My client was bereaved of a younger brother through cancer. He died at 14, she was in her early 20s when he died. She is now in her 40s. She can remember the events of his illness in detail, but is distressed at forgetting all of his pre-cancer life. What is going on & how would you help?
Hi John,
Thanks for your interesting question. It sounded like your client somehow blocked off her memory of having a "better" time with her brother (i.e., before he had cancer). This reminded me of William Worden's (2008) idea of complicated mourning. Relational, circumstantial, historical, personality, and social factors could contribute to her way of mourning.
Before I'd make any suggestions, I'd like to know some of the factors above. For example,
1. How close was your client to her brother?
2. What was the process of his cancer and his death? How did his suffering and death impact her and the rest of the family?
3. Generally how well has your client grieved the loss of her brother?
4. How much support did she and her family receive after the death of her brother?
5. More related questions to clarify her mourning, personality and coping styles, etc.
Best wishes,
Stephen
Thanks for your information, John. To protect the confidentiality of your client, I will send you a private message.
Assuming that your client suffers from complicated mourning/grief, chapters 5 and 6 on the subject in William Worden's (2008) classic Grief counseling and grief therapy might be helpful.
http://www.springerpub.com/grief-counseling-and-grief-therapy-fourth-edition.html
Dear John,
I have some suggestions based on my clinical experience. If you work with your client to go backward drawing the time line from her birth to date and discussing important event in life(both negative and positive). You may have to explore more details as your client may just skip some time points. Also worth to explore any guilty related to pre-cancer stage especially any sibling rivalry or family issues.If it is the case this could be a motivated forgetting.
You may also ask her to bring some family photos of that time period to the session and discuss about the day, place, event who else attended, what happened before the photo was taken and after it. This will work as a memory stimulation. It is helpful to get down a family member if ethical and other concerns are not violated. This is an eclectic approach I have used.
best wishes
Kanthi
John, fascinating question but I tend to agree with some of the above responses - a little hard to help without more specifics which understandably need to remain confidential.... But generally not surprised that a sibling 6 years older is unable to remember her brother pre his illness..... The suggestions of Timeline and photos mentioned above are excellent... but my question is why at age 40 is this issue surfacing..... does she have her own children or unresolved issues from her own growth and development.... For me the key is why NOW is it so troubling..... Good Luck!
Thanks Patricia. There are various reasons why it may be getting worse now, all of which she and I have discussed, but in order to preserve her confidentiality, are difficult to discuss here. I think the prolonged grief has been around for a long time. She has tried other types of counselling before working with me.
My guess would be that tehre might some "blocking images", meaning imagery of the cancer period, that are blocking the other memories. In my experience EMDR on these images/memories usually leads to access of the pre-cancer period.
Good luck!
Hello John,
I see that you've gotten some great responses here, and as you've probably come to learn that grief and loss can do some very confusing things to a person. But I'm going out on a limb here by asking if you've considered trying some hypnosis? It's certainly not as complex as some of the other feedback, but perhaps it's worth trying at this point. I wish you and your family all the best and much luck in finding your answers.
Allyson
Hello John,
Perhaps the client has suffered a temporary amnesia as a result of the traumatic loss of her brother. From body psychotherapy perspective, perhaps its important that the therapist take note of what is happening at the body level. There could emotional holdings at the body level.Helping the client have a dialogue with that body part can help. Other approaches like drawing out her earliest memory of her family where she grew up with her brother can also be of help. some clients do reconnect with their lost memory though deep tissue body work.
Yuju
Dear John,
This is what happened to children who were sent - all of a sudden by train with an address on a paper around their neck - to Sweden from Finland during the second world war to escape the bombing. We were taught by our therapy teacher that it does not really matter if you remember the whole scenario, there may be scents, sounds, fragments of pictures that come to the client's mind and that is enough in order to work with the trauma.
I want to add to the recommendation of EMDR. I assume the brothers death was very traumatic. "Blocked" memories are difficult to access with any cognitive focused approach. There are ways to process the block. I would honor the block as a protective mechanism that developed to protect the client from deep psychic pain. This may sound paradoxical because the client appears to be stuck in her grief. By remembering the death rather than the full spectrum of her memories is felt as less painful. The paradox is "positive" "remembering is short lived and is followed with a deeper sense of loss unless or until the trauma itself is reprocessed.
Thank you all for your suggestions. What is working to date is to take the client back to her earliest childhood memories and then work forwards. The client is encouraged by this.