Practitioners can work collaboratively with young people to discover ideas and strategies to assist with difficult emotional, physical, behavioural and cognitive responses to grief. These strategies are best used when a working relationship is already established and there has been adequate space for the young person to describe their experience. It is important that strategies and ideas are explored in a manner that does not dismiss or minimise the significance of the source of the grief.
There can be a reluctance, even a sense of guilt in changing ways of being, (even when painful), if changing implies ‘betraying’ the memory of the person who has died or the loss sustained.People deep in grief can feel a tension in exploring ways to feel better as if they are forgetting the person or the loss.
In working with a young person, use of real words or ‘evocative language’ (Worden 1991) can be useful for assisting expression. Referring to someone as having ‘died’ rather than ‘passed on’ encourages facing a description without ambiguity or the softening that can occur when obscured through language.
Young people might find the following ‘Things that might help in managing grief’ useful as suggested by headspace:
- Accept your feelings- It's OK to feel sad about losing someone special, and to take time in coming to terms with what has happened. Losing someone is stressful and upsetting, and it's normal to experience strong emotions.
- Allow yourself time to grieve and maybe to cry- You might need a safe place at home or at school to go when you're especially sad.
- Take time out- Being around other people can sometimes be stressful and overwhelming, especially if they are also grieving. Go for a walk, listen to some music, sit in a park or do something enjoyable like shopping or going to a movie.
- Collect memories of your loved one in a way that feels right for you- Perhaps write about them and the things you did with them. Collect photos, make a scrap-book or journal, create a website or blog, write music or poetry, or create some artwork.
- Find a way to say goodbye in your own way and in your own time- This might mean going to the funeral, writing them a letter, or having a memorial service.
- Express your feelings in some way- Talking to others can be helpful, but it's not the only way. For example, write about your feelings, or use music or art to express your thoughts.
- Allow yourself to feel happy and to move on with your life without feeling guilty- People sometimes feel bad if they let themselves smile, or if they seem to be moving on. It doesn't mean that you have forgotten the person you have lost. Your loved one would have wanted good things in your life.
- Plan for times that may be hard, like Christmas or anniversaries- Perhaps arrange to spend time with friends, do something enjoyable for yourself, or mark the occasion in a way which is meaningful for you.
C5. Experiential behavioural strategies
This element from CBT encompasses a number of strategies including relaxation and activity scheduling.
Grief can lead to a sense of timelessness and difficulty in negotiating daily tasks. Some scheduling may be particularly helpful for some young people in gaining a sense of control and mastery. Relaxation can assist in both physical and emotional areas where grief can be overwhelming.
Mindfulness refers to a present moment awareness of thoughts, emotions, physical sensations and actions. Mindfulness in DBT is a series of exercises that are designed to assist the focus on the present as a way of reducing overwhelming feelings.