David Roberts[/caption]David Roberts —I have previously written about grief work with chemically dependent clients (The Challenges of Grief Work with Chemically Dependent Individuals; Recovering the Self, Vol. II, No. 3). I have viewed grief issues differently with chemically dependent individuals since the death of my daughter Jeannine over eight years ago. I have discovered many similarities in the journeys between chemically dependent individuals, who are working to achieve sobriety, and non-chemically dependent, bereaved individuals who are trying to adjust to life without their loved ones. These similarities have facilitated success for individuals who are both dealing with recovery from addiction to legal and illegal substances and those who are dealing with ongoing grief issues.• The need for adequate support: Chemically dependent individuals rely on support from self-help groups, such as Alcoholics Anonymous and Narcotics Anonymous, to help them attain a drug-free lifestyle. Regular attendance at these self-help meetings helps them feel less isolated during their recovery journey. Support, in addition to counseling and/or therapy has proven to be, in my experience, most successful in helping chemically dependent individuals. Counseling with a therapist trained in grief, loss and trauma can also be a successful combination with support groups, for bereaved individuals. Individuals who have experienced loss will go to a support group best suited to meet their needs. For example, a parent who has experienced the death of a child will go to a bereaved parents support group. Inadequate support networks for both grieving and chemically dependent individuals can be detrimental to their progress. Inadequate support for chemically dependent clients can mean relapse to their drug of choice. Grieving individuals whose support networks are inadequate may become victims of complicated grief. For chemically dependent individuals who have specific grief issues, attendance at a support group specific to their loss is also indicated.
• Stories are the key: The significance of the journeys of both chemically dependent and bereaved individuals is enhanced by the stories that they tell about their addiction and their deceased loved ones respectively. Storytelling is therapeutic for both recovering chemically dependent and bereaved individuals because it helps them make sense out of their worlds. The stories that chemically dependent individuals tell about their struggle with addiction serve to reinforce for them the importance of abstinence and recovery. For bereaved individuals, their deceased loved ones come to life through the stories that they tell.
• Emphasis on being proactive: Bereaved individuals are encouraged to develop their own personal self-care plans, which can include ways that they can nurture themselves physically, psychologically, spiritually, and emotionally after loss. Chemically dependent people are also encouraged to develop relapse prevention plans. These self-generated plans help bereaved individuals identify their triggers or stressors contributing to return to active use and ways to manage those stressors. Self-care and relapse prevention plans should be modified, as the bereaved and chemically dependent individual’s needs change. Dealing with ongoing grief issues should also be a part of a relapse prevention plan for a chemically dependent client.
• The journeys of both the chemically dependent person and bereaved individual are circular rather than linear. A chemically dependent individual may re-experience urges to use at any time in their recovery due to contact with old people, places, and things that contributed to their use, or due to stress. For the bereaved, the continuous occurrence of milestone events (i.e. birthdays, death anniversary dates etc) can result in a return to the intense emotional pain of early grief. Both chemically dependent and bereaved individuals learn to live with a certain amount of pain or sadness. This sadness or pain for chemically dependent individuals originates from the past irreversible consequences of their use (i.e. lost jobs, failed marriages; past legal system involvements). For bereaved individuals, the pain or sadness is due to the permanent physical absence of their loved ones.
• Both populations can experience disenfranchised grief: Disenfranchised grief occurs when “the bereaved are denied an opportunity to express their feelings.” The grief may be hidden because the individual is not “considered entitled to these feelings” (Kastenbaum, 2009). Sibling grief is one type of disenfranchised grief that I have observed in both populations. Many times, siblings question whether or not the loss of their brother or sister is theirs to grieve due to the amount of attention given to the parents’ pain. Elizabeth Devita-Raeburn eloquently discusses this issue in her book The Empty Room: Understanding Sibling Loss. I also believe that chemically dependent individuals experience disenfranchised grief when a friend who is chemically dependent dies as a result of an intentional or unintentional drug overdose.
• Use of creative expression to find meaning: Bereaved individuals and chemically dependent individuals both use a variety of creative outlets to express the challenges of their struggles with addiction and loss, respectively. Music, art, and poetry are three types of creative expression that seem to have been the most popular with the chemically dependent clients and bereaved individuals who have crossed my path. Allow your clients to use the form of creative expression that they find to be the most meaningful in their journeys with loss and in their recovery efforts.
• Design of individualized interventions: Whether you are dealing with chemically dependent and/or bereaved individuals, treatment is always client driven. The interventions that you utilize with both bereaved individuals and chemically dependent individuals need to be tailored toward the problems and challenges they identify.
• Chemically dependent and bereaved individuals need to rewrite their life stories to account for their new reality: Chemically dependent individuals learn to live life again without the presence of drugs in their life. They may also mourn the loss of their drug of choice. Bereaved individuals rewrite their life stories to account for the physical absence of their loved ones. The ability for both chemically dependent and bereaved individuals to negotiate their journeys to find meaning again is the key to their long-term success.
In closing, there are other things to consider when working with chemically dependent and/or bereaved individuals:
• Chemically dependent individuals need to be constantly reminded about the need for abstinence from legal and illegal drugs, in order for grief work to be effective.
• Professionals can be most helpful in helping these population and find meaning and significance through listening to their stories, celebrating progress, and connecting them with appropriate support networks. In this context, the professional becomes a companion and an important part of the journey.
• Remember that not everyone grieves or attains sobriety the same way. It is our job to understand individual needs and strengths, and work from that perspective.
Suggested Reading: Kastenbaum, Robert J., (2009) Death, Society, and Human Experience (10th Ed). Needham Heights, MA: Allyn & Bacon.)
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About the Writer
David J. Roberts, LMSW, CASAC, became a bereaved parent after his daughter Jeannine died of cancer on 3/1/03 at the age of 18. He has been employed in the addictions field for 24 years and is an adjunct professor at Utica College. Dave is the owner of Bootsy and Angel Books, LLC whose mission is to provide resources on grief for bereaved individuals and professionals. He has co-authored two books on navigating through grief during the holidays and pet loss and has presented at national conferences of 'The Compassionate Friend's and 'Bereaved Parents of the USA'. Dave is also a contributing writer for the Open to Hope Foundation.
