Grief Counselling – Case Study: How to help clients overcome grief

After losing her grandmother, Rima was experiencing lack of interest in her work, relationships and life in general. She connected with me with a question “whether grief therapy can help her?” and if yes then “How?” 

After having an initial conversation over the phone, we planned for a consultation session.

Grief Counselling – Step-by-step guide

Intial Consultation or Pre-therapy Session: 

(Rima visited for a counseling session as a result of her partner recommending it. Rima agreed with her partner that she had been feeling low in mood, distant from her partner and had lost interest in life over the last six months. She agreed that it was time for her to try and do something about it.)

Rima :  Nitin, I lost my grandmother. The both of us were really close to each other. It has been 6 months since she passed away, and Nitin, you know all this time that I have been feeling unmotivated, distant and even sad at times. I don’t even like talking about my grandmother as I don’t believe that she’s no more and whenever someone tries talking about it, I get very upset.

As always in the initial consultation session of Grief Counselling, after hearing Rima’s challenges, I began by psycho-educating Rima about the core concepts behind the process I follow. I suggested Cognitive Hypnotic Psychotherapy (which is an eclectic approach to Psychotherapy) for working through the lack of interest in work, relationship, and overall life that she was facing. Then I walked her through the pre-coaching process. 

After helping her understand the therapy process, I added that in her case, once we have defined the current problem and outcome clearly, I will help her –

I informed Rima that the approach will include:

1. Defining the Existing problem clearly
2. Defining the expected outcome from the sessions clearly.
3. Exploring her feelings towards her grandmother and also the grandmother’s passing away.
4. Completely embracing her feelings including grief and then moving on from the grief.
5. Identifying observable changes that will indicate that the client has achieved the expected outcomes or that she is now capable of achieving her expected outcome.

Session 1: Defining Challenge and Desired Outcome

The first session I used the Meta Model*¹ in combination with the SOFT SEA Coaching*² framework to help Rima define her current situation, desired outcome, and expected future. 

I started the first session by asking Rima to summarize the challenges she wanted to overcome through therapy in her own words. 

Rima : I have lost interest in my life and I constantly feel sad. The sadness keeps growing day by day

I asked Rima to reframe her problem statement using the following format:

 I feel …………… about…………… when……………

Rima:

I feel lost about my life when I remember all the support and guidance, I received from my grandmother 

I asked Rima to read the statement a couple of times and tell me what was the desired outcome that she wanted to achieve at the end of these sessions in the format:

 I wish ……………………….

Reema : 

I wish to be able to make peace with the passing away of my grandmother and feel happy about the things that I have in my life.

I asked Rima to create a list of all the things in her life that she can be happy about.

Rima created a list with 6 things that she could immediately identify that she should feel happy about but Rima said she doesn’t.

So I asked her, What are the things that you enjoyed doing and wanted to achieve in your life?

Rima : Nitin, before my grandmother passed away, I wanted to have a child and wanted to play with my child. But ever since my grandmother passed away my relationship with my husband had become a bit strained.

I asked Rima to write down her desired future as her home assignment.

Session 2: Working with Grief

We began session 2 in the next week by asking her about the week and any changes that she noticed in her behaviours, thoughts, or emotions. Rima mentioned that while she was writing about the future, she actually started believing that it was possible to achieve that, which seemed almost impossible before the grief counselling sessions. 

As I had asked her to do some homework, I was going through it wherein she described the following :

1. She has been able to move on from her grandmother’s death
2. In terms of her relationship with her husband, she had a fulfilling relationship with her husband.

Further, I helped Rima experience a deep hypnotic*³ state and then asked her to imagine herself in the moment where she heard the news of her grandmother passing and then continue the imagination till she witnessed the last rites in her imagination as well. 

I asked Rima to imagine this till she started getting in touch with anger. Once her body language reflected that she was in touch with the anger, I continued into the next process called “Hypnodrama*⁴“.

I asked who was she angry towards?

Rima responded by saying “God” for taking the grandmother away from her. I asked her to imagine the God she believed in and express her emotions, her anger, her sadness towards God.

Rima started venting out her emotions in her imagination, I encouraged her to vent out everything she was feeling. As Rima started calming down, I also asked to imagine the grandmother with her and God. 

Nitin : I want you to express your feelings to your grandmother. 

Rima expressed her feelings, her body language depicted both sadness and yet a sense of relief or closure. Once she felt calmer, she said she could let the grandmother go with God and she knew that the grandmother was happy and at peace with that journey. While she was saying this, she visibly looked happier. 

Nitin : Rima, I want you to imagine her life going forward. 

Rima imagined working towards improving her relationship with her husband, having a child in future. 

I asked Rima how she was feeling?

She replied Calm

I asked Rima to tell me 3 situations in future wherein she would like to experience a similar kind of Calmness.

I further did the NLP Anchoring process with her.

At the end of the session, Rima looked relieved and said that she feels happy knowing that the grandmother is happy and at peace.

Session 3: Working with Relationship Issues

In the third session, Rima reported that she had started feeling better in the past week. I reminded Rima that her second outcome was to have a fulfilling relationship with her husband and that we shall focus on this during today’s session.

I further explained Rima how the concept of relationship began, about the 3 major reason of the conflict in a relationship, i.e 

1. Money
2. Communication
3. Physical Intimacy

I asked Rima to think about the relationship she has with her husband and tell me what according to her would be the major source of conflict.

Rima said that Communication was one of the major conflicts; she added Actually, I need to communicate with my husband clearly about how I am feeling and say sorry for anything I said or did during that time that may have hurt him. I think sometime I would also like to discuss with my husband my desire to start planning for a baby. 

I further explained to her about Suggestibility*⁵, Sexuality*⁶ and Love Languages*⁷. I asked Rima to think and tell me what could be her and her husband’s love language.

For home assignment, I asked Rima to :

1. Write down the key points of the conversation she would like to have with her husband. 
2. To do a mental rehearsal about the conversation a couple of times. I said, once you feel comfortable, 
3. You may have the conversation in reality with your husband in the coming week.
4. To take a small love language online quiz with her husband

Rima said that she thinks she will be able to do that.

Session 4: Session Closure

In the fourth session of grief counselling Rima mentioned that her past week went really nice and that she had the conversation with her husband and it went better than what she expected. She also spoke about planning for the child and her husband was happy listening to that.

In this session, I taught her how to do self hypnosis*⁸ for future concerns and at the end of the session I informed her that now the both of us could stay in touch with each other.

Going ahead:

Over the next couple of weeks, Rima stayed in touch with me and kept informing me about how things were going. After about a month both of us decided to terminate the sessions as Rima was doing well and felt she could handle things by herself going forward.

My Observation: 

The grief counseling process used by me really surprised me by its effectiveness, especially given Rima’s initial reluctance to even continue the counseling sessions.

References for techniques used

1. Meta Model
2. SOFT SEA Coaching
3. What is Hypnosis?
4. Hypnodrama
5. Suggestibility
6. Sexuality
7. Love Language
8. Self Hypnosis

The concepts and techniques discussed during this case study are based on the topics covered during the Cognitive Hypnotic Coaching® Diploma and the Cognitive Hypnotic Psychotherapy® Diploma Program.