A death can place what seem to be unbearable burdens on the shoulders of friends and family of the deceased. These are rarely single problems and are more often a
terrible mix of practical, emotional, and philosophical difficulties. Financial deficits and childcare concerns may be mixed with panic attacks and questions about a just universe. Legal disputes over a will may be complicated by guilt over whether the death could have been prevented and worry that God is exacting punishment for some sinful behavior. We rarely realize how much we take for granted about daily life, and the nature of death, until we are confronted with the profound absence of someone we love and depend on.
For some, if not many, friends and relatives help postpone or reduce the stresses of these kinds of problems by providing friendship and practical day-to-day assistance in the months following a death. The type of assistance though, is usually temporary and often only postpones the most difficult trials of
grief and bereavement. When friends and family return to their own lives (usually after three or four months), the full emotional impact of the death may begin to weigh terribly on the bereaved. Painful feelings can become overwhelming, the ability to manage responsibilities may not return, and signs of grief may grow into clinical symptoms of anxiety and depression. These are often the conditions that concern the bereaved and those around them and trigger the call for
In some cases that many find puzzling though, the bereaved appears to successfully navigate the time following the death without great difficulty. The initial
grief fades and months or even years pass before these individuals notice that something is wrong. Often, those in this state find they are, "stuck "and unable to, "move on" with life and/or surprised when another loss or separation at this later date creates a downpour of unexpected and painful emotions. For these bereaved, the call for
professional counseling can obviously come much later.
The feelings that accompany these puzzling experiences are often those of being overwhelmed, lost, and confused with internal and external changes that appear too large to understand and manage. This is where the benefits of an alternative point of view may grow clearer. For the bereaved to begin to understand where he or she is and see that they're not, "going crazy," a turn to trusted others may be invaluable in recognizing what is incomprehensible alone. Another person, with an observant eye, a willing ear, and hopefully, an understanding of the consequences of death, has the ability to help clarify the circumstances the bereaved is immersed in and the direction of firm ground to stand on. From this point, one can begin to make choices that form the foundation of a new approach to living.
The person with these qualities is often one who has made it his/her vocation to provide such assistance - usually a counselor, social worker, or psychologist. Some bereaved are fortunate though to have a close friend or family member with these traits. This is unfortunately rare. It can also be the case that a death has created problems between the bereaved and some friends and family - making a turn to them for this kind of
counseling unhelpful and potentially complicating.
While it is a matter of personal preference, in many cases, whether to make use solely of friends and/or family to work through the challenges of bereavement or to consult with a professional, some circumstances call more clearly for someone with expert knowledge and training. Those experiencing a complicated bereavement involving symptoms of clinical depression, debilitating anxiety, and/or substance abuse, for example, are unlikely to get sufficient help from an untrained person. In these cases, consultation with a mental health professional is likely the most sensible and practical route back to health.
Types of Assistance
Regardless of the basis for a choice to seek expert assistance, a local search will likely present several options. The most common are individual counseling, support groups led by professionals, and support groups composed only of other grieving members. Each of these approaches has its' strengths and those seeking assistance may choose one or more from among them.
One-on-one or, "individual" counseling offers the devoted attention of a single expert in a completely private context. The focus of this modality permits a more detailed and complete understanding of the concerns for which the bereaved may be seeking assistance and also allows the pace of progress to move according to his or her level of comfort - a potentially important benefit at a time when many bereaved feel helplessly and haphazardly tossed around by life. One point to consider that may dissuade some from individual counseling is that it is likely to be the most expensive form of assistance available. Even if one is concerned about financial limitations though, it is still often useful to see an expert for a consultation (which may be free) to discuss one's options. If cost is a concern, it's worth inquiring regarding sliding-scale fees. Many counselors employ this type of fee structure, which allow individuals to pay a reduced rate based on income.
Groups, which are usually less expensive than individual counseling, offer the additional advantage of the unique experience of being with others engaged in similar struggles - particularly if the group is created specifically to address a more specific
grief and bereavement experience such as the loss of a child, a spouse, a formerly abusive parent, and/or a loss to suicide. The ability to see others in this setting can provide a clearer understanding on the bereaved's part, that he or she is not strange or "crazy" but is rather a normal person in very difficult and not uncommon circumstances. Some also find that, in addition to the benefits of learning from others, the ability to help fellow group members through one's own experiences adds meaning to the struggle to recover from loss.
As in individual work, groups led by an expert can provide a greater opportunity for a close understanding of oneself and circumstances - both because of the knowledge and training a professional brings and because of his/her ability to keep the group organized toward these goals. For those with a desire for a greater feeling of independence from professionals,
grief and bereavement groups composed only of fellow bereaved may be a better choice. These groups will tend to lean more towards support than explicit self-understanding though this type of benefit can certainly emerge over time from ongoing supportive contact with others. A further benefit of, "peer only" groups is the ability, in many of them, to "drop in" as you wish - when you feel a need and according to your schedule.
Counselor-led groups more commonly meet at a scheduled time, usually weekly over a period of weeks or months. This permits them to make use of the familiarity, and even intimacy, that develops over time to understand the members' challenges in greater depth than one might find otherwise.
The length of time one continues to see an individual therapist or remain in a group will depend, to a significant degree, on the challenges for which the bereaved is seeking assistance. That said, most bereavement assistance involving professionals is time limited to somewhere between three and six months though this can usually be extended depending on the need.
The Search for Assistance
A good place to begin a search for a grief and bereavement specialist is your health insurance provider. If you don't have health insurance, or your provider doesn't cover bereavement counseling or does not have bereavement specialists among its providers, it may be necessary to seek someone who practices independently. The internet can be a good place to begin a search using search terms such as "grief counseling" and "bereavement counseling". It may also be useful to contact a family physician or religious institution for assistance. For cases in which the death resulted from a criminal act, your local district attorney's office may be a helpful resource as well.
For help in the New York City area, where the author of this website practices, try all of these methods and/or try the Available Services section of this website.
280 Park Ave South, Suite 12H New York, NY