Grief Recovery—2

We sometimes avoid spending much time ministering to the bereaved and grieving because we are afraid of becoming too emotionally involved or that our own inner feelings will "hang out" for others to see. This second article, describing the five sessions of a Grief Recovery Seminar, may help us get a handle on those fears.

Larry Yeagley is chaplain of the Huguley Memorial Medical Center, Fort Worth, Texas.

Grief Recovery is a five-week support program that utilizes audio-visuals, group dynamics, didactics, and assignments to bring the lives of hurting people back into focus. The first article in this series described the need for Grief Recovery and how a pastor (or other professional) can get started in this program. This second article will describe in detail the five sessions of a Grief Recovery Seminar.

The first session

My first task as one who leads out in helping people deal with grief is to develop a level of trust. I have learned that this is absolutely vital to the success of the program. To build this trust level, I clarify the following guidelines at the first session: (1) The presenter will not lecture on theology; (2) no confrontive group therapy techniques will be used; (3) nobody will be forced to share; (4) judgment will not be passed on anybody's feelings; (5) the presenter will facilitate the expression of feelings only when a person desires to express feelings; (6) gentleness is the key to all interaction; (7) there will be no charge for the program.

I start by giving persons in the group a chance to talk about why it is difficult for them to grieve. I jot their reasons on the chalkboard. This usually leads to a discussion of the insensitivities of individuals or society in general. It is a safe and nonthreatening type of sharing.

The most common problem in grief is not knowing what reactions to expect from oneself. For this reason I use a three-step approach to develop a picture of normal grief reactions: I ask the group, first, to help me construct a list of the reactions portrayed in "Soon There Will Be No More Me" (Churchill Films, 662 North Robertson Blvd., Los Angeles, California 90069). This is a very nonthreatening exercise, and the group produces a long list after viewing the film. The second activity is more threatening. I ask them to share the feelings they had as they watched the film. I add these to the list on the chalkboard. The third request is totally voluntary, but much more threatening. I ask them to add their reactions, not to a film, but to their most recent loss. I emphasize that a wide range of emotions is normal and healthy, and I urge the group to allow grief to happen instead of damming it up inside.

By now the group has experienced the arousal of painful feelings. They have also had a chance to let some of those feelings come out into the open. There are four goals that I encourage the group members to accept at this point: (1) Believe that the loss really happened; (2) allow yourself to experience the pain of losing; (3) gradually become accustomed to familiar environments associated with the lost relationship; (4) say goodbye to the relationship as it once existed but can no longer exist.

To accomplish these goals, I give the following general assignment to be fol lowed during the entire five weeks of the seminar and beyond.

1. Think. Deliberately take memory trips to places and events connected to your relationship with the person now gone. Think through every facet of the relationship.

2. Write. Keep a journal in which you write your feelings and thoughts about the lost relationship.

3. Talk. Share your feelings with a person you trust. Be sure the person will listen nonjudgmentally.

4. Weep. Do not hold back tears. Weeping alone is not as therapeutic as weeping with another person.

The last twenty minutes of this first ninety-minute session is devoted to introductions. This is entirely voluntary. I invite each group member to give his name and to share his most recent loss. I encourage each to be brief so that everybody can share if he wishes.

This is the most threatening part of the first session, but it provides one more opportunity to get inner feelings out into the open where they can heal. As one man put it, "I felt so much better after I got some of the pressure off."

In conclusion, I assure the group that the first night is the most painful. The next day I send each person a letter encouraging him to attend the following session.

The second session

The second session begins with a review of the normal range of grief reactions. I sometimes show a short filmstrip that depicts the emotions of grief. ("When Disaster Strikes Coping With Loss, Grief, and Rejection, Part Two," Human Relations Media, 175 Tompkins Ave., Pleasantville, New York 105 70.)

The largest part of this session is used for group sharing. I strongly encourage members of the group to share their experiences with the assignment of thinking, writing, talking, and weeping. A few will be anxious to tell how doing the assignment brought easing of the pain. There will be questions and comments totally unrelated to the assignment. Those who are attending for the first time are encouraged to share their loss with the group.

I let the discussion flow freely. The role of the presenter during this free exchange is to gently enable people to identify, own, and express their feelings. Sometimes this is done by a few short comments. Perhaps a question or two is all that is needed.

Take the case of Mary. She came to the second session with a tightly con trolled expression on her face. During the discussion she told the group that she was the strong person in the family. She thought she was doing well because she wasn't crying and had not cried since the death. As she told this, she had a smile on her face, and an occasional nervous chuckle came out. Very quietly I said, "Mary, let me see if I can help you put your finger on how you are feeling right now. Can I interpret the tense smile and the occasional chuckle as happy feelings?" That's all that was needed. Mary shook her head No as the tears came to her eyes. I knew she couldn't say more at that point. I simply said, "Mary is saying that her smiles cover the real feelings of anger and sorrow. Have any of the rest of you had this experience?" At that point others spoke about how they covered their real feelings. Eventually, Mary was able to put her feelings into words.

During the sharing time of this second session there will be many opportunities for the presenter to emphasize, or reemphasize, a key point about the nature of grief or the need for achieving the goals set during the first session.

Let me illustrate. Jack told the group that after his memory trips and journal exercises were completed he was troubled by thinking he heard his wife coming into the house. Several times he thought he heard her voice. He asked whether something was wrong with him. A few other people said they had had the same experiences a few times.

At this juncture I went to the board and drew a horizontal line. At the left end of the line I drew an X to denote the intellectual acceptance of the loss. At the right end, I drew an O to denote acceptance on all levels. Just above the horizontal line I drew a wavy line between the X and the O. Then I said, "Your question about whether this experience is normal is a good one. I don't think you need to worry. Nearly 50 percent of those who lose an important relationship experience hallucinations during the early months of grief. Intellectually, you know the person is gone, but until that loss is accepted on all levels, that person will be with you emotionally. This wavy line represents the presence that remains because of the searching and pining still taking place. Thinking you hear or see the person is common. That will no longer occur once you reach the goals we set last week."

During the last twenty minutes I explain the assignment for the second week. I draw two interlocking circles. Then I erase one circle and everything within it, leaving the remaining circle with a crescent missing. I ask, "Can anyone interpret what I have done?" A variety of answers are given: "When someone dies, there is a part of you missing." "After somebody you love is gone, you feel less than whole." "You may feel like something is missing, but there is a lot of you left." "There's an empty space that nothing can fill in just the same way."

I respond, "All of these interpretations may be true, depending on the person. One thing is certain losing puts a real dent in your self-esteem, doesn't it? These are real feelings. They are common and to be expected. Even though we don't feel like it, it is true that all of us still have the capacity to live and love creatively. You may not be able to believe this right now, but I want you to do something this week that will gently nudge you beyond your grief. It will help you to realize that there is still a purpose for your life."

The assignment I then give builds self-esteem. I ask them to list their personal assets and to set short- and long-term goals for using them. They are also to list personal liabilities and goals to improve them.

The third session

This meeting begins on a little lighter note. I ask group members to share their assets and goals. There is usually some laughter and bantering about sharing personal qualities. At times the laughter is a reflection of joy, but laughter is also a way of expressing pain. Burl Ives sang a song in which he called tears a "funny way of laughing." Laughing may be a funny way of crying during parts of Grief Recovery.

The value of this exercise has proven to be greater than I originally estimated. An example is Arlene. She had always been very dependent on her husband. She never worked outside the home. When her husband died, she was a helpless person who despaired of being able to survive. During this discussion she told the group that she believed herself resourceful, even though she had become too dependent on her husband. Her short-term goal was to learn to drive a car. Her long-term goal was to get a job outside the home. About six months later Arlene wrote me that she was the proud owner of a driver's license and a new job! It was the assets-liabilities assignment that motivated her new way of life.

A major portion of the third session is devoted to group discussion of problems people face in grief. This is stimulated by showing an eleven-minute film entitled "Harriet" (Mass Media Ministries, Inc., 2116 North Charles Street, Baltimore, Maryland 21218). The problems depicted include: anger that is displaced or turned inward; guilt that is crippling the forward movement of life; estrangement and isolation; avoidance of the pain of grief; return to usual activities too soon; shrine building; expecting more from a supporting relationship than can be given by one person; perpetuation of grief in an effort to perpetuate the secondary benefits; loss of identity.

The secret of this discussion is to allow the group to arrive at solutions. The presenter should share solutions, but only after the group has exhausted its ideas.

Grief makes people very tense; it is a highly stressful experience. For this reason I decided to include principles and techniques of stress management and relaxation exercises in this third session.

Stress management includes discussion of ways to cope and ways of altering life spaces to conserve the expenditure of energy. Relaxation techniques are not tightly woven into any particular religion. Group members are encouraged to adapt the method to their own religious philosophy. Along with relaxation I suggest that group members practice meditation in keeping with their particular faith. The assignment for the week is to do something good for yourself. This is an effort to build self-esteem and to create relaxation.

A second part of the assignment is designed to lower the denial level that prevents people from believing that their loss really happened. It also is designed to give them a realistic view of how well they are adjusting to their loss. This portion of the assignment asks the person to list all the losses he has had from childhood to the present and to describe the nature of the lost relationships. He is to indicate when he first realized that death was a possibility for himself personally. Finally, he is to write down how he handled his feelings about losing the people on his list and how he handles feelings in general.

This is a big assignment, but I emphasize to the group the importance of doing it faithfully.

The fourth session

The fourth session begins with a close look at the assignment given the previous week. Group members share with each other what they did to be good to themselves. Some report buying a dress or a suit. One lady went to dinner with a longtime male friend. It made her feel "just a little more whole," she said. A member of one group went to the beach with her small children. A middle-aged woman refrained from the daily grave visit and spent three days with a friend in another State. Many go to the beauty salon for a new hairdo. An elderly gentleman went to the lake and walked the beaches. He enjoyed the solitude and the chance to tell God some important feelings.

This exercise puts people in touch with themselves again. It helps them to sense once again that they are important.

The loss-history assignment is an important part of this fourth session. I ask for a few volunteers to share their history with the group. Their losses, facts about the relationship, the manner of adjustment, and the usual way of handling feelings are all recorded on the chalkboard.

From these case studies we discover why persons are having difficulty adjusting. Some discover that too many losses have occurred too close together for adjustment to come easily. Others realize that they have a history of bottling strong feelings inside. Sometimes both of these situations exist for the same person.

By the fourth session most people are not denying the reality of their loss; they are going through some of the pain. But the majority are not yet willing to say goodbye to the relationship.

Saying goodbye to a lost relationship is essential to real healing. For this reason I do not apologize for urging group members to begin this process. I emphasize that I do not want them to say goodbye to the person, to the memories, or to the hopes of future reunion. But they must say goodbye to the relationship as it was and can be no longer. Knowing it is not possible to do this in a single step at one time, I encourage them to do it in bits and pieces. I ask them to think through very thoroughly some of the less important parts of the relationship and say goodbye to these. Gradually they can move toward saying goodbye to the most intimate aspects of the relationship.

While I do not agree with the entire technique and philosophy of Dr. Donald Ramsay, of the University of Amsterdam, I do like to show his filmed sessions with a woman suffering longstanding grief. As the woman finally relinquishes her relationship with a dead daughter, the healing is obvious to any group watching. The film ("Grief Therapy," Carousel Films, Inc., 241 E. 34th Street, New York, New York 10016) prompts weeping, which is important to some in the group who have not been able to cry. Watching this film also encourages group members to begin saying goodbye to their own relationships that can no longer be.

A woman wrote me two years after attending Grief Recovery. She did not say goodbye to her relationship with her 60-year-old mother until months after the program ended. She drove to Indiana to visit her mother's grave. In the cemetery she thought through every aspect of their relationship. Step by step she said goodbye. As she put it: "Finally healing began to come."

Loss of faith is frequently a problem in grief. Many Christians report not being able to pray and read the Bible. Church attendance is reduced or nonexistent. Long-held spiritual concepts are often questioned after a major loss.

In the group we discover that loss of faith during grief is very common and very temporary. Group members usually share experiences of how they handled their temporary loss of faith.

The fifth session

This last meeting is comprised of three parts—assessment, long-range planning, and farewells.

Members of the group are asked to assess their progress on a scale of 0 to 10. They are also asked to tell the group what contributed to their progress or lack of progress, including their success (or lack of success) in saying goodbye to the lost relationship.

Long-range planning includes group interaction about how to get back into social involvement and how to combat despairing loneliness.

Saying hello includes farewells. This is a reality of life and a part of Grief Recovery. Words of thanks and farewell are freely spoken. Son of the people wish to keep the new relationships formed with other Grief Recovery participants alive. They exchange addresses and phone numbers.

The effect of Grief Recovery was summarized by one woman who said, "We have come to the close of Grief Recovery, but I wish we could be together always. It has been so warm in this group. We have felt so much love. Because of this experience our lives will never be the same. We have become like a family."

Just before the last session ends, I tell the group about plans for follow-up. This includes telephone calls, personal visits, and additional group meetings.

The final article in this series will focus on follow-up, counseling, and preventive ministry.

Ministry reserves the right to approve, disapprove, and delete comments at our discretion and will not be able to respond to inquiries about these comments. Please ensure that your words are respectful, courteous, and relevant.

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Larry Yeagley is chaplain of the Huguley Memorial Medical Center, Fort Worth, Texas.

November 1983

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