When working with clients who are struggling with loss and its accompanying grief, it is useful to address issues of attachment. The survivor resorts to coping mechanisms developed during childhood, and there they stay until the grief process moves them into new and more mature ways of coping with their grief. Professional help is indicated to facilitate this process. Important to the process is the subject of attachment. More specifically, how attached was the survivor to the deceased, how do they describe their relationship with the deceased and what is the quality of their attachment to other people in their life? After years of counseling the bereaved, it is my opinion that grief and attachment need to be addressed simultaneously during treatment.
First a look at models of grief. Elizabeth Kubler Ross believed that the dying underwent five stages: denial, anger, bargaining, depression and acceptance. Later she suggested that families of the deceased go through the same stages. William Worden talks about Tasks of Mourning: accepting the reality of the loss, experiencing the pain of grief, adjusting to the environment in which the deceased is missing and emotionally relocating the deceased and moving on with life. Grief and mourning aren't tidy processes. Stages and tasks are complicated, non-linear and have a life of their own. The progression may never fully end. The notion of letting go of the deceased in order to move on is a myth. The bereaved move on in spite of their grief. My work as a therapist may best be described as helping the bereaved re-invent themselves and create new lives. C.S. Lewis in A Grief Observed noted that grief feels a lot like fear. In fact, scientists have found that brain chemistry is altered with grief, and like fear it is a stress reaction with an increase in the stress hormone cortisol. Sleep patterns change, loss of appetite is common and the immune system is compromised. In other words, stress reaction is attended by deep physiological changes.
The need to address attachment in the midst of physiological and emotional upheaval is a daunting task as well as an illuminating one. Exploration requires careful, empathic attention by an experienced therapist. The exploration of attachment style alongside the tempo of grief work is synergistic and fundamental to healing. A narrative of the relationship the client had with the deceased is a natural and necessary part of the grief process. But a description of relationships the client has or had with members of her family of origin gradually emerges. Useful is The Adult Attachment Interview (AAI, George, Kaplan & Main, 1984, 1985, 1996). It includes a series of questions that elicit five adjectives that would describe each parent; specific memories supporting the description; what the speaker did when emotionally upset or physically hurt or ill; parents response; salient separations, loss and abuse experiences; effects on adult personality and why parents acted the way they did.
Through the above tools, clients develop a sense of who they are and gradually who they seek to be. This in turn becomes a platform for the creation of a new life without the deceased.