I’ve been thinking a lot the last several months about the process of grief and how central it is to all therapy. I've come to understand grief less as something that visits us in rare moments of loss or trauma but as an ever-present part of daily life. Not unlike the filtering of everyday toxins for which we rely on our liver to metabolize, the world is filled with emotional matter that our bodies must process every day. On an ordinary Tuesday, we witness acts of terror on the news, endure all sorts of personal disappointments and/or watch people sort through garbage cans. Yes, some of these require more effort for us to metabolize, and not every day is a typical Tuesday (and for many, no Tuesday is typical). What I’m getting at is that grief, it seems to me, is omnipresent. As with our liver, whether we are attentive to it or not, our emotional organs are always at work. Grief is the best word I can come up with to describe the constant shifts our emotional bodies endure to make new room for new features in our emotional reality.
Below is the latest in our series of collective conversations. In this post, we address the different forms of grief we see in our NYC therapy practice whether grief over changed relationships, behaviors or a sense of belonging.
Matt: Grief is often understood quite narrowly in therapy as related to the death of a loved one or a similar tragedy. As therapists, we know that grief has a place in all sorts of loss. What are some of the ways you deal with grief in your practice?
Heather: There is a great deal of grieving that can happen in relationships with people who are still alive. There are plenty of relationships that become hurtful and toxic. In order to move on from the relationship or even, downgrade the relationship (i.e. from a very close friend to acquaintance), sometimes we have to cut off people who are still on this Earth so they stop hurting us. I actually think this is the most common and “under-reported,” if you will, type of grief. When we have hope and expectations in relationships, that is what drives the relationship to thrive and grow. But when the other person is unwilling or unable to meet those expectations, we find ourselves getting hurt and disappointed over and over again. And if talking about this directly with the person does not inspire change, sometimes we have to choose between continuing to be hurt or cut off that relationship. By the latter, I mean to either leave it behind and end it totally or lower expectations to reflect a more realistic picture of what the relationship can be.
Rachael: Yes, Heather! We also at times have to kill off behaviors that hurt us. When we are ending and reorganizing a behavioral process, there seem to be losses that we don’t often see. We are grieving for not only the person, but the behavior or place that may have been, at once, destructive and a comfort.
When we decide to stop behaviors like smoking or calling an ex, we are saying goodbye to behaviors that we hold dear. It’s a relationship. With smoking, it’s the relationship to how we end a meal or start our day. We have to mourn the loss of this and find a new way to do all of those things. Similarly, times when we would have called an ex or an ex-friend on the walk to work, we look up their number and know we can’t call. Maybe it’s because we ended the relationship because it’s toxic to us or because they passed away. If we give them the attention they deserve then we honor the loss and create new and healthier behaviors.
Karen: I have found that my years as a therapist have allowed me to become quickly attune to grief. It has become something that feels so very human to me and I treat it with great care. I have been wondering a lot lately about how grief works at a social level. How does grief show itself at a community level? Does this apply to what our culture is dealing with right now?
Matt: I love your question, Karen. Our culture is dealing with so much that it seems perhaps minimizing to name some of it, but certainly the recent string of terrorist attacks and shootings–both by and of police officers–is a collective emotional experience that we’re all having. Not to mention fears over how the political process will play out in response. Perhaps we could speak to the ways we see that collective process working well. Ideas?
Heather: There is a feeling of heightened violence, bigotry and fear present but it doesn’t always come up directly in the therapy room. My sense is that it feels so big that people don’t know how to begin to give voice to it; yet I have noticed so many people observing just feeling very “off.” I've been wondering how this grief is manifesting itself in folks and I am looking for ways to name what is happening–how to honor these events and shifts and to make sure we don’t collectively get stuck in grief.
Matt: It seems that often patients relate to the sort of grief we’re now talking about–racial violence, terrorism, jingoism and xenophobia on display in electoral politics–as somehow not the sort of thing they ought to talk about in therapy. It comes up as a sort of aside as it might at a social event. We’ve classified these domains of so-called personal grief and social grief as distinct. Most people assume that only the former has a place in therapy. I think this is related to the way we’ve dichotomized public and private spheres. The 1960’s adage that “the personal is political” had its moment in psychotherapy, but largely, psychology has constructed itself as apolitical. In some ways, we’re so saturated with terror and violence that many people have dissociated themselves from its impact. How do we welcome a discussion of “social grief”?
Kiran: I have learned that there seems to be some level of grief in most people’s lives in varying degrees. I’ve been wondering for a long time now how we as people can be more accepting of this feeling and yet not let it paralyze us in the long term. In my practice, I have been talking with many patients about grief connected to “homeplace”–a sense of not feeling like one fully belongs. Whether it’s not fully belonging in NYC because of migration from another place, in one's physical body because of bodily changes, spiritually or in relationships, grief can manifest in a multitude of ways, which can shake the sense of “home” or belonging. My clients have taught me that the grief of leaving one’s home–whether it’s because someone moved across the world or across the country–never really goes away. The grief or feeling of loss takes on a different form over time. However, that pull for what once was is often very present years later. It is the loss of the physical space, family members, friends, smells, attitudes and familiarity that is missed. This sense of “homeplace” is often not replaceable. While client’s continue to live healthy, productive lives, there is a constant negotiation that takes place in terms of trying to find “homeplace,” when the answer may be about living with a loss while creating other places of belonging.
Matt: It’s meaningful to take in all the forms of grief we experience in our work as therapists. It seems clear from what we’re all saying that grief is an ordinary and unavoidable part of life. Which is to say, we don’t treat grief in the sense of treating a disorder. We experience it with our therapy patients as we experience many things they go through in our time with them. The grief therapy, then, is not about fixing grief, but in some ways, it’s the opposite–finding that which needs to be grieved and facilitating the process, perhaps, by removing what’s in the way.
