A Challenging Population
Chemically dependent individuals like the rest of us, experience grief. In my 27 years of employment in the chemical dependency field, many individuals that I counseled experienced grief due to the death of a family member or friend. Working with grief in chemically dependent clients is challenging, due to the fact that they use drugs, to avoid experiencing pain. Effective grief work is predicated on being able to confront, honor and transform pain. Another challenge that chemically dependent individuals experience is delayed grief. Essentially, they can medicate the pain of grief for years after the loss occurred. Once they make the decision to become drug free, they begin to experience the raw pain of their earlier loss or losses shortly after that, regardless of how many years have passed. Chemically dependent individuals need to be constantly reminded about the need for abstinence from legal and illegal drugs, in order for grief work to be effective. In addition, they may also need to be taught specific socialization skills to access appropriate supports for their chemical dependency and their grief.
Are We Really All That Different?
I became more mindful of grief in the chemical dependency population after my eighteen-year-old daughter Jeannine’s death in March of 2003. I think one of the reasons that I did initially was because I was getting referrals at my place of employment for individuals who were assessed as having unresolved grief issues. However, as I began to evolve in my journey, the grief work that I did with chemically dependent individuals began to evolve as well. It was empowering for me to share tools that I knew worked for me, and empowering for me to watch many individuals I worked with embrace them during therapy.
In addition, I have discovered tools that have helped chemically dependent individuals embrace a drug -free lifestyle and do effective grief work, and non-chemically dependent individuals striving to find meaning in a world without their loved ones:
Stories: The significance of the journeys of both chemically dependent and bereaved individuals is enhanced by the stories that they tell about their addiction and their deceased loved ones in communities that support them.
Storytelling is therapeutic for both recovering chemically dependent and bereaved individuals because it helps them make sense out of their worlds. The stories that chemically dependent individuals tell in Alcoholics or Narcotics Anonymous meetings about their struggle with addiction serve to reinforce the importance of abstinence and recovery. For bereaved individuals, their deceased loved ones come to life through the stories that they tell in support groups specific to the type of loss that they experienced.
- Self Care Plans: Bereaved individuals are encouraged to develop their own personal self-care plans, which can include ways that they can nurture themselves physically, psychologically, spiritually, and emotionally after loss. Chemically dependent people are also encouraged to develop relapse prevention plans. These self-generated plans help bereaved individuals identify their triggers or stressors contributing to return to active use and ways to manage those stressors. Self-care and relapse prevention plans should be modified, as the bereaved and chemically dependent individual’s journeys evolve. Dealing with ongoing grief issues should also be a part of a relapse prevention plan for a chemically dependent client.
- Use of creative expression: Bereaved individuals and chemically dependent individuals both use a variety of creative outlets to express the challenges of their struggles with addiction and loss, respectively. Music, art, and poetry are three types of creative expression that seem to have been the most popular with the chemically dependent clients and bereaved individuals who have crossed my path.
- Embracing Transformation: Chemically dependent individuals learn to live life again without the presence of drugs in their life. Bereaved individuals rewrite their life stories to account for the physical absence of their loved ones. The ability for both chemically dependent and bereaved individuals to transform their pain to find meaning again is the key to their successful journeys.
The journeys of both the chemically dependent person and bereaved individual are circular rather than linear. A chemically dependent individual may re-experience urges to use at any time in their recovery due to contact with old people, places, and things that contributed to their use, or due to stress. They can also revisit at anytime the past irreversible consequences (i.e. failed marriages, lost jobs) of their use .For the bereaved, the continuous occurrence of significant events related to their deceased loved ones’ lives (i.e. birthdays, death anniversary dates etc) can result in a return to the intense emotional pain of early grief. Reinforcing that sadness and pain can co-exist and, in some cases, promote continued transformation, is important to emphasize with both populations.
Considerations for Professionals
I want to end this article with some points and interventions that should be considered by helping professionals when addressing grief and loss issues with chemically dependent individuals:
? Create a safe, non-judgmental environment for grief and loss to be expressed.
? Chemically dependent people are resilient and have strengths that can help them in their grief journey. Have them identify those strengths and utilize them to their advantage.
? Honor their non-death related losses as much as their losses related to death. Those losses are more likely than not related to their addiction and if not addressed, can set the chemically dependent person up for relapse.
? Assist them in finding a bereavement support group that will meet their individual needs. The combination of adequate support networks and therapy, increase the chances of long-term sobriety for chemically dependent individuals.
? Encourage them to find their own individualized ways to grieve.
? Obtain ongoing training in grief and trauma issues. If you do not have that expertise, refer them to a professional who does.
I have experienced many fulfilling moments when working with chemically dependent individuals. Many of them are bright, creative, passionate individuals who when sober have a plethora of gifts to offer to others, and who have done meaningful work to help other chemically dependent individuals. The decisions that chemically dependent individuals make to use drugs addictively don’t make them bad people; they are guilty only of making bad choices.
Updated: January 4, 2015