I talk about writing a book a lot. I might have even mentioned it on a blog or two in the past. It is something I have always wanted to do and something that I have always felt I have it in me to do as well. When I was younger, my main issue was I had no idea what to write about, and now as I approach my fiftieth year I find I have an awful lot to write about and the constant belief in my head and heart that I don’t have the time to write anything other than the occasional blog! Therapists are a strange breed…
My wife asked me again this morning as we were walking into Bromsgrove about what I was going to write. Was it going to be for ‘people’ or ‘therapists’ (interesting that she separated the two categories out I thought, but that is a conversation for another day I think!).
It got me thinking though and in my minds eye I have a very easy to read and use manual on how and how not to do counselling and therapy with people, something that helps counsellors and therapists understand their clients better and improve their understanding of what the work really is and how to do it in a truly humanistic way, with the person at the heart of everything. Interesting for those in the field or with some form of interest in counselling and therapy as a profession, but not necessarily something people would buy their husband or wife for Christmas!
As with a lot of things in our marriage and life, my wife clearly disapproved of this as a plan! As someone who is regularly forced to read my wittering on here she believes that a book about the people I work with would be much more interesting and something that she would rather enjoy reading to. Obviously my obsession with Irvin Yalom dictates that this tickled my ego somewhat and it got me thinking about different clients who I have worked with in the past who impacted me greatly and who I learned a lot from.
As I approached my office (I am on leave this week, but obviously I still had to come into the office… Yeah, that is a blog for another day!) one client leapt out at me and when I thought about the brief time I worked with them and how they managed to change things for themselves in such short order I actually started crying a bit (this is not unusual, I cry a lot, and happy tears are always OK!).
I met this particular client only five or six times in total and only one of those meetings was one to one. The others were as part of a group for people experiencing long term depression. In the first of these group sessions the client did not even speak that much, only to confirm their name and say that they hoped to learn more about their depression through attending the sessions.
It was a lively group as I remember it, a lot of energy and laughter which is not unusual in a group such as this, but it is rare that there is so much early on in the process. The group bonded quickly as a result and soon it felt safe enough for people to discuss why they were there and how they experienced their depression. When it came round to this client we were all a little taken aback by the fact they were happy to speak in front of everyone, and deeply saddened when they explained what had triggered their depression.
They had lost a child. Strangely enough, I can only remember that it was a young child and we never discussed the details of how the child died in the group. It didn’t feel necessary I suppose, nobody asked the client and the client didn’t offer any details, but what they did do was express their grief and sadness in such a way that it was impossible to not be affected by what they were going through.
Over time the client spoke more and more about how the loss of their child had triggered the depression in them and also affected their other children and partner. It was taking the client everything they had to just keep supporting the other children and they had little time or space to feel their grief day to day. This was leading it to go deeper inside them and the depression was numbing them enough so that they could still function, but not feel anything much. There was not sadness, no joy in anything, just numb and barely enough energy to keep doing the basic daily tasks that their other children needed from them.
After four or five group sessions the client asked for a one to one appointment, which I always offer people attending a group as a supplement to the work they are doing within the group. This was arranged and the client turned up to the appointment very energised, almost excited and about twenty minutes early!
When we sat down it was clear the client had an agenda and something they wanted to talk about. The client had been to see a grief counsellor after their child died and the client had explained to the couunsellor that they were daily having such strong feelings of grief that they could barely function, that every time they went into the child’s room or saw a picture of them they burst into tears and broke down for a time. This was distressing for the client and also for the other children who were also finding it difficult to process their own experiences of loss and grief. As a result of this the counsellor had advised the client to take down all the pictures of the child and also move anything that was reminding them or the other children of the child and put them away somewhere safe. Desperate, the client did what was advised and soon afterwards the client noticed that the depression really started to kick in.
This made some things easier, the client was not breaking down in tears any more and the other children seemed to be doing ‘better’, in that there were not crying as much and were doing well enough at school. What the client noticed now though was that no one had spoken about the child for a long time, maybe weeks, and that everyone in the house now seemed to be actively avoiding mentioning the child around them. The client had spoken to their partner and the partner had said that they all thought this is what the client wanted, that is was making it easier for them to deal with their feelings. This shocked the client, the fact that their grief had now taken over the dynamics of the whole family and as a result everyone was still deeply sad, grieving and in pain, but they were all now doing it in isolation.
The client then said something that really took me aback. They told me that on the advice of the counsellor, they had moved the urn with the child’s ashes from the living room and into a closed cabinet in their bedroom. The client became really upset at this point and I am not ashamed to say I cried with her for a time as she re-connected with he feelings of sadness, guilt and despair that comes with the grief of losing anyone one loves, but I think especially when one loses a child.
I just need to put a little theoretical context in here. I have read many books on grief in the past. I have sat in CPD events and watched things online and a lot of these things try and tell you that there is a ‘right’ way to grieve. In my experience, personally and professionally, that is patent nonsense. Everyone is different and everyone will grieve differently for the people they lose. There is no ‘one size fits all’ approach to grief I’m afraid. As therapist and counsellors it is important we recognise that and treat each person that comes into our room as an individual and tailor our approach and how we treat them accordingly.
That said, when the sadness passed in the room, I found myself a little angry with the counsellor who recommended putting a child’s ashes in a cupboard. Maybe it was the right thing. Maybe the client needed a break from the raw emotion of her grief so that she could find some space to begin to heal, but by avoiding grief, we run the risk of it turning into something much more harmful.
We cant avoid grief, it is inevitable in all of our lives and we need to build up a level of resilience and OK’ness around it otherwise we will be knocked over each time it happens. Avoidance in awareness is OK as long as it is finite and we know at some point we need to face and process the grief to truly move through it and even grow through it too.
The client and I spent the remainder of the session discussing this. She was genuinely shocked when I suggested she get all the pictures out and putting the ashes back on the fireplace where they had sat before. She also seemed surprised when I suggested she continue to talk to her child as she did the housework, to say good morning to the child and tell them how their day had gone. She was already doing this, she was just doing it in her bedroom, alone, so the other children didn’t see her and get upset. So I just told her it was OK to still cry sometimes when they feel sad, but also to share happiness in that front room again when all of the family were together, or when they were in there by themselves. We need to learn to laugh and feel joy again after losing someone we love, this means we feel the sadness and pain of the loss too, but that is the price we pay for loving people I’m afraid. To laugh and love, we need also to feel sadness and pain sometimes.
After the one to one I never saw this client again. I got an email a couple of months afterwards and I really wished I had kept a copy of it because it was one of the best emails I ever received.
The client was doing great, they had found a new part time job and were loving it. There was laughter and joy in the household again, they spoke to all of their children every day (even the ones not physically there) and shared the laughter and the sadness together. The children were much happier, doing really well at school and their partner was also doing great. They were talking, crying, laughing together again and had even booked a family holiday for the first time since they lost their child. There were still difficult moments, but these were often followed by loving and caring moments that were special in their own way. The client was not experiencing any symptoms of depression, but they assured me that they would talk to their GP and get help if they ever felt them creeping in again.
My heart burst with happiness as I read that email and is one of the reasons why this client has stayed with me as strongly as they have. In less than two months the client had gone from being clinically depressed and attending a depression therapy group, to having a new job, permission to grieve, but also, permission to live, love and enjoy life again. In two months! And they did most of the work themselves, well, them and the group of people who helped them trust by sharing their difficult stories and experiences and then one lucky therapist who really only had to give them a basic permission to grieve and to share that grief with the people closest to them.
I wish all my client memories were this lovely and positive. Some are, some are not, but it is clients like this that energise me and make me feel like the luckiest person in the world to be able to do what I do.
That makes me more confused about what to say to my wife about books though! Should my wisdomous words be used to support therapists and counsellors to grow or should I do something that would help ‘people’ instead? Maybe I should just do both, though I just haven’t got the time…