The Therapist Mourns His Mother's Death: Being With Clients While Heartbroken

The Therapist Mourns His Mother's Death: Being With Clients While Heartbroken

by Bob Livingstone
Therapist Bob Livingstone offers grieving therapists advice about the effects of mourning upon therapeutic practice.

50% OFF ALL DVDs!
All DVDs for solo practitioners are 50% off through January 31st!

My mother died Dec. 18, 2005. She was 84 years old and died of complications from open heart surgery. I am a psychotherapist in private practice and had to return to work shortly after her death. I wondered how I would deal with my deep and heart-stabbing grief while I tried to help my clients work through their issues. Yet, little in graduate or post-graduate training prepares us to deal with such a time in therapy, let alone our lives.

I was fearful that a client would make a comment that would trigger me to sob in the middle of a session. Although I felt very raw in those days after her death, I knew I needed to maintain the boundary between therapist and client. After all, the therapy sessions were for my clients' benefit, not mine. Breaking down and sobbing would definitely make the session about me.

I was also worried that my level of concentration would not be one hundred percent. Normally, I can focus naturally on what a client says while seeking out a helpful response at the same time. I've become adept at checking in on my countertransferance, noticing if the client is saying anything to stir up my issues or causing me unexpected anger, sadness, or confusion. It is important for me to be aware of these feelings because they may indicate unresolved issues. In this period of grief, I wondered if I could be anywhere near as effective at this as I normally was.

As a therapist, I expect myself to be entirely present throughout the therapy hour. I expect myself to help heal clients' wounds, help them feel better about themselves, and assist them in alleviating their pain. During optimal circumstances, these goals are difficult to attain. While in the throngs of grief, it was going to be exponentially harder.

Still, I wondered what insights, revelations, and understandings I would develop while in a state of grief and mourning. Was it possible I could use my own grief during therapy sessions to help clients work through their grief?
How would I react with clients who were grieving their own losses? Would I hide my grief, break down myself, or make use of my grief for the client's benefit?
How would I react with clients who were grieving their own losses? Would I hide my grief, break down myself, or make use of my grief for the client's benefit? I soon found I had a chance to face these questions when I began engaging Abe about the loss of his father.

Abe's Loss

I have been working with Abe, an 18-year-old man whose father died when he was three years old. He is very bright and has a basic curiosity about how the mind and emotions interact. Abe is a seeker of all life's truths. He is very social, does well academically, and also has strong interests in drama, sports, and politics. Abe came to see me because, for the first time, he was experiencing a myriad of feelings about his father's life and death. He found these feelings to be at times overwhelming and unpredictable. He would start crying out of the blue or become agitated for no apparent reason, all the while struggling to make sense of what was happening to him.

Abe's father was only 37 years old when he died from cancer. His dad was active in city and regional politics, and a successful attorney. He loved baseball, politics, marathon running, and his family. Abe imagined that his dad was a larger-than-life figure who he should have had the opportunity to bond with. Instead, he never got to know the man and had no memories of him at all. Over the years he heard stories about his dad, but felt guilty, angry and hurt because he felt no connection with him.

Throughout his childhood, Abe's mother and older brother talked often of his father, their memories and their sadness from missing him. But Abe could not relate to their sadness since he had no memories of his father. When Abe reached his late teens, he began to notice that his life was off kilter. He found himself being sad and angry for no reason. At other times, he had difficulty with rejection and was quite moody. Abe noticed these changes and wondered if they were part of normal adolescence or if they had something to do with his father's death. As he began to face his loss, he began to grieve for the first time. He began to understand that a void was created within him after his father died; when he tried to conjure up memories of his father, nothing was there but his own sadness and anger. He was overwhelmed with the pain of not having his father's guidance and love in his life. Abe found that he felt emotional much of the time and that his feelings of loss were right on the surface.
Abe told me he had a bittersweet relationship with these feelings of grief, yet he let on that, "It feels good to grieve; it makes the loss so much more real."
Abe told me he had a bittersweet relationship with these feelings of grief, yet he let on that, "It feels good to grieve; it makes the loss so much more real."

Disclosing My Mother's Death to Abe

As Abe spoke, I felt as though he was hitting the same complex note that I was facing in my life. I'd been thinking the same thing about my mother. I wondered if I should share my feelings with Abe. Would this approach be over the top and way too intense for him and me? Was I doing this because it would make him feel better or was I really doing it because it would make me feel better? I paused a moment and decided that my words would likely be helpful to him. It is difficult in the moment to know for certain if our self-disclosures will be beneficial for our clients, yet we must proceed with sharing based on what we sense and intuit.

I told Abe that I thought I understood what he was feeling. I shared that I run five miles every day while listening to music and I cry deeply when memories, thoughts, or feelings about my mother arise. Abe said that he had similar feelings about crying over the loss of his father. The powerful sadness opened a door that allowed him to make his father's death real instead of some distant intellectual construct. Although he had no memories of him, he truly knew that his father loved him, and he feels this love when he is immersed in tears. This spiritual connection provided solace to Abe.

I learned from this encounter that although I was grieving and not operating on all cylinders in the regular world, in the therapy office it was okay to trust my intuition to intervene.
I learned from this encounter that although I was grieving and not operating on all cylinders in the regular world, in the therapy office it was okay to trust my intuition to intervene. There is always some risk with a powerful intervention that clients will feel frustrated, misunderstood, and even possibly shamed. Yet, at the same time, mistakes can be utilized in the therapy if the therapist is open to dealing with the client's disagreement or fallout. With Abe, though, I felt confident that I was connecting with him in a meaningful way and that he was having none of these negative reactions. In fact, it led him to reveal more about what was going on inside of him.

Deciding to Hold Back Certain Grief Reactions from Abe

Abe talked about his experience of sharing his feelings about his father with his peers. Most of them seemed to suggest that he needed to "get over it." It seems that exploring themes of loss in a deep way is as taboo now as it was when my father died in 1966. This was the same attitude I felt from peers and adults at the time. I found my mind drifting back to the day of my father's death and I began to feel angry.

Yet, I knew that this was not the time to process my memories of the loss of my father, and I would have to come back to it later.
Yet, I knew that this was not the time to process my memories of the loss of my father, and I would have to come back to it later. Instead of sharing those awful memories, I encouraged Abe to continue searching for people who could support him. I realized that he believed this type of support was almost non-existent, but I nonetheless urged him to persevere.

Abe found one. During a tour of historic sites of the civil rights movement, he met the daughter of a slain civil rights worker and they shared their common story of losing their fathers when they were young. Abe was able to feel a deep connection with this woman and express his anguish over his loss. This experience served to move the grief along. As Abe told me about this experience, I remembered what it was like when I first heard of my mother's death. Unlike my father's death, where I didn't feel anything but numbness for years, my mother's death affected me immediately. My sister called to say that my mother had died during the early morning. The doctors did their best to save her, but she only fought as long as her body and spirit would allow. When I heard this, I moved from panic to sorrow to relief in a matter of moments. This pattern would repeat itself continually after that horrible day.

I thought about sharing the details of the day my mother died with Abe, but I decided that this was more about my own work and would not necessarily advance his mourning process. I knew that I could drift into the terrible memory and totally lose the therapeutic focus. So, I decided to process this experience on my own during my daily run the next day and in the present listened more carefully to Abe.

Using My Own Grief to Connect to Abe's Grief with Few or No Words

Abe told me that he was worried about what his grief would be like as he got older. Would he feel resolved about his father's death? If so, what would that feel like? Would he ever feel more of a connection with him than he did now?

I was facing a very similar existential dilemma. I was unclear if I would ever feel resolved about my mother's death. Would this pain ever let up? I decided to keep this struggle to myself, and said to Abe that it was wonderful that he was so introspective and that he valued challenging himself emotionally. I also said that he did not have to worry about finding answers to these questions, because he would discover solutions over time.

There were times during my sessions with Abe that he would experience deep, intense, overwhelming sorrow. I would empathize with his angst and at the same time have sharp, clear memories of my mother's last days in the hospital. I knew that I could not let these memories overtake me, which might lead me to obvious distraction or painful screams—at least not while Abe was in the room. I felt a deep empathy for Abe. I needed to use few words, and mostly utilized the invisible therapeutic bond between us. This was a moving and healing time for Abe. At times my grieving energy connected with his without me having to state directly what I was thinking about regarding my own losses; the unspoken connection was what was needed. I felt the presence of my mother's spirit in the room, filled with warmth and wisdom. I felt her smiling over me and letting me know I was doing great work.
I was learning to use my grief, sometimes directly, and, as in this moment, indirectly in my work with Abe.
I was learning to use my grief, sometimes directly, and, as in this moment, indirectly in my work with Abe.

Abe, as an 18-year-old, fluctuates between the need for independence and the need for being dependent upon his mother. While this dilemma plays out with all the adolescents I work with, Abe is unique in that he is aware of these forces literally pulling him apart. I continue to be amazed at the level of his insight. He knows that on the one hand he wants his mother to grant him unconditional freedom. On the other hand, he realizes that at times he is motivated by the look of disappointment upon her face.

He told me that he and his mother had been fighting because she felt he was not giving his best efforts academically, socially, or in his drama work. It became clear that his mother's definition of best effort was not the same as Abe's. After a long and, at times, difficult discussion, both Abe and his mom cried. They came to accept each other. Abe now realizes that deep down inside his mother only wants him to be happy.

As Abe recounted this story, my eyes filled up with tears, but didn't stream down my face. I am unsure if Abe noticed this, but it would have been fine with me if he had, because my crying validated his feelings of loss. My showing of emotion also enhanced my alliance with him, and I am sure he realized that I was moved by his story and resonated with what he was going through.

I stated that he was fortunate to discover his mother's unconditional love for him at such a young age. My mother and I did not feel at ease with each other until I reached my forties. As time went on, we became closer and closer. I let down the wall that I had built up since I was 15 when my father died. When my mother died, we knew we loved each other without any reservations. The pain of her loss is often overwhelming and sometimes I miss her so much I can hardly breathe. I'm grateful, though, that I had the opportunity to experience unconditional love—a feeling you can never have if your heart is sealed shut.

I shared with Abe that I felt that he was way ahead of the game in this respect, and that he was ahead of where I was at that age. He was able to appreciate the his mother's good attributes , as well as notice her less than admirable qualities, such as being overly protective. I mentioned that being able to tolerate as well as appreciate the good and the imperfect in his mom would make it easier to tolerate those aspects inside him. He responded to my comments by affirmatively nodding his head while tears formed in his eyes. He was aware that he had a special relationship with his mother; he could share most anything with her and she would still love and accept him. He felt that I understood his relationship with his mother and this tightened my connection with him.

Finding Some Grace in the Sorrow of Grief

I was so raw during those first few weeks after my mother's death. At times I felt that I had lost the means to filter out any kind of physical or emotional pain.
I was so raw during those first few weeks after my mother's death. At times I felt that I had lost the means to filter out any kind of physical or emotional pain. This stark vulnerability somehow increased my need to do my job well. Even in this early stage of loss, I realized that having a purpose helped in the recovery process. My main purpose was to help others heal from loss and trauma.

I feel that my work with Abe has been successful. I was able to help him understand that the loss of his father did impact his feelings of rejection from peers. I also helped him discover the gifts of grieving: the release of the angst and ultimately a real connection with his father. As I experienced this sense of a successful therapy with Abe, I felt a sense of spiritual grace surround me. This phenomenon seemed more important to me now than at any other time of my life.

During one session, I asked Abe why he thought his dad died at such a young age. Abe told me that he supposed his father died when he did because he learned all the wisdom that he was meant to learn, and therefore it was time to leave this earth. He recognized that it was comforting to give himself a reason why such tragedies occur but that these words did little to heal him.

I think that each client has the right to have his own spiritual and religious beliefs. Just the same, it is worthwhile to explore their beliefs. I shared my feelings with Abe to illustrate this point. I mentioned to Abe that I have no idea why my parents died when they did. I haven't uncovered any words of wisdom that give me solace. Expressions like, "It was God's will," "She is in a better space now," or, "It was her time to be with God" do nothing for me. This terminology may be well intended, yet is often not meaningful to the newly bereaved. I much prefer people to be good listeners and share their experiences of loss than to repeat some Hallmark Card homilies. I noticed how cynical I sounded, and decided to change the subject and come back to it later. I didn't think my words were harmful to Abe, nor did I believe they had therapeutic value. Indeed, Abe did not seem to connect to those comments one way or another, so it was best to move on.

When I first began working with Abe, he was very sensitive to rejection. He would feel rejected at times even when it wasn't clearly the case—such as when he joined a conversation with his friends late and they would not immediately respond to him. This level of sensitivity can occur while one is in the midst of grieving. I shared a story with Abe that he related to: One recent Saturday soon after my mother's death, I was feeling angry towards my wife because she could not anticipate what I was going to think or feel in the next five minutes. I cannot know what I will feel in the next five minutes, so how could I expect her to do so? However, I was feeling so raw and lost that I put those expectations on her. Suddenly I began to sob and said to my wife, "I'm really missing my mother." She hugged me and said. "I didn't know you cared for your mother so much." "Neither did I," I replied.

Feeling the Presence of the One who Died

I recently celebrated my 55th birthday, the first one without my mother. She used to call me and we would talk endlessly about the condition of the world. I knew she was on my side and I was grateful. As I headed out the door for my run that morning, I noticed something different. The sun was shining immediately after an early morning downpour. I felt my mother's presence caught between my imagination and the spirit world.

As I started to run, I listened to Etta James singing "Somewhere There's a Place for Us" and it felt as though my mother was actually listening with me. I saw her alive, laughing. Then I imagined her dead, eyes closed, smile on her face, and felt a deep sense of gloom. I wondered if this was the only connection I would ever have with her again. Although I was still running, I suddenly felt as though I was standing still. A brand new thought entered my mind: Will my spirit join hers when I die? If so, how will it be? Will I be surrounded by her unconditional love? Will I have the ability to move from the spirit of one loved one to another? Is this what heaven is like? This was the first time I ever considered that there might be an afterlife. Before this, I had always been so cynical about it. Perhaps this major gift comes out of my mother's dying.

I shared this story with Abe, and I asked him if he believed in an afterlife. He wasn't sure, but he felt that he was in touch with his father's spirit. He talked about coming-of-age events like shaving and dating. When he reached these events, he felt that his father was instructing him how to succeed at them. Tears came to his eyes as he shared this story. He was aware that these grief-filled moments brought him closer to his father's spirit.

I shared this experience with Abe, because I sensed that he was wondering about the afterlife and I hoped it would be another experience where I could connect with him. I did not have a sense that Abe would feel pressured to agree with me, but that it would stimulate his own thinking and feelings, which would further his healing process.

I didn't share Abe's experience of not having any memories of a deceased parent and I attempted to help him come to terms with this burden. He knew innately that his father loved him, and this grounded him for the deep work he immersed himself in. I felt that my job was to guide him from the point of numbness, to healing his deep wounds and gaining a fuller understanding of what happened to him when his father died. When possible and relevant,
I often direct those clients who are dealing with mixed feelings about the loss of a loved one to find a place inside to hold that loved one in a peaceful manner.
I often direct those clients who are dealing with mixed feelings about the loss of a loved one to find a place inside to hold that loved one in a peaceful manner.

I am not sure what Abe will go through or what this place will be like when he discovers it, but I feel honored to participate in his voyage. I do know that I have been blessed with the rare opportunity to help a client face his grieving process while dealing with the death of my mother. And I believe that going deeper into my own grief helped me understand Abe's losses more fully, connect to him in a real way, and assist him in coming to terms with the loss of his father. The pain of loss can be a powerful means to heal others.

[section:have-a-strategy-in-place">Suggestions for therapists in the initial stages of recovering from the loss of a loved one] [section:Have a strategy in place

Now is not the time for flying by the seat of your pants. If your style is to not share your personal life with your clients, there is no reason to change that now. My style has been to self-disclose and share parts of my life with clients when I believe that this information will enable them to work through conflicts and grow emotionally. I continued this way of working after my mother died. Still, I needed to remind myself that I was telling my story for the client's sake, not mine.

Take Care of Yourself

How often have we instructed our clients that self-care was of supreme importance? This principle also applies to therapists who are in the early stages of grief. I exercise almost every day, and writing has also been a healing vehicle. Individual therapy, grief support groups, and other self-help groups are viable options. I feel that it is important to face and embrace the pain of my mother's loss every day. This way of mourning is not for everyone. We all need to discover our own pace and our own means to work through the anguish.

Be Self-Aware

Whether you are alone or in a therapy session, you are always grieving. You cannot just turn it on and off like a light switch. If you suddenly feel profoundly sad during an interaction with a client, you need to ask yourself why you are feeling this way. During the past month, my despair came from the death of my mother. I trained myself to be aware of why I felt the way I did, what triggered my feelings, and what the client said that caused me to feel sad. Then I would determine if I would use this experience to illuminate what the client was facing.

Integrate your knowledge of grief and your own loss

Sometimes I am overwhelmed with feelings of hopelessness. I recently came down with a sinus infection for the first time in a decade. There are nights that I do not sleep very well. I realize that all of these unwelcome changes are the result of losing my mother and that they are normal. I also know from experience that my grief will gradually subside and at some point in time I will not feel as devastated as I do today.

Suggested Resources on Grief and Mourning

Livingstone, B. (2002). Redemption of the Shattered: A Teenager's Healing Journey through Sandtray Therapy, http://www.boblivingstone.com.

Livingstone, B. (Planned August, 2007). The Body-Mind-Soul Solution: Healing Emotional Pain through Exercise, Pegasus Books.

Simon, S, & Drantell, J. J. (1998). A Music I No Longer Heard: The Early Death of a Parent, Simon and Schuster.

Grollman, E. (1995). Living when a Loved One has Died, Beacon Press.

James, J. W. & Friedman, R. (1998). The Grief Recovery Handbook, Collins.

Worden, J. W. (2001). Grief Counseling and Grief Therapy: A Handbook for the Mental Health Professional, Springer Publishing.



Copyright © 2007 Psychotherapy.net. All rights reserved.
Order CE Test
$15.00 or 1.0 CE Point

CE points are a great way to save if you need multiple CEUs. Get up to 45% discount when you buy packages of 10, 20 or 40 points. Your CE points will be redeemed automatically at checkout. Get CE packages here.

Earn 1.0 Credits
Buy Now
Bios
CE Test
Bob Livingstone Bob Livingstone is a Licensed Clinical Social Worker with a 19-year private practice and the author of The Body-Mind-Soul Solution: Healing Emotional Pain through Exercise, published by Pegasus Books.

Livingstone also wrote the critically-acclaimed Redemption of the Shattered: A Teenager's Healing Journey through Sandtray Therapy. The Therapist magazine states, "The journey from torment to peace is profound, and it is vividly rendered. The honesty of his writing is a gift to anyone who has experienced trauma, alienation, the inability to digest or to forgive." He has focused his work on bereavement groups, anger, and helping children from divorced families. He utilizes his life experiences as well as professional ones to connect and assist clients. Bob holds a Masters Degree in Social Welfare from the University of Kansas in 1979. He can be reached at 650-347-5167. You may also visit his website at www.boblivingstone.com.

CE credits: 1

Learning Objectives:

  • Reflect on when and how to disclose personal, emotional information to clients.
  • Increase awareness of how therapists? grief can be used as a therapeutic tool with clients.
  • Consider strategies for therapists who are in the initial stages of recovering from loss.