Grief is a complex process, but Laura Palomares explains it so that everyone understands.
The kind of sadness, longing, and even despair we feel when we lose something or someone with whom we feel close has a name in psychology: grief.
In fact, grief is one of the most painful psychological processes that exist, and can sometimes make us unable to enjoy life. Of course, psychological assistance through therapy with psychologists can help us overcome that discomfort and accept that there are certain moments that will not return and that this is natural.
Precisely this experience acquired in psychotherapy gives psychologists a unique perspective on what grief is and how we can manage it emotionally. For this reason, this time we interview a specialist in the field: Laura Palomares, from Avance Psicólogos, who works in grief therapy.
Laura Palomares: the point of view of a grief expert
We spoke with Laura Palomares Pérez, an expert psychologist in grief and emotional ties and Director of the Madrid psychology center Avance Psicólogos, to talk to us about grief, both in relation to the pain it causes and in relation to how to work in psychotherapy to get over it.
Normally it is understood that grief is something that arises when losing someone you love, due to a breakup or death. However, there are other causes, right? What defines grief?
Grief is a state of recovery and readjustment after a loss. For this reason, we should not consider grief a disease, but rather a normal process of rebalancing with different phases, which will help us to gradually recover normality.
The loss can be due to the breakdown of a relationship or the death of a loved one, but in fact it can be due to the loss of a job, a home, a drastic change in life, the loss of a pet, the amputation of a member, etc.
The grieving process will be different depending on how important the loss is to us, whether it is a loved one or an event that causes a life change.
Grief is to some extent a normal psychological phenomenon when it appears after losing someone or something that was important to us. From what point is it understood that it is a reason to attend psychotherapy?
The grieving process involves a series of phases that it is important to respect. We say that a duel is pathological or unresolved, when there is a blockage in any of them.
If we have settled in sadness or anger, we do not find meaning in our lives, we do not finish believing what happened or we recreate the loss with the same emotional intensity as when it happened, if we notice that new fears have appeared since then, such as the death or illness, phobias, anxiety or panic crisis, etc., that reason to attend psychotherapy.
Sleep or eating disorders, obsessive or catastrophic thoughts or compulsive behaviors are other signs that must be addressed.
They also indicate that there is a grieving without resolving behaviors such as keeping all personal belongings as the loved one left them, talking about him in the present or not talking about him at all.
What are the fundamentals of psychological therapy applied to grief suffering?
Psychological therapy starts from the knowledge that expressing the emotions of anguish and pain without fear of judgment is decisive for overcoming grief.
At Avance Psicólogos we work from different currents of psychology, taking advantage of each of its techniques. In this way, humanistic psychology manages to deepen the emotional and make it emerge, with different techniques such as role playing, the empty chair, the evocation of memories through photographs and objects, etc.
It is about delving into feelings and favoring the resolution of ambivalent emotions, guilt, anger, unresolved situations, etc., with the aim of preparing for farewell, which does not mean forgetting the loved one or object of grief , but to find a new place for it in our emotional imaginary.
On the other hand, cognitive behavioral psychology helps to restructure the new situation in the face of loss at the level of thought and behavior, favoring the application of resources to gradually assume and face the new reality in the face of loss.
The application of Third Generation Therapies, especially Acceptance and Commitment Therapy, focuses on accepting the loss without forgetting the context and values of the person, fundamental for the grief to flow naturally and according to differences. individual and specific needs of each person.
Based on your experience in Advance Psychologists, what are the strategies that a therapist must follow to adapt to this reason for consultation by a patient?
Deep respect for the pain of the person who comes to the consultation, from an attitude of absolute and unconditional accompaniment, is fundamental in the therapist’s way of being and feeling the relationship with the patient. Without this there is no therapy. The therapeutic relationship should feel like an extremely safe space, in which there is no room for judgment or haste.
From there, the therapist focuses his attention on supporting and accompanying to facilitate the acceptance and recognition of the loss, to express the emotions and feelings that come from it, to face in a practical way the new life situation and reality in the face of the loss and finally, to accompany the farewell with a new sense of life.
How do you recover and return to normality? How long does it usually take to get over grief?
Recovery occurs with the closure and overcoming of each of its phases, respecting the times of each person and making sure that they are resolved.
The phases of grief are denial, that is, not accepting or assuming the lack of the loved one that usually occurs at the beginning, at the moment of shock; the anger phase, which consists of feelings of rage and anger many times against the world, with the need to look for guilty, sometimes also anger against oneself, and even buried anger with the person who has been lost, when we feel “abandoned” by it; the phase of sadness, which is accompanied by feelings of loss of the meaning of life, but which begins to be a preparation for farewell and to reach the last phase of acceptance, with which peace is finally achieved.
These phases do not always occur in order and tend to mix, and they occur until their resolution naturally if they are respected and worked properly during therapy. The acceptance phase comes from allowing the previous ones, especially pain and sadness, although very often the person who is grieving feels forced to recover by those around him. Expressions such as “you have to be strong”, “you should be better”, only slow down the grieving process and increase the anguish.
As for the time of the grieving process, it usually depends fundamentally on the level of depth and intensity of the bond, individual personality traits, the support of the environment that the person has, etc. Establishing an approximate time is not easy. It is also important to bear in mind that, if the loss is sudden, the grief takes longer and is at greater risk of becoming chronic.
To finish … could you explain a case of a grieving patient whose recovery makes you feel especially satisfied?
I can think of several, of which I keep a pleasant memory and a special affection, but I will tell you about two.
Once R., a 28-year-old woman, fun and vital but complained of having spent months with anxiety and severe back pain that did not respond to any physical cause, came to the consultation. When delving deeper during the first evaluation sessions, R and I recognized the deep pain that she still felt for the death of her father, which happened 8 years ago, suddenly due to a heart attack. Her emotion in talking about it was as if it had just happened, and her crying was desperate.
By the time we got to work on his grief, also taking into account the avoidance that he had been giving in his environment since then, his physical symptoms disappeared, he stopped suffering back pain, the anxiety was subsiding and the best thing is that the relationship with his mother and partner improved significantly.
I remember a recent case, that of A., a 36-year-old man who is practically discharged and only attends follow-up sessions every two months at the present time. A. and I were struck by the fact that he felt intense anxiety again, with serious difficulty sleeping, and deep sadness. He told me about the tremendous frustration he felt at having to sell his beach house.
That house was a refuge for him, it meant much more than a material property; For A. this house symbolized a safe place, which provided him with rest and the possibility of recovering from the fatigue to which he was subjected throughout the rest of the year, due to the intensity of his work.
Once we understood that he was in full mourning, we were able to work on it and even formalize a farewell to the place, the house, the neighborhood, etc., with the purpose of finding an alternative way to spend the holidays and disconnect, in the same city in the how much he liked to enjoy his vacations.
The moments of grief, especially when they are due to the loss of a loved one, are the hardest and most difficult in a person’s life. But we also know that if they are channeled in a natural way towards their overcoming, they are moments of profound transformation that entails many positive aspects. The person becomes more aware of enjoying the present, develops resilience, learns to relativize and even loses fears.