Walking Our Clients Through Grief When the World Seems Amiss

Walking Our Clients Through Grief When the World Seems Amiss






It was just a few weeks ago that I had pulled away from a doctor’s appointment, headed back to my office, when my car radio broadcast that the Notre Dame Cathedral was on fire.

A few days later, it was the news about Sri Lanka and the bombings.

I immediately thought of the many people experiencing not just overwhelm and grief, (as I had at that moment), but sheer terror as they lived out or had known those affected by the events unfolding. It seemed incomprehensible. The reminder that yet again, and without warning, our lives are capable of changing in an instant held true. Yet as we live in this world we are continuously shown that evil exists, disasters will occur, and if we hold anything (or anyone) dear, sorrow will eventually  become an unfortunate reality.

Understandably so, it is during these times, as the world seems all amiss, our clients will often set aside their initial and designated areas of focus to process through what may be occuring today. Their need to make sense of the event, while attempting to comprehend  the unthinkable becomes our priority.  These also are the times I like to check in with others, even if they do not voluntarily bring their concerns about the event to our session.  With social media at the fingertips of all ages, triggers are everywhere, and we are wise to investigate how the news of the day unconsciously could be impacting those we serve.

The International Society for Traumatic Stress Studies lists common responses to traumatic events as:

• Deep sadness
• Irritability
• Self-blame
• Nervousness
• Increased anxiety
• Confusion
• Negative thoughts
• Relationship problems
• Problems sleeping

Although these symptoms can be indicative of many other concerns, I have found it important to note that during times of any media heightened tragedy they are worth exploring.

In is also in times of grief processing, the importance around how we as therapist’s interrprut our own past experiences becomes heightened. The response of  “numbing and dumb” our pain, which so many of us have been encouraged and modeled, all the way to allowing the present situation to collude with and misinterpret what is actually occuring represents the varied, yet unhelpful ways we may interfere with affective grieving.

As a therapist I recognize that grief events are strung together like a string of pearls and each experience I mourn, impacts the way I see the next. If my task is to walk with others through their own grief, the exploration of my past with another professional is paramount. My lack of not working through my own suffering, pain, and loss can prevent me from supporting others while they attempt to do so themselves. Understanding how I cope, adapt and give meaning to loss  as I integrate it into the therapeutic process must be done if I am to be helpful.

After doing my own work, I will then be able to sit with others as they agonize, allowing them them to do so without trying to fix or miminize their experiences. This way of “holding space for others” without judgement allows whatever needs to emerge happen.  It is here where we see, healing begin, recognizing our greatest pains have become somewhat redeemed as we are granted the privilege to be a vessel of hope to those who are seeking relief. 













The Psychotherapist Manifesto for Self Care

The Psychotherapist Manifesto for Self Care

I will tend to my own physical needs, making sure I am sleeping well, maintaining a healthy diet and engaging in regular exercise.

Just as I encourage my patients and clients to do, I will learn to recognize and actively tune into any psychosomatic messages my own body could be reflecting back to me, and will seek help as needed.

I will remember that my relationships outside of work that are enriching, encouraging and leave me feeling refreshed are often the fuel which allows me to give back. I will take time to maintain positive friendships (without excuse) and be OK with distancing myself from those who do not contribute to my overall well-being.

I will also recognize when I need more psychological support than my own friends or significant others are able to provide, and will actively consider seeking out my own therapist when that happens.

As engaging and listening to others share significant trauma and heartbreaking experiences on a regular basis can be difficult, my own distress levels will eventually be impacted. I will remember to check in with myself around any vicarious trauma symptoms I may have picked up, and tend to those appropriately.

I  will give myself a break when I feel overwhelmed with the sadness of the world and intentionally will seek consultation and reprieve through a trusted collegue. If I do not have one available, I will make it a priority to find someone who can fill this role. I am not meant to do this kind of work in isolation.

I will make time for vacations, family and outside interests. Joy, rest and well-roundedness make for great therapists.

Appropriate boundaries, time management and  the word “No thank you” does not make one “selfish” or “mean”.  In fact, when applied, I will recognize, these nesessary modifications make me even a better person as I engage with the relationships that matter most.

If I have a hard time with disappointing others, I will have the humility to recognize that my compassion likely drew me into this profession, and it can also become my demise if I am not careful. I will honestly assess my own codependency needs and will make necessary adjustments without guilt or self imposed anxiety.

I will take time to recognize that the impact I make may not ever be fully known or even brought to my awareness. I will learn to be ok with that, having a quiet trust that if all I did was allow another person to be “fully seen”,  I have indeed done quite a lot.

Finally, I will take time for remembering that on a daily basis,  the opportunity to impact the trajectory of another’s life, if only by listening, encouraging and sharing a few clinical skills learned along the way is more than an honor. In fact, it is through this gratitude any bumps and bruises endured  in the process suddenly seem minor when compared to the opportunity for having  had made a difference.

The Lesson In Not Knowing

The Lesson In Not Knowing

It has always been interesting to me that patients (or clients) would come in and be in one of three stages:

Stage one was “I know what I want to do, or I need to do.” In this stage they are so certain about their decisions they are simply wanting permission to do what they are going to do anyhow. No matter how you respond, they hear you as confirming their decision. If you call attention to their unguarded remarks that suggest otherwise, they protest that they misspoke or that you didn’t understand their meaning.

Stage two is the negative certainty whereby they say, “I know where this is going and I know why this is falling apart.” “In fact, I knew this was going to happen!’ In this stage they know why others did things or what they really meant when they said whatever was said.

Stage three is “I should have known,” or “Something told me this at the outset but I just didn’t listen.”

Stage four is identified by, “What am I going to do. I don’t know what I’m going to do. Why me? Why this? Why now? Eventually, I just don’t know anything anymore.”    Not so suddenly, they become teachable.

Like so many of you, I went to college not to learn, but rather to show them what I already knew. So, I didn’t learn a lot. In graduate school, and certainly in supervision, I discovered the truth, the “real truth”.

I remember saying to my supervisor, “Bob, I have two hospitals who think I’m a hero, and yet the truth is, I don’t know what in the hell I’m doing.” With more grace than I deserved, he put his arms around me and said, Today your education begins.”

With eighty-five percent of our motivation being unconscious, we still think that we know why we do things. We at least think we ought to know, though the unconscious is like the back of our heads.

It’s been with us all of our life, but we’ve never seen it ” up close and personally.” Well at least not without those relationships (often our spouse), which serve as mirrors. When someone asks most of us “why” we did something or said something,  at our most honest and vulnerable moments, we only have about a fifteen percent chance of being right. It is like when we asks someone who has lost their keys, “Where did you lose them?” If they knew, the keys would not be lost.

Simply said, our beliefs and expectations about “ knowing”  don’t actually serve to make us smart, but instead invite shame when we don’t.

It was one of my great pleasures to be trained by an Atlanta psychiatrist, Ed Usey. I was working with the son of a couple with whom Ed was working. I was permitted to listen to the recording of the parents session. The father said to Ed, “You said do thus and so, and we did and it didn’t work. You said to do this and that, and we did and it didn’t work. Ed why didn’t it work?” Ed said, “Hell I don’t know. I’m not Kennedy. I don’t know everything!” Stunned I stopped the recording and said, “Ed why didn’t you give him the answer? Even I know the answer.” Ed turned to me, looking over his readers and said, “Right, you would have given him the answer! I was trying to teach the lesson!” I paused a moment as if I understood, but finally broke my silence to ask, “Ed, what’s the lesson?” Ed responded, “That it is okay not to know”.

I’m suggesting that it is not only “Okay” to not know, it some instances, is actually preferred. If we can endure our shame and vulnerability (from the erroneous thinking  that we ought to know), we gain wisdom beyond intelligence. It will in fact, be well worth the experience, allowing us to become teachable in that moment.

It takes real courage to admit that you “don’t know”, even when you think you may. If however, healing is about authenticity, integrity, and vulnerability, perhaps, for the sake of the therapeutic relationship, we opt for the courage of our own vulnerability. What if at the risk of looking inadequate, we model a new way of authentic comfort, regard, acceptance and support by trusting that the healing happens in the warmth, safety, and quality of the “with-ness,” and not the bright light of our adequacy?

Perhaps then we would know that all of the biases, presumptions, and certainties to which we cling, were totally intact by the time we were thirty-six months old and that those are the eyes through which we have presumed to see and know.  Thus, our belief system, forged at such an early and misinformed, ill informed, or uninformed age, still blinds, contaminates, and keeps us disconnected until we are willing to see thing differently.

Then, as Shelton Kopp wrote, “Even a stone, can be a teacher”.

Maybe that’s what it is to “open blind eyes”, those being first our own. It might also be that young belief system that not only keeps us from each other, but creates the stress and disillusionment we convert to somatic complaints. Be more suspicious of your “certainties” and more respectful of your “hunches”. Perhaps it is in this vulnerability, that we find peace, safety, and the joy of more curiosity and less judgement.  The quality of your life may depend upon your vulnerability and willingness to see things differently. Paradoxically, as a therapist, you don’t have to be certain, in fact, it’s more courageous, even preferred, to be willing to, “not know”.

Dr. Bessel Van der Kolk

Dr. Bessel Van der Kolk

Dr. Bessel Van der Kolk

Receives the American College of Psychotherapy

2018 Anam Cara Award


There are many who change how others think, but few with the wisdom and courage, to influence the path of an entire professional culture. Such a man is Bessel Van der Kolk.” — The American College of Psychotherapy


In the field of trauma and psychotherapy, you are probably aware of the accomplishments and contributions of, the world-renowned trauma expert, Dr. Bessel Van der Kolk. However, today, I would like to introduce you to the man I’ve come to know, both personally and professionally. Beyond his accomplishments, I would like to introduce you to “the man he is,” for this is who I would want you to know even better.

Few know that Van der Kolk gifts and wisdom, specific to the healing of trauma, were born out of his own wounding and grounded in a history of difficult experiences. Despite his statue in trauma treatment, psychiatry, and psychotherapy, his willingness to demonstrate vulnerability, authenticity, and share personal insight, has been nothing short of awe-inspiring.

Born in 1943, in The Hague, during the German occupation of the Netherlands, he was exposed to trauma as a child. As a child he had to endure the great Dutch famine as well as the ravages of World War II. His father had been a prisoner in a Nazi work camp and he lived surrounded by Holocaust survivors daily. He describes his mother as cold, withdrawn, and unhappy while his father, prone to rage, frequently abused him. On his own by his teen years, he wandered to France and, having stayed in a monastery, considered becoming a monk.

In the 1960’s Van der Kolk relocated to the United States to pursue his education and eventually became a Harvard trained Psychiatrist. By the 1970” while working with VietNam Veterans related to posttraumatic stress disorder his interest and research intensified. In the 1990’s he became a proponent of repressed-memory therapy for which he came under heavy fire and controversy.

Through the early 2000’s he was a lecturer, teacher, and professor while serving as President of the International Society for Traumatic Stress Studies and co-director of the National Child Tramatic Stress and Complex Trauma Network. He currently is the Medical Director of the Trauma Center, Professor of Psychiatry at Boston University Medical School and has a private practice in Boston.

Known for being opinionated and outspoken, Van der Kolk is not a stranger to controversy. Bessel recently left a non-profit trauma center which he founded and served and has begun yet another non-profit trauma center in Boston. Amid such controversy, I have observed him in very difficult situations and witnessed his composure and demeanor to consistently be one of patience and compassion.

With over one hundred and fifty articles on trauma and three highly regarded books, he has traveled around the globe tirelessly, teaching and training thousands of providers about the healing of trauma. His most recent book, The Body Keeps the Score, been acclaimed as “ground breaking” for it’s insight, clarity, and the integration of psychophysiology, psychology, and neuroscience. As psychotherapist, I can attest to the fact that we all are richer for his contribution to our field. The wisdom and insight Bessel has brought to the art and science of healing trauma has, undeniably, changed the way clinicians will practice for years to come.

On behalf of the American College of Psychotherapy, it is my privilege and honor, to present the 2018 Anam Cara Award to Dr. Bessel Van der Kolk.


Wayne Hulon

Executive Director
The American College of Psychotherapy