First, to give credit where credit is due. This post was inspired by a blog post that I read this morning on the proposed change in the psychiatric diagnostic manual (DSM) regarding grief. To get the specifics, I recommend reading the excellent (although heartbreaking) post. Briefly put, the DSM editors are proposing that a person who has suffered the loss of a loved one may be diagnosed with major depressive disorder two weeks after the loss.
Those who support this change argue that it will make it possible for insurance companies to pay for treatment for the bereaved. The not-so-unrealistic fear is that the change will medicalize and pathologize normal grief. Those fancy “-ize” words are just another way of saying that grief will start to be considered an illness with symptoms that must be managed and made to go away.
Those people who are my clients know that I am not anti-medication. Sometimes it can be a very helpful bridge. If you cannot get out of bed, it’s hard to show up in your therapist’s office to do the work you need to do. But we need to be very clear that grief is neither abnormal nor an illness.
Perhaps Stephen Levine put it best when he wrote, “Grief is the rope burns left when what we love most has been pulled from our grasp.” Grief is a normal response to loss. Grief honors the heart connections that we share. Grief the honors the importance of what we’ve lost. Grief is not a problem to be fixed but a journey to be walked. In our grief our most pressing need isn’t for a prescription to make our feelings go away but for people brave enough to bear witness to our journey.
In the Hebrew Old Testament Job endures one unthinkable loss after another. At first, his friends come and sit with him in silence. (My professor, the late Dr. L.D. Johnson. used to say it was the last kind thing they did. Later they tried to explain it all.) In our grief, we need people who will sit with us without trying to make it all better. People who will not tell us not to cry or be sad.
In our grief, we need to hold our feelings with fierce courage. We need our tears and our sadness. Sometimes we need or anger. Sometimes we need to let loose with the screams that come ripping out of our guts. My friend had lost both her husband and her child, and when I asked her how she was, she said, “Sometimes I just stand in the middle of my house and scream.”
We don’t “get over” loss in a week. Or two. If the loss is deep enough and terrible enough, we will spend the rest of our lives trying to figure out how to live with it. That doesn’t mean we will never be joyful and happy again. It means that we live with the knowing that our lives will never be the same again.
As a counselor who works with grieving clients, I am not presumptuous nor foolish enough to think that my role is to make their feelings go away. My role is three-fold: to help them find containers for the expressing of those feelings, to bear witness to their story and their feelings and finally, to help them find their way to whatever the next chapter of their lives will be.
Grief work is soul journey. And soul journey can never be undertaken by prescription.