Grief and Degrief, Part 3

The Art of Holding Space: Degriefing from the Therapist’s Perspective

By Lyn Prashant

Originally published in Massage & Bodywork magazine, June/July 2002.

“Grief is the most available, untapped emotional resource for personal transformation.”

Holding space is one of those phrases that evokes furrowed brows and quizzical expressions from the uninitiated. Like comedian George Carlin’s popularized use of such oxymorons as “jumbo shrimp” and “military intelligence,” holding space presents its own contradictory challenges in the world of grief and bodywork. Yet, it is a critical element in the Degriefing process.

"Holding Space”

This concept allows grieving clients to:
1. Have their grief experience normalized.
2. Feel another’s authentic presence while being in their shattered state of being.
3. Listen to themselves express their grief, and hear what they are saying.
4. Feel someone caring about them.
5. See that they are being focused upon.
6. Practice self-expression.
7. Find relief in their communication.
8. Witness being seen.
9. Feel vulnerable, yet safe.

In the lightning-paced world we have learned to live in, I’ve seen people ask the question “How ya’ doin’?” while walking by faster than the speed of light. In response, we might yell, “Fine, thanks” as we race in the opposite direction attempting to accomplish the first 50 tasks set aside for the morning’s duties. As a culture, we have seemingly lost the grace required to relate with casual social intimacy. Taking time to stop, connecting eye to eye and heart to heart, exchanging a genuine salutation and embracing a nurturing moment of connection all seem to be things of the past. We continually miss the moment in our hurry.

My younger sister Donna, who has become my most recent, significant teacher, knows our lack of social intimacy all too well. As she continues to deal with the challenging condition of breast cancer, she is the model of grace and dignity. Due to metastasized breast cancer she copes with brachial plexus nerve pain, advanced lymphedemic swelling, the use of her right arm, advanced lymphedemic swelling, profound discomfort and survival anxiety, and constant doctor visits, check-ups and scans. As a result, she feels she has lost both control and independence, and that her body no longer belongs to her — now it belongs to science.

She has gone through chemotherapy, radiation and various integrative treatments such as acupuncture and massage, and has found her energy to be predictably unpredictable. Sometimes she feels alert and ambitious or conversely nauseous and numb. The many complications from the cancer, as well as the side effects of the treatments, can require full-time attention.

One evening she called me with a humble, simple, yet puzzling question: “What do people really want to know when they call and ask ‘how are you’? They all know I have cancer,” she said. “So what is it they’re really asking?”

She said after they ask “how are you?” people often don’t know what else to say. Donna told me she feels compelled to rescue them from these awkward silences. So even when exhausted, she might obligatorily pick up the conversation, responding to the typical questions: “How was your chemo treatment?” “Are you nauseous?” “How is the pain?” “How do you handle it?” “Has your hair fallen out yet?” “Will you buy a wig?” “Are you scared?”

In the midst of all those well-meaning conversations, Donna hears the meta-communications (the messages) projected by thought between the spoken words, often referred to as “reading between the lines.” It is the sound of all the questions not being vocalized.

“Why don’t they express the most authentic sentiment, and not just make small talk?” Donna asks. “Aren’t they really calling to tell me, “I love you.” “I’m really scared.” “I’m just thinking about you.” “I feel so helpless.” “What do you need?” The genuine question that most don’t ask is, “How can I be of service to you?”

Donna’s response to those concerned might be simply asking them to lend a compassionate ear. “Hear me. Allow me to express myself without giving me advice or trying to make it better. Please stop assuring me that you know that it is going to be all right. Just see me. Just be with me. Be responsible to me, not for me.”

How simple, conceptually, it is to share our presence with another, rather than always doing for them. Practicing the art of co-existing comfortably in silence where no dialogue is used to fill the space, is one of the primary lessons taught in the Degriefing process.

Types of Holding Space

During my training as a physical education instructor, I taught soccer to elementary school children. There were two basic teaching strategies I favored. In the “part-whole-part” method, I would break a sport into drills or lessons and teach isolated pieces and then combine them together to teach the “Game of Soccer.” In the “whole-part-whole” method, I would toss the soccer ball into the middle of the field and yell all of you in blue, get the ball across that line and those in white, your goal is the opposite direction.

The same was so for Sept. 11, 2001, when I was teaching a Degriefing seminar to 75 health professionals in Rochester, N.Y. In that tragic moment of national crisis, the students and I were in an authentic “game,” and the tools we were practicing were skills we needed to use immediately. The students knew the intention; now they would have to experiment with strategies to accomplish their goals. Pragmatics would teach a lot. Refinement would come later.

During a private counseling session, a bedside visit, a bodywork session, or in the midst of an actual crisis, the facilitator has the opportunity to practice therapeutic communication skills. Compassionate listening (non-reactive) and active listening (paraphrasing and actively feeding back the information) are used. These tools facilitate the establishment of trust, promote comprehension, and thereby allow a deepening sense of the client’s own emotional experience.

During the Degriefing process, the clinician is also practicing somatic resonance, sensing with their body and using it as the barometric instrument for assessment. When we are able to mirror the client in “a field of presence,” it encourages self-reflection. It is then one might experience the safety to permit feelings of vulnerability in a trustworthy environment. Individuals often confuse vulnerability with weakness, misunderstanding the power of vulnerability (allowing oneself to be seen), allowing the benefits of this process to provide deeper healing.

Facial expressions, word content, meta-communications, body language, body odor, voice quality, emotional expression and physical appearance are all things I make a mental note of when assessing a client during a session. Degriefing calls this the “eco-somatic” state, which is made up of the “body/mind mindset” — the person’s emotional coping climate expressed in conjunction with the pragmatic functioning of the body. It can be recognized and acknowledged as the state of shock impact.

Observing both the client’s body language and verbal communication in the midst of a grief crisis allows the counselor to assess which therapeutic techniques for the transformation of grief will be employed in the process of healing. Holding space is one of these techniques.

Defining the Yin and Yang of Holding Space

Holding space is achieved by using one’s awareness (psychic intention) to image or visualize a field of support, with presence, focus and undivided attention. This can feel like emotional care to the recipient. The metaphoric light streams from your heart center (fourth chakra) and intuitive center of the brow (fifth chakra). For example, think of the two blue beams of light that shone throughout April, representing the fallen World Trade Center Towers. This type of holding space represents the gift of recognition and non-judgmental presence.

There are two types of holding space, psychic and somatic. Holding psychic space is using one’s presence, direct-eye contact, and undivided attention and listening skills to acknowledge, support, hear, recognize and connect with the grieving individual through an intention to serve, rather than solve a problem. The therapist visualizes the supporting energy field and projects clarity and understanding to the client. The therapist uses their own intention or energy to radiate “a flowing field of perception” to bring the client into a place of self-awareness. This thought-form can be felt and held. It is a sensation of awareness based in a calm, yet fierce intention within the core of the being to be alert, present and responsible to the other.

Holding somatic space is using awareness techniques (specifically the breath) to observe and pay close attention to the feelings and sensations in one’s own body, while in the role of the listener. When we do this, we can also note our emotions and inform ourselves as to our own grief-work still needing attention. The other individual remains the focus, even as this self-awareness technique enlightens the listener about his or her own triggered issues.

The client, feeling the attention, has the opportunity to hear their words expressed. They are often able to recognize (what sounds, feels and appears to be) the authentic and accurate expression of their communication regarding their loss-related experience. This gives them the opportunity to revise, reassess, revisit or modify what they have said. The experience of hearing themselves and listening to their choice of words is the basis for much of the cognitive work in the Degriefing process.

Being Heard

Grieving people need to be heard. I explain in Degriefing seminars that I am hearing, feeling, observing and sensing the client for the purposes of acquainting and preparing to respond, not react. In Degriefing, the main difference between responding and reacting is the use of the nostril breath for consciousness and slowing down the body’s reactivity. With awareness we can affect change. Degriefing teaches the “re-languaging” of the expressions of grief, or psychosomatic semantics (addressed in Part 2)

In 1984, I lived at the Living/Dying Project, in Santa Fe, N.M., with my late husband Mark. There, I met Stephen and Ondrea Levine, noted seminar leaders and authors of many books on the subject of conscious living/conscious dying. Stephen Levine personally taught me “we can only be present for another’s grief to the extent that we know our own.”

As health care professionals, I believe strongly that we are morally responsible to explore our own grief. This is imperative to prevent both transference and counter-transference — a common phenomena when entwined with a profoundly powerful, provocatively activating emotion such as grief. I’ve been told by some of my clients that they have held back tears during massages because they didn’t want to “freak out,” dump on, or upset the Degriefing practitioner.

Clients explain that during their own emotional release, the therapist might freeze, hold their breath and start working too fast. Many counselors and massage therapists might intervene or stifle the moment in the midst of an important catharsis provoked during a session, due to their own discomfort. It can be too re-stimulating for their held, unresolved feelings of grief deeply harbored in their body. Last month a massage therapist colleague told me, “You can have the hard cases, I just want to do pampering. I don’t want to deal with grief. It is too upsetting and I never know what to say.”

Personally, I experience grief work as deeply satisfying, interpersonal, transformative work. Ram Dass, author of Be Here Now, has said, “Working with the dying is some of the juiciest sadhana (spiritual work) on the planet.” Since grief is the body’s response to any type of loss, most prominently death, I am referring to all of life’s daily griefs that accumulate in our physical system.

How to Hold Space

Somatically, holding space is achieved by the listener who observes her own physical space. This happens with slow and steady nostril breath to guide us toward staying in the present moment — noticing, observing and feeling our feet on the ground. Focus on hearing, feeling and sensing the client. As conscious professionals, it behooves us to have done work with a variety of therapeutic tools to better know our own grief so we can be more available and centered for another’s. Learning to hold space has tremendous benefit, both professionally and personally.

Mentally, we can hold space as well, using psychosomatic semantics to actively feed back what we have heard by choosing words that empower, support and encourage the other to become more aware of their expressed communication. Learn to integrate and observe your presence in the activity, while staying focused on hearing the other’s communication.

Spiritually, we hold space by combining mental intention with heartfelt compassion, staying present to witness the client’s expression. It is the ability to use reflection rather than projection, so we can mirror the client, rather than project our opinions or beliefs on them. With the use of skillful non-interruption on the part of the counselor, the client gains insight into his or her own story. As people speak, they often process. We serve as a non-judgmental guide to assist the grieving individual to recognize their place in their story of loss.

Emotional authenticity is another element in holding space. Modeled by the professional, emotional authenticity allows what is natural and genuine to be present, sensed and communicated clearly for the highest good of the client. Grief is as universal as the smile. When I smile, you might also. When I cry, your eyes too might mist. Appropriate personal disclosure by the counselor, the display of genuine emotions and heartfelt compassion are components in this element of holding space.

Holding space can be practiced therapeutically with a client sitting, lying in bed or on a massage table, or on the phone for a professional session. Whether it’s a two-hour session in person or 10 minutes of undivided attention on the phone, much grief relief can be felt just by being heard. The intention is not to solve anything, but rather to give the gift of one’s presence for unconditional support and nurturance.

Why Do It?

When loss happens and grief results, many people find they have very few safe places to turn. We are not “integrated” in our relationship to either life and death, or life and loss. In our work lives, we are typically given three days to grieve loss and then “move on” and “get over it.” Degriefing teaches us to redefine our relationship to the loss, rather than just “get over it.” Grief is like traffic — it just doesn’t quit. There is no end to grief; it is a constant. Just ask anyone who has been in its throes. But grief can be transformed into something more manageable and more tolerable — this is the premise behind Degriefing.

Degriefing is an oxymoron that reminds us that grief is the most available emotion for personal transformation. While honoring individual differences, recognizing the similarities and knowing that each individual’s grief process is uniquely their own, we can hold space for an infinite number of possibilities. By practicing the art of holding space, we support each person’s journey toward self-empowered authentic individuation.