Translate

power by WikipediaMindmap

Wednesday, April 1, 2020

Common Reactions to the COVID-19 Crisis: Waves of Grief

During the current COVID-19 crisis, many people have told me that their grief about the crisis, which is similar to the grief that you might feel for other losses, comes in waves (see my article: Grieving Losses During a Crisis).  They told me that they might feel fine one moment and then they suddenly feel a wave of grief pass over them.

Common Reactions to the COVID-19 Crisis: Waves of Grief 

Waves of Grief During a Crisis Are Common
Just like any other loss, the grief that people are feeling during this health crisis is real and understandable.  So much of life, including in-person contact with loved ones, has been upended, and this is a significant loss.

The fact that no one really knows how long this crisis might last can intensify your grief.  For instance, if you knew that the crisis was going to last another 30, 60 or 90 days, you would have an idea of when you might experience light at the end of the tunnel. However, at this point in time, although there are various projections, no one seems to know for sure when this pandemic will end in the United States.  So, it can feel like it's endless and the losses are permanent.

Emotions often come in waves.  When I'm working with a psychotherapy client and doing trauma therapy, I usually can expect to see the waves of emotion--whether it's sadness, fear, anger, or whatever emotion the client is experiencing.

Before doing trauma work in therapy, I provide psychoeducation about the work, including how emotions usually rise, reach a peak and subside.  One of things I do while working with a traumatized client is to track these waves of emotion as well as the discharge of these emotions by observing how the client reacts during therapy (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation About How Therapy Works).

When you cry, sigh, yawn or feel waves of emotion throughout your body, from a Somatic Psychotherapy perspective, you're discharging energy or emotions.  Although it might be unpleasant to go through a wave of negative emotion, it's usually better to allow yourself to feel it and allow it to go through you than to try to stop it because when you feel the emotion and allow it to discharge, you're self regulating your mind and your body.

Fictional Clinical Vignette: A Normal Response to a Crisis: Waves of Grief
The following fictional clinical vignette, which is a composite of many different cases, illustrates how grief is felt and discharged during a trauma therapy session:

Alice
When Alice learned that her husband, who was a firefighter, had died at the World Trade Center during the 9/11 attack, she was shocked and felt emotionally numb.  All she could think was that she was having a nightmare and any moment she would wake up and she would realize that it had all been a bad dream.

As her shock wore off a few weeks later, Alice felt very angry because she heard that her husband and the other first responders at the World Trade Center site didn't have the proper equipment to communicate with their superiors.  She felt such rage towards everyone involved because she believed that her husband would have survived if only he had the proper equipment.

She also felt rage when she heard that there had been warnings at the Federal level about the possibility of a terrorist attack that went unheeded.  From her perspective, she couldn't believe her husband was dead due to the incompetenence at such a high level.

She received a lot of support from the fire department's counseling unit as well as individual firefighters who worked with him, friends, family and neighbors. But she still felt alone and lonely as waves of grief washed over her.

A few months later, Alice decided to start therapy because she was feeling overwhelmed by the loss of her husband.  She felt enveloped by grief all the time, and she didn't have a sense of relief from it.

At the recommendation of a friend, Alice sought therapy with an experiential therapist who was a trauma therapist.  As part of the psychoeducation Alice received in her therapy, she lealrned that, in fact, grief comes in waves and she became more aware of periods of when her grief was heightened and when it had somewhat subsided for a period of time (see my article: Why Experiential Therapy is More Effective Than Regular Talk Therapy)

Before this, Alice hadn't paid attention to the wave-like experience of grief that ebbed and flowed.  Her therapist explained that similar to physical pain, emotional pain had a rise, a peak and a reduction similar to a wave.  Her therapist told her that many people who have physical pain can learn in therapy how to detect their waves of pain rather than believing that they have constant intense pain all the time.

Developing an awareness of the ebbs and flows to grief is an awareness that's similar to mindfulness.  The client learns to maintain a dual awareness of experiencing the pain (physical or emotional) at the same time that s/he is observing her reactions.

With guidance and practice, being able to maintain this dual awareness is a skill that can be learned in trauma therapy with a therapist who practices experiential psychotherapy.

 At first, Alice struggled with the observing part of the dual awareness.  She felt too immersed in her grief to do anything other than experience it.  But, over time, gradually, Alice learned to be more aware of her waves of grief as well as the dissipation or discharge of it when she cried, which brought emotional relief.

In learning to be more mindful of the grief she was feeling, it was as if Alice developed another part of her mind that was slightly outside the experience.  In psychotherapy jargon, this would be called "an observing ego."

Alice learned from her psychotherapist that:
  • When we speak of an observing ego, we're speaking metaphorically.  It's not like we can physically locate an observing ego in the brain.  It represents a healthy split in consciousness where a part of the mind witnesses what's going on for the individual.  
  • The observing ego allows us to perceive change in ourselves, and this is what allows people who are experiencing physical or emotional pain to witness their own experience.
  • Not only does the observing ego allow us to witness our reactions and changes in our reactions, it also grants us a sense of agency and we feel empowered by it because it can guide us to do what's best for ourselves.
  • Most people have an observing ego to a greater or lesser degree.  If you've ever had the sense of observing your reactions to a particular situation, your observing ego was at work.
  • The ability to strengthen the observing ego can be learned in experiential therapy.
  • There is usually a discharge, which can be very subtle, at the end of a cycle of emotion.  This discharge, which is often a letting go of emotion or subtle physical energy can come in different forms, including crying, yawning, sighing or feeling small waves of energy move through the body.
Being able to observe the ebb of flow of her grief at any given time, Alice no longer felt like she was "going crazy" when a tidal wave of grief came over her for no apparent reason.  Similarly, when she observed that she was feeling a little better or she was able to enjoy a visit with a friend or laugh at a joke, she realized this was also normal and it was part of the cycle of grief that she felt on most days.

After helping Alice to develop coping skills and techniques, her therapist talked to Alice about EMDR therapy to help Alice heal (see my articles: What is EMDR Therapy?,  How Does EMDR Therapy Work? and Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

As Alice continued with her EMDR therapy sessions, she still missed her husband on most days, but she no longer felt overwhelmed by her grief.  She also realized the periods of time when she felt on an even keel emotionally were getting longer and more frequent.  Gradually, her sense of relief expanded and she had more full days when she felt a sense of well-being.

Conclusion
Even though the fictional vignette above deals with the 9/11 World Trade Center attack, the concept of wave of grief applies to other losses and crises.

People experience grief when they go through major losses, whether it's the loss of a relationship, the loss of a job, a downturn in their finances, and so on.  Grief isn't only about death.

As mentioned earlier, grief is a normal and common response to loss.  Since the current pandemic encompasses losses on many different levels, both emotional and practical, it makes sense that many people are experiencing grief.

A wave is like a crescendo.  It has a rise, a peak and a fall.  Developing an awareness of this cycle and the observing ego to recognize it is part of experiential therapy.  

When a client develops this mindful awareness of their own emotional process, s/he experiences a sense of agency and control over herself and her emotions in situations that are often uncontrollable.

Getting Help in Therapy
Although grief is a common and normal response to loss, including the losses that many people are experiencing during this pandemic, attending experiential therapy, like EMDR therapy, Somatic Experiencing, AEDP therapy, and other forms of experiential therapy, helps you to heal faster than if you were to try to overcome it on your own or if you were in regular talk therapy.

An experiential therapist can teach you the skills and guide you through the grieving process in a way that you can't do it on your own.

Rather than suffering alone, help is available to you.

Many psychotherapists, including me, are providing online therapy (also called telehealth, teletherapy or telemental health) during the COVID-19 crisis while we're unable to do in-person therapy in our offices due to the need for physical distancing (see my article: The Advantages of Online Therapy When You Can't See Your Therapist in Person).

Working through grief with an experienced psychotherapist can help to alleviate your emotional pain.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, Somatic Experiencing therapist who works with individual adults and couples (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

Emotionally Focused Therapy is available for couples therapy.

I'm currently providing online therapy while I'm out of my office during the COVID-19 crisis.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (212) 726-1006 or email me.


































No comments: