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Section 4
Shattering Assumptions of Grieving Clients

CEU Question 4 | CEU Test | Table of Contents | Grief
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs

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On the last track, we discussed Feelings of Isolation.   There are four basic reasons grieving trauma survivors experience feelings of isolation.  These reasons for feelings of isolation are difficulty participating in social gatherings, perceived outcast status, blaming the victim, and the "Just World" philosophy.

On this track we will discuss Shattering Assumptions.  As you may know, grieving clients may be forced to reconsider three assumptions about themselves.  They are the loss of invulnerability, the loss of an orderly world, and the loss of a positive self-image.  As I describe these three assumptions, see if they have been reconsidered by a client you are currently treating.

Three Shattering Assumptions

#1 The Loss of Invulnerability
You may already know that the loss of invulnerability is an assumption which is generally reconsidered naturally.  As you are aware, a common attitude among young people is that "it can’t happen to me."  Later in life, specifically around middle-age, most people begin to reconsider this assumption naturally.  However, trauma survivors are forced to shatter the assumption of invulnerability prematurely.  Therefore clients may no longer feel the world is a safe place. 

As you may have experienced, some clients begin to live in fear that the trauma will happen again.  For example, Mike’s father, Charlie, was with him when Mike died in a car accident.  Charlie, age 49,  stated, "I always knew wrecks were a common thing.  Used to see them all the time on the way to work.  But I never thought I’d lose my son to a wreck.  Now, everywhere I go, I’m scared an accident will happen.  It’s so bad, I can’t even drive anymore."  Do you have a Charlie whose loss of invulnerability resulted in fear of normal activities?

#2 The Loss of an Orderly World
Clearly, the loss of an orderly world is an assumption closely related to the "Just World" Philosophy from track 2.  As you may already know, traumatized clients may be forced to realize that all their best efforts cannot prevent bad things from happening.  While clients would like to believe that the world is orderly, their experiences may contradict that belief.  As a result, the loss of an orderly world becomes a reality.  Are you treating a client has had the assumption of an orderly world shattered?

#3 The Loss of a Positive Self-Image
In my experience, one of the most profound losses clients experience is the loss of a positive self-image.  Would you agree that the loss of a positive self-image may affect a client’s ability to work and to relate to others?  Charlie’s wife, Rachel, assured him that he was valuable and loveable, but he had trouble believing it. 

Charlie stated, "I feel bad, like it’s my fault.  I mean, I was there and I couldn’t do anything to stop it.  That makes me feel like a dirt bag.  A pissed off dirt bag, at that.  Mike died and I lived.  Do you have any idea how that feels?  Rachel tells me it’s not my fault and that I’m a good guy, but I can’t even really talk to her about it."  Charlie’s anger and his resentment of himself led to the loss of a positive self-image. 

4-Step New Perspective Technique
To help Charlie regain a positive self-image, I decided to try the New Perspective technique.  As I describe this technique, compare it to your method of helping clients to regain a positive self-image.  

--The first step in the New Perspective technique is for the client to explain his or her current perspective on his life.  Charlie stated, "Well, my past is wasted because Mike is gone.  The present is painful, and the future looks pretty dark.  What now?"  Charlie’s answer was what I expected. 

-- The second step was to help Charlie see other important aspects of his life again.  I stated to Charlie, "Rachel is part of your past.  As your wife, will Rachel be part of your future, also?" 

-- Charlie answered me by completing the third step of the New Perspective technique when he stated, "Of course. What, do you think I’m some sort of dirt bag who’d leave his wife after our son died?"  My answer was, "No, Charlie.  I know you’re not a dirt bag."  In addition to explaining his current perspective on life, and seeing other important aspects of his life, the third step was for Charlie to dispute his own beliefs.  By using the New Perspective technique, I got Charlie to dispute his negative self-image of being a dirt bag. 

-- The fourth step in the New Perspective technique is for the client to rebuild a positive self-image.   I asked Charlie to write down all the positive things he did for Mike before the accident.  Charlie then took his list of positive behaviors home to Rachel, who added additional positive behavior she had witnessed.  I reviewed Charlie’s positive behavior with him and asked him if he still felt his past was wasted.  Charlie stated, "No.  I just wish it wasn’t over.  But like Rachel said, I was a good dad to him and I have other kids I still need to be a good dad to." 

Though Charlie had experienced the loss of a positive self-image, he was able to regain his self-image using the New Perspective technique and through the help of a loving family.  Are you treating a client whose family support system may be useful in helping to implement therapeutic techniques?

On this track, we discussed Shattering Assumptions.  The three assumptions we discussed were the loss of invulnerability, the loss of an orderly world, and the loss of a positive self-image.

On the next track, we will discuss Secondary Wounding.  In my practice, I have found five basic types of secondary wounding experiences. They are disbelief, discounting, ignorance, labeling, and cruelty.

Peer-Reviewed Journal Article References:
Bellet, B. W., LeBlanc, N. J., Nizzi, M.-C., Carter, M. L., van der Does, F. H. S., Peters, J., Robinaugh, D. J., & McNally, R. J. (2020). "Identity confusion in complicated grief: A closer look": Correction. Journal of Abnormal Psychology, 129(6), 543.

Captari, L. E., Riggs, S. A., & Stephen, K. (2020). Attachment processes following traumatic loss: A mediation model examining identity distress, shattered assumptions, prolonged grief, and posttraumatic growth. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. 

Ferrajão, P. C., & Elklit, A. (2020). The contributions of different types of trauma and world assumptions to predicting psychological distress. Traumatology, 26(1), 137–146. 

Online Continuing Education QUESTION 4
What are three assumptions clients may be forced to reconsider? To select and enter your answer go to CEU Test.

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