The bereaved bereavement counsellor

April 2016 and I was fortunate enough for a job and myself to stumble on each other. This amazing role was running the bereavement service in the busy local hospice. To be able to apply my psychotherapy to the bereaved and those facing death was an honour and privilege, to walk alongside people during what was often the hardest experiences of their lives. I felt the responsibility suited me and I eased into the role naturally and harmonised with the philosophy of the environment. Then on 1st July 2016 my father died suddenly from a stroke in his sleep and everything I had ever learnt, studied, experienced, practised, witnessed or knew about bereavement flew out of the window like the black raven of despair escaping the end of the world.

So then I found myself away from work and plunged into a process that truly defies logic and reason. I can visualise this as like being chained to a ghost train on my own, with no control over what I faced or what was thrown at me. It felt like there were others in the carriage, but I couldn’t quite see them or feel them, but I was aware of others joining and sitting next to me for part of each journey. They distracted me, held me, showed me images of happier times, made me laugh but then on every corner I that I encountered, the train would turn back into the darkness, with just the rattling metallic echoes of the impending doom just about to shake me from my seat. This I understood to be the emergence of shock.

Theoretically, this can be looked at as the first stage, task or phase of grief, depending on your choice of therapeutic approach to bereavement. All of which really meant nothing during this time, they were just meaningless words that I hung onto empty coat hangers, to make me feel like I was actually undertaking something. I became busy, used my skills of planning to organise the funeral. On a selfish level, I wanted it to be the finest festivity of the year, to embrace happiness and pull it towards me, to change the direction of this tedious train that repetitively attempted to jolt me into acquiescence. What shock meant to me was a calm state of busy, without any real emotions getting in the way. It embraced my whole being like numbness. This is often described by behavioural psychoanalysts such as John Bowlby as a ‘protective mechanism that temporally shields the individual from the full impact of the loss’. It is during this stage that it is very difficult to feel any emotion. I felt very unconnected to others. This was numbness on a level that I had never experienced before, yet I wanted to understand and be fully briefed on what I was embarking on. I researched into the concept of the ‘bereaved bereavement counsellor’, yet I found no reply, do they actually exist I asked myself? I felt lost and hopeless. So what do I do now? I spoke to my clinical supervisor and demanded answers from him about what was expected of me now? He gave me no answers, and this infuriated and enraged me. I have now learnt that there are no answers. This searching and yearning aspect of grief is often to find reassurance and meaning within a world that offers very little of this. Colin Murray Parkes, the British Psychiatrist who specialised in grief, views this as the second phase of bereavement and is often where anger is present as we fight to accept the veracity and permanence of the loss. My professional stance was forcing me into trying to understand what I was experiencing yet my inner core of self was just really missing my dad.

I was also becoming more conscious of the feeling that this was somewhat bearable, that the pain of grief was accepted and almost embraced. I had got used to the tireless, clunking of the train, it became frighteningly reassuring, I was driving this now and I understood the well-trodden route. This element in me to be in command of everything was steering me into complacency. The day after the funeral everything changed.

I can taste and smell the darkness. It is bitter and stale, its pungent aroma constricts my breathing, my chest cannot fully contract and I panic. No-one can reach me; no-one knows where I am. The train is no longer there; I am paralysed and trapped in the gap where it once hurtled. The silence startles me now.  All I can hear is my own inner voice taunting me that this is now my life, alone and here. It begins to play tricks on me. The darkness became full of auditory, visual and disturbing messages, that people felt guilt towards me and that they felt that they had to be ‘nice’ to me. I was told I was weak convincing me to just lie down and stay. I did for three days and nights. I lost track of time, I was unaware if it was day or night. These hallucinations are a natural part of grief and make the link between ‘thoughts and feelings’ real, according to William Worden. I couldn’t eat, I feared to sleep as this was where my dreams reinforced these pessimistic thoughts. The pain punctured my heart and I bled without pausing. I felt ‘needy’, an unfavourable quality, yet I embraced it, wore it, like a cloak of vulnerability that was paraded for all, yet no-one came. My voice may have been screaming but it was silent as I lay waiting for the next day, I dreaded its arrival yet I feared its demise. Every second ticked slowly, an hour felt like a day. Everything was in slow motion, this stage of depression halted my existence; it locked my doors and bolted my view on the world. Yet I still saw a shimmer of light, that radiance was my belief that I would be ok one day again. I kept that alive and that enabled me to go deeper into the void and to discover and allow these sinister and dark thoughts to exist. Almost like a lifeline of oxygen that a deep sea diver would carry, knowing that they were exploring danger, but they knew that they would resurface and breathe and be in this world and that they would be ok one day. That was all I said to myself and it worked. I understand profoundly that many people do not carry that conviction and become lost in the darkness, unable to find their future. They become stuck and embroiled in the depression, so it becomes them and that is often at the point I meet them as clients, to allow their vulnerability to surface and to breathe oxygen and hope into their being. When Sigmund Freud very famously wrote about depression or melancholia in his paper in 1917, he described it as ‘mourning’ and was rather distinct between this and clinical depression. He felt that those who were grieving saw the world as ‘empty and poor’ and those who were clinically depressed saw themselves as ‘empty and poor’. Another theory by Elizabeth Kubler-Ross in her book ‘On death and Dying’ (1969) with regards to the depression stage,  encourages us to allow these feelings out as they are preparative work in order to get ready for acceptance of the loss and they are transient, unless prerequisite factors, often earlier traumas, compound the depression. I was still undeveloped emotionally to leave behind this entrapment but I was able to peer outside again. I kept moving, unsure of what direction, but I made sure I stirred. I gradually became aware of others, who came and sat with me. I felt the empathy and understanding streaming through from those around me, I was actually feeling again. It hurt, I cried for hours every day, unashamedly, openly and publically. Often howling as the tears streamed down my exhausted face, I never felt hesitant of my pain. But I felt different; this new world was no longer safe, everything I had ever known had altered. So how can I live here? Things have to change. I changed.

I noticed I was becoming more anxious, I couldn’t face people. My front door was my protector, yet my jailer. This anxiety was like the crossroads from the depression to the change. William Worden describes anxiety as the ‘awareness of one’s own mortality’ (1976) and I began to think about the impact that my own death would have on those left behind. Thoughts like “who would organise my funeral?” Would appear in my mind and they shocked me. The anxiety I felt could have gone two ways, it could have controlled me, kept me locked in and denied me of living my life. But my stubbornness stepped forward. I learnt to override this feeling; I would literally throw myself out of the front door, exposing myself to the fear itself, which was often the warmth of the sun on my face and everyone else’s life carrying on as normal. Yet I would walk hunched over, head down, earphones in, sunglasses on avoiding eye contact. I did not want this feeling to stop me from doing things. So what I was beginning to notice was how I would push myself into different challenges, rather than passively cruising through this bereavement I was actively forcing myself to go to the darkness, to taste fear, to question everything. It can be argued that to evade the pain, prolongs the grief. This was often discussed by Parkes (1972) who researched about avoidance techniques where people go travelling or only think of happy times. In the long term, this actually disrupts the natural process. Another viewpoint is that death is a ‘human given’ and although the knowledge is there it never shields us from the pain. So although I wasn’t thinking therapeutically ‘this is what I should be doing’, innately I was walking towards it, well actually I was running.

This idea of change was not deliberate, it just began to happen. I suddenly realised that each moment was unique and I had the opportunity to live it my own way. I was off work and my children had gone to stay with relatives, I was alone and quite fearful. I felt very abandoned and uncomfortable with myself. It was at this point that I began to really connect with people I trusted and those who would let me grieve in their presence. So for once in my life, I had no plan, no goals, no motives, and no direction. Each day would begin and I was led by my instinct, rather than my obligation. I felt free to explore not only the world around me but the new world inside me. I was learning to adjust to life without my dad and this led me to a regressive, childlike state. Many attachment theories, most notably John Bowlby, talk about the effects of death and separation from our parents as being ‘biologically programmed’ within us and that we become ‘disorganised and then reorganised’ through the stages of bereavement’. This is certainly what I was feeling now. I felt like a’ teenager’, I went back into my past to search for meaning and happiness. I realised how much choice I did have in my life and I questioned why I wasn’t accessing this. I allowed all my emotions to co-exist, I would cry and laugh at the same time, I would express rage and frustration, I felt heartbreak and I felt joy. I travelled around the country visiting friends and making new ones. I painted my living room wall black and covered it in framed images of all the singers and bands I liked. I had pink streaks added to my hair. I went out nearly every night. I would wake each morning and be led by my desire to feel, to live. The recognition of my own mortality was guiding me to grasp my formative years and bring it forward kicking and blaring into the present. My existence was limited and there were no more excuses to put things off. I engaged with my friends and family on a much deeper level than I had ever experienced. I was open about how I felt and would tell them, I didn’t have to pretend about anything. If anyone asked me how I was, I would go into detail about everything I was feeling, somewhat overwhelming to many who were often expecting just a polite “I’m ok” although I was experiencing a loss, I was actually gaining so much.

As the weeks moved on, I began to reintroduce aspects of ‘normality’, yet I feared normal as that means everything has returned to its previous position, but I hadn’t and never will. This often described by Worden as the task of ‘adjusting to an environment in which the deceased is missing’ I had accepted he was gone and now I had to make arrangements to begin the process of moving on. I was very nervous about returning to work and I wanted to acknowledge the clients pain and loss and also their therapeutic ‘phantasy’ about why I was off for so long. Both Melanie Klein and Freud spoke about these unconscious processes that occur within clients. That with developing knowledge and maturity they materialise as verbal projections. I knew they would ask me on my return why I was off and how that may appear as anger or rejection. My supervisor suggested that I wrote to my clients to explain why I was off, to protect them from ‘introjectional’ phantasies that could in the long term cause more emotional harm. The letter was painful to write, I wanted to be honest, reassuring and supportive, without saying too much. Mostly I wanted my clients to know that I would be back and that I had not abandoned them. To me this was about mirroring and reinforcing an affirmative and optimistic bereavement.

After eight weeks off I returned to work at the hospice, where there is no escape from death and bereavement. So how can I do my job now? How can I support others and provide adequate and professional care? Actually, how can I not? How can I not feel for others on a parallel height of experience? I slowly began working with clients. What I noticed immediately as the session began was the need of the client to see how I was. Traditionally I would challenge this line of questioning, however this felt genuine and appropriate to engage with. I answered their questions and acknowledged how difficult it had been. They gave positive feedback about the letter I sent. I also normalised the process and how death happens to everyone. I noticed aspects of self-disclosure coming into the continuing sessions that were constructive for the client to hear as it reinforced the stage or phase they were presently actioning. In other areas I wouldn’t be so open; my previous work in substance misuse and secure psychiatric units rendered that an inappropriate risk. Yet in this field, there is almost an instinctive requirement, clients want reassurance that what they feel is universal.

As I look reflectively on this stage of my life and what I draw from this life event, is that we cannot prepare ourselves for bereavement. No amount of training or experience can ever give us the vanguard over this guaranteed occurrence. What I have learnt, is the conviction I had in knowing that one day I will be ‘ok’ again, never the same again I accept that, but ‘OK’.