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If you go to the books page on Amazon and enter the word “grief” in the search box, you’ll receive a message saying there are “over 60,000 results” available.

To winnow the choices, you might decide to view only those titles released over the past 90 days. This narrows it down to “over 10,000 results for ‘grief.’’’

Titles published in the past 30 days? “Over 5,000 results for ‘grief.’”

Finally, if you click on books “Coming Soon,” you receive a somewhat manageable “541 results for ‘grief’” (at least that was the case as September drew to a close).

This prodigious output would seem to support the statement that grief is a universal and yet very individualized experience — one that continues to captivate and challenge us as humans. The ever-increasing numbers of books, journal articles and other reports on grief and loss also hint that our thinking about this experience continues to evolve.

Counseling Today recently invited several American Counseling Association members with in-depth knowledge in the area of grief and loss to share their insights on specific aspects of grief that they believe to be largely overlooked or misunderstood. 

Maintaining continuing bonds with the deceased

By Kenneth J. Doka

In recent years, there have been significant challenges and changes to the understanding of grief. These changes include such aspects as:

• Extending the understanding of grief from reaction to a death of a family member to a more inclusive understanding of loss
• Acknowledging that there are no universal stages in grief and recognizing the very personal pathways that individuals take when experiencing loss
• Recognizing the multiple and multifaceted reactions that people have toward loss (rather than seeing grief as primarily affect) and the ways that responses to grief are influenced by culture, gender and spirituality
• Seeing the possibilities of transformation and growth in mourning rather than coping passively with loss
• Moving from understanding grief simply as a normal transitional issue to recognizing its more complicated variants and the necessity for careful assessment
• Acknowledging that certain individuals show great resilience as they cope with loss and grief
• Maintaining a continuing bond with the deceased rather than pushing to relinquish ties to the deceased 

It is this last area of continuing bonds where I wish to focus. Sigmund Freud, over a century ago in Mourning and Melancholia, argued that bereaved individuals must detach from the deceased by withdrawing emotional energy from the person who has died and reinvesting it in others to go forward with a healthy life. 

This notion has been deeply challenged in recent years. In their groundbreaking 1996 book Continuing Bonds: New Understandings of Grief, Dennis Klass, Phyllis Silverman and Steven Nickman drew on research with bereaved children, spouses and parents, as well as teachings of Eastern religions, to both emphasize and demonstrate the importance for many bereaved persons and groups to maintain an ongoing connection to the individual who has died. They stressed that connections of this type were comforting and eased the grief of those who were bereaved.  

Bonds are maintained in several different ways. First, we always retain memories of the deceased. This is critical. Many bereaved individuals fear that as they cope with loss, those memories will fade. This exacerbates their sense of loss and impedes the grief process. Counselors should affirm to clients near the beginning of grief therapy that the goal is not to diminish memories of the deceased but rather to help them find comfort in such memories as the pain of loss lessens. The amelioration of grief means that over time, the intensity of the grief experience lessens, and individuals function in ways comparable to (or perhaps even better than) the way they did prior to the loss.  

The fact that these memories are always retained is also a reason for subsequent surges of grief that may occur years after the loss. For example, think of a young woman whose father died when she was a little girl. Two decades later, as she walks down the aisle to be married, she has deep pangs of grief that her dad is missing this event. In fact, at the termination of a counseling relationship, it is helpful to suggest, and even to identify, the significant life events or major transitions that might generate such surges of grief in clients.

Second, important attachments become part of one’s own biography. We are influenced by so many factors. The ways that one interacts with others who are important in one’s life frame an individual’s personality. In addition, significant attachments in one’s life leave their legacies, and sometimes their liabilities, on the identity of the bereaved individual. Those legacies (and sometimes liabilities) can include everything from personal gestures to beliefs to the ways that one views self and relates to others and the world. 

Third, survivors retain spiritual ties such as the belief that the deceased is interceding for them (or will intercede) and that they will be reunited in an afterlife. Many spiritual systems have beliefs and practices that strive to retain a connection with the deceased, such as Roman Catholic Anniversary Masses or the Jewish Mourner’s Kaddish — a prayer said at the memorial service as well as for 11 months following the person’s death. In fact, Klass’ interest in Eastern religions was one influence on the development of his theory. Klass pointed out that in traditional Chinese worship, the veneration of one’s ancestors was a common practice that served to reinforce a continuing family bond across generations.

Furthermore, many bereaved persons report extraordinary experiences in which they have sensed the continued presence of the deceased in their lives, whether it is dreaming about the deceased or other ways in which they believe they have encountered the deceased. Such experiences are, in fact, quite common in bereavement.

Finally, increasing numbers of bereaved persons are using the internet and social media, particularly Facebook, to provide death notifications and to continue ongoing relationships with the deceased. For example, they may visit the Facebook page of the person who died, comment there on pictures, post memories and even leave messages to the deceased. It is not unusual for mourners to “keep alive” the digital identity or Facebook page of a person who is deceased. 

Continuing bonds can be applied to groups, communities and even nations. Communities may name parks, streets or buildings after individuals or erect memorials to the person. Nations may honor ties with deceased leaders by naming cities after them and building monuments or establishing holidays to celebrate them.

While continuing bonds are generally healthy, they can at times be problematic when we fail to acknowledge the death or are burdened by promises made to the deceased prior to death. For example, one client, a young widow, promised her spouse prior to his death that she would never remarry. Now she feels torn between her promise to her dead husband and her desire to engage in a new romantic relationship. 

Continuing bonds are natural and normal responses in bereavement. Yet we need to guide clients so that these bonds do not become chains that inhibit their adaptations to loss and perhaps even their personal growth.

— Kenneth J. Doka is professor emeritus of counseling at the College of New Rochelle and senior vice president for grief programs at the Hospice Foundation of America. Contact him at kndok@aol.com.

School counseling: Grieving children and adolescents

By Jillian M. Blueford

We often see grief as a common reaction to loss, but at times we try to separate it from who we are and who we want to be. We treat grief the way we treat many life stressors, tending to what is most immediate in hopes that one day, that stressor will be a thing of the past — something we have “overcome” or “persevered” through. However, grief involves a lifelong shift that does not work on a timeline or according to expectations. 

This experience is especially true for children and adolescents, who are not immune to grief and who could have a longer time to navigate their grief while anticipating additional losses in the future. Grief can permeate every aspect of life, and it affects children and adolescents in ways that are as unique as they are during these fast-moving developmental stages. Reflecting on my professional experiences counseling grieving children and adolescents, I have yet to encounter two young people with the same grieving response.

Although we have established that a child’s or adolescent’s response to loss will vary and can appear at any time, we can expect for their grief to influence their presence at school. School is a significant part of many children’s and adolescents’ upbringing. So, naturally, their grief might make an appearance in the classroom, in the cafeteria, on the playground, at sporting events, during choir performances, at club meetings and elsewhere. 

This also means that school counselors may be called on to provide services. These services are often introduced after a school staff member is made aware that a student has endured a death-related loss. According to Judi’s House/JAG Institute, 1 in 14 children in the U.S. will experience the death of a parent or sibling by age 18. This statistic does not account for the deaths of other family members, friends or community leaders, nor does it cover the nondeath losses that children and adolescents endure (e.g., moving, separation of caregivers, pandemics, changes in health, financial instability). COVID-19 has shone a light on some of these losses, but the truth is that many of these losses happen so frequently that we do not recognize these changes as they happen, nor do we seek to understand how children and adolescents grieve these losses long term.

In my experience providing counseling services in schools and outpatient settings, I have often been asked, “What does grief look like for children and adolescents?” I perceive this question to mean “what behaviors stand out for grieving children and adolescents?” But I tend to shift the focus to time and circumstances. 

When we first encounter a loss, it can throw many of us for a whirl. Our appetite, sleep patterns and engagement level with our relationships may be affected. It is typical and expected to be bombarded with an influx of thoughts and emotions. This is no different for children and adolescents who experience a loss.

Furthermore, I expect the academic performance of children and adolescents who are grieving to change. I expect them to become more distracted in class, to potentially distance themselves from others, and to ask more questions about death and the safety of their world. I particularly try to understand how recently the loss occurred and the relationship or attachment the child or adolescent had with what they lost (e.g., a person, experience, material item, health). Those markers give me a better idea of how the child or adolescent has been responding and areas within their grieving process that negatively affect their daily activities over time.

If we tend to focus only on the losses that children and adolescents endure during an academic year, then we may forget to ask about their history of losses. Having this information can help us conceptualize current grieving responses that may otherwise feel sudden and unusual. Understanding the timing also helps illuminate “re-grief,” or the understanding that as children and adolescents mature, their recognition of their losses will change. This can lead to a resurgence of grief, especially as children and adolescents reach developmental milestones, many of which happen while in grades pre-K-12. 

On top of the other responsibilities that school counselors have, fully addressing a child’s or adolescent’s grief can be overwhelming. Given that grief does not have an end date, engaging with grieving students is an ongoing responsibility and requires different care and attention levels. School counselors may believe they have already put in intense effort to support a grieving child or adolescent, but in fact this effort requires a lot of ongoing listening, empathy, validation and education.

Any adult can benefit from a refresher on how children and adolescents respond to a loss. I have seen these educational conversations make all the difference when students are mislabeled as “problematic” but are really just having a difficult time with their grief. Caregivers and families, who are often grieving themselves, can especially benefit from understanding the unique aspects of child and adolescent grief. School counselors should identify resources and strategies that adults in other environments can use as well. 

The organizations listed below provide curricula, podcasts, interactive activities and strategies supported by data. Share these resources with families and any adult who interacts with children and adolescents.

• Coalition to Support Grieving Students
• Judi’s House/JAG Institute for Grieving Children and Families
• The Dougy Center
• National Alliance for Children’s Grief
• National Center for School Crisis and Bereavement
• Grief-Sensitive Schools Initiative

In addition, connect with local counseling professionals, particularly in bereavement settings. Often, these organizations will host grief camps and services for children, adolescents and their families at little to no cost. They can also serve as consultants to supplement your understanding of grief and loss and perhaps provide in-person individual and group services.

My first experience providing counseling was through my time as an intern for a hospice bereavement center. In visiting schools and facilitating grief groups, a passion was sparked in me for addressing grief and loss. It was the school counselors who often advocated for our services, referred families and empowered grieving children and adolescents to believe that they were cared for and not alone in their grief. 

— Jillian M. Blueford is a licensed professional counselor, national certified counselor and clinical assistant professor in the Department of Counseling Psychology at the University of Denver. Her primary research expertise falls under grief counseling training and preparation and counseling grieving children and adolescents. Contact her at jillian.blueford@du.edu.

Working with military grief of noncombat deaths

By Joanne Steen

In the United States, there seems to be a widely held belief that military personnel die only in war. However, total military deaths since 9/11 paint a much different picture of how and where U.S. service members have died. In the first seventeen years after 9/11, a total of 22,365 U.S. military personnel died on active duty, according to the Department of Defense (DOD). Of this number, 31% died in Iraq or Afghanistan, while the remaining 69% died in the line of duty, but not in armed combat or war. 

These statistics are surprising to many, and they emphasize a sobering reality of military service: Military personnel regularly die in the line of duty, both in peacetime and in war. 

I learned this lesson the hard way. I married a Navy pilot several years before 9/11 and never worried when he flew. He loved to fly, was well-trained, and the U.S. was not at war. Life was better than good — until the day the helicopter he was flying exploded in midair as he and his six-person crew were returning to Naval Station Norfolk in Virginia. There were no survivors.

War deaths embody the ultimate sacrifice made by military personnel in the defense and protection of our rights, freedom and homeland. But apart from armed combat and war, service members also lose their lives in other military operations worldwide; in terrorist attacks at home and abroad; in training to maintain their operational readiness levels; because of accidents, equipment failure or human error; by suicide or homicide; and because of illness and disease. 

Counselors who work with surviving families or veterans benefit from knowing these common causes of death in the military, because how a service member died is very important within the military culture. The cause of death can deprive survivors of validation of their loved one’s service and unfavorably affect the support they receive.

Prior to 9/11, there was little in the way of literature and military-focused grief resources for family members or professional service providers. Survivors such as myself struggled to cope with this life-changing loss and a grief that few others seemed to fully grasp. The grief constructs of prolonged grief disorder or complicated grief didn’t easily adapt to military grief. As a survivor, I sometimes felt like a fish out of water, isolated in military grief and unable to chart a path forward on my own. 

In hindsight, here are three things I wish my therapist and I had known when my late husband was killed. 

1) Military grief has a long shelf life. Military grief can be complex, complicated and messy. Contrary to another popular belief, military families are not prepared for the loss of their loved ones.

Like a perfect storm, military grief is the result of the intersection of three powerful circumstances: the death of a loved one who died much too early in life (the average age of death is 28, according to the DOD); the high likelihood that death was sudden, unexpected and potentially violent in nature; and the unique factors that military service brings to death. A few of these factors include a sudden death far from home; a traumatic notification and casualty assistance process; limited details or classified information; unrecoverable, unviewable or partial remains; the soul-searing traditions of a military funeral; and the realization that common symbols of our country, such as the American flag, have become personal symbols of loss.

Some military families live on base or post, and when their service member dies, they are given a limited time to relocate off the military installation. When Laura Monk asked for a few more weeks to move off post after her husband, U.S. Army Specialist Austin Monk, died of leukemia at age 22, her request was denied. “All the grief books I had read said not to make any major decisions the first year,” Laura recalled, “but before I was ready, I had to leave the home Austin and I shared, plus my support network on post.” 

2) Noncombat deaths can be marginalized and the associated grief disenfranchised. In many areas of our country, knowing a military family is the exception rather than the norm. As a result, the challenges faced by these families and veterans are often unrecognized or misunderstood. 

Couple this limited awareness with the pervasive belief that military personnel die only in war, and the families who experience noncombat losses often find their service member’s death marginalized. U.S. Air Force Master Sgt. Steven Monnin battled posttraumatic stress disorder before ending his life in 2004. His surviving spouse, Elizabeth Monnin, recalled going to an event in support of surviving families and seeing an object that was akin to a traveling memorial. When she inquired if her husband’s name could be added, she was asked how he died. After Elizabeth explained, she was told, “No, this is for real heroes.” While not all replies are this extreme, many conversations send a not-so-subtle message that combat deaths garner more appreciation and greater respect than do noncombat deaths. 

3) Finding meaning in noncombat deaths can be challenging. Families of military personnel who were killed in armed combat or war usually find meaning in their loved one’s direct actions to protect or defend the nation from those who want to do great harm to America. They find purpose in their loved one’s ultimate sacrifice for the greater good.

But what happens when the death seems senseless? Finding meaning in a live-fire training accident or an exploding helicopter can be difficult. Families sometimes turn to making meaning out of their loved one’s life rather than their death.

My search for meaning in my late husband’s death was long and painful. Eventually I concluded there was no great meaning in his death, but I found renewed meaning in his short life. He loved his family, loved his country and loved to fly. He was simply one of the good guys and was memorialized by his commanding officer as “the man every father secretly hopes his daughter will bring home.” What more did I need to search for? 

— Joanne Steen has more than 20 years’ experience as a national certified counselor, author, and educator on grief, loss and resilience, with a specialty in traumatic and line-of-duty losses. She is the co-author of Military Widow: A Survival Guide and the author of We Regret to Inform You: A Survival Guide for Gold Star Parents and Those Who Support Them. She is the founder and principal consultant of Grief Solutions, which offers customized training and resources on grief. Contact her at joanne@griefsolutions.net.

‘You aren’t grieving correctly’

By Claudia Sadler-Gerhardt

“Why are you still wearing your wedding ring?”

“You shouldn’t be dating yet. It’s too soon.”

“Why aren’t you dating yet? It’s been long enough.”

“Your kids need a dad. Find another husband.”

“Are you really still sleeping in your marital bed? Still living in the same house?”

“Plenty of divorced people are single parents, so this isn’t any different.”

Losing an intimate partner is profoundly life-altering at any time, but for a young adult (those ages 20 to 40), the loss is atypical and unexpected. There also appear to be societal expectations regarding what such off-time widows or widowers should do or should not do during this time of grief. Research supports that partner death increases the risk of physical and mental health concerns, including depression and anxiety, financial insecurity, loss of identity and loss of social connections. For the young widow or widower with children at home, becoming a sudden and unexpected single parent and the only income earner can be overwhelming. 

There is a paucity of research and literature about off-time widowhood. There is also a lack of role models for the young widow or widower because cohort members are unlikely to have lost partners. Additionally, there is ambiguity about what behavior is socially acceptable for this age group. Support programs are often geared toward widows or widowers in later stages of life who have different needs and concerns than the younger widow or widower does. In addition, young parents who are simultaneously working and raising children have a lack of discretionary time for obtaining grief support.

Given the current COVID-19 pandemic, the continuing opioid crisis and high rates of motor vehicle accidents, it is likely that rates of young spousal death may increase. A colleague and I recently conducted a qualitative research investigation (unpublished) with six young widows and one young widower (all 20 to 40 years of age) whose partners had died within the past 10 years. We hoped to learn about their lived experience of widowhood, including relational, financial, parental and personal changes resulting from the death of a spouse or partner. 

The first blatant phenomenon was that all of these widows and widowers had been told by someone that they were not grieving or acting correctly. Most of the issues revolved around when to date again (or not), when to remove wedding rings, when to change beds and whether to allow children to join the parent in the bed, and how to relate with their in-laws. Comments ranged from “children need a dad/mom” to opinions that it was way too early for the widow or widower to be dating. Another concern was the awkwardness of possibly dating someone who had known the spouse before their death. In-laws often disapproved of the surviving spouse returning to dating because that could essentially result in their adult child being “replaced” in the family. Additionally, it can be challenging for the surviving spouse to interact with or to maintain a relationship with their in-laws after the death of their spouse.

Another big change involved social and friendship relations. The participants reported losing friends who were uncomfortable having someone who was now single in a group of couples. In addition, friends were often uncomfortable asking or talking about the spouse or partner who had died, under the guise of not upsetting the griever. Widows reported feeling as if they didn’t fit in. Many were encouraged to “move on,” to remember that they were still young and needed to find someone to be with. Others were told that being widowed was similar to being divorced. Although in death, unlike with divorce, there is no other parent to help out.

Another big area of struggle related to identity. Who is this person now that they have been widowed? Are they still married or suddenly single? Stereotypical widows are not 40 years old. The young widow or widower often deals with being the only wage earner, a solo parent and the primary housekeeper and has little time to work on self-identity. 

Most of the participants in our study were parents who expressed a need to stay healthy for their children. Children often were scared that the surviving parent might die. Work, parenting and other tasks left little time for the surviving parent to engage in self-care or grief support. Finding some semblance of balance was challenging. Social media was a convenient resource for helping these individuals learn about grief and obtain supportive networks. There are online groups for young widows, and there are also hospice services for their families. Making time to exercise was another challenge that was noted, although most of the study participants acknowledged its importance. 

I have worked with many grievers for several years, taught undergraduate and graduate grief counseling courses, and presented numerous grief workshops. So, what have I learned about young off-time widows and widowers from a clinical counseling perspective? 

Assessment is absolutely critical. Do not make assumptions. Assess from a biopsychosocial-spiritual perspective. Obtain referrals if appropriate. Assess family and in-law relationships.

Recognize the unique needs of the widow’s or widower’s developmental stage.

Give consideration to the utility of telehealth appointments if appropriate.

After ensuring that basic needs are being met, work with the widow or widower on areas such as identity and roles, social support, self-care and grief support. 

Be aware that widows and widowers will likely experience others telling them how to grieve in the right way. Foster their ego strength in making their own decisions. 

Above all, be a safe companion for these grievers while allowing time for their stories to be shared. 

— Claudia Sadler-Gerhardt is a licensed professional clinical counselor with supervision designation in Ohio. She is a past president of the Association for Spiritual, Ethical and Religious Values in Counseling, a division of ACA. Contact her at drclaudiasadlergerhardt@gmail.com.

Behavioral manifestations of grief in young clients 

By Rebekah Byrd

I had been working with Kai in play therapy for about six months because he was at risk of being kicked out of his third preschool due to problematic behaviors. He had been working hard and making progress but seemed to regress and was also experiencing a recent and intense overdependence on his mom. 

Jordan, an adolescent, was referred to me because he was having explosive emotions. His temper tantrums had become so aggressive that his grandmother no longer felt safe around him.  

As counselors, we are often working with children and adolescents because of an identified behavioral issue. We know that the presenting issue is rarely the problem. Rather, it is often a behavioral manifestation of the real underlying concern. Similarly, other reasons for seeking counseling services, such as anxiety or depression, are frequently manifestations of unrecognized grief and loss that have been unidentified, untreated or, often, misdiagnosed.

It is imperative that we remember and help other important figures in a child’s and adolescent’s life understand that what adults may understand as grief and loss might look very different for children and adolescents. Many of the concerns raised in Kai’s and Jordan’s cases are behavioral manifestation of grief. Regression, volatile emotions, acting-out behavior, temper tantrums, overdependence, a constant demand for attention, and aberrant activity are all common manifestations of grief among children and adolescents. The question is, how often do we miss these? 

In the third edition of his book Play Therapy: The Art of the Relationship, Garry Landreth noted that when we focus on the problem, we miss the child. In my experience, children and adolescents are always communicating. Kai told his parents that his teacher had died. He was struggling to understand this. His parents assumed he was regressing into his old ways of lying. They were in disbelief that we had come so far in six months only to be right back where we started. Kai’s behavior had amped up to a level that seemed worse than when his preschool teachers were stating that he was at risk of losing his spot in the school’s program.  

Full of frustration, worry and fear, Kai’s parents were asking me what to do. I understood that Kai was dealing with some very real themes of death and dying in the playroom. He was doing difficult work and trying to process these concepts through play in a very real way. I encouraged the parents to see these behavioral concerns as symptoms of grief and loss instead of assuming that Kai was reverting to old behaviors. We turned our focus to the child rather than on the problem.  

Almost immediately, Mom started sobbing. She kept saying, “The assistant T-ball coach!” Dad then realized what was happening. They both remembered that Kai’s assistant T-ball coach had recently passed away. When Kai reported that his teacher had died, his parents had dismissed it as a lie, never considering the impact that an assistant T-ball coach could have on their 4-year-old and not thinking about how many 4-year-olds call any adult who works with them their “teacher.” 

The parents felt awful that they had dismissed Kai’s real feelings of grief and loss and had also missed the opportunity to comfort him when he reached out to them using his words. (This was a major accomplishment for Kai, as it would be for most 4-year-olds who don’t understand grief and loss, much less why they are feeling such strong emotions.) The parents felt ridiculous for not putting this together sooner, and we were able to process that.  

As counselors, we don’t always have this information, and as school counselors, we might not meet with parents or other important adults as much as we would like in order to put these pieces together. So, it is imperative that we recognize the many facets of grief and loss and the impact on children and adolescents so that we can assist in the healing process.

Jordan had suddenly lost his mom, and his grandmother was now his guardian. His loss was front and center for him and for those around him daily. However, his family had thought that Jordan had already worked through the loss of his mother. These “new” behaviors he was exhibiting (explosive emotions, temper tantrums, aggression) were treated as somehow being separate. It can be easy to assume that caregivers will make the connection between an adolescent’s acting out and their experience of grief, but what happens when the family/caregiver doesn’t see it that way or is too mired in their own grief and loss and is triggered by what this is bringing up for them?  

When parents or caregivers are also grieving, adolescents may keep their sorrow to themselves. They may feel pressure to be “OK,” or they may feel responsible for not causing their grieving parents or caregivers further distress. 

In addition, adults may recognize the issue of “primary loss” with children and adolescents — the substantial loss that often refers to the death of a loved one (in this case, Jordan losing his mother) — but overlook or lack awareness of the many secondary losses. “Secondary loss” refers to all the subsequent losses associated with the primary loss. In Jordan’s case, the secondary losses included losing his sense of safety and attachment to the world, his main source of support, his family role, his carefree attitude and happiness, his home (his mother’s death meant he needed to move in with his grandmother), his regular bus route and bus ride with familiar faces, and the list goes on and on.  

Counselors must also understand how culture plays a role in child and adolescent processing and displays of grief and loss. Many types of grief and loss exist (e.g., ambiguous loss, anticipatory grief, complicated grief, delayed grief, disenfranchised grief, traumatic grief), along with different models for engaging in this process. Counselors must be able to recognize, acknowledge and affirm needs associated with grief and loss issues to assist clients in their healing journey. Because children and adolescents are not always able to verbally process feelings, the use of play therapy and expressive arts may be essential to the process of helping them cope and heal.

— Rebekah Byrd is a licensed professional counselor in Tennessee, a licensed clinical mental health counselor and licensed school counselor in North Carolina, a national certified counselor and a registered play therapist supervisor. She is an associate professor and director of the Institute for Play Therapy and Expressive Arts Education and Research at Sacred Heart University and co-author, with Chad Luke, of Counseling Children and Adolescents: Cultivating Empathic Connection. Contact her at byrdr@sacredheart.edu.

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Helping professionals and the experience of personal loss

By Barb Kamlet

Two significant worlds collided in my life on Aug. 28, 2006. On that date, I started graduate school to earn my master’s degree in counseling and, earlier that day, my father and my family learned of his terminal diagnosis. In my first journal entry for my first class, Cultural Issues and Social Justice, I wrote the following: “Today I learned about two new cultures — those who believe they are living and those who know they are dying.” 

It was a poignant and challenging time to be the grieving daughter of my dying father as I was going to graduate school to become a grief counselor. During the next 21 months, until my father’s death, I discovered yet another culture — that of helping professionals experiencing personal loss. It was a time filled with painful support gaps and myriad self- and other-imposed expectations that, as a therapist-to-be, I “should” already possess whatever coping skills I would need to navigate through the experience of my dad’s illness and death.  

I rose to the occasion by confusing my roles. I became the counseling professional in interactions with my family — interpreting what I thought they needed to know and screening out what I thought they didn’t — and the grieving daughter with my colleagues — people who couldn’t remotely understand the relationship I had with my dad or the grief I was experiencing. Clearly, this was my way of avoiding what was really going on inside me.  

Perhaps it was because I was working as a hospice grief counselor where my dad died that those expectations were so prevalent and that my questions eventually became twofold: Was I the only therapist who felt like this and, whether I was or not, could I go someplace for support where I wouldn’t be known, where I wouldn’t be using my “therapist brain” and where I wouldn’t run into my own clients if I chose to attend a grief support group?  

Sadly, when I tried to research grief support for hospice professionals for my group’s class project, there wasn’t much, if any, to be found. So, real-time research became my invaluable go-to. In the course of that research, I learned there were other counselors and helping professionals who were experiencing similar challenges around their own personal losses. 

Many spoke about a logistical challenge: In trying to find their own grief counselor, they faced a very real possibility of creating a dual relationship, particularly if they lived in a small community. Another common theme that echoed my own experience was the self- or other-imposed pressure to stay in role as a counselor, particularly with other grieving family members and counselor colleagues. Yet another widely expressed concern centered on the issue of transference, countertransference and possibly crossing professional boundaries when sitting with their own grieving clients. One interviewee expanded on that challenge, stating, “As a provider of grief support myself, this also led to my delayed reaction, as when I felt something, I intellectualized it.”

As Marion Conti-O’Hare wrote in The Nurse as Wounded Healer: From Trauma to Transcendence, “All too often … health professionals are reluctant to reveal themselves because of the potential for vulnerability, created largely by an orientation toward perfection and flawless performance.” For counselors and other helping professionals, hiding behind their professional role can serve as a protection or mask that allows them to compartmentalize or intellectualize their own grief. This is a means of avoiding potential vulnerability and the painful feelings of grief that we encourage our clients to journey through. 

As a result of my research, I have had the opportunity to present at several national conferences, and the question I am asked most frequently is this: “We have a colleague whose loved one died recently, and we’re wondering how to help.” Knowing the challenges that we, as grief counselors, experience around finding our own support when we are grieving, I think the answer is a simple one. We should do just what we do for our clients and other grieving people in our lives — meet them where they are and ask them to share their story. Pervasively during my research, grieving colleagues, much like our grief clients, wanted the opportunity to share their story and have it heard without judgment.  

A grief counselor captured the essence of that need when she wrote: “This time has been utterly transformative as I have experienced it through many lenses of the heart and mind and soul — and with both personal and professional perspectives. It would help me to be able to share this with someone interested in the many facets and [to be] able to ask questions that might assist me in organizing, integrating and reconciling my experience.”  

Another colleague wrote more succinctly, “Not sure if you’ll find any added themes from my story, but I felt like sharing it anyway as a way to deal with my own grief.”

To paraphrase something ACA President S. Kent Butler wrote recently in his column for Counseling Today, when it’s us as counselors who are the bereaved, can we allow ourselves to be our human self rather than our counselor self? I challenge every counselor working with grieving clients to be the role model for your clients and for our grief-denying society at large by giving yourself the grace to be your human self when you find yourself in that sacred space of grief.

— Barb Kamlet is a licensed professional counselor and national certified counselor. Her private practice, GriefJourney Counseling PLLC, is in Aurora, Colorado. In addition, she is the co-founder and executive director of Shimmering Wings, a nonprofit dedicated to providing support and resources to individuals who have experienced a childhood death loss. She continues to do hospice grief counseling. Contact her at griefjourneycounseling@gmail.com.

Jonathan Rollins is the editor-in-chief of Counseling Today. Contact him at jrollins@counseling.org.