Grief psychotherapy in London
Offering psychotherapy in London, I observe the processes of decay, loss, or grieving almost every day. Accompanying clients through the after-loss pain has taught me that grief doesn’t happen in a vacuum. This is the price we pay for love. Loss, destruction, decay, or degradation are universal processes. They destroy the status quo and entirely change the life we’ve known so far.
Everything that I love and that is important to me now, I will lose sooner or later. For instance, I experienced this almost two decades ago, when I left my home country, Poland, leaving people, places, customs, work, and possessions behind and moved to London, which was then unknown to me. Some of my friendships did not last the time test, some close to me and beloved people died, favourite places changed, aged, decayed, and deteriorated. It took me some time to accept my irretrievable loss and start a new chapter in my life. Before that, however, I have been through grief.
The city of London, a meeting place for people of so many cultures whose daily relationships with loved ones, family, friends, and colleagues, as well as their interests, priorities, goals, and ambitions are so different – and at the same time – so dependent on each other. Londoners are inseparably linked by processes of constant change, in which the loss of someone or something important is an integral part, leading to mourning, where feelings, behaviours and sad thoughts, despair, anger and denial hurt, the resulting wounds bleed and leave scars. Hall (2011) rightly states that mourning is the price we pay for love, it is a consequence of the bonds that bind us to other people, animals, the environment, objects and culture.
During psychotherapy in London, I observe the processes of decay, loss and grief almost every day. Each change, transformation, and evolution of a client in therapy means abandoning the collected in life, destructive mechanisms of thinking about oneself and others in the world. Replicated and established patterns in relations with others or in relation to things, objects, culture, etc., give an unreal belief in their uniformity, specific dynamics and reinforce the false belief that a person has a real influence on most of the events that take place in life. In this reflection, we often discover something that Angelou (2008) captured perfectly in her essay ‘Letter To My Daughter’, in which she writes that ‘You may not control all the events that happen to you, but you can decide not to be reduced by them.’ We have no control over the crises encountered on the life’s journey, but thanks to the ability to experience mourning, we do not bear their burden indefinitely.
Neimeyer and Sands (2011) indicate that in the process of transformation following the loss or death of a loved one, it is essential to find a ‘new’ sense and discover meaning. The psychotherapy offered by me in London focuses on helping to deepen human awareness in the face of loss, and my role is to actively listen, engage, be interested, understand, empathise and accept the individual style of experiencing loss.
In this process, I am closest to the concept of existential psychology and psychotherapy, where the subject of the meetings may focus on searching for the meaning of life, its limitations and what it should look like. Yalom (2008), one of the precursors of existential psychology, pointed out that stress before passing away, loss or death increases and disappears throughout the human life cycle:
“It’s not easy to live every moment wholly aware of death. It’s like trying to stare the sun in the face: you can stand only so much of it. Because we cannot live frozen in fear, we generate methods to soften death’s terror. We project ourselves into the future through our children; we grow rich, famous, ever larger; we develop compulsive protective rituals; or we embrace an impregnable belief in an ultimate rescuer.”
There is no proper way to experience grief. In the face of the crisis of life and awareness of its degradation, extreme emotions appear, and the form of their expression depends on the person’s character, environment, family relations, country of origin, tradition, faith, and spiritual needs. My priority in psychotherapy is to understand the cultural context of the mourning person and the importance of the rituals of saying goodbye to the deceased, such as the type, place and manner of funeral, emotions and behaviours expected by the environment, family beliefs about death, accepting or making condolences, flowers, gifts, etc. In some cases, survivors of the death of a loved one may feel an internal conflict because the cultural norms imposed on them are contrary to their personality, e.g., a quiet, secretive person may feel discomfort from the pressure of the environment to openly express feelings in public.
In the psychotherapy I offer in London, I focus on the client’s relationship with the ‘object’. I draw my knowledge from the concept of Winnicot (1951), who originally created it based on research and analyses of a children and their so-called comfort object(s). This theory is now being used successfully in the psychotherapy of grieving adults. Such a ‘transitional object’ can be an emotionally important item that represents a bond with someone or something lost. These are often personal belongings of the deceased; a locket, a lock of hair, a scarf, or a photo. These things are also helpful in transforming grief, anger, and self-doubt, and are of great importance in the emotional, cognitive, and behavioural dimensions.
The dynamics of mourning vary and depend on several factors; the type and quality of the relationship a person is in, the ability to relive their own emotions and childhood experiences, and, most importantly, trust and ability to express own emotions honestly. However, non-mourning, by definition, is not currently viewed as a disorder. Likewise, the timing of mourning is an individual matter. No grief or so-called abbreviated grief may be the result of a weak attachment to a deceased person, environment, object as well as the appearance of something or someone new in place of the person who has passed away, e.g., when a person enters a new romantic relationship soon after the death of a loved one, becomes pregnant after their miscarriage, integrate with a new environment after leaving the old one that has treated her cruelly, etc. And finally, shortened mourning may occur when a person expected the death of a loved one, e.g., as a result of cancer, old age, decrease in employment or the assumption that the person will be rejected by a beloved person. Sometimes, however, the absence or shortened grief may run counter to environmental expectations and family or cultural traditions. Then, psychotherapy focuses on reducing the feeling of guilt and shame that may arise because mourning does not meet the ‘standards’ imposed by the immediate environment and family.
Recent studies show that depression and anxiety disorders are not related to grief, although some symptoms are similar. Correct diagnosis and clinical evaluation in psychotherapy are essential because the method and plan of therapy will depend on it. Depression-anxiety disorders, like grief, can cause intense sadness, insomnia, decreased appetite, and weight loss. Grief, however, unlike depressive disorders, comes in waves and diminishes over time, where the peak of grief comes with memories of the deceased. In turn, the so-called melancholic depression (as opposed to atypical depression) is a more permanent and common disorder, where the presence of loved ones does not improve the condition. The grieving person experiences the world as an empty and bad place, while the person suffering from clinical depression identifies with feeling of emptiness, hopelessness and darkness. Research proves that extreme stress related to loss and inadequate grief can lead to many diseases – such as disorders of the cardiovascular, digestive and immune systems, cancer, and mental disorders.
As a psychotherapist, I see mourning as a healthy process of human transformation. It is a journey in which it is essential to search for the meaning of loss, pain, death, in order to find a new sense of existence at the end. In this journey, not only memories and reflection on what has been lost, but also related items that have a significant dimension to the lost bond, can be helpful. The death of someone or something close to our heart does not necessarily mean the end of the bond with memories. These, even after overcoming the crisis, are worth cultivating, as it is the relationships that are important to us that shaped our humanity.
Hall, Ch. (2011). Beyond Kübler-Ross: Recent developments in our understanding of grief and bereavement. InPsych. Australian Psychological Society. 6 p. 33.
Neimeyer, R. A., & Sands, D.C. (2011). Meaning reconstruction in bereavement: From principles to practice. In R. A. Neimeyer, D.L. Harris, H.R. Winokuer, & Gordon F. Thornton (Eds.), Grief and bereavement in contemporary society: Bridging research and practice (pp. 9-22). New York: Routledge.
Angelou, M. (2008) Letter To My Daughter. London. Little, Brown Book Group
Yalom, I. (2009). Staring at the Sun: Overcoming the Terror of Death. London. Piatkus Books
Foto: Karim Manjra