Grief Therapist asks about using AfterTalk

Dear. Dr. Neimeyer–

I’m a grief therapist who works frequently with clients who have had difficult losses–sometimes of life partners, sometimes of parents, sometimes of children.  And I’ve been fascinated by AfterTalk ever since I encountered it, as many of my clients are eager to restore a sense of connection and communication with those they have loved and lost.  The “Therapist Portal” on the site sounds like a great way to facilitate this, simply by encouraging my clients to include me as a recipient of an email whenever they post a “shared conversation” on which they’d like my comments.  One big advantage of this is that it provides a secure way to have exchanges between scheduled counseling sessions, allowing me to provide more support while helping my client practice positive coping and meaning-making about the loss, and strengthening their continuing bond with their loved one.

But in using this convenient tool in therapy, do you have any tips or cautions I should observe?  I’ve asked people to write letters to their loved ones before, but usually in their journal.  I don’t know if there are any special considerations that come to mind for you as you do this, but I have a couple of clients in mind who I think could really benefit.

Bryan

Dear Bryan—

I agree with you that “saying hello again,” as our colleague Michael White once put it, can be a healing practice in grief therapy, encouraging clients to restore a conversation with a loved one that was interrupted by death.  As you likely have discovered as well, it is equally helpful when there is “unfinished business” in the form of unresolved relational issues with the deceased that call for post-mortem negotiation or forgiveness.  And just as you state, AfterTalk can provide a convenient and contemporary forum for doing so, one that grants total control to the bereaved to decide who, if anyone, can view an otherwise “private conversation” with the deceased.  In this respect, it strikes me, as it does you, as the optimal tool for grief therapy.

And yet, like other components of therapy, it pays to approach the integration of AfterTalk or other forms of letter-writing to the deceased with thoughtfulness to maximize its benefit.  Here are a handful of suggestions for doing so.

  1.  Assess the client’s need and readiness.  Not all bereaved clients need primary attention to restoration of the relationship:  Some may need to build basic “self-capacities” for emotion regulation, self-care, and ability to voice personal experiences, and others may feel greater need to process the “event story” of the dying before turning attention to the relationship to the deceased.  Approaching clients with an open query along the lines of, “What do you sense you need now to help you cope with this loss?” can help you get a sense of this, and whether relational work of corresponding with the deceased is the highest priority, or if something else is at the top of the client’s emotional agenda.
  1.  Negotiate a specific focus. Talking a bit about what the client might like to say or hear in an “exchange” of correspondence with the deceased can help give direction for the task, without becoming overly prescriptive.  Depending on the issues that are surfacing in the therapy, you might suggest one or two “conversation starters” like, “You always supported me when…”, “The biggest gift you gave me was…”, or “What you never understood was….”  But use a light touch:  most clients can find their growing edge without a great deal of therapist priming.
  1.  Establish conditions of safety.  People who write an AfterTalk letter on their own probably have an intuitive sense of when and how to do so.  But when we as therapists suggest the idea, it helps to talk through briefly such issues as where they would write (in privacy or with a trusted friend or family member nearby; at home or in nature), when they would do so (to avoid interruption and to offer a transitional period before work, social or family demands), and whether they would find a preparatory period useful to put them in the right mood for the writing (such as meditation or listening to a particular kind of music).  Helping clients think through these issues of context greatly improves “compliance” with the assignment, and leads to deeper engagement with the task and the deceased.
  1.  Plan an exit strategy.  For most people, writing a letter to the deceased (or from the deceased to them) is an emotional experience, especially when undertaken for the first time.  So plan with the client what he or she might do to shift from the writing back into life.  For example, my clients have used some of the same things on the back end that they use on the front end, such as listening to soothing or inspirational music or meditating for 20 minutes.  But others prefer something more active, like planning to have a coffee with a trusted friend with whom they can process the experience, or exercising.  As the Dual Process Model reminds us, grieving commonly involves alternating between reflecting on the loss or the loved one on one hand, and reengaging life on the other.  Helping clients segue from one to the other is therefore a useful service.
  1. Integrate the writing into therapy.  Consider with the client whether he or she would prefer that you respond in an email to the letter, or that you bring a copy of the letter to the session to process further face to face.  In the latter instance, I typically ask the client to read it aloud slowly, which commonly brings the relevant emotions, questions and issues into the room for further discussion, or alternately ask the client if he or she would prefer that I read it aloud as he or she listens.  The latter “self-distancing” perspective tends to promote more client perspective-taking, almost like examining oneself in a mirror.  Each therefore has its advantages, and I occasionally do both, beginning with the client’s reading, followed by my own, cuing the client to reflect on whether hearing the letter in the two modes led to any different observations or insights.
  1.  Consider circulating the letter to a community of concern.  Talk with the client about whether there are others, such as trusted friends and family, who might benefit from sharing access to the letter, or whether it is really something simply for an audience of one.  Appreciative letters that express gratitude for the past, present and future role of the deceased in the client’s life may be especially heartening to circulate through AfterTalk’s sharing function, soliciting others’ support of the client and celebration of the deceased.  This helps overcome some of the isolation of grieving, making it clear that the client is still a vital member of a community that holds them and their loved one. AfterTalk accommodates this with its Friends and Family feature (click this link for more about this: Friends and Family and Therapist)
  1.  Build a bridge to action.  The cathartic and reflective functions of letter writing are most meaningful when they open naturally onto constructive action.  Thus, we might encourage clients to identify some concrete step that would follow from their letter, one that is in keeping with its central theme or message.  For example, the client might be moved to write a letter of gratitude to friends who were especially generous in their support, or undertake a “random act of kindness” in the deceased person’s honor, perhaps of a kind that he or she might have done in life.  This underscores how the goal of grieving is not merely to manage turbulent emotions in the privacy of our hearts and minds, but ultimately to draw on the relationship with our loved one to reengage life with renewed vitality and compassion.

–Dr. Neimeyer

FOR MORE ON HOW GRIEF THERAPISTS CAN USE AFTERTALK AND ITS THERAPIST PORTAL, CLICK THIS LINK:

HOW TO USE AFTERTALK IN YOUR PRACTICE

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