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Helping Grieving People: When Tears Are Not Enough: A Handbook for Care Providers

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This book could easily be called a bible given the depth, breadth and soulfulness of its content. Dr. Jeffreys speaks of the need for the care provider to communicate from the head, hand and heart, and he does just that in this book. It is rare to find a text so full of relevant information, well organized, well presented, and at the same time nurturing the heart of the reader. This makes for an amazing experience. The care provider leaves this book with heightened empathy, with increased love of self and of fellow man, what a unique gift! I have been in practice over 25 years as a psychologist with a specialty in grief, loss, and trauma. I trained with the senior staff of Elizabeth Kubler Ross, MD and I find Dr. Jeffrey's book to be the most comprehensive writing I have ever encountered on this topic. I highly recommend it for everyone, the professional, the friend or family member and each individual, for we are all grieving people at some time , arn't we?

This book is a gift to clinicians and lay people alike. As a counselor working with grieving families for fourteen years, it immediately gave me fresh insight and hands-on tools for working with the complexities of those who are grieving. Each situation for a respective client is unique. This book helped me to think outside the box, and to bring even greater depth to the healing process.

I also believe this book would be directly helpful to those who are personally grieving. It addresses one of the questions that my clients most often bring to sessions: "Is what I am experiencing normal?" This book is laid out in a highly readable and organized fashion. I have a full library of books on the subject, and this is the best one I have seen thus far.

Dr. Jeffreys has written a highly readable, comprehensive book on grief. Not only does he cover grief from an academic viewpoint, he teaches us, the readers, how to "celebrate the dignity and authority of the grieving person" as an "exquisite witness." Helping Grieving People: When tears are not enough helps us to understand that all change contains loss and grief. This book contains personal stories and practical, easy to follow directions for coping with grief and/or helping another. Jeffreys teaches us how to integrate thinking, feeling, and doing. He makes distinctions between the usual (or expected grief process) and complicated grief. He includes exercises and case studies to clarify the material. The book is appropriate for grief counselors and lay people alike. Highly recommended.

J. Shep Jeffreys writes from the depths of his personal experience of losing a child, but he also writes from the expertise of having worked as a psychotherapist with families who facing what he and his family have lived with.

Be prepared for what he calls "Cowbells" i.e. to re-experience your own losses as you read this book.

Be prepared for a wake up call to rise the highest standards of sensitivity and integrity in your work with people who are bereaved or who are facing death.

I purchased Helping People Grieve as a required text for a class in Loss and Bereavement that was taught by its author. It is a rich volume packed with practical as well as theoretical information. Shep Jeffreys left no stone unturned as he provided valuable information, tips and techniques for care providers. This book might have evolved from his own loss, however it is written in a way that his readers can relate and assimilate into their own situations. I would recommend this book to everyone. It provides information for care providers, however it is also beneficial even if the reader is not actively providing care or actively grieving. Some time in our lives we will encounter grieving people and this book prepares us for those moments.

As a result of my own experience of bereavement, I started reading works by other people about their own personal experiences of bereavement such as Joan Didion's book THE YEAR OF MAGICAL THINKING (2006). In addition, I started reading works in the professional literature about loss and mourning, including Freud's famous essay "Mourning and Melancholia" (1917).

Then I recently read the second edition of J. Shep Jeffreys' book HELPING GRIEVING PEOPLE - WHEN TEARS ARE NOT ENOUGH: A HANDBOOK FOR CARE PROVIDERS (2011). In my case I am not trying to be a care provider for anybody else but myself.

Jeffreys ably covers certain works in the professional literature that I had read as well as other works that I had not read. In the spirit of giving credit where credit is due, he surveys the professional literature and summarizes what each author says - without trying to adjudicate competing claims made by different authors. But his own contribution is in the overall editorial apparatus that he uses in organizing the book and in the direct editorializing that he occasionally provides as he proceeds, most notably on pages 46-49.

As Jeffreys explains, attachment theory as advanced by John Bowlby and others dominates the professional literature about loss and mourning. Briefly stated, we form attachments, which are also referred to as attachment bonding and attachment bonds. We feel a sense of loss in our lives when we experience the loss of an attachment bond with someone or something (including the loss of our dreams in which we had invested ourselves).

In other words, no attachment bond = no experience of loss = no experience of mourning a loss.

As Jeffreys indicates, there are two broad categories of loss:

(1) loss due to the death of someone significant in our lives, which is also known as bereavement, and

(2) nondeath losses.

As Jeffreys discusses nondeath losses, it turns out that nondeath losses can include a wide range of losses, because we can and usually do form a wide range of attachments in our lives.

So loss = loss of attachment bond.

Whenever we experience loss (i.e., the loss of an attachment bond), we need to mourn our loss. At first blush, this sounds straightforward. But there is a serious complication. Depending on our earliest attachment bonding, we may or may not be able to mourn in a healthy way. Jeffreys refers to our earliest attachment bonding in terms of secure attachment bonding and nonsecure attachment bonding.

As a result, we need to speak of (A) a healthy way of mourning, which is connected with secure attachment bonding in our earliest experiences in life, and (B) an unhealthy way of mourning, which is connected with nonsecure attachment bonding in our earliest experiences in life.

Jeffreys identifies three patterns of nonsecure attachment bonding (pages 52-57 and 307):

(1) anxious-ambivalent nonsecure attachment bonding;

(2) dismissive-avoidant nonsecure attachment bonding; and

(3) fearful-avoidant nonsecure attachment bonding.

Jeffreys' account of the three nonsecure forms of attachment bonding helped me understand the import and implication of what my mother told me years before she died - that I had been a colicky baby. To this day, medical doctors do not understand why some babies are colicky. However, it seems unlikely that as a colicky baby I formed a secure attachment bond with my mother. It seems far more likely that I formed a nonsecure attachment bond with her as a result of being a colicky baby, not as a result of any deficiency on her part.

People who experienced nonsecure attachment bonding in their early lives will not be able to mourn losses in their lives in a healthy way, unless and until they somehow experience a new kind of containment experience that they had not experienced early in life. Containment experience is the opposite of abandonment experience, and vice versa.

In the professional literature about loss and mourning, the terms "resolved" and "unresolved" are used. When the healthy mourning process has run its course and been completed, the mourning process is described as having been resolved.

However, people who are not able to mourn in a healthy way do not experience the resolution of their mourning process. As a result, their uncompleted mourning process is described as unresolved. Unresolved mourning remains in their lives - perhaps to be resolved at a later time, if and when they later learn how to experience a new pattern of containment experience to replace their old pattern of abandonment experience.

The mourning process is work, the work of mourning. The mantra to feel the feelings applies to the mourning process. In addition to feeling the feelings of mourning, one needs to express one's feelings somehow, sharing them with others who are able themselves to serve as Exquisite Witnesses (or care providers), as Jeffreys describes me. The Exquisite Witnesses serve the purpose of containment. The emerging process of containment facilitated with the help of the Exquisite Witnesses enables the mourner to learn a new pattern, the pattern of containment, to replace the old dysfunctional pattern of abandonment. However, as Jeffreys emphasizes, there is no one right way to mourn.

Jeffreys forewarns would-be Exquisite Witnesses to be alert to experiencing what he vividly terms Cowbells. He tells a personal story to explain his use of this term (page 5). The basic point is that the Exquisite Witness needs to be alert to how she or he is responding to the mourner. In other words, the mourner is expressing her or his feelings. As the Exquisite Witness listens attentively and empathetically, the Exquisite Witness may experience feelings in herself or himself that signal some unfinished business (i.e., unresolved mourning) from the past.

Now, regarding the work of mourning nondeath losses, I would suggest that Susan Anderson's book THE JOURNEY FROM ABANDONMENT TO HEALING (2000) is basically about mourning nondeath losses. Even though she focuses on the experience of being abandoned by one's marital partner, or by one's lover, she is basically discussing abandonment feelings. In nondeath losses, we experience abandonment feelings. For this reason, her book can be read by anyone experiencing abandonment feelings connected with nondeath losses.

At her website, Susan Anderson, C.S.W., makes her essay "Suffering the Death of a Loved One" (2006) available. The URL for her website is www.abandonment.net. In this essay, she emphasizes that mourning losses due to death is not the same as mourning nondeath losses, even though both kinds of losses involve attachment bonds.

Anderson's claim that mourning the death of a loved one (bereavement) is not the same as mourning nondeath losses strikes me as an important claim. Her efforts to explain as explicitly as she could how the two mourning processes are different helped me sort out my own experiences into the two broad categories discussed by Jeffreys, mentioned above: (1) mourning the loss due to death and (2) mourning nondeath losses.

However, Anderson herself does not explicitly discuss how mourning the death of a loved one (also known as bereavement) might be accompanied by mourning a backlog, as it were, of unresolved mourning of nondeath loss or losses. Jeffreys also does not explicitly discuss this kind of situation, even though he does indeed discuss more global terms such as complicated grief, chronic grief, and prolonged grief (pages 306-311) and even comorbidity (page 311).