Working With The Themes of Grief

During my Master’s program, I came across a research project completed by Susan Carter (1989), entitled “The Themes of Grief.”  Utilizing content and thematic analysis, Carter identified nine (9) core themes inherent in the narratives of her study population of grievers: Being Stopped, Hurting, Missing, Holding, Seeking, Change, Expectations, Inexpressible and Content.

Clients presenting with the phenomena of grief seek support and a way to come to terms, work through – process and reconcile oneself with the traumatic lifetime events/losses they have endured.  In 1993, I revisited Carter’s study and theory of ‘The Themes of Grief’ and created a grief assessment instrument utilizing the core themes and their content referred to as TOG (MOT – 1995).  I also prepared a poem as a handout for use with grievers to introduce them to Carter’s concept of the themes of grief. 

The goal was twofold: to generate an objective measurement of the client’s presenting bereavement response according to the depth of content noted within each theme.  This tool and the scores represent my meager attempt to reflect the depth of a grievers experience concerning the vast phenomena of grief endured at a particular moment in time.  Subjectively, clients state that working with the themes of grief is beneficial towards facilitating, understanding and reconciling themselves with the loss at hand.

I continue to use TOG as a research grief assessment tool (MOT, 1995) in my practice and would like to share the poem, Healing + Recovery (1993) utilized with grievers to introduce Carter’s nine themes of grief as identified below in italic, bold print:

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Trauma Counselling – Depth Levels of Conversation

In my last article, I provided brief descriptors of the first 3 levels of conversation – formal operations, contact maintenance and standard conversations.  In this article, I present brief descriptors of the last two, and what I consider are, the ultimate goal and true depth levels of therapeutic conversations:  Level 4 – Critical Occasions and Level 5 – Intimacy essential to achieve with survivors of traumatic lifetime events (TLE) towards healing and wholeness.

Level 4 – Critical Occasions – are essential conditions to meet for significant life-change and growth and implies that the client is both accessible to work and seeks to truly express the impact and depth of their inner experiencing.  The therapist genuinely and willingly joins the client in this degree of depth conversation.  Critical attention is provided to the revisiting of particular and significant times, relationships and conversations that made a difference, sometimes referred to as a crisis turning point or that moment in time when the stage was set within a sequence of events where one’s future outcomes were influenced [duly or unduly] in a significant way.  Conversation at this depth level results in genuine changes in words, thoughts, feelings and acts of both participants. 

This depth of client and therapist conversation is a highly desirable state of emotional investment where the client revisits the impact and a difference in one’s sense of being follows.  Emotionality is in the moment and there are candid descriptors of past and present, inner experience with self-questioning.  The client’s focus and concern is upon expression of their inner experience and the talk varies in form, tempo and emotional toning.  Typically, this depth of talk is prompt where fluid clusters of percepts emerge with slight hesitancy noted with the new material coming into consciousness.  At this point, the therapist is not forgotten, but part of the background, while the client accesses deep states of inner awareness.  The client’s use of adjectives and adverbs expressed at this time conveys the texture and colors of their inner experiencing which may be enhanced by the use of exclamations, slang, profane or obscene remarks.  Typically, body posture is relaxed and open, and one’s body language changes in keeping with the emerging emotions. 

However, intense immersion and overt behaviors ranging from rigidity to utter limpness or physical contortions visible in one’s face or body may also occur.  The client is on the expressive side of their presence, their accessible and attention is somewhat reduced for they are strongly focused on inner flow.  This is the place of change potential or cross-roads talk where participants emerge with a difference in perspective, attitude, or emotion.  This is a powerful plane where repeated returns to a word, topic, feeling or phase occur without conscious awareness. 

In these moments, the client may be unable to recall something particular, there can be abrupt switches of topics or feelings, a loss of one’s train of thought with a felt sense presents of either physical restless or unusual immobility.

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Reflections of a Trauma Nurse/Counsellor’s Academic, Research & Clinical Experiences: Trauma Memories [TM]

Experts assert that traumatic memory [TM], unlike ordinary memory, may not be altered by the passage of time.  Some argue that traumatic memory is ‘frozen in time or timeless, inflexible, invariable, and immutable or not capable or susceptible to change’ [1].

TM’s are believed to be unique memories that resist integration or are dissociated from ordinary verbal, autobiographical memory (AM).  The theory of state-dependent memory, learning and behavior and model of ideodynamic healing [2] is devoted to understanding and treating TM.  The lack of proper integration of intensely emotional arousing experiences noted in traumatic events into the memory system (AM), results in dissociation and the formation of TM protected by amnesic barriers.

The consequence of dissociation of TM, especially clients with complex, posttraumatic stress and dissociative symptomology or disorders, is that the various components are also dissociated from one another (fragmented).  These dissociated verbal memory fragments, in turn, are dissociated from affect (feelings), beliefs, and the somatosensory (body, 5 senses) dimensions of being plus one’s behaviours associated with the traumatic experiences.  Each dimension is in turn dissociated from one another or the sense of self is unaware of the other.  In Jungian psychology this is referred to as the unconscious or shadow. 

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Reflections of a Trauma Nurse/Counsellor’s Academic, Research & Clinical Experiences Crisis Counselling Intervention Strategies

Crisis states, grief work and bereavement are phenomenal experiences and a short period of decompression for the bereaved to feel safe, secure and regroup is critical.  Then, the bereaved can move into acceptance, sharing their pain inherent in loss, dealing with their memories of the lost person, status or object(s).  Open expression of pain, sorrow, hostility, and grief means being free to feel and mourn one’s loss(s) openly, usually by weeping, and to express one’s feelings.  To understand the intense feelings associated with loss means facing the fear of going crazy and a normal part of the grieving process

When feelings of sorrow, fear, guilt, and hostility are worked through in the presence of a caring person, these feelings gradually subside and the rituals to express grief aids in this process.  Resuming normal activities and social relationships without the lost person, status or object(s) at one’s side is another important step.  Working through the memories and feelings associated with loss helps the bereaved obtain new patterns of social interaction apart from the person, status, and object(s) that are gone.

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A pivotal aspect of successful crisis resolution is grief work and bereavement in response to any acute loss.  Our rational, social nature implies attachment to other human beings, a view of ourselves in relationship to the rest of the world; our family, friends, pets and home.  Death and the changes following any loss are as inevitable as the ocean tide, but because loss is so painful emotionally, our natural tendency is to avoid coming to terms with acute loss immediately and directly.

Grief work takes time and is not a set of symptoms to be treated, rather the phenomena of grief involves a process of suffering that a bereaved person goes through on the way to a new life without the lost person, status or object of love, pining and searching, anger and depression, and finally turning toward recovery. Continue reading →

Reflections of a Trauma Nurse/Counsellor’s Academic, Research & Clinical Experiences

Neo-Ericksonian Approaches to Persuasive Healing [3]

The use of Eriksonian hypnotic techniques helps to locate sources of psychological and physical pain to facilitate the natural healing powers of the individual.  A wholistic application of hypnosis incorporates wellness, higher consciousness and optimum performance.  Trance can be used effectively to promote joy and harmony as well as quiet disharmony. 

The promotion of wellbeing is a more efficient and beneficial focus of attention than a constant concern with diagnosis and cure.  Specific, identifiable thoughts, actions and experiences create wellbeing and peak performance.  Internal and external events are available to everyone, but not everyone pays attention to them or takes advantage of them.  Clinical application of hypnotic trance is an effective way to direct attention toward these events.  

Goals of Healing Trance:

1. To capture attention
2. To focus and nourish wellbeing
3. To promote contentment
4. To support optimal wellbeing
5. To precipitate peak experiences
6. To expand self-awareness, self-expression and self-mastery

Healing Trance Employs:

1. Metaphors: is a figure of speech in which a word or phrase literally denoting one kind of object or ideas is used in place of another to suggest a likeness or analogy between them. (i.e., drowning in money).
2. Stories:
3. Direct or Indirect Suggestions Found in: 

• found in poetic allusions (hinting)rhymes
• puns – humorous use of a word in such a way as to suggest two or more of its meanings or the meaning of another word similar in sound
• mythic symbols
• entrancing rhythms

      4.     Advantages of Healing Trance:

1. Flexible and adaptive
2. Conforms to the needs and interests of most people
3. A direct route to wellness as a way to pay attention to relevant landmarks to provide a pleasant trip.

Elastic waves of the earth and waves of a human life energy field are phenomena innate within and requires the use of mathematical equations, sensory-perceptual ability or words to discuss these matters that are otherwise invisible to the naked eye equipped with two dimensional vision.  The nature/nurture controversy remains.  I believe it is important for all helping professionals to comprehend the gist of complexity inherent in human nature.

To serve the purposes of this article, I will reduce my thesis into a paragraph: a succinct statement to introduce my hypothesis concerning the nature of a person: 

A person is a 3 dimensional being of mind, body and spirit with both open and closed systems contained within a heavy vessel, named and known as the self, affected and influenced by many factors/forces surrounding and operating within the spirit of the  being (etheric body, light vessel/body, breath/life essence) that is known before we are born and contained within the  physical body (heavy vessel/form); embodied or  disembodied (out-of-body) or in a mind-altered state,  but never-the-less grounded by electromagnetic fields within and on planet earth which orbits within a vast universe Star Treckee’s call the ‘final frontier’ and simply awaits departure upon final breath…[4]. 

Phenomena:  is extraordinary or remarkable material known through the senses rather than thought or intuition. Phenomenology is the study of human consciousness and self-awareness as a preface to or a part of philosophy containing descriptors of the formal structure of the objects of awareness, and of awareness itself, in abstraction from any claims concerning existence (the internal time consciousness).  Phenomena can be about the rare, significant, unusual, or an abnormal person, thing or occurrence of scientific interest susceptible of scientific explanation description and explanation [2].  Grief is one example of a phenomenal experience!

Wave:  undulation coined in 1646 describes vibrations – the rising and falling of waves, a wavelike motion to and fro in a fluid or elastic medium propagated continuously among its particles, but with little or no permanent translation of the particles in the direction of the propagation.  In 1802, undulatory theory was coined and is a theory in physics: light is transmitted from luminous bodies to the eye and other objects by an undulatory movement called wave theory.  The vibration is the pulsation caused by the vibrating together of two tones not quite in unison.  A wavy appearance, outline or form [2].

Cerebral spinal fluid (CSF) is encased and baths the ominous central nervous system (CNS) which is a closed system and has a vibrational rhythm deeply connected to breath.

Cranial-sacral treatments is an kinesthetic, healing art form and trained body workers can feel and work with the rhythm referred to as the cranio-sacral pulse, typically at 6-8 beats per minute and facilitate healing. 

My research dream is to convert pre/post-treatment trauma assessment scores to visually be able to see an artistic representation of a person’s trauma/healing vortices and gaze upon timeless waveforms [4]. 

Author:  Dr. Linda AK Thompson, BGS, MA, CCC, PsyD, FAAETS
Owner, Matrix of Trauma (© MOT ™):  Research, Advocacy, Healing

References:

1. Gerber, Richard. (2001). Vibrational Medicine: The #1 Handbook of Subtle-Energy Therapies.  Third Edition.  Bear & Co: ISBN: 1-879181-58-4 
2. Merriam-Webster, Inc. (1985).  Webster’s Ninth New Collegiate Dictionary. Thomas Allen & Son Ltd, Markham, ON: ISBN 1-919028-66-7
3. Neo-Ericksonian Approaches to Healing Trance: Author & Date Unknown.  Published in The Script.  International Association of Counselling Hypnotherapists (IACH): www.hypnotherapyassociation.org
4. Thompson, Linda A.K. (1996).  The Matrix of Trauma:  A dissertation – partial fulfilment for requirements for degree of doctor of psychological traumatology in psychological assessments and etymology.  © Unpublished/Sealed.  Summit University of Louisiana, New Orleans:  Louisiana.

Reflections of a Trauma Nurse/Counsellor’s Academic, Research & Clinical Experiences

The 21^st Century Wellness Paradigm

I believe my mother’s disclosure, about the details of my traumatic birth, was the second best birthday gift I ever received.  Surviving birth trauma as an arrested footling breech presentation [2], within a near-death experience (NDE) secondary to my mother’s hemorrhaging; us being packed in ice while awaiting the arrival of a physician to the scene – to simply be saved and granted the opportunity for a viable life – this is the first and greatest gift of all – the first breath. 

However, there are costs, consequences inherent in most heroic life saving measures.  My   traumatic birth imprint, the resultant NDE trauma response was my blueprint that did accumulate additional trauma response from additional traumatic events I survived across my lifespan.  Few understand I’m a sensitive – sentient with deep sentiment at my core.  I adapted and learned to live within the confines of my trauma vortex container that impacted me and altered my entire psycho-social-spiritual development within the cultural climate I was reared in.  Most important for me remains the invisible, mystical and sacred path I choose to travel that sustains me, and that is another story.

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Reflections of a Trauma Nurse/Counsellor’s Academic, Research & Clinical Experiences   Mid-Way – Traumatogenic Wounds & Beacon Messengers

In my mid-thirties in the mid-eighties, I remember sitting in a sociology class and our professor announced that every family system has skeletons in their closets somewhere down the line and across the generations.  Not only was I naïve about deception, I was also unaware of skeletons contained and held secret (closeted) by at least one living family member who contains the  transgenerational wound – traumatogenic [11]. 

My masters to doctorate process spanned 8 years of intense theoretical studies and I progressed to bifocals.  I am indebted to the vast number of academic/clinical teachers involved in my career/skill sets and development – quite amazing when I think back to the 16 year old who dropped out of school to simply be a practical nurse.  I still like those two words.  I am unable to formally acknowledge/thank all of my teachers to whom I remain grateful, however, there are some I refer to as ‘beacon messengers.’ It is their messages that stay with me and I hold onto dearly to sustain my faith, hope and fortitude to remain on track so that the bedside trauma nurse could and indeed did transition to become a trauma counsellor.

From 1989 to February 2012, I operated as a dual-role professional:  a Canadian Certified Counsellor (CCC) and Registered Nurse (RN).  In June 2012 and after 46 years of service, I prematurely, but gracefully surrendered [4] and placed myself on the RN inactive list and this is another story.  My current plan is to maintain my status as a CCC and owner, senior consultant of Matrix of Trauma (© MOT ™) for as long as my services are required and deemed helpful by the client population I serve.  My beacon mentors originate from both fields of nursing and counselling:

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Reflections of a Trauma Nurse/Counsellor’s Academic, Research & Clinical Experiences

My Beginning:  Have Trauma Will Travel & Rude Awakenings:

In 1989, this is what I said to myself ‘have trauma will travel’ on a novel path and idea that this trauma nurse, retiring from bedside intensive care unit (ICU) nursing could transition, with transferable skill sets gained as a mid-life professional, into a private nursing practice to be a grief counsellor.  A good naïve innocent thought until I realized from my own bereavement that the phenomena of grief requires master level education/training in order for me to be helpful or acceptable in any professional association providing counselling services[21]. 

Google search Psychotraumatology and Wikipedia high-lights three professionals: Frank Ochberg, MD is named the founding father of modern Psychotraumatology; Gottfried Fisher, PhD is named the founder of Psychotraumatology in Germany, and Steve Abadie-Rosier is an expert in criminology and considered the ‘psychoanalyst of the irrecoverable or the borderline.’  Goggle search Psychotraumatology Canada and Wikipedia high-lights the Canadian Friends of Herzog Hospital.  I was pleased to see the range of services now available and of particular interest to me is The Soldiers Project.  My father was a WW2 veteran and post-war a firefighter. During his end-of-life and palliative care journeys, I suffered great sadness alongside my family as my dad, my hero – died so hard.  This is another story.

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