Grief is a natural response to loss that affects nearly everyone. Grief can be defined as any type of loss that disrupts our lives, such as the loss of a relationship, health, financial stability, or the death of a loved one. It can leave you feeling isolated, anxious, depressed, or overwhelmed.
Dialectical Behavior Therapy (DBT) can equip you with valuable tools to navigate this challenging time and find solace after loss. Mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance skills can empower you to navigate effectively the waves of grief and to find healing on the other side
Mindfulness: Grief can cause any of us to feel stuck in the past, overthinking what happened and holding onto regrets or worrying about the future. Mindfulness skills, with their focus on what is happening right now, help us stay grounded in the present moment. When we are mindful, we are not holding on to or pushing away the past or future; we are increasing our awareness of the present moment, as difficult as that may be during the grieving process. During this time it can be helpful to observe and describe the difficult emotions that come up and allow time and space to process them nonjudgmentally.
Exercise: Mindfulness “What” Skills – These skills consist of observing, describing, and participating. Practice nonjudgmentally observing your thoughts and emotions, drawing yourself back into the present moment. For example, instead of saying “I should have done more” you can say “I notice that I am feeling regret.” This adds a degree of separation between you and the difficult emotions that arise.
Exercise: Grounding – If you notice difficulties with being present, you can try grounding techniques. Engage your senses to anchor yourself in the present. A helpful tool is the “Five Senses Exercise.” Describe five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. This is particularly useful when you find yourself overwhelmed by difficult emotions.
Interpersonal Effectiveness: Grief can be isolating. We may think that no one understands how we feel or what we are going through. DBT’s interpersonal effectiveness skills aim to maintain and improve our relationships with others. These skills are useful if we feel like our needs aren’t being met during our grief or for when we may need additional support.
Exercise: DEAR MAN – This stands for Describe, Express, Assert, Reinforce, stay Mindful, Appear confident, Negotiate. You can use this set of skills to ask for something that you need or even to set a boundary, for instance, around certain topics of conversation.
Exercise: Validation – Remember to validate the emotions of those grieving around you but also to validate yourself. The grieving process is difficult so remember to give yourself grace as you move through it.
Emotion Regulation: Grief can manifest in a variety of emotions. Some of these emotions hit one at a time; others feel like they come together all at once. By practicing emotion regulation, we use techniques to feel more in control of our emotions and to manage them more effectively.
Exercise: Check the Facts – During the grieving process people often feel guilt or shame. It’s important to check the facts here. If the emotions don’t fit the facts of the situation, focus on what does. Often, grief and shame emerge as a way to distract from other emotions, such as sadness or anger.
Exercise: Coping Ahead – When grieving, there can be a variety of secondary losses, such as loss of a support system, loss of financial security, or even loss of identity. These losses add to the emotional toll of grief. When these losses are presented, it may be effective to create a plan in advance to manage any difficulties that may arise. Imagine yourself coping effectively with the situation, What would that look like? What would you say or do? Once you decide upon a course of action, you can mentally rehearse the plan.
Distress Tolerance: Intense emotions can hit us when we least expect them. Through the use of distress tolerance skills, we can learn to tolerate waves of strong emotion more effectively.
Exercise: TIP Skills – TIP stands for Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation. These skills are effective ways to reduce the intensity of emotions through our biology. Some examples you can try are splashing your face with cold water or going for a run. These skills help you reduce intense and overwhelming emotions so that you’re able to survive those really difficult emotions.
Exercise: Self-Soothing – This skill involves being intentionally nurturing to yourself by attending to your senses. You can choose to self-soothe via your sense of smell (e.g., lighting a candle), taste (e.g., eating your favorite meal), touch (e.g., wrapping yourself in a fuzzy blanket) , sound (e.g., listening to your favorite song), or vision (e.g., looking at the stars). The idea of this skill is to take care of your body to then in turn nurture your mind. This is crucial during the grieving process, when neglecting our needs can make us more vulnerable to experiencing intense emotions.
Exercise: Reality Acceptance – As painful as loss is, fighting against it only increases your suffering. With reality acceptance skills, you acknowledge what is happening, no matter how difficult that reality is. You might notice and try to reduce tension in your body as you practice acceptance. And it can be helpful to remind yourself that even though life contains grief and loss, it also contains beauty and joy and other positive experiences and can therefore still be worth living.
In addition to tapping into DBT skills, remember to be patient with yourself as you grieve. It can take a while to move through this experience. And don’t hesitate to seek professional help if you’re struggling. With time, self-compassion, and support, healing is possible.
-by Karina Luis, Gatewell Practicum Student