Helping Your Clients Navigate Grief Work

serious manThe DSM-5 lists Persistent Complex Bereavement Disorder as one of its conditions for further study. Previously called complex or complicated grief, this condition affects seven percent of people going through bereavement.

The ability to help clients navigate this rough passage is a useful one for therapists, especially those working with populations hit by multiple loss through chronic illness, violence, and suicide.

Let’s look at the myth of Orpheus as a frame for treatment planning, interventions, and resolution.

Orpheus’s partner is bitten by a snake and dies. Unwilling to accept this loss, Orpheus determines to go down to the underworld to retrieve his partner.

First stage: Loss. Your new client Jim comes to therapy in order to process his partner’s recent death. His attitude toward the death is characterized by difficulty in accepting it, almost a disbelief in the finality of the event, and intense yearning for his partner. He reports a loss of meaning to life (“I feel like half of the world is gone, and the half that’s left isn’t worth much”), as well as bitter feelings. Although he doesn’t say it, it soon becomes clear that one of the reasons he’s coming to therapy is to be in an environment where his partner is still alive and where Jim can experience this in the narrative he tells.

Orpheus descends to the underworld. Here, because of his ability to sing, he convinces the king and queen of the underworld to release his partner to him.

Second stage: Retrieving the dead. Jim’s ability to experience the presence of his partner is directly related to telling his story. All the episodes of their life together are sung. Singing or singing out also relates to an infant’s crying as it attempts to elicit what it needs from the environment. Jim’s narrative is effective, and elicits a positive response of empathy and compassion from you. This narrative repeats and cycles as it needs to, a pattern familiar from trauma recovery work. The effect is similar: the “impossible event,” the one that can’t be survived but that happened anyway, is gradually lived through in therapy.

Orpheus is given back his partner, with the proviso that he not look back until both of them are out of the underworld. He breaks this directive and catches a glimpse of the partner, who immediately returns to the underworld and death.

Third stage: Failure. At this stage in the work, Jim reexperiences his partner’s death. The very act of remembering increases awareness of the finality of death and loss.

Orpheus attempts to repeat the retrieval but is turned away. He continues to grieve, his song of mourning so powerful that the rocks and trees uproot to come and listen. He meets a band of maenads—ecstatic followers of Dionysus. Deaf to his song, they tear him limb from limb. He goes back to the underworld and rejoins his partner.

Fourth stage: Returning to life. At this point Jim is at risk for an escalation of depressive symptoms. The work here is to support him in not turning away from what he now knows: that he’s sustained a loss that is irreversible for which he won’t be directly compensated. You support him in mourning, not just the death but the unyielding nature of the world. You also support him in voicing his rage at the unfairness of this. Gradually you shift to helping him consolidate his insight in session through dialogue and outside session by some commemorative activity.

Jim fails at his task he originally came to therapy to accomplish, which was to negate or take back his partner’s death. He’s able to confront this failure in therapy and accept it, which provides closure to his loss and leaves him available to return to life. It also positions him to, at some future point, reaffirm the relationship with his dead partner in more imaginal forms—dreams, memories, and associations.

The myth of Orpheus provides a framework by which to address and engage complex bereavement, as well as a compelling image of the risk of not providing treatment. I recommend you consider it as a viable treatment option.

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Helping Your Clients Navigate Grief Work

Peter Cashorali, LMFT

Peter Cashorali, LMFT, is a therapist in private practice in Pasadena. Visit for more information.


APA Reference
Cashorali, P. (2014). Helping Your Clients Navigate Grief Work. Psych Central. Retrieved on May 28, 2020, from


Scientifically Reviewed
Last updated: 26 Nov 2014
Last reviewed: By John M. Grohol, Psy.D. on 26 Nov 2014
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