MOTHER'S DAY

Grief Counseling

Last week, the Association for Death Education and Counseling (ADEC) held its 30th Annual Conference in Montreal, Canada. There were several important presentations, some of which I will be writing about later. However, today I want to concentrate on one session that is relevant to a topic that has been in the popular press and on the television show Boston Legal: Is “grief counseling” helpful or harmful to the bereaved?

After years of research, there is little reason to doubt that psychotherapy is an effective way to help most people who are experiencing distress. Both professional journals and the mass media have reported that despite the theoretical approach of the clinician or who is receiving the therapy - individuals, family, or groups - clients are in significantly better shape after therapy than those who do not take advantage of it.

For the subset of psychotherapy known as grief or bereavement counseling, however, the effectiveness of therapy is not as well established. There are three reasons for this lack of clarity:

1. Contrary to other therapeutic areas which aim to treat and assuage preexisting, specific disorders and problems with living, bereavement counseling is most often practiced as a preventive treatment. Its goal is to diminish a client’s probability of suffering future psychological or physical problems. Unlike non-bereavement therapy, there are no easy means to examine the impact of treatment on a pre- and post-treatment basis.
2. Most bereaved people have a tendency to improve in their adaptation to the loss without any professional assistance. Only 10-15% of those whose loved one has died experience suffering and grief so intense and for so long that they develop psychological and physical debilitation, sometimes to the point of being fatal.
3. Many studies have failed to distinguish between the three broad categories of bereavement interventions as delineated by the Institute of Medicine (IOM): universal, selective, and indicated.

• Universal interventions are those that focus on anyone who is bereaved without considering individual death-related risk factors or preexisting functioning.
• Selective interventions are oriented to those whose loss has the potential for causing high distress such as those whose child died violently, suicide survivors, etc.
• The third category, indicated interventions, addresses those who present significant problems adapting to the death. These problems could include normally recognized psychological symptoms such as depression or other clinically important complications such as guilt, loss-related intrusions,  rage, etc. It is also important to note that the complicated grief these mourners suffer will not diminish just because of the passage of time nor can it be simply reduced to common psychological disorders such as depression and PTSD.

Because of these variables, the reports of how helpful counseling is for the bereaved have ranged from favorable to neutral to harmful.

At the ADEC conference, Joseph Currier and Robert Neimeyer presented the findings of their analysis of the existing research and tried to make some sense out of the disparate results. They, along with Jeffrey Berman, conducted a comprehensive meta-analysis of 61 published, controlled research studies on the efficacy of bereavement counseling. Besides examining how effective counseling can be, the researchers also attempted to determine if timing for starting therapy; the method of recruitment; the mode of death; or the bereaved person’s sex, age, or relationship to the deceased had any bearing on the results.

Without going into the details of the study, let me summarize what they found. Their analysis showed that general bereavement counseling has a slightly helpful effect that continues for only a short time after the intervention ends. These findings are similar to those for generically applied trauma interventions. However, when Currier, Neimeyer, and Berman delved more deeply into the data, they made some interesting discoveries.

• Interventions that addressed the universal population did not produce any statistically better results than those that occur from the mere passage of time. Most people have the personal resiliency and available societal and familial support systems to help them adapt to the loss, whether they receive counseling or not.
• For those who qualify for selective interventions, counseling did provide more benefit, but it was short-lived and not statistically significant later.
• However, if the proper steps were undertaken to assess if the client was having specific problems in adapting to the loss and if any of these problems were subsequently addressed, i.e., indicated interventions, the effects of the counseling were the same as in other areas of psychotherapy.

It is also noteworthy that Currier, Neimeyer, and Berman found that except for the method of recruitment, no relationship existed between the other possible factors (the sex or age of the bereaved, timing of therapy, etc.) and successful therapy. The only effect that the method of recruitment had was with clients who were either self and/or clinically referred. Referred clients experienced better outcomes than those who entered therapy as the result of aggressive outreach programs.

So, the answer to the question “Is ‘grief counseling’ helpful or harmful to the bereaved?” is “It depends.” As Neimeyer said at the conference, counseling helps, unless it doesn't  In other words, for those bereaved individuals needing indicated interventions, the higher the level of bereavement-related distress, the greater the benefit they will receive from bereavement therapy.

Mother's Day !

Talk Better To Yourself !

We tend inflict so much suffering upon ourselves through negative self talk. It’s really amazing when you think about it. So much suffering due to words running through our minds…

In this post I’d like to share my top 10 self-damaging things we tend to say to ourselves. I have my own experience with negative self talk, believe me!

One tool for overcoming negative self-talk is to call it what it is. I’ll say more about that in a minute. Here is my list of the top ten things to avoid saying to yourself.

1. I’m not worth it.

This is a direct assault on your self-esteem and it is simply not true! Telling yourself you are not “worth it” only perpetuates negative beliefs you may have picked up early in life.

2. There’s no use.

Telling yourself there is no use steals your personal power and leaves you with no motivation.

3. I can’t do it.

Again, very disempowering. There are times when you truly cannot do something, however, most of the time this one is delivered as more of a self-attack than a statement of fact.

4. I’ll never follow through.

This is a set up for failure before you really get started. We all know that success comes one day at a time. Telling yourself you will fail before you get started is shooting yourself in the foot.

5. People won’t like me.

A set up for rejection. When you enter a new situation telling yourself that people won’t like you, it can become a self-fulfilling prophecy!

6. Others are better than I am.

We all tend to compare ourselves to others. Sometimes we exercise prejudice against ourselves, though. Telling yourself that others are better than you is an assault on your self-worth.

7. I am not enough.

A huge one for people who feel inadequate to meet the demands of life. A sense of personal inadequacy is very discouraging – don’t reinforce it!

8. I must be perfect.

The way to guarantee failure is to criticize yourself whenever you are imperfect, which is all the time. We are perfectly imperfect!

9. My opinion doesn't matter.

More low self-esteem in this statement. To say this one to yourself, you must consider yourself unworthy.

10. I’ll never be any different.

We say this as if we are written failure into stone. It’s a hopeless thought. Just say no to this one!

What To Do About Negative Self-Talk

Follow these steps to get a better handle on your negative self-talk:

1. Catch yourself. So often we run on autopilot and allow our minds to ruin our day. So, start each day with the conscious goal to catch yourself saying negative things.

2. Call a spade a spade. Next, label what you just said! Recognize it as negative self talk.

3. Use the following formula: “I just had the thought…” (repeat the negative thought here).

If you caught yourself saying, “I am not worth it,” for example, then you would pause and say, “I just had the thought, ‘I am not worth it.’”

Using this formula securely labels the thought as a mere thought. If you do not realize that what you said was just a thought, you run a higher risk of taking it personally and allowing it to ruin your day.

4. Take a deep breath and move on!

You ARE Never Alone !

Yes Accept Please !

“Thank You.” Why is that so hard to say? Why is a compliment so hard to accept? I have never been great at taking a compliment, but since my surgeries, I am even less able to simply say, “Thank you.” I have difficulty taking credit for my accomplishments and yet find it astonishingly easy to beat myself for my perceived failures. No more.

Since last January, I have lost over 110 pounds. With a bionic back, I have dropped 12 clothing sizes, eliminated my high cholesterol and hypertension, lost over 30% of my weight and more than 20% of my body fat. Yet, ironically, when I weigh-in each week, rather than look at the incredible accomplishment I have achieved, I concentrate on the weeks when I do not lose, or the fact that my favorite pair of shorts still refuse to fit. When complimented on my weight loss, I downplay my accomplishment, offering explanations along with a healthy dose of self-deprecation. No more. The next time I am complimented on my weight loss, or told I look good, I shall say, “Thank you.”

Since having a multi-level spinal fusion last February, I went from hardly being able to take ten steps, to running miles on a treadmill, lifting weights and, in general, being in kick-butt shape. Friends and family tell me: “you look like nothing happened to you, like you are healed.” Rather than focus on the leaps and bounds I have made in physical therapy, I concentrate on the days when I cannot get out of bed, when I can’t get to a workout. No more. I fought tooth and nail to get myself back into shape. I do 7 hours of physical therapy a week. I walked out of the wheelchair and I did it one step at a time. The next time I am complimented on my recovery, I shall say, “Thank you.”

I have fought with mood swings and depression since I was a teenager. This past year and a half has been he!l on my emotions. I could have succumbed to depression and truly given up, but I fight, every day, to keep my sanity and to not give in to the loud voice in my head that tells me that I should give up, stay in bed, cry all day. I have been told, many times, “I don’t know how you do it. I would never get out of bed.” But, rather than focusing on the depression and the mood swings that I do control, I focus on the days when I can’t control it.

I focus on those days when my moods get the best of me and I cry, or yell, or give in. I forget that out of 30 days, I got through 28 of them without breaking down and I beat myself up about the day that I lost control. No more. I work very hard to control my emotions. I fight against the depression as best I can, as often as I can. The next time I am complimented on ability to fend off depression, I shall say “Thank you.”

Every day is a battle in the war against life with chronic pain. Rather than focus on the wins, I concentrate on the losses. No more. I will try to take credit for the war that I am winning, not the battles I have lost and when I am complimented on my accomplishments, I shall say “Thank you.”

Theres A Spacial Angel in Heaven

The Easter Period is a time to Remember all of the Angeles that are close to us during our growth and development process.