The kind of sadness, longing, and even despair that we feel when we lose something or someone we were close to has a name in psychology: grief.
In fact, grief is one of the most painful psychological processes that exist , and can sometimes make us unable to enjoy life. However, psychological assistance through therapy with psychologists can help us to overcome this discomfort and to accept that there are certain moments that will no longer return and that this is natural.
It is precisely this experience gained in psychotherapy that gives psychologists a unique perspective on what grief is and how we can manage it emotionally. That is why, on this occasion, we interviewed a specialist in the field: Laura Palomares, from Avance Psychologos, who works in grief therapy.
Laura Palomares: the point of view of a grief expert
We spoke to Laura Palomares Pérez, a psychologist who is an expert in grief and emotional bonds and Director of the Madrid-based psychology centre Avance Psicólogos, to talk about grief, both in terms of the pain it causes and how psychotherapy works to overcome it.
It is usually understood that grief is something that arises from losing someone you love, through a break-up or death. However, there are other causes, right? What defines grief?
Grief is a state of recovery and readjustment after a loss. For this reason, we should not consider grief as an illness, but as a normal process of rebalancing with different phases, which will help us to gradually recover normality.
The loss may be due to a break-up of a relationship or the death of a loved one, but in fact it may be due to the loss of a job, a home, a drastic change in life, the loss of a pet, the amputation of a limb, etc.
The grieving process will be different depending on how important the loss is to us, whether it is a loved one or a life-changing event.
Grief is to some extent a normal psychological phenomenon when it appears after losing someone or something that was important to us. From what point is it understood that it is a reason to attend psychotherapy?
The grieving process involves a number of phases that it is important to respect. We say that a grief is pathological or unresolved, when there is a blockage in any of them.
If we have settled down in sadness or anger, we do not find meaning in our lives, we do not end up believing what happened or we recreate the loss with the same emotional intensity as when it happened, if we notice that since then new fears have appeared such as death or illness, phobias, anxiety or panic attacks, etc., that is a reason to attend psychotherapy.
Sleep or eating disorders, obsessive or catastrophic thoughts, or compulsive behaviors are other signs that need to be addressed.
They also denote unresolved grieving behaviors such as keeping all personal items as the loved one left them, talking about him in the present tense, or not talking about him at all.
What are the foundations of psychological therapy applied to grief?
Psychological therapy starts from the knowledge that expressing the emotions of anguish and pain without fear of judgment is a determining factor in overcoming grief.
In Avance Psychologos we work from different currents of psychology, taking advantage of each of their techniques. In this way, humanistic psychology manages to deepen the emotional and make it emerge, with different techniques such as role playing, the empty chair, the evocation of memories through photographs and objects, etc.
It is about deepening feelings and encouraging the resolution of ambivalent emotions, guilt, anger, unresolved situations, etc., with the aim of preparing for the farewell, which does not mean forgetting the loved one or object of the grief, but finding a new place for it in our emotional imaginary.
On the other hand, cognitive-behavioral psychology helps to restructure at the level of thought and behavior the new situation in the face of loss, favoring the application of resources to assume and face the new reality in the face of loss.
The application of Third Generation Therapies, especially Acceptance and Commitment Therapy, focuses on the acceptance of the loss without forgetting the context and values of the person, which are fundamental for the grief to flow naturally and according to the individual differences and concrete needs of each person.
From your experience in Avance Psychologues, what are the strategies a therapist should follow to adapt to this reason for consultation by a patient?
The deep respect for the pain of the person who comes to the consultation, from an attitude of absolute and unconditional companionship, is fundamental in the way of being and feeling the relationship with the therapist’s patient. Without this there is no therapy. The therapeutic relationship should feel like an extremely safe space in which there is no room for judgment or haste.
From there, the therapist focuses his attention on support and accompaniment to facilitate the acceptance and recognition of the loss, to express the emotions and feelings that come from it, to confront in a practical way the new life situation and reality in the face of the loss and finally, to accompany in the farewell with a new sense of life.
How do you recover and return to normal? How long does it usually take to get over grief?
The recovery is given with the closing and overcoming of each of its phases, respecting the times of each person and making sure that they are solved.
The phases of mourning are the phase of denial, that is, not accepting or assuming the fault of the loved one that usually occurs at the beginning, at the moment of shock; the phase of anger, which consists of feelings of rage and rage many times against the world, with the need to look for guilt, sometimes also rage against oneself, and even the buried anger with the person one has lost, feeling “abandoned” by him/her; the phase of sadness, which is accompanied by feelings of loss of the meaning of life but which begins to be a preparation for the farewell and for reaching the last phase of acceptance, with which one finally reaches peace.
These phases do not always occur in order and they tend to mix, and they will occur until their resolution in a natural way if they are respected and worked on properly during the therapy. The acceptance phase comes from allowing oneself the previous ones, especially pain and sadness, although very often the person who is grieving feels forced to recover by those around him. Expressions such as “you have to be strong”, “you should be better by now”, only hinder the grieving process and increase the distress.
As for the length of the grieving process, it usually depends mainly on the level of depth and intensity of the bond, the individual personality traits, the support of the person’s environment, etc. Establishing an approximate time is not easy. It is also important to note that if the loss is sudden, grief takes longer and is more likely to become chronic.
Finally… could you tell us about a case of a grieving patient whose recovery makes you feel particularly satisfied?
I can think of several, of which I keep a pleasant memory and special affection, but I will tell you about two.
Once, R., a 28 year old woman, came to the clinic. She was funny and vital, but she complained of months of anxiety and strong back pain that did not respond to any physical cause. During the first evaluation sessions, R and I recognized the deep pain she still felt after her father’s death 8 years ago, suddenly due to a heart attack. His emotion in talking about it was as if it had just happened, and his crying was desperate.
At the moment we started to work on his grief, also taking into account the avoidance that he had been experiencing since then, his physical symptoms began to disappear, he stopped suffering from back pain, his anxiety began to subside and the best thing is that his relationship with his mother and his partner improved significantly.
I remember a recent case, that of A., a 36-year-old man who is practically discharged and only goes for follow-up sessions every two months at the moment. A. and I were struck by the fact that he was once again experiencing intense anxiety, with serious sleeping difficulties and deep sadness. He told me about the tremendous frustration he felt about having to sell his beach house.
That house was a refuge for him, it meant much more than material property; for A. that house symbolized a safe place, which provided him with rest and the possibility of recovering from the fatigue to which he was subjected during the rest of the year, due to the intensity of his work.
Once we understood that he was in mourning, we were able to work on him and even formalize a farewell to the place, the house, the neighborhood, etc., with the purpose of finding an alternative way to spend the holidays and disconnect, in the same city where he liked so much to enjoy his vacation.
Grieving moments, especially when they are due to the loss of a loved one, are the hardest and most difficult in a person’s life. But we also know that if they are naturally channelled towards overcoming them, they are moments of profound transformation that bring with them many positive aspects. The person becomes more aware of enjoying the present, develops resilience, learns to relativize and even loses fears.