Dealing With Grief In Therapy For Teens

In Our Grief Therapy With Teens, We Don’t Dismiss Teens’ Grief, No Matter How It’s Expressed

In our therapy with teens in NYC, we know there are all sorts of ways adults can dismiss teens’ emotional experiences as “just” adolescence, grief included. Everyone grieves in different ways and at a different pace. Sometimes teens can be extremely dramatic and this can make it easy for parents and other adults to dismiss their feelings. While some behavior may, in fact, be drama, it’s important to see that dramatic expressions of grief are often covering up very real grief that should be taken seriously. An ongoing struggle with grief can sometimes be lost in the differences in the ways teens express their grief.

In our therapy with teens, we take teens seriously by not being distracted by the, at times, immature qualities of the expression of grief. We don’t allow grief’s expression to cause us to cast it aside. We’re aware that teens learn how to grieve or more accurately, they learn how to display their grief and how to share it. Knowing this, we move closer to a teen’s grief and offer them other options and ways they can share their grief with others.

Grief Is A Natural Process That Can Also Become Complicated And Stuck

When we talk about grief, we think about it as, at once, natural and a process that can become stuck or otherwise complicated. By considering grief an organic response to loss, we can make room for the fact that it’s going to be uncomfortable for awhile, while also understanding complicated grief as getting stuck in an otherwise natural process.

What is complicated grief? Formally, the idea is that grief that doesn’t resolve a year after the traumatic event or loss is considered complicated. In daily practice, though, most therapists would consider grief complicated when an individual has trouble resuming everyday activities and thinking less and less about the loss at a time that feels out of scale. It should be said that therapy isn’t necessarily needed for all grief, but when someone isn’t “moving on” when it seems like he or she should be, we do urge that this get attention. But that doesn’t mean we, as therapists, assume something is broken in the process of grief.

Complications in regards to grief shouldn’t be seen as “milking it,” being overdramatic or having a more significant psychological problem. This is especially important for teens given the preponderance of dismissiveness when it comes to their expressions of grief.

While Teens’ Expression Of Grief May Seem Puzzling, Parents And Other Adults Need To Get Close

Emotions don’t rest alongside one another as discrete, wholly separate life experiences. Their boundaries are porous. When people grieve, they are not only grieving what just happened–whether the loss of a friend, a loved one or the end of a relationship–but they’re also grieving everything they’ve ever grieved before, every loss they’ve had before. In many ways, teens haven’t yet developed some of the bad habits we have as adults in too narrowly defining and too discretely slicing up our understanding of emotions. As adults, we often assume and talk about emotional experiences as though we are experiencing one discrete, definable thing.

But, when observing teens’ experiences of emotional events, it can seem to adults like they’re all over the place. The scale of teens’ responses can seem out of proportion. They often don’t have a language for grief, but instead, borrow expressions from friends, media and culture. As adults, it’s important we account for this by broadening our understanding of emotionality.

What follows from this is, we hope, a greater capacity for parents and adults to get close to a teen’s grief. As we often say in our therapy with teens, what’s more important than teaching teens something, correcting their behavior or even, helping them feel better is being close to them in their emotional experiences. For our part, we help parents and other adults understand what may seem puzzling about how teens work through grief in the hope that this understanding can allow adults to get closer.

We Also Support Teens To Communicate Their Struggle With Grief To Their Parents

A common conversation we have with teens in our practice is something to the effect of asking: “How can we help you convey to your mom or dad how much you’re struggling with this?” Then, together, we look at how to package it better to get their mom or dad’s attention.

Parents need to be both challenged and supported to listen and understand what their teens are saying to them, but teens need those same challenges and supports as well. What does this support look like? The straight answer is it often looks like telling a kid to speak up about what he or she needs. We help teens recognize that speaking in confrontational ways, however justified they may feel they are (and maybe they are), just isn’t going to get them very far.

We also help teens be more empathetic to the ways it may be hard for their parents to make sense of what they’re saying–either because of more general generational challenges or because of their parents’ own emotional limitations, especially with grief. Some parents aren’t great with feelings and while that’s not an easy deal for a teen, he or she does need to take some ownership nonetheless of trying to get heard. Maybe they need to accept those shortcomings and try to find new ways of communicating in the language their parents understand.

A Teen’s Grief Can Also Look Like Anxiety Or Anger: We Can Help Translate

In our page on teen therapy, we say, “we speak teen.” It’s more than just a catchy phrase. Practicing therapy with teens really does feel like working as a translator at times. Grief is one of these occasions. With teens, grief can express itself in a wide variety of ways. For example, one common way is anxiety–perhaps your teen seems to worry about the subway or a given social situation rather than grieving a loss. What makes this difficult is anxiety is also so often misunderstood as other things too such as inattention, irritability and anger.

Anger is another way grief can express itself in teens, including picking fights with parents, siblings or friends. Why? In some respects, anger is an easier emotion than others. There are tons of models for how to express anger. It’s “safe,” in a sense, inasmuch as it doesn’t expect much in return and doesn’t come with a risk of rejection because the rejection is already built in (of course, you’re not going to like me being angry at you). It’s also hard to understand grief within oneself and so there may be very real anger about the fact that there is this strange feeling that has moved in and won’t go away.

Working with both teens and their parents in our therapy practice, we never encourage parents to simply accept the anger. Anger expressed rudely or with hostility should be rejected with a “Hey, I get that you’re angry, but you can’t take it out on me. If you want to talk, you’ll have to find a nicer way to engage with me.” However, we do want parents to engage and not just shut a teen’s response down. Supporting both parents and teens to recognize that there may be other things going on underneath can help.

Grief Can Also Lead A Teen To Withdraw: We Help Parents Influence A Teen To Reconnect

Like anxiety or anger, grief can also present itself in teens as withdrawal. Withdrawal is always a particular challenge for the obvious reason that it makes the person who has withdrawn, by definition, unavailable. At times, it can be difficult to recognize the root of a teen’s withdrawal as grief. Parents often need help recognizing that their teen’s withdrawal is a symptom of grief rather than merely normal adolescence.

In extreme cases of withdrawal, our therapy with a teen begins just with a parent or parents. In this instance, we work with parents to help influence the teen to reconnect, at least enough to be able to participate in their own therapy.

Drugs And Alcohol Can Be Tempting And Available Tools For Teens To Deal With Grief

Drugs and alcohol are as available to teens as they are to anyone and the temptation for teens to use substances to bury grief isn’t unique to teenagers either. What is different, however, is that there may be less developmental capacity to process grief, ask for help and make use of other coping skills. Teens, if they are newer to grief, may not understand that the pain is normal and a process they’ll work through. Or if they are stuck in their grief, drugs and alcohol may provide a temporary relief.

Teens try drugs or alcohol for all sorts of reasons, but they come to depend on substances because they are in emotional pain. Despite of what was told to us in the 80’s, it’s rarely the trying that gets teens (or anyone) in trouble. Like all drug and alcohol use in teens, we work to be curious about the root of the substance use whether grief or another cause.

What Is The Cure For Being Stuck In Grief? Relationships

On some occasions, a teen may really need medical help with overwhelming grief and may benefit from short or long-term medication in consultation with his or her parents and a physician. This needs to be investigated. In general, though, we often tell both parents and teens that the cure for being stuck in the agony of grief is relationships. When parents are available to be close to their teen’s grief and to take it seriously, the pain becomes more manageable.

Ultimately, grief is, at its best, a cultural activity. Some of our best practices around death reflect this–coming together, celebrating and mourning together. When grief is contained to more private spaces, it can stall. This is indicative of a broader position we have in our practice, namely that emotions writ large are social. We have endless cultural rituals related to emotionality. Cultural rituals around grief are among the more established, largely because grief is often experienced by groupings of people (i.e. loss of a loved one, tragedy in a community, etc.). Grief is also universal–we all experience loss and trauma.

Collectivity and the socializing of grief are so important, especially for young people. A huge part of the role of therapy for teens that are grieving is to look at what’s in the way of socializing grief, whether it’s a misunderstanding or minimizing grief by parents, discomfort in getting close to pain and sadness, a teen who hasn’t adequately conveyed his or her grief, etc.