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Anthony Quintiliani, Ph.D, LADC

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January 22, 2021 By Admin

Loss, Grief and Suffering in America

Loss, Grief and Suffering in America

By Anthony R. Quintiliani, Ph.D., LADC

Other than our nation’s suffering during The Civil War, The Great Depression, and World War II this past year has been one of the most stress-filled, fear-filled times in our history. Here is a list of the reasons behind it all: the COVID-19 pandemic, racial injustice, legal reactivity, massive unemployment, loss of housing, quarantines, closed schools and colleges, powerful political demonstrations, and a “president” who betrayed his trust and incited riotous violence against the Capital of the United States. Also a “president” who has been impeached not once but twice by The U.S. House of Representatives. What a year!

Types of Loss, Grief and Suffering

Along with the above, we have witnessed increased anxiety, depression, fear, anger and traumatic stress. Although death (loss of a loved one) is by far one of the most severe stressors, we also suffer from the virus, separation/divorce, developmental stress, incarceration, and the loss of the way of life in pre-COVID-19. Americans are suffering from various bio-psycho-social-spiritual dimensions of stress, loss and grief. Perhaps the correct words to use are “complicated grief.” Our current experiences with loss and grief go far beyond the stage-based versions of E. Kubler Ross; our current complex grief does not follow neat linear progressions, and includes more serious symptoms. For those who also experienced childhood trauma of various forms or developmental regressions the current experience is more exasperating and dangerous. When loss is catastrophic reactions may include nightmares, shame, guilt, regret, hopelessness and suicide. Cultural differences also play roles in loss and grief as well as its treatment. Therapists must also be aware of the influence of race, gender, sexual orientation, and age.

Treatments for Loss and Complex Grief

Treatments for loss and complex grief are many, but with varying levels of success. Matching treatments to client characteristics, and developing a powerful clinical alliance are important for therapeutic success. Below, I list (only) various treatments, most supported by empirical research and practice. I will leave it you the reader to look more deeply into treatments or interventions they may prefer. Here is the list: Trauma-Informed Cognitive-Behavioral Therapy, Mindfulness-Based therapies/practices (breath work, meditation, yoga, tai chi, qi-gong and MBSR or ACT), Continued Bonds Theory – the changed internal relationship with the lost person, and Attachment-Informed Grief Therapy – utilizing attachment styles of secure, insecure, anxious or avoidant.

Many therapeutic interventions may be helpful: social-emotional support, recovery journaling, music, exercise, imagery, play therapy, and sand tray work. Generally especially strong empathy is required. Self-care of the therapist is a must. Using Maslow’s Hierarchy of Needs may be helpful.  Other active interventions include empty-chair work (sitting in the “worry chair” or the lost person chair), self-talk or out-loud talk using stimulus words like relax, breathe, not me, etc. Social networking with new people in groups is often helpful. Improving client self-care and participating in activities associated with joy or satisfaction moves the mind to other things.

In the end, if so many various interventions fail to meet needs, people should consider joining a formal, therapeutic bereavement group. Loss is emotionally tough, and recovery requires complete emotional activation.

For more information refer to: comments of A. Bodner, Ph.D. in The New England Psychologist, p. 2 (Winter, 2021). Hanlon, P. (2021). The Many Faces of Complicated Grief. The New England Psychologist, pp. 1 & 4 (Winter, 2021). Cormier, S. The Transformative Power of Loss. Psychotherapy Networker,  pp. 17-18 (January-February, 2021). Cacciatore, J. (2020). Grieving is Loving: Compassionate Words for Bearing the Unbearable. Boston, Wisdom Publications, pp. 1-8.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Coping, Covid-19, E.Kubler-Ross, Featured, Grief, Happiness, Healing, Human Needs, Inner Peace, Joy and Suffering, Personal Suffering, Practices, Relational Suffering, Self Care, Suffering, Tools, Treatment Tagged With: AMERICA, COPING, COVID19, E. KUBLER-ROSS, EMOTIONAL, GRIEF, HOPE, JOURNALING, JOY, LOSS, LOVING, MINDFUL, MINDFUL HAPPINESS, MINDFULNESS, PRACTICES, SELF, SOCIAL, SUFFERING, THERAPISTS, TREATEMENTS, TREATMENT

March 30, 2017 By Admin

Helping Therapists Work with Diversity

Help For Therapists: Working with Diversity

Clinical interventions, especially strongly evidence-based interventions, impact clients via new skills and practices in mind-body clinical realities. No matter how good (or “good enough” ) a clinical intervention is it requires a highly positive, active therapeutic relationship. As ample research suggests, a strong and positive therapeutic relationship in therapy enhances client trust and courage – thus expanding their experimenting with new ways of being, thinking, and doing. A huge problem is establishing such a therapeutic relationship is the inability of some therapist to bond with diverse people – people not exactly like the therapist. Below I will present information from clinical  and social psychology about
what general variables/differences to be most mindful about.  This information will be noted in three categories: Universals; Group Differences; and, Individual Self-Development (within groups). If therapists practice paying more attention to some of these basic realities in their clients, the expectation is that their therapeutic relationship/alliance will improve along with their clinical outcomes.

UNIVERSALS: Here is the listing – Similar Life Experiences/History, Biological Similarities, Social Similarities, Psychological Similarities, Emotional Similarities, Self-Awareness Valences, Use of Symbols, Use of Art, Compassion and Aggression, Love and Hate, and, Differences in the Above. Noticing, being mindful of, and using these realities in therapy should improve alliance and clinical outcomes.

GROUP DIFFERENCES AND SIMILARITIES: Here is the listing – Gender, SES, Age, Geography, Race, Ethnicity, Culture, Abilities, Disabilities, Religion, Marital Realities, Sexual Orientation, Urban/Rural, Education, Environmental Exposure (good/bad), etc. Again, therapists who are highly mindful of these realities will do their best to integrate them into their work with clients.  Good work here will improve the alliance and clinical outcomes.

INDIVIDUAL SELF-DEVELOPMENT: Here is the list – Genetic Transfer, Modeling Transfer, Familial Transfer, and All Non-Shared Experiences in Life. Therapist who make it a norm to differentiate carefully between individuals in therapy – and who actively use these differences in their work – will most likely experience stronger emotional ties/alliances and better clinical outcomes.

If you have not been fully conscious of using such differences and similarities in working with your clients, you may want to select a few variables and begin.  Begin NOW!

For more information refer to Pomerantz, A. M. (2017). Clinical Psychology: Science, Practice, and Culture. Los Angeles, CA: SAGE Publications, pp. 69-93. See also the DSM-V emphasis on culture and diversity in treatment.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

 

Filed Under: Activities, Diversity, Featured, Leadership, Therapist, Therapy Tagged With: DIVERSITY, MINDFULNESS, THERAPISTS, TRAINING

March 23, 2017 By Admin

Even More Psychoanalytic Gems

Psychoanalytic Gems – Even More

D. W. Winnicott has made significant clinical contributions to both building therapeutic alliance and maintaining a positive, helpful focus in psychotherapy. Below I have noted various approaches to
use in your therapy.  Use of these “gems” requires considerable knowledge and skill by the therapist.  Here is the list:

  1. Respect the client’s agency, and do nothing to exert direct control over her/him.
  2. Continue to support personal goals, striving, and motivation in your client.  Promote healthy maturational processes in this growth.
  3. If you understand how, use transitional space/transitional objects in our therapy to enhance positive emotional holding and nurturing of the client’s true self. Build more safety.
  4. Work to improve the client’s self-identifications, self-image, and self-objects. Where helpful note that initial introjections are the product of attachment experience. They occupy both intrapsychic and interpersonal space and time.
  5. Introduce playful free association as a method in your therapy. Use interpretation only when it is helpful.
  6. Support directly the client’s need for “continuity of being” in both therapy and day-to-day life experiences. This often includes integration of the true self and false self.
  7. Use gentle reflection to help move insight into action: changes in thoughts, emotions, and behaviors.
  8. Notice both transference and cuntertransference experiences in therapy. Use these to better understand your client, as well as yourself.
  9. When possible enhance the client’s safe use of self soothing behaviors as a form of “primal satisfaction.”
  10. Help your client to integrate fragments of unhelpful past experiences.  This process should help to enhance the presence of a coherent self-narrative.   Such narratives often involve early traumatic experiences, and may be activated in the here-and-now of therapy.
  11. Do whatever is possible to re-integrate the sense of a secure self.  Maintain a safe and accepting therapeutic environment to do so.

For more refer to  Giovacchini, P. L. (1990). Tactics and Techniques in Psychoanalytic Therapy. Vol. 3, The Implications of Winnicott’s Contributions. Northvale, NJ: J. Aronson, pp.1- 243.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

 

Filed Under: D.W. Winnicott, Featured, MIndfulness, People, Psychoanalytical Psychotherapy, Psychotherapists, Psychotherapy, Therapist, Therapy Tagged With: CLINICAL, D.W.WINNICOTT, PSYCHOTHERAPY, THERAPISTS

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