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Reflections on bereavement

The experience of loss and grief from bereavement are often explored in psychotherapy. Finding a way to cope and move forward, when the weight of emotion feels intense. The knowledge that life ends and how we go through the associated grief is something that is hard to prepare for. Much is written about loss and grief, but from experience some common themes do emerge.

Loss is not a straight line

How do we deal with, process and manage bereavement, loss and grief? There is evidence of stages, an indication of what one might experience and how one might cope. This is always reassuring to think that we can put structure around what can feel chaotic, especially when the emotions can feel unbearable. Being able to feel that we have some control of our emotions when we are potentially overwhelmed by them. How we think about such guidance is where the challenge lies. Loss is not a straight line. The emotions surrounding it can be complex and rarely follow any neat progression. Can we be reflective, aware of how we feel and avoid pressuring ourselves to ‘move on’? Is it possible to let the emotions happen and not feel that we have to be good at how we handle death and grief?

Loss is individual

Speaking of stages and process around loss can give structure to what is going on, but can also cause us to compare ourselves to others. Seeing that everyone moves at a different pace, for whatever reason, can be hard to manage. How do we feel when others seem to be moving on, but we feel stuck? This is the point at which the individuality of death can feel most important. Everyone experiences it in a different way and thus will grieve differently. Being aware of this and resisting comparisons with others can make us feel more able to cope and less isolated with our individual experience.

Also individual is the actual response to death. The relationships that we have to the deceased always come with a different set of emotions. One person’s extreme grief can contrast with someone else’s mild sadness. Being able to express and value whatever emotional response one has is important, and ideally every response can be heard.

Loss can feel ‘ugly’

Sadness is probably the obvious emotion that comes to mind when we think of loss. Therefore, to experience anger, frustration, annoyance, and other emotions that feel a long way from sadness, isn’t easy. I once heard it described as the ‘ugly’ side of grief. It is however quite likely that one could feel any or all of these. They are hard to make sense of and hard to share with those who are also grieving. Can we share these feelings, or do they feel too challenging to be brought up? The ‘ugly’ emotions are part of grieving, so how do we find a way to acknowledge them and not feel that we are being hurtful towards the deceased or those who are also grieving?

Loss has associations

When we talk about loss and grief, it often isn’t always about one event. To grieve is to be open to a series of emotions that might take us far from what has actually happened. Past events, personal experiences, present issues can’t be neatly separated when we experience loss. Being open to this and able to acknowledge that life events don’t happen in isolation can help to frame one’s emotional response.

Loss, grief and psychotherapy

In all these reflections the common theme is that we need the space to reflect and process loss and grief. A strong support network of family and friends can be helpful. Sometimes however such a network is hard to find or speak with and at this point talking therapy can provide that reflective space. Psychotherapy for bereavement gives the bereaved the opportunity to be reflective and open with every emotion and ultimately work through their grief.

 

David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove . To enquire about psychotherapy sessions with David , please contact him here, or to view our full clinical team, please click here.

 

Further reading by David Work –

Compulsive use of pornography

Mental health in retirement

Subjective perception, shared experience

In support of being average

Collective grief

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I worked as a psychotherapist with death. Here’s what I learnt

Most psychotherapists have specific experience in one or multiple fields and one of mine happens to be death.

From 2012 to 2016, I worked at a large UK hospice as part of the clinical team supporting both patients and relatives. The work was confronting, humbling and hugely varied and it taught me a few things about death which I would like to share.

Why did I choose death?

Every psychotherapist who is well trained and has undergone their own analysis or depth psychotherapy knows that they cannot be ‘good’ at working with every patient group. None of us can be good at everything and this is especially true in the field of psychotherapy where we have our own history, traumas and blind spots. Equally, we also know not only where we are not so good, but also which challenges or pathologies we like working with and with which we get good results. For me, one of these is death.

I understand why – I was raised by a father who was already 60 when I was born. Throw in his fairly volatile and depressive personality, no other relatives and being moved from country to country as a kid, and I was left hypervigilant about his health.

I remember I would come home from nights out in my late teens, ears still ringing from whichever nightclub I had been in, and intently try to listen for his snoring as I passed his bedroom door on my way to bed. Sometimes it would take quite some time for my ears to pick up signs of life and during those moments my mind would anxiously imagine that he had died and I was all alone.

As it happened, despite my father’s depressive nature, his diet of sugary drinks and biscuits and his penchant for getting divorced (six times), he managed to live to 94. So much for the predictability of death!

Being reminded about death makes us anxious

This first point brings together empirical research in the field of how we cope with death anxiety – terror management theory (TMT) – and my own lived experience working as a clinician with patients who were dying.

TMT is a research field I used in my MA on this topic and the underlying premise is that we are all, at our core, terrified of death; we are, as far as we know, the only mammals who have sufficient consciousness to know we are going to die and yet, alongside this, need to somehow lead meaningful lives.

When exposed to direct or indirect reminders of death, the research shows that our anxiety levels increase exponentially and heavily influence our decisions in favour of safer, more conservative choices. It’s fascinating stuff.

My experience of working with patients versus their relatives was quite distinctly opposed, even though on the face of it, I was dealing with a similar ‘presenting issue’. Working with relatives who were either pre- or post-bereavement was often messy – there would be a lot of tears, for example – and sad, but it did not make me feel anxious. They had gone through something and I hadn’t. There was a separation between us. And the work,
however hard, was grief work, which has a trajectory.

What rendered me anxious was working with patients, which quite literally meant sitting with death. My first experience of this was in seeing a patient for an initial consultation who had resisted having any therapy for quite some time and finally decided that the time had come for him to do some work with me. He was relatively young, reasonably fit (given he had stage four cancer), middle-class and clearly a positive character. I liked him. We agreed some key areas he wished to look at and parted company planning to meet at the
same time and same place (the hospice) one week later.

A week later I arrived at my office and opened the patient record system to check on him and other patients who had been referred to me. I had been looking forward to my session with this first patient, only to read that he had died. Not only that but he had died the evening after I saw him and yet had walked out of the hospice comfortably under his own steam. This was not the plan (his nor mine) and was not supposed to happen. But it did.

Working with death is both the easiest and hardest thing to do

Grief work has been extensively written about and, if you are that way inclined, there are numerous models of how to work with grief that can be applied including the now simplistic and ubiquitous ‘Five Stages of Grief’ by Elisabeth Kübler-Ross. The models are not complicated and nor are the steps. What’s hard is being with death and the feelings that death brings up for us.

Part of my role at the hospice was to recruit and train volunteer counsellors at our yearly intake. These volunteers would go through a ten-week training programme on top of the basic clinical training they had already undergone, and did so in part to gain clinical experience and for many also because they had an interest in death.

We would generally over-recruit by 100% as invariably there would be people who would drop-out of the course for family reasons, personal reasons or a general lack of skills.

However, there was one particular week during the training when we would see the most leavers and that was week four – this happened year after year. In week three the trainees left the classroom environment for the first time and were given a tour of the hospice including the inpatient unit.

The inpatient unit in any hospice is generally where patients come to die. Nothing advertises this reality and compared to most hospitals the ward was bright, cheerful and airy with views over a beautiful garden. The trainees would see one of the empty rooms and be aware of the presence of patients behind the other closed doors. The unease was palpable. Death had become real.

By the following week we had usually had four or five counsellors leave ostensibly for ‘personal reasons’ but after four years the pattern was impossible to ignore: it is one thing to conceptualise death; quite another to be face-to-face with it.

In death there is no ‘us’ and ‘them’

Most of the issues or challenges that I work with, are not ones I have directly experienced and nor will I. I can work with addiction without having been an addict, I can work with eating disorders whilst always having had a healthy appetite and I can work with abandonment as the person doing the abandonment is not my parent.

Death is different.

There is a part of us all that lies hidden, that knows that we face the same fate and try to escape it. And we all can, at least temporarily. But, no matter how hard we try, how much money we have and how ‘good’ a person we are, we will all have to face an uncertain death. Death is ‘us’.

I am a good clinician but I have never felt the same degree of helplessness as when sitting with a patient who is dying and somehow trying to be of use as they face regrets and terror. It is extremely humbling and difficult.

Psychotherapy treatment does not always take place in a consulting room

I am psycho-analytically trained and that means that I tend to see my patients in private practice at the same place, on the same day and at the same time every week. Ongoing. I attempt to remain as consistent as I can and with most of my clinical work the relationship we build lasts many months if not years. This is not how it is working with death.

I have ‘treated’ patients by their bedside, quite frequently with nurses busting in and out of the room and yet been able to offer something.

I have given sessions that lasted little more than minutes as that was all the patient could endure before the pain or hallucinations took them away from contact with me. They were worthwhile.

One session that remains firmly embedded in my mind was with patient who was dying from a brain tumour. She was in many ways hardly recognisable as a human; she had lost her hair, her body shape, was covered in scars from operations and swollen from steroids.

I will admit it was hard to sit with her.

This patient told me about a door at the bottom of her bed that led to her sister’s beach hut in Devon where she was able to run on the beach with her sibling. She asked me if it was real. I thought about this knowing full well that her experience was, at least by way of clinical explanation, a hallucination caused by the morphine. She seemed to gain a lot of joy and peace from her ‘hallucination’ and so that is what we talked about. This was
therapeutic for her. It was a way of escaping her predicament and feeling like the master of her own life again.

Oh, and unlike the planned ending I usually co-create with my private practice patients, it was rare to have a ‘planned’ ending with a hospice patient. Whilst they would happen on occasion, the ending was usually dictated by death and I would learn of this via the digital patient record system at the start of my day.

Grieving is not complicated when the relationship is one that is secure and loving

Prior to working in this field, I had naively assumed that the closer a relationship – especially between parent and child – the more complicated and sadder would be the grieving process. This is not the case.

The complicated cases of grief were often those where parent and child were estranged and the now adult child was suddenly involved in providing care for their parent. What made the grief complicated was that it was not just the grief of the death of that parent, but the grief of never really having had the parent they wanted and needed. The death symbolised the loss of all hope that things could and would be different.

In secure and loving relationships, the lost loved one (often a parent) could be mourned and grieved for but it was generally something that the bereaved could do themselves and with other loved ones – I was not needed.

Hidden psychopathology surfaces when approaching death

Part of my role was to attend multi-disciplinary clinical meetings, particularly in the cases of patients who seemed to be psychologically struggling.

It was from working with these patients that I came to understand how severe psychopathology can find a place to hide throughout a lifetime and it is not until the approach of death, as more and more of the socially sanctioned hiding places are stripped away, that the patient’s real pathology surfaces.

In one case I recall working with a patient who was successful both professionally and personally and yet who was now clearly fragmenting and displaying all the signs of having a personality disorder. He had the whole clinical team running after his every whim and would present contradictory parts of himself to different team members. The result was that his internal conflict played out in the clinical team as overt conflict. It was only through helping them (and them helping me) to think through what was ‘being put into us’ that we could understand his pathology and step out of the projections. He created chaos in lieu of being able to control his life as he had done for 70-odd years, and the chaos protected him from facing death.

We can only stare at the sun for so long

Irvin Yalom, the great existential psychotherapist wrote a book on death with the title ‘Staring at the Sun’, which I believe to be an apt analogy for how we humans deal with the reality of death. Just as it is blinding and impossible to stare at the sun for any length of time, so it is with death. We can squint at it, consider it, intellectualise it, rationalise it, but we can only really be with it for a short while before it starts to overwhelm us and we must look away.

I used to leave the hospice with a skip in my step and noticed that I would generally play my music louder than usual in the car on the way home. I got curious about this and realised that I had been unconsciously playing my own little game with death which went something like ‘Ha! Today you don’t get me!’. Nothing wrong with this and if death can make us feel more alive that is a good thing. But I also recognised my own history
repeating itself stretching back to me listening at my father’s bedroom door for signs of life – ‘not today…’.

After four years I made the decision to leave palliative care and focus more on private practice. Interestingly within a couple of years the whole team I had worked with had moved on and most had also left palliative care. I think we had perhaps collectively stared at the sun long enough and turned away to instead be a little more in denial like everyone else.

 

Mark Vahrmeyer, UKCP Registered, BHP Co-founder is an integrative psychotherapist with a wide range of clinical experience from both the public and private sectors. He currently sees both individuals and couples, primarily for ongoing psychotherapy.  Mark is available at the Lewes and Brighton & Hove Practices.

 

Further reading by Mark Vahrmeyer – 

What is Love?

What is the difference between loving and longing?

Why do we expect women to smile and not men?

Is there something wrong with me for hating Christmas?

Why do some of us feel a constant sense of dread?

 

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Collective Grief

Recent Events: The Death of Queen Elizabeth and COVID

The recent death of Queen Elizabeth has drawn people together in grief in a ways both individual and shared. Having been Queen and a globally public figure for 70 years, her death felt like the loss of what had been a constant and stable presence in our lives.

The COVID pandemic forced us to engage with mortality in a way that many people hadn’t ever had to. We found ourselves experiencing emotions and feelings in ways that were unexpected and unsettling. We had to find a way to feel safe, in the face on what could feel like an invisible threat. Sharing the vulnerability of COVID became a way of coping with our feelings when so much felt unknown and uncertain.

Both of these events gave rise to feelings of loss and grief that were public and shared, yet they felt very different.

Contrasting experiences of grief

The experience of loss is something that no one can assume to avoid in life. It is part of human existence and can be the most obvious way in which we experience grief. The experience of grief is subjective and effects people in ways as individual as we are. Whilst some people appear unmoved and stoic, others can feel intense and uncontrollable emotions. Grief can be present in life in ways that can be hard to explain, either at the time, or at points in the future.

The death of a public figure and our sense of grief gives us an understanding of how we related to that person. Do we feel the loss of someone that we felt a closeness to, or do we find ourselves having ambivalent feelings? How does the loss affect our lives and what does it mean for us? Answers to these questions show us how unique our grief can be.

Sharing our grief over the death of Queen Elizabeth can feel as if it gives us permission to mourn and experience our own grief. We can attribute our emotions to an event that is shared and understood. We find comfort in sharing grief with others with a similar lived experience.

Looking back at the pandemic it could be hard to find ways in which to express feelings of grief, when everyone was trying to make sense of what was going on. Why we felt the way that we did wasn’t always easy to understand.

The pandemic also challenged us to experience death in ways that were far from what anyone would want. The absence of the ability to share grief at collective events like funerals and memorials left a sense of something unfinished and denied us the opportunity to find ways to understand our grief.

Comparable experiences of grief

Comparing the experience of loss and grief between the COVID pandemic and the death of Queen Elizabeth might seem rather obtuse. Both are joined by the collective nature of the events and how there felt like something inescapable about being aware of a collective sense of grief.

There is some comfort in the shared nature of what has happened and the sense that ‘we’re all in this together’ offers some reassurance, yet grief is still an individual experience

Grief and Psychotherapy

Loss and grief are parts of our existence, yet they can affect us in ways that can be unpredictable and unsettling. Being able to think with a therapist about how one is experiencing loss and grief can help to give understanding and a sense that what can at times can feel overwhelming can become less acute.

 

David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove .

To enquire about psychotherapy sessions with David , please contact him here, or to view our full clinical team, please click here.

 

Further reading by David Work –

The challenge of change

Thinking about origins

Bridging Political divides

Save? Edit? Delete?

Football, psychotherapy and engaging with male clients

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Loss

You can hold yourself back from the sufferings of the world, that is something you are free to do and it accords with your nature, but perhaps this very holding back is the one suffering you could avoid.”? Franz Kafka

Loss is a feature in almost every encounter we experience as psychotherapists. It’s a common part of being human. In this article, we will look at what loss is and what we can do with it.

What Is Loss?

Loss is a term we use to describe many experiences and not just death. Although bereavement is what we associate with loss, more everyday losses that we experience include loss of identity, the loss of childhood experiences, the loss of friendships or relationships or simply the loss you feel from a change in situations. Loss can be experienced in a range of different ways, and if not properly processed, it can have a profound impact on your life and mental well-being.

How To Cope with Loss

Experiencing a loss can make you feel like you have a lack of control. It’s therefore helpful to look at the things you do have control over and do things to make you feel more in control. Breaking things down into smaller, more manageable pieces ensures you don’t overwhelm yourself. For example, maintaining a routine and slowly introducing smaller goals can give you a sense of purpose.

Therapy is also a great tool for working through your loss, whatever that loss may be.

How Therapy Can Help With Loss

Talking to a professional psychotherapist can help you understand your feelings of loss and support you in overcoming them. As therapists, we reflect mentally through our own experiences and mirror them onto our clients, so they feel understood. Grief and loss cause pain, and this must be managed to ensure a healthy life.

This reflective process helps clients understand what they are doing to manage their grief. We’re not here to judge, but to bring awareness to it so it can be looked at more in-depth. Over time, through exploration of these survival strategies, the frightening experience of grief will pass. Sometimes, a loss must be examined from different angles to be able to move forward.

As therapists, we don’t judge. We provide a safe, calm space to listen to you. We understand that people who have experienced loss have so much going on in their lives and can struggle to make sense of it. We help you reflect on what is happening and help you to navigate through it.

Darian Leader’s book, The New Black, revisits Freud’s concepts of Mourning and Melancholia and explores the more subtle experience of loss and argues that modern life holds pressure to treat loss with medication. However, this adjusts the chemicals within the brain which has led to complex and unconscious causes of depression. Although drugs can be helpful, they rarely resolve the underlying cause of loss and depression.

Leader while praising Freud’s new thinking about depression, argues that he misses a vital element of mourning, its communal aspect and looks at various cultures and how they share the process of mourning.

In the book, Darian Leader argues that Freud missed a vital element in mourning: its communal aspect. In different cultures, many share the process of mourning, and mourning should be shared whether it’s a death or more everyday loss.

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

 

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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Interpersonal Therapy (IPT) Explained

When we are feeling depressed it is common to withdraw from those that we are close to, to shut ourselves away, turn down social invitations and generally pull away from friends and family.  By doing this we are refusing the help and support of others, possibly because we feel bad about ourselves or that we have failed in some way, or that we will burden others. Friends and family may feel hurt and rejected by our withdrawal, they may not understand and feel that they are being shut out consequently may start to pull away from us.  We may then interpret this behaviour as confirmation of our view of ourselves as ‘a burden’ or ‘a failure’ consequently perpetuating, and even increasing, our symptoms of depression. Thus a vicious cycle is inadvertently created.

This example illustrates the fundamental concept of IPT – that depression can be understood as a response to current difficulties in relationships and in turn depression can affect our relationships. If a focus on your current relationships makes sense to you then IPT could be the therapy approach for you.

IPT is time limited, usually between 12 and 16 sessions, its structured and is recommended in the NICE Guidelines (National Institute for Health and Care Excellence). NICE is like the NHS Bible and recommended treatments are well researched and evidence based.   

The main focus of treatment is on relationship difficulties and on helping you to identify how you are feeling and behaving in your relationships.  IPT typically focuses on the following relationship problems:

  • Conflict within relationships – this can often be difficulties within a significant relationship where the relationship has become ‘stuck’ in arguments or disagreements  and has become a cause of stress and is having a significant impact on mood.
  • Change in circumstances such as redundancy, breakup of relationship or other life event that has affected how you feel about yourself.  This can include happy changes such as becoming a parent or moving. However significant change can be difficult to adjust to and have an impact on how we feel about ourselves and others.
  • Bereavement – it is natural to grieve for the loss of a loved one however sometimes we don’t seem to be healing from the loss.  We can continue to struggle to adjust to life without that loved person.
  • Isolation – Difficulties in forming and maintaining relationships – this can be due to not feeling close to others or not having many people around.  Not having company or support of others can be stressful and leave us feeling very alone.

During the first few sessions of therapy we will gather information about your difficulty, create a time line of your symptoms and discuss current and past relationships in your life.  Once we have gained a good understanding of the problem and the connected relationship difficulties we will collaboratively agree on which of the 4 areas therapy will focus on.

The benefits that IPT can bring include:  Improvement in relationships, including relating to others and communication, learning to cope with emotions and life changes, problem solving, processing loss and grief, and overall an improvement in mood and psychological distress.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

 

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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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.

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