Are you considering therapy near you, but not sure what approach to take? If so, you're not alone. Many people are interested in investing in themselves by seeking therapy, but may not know the difference between top-down and bottom-up approaches. Understanding these differences can make a huge impact in how effective your therapy is, so it's important to do your research. In this blog post, we'll discuss the difference between top-down and bottom-up approaches in therapy, as well as the magic in bottom up approaches.

Understanding Top-Down Approach to Therapy

When it comes to therapy, there are various approaches that therapists can take to help their clients navigate through their challenges. One such approach is the top-down approach. This approach focuses on addressing thoughts and behavior as the primary factors influencing an individual's well-being.

In a top-down approach to therapy, therapists often start by exploring their clients' thoughts and beliefs. They help clients identify any negative or irrational thinking patterns that may be contributing to their struggles. By challenging these thoughts and helping clients develop more positive and realistic thinking, therapists aim to bring about lasting change in their clients' behavior and emotions.

This approach emphasizes the importance of cognitive restructuring and cognitive-behavioral techniques to promote change. Therapists may use interventions such as cognitive reframing, thought-stopping, or problem-solving skills training to help their clients gain insight into their thought processes and make healthier choices.

While the top-down approach can be effective for some individuals, it may not be suitable for everyone. Some clients may benefit more from a bottom-up approach, which focuses on the mind-body connection. This approach recognizes that our bodies can store unresolved trauma and emotional experiences, leading to various psychological and physical symptoms.

If you are looking for therapy near me, it is important to consider which approach aligns best with your needs and preferences. Remember that therapy is a personal journey, and finding the right fit with a therapist who utilizes an approach that resonates with you is crucial for effective treatment. Whether you opt for a top-down or bottom-up approach, therapy can provide you with the support and tools you need to navigate life's challenges and achieve a sense of well-being.

Contrasting Thoughts and Behavior vs. Mind-Body Connection

When it comes to therapy, there are two primary approaches that therapists often employ: focusing on thoughts and behavior or exploring the mind-body connection. Both approaches have their merits and can be effective depending on the individual and their unique circumstances.

The traditional top-down approach to therapy emphasizes the importance of thoughts and behavior in influencing one's emotions and well-being. Therapists using this approach may help clients identify negative thought patterns, challenge distorted thinking, and develop more adaptive behaviors. This approach can be highly effective in helping individuals gain insight into their thoughts and behaviors and make positive changes.

On the other hand, the bottom-up approach to therapy emphasizes the mind-body connection and the importance of addressing physical sensations, emotions, and bodily experiences. This approach recognizes that emotions and traumatic experiences are stored not only in our minds but also in our bodies. Therapists using this approach may incorporate techniques such as body-focused therapies, somatic experiencing, or mindfulness practices to help clients become more attuned to their bodily sensations and work through past trauma.

Both approaches have their place in therapy, and the choice of approach often depends on the individual's needs and preferences. Some individuals may benefit from a more cognitive-focused approach, while others may find that exploring the mind-body connection brings about deeper healing. It's essential to find a therapist who offers both approaches and who is invested in understanding and supporting your unique healing journey.

If you're considering therapy and wondering, "Is there therapy near me that offers both top-down and bottom-up approaches?" it's important to do your research. Finding a therapist who is experienced in both approaches and has a genuine investment in yourself can greatly enhance your therapy experience. Remember, therapy is an investment in yourself, and finding the right therapist is crucial for your healing journey.

The Magic in Bottom-Up Approaches

When it comes to therapy, there is something truly magical about bottom-up approaches. These methods recognize the undeniable connection between our minds and bodies and use it to facilitate healing and growth.

One such approach is Eye Movement Desensitization and Reprocessing (EMDR), which has gained significant recognition for its effectiveness in treating trauma and anxiety. EMDR works by targeting the underlying emotional distress associated with traumatic experiences and reducing the intensity of triggering responses. This therapy encourages individuals to engage in bilateral stimulation, such as eye movements or tapping, while simultaneously recalling distressing memories. Through this process, the brain is rewired, allowing for adaptive resolution of traumatic events.

Research has shown that EMDR can result in a decrease in responsiveness to triggers, reducing symptoms associated with post-traumatic stress disorder (PTSD). This bottom-up approach emphasizes the importance of engaging the body's natural ability to heal and reprocess traumatic memories.

Investing in yourself through therapy can be a life-changing decision, and finding the right therapy near you is crucial for your well-being. Bottom-up approaches, like EMDR, offer a unique and effective way to address underlying emotional distress. By focusing on the mind-body connection and targeting the root causes of distress, these approaches bring about lasting change and growth.

If you are struggling with trauma, anxiety, or any other mental health issue, consider exploring bottom-up approaches like EMDR. The magic lies in the ability to tap into your body's innate healing capabilities and find true relief from distress. Remember, therapy is an investment in yourself, and the right therapy near you can lead you on a transformative journey towards healing and well-being.

Why invest in a specialist?

Investing in a specialist for your therapy needs can make a significant difference in your overall well-being and long-term success. Research consistently shows that specialized care leads to better outcomes compared to generalist approaches. 

Why settle for a therapist who may have a broad understanding of various issues, when you can see someone who specializes in your specific concern? Whether it's sexual abuse, postpartum struggles, imposter syndrome, people pleasing, or childhood trauma, seeking out a specialist ensures that you receive targeted and effective treatment.

The impact of specialized care extends beyond your mental health. It can enhance your overall functioning as an employee, improve your earning potential, strengthen your relationships as a friend, parent, and spouse. By addressing your specific issues through specialized therapy, you can experience transformative healing and personal growth.

Another crucial consideration is the time factor. Why wait to feel better and begin your journey to true healing? By seeing a specialist, you can get results more quickly, allowing you to start feeling better and living a fulfilling life sooner.

Finding a specialized therapist is easier than ever with the help of technology. Simply search "therapy near me" online, and you will be connected to a wide range of professionals who specialize in your specific concern.

Investing in yourself through specialized therapy is a decision that can change your life. Don't settle for a generic approach when you can receive personalized and impactful care from a specialist who truly understands your unique needs. If you're ready to accelerate your healing and begin living the life you deserve to have give our office a call today.

Sending Love & light,

Jamie Vollmoeller, LCSW

According to a study conducted by the insurance company Lemonade, 7 out of 10 American households have at least one pet. Pets are considered beneficial for mental health, providing companionship, emotional support, and entertainment. Furthermore, as is stated by the National Institutes of Health, pets are also found to improve human health by decreasing cortisol levels, lowering blood pressure, and improving mood.

If you are reading this article, chances are you are grieving the death or absence of a beloved pet, or you have learned your pet is terminal. Maybe there is something else going on. If not, you may be doing research to help someone who is going through such experiences. Whatever your reason for being here right now, I think we can all agree the key importance of pets in our lives cannot be dismissed.

We have all heard (or made) the statement, “that animal got me through a dark, bad time in my life.” I vividly recall my dachshund, Sierra, who I adopted only a few months after the death of my mother. While I knew she could not replace my mother, her unconditional love did help to fill the heavy void within my heart. As a dog with special needs (she was born with microphthalmia, which affected her vision) and me as a human broken by despair, we helped each other. Indeed, Sierra was my best friend.

Sadly, Sierra is no longer here, but I will never forget the bond we shared.

A child holding a dog Description automatically generated with low confidence
The therapist/writer, Valerie, with Sierra.

When we consider the comfort, joy, and support given to us by pets, it makes sense why losing them can be devastating to our psyches. For some of us, our pets are closer to us than our own family members and friends – and indeed, they are our family members, repairing the wounds we suffered from others. Pets can offer the connection we need to remind ourselves we are loved. Simply think of the last time your dog ran to greet you as you came through the front door or your cat snuggled and purred on your lap.

Grieving a pet after euthanasia (being “put down”)

For some people, one of the most painful, difficult decisions they will ever need to make is to allow their beloved pet to be euthanized or “put down.” Euthanasia is frequently the merciful decision if the animal’s prognosis is poor. However, the realization of knowing you made a critical decision regarding your pet’s health and life can result in guilt, thus intensifying the grief process. You may swarm yourself with the “what-if” thoughts, such as, “should I have got a second opinion from another veterinarian?” or “is it at all possible the veterinarian was wrong and more could’ve been done?” or “did my cat even really want to die despite her being so sick?”

Unlike humans, who can help prepare for their demise through completing advanced directives, pets are incapable of making their own decisions. Thus, it is not surprising that devoted pet owners may feel complex emotions about if they did the right thing.

Grieving a pet due to an accident

A few years ago, I scheduled for my cats to be spayed. Since this was a routine procedure and my cats were seemingly healthy, I had expected nothing catastrophic to happen. Instead, I figured my cats would be fine, and that I was doing the right thing by helping control the excessive cat overpopulation. Luna recovered well. Tragically, though, my lovely dilute calico Maine Coon mix, Starla, died from the anesthesia. Post-mortem, the veterinarian discovered she had a hereditary form of hypertrophic cardiomyopathy, which is relatively common in the breed. I was devastated, shocked, and angry. I never thought trying to be a responsible pet owner would result in my cat’s untimely death.

In time, I realized Starla likely would’ve died young regardless due to her underlying condition. But in that tsunami of grief, it was difficult for me to think clearly. Rather, I thought there was an injustice.

Like my experience, some pet owners have complicated grief due to an accident that killed their pet. Whether this be a health-related issue like my Starla, or perhaps a beloved dog getting out and run over by a car, or a cat running away, such an unexpected event can complicate the grief process. They may also experience guilt or think they have failed their companion.


Starla as a young kitten, a few months before the veterinary procedure.

Grieving a pet due to surrender/rehoming and other such reasons

A final form of grief over a pet is not due to death at all, but rather in instances that an owner needs to make the difficult decision to rehome their pet. This can be for a myriad of reasons. Perhaps their animal is aggressive and thus unsafe around the children. Maybe someone in the home is ill, requiring much care, and stretching resources thin for the caregiver. Or perhaps the pet owner is experiencing unforeseen circumstances, such as job loss, eviction, or other life-changing events. The person could have become disabled and realized they do not have the ability to care for something dependent on them. Whatever the reason, the person has made the decision to give up their pet.

This type of grief presents its own challenges. Like the other two types, there is guilt, but it can be even more severe because it can be coupled with a sense of betrayal. Furthermore, such owners are also stigmatized by others, such as animal shelters’ social media pages that can portray them to have no justified excuse whatsoever to surrender their animal. This type of loss often is faced in secrecy because the owner is afraid to admit the reason behind what happened, aware they may be shunned for the violation of a social norm.

Whatever the reason for the pet loss, it is loss. It hurts. And it can hurt just like any other loss. Grief is not only for the death or absence of people.

The following are ways to help cope with the loss.

1. Recognize your grief is valid.

As a grief therapist, I can assure you it is normal to be distraught after the loss of a pet. There have been moments when my clients have confessed that they feel more heartbroken over losing their pet versus significant people in their lives. Some express feeling embarrassed or ashamed, saying things like, “the truth is, I’m sadder about my dog dying than my grandfather, but I know I’m supposed to be sadder about my grandfather.” In response, I challenge them to consider that unlike their grandfather, they lived with their dog. Their dog was never callous toward them, never judgmental, only a loving friend. And thus, of course it makes sense they would feel more grief for their dog.

For some people, pet loss can be the most difficult loss they have ever experienced. It is important for us to normalize this type of grief.

2. Understand that grief presents differently for everyone

Grief will manifest itself differently depending on the individual. In a family who lost their pet, one person may be angry. Another could be crying nonstop. Still another may seem indifferent. One person may say “she was just a cat” and think about getting another cat right away, while someone else may exclaim, “she was more than ‘just’ a cat; she was my friend, and no, I don’t want another cat!”

All people will progress through their grief journeys at their own pace, facing difficult obstacles and emotions. It is also not a linear process; instead, grief can “go backward” or be experienced more like a web or set of highs and lows. These experiences are normal.

To be of support to someone grieving their pet, simply validate their emotions. Let them know it is okay to feel the way they do.

Remember, too, that other pets in the household can grieve. When Starla died, Luna wandered aimlessly around the home for days to look for her. She seemed to finally realize Starla was not coming home. Since then, I added other cats to the family. Luna tolerates them, but she has never shown the bond with them she had with Starla.

3. Join a support group

Some individuals do not want or need a support group. For those who would like to feel less alone or are having a hard time coping because they feel their loss is misunderstood, they can benefit from peer support. They can find solace in communicating with others who are going through the same thing. There are many support groups on social media platforms such as Facebook specifically for pet loss.

4. Talk with a therapist

Yes, it is okay (and encouraged!) to reach out to a therapist to help grieve the loss of a pet and to learn coping skills for effectively managing that loss. As a grief therapist myself who has had my many heavy cries for losing a beloved pet, I will never judge you for talking about this issue to me. And it’s not just me – there're many therapists out there who would love to work with you through this issue, offering compassion, empathy, and loving support. You are not “weird” for grieving.

5. Honor your pet through memorials and rituals

For some people, a healthy way to express their grief is to honor their pet through memorials and rituals. Some veterinarians will send a grieving owner a sympathy card along with mold of the animal’s paw print. Meanwhile, some owners may choose to keep their dog’s collar or their cat’s favorite toy. Other owners may find comfort in reading the poem called The Rainbow Bridge, which suggests pets go to a special place in heaven accessible by crossing a rainbow-colored bridge.

Some people may find comfort in burying their animal in their backyard, while others may choose to do so at a pet cemetery. Others may do neither, choosing to keep the cremains, and others may not want any objects to serve as reminders. Again, there is no right or wrong decision here – all that matters is what will help you.

- Valerie Smith, LMSW, CFTG

In our hectic daily lives the quality and quantity of our sleep is often overlooked. And this is due to a myriad of reasons including children, work, stress, and interpersonal issues, to name a few. For many, this is even the case in the face of regular reminders about how sleep is connected to our mental health on the news and social media. 

So, what exactly does happens when we close our eyes? And how can we improve the quality of the rest we are able to get?

Benefits of Sleep

I’d venture to guess that everyone has, at one point or another, not gotten enough rest and felt irritable or had trouble concentrating. And this universal experience is really indicative of the larger impact that rest has on our lives. Sleep is a biological function that impacts our hormones, immune system, and metabolism. Likewise, sleep impacts us neurologically in regard to our mood, cognition, and attention. And the list goes on for both as research and science around sleep improves.

In regards to mental health, we know that many diagnoses, like depression, anxiety, and PTSD have symptoms that relate to sleep disturbances. For instance, studies show people who are suffering from depression may find it hard to fall asleep. Some people with anxiety may report similar issues with insomnia, if they find themselves worrying while in bed. PTSD can be associated with anxiety and nightmares that impact the quality and quantity of sleep hours. Likewise, studies have shown that symptoms of mania and psychosis can emerge due to sleep deprivation. 

This is all to say, getting an appropriate amount of shut-eye, without interruption, on a regular basis, may be significantly helpful in deterring the onset of mental health symptoms. 

Improving my Sleep

So, the science is there, but it doesn’t change the fact that life happens. What can we do?

  1. Set up a routine. Try to be consistent in going to sleep, in the same place, at the same time each night. Likewise, try to wake up at the same time each morning.
    1. Try to get between 7 and 9 hours of sleep each night.
  2. Make sure your environment is comfortable.
    1. Set the thermostat to a comfortable setting, shut the lights off, turn off noise so it’s quiet.
  3. Electronic screens have been shown to negatively impact our sleep because of the blue light that they emit, so give yourself 30 minutes of screen-free time before trying to sleep. 
  4. Avoid caffeine, alcohol, or large meals before bed.
  5. Exercise during the day.
  6. Try not to drink a lot of fluid before bed.

Using a Professional

These are just some general tips to help improve your routine. In some cases, medication or medical intervention, like a CPAP machine, may be necessary. Be sure to visit your primary care doctor on a regular basis to inform them of concerns regarding your sleep. For example, if you wake up in the middle of night, struggle falling asleep, or if someone is concerned about your breathing while you're sleeping.
As previously mentioned, sleep disturbances can be a consequence of a mental health diagnosis. If you feel you are overwhelmed, struggling with your mental health, or just need someone to talk to, you can reach a qualified clinician at Long Island EMDR and schedule an intake appointment at your earliest convenience. To do so, call 631-503-1539 or visit our website.

- Nicholas Costa, Social Work Intern with Hunter College

The word trauma is used in many different contexts, and it has recently been more of a topic of conversation in recent years. When people think of trauma, the typical images that may run through their heads are of war veterans, sexual abuse survivors, or even other kinds of abuse experienced. However, I believe that the population of caregivers as well as loved ones of those who are battling a deadly disease or severe medical conditions experience a trauma that does not get noticed enough. This is what can be termed secondary trauma, when one learns about the traumatic experiences of a loved one. Try painting this picture in your head: sitting in a hospital room beside the hospital bed for days in and days out with no end in sight, having not much to do other than observe your loved one in pain while they are in the hospital or at home, as well as even possibly having to dedicate all your time to care for your loved one.

Unfortunately, my family recently experienced a significant loss. My stepbrother, who was battling cancer since November of 2015, had passed away on Christmas Day. His battle with cancer is one that will never be forgotten by those who surrounded him. My stepmom and dad were his caregivers throughout the whole process. As a mental health counselor, I was keen on observing the impacts his battle with cancer had on them. For the sake of their privacy I won’t divulge, however the countless sleepless nights as well as hospital visits speak for themselves.

What are grief disorders?

Our reactions to bereavement vary from person to person, everyone has their own way in which they react to the loss of a loved one. Grief disorders come into play when an individual is experiencing prolonged as well as complex grief symptoms, these symptoms are typically more challenging for the individual to live with as well as may cause significant impairments to your normal functioning. 

Some symptoms that are consistent with complex grief are: excessive irritability, consistent insomnia or sleep difficulties, intrusive thoughts about the loss, feelings of futility, as well as having a strong sense of responsibility for the loss. These are just a few of the symptoms that correlate with complex grief; it should be noted that if you are experiencing these symptoms and if they are lasting more than two months after the loss, it can be a signal of a prolonged grief disorder. 

The Impact

It can go without saying that in these kinds of circumstances, we have someone who is ill and may be getting traumatized in the process as well as a caregiver or family member watching all of this play out in front of them, can have a significant impact on how we are perceiving this kind of trauma. I believe that this statement describes the experience of caregivers and loved ones during this time, “for some caregivers and loved ones, watching the death of someone close to them, while making no attempt to stop it, can be excruciating and lead to shock and extreme emotional distress,” (GoodTherapy). 

Intrusive thoughts are common when talking about mental health and discussing our emotions. Intrusive thoughts are simply thoughts that enter the mind unwillingly that cause some sense of discomfort, or they can be images or impulsive urges that pass through your mind. In a situation like this, it is common for people to have constant intrusive thoughts about the person who has passed. Those who have a history of addictive behaviors may resort back to old unhealthy habits, and it's even possible for one to develop a fear that is related to the loss in some way (i.e. if the death was caused by a car crash, a fear of driving may develop). 

Why is it so complicated?

The history of it all. It’s true, the history that one has with the one who has passed can impact the way that they experience grief. Whether that history is traumatic, joyful, distressful, or filled with unforgettable memories, each has a unique way of causing a domino effect. For example, if the one you have lost was a significant factor in your trauma history it may be difficult for you to wrap your head around how to grieve this individual. Feelings of confusion, conflicting emotions, feeling alone in the grief, as well as feeling guilty for holding negative feelings/thoughts towards who has passed. We see you, and it’s okay to be going through all of these emotions and barriers.

Ultimately, it is up to you to decide how you want to experience grief and how you would like to progress on the path of healing, if needed. Your family may have their own words and ways of going about the loss, but this is not something that needs to be conformed to or feel as though you should be matching the level of emotions of your family members. No. It is your journey. It is your life to drive forward. It is your time to take care of yourself, and if you start questioning the reality of you being able to take care of yourself or if you have hesitations about doing so; just remember how much you have cared for your loved one and pull that energy inwards and direct it towards you.

Grief and loss is unfortunately something that we all come to know all too well. Even with that, it still feels like getting hit with a ton of bricks whenever it happens. Throughout our lives, we make connections, friendships, relationships with people that are not forgotten. It is important not to remember your loved one as they were during their last struggling moments, but to remember them by how they were around you.

- Conor Ohland, MHC-LP

Moral injury has been defined as, “In traumatic or unusually stressful circumstances, people may perpetrate, fail to prevent, or witness events that contradict deeply held moral beliefs and expectations” (United States Department of Veteran Affairs). 

Essentially, moral injury can occur when someone either engages in or witnesses an event and/or action that goes against their own personal values, ethics, and beliefs. There are two types of acts that can lead to moral injury; acts of commission and acts of omission. Acts of commission refer to actions people take that go against their own morals and/or belief systems. While acts of omission highlight when someone intentionally does not take action on something that leads to an adverse event that goes against their own morals and ethics. 

To clarify, an example of an act of commission may be that a military member kills civilians in the midst of performing combat related duties. An act of omission might be a physician not taking someone off of life support despite patient suffering due to the patient's family making the decision to keep the patient on life support. 

So why are we talking about this?

Well, oftentimes we tend to associate the term “moral injury” with military personnel and military related tasks/traumas. However, moral injury extends to multiple life experiences in addition to the military experience. For example, those who are in the healthcare and/or mental health care field, first responders, survivors of crime, and survivors of intimate partner violence may also deal with the negative thoughts, feelings, and even potential decrease in functioning related to traumas associated with moral injury.  

What types of situations can lead to moral injury?

While we can take an educated guess that engaging in and/or bearing witness to a violent war event is traumatic and will create moral injury in most of us, there are other scenarios in the civilian world that can also inflict moral injury.

For example, during the height of the COVID-19 pandemic, healthcare workers across the world were stretched incredibly thin; working longer hours, having to isolate from their families for extended periods, seeing a high volume of patients, and not always being able to help dying patients see their loved ones one last time before they left this world. The unimaginable stress of working in healthcare at the height of the pandemic led to unavoidable moral injury on various fronts, given there was so much out of our control and so many difficult decisions had to be made. There are even people who blame themselves for others' deaths after unintentionally and/or unknowingly exposing people to the disease, healthcare workers or not.

Then, there are those who are survivors of violent and/or sexual crimes that often suffer with depression, anxiety, social isolation, grief, and resentment towards themselves, others, and the world based on their own traumatic experiences and moral injuries sustained. They might blame themselves for what happened to them, whether that be rape, sex trafficking, or assault. They may know their assailant and still have love and/or affection for them, which creates an internal storm of emotions and confusion.

People who suffer with moral injury often deal with bouts of depression, shame, anger, disgust, distrust, and self loathing. Such feelings can compound with clinical depression, anxiety, or even post traumatic stress disorder that makes moving forward in our lives that much harder. Maybe we notice ourselves to “shut ourselves off” to others, the world, and ourselves…we just can’t trust anything or anyone anymore which creates negative bias that impacts how we live our lives. We feel more isolated because we feel shameful or disgusted by what happened, so we disengage which ultimately fuels the anxiety, anger, sadness, poor sleep, helplessness, and hopelessness that may come with moral injury. 

So, what do we do to heal?

Much like any emotional wound, it is important to be able to have the felt safety to talk about our moral injury without being judged. Simple, right? No! Dealing with the dissonance that comes with moral injury is hard enough for the sufferer, but it is discouraging when we think about telling a trusted loved one with fear of being met with “well, why didn’t you just do this?” or “Oh, I would have handled that way differently” or “You could’ve just said no”. Sometimes we may be met with such responses; or, sometimes we may have unconditional love and nonjudgmental support. But we can’t know until we put ourselves out there as a first step in healing. Again, I acknowledge that this is far from easy.

Research also points to forgiveness and self compassion as means of coping and healing from moral injury. How is that done? Well, therapists can help you talk about the event(s) leading to your moral injury followed by discussion of negative beliefs you hold about yourself, others, and/or the world as a result. From there, your therapist can help you find ways to accept the reality of the occurrence and forgive yourself to release the hold of self hatred and condemnation. Your therapist can teach skills to reinforce self compassion, such as learning self empathy and acceptance to lift the burden as well. This work is nowhere near easy, but with time and dedication, the wounds of moral injury can be healed so that you can live your life again.

- Jackie Martinez, LMSW (NY), LCSW (NC)

For some people dealing with the death, illness, or absence of a *significant person, the holidays can be a time of mixed emotions like sadness, guilt, grief, as well as hopelessness. On one hand, we are expected to be festive and merry; on the other, we are reminded that person is no longer here or in the capacity they once were. It can be exhaustive to cope or grieve. Unlike an anniversary or birthday, where the day itself can be dreadful but otherwise there are limited triggers about it, the holiday season is different. The sights, sounds, activities, and gatherings go on for weeks.

Note: I use the term “significant person” rather than “loved one” in recognition that grief is complex. Not all people had loving, supportive relationships with the person who died, but regardless that relationship was still of profound importance. “Significant person” is thus an inclusive term.

Unquestionably, some holidays during other times of the year can be bittersweet, such as Mother’s Day or Easter. Yet as a culture, the holiday season seems to be the most profound in its importance for its emphasis on family gatherings. Thus, it is not surprising that for many people Thanksgiving through New Year’s Day can be especially hard.

The Grieving Grinch

A long time ago, I was close to someone who detested Christmas. He was a classic Grinch. From around September and onward, he would be triggered by reminders. It could not be avoided – every store was already getting decked out with Christmas decorations and toys to sell. By the end of October or perhaps early November, Mariah Carey was already bleating over the speakers at every store. This despair from September through January went on for years, with me making every effort to try to make the months more tolerable for him. Eventually, though, I realized he was too caught up in his grief. I told him that he has no control over the holiday season; that he must radically accept it will come every year no matter what, and that the more he fought against it the more it would breed misery for him. I encouraged him to instead honor his losses, truly grieve, but to still try to enjoy other aspects of the season. He insisted he wanted to avoid it. I asked him to consider, “how exactly would you avoid Christmas?” and he said he would lock himself in his room. My response: “Which would mean you would need to sleep for months. You wouldn’t be able to turn on the TV, go on the internet, listen to the radio, really… anything. Because the point is that no matter how much you try to ignore Christmas, it will come anyway.” I don’t know why, but somehow that dry, matter-of-fact response got him to begin thinking differently – he finally stopped fighting the “hatred” which in truth was grief. He was avoiding his grief.

Grief Coping Strategies

While by no means a complete list, the following are tips you may use to help you get through the holiday season if caught in grief.

Skip the holidays – but with a plan

Yeah, I know. I just got done writing about that person where I gave him the exact opposite advice. Hear me out.

The holidays are stressful enough. Compounded with grief, they can feel downright unbearable. The traditions, shopping, cooking, family, parties… all of it can feel tiring even when thinking about it. I want you to know it is okay to skip the holiday season. You may face backlash for saying no to Thanksgiving dinner, but your self-care comes first.

Remember these points before canceling your holiday season:

1) The holidays will come again. This year you may not have the energy to deal with the holidays, but next year may be different. At that time, you may feel ready to engage again. Do not think you have to be in a rut each year. That is unfair to you.

2) Ask yourself, “am I skipping the holidays to help myself or just to avoid the pain?”. If you need to, take your pen to paper to come to this answer. You may truly want to skip the holidays, or  maybe you are feeling pressured by others (family, society, etc.) to celebrate.

Additionally, ask yourself if you are prioritizing your self-care versus having avoidance. In psychology, avoidance coping is a maladaptive coping mechanism (in other words, an unbeneficial or unhelpful technique) that means to avoid processing the thoughts, feelings, and stressors associated with an issue. In grief, this can mean you are refusing to process the loss of the significant person, procrastinating things that need to be done that remind you of the person, or being in denial of emotions you are feeling. While this seems helpful in the present moment, it only intensifies the anxiety. It festers like an untreated wound.

3) Decide what you will do for the holidays, rather than only what you will not do. Remember that if you say no to going to dinner at Uncle Joe’s house, ultimately the rest of the family will be there. Then what? What is your plan? Before that day springs up on you, plan accordingly. If your idea of self-care is to binge-watch Cobra Kai in your bedroom on Thanksgiving, do so! But do not wait until the holiday arrives to try to plan as that may increase your negative emotions; you may make yourself feel unintentionally worse.

4) You may have regret or sadness if you skipped the holiday. On that day, you may go on social media only to notice the get-together at Uncle Joe’s house looked fun. Maybe there is a funny video of your younger cousin making a snide comment on TikTok. Maybe your sister posted a Facebook video of your three-year-old nephew unwrapping presents with a big smile. Ask yourself if it is worth you skipping the holiday or instead if you may find happiness in being with others.

Did you watch A Muppet Family Christmas special when you were younger? If so, remember when Fozzie Bear and his friends drove to Fozzie’s mother’s house with the intention of spending Christmas with her, only to find out she rented out the home to a man and his dog who wanted to avoid everyone for Christmas while she ran off to Malibu? Although the man was upset at first that his holiday did not go as planned, he ended up having an even better time because he allowed himself to join in the festivities.

5) Or you may have an even better day if you put yourself first! In that same special, Fozzie Bear’s mother was having the time of her life on the beach in Malibu.

Do not make comparisons

It is tempting to see other individuals or families enjoying festivities and comparing their experiences to your grief. You may feel worse, like you “should” feel merry.

It is important to remember that even under the best of circumstances, the holidays are stressful for most people and families. The sappy, magical events shown on television and captured in greeting cards are rarely the reality. For instance, you do not know if the hostess of the dinner was in a vicious argument with her spouse only minutes before the guests arrived, only to hide it all behind a beaming smile. You do not know if the parents are struggling to buy presents for their children. Instead, think about what you do have – you may feel more gracious!

Extend yourself to others

If you have the time, consider volunteering your time to someone who needs the extra support (Long Island Volunteer Opportunities). This could be spending the holidays at a hospice, nursing home, hospital, soup kitchen, or shelter. Your love and support toward a stranger may make their holiday memorable and bright, while benefiting your own mental health by taking your focus off the grief. Volunteering is very helpful in the healing process of grief!

Alternatively, reach out to a family member or friend who may need some help right now.

Remember that the anticipation can be worse than the day

In my work as a grief therapist and as someone who has experienced significant losses, I have noticed the phenomenon of anticipation being worse than the holiday itself. My hypothesis is that by experiencing the surge of emotions beforehand, we are thereby allowing ourselves to think the day itself will be awful, which will make us feel better when that day arrives, and we find we are okay. In essence, it is making us “cope ahead” by going through the storm beforehand.

Find support

You may reach out to friends and family for emotional support with your grief, but are worried about doing so because they may be preoccupied with the holiday season. Consider joining a grief support group.

Let yourself feel your emotions

Your emotions are valid. Do not think you must feel happy because it is the holidays or otherwise there is something “wrong” with you. If you feel angry, let yourself vent. If you feel sadness, allow the tears to flow. If you feel lonely, reach out to a friend.

Ask for help

We as a culture tend to be cautious of asking those who are grieving if they need help. We may assume it would be an unwanted reminder or we simply do not know what to say. Other times we may think that the bereaved are doing okay.

Please speak up if you need help from a friend, neighbor, or family member. Perhaps that entrusting someone else to make a particular favorite dish, cleaning up the house, or getting some other tasks done. People tend to feel satisfaction when they know they are caring for someone they love.

Other ideas

Are you looking for more ideas for coping through the holiday season? If so, go here.

- Valerie Smith, LMSW

Losing a parent is a life-changing, profound experience that almost everyone will go through at least once. In fact, the death of a parent is one of the most common types of death, and as a society, we expect we will outlive our parents. As a result, while the grief that accompanies the death of a parent can quickly be recognized with the inundation of flowers and sympathy cards, this commonality seems to minimize the loss and makes us think we should “get over” it soon. The truth is, it can still be a tremendous loss – and this sense of “get over it” can make the healing even more difficult because it comes with guilt.

While the death of a parent regardless of one’s age is universally a colossal experience, the death of a mother or father as a young adult can be even more devastating because it is compounded with unique obstacles. For instance, there are milestones that the parent is expected to be present for, such as college graduations or weddings, and it can seem impossible for anyone else to fill that space. Plus, for young adults, this type of loss can be especially difficult because they are on the cusp of dependence versus independence. While they strive to depend on themselves, they still may turn to their parents for financial assistance, emotional support, or the wisdom of lived experience.

And we know this much: When a parent dies suddenly or expectedly, there is an absence – an emptiness, perhaps – that arrives with the realization someone so significant is gone. Regardless of the relationship dynamics, whether it was balanced and warm versus chaotic or cold, the death will have a huge impact.

Some beliefs among young adults who have dealt with the death of one or both parents

“I feel so alone and misunderstood.”

“My best friend says she ‘get its’ because she lost her grandma. But I lost my mom. It’s just not the same.”

“I will never feel loved that way again.”

“Everyone is telling me I need to ‘get over it’ and start living my life. But how am I supposed to move forward knowing I’ll never hear Mom’s voice ever again?”

“Dad’s gone. Who is going to walk me down the aisle?”

“I’m so sick and tired of my friends complaining about their silly problems! They have no idea what it’s like to be in this much pain!”

“I’ve always wanted to be a mother. I wanted so desperately to have a family of my own. Now that I’m pregnant, I should feel excited. But instead, I’m just thinking about that my baby will grow up without grandparents.”

“Thanksgiving is going to be weird this year. Dad always sat at the head of the table. He always carved the turkey. He always said grace. I just don’t even want to go.”

“Mom has been an absolute mess ever since Dad’s been gone. I want to help her, but she doesn’t seem to care that I’m hurting too. It feels like she’s gone too even though she’s here.”

“They say they’re ‘here for me’ but they’re not. No one wants to talk about Dad anymore now that the funeral’s over. If I say something, I’ll sound negative.”

“My friends have told me I need to start ‘living my life’ again. They’re sick of me being so mopey and depressed. I’ve noticed they’re pulling away from me. Now I feel like I’ve not only lost my parents, but even my own friends, the same people who said they’ll always be there for me no matter what.”

“I hate to admit it… I feel guilty saying it… but yeah, I’m jealous of my friends. While they’re looking forward to happy things like getting married or graduation, I’m taking care of my mother who is terminal. She’s going to die and that’s that.”

“It pisses me off when people tell me ‘She’s in a better place now.’ It invalidates how I’m feeling.”

Above: Me on my wedding day, trying to replicate my most favorite photograph of my mother on her wedding day in an effort to feel her presence again.

The adult orphan syndrome following the death of a parent

For most people, they have known their parent(s) longer than anyone else in their lives. Whether the relationship was positive or negative, or there were additional issues like separation, parents still shape their children.

The identity of “son” or “daughter” is the first identity upon us all. Most people were cared for by their parents as they grew up, even if not done well, and their parents witnessed all the obstacles along the way – seeing all the rises and falls, all the happiness and despair, all the pulling in and pushing away for guidance.

By adulthood, we have formed far more identities while carrying over some from childhood. Yet the age never matters – we continue to be a son or daughter, the role carried from since the beginning.

To lose a parent thus brings about a role loss. When I lost both of my parents, I realized my first role – “I am a daughter” – was destroyed too. And my first sense of constancy, of a promise something will always endure, had died too. We all seem to realize we will likely outlive our parents, but the idea of them dying is so often shaken off until it happens. We see the relationship as permanent as the sun rising with every dawn.

Losing a parent in adulthood can bring about complicated emotions, one of them being abandonment. Even people who are very independent from their parents can still feel abandoned because the sense of constancy has been disrupted.

For young adults who were the main caregiver for an aging, disabled, or ill parent, the grief can be exacerbated since two roles are now lost: the role of being one’s child but also serving as their “parent.” It may also mean having to adopt new roles in the family going forward, such as needing to help the surviving parent with paying bills because they feel overwhelmed and that was always done by their spouse.

All of these issues are recognized by some researchers as what they call “adult orphan syndrome” in that the feelings of abandonment, confusion, role changes, lack of support, and idea of being alone are universal regardless of age. For some, the idea of being an orphan as an adult may sound insensitive to children who are orphaned, but it is not meant to compare or dull that pain – only meant to show that the feelings and complications can still exist.

It is interesting, too, that this type of loss has no such word in English. An orphan literally means a child whose parents are dead. A widow is a woman who lost her spouse; a widower a man who lost his spouse. Yet why not a word for those who lost a parent in adulthood?

Challenges faced by young adults experiencing parent loss

Although parent loss can be painful at any age, there are differences that are driven by our age brackets.

First of all, most young adults have parents who are alive and likely well. They may be mostly independent, but they know they can still rely on their parents when needed (obviously there are exceptions, but I am speaking in general). They and their friends will be “going home” for the holidays during college breaks to stay with their parents. They know their parents will be there at their commencement ceremonies, sharing in their joy for their successes. They excitingly call their parents when they get engaged, wanting them to be the very first people to know. Then during the engagement months, their parents are involved too, with the mother helping with choosing the dress and adorning her daughter on her wedding day, and the father walking her down the aisle. Parents, too, are also usually the first to learn when their child and the child’s partner are expecting a baby. And they are there for the baptism or other ceremonies, there for the birthday parties, the holidays, for help with childcare.

While these above milestones can still occur despite the death of one or both parents, it feels different. I will honestly admit I skipped my commencement ceremonies from college and graduate school (the pandemic did postpone the latter ceremony by a year, but regardless, I still did not go even when it was happening). I did not want to be “that person” who was there without their parents, that adult orphan. And while I was proud of myself, having been summa cum laude both times, I did not feel there were others to share in that sense of accomplishment.

I can also say that among my friends and family members, most of them do not understand what I have gone through as a parentless young adult. That is not subjective; it is factual. Some are fortunate to still have their parents. Others have lost their parents, but that was not until their mothers and fathers were in their geriatric years. My grandmother died at the advanced age of 93, an age considered a “life well lived.” My mother died at 57. While the adult orphan syndrome happens at any age, and pain is pain, it still does not feel the same. There is the lingering thought, “she should be here.”

Healing from parent loss as a young adult

The goal of bereavement therapy is not to “get back to normal.” That is impossible, for life has forever changed due to the death of the parent. The idea of having to “move on” is counterproductive, and in fact can make someone feel worse because they are burying the emotions they need to process. Instead, the goal after such a loss is to learn to redefine one’s life and to feel fulfilled despite the loss. It also not only the loss itself that must be explored, but also the update in roles, the severance of expectations, and all other things that come with death.

Losing one’s parent can unearth disturbing thoughts. It can make someone question their own mortality with the realization they too will die someday. They may think things like, “since Dad died at 45, that means I’ll die at 45 too” even if they realize that is irrational. Additionally, it can make one reflect on the importance of other relationships in their lives. One person may become closer to their siblings or friends, while others may distance themselves, and still others may decide to focus solely on their spouses and their children.

Such a loss can also be an inspiration to make newfound changes in one’s life – some for the better. For me, I was smacked with the realization of, “I must rely on myself. I am an adult” the moment my father died. This realization did not strike me when I moved out at age 19 to live across the country. It did not fall upon me on my wedding day. Hell, it did not even come up during the discussions with my husband about starting our own family. No, it really took him dying for me to have this fricken’ epiphany. Only a month after his death, I was on job interviews to have greater opportunities. Right now on the weekends, I am house-hunting with my husband rather than doing the same ol’, some ol’ things we did with our friends. We are trying to conceive.

I was already following a plant-based and low-alcohol lifestyle, but after my father died, I made the full commitment to being healthy. I make selective, nutritious choices, and I do not drink at all. A healthy lifestyle is my priority now, my sworn vow to myself, because I don’t want to die the way my parents did if I can help it. I want to live. One profound effect of the loss of one or both parents is the opportunity for positive changes.

The next step

Long Island EMDR recognizes the aftermath of a death is a significant, life-altering process. Some of our clinicians specialize in grief and bereavement, including having specialized training in this important field. We offer individual therapy and group therapy for this topic. In fact, we are even starting a group called Millennials in Mourning, which is specifically for Millennials and older Zoomers who have experienced parental loss. It will be led by me, Valerie Smith!

Reach out today to learn how we can help you navigate through this challenge while building a brighter future.

About the author, Valerie Smith, LMSW
Valerie Smith, LMSW, CFTG, is a therapist, social worker, and certified forest therapy guide at Long Island EMDR under the supervision of our clinical director, Jamie Vollmoeller, LCSW. Valerie possesses a bachelor and master’s degree in social work from Adelphi University and Fordham University, both from which she graduated summa cum laude. Valerie is also a certified forest therapy guide through the Association of Nature and Forest Therapy (ANFT), where she trained in the Rocky Mountains to master sensory-based, mindful activities through a biophilic perspective. Valerie is passionate about the health benefits of a plant-based diet as well as holistic wellness. Valerie is trained in EMDR and TF-CBT, with experience in DBT-informed skills. She focuses her treatment on adolescent girls and young women with C-PTSD and PTSD. Additionally, she helps people with life-threatening disease and their caregivers. Finally, she works alongside those experiencing grief and bereavement, especially young adults who lost one or both of their parents/guardians.

Everyone ruminates. Whether it’s thinking about something we said to someone, something we did wrong, or some recent event that is stuck in our mind. Ruminating thoughts can be defined as repetitive and recurrent, negative, thinking about past experiences and emotions (Michael, et al., 2007). However, while everyone experiences ruminating thoughts at some point in their life, for some, rumination can be distressing, difficult to stop, and can lead to dysfunction in their day-to-day lives.

Why do we ruminate?

When we think about ruminating, it’s important to acknowledge that it often comes from an effort to cope with distress. For instance, analyzing an experience can better prepare us to encounter a similar experience in the future. Or it can help us mend some relationships that were negatively impacted by an event in the past. But, when these thoughts aren’t leading to any productive change we can see individuals obsess over these thoughts, become anxious and depressed, isolate, or begin using / increasing their use of mind-altering substances.

Types of ruminating thoughts?

Ruminating thoughts can be very diverse. For some, they may ruminate about their hands being dirty and that they may get sick. Others may ruminate about suicidal thoughts, including existential themes about the meaning of life. Some may continually think about a traumatic experience, like an assault or some form of abuse. As well, some of these ruminating thoughts may be untrue distortions of events. For example, repeatedly thinking about being sexually assaulted may come with false thoughts that the victim somehow provoked their assailant or deserved to be assaulted.

Are my ruminating thoughts true?

Our experiences mold our self-esteem, or the way we perceive our behaviors, abilities and traits. A traumatic experience can leave individuals with warped perceptions of themselves that can have a detrimental effect on their day-to-day lives. Especially the formation of a negative self-esteem, or negative self-concept, is associated with feeling disempowered, hopeless, and helpless. Ruminating on these experiences, or even these self-beliefs, has been shown to exacerbate and prolong negative moods, and hinder social interaction and problem-solving skills (Wang, et. al, 2018).

Are ruminating thoughts part of a diagnosis?

Ruminating thoughts can be associated with a number of mental health diagnoses, including:
● Depression 

● General and social anxiety 

● Substance abuse disorder 

● Bulimia 

● Binge eating disorder 

● Obsessive-compulsive disorder

● Post-traumatic stress disorder 

● Personality disorders, like borderline personality disorder 

There is hope!

Ruminating thoughts are treatable and manageable. Treatment often aims to interrupt the thought processes and improve coping skills to replace rumination. Some individuals find relief from medication management, cognitive-behavioral therapies, and mindfulness techniques. 

If you experience ruminating thoughts and are looking for a way to move forward, please call our office and schedule an appointment. Our licensed clinicians and therapists on staff would be more than happy to work with you.

-Nicholas Costa, SFT Social Work Intern

Art therapy is a newer form of therapy. It is an integrative mental health practice that is designed to improve the lives of individuals, families, and communities through the process of art-making, creative process, applied psychological theory, and human experience within a therapeutic relationship.

Art therapy should be done by a trained professional of art therapy. This will improve the  effectiveness as art therapists are trained to create art therapy exercises that are designed to not only support you but also to help move deeper into your therapeutic goal.  Art therapists are trained to use their knowledge to support your personal and therapeutic treatment goals throughout treatment. Art therapy has been used to improve cognitive and  sensorimotor functions, help support a better relationship with self-esteem and self-awareness, produce emotional resilience, promote insight, enhance social skills, reduce and resolve conflicts and distress.

Art therapy is a wonderful tool therapists use to help patients interpret, express, and resolve their emotions and thoughts. This is a newer type of therapy and was first established in the 1940s however the practice did not become more widespread till the 1970s. Like other expressive arts therapy, such as dance therapy or music therapy, it draws on creativity.

Inaccurate Use of Term 'Art Therapy'

Often people mistake  “Art therapy” for things that are not necessarily due  to a lack of knowledge about the profession. However these situations provide an opportunity to offer accurate information and educate the public. This modality must be done by a trained art therapist or it is technically not art therapy. Some products that are mistaken for art therapy are adult coloring books and paint by numbers. Art therapists are not art teachers, their goal is not to make you a better artist but to help you improve your mental state through the use of art.

How Art Therapy Works

Many people ask "What is art therapy and how does it work?" It is all about  expression. The process of creating is the most important thing, not the end product which is why anyone can do it. Often many people shy away due to a fear of not being an artist but this type of therapy is for anyone. It is designed to use the expressive arts as a way for people to understand and respond to their emotions and thoughts with a valuable new perspective, not only that artistic expression is good for mental health as it is often related to relaxation.

During a session, an art therapist works with clients to understand what is causing them distress. Then the therapist guides the client to create art with an art directive that addresses the cause of their issue or explores it further. During a session, art therapists may:

Through different mediums and art techniques art therapy engages the mind, body, and spirit in ways that are not dependent on verbal articulation alone. Due to the way it engages the body and mind it causes various symbols to be created through the art process, this process also invites modes of receptive and expressive communication, which can benefit those who have limitations of language.

Who are Art Therapists

Art therapists are clinicians who are trained both in traditional clinical therapy and art therapy. Art therapists work with people of all ages and various populations. All art therapists are required to follow an ethical code. All art therapists are also required to have a master’s level education, as well as engage in supervision hours under a trained professional in order to obtain their license. This prepares them for various populations and gives them the ability to perfect their work.

Where Art Therapists Work

Art therapists work with individuals, couples, families, and groups in diverse settings. Some examples include:

Does Art Therapy Work?

There is growing evidence that art therapy helps conditions such as anxiety and depression, trauma, low self-esteem, PTSD, Bipolar  and similar disorders. It has also been used with those facing terminal illnesses such as cancer and those hospitalized experiencing pain, as well as it has been used with people working to develop effective coping skills, including prison inmates

Many clients are reluctant to explore art therapy because they think that they have to have artistic talent for it to work or see it as "arts and crafts" rather than see it as an effective tool. This mindset can be very limiting and can hinder the  effectiveness for these clients. It is important to go in with an open mind.

Is Art Therapy a Good Fit?

There's no way to tell for certain whether art therapy is a good fit for any given person. Therapy is not one-size-fits-all, and a client and therapist may need to use multiple different approaches and techniques in order to find what works best for you. However, if a patient is drawn to art or has had trouble expressing with traditional therapy, art therapy may be a wonderful fit for you.

When choosing a therapist it is good to consider the following. As a potential client, ask about:

Often you should be able to tell in 1-3 sessions if this works for you.

Think Art Therapy Would Benefit You?

If you feel like art may be a good avenue for you to work through your mental health concerns please call our office and ask for Jillian Martino. Jill is our art therapist on staff and would be more than happy to help you work through your concerns through art. Jill specializes in LGBT issues, trauma, children and couples. Contact our office today to set up a free 15 minute consultation.

-Jillian Martino, CAT-LP

Throughout Western societies, we buy into the prevalent sociocultural belief of the stage theory of grief. As if to bring comfort and understanding of our loss, we are told we should progress through a series of five stages: denial, anger, bargaining, depression, and acceptance.

Even while I was in graduate school for social work, I can vividly recall some professors ascribing to this model, never once questioning if their claims were accurate since it seems to be a universal statement as true as 2+2=4.

In short, this belief pushes the idea that bereaved individuals must undergo a specific sequence of reactions over time as the result of the death of someone who was significant to them. Not only is this inaccurate since individuals may not experience all the stages in their set order, but it also is stigmatizing to those who never experience the stages at all as they may think there is something “wrong” with them. Thus, I argue that the stage theory should be abandoned, for there are newer, different models that are more accurate for illustrating the grief journey.

On the History of the Five Stages of Grief

In 1969, psychiatrist Elisabeth Kübler-Ross introduced the model in her groundbreaking book On Death and Dying. At the time, there was a severe deficit in medical schools on the topics of death and dying, which motivated Elisabeth Kübler-Ross to do the research herself by observing the reactions of her patients with terminal diseases. She was also influenced by some researchers with stage models from decades earlier.

Quickly, the Kübler-Ross Five Stages of Grief model was branded as universal knowledge among the medical community, scholars, and the public at large.

Later, Kübler-Ross clarified she never intended for the stages to be viewed as a linear progression, and that she wrote them in a way that was misunderstood. She added she meant for the stages to reveal how people with terminal illness cope with learning they are close to death, not as a reflection of how people grieve once that person has died.

In a later book Kübler-Ross coauthored, she lengthened her model to consist of all forms of loss, such as bereavement (the specific term designated for the death of someone who was significant), the end of a relationship, unemployment or loss of income, substance abuse, incarceration, infertility, and the diagnosis of disease. Thus, at best, the model is helpful for understanding grief across multiple contexts.

Major Problems with the Model

Unfortunately, there are significant problems with the Kübler-Ross model. They include the following:

Please note: For a detailed report on the problems resulting from the Kübler-Ross model from an academic perspective, please visit the citations at the bottom.

On Grief Recognition and Resolution: The TEAR Model

In an effort to replace the Kübler-Ross model with a more practical, forgiving model to help people navigate through their bereavement, therapists and other professionals have adopted the TEAR model. This is also known as the Four Tasks of Mourning and is explored in-depth by researcher J. William Worden.

T: To accept the reality of the loss.
E: To experience the pain of the loss.
A: To adjust to the new environment without the lost object.
R: To reinvest in the new reality.

Notice the paramount difference between the two models. In the 5 Stages of Grief, acceptance is at the end of the sequence which assumes the work has been completed. Conversely, in the TEAR model, acceptance is at the start of the journey. In other words, grief work can only begin once the mourning period has ended. It must come after the sympathy cards, texts and phone calls have stopped. It approaches when the bereaved individual is expected back at work or school, operating as if things are “normal” like nothing happened.

This comes after the mourning period, after when the sympathy cards, texts and phone calls stop coming. This is when the bereaved individual is expected back at work, operating as “normal” like nothing happened.

It is time we discard the widespread belief that grief is a set of prescriptive stages. We should embrace grief as an ongoing set of work, ready to be approached only once the public mourning has ceased. Acceptance is the prerequisite to face true, raw grief, and from it come recognition and resolution.

Further Reading:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375020/

https://web.archive.org/web/20100322212850/http://home.windstream.net/overbeck/grfbrf13.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375020/

About the Author, Valerie Smith, LMSW:
Valerie Smith, LMSW, CFTG, is a therapist, social worker, and certified forest therapy guide at Long Island EMDR under the supervision of our clinical director, Jamie Vollmoeller, LCSW. Valerie possesses a bachelor and master's degree in social work from Adelphi University and Fordham University, both from which she graduated summa cum laude. Valerie is also a certified forest therapy guide through the Association of Nature and Forest Therapy (ANFT), where she trained in the Rocky Mountains to master sensory-based, mindful activities through a biophilic perspective. Valerie is passionate about the health benefits of a plant-based diet as well as holistic wellness. Valerie is trained in EMDR and TF-CBT, with experience in DBT-informed skills. She focuses her treatment on adolescent girls and young women with C-PTSD and PTSD. Additionally, she helps people with life-threatening disease and their caregivers. Finally, she works alongside those experiencing grief and bereavement, especially young adults who lost one or both of their parents/guardians.

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