Beyond Sadness: Understanding Grief

Grief is a natural response to loss. In theory, we all understand that grief is part of the human experience, but when loss actually happens in our lives, the intensity and unique shape of our grief can still catch us off guard. Yet just because grief is part of the human experience, doesn’t mean we have to cope with it alone, or reign in how we express it. In this post, we’ll explore different kinds of loss and grief, and how to know when it’s time to seek therapy for grief.

How Grief Manifests In Different Ways (Beyond Sadness)  

To understand nuances in the way we feel grief, it’s important to remind ourselves of the importance of close relationships. Close relationships are part of our biology; we seek out close relationships for many reasons such as safety, survival, and emotional regulation. It’s important to feel cared for and it's important for us to care for others. Close relationships also influence our motivations in life, and our interests. They are an integral part of being human. So when someone close to us dies, so much for us changes without them. 

“Grief is the form love takes when someone we care about dies. Our experience of grief is our reaction to all the changes we experience during bereavement.” —The Center for Complicated Grief  

In the beginning of bereavement, it's like the world has turned upside down without this person. Losing someone close to us can lead to many changes in our lives: who we spend time with, who handles certain household tasks, who we talk to about certain things, how we envision the future.

With all of these changes in the wake of someone’s death, acute grief can look and feel like other emotions such as (but not limited to): 

• Anger

• Hurt

• Anxiety/fear

• Guilt

• Numbness 

• Hopelessness

As time goes on we start to cope, process, accept these experiences and adapt to life without this person. We don’t feel these feelings as intensely on a day-to-day basis, although the intensity may return when important grief milestones come up, like the anniversary of their death, or a big life event such as a graduation or wedding. We also might start to feel other parts of grief, such as love, gratitude, inspiration, or determination to honor their memory. 

It’s important to remember that grief is not a linear process. You can have good moments and painful moments all in the same day. You can experience this variety of grief a month after loss, a year after loss, even 10 years after the loss. There is no time limit. We typically never “get over” our loss but learn to adapt to life without them and live meaningfully. 

What is Ambiguous Loss & Grief? 

While death is the scenario most often associated with grief, there are many other kinds of loss that can lead someone to grieve. According to the Mayo Clinic, ambiguous loss or ambiguous grief is a term for the experience of profound loss and sadness when a person hasn’t experienced the death of a loved one.

Ambiguous loss can include: 

• Relationship breakups (this includes romantic partnerships but can also include friendships) 

• Infidelity

• Job layoffs or career transitions

• Miscarriages and infertility struggles

• Family estrangement

• Financial problems

• Moving to a new place

• Natural disaster

• Political unrest

• Changing belief systems

Types of ambiguous loss: 

• Leaving without a goodbye: This type of loss happens when you lose physical connection with someone but you’re not sure if they’re dead or alive, such as addiction, abandonment, or they’ve gone missing. The uncertainty, lack of closure, and inability to mourn as a family or community with a ritual such as a funeral can compound feelings of grief. 

• Goodbye without leaving: This type of loss occurs when you’re grieving a person who is physically alive but not engaged in your life as they once were due to a chronic illness like dementia or another medical issue, estrangement, incarceration, or addiction. The change in the relationship, even if the choice was yours, can be very painful. 

• Situational goodbye: Grief isn’t always the result of death or even a change in a relationship. Witnessing loss in other places, such as war, natural disaster, a shooting or violent crime in your community, or political unrest, can stir feelings of grief. Other, less life-threatening experiences are also valid reasons for feeling grief, such as job loss or financial struggles. 

Practical Strategies for Coping with Grief

Whatever kind of loss you’ve experienced, remember: there’s no right or wrong way to grieve. Focus on being present with what you need. When experiencing acute grief, try to pay extra attention to the ways you are caring for your basic needs— 

• Am I getting enough sleep? 

• Am I eating enough?

• Am I moving enough? 

Time alone can be helpful. Sometimes in our grief we want privacy. Sometimes time with others can be helpful; we need support and company in our experience. Be present with which one you may need. 

These strategies can also help you process your grief: 

• Journaling through the experience 

• Talking with others about your loss, whether it’s the death of a loved one or a more ambiguous loss. Let others in on how you’re feeling and what you’re thinking. 

• Grief counseling/therapy. Individual therapy for grief is helpful, but so is group therapy where you can connect with others who have experienced loss. 

• Find ways to continue to connect and maintain your bond to your loved one. Rituals, memorializing them, looking at pictures, talking or writing to them, creating something with them in mind—these acts are healthy ways to express and release emotions so that they’re not bottled up inside.

• Let others help you and tell them what you need. Humans do not typically grieve well alone.

When to Seek Mental Health Therapy for Grief 

Therapy can be very beneficial at any time after a loss, but you might consider starting therapy if you are experiencing persistent and intense experiences of grief for an extended period of time that significantly impacts your daily functioning. According to the American Psychiatric Association, it might be time to seek grief therapy if you’re experiencing any of the following:

• Intense longing for the deceased

• Preoccupation with thoughts or memories of the deceased

• Identity disruption, feeling as though part of oneself has died

• Disbelief about the death

• Avoidance of reminders of the deceased

• Intense emotional pain, such as anger or sorrow

• Difficulty reintegrating into daily life

• Emotional numbness

• Feeling that life is meaningless

• Intense loneliness

If you are experiencing these symptoms beyond the acute phase of grief, you may be experiencing Prolonged Grief Disorder (PGD). A therapist trained in grief counseling can help you develop tools and insight to move towards living life in a meaningful way after the loss of your loved one. 

Grief Counseling Near You

Just as grief is essential to the human experience, so is asking for help when we can’t cope alone. No matter what type of loss you’ve experienced, no matter how you feel about it, from intense to numb or ambivalent, ECC therapists are here to help you emotionally process your experience and navigate your new normal. If you need support with grieving, moving on from death, divorce, estrangement, or another type of loss, we're here to help. Book an appointment today to get started. 

About ECC: 

Empowered Connections Counseling is a practice of licensed therapists providing quality, multidisciplinary counseling for relationships, families, children & teens, and individuals in Chicago and across Illinois. Whether by in-person session or via telehealth, we work with clients to find the therapist and treatment methods that best suit their needs. Connect meaningfully with your life by booking an appointment today.

5 Tips for Healing Your Self Image

It’s summertime: season of beach days and gatherings with friends and family. With all the warm weather we’re wearing less layers to cover up the parts of our bodies we might feel self-conscious about. Maybe you’re getting ready for a big event like a wedding or reunion, but you’re feeling anxious about how you’ll look and what people will think. In this post, we’ll talk you through healing your self image, the therapy interventions that can help, and five tips for getting started. 

What is self image?

Self image is related to what you see when you look in a mirror; however, it goes much deeper than that. Self image also refers to how we see ourselves on a more holistic level, both internally and externally. Self image is also connected to your self-esteem, the way you see yourself affects the way you feel about yourself.

When to seek professional support for your self image

A certain amount of self-consciousness about our bodies is a normal part of being a human in a body around other human bodies – the human brain is wired to notice our similarities and our differences. But sometimes that self-consciousness can lead to profound negative self image, and even self-harm. 

There can be many contributing factors to negative self image, from family dynamics to school and workplace culture, to popular media. Maybe you grew up in a family culture where negative body talk was normalized, like a caregiver who made critical comments about their own body—or yours. Maybe it’s because you were bullied at school, or you witnessed other kids get bullied. The media is another common source of negative self image; many of us have been immersed in imagery of idealized body types (thin, white) from a young age. 
Whatever the reasons why you might have developed a negative self image, it’s important to know that this is something you can change and heal, with support from a therapist. If the negative self image becomes intrusive to your daily life, making it hard to function or enjoy everyday things, or if it is leading to self-harm behaviors or disordered eating, then it’s time to seek support from a therapist. 

What kind of therapy methods can help improve self image?

There are a few different therapeutic approaches that can help improve your self image: 

• Mindfulness Therapy: Mindfulness Therapy is a form of psychotherapy that helps clients to focus on the present moment. It uses techniques such as breathing methods, guided imagery, and other practices to relax the body and mind and help reduce stress.

• Art Therapy: Art therapy involves the use of creative techniques such as drawing, painting, collage, coloring, sculpting, along with others to help clients express themselves through art and recognize the psychological and emotional undertones in their art. Art therapy can help clients interpret the nonverbal messages, symbols, and metaphors often found in these art forms, which can lead them to a better understanding of their feelings and behavior.

• Cognitive-Behavioral Therapy (CBT): CBT is a form of therapy that combines cognitive therapy (focusing on helping clients identify their thoughts and how to change the way they think) with behavioral therapy, which is an approach that focuses on changing people’s behavior. 

• Strengths-Based Therapy: Strengths-based therapy focuses on a person’s internal strengths and resourcefulness to improve resilience and reshape the narratives they’ve believed about themselves.

5 tips to help improve your self image

1. Focus on recognizing your strengths and achievements. Write them down or make a collage to illustrate them.

2. Practice positive affirmations, and be consistent with it. Here’s an example affirmation to get you started: My body is my home; I will build it up, not tear it down.

3. Write a love letter to yourself in which you recognize the value you bring to yourself and others.

4. Reserve time to take care of yourself, and do the things you love, such as your favorite hobbies.

5. Try to have a mindful moment by deep breathing when you notice you are having a lot of negative thoughts about your body.

Self image therapy near you 

The way you see yourself affects the way you feel about yourself. When we need help seeing ourselves more clearly so that we can honor and love ourselves, a therapist can help. At ECC, we work with patients of all backgrounds and walks of life to heal their self image. Our diverse group of licensed therapists offer a multidisciplinary approach, combining mindfulness, art, and CBT practices to meet clients’ needs. If you’re struggling with your self-image, we’ll connect you with the right therapist and therapy method to help you thrive. 

About ECC: 

Empowered Connections Counseling is a practice of licensed therapists providing quality, multidisciplinary counseling for adults, children & teens, relationships, and families in Chicago and across Illinois. Whether by in-person session or via telehealth, we work with clients to find the therapist and treatment methods that best suit their needs. Connect meaningfully with your life by booking an appointment today.

Coming Out to as Queer to Your Straight Partner

While many LGBTQIA+ Americans living today realized their orientation and came out of the closet when they were teenagers, there are many adults who experience this at an older age and have the challenge of coming out to a romantic partner. It can be emotionally fraught to not only face the reality that your orientation is different than you originally believed, but to admit this to your partner. There is so much to consider – will they be supportive? Will this fundamentally change the nature of your relationship? If you’re anxious or unsure about how to come out as queer to your straight partner, we offer some guidance in this post to help you prepare for the conversation. 

Start with Self-Reflection 

Before you ever come out to anyone else, it’s helpful to take time to be curious about yourself and your own exploration. You definitely don’t need to have all of the answers, but having a sense of how you identify, your emotions surrounding the exploration of this part of yourself, or even your own questions that may still be unanswered, can help you feel capable of talking it through with your partner. 

Borrow From a Few Therapy Methods

There are a few therapy methods that can help you self-reflect and emotionally prepare to come out to your partner, as well as other people you trust.

• Narrative Exploration: Think about the narratives that have impacted your relationship to self, gender identity, and sexual orientation. What narratives have made it difficult to know or acknowledge this part of yourself? What narratives are you holding onto about queerness that don’t fit with your values, and how do you want to reauthor these narratives? While this is a story that may still be unfolding, this kind of curious exploration can allow you to better understand and better communicate to your partner some of the complexities that go hand-in-hand with coming out as an adult or as someone in a straight- or cisgender-presenting relationship.

• Write It Out: Feeling overwhelmed and afraid you won’t touch on important parts of your narrative? There is nothing wrong with having a list of things you want to address when coming out to your partner. Being able to refer to a written list of thoughts can help you stay calm and confident if you start to feel overwhelmed.

• Grounding: It’s normal to be nervous and maybe even afraid, but coming out to your partner is an important conversation to be present in. Think about what you can do to ground yourself and stay in the moment. Hold a warm cup of tea or a cold glass of water; light a candle with a soothing fragrance; have your favorite Squishmallow at the ready.

• Take Space: Even if the conversation is going well, coming out can be very emotionally overwhelming for a lot of reasons. Pay attention to what your body is telling you and allow you and your partner to take a break and come back if you need it. 

Prepare for the Conversation

Despite how long or how well you know each other, it’s hard to know how your partner might react when you come out to them, so plan to have the conversation in a private, comfortable space. 

Prioritize your safety – emotional, psychological, and physical. It’s okay to take space or disengage from the conversation if your partner isn’t responding supportively. 
Ask trusted friends or family to be on standby. Maybe you’re sure your partner will celebrate you, or the conversation will go better than you expected; maybe you’ll be surprised, or overwhelmed, or unsure of your partner’s reaction – either way, having a support system can be incredibly important and validating. 

Come into the conversation with honesty and intention: what do you want the relationship to look like after you’ve come out? Be clear about your feelings and thoughts.

Give It Time

Coming out can be emotional for a multitude of reasons. While a partner’s response of anger, frustration, shock, confusion, or grief may feel hurtful to you or not be the response you were hoping for, hold space for their feelings. Coming out can be a big shift, and just like you likely needed time to process what this means for you, your partner likely needs space to do the same. That being said, if you begin to feel unsafe or at risk, end the conversation and prioritize your safety. 

Find a Queer-Friendly Therapist Near You

Wherever you’re at on your journey of coming out and accepting your queerness, you deserve support. Our sexual and gender identities can have a unique impact on our mental health – from how safe we feel to express our full selves, to facing discrimination, to coming out to loved ones and peers. ECC therapists are here to help you navigate the challenges and the joy, and find the path to being your authentic self. Our diverse, multidisciplinary team supports individuals, relationships, and families of all backgrounds and identities. We’ll help you find the therapist and therapy methods to help you thrive. Reach out today to book a session. 

About ECC: 

Empowered Connections Counseling is a practice of licensed therapists providing quality, multidisciplinary counseling for adults, children & teens, relationships, and families in Chicago and across Illinois. Whether by in-person session or via telehealth, we work with clients to find the therapist and treatment methods that best suit their needs. Connect meaningfully with your life by booking an appointment today.

Collaboration, Connection, and Community: Q&A with ECC Therapist Peter Beer

Not all therapists start out knowing they want to be therapists. Some, like ECC Affiliate Therapist Peter Beer, start out in an entirely different field and realize that human relationships are what they want to dedicate their careers to. In his Q&A for our blog today, Peter shares about what led him to therapy and the approaches he finds beneficial in working with clients. And with June being Men’s Mental Health Month, he shares about the most common issue he sees among young men seeking therapy for the first time—loneliness—and how he coaches them through it.

Peter Beer, MA, AMFT

Affiliate Therapist

What inspired you to become a therapist? 

So many reasons! I actually took a roundabout way to this field—my undergrad was in Industrial Engineering. Although I enjoyed a lot about being in STEM, I found myself wanting more relational pieces to my daily work. I also wanted to feel more directly involved in helping others, particularly in my local communities, and have a career that allowed me to incorporate social justice into my work. Finally, I knew from personal experience how powerfully healing therapy could be, and I wanted to try and impart that to others!

If there’s one thing you could say to a person thinking about starting therapy for the first time, what would it be?

It can be daunting to jump into therapy for the first time—and even more daunting to choose a first therapist! But the biggest thing to remember is that you, as a client, have agency in deciding what that therapy experience should look like and feel like. Have a conversation with your therapist about what you’re looking for so that you can get a feel for how you want sessions to go (and if that’s difficult to articulate for now, no worries, that’s what the therapist is there to help put specifics to!)

In your bio, you say that you draw from a few different therapy approaches: Solution-Focused therapy, Collaborative Language Systems, and Symbolic-Experiential therapy. Can you talk more about what those are and why you find them helpful as a therapist? What kind of benefits do you see for your clients (or hope to see for your clients) through them? 

I see solution-focused and collaborative approaches in similar ways, because they both highlight the client’s own strengths and abilities to facilitate change. I believe everyone has the capacity to heal, and my job is simply to help them unlock that capacity. To me, Solution-Focused Therapy is all about helping clients find the language to describe where they want to “go.” Collaborative Language Systems is about empowering a client to take the lead on directing a session. Both approaches center around the concept that nobody knows better than yourself what feels helpful. I also believe both approaches are inherently trauma-informed as they allow clients to set their own pace in sessions.

Symbolic-Experiential Therapy, to me, is more about how I believe change occurs. In this approach, therapy invites emotional experience into the room so that clients can feel something different during the session. I believe that in order to be different, oftentimes we have to feel different first! That’s what I aim to do in a safe and secure way.

June is Men’s Mental Health Month. Stats show that 16% of American men are in mental health therapy, vs 25% of women. When you talk to men and boys who are seeking therapy for the first time, what comes up? What kinds of experiences make them decide to choose therapy? How do you coach them through overcoming the stigma around seeking help? 

Most of my experience currently is with teens and families, so I might be able to speak to this from an adolescent perspective best. I see a lot of boys—especially in high school—struggling to find community. Many boys aren’t encouraged or taught how to form close, supportive emotional connections with friends. And so attempts to find a sense of belonging can end up being unsuccessful or even damaging to themselves and/or others. Sometimes those attempts to find belonging don’t occur at all. I’ve gotten many teenage referrals who are simply needing generative human connection. For these clients, I aim to meet them where they’re at, and I use my own therapeutic relationship with them as a way to explore what safe, validating interactions can look like.

What are you reading / watching / listening to right now?

I’m currently on a Brandon Sanderson kick! So I just finished Elantris, and I’m on the second Mistborn book. I’ve really liked fantasy recently as a way to access some playful imagination. The other book I’m in the middle of is Warrior Girl Unearthed—young adult books can just be so sweet and enchanting, so I’m hoping this one pans out that way! I’m also an avid bridge player, so my current e-content is full of bridge educational videos and series (Peter Hollands and Gavin Wolpert are my favorites!)

Applying Harm Reduction in Mental Health Therapy

We utilize the principle of harm reduction in our everyday lives without really thinking about it: recycling, driving with a seat belt, donning protective gear to use power tools, putting on a helmet to ride a bike, or using bandaids or heel guards when wearing new shoes. While these actions don’t completely prevent the possibility of something like a car or bike accident, they reduce the likelihood of life-threatening consequences. In a therapy setting, harm reduction is a useful–and proven–approach to treating people who engage in higher risk behaviors. In this post, we explore how and why harm reduction is improving mental health outcomes. 

What is Harm Reduction? 

Harm reduction is an evidence-based therapeutic approach that focuses on reducing harm associated with risky behaviors. Its roots began in communities centered around sex work and substance abuse: in the 1980s as the AIDS epidemic grew alongside heroine and crack cocaine addictions, harm reduction became a useful approach for preventing blood-borne infections and treating substance use disorders. But research has shown that harm reduction can be applied anywhere that behavioral harm or risk can occur, i.e., self harm, eating disorders, relational dynamics, maladaptive coping skills, and more. 

Harm reduction aims to reduce negative effects of a behavior without stopping the behavior completely or even at all, particularly if stopping that behavior would increase an individual’s distress or create unrealistic expectations that they cannot meet given their current mental health condition. Harm reduction theorizes that pressuring individuals to stop certain behaviors can actually escalate feelings of distress, lead to more of the unwanted behavior, and fuel cycles of guilt and shame.

Critics of the movement have vocalized concern since its inception, saying that harm reduction enables and encourages drug use and other risky behaviors, rather than stopping them. However, its practical applications, such as overdose education and naloxone delivery, have proven highly effective in reducing death rates among substance users, and it is emerging as an effective strategy for other mental health conditions such as self-harm.

Harm reduction also recognizes and prioritizes bodily autonomy, choice, sustainability, and safety by centering individual and community needs, as well as working to minimize the harmful effects of risky behaviors instead of simply ignoring or condemning them. 

“Harm reduction holds that society has a responsibility to care for all people, no matter their choices, behaviors, or desires. It views individuals as the sole authority on what happens to their own bodies — and it acknowledges that trying to force an outcome or behavior change on a person who doesn’t want it is not only destined to fail, it’s a violation of their consent and dignity.” – Devon Price, Ph.D., Psychology Today

Because harm reduction centers the person, their needs, and their goals, it is inherently trauma-informed, person-centered, and culturally competent when utilized appropriately.

How Is Harm Reduction Applied in Mental Health Therapy? 

In applying a harm reduction approach to mental health treatment, the therapist aims to meet the client where they're at, and without judgment. This means they will take several things into consideration: 

• The individual's goals: The therapist will not assume that full recovery from a mental health condition such as self-harm, substance use, or an eating disorder is possible or even the client’s own personal goal.

• The complexity of recovery: The therapist also acknowledges that recovery from certain mental health conditions is not linear and that relapses happen for a variety of reasons.

• Unintended consequences: The therapist is aware that abstaining from a certain behavior such as self-harm or disordered eating can have negative consequences that can trigger distress or lead an individual to engage in other unwanted or unsafe behaviors.

• Collaboration: The therapist will prioritize creating a collaborative environment and work with the client to build a treatment plan tailored to their needs and centering their goals.

In harm reduction-based therapy, the goal of treatment is not to stop the individual's behavior but to get curious about what needs those behaviors are meeting for the individual, help them work through those ideas and feelings, and find less harmful ways to live. 

Some practical examples of harm reduction strategies look like: 

• Self-harm: Snapping a rubber band against the wrist whenever the urge to harm becomes overwhelming; learning about proper wound care and safe anatomical positioning.

• Eating disorders: Purging once daily instead of three times daily; opting to eat something small, like an apple, instead of nothing; decrease excessive exercise by 10 minute intervals. 

• High-Risk Sexual Behavior: Get tested regularly; use a condom; use a safeword; use pre-exposure prophylaxis (PrEP).

• Unhealthy Relationship Dynamics: Instead of a cut off, begin to institute small boundaries or limit communication.

• Addiction: Decreasing the amount of a substance consumed but not abstaining; nicotine patches or gum; using syringe exchange programs or safe consumption sites.

What Are The Benefits of Harm Reduction in Mental Health Therapy? 

There are several benefits to harm reduction-based therapy: 

• It reduces stigma of the risky behavior between the therapist and individual, making it more likely for the individual to continue care, because they know they can receive nonjudgmental support, even if they’ve relapsed.

• It makes change more accessible by meeting individuals where they’re at and identifying what is desired or achievable at any given time instead of setting expectations (self, social, familial, cultural) that can’t be met, which can often lead to cycles of shame, disappointment, self deprecation, self hatred, etc. 

• Positive change vs. coerced change: harm reduction also seeks to transform the individual’s relationship to change itself by facilitating positive, self-led change, rather than coercing them into conforming to outside pressure.

• It can help rebuild the individual’s connection to self and open the door to identifying needs by requiring intentionality when engaging with behaviors. 

Finding Harm Reduction Support Near You 

Harm reduction is all about ending the cycles of shame and fear tied to our riskiest impulses and maladaptive coping mechanisms. When you have a nonjudgmental therapist who is committed to your safety and autonomy, you can feel safe enough to get curious about what needs those behaviors are meeting in your life, and begin to forge your own path toward healing. If you're seeking harm reduction support, reach out to us today. We’ll connect you with the therapist and therapeutic approach to help you thrive.

About ECC: 

Empowered Connections Counseling is a practice of licensed therapists providing quality, multidisciplinary counseling for adults, children & teens, relationships, and families in Chicago and across Illinois. Whether by in-person session or via telehealth, we work with clients to find the therapist and treatment methods that best suit their needs. Connect meaningfully with your life by booking an appointment today.