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July 24, 2017 by Brighton & Hove Psychotherapy Leave a Comment

Grief – how to grieve?

Grief is often referred to in the context of intense feelings experienced with the loss of a loved one. The loss we experience is often caused through death. Grief is, therefore, synonymous with bereavement.

This, however, is nowhere near the whole story. In order to know how to grieve, we need to understand grief.

When we are told that someone is grieving, we may assume they are feeling intensely sad. Although this is often true, grief is comprised of a multitude of emotions, and sadness is only one. One of the early pioneers of grief work (yes, there is such a thing), was Elizabeth Kübler-Ross. She suggested grieving was an active process that required a “working through of emotions” broken down into five core groups: denial, anger, bargaining, depression and acceptance. Sadness would fall into the ‘depression’ group in this model.

Since Kübler-Ross, plenty of other models have been proposed. All of these have added something to the field. I will not directly elaborate on these in this blog, but further information can be found on the Internet.

Grief is, therefore, an umbrella term for a whole host of emotions, and it is a verb.  It is something that we must allow ourselves to experience and actively engage with.

 Why should I grieve?

Emotions exist within us, whether we consciously acknowledge them or not.  Where we are unable to feel them (through repression, which is always unconscious) these emotions will often express themselves as a conversion reaction. They will be expressed through the body such as in aches and pains. They may be expressed through even more obscure symptoms, such as a loss of physical movement.

Where we are aware that we are feeling grief, but actively suppress the feeling, emotions are likely to manifest as anxiety or depressive symptoms, which can persist for years.

Thus, there is no escaping it, grief must be felt and ridden out, like a storm. To complicate things further, it is not a linear process. We might have felt anger (perhaps with our loved one for leaving us) and moved onto bargaining (“If only I had done more for them…”) However, this does not mean that we will not return to anger again. And again…

We must grieve because we need to acknowledge what we feel.  If we do not (because we can’t or won’t) things get complicated.

How do I grieve?

Grieving (in the context of bereavement) used to be a socially prescribed activity which was both acknowledged by the wider community and defined as a process. Those who were bereaved would often wear symbols of their grief – black clothes or a black armband. Within their community, it was acknowledged that they would be grieving for a set period of time, often a year. This practice has largely been lost in northern Europe. However, in southern Europe, it remains common in more traditional communities to see widows wearing black for the remainder of their lives.

Religion

Love it or hate it, the one thing religion gave (or gives) us is a powerful story of what happens after we die.  From the Vikings with Valhalla to the Christians and Heaven, the concept of an afterlife can bring great solace to loved ones who are left behind.  The loss of socially prescribed ways of mourning, combined with a loss of religious beliefs, has made grieving more difficult.

Meaning making

A universal task in coming to terms with grief is to find some sense of meaning within it, and to weave this together into a narrative. We are no longer provided with cultural narratives in the way that we once were. This then becomes something that we need to do ourselves.

Why is grief hard for some people?

When I embarked on my own professional psychotherapy career, working directly with dying patients and their relatives, I imagined that the loss of the deceased would be felt most acutely where relationships had been close, connected and happy. However, the inverse was true. Where relationships had been difficult, strained, or even devoid of contact for long periods of time, the bereaved would often struggle to process the loss far more. This occurred particularly where the relationship was between a parent and their (adult) child.

The reason for this lies in attachment and in how we learn, through attachment, to feel.  For those of us lucky enough to grow up in homes where there is no abuse or neglect, and no unexpected losses, we find it relatively easy to move in and out of relationship – to say ‘hello’ and ‘goodbye’. With the security of the relationship comes an ability to feel emotions and make sense of what is being felt. Thus, the process of grieving, whilst hard, is something that can be actively undertaken.

In some parent/child relationships, the child has been significantly disappointed by the parent in the past. Parental neglect and/or abuse can lead to an accumulation of unacknowledged earlier losses in the relationship. In these cases, the final physical loss of the parent can make it very hard to come to terms with the enormity of all the losses that person represents. The loss is not only of the relationship and person, but also of hope. If the relationship between parent and child was strained or difficult, it is likely the bereaved will be poor at navigating his or her emotional states. This makes grieving terrifying, at best, or unthinkable, at worst.

Grieving is normal

As a clinician, I get a lot of fulfilment in helping clients to grieve. It is different from any other presenting issue they bring to me. Grief is the universal leveller. We will all experience it at some point in our lives. The way out and through grief is always the same – we have to feel the full range of emotions that our grief brings up.

Grief is not a mental health condition, and yet many people become stuck with their grief. When this happens, the secondary symptoms can mutate into more complex conditions such as anxiety, clinical depression and panic attacks.

Mark Vahrmeyer is a UKCP-registered psychotherapist working in private practice in Hove and Lewes, East Sussex. He is trained in relational psychotherapy and uses an integrative approach of psychodynamic, attachment and body psychotherapy to facilitate change with clients.

Click here to download a PDF version of this post.

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Filed Under: Attachment, Families, Loss, Mark Vahrmeyer Tagged With: attachment, Emotions, Family, grief

June 6, 2017 by Brighton & Hove Psychotherapy Leave a Comment

Love, commitment and desire in the age of choice

Throughout history, the institution of marriage and our understanding and expectations of committed relationships have shifted with the socio-political and economic tides. Where once marriage was primarily an economic arrangement to maintain patriarchy and secure lineage, by the end of the 19th century, new id

eas about romantic love were emerging. Whilst love was not yet understood as a precondition for marriage, it was now considered that marriage was a viable arrangement in which it might flourish.

The social and cultural revolution of the ’60s saw sex liberated from reproduction with the advent of the contraceptive pill. With the rise of feminism and the gay movement, sexuality was redefined as a property of the self and sexual expression as a fundamental human right.

The age of individualism has coincided with an erosion of the old structures and traditional institutions of extended family, community and religion. In the West today, the couple has become the central unit in our social organisation.

Disconnected from many traditional resources, the modern couple is thrown back upon itself to sustain the emotional connection and protections once provided by much larger social networks. A tall order, therapist and author Esther Perel suggests, to find all of this located in one person. We are freer then ever before and yet, paradoxically, also more alone.

Romantic love and desire is now the cornerstone of commitment in modern relationships. Definitions of commitment are largely organised around assumed notions of monogamy.  As Perel reminds us, where once monogamy meant one sexual partner for life, it is now understood as one person at a time. In modern marriage, the new monogamy principle contains an implicit commitment to no longer pursue sex with others.*

The demands on the modern couple are immense and complex. How do we reconcile a need for safety with a need for adventure, and can we find them both in one person? Can we desire, Perel asks, what we already have?

Consumer ideals of personal satisfaction, happiness and fulfilment drive and perpetuate the myth of “the one” perfect partner with whom we might find completion. Seductive as the notion is, it perhaps does more to fuel dissatisfaction and disappointment, as the statistics on divorce might reflect. Indeed, the consumer principle depends upon dissatisfaction, and inevitably and conveniently, peddles the cure. In the digital age, we are drowning in an ocean of relentless choice and the tantalising promise that opportunity and fulfilment could be just one swipe away. Our anxiety is rising in proportion. What impact does this have on modern relationships?

It is so often the case that couples come to therapy as slightly diminished versions of their true selves.  Indeed, relationships can feel so burdensome at times, so filled with worry and responsibility that there may be little space to connect to a sense of ones self at all. Loneliness in the presence of another abounds.

Couples therapy can offer a refuge for couples to pause and reflect, to consider and understand the cultural constraints, constructions and contexts of modern love. It can support people in an understanding of their personal emotional histories and how they inform and shape the people they have become. In our original family, we learn how to feel about our bodies, our gender and our sexuality. In couples therapy, we can explore the impact of then on now.

Whatever else love is, it is a story, and one we might be wiser for reminding ourselves that can be reviewed, re-visioned and retold. Perhaps it is time to cultivate new conversations about love and desire, to set them within an ecological narrative that acknowledges complexity and nuance. One in which we might learn more and fear less the natural tension that exists between the erotic and the domestic and the contradictory longings of modern relationships, such that we can remain alive to our partners, our selves, and our world.

* I speak here in very broad terms and acknowledge newly emerging paradigms in sexual identity and relating. To be explored in future blogs.

Gerry Gilmartin is an accredited, registered and experienced psychotherapeutic counsellor who is available at our Hove practice.

Click here to listen to our podcast on this post.

Click here to download a PDF version of this post.

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Filed Under: Families, Gerry Gilmartin Tagged With: couples therapy, Relationships, self-awareness, sense of belonging

May 9, 2017 by Brighton & Hove Psychotherapy Leave a Comment

Shame

What is shame?

Shame is hard to talk about, as we tend to manage it through secrecy. We hide what we are most ashamed of about ourselves. Unfortunately, shame is bound up with our bodies and so moments of feeling ashamed can often be accompanied by physiological responses which feel exposing and so exacerbate our shame further. Shame is a social experience as it seems to rely on the presence – in reality or in our minds – of an observing other or others.

Shame can also be linked to social differences, such as class, sexuality, ethnicity or disability. This is because at a social level, certain groups are made to feel shame for the rest of society. In this way, shame is also connected to power. Shame can be culturally specific – i.e. what might be regarded as shameful for one culture may be less or more so for another.

Potential origins of problematic shame

Shame is thought to be bound up with feelings about the ‘self’ and identity. It arises at an early stage in childhood when we realise there is a gap between our experience of ourselves from within and how we might be seen from outside. Shame is therefore linked to self-awareness and how we might appear to the ‘other’. Early in childhood this ‘other’ will be main caregivers and their responses provide a blueprint for later experiences of being ‘seen’. How early family relationships mirror back to the child approval or disapproval is likely to shape their relationship to shame.

Shame does have positive functions. It helps us know about appropriateness in our relationships with others. Shame is normal and a part of being human. In an ideal world, we would all be able to experience shame fleetingly.

However, chronic shame is highly problematic for many people. As shame is very inhibiting, it can prevent healthy openness and authenticity. Whatever is felt to be shameful in the person must be covered up.  This protective mechanism further complicates the damage shame can do to healthy development and the quality of relationships. Examples of this might include; vulnerability hidden away behind a veneer of toughness or aggression, angry feelings that are disguised and managed by over-compliance, sexual desires that need to be suppressed and protected by prudishness or disgust. This list could go on.

How psychotherapy and counselling can help break the cycle of shame

Individual psychotherapy can often be the starting point for the individual to test out and expose their hidden shame. Sometimes, people are very aware of what shames them. However, this is not always the case and not all areas of shame are fully known about. It can be a surprise, during psychotherapy or counselling, to realise certain memories, experiences, thoughts, or feelings produce intense shame. The therapist helps investigate and tackle shame through their specific type of therapy. In this process, it is also their non-judgmental and accepting attitude that helps to undo earlier experiences of disapproval and criticism.

While the idea of a psychotherapy group can feel intimidating for people struggling with experiences of chronic shame, the non-judgemental atmosphere of the group can dissolve shameful feelings powerfully. Because shame is based in the experiences or fantasies of disapproving other/s, stepping into a social domain such as a group can help engage with and counter these feelings in a very direct and immediate way.

Secrecy fuels and exacerbates shame, however, it can also feel that it is the only way to protect the self from the experience of being seen in a shaming way. The safe and non-judgemental relationships offered in individual psychotherapy or group psychotherapy can provide the opportunity to take tentative first steps towards breaking out of the destructive cycles of secrecy and shame.

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

Click here to listen to our podcast on this post.

Click here to download a PDF version of this post.

Face to Face and Online Therapy Help Available Now

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Filed Under: Claire Barnes, Families, Relationships Tagged With: Family, group therapy, Interpersonal relationships, shame

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