- The Grief of Change - Dependency and Separation

Imagine if the grieving, pain or loss of losing a loved one seemed like it would never end and you could bring back that person - if we think of addiction as a relationship, and you did this, it would be called relapse.

I was recently supporting a colleague with a training weekend and we were looking at grief, bereavement and the process around this. This reminded me of many conversations I have had over the years about attachment, addiction and the difficult process of separation for harmful substance use. The word I find myself using a lot in the field is ‘dependency’ and if we follow this through means that at some point, some kind of change or separation must occur for a healthier way forward, and space to be created to help make meaning.

For this blog I though I would just share these thoughts using ‘Worden’s 4 tasks of grieving’ model that we discussed on the training weekend. My hope is to share the main reason I think there is a need to reflect on the current psychosocial/ psychotherapeutic support for people seeking help with their dependency. If we apply some of the learning around separation anxiety and bereavement, this is a very complex process.

Worden’s Tasks of Greiving: 

 1. Make meaning and understand the reality of the loss. This is about accepting that you really want change in your life and understanding how your life will change if you chose to separate from substances or other addictions. It may be a window into understanding what your addiction represents for you and how it has helped you survive. It may be a chance to look at why this may have occurred, how it serves you and what you may be left with if you chose to change and lose something that has been figural in your life.

 2. Experience the pain of grief, change and difference. Rather than objectifying addiction as a ‘bad’ experience, the task here is about understanding that, although this way of being may have carried painful consequences for you and the people in your life, you are choosing to say goodbye to a routine, relationship, activity and experience that has been central part of your life. For some, the grief of change and difference inherent in separation from the relationship with addiction, represents a far greater existential threat than staying and tolerating their relationship with substances.

 3. Adjust to an environment with the difference, missing and change. For some, this can be a trauma inducing process, others may gain a sense of freedom, or anywhere in between. It can be crucial in this phase to have lots of social connection to help make sense and meaning of the change. As with any grieving you may have a sense of recall about how good thing used to be, or a desire to return to the familiar when things are not great. Some people report a sense of impending doom about the future; what may happen(again) and so get stuck in an existential impasse. Social contact will help regulate all of these and hold the emotional rhythm, supporting us in bringing back the energy of all those ‘yesterdays’ to be available for us in forming a new present. Creating the potential for a separation which is secure enough that thoughts of a return to dependency and desensitisation no longer holds the same value or energy.

 4. Find an enduring connection with the loss, change and difference, while embarking on a new stage of life. This is a crucial phase for the self esteem, especially in regards to shame. One of integrating our experiences into a new sense of whole self, processing grief and loss so that we can breathe life into a new, more secure sense of our tomorrows. Over time ,the challenge is to make peace with your past experiences and ensure that, where possible, these do not determine your future. I remember feeling shame when interacting with colleagues, worrying that people would judge me, as I was judging myself and this limited my opportunities and potential. I had to find a way to have the new experiences whilst holding the totality of me, including the history of who I am and the potential of who I can become. This is when I learned the value of “being curious not critical”, it helped me to explore the juxtaposition of both hope and history in becoming a more integrated whole.

Hope -

My hope is that this brief blog will share a way of looking at recovery through the lens of a therapeutic grief model. If we embrace this psychotherapeutic model, within the psychosocial offer already available, we could increase the therapeutic value of the spaces we create. This could be a powerful approach when working in the field of addiction, giving focus to the requirements in therapeutic alliance and exploration. One that I believe can better support people making authentic meaning of their dependency and preparation for embracing real change, when they are ready to move towards this and step into the first of their desired ‘tomorrows’.

“Every one of us is losing something precious to us. Lost opportunities, lost possibilities, feelings we can never get back again. That’s part of what it means to be alive.” 
― Haruki Murakami

 “It's so much darker when a light goes out than it would have been if it had never shone.” 

― John Steinbeck, 

Andy Ryan and Angela Carr

Twitter @In_to_recovery