Interview with Laura Palomares: the duel seen by a psychologist

The kind of sadness, longing, and even despair we feel when we lose something or someone we felt close to has a name in the field of psychology: grief.

In fact, Grief is one of the most painful psychological processes that exist, and sometimes it can make us unable to enjoy life. Of course, psychological assistance through therapy with psychologists can help us overcome this discomfort and accept that there are certain moments that will not return and that this is natural.

Precisely this experience acquired in psychotherapy gives psychologists a unique perspective on what grief is and how we can manage it emotionally. For this reason, on this occasion we interviewed a specialist in the field: Laura Palomares, from Avance Psicólogos, who works in grief therapy.

Laura Palomares: the point of view of an expert in grief

We spoke with Laura Palomares Pérez, an expert psychologist in grief and emotional ties and Director of the Madrid Psychology Center Advance Psychologists, so that he can talk to us about grief, both in terms of the pain it causes and in terms of how psychotherapy works to overcome it.

Normally it is understood that mourning is something that arises when losing someone loved, due to a breakup or death. However, there are other causes, right? What defines mourning?

Grief is a state of recovery and readaptation after a loss. For this reason we should not consider mourning a disease, but rather a normal rebalancing process with different phases, which will help us gradually recover normality.

The loss can be due to the breakdown of a relationship or the death of a loved one, but it can actually be due to the loss of a job, a house, a drastic change in life, the loss of a pet, the amputation of a limb, etc

The grieving process will be different depending on how important the loss is to us, be it a loved one or an event that causes a life change.

Grief is to some extent a normal psychological phenomenon when it appears after losing someone or something that was important to us. From what point is it understood that it is a reason to attend psychotherapy?

The grieving process involves a series of phases that it is important to respect. We say that a duel is pathological or unresolved, when there is a blockage in any of them.

If we have settled in sadness or anger, we do not find meaning in our lives, we do not finish believing what happened or we recreate the loss with the same emotional intensity that when it happened, if we notice that since then new fears such as death or disease, phobias, anxiety or panic attacks, etc. have appeared, that is the reason to attend psychotherapy.

Sleep or eating disorders, obsessive or catastrophic thoughts or compulsive behaviors are other signs that must be attended to.

Behaviors such as keeping all personal belongings as the loved one left them, talking about him in the present tense, or not talking about him at all also denote that there is unresolved grief.

What are the foundations of psychological therapy applied to grief suffering?

Psychological therapy is based on the knowledge that expressing emotions of anguish and pain without fear of judgment is decisive for overcoming grief.

At Avance Psicólogos we work from different currents of psychology, taking advantage of each of its techniques. In this way, humanistic psychology manages to delve into the emotional and make it emerge, with different techniques such as role playing, the empty chair, the evocation of memories through photographs and objects, etc

It is about delving into feelings and favoring the resolution of ambivalent emotions, guilt, anger, unresolved situations, etc., with the aim of preparing for the farewell, which does not mean forgetting the loved one or the object of mourning, but rather finding a new place for them in our imagination emotional.

On the other hand, cognitive behavioral psychology helps to restructure the new level of thought and behavior. situation before the loss, favoring the application of resources to gradually assume and face the new reality before the loss.

The application of Third Generation Therapies, especially the Acceptance and Commitment Therapy, focuses on the acceptance of the loss without forgetting the context and values ​​of the person, essential for mourning to flow naturally and according to the individual differences and specific needs of each person.

Based on your experience at Avance Psicólogos, what are the strategies that a therapist should follow to adapt to this reason for consultation by a patient?

The deep respect for the pain of the person who comes to the consultation, from an attitude of accompaniment absolute and unconditional, is fundamental in the way of being and feeling the relationship with the patient of the therapist. Without this there is no therapy. The therapeutic relationship should feel like an extremely safe space, in which there is no room for judgment or haste.

From there, the therapist focuses his attention on supporting and accompanying to facilitate the acceptance and recognition of the loss, to express emotions and feelings. that come from it, to face in a practical way the new vital situation and reality before the loss and finally, to accompany the farewell with a new sense of life.

How do you recover and return to normality? How long does it usually take to overcome grief?

Recovery occurs with the closing and overcoming of each of its phases, respecting the times of each person and making sure that they are resolved.

The phases of mourning are denial, that is, not accepting or assuming the lack of the loved one that usually occurs at the beginning, at the moment of shock; the phase of anger, which consists of feelings of rage and anger often against the world, with the need to find guilty, sometimes also anger against oneself, and even the anger buried with the person who has been lost, feeling "abandoned" by she; the phase of sadness, which is accompanied by feelings of loss of meaning in life but which begins to be a preparation for the farewell and to reach the last phase of acceptance, with which the end is finally reached. quiet.

These phases do not always occur in order and tend to be mixed, and they occur naturally until they are resolved if they are respected and worked on properly during therapy. The acceptance phase comes from allowing yourself the previous ones, especially pain and sadness, although very often the person who is grieving feels forced to recover by those who surround. Expressions like “you have to be strong”, “you should be better now”, only hinder the grieving process and increase the anguish.

Regarding the time of the grieving process, it usually depends fundamentally on the level of depth and intensity of the bond, individual personality traits, the support of the environment that the person etc Establishing an approximate time is not easy. It is also important to take into account that, if the loss is sudden, the duel takes longer and runs a greater risk of becoming chronic.

To finish… could you explain to us in detail a case of a bereavement patient whose recovery makes you feel especially satisfied?

I can think of several, of which I keep pleasant memories and a special affection, but I will tell you about two.

Once, R., a 28-year-old woman, amusing and vital, but who complained of months of anxiety and severe back pain that had no physical cause, came to the clinic. When delving deeper during the first evaluation sessions, R and I recognized the deep pain that she still felt due to the death of her father, which had happened 8 years ago, suddenly due to a heart attack. Her emotion when talking about it was as if it had just happened, and her crying was desperate.

At the moment in which we began to work on her grief, also attending to the avoidances that since then had been occurring in her environment, her physical symptoms they disappeared, she stopped suffering from back pain, the anxiety subsided and the best thing is that the relationship with her mother and her partner improved significantly.

I remember a recent case, that of A., a 36-year-old man who is practically discharged and only attends follow-up sessions every two months at the present time. Our attention was drawn to A. and to me that she again felt intense anxiety, with serious difficulties sleeping and deep sadness. She told me about the tremendous frustration she felt at having to sell her beach house.

That house was a refuge for him, it meant much more than material property; for to. that house symbolized a safe place, which gave him rest and the possibility of recovering of the fatigue to which he was subjected throughout the rest of the year, due to the intensity of his job.

Once we understood that he was in full mourning, we were able to work on it and even formalize a farewell to the place, the house, the neighborhood, etc., with the purpose of finding an alternative way to spend the holidays and disconnect, in the same city where he so liked to enjoy his vacation.

Grief moments, especially when they are due to the loss of a loved one, are the hardest and most difficult in a person's life. But we also know that if they are channeled naturally towards their improvement, they are moments of profound transformation that entail many positive aspects. The person becomes more aware of enjoying the present, develops resilience, learns to relativize and even loses fear.