Moving beyond the stages of grief
As a culture, we seem to be very familiar with the stages of grief: denial, anger, bargaining, depression, and acceptance. What we are less familiar with is the tasks of grief, or how to process our grief and move forward after a loss.
Grief is an active process – it requires us to work in order to move forward
We hear that “time heals” and “you need to grieve” but no one tells how to go about grieving except to cry. How do you begin to really move on? Grief requires that we actively engage with our pain, which is why a lot of people get stuck in their grief and find it difficult to truly move forward. In this week’s video, we talk about the tasks of grief which is the work of J. William Worden, PhD, ABPP, author of Grief Counseling and Grief Therapy: A Handbook for the Mental Health Practitioner, now in its fourth edition.
Caregivers may find it most difficult to move forward after loss
In my professional experience, those who have been caregivers for a family member find it most difficult to “reinvest in the new reality” which is one of the tasks of grief. So much of a person’s life is put on hold when caring for someone who has a chronic illness that moving forward is especially difficult because it can be difficult to remember what you used to spend your time doing before your ill loved one became the center of your life.
The tasks of grief help you begin to truly move forward
By participating in the active process of grieving you will be able to move on and begin your life again, even if the loss is unwelcome.
Grief is more than just death
Don’t forget that we grieve many losses, not just death! The loss of a marriage through divorce, the breakup of a relationship, a friend moving away, a child growing up and beginning their life, the loss of a job, retirement, all of these things can be accompanied by a natural feeling of grief.
I was reading a recent and very disturbing article on PsychCentral this morning, entitled: “What’s In A Name? It May Determine If You Can Get Therapy” by Janice Wood. I was already familiar with the 2003 study that found those with black-sounding names were less likely to receive call-backs for job interviews than those with white-sounding names but I never dreamed that might be a factor in receiving mental health services! A very small scale (but still disheartening) study by the University of Vermont published in The Counseling Psychologist found that while callback rates for black-sounding and white-sounding names were the same, clinicians were more likely to tell those with black-sounding names that their case loads were full and that they would not be able to see them. They found “Allison” was invited to speak to the therapist 12% more often than “Lakisha.”
Institutional racism is the: “…societal patterns that have the net effect of imposing oppressive or otherwise negative conditions against identifiable groups on the basis of race or ethnicity.” –Tom Head*, CivilLiberties. About.com. Rather than the individual prejudice of one person, or in this case one clinician, institutional racism has to do with the prevailing ideas a society has about a race or ethnicity that lead to widespread negative ideas that can be so insidious we do not recognize them. I doubt that any one clinician says to themselves: “I won’t call Lakisha back.” or “I don’t want a black client” but they may have preconceived notions about the class of a potential client based on race. For example, they may assume that “Lakisha” has Medicaid or less attractive insurance that perhaps has a lower reimbursement rate than “Allison.” The may assume that “Lakisha” works a menial job with less flexibility to have daytime appointments that “Allison” might. While they might not realize that these stereotypes and assumptions are racist – they are. In fact, NAMI the National Alliance on Mental Illness reports that African American males “are more likely to receive a misdiagnosis of schizophrenia when expressing symptoms related to mood disorders or PTSD.” In fact, African Americans as a whole are overdiagnosed with Schnizophrenia according to William B. Lawson, MD, PhD, professor and chair of psychiatry at Howard University College of Medicine in Washington, DC. 
It is troubling that in 2016 that an individual in need of mental health services might suffer for their race. It is especially upsetting when you take into consideration that “according to the Health and Human Services Office of Minority Health, African Americans are 20% more likely to experience serious mental health problems than the general population.”  It is important, as professionals, that we strive to give the same quality of care to all those who seek our services. It is equally important for people of color who are seeking mental health services to advocate for themselves as they seek treatment for themselves. Learn more about self advocacy at NAMI.org. For more on Racial Disparities in Mental Health Treatment visit SocialWork at Simmons’ blog
* You will have to forgive me using an old friend as the source of my material, he also happens to be one of the most-read authors on civil liberties on the internet!