Continuing Professional Development Unit Birmingham City University Bereavement Day TWO Counselling Course Facilitator: David Forrest davidforrest@gestaltuk.com www.gestaltuk.com davidforrest@uktherapist.net LOSS and our Support Rare are the practitioners who are themselves untouched by the pain of loss. We must remember and perhaps relive the meaning of those moments in our own lives to share deeply the anguish of those who find themselves never far from reminders of the losses they have suffered. The more we keep alive memories of our own moments of vulnerability, the more vital and authentic is the support we render. The quest for meaning is, in the last judgment, a shared journey. Horowitz R., 2002 PSYCHOTHERAPY AND SCHIZOPHRENIA: THE MIRROR OF COUNTERTRANSFERENCE Clinical Social Work Journal, Vol. 30, No. 3, pp235-244
Kubler-Ross: denial anger bargaining depression acceptance Denial Anger Bargaining Depression Acceptance Denial D A B D A Anger Bargaining Depression Acceptance
Denial Anger Bargaining Depression Acceptance Denial Anger D A B D A Bargaining Depression Acceptance Denial Anger Bargaining Depression Acceptance Denial
Denial Anger Bargaining Depression Acceptance Anger Denial Anger Bargaining Depression Acceptance Bargaining
Denial Anger Bargaining Depression Acceptance Depression Denial Anger Bargaining Depression Acceptance Acceptance
Counselling Support Philosophical Observation / Attending / Listening Spiritual No exertion of influence but enable. Psychological Encourage telling story / express the pain. Check coping. Sociological Encourage emotional release/containment Physical Exploration of diet & sleep patterns. Medication Counselling Support Philosophical Spiritual Psychological Sociological Physical Questioning / Challenging / Reflection Encourage contact with others / Support group. Carefully explore / arrange meeting with clergy if wanted. Facilitate expression of pain (grief). Explore personal issues to gain insight. Address faulty cognitions. Encourage ritual of meeting with friends. Check out environment Encourage physical activities. Review medication.
Counselling Support Philosophical Spiritual Psychological Sociological Physical Observation / Attending / Listening Questioning / Challenging / Reflection Encourage contact with others / Support group. No exertion of influence but enable. Carefully explore / arrange meeting with clergy if wanted. Encourage telling story / express the pain. Check coping. Facilitate expression of pain (grief). Explore personal issues to gain insight. Address faulty cognitions. Encourage emotional release/containment Encourage ritual of meeting with friends. Check out environment Exploration of diet & sleep patterns. Medication Encourage physical activities. Review medication. Intervention Strategies Prescriptive - recommend a particular line of action Informative - instructs in some way Confronting - offer a challenge Cathartic - enable release of tension o bereavement o adjusting to disability o shock after trauma o express feelings following assault o enable release of anger or self doubt depression Catalytic - draws client out & encourages discussion Supportive - support, validate & encourage.
Intervention Strategy: Prescriptive Prescriptive - recommend a particular line of action Intervention Strategy: Informative Informative - instructs in some way
Intervention Strategy: Confronting Confronting - offer a challenge Intervention Strategy: Cathartic Cathartic - enable release of tension
Intervention Strategy: Catalytic Catalytic - draws client out & encourages discussion Intervention Strategy: Supportive Supportive - support, validate & encourage.
Denial and Anger Shock or numbness may last for hours, days or weeks. Sometimes panic alternates with numbness. The numbness insulates us and at times enables us to cope with the myriad of details that need to be faced. Functioning is in a state of unreality. We are only vaguely aware of what is going on. Experiences are often blurred or hazy. Anger is one of the few outlets. It may be lashed out freely, unexpectedly, at almost any target Anger provokes moments of aliveness. Some look stoical as if they are coping without much emotion Our Support, our Loss Our role is not to offer the promise of a cure, but rather a steadfast emotional presence. Bearing witness to suffering and maintaining hope, even when clients themselves have abandoned all hope, is a necessary part of the experience of mourning and ultimately a step along the path to selfacceptance. Horowitz R., 2002 PSYCHOTHERAPY AND SCHIZOPHRENIA: THE MIRROR OF COUNTERTRANSFERENCE Clinical Social Work Journal, Vol. 30, No. 3, pp235-244