A Targeted Approach to Help Clients Who Feel Empty Inside

In their search for relief, comfort, or “answers,” a grieving client might spend a lot of time revisiting memories of what once was.

But what starts as a pattern of coping can quickly spiral into painful rumination.

So how can we help clients work through their grief? And beyond that, how can we do it in a way that doesn’t keep them stuck in the past?

In the video below, Christine Padesky, PhD shares two cognitive restructuring strategies to help clients process complicated grief (and begin to reengage with life).

Click here for full transcript

This was a woman whose child had been murdered, and she was, I think, given the circumstances doing pretty well in her life. But she came to therapy because she was aware that she wasn’t really… It had been more than a year since the child had been murdered, and she was still kind of stuck at the point of ruminating about the murder all the time. And so, in terms of those various things, I did have her bring in pictures of her child, and some of the news clippings about the murder and encouraged her to be talking to family about her child. I did teach her emotion regulation strategies, mostly breathing, gave her permission at brief timeouts in session if she started feeling real overwhelmed, but also encouraged her to stick with her feelings and cry in session, to learn that she could feel those intense emotions and they wouldn’t go on forever.
But a lot of the work that I did with her was cognitive restructuring. And what I found was that, when she thought about her child’s death, she had a lot of imagery tied to the murder and the death. She knew a bit about the murder from the police reports, and her mind was just stuck on those minutes before the murder occurred and the murder itself. And then that’s where all of her thinking was. So one of the things that I did very early on, that was really helpful to her is, I moved her beyond that point just before and just at the moment of death. And I said, “And then what?” That question, “And then what?” Startled her the first time I asked it. But I said, “And then what happened to your child? What do you believe happened after she was dead?”
And at that point, the woman, actually I expected her to cry, but she actually looked at me and her eyes widened a bit. And she said, “Well then her spirit was released from her body.” And that led us to talk about what she believed about life after death. And it seemed she is… It’s true of many people who get stuck, particularly with a traumatic death like murder. She really hadn’t thought much about her daughter being released from all this pain and fear. And so we spent quite a bit of time then in imagery, imagining her daughter free and beyond, and on the other side of the murder and the suffering, and imagining her now at peace. And, the woman was quite religious and believed in heaven. So she was able to imagine her daughter in heaven. And I gave her a lot of exercises to think about her daughter now being in this better place, where her spirit was free.
So that was one type of cognitive restructuring we did through imagery. Second thing is, she had a belief and she said it’s very difficult for her to be happy. “How could I be happy after what she went through?” And there, it’s often helpful to just reverse roles. And I said, “If the roles were reversed, if your daughter had grown up and if you had been murdered and killed, would you want your daughter not to be happy the rest of her life?” And of course, that wasn’t what she would want for her daughter. And I would say, “Well, why not? Why would you want her to be happy?” And so that was another turning point for her. And she began to think that maybe she didn’t have to stay unhappy her whole life just because her daughter had such an unhappy end to her life.
And so, we then worked on her crafting, which took a number of weeks, her crafting a personal statement and way of thinking about this that would help her feel okay. And what she came up with was something along the lines of, he murdered her, but her spirit was laughter and love. And I’m going to live my life with laughter and love, moving forward in homage to her, and that will keep her spirit alive and that’s what she would want for me. And that really was a permission giving belief for her to begin to resume her life and move on. So those are some examples of how you can use cognitive restructuring to help people move beyond complicated grief to reengage in their lives again.

Grief and loss are universal, but their impact can feel deeply personal. That’s why you need a toolbox of targeted Strategies to Help Clients Process Grief and Loss.

Inside, you’ll hear from Frank Anderson, MD; Janina Fisher, PhD; George Faller, MS; Richard Schwartz, PhD; and many more.

Please check it out, but before you do, I’d like to hear your thoughts. How do you help clients work through grief and loss? Let us know in the comment below.

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