A natural course of grieving is seen as one in which increased levels of acceptance of the loss and a return to daily functioning takes place within about two years following a bereavement (Bonanno & Kaltman, 2001). A longer response to a bereavement may result in an intensification of physical, psychological, and social issues which may manifest as a passionate yearning and longing for the deceased person, disbelief, anger, avoidance, and a limited interest in day-to-day life (Stroebe, et al., 2007; Waller, et al., 2016). In this case the passing of time does not reduce a person’s emotional pain and results in complicated grief for which help from a bereavement therapist may be sought (Schut & Stroebe, 2010; APA, 2020).
When dealing with complicated grief, bereavement counselling aims to do a number of things for a client: restore functioning, to remain emotionally connected to the deceased, engender hope that change is possible, facilitate meaning reconstruction, and promote post-traumatic growth (Calhoun & Tedeschi, 2001; Stroebe, et al., 2005; Neimeyer, et al., 2010). However, therapeutic interventions designed specifically for grief appear to be ineffective with many clients not experiencing the reduction in subjective grief that a therapist may anticipate (Currier, et al., 2008). This may be due to the underlying challenges confronting the bereaved person and the therapist in that ‘you have a brutally objective reality associated with the death of a loved one. Eternity will not return the other. No effort, no psychotherapeutic movement or change will re-establish that lost world. And so, I think we are dealing with a problem that is high up on the scale of human distress’ (Neimeyer & Wogrin, 2008, p. 16).
Given the permanence of the loss, the challenges confronting a bereaved person can be profound by requiring them to re-establish a changed sense of self and a reconstruction of their relationship to the deceased (Field, et al., 2005; Neimeyer & Wogrin, 2008). These challenges may also be equally profound for the therapist in clinical practice as they look to support their bereaved client.
References
APA (2020) American Psychological Association (APA) Dictionary of Psychology Washington, DC. [Online]. Available from: <https://dictionary.apa.org/> [Accessed October 11th, 2021].
Bonanno, G. and Kaltman, S. (2001) The Varieties of Grief Experience. Clinical Psychology Review, 21, pp. 705-734.
Calhoun, L. G. and Tedeschi, R. G. (2001) Posttraumatic growth: The positive lessons of loss. In: Neimeyer, R. A. ed. Meaning reconstruction and the experience of loss. Washington DC: American Psychological Association, pp. 157-172.
Currier, J. M., Neimeyer, R. A. and Berman, J. S. (2008) The effectiveness of psychotherapeutic interventions for bereaved persons: a comprehensive quantitative review. Psychol Bull, 134(5) Sep, pp. 648-661. <doi: 10.1037/0033-2909.134.5.648>.
Field, N. P., Gao, B. and Paderna, L. (2005) Continuing bonds in bereavement: an attachment theory based perspective. Death Stud, 29(4) May, pp. 277-299. <doi: 10.1080/07481180590923689>.
Neimeyer, R. A., Burke, L. A., Mackay, M. M. and van Dyke Stringer, J. G. (2010) Grief Therapy and the Reconstruction of Meaning: From Principles to Practice. Journal of Contemporary Psychotherapy, 40(2), pp. 73-83. <doi: 10.1007/s10879-009-9135-3>.
Neimeyer, R. A. and Wogrin, C. (2008) Psychotherapy for Complicated Bereavement: A Meaning-Oriented Approach. Illness, Crisis & Loss, 16(1), pp. 1-20. <doi: 10.2190/IL.16.1.a>.
Schut, H. and Stroebe, M. S. (2010) Effects of Support, Counselling and Therapy Before and After the Loss: Can We Really Help Bereaved People? Psychologica Belgica, 50, pp. 89-102.
Stroebe, M., Schut, H. and Stroebe, W. (2007) Health outcomes of bereavement. The Lancet, 370(9603), pp. 1960-1973. <doi: 10.1016/s0140-6736(07)61816-9>.
Stroebe, W., Schut, H. and Stroebe, M. S. (2005) Grief work, disclosure and counseling: do they help the bereaved? Clin Psychol Rev, 25(4) Jun, pp. 395-414. <doi: 10.1016/j.cpr.2005.01.004>.
Waller, A., Turon, H., Mansfield, E., Clark, K., Hobden, B. and Sanson-Fisher, R. (2016) Assisting the bereaved: A systematic review of the evidence for grief counselling. Palliat Med, 30(2) Feb, pp. 132-148. <doi: 10.1177/0269216315588728>.
