A Question from a Therapist

Dear Dr. Neimeyer,

As a therapist, I find AfterTalk a helpful resource for many of my clients, who appreciate the encouragement to write to their loved ones about their grief and their love, and sometimes to seek the deceased person’s counsel or forgiveness. But I’m currently seeing a man who is a scientist, and who resists corresponding with his wife who died over a year ago because it feels “unrealistic.” He is equally resistant to having an imaginal conversation with her in an empty chair. So my question is, what should I do?

Terry

Dear Terry,

At one level, the answer is simple: “Something else!” Just as every grieving person is unique, so too our approaches to therapy need to recognize this uniqueness, and adapt accordingly. I find it helpful to think of two orienting questions to direct my intervention: What does the client need? and What is the client ready for? Either question alone is insufficient: A client who needs X may not be ready to approach it directly, and what a client is ready and willing to do may not correspond to a deep need. Orienting by the first question alone tends to produce repeated non-compliance, resistance or even premature termination, whereas orienting only by the second tends to produce a therapy that is superficial, failing to attend to the core issues. Neither is effective in the long run.

So first, see if you can define what your client most deeply needs–something you might be able to infer, but also might be able to ask him. If he were to say, “I need my wife back,” I’d take that as the beginning of the conversation instead of the end. What would she bring him that he currently lacks? A partner in conversation or activity, a purpose for living, someone who loves him, a sense of security? Any one of these might then legitimately be pursued in his present life, in small steps or large, drawing on his signature strengths as a person, and in his case, as a “scientist.” How can he think realistically about the project of achieving X? What would be the first step toward accomplishing it? If his behavior were an experiment, what would he hypothesize would happen if he did Y? If that experiment proved unsuccessful, how would he redesign it? If successful, what would be the next step in his research program? In other words, using a strengths-based perspective, draw on the client’s core values, skills, ways of thinking and acting to make progress toward meeting the needs revealed by your questioning.

Second, be sure to check to see whether your client is really ready to take a given step implied by the need. For example, he might say he needs a close relationship with a partner that would give him a sense of purpose and security, but on further questioning, acknowledge he does not feel ready to begin dating. What then might he be ready to do that represents a small step in this direction, perhaps something that would ready him ultimately for the kind of cultivation of a relationship of the kind he desires? Perhaps he would be willing to participate in a meet-up with people who share his interest in biking, or attend a social gathering organized by his friends, church, or work colleagues. Respecting his rationality, you could nonetheless partner with him to define a credible plan of treatment, even if imaginal conversations with his wife feel too fanciful to make sense to him. Orienting to the “crosshairs” where need crosses readiness can help you target an appropriate intervention.

Dr. Neimeyer

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