Recognizing and treating disenfranchised

By Tricia Toth, RCC

“I feel like my son is dead,” Mary* cried, Mary feels devastated and alone. while she sat across from me on a pale- “I have no one to talk to or turn to. yellow couch. “He is walking the streets, Dustin has burned so many bridges that sleeping on them actually, and yet, he is everyone seems relieved he is no longer no longer a part of my life.” in our lives. I’m trying to move on, yet Five years earlier, her 15-year-old there is no one who understands this son Dustin began to associate with an loss.” older peer group. Mary and her husband I explained to Mary that, like Pete had found drug paraphernalia in many others in her situation, she is his room, confronted him, and had him experiencing disenfranchised grief. attend a series of meetings for drug and alcohol awareness. However, Mary Disenfranchised grief said, “Dustin slipped away from us. He Disenfranchised grief is experienced became defiant and argumentative.” The while mourning a loss that is not Disenfranchised couple experienced their “bottom line” accepted or understood by others grief may occur two years earlier, when Dustin had stolen — losses that are not given adequate when others do a large sum of money from them along validation and leave the mourner feeling with their family car. unheard and unsupported. The loss not appreciate the With clinical support, they hosted an often has a stigma associated with it or magnitude of the intervention; ultimately, Dustin chose to the relationship one has with it. Also, grief following the not to fulfill their expectations and, because it has not been discussed enough loss of a pet, or consequently, left their home. by those experiencing it, the loss — and after an Mary talked to me tearfully of her the depth of that loss — may not even be or , or many nights of lost sleep, calls and recognized or understood by others. associated with visits from the RCMP, and Dustin’s For example, disenfranchised grief the loss of a healthy two near-death overdoses. Although may occur when others do not appreciate child for parents Dustin is very much alive, she and her the magnitude of the grief following husband are grieving the loss of the life the loss of a pet, or after an abortion or who deliver a child and relationship they once had with him. miscarriage, or associated with the loss of with delays.

INSIGHTS magazine 15 a healthy child for parents who deliver Loss and shame is considered taboo, in part because a child with delays. Others may not acknowledge or they don’t know what to say, and also There may be a reluctance to discuss recognize our grief for several because they do not want to hurt the the loss due to associated guilt or reasons. One is that there are cultural person mourning. shame, such as in cases of accidental differences where some losses are When Jack’s daughter Sara death, , or overdose. considered more significant than committed suicide, he had never felt Disenfranchised grief may also be others. Within North America, the so alone. Not only had he lost his only experienced when there are negative most recognizable loss occurs when daughter, but he also felt he had no one feelings associated with the deceased, to talk to. He thought he should have such as in the death of an abusive recognized the signs of her growing partner or when an affair has taken One of the most popular depression and desire to end her life. place. Estrangement from a relationship, posts on my blog site “She slept a lot and she was no rather than a death, may bring about was acknowledging the longer interested in dance, which she disenfranchised grief. For example, the grief people feel after usually loved. I just chalked it up to her loss of an ex-partner and/or their family the loss of a pet. being a teenager,” he said. members due to divorce, disconnection Following Sara’s death, Jack was due to substance abuse, mental reluctant to reach out for help, because health problems such as dementia a biological family member dies. he felt others would not understand or Alzheimer’s disease, and family However, shame or guilt associated or may judge him. Ultimately, his alienation resulting from different belief with our loss may prevent us from own pain became unbearable, and systems, religions, or political doctrines. adequately talking about it or seeking he contacted me for counselling and Other examples, include disenfranchised support from others. For instance, support. Jack was both relieved and grief resulting from unfulfilled goals and when a friend or family member dies frustrated to learn he was experiencing aspirations, failed business ventures, due to suicide, surviving members may disenfranchised grief. While Jack was and changes felt after an economic feel they missed the signs of depression comforted in knowing he was not alone downturn, such as losing a home or job, or could have somehow prevented in his grieving process, he was equally bankruptcy, and alterations to lifestyle the tragedy. They may even feel they disappointed that discussing death by and supports. Grief can result from contributed to the death. Consequently, suicide is so taboo. moving from one home, community, or they may be reluctant to reach out for In Canada, there are over 200 cultural upbringing to another. help. For some, asking about the loss suicide attempts every single day, with

3 Help clients know they are not alone 4 2 Identify Validate their support the loss system

1 Provide non- 5 Extend help judgemental 5 to others support Steps in Treating Disenfranchised Grief

16 INSIGHTS magazine In Canada, there are over 200 suicide attempts every single day, with approximately five per cent resulting in death. Every death by suicide impacts up to 10 others who are mourning their deaths. approximately five per cent resulting in dependency on medication and couples who experience miscarriage or death. Every death by suicide affects intervened earlier. stillbirth, they not only lose their child, up to 10 others who are mourning their Ultimately, Renay passed away after but also the family they had envisioned deaths. Yet, those who bereave a death injecting heroin laced with fentanyl. for themselves. due to suicide often do so in silence. Drug overdoses involving the opioid The death of a beloved pet is Doug and Frankie experienced fentanyl now account for 81 per cent another example of a loss that may be a profound loss and lack of support of all overdoses in British Columbia, minimized or unrecognized. when their daughter Renay died and the number of deaths by overdose After Malcolm’s wife Louise from a drug overdose at the age of has increased by 143 per cent within died following a battle with breast 32. Renay initially became addicted the same time period last year, January cancer, his children suggested he get to prescription drugs following a to July. British Columbia has identified a dog. Initially, he did not want the car accident in her mid-20s. As she the current drug crisis as an epidemic, responsibility, but his daughter and son, became more dependent on drugs for but families left to mourn death from who reside a province away, insisted pain management, she became more overdose are often reluctant to share because they felt their dad could use desperate and resourceful in accessing their experiences. the company. Malcolm explained to me prescription and street drugs. that his companionship with Mowat, a While Doug and Frankie sat hand Minimized or unrecognized Labrador retriever, was instant. in hand, Jack said, “She had her whole loss “As soon as Mowat saw me, he life ahead of her. We will never see her In some instances, others may minimize rested his head on my foot. He seemed marry. We will never be grandparents.” the loss. For example, because some to know I was missing Louise.” Prior Doug and Frankie are both in the health people do not consider a foetus a child, to Malcolm’s retirement, Malcolm care field and felt they should have they may minimize the experience of and Mowat were inseparable; Mowat recognized the signs of her increasing loss due to miscarriage. However, for often accompanied Malcolm on his

INSIGHTS magazine 17 Treatment considerations Disenfranchised grief should be given recognition and validation just as any other loss. The loss each of us experiences is real. It needs to be understood that grief is subjective and each person’s reaction to loss can vary. What one person finds devastating may be completely bearable for someone else. We should be careful not to assign our own judgement, but rather gain an understanding of the loss through the perspective of the client. Just as each person’s experience with disenfranchised grief should be given individual recognition, so should their respective treatment plan. A client who is suffering from poor self-worth and lack of motivation may benefit from cognitive behavioural therapy. The loss of a job may be best treated with a solution-focused approach — a plan of action for exploring new employment or training options. A person who experiences the loss of a pet may benefit from discussing the significance of their relationship in depth using narrative therapy or expressing their A person who experiences truck driving jobs. Malcolm described grief through creative or symbolic work the loss of a pet may their bond as “totally non-judgemental using art therapy. Working with clients benefit from discussing love — best friends.” Malcolm said that who have experienced loss through the significance of their with a pet, the relationship is free of miscarriage or abortion may benefit conflict and drama. “Mowat was loyal from an exploration of the mind-body- relationship in depth and happy to see me — more than my spirit connection through a holistic using narrative therapy kids were,” he joked. psychotherapy approach. or expressing their grief When Mowat passed away following Losses can be particularly difficult through creative or symbolic an abdominal infection six months ago, for children as they often do not have work using art therapy. Malcolm was devastated. Malcolm’s any say or influence in the situation, daughter, who worried because such as with a move or change in her father had stopped eating and schools. Treatment is beneficial in socializing, initially contacted me. It giving them a voice and opportunity was difficult for Malcolm to explain to to express and work through their others the depth of his loss. Malcolm emotions. Play therapy may be said he was deeply hurt and offended especially helpful, as children often lack when his neighbour commented, “It’s the skills and maturity to understand just a dog.” Malcolm considered Mowat the source of their pain. to be one of his closest companions. Let your client know that others

18 INSIGHTS magazine have had similar experiences. One of necessary towards intervention. the most popular posts on my blog site Fortunately, there is a growing was acknowledging the grief people feel recognition of disenfranchised grief, after the loss of a pet. For many, they and supports are becoming more considered their pets one of their closest available for those facing challenges. companions in life, yet others often Most schools now employ counsellors, minimized the loss. Many who read the Stigma provide peer support, and offer associated with post found comfort in knowing they preventative programs. Universities disenfranchised were not alone in their bereavement. grief prevents those and colleges now have counselling and Encourage the client themselves affected from opening support available for students. Crisis up and seeking to give the loss appropriate validation. intervention teams are put in place support. Discussion and identification of the after a loss or tragedy in the work loss may be validation enough for the place, and counselling support has client, but some clients may benefit by become a part of employee assistance giving the loss symbolic recognition — packages. Suicide awareness is much for example, writing a letter, wearing more common, and resources are a piece of jewellery, getting a tattoo, available for families to discuss their creating an art piece, or performing a loss and share their stories with others. ritual or ceremony. With continued discussion and Help your client identify and seek a growing initiative to combat out their support system. It is important disenfranchised grief, those affected for your client not only to know they are will become more confident in sharing not alone but also to recognize where their painful experience and their they can go for help. Some losses result healing, which will in turn benefit both in our clients becoming a support to those affected by disenfranchised grief others who have had similar experiences What one person finds and their caregivers. ■ themselves. I have had clients write devastating may be *All client names and some details have been pieces and share them with others as completely bearable changed to protect client privacy. well as join or initiate support groups. for someone else. Although disenfranchised grief is We should be careful gaining attention, we have a long way to Tricia Toth, MSW, RCC, RSW, owns and not to assign our own operates Great Life Counselling. She works go. Many people still feel unsupported. in the areas of trauma, addiction, and mental Stigma associated with disenfranchised judgement, but rather health, as well as supports individuals grief prevents those affected from gain an understanding and couples work through barriers. She opening up and seeking support. of the loss through the is committed to assisting others live their greatest life. For further information, Awareness of disenfranchised grief in client’s perspective. go to www.greatlifecounselling.ca or email and of itself is one of the first steps [email protected].

References opioid-crisis-136-people- CBC News (2017, in-b-c-in-2017-coroner- statcan.gc.ca/tables- World Health died-of-suspected-drug- September 7) Fentanyl says-1.4279165 tableaux/sum-som/l01/ Organization (2017, Brown, Scott (2017, overdoses-in-april detected in 81% of illicit cst01/hlth66c-eng.htm August) “GHO | By May 31) Opioid crisis: Statistics Canada. (2015) drug deaths in B.C. in category | Suicide rates Province on pace Canadian Association “ and suicide What’s Your Grief 2017, Coroner says. – Data by country.” for more than 1,400 of Suicide Prevention. rate, by sex and by age (2017) Disen-whaaaat?? Retrieved from http:// Retrieved from overdose deaths in Retrieved from https:// group (Both sexes rate).” Understanding www.cbc.ca/news/ http://www.who.int/ 2017. Vancouver Sun. suicideprevention.ca/ CANSIM, Table 102-0551. Disenfranchised Grief. canada/british-columbia/ mediacentre/factsheets/ Retrieved from http:// understanding/suicide- Retrieved on August 27, Retrieved from https:// fentanyl-detected-in-81- fs398/en/ vancouversun.com/ in-canada/ 2016 from Retrieved whatsyourgrief.com/ of-illicit-drug-deaths- news/local-news/b-c- from https://www. disenfranchised-grief/

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