Grief is chosen as the IPT focus area when psychological distress is associated with the death of a person close to you. Grief can also be conceptualized more broadly as other losses in your life, such as loss of a relationship, loss of physical health, infertility, anticipatory grief of another’s or of one’s own death. The goal of grief as the focus area is to help you work through the phases of loss and to help you come to a resolution of your grief. Working through grief not only means fully exploring and understanding your grief reaction, but also communicating that experience to others and developing a social support network.
In additional to shock, anger, guilt, depression, despair and hopelessness, a sudden loss may leave you feeling with a greater sense of vulnerability and heightened anxiety. The safe world you once knew, no longer exists. You may fear for yourself, your family and friends, and become overwhelmingly preoccupied with thoughts that such random events can happen again. Along with the primary loss of the person, you may experience concurrent crises and multiple secondary losses. These losses include lost income, loss of home, loss of support, or loss of social status. It takes time for families to reorganize after a loss.
As noted, not all grief cases involve the death of a loved one. Some losses such as loss of health, loss of financial status, infertility can be experienced as a grief reaction. If a change in your life is significant, you may experience that change as a loss.
Here are some important considerations about grief and loss.
When deaths or losses are perceived as preventable, there may be a strong sense of the “What if’s.” Preventable deaths or loss are likely to increase a sense of guilt and anger.
With some losses, the death is instantaneous. Many survivors find the knowledge of an instantaneous death to be comforting, as they feel that the person who died had no or little awareness of what was happening. In others situations, there is a question whether the deceased suffered pain or anxiety or a prolonged death. These fears may dominate the person’s thoughts, rather than the memories of the person themselves. These thoughts, however, can become a diversion from grieving and disrupting the grieving process. Imaginings or memories of the traumatic death may cause so much distress that remembering the person who died may be actively avoided.
A traumatic death predisposes a grieving person to be at a much greater risk for suffering subsequent complicated mourning with PTSD symptoms.
Asking ‘Why’ is a common response to death, particularly an unexpected or sudden loss. Asking “Why”, however, is counterproductive for the healing process. As a therapist, it is important to help you ask “What can I do about it now?” “How can I help?” or “How do I pick up the pieces and go on living as meaningful as possible?”
Religion can play an important role, as it has been to be a protective factor in the grief reaction. Some people abandon religion during loss. Discussing your religious views, examining how the loss has changed your religious views, and helping you to reconnect with religion may be part of the therapeutic process
Delayed grief reactions are possible
A strong social support network will help you mourn the loss more effectively
The main therapeutic goals in IPT when grief is chosen as a focus area are to help you through the mourning process and to help you re-establish interests and relationships. You and your therapist will reconstruct the positive and negative aspects of your relationship with the deceased, or the positive and negative aspects of the loss in your life. Often when a loss is experienced, the positive aspects of your relationship with the deceased or old role are magnified and the negative aspects are minimized. People may feel that remembering negative aspects of the relationship is disrespectful to the deceased, whereas others fear that they might not remember important aspects of the relationship, or they may lose their cherished memories of the loved one. You and your therapist will work together to help you navigate the mourning process in a successful way. An important part of therapy will help you evaluate the availability and use of your social support network. Social support is psychologically beneficial, but people might turn away from others after they have suffered a significant loss. Your therapist will help you to use the social support available and to ask for extra help when needed.