Saying Goodbye in Therapy: Dealing with Grief

Many years ago I wrote an article on a Gestalt therapy theory about and method of working with grief (Psychotherapy: Theory, Research and Practice, Vol. 3, No 2, Summer, 1971).   While I still view many ideas in that article as relevant, I had not had much experience grieving losses in my own life when I wrote it and was not able to understand empathically the complexities of grief.  I now have a more nuanced view of it,  both in how people struggle with it, and how a therapist can help their clients work it through effectively and completely.  

In many cultures there is an established structure for the grieving process.   Religious Jews will go through a 5-stage mourning process, the third of which is a period of 7 days called sitting shiva where the grieving person talks about the dead person and accepts the comfort of others.  Irish Catholics might have a wake, where the mourners talk about the dead person with fond reminiscence.  But for many people in our culture, there is no organized grieving process, thus much unfinished business.   

I have continued to find over the years that many clients have failed to go completely through the grieving process and achieve resolution of a relationship that was ended by  death, divorce, termination of a love affair, or in some other way.   There is usually powerful emotional unfinished business the person has with the individual that is no longer in their life. The relationship doesn’t have had to be a totally loving one, but can be one of ambivalence with a mixture of love, resentment and hurt.  But whatever the quality of the attachment, the surviving person must go through a process of grieving and dealing with all the other unexpressed emotions that may complicate the grieving process.  Because the feelings are usually painful, and the typical client was never taught how to grieve or have it modeled in a healthy way by caregivers, many are afraid of the intense feelings and avoid doing the grieving.  But grieving is a normal part of life  and is appropriate and necessary for a vibrant existence that doesn’t have a lot of unfinished figures competing with present experience.  And for a therapist to deal effectively with their own clients’ grieving, they need to be comfortable with those intense emotions in themselves so that they can provide the empathic support and techniques their clients need to do this work.  

Grieving the Loss of a (mostly)  Love Relationship

There is, of course, no time limit that can be placed upon the grieving process.   But saying goodbye to the relationship that has ended has to be complete for the person to free up the attachment energy that is locked into the lost one.  Freud referred to it as work in Mourning and Melancholia.   He described it as a process by which libido(psychic energy) is withdrawn from the lost person; and that when one goes through mourning,  the energy gets reinvested back into the ego.  That energy can then be invested in other people or activities in the person’s life.   

Fritz Perls described the avoidance of grieving a “hanging on” reaction and used the metaphor of eating to describe the avoidance process.  To assimilate anything, including the positive aspects of a past relationship, one needs to “bite through and chew up” cognitively important aspects of the relationship.  By so doing, there is an assimilation of the positive aspects of the one that is gone.  There can also be a resolution of negative feelings that have not been accepted and consequently not expressed.  For example, the person may feel guilty about feeling angry at the leaver for “abandoning” him or her.   They know that, unless it was a death by suicide, the person didn’t really choose to leave and the resentment is irrational.  But when the  survivor expresses all the emotions, they are then enriched  because they can remember with joy the missing individual and, if a lot of resentment, understanding and acceptance of why the resentment is understandable.  Without achieving this resolution,  the person is left with a nagging  sense of something missing in the present.  There can be depression, a lack of vitality, a withdrawal from active engagement with others. The person might not even realize that there is unfinished business.  If it’s the death of a loved one, the survivor may compare all new relationships to the one that is gone.  The person may even feel guilty about the idea of letting go,  seeing the hanging on as proof of one’s  love.  If many of the feelings are negative and they experience guilt or shame, the person can then understand the reasons for these feelings and forgive themselves.  

Reasons People Avoid the Grieving Process  

1.  They are afraid of feeling grief because they were never taught to do so and were therefore not supported in experiencing it by caregivers who, themselves, may have been phobic about the feeling of grief.  For example, the parents of an ex-client prevented her from going to the funeral of a beloved grandmother supposedly because they thought the experience would be too panful for her.  

2.  Caregivers did not provide healthy modeling for grieving.  The woman above who wasn’t allowed to go to the funeral didn’t see her parents mourning the grandmother.  So she implicitly viewed mourning as much too painful.  Although we had met for a long period of intensive psychotherapy, she came in one day and told me that she felt she had accomplished much in therapy and wanted to stop.  That very day!  When I explored this decision, it emerged that she unconsciously wanted to avoid the grief of saying goodbye to me.  

3.  They may not recognize they have buried their grief and, even when they do, are afraid of experiencing the intensity of it.

4.  There is a lot of messy, complicated “unfinished business” between them and the person who is gone that makes it difficult to go through the grieving process.   

5.  If it is a loved one who has died, they don’t want to let their love for that person dissipate, feeling they would betray their love if they mourned that person and were free of those painful emotions.  

In a future blog post, I shall discuss ways that I work with people who are suffering from incomplete grieving.