CSR+Working+With+Loss+and+Bereavement+Part+1

COMPREHENSIVE STUDY RESOURCES FOR STUDENTS OF COUNSELLING AND PSYCHOTHERAPY
COUNSELLING STUDY RESOURCE
Preparing to Work with

Loss and Bereavement:
Part 1
Lecture Transcript
Good evening to everybody. I'll just turn that down. Good evening to everybody. It's
good to have you here. Just to remind everyone, this is a two-part lecture. So the second
part will be delivered after this week. So it'll be next week. That will also be when the
CPD certificate is put up. So, this will be loaded up on Thursday, but it won't be a CPD
certificate. And then, when we do the next one, it will be loaded up and then there'll be a
CPD certificate. It'll be a two-hour CPD certificate. So I hope that makes sense to
people.
So, welcome to working with loss and bereavement. So, first of all, please note I put a
warning and triggering alert because of the lecture content the presenter (that's me, the
presenter) will be describing and explaining subjects connected with loss and
bereavement. So it's really just respectful to highlight that as we go through this. It may
be that some of you have experienced loss or are experiencing it. So, just to be careful to
look after yourselves. Usually if I was delivering this in a classroom, I would say to
people if it's a little difficult, maybe, to pop yourself out of the room and go get yourself a
cup of tea and then pop back in again.
Did you know that this resource is available

in the Counselling Study Resource with links to related topics
for further reading? Read it online.
COUNSELLINGTUTOR.COM 1
So with the warning and triggering alerts covered, I'm going to look at the learning
outcomes. Well, the aim is to gain an overview of theories and types of grief. So this is
the foundation. This is very, very much going to be a foundation for the next lecture
where I'm going to be talking a little bit about interventions. The objectives are to
describe the main theories around grief. We're going to critique one theory of grief, and
we're going to analyse and talk about differing types of loss.
Something new we've done for this series of lectures for 2017 is we're going to put in
learning outcomes. What I've done is I've kind of thought about the kind of learning
outcomes that might be in your assignments. So one is named key theorists in the
development of grief models, described the differing theories around loss and grief,
discuss the criticism of one major model of grief, and analyze differing types of loss. So
I'm guessing that slightly different divisions of that could come up in your assignments.
So those are the kind of learning outcomes that this lecture will address. So I'm going to
start off with a slide which tells us a universal truth about the work we do. Clients can
only go as far as the therapist is willing to travel. If we've not processed our own issues
around loss or grief, then it's going to be hard for us to really get into the client's frame
of reference and to work with theirs. And with loss and grief, it can bring up some really,
really strong emotions that can completely disconnect therapists from the
intersubjective world, which is that distance and relationship between themselves and
the client, and really just kind of takes in the intrapsychic world, which is their own
process. In other words, they can be so lost in their own process. They can just not see
the clients at all, therapeutically.
So what I would say is it's sometimes useful, certainly in your own therapy, to explore
loss if it comes up. If you have got losses around, take that to supervision and think
about whether you can work with clients who are going through loss and grief.
So, to be of service to the client (this is kind of a universal truth with a lot of the theories
we're going to look at), we need to understand the intrapsychic process (that's knowing
ourselves). We need to have an understanding of our own processes.
We also need to understand the sociological context of loss and grief (societal and
cultural values). It's worth remembering that not everybody explores or experiences
grief in the same way. Even if we feel grief, the societal part of where we're at and the arc
of time where we find ourselves will have an influence on how we grieve and our
understanding of it. I'm going to touch a little bit on that as we move through this
lecture.
The psychological impact of grief; that's the client's experience. So we need to

understand how grief can impact. As we will see, grief is a wide-ranging trouble that
people have in their lives. It can affect people in quite different ways.
We also need to know the somatic impacts of bodily feelings. I'm going to talk again a
little bit about that, some observations about loss and grief, the process of the other
dying, how it might impact on clients, and things to be aware of.
So if we think about preparing the ground, I've put some statements here. So the first
thing to ask yourself as a therapist is how does your experience of loss and grief live with
you today? Is it kind of livable? Have you dealt with it? Have you gone through any
cycles or high emotions around grief? Where are you at with it? If I was in class and
asking students this now, I would be asking them to kind of reflect themselves and feed
back. I'm not asking you to do that now, but it might be worth you taking some notes, so
when lectures is over, just reflect on it. How does your experience of the losses that
you've had in your life sit with you today? Have you come to terms with the loss? Do you
have access to personal therapy? This is super important because what can happen is
that we can work with clients and all of a sudden, losses that we felt had been dealt with
all of a sudden just come to life again. It might be if they're overwhelming, the best place
for that is to take it certainly to your supervisor to explore how that fits with the client
and how that might be interrupting psychological contact with you and the client, but
also about looking after yourself.
I think that if you've got a supervisor, they should be experienced with clients who have
experienced loss in associated grief. I think supervisors should have a real handle on this
because this comes up more times than one would think. And in fact, I was speaking to
someone a few years ago who kind of made quite an acute observation that said that
most client presentations actually have some elements of loss. Thinking it through, it's
like, actually, yeah, that's true. So supervisors should have a real understanding of the
grief process and be able to support you and your client when you're working with
clients who have got experience in loss and grief.
So we're going to start off by asking a very basic question. What is grief? To do that, I
looked into a dictionary. So I thought that might be a bit of a start, and I found this
quote in the Collins English Dictionary. It's definition, and it's a noun. "It's a deep or
intense sorrow or distress, especially at the death of someone". "Something that causes
keen distress and suffering". "Trouble or annoyance", which really doesn't fit. There's
some derived form, which is griefless. It comes from the Anglo-French 'grever', which
means to grieve. So that gives us a little clue about what grief is, but the dictionary
definition really doesn't give us a wide enough view to be able to kind of take that
knowledge and use it therapeutically.
So with that in mind, we're going to start with possibly the most well-known person who
researched loss and grief. And that's Elisabeth Kubler-Ross. Kubler-Ross was a Swiss-
American psychiatrist. She was a researcher in near-death studies. One of the important
things to understand is that she actually did research with people who were dying, not
people who had experienced a loss. She was actually doing a research on people who
were dying themselves. And in 1969, she published a book entitled On Death and Dying,
where she first discussed her theory on the five stages of grief.
It became known as an acronym called DABDA. DABDA was denial. So the idea was that
when people first found out that they were going to die (maybe they've got a difficult
diagnosis, terminal diagnosis), they may deny it. They may say, "Well, that's not me. The
results are only someone else's results". Also in terms of people who have had a
bereavement (they've lost someone), it might be that they just deny that the person's
died. I'm sure that a police officer knocks on the door and says, "I'm afraid someone's
been killed in a car crash". "Oh, it can't be them. It can't be them". They start denial.
They are not accepting the truth that actually the person's not going to be there
anymore.
Anger: That's the emotion that comes up where people are angry. They are angry at the
loss. They may be actually angry at the person who's died. I was doing a research this
week for this lecture and I found quite an interesting thing. It wasn't really related. I was
kind of looking for something else and I found a newspaper article about a woman
whose husband had died and he hadn't told her that his business was going bankrupt.
She was furious with him, absolutely furious with him. She'd had double losses, had lost
him, and also, effectively, her standard of living and all that kind of surrounded their
house. So it's very possible that clients can get really angry at the person who's died. It's
quite a normal situation. Also, people who have got terminal diagnosis may be angry at
themselves. "If I had just done this". "If I had just done that". "If I had just stopped or
done more of this". And they become angry at themselves.
Bargaining: Bargaining is a state of mind where people kind of say, "Well, if I do this, am
I going to get better?" You ask a lot of doctors and doctors will say when they've given
someone a terminal diagnosis, they may say, "If I eat more fruit, will that prolong my
life?" The medical facts are that, actually, it won't. People go and do bargaining
behaviours. They might try to alter their lifestyles in the hope that their lives will extend.
That's what bargaining is. Also, for people who've experienced someone dying, it's also
about kind of saying, "Well, I'm sure that it should've been me". That's one of the classic
things that people say; "It should have been me". And I hear that a lot. I've heard it a lot.
Depression: In terms of the model, that's about low mood, feeling depressed, sad, and
generally very kind of low about the whole situation of either having a very difficult
diagnosis or losing someone.
And then, the grief comes in where people start to really feel the grieving.
And finally, acceptance. The 'grief' is just one I've just put in, but it's actually called
DABDA—denial, anger, bargaining, depression (there's grief in that), and also,
acceptance.
Now, the only problem with this model is that it's a linear model. For anybody who's
worked with anybody who's grieving or any client who's come with distress around
losing loved ones, you'll soon realise that this linear model with denial, anger,
bargaining, depression, and acceptance actually is not how clients present. They might
have all these, but they might not be in that order. And it's one of the major criticisms of
Kubler-Ross' work; that it was a bit kind of straightforward, a bit simple.
One of the reasons I believe that this particular model has found popularity, certainly, in
other areas of the medical profession, is that it's an easy model to teach effectively. So
it's a very, very easy model to teach. It's easy to teach healthcare professionals and it's
also easy to share with people who might be bereaved.
So with that in mind, the critique comes from Collin Murray Parkes. He was a
consultant psychiatrist at St. Christopher's Hospice in London. He credits Kubler-Ross
with the five-stage framework. However, he said the model had not proved durable.
"Like all pioneers, we learn that the new concept is not as simple as initially described".
Dr. Murray Parkes told the British Medical Journal that, "It's no longer considered a
linear progression, one size fits all approach". So by the middle of the 1970s, people
were moving away from the Kubler-Ross model and very much thinking that unlike the
DABDA, people grieve in different ways, which kind of brings us on to alternative
approaches.
Parkes and Bowlby (Yes, that's John Bowlby, famous for attachment) came together and
they founded their own attachment model. Now, in the next lecture, I'm going to be
talking about how attachment and loss can work with clients. Their model talked about
numbness (a sense of unreality and disbelief) and yearning (severe feelings, including
panic, crying, and physical pain).
For next week, I'd like people to kind of keep that in mind (the physical pain) because
I'm going to be talking about how, sometimes, clients in the therapy room can have the
same somatic feelings as the person who's just died. So for instance, for someone who's
had a brain tumor, it might be that the client is saying they've got real headaches, or for
someone who's died of intestinal issues, the client might say, "I've got real pain in my
stomach". I'm going to explore a little bit more about that next week. This yearning
phase is severe feelings including panic, crying, and physical pain.
And then, disorganisation and despair (depression, despair and apathy). Apathy is, of
course, when people just can't be bothered doing anything. They're not motivated to do
anything.
And then finally, reorganisation (identity revised, ready to move on): Now this is quite
an interesting idea because the identity revised is where people start to identify
themselves in the world as no longer being connected or moving away from the
connection of the person who's died. They re-establish their identity. Bowlby also talked
a lot about how attachment can impact on how people grieve. I guess I'm going to be
talking in some depth about that in the next lecture.
And then in 1990, William Worden came upon the four tasks of mourning. Worden's an
American psychologist and he came up with these four tasks. It's interesting that, as you
can see in the arc of this, we're moving away from more of a kind of visceral feeling
process that people might have to a more cognitive process. It's a kind of trail that is
leading to the more modern theories in loss and bereavement.
So task one is to accept the reality of the loss. So really as a therapist, one of the things to
be thoughtful of when you're working with clients is that the person they're talking
about is no longer there (I'm going to use the word...) corporeally. Corporeal means
physically. There are a lot of people of faith positions who may think they're in another
place or they've to Heaven or wherever that faith position informs them that people go
and they die. But actually, corporeally is to accept the reality of the loss. The person is
gone. They won't be coming back.
The second task is to work through the pain and the grief. So what Worden is really
saying there is that people who are bereaved have to go through the process of feeling
really bad about it and to try and find a way through that.
The third one is to adjust to the new environment. Through the years, I've lost friends
and it's interesting that their partners have had to change their lives. What's really
fascinating is they do things after the bereavement they will not have done. They find
new friends. They find new activities or new hobbies and move on, generally speaking.
And then, task four is to find an enduring connection with the deceased while moving
forward with life. So again, this is really important. This isn't just putting the pictures
away and never talking about the person who's died. This is about very much finding a
way that the person can still exist in conversations, keeping people in conversations,
pictures, remembering the person who's died, but at the same point, accepting loss and
moving forward.
The thing with the four tasks of mourning is they're not linear, so that people can go
back to the tasks as they need them.
Now, what really kind of piqued my interest was some really new research by Strobe and
Schut (I think that's how I pronounce it) called the dual process model. They're
Norwegian researchers. As a result of their research, they found that people oscillated
between the emotional aspects of grief and a more restorative approach. So I read that
people have two processes. We have the cognitive and we have the effective domain. The
cognitive domain is how we think. The effective domain is how we feel. What they're
basically saying is in grief, clients or anybody will move between those two processes.
The restorative approach is about restoring someone back to an equilibrium where they
can move on with their life
They recommend the bereaved can be supported in doing this. So what I'm going to
show you is what they call the dual process model. One of the things that might be
striking is that it's a really big step from the kind of emotional process model that
Kubler-Ross was talking about.
The dual process model is basically two processes that work all the time. If we look at
the top here (if you follow my arrow, I'll just move it around. There we go), everyday life
experience. So basically, people oscillate between two positions. In other words, the
grief breaking through, feeling very sad, feeling tearful, breaking bonds and ties, the
reality of loss and realising that actually that person isn't coming back. Denial and
avoidance of restoration changes. In other words, part of being in the loss orientated
aspect of self is that there is a resistance, maybe, to move on.
Now, the restoration orientated side is attending to life's changes. So that might be
practical things like changing people's names on bills, electricity bills, bank accounts—
that type of thing. It's the very kind of business-like stuff that goes around when
someone's died.
Doing new things.
Distractions from grief.
Again, there's a denial and avoidance of grief. And that can be with a distraction. It
might be that people try to distract themselves. That can be sometimes healthy, so they
don't get completely lost in the process, that they have a cognitive view of it.
And also, new roles and identity.
With the dual process model, bear in mind this isn't just a therapeutic model for
counsellors and psychotherapists. It can be used by any healthcare professionals. In fact,
I walked by my local undertaker the other day because one of my practice rooms is just
literally at the other end of a road where there's an undertaker. I happened to look
through the window and the undertaker or the staff had done a course on the dual
process model.
The way I read it is that it is a cognitive approach where clients are encouraged to kind
of attend to life changes. They kind of look at ways of distracting themselves from grief,
acknowledging as grief, but also about people getting on with their lives and finding new
roles and identities and relationships.
So it's quite a move away from the very early work of Kubler-Ross. In 21 years, we've
gone from a very process-driven model of visceral feeling to one that involves the
cognitive and a kind of task-based approach to grief.
So the dual process model of coping, with Strobe and Schut, is intrusion, breaking
bonds, denial, and avoidance on one hand. So that's very much about being in the grief.
And on the other hand, restoration orientating is attending to life's challenges, doing
new things, distraction, and denial and avoiding it. That might possibly be that people
just kind of say, "I'll put some time aside to be upset, but really I have to get on with the
practical things. Get the kids to school, getting on with my job (that type of thing)". It's
also the new role in life that people find themselves in once a partner or someone close
to them has died, and how new identities are formed. So the dual process model is
almost like a coaching model, if I'm honest. When I looked at it, it looked like a coaching
model where there's a kind of a lot of encouragement for people to work in this
particular model (restoration model)—acknowledging the other side, which is a loss-
orientating process. So they're two distinct processes and people oscillate between them.
A bit like this. That's an oscillation. There we go.
So having kind of done the foundations of the theories, what I'm going to do is I'm going
to look at the types of loss that people have. What I've done is it depends on who you ask
or where you go to look for the information. There are huge amounts of types of loss that
one can research, but what I've done is I've used the types of loss that I see and have
seen on a regular basis in my practice.
So the first is what I call normal grief. The second is anticipatory grief. The third is
complicated grief, secondary losses in grief, traumatic grief, and collective grief. So we're
going to have a look at those.
We're going to start off with normal grief. Now, when I say normal grief, in terms of
grief, the process of normal may feel a bit out of place, but it's the ability for clients to
move on with their lives. There's a gradual lessening of intense emotions with
individuals being able to engage with their daily lives. When I was putting this together,
I remembered that for about four months, I worked at a hospice as a counselor. And the
clients I saw would have fitted into the normal grief process. They came for a couple of
sessions. They talked about the bereaved. They processed a lot of what was going on for
them. Yes, they may have talked about feeling guilty, about not giving their jobs up, or
maybe having to put someone in care, or maybe earlier stuff about if they had just done
this or they had just done that. But generally after about two or three sessions, where
they found out it was quite normal for people to have these feelings, they end the
therapy. The reason for that is they wanted to get on with their life and really to engage
in the more restorative side and get on. So one of the reasons I left was that I was never
getting past three sessions with most of the clients I saw. I decided that I wasn't kind of
stretching myself therapeutically so I wished them well and I moved on. But normal
grief, or sometimes referred to as uncomplicated grief, is where people can just move on
with their lives. Yes, it's difficult. Yes, it's uncomfortable. Yes, it's very sad. But actually,
they can engage. They have the internal resources to move on.
Now there is something called anticipatory grief. This can be things like terminal illness,
loss of role or function, separation, or loss of future. This is quite an interesting one.
This is what I would say that we come up with more times than we really realise in
therapy. Terminal illness really speaks for itself. That's an illness that is going to end in
an end of life. But the other three (loss of role or function, separation, or loss of future)
can come up with clients who have not actually lost someone. So you might have
someone who is seeing their children go off to university for the first time and all of a
sudden, it's an empty house and they've lost their roles as parents. They've lost their
roles. They're used to looking after their children. Their children have fled the nest and
they're wondering what their lives are going to be.
It was really interesting; I had lunch with someone this week whose name I won't
mention. Their child had gone off to university and there was a palpable sense that this
person was wondering what life would bring now and how they're going to move on in
life and fill the void of what was a loss. I mean the children were only a few hundred
miles away, but nevertheless, it really felt like a loss (loss of role). That can be
redundancy. That's something that can be a loss. Retirements can be a loss.
You can see that there's so much loss that can be brought up in the therapy room. Loss
of being able to play football at a certain level; you can see where I'm coming from. A
part can be separation. So things like divorce or separation, where people are moving
away from each other. That's a form of loss.
Not all separations are acrimonious. Sometimes, it's necessity. Again, I've got a friend
who went to Australia to start a relationship just because the lives that her and her
boyfriend wanted to live. It was incompatible with them being together. They loved each
other very much, but it wasn't enough. And here is another kind of observation, I would
say, where we're working with loss like this. Sometimes, love isn't enough. So if we're
working with such people who are separated, perhaps their ambitions or their values are
very, very different. And that is a loss.
Also, loss of future: I'm old enough to remember it. I'm not making a political point, but
I do live in the north of England and I can remember, when I was living in Gorton, the
manufacturing firm closing down. I'll let you into a little secret. I worked at the
unemployment benefits office for about six months as a casual member of staff. And I
can remember grown men coming in who have been engineers all their lives crying
because they had no future. There was no work for them. And that's a very, very
powerful loss. It links into identity. It links into self-structure and self concept. It also
links in to how one feels about themselves and their community. So, anticipatory grief,
sometimes, is very, very powerful. Just the idea that these things are going to happen
can be very powerful and something that is worth just remembering when you're
working with a client.
Now, I am going to talk about complicated grief. Now, complicated grief is a

combination of traumatic and prolonged yearning for the deceased person. There's no
kind of one indicator for complicated grief, but what I would say with complex grief is
that sometimes clients don't admit the person's died. I've come across this where
someone just says they are not dead. They're still around and no matter what evidence
(you went to the funeral service), yet they're still not dead. It does happen. Complicated
grief is very, very difficult to work with. What can sometimes happen is that people go
into a psychotic state and they sit in the middle. They sit in the middle of the restorative
model and the grief model with the dual process. They don't engage with moving on
with their lives, but then again, they don't invest in the feelings of loss. They are in a
kind of limbo. They're in suspension and that suspension can generate quite a kind of
sometimes quite bizarre presentations. I've never met it in a client, but I can say with
confidence that I have met it in people I've met through the years. I know at least two
people I can think about when I was making this lecture, where someone just won't
admit the person was dead. They just won't admit it. I remember one person was saying,
"They're just in the next room", and someone kindly said, "Well, no, they've died. You
went to the funeral." "No. No, they're in the next room". That can be quite difficult to
work with. I have to say that I wonder how many people with complicated grief turn up
to see a therapist, because I'm wondering if they're in a position to actually engage with
the process of letting go of that person.
Now, I'm going to spend a little time on what's called secondary grief. This is something
that comes up a lot in therapy more than you'd think. Someone said to me the other day
that they were a bit worried about a client because the client's partner had died, but they
weren't talking at any level about the bereavement and loss and how they felt about it.
They were talking about everyday things. So I said, "What kind of everyday things are we
talking about?” ”Well, bills and schools and all that kind of stuff". And what can happen
is when someone dies, the wreckage that's left behind of their death—this can be
emotional definitely, financial, or structural. It could be all sorts clutter up the process
of grieving. I've put up a picture of a woman holding a baby and she's looking at her
house. So I think this is a recent earthquake in Mexico. And sometimes, there's just so
much that gets in the way. So when clients do come along and talk about things that may
not be connected at all with the grief or the loss or the person who's died, it might be
worth thinking about and kind of thinking clinically and thinking to yourself, "Hmm, I
wonder if they've got secondary loss or secondary grief".
Now, this comes after primary grief. So at this point, they've accepted the person's died.
It can be things like loss of a relationship. So when people died, they may have a very
unique relationship. I'm sure that everybody who has a loved one who dies has a unique
relationship. It could be they have a business relationship. So it could be that if two
people are in a business and one of them dies, there's the trauma of having to work out
what they did in the work and how they're going to pick that up. And one of the things
that really struck me is I don't know if you remember Eric and Ernie Wise (Morecambe
and Wise). They were comedians in the seventies. They were really popular. For those of
you who watch UK TV, they're like the Ant & Dec of the 1970s. They were massively
popular. Eric Morecambe was the tall guy with the glasses. He died and Ernie Wise, his
partner, really, really struggled because they're identified as a partnership. This, on a
macro level, can filter down into how people stand in society. I've got one or two female
friends whose husbands have died and they never get invited around to their married
friends anymore because they're not a couple. People feel a bit uncomfortable, maybe, so
the sudden invitations to go to somewhere, not to lose friends (that type of thing).
It could also be the loss of material things. So in this case, the picture could be a house.
Many years ago, I had a customer who died and he had indebted his business to such an
extent that, literally, two days after he died, his wife was on the road to being evicted
from the house. The bank was empty. The business had collapsed. So she'd lost him and
she'd lost all her lifestyle literally within a month. Can you imagine that?
Loss of role: This can be, again, when people have a role in life to look after someone or
do something and all of a sudden that disappears when someone's died. It can fit really
well with people who care. In my guess, a nurse who cares for someone long-term and
all of a sudden, the person dies and that role becomes redundant. One of the things to
watch out for (I can speak again, from personal experience) is if there's someone who's
got a carer's allowance, who's caring for someone, and all of a sudden they die, they lose
the role of carer. So they have to kind of make their way in the world the best they can,
but also, they lose the financial support of being a state-paid carer. So they lose their
lifestyle again. So that's secondary.
Loss of support: If someone is in a team and all of a sudden, someone dies, you feel
you're not supported.
Loss of the future: Again, people make plans, don't they? I've got lots of friends who've
made plans. One particular one I was thinking about today, he'd got his life mapped out
when he retired. The only difficulty with that was that when he found out he had a
terminal illness, it didn't really matter. In fact, Victoria Derbyshire, who's a famous TV
presenter, has gone on record as saying pensions and all these kind of stuff she had for
the future don't really matter because she's got a very serious illness. So people can lose
their future; plans travelling round the world, dream holiday, place in the country. All
that can disappear. And here's the thing; it can be the focus of the grief. So the grief can
be the focus on all these things as opposed to the person who's died, and you have to
work through the secondary grief first or the client has to before they can come to the
primary grief. It's almost like they have to get because these are the things that they're
having to function with in the world. Sometimes grieving the person who is gone is a
luxury because they have to find somewhere to live. They have to sort themselves out
with the finances and so on and so forth. So that's secondary grief.
The final one is traumatic grief. I've put a picture of a bee. It's interesting. I'm from
Manchester. The terror attack; I know there've been attacks all over London and all over
the whole of the country through the years. Traumatic grief is sudden, unexpected, and
often results in a horrific or frightening circumstances. These can be things like natural
disasters, terrorist attack, or suicide. Other traumatic losses can be losing your child.
Anything that is out of sequence (loss of a child) is probably a really good example, if I
could use that term, for traumatic grief because as we kind of go through the arc of our
lives, we realise that people die. As children, we see funerals. Uncles die. Grandparents
die. And we realise there is a kind of natural order for it, but if people die not in a
natural order, then it can cause trauma. Sometimes with traumatic grief (I'm going to
kind of focus on this in the next lecture), you have to work with the trauma first, and
that might not be therapy. That was one of the things I learned when I did my course. It
might be very practical support, like finding someone who will be mapping support who
you can go and sit with you, you need to see a doctor (that type of thing) before you can
even get to the grief. I am going to expand on that in the next lecture.
The last one we're going to look at is collective grief. I'm reminded that in the last couple
of weeks, certainly, when this lecture was recorded, Um, it was, it was 20 years since
Princess Diana died. Collective grief is where millions of people mourned her loss. I can
remember 1992. I can remember that the world (or certainly the world I lived in. I am
not saying the whole world) changed. I'll share what I think is an interesting story.
Where I used to live, I used to go to the end of the street and there's a shop that sold
barm cakes or bread cakes (if you live in London) or baps (if you live in Leeds). I bought
some regularly on Saturday mornings for years. The woman behind the counter got us
talking about Diana and she said, "Do you know I'm just like Diana?" I wasn't a therapist
at the time. I went away and I thought, "That's a bit of a ridiculous statement". But as a
therapist reflecting on that, I realise that what can happen is with collective grief. It
triggers our unresolved grief or grief that people have. It can kind of flare up. We've seen
a lot of collective grief. I was in Manchester not long after the terrorist attack and St.
Ann Square, which is a kind of central point in Manchester, was full of flowers.
I was just recording today's podcast with Ken, and I've touched on this. Someone started
singing Don't Look Back in Anger, which is, of course, a song written by Noel Gallagher,
who's a famous son of Manchester. It was really touching to hear people singing this. I
felt emotional, but what was really interesting with grief is there's a sense of identity.
I've seen bees, which is a symbol of Manchester (Manchester worker bees), on lots of
cars and tattoos—people identifying in the best way they can. And sometimes, that can
be really, really significant. It can be significant because people may be using the grief of
another to process a more personal grief.
So in the next lecture, I'll be talking about working with secondary, complex, and
traumatic grief. I'm going to be looking, especially, at attachment in the grieving
process. There are some things that are really useful to understand with people's
attachment styles, because if you think of attachment, attachment is how people interact
with others and that can play out into grief. So I'm going to be talking about that. And
I'm going to talk a little bit about mummification. I'm not going to give the game away a
little bit on that. Some of you will be able to research it, I'm sure, but that can be
something that we see with some clients. Also, I'm just going to touch just a little bit on
the cultural aspects of grief, because people grieve in different ways and as I said earlier
at the beginning of this lecture, the culture you're in will inform, to some extent, how
you grieve. I guess we saw that with Diana, Princess of Wales. We saw that with the
Manchester bombings and, of course, the London attacks and Grenfell Tower. I could go
on and on about where people come together and grief, but there is a strong cultural
component. And as therapists, we mustn't miss that because the cultural component, I
believe, gives people a sense of belonging and connection. We need to work with that
because I think that's really important.
So I am going to ask for questions, but before we hit questions, I just want to go through
a couple of things I've done a little differently for the lectures for this academic year. I
put some newspaper articles in. They're really, really interesting newspaper articles;
commentators who talked about grief, things like customs, and things like 'you can't fix
people in grief'. You've got to let them fix themselves. So have a look at those.
I've also put some references in that I've used when I made this lecture. And finally, I've
put some useful links and things like an attachment style quiz, childline, the Samaritans,
prevention of suicides, cruse—that type of thing. And also, some reading; the reading
links are really useful. If you click on the link, you'll actually go to a page in a book on
Google Books so you can see the actual text written by the people who have written it. So
that could be useful.
So again, just to recap, this is the first of a two-part lecture. So the CPD certificates will
be only put on the CSR after the second lecture, which will go up in two weeks’ time.

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COMPREHENSIVE STUDY RESOURCES FOR STUDENTS OF COUNSELLING AND PSYCHOTHERAPY

COUNSELLING STUDY RESOURCE

Preparing to Work with

Did you know that this resource is available

The psychological impact of grief; that's the client's experience. So we need to

Doing new things.

Distractions from grief.

And also, new roles and identity.

Now, I am going to talk about complicated grief. Now, complicated grief is a

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