Transforming the Weight of Grief Through Psychological Flexibility

This article is the third in a series from Dr. Elisabeth Morray, VP of Clinical at Alma, on Psychological Flexibility.

Psychological Flexibility is a concept and process at the very heart of acceptance and commitment therapy that can be uniquely and remarkably helpful in times we're living in for all individuals, but especially for therapists themselves.

To put it simply, Psychological Flexibility refers to the ability to remain emotionally open, fully present and focused on what matters most, even in the middle of conditions that challenge us.

Every once in a while I come across something that draws me back into the beauty of the work I do as a therapist. I recently listened to an episode of Anderson Cooper’s podcast in which he and Sara Bareilles spoke about grief, and it moved me in ways that I have struggled to wrap words around. It left me with a question that I have not been able to shake: how can something be at once the most painful emotional experience a person is likely to encounter, and also the strongest connection to what makes life meaningful?

In their conversation, and in the song she shared, grief was held in a way that seemed to transform it. It didn’t stay contained as pain. It moved… into stories, into memories, into music. In her song, she seemed to translate something exquisitely painful into something equally exquisite — an opportunity for deep connections with others and the losses that they have carried.

As a therapist, I spend a lot of time sitting with people in these moments. Sometimes the grief is what has brought them to therapy in the first place. Maybe it was the death of someone they love or the loss of a much-wanted pregnancy. Oftentimes it’s something more ambiguous. A friendship ended unexpectedly, or a version of their life that they were invested in was no longer possible. Grief in countless forms makes its way into therapy, where it can be recognized, held, and even transformed.

Being with grief, instead of moving away

These are the moments in which I find the psychological flexibility model so powerful — those moments in which my clients and I find ourselves in the presence of grief. Other approaches might lead us to help them “manage” the pain or “resolve” the grief. To move on, move past, move away.

Psychological flexibility — an approach rooted in the willingness to come in contact with the full range of emotions that we experience throughout the course of our lives — allows for something very different. It beckons us to lean into the pain, and to notice what is contained within it, to listen to what it has to say to us. The truth is that grief is not separate from what we love, but rather a reflection of it. Even when the pain feels unbearable, most of us would not choose to give that connection up.

I think about the ways in which grief shows up in my own life, often in unexpected times and places. They tend to emerge in the transitions between moments. It’s when I wake up on a Saturday morning and realize that I don’t have anyone to drive to a soccer practice or a theater rehearsal that the grief about my twins’ departures for college hits me. It’s when I encounter the notebook with the notes I took about a project that was abandoned because it doesn’t align with the new strategy that the loss of a role in which I had been deeply invested feels most real. It’s when I scroll past a social media memory with a friend who is no longer in my life that the pang of loss hits me. Nothing dramatic has happened, but in those moments, just under the surface, the loss is present.

These moments are ones often accompanied by the urge to move past or to push away. To tell myself that this is all just a part of growth, just keep going, get to the other side. However when I stay with them, even briefly, something else becomes clear. These moments are powerful reminders of what is most precious to me. The kinds of things that I wouldn’t want to rush past or overlook.

What this looks like in therapy

Of course, those kinds of moments show up constantly in the work I do with my clients. When it comes to my capacity to notice when grief shows up, to sit with it, and even to turn towards it, psychological flexibility skills are critical.

When the grief shows up in big, loud, and obvious ways, responding flexibly often looks like responding with small, basic gestures that keep the client, and myself, grounded in the here and now. I might put my hand to my chest and say “I just noticed how heavy it felt when you mentioned that memory. Can we sit with that for a moment before we push past?” I might encourage the client to notice the sensation of their feet resting on the floor, and to their ability to direct their attention to simple physical sensations when their emotions feel most overwhelming. Or, I might sit with them as they allow the wave of intensity to pass over them without having to analyze or narrate it.

The small flickers of grief call for a different kind of psychological flexibility — a kind that may involve responding in ways that amplify them, that bring their meaning and their message to the surface. It can be so easy to overlook the quiet signals that grief has entered the room — the catch of the breath when a name is mentioned or pivot away from a memory. The moment that could be dismissed as unimportant or trivial, but is mentioned anyway.

I try to watch carefully for those openings, and to invite my client to step inside them when they arise. “What was showing up for you just then? In that moment, underneath the excitement I heard in your voice about this opportunity, I think I heard a bit of sadness about what this requires you to leave behind. Did you notice that?” I think of myself in those moments as helping give grief a voice — because what it has to say, whether stated loudly or barely whispered, is so important.

The common element in these therapeutic responses? It is a process of transformation. As therapists, we create a context in which clients can try out new ways of responding. Perhaps the familiar (and likely rigid) response is to encounter grief with avoidance. To try to move away from the thoughts and memories that are connected to what has been lost, in hopes of being able to get some relief from the painful emotions. In these moments, we can encourage a different response — a slowing down, a pause, a leaning in — and then together notice what is on the other side of the pain for which we have made space. What is there is often rich, precious, and meaningful.

Giving new meaning to the weight of grief

It sounds simple, and in many ways it is. However, it is rarely easy. Psychological flexibility is what can allow our clients and us, as both therapists and humans who know grief, to remain connected to what feels most meaningful and important, even when it has been lost. We can notice those flickers of grief, and offer them our attention. We can willingly and actively make space in our lives for this pain.

As clinicians, rather than trying to make what is painful disappear, we have an opportunity to help our clients transform their relationships with the heaviness. To experience in its weight the incredible substance of what was loved and lost.

Few of us will have the opportunity to take our own pain, and those of others, and transform it into music in the way Sara Bareilles could. As therapists, however, we are called to wield the instruments of psychological flexibility and to produce our own versions of artistic magic. We can create spaces in which grief can be shared, held, and ultimately transformed into connections to what is most important, meaningful and real in our clients’ lives. That process has a creative and transformative power all its own.