Monday, February 28, 2011

Dr. Alan Wolfelt Responds to "The Truth About Grief "

The following is written by Alan D. Wolfelt, and with his permission I am pleased to reprint it here.

A new face has appeared in an old debate. The new face: Ruth Davis Konigsberg, author of the recently published book The Truth About Grief. The old debate: the art of caring for people in grief versus the supposed science of bereavement.

Konigsberg, a journalist who has written for popular magazines such as Glamour and ELLE, takes issue with the need for grief counseling. She informs readers of her new book that science is beginning to prove that most people are resilient enough to get through loss on their own. She questions the efficacy of grief counseling and suggests that it can actually be harmful. In the book, she refers to those of us who support people in grief as a “cottage industry” and, in referencing my body of contributions to death education and counseling, lays claim to my motivations. She conjectures that those of us who became caregivers to people in grief because we suffered prior losses in our own lives do not have the objectivity to embrace a more scientific approach to grief care.
I met Konigsberg briefly in the fall of 2009, when she attended a two-hour workshop I facilitated in Cherry Hills, New Jersey. She informed me that she was writing a book that would “question the efficacy of stage theory” as proposed by Elisabeth Kübler-Ross in her 1969 bestseller On Death and Dying. I recollect that she didn’t seem very happy when I informed her that the stage theory of grief had been debated for years and that indeed, Kübler-Ross herself never intended for the theory to be seen as a scientific, prescriptive model. In fact, I reminded her that Kübler-Ross had warned against grief being understood as an orderly and predictable experience and that her theory was based purely on her own observations of people who were dying (not the family members who were grieving). Despite my clarifications, upending grief care obviously remained the goal of her book.

For years I have advocated the art of companioning people who are experiencing grief and loss. (My philosophy is described most fully in my book Companioning the Bereaved: A Soulful Guide for Caregivers.) I am honored that there is now an international network of people who have trained with me to learn the companioning philosophy of caregiving. Yet I realize and accept that scientists are often skeptical of this soul-based approach to caregiving. We are witnessing, and Konigsberg is collaborating with, a backlash toward a more “scientific” approach to grief care. We should not be shocked by this trend, in that our culture has long tried to go around grief instead of through it. As one European author noted, “The first thing you need to know about Americans is that they think death is optional.”

One of the most articulate spokespersons concerning this scientific trend and its implications has been Thomas Moore, who noted the following: “It’s not surprising that as our culture advances in information and technology, we seem to become more inarticulate about matters of the heart. We quantify ‘human behavior’ and develop programs of therapy and treatment, and yet the procrustean trimming of the soul to fit our programs of science doesn’t have much effect. We still encounter the soul briefly, as a set of problems, rather than as a creative and constructive source of life.”

Questioning the Value of Grief Support

I submit that this is not the first (nor will it be the last) time that a journalist in search of an angle to sell an article or a book has questioned the value of grief counseling. It happened after the Columbine High School tragedy. When the flawed analysis of the causes, the emotional interviews with those impacted, and the coverage of the funerals were over, the media felt the urge to find yet more storylines. They found me—a grief counselor, a man who started the Center for Loss and Life Transition decades ago in an effort to help people devastated by loss, and a person who finds meaning and purpose in educating and training people about the importance and value of supporting each other in times of grief. And they openly questioned the philosophy of my work.

Konigsberg might well instill in her readers the belief that after someone they love dies, they would be better off if they “bucked up,” “carried on,” “kept their chins up,” and allowed “time to heal all wounds.” Over the years a number of journalists have asked me questions such as, “Aren’t you just getting paid for listening?” and “Don’t you think traumatic pain is better off denied?” While Konigsberg and her kind question the need for what I and others do to support people in grief, I do not allow their doubt to keep me from being humbled and honored to create safe places for people to mourn life losses.

Some scientists who do research in the area of grief counseling (which Konigsberg sources) have unfortunately embraced the assumption that grief counseling is ineffective or potentially detrimental—based on very few reports. Thankfully, this finding is not supported by peer-reviewed research. My colleagues at the Association for Death Education and Counseling (ADEC) appropriately “recommend that researchers and clinicians alike focus their attention and concern to issues of efficacy.” They go on to state that, “Questions such as, Is grief therapy effective? For whom and in what form is it effective? and At what point might interventions work best? have yet to be established.” I discovered some time ago that our modern understanding of grief all too often lacks an appreciation for and attention to the spiritual, soul-based nature of the grief experience. As authors such as Frankl, Fromm, and Jung noted years ago (and Hillman and Moore more recently), academics have been too enamored of the natural sciences and laboratory methods of weighing, counting and objective reporting.

Perhaps scientific research and soul-based caregiving are not mutually-exclusive and will one day work together in assuaging the human condition. In the meantime, caregivers should not be discouraged from providing grief counseling to those so clearly in need of our compassion and support.

Many mental healthcare providers have been urged to “treat away” care-eliciting symptoms such as depression, anxiety, and loss of control. In attempts to gain scientific credibility and to be respected as part of traditional mental health care, we are at risk for disrespecting the very people who need and deserve our compassion and support.

Yes, I believe in the “grief work” hypothesis that Konigsberg dismisses. As a bereavement caregiver, I am a companion, not a “guide” (which assumes knowledge of another’s soul I cannot claim). To companion our fellow human beings means to witness and learn as opposed to playing the “scientific expert.” My 11 tenets of companioning the bereaved are as follows:
  • Companioning is about honoring the spirit; it is not about focusing on intellect.
  • Companioning is about curiosity; it is not about expertise.
  • Companioning is about learning from others, it is not about teaching.
  • Companioning is about walking alongside; it is not about leading or being led.
  • Companioning is about being still; it is not about frantic movement forward.
  • Companioning is about discovering the gifts of sacred silence it is not about a filling every painful moment with talk.
  • Companioning is about discovering the gifts of sacred silence; it is not about filling every painful moment with talk.
  • Companioning is about listening with the heart. It is not about analyzing with the head.
  • Companioning is about bearing witness to the struggles of others; it is not about judging or directing those struggles.
  • Companioning is about being present to another person’s pain; it is not about taking away or relieving the pain.
  • Companioning is about respecting disorder and confusion; it is not about imposing order and logic.
  • Companioning is about going to the wilderness of the soul with another human being; it is not about thinking you are responsible for finding the way out.
You’ll note that a central role of the companion to the mourner is related to the art of honoring stories and being taught by the true expert—which is the person going through the experience. Yes, I realize that the art of honoring stories sounds soft to scientists, but the good news is that it seems to work, and I plan to keep on teaching about the long-held understanding that telling and re-telling personal stories of love and loss are essential elements of supporting people in grief.

The very real risk of the new science of loss is that caregivers might be contaminated to the point where they see little, if any, inherent value in what Henri Nouwen once described as “hospitality”—the creation of a space where the stranger can enter and become a friend. He observed that hospitality is not about trying to change people but instead offering them space where change can take place. This is not about some “phased model of grief as an expression of stageism” that Konigsberg has attacked, but instead about the human need to mourn authentically without any sense of shame or need to “resolve” or “get-over” one’s grief.

I suspect that once Konigsberg does experience the need to mourn (she suggests that those of us who suffer losses also lose our scientific objectivity), she might then, and only then, understand that the death of someone loved totally transforms us as humans, and that transformation means an entire change in form. I couldn’t disagree more with Konigsberg’s assumption that, “It turns out people are pretty well programmed to get over loss.” On the contrary, people are transformed by loss in ways that often enrich our living and enhance our empathy for others when they experience loss. One day, I foresee and I hope, Konigsberg may well come to understand that reality herself.

Final Thoughts About the Science of Grief

While the researchers that Konigberg cites in her book naturally try to analyze grief, we should not be shocked with their scientific findings that attempt to measure a soul-based experience that is not easily measured. If one believed in the myopic assumption that scientific studies hold the key to the mysteries of grief, there may be a temptation to agree with her thesis that grief and mourning are best left to scientists. We sometimes forget that caregiving originated in the arts, not the sciences.

Because I am a counselor who bears witness to people in grief, I must respond to the demands of pragmatism. The purpose behind being open to the mysteries of grief is not to satisfy some ivory tower discussions or to produce fodder for academic theories or scientific findings. Instead, what myself and other caring people do to help people in grief every day testifies to the reality that our culture is full of people who lack support to openly mourn life losses. Despite Konigsberg’s cynical reference to my book Living in the Shadow of the Ghosts of Grief, many people do, in fact, carry their grief to their grave. My fear is that her book and others like it will do much more damage than good as she projects that we as humans are “programmed to get over loss.”

Contemporary, objective research often operates under a dictum to analyze and define a portion of the natural world, to “take it apart” if you will. Yet sometimes we forget that grief is an irreducible mystery that is something to be pondered, not always explained. I suggest that much of the modern research on grief propagates what we might term soulless reductionism—trying to measure grief and assumes that the goal is to get rid of symptoms and “resolve” it as quickly and efficiently as possible. Yet, loss often starts with chaos, and chaos isn’t easily measured or managed.

When the academic researchers enter into grief’s domain, beware. As one astute author observed, “Technology is the art of so arranging the world that you do not have to experience it.” Scientific research on grief may well reinforce our culture’s desire to avoid grief instead of befriending it. To borrow a phrase from the musical group R.E.M., we “shiny, happy people” have been more than willing forget that the purpose of mourning is to actively and outwardly embrace the death of someone we love without the fear of being judged as being “out of control” or “not handling it well.” Despite Konigsberg’s assertion, grief waits on welcome, not on time. (I imagine that our current cultural trend toward parties instead of funerals after the death of someone loved is something she would also celebrate.)

Yes, when it comes to matters of the heart, be it love or grief, not everything can be “proven.” In my thirty-plus years of helping people mourn life losses, where intellect and feeling often clash, I truly believe the heart is often the seat of greater wisdom. So, let Konigsberg and others try to sell their articles and books that promote their scientific bias, and I’ll keep penning my heart-based articles and books that my readers tell me help them feel supported and understood in their grief. In addition, I will continue to say to my friends and colleagues in grief care, “Please be humble yet proud of what you do each day to support your fellow human beings during times of lost love.”

We have the opportunity to be companions, to listen with our hearts, and to be curious rather than certain. Thank you for taking the time to read my response to this new book, which questions the very core of what we do each and every day. Remember—integration of loss often occurs in the space of not knowing. In reality, we don’t need to be joined at the head with a mourner; we need to be joined at the heart!

Dr. Alan D. Wolfelt is honored and pleased to serve as the director of the Center for Loss and Life Transition in Fort Collins, Colorado. He is frequently invited to speak across North America about his philosophy and practice of “companioning” versus “treating” people in grief. His sponsors include hospices, hospitals, universities, mental health agencies, ministerial associations, and funeral homes. You can contact him at DrWolfelt@centerforloss.com or phone him directly at (970) 217-7069.


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8 comments:

  1. Marty,

    Thank you so much for sharing this - it has certainly allowed me to reflect upon the work we do. It also highlights the divide between practise and theory. I believe in both and hope that one day I'll be able to contribute worthwhile research that comes from the heart to the field of grief and loss.

    Tabitha x

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  2. Marty, Thanks for posting this here! Dr. Wolfelt is one of my favorite authors and I think he makes an excellent argument for "companioning" grieving people. I hope, too, that the TIME article doesn't encourage people to deny their grief and repress their emotions about that grief.

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  3. What an excellent article indeed! When someone we love dies, out heart is broken and why would we not comfort and heal the heart? I recently wrote a paper about resilience and yet, what I discovered was many unproven questions about how a person becomes resilient in the face of adversity. I pray that as a human society we never stop addressing the needs of the heart.
    I am such a devotee of Dr. Wolfelt's work use his books in my own work.

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  4. I think a good editor could have cut this post in half and done readers a great service. Dr Wolfelt's concept of companioning sounds a lot like what I would call spiritual direction.

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  5. I wanted to like this book because of it's stance on the stages of grief, but I am very concerned that the views expressed are going to reinforce the pressure so many feel to get on with it quickly.

    Many people do not need grief counseling but for those that do it can make all the difference.

    I find a blatant contradiction in her view that those of us who have experienced loss can't be objective (implying a lack of resilience) while at the same time insisting that most people are resilient enough to get through a loss without ill effect.

    I think it's impossible to support people who are grieving unless you've experienced and healed from a loss. I am also very concerned by the number of coaches, counselors and authors out there who are promoting themselves solely on the basis of their own losses. One does wonder if they are trying to help others in order to heal themselves especially when their losses are recent.

    Thank you Marty for sharing Dr. Wolfelt's comments. Whether we agree with Ms. Konigsberg or not, her book has certainly elicited some interesting and productive conversation about what we do, something I've obviously given some thought to...
    Grief Counseling, Bad for You?

    Do You Need to Experience Grief to Help the Grieving?

    I hate grief memoirs!

    Of course a lot of what we do would be unnecessary if we had a well educated population able and willing to offer the support of compassionate friendship.

    Susan

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  6. I am new to this list, but thank you for sharing Alan's article. The one in Time had me "up in arms" so to speak because it felt like she missed the point about what grief counselors do and what deep grief or traumatic grief is like for the one who experieinces it. Working through grief is soul work and many people are afraid to look into this place inside without support. The problem with journalists writing an article like this is that people believe them and they have no experience, and don't believe us and we work daily with the population in question. Figure that one out! Glad to see some great comments and thanks for letting me share.
    Kay

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  7. I noticed that you didn't comment on George Bonnano, whose work she referenced heavily. He didn't discount counseling - and she doesn't either really - but questions where the evidence to support it is. Where are the studies? Most actual research can find no difference between those who do and don't use support groups.

    If one moves on at the same pace without "working" at grief as someone who does, then what is the point of counseling and groups aimed at grievers?

    Both Bonnano and Konigsberg pose a different viewpoint and I can understand why it is threatening but shouldn't the idea of treating grief as though it was an emotional illness deserve more than anecdotal evidence as support? Where is the Bonnano type studies that support your stance?

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  8. I am not a mental health professional. I have not yet read the aforementioned article written by Ruth Davis-Konigsberg, which is debated in this article by Dr. Alan Wolfelt. I am, however, a bereaved mother as of February, 2011.

    Prior to the loss of my daughter, I was highly functioning. Any parent who has lost their child (in this case my only child) knows it is not something you ever really "get over". While I have been fortunate enough to have a very supportive family and circle of friends, I am also aware that there is often some level of discomfort (perhaps my own), in discussing or exhibiting the truly shattering effect this has had on me.

    I have engaged in grief counseling, as well as a grief support group. I have been most fortunate in that both counselors have provided the type of support that Dr. Wolfelt endorses in this article. The idea that anyone would suggest to me that compasionate counseling is unneccesary is absurd, as is any suggestion that I "will get over this". While I will "survive" this, I know I will do so with an altered sense of meaning as well as with an altered sense of self.

    Compassionate counseling is just that - an opportunity to openly express the true impact this loss has had on me without judgement, and without fear of upsetting those I love.

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