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

2 comments on “A therapist experiences heavy losses…

  1. I have lost four of my children . The first ar 8 and -1/2 months preganate . I never got to see or hold him which made it harder , my nexts was my 2@year old son killed in a three car crash . It was hard to identify his body , every organ was ruptured . It took me two years to start to feel totally functional. Than my beautiful -4 year old daughter took her life but a gun shot wound to her head in school . She was in counselling and being bullied in school .i just felt why couldn’t I have done ore and saved her. Two years later my oldest son dies of a massive heart attach. It hasn’t been easy , I journel , pray . Started a begreivement group and started the fist Mothers Against Drunk .drivers in our county .its still hard on special days. But I thank God for each and every moment I had with them . Healing comes in your own time , not one set you others .

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