The AAMFT Blog

Loss, Grief, and Resilience: Finding Light Through the Darkness

 

By Froma Walsh, PhD

Professor Emerita, University of Chicago

and Co-Director, Chicago Center for Family Health 

 

National Grief Awareness Day, on August 30th, 2024, is intended to raise awareness and support for the experience of grief.  In these turbulent times, families have suffered devastating losses of loved ones, from the anguish of Covid-related deaths to gun violence, drug overdose, suicide, environmental disasters, and war. More attention is urgently needed in MFT training and practice to help the bereaved to heal and forge pathways ahead to live and love fully beyond loss.   

 

Attending to Death and Loss: The Shared Human Experience 

Of all life experiences, death and loss pose the most painful and far-reaching challenges for surviving loved ones. Yet, in our American cultural aversion to facing death, the profound impact of loss is minimized. Many are isolated in their grief, lacking vital connection, understanding, and support. Recovery is hindered by workplace demands, lack of paid bereavement leave, financial duress, and barriers to resources that disproportionately affect racial/ethnic minorities and other marginalized communities. In our ethos of “the rugged individual” and faulty notions of resilience, the bereaved are often urged to quickly gain “closure,” "bounce back," and move on, and are advised to "keep strong" and count their blessings. Caring spouses, family, and friends who are uncomfortable and unsure of what to say or do may withdraw over time. Too often, grief is unacknowledged or minimized, as in pregnancy loss or the death of a cherished pet. Covid-related losses may be suppressed by the understandable wishes to put the pandemic behind us (Walsh, 2020; 2023).   

Attending to death and loss is challenging for therapists, as well. We may feel uncomfortable, unsure of what to do, or even helpless: death is not a problem to solve. In meeting with a couple after their baby's death, the father said: "I don't know why we're here--what can you do? You can't bring back our child!"    

In our personal lives, we all face painful losses, our own mortality, and family legacies of loss that may constrain our engagement with the bereaved. Yet, by attending to our own losses, our common humanity can enrich our work with those in distress.  

 

Death and Loss:  A Hole in the Heart of the Family 

In the mental health field, most grief treatment models focus narrowly on reducing individual symptoms. The DSM diagnosis of Prolonged Grief Disorder can pathologize diverse experiences. A systemic practice approach is vital to humanize our understanding and expand our attention to influences in family and social contexts in suffering and healing. We address the impact of loss in couple bonds, among siblings, and in the family system, affecting all members, their relationships, and family functioning. Stressful adaptational challenges --as with the loss of a caregiver or breadwinner--compound distress. Rippling through kinship networks, loss touches many lives with immediate and long-term ramifications. Couples and family bonds can be broken, hopes and dreams are shattered. Submerged pain of overwhelming loss can surface years later in problems in life pursuits or other relationships, which may bring people to therapy.    

 

Resilience-Oriented, Systemic Practice with Loss and Grief 

Over my career, from early collaboration with Monica McGoldrick, my specialization in clinical training and practice has been the development of a resilience-oriented systemic approach with complicated loss (Walsh, 2023). At the core is the conviction that distressed couple and family processes can be strengthened to support healing and positive adaptation for all members and their bonds.  

Best practices in understanding and helping bereaved clients are informed by early family systems studies and a growing body of grief research: 

• Mourning and adaptation are varied and complex processes over time. There is no right way to grieve, no timetable, and no fixed sequence of stages to complete resolution. 

• Attention oscillates between grieving and addressing adaptive challenges.  

• We heal through our grief, not by getting over it.  

• People die; relationships don't die. Adaptation is facilitated not by detaching but by transforming attachments into continuing bonds through spiritual connections, rituals, memories, stories, and deeds.  

A resilience-oriented systemic approach applies core principles and methods of strength-based, collaborative practice (Walsh, 2023). Therapists provide a safe haven and compassionate listening and inquiry to understand both the shared and unique experiences of loss. We depathologize and humanize grief processes and support the inherent human capacity for resilience, helping those who are struggling to cope, to adapt, and to thrive. We facilitate--or repair--vital connections and communication to strengthen kin and social support, mobilize community and larger systemic/institutional supports, and tap cultural, and spiritual resources. In complex and traumatic loss situations, we attend to conflictual or estranged relational dynamics and to deep concerns that complicate grief. When working primarily with individuals, we may employ coaching methods or flexibly combine couple or family sessions, group formats, and community rituals and collaborative action in situations of collective trauma and loss. Applying the research-informed Family Resilience Framework (Walsh, 2016), we strengthen key relational processes--shared beliefs and practices-- that facilitate resilience. We highlight the power of connection, meaning-making, hope, and transformation for individuals, families, and their communities to heal from unbearable loss and go forward to thrive.  

Walsh, F. (2023) Complex and Traumatic Loss: Fostering healing and resilience. New York: Guilford Press. www.guilford.com/p/walsh6 

Walsh, F. (2020). Loss and resilience in the time of COVID-19: Meaning-making, hope, and transcendence. Family Process, 59(3), 898-911. doi: 10.1111/famp.12588   

Walsh, F. (2016). Strengthening family resilience. New York: Guilford Press. 

 

Top 4 Messaging Mistakes Made by Marriage And Family Therapist Websites

This content is provided by zynnyme, an affinity partner of AAMFT. This information is not necessarily the view of AAMFT and should not be interpreted as official policy. 

Your private practice website is a hub for connection with potential clients. The messaging you use on your website and other marketing materials is meant to connect, inform, and motivate people to act for themselves. Your message could be the difference between someone being stuck in their pain and someone finding help to heal their pain.

But when you search for marriage and family therapists online or through a directory, you may find a lot of the messages have made some simple mistakes that we want to show you how to avoid.

Mistake #1: Ask a lot of questions

Imagine if you are meeting with someone you don’t know, naturally, you ask a lot of questions to get to know them. Yet, part of having a solid marketing plan is knowing who you do great work with and being able to speak to the pain of those ideal clients. You should know generally something about their pain. If you start your website asking a lot of questions such as: Do you feel stuck? Do you not feel like yourself? Do you struggle with anxiety or depression? Are you grieving the past or something in the current present moment? You communicate that you aren’t sure who you are speaking to and are unsure of what they might generally be going through.

Instead of asking a lot of questions, peppering them with all the possibilities of what could be going on, speak to the common pain points of your clients. This takes knowing who you want to work with though. You can’t speak to everyone in one message. You need to hone in and speak to the clients you do the best work with.

Imagine moving away from the questions and more into painting a picture of what they might be going through. For example, "you woke up this morning with a tightness in your chest that is all too familiar. You do your best to push down the anxiety and worry, but day in and day out, it creeps up on you rendering you exhausted. You can’t focus at work. You miss appointments or space out in conversations with friends and loved ones. You worry so much about what others think about you, you just never feel like you can let your guard down."

How does that messaging feel compared to questions? It conveys attunement, and an understanding of the client because you know other clients like them. They aren’t alone and you know how to help.

Mistake #2: You aren’t clear about how you help

So many therapist websites speak in generalities about how they help. Many therapists talk about how they hold a safe nonjudgmental space for their clients. I hope they do! That is important, but that is the standard across the board. Besides, does a client really know how a nonjudgmental space being held for them helps? Probably not other than that there is comfort.

Instead, speak to how you show up as a therapist, giving good, informed consent about what to expect from you as a clinician. We aren’t speaking about being competitive and comparative with other clinicians. You never need to put down others to put yourself out there. You simply want to stand out clearly about what is unique about you in this work.

For example, I help anxious, high-achieving adults to simmer their anxiety so they can be comfortable in their own skin. I meet with my clients weekly because that is what gets better outcomes for the way that I work. I’m not a therapist who gives homework, instead, you will learn tools you can use outside of the session to use your body's wisdom to help you integrate more calm states in your day-to-day. Many of my clients love that they get to move their bodies during sessions and that there is a lot of laughter in the process of healing, It doesn’t always have to be so serious as you see on TV.

In this example, you can learn more about how the therapist works and what to expect. This gives the potential client way more information to decide if this is a good fit for themselves. Maybe they decide they don’t like what they read. That’s a good thing because it’s helping them tune into their own wisdom about what they need and it expedites them on the path to finding the right therapist for them.