Counseling: Loss

Chapter 7 Loss - W. Eugene Gibbons

Now Abraham and Sarah were old and well stricken in age; and it ceased to be with Sarah after the manner of women. Therefore Sarah laughed within herself, saying, After I am waxed old shall I have pleasure, my Lord being old also? (Genesis 18:11-12.)

It is difficult to understand fully the depth and complexity of Sarah's feelings when she learned that her future was to be different than she had supposed. Since she was mortal, subject to the same trials and feelings we all face, we might suspect she had anguished greatly over her barren state. It is obvious that the bearing of Isaac was a great blessing to Sarah, and she may even have viewed her previous inability to have children as an invalidation of herself as a woman or a wife. As many women in the Church know, such a limitation is often viewed as a loss. There are many similarities between Sarah's experience and our experiences today.

We understand that this life is not intended to be without stress, pain, and difficulty, and loss is simply part of life. Unfortunately, many people are not prepared to accept the reality that loss and pain are unavoidable and that ultimately they can be sources of growth.

What Is Loss?
There are five main categories of loss: (1) death; (2) loss of social role (through divorce, inability to bear children, single parenthood, etc.); (3) loss of employment; (4) loss of health or body function (through stroke, heart attack, hysterectomy, loss of limb, paralysis, mastectomy, etc.); (5) loss of self-esteem (from deciding not to go on a mission, from marrying outside the temple, from being an unwed mother, from lack of affluence, etc.).

Since loss is a universal experience, the problem for those who counsel is to understand how people perceive their loss, how they respond emotionally to it, and what they are doing about it. Dr. Elisabeth Kübler-Ross has identified the stages a person may pass through in one of the greatest losses, the death of a loved one. The steps are (1) denial (shock); (2) anger (emotion); (3) bargaining; (4) preparatory depression; and (5) acceptance (increased self-awareness and self-reliance). fn My professional practice has taught me that even though death is only one form of loss, the stages described by Kübler-Ross may apply to all forms of loss. The question may not be whether people will pass through such stages, but rather where, why, when, and for how long they might become entangled in one of the stages. It is typical for people to experience these stages, and it would be a great disservice to those we seek to help if we automatically assume they are incapable of successfully dealing with loss simply because they manifest unusual behavior or other signs of stress. We must guard against any suggestion to those in mourning that they are unequal to the tasks before them or that they should not be called upon to bear such heavy burdens. Even though painful, loss can and ultimately must be understood and accepted as a challenge, an opportunity for growth, and a way to discover the purposes of life.

Responses to Loss
People face loss with varying degrees of emotional strength, intellectual ability, personal discipline, and with various philosophies of life. For example, complaints about loss do nothing to change that loss and must ultimately be given up. M. Scott Peck, in his book The Road Less Traveled, says, "Most do not fully see . . . that life is difficult. Instead, they moan more or less incessantly, noisily, or subtly, about the enormity of their problems, their burdens, and their difficulties as if life were generally easy, or as if life should be easy. They voice their belief, noisily or subtly, that their difficulty represents a unique kind of affliction that should not be and that has somehow been especially visited upon them, or else upon their families, even their species, and not upon others." fn

The responses to our help from those who are dependent, irresponsible, impulsive, or critical may be quite different from the responses of those who look to the future with faith. Some people's only strength will be our own faith in their future. Other people will display astonishing courage in the face of great loss. A beautiful, young, Orem, Utah, teenager recently lost an all-out struggle with leukemia, but this young lady, who was courageous far beyond her years, became a symbol of hope to others. The world has been told of her zest for life, of her great faith in a kind, loving Heavenly Father, and of her determination to find purpose and meaning in her own suffering. Strength, courage, joy, and lasting unity grew out of her family's crisis and loss. The support provided by friends, religious leaders, and others, was accepted much more deeply by the leukemia victim because of her uncomplaining determination. Had she been a constant complainer or resentful of her lot, she might have spurned any help offered by others.

It is probable, then, that we who would help others will be seen quite differently by the different individuals we wish to help. Nevertheless, different people suffering from loss may have similar feelings, frustrations, and fears, so our role with them will need to be constant. Our concern for them and our acknowledgment of their unique personalities prepares us to help them.

Perhaps the most striking symptoms of loss are the troubled person's many emotional and physical problems. These may include hostility, anger, guilt, loneliness, feelings of rejection, self-pity, irritability, despair, helplessness, numbness, low self-esteem, loss of identity, sleeplessness, anxiety, fatigue, isolation, bewilderment, confusion, loss of appetite, shortness of breath, apprehension, alienation, depression, dependency, and a sense of unreality. Obviously, all people do not experience all of these symptoms, but most manifest various combinations of them.

Two rather universal emotions experienced by those in crisis are powerlessness and loss of control. Panic is often a result. Such emotions are usually associated with dependency on others, which can cause many other problems. Generally, a sense of personal control will not return until the afflicted person works to resolve his feelings, thus becoming an actor rather than a reactor.

Support
Our support is critical to helping the person resolve his feelings, and fundamental to that support is our belief that the grieving person is capable of doing so.

Perhaps the most important thing a counselor can do is to treat the troubled person as an individual. It is thoughtless, insensitive, and demeaning to treat a person as an object. We sometimes assume we know what a neighbor is going through simply because we have watched someone else struggle with a similar problem. But even members of the same family react differently to exactly the same loss. However, it is often difficult to know what another person is going through. Often a person experiencing loss will cling as long as possible to what he perceives as an "expected" behavior, and it may be some time before we can discern the depth of his feelings. Sometimes a person will present a facade, such as a "stiff upper lip," while experiencing overwhelming fears and stress.

Relating to the Troubled Person
Your success in helping someone who is suffering from loss will depend on the kind of relationship you have with him. Most people are very protective of what they say and how they disclose feelings. Their experiences may have taught them how unwise it is to spontaneously trust and confide in others. If the troubled person senses any insincerity, lack of interest, or emotional aloofness in you, he will probably deny his feelings and refuse to discuss his problems. He is already struggling and will not risk losing more to you through premature trust. Therefore, your first task is to develop the person's trust and confidence. Perhaps the quickest way to destroy these two essentials is to be too quick with false hope, easy answers, and insincere or hollow reassurances. The person suffering the loss will know in a moment that you are responding from your own discomfort and that your advice probably has little value. Your genuine concern, support, and encouragement is what is needed. Your relationship may not be established with a casual five-minute talk in the hall or with a fifteen-minute phone call.

It is not unusual for a person suffering from loss to be quite receptive to building new relationships, and if you are sensitive, empathic, and genuinely concerned, the person will be open to your help. Most of all, be yourself, be natural, be sincere. A spontaneous squeeze of the hand, an embrace, the unexpected phone call, and other gestures of concern and genuineness are invaluable.

As the relationship strengthens, it is not uncommon for the troubled person to depend on you more than he normally would. This should not be of particular concern to you. Just be careful not to encourage unnecessary dependency that moves someone away from, rather than toward, self-reliance. You will not complete your task as a counselor until the person is capable of making his own decisions and is independent of you.

Giving Reassurance
In the early stages of your counseling, it is important to help the troubled person identify and discuss his feelings and fears. He needs to be reassured that his experience and feelings are natural and that he has not suddenly lost his mind or turned from the Lord. But be careful not to deny that his feelings are real.

Most people are ashamed to admit feelings of anger or ambivalence, as they sense it communicates to others that they no longer have control over what is happening or what has happened to them. Anger and ambivalence are not necessarily signs of hopelessness, but are real feelings that you can acknowledge while offering hope that change can come.

Timing and Additional Resources
One of the troubled person's great assets is his concerned friends, neighbors, and family members, who can give tremendous emotional support. But in giving this support, we may spend so much time with the person that he has no time to be alone to ponder his loss. A person may need time to reflect, meditate, and understand what is happening to him. He will not have this time if he is always surrounded by well-meaning people who are constantly offering support and encouragement. On the other hand, many friends may have a tendency to abandon the person after a week or two. His greatest grief and pain often come after the immediate crisis, long after most of his friends have stopped visiting and checking on him. It takes time to deal with loss, and those who are helping someone troubled by loss need to understand this and be available for quite some time. A good counselor will help the person explore how he feels several weeks or months after his loss. These feelings will reveal his direction, his progress in finding answers to his problems.

Helping People Solve Problems
Perhaps the best way to help is to teach problem-solving skills. During a crisis, most people do not think things through in an organized or logical fashion. Many people feel overwhelmed by their circumstances, and logic has little relevance for them. It is important to help the person think clearly and act responsibly. As discussed earlier, it is also important to help him understand his feelings, but it will not help him to go on hour after hour bemoaning his situation and indulging himself in his feelings. Sometimes the person may be overwhelmed by irrational fears that need to be confronted. If carried too far, such behavior, if unchallenged, reinforces the person's hopelessness and helplessness. It confirms his feelings of loss of control and suggests that the answers to his problems can be found only outside of himself. This creates an unhealthy dependency and invalidates the person as a responsible, capable parent, mate, child, and human being.

After he has sorted out his feelings, the person suffering loss needs to set some realistic and appropriate goals to help him get on with his life. If he seems to have little information to help him make responsible decisions, you can help him find the information he needs. To gather data and to think of possible solutions and their consequences may be of great help to those who have suffered great loss. It will help prevent the impulsive, emotional behavior so often observed in those who are unable to cope with loss effectively. A friend and colleague, Dr. Dave Seamons, developed the worksheet at the end of this chapter to help people solve problems.

It is helpful to ask the person with a problem to define or describe it. Then, seek their ideas as to what solutions they can think of. Write these under "strategies." You might offer additional alternatives. It is fine to write down some wildly unrealistic solutions to help improve creative thinking and to add some humor to the process.

Do not be too quick to suggest that some choice be made from among the alternatives. It may be better to send the person home to ponder additional alternatives. The important thing about using this form is that it provides concrete possibilities to the person who feels overwhelmed.

Avoid imposing pat answers and solutions on the person. If he follows your suggestions and they work poorly, he need not assume responsibility for the failure, as it was not his idea. In addition, he may not try very hard to make the idea work since he did not help come up with the idea. The idea might be completely inappropriate for his situation, which he alone really understands. If your idea is successful, the person may come back for more help and eventually become dependent on you.

Even though the decision-making may take longer than if you were just to give quick suggestions, it is better to sit down and work through the issues with the person so that the alternatives are carefully evaluated before one is selected. The time spent fostering self-reliance in solving problems will increase the likelihood of the problem being solved.

Seeking Spiritual Direction
A person suffering from loss may find prayer of great help. However, if a person is blinded by denial, anger, or guilt, he may resist the very spiritual solace he could receive. It is wise to link logical decisions to spiritual guidance. Rarely is it appropriate to promote the idea that there are practical answers apart from prayerful ones. We wish to promote the notion that prayer is practical, though it does not stand alone. Prayer is an absolute necessity, but it is especially useful after the person has gathered information, pondered alternatives, and made some tentative decisions. Of course, prayer is helpful at any time.

In Conclusion
Most people can resolve their loss without suffering deep or long-standing emotional or psychological problems. However, when those who already have problems are also faced with loss, more serious complications can arise. Seriously depressed people who are potential suicides should be referred to professionals rather quickly. Angry, hostile, dependent people with low self-esteem may not be particularly dangerous, but they can resist your attempts to help by constant negative thoughts and feelings. They can take all your time and energy if you let them. In some cases, it may be well to refer them to professionals. If you continue to counsel them, you may need to structure your time in a manner that permits at least weekly visits. However, refuse to be on twenty-four-hour call. Plan your meetings in such a way that the people you help will learn to anticipate the occasion as their special opportunity to discuss feelings, problems, and potential solutions with you. They may not learn to discipline their emotions or to search themselves first for solutions they can call every night at 11:00 P.M.! Your suffering friend will be angry if you permit and foster dependency because he knows this is not good; but he will also be angry if you fail to meet his demands and needs. Thus, the only sure way of helping such a person is to place the responsibility on his shoulders to struggle alone at times. Encouraging late night crisis calls teaches the value of crises. (They get results.) Giving an assignment to fulfill before the next meeting teaches responsibility and the fact that life is not a constant crisis.

You may need to discipline yourself so as not to reject or strike back at people who display thoughtless and demanding behavior. Some people will be very good at "setting you up" to be their "savior" by expressing a great deal of appreciation for you, by complimenting you on your decisions and advice, and by suggesting that no one understands them like you do! Nevertheless, be tolerant of such behavior; the person is usually not aware that he is fostering dependence on you.

Even though you should be sensitive about how you introduce the idea, those you counsel should try to begin serving others. They need to move beyond their own self-pity and pain. Losing oneself in serving others brings more solace than anything else. It is difficult to become bogged down in depression and self-pity while lightening the burden of someone else.

You can do much to help those suffering from loss. Remember that they normally function well but that they are temporarily uncertain and overwhelmed. Help the sufferer by trying to understand his feelings and behavior without being shocked or dismayed. Be yourself. You are the most powerful help you have to offer.

Loss: Notes

1. Elisabeth Kübler-Ross, Death—the Final Stage of Growth (New Jersey: Prentice-Hall, 1975), p. 10.

2. M. Scott Peck, The Road Less Traveled (New York: Touchstone Books, 1978), p. 15.