Circular Grief Perspective

By Robert Cravens AbD, LMHC

After several decades of watching people suffer from grief, I have noticed that not only is grief fairly misunderstood by those suffering from it but, also by many mental health professionals attempting to treat those experiencing grief. The nuances of grief are individually unique and require similar approaches in treatment that address those distinctive problems. It has been my observation that grief is multilayered and circular in nature, with the ability to reemerge at a later date if triggered by specific stimuli. The Circular Grief Perspective I developed and utilize in practice illustrates this movement through an identifiable cycle. The Circular Grief Perspective is a tool to help facilitate the psychotherapist in tracking the grief process so effective and appropriate treatment methodologies can be applied.

Circular Grief Perspective (Cravens, R. 2004)

Status quo

The cycle begins with the idea that an individual begins in a state of status quo. Status quo assumes a state of being or maintained equilibrium prior to the actuating event. An individual’s “status quo”, refers to their cognitive, emotional and behavioral state prior to the loss. Since no two people are alike, status quo is also an individually unique state. As our daily life changes, so does the status quo. Status quo is always in a continual state of fluctuation and correlates directly with the individual’s life stage. This does not infer that a normal or non-dysfunctional state-of-being did or did not exist prior to the actuating event.

Actuating event

Loss becomes the catalyst for grief dysfunction in scores of individuals. The actuating event is the point at which a loss occurs or a stimulus is applied that is representative of earlier grief. The actuating event from which grief develops can be either real or imagined. Of importance is the reality of the loss in the mind of the afflicted individual. Specific stimuli may also reactivate grief in the future. Memory may be triggered by a song, a smell or other sensory stimuli which may reactivate the grief cycle.

Grief

Various definitions of grief often entail laborious conceptual notions that are based upon specific applications or occurrences. Grief, while multifaceted, simply entails a loss that in turn usually creates specific emotional, cognitive, or behavioral dysfunction. Grief is a normal and natural process that all individuals experience in their lives. Society generally uses the words, grief and bereavement interchangeably but there are distinct differences between the two.

Bereavement is a period of sadness and/or loneliness over the death of an individual. While grief usually accompanies bereavement, bereavement is not always a condition of grief. Grief is about loss. While far from inclusive, grief can be triggered my countless events other than death including, a friend’s rejection, divorce, or the loss of material objects such as a set of car keys; all can trigger grief states and associated dysfunction within an individual.

Dysfunction

The dysfunction created by grief does not manifest itself the same in every individual. While no two individuals who experience the same loss experience grief similarly, adults experience loss differently than children and adolescents. Loss for children and adolescents is typically more distressing than with adults because their coping skills have not yet fully developed. Loss is also more devastating for those individuals with a more vulnerable mental state. An individual’s dysfunction associated with loss may be brief or significant. The dysfunction associated with the loss varies in proportion to the individual significance of the loss thereby affecting cognitive, emotional and behavioral states. Anger Depression Maladaptive patterns of thinking

Example: Grief with three specific dysfunctions to be treated individually.

Varying degrees of dysfunction are associated with loss. Dysfunction usually manifests itself in a manner which creates difficulty in coping. Grief dysfunction is unique for each individual and may range from simple dry mouth and anxiety to experiencing hallucinations. Grief in any individual can be particularly dangerous if a significant mental health disorder currently exists. Dysfunction is unique to an individual and not every individual experiencing grief can or should be treated identically. Each dysfunction created through grief and treated in therapy should be addressed and treated as a separate dilemma.

An individual suffering from grief may experience multilayered trauma in which several dysfunctions occur simultaneously. This is of particular importance as the therapist needs to track and provide psychotherapy for each of the dysfunctions individually. This methodology of grief therapy allows the various dysfunctions to be “directly targeted” in a manner in which the individual is not subjected to excessive time or useless therapeutic constraints.

Revitalization

The Circular Grief Perspective relies on a revitalization course of action. This methodology, through either self-help or professional therapy, plays a vital role in an individual’s attempt to regain a sense of self and return to their status quo. Addressing individual grief through some form of therapeutic revitalization technique is essential for the individual to return to a state of status quo. While simple deep breathing exercises may solve uncomplicated dysfunction arising from grief, professional therapy is required for individuals suffering from excessive and/or multi-layered grief dysfunction. Individuals suffering from traumatic grief may seek dangerous or sometimes deadly solutions for their grief. Analyzing the grief and utilizing appropriate therapeutic intervention assists the psychotherapist in healing the client and helping them return to a previous status quo existing prior to the loss.

Whether the individual experiences the death of a loved one, the rejection of a friend, a divorce, or any other loss, honest talk and subject examination is of utmost importance. It is important to let clients know that dysfunction is a part of grief and a normal reaction to loss. Encouraging individuals to live a healthy lifestyle (meals, sleep, etc) aids the therapeutic process. The therapist’s ability to devise creative methods that encourage the individual to think positively and express emotions productively will enable the individuals return to a norm specific state of status quo.

Conclusion

All individuals experience grief on various occasions throughout their lifetime. The point before an individual’s actuation event (loss) is known as the status quo. The actuating event triggers the grief process and associated dysfunctions, Grief dysfunctions may occur simultaneously requiring a targeted treatment modality. With the help of the revitalization process, either self-help or professional, and individual may be brought to a previous state of status quo. The Circular Grief Perspective I developed and utilize in practice illustrates this movement through an identifiable cycle. The Circular Grief Perspective is a tool to help facilitate the psychotherapist in tracking the grief process so effective and appropriate treatment methodologies can be applied.

Robert Cravens AbD, LMHC Cravens Professional Services, LLC Therapynow@earthlink.net