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What Therapists Need to Know About Death

what therapists need to know about death When Death comes knocking, do we have a choice about whether to answer the door? If we do, what might we find on the other side?

From the moment we take our birth on this earthly plane, we are on a trajectory toward death. As much as we shun the idea out of fear of what awaits at the end of the ride, it can also be an invitation to live as fully and richly as we can.

Most cultures view death as the ‘grim reaper,’ with scythe in hand, head hiding beneath a black hood, poised to snuff out our pilot light. What if it was simply an open door that welcomes us to something different, perhaps grander than what we are experiencing now?

Two dear friends shared that they had just lost loved ones; one whose elderly mother died suddenly on Sunday and he had just spoken with her on Friday and another whose close friend died young and unexpectedly today of a heart attack.

Then, this morning, I read that noted author, speaker and recovery specialist, John Bradshaw had died on Sunday. People are always taking their leave and unless it is someone close to us or a celebrity whose work was meaningful to us; we are apt to distance ourselves from it.

How do we hold space for another when they are in grief mode, which can look all sorts of ways? Over the years, I’ve said goodbye to my grandmothers, aunts and uncles, cousins, friends, my husband and both my parents.

As much as I know that death is part of the life cycle, it doesn’t mean it is easy to accept. What has helped me is the loving and sometimes silent presence of those around me. Death is an all too human experience, as raw and real as it gets. No one escapes it. It is one thing that unites us as a species.

When Death came calling nearly two years ago, I couldn’t hide and pretend that no one was home. I whole-heartedly (no pun intended), since I had a heart attack on June 12, 2014, answered the door and found that it had run away, at least for the time being and left in its wake an important message it wanted me to remember: “Everyone is on loan to us. Love them now. Every moment is precious. Embrace it. We never know when our last breath will be taken, so don’t miss a chance to live and love full out.”

As a result of these losses and my own inner work that has helped me to integrate them, I have become a bereavement counselor; a guide who walks with those who are on this path, whether witnessing or the directly experiencing side of the relationship with the angel of death. I also teach this topic to clinical professionals, since if we are able to accept the reality of it in our own lives, we are that much better able to serve our clients who are facing end of life choices for themselves or loved ones. I encourage you to do your own examination and exploration on the topic, so that you are better equipped.

One Question I Ask is This:

If you could know the exact moment and method of your death, would you want to be told? There are many times when my answer is yes and others, when it was to be said aloud, I would plug my ears with my fingers and say, “la, la, la la, I can’t hear you,” as if I was a mischievous child.

In the first case, I wonder if it would change the way I live my day to day. Would I be more open and loving? I know I would worry less and take greater stretches and leaps. I would do the things I fear to do. I would tell people how I truly feel and not hold back a syllable. In some cases, I would sit in silence with those for whom words don’t adequately convey how I feel about them.

Since I may not ever be able to predict when I will indeed walk through that open door to whatever awaits, I live as if it could be today.

What Is the Difference Between Bereavement, Grief and Depression?

Bereavement is the process related to loss that may include a series of behaviors, such as crying, verbal or non- verbal expression, lack of appetite, sleeping excessively or insufficiently.

Grief is a reaction to any form of loss. They each include a vast array of emotions, ranging from sadness to anger. Those who are grieving may find that their bereavement process differs, depending on his or her background, beliefs, relationship to the person or animal who has died, their coping skills and levels of support around them.

Depression is a clinical and medical diagnosis that may resemble grief reaction, but is often bio-chemical and treatable with pharmaceutical intervention. You can’t medicate away grief.

What Issues Around Death Do Clients Bring to Sessions?

  • Fear of what awaits
  • Dying alone
  • Being in pain
  • Regrets about past behaviors
  • Denial about its impending nature
  • Anger that someone they love is dying or has died
  • Anger about their own end of life
  • Family members arguing about their estate
  • End of life care, whether it will be at home, in a hospital or nursing home
  • Not wanting to leave loved ones on their own
  • Financial challenges
  • Wistful about what they will miss, such as family milestones
  • The empty place at the table
  • Anniversaries of death
  • Creating a new sense of normal
  • Various bereavement styles
  • Funeral planning
  • Questioning why God would allow someone to die
  • Death as a result of addiction
  • Suicide
  • Loss of a child
  • Widowhood
  • Needing to make peace with their past and making amends

How Can You Help Your Clients Navigate the Loss Landscape?

  • Sometimes the mere silent presence of a witness eases the pain at least for the moment.
  • Remind them that they will feel a myriad of emotions, sometimes simultaneously.
  • Tell them that no emotion is wrong or bad. It is also not unusual for a grieving person to laugh in the midst of their sadness. A sense of relief or euphoria is not uncommon.
  • Encourage healthy expression of grief that causes no harm to themselves or others.
  • Discourage self -medicating grief with drugs, alcohol or cigarettes.
  • Support them in talking with trusted friends and family about their feelings. When people repress emotions, they often return in dysfunctional ways.
  • Focus on good self- care, such as sleep, eating, drinking and bathing.
  • Know that there are loss layers and one may follow the other without a break in between.
  • Ask if there are specific spiritual practices that comfort them.
  • Help them to create new rituals that sustain them.
  • Offer suggestion for an action or charity to honor a loved one.
  • Have them write a letter to that person or animal?
  • Allow for time to heal. There is no statute of limitations on grieving.

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What Therapists Need to Know About Death

Edie Weinstein, MSW, LSW

Edie Weinstein, MSW, LSW is a journalist and interviewer, licensed social worker, interfaith minister, radio host and best-selling author. www.opti-mystical.com

 

APA Reference
Weinstein, E. (2016). What Therapists Need to Know About Death. Psych Central. Retrieved on December 11, 2018, from https://pro.psychcentral.com/what-therapists-need-to-know-about-death/

 

Scientifically Reviewed
Last updated: 26 May 2016
Last reviewed: By John M. Grohol, Psy.D. on 26 May 2016
Published on PsychCentral.com. All rights reserved.