EMDR Chat #45: What about Grief and EMDR Therapy?

What is the appropriate length for the grieving process?  What is necessary?  What is unnecessary?  And can EMDR therapy play a role?  In this episode, Curt and Michelle discuss how EMDR therapy can provide help and healing for those dealing with grief and how EMDR clinicians can approach grief in the therapy room.

Transcript

SPEAKER_00 0:12

Welcome to EMDR Chat with Kurt and Michelle. I'm Dr. Curtis Roundse.

SPEAKER_02 0:17

And I'm Dr. Michelle Gottlieb. For some reason, Kurt is confused about the name of our therapy. I don't know why.

SPEAKER_00 0:22

That's because it's because everybody says E D M R when I talk about it. So I'm starting to say what they say.

SPEAKER_02 0:31

No, it's EMR. MDR. Okay, good. Let me do it for how many years, Kurt?

SPEAKER_00 0:38

Let me write that down.

SPEAKER_02 0:41

So hi everybody. We're glad you're here. And what we're having to talk about today is not as silly as what we were just talking about. Kurt, it's really interesting when I talk to clinicians who are working with clients who are dealing with grief. And I hear so many different things. And part of it is just our cultural expectations, our religious expectations. But one of the things that I hear a lot is we shouldn't do EMDR therapy on grief because this is a normal process and people need to work through it. What's your response to that?

SPEAKER_00 1:19

Well, it it is a normal process, and definitely we will work through it. And one of the things that we find is that different cultures, you know, different families, different religions may have kind of established steps that people go through. But even though it's normal, it doesn't mean that it doesn't get complicated sometimes. And that our grieving process can lead to a mourning factor where our identity is changed and it becomes more and more complicated. So EMGR doesn't take away anything that's normal is necessary for the brain, for us to go through losses. But what it can do is take away that which is unnecessary. And people suffer often because the unnecessary they believe is necessary.

SPEAKER_02 2:13

Right. And and even, I mean, a couple of things. One, that statement, EMDR does not take away that which is necessary. That's true, not just in grief, that's in all aspects of everything. Don't forget that. But there is, and you have a story that I want you to tell in just a second, but there is, again, an assumption that grieving should take a certain amount of time. If you're doing it right, whatever that means, it should take a certain amount of time. And you have a story that kind of relates to that.

SPEAKER_00 2:43

Well, this goes back many years ago when Francine was uh beginning doing the trainings, and she had a story about grief and loss, and she would tell the story. And I hope I get the details as close to how she would tell it. But Francine was still working at her office at uh Menlo Park, the Mental Research Institute, and uh she was in the midst of creating EMDR, developing it in those days, and uh some of her colleagues brought a young woman to her that had a newborn child, and uh the newborn child ended up getting very ill. Uh the woman called the pediatrician, and the pediatrician told her to please come in first thing in the morning but keep the child upright. And Francine would pause and she would say, How long in your paradigm, in your framework, be it cultural, be it religious, how long is grieving long enough? Is it two years, like some research says? Is it one year, like some religions have a one-year grieving process? Is six months too early to take care of the unnecessary parts of grief? What about three months? Would someone be considered as not loving someone if they after three months? And then she would say, What about three days? And this is a story she told. The young mother had the newborn, and that she did what the doctor said. She was holding that child on her left side, on her left breast, and she was rocking in a rocking chair. And as she was doing that, uh somewhere between 4 a.m., 4 20, she fell asleep and she awoke and discovered that her little baby had had passed away. I think later on they found out it was Sid's sudden infant death syndrome. But that woman was just devastated, believing that somehow her lack of awareness had killed her child. And she came in distraught, upset, grieving, and just beyond con consolation. And she came in and the death had occurred three days previously, and she had a feeling along her left side, like electric uh shock, it was unpleasant. That's where the baby had laid, and she could feel the presence, and it was so horrible for her. She was so distraught. So Francine targeted those feelings and the loss. And during the reprocessing, at some point that the discomfort that she felt on her left side, her left chest began to get light and float and become almost like butterflies. And then it went into her heart and she says, I will have him here forever. And when she left, Francine would say, She was still grieving. But what had happened is that EMDR had helped remove the unnecessary part of that horrific responsibility she felt and the physical sensation that was haunting her. She would still grieve. That's necessary. But what it took away was that which was unnecessary.

SPEAKER_02 6:04

Right? And I think that's such an important piece and so confusing for so many of us is that she should have um continued to be uh non-functional, right? But why? I mean, why? Why? I mean, like I had a client who um her two-year-old son was killed in a terrible accident and she wasn't there. And she, and of course, you know, what we often do when we're not there is we fill in that picture. And so she was just haunted by the picture of her son's death. And we targeted that, and she was able to get back to work and she was able to get back to living, always mourning her child. And what's interesting for her is you know, you said, you know, for your um Francine's client, it was butterflies. For her, she came from a Christian belief, and she that now saw her son being held by Jesus. And that allowed her to go forward with her life. So, um, but I think this leads to what a lot of our clients believe too, is if I'm not tortured by this, then I didn't really love them. I didn't, you know, I'm gonna forget them.

SPEAKER_00 7:14

Right. It's the fear that a lot of times it's in EMDR speak, it's it's blocking beliefs. That, you know, oftentimes there's this belief that I have to feel some level of horrible, torturous upset uh in order to really sh know that I love them. And somehow, if I'm able to mourn, able to grieve, I'll still cry. Things will still trigger me. That's normal. But I'm not inconsolable, I'm not paralyzed by the loss. And that's the piece that we can help with people who are grieving and and and in the midst of complicated bereavement. And I I want to point out a great resource. You know, Roger Solomon and Rando have done a lot of a lot of work on this, and you can find uh writings out there, you can find workshops out there on grief and uh complicated bereavement. So that for EMDR therapists, it's very they're very helpful and they're very authoritative in in what they do and integrating that EMDR piece.

SPEAKER_02 8:16

Um and let me throw one thing. EMDR Professional Training also has a grief workshop done by uh Dr. Deborah Silveria. Let me throw that one in too.

SPEAKER_00 8:23

Absolutely. Yeah. And so one of the things that, you know, when people are are uh dealing with grief, you know, one of the questions we often get is okay, what do we target?

SPEAKER_01 8:36

Right?

SPEAKER_00 8:37

And I I I have another quick story to tell. It's the it's a story about a woman who was a wife of a firefighter. And uh uh I had seen the firefighter due to some work-related incidences that he had to endure, and we did EMDR on that. And there was about a two-year period of time where he and his wife had tremendous amount of losses, like both sets of parents passed, uh a brother and uncle, you know, uh close friends. And during the whole time, this woman was the rock of Gibraltar. She's the one that would sit at the hospital, she was the one that would visit the family, she was the one that would cook meals and prepare them, she was the one that would hold hands, and she was the rock of Gibraltar. And then the day come when their family dog died. And she was absolutely inconsolable. She was in the bed, she couldn't function. And of course, everyone would, you know, many people make judgments. Only a dog, why why why are you so upset about that? Look at all the other stuff that you've been through. But any loss opens the door to any unresolved losses. And so for her, her rock was the dog during all that time where she was strong for other people. And so the loss of that pet became a target. And it also allowed us to then deal with all the other losses that she had been so strong for that she had really not grieved. She had to be strong for other people. So there are past targets that we go after. And then maybe we may want to talk about some of the present triggers that we find in grief.

SPEAKER_02 10:26

Um, I'm I'm gonna do a quick aside and I want to come back to that because you just hit on one of my pet peeves of um I'm strong. That means I'm not crying, I'm not mourning, I'm not doing whatever. I'm sorry. I think people who are crying are also very, very strong.

SPEAKER_01 10:42

All right.

SPEAKER_02 10:42

So yeah, just want to put that one out there. Um, yeah, I think all of the the targets we have when they found out the person died, when um the um it maybe the funeral or um having to tell someone. Um but as I alluded to just a second ago, sometimes the worst target in the past prong is the vision of when that loved one died, even if they never saw it.

SPEAKER_01 11:09

Right.

SPEAKER_02 11:10

I had a client who was um she worked for a retail facility and it a car rammed through the window, and people, her co-workers were killed. She wasn't there, she wasn't at work that day, she didn't see it. Um, but the image she she had were the people who were killed, you know, the car accident. Right. And we targeted, she never saw it, but we targeted that, and that's often the worst target.

SPEAKER_00 11:37

It's the brain that fills it in. You know, we we didn't see it, but we imagine how horrible it is, and and the memory is just as bad as if we had seen it, or the m uh the uh imagination is just as bad. And the other thing is we all uh is the nightmares that may come during that time is they are very useful targets. But the other thing, Michelle, is as we deal with all the past, the thing that I often is very um str strong in in my patients is it's the present triggers now. It's wake it's waking in the morning and walking down the stairs and not smelling the coffee that that other person would make. Uh going back to their church or synagogue for the first time now without that person. Uh here and you know how many times we we hear a song?

SPEAKER_01 12:31

Right.

SPEAKER_00 12:32

You know, all these present triggers. Um when God forbid you lose a child, difficult hanging around other parents that have children your child's age.

SPEAKER_02 12:44

Or how old your child would be, you know, as you continue on, right?

SPEAKER_00 12:48

Yeah, you know. You go to a graduation of some of your friend's child and know that yours uh would have been there.

SPEAKER_01 12:56

Right, right.

SPEAKER_00 12:58

Those are all good targets, present triggers for EMDR and and for future templates. Right.

SPEAKER_02 13:04

I have one that the husband was a very, very loving husband. And when he and he always would put the wife's towel in the dryer, so when she got out of her bath in the morning, he'd wrap her in this nice warm towel, and then he died.

unknown 13:21

Yeah.

SPEAKER_02 13:22

You know, and it's you know, it it's the putting on the towel that's not so warm, right? And not being wrapped up by her husband. And it's you know, it's those it's those things that are so wonderful and loving and hard. But I'm gonna say another one that's really difficult too is it's the not having the relationship you always wished for.

SPEAKER_00 13:43

Yes.

SPEAKER_02 13:45

That's another thing that we can have the fantasy or the the loss of the fantasy, right? That can be another piece of the work that we do as well.

SPEAKER_00 13:54

That we you know we worked so hard we wanted to reach higher and live this life together.

SPEAKER_01 14:01

Right?

SPEAKER_00 14:02

And that's gone. Or we wanted to we wanted to have grandchildren and that opportunity's gone. You know, all of those things that are real and we will grieve, uh, and it's necessary. But the idea of having to have torturous suffering in order to demonstrate our love for our lost loved one. Uh but and by the way, it doesn't have to be the loss of a loved one. It could be a loss of a job. It could it could be a loss of uh, you know, think of the poor pe the people at the fires, their homes, the earthquakes, you know, of floodings. You know, so all of that is not just people, but it's the things that mean a lot to us and and uh often involve people, you know, like our family's homes gone, it got burned up in the fire, got taken away by the flash flood, right? Uh and how that impacts the rest of our life.

SPEAKER_02 14:58

And uh, you know, you mentioned pets, and uh pets are family members for those of us who love our animals, they're they're family members. And um, so we need to be careful, and this goes for everything as a clinician, that we don't put our value on it of like that's stupid. Why would you mourn the the you know the cat? Um because the cat was important to that person, and so it's important that we we target that, right? We don't put our we don't put our values on that.

SPEAKER_00 15:24

That's right. It's just like uh, you know, think of the little child that loses their favorite stuffed animal. And how horrifically upset they become. And, you know, adults say, well, it's just a stuffed animal, we'll get you another one. Well, that's not the point. We gotta we gotta uh be attuned to their suffering, but also be that um one that helps them move through the journey of the lost.

SPEAKER_02 15:55

So, Kurt, how would you, when you've got a client, what helps you determine whether they are going through grieving, whatever it is they're grieving, um, in a healthy manner? Um, when when do you see it as complicated? When do you step in? When do you not step in? How do you make that clinical decision?

SPEAKER_00 16:15

Uh if someone's coming in to see me because of a loss, I'm going to assume that there's a clinical reason for them to come in. And so I'm going to do the history taking. We're going to explore what that loss means, and I'm going to target it. It EMDR won't take away anything that is important, but it can certainly take away that. Sometimes that which is unnecessary is also invisible to the one who's had the loss and to the clinician observing, because our belief structure says, oh, that's normal. Of course you would feel that way. And with the MDR, what we realize, a lot of that which we believed was normal, it doesn't have to be. And so even dealing with the loss and targeting those things which what what might we might consider normal, I I always like to check it out.

SPEAKER_02 17:13

Well, and I think then the next piece of that, again, our assumptions as well, is this clearly cannot be a suds of zero. We'll never reach a suds of zero on that. Like my woman whose two-year-old son was killed. Like this could never be a zero. Except it did become a zero because that memory got transmuted into Jesus holding her child. And let's define zero. Zero does not mean no sadness. She will always be sad about the loss of her baby. Always. But it's not that gut punch, it's not that visceral reaction, it's not the electrical charge anymore.

SPEAKER_00 17:49

You know, it's kind of like what we say in our trainings. What we what we're trying to do, and what EMDR does effectively, it does re-edit, restructure, and stores the memory in a different way. And we want whatever horror that is there, we we want the horror to be an adjective describing the incident, a horrible incident, rather than horror being an emotion we still hold in our heart.

SPEAKER_01 18:20

Mm-hmm.

SPEAKER_02 18:21

That was very well said, Curtis.

SPEAKER_00 18:23

Sometimes I surprise myself.

SPEAKER_02 18:27

Um so, and you know, we talk about, you know, let it be historical, not hysterical, right?

SPEAKER_00 18:32

Uh yes.

SPEAKER_02 18:33

Yeah. So yes, I mean, this is but this that that those blocking beliefs that you were talking about a few minutes ago, that comes up there too. If I allow this to go to a zero, that means I didn't really love them, therefore I'm not really mourning, or I'm not doing it right, or whatever that is.

SPEAKER_00 18:53

Or or people will think I don't love. We project it out and and we think other people will think badly of me if my life goes on. And there will be people that judge judge people. I I mean I've heard that, and and patients have talked about that. Right. You know, but that's that's the other person's problem, not right the one that's suffering.

SPEAKER_02 19:16

And I'll tell you a cognitive interweave that I often use for, you know, if I let this go, that means I didn't really love them that, you know, um, is flip it around. Okay, you died, and whoever it is who died, they're alive. You want them to be tortured by this for the rest of their days. Well, of course not. Right, go with that. You know.

SPEAKER_00 19:36

Right. I I I will often say, you know, most of those that love us and pass want us to live life that they can't live with us now.

unknown 19:46

Yeah.

SPEAKER_02 19:46

Uh-huh.

SPEAKER_00 19:48

Yeah.

SPEAKER_02 19:49

That's lovely. Where'd you just go? You just thought about something.

SPEAKER_00 19:54

Well, it's just the patients who have said that and realize that uh uh the the joy and celebration they can actually have when they are living out their life now uh as sort of a uh a monument to the one who's gone and can't live that life. They are doing it now.

SPEAKER_02 20:15

And that's where future templates can come in so beautifully. You know, of um that trip that you always plan to do together, right? Well, you're still gonna do it, but you're gonna do it maybe with a picture of him or I don't know, something that, you know, holding a his favorite shirt. I know that you're doing it together in honor, in memory of him.

SPEAKER_00 20:35

That's right.

SPEAKER_02 20:36

And so future templates can really help to uh make that come to life and make it be okay, right?

SPEAKER_00 20:44

That's right.

SPEAKER_02 20:46

So we are um about out of time. Um what I want to say with this is someone comes in with grief, you don't have to decide is it complicated grief, is it knock-up? Just do the work. Their brain will take care of the rest.

SPEAKER_00 21:01

Yes, it's oriented to heal and to cause health, and we just got to get out of the way.

SPEAKER_02 21:08

Like everything, right?

SPEAKER_00 21:10

Like everything.

SPEAKER_02 21:11

All right. Um, so thank you all for joining us. Um, this is an important topic. Again, there's lots of workshops out there, as Kurt said. Um, don't be afraid to do the work and don't let your junk get in the way.

SPEAKER_00 21:24

Right. Until next time.