A therapist experiences heavy losses…

Dear Dr. Neimeyer,

Following a succession of family deaths over an 18 month period, compounded by a difficult move to another part of the country for my husband’s work, I find myself struggling emotionally with my career as a psychologist.  Feeling overwhelmed, I took time off from my practice, and now have to start again in another region. I don’t know if I am capable of continuing my practice until such a time that I feel confident in my abilities.  A recent indication that I wasn’t there yet came when I tried to attend a training workshop on grief.  My response to the conference content took me by surprise; I felt panic and dread, and tolerated the topic until lunch time, and then fled.

I have made limited progress in getting back into my practice, and my feelings about this vacillate from guilt, to enthusiasm, to absolute dread.  I have no idea where I’m heading, where my passion lies, or what capabilities I have left.  I am terrified and ashamed of myself. Are these feelings reasonable, or am I just avoiding “getting back on the horse after a fall?”  I want to be enthusiastic, productive and compassionate in life, but the truth is that I am not.

I’m happy for this to be shared with others who may be struggling with grief.  My hope is that by revealing, with humility, that even those of us who have spent many years learning, advising and suggesting how to cope with life’s adversities will let others know that we can be equally lost, confused, and vulnerable at times in our lives. Kindest regards, B.

Dear B.,

First, thanks on behalf of all readers for the gift of your humility and transparency.  Certainly it is true, as you imply, that we stand on the same level playing field as our clients when our own lives are torn apart by heavy losses, and particularly when those losses are multiple and closely clustered.  Elsewhere in this collection I have offered some concrete ideas on disentangling multiple loss, so here let me concentrate on offering some ideas about your conundrum as a “wounded caregiver” who is trying to figure out how to address your own preoccupying and sometimes surprisingly disruptive pain, while also contemplating how to return to a professional career that has long been a source of meaning to you.

You ask whether your feelings are reasonable, or whether you are merely avoiding getting back in the saddle.  My initial sense is that the answer to both parts of this question is “yes.”  That is, it is entirely understandable that we are vulnerable to the same disorienting and disruptive grief that our clients can suffer, and equally understandable that a wise part of us lets us know that we are not yet ready to resume life as usual–especially when that life centrally involved listening, without distraction or personal “triggering” to the suffering of others.

What then is needed to manage these tumultuous and self-critical feelings, so as to gradually embrace once again a meaningful career?  A critical step could be cultivating self-compassion alongside other-compassion, as in metta meditation in which one focuses on a repeated mantra after calming and clearing a space through focused and deep breathing, in the course of which one directs “loving kindness” to oneself, beloved others and benefactors, casual acquaintances, and even problematic or difficult people.  As a professional caregiver, you might also extend this list to include a ‘difficult client.”  Numerous internet sites and books can offer instructions for this practice, which both helps soothe painful emotion and direct compassionate attention to those who need it–oneself included–without the immediate pressure to engage the distress of others in a face to face way.

A second step is to take an honest inventory of your own needs.  Who in your own life displays “willingness to listen with a compassionate heart, and be a gentle companion in a time of despair?”  This could be a friend, family member, or another caring professional who is not currently burdened by the same or comparable losses.  Perhaps your grief needs as its most essential audience you yourself, bidding you to give it the time it deserves through journaling, expressive arts, or body work.  In other words, if you deeply ask, “What do I need in my grief, and what steps am I ready to take to secure it?” you may find that the way forward begins to open.

Finally, as you make progress in self-soothing, cultivating loving kindness toward self and others, and identifying and acting on your own loss-related needs, you will begin to naturally make room in your heart, mind and conversations to again hold the suffering of others.  Very likely this will first become evident in the form of greater patience with the distress of friends and acquaintances, and then begin to generalize to people you don’t know personally, but who you encounter in informal ways.  When you can sit with their distress without it triggering your own, with no attempt to push them toward some answer for which they are unready or to push them away altogether, you will know that you are again ready to begin seeing clients.  Though doing so should be undertaken slowly, just beginning with a few sessions per week, even this will require bravery–exactly like getting back in the saddle after a bruising fall from a horse.  No one requires that you immediately enter a rodeo or lead a cattle drive, but merely stay on the horse and find a path forward together for the hour of a conventional session.  With steps like these, reengagement with your life as well as your grief can again come to feel natural.

Dr. Neimeyer

3 comments on “A therapist experiences heavy losses…

  1. Thank you for this very honest exploration of how grief hits us professionals as hard as it hits our clients. I’m a psychotherapist and since my husband died 7 months ago I haven’t seen any clients. I think shame can hit hard: someone I know said “I suppose it’ll be easier for you, being a therapist…” Wrong! I have contemplated suicide; I have stayed in bed for days; I have felt the meaninglessness of loss. Dr Neimeyer is right: self-compassion is essential. We cannot expect that we won’t react to loss in any other way from the rest of humanity.

    I send deep understanding and heartfelt compassion to you in your hours of need. May you find a path forward and may we, together, find peace in our hearts.

  2. Dr. Neimeyer,

    Such a sensitive and helpful reply to this suffering therapist, B. I appreciated your expression “wounded caregiver.” In my speech I have sometimes used “wounded healer” but I like your choice of phrase more.

    For sure B has lost her moorings but someday she will be in a good place to share even this experience with other suffering souls. Jung believed that as therapists we cannot take a client to places that we ourselves have not gone. I believe that.

    I think it would be such a great thing if B would take your advice of self-compassion and add a lot of self-care. I would like to see her indulge her every sensibility – maybe write and paint or cook and even join a yoga class. All with a self-emphasis made consciously as in “This is for you, B; you’ve had a rough and painful time and you need this self-care for yourself now. You need to help yourself to heal. It’s not a luxury; it’s a necessity.” Rest and sunshine on one’s face during long walks can also bank some elevated feelings to raise one’s confidence again.

    I would also like to share a little here about moving a practice. It’s not a walk in the park but it can be done. Once, years ago, when the sorrows in my own life were actually on hold I moved for my husband’s job to lands in the North. I felt optimistic that I would have little trouble beginning my practice anew. The timing seemed perfect and we thought the change of home and scenery would be good for both of us. My colleagues wondered what the heck I was doing given my practice was large and well-established.

    Well, my new community couldn’t figure out my extroverted personality and I was astounded at how reserved my entire town was. I wondered if maybe my colleagues were right! But it only took one woman (who eventually became a client) who told me, kindly, that my new community has a very quiet way of living life and that they will “eventually” see my therapeutic gifts but – in the meanwhile – I might like to take it a “little” more slowly. Then she smiled. What a wonderful and unexpected gift she gave to me and how grateful I was to receive it.

    It took me seven months until I was up and walking, not running anymore. I also switched gears and focused on running groups and less so on a one-on-one practice in the beginning. I simultaneously removed my grief profile in that interim knowing a temporary respite was a healthy choice. I signed up for art classes and joined a woman’s group to help the less fortunate. I began two groups: women in transition (since I was learning those ropes) and a men’s group I called “Finding The Inner King.” Both were highly successful and referrals began from there.

    As we both know, Dr. Neimeyer, we never know what life is going to throw at us and being able to offer ourselves that compassion you always write about with us is where we must begin. I must also tell you that I know some cowboys and a few cowgirls out in Montana and Wyoming and when I’m lucky I can get out there and ride with them. They would wholeheartedly agree with your sagacious advice about not needing to lead a cattle drive when what is called for in B’s case is a slow and steady ride through the mountains before any open-fielded galloping.

    Mary Jane Hurley Brant, M.S., CGP

  3. If so, I encourage you to register for the upcoming pet grief workshop “Where Grief Meets Love”. The one thing about grief, you may choose to be by yourself, but being by yourself is not a prerequisite to grieving. Grieving is meant to be done in a trusted community, with people who have experienced and ‘get’ pet grief. THIS WORKSHOP IS FOR YOU IF: You’ve been grieving the loss of an animal You’ve been looking for a safe place to express the grief you are experiencing You would like to have your grief witnessed by others who ‘get’ it You have been looking for like-minded people in a nonjudgmental environment who understand pet grief You’re looking for a different way to work with your grief I’ll be sharing the methods and techniques that have been successful for me in befriending my grief, with the intent they will give you a way for meeting and working with your own grief.

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