when someone you love, loves someone who is dying

English: Moon

English: Moon (Photo credit: Wikipedia)

This is much more of a personal post for me, but it feels like an ok time to post it. You might have seen that my dad died recently. He died of cancer, a diagnosis he only knew not even five weeks before his death. I’ve had various interactions with people at all points that have made me think, and I wanted to share them, for anyone else out there. They’re not definitive- what hurt me might help someone else, and vice versa. If you have your own positive or negatives to add, please feel free to do so in the comments.

  • At diagnosis, don’t minimalise- don’t say ‘oh that’s the best kind of cancer (or other disease)’ or ‘that’s a really slow-growing cancer/disease- they should be fine’. Don’t assume that it is caught early. Cancer – even ‘types’ of cancer have such radical variation in them that a) unless you’re the oncologist involved in their care, you don’t *know* if it’s the best kind of cancer (the most virulent of breast cancers is an awful lot ‘worse’ than the ‘best’ kind of breast cancer) and b) your loved one may realise that it’s the ‘best kind’ of cancer, but right now they are assimilating the idea that someone they love HAS cancer. If they’ve just found out, they probably don’t know much more than ‘type’. Individual differences mean nothing right now- it’s ALL potentially bad.
  • If they find out it’s terminal, and tell you how long they have left (usually a ‘best-case scenario’), the textbook way NOT to respond is to say ‘but you always say that’ (yes- I’m still bitter). Also, don’t say ‘it might be much longer – you don’t know’. It might be, but in my case it was actually much shorter and when you are talking weeks when you thought you had years, I suspect that ‘a month’ longer isn’t much solace in the grand scheme of things
  • When someone tells you that they (or their loved one) has cancer, try and respond in a way that is relevant to them, rather than relevant to you- a lot of people said ‘I’m so sorry’ to me, and I was fine with that. But personally, the most helpful responses were ‘cancer is a b*stard’. It let me be angry momentarily, rather than forcing me to sadness. If the person tells you and you don’t know how to respond, DONT IGNORE IT, even if you think they want that- at the very least check out ‘would you rather not talk about this’- it is easy to misinterpret, especially if your loved one is in a state of grief.
  • On that note, don’t assume that the person telling you is sad. I was, but I also had a *really* complex relationship with my dad, and actually, I was grieving a lot more than just the incoming physical death of my dad. I was grieving my childhood, the inability to be able to repair some of the things (because when someone won’t acknowledge that they don’t have long, you may not want to risk alienating them)
  • If you want to help, offer specific help. Don’t be ‘there for you if you need it’, but BE THERE for them. Send a random text message every few days- don’t expect a response, but be mundane, make the connection. Remind people that you are there, because they probably feel quite alone. If you want to make them a meal say ‘I was thinking of making a lasagne tonight and wondered if you fancied a night off cooking- I make an amazing lasagne and would love to drop one round’. Offer a low-key visit; whatever feels appropriate.
  • It’s hard to know what to say. It is. I’ve been on the other side also. And say that, but don’t *just* say that- that lays the responsibility on the person dealing with this. ‘I don’t know what to say, but I wanted to let you know I was thinking of you’ or ‘I don’t know what to say, so I made you a cheesecake’ are probably appreciated (especially if they like cheesecake. No-one made me a cheesecake, sadly)
  • When death happens, or at any point in the process to be fair, if the person you love doesn’t have religion, DONT DO RELIGION ON THEM. If it is important to you to pray for them, or light a candle for them, do it. If it’s important for you that they *know* you’re doing this, ask who you’re trying to help. If they have never mentioned religion or are anti-religion, making statements about where you think their loved one might have gone (heaven, etc), it has the potential to be insulting and inappropriate, not to mention potentially alienating, and the last thing that person probably needs right now is to lose someone else from their lives.
  • The funeral may take some time. Don’t assume it will all be over fast. It just isn’t always. Your loved one may also feel in a state of stasis at least until the funeral happens. Grief is complex.

Being on this side of the fence has taught me a lot about how I respond to death (or cancer) in other people. It has shown me some of the things I did wrong when a friend was diagnosed with cancer (some of the points above are based on things I’ve said too) and it has also underlined some of the things I did right. Maybe they will help someone else. The relevance for us as trainees is to remember that death probably isn’t that simple, and even a seemingly simple statement about a diagnosis *probably* isn’t that simple. I will forever be grateful for my therapist’s reaction when i told her- immediate compassion and recognition that it just wasn’t that simple.

Guest blog – Wade Miller-Knight: clients who’ve been bereaved

This month’s guest blog comes from Wade Miller-Knight who talks about working with bereaved clients

I have been a qualified counsellor since 2008. Besides private practice, I serve as a volunteer counsellor in a bereavement agency in west London. I work in a person-centered way. Independently of counselling I am an active Unitarian and secretary of their London District managing Council. Long ago I used to be an economics writer. My website is available here

Working with clients who’ve been bereaved
My first tip is: read some theory (Worden, Parkes, Kubler Ross) because it’ll help you pass your course. And leave it at your agency’s reception desk before you greet your client. Most bereavement theory is at best problem-centred (“tasks” or “stages” of grief; “complicated” grief) rather than person-centred, and at worst hooey.
The person-centred mantra that each client is unique is specifically true of bereaved people. One death: two siblings in the same family, or two parents, may grieve very differently from each other. So much so that my main benefit for some clients is has been to facilitate them to accept and allow their uniqueness within themselves. I had a client, for example, who was so glad that their very young daughter had died. A good theorist will tell you that, second only to bereavement by murder and perhaps suicide, parents whose child has died usually suffer more deeply and for longer than any other category [yuck] of bereaved people. There’s statistical evidence to support this assertion. You leave statistics outside the counselling room door too. As it happens, that client shared context for their feelings that “made sense” to me. Which helped my empathy. But even that shouldn’t be necessary – it’s their feeling, not mine, and feelings may be congruent or less or more incongruent, but never wrong.
A recently-bereaved client was loving a new partner. All they needed was to become inwardly at peace with this. Perhaps some people in their life were baying “too soon” or, worse, “you shouldn’t”. Two sessions with my UPR and the client’s mind, heart, and partner were aligned. Shortest successful counselling I’ve ever done.
In parallel for yourself, by the way, if someone in your life dies while you are seeing bereaved clients. If your own thoughts or feelings (tears, shoulds, if-onlys, etc) are intruding into the mind/heart-space between you and your clients, I’d recommend you ask for a two or three month break, then review yourself, probably with support at your own counsellor’s. If they’re not intruding, why let some rule-of-thumb conventional wisdom get in the way of continuing your good practice?
What if your client has had a spiritual experience? Such experiences are not commonplace, “normal” in the statistical sense, in contrast to, for example, tears; but neither are they rare. Over time, I’ve heard a range, from clients whose late loved one is palpably present at a place in their home, to their being symbolically ‘seen’ in the agency’s garden, to direct connection via a medium, to a visit in spirit at the moment of leaving this world¬† from the person who was dying (as well as a fully-down-to-earth making of a new close friend after meeting them grieving at a nearby grave in the cemetery). Again, what seems to ‘work’ for me is to welcome them all. I experience UPR as a wonderful and simple resource for receiving, and responding with, whatever the client brings, rather than having thoughts or opinions about it.
Not everyone will be free of grief by the end of their last session – even with the best counsellor, a client may not recover their enthusiasm for living, and neither you nor they can recall or replace eight departed siblings and restore an 80-year-old body to the health it had at 25 – but often through their work with you they will have made a very worthwhile difference in their lives, and it will be for the better.
Wade Miller-Knight