Albeit electronically, as
GriefPerspectives “goes to press†this month, the
36th annual conference of the
Association for Death Education & Counseling is getting underway in
Baltimore, MD. During these days, more than 600 professionals who deal with death and grief counseling will gather along with many others who join the conference virtually via webcast;
click here for more information on viewing the webcast sessions. These professionals will discuss—and debate—how we describe grief, what the process includes, how it proceeds, how to support people who have suffered or are suffering loss, and perhaps most significantly, what to do when grief seems to go awry. So as this huge conference of
“thanatologists†gets under way, permit me to offer some “global insights†gained from nearly 30 years in this field.
First, be careful not to underestimate the power and effectiveness of an intervention. 
Whether a trained and experience professional caregiver or a volunteer seeking to support a grieving friend, we can easily overlook the obvious. Perhaps we think this brief conversation or that phone call does not really make a difference. Remember, however, that not much is required for most bereaved people to feel supported and embraced in their suffering. A phone conversation with a good listener is far more than many of them will ever get from their own families or friendship circles.
During these first decades of my career, I have informally surveyed clients on what helped most in the early aftermath of grief. Rarely do people recall specific words that were helpful, but practically no one has forgotten the power of a caring presence on the other end of the phone or at the door, especially many months after the loss. See the research report below for more confirmation of this fact.
Second, be cautious about asking too many "feeling" questions early in the conversation. 
In their book,
Grieving Beyond Gender: Understanding the Ways Men and Women Mourn (Routledge, 2010) Ken Doka and Terry Martin talk about the instrumental griever and the importance of not pushing too hard to get an emotional/affective response to the experience. I think all of us have some "instrumental" griever in our style, and therefore, we need to be aware that too many "feeling" questions early in a conversation stifles the very expression for which we are looking.
Early in my interaction with grieving people, I am most likely to offer prompts such as, “Tell me about what happened…†and “Would you tell me a bit more about (person who died)?†After I have heard the story and asked for clarifying details I will begin asking questions about meaning: “What do you make of this?†or “How have you found yourself making sense of all this so far?†While emotional expression can be vitally important, I have often found these last two questions help us get there. Instead of asking, “â€How do you feel about that?,†I most often ask “So what do you think about that?†or “What do you make of that?†People who easily access emotion tend to do it in response to such questions; people for whom emotional expression is a more latent concept typically do not share much emotion in response to “feeling†questions anyway. Doka and Martine are among the
webcast presenters from the ADEC conference in Baltimore.
This leads me to my third observation: grief is not fundamentally about emotional expression. This is an outdated concept based on the frequently cited but empirically unsupported notion that one must "Feel it to heal it." Actually, our best theories of the grief process today agree that what is happening in bereavement for the grieving person is that he or she is
making meaning of the loss. As a matter of fact, I think the best description of grief is “the process of making meaning of the experience and identity in the face of loss.†In other words, in loss, we are constantly asking ourselves two questions: "What does this experience mean to me?" and "Who am I now in the face of this loss?" In my opinion, the grief process is a gradual answering and redefining of those two questions.
Fourth, make sure that early attempts at support for a grieving person focuses on him or her telling the story. 
Introspective reflection, opportunities to hear about feelings, thoughts and meanings will come soon enough. In the early going, make sure that clients get the valuable opportunities to tell the fully nuanced version of the loss (and pre-loss) story. Make follow-up questions about the facts and details of the story, not about the responses to the story. Your client will go to feelings, thoughts and reflections soon enough. While he or she is telling the story, make sure you are offering prompts like, "Tell me more about that..." and "What else happened?" and "That sounds really hard. What happened next?"
Remember that within a few weeks, even family members and close friends tire of hearing the story so supportive professionals and volunteers may be the only people willing to listen to it. Elicit details and embrace the story. In the telling of the story and THEN reflecting on its meaning, clients will most likely find the most authentic way through the grief process.
COMING NEXT MONTH: Continuing our occasional series for this year, Bill Hoy will reflect on the important contributions of another of the leading voices in bereavement—
J. William Worden.
Author:
William G. (Bill) Hoy is an educator, counselor and author who has specialized in end-of-life and bereavement care for nearly 30 years. Dr. Hoy’s passion is equipping the next generation of physicians and other healthcare professionals through his research, writing and teaching responsibilities on the clinical faculty in Medical Humanities at Baylor University. His newest book is
Do Funerals Matter? The Purposes and Practices of Death Rituals in Global Perspective (Routledge, 2013).
