Loss, Grief, and Attachment in Life Transitions

A Clinician's Guide to Secure Base Counseling

Jakob van Wielink, Leo Wilhelm, Denise van Geelen-Merks, Robert A. Neimeyer, Darcy L. Harris

• Publisher: Routledge
• Year: 2019
• ISBN:
  9781000134704
• Edition: 1
• Topic: Psychology
• Subtopic: Social Psychology
• Index: Psychology

Loss, Grief, and Attachment in Life Transitions gives readers an attachment-informed grief counseling framework and a new way of understanding non-death loss and its treatment.

Loss and grief are viewed through a wide-angle lens with relevance to the whole of human life, including the important area of career counseling and occupational consultation. The book is founded on the key themes of the Transition Cycle: welcome and contact, attachment and bonding, intimacy and sexuality, seperation and loss, grief and meaning reconstruction. Rich in case material related to loss and change, the book provides the tools for adopting a highly personalized approach to working with clients facing a range of life transitions.

This book is a highly relevant and practical volume for grief counselors and other mental health professionals looking to incorporate attachment theory into their clinical practice.

1
Exploring Loss

You cannot prevent the birds of sorrow from flying overhead,

But you can prevent them from making nests in your hair.

(Chinese proverb)

A Case Study

Emily seems exhausted as she enters the counselor’s practice. It seems that everything is weighing her down. A moment later she confirms this. Sometimes it takes so much effort to get out of bed that she calls in sick. The company doctor advised her to seek help. And that’s why she made this appointment. A lot has happened in the past six months. The company downsized and the department she had worked in for eight years had been closed in the reorganization. She was transferred to another department. Her colleagues were transferred to other positions in the organization. She has difficulty finding her place in the new team. She misses her old colleagues and the way they divided the work and interacted with each other. When asked how she said goodbye to her old team, she indicated that there was actually no goodbye. It became increasingly empty in the department because there was less and less work and her colleagues were transferred to a new department, one after the other. As a result, she was almost relieved when she heard that she had been given a different function. She left as quickly as she could.

Where do you know this ‘leaving, without looking back’ from? Have you ever experienced this before in your life? She is visibly startled by this question and is silent for a while. And then she starts to tell her story. She was just a little girl back then. About seven years old. She formed a family with her mother, her father, and two boys from her father’s earlier relationship. One day she came home from school to find her mother crying on the sofa. Things had disappeared from the living room and the coat rack was half empty. Her father had left with his two sons. Shortly after, the house was sold and she moved with her mother into a small apartment. She had to go to another school. She only saw her father and her half-brothers once in a while, until they drifted apart completely. When she moved to her own apartment at seventeen, she resolutely decided to focus solely on her future. She banned her father and her half-brothers from her mind and saw her mother only occasionally.

Recognizing, Acknowledging, Exploring, and Enduring Loss

Clients like Emily have a problem, a question, something they encounter in daily life that makes them see a counselor. This is the starting point. Using the starting point as a reference, the counselor examines underlying themes or questions. These are as relevant as the initial question, often unbeknownst to the client. Together they explore. This work can be compared with archaeology or treasure hunting.

In almost all types of attachment interventions, emotional recovery from past experiences of loss is going to be the key. Individuals need to work through grief and loss issues, which implies some form of education as to the origin of their feeling. In this archaeological dig for origins, the identification and validation of feelings is important. People need help to understand the cause of their attachment patterns …, whatever these might have been, these experiences need to be grieved, otherwise there will be no resolution.

(Kets de Vries, 2016, pp. 44–45)

Important events and experiences, which have either hindered or helped the client, are to be uncovered in their past and impact their consciousness and most certainly their subconsciousness in the present. These experiences, convictions, and qualities may be ‘dug up’ and brought to light.

Tip: When guiding someone with loss, we operate on the experience that every question, every problem, and every complaint a client presents is at base always about loss. This is true even if the client is not yet aware of the loss, just as Emily did not connect her past experiences with her father leaving to her present fatigue due to the company reorganizing. Each change the client desires, a change for which the client seeks counseling, is in fact a moving away from something or somewhere, not wanting something anymore, or a moving towards something or somewhere, wanting something else. Both movements are about separating from an old situation. The client comes to us for support and counseling during this process, saying ‘I can’t do it alone.’ As counselors, we work on the assumption that, with every issue at hand, underlying unconfronted loss, unexpressed farewells, and unfinished business is always resonating, regardless of the question or the apparent reason.

During the client and counselor’s exploration of the themes of the loss the client has undergone, they may work through the following steps (Fiddelaers-Jaspers, 2010):

• Recognizing the loss
  During the intake, the client tells you his or her story and may have a question. This story evolves in every subsequent meeting, which helps the question to unfold more clearly. As a counselor you always need to listen with healthy curiosity to the client’s developing story and on each occasion, make a new assessment of the question. Time and again you invite the client to continue searching within the story. Together you go looking for new starting points, for decisive moments in life. Together you look for choices and decisions that were made, conscious and unconscious, that might have been necessary or even inevitable at that time, but are perhaps no longer helpful in the present. You search for moments of deliberate or subconscious separation in which your client suffered loss.
  A distinction can be made between two types of loss:
  • Locatable loss:
    • These losses are easy to recognize. They occurred at a specific point in time and can be connected with or localized in a moment. Examples of such events are death, divorce, having to move, and the like. A precise connection with a date or a period in time can be made. In Emily’s case, the moment her father moved out is a locatable loss.
  • Ambiguous loss:
    • It is difficult to determine the point in time or the period of ambiguous loss. This refers to less tangible issues such as an unfulfilled desire to have children, a poor relationship with (one of the) parents, lost hope, lost dreams, illness, and so forth.
    
    In counseling, making this distinction is of great value. For clients with ambiguous loss, actual loss is harder to name, recognize, and acknowledge.
    It is also important to define the difference between primary and secondary losses:
  • Primary losses:
    • These are the losses that are immediately noticeable, the losses that are in clear view or ‘in the foreground.’ These losses can be the direct inducement of grief. Emily’s father leaving was such a primary loss.
  • Secondary losses:
    • These losses seem to develop in the background as a result of primary loss. Secondary losses are a direct result of primary losses, although not immediately visible. Often, because of this, they aggravate or weigh down the grief. The loss of Emily’s half-brothers through her father’s leaving could be viewed as a secondary loss, although it also counts very much as a primary loss.
    
    We can divide these types of losses into quadrants (see Table 1.1). These can be useful and help your client gain an overview of and insight into the losses in his or her life.
• Acknowledging loss
  During their search together, the client learns to recognize his losses. Once he recognizes them, he will be able to acknowledge them. He can then acknowledge how painful it was, the impact it has or had, and what is missing as a result. In short, acknowledgement is about more than just establishing the reality of loss. Acknowledgement is accepting how the loss changes the course of one’s life. Once we have started to pinpoint the losses in the ever-evolving story of the client, part of our role as a counselor is to use our expertise and experience to confirm that the client has indeed suffered loss. You could also say that, as a facilitator, you help interpret and in a way subtitle certain events and experiences. By accepting that there was loss, the client is inevitably invited to assimilate the loss and to feel the grief that goes with it.

  Table 1.1 A Four-Quadrant Model of the Categories of Loss

  	Primary loss	Secondary loss
  Locatable loss	The parents get divorced when the child is still young.	Loss of sense of security, strained bonds due to the divorce, loss of friends and family who chose or had to choose between the two parties.
  Ambiguous loss	Marital infidelity of a parent, which is eventually discovered, causing the marriage to later end in divorce.	Loss of confidence and trust, loss of coziness and ambience at home during the period of conflict leading up to the divorce.

• Exploring loss
  When you base your work as a counselor on the life story of the client, by asking questions, doing exercises, or giving assignments, you are together exploring the client’s losses. Naturally, the actual circumstances surrounding the loss play a major role. However, the feelings, the (subjective) experience, and the meaning of the loss play the greatest role.

While helping your client to recognize, acknowledge, and explore loss, you will regularly experience that you are touched by his or her story. Perhaps you are shocked by what the other person has experienced, or a memory of a personal experience rises to the surface. You may become annoyed, or feel the need to solve the problem for the other person. Whatever happens to you when in contact with your client, it is important to be aware that it is there. You can then learn to discover when your personal experiences get in the way and cause transference or possibly countertransference. Through training, supervision, and peer-to-peer learning, you will gain more insight into your reactions when your own experiences and sensitivity get in the way. In this way, you learn to allow your experiences to be present alongside those of the client so that you can remain close to him or her and stay present while he or she is working on the loss at his or her own pace and in his or her own way. You offer guidance, exercises and ask questions. And you endure. You endure that you yourself are touched by the intense emotions of the client, that sometimes you have to slow down and that sometimes you have to take one step forward and two steps back. Adapting to this unruly reality, which can cause discomfort for the client as well as for the counselor, is called enduring during loss.

• To endure during loss.
  Loss can have a major impact on the daily life and functioning of the client. He or she has to endure the reality that the disruptive effect the loss has on his or her life can barely be influenced by any conscious choice.
  For the counselor, it is important to continuously improve the ability to experience the personal sensitivity, the ability and inability to be present in the background during stories of loss.

The case study, the dialogues, the theory, and the exercises in this book will teach you to recognize the losses your clients have suffered. The exercises, which allow you to explore loss in alternating roles of counselor and client, help you to recognize the themes and explore them further. By reflecting on your feelings and behavior during the exercises, you also experience what grief and loss has brought about in your life and what is touched within you. You may also experience what is meant by the term enduring.

Grief

Not only is it important to make a distinction between locatable and ambiguous loss, we also need to discern between loss on the one hand and grief on the other.

Definition: Loss is about permanently missing something or someone, saying goodbye, breaking the connection and the bond with someone or something with which a meaningful relationship had been maintained.

Definition: Grief is about dealing with a sum total of feelings, thoughts, physical sensations and behavior that can be experienced when one separates from something or someone they had a meaningful relationship with, whether voluntarily or forced.

We say ‘can be experienced’ intentionally. The way in which we grieve is the result of the way in which we choose to deal with the reality of loss. At the same time, grief is an autonomous process. This means that grief can appear all of a sudden, uninvited, as an unwanted intrusion. Grieving can also be done consciously, when the client is aware of the loss and its effect on his or her life. Grief may also come out later, sometimes much later than the moment in which the actual loss occurred. The function of grief is to be able to once again liv...

Table of contents

• Cover
• Half Title
• Series
• Title
• Copyright
• Contents
• Series Editor’s Foreword
• Acknowledgments
• List of Illustrations and Tables
• About the Authors
• Introduction
• 1 Exploring Loss
• 2 To Welcome and Connect
• 3 Attachment and Bonding
• 4 Sharing Intimacy and Outlining Sexuality
• 5 Separation and Loss
• 6 Grief
• 7 Meaning Reconstruction
• 8 Resilience—Coping, Trauma, and the Brain
• 9 Grief in the Context of Work
• 10 Dialogue: Putting Loss Into Perspective
• Bibliography
• Index