Working with Grief Using Acceptance & Commitment Therapy

Photo by Danielle MacInnes on Unsplash

Jacob Martinez, MA, LPC

In my last post I talked about how grief can teach us Acceptance & Commitment Therapy. Today I’ll show you some practical tips for working with the bereaved.

Remember It’s Still About Flexibility

When working with a grieving person the overall target is still to increase psychological flexibility. When a person in our life dies our behavioral repertoire can shrink down around us. This is typical and completely normal for a period of time after a death.  The narrowing of our behavioral repertoires only becomes problematic when it persists and continues to obstruct valued living over time. Now to be clear, grief itself is not something that just happens for a bit and then goes away, it’s a continual process that lasts a lifetime. A person who is still consistently grieving 15 months after a death in the exact same way that they were grieving a week after the death however may be experience what we would call complicated grief. In a sense, they are stuck in this very painful and narrow experience which affects everything in their life. As time goes on we expect that our grieving process will change and integrate more completely with the values that guide us. So, in determining whether an individual needs extra attention in expanding their behavioral repitoire following a loss keep an eye on those areas of life in which the person now seems restricted, and those where there behavior may seem less restricted. It can help to point out workability of various behavior patterns and have the individual examine what areas of their life have been set aside during this grieving process.

To get unstuck all we have to do is get moving.

As painful as grief can be, I’ve worked with many families who feel as though they must stay embedded in it as deeply as they can to honor their loved one. For them, continuing their lives and feeling the full range of human experience is a kind of betrayal. It is possible to live a full and meaningful life of your own and still grieve deeply. It isn’t necessary to believe this statement is true, or to understand it to do it. I use a special grief formulation of the ACT Matrix with my clients to help them jumpstart this process, you can watch this linked video to see this in action. In doing so we examine our own values, as well as those of the deceased, and make a choice of whether or not to incorporate some of theirs into our own life. Then we go out into the world and practice embodying those values and see how it feels and works for us to do something in this very intentional way. From this work it is easy to incorporate meaning making and perspective shifting experiences that might benefit the client in all sorts of other areas of their life.

I like to think of this as a kind of “grief in motion”, an antidote to the very stagnant, stuck, complicated grief that can swallow us whole. Keep it simple and focused on behavior and function. Grief isn’t about eventually “moving on”, “coming to terms”, or “finding a new normal”, it’s about grieving and being in the same breath, moment by moment.

As always, as a behavior analyst or therapist, you must attend to your own behavioral repertoire and practice inside your ethical boundaries. Seek appropriate supervision and reference local practice governing bodies if you are unsure about the bounds of your practice as a therapist or behavior analyst.

To learn more about ACT and ACT related concepts, check out our series and continuing education offerings at ABA Outside the Box, and be sure to subscribe to bSci21 via email to receive the latest articles directly to your inbox!

Jacob Martinez is an ACT therapist and trainer living in North Texas. He is the President of the Texas ACBS Chapter and host of ACT Naturally where he interviews great therapists, talks mental health & wellness, and shows you how to do ACT. Check out his work at ACTNaturally.net

 

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