Time does not heal action does!

Transcription

1 Time does not heal action does! Identifying and treating grief and loss issues in early recovery. What is the first thing you think of when I say the word GRIEF? 1

2 Loss? Sadness? Separation? Change? Anguish? Ache? Hurt? Grief Stages? Tasks? Symptoms? Normal? Complicated? Pathological? Adaptive? Emotional Mental Social Spiritual Physical Grief is an Response to loss. A normal and natural reaction to loss of any kind. Grief is the conflicting feelings caused by the end of or change in a familiar pattern of behavior. James, J.W. & Friedman, R. (2009). The grief recovery handbook: the action program for moving beyond death, divorce, and other losses. New York, NY: HarperCollins 2

3 1. Don t talk about it Grieve alone 2. Don t feel bad Don t cry, don t show emotions 3. But if you don t cry, it means you didn t care 4. Just give it time grief should only last a year 5. Have to be strong for others 6. If it hurts, use sugar, fat, nicotine, alcohol, drugs or work real hard to feel better - and ignore, joke about, or deny that you're doing this. What about stages of grief? Denial Anger Bargaining Depression Acceptance 3

4 Elisabeth Kübler-Ross, M.D On Death and Dying Interviewed 200 patients Patients had been told doctor they had a terminal illness Kübler-Ross, E. (1969). On death and dying. New York, NY: Macmillan Publishing Misunderstanding The stages have been very misunderstood They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have but there is not a typical response to loss, as there is no typical loss Kübler-Ross, E. & Kessler, D (2005). On grief and grieving: finding the meaning of grief through the five stages of loss. (p. 8) New York: Simon & Schuster. Potential Harm the word stage implies that time is a component. The suggestion to grievers that they are in a stage can freeze them into inaction waiting for time to make that stage pass. There are no stages of grief. But people will always try to fit themselves into a defined category if one is offered to them. Sadly, this is particularly true if the offer comes from a powerful authority such as a therapist, clergyperson, or doctor James, J.W. & Friedman, R. (2009). 4

5 1. Death 2. Divorce/End of a relationship 3. Financial Change 4. Job Loss 5. Loss of health 6. Pet Loss 7. Legal Problems 8. End of Addiction 1. Loss of Trust 2. Loss of Safety 3. Loss of Control 4. Loss of Identity 5. Loss of Childhood 6. Loss of Spirituality 5

6 I don t ever want to forget Incompleteness Those things that we wish had been better, more or different in the relationship with what we lost. James, J.W. & Friedman, R. (2009). Loss History Graph Relationship Graph Recovery Components Apologies, Forgiveness, Emotional Statements Completion Letter 6

7 Loss History Graph Which losses are incomplete? 1. If you are unwilling to think or talk about the loss. 2. If fond memories turn painful. 3. If you only want to talk about the positive aspects of the relationship. 4. If you only want to talk about negative aspects of the relationship. 5. If you have fear associated with thoughts or feelings about the relationship. Indications of Unresolved Grief caused by Incompleteness. Relationship Graph Line up is POSITIVE Line down is NEGATIVE 7

8 Completion Letter Apology: Make apologies for something that you may or may not have done that hurt someone else, or harmed the relationship. Completion Letter Forgiveness: Forgive the person you lost for the things they did or did not do that were harmful to you. If you have difficulty with the word forgive, say something like: I acknowledge the things you did or did not do that hurt me, and I m not going to let the memory of those things hurt me anymore. 8

9 Completion Letter Significant Emotional Statements: Put into words the thoughts and feelings that you were not able to say because you lost the opportunity when you lost the relationship. 9

10 Completion Letter Dear Dad, I ve been thinking a lot about our relationship, and there are some things I need to say. I need to apologize for I forgive you for the times you Alternatively, Dad, I remember when you, and I m not going to let that hurt me anymore. Dad, I want you to know (significant emotional statement) I love you and I miss you. Goodbye Dad Alternatively, I have to go now, and I have to let go of the pain. Goodbye Dad Counselor Skills Ability to deal with own losses. Awareness of the different losses clients may bring Understanding that each client s grief is uniquely different. Recognize the healing power of simply listening to the client tell the story of their loss. Understanding of the losses associated with trauma. Understanding of the relationship between relapse and loss Understanding the importance of effectively terminating the therapeutic relationship. 10

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