Using Acceptance and Commitment Therapy for Grief
The fantastic thing about ACT is you can use it to help many people.
Grief is such a painful experience. It can feel exhausting, overwhelming, and paralysing.
You encounter painful and destabilising losses that throw your life into turmoil.
How do you find a way back to normality? What will life look like tomorrow? Where will you find comfort?
What is grief?
Grief is not necessarily bereavement. You can experience grief after any loss. For example:
- A relationship ends because one of you wants to leave.
- A friend stops talking to you.
- You develop a long-term health condition.
- You discover you weren’t selected for something you wanted so much.
- You retire with a sense that you didn’t reach your full potential.
- A work colleague bullied you out of your job.
- Events outside your control force you to move home.
Losses can bring about deep sorrow that can trip you up. One day you’re moving along with ease, and the next, you realise that life will never be the same.
How do you work with grief using ACT?
As with most of my therapy work, I find it helpful to start with sensitivity to a person’s context. When grieving, the days are often effortful and draining. It helps to be gentle and to go slow.
I risk rushing clumsily into exercises to help them feel better, applying a little defusion or observing-self interventions to alleviate my sense of powerlessness. To do so would probably miss valuable opportunities to connect on a more powerful level.
Going slowly helps both you and your client. A slower pace allows you to embody awareness and openness to experience. Notice and embrace your fear and uncertainty, and create a context where you can show your client how to do the same.
“If you’re going through hell, keep going.”Winston Churchill
ACT invites us to approach life by carrying our experiences and taking action. You help your client when you gently and consistently find ways to support their mobility.
It’s not easy, of course. Many people express notions that they do want to move forward; they don’t want to forget.
Others describe feeling incapable of living. While they may not be suicidal, they feel overwhelmed by the loss and cannot muster the strength to be around others.
How does your client remember their loved one?
They dispelled the myth that people go through stages of grief. In all the clients they’d helped, there was no observable pattern to suggest that it was an accurate or workable theory.
What they did observe was something else more helpful. Typically, when a person feels stuck with their grief, it is due to one of two reasons:
- They placed the lost other on a pedestal.
- They demonised the other person.
In ACT, our job is to ask what’s the function (WTF?). In other words, what is the relationship between these actions and the consequences? What are the relationships between these two actions and the contextual relations?
When a person idealises or demonises a lost loved one, it probably serves a similar function; to avoid pain. If you view sadness, fear or shame unbearably, you’ll be more likely to adopt one of these responses.
One of your jobs is to gently and persistently explore the feelings behind the avoidant pattern. In the Grief Recovery Handbook, the authors invite you to use letter writing. It provides a vehicle through which a client can practice psychological flexibility in response to painful emotions.
Together with your client, you help them construct a letter (that they never send) exploring several factors, including:
- What are you grateful for from the other person?
- What were your hurt or angered by?
- What did you want or need from them that they did not give?
- What do you regret?
- What do you like to apologise for?
Depending on the context, you can reorder the questions.
Clients have often found the process both painful and therapeutic. It has helped them move forward from despair and hopelessness. They began to feel less stuck and saw glimmer after glimmer of hope that developed into something brighter and more consistent.
Moving forward requires compassion. We must be curious about different perspectives, willing to experience discomfort, courageous to keep going and open up to uncertainty, and flexible to experiment when we feel stuck.
We need to liberate ourselves from our grief emotionally and practically. Obsessing over social media profiles, photographs, and possessions do little to minimise suffering. Neither does shutting everything out. People need to choose what they do and how they do it. We all have that right.
And, when invited to help someone who feels like they cannot or don’t want to move forward, we need the skills and the willingness to move alongside.
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