Sometimes, it really does take one to know one. Not every counselor can work well with every patient. It is hard to understand how people can presume to know bereavement and grief when they have lost no one of significance in their lives. Surely everyone has experienced loss at some time. However, the death of a tame woods animal is usually, qualitatively, very different from the death of one’s parent or sibling or spouse or child.
Conventional wisdom in the mental health fields holds that personal experience with a patient’s issues will interfere with required objectivity in the treatment of the patient. It is said that a subjective view will produce fractured treatment, unwieldy counter-transference issues, and unhealthy end results. This is not always so. Personal experience with bereavement, and good restorative grief work, can lead to excellent therapeutic alliances and impressive outcomes for patients.
Objectivity is not necessarily the highest goal for which the grief counselor must strive. Certainly the highest goal is the formation of a therapeutic partnership with the patient. Rapport matters. The partnering involves trust. It involves a feeling of acceptance. It involves the patient’s belief that the therapist values the patient, understands the problems, and has the patient’s best interest at heart. The therapist shows respect for the worth and dignity of the patient by active listening. Psychotherapy is the purchase of friendship, as one psychologist pointed out. It is often a one-way friendship in which only the patient’s life is discussed in detail. The therapist freely adds vignettes from his own life, in relation to clarifying a patient situation or comments. While objectivity may be important in some form, it is not the most primary goal in effective counseling.
Furthermore, there is no such thing as complete objectivity in interpersonal relations. The word objectivity can be defined this way: existing independently of perception or an individual’s conceptions; uninfluenced by emotions or personal prejudices. Freudian psychoanalysis is considered to be the prototype of objectivity in psychotherapy. Even there, no strict objectivity exists, nor did it exist in Freud’s life and time. His patients came to his home, the location of his offices. They had lunch with his wife and played with his children. Many of his patients were also his professional followers and colleagues. Objectivity is virtually impossible under such circumstances. Objectivity did not exist in this case. All of us are influenced by our emotions and perceptions. That is the nature of the human condition. It is true for the patient and it is true for the counselor. We are only human. We are also compassionately human.
The concept of objectivity in grief counseling should be revised. Bereavement and grief are inherently non-objective. Death and dying evoke some of our strongest, deepest feelings. No one gets rid of those feelings. The subject of death and dying affects all of us. Eventually, everyone suffers significant losses. Eventually, every one of us will die. Our work in this field is heavily influenced by our emotions and personal perceptions. This is well known and carefully documented. The only remaining question is the weight of any of our uncontrolled, poorly managed emotions and perceptions in the treatment of our patients. If we are continuously introspective and insightful, accepting of our woundedness, and able to exercise thoughtful control over our emotions, that is the most we can ask. Self-awareness is vital. That is sufficiently objective. It is good enough for outstanding grief counseling to be accomplished. That is the purpose of our work.
Psychologist Stephen Diamond writes: “One of the advantages of being a psychotherapist is that we get to focus sometimes on the suffering of others rather than our own. And we can find meaning and fulfillment in supportively helping others survive suffering. But note that it is the woundedness itself — and not necessarily the fully healed psyche of the psychotherapist – that deepens and intensifies the wounded healer’s compassionate healing power. Indeed, I would say it is partially the psychotherapist’s personal acceptance of his or her own (and life’s existential) suffering and imperfection that enhances the capacity to heal others.” Psychologist Carl Jung created the term wounded healer and remains one of its primary examples. This is creative suffering.
The wounded healer is sometimes the best choice of therapist. This is a fundamental principle of Alcoholics Anonymous and many other self-help groups. It is also true of many special situations; e.g., child death and Holocaust survivorship. Those who have been through the trouble are frequently best suited to earn the patient’s trust and confidence and lead the way to healing. Prepared to lead through some of the difficult grief work. They are at least a few steps ahead of the patient and able to guide the pathways forward. Bereaved patients are strongly inclined to greater trust of those who have had – and survived – experiences similar to their own. The patient need not waste time in lengthy testing of the knowledge, sensitivity, and genuine caring of the counselor. Death should not be a stranger to the grief counselor. Therapeutic benefits will often be much quicker, healthier, and more durable if the grief counselor himself is a wounded healer.
Rea L. Ginsberg is a retired social worker and hospice coordinator.