grief – Licensed Mental Health Counselor

Why The Death of Kobe Bryant Hurts So Much

27 Jan 2020by Torey C. Richards, LMHCLeave a Comment

The tragic death of Kobe Bryant is a hard pill to swallow for many people and not just his fans or sports fans. I could go on and talk about all of his great accomplishments on and off the basketball court, but that’s not what this post is about.

One of the reasons his death is so shocking is because he was a relatively young person who had overcome the odds and created so much success in his life. He was one of the best basketball players of all time, a multimillionaire, a philanthropist and devoted father. He was just getting started on the second act of his life which looked just as promising as his first. He appeared to have everything and more to come. And then he was suddenly gone along with his daughter and several other precious lives.

The reason the world seems to take a collective pause when we lose our celebrities and heroes unexpectedly is because it reminds us of our own mortality. It reminds us that at any moment, we too could be snatched off of the face of the Earth without warning.

Many people become anxious and depressed at this thought. They have what many professionals call death anxiety. Instead of becoming anxious or depressed at this reality, we should embrace it and use it to remember to live each day to its fullest. To stop being afraid of life and to live it while we still can. To let go of grudges and move on. To appreciate our families, spouses and friends. To love and not hate. To not put off things until tomorrow because tomorrow is not promised. To let go of the past and live fully in the moment.

In her book, The Top Top Five Regrets of the Dying, Bonnie Ware writes about the insights many people who are dying have had. The beautiful part about this is that we don’t have to be terminally ill or on our death beds to learn from these individuals clarity about life. Ware reports that the top five regrets of people who are dying are:

I wish I’d had the courage to live a life true to myself, not the life others expected of me.

“This was the most common regret of all. When people realise that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honoured even a half of their dreams and had to die knowing that it was due to choices they had made, or not made. Health brings a freedom very few realise, until they no longer have it.”

I wish I hadn’t worked so hard.

“This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship. Women also spoke of this regret, but as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.”

I wish I’d had the courage to express my feelings.

“Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result.”

I wish I had stayed in touch with my friends.

“Often they would not truly realise the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying.”

I wish that I had let myself be happier.

“This is a surprisingly common one. Many did not realise until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content, when deep within, they longed to laugh properly and have silliness in their life again.”

As we celebrate the life of Kobe Bryant, his daughter and the seven other people killed in this tragic accident, let’s also vow to live a more fully, intentional life with less regrets.

Grief Counseling, Popular Psychology

Survivor’s Guilt: Dealing With Being “One of the Lucky Ones”

27 Mar 201927 Mar 2019by Torey C. Richards, LMHCLeave a Comment

Imagine being in a tragic event such as an earthquake that killed dozens, hundreds or even thousands of people, but you survived. Yet you had to bury family members and friends. You were right next to someone who didn’t make it, and you don’t understand why them and not you?

Days, weeks and months go by and you can’t shake that feeling of guilt, loneliness and wondering if you could have done something different to save someone else. When everyone is telling you that you should be happy that you survived, you don’t feel lucky. You may even feel undeserving of having survived.

You may feel like you can’t talk to anyone about what you are going through, after all, what do you have to complain about? You lived! You survived. You were one of the lucky ones! However, for many people who survive such horrific events, being a survivor is just the beginning of what can be a life-long, debilitating relationship with survivor’s guilt.

What Is Survivors Guilt?

Survivor’s guilt is something that may develop in some people who experience and survive a traumatic, life-threatening event. It is something that is common in war veterans, airplane crash survivors, survivors of natural disasters and mass shootings.

In her blog on Psychology Today, the Stoic Warrior, Nancy Sherman, PhD states that survivor’s guilt begins with an endless feedback loop of “counterfactual thoughts that you could have or should have done otherwise, though in fact you did nothing wrong”.

Recently two of the Parkland mass shooting survivors killed themselves a year after the tragedy and one of the father’s of a girl killed in the Sandy Hook school shooting also committed suicide. According to their family and friends, they all had a very difficult time coping after the tragic event and appear to have been suffering from survivor’s guilt.

While not everyone who survives such tragedies will experience survivor’s guilt, some signs and symptoms include:

Having flashbacks
Feeling irritable
Having difficulty sleeping
Feeling numb or disconnected
Feeling unmotivated
Feeling helpless
Feeling an intense sense or fear or anxiety
Experiencing physical symptoms such as headaches, stomachaches, and heart palpitations
Having suicidal thoughts

Survivor’s guilt is a normal response to loss, even if it may appear abnormal to someone from the outside looking in. They may be bewildered to why this seemingly “lucky” person is suddenly withdrawn, depressed or even suicidal.

Some studies suggest that individuals who suffer with depression or have experienced childhood abuse may be more susceptible to survivors remorse since both issues appear to break down a person’s healthy defenses and coping skills making dealing with such tragedies even more difficult.

If you or anyone who know may be suffering from survivor’s guilt, I have gathered these helpful tips from the Psychology Today website:

Give yourself time to grieve.
Consider thinking about who was really responsible, if anyone.
Remember to take care of yourself physically and psychologically.
Think about what those who are close to you are feeling about the situation.
Remind yourself that you were given the gift of survival and feel good about it.
Try to be of service to someone or something.
Remind yourself that you’re not alone.
Be patient.
Share your feelings with those you trust.
Try to stick to a daily routine.
Consider journaling your feelings.
Get professional help, as needed.

I think it it important that after such tragic events, especially man made, horrible events like mass shootings, that while we are grieving for the ones we loss and reaching out to their families, that we don’t forget those who survived, the “lucky” ones, and reach out to them as well and continue to reach out and support them.

As you can see by the recent suicides, it can be a year or several years after the incident where the survivor reaches his or her breaking point. It also goes to show the bigger pictures of such tragedies and the very far reaching affects they can have on our society.

Popular Psychology

Those Left Behind: The Aftermath of Suicide

1 Sep 2016by Torey C. Richards, LMHCLeave a Comment

Early yesterday morning I got a call from the Health Services Administrator (HSA) at the jail informing me that a nurse had committed suicide overnight.

It was a shock because I knew this nurse and had just saw her two days earlier. The HSA wanted me to come in and help break the news to the other medical staff and offer support to those who needed it.

I prepared myself for that, but what I wasn’t prepared for was getting a call from her grieving fiancé who of course was having a very difficult time dealing with the tragedy.

He had spoken to her before she committed suicide, through text messaging. She had texted him a picture of a bunch of pills, but she had done that before and he thought it was an attention seeking, manipulation game and so he ignored it.

Now that she is gone he is blaming himself.

The night shift nurses, the ones that worked closes with her took it the hardest. Especially one young nurse who had grown attached to her. She broke down and sobbed continuously. She kept talking about how strange it was going to be to come to work and not see her there.

This woman also left behind two young children.

It is estimated that each suicide affects at least six people, including family, close friends, co-workers and neighbors.

After a loved one has committed suicide, it’s not uncommon for those affected by their death to start falling apart from the intense grief and the fruitless search for the answer “why?”.

The people left behind to deal with the impact of suicide often find themselves so emotionally devastated that it’s hard to move forward.

This feelings often include:

Shock– most people experience shock or a sense of emotional and physical numbness as the first reaction to learning someone they care about has committed suicide. It’s the mind and bodies natural way of trying to slow things down until it can try to make sense of what happened.
Anger– people often feel anger, either directly or indirectly. They may be angry at the person who committed suicide, angry at themselves for not being able to prevent it, or angry at the persons therapist for not being able to “cure” the person.
Guilt– Loved ones, in an attempt to find answers to why a person killed themselves often ruminate on signs they may have missed. They may blame themselves for not expressing love, for being too distant, for not believing the person when they said they were depressed for the 1ooth time. The “what ifs” can go on and on.
Fear– Once someone has committed suicide, it’s not uncommon for family members to become afraid that they will lose someone else to suicide or that even they themselves could possibly commit suicide.
Relief– It’s also not uncommon for family and friends to feel a sense of relief, especially if the individual suffered from chronic mental or physical illness (i.e, intense pain) or even if they person had been on a long, steady decline of self-destructive behaviors such as drug addiction.
Depression– While it’s natural to go through grief when you’ve lost someone close to you, it’s not uncommon for grief to turn into depression if that loved one took their own life. The person may experience sleep disturbance, lose of appetite and loss of energy. This can translate into feelings of life being worthless and losing joy in things one once found enjoyable.

In normal grief, all of these feelings will start to ease up overtime, it only becomes concerning when they remain very intense and do not seem to improve with time.

For people affected by an individuals suicide, it’s important that they:

Stay Close to family and friends– having a good support system is important to keep an individual from isolating themselves and ruminating on the suicide, especially in the first 6 months. The person may not feel like being around others and may not be ready to talk about their feelings, but they still need to have supportive contact.
Give children special attention– Children especially may have a hard time coping with a loved ones suicide. They need special attention so that they can express their emotions and talk them out. They need to know that grief is a normal process and need the adults in their lives to model healthy grieving for them, including open communication, sharing feelings and reminding them that they are loved and supported.
Be aware of special occasions– holidays, birthdays, anniversaries, etc., can all be very stressful times.People may need extra support or checking up on.

It takes time to heal from the loss of a loved one, especially when that person has committed suicide. While the pain may feel like it’s never going to go away, it will get better. Having the support of loved ones will help with that process.

Remember to express love for the person that was lost, love for the family and friends that are still here and and love for yourself.

Popular Psychology

Helping Someone Who Has Lost Someone To Suicide

2 Apr 2016by Torey C. Richards, LMHCLeave a Comment

Earlier this week I was called to talk to a juvenile who had witnessed her boyfriend shoot himself the night before. He didn’t make it. She was obviously upset and making her way through the various stages of grief, but what was most pronounced were denial and anger. She is only 15 and he was 18. His life already over. Her life changed forever. As I listened to her talk, first with disbelief, then with anger at herself for not stopping him, then anger at him for leaving her, until she finally broke down in uncontrollable sobbing before returning back to anger and guilt directed towards herself.

Sadly, during my career I have dealt with a lot of death, but suicides always present their own unique set of challenges. People who have lost someone to suicide often not only feel the grief and tremendous loss that comes along with death in general, but they often also feel guilty that someone they knew decided that whatever they were going through was too much to bear.

A couple of years ago in an auditorium filled with crying high school students, teachers, and parents, after a popular student athlete killed himself, what I heard most was people blaming themselves for not recognizing signs that weren’t there. While sometimes suicides come with warnings, often they are very abrupt.

The irrevocable pain the loved ones of someone who committed suicide feel can cause them to become an emotional and mental wreck. Those of us looking in from the outside often want to help, but are unsure how.

You don’t have to be trained as a mental health professional (trust me, often times all the training in the world doesn’t make it easier), but here are some ways you help someone you know who has lost someone to suicide.

Let them come to you.

As part of the Crisis team I had to go to several schools over the course of five years after a student had committed suicide. I would walk into a school I didn’t know and come face to face with distraught students, teachers, and parents I didn’t know. It is scary. The best thing I did was to be there and let those who wanted to talk come to me. If I saw that someone was obviously very upset I would go to them, hand them a tissue, sit next to them, and wait for them to open up to me. It always worked.

As a friend, try to normalize things. Let the moment be as natural as possible. When they are ready, they will talk as long as you are there.

Remember the good times.

This is a lesson I learned from watching other, more seasoned mental health professionals during those crisis moments. While acknowledging the tragedy of what happened is important, it can be just as important and powerful to help them remember the good times they had with the person they lost. While this may seem counter-intuitive, I’ve seen it work miracles in helping someone stop reflecting on death and to start celebrating someone’s life. I’ve seen people go from sobbing to laughing and from being unable to process the tragedy to opening up completely. So, when they are ready, encourage them remember and talk about happy memories about the person.

Ask good questions.

The young lady I spoke to earlier this week said what most people who lost someone to suicide say at some point; “I don’t understand why he did this.” Naturally I wanted to help her process that, but I knew it was more important that I resist that urge and get her to talk about herself.

It’s important to avoid statements like, “I’m sure you did everything you could”, but instead ask questions like, “Tell me what have you been thinking?”, “What was it like the last few times you were together?”, “What did you see?” These questions allow the person to open up as slowly and as much as they want to.

In the case of the young girl I spoke with earlier in the week, the last question was a big one because she had witnessed the suicide and it allowed us to process that entire scene at her own pace.

Be there, be mindful.

When someone experiences such a tragedy, often they are inconsolable. That is one of the few things that bothers me about getting sudden calls to talk to someone when they have just lost a loved one. I know that generally, with everything so raw, there’s not much I can say that is going to make them feel better in that moment.

What I do, and what you can do as well, is just be there. I sit with them and make myself available. I allow them to cry or to say nothing if they don’t want to. As a friend, you can do the same. You can put your arm around them, hug them, or just be there as a source of comfort. That can be more powerful than trying to find the right words to say.

Find the balance between intrusion and distance.

It is common after someone has lost someone that they will want to be alone so that they can figure out their own emotions and thoughts. You can give someone mental space while still remaining physically present.

What that means is, you can be in the same room with the person, but allow them silence if that is what they want. Allow them some space if that is what they need. You can even be in another room and remind them that you are there for them if they need you.

Offer practical help.

After an incredible loss, the person suffering will need help if they realize it or not. After my father died I spent countless days not eating, not showering, and only wanting to sleep. I didn’t even realize I was doing those things, I just remember that my life felt upside down.

Allow the person to go through the natural grief and mourning process, but also offer to help do things to make this time in their lives a little more manageable.

For instance, go grocery shopping for them, pick up the kids, and remind them to eat, to shower, or even ask them how you can be helpful. They may not know that they need help or even have the awareness to be thankful for the help you give them, but trust me, it will help them make it through the darkness.

Allow them to problem solve on their own.

Eventually, the person will ask more of the tough questions about why the person did what they did and what they could have or should have done. Try not to get caught up in problem solving for them, but allow them to work through that themselves. You can be there for them by asking intelligent questions like; “What thoughts did you have when the suicide first happened?” What thoughts do you have now?” But allow them to reflect and figure that out on their own so that they can put it in perspective for themselves.

Suicide is a tragedy and people who have suffered such an extreme lost need good friends to help see them through it.

Popular Psychology

What We Can Learn From The Dying

18 Nov 201418 Nov 2014by Torey C. Richards, LMHCLeave a Comment

I’ve read a lot of books and information about death, grief and suicide. Those books have been both some of the most depressing and uplifting books I have ever read. Some of the most interesting books have been on people who were terminally ill like a book written by Bronnie Ware called The Five Regrets of the Dying.

We can learn a lot from the regrets of the dying as regrets can give us insight if we look at them as things we can change so that hopefully we won’t have the same regrets. Here we’ll talk about the top five regrets of the dying as mentioned in The Five Regret.

I wish I’d had the courage to live a life true to myself, not the life others expected of me: Many of us live lives that are inauthentic to who we really are and what we really want. It’s hard not to when we have been bombarded since birth by our parents and later by society about who we should be and what we should want, even when it contradicts our true desires. Even more disturbing is that many of us have been so brainwashed that we don’t even know when we are living inauthentic and think that the thoughts and goals that have been inserted inside of our minds by culture, society and family, are really our own when in fact they may be keeping us from living authentically. Something we can work on is recognizing this and attempting to live a life that is more inline with our true desires and goals.
I wish I hadn’t worked so hard: We are taught that we are supposed to work hard and as a matter of fact, many people enjoy working hard, but many use working hard to escape dealing with other issues or work hard because it is what is expected of them. However, most people who are dying wished they would have spent more time doing things that nourished them, such as hobbies or spending time with friends and family, instead of working and collecting material items that now serve them little to no purpose. Sometimes we must work hard in order to pay the bills and “free time” doesn’t seem like an option, but we still have to find the time to do things that will serve us better spiritually.
I wish I had the courage to express my feelings: How many times do we hold our tongues and not say the things we really want to say to family, friends, etc? We end up becoming passive and not assertive in order to save face or avoid a potential argument. Furthermore, a lot of people have trouble expressing love and affection and miss out on opportunities to let others know how they truly feel about them. In order for us to live a life with less regrets, we have to live a more authentic life where we are not only in touch with our true feelings, but are able to express them.
I wish I had stayed in touch with my friends: It’s easy with the pressures of life and how fast paced things can be, to lose touch with our friends, but having healthy, nurturing relationships adds to the overall happiness and quality of life. Maybe today you can find a way to start re-connecting with good and healthy people that will help bring joy to your life.
I wish I had let myself be happier: In the book Five Regrets of the Dying, most people didn’t realize until they were dying that happiness is a choice. Sure things happen to us, many that are out of our control, but we still choose how to deal with that situation and how we will let it affect us. We can start becoming more aware and make more conscious decisions about how to deal and respond to those situations instead of allowing them to bring us down, make us angry or throw us for a loop.

The good thing about other peoples mistakes and regrets is that we can learn from them and hopefully not end up having the same regrets. We can all start today by looking over this list and incorporating our own so that we can live a happier, more authentic life.

Therapist are Humans Too

Am I An Effective Counselor? A Case Example On Counselor Effectiveness And Struggles When Working With A Client

21 Jan 201321 Jan 2013by Torey C. Richards, LMHC4 Comments

Often as a counselor, it’s not always easy to know when I am truly being effective in helping clients live better lives. This can be difficult because clients often lie, not only about their feelings, but also about their behavior, about following through with treatment recommendations and even about getting better.

Clients often put up lots of psychological defenses and resistance that make it difficult to know how effective treatment is being. Many of them learn how to better mask their symptoms, while all the while their depression, anxiety, compulsions, etc. are still raging inside of them, causing marked distress.

Of course there are many ways a counselor can try to verify the effectiveness of treatment such as assessment tools and reaching goals set forth in treatment plans, but most clients know how to fake those as well.

One of the most powerful ways to verify if treatment is being effective is through my own observations of the client during sessions. Clients who are depressed or anxious for example, tend to display those affects during therapy and as they progress, those symptoms tend to decrease and the clients whole persona will seem to improve.

Of course there are the times when a client will tell me how much they have changed, how much I have helped them or how much better they feel from counseling. And times when teachers or parents will tell me about the improvements they have seen in a student I’ve been working with, but sadly, in the school based program I do most of my counseling at, that type of feedback isn’t as common as I would like it to be. Still, when it happens, it feels great.

Case Example

For a little over a year now I’ve been working with a client we’ll call Suriyan. Suriyan came to me after she lost one of her parents suddenly. She was obviously grieving so I started working with her through her grief and put her in my grief counseling group. It was obvious almost immediately that Suriyan was grieving harder than anyone else in the group which consisted of other students her age, all whom had lost a parent within the last year.

Through individual counseling I realized that one of the reasons Suriyan was grieving so hard was because she had a pre-existing issue dealing with depression and self-injury, and on top of that, unlike the rest of the grief counseling group, her grieving is what we call complicated grief. Her parent had not only died suddenly, but she blamed her parent for dying and blamed herself for allowing her parent to die, although her parent died of a disease neither one of them had any control over. They had lots of unfinished business she was internalizing.

She felt that her parent was her best friend and had chosen to abandon her.

Suriyan initially was very resistant to counseling. She rarely participated in group and in individual sessions she would cycle between talking about her feelings, to being extremely angry, to totally shutting down. On top of that, she was cutting herself to deal with the pain and anger, and had become suicidal. She wanted to be with her parent. Her thought was, if my parent didn’t want to be here with me, why should I be here.

I was extremely worried about Suriyan, especially as the weeks went by and her depression wasn’t lifting. I was throwing everything at her, counseling wise, to try to get her to understand that she needed to let go of the anger and guilt she felt for and towards her parent. I felt like I was failing her and wanted to refer her to another counselor, but she didn’t want to see anyone else. As little as I seemed to be helping her, we had built a pretty good therapeutic relationship.

I started reading academic journals on grief, referring to other counselors for clinical advice and reading books as fast as I could to try to find new techniques, but ultimately patience on my part and time appeared to be the most effective technique.

In time her depression seemed to lift and she was able to talk about her parent’s death without placing blame on herself or her parent. She started participating in group, following my recommendations and keeping a journal to write in, which also seemed to help. By the end of last school year she had stopped cutting herself, was happier and was definitely in a better place.

Then summer came.

I tried to make sure over the summer she had access to counseling and even to me if needed, but when school started back this year she was almost even more depressed and upset about her parent’s death than when I first met her.

Now she was even more resistant to therapy, often missing appointments, yelling at me in session and walking out of sessions when I tried to get her to talk about things she was trying to avoid, like her suicidal thoughts, self-injury and how she was dealing with her parent’s death.

She would always come back, always wondering if I was mad at her or upset, which I never was. I knew her outbursts and “resistance” were also ways she was testing my claim of unconditional positive regard for her. She was suicidal again however. She had once been a highly motivated student, a senior with a dream to go to one of the top university’s in Florida, but now she claimed to not care about that or even graduating high school. She saw no point in anything.

She was also cutting herself again and one day in my office, after recently cutting herself in school and saying she wanted to kill herself, I had to have her involuntarily hospitalized. She was furious with me, but I knew at the time I had no choice and it broke my heart seeing her taken away, but I was positive I had did what was best for her.

She yelled that she would never come see me again or forgive me, but a week later she was released from the hospital and we settled back into a regular counseling routine. She was angry with me, but was actually thankful and told me that had I not had her hospitalized that day, she was positive she would have went home and killed herself.

Over the next few months we had our moments of resistance, but I wanted to continue to push her and to keep her goals in mind because I knew that once she got through this fog, she could be lost without guidance. I kept reminding her of her dreams and encouraging her to focus on the bigger picture. She is a brilliant young lady with huge aspirations that tended to get lost in the darkness of her depression.

There were some sessions when she didn’t want to talk so we worked on her college application or essay. Other times we just talked about random things, but through random conversation, we would end up talking about whatever was bothering her. In time she stopped cutting herself and her depression started lifting again. She started to focus on school although she had giving up somewhat on her dream of going to her first choice of college. I think she was afraid that she wouldn’t be able to take getting rejected, but I kept encouraging her to have faith while also preparing her just in case she got rejected. Still, the Universe seemed to be smiling upon her. She was winning award after award and was even “Senior of the week” recently.

She still had her bad days like over the Christmas break, which was only her second Christmas without her parent, and she will have other bad days, but she is moving forward and smiling a lot more. On top of that, she told me this past Friday that she had just gotten an acceptance letter from her first choice university. Not only did she get accepted, her first semester and perhaps even more, are already paid for including room and board. She was so excited and I was one of the first people outside of her family that she called to tell.

I was so happy because I know how much she wanted this and what this would do for her self-esteem and the doors it will open for her future. She would not only be the first person in her family to go to college, but she is going to probably the top university in the state of Florida.

She was so thankful for, “All you have done for me. For not giving up on me and for to encouraging me to follow my dreams.” I was nearly in tears because I was so happy for her, but I was quick to remind her that everything she has done to get to this point is all her and not me. She did all of this and I was just there to help guide her, but she did all the hard work. It was important to me that she took credit for her achievement so that she would know she could achieve anything she set out to, by herself if she had to.

When I got through talking with Suriyan, I was able to sit back and see how far we had come together and say that counseling had been effective. Sure it’s not done, she still has some tough days ahead, but I’ll work with her through those days until she goes off to college and even then, I will make sure she is in contact with a good counselor and make sure she is aware of the great support groups they have on campus.

I don’t do this type of work for me, I do it to help people live their best lives so this is not about me being a good counselor. There are times when I am unsure of if I am a good or effective counselor, but there are days and clients like this, when I can look back and reflect and say, yes, I am a good counselor.

Uncategorized

Looking at the Five Stages of Grief in Our Daily Lives

9 May 20129 May 2012by Torey C. Richards, LMHC1 Comment

Elizabeth Kubler-Ross developed the five stages of grief theory after her work with terminally ill patients. It is a widely used theory used to explain what happens when people are coping with dying and now is even used outside of death to include any experience of loss including divorce, separation and bereavement. The five stages are:

Denial- “I am fine”
Anger- “Why me! It’s not fair!”
Bargaining- “I’ll do anything for a few more years!” “I promise to go to church everyday!”
Depression- “I’m dying, what’s the point of trying to be happy?”
Acceptance- “I can’t fight it. It’s happening. I might as well be prepared for it the best way I can.”

People often go through these stages in different orders and sometimes from one to the other and back again. For example, someone can be in acceptance and go back to bargaining, or go from denial to depression while skipping anger and bargaining. While this theory has most widely been studied and accepted in dealing with the dying and grieving, in my experience, I’ve notice that it seems to apply outside of these populations.

The Five Stages of Grief Outside of The Grieving Population

Substance Abuse

In working with substance abuse users, they often times also experience the five stages of grief. There is a period of denial that there is a problem, anger that there may be a problem, pleading with themselves or a higher power to take away the problem, a period of depression as the reality of the problem starts to set in and then acceptance eventually sets in, more so in those seeking treatment compared to those who do not seek help and seem to remain in the denial stage. Even family members of substance abusers tend to go through the stages of grief in dealing with the family member who is abusing substances.

Loss of a Relationship/Affair

Often times the unseen or unwanted end of a relationship sends someone through the five stages of grief. The same sometimes happens when an affair is discovered or sensed. The person first is in denial and then as further evidence is discovered, the person becomes angry and then bargains with themselves, the other person, the universe or whoever for this not to be happening, and then they usually fall into a depression and then eventually acceptance which allows them to try to deal with the reality of the situation in a healthy way.

Sexual Abuse

In cases of sexual abuse, families often go through the five stages of grief. Sometimes it’s a mother who goes through the stages when confronted with evidence or suspicion that one of her kids is being molested by a new boyfriend. Recently I started working with a young girl who was sexually abused by her uncle, who had recently gotten out of prison for sexually assaulting a minor, but still no one in her family believed her until a year later when her younger sister became pregnant with her uncle’s baby. That tragedy could have been avoided if the family would have not stayed in the denial stage for so long in realizing that her uncle was a sexual predator.

Mental Illness

I wrote in a previous post about parents denial of their child’s mental illness. From my experience, parents often go through the five stages of grief when it comes to facing the fact that their child has certain challenges such as ADHD, anxiety or mood disorders or even more severe issues. Mentally ill individuals also sometimes go through the fives stages of grief, not wanting to admit or accept that they may have a depressive disorder, an anger problem, or whatever it may be. This is what usually keeps them from seeking help for years until they finally reach the acceptance stage.

Everyday Life

I know there are many other times and situations in which the five stages of grief can be applied, but the ones I named above are the ones I seem to deal with the most. How have the five stages of grief showed up in your life? Have you been diagnosed with an illness and went through a period of denial, anger, bargaining, depression and finally acceptance? I know when I was diagnosed with type II diabetes I went through the five stages of grief and it was only when I reached the acceptance stage that I was able to actively take control of my life.

Grief Counseling

Dying Changes Everything

26 Mar 201227 Mar 2012by Torey C. Richards, LMHCLeave a Comment

My New Grief Group Part 2

Grief work is definitely an extremely rewarding experience. My grief group is still my favorite group of all and we are on week four I think. There is just so much I get out of the group and yet it is one of the most emotionally draining parts of my week.

Last week one of the members came to me in private and broke down crying. She was angry, angry at God, angry at her mother and angry at herself. She blamed God for taking her mother. She blamed her mother for not telling her she was going to die (her mother was sick and she assumed her mother knew just how terminally ill she really was) and she blamed herself for not being there when her mother died (as if she were psychic).

I listened to her frustrations and processed her irrational thoughts with her, but it was hard for me to see and hear such a beautiful girl in so much emotional pain, knowing that the only thing that could make her happy was implausible. So much had changed in her life since her mother had passed away…

Her mother was her sole guardian, so right now no one has any real guardianship legally over her although she is staying with an aunt. Her grades in school are suffering and her dreams for the future have been derailed because “nothing matters any more”. At seventeen, in high school, no one should lose their mother. “It’s not fair” are the words she cried out and I agree with her, it’s not fair, but it’s what happened and now we have to try to find the strength and the courage to move on. The road ahead is not easy, but it is doable. It’s at these times I definitely try to encourage my clients spiritual beliefs, because at times like this, they are often all we have to try to make some since of what has happened, why it has happened, and how to move forward.

I would do anything to make this client and all the clients in my grief group happier, and I know the fifty minutes they spend with me a week processing and dealing with their feelings over thier loved ones death may not always be the most pleasant way to spend their time, but I know it is necessary to deal with it now while it is fresh than to bury it and have to deal with it repeatedly later in life.

Grief Counseling

My New Grief Group

10 Mar 201227 Mar 2012by Torey C. Richards, LMHC6 Comments

About three weeks ago I started my first grief group. Normally I had dealt with grief sporadically. It always seemed to be one of those things that came out of the blue and I was never truly prepared for, but about three weeks ago I was referred a handful of students who’s father, brother or mother had all died within the past two months and I figured it was the perfect time to add a new group to my array of groups that had only included anger management, life skills and substance abuse groups for the past three years.

I had been hesitant about adding a grief group because I don’t really like dealing with grief. I find it to be such a sad subject and I definitely didn’t want to spend fifty minutes a week surrounded by grieving teenagers. I thought it would be draining and depressing, but today I finished my third meeting with the five students in that group and so far find it to be my most spiritual and emotionally rewarding group.

Two members of my group are sisters who lost their mother to heart disease a couple of months ago. Another is a young man who lost his brother during a botch robbery. Another young woman lost her mother to cancer. Another young man lost his father to diabetes and the newest member of our group lost her mother due to complications due to lupus. I myself lost my father a little more than ten years ago to a car accident, so I was aware that there would probably be some emotional issues rising within myself as I conducted the group.

Right now I am battling controlling those emotions. Today as I was leading an exercise that dealt with what we missed the most about the person that passed away, I felt my eyes starting to water and I fought hard to not show it. I know on one hand it may be good for the group to see me dealing with my own issues of grief, but on the other hand I feel as the facilitator of the group, I need to always (or at least 99% of the time) be in control of my own emotions. I’ve never gotten grief therapy myself and have avoided talking about my father’s death in my own personal therapy, so yes I know this is “unfinished business”, but in the line of therapy, we therapist are human and there will always be times we knowingly or unexpectedly come across unfinished business or counter transference issues.

Eventually I’ll figure this out. I’ve told the group that there may be times when we are all crying together, and that’s okay, normal and healthy. Maybe I was preparing them so they won’t be shocked when and if I too start crying. I’ve never cried in a therapy session, not that I haven’t felt like crying, I just never allowed the tears to fall. However, in this group, I not only think it may at some point be appropriate to shed my tears, but also enlivening for me and the group members as they look to me for guidance on how to deal with their own grief.