24 Grief and Loss Across the Lifespan
rebuilding identities, negotiating transitions, surviving trauma, and maintain-
ing morale.
Boss, Roos, and Harris (2011) suggest intervention to assist those with
ambiguous and nonfinite loss. The clinician is to: (a) name and validate the
loss; (b) help the client find meaning in their new role; (c) address trauma
when it is present; (d) temper mastery—by which they mean tempering
the mourner’s expectations to have control of, or overcome the situation;
(e) help the griever reconstruct identity; (d) normalize ambivalence—
recognizing that having both love and hate for the person who is changed
from their previous persona is normal; (e) revise attachment; (f) discover new
hope; and (g) identify resources for support.
Walter (2003), in her research with people adapting after the loss of a life
partner, also emphasized the issue of validation. She recognized that gay and
lesbian couples often had little recognition and validation of the loss of their
life partner. Mourning a disenfranchised loss, and often denied access to the
usual rituals of support after death, such an individual benefits from having
someone with whom to reflect on how his or her identity is changing and has
changed. Further, Walter notes the “two incompatible urges” (p. 245) of want-
ing to cling to the pain of the loss, but also to move on to the new life ahead.
Seldom do people have social contacts ready and able to provide the nondirec-
tive approach necessary to accompany bereaved individuals as they review
these opposing urges and reflect upon prior experiences. Grief counselors are
called upon to patiently be with and witness the pain and possible growth that
comes from loss.Mindfulness as an Intervention for Grief
Mindfulness has become widely known and accepted as a practice for becom-
ing more attuned to one’s own internal sensations, emotions, and responses,
as well as to tune in with others. Starting as mindfulness meditation, pop-
ularized in Jon Kabat-Zinn’s (1982, 1990) work, mindfulness has many new
iterations that apply to practitioner’s own practices as well as to the work we
do with grievers. Cacciatore and Flint (2012) synthesized much of this move-
ment in their ATTEND model of bereavement care, making the point that it
is for use by the practitioner/therapist; it is for use within the therapeutic
relationship; and it is for the client’s use. The pillars of the ATTEND model
are: attunement, trust, therapeutic touch, egalitarianism, nuance, and death
education. Attunement comes first and is likely the integrating principle of
mindfulness. Attunement requires attending to oneself and others’ well-being
and being. It entails empathy, responsiveness, intentional attentiveness, and
allowing each person to observe and accept pain and suffering as well as posi-
tive emotions. Dan Siegel puts this at the heart of being a mindful therapist
(2010b) and notes that “presence” is a sense of being open to the other (the
client) while attunement requires presence but also includes “focused atten-
tion and clear perception” (Siegel, 2010b, p. 35).
Cacciatore and Flint (2012) define trust as compassionate communica-
tion that allows the client to know there is safety and care within the relation-
ship. The second T in ATTEND is therapeutic touch, which they acknowledge
is controversial. Nevertheless, therapeutic touch conveys caring with a gentle