LOYOLA SCHOOL OF THEOLOGY

2014-2015

UNNDERSTANDING PASTORAL COUNSELING FOR BEREAVED PEOPLE

A Term Paper For Theo 289: Pastoral Psychology and Counseling

By

Nguyen Van Hoang, C.S (Scalabrinians)

Pro: Fr. James W.U. Gascon, SJ

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 Introduction

As human beings, we cannot avoid death. It may suddenly come to us or our loved ones

in any moment of our life. We normally are afraid of death; we struggle to preserve our lives as

much as we can. Death is a reminder of our finality, our limitation. If we believe something

beyond death or the life to come after death, death become something positive, which directs our

life becoming more meaningful and valuable. However, the death of a loved one always brings a

painful experience to us.

Different cultures and different people may have different views and different beliefs

about death. A death in other words is a loss, a loss of a person. It is not simple natural

phenomenon which we are easy to accept. It is a loss of our loved one, a loss of relationship. In

my life, I have encountered many people who faced the death of their loved ones. How did I

comfort them? I learned from some others that “just keep silent!” I acknowledge that it is great

help for a bereaved person when I am silently present. However, I did not understand what

happen within a person who losses their loved ones. How can I accompany them in a more

effective way? Therefore, doing this paper is the way for me to learn more about the feelings,

reactions of bereaved people.

What is nature of grief which caused by loss of family members or close friends. Are

ways to help clients or bereaved persons to overcome and to cope with their loss? What is

necessary skills or knowledge of helpers or counselor need to have? Precisely, the goal of

counseling for bereaved people is to enable everyone, the children as well as the adults, to

reformulate the personal meaning of life, prevent lasting distress, and preserve personal,

psychological, and spiritual integrity (Richard K James and Burl E Gilliland (2001) p421). This

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paper is mainly presented and used for non-professional counselors such as pastoral workers,

especially for me as future priest. It focus more on crisis intervention for bereaved people.

I. Nature and Process of Grief of Bereaved People

1. Nature of Grief.
It is important to look at the meaning of the word “bereavement,” in order to distinguish

from another sadness, caused by different depressions or causes. Eugene & Sarac (1997) define

that bereavement is a powerful word for our reactions to the overwhelming way death attacks us

in the loss of a spouse, a child, or another loved one (from On becoming a counselor, a basic

guide for nonprofessional counselors pp 372-373). In another words, it is the way of behavior,

emotion and feeling of bereaved person in response to the loss of his or her loved one. It is

process of grief. This process can prolong depending on personality of bereaved persons and

their relationship with the dead person.

Moreover, the process of grief can lead to emotional maturation as well as leading to

pathological states when it is delayed or unresolved (Eugene Kennedy and Sara C. Charles, M.D,

1997, pp. 347-348). Bereaved people usually pass through different stages (being presented

latter) of normal grief and eventually they can cope with the loss of their loved ones. They

cannot live their normal life without dependence on the decease. They become more mature in

coping with the reality of life.

However, there are abnormal symptoms of grief which caused by the death of loved ones.

Indeed, Howard Clinebell (1984) states that there is evident of psychophysiological illnesses are

related to unhealed grief, (p 219). How traumatic it is, depends on the nature and importance of

relationship bereaved person with the death. Therefore, it is very important for the helpers to

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identify which symptoms of grief are normal in process of grieving and which are not. If the

process of grief prolongs in certain period of time, and a bereaved person has not improve in

coping with the loss, it may be a sign of abnormal grieving. The bereaved person needs to seek

professional help to understand more about these symptoms. The process and kind of treatment

may depend on the level and nature of problems which related to the loss of their loved one.

2. Stages of Grief
There are many theories or models which arrange process of bereavement and how they

deal with process of this grief. However, I just present here one model which considered more

comprehensive and well known. John Schneider (1984) developed a comprehensive model called

“the process of grieving” (Richard K James and Burl E Gilliland (2001) p425-426). This model

mainly explains the normal process of grieving. It is summarized follow:

Stage 1: The initial awareness of loss, the impact of loss threatens the body’ sense. There

are some behaviors, emotions or feelings such as confusion, detachment, disbelief as response to

significant loss.

Stage 2: Attempts at limiting awareness by holding on, it means using all positive

perspectives of loss that has worked in the past to cope with some reactions of initial awareness

of loss.

Stage 3: Attempts at limiting awareness by letting go, a bereaved person tries to separate

from dependency or attachment to lost person. During this stage, the bereaved may decide to

give up his or her belief or value.

Stage 4: Awareness of the extent of loss, one recognizes as morning, the most painful,

helpless, and hopeless. It is extreme grief and one feels defenseless in coping with reality of loss.

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 Stage 5: Gaining perspective in the loss, the bereaved people reach a point of accepting

what is done is done, and try to make peace with the past.

Stage 6: Resolving loss, the bereaved people can see and pursue activities unconnected

with the loss without reaction to it. They forgive themselves and others.

Stage 7: Reformulating loss in a context of growth, one discover potential than limits,

seeing problems as challenge to overcome. One discovers more about his or her strengths and

limits.

Stage 8: Transforming loss into new levels of attachment, it is integration of physical,

emotional, cognitive, behavior, and spiritual aspects of person. This stage does not end the

process of loss and grief but makes bereaved people to have greater openness and willingness to

surrender the reality of life.

Moreover, there are also some exceptions which depend on the situation of loss. Wayne

E. Oates (1976), describes some behaviors, emotions and feeling in grief process of sudden

death: shock, panic, numbness, and fantasy formation (in Pastoral care and counseling in grief

and separation, P38). It means after the process of panic and numbness, the bereaved persons in

the situation continues to reach out as if the deceased loved one were still there.

There is another kind of bereaved people who have the grief wound that does not heal.

Some danger signs that may indicate pathological grief if they persist over several months or

longer: increased withdrawal relationship and normal activities; the absence of morning;

undiminished morning; severe depression that does not lift; undiminished anger; guilt; loss of

interest in life (Wayne E. Oates (1976)pp 36-37). In these situations, the role of helpers are very

important to assist the bereaved to cope with grief.

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 II. TYPES OF LOSS AND INTERVENTION STRATEGIES.

They are many types of the loss of people caused by death. Each type has its own impact

to the people whom left behind, which depends also on their relationship and personality of

bereaved people. However, I would like to present two types of loss, together with case examples

and intervention strategies which generally considered as most stressful for people who left

behind.

1. The Death of a Spouse

The death of a spouse is one of the most emotionally stressful and disruptive events in

life of bereaved spouses (Cramer, 1990; Couric, 1999; Leahy 1993). Because of dependency on

his or her spouse, a bereaved spouse faces many problems during process of grieving not only

personal emotion but also social, financial, family problems. It means that their life were used to

be identified with deceased spouses, and now they are left alone.

Case example: Rechard K Jame & Burl E Gilliland (2001) give a case example and

explain how to prevent crisis for deceased spouse. Stuart Wynn, a44 year-old machinist, his wife

Kate, a 42 year-old bookkeeper, and their daughter, Anne, an 18 year-old high school senior,

were stable, middle class in large city. Kate Wynn got a stroke on the way to work and was

brought to hospital. The husband rushed to the hospital after receiving the news. Kate Wynn was

under intensive care, but she died after 24 hours, leaving her husband and her daughter in stage

of grief (from Crisis Intervention Strategies, pp439-442).

At this moment, crisis worker, the attending physician, hospital chaplain, showed

emotional support and empathic understanding to both Stuart and Anne. Stuart and Anne needed

to be assured that all appropriate medical measures had been used to save Kate. Moreover, they

need also provide referral resources that Stuart needed immediately to arrange funeral,

notification of kin and of friends. This is initial intervention strategies.

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 After the burial of the wife, there is a need to have individual counseling for Stuart and

Anne. Counseling for grieving people focus on the issue of loneliness and bereavement because

of the absence of Kate. It needs also to identify function and role of Kate in the family before;

and there is a need to reassign the role and function for Stuart and Anne. Lastly, counselor also

refers Stuart to spouse-survivor support group. The nature and activity of the supporting group is

presented in the last part of this paper.

2. The Death of a Child or children.

The death of a child is major life crisis and major loss for the parents (Edelstein, 1984;

Finkbeiner, 1998). Indeed, the death of a child is very traumatic for parents regardless to the ages

of both parents and the child. For the parents, the death of their child is unnatural and wrong

(Rechard K Jame & Burl E Gilliland, 2001, p 428). Therefore, the process of acceptance and

adjusting with the loss of the child takes more time; even some cases it effects the rest of the life

of parents.

Case example: Brad Drake, age 34, a rural postal carrier, and his wife Helen, age 30, had

twin sons, Herbert and Hubert, age 6. One afternoon, while Brad was doing chores in the barn

behind the house and Helen was preparing meal, Hubert was crossing the highway in front of the

house and was struck by an automobile. The parents rushed him to the hospital 22 miles away,

but Hubert was pronounced dead upon arrival (Rechard K Jame & Burl E Gilliland, p 442).

Rechard K Jame & Burl E Gilliland, (2001) found that the dead of Hubert made the

parents a feelings of grief, hurt, guilt and powerless (p442). Perhaps, they are bombarded with

question: “why did happen to them?” They had deep sense of searching for answer and meaning

of the death. Therefore, a counselor try to express empathic understanding and acquire

knowledge about the parents’ grief caused by the death of the child. During counseling, the

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counselor tries to explore about the previously unidentified and unspoken anger and guilt.

Especially with the feeling of being guilty in this case, the parents may blame themselves for the

death of their son.

It is good for the parents to share about their grief, about their son, and about the feelings

they had with Hubert before and after his death. This process also gives them chance to shed

their tears. The counselor should affirm that they were the best parents they could be. Moreover,

Rechard K Jame & Burl E Gilliland, (2001) also point out that it is very significant to assure

Brad and Helen that the grief and pain will continue for long time and it is normal (p443).

Besides individual and couple counseling, the bereaved parents should be referred to

parent-survivor supporting group. They can talk, share grieve and cry about their loss of

children. Moreover, it is also good to provide books, other reading material, film, audiovisual

material about bereavement in parents for them. They can learn and help themselves move on in

their life.

It is important for a helper to accompany the bereaved people to go through normal grief

and to prevent them get into lasting major depressive disorder. However, the diagnosis of major

depressive disorder is not generally given unless the symptoms are still present 2 months after

the loss (DSM-IV, p741).

III. THE ROLE OF HELPER AND PASTORAL PSYCHOLOGICAL RESPONSE

TO BEREAVEMENT

1. Role of Helpers (Counselors)

In my understanding, it is significant for a counselor to understand the reactions of

bereaved people in the process of grief. Their reactions and emotional responses are attempts to

help them to cope with the loss of their loved ones. It is normal in most of cases. A counselor can

manage herself or himself and be more effective in helping counselee if he or she understand

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well the process of grieving (Eugene Kennedy and Sara C. Charles, M.D 1991, p347). Therefore,

a helper should not prevent nor interrupt this process of grieving. A counselor is simply

accompanying the bereaved on the process of grief.

Indeed, impatience, vulnerability, controlling can possibly destroy the process of

grieving. (Eugene and Sara, 1991, p354). This can prolong the process of grief. Moreover, the

helpers need to be ready to receive and enable to tolerate expressions of anger from bereaved

person (p356). It is one of behaviors in the process of grief which is mentioned above. It is

significant not to stop them, but help them to realize that it is right to express their anger in the

process of grieving. It is also significant to show empathy, sensing the feelings, the emotions of

the bereaved.

Another thing which a helper should consider is to know how and when to say during

process of grief. This is not particular time in the process of grieving which a helper should say

or should not. It depends on the situation which a helper senses that he or she should say

something. Clinebell (1984) proposes some useful questions which a helper can ask grieving

people. What have you been feeling since the death? What sort of memory keeps you coming

back? Do you feel much anger? How often you let yourself cry? (p224). These are questions

which can help a counselor to understand more about his or her client. However, Rando, (1984)

emphasizes that empathic listening to the bereaved and the family is most useful skill of the

helpers (in Rechard K Jame & Burl E Gilliland (2001) Crisis Intervention Strategies, p.436).

Indeed, a better understanding the meaning of grief frees counselors to enter into the sorrow of

others with less fear. It means that though a counselor is empathic, he or she should not become

also sorrowful. The helper can avoid losing oneself in bereaved person.

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 2. Accompanying Bereaved People in Broader View.
Accompaniment of bereaved people on broader view means that a counselor or a helpers

looks at a bereaved in his or her own self, but also in the context of family, society and culture.

Therefore, the first thing which a helper should do if possible is to let the community and

family’s members know about the nature and the process of grief. This knowledge helps the

family’s members and community’s members more empathetic and understanding bereaved

people. They can avoid be embarrassed and uncomfortable when the process of grief is carried

out. Especially it helps them to avoid judging bereaved persons in a negative sense. I recall that

there was time my neighbor was crying, shouting upon the death of her husband. It was kind of

lamentation. The thought came to my mind was that she was pretending, just to show how much

she loved her husband. I was wrong because I did not know much about the process of grief of

bereaved people.

Another thing which we should not do is to let bereaved persons alone. They struggle to

cope with the loss of loved ones, the loss of attachment and dependency. They need friends,

relatives and family’s members to be with them. Indeed, the presence of these people helps

bereaved people feel supported and realizing that they are not alone. They feel that someone

understands their feeling of pain and sorrow. Furthermore, for Howard Clinebell (1984), a

counselor should encourage the bereaved family to talk together about their loved one, the

circumstances of the death, the memories and attributes they most cherish about the decease

person (p223). The share may help them to accept that their loved one is no longer with them.

They may be easier to let go from dependency on their loved one.

As I mentioned above, each culture has its own view and understanding about death.

Moreover, differentiations in carrying out ritual of morning also depend on sociocultural

structure. We should not prevent these rituals of morning to be carried out. It has emotional

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effect on the bereaved people. It perhaps a way of which they use to cope with the pains.

However, there exists cultural or social judgment which may prevent the work of morning.

Eugene Kennedy and Sara C. Charles (1991) make a point that a counselor should be able to help

bereaved people be free from this judgment, and they can carry out ritual of morning freely. It is

for them right to do that.

Lastly, it is good also for a counselor to refer bereaved person to join supporting group.

This group is formed by those who have experiences of grief due to the loss of their loved ones.

Counselor invites bereaved persons to join this supporting group. David K. Switzer (1989) shows

that it is not group therapy in technical sense but to give a change for bereaved people to share

and listen to experiences (feelings, emotions and reactions) of one another, from Pastoral Care

Emergencies Ministering to People in Crisis, p 126. Then, with leadership of facilitator (can be a

counselor or who are trained about counseling) give some inputs which can help them to realize

some insights. This support group not only gather in formal sessions, but also they can gather to

in some activities as friends such as go out for meals, visiting each other,.., etc.

Conclusion

The loss of loved one is painful experience for all of us. When one encounters this reality,

he or she tries their best to cope with the loss. There is process of grief which is normal, and

most of bereaved people go through. It is important for me to understand this process of grief and

with some skills or ways to accompany bereaved person in this process. The purpose of

accompaniment is to prevent bereaved people from lasting crisis, to help them integrate their life

again without their loved one.

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 However, it is also significant for me as a helper to discover some symptoms which are

not normal, especially it happens too long after the death of their loved ones. In this case, a

helper can have counseling sessions with bereaved person if he or she is competent to help. In

the case of necessary, a helper can refer bereaved person to another counselor, who is more

competent for the wellness of bereaved people. I imagine that as a priest in future, I will

encounter this situation. I will accompany some bereaved people as a pastor to go through

process of grieving. However, in case of the existing some abnormal symptoms in process of

grief, I would refer to them to professional help if I am not so competent in helping them as a

counselor. For me, perhaps it is also helpful for bereaved people to seek spiritual help, through

prayers, spiritual activities. However, it has to be done after a certain time in the process of grief.

They may find strength and meaning of life in God’s presence. Indeed, blessed are they that

mourn, for they shall be comforted (Mt 5:4).

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