC-S, LMFT-S

Apr 15
2021

The Container You Create

With the rise of telehealth and the quick ubiquitous implementation of it, and then the long year that has followed; it might be a good time to pause and consider how your therapeutic container is treating you.

One marked benefit of hosting sessions in your own space is the fluidity with which therapy can exist in the midst of your daily life. Being in your space means being around your preferred creature comforts (including possible “therapy animals”). This shift means skipping the commute to the office, creating possible ease in childcare or work/school scheduling.

There are also noted drawbacks to this technological switch.

Pre-Covid, there was a certain ritualistic bookending on either end of the session that occurred by way of driving or walking to the office, sitting in the waiting room, then traveling to your next destination. There was inherently a moment for reflection and integration. On the front end, preparation time was available- a review of the week, or of existing material. Post-session, there existed a buffer between what came up in session and whatever real-world situation required your immediate attention. If something difficult arose or trauma processing occurred, that time and space enabled a somatic come-down before the stressors of the day reared their incessant heads.

Now, when working over a telehealth platform, it is not uncommon to jump from work into session then back into life mode, and vice versa.

Here are some considerations to create appropriate space and get the most out of your sessions and reclaim the quiet spaces that used to buttress session:

– To prepare for session: Dedicate a space in your home for this time. If possible, make sure not to be backlit, and sit in a comfortable seat. Have a glass of water and blanket within reach. Whenever possible, use this dedicated space for each appointment.

– Ensure you have a sonically private space where there won’t be intrusive noises and no one is within earshot

– Plan for at least 15 minutes prior to the session to prepare. This might look like making some tea, taking a walk, free-writing, or some form of creative expression

– During the session: turn off your self-view. If using a platform that enables the removal of your tiny thumbnail mirror, I suggest it. Not only is it distracting, but it potentially feeds the part of you that might be tempted to ensure you’re doing therapy “right.”

– After the session: instead of closing the computer and heading back into your life of working, emailing, parenting, or erranding— make a conscious choice about what this transitional moment looks like. Can you use another 15-minute pause prior to quotidian demands beckoning?

– Grounding both into session and after the session as a form of aftercare is an integral part of this work. You can enlist your therapist for some specifics here based on what you’re working on

Reflect on what this switch has meant for you— what are you missing from in-person sessions? What is working better for you remotely? The space itself, no matter its iteration, is part of the therapeutic processing—this can be a topic you internally and externally and consciously explore within the therapeutic realm.