Significance of the study and its implications for practice

The present study is relevant in the light of the paucity of research into the therapists’ lived experience of grief and their experience of on-going clinical work in the midst of their vulnerability. Research into therapists’ vulnerability has largely comprised anecdotal accounts, quantitative studies and unpublished dissertations which have generally lacked rigour, depth of analysis and generalisability. Two recent studies (Broadbent, 2013; Kouriatis and Brown, 2013-2014) have attempted to bridge this gap

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by exploring this phenomenon using IPA: the first studies to do so. The present study constitutes a further contribution to this under-researched area.

Broadbent’s (2013) study, however, involved four participants, all of them female. In contrast, the present study utilised accounts from seven participants, of whom five were female and two male. The data that has emerged therefore reflects the study’s more gender-balanced sample, an aspect which strengthens the transferability of the findings. Moreover, the present study has brought to light aspects of the phenomenon of therapists’ bereavement and their on-going clinical work not captured in

Broadbent’s study. For example, Broadbent’s research did not capture therapists’ difficulties in managing their grief whilst in the room with their clients, an important finding of the present research. The existentialist framework of the present study, which is not shared by Broadbent’s research, offers a broader perspective on the topic.

In a similar way, Broadbent (2013) discusses the validating role of supervision when practicing therapists experience bereavement. However, the issue of supervision did not emerge as figural in my transcripts and was therefore not prominent theme in the present study. Perhaps this is a reflection of my particular group of participants as well as how these themes were touched on and explored in our interviews.

Participants largely spent a significant amount of time exploring their lived experience of loss and how they experienced the therapeutic encounter with their clients in the aftermath. I sought to bring the issue of supervision in via my interview schedule but felt that participants, on the most part, did not delve particularly deeply into their experience of this. As such during analysis of the data, I found this aspect to be less figural and representative than the others.

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Kouriatis and Brown (2013-2014) also conducted a similar IPA study of therapists’ loss experiences and the impact of loss on their on-going therapeutic work. Whilst the present study is similar in that it sought to limit the disenfranchisement of loss by allowing participant’s to define ‘significant other’, Kouriatis and Brown (2013-2014) take this one step further allowing for any significant loss, as defined by participants including those not confined to bereavement. As such, the present study, focusing specifically on loss through bereavement, presents a somewhat more homogenous sample and might allow for more transferability. Furthermore, Kouriatis and Brown (2013-2014) interviewed six therapists from their own professional and academic environment which may have hindered bolder self-disclosures on this sensitive topic.

This research has a number of potential implications for practice. Acknowledging the open-ended, individual and evolving nature of grief gives individuals the space, freedom and acceptance to absorb the all-encompassing nature of loss. This is as pertinent for bereaved therapists as for individuals generally. While revealing that loss experiences are gradually integrated into a person’s worldview, the current study also underlined the importance of recognising that grief is not always linear and that other life experiences can interact with one’s experience of loss at any time, changing the course of its development. This suggests the importance of counteracting any tendency to disenfranchise grief over time (Doka, 2009; Martin, 2011). As therapists, we can utilise our knowledge and understanding of grief to enhance our self-

awareness and self-monitoring, not simply for the benefit of the therapeutic endeavour but also for our own benefit.

The current study also suggests that therapists might gain by challenging their unrelenting standards and developing a more compassionate approach to their own vulnerability. This would involve unpacking the intricacies inherent in the therapist’s

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professional and personal identity: the ‘self’ which informs their work (Mearns & Cooper, 2005). It would require looking more closely at the influence of training and theoretical knowledge as well as of significant life events. While therapists are taught to be discreet (especially in the therapy room), such discretion can at times interfere with their ability to share their loss and learn from others (Martin, 2011). They may need support or advice on how to continue in practice (Adelman & Malawista, 2013).

By normalising and sharing experiences that impact them, therapists may be able to break away from the fear that self-exposure will be met with personal or professional sanctions. They may be more inclined to work through their difficulties

therapeutically and by accessing professional support. They may also be more inclined to be compassionate towards fellow therapists who may be exposing their vulnerabilities. By acknowledging their human limitations, therapists open up the possibility of better managing or supporting themselves. By recognising that personal life crises (such as loss) can and do enter the therapeutic space, therapists may perhaps gain insights into how their vulnerability could be used for greater connection with clients.

Given that the personal and professional lives of therapists often merge, their ability to process their own grief is closely tied to the intricacies of their working selves. While much of their working life is spent in the company of others, paradoxically they are often alone with their thoughts, feelings and reflections (Adelman & Malawista, 2013). In this situation, education and self-advocacy and care, sensitivity to loss, self- validation, and dialogue all have a role to play in preventing the “silent but terrible collusion to cover up pain” (Verghese, 1998, p.341). In tandem, they can foster an authentically supportive professional environment which could facilitate the integration of loss.

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Therapeutic work is often unpredictable and laden with ambiguity and uncertainty. Therapists cannot predict what clients will bring to the therapeutic hour, nor what might arise during it. This uncertainty is heightened when a therapist is grieving or in a similarly vulnerable space. Bracketing and leaning on professional rules can be of help as therapists navigate this unpredictable environment. While they may have ample support at home related to their loss, at work there may be a bracketing off of their experience of grief. This is especially the case where therapists are working alone or in an environment which does not encourage open reflection or provide the space to reveal vulnerability.

Bracketing comes at a cost, however. For one thing, it may impact on therapeutic presence. As a promoted therapeutic technique, bracketing may also be applied rigidly in an attempt to ensure the therapeutic space is not contaminated by therapists’

material and as a means of self-protection. Moreover, bracketing does not necessarily eradicate the therapist’s influence; even the use of technique cannot separate

therapists from their sense of embeddedness in the therapeutic encounter. This may lead to a negation of their self-experience (Jaenicke, 2007).

It is also important to remember that even if a client is unaware of a therapist’s bereavement, this does not mean that the client will not pick up on the therapists’ altered state or be impacted by it. Rather than being seen as problematic, this may provide therapists with an opportunity to consider in greater depth how they are engaging with clients in their state of vulnerability. Therapists may also be stimulated to reflect on how their attempts to separate the personal from the professional, the vulnerable from the strong parts of themselves might shape the way therapeutic work unfolds.

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The findings also suggest that in order to be able to utilise their loss experience for the good of therapeutic work, therapists need to have reached a particular point in their own grieving process: one where they have access to their emotions in a way that enhances the therapeutic relationship and allows them to attune with the client. This might be facilitated by tailored supervision and by peer engagement and support, which might in turn have the effect of opening up dialogue in relation to therapists’ bereavement and vulnerability.

The experience of loss is a transformative process with potential benefits for

therapists, including increased self-awareness, improved self-esteem, a greater sense of resilience and personal strength, and stronger belief in one’s ability to cope. All this has an impact on therapists’ ability to be present with their clients. It seems that embracing one’s vulnerability by softening (rather than tightening) one’s therapeutic stance as the grieving process progresses enables a more active, attuned engagement with clients.

Bereavement deeply affects a therapist’s personal and professional life. The relative paucity of research in this area presents a further difficulty for therapists attempting to cope with loss or other life crises. In this situation, the difficulties experienced by therapists may be negated, while self-sacrificial behaviours are encouraged. By highlighting the complexity of therapeutic processes when therapists are in the midst of grief, this research constitutes an invitation to training institutions to encourage more open dialogue, especially in relation to the merging of therapists’ personal and professional lives in the course of their work. This echoes Martin’s (2011) research findings and sentiments that celebrating our humanity in its many facets might

contribute to the de-stigmatisation and recognition of the wounded healer in education and a more open attitude to this across the helping professions.

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Given that the ‘self’ is the primary therapeutic tool utilised in therapy (Horvath & Symonds,1991), it is crucial that therapists give voice to their experiences.

Paradoxically, the life of a therapist can be a lonely one, and this is only exacerbated by traumatic life experiences such as the loss of a significant other. By recognising and normalising these natural human occurrences via research and open dialogue, we may facilitate more active engagement with them by professionals in the field, gain a greater understanding of therapeutic processes, and explore how therapists might access greater support when navigating this uncertain terrain.