So, you think you need grief counselling?

To begin, Susan wants  the reader to know that she has been, literally and figuratively, on both sides of the counselling couch: she has been a client, and she has been a therapist.

Further, we both want to make it clear that this blog is not meant to discount either side of that couch!

But: we do want to push against the idea that everyone who is grieving needs to have counselling. Grievers often wonder ‘What is wrong with me?’ when their grief feels overwhelming and exhausting. Close friends, family, and colleagues sometimes drop ‘helpful’ suggestions that maybe ‘finding a professional to talk to might help’?

The idea that professional counselling is needed for all (even most) grief experience continues to be a common misconception. At Grief Matters, we worry that the stigma of grieving pushes people into counselling too quickly. That is, people turn to counselling because they do not have grief-literate circles of care.

At Grief Matters, we have a few basics principles about grief and grief literacy that go against the idea that all grief needs counselling:  

· Grief is a part of life. Losses of all kinds will happen to all of us. Grief is a typical response to meaningful loss.

· Grieving is unique to each person. No two people will have the same experience, even if they have the same or similar losses.

· Regardless of what loss / grief you are experiencing, it may feel like the ‘worst grief possible.’ All feelings are valid. Hierarchies and comparisons of kinds of grief and ways of grieving are usually not helpful.

· Seeking counselling of any kind is a personal choice. Two things can be true: research shows that a) counseling can be helpful for grievers; and b) the majority of people experiencing grief do not require counselling.

The Public Health Model of Bereavement Support makes this latter point clearly.

This model was created in Australia and has been adapted in Ireland. The pyramid demonstrates the percentage of bereaved people who are at risk of ‘prolonged grief disorder’ (you can read about that here or here). These are the folks who are most likely to benefit from professional help. In the model, the black numbers are the percentages of risk that the authors thought might occur. The red numbers are what they found in a survey of about 600 people.

We like this model for a couple of reasons. First, it demonstrates in a very concrete way that the percentage of people at high risk of prolonged grief disorder (and thus most amenable to grief counselling) is a small portion of the population (6.4%). This flies in the face of what Susan hears in the grief and counselling worlds that she works in: the idea that all grievers need therapy.

In addition, the model illustrates something we believe deeply at Grief Matters: that 100% of people who have experienced the death of someone can benefit from a world with greater grief literacy.

There are a few cautions about this model. First, it only addresses grief in the context of a family member dying. The survey was done through funeral homes contacting ‘next of kin.’ We know that grief is much more than a family of origin experience. We grieve friends, animals, circumstances, relationships, celebrities and much more.

Second, the participants in the survey were only contacted by the funeral homes for deaths within a short time frame (18 months). The person invited to fill in the survey was the main contact; further, there was only one participant per family. We know that grief has no timeline, and that family members will each respond uniquely to a death.

Finally, the research was done pre-COVID. The pandemic may have increased the numbers of people at risk of prolonged grief disorder. Research is needed to confirm that.

With all those caveats, at Grief Matters we are still enamored of this model. Why? Because it pushes us to think about how ‘over-professionalizing’ grief takes the responsibility away from us – the friends, family, and colleagues – to step up and show up for grievers. If our family, neighbours, and workplaces were grief literate, would we still feel we need counselling? Some would; fewer would not.

So, if you think you or someone you know might need grief counselling, ask yourself some questions: What are your assumptions about grief (e.g., that all grief needs therapy; that your grief is different than other peoples?; that your grief should ‘resolve’ more quickly?). Also, look around and reflect: Are there other options for support in your communities? (e.g., there are often resources and information online and in your local library) - having extra support can benefit us even when we are doing counselling.

We can all benefit from understanding grief better. We think part of that understanding is to normalize grief; normalizing grieving means understanding that grievers do not all need to seek professional help.

Sometimes when you have a hammer, everything can be a nail. Counselling is important when counselling is important. For grief, if you really want to talk to a professional, then seek one with whom you feel comfortable and confident. But please do not feel that you have to seek professional counselling to grieve well.