Improving Countertransference of Bereavement
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What is my problem?
I did not major in the profession that is relevant with social work during my undergraduate time. So I have never thought about which group of individuals I cannot handle before. I have never heard of the words bereavement and countertransference either. After three months' learning of social work knowledge, I begin to recognize that I really do not know how to deal with the clients who are bereaved. I will have the countertransference of bereavement. This is mainly because of my own grieved similar experience in the past. I will do some retrospect of bereavement and countertransference, and then tell something about my experience and how it influences me on this kind of cases.
“Bereavement, which entails the severance of a bond, presents a challenge which all are reluctant to face” (Glick, Weiss, & Parkes, 1974, p. 285). Bereavement is mainly about a natural phenomenon after the loss of a loved one and an experience that happens some time through people's life process, and then it probably occurs more and more frequent as people getting old (Stroebe, Stroebe, & Hansson, 1993). Bereavement causes a crisis for individuals and families (Glick et al., 1974). “The immediate impacts of bereavement are a sense of abandonment, shock, and denial, colored by guilt and sometimes anger, and accompanied by intense and persistent longing for the one who has died” (Glick et al., 1974, p. 4). Bereavement is different from one to another, because everyone has diverse life experience. So everyone has their own definition, understanding and boundaries of bereavement. According to DeVaul, Zisook and Faschingbauer (1979), there are at least three partly overlapping phases of grief—the first one is an initial period of shock, disbelief, and denial; the second one is an intermediate acute mourning period of acute somatic and emotional discomfort and social withdrawal; and the last one is a culminating period of restitution. There is still little agreement of the question of how long grief lasts among scholars and some researchers found a few features of grief, especially those relevant with attachment behaviors, to continue several years or longer after the loss (Shuchter, & Zisook, 1993). There are four general types of reactions of grief, including shock—a dazed sense of unreality, as might accompany any traumatic event; protest—active attempts to maintain contact with the deceased; despair—disorganization of behavior, often with a sense of helplessness and depression, as the bereaved accommodates to the reality of the loss; and reorganization—the establishment of new object relations (Averill, & Nunley, 1993). Bereavement also can produce the disruption of accustomed patterns (Glick et al., 1974).
Countertransference is the counterpart of transference and involves feelings, wishes and unconscious defensive patterns on the part of the social worker (Hepworth, Rooney, Rooney, Strom-Gottfried, & Larsen, 2006). As defined by Hepworth et al. (2006), countertransference is the real and unreal professinal's reactions that can be caused irrespective of origin and can be based on their own past or present experiences or client characteristics to those trauma survivors. James and Gilliland (2001) pointed out that working with clients who have had similar experiences may reawaken unresolved thoughts and feelings of the professionals who are involved in crisis work. So there is more possibility that the professionals may probably experience compassion fatigue or secondary trauma (Hepworth et al., 2006). Hepworth et al. (2006) also mentioned “these countertransference behaviors may evidence a lack of professional distance, unprofessional conduct, and burnout” (p. 556).
My countertransference of bereavement
My sad bereavement is about my grandmother and my third aunt. Actually I had always believed that everyone in my big family would not die. I knew it was an impossible and over-ideal thought, but I really believed so. Then everything changed suddenly because of my third aunt's death. I usually live in my third aunt's home from my birth until 12 years old. Because my parents were always very busy and they sent me to my grandmother who lived with my third aunt together. After I was 12 years old, my grandmother moved to my home to live together with my parents and me. I often said my third aunt was more like my mother than my real mother. It was a cold November and had just snowed. My third aunt came to my home to see my grandmother. I hurried to go to my senior high school to have evening classes. I just greeted her and then went out. I had never known it was the last time I saw alive her. Three hours later I heard of her death with no mental preparation. She was crashed seriously by a truck and died immediately. When I knew this news at first, I did not believe it at all. I told to myself maybe it was just a nightmare and everything would go back to the past after I woke up. Probably two or three days past, I began to accept this fact. The most willing thing that I wanted to do is to go to sleep and then maybe I could dream my third aunt and talked to her. But the funeral broke my phantasm into pieces. It was the most miserable experience of my life. This is the first stage of the bereavement that DeVaul et al. (1979) described. Then I turned into the second stage of the bereavement of DeVaul et al. (1979) mentioned. After the funeral I began to meet insomnia and felt terrified with no reasons every night. I did not want to talk with any one and did not know what I should do. I found the values that I had believed before were not correct and my spiritual world was broken down. No one could help me and no one really knew and understood what I was thinking at that time. I was in deeply depression even in despair. I never want to remember the days of that period of my life because they were so dark and hopeless. I started to become well gradually after three months of my third aunt's death. I came to the last stage of bereavement as DeVaul et al. (1979) referred to. I thought a lot during that sad period and then I had to know the world again and reestablished my spiritual world again. The whole bereaved process I experienced after my third aunt's death included all the four types of grieved reactions (shock, protest, despair and reorganization) that Averill and Nunley (1993) pointed to. I think shock and protest were involved in the first stage of bereavement; despair was involved in the second stage of bereavement; and reorganization was involved in the last stage of bereavement. However, the death of my third aunt was not the end of my bereavement. After more than one year, my loved grandmother died. I had to experienced another bereaved period.
Because of the experience I mentioned above I find I will have the countertransference with the clients who are experiencing the bereavement. They will make me to remember the sad and painful time I past before. I cannot be that objective and rational, and then I will be dominated by my severe emotion. I think I may have one of the typical manifestations of countertransference—trying to impress or being unduly impressed by clients (Hepworth et al., 2006). I will refer to how the two aspects of this typical manifestation will influence my job as a social work to handle the clients who experience bereavement below. Maybe I will fall into the depression as well.
At first, I think I will be unduly impressed by clients. I think I am a very susceptible and over-thoughtful person. If a client tell me that he or she have just lost a loved person, such as his or her parent, grandparent or other intimate relative, I will feel very sad. Then when the client begins to talk about the bereaved situation, I will start to remember my lost third aunt and grandmother unconsciously. Actually this is the secondary trauma for me. I really do not know if I can bear these traumas again and again. I will be very upset and do not know what I should do. Just as Glick et al. (1974) mentions “Even as we rally around to help, we may not know what to say and so end by saying almost nothing” (p. 286). Finally, maybe I cry with the client together and say something useless. It will be a very bad feeling for me, so I really do not want that happens.
Secondly, I probably impose my own thoughts and emotion on my clients. It is possible that my client who is experiencing bereavement is not that sad and depressed at first. But then he or she becomes more grieved because of my grieved emotion. So it will be a very terrible result. It is just like a vicious circle. On the other hand, I may emphasize my thoughts of bereavement on my client and I will be very desired that he or she can follow my suggestions, because I have the bereaved experience and I think my perspectives are right. Actually there is no right or wrong method to deal with the bereavement absolutely; it depends on different persons and different situations. So my opinion may be unsuitable for others. For example, I think the funeral was too grieved that it was a very big setback to me and I really spend much time to forget the bitter memory it brought to me. So I probably advise my client not to take part in the funeral, but if my client does so, he or she may regretful in the future.
In addition, I have a thought that bereavement is a process that everyone must experience and it is an element of a life. So I think no one can really help you except yourself during the grieved period. Just as the perspective of Glick et al. (1974), “Grief we may decide is a ‘private matter', like an infectious illness for which social withdrawal and the passage of time are the only treatments. And so, as soon as we can, we may leave the griever alone, to deal with his or her grief in isolation” (p. 286). In my opinion, no matter what the social worker say or do is not very important; the clients must rely on themselves to go through the bereavement. I think this view will have a negative impact on my treatment to the clients.
My improving plan
In my view, there are two main ways to improve my countertransference of bereavement. First of all, I should often do some self-reflection and self-assessment, and always remain the appropriate distance with clients. “Introspection and self-assessment, as well as the ability to maintain appropriate boundaries and distance, will assist you to achieve or regain a realistic perspective on your relationships with clients” (Hepworth et al., 2006, p. 556). I can write some reflective dairies of assessment logs and then retrospect them regularly to find the problems and the improvement.
The second way is more about the assist from others like my future colleagues and supervisors and doing some counseling. The consultation should contain the discussion of this kind of countertransference with colleagues and supervisors, in which I can expose and explore my feelings and obtain their perspective and advice (Hepworth et al., 2006). This can reduce the secondary trauma of mine and help me solve the rest of the problems absolutely.
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