I was away recently giving a workshop for some people in mental health and corrections. We were focusing on how to apply DBT in their settings. Many people know that DBT is good at helping people reduce self-harming and suicidal behaviours, and of course, these are some of the highest priorities in treatment. You can’t benefit from treatment if you’re not alive. The next highest priority is often referred to as therapy-interfering behaviours, including things the client or therapist does that get in the way of therapy. Other key priorities include enhancing the client’s quality of life and building skills (often done via a DBT skills training group). What people often overlook is that there’s a whole set of what we call secondary targets in DBT. These are patterns or extremes that clients (and sometimes therapists) can get stuck in, and they make it hard for therapy to progress or for clients to reach their goals. There are six secondary targets, so I won’t review all of them here, but two important ones kept coming up at the workshop.
One of these is referred to as inhibited grieving. This includes active or passive ways that people avoid or escape their emotions, particularly emotions relating to loss or grief. When we lose something or someone, think of tragic or regrettable things about our past, or our lives are simply not the way we want them to be, it’s natural to feel a sense of sadness, grief, and loss. The most effective way to get through this usually is to allow it to run its course, experience the feelings of sadness when they arise, seek support as needed, avoid avoiding our regular activities, and take good care of ourselves. I’ve recently experienced an important loss and am revisiting this whole process firsthand, so I’m trying to take my own advice. Sadness arises at various times throughout the day, often inconveniently when I’m trying to focus on something else, and I’ll do my best to take a breath, step back from what I’m doing, and just experience it. Thoughts, worries, and regrets also arise, and I do the same thing with those, trying not to get too wrapped up in them but allowing them to just be. At the same time, I try to keep up my normal self-care routines (and for anyone who has read this blog for any length of time, you have probably gathered that I’m a creature of habit!).
This is so much easier said than done. Grief and sadness are painful and sometimes feel overwhelming or even intolerable. That’s where “inhibited grieving” comes in. It’s normal to feel like escaping or avoiding these feelings. You might find that you do this actively, such as by distracting yourself, spending a lot of time cleaning the house or trying to get work done, keeping your mind busy all day, using alcohol or drugs, and so forth. You might also passively avoid by suppressing your thoughts and feelings or not expressing how you really feel to people you’re close to. Some of this avoidance is necessary to get through the day and function at work or other activities. Even so, if you get too used to avoiding or escaping grief, you lose the opportunity to fully digest the experience. Give yourself time to experience the sadness and whatever else comes up without immediately escaping or avoiding it. When it comes to grief and loss, our emotions are often our best guide to what to do. An old zen teacher I knew once said, “Emotions… just want to be felt.” ~ Alexander L.Chapman, Ph.D., R.Psych.