Introduction
Narrative therapy is a psychotherapy treatment that aims to identify and transform the effects of the patients’ concerns and help them reassess their values and skills to address life-challenging events. In this paper, narrative therapy is examined through the lens of grief counseling. This analysis focuses on patient Kelly and her experience of continued attachment to a deceased partner, Jack, as her source of inner strength. Narrative therapy techniques can be particularly helpful to redefine Kelly’s strength to continue fulfilling her life and career (Rafaely and Goldberg, 2020). I chose Kelly with the grief management problem because her story reveals Kelly as a strong-minded and courageous woman struggling since her early years for her parents’ approval and constant need for reassurance in self-value. Such a background has significantly enhanced Kelly’s experience of dealing with the grief of losing her loved one and high expectations from herself to be stronger in the face of her family, friends, and patients.
Defining the Problem
The primary social discourses supporting the life of Kelly’s problem derive from her family. In particular, the very extreme women’s dominant discourse culture has been long established in her family, which affected the patient’s relationship with her mother. Kelly felt that this was her lifetime responsibility to make her mum happy and please her by putting in all the effort she could, which was never enough. In contrast, her partner, Jack, was the only person in her life who was very supportive and loving. Therefore, losing her partner made Kelly lose the confidence and support that Jack used to provide. This problem keeps affecting the patient’s life, including her emotions, work, social relationships, and, most importantly, her faith in herself.
Given that Kelly shared her experience of deep confusion and sadness for the first time after Jack’s death, it becomes more evident how this loss has severely affected her personality. The patient has locked herself in trying to avoid feelings of grief, devastation, and depression. The problem also affects her patients as she has developed the fear of losing each of them. Kelly has lost the belief in her power of being a good healthcare worker, a good friend, and a good daughter.
Based on the patient’s story of her childhood and close attachment to her father, it was similar to the bond she had with her husband. Kelly was highly dependent on the approval and support of the two most important men in her life. Losing both of them means losing the solid foundation for Kelly to keep evolving and fulfilling her goals in life. The grief of losing a partner is a highly prevalent issue affecting every person facing its pain and pressure. Such experience is treated differently among different cultures, although it is, for the most part, a devastating and destructive experience for the individual. Kelly is dealing with continued attachment to the deceased and experiencing deep grief as a multifaceted response to losing her partner.
Contextual Variables
Examining the contextual factors forming Kelly’s experience and self-development in life is crucial for deciphering the conceptual understanding of the grief of the patient. Kelly is a thirty-two-year-old white American, heterosexual female, born and raised in California. She was an only child and grew up in a financially adjusted family. Kelly was an academically strong student who got accepted at Harvard University to study medicine, following in her father’s footsteps. She was also successful in her social relationships with peers and her partner. Kelly’s friends and husband always emphasized her passionate, generous, and driven soul; she is determined to make the world a better place to live in. Concerning her personality, she was a very outgoing person, a social butterfly who ensures everyone feels good around her.
The factors mentioned above are considered the fundamental filters in individual and collective experiences of grief. Other contextual variables such as “the specificity of the nature of the death, relation to the deceased, family relations, and cultural practices and expectations” also impact the life of the problem (Maddrell, 2016, p. 173). The unexpected death of Kelly’s partner, the strong attachment to Jack, and the previous experience of losing her father define her current experience of the problem. They also identify the normative parameters for the patient’s behavior and individual expression of grief. For instance, the gendered experience of losing loved ones is commonly characterized in the context of a stereotypical dichotomy regarding more cognitive articulations of loss among women and more instrumental responses among men (Maddrell, 2016). Additionally, understanding cultural values and practices are similarly significant for shaping grief responses.
Bereavement has resulted in dynamic shifts in Kelly’s sense of self and her emotional patterns, impacting other people, her job, and her perception of support and consolation. She was raised in a male-dominated culture, which has undermined her self-worth and inner power, specifically after losing Jack. Her mother plays a pivotal role in supporting the life of the problem because she always forced her to do more and is her constant support and reason for happiness. Jack, however, was the special person in Kelly’s life since he made her feel special, valued, and always enough. He would be the person encouraging Kelly to decrease the influence of the grief problem in her life. From the epistemological point of view, the problem of losing a partner and experiencing grief implies special and significant moral knowledge (Mitchell, 2017). Kelly had a unique moral knowledge of her close bond with Jack, which now has a remarkable influence on her character as a griever.
Making Trouble for the Problem
While working with my grieving client, Kelly, the externalizing approach served as the theoretical and therapeutic framework of narrative therapy. The techniques of narrative and solution-focused treatment aim to redefine the meaning of the problem to help the patient address its damaging impact on her life. In the field of narrative therapy, grief is regarded as the natural, multifaceted response to the loss (etiology) of something or someone special for the individual that developed feelings for the deceased (Rafaely and Goldberg, 2020). The mechanism of change in narrative therapy enables patients to alter the meanings of lived events or circumstances. Such a theoretical approach raises awareness of the individuals’ skills and capacities that help them recognize the traumatic story through retelling it and generating new meanings. It is an effective measure that can be applied to clients experiencing a multitude of grief-related problems.
Narrative therapy techniques for grief counseling, such as identifying unique outcomes and externalizing the problem and its literary reflection, view grief as an inherent human condition. Narrative therapy offers the following steps to address grief counseling through the focus on meaning-making:
- Externalizing the problem (Kelly views herself separately from the grief);
- Helping Kelly recognize the times when she felt strong and resilient (searching for unique outcomes);
- Connecting unique outcomes in the past (associated with Jack) to current problems and deciphering Kelly’s actions in the future;
- Examining Kelly’s social network to support her strong points;
- Implementing letters, journal writing, and other literary tools to accelerate and develop the new “self-narrative.”
Empirical Evidence
There is a broad scope of research dedicated to narrative therapy treatment of grief counseling based on empirical evidence. For instance, the case study conducted by Peri et al. (2016) reveals how narrative reconstruction can help individuals with prolonged grief disorder (PGD). The results demonstrate a clinically meaningful decrease in psychopathology measures and an additional decrease at a three-month follow-up (Peri et al., 2016, p. 8). The evident improvement was associated with an increase in narrative organization strategies. The “grief snow globe” narrative therapy designed by Rafaely and Goldberg (2020) helps clients better understand how to process their grief efficiently by maintaining the ongoing ties with the loss. This method develops new perspectives on loss and is suitable for all ages and groups. Concerning more in-depth consequences of grief, including depression, Rad (2017) introduced a study about the impact of group narrative therapy on the level of depression among children coping with grief. The results revealed that depression among children who had lost their loved ones was significantly reduced at the end of the narrative therapy sessions.
Conclusion
The main task for Kelly was to experience her grief in her unique way to deepen the connection with other people and herself through narrative therapy. It is the transpersonal and transformative process of healing Kelly’s bereavement. The main concern I had about the utilized interventions is how Keely would go through the part of processing a loss in finding her new purpose in life, given the close attachment to Jack. It would be helpful to name the problem and endow it with a new meaning for Kelly. The existing research has covered the majority of related issues of grief counseling, including various contextual patterns. However, it would be helpful to examine further validation using larger samples.
References
Maddrell, A. (2016). Mapping grief. A conceptual framework for understanding the spatial dimensions of bereavement, mourning and remembrance. Social & Cultural Geography, 17(2), 166–188. Web.
Mitchell, J. (2017). The epistemology of emotional experience. Dialectica, 71(1), 57–84. Web.
Peri, T., Hasson-Ohayon, I., Garber, S., Tuval-Mashiach, R., & Boelen, P. A. (2016). Narrative reconstruction therapy for prolonged grief disorder—rationale and case study. European Journal of Psychotraumatology, 7(1), 30687. Web.
Rad, V. G. (2017). The impact of group narrative therapy on the depression of children suffering from grief. Specialty Journal of Humanities and Cultural Science, 2(3), 31–37.
Rafaely, M., & Goldberg, R. M. (2020). Grief snow globe: A creative approach to restorying grief and loss through narrative therapy. Journal of Creativity in Mental Health, 1–12. Web.