On the last track, we discussed the physiology of grief as
it relates to clients suffering from post-traumatic stress syndrome. I
have found that there are three major physiological aspects
of grief. They are the mind-body connection, acute
stress reactions, and emotional triggers.
On this track, we will discuss Mind Sets of Grief. In
my practice, I have found that there are three basic mind
sets of grief. They are absolutist thinking, intolerance of mistakes, and denial of personal difficulties. As
I describe these three mind sets of grief, you
may want to use this track as a checklist for clients you
may be treating.
Three Basic Mind
Sets of Grief
#1 Absolutist Thinking
Tony, age 33, experienced absolutist thinking. Tony’s absolutist
thinking led him to believe that the people in his life were either for him
or against him. Tony,
grieved the loss of his son Robert, age 6, in a boating accident. Tony
and Robert were fishing when Robert fell overboard and drowned. Tony
stated, "Ever since Robert drowned, everyone I know has taken a side. People
either think it was a total accident or they think it was my fault. It
has to be all or nothing. There is no in-between."
absolutist thinking applied to others. To find out if he applied absolutist
thinking to himself, I asked Tony if he put his feelings into extreme
categories and assessed them according to extreme standards. Tony stated, "Yeah. I’m
a total failure, if that’s what you mean. My son died and I was
just six feet away the whole time." Would you agree that Tony had
applied absolutist thinking to himself as
well as others.
I stated to Tony, "Judging yourself with the same "all
or nothing" attitude will prevent you from making allowances for partial
success or failure. Absolutist thinking is sometimes a characteristic
of grieving clients, but is it possible for you to feel you can make mistakes
and still have some successes." Are you treating a client like
Tony who has applied absolutist thinking to himself as well
as others regarding the events surrounding his or her loss?
#2 Intolerance of Mistakes
Robert’s drowning death had also reinforced Tony’s intolerance
of mistakes. Tony stated, "I did everything right until
I let him stand up. We were both wearing life jackets. But he kept
asking if he could stand up. I told him no several times. But then we
stopped to fish and after I anchored the boat, Robert asked to stand up again
and I let him. It was no problem. The kid had good balance. But
then we were motoring back across the lake and he stood up to get a better
view and went over. Now I know how the tiniest error can result in death."
believed he had made a mistake that caused the needless death of his son, Robert. As
a result, Tony had increased his feeling of intolerance for mistakes. Tony
stated, "Sometimes even harmless mistakes make me relive Robert’s
death. Last week my wife, Jenny, accidentally put salt in her coffee. I
got so depressed and started crying. I know Jenny is getting really sick of
my inability to cope."
3-Step "Internal Shouting" Technique
To help Tony overcome his intolerance of mistakes, I tried
a simple technique called the "Internal Shouting" technique. Evaluate
the "Internal Shouting" technique to decide if
a client you are treating could benefit.
a. To begin the "Internal Shouting" technique, I first asked
Tony to choose a short phrase he could use to respond to himself
when he noticed his mounting feeling of intolerance. I offered Tony examples
like "Stop it!" or "That’s enough!" I
suggested that the phrase might be one that helps him to feel angry.
b. Second, I explained to Tony that any time he felt intolerant,
he should shout the phrase internally. I stated, "Mentally
shout at yourself and try to drown out your intolerance."
c. In addition to choosing a short phrase and shouting
internally, the third step I explained to Tony was
that he might reward himself if he successfully avoids intolerance
after using his phrase. Tony chose a watching a little more sports on
TV as his reward. As you know, the reward was positive reinforcement
so that Tony became less likely to continue his intolerance. I explained
this to Tony and stated, "The important thing is to catch yourself just
as you start, in order to avoid intolerance of mistakes." Would
Internal Shouting work for your Tony?
#3 Denial of Personal Difficulties
In addition to absolutist thinking and intolerance
of mistakes, the third mind set of grief I have identified
in my practice is the denial of personal difficulties. For
example, Leo, age 72, grieved the loss of his wife, Doris. The couple
had been married for 51 years. Leo stated, "In the last few years,
I really had to start counting on Doris. Lots of things get real hard
when you get old like me with arthritis and poor eye site." Leo
depended on Doris to help him with personal difficulties such
as reading, getting dressed, and walking up and down stairs. Leo denied
his personal difficulties to his family.
Leo stated, "I’m
the man in the family, so I can’t be seen as weak or incompetent." Would
you agree Leo could have benefited from sharing his personal difficulties with
a family member? I stated to Leo, "How would Doris have wanted
your problems handled?" Leo explained "I know Doris
would have wanted me to get help. I guess I better tell my daughter. She’ll
know what to do." Have you had experience treating a client like
Leo who is denying his or her personal difficulties resulting
from a loss in order to appear competent and strong?
On this track we have discussed three basic mind sets of
grief. They are absolutist thinking, intolerance
of mistakes, and denial of personal difficulties.
On the next track we will discuss The Positive Side of Grief. I have found
three positive sides of grief. They are the appreciation of life, strengthening
of family ties, and finding meaning in suffering.
Peer-Reviewed Journal Article References:
Barlé, N., Wortman, C. B., & Latack, J. A. (2017). Traumatic bereavement: Basic research and clinical implications. Journal of Psychotherapy Integration, 27(2), 127–139.
Diminich, E. D., & Bonanno, G. A. (2014). Faces, feelings, words: Divergence across channels of emotional responding in complicated grief. Journal of Abnormal Psychology, 123(2), 350–361.
Katz, A. C., Norr, A. M., Buck, B., Fantelli, E., Edwards-Stewart, A., Koenen-Woods, P., Zetocha, K., Smolenski, D. J., Holloway, K., Rothbaum, B. O., Difede, J., Rizzo, A., Skopp, N., Mishkind, M., Gahm, G., Reger, G. M., & Andrasik, F. (2020). Changes in physiological reactivity in response to the trauma memory during prolonged exposure and virtual reality exposure therapy for posttraumatic stress disorder. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication.
Ruscher, J. B. (2011). Moving forward: The effect of spatiotemporal metaphors on perceptions about grief. Social Psychology, 42(3), 225–230.
Online Continuing Education QUESTION
What are the three basic mind sets of grief?
To select and enter your answer go to .