286 Grief and Loss Across the Lifespan
of countertransference may cause clinicians uncertainty in exploring military
trauma. Supervision allows the therapist to process and clarify the therapist’s
reactions to the horror, pain, and terror that the client may discuss; this may
help the therapist stay more attuned to the client’s needs (Sherwood et al.,
2003).
With a client like Wesley, the goals of intervention would be to discuss
his trauma history, reduce the psychological symptoms which may be exac-
erbated by his physical symptoms, and use case management to connect him
and his wife with concrete services, as needed (Sherwood et al., 2003). Other
interventions that could be considered, as illustrated in the case of Wesley,
would be individual therapy and/or couples therapy. Family therapy could
be considered if the situation called for it. Once Wesley had the opportunity
to discuss his feelings related to his military loss and how it impacted his life,
he was ready to include his wife in our discussion. This allowed him to dis-
cuss and grieve opportunities that he felt they missed because of his fears and
anger. Using the LR technique, we looked back at his life to address his trauma
memories and unresolved grief, resentments, and/or remorse (Sherwood
et al., 2003). He saw how his anger redoubled with the death of each child. He
wanted to apologize to his wife for being “less than the man he wanted to be”
with her.
Individual treatment for Wesley focused on treating the trauma-related
symptoms. Sherwood et al. (2003) note that anxiety management training
(AMT), stress inoculation training (SIT), eye movement desensitization and
reprocessing (EMDR), and cognitive behavioral therapy (CBT) are possible
interventions to be considered. In light of Wesley’s terminal condition, indi-
vidual counseling, CBT techniques, and relaxation techniques seemed to be
the best course of action for Wesley. Close contact with the rest of the health
care team was also very important so we all understood current care needs
and prognosis. Following Wesley’s death, we came together as a team to pro-
cess the care and how we handled the death. We read a letter that Betty wrote
to us. She closed her letter with “Thank you for all of your wonderful care
of Wesley. I want to particularly thank you for giving me the chance to truly
know and better understand my husband.”SUMMARY
Later adulthood is filled with a variety of losses but provides opportunity for
growth in self-reflection and reinvention. This phase of life brings a gradual
release from many of the daily demands of work and family, depending upon
one’s resources and health, and the chance to invent a new structure to life.
There is more individuation at this phase of life than during any other. Thus,
although older adults have many issues in common they also have many dif-
ferences from one another, having lived long and different lives.