46 Grief and Loss Across the Lifespan
The Five Vs are validating, valuing, verifying, ventilating, and being
visionary. Validating is often one of the first steps of work with the bereaved,
particularly if the loss is disenfranchised. The primary task of validation is
to help the bereaved to identify areas where they may not feel sanctioned to
grieve, and to recognize and validate the right to be a mourner. Particularly
when a pregnancy has not been revealed, the bereaved parents may not have
others who acknowledge their loss. Helping women and couples to recognize
the right and necessity to mourn is a critical first step to facilitating the healing
process.
Valuing and verifying may be subsumed within the validating domain.
By recognizing that the lost entity had value to the mourner, the clinician vali-
dates the griever’s right to mourn. Implicit within this is a message that the
pregnancy/healthy baby was of value to the bereaved parent and that there
was worth to what was lost. Helping the bereaved parent to discuss all aspects
of the lost entity/person’s value acknowledges the importance of the dis-
rupted bond (a domain for exploration). Verifying includes any intervention
to assist the bereaved with gathering tangible mementos and/or developing
rituals that “make real” the loss. These reminders can be used by the parents
to stimulate support from friends and family. Creating memory boxes with
footprints, handprints, locks of hair, and pictures if possible is useful to par-
ents’ own grieving, but can also be used to remind others that the baby had a
presence in the world.
Most social workers and other grief clinicians are quite familiar with
ventilating. They regularly urge clients to “vent,” to “let it all out,” or in other
ways be emotionally expressive. Ventilation can be done in a variety of ways
and does not always need to incorporate tears. Indeed, if the clinician falls
prey to the grief-work hypothesis and insists on tears as a form of ventilation,
they actually risk harming the mourner. Ventilating entails an expectation that
the bereaved is able to talk about the loss with authenticity and consistent
affect and content, not necessarily overt tears. In pregnancy loss, gender ste-
reotypes of mothers mourning with tears and fathers with rigid control often
hold true, but not always. In my practice, I have found that mothers often are
overtly emotionally expressive until the due date and then their partners all
of a sudden start to express anger, sadness, and irritation. It seems as if the
partners “stay strong” for the mother and once her emotion has run its course,
the partner’s authentic response is allowed expression. Ventilating may lead to
meaning-making and the clinician should explore the many ways the loss has
affected the griever’s life. Further, in this phase of work the grief therapist is
most compelled to remain quiet and provide support but no platitudes or trite
phrases that could interrupt the mourner’s ability to ventilate their thoughts,
feelings, and reflections freely.
Being visionary is often part of the ending process, but occurs throughout
the work (whether formal grief work in a therapeutic setting or in supportive
friendships). This generally entails assisting the bereaved person to think
through likely future events and recognize their potential for intensifying grief
feelings (Rando’s [1993] STUG reactions). In being visionary, the grief therapist
can share lessons learned from others about when and where grief is likely to
be heightened. With perinatal loss, the due date for a lost pregnancy often
revives feelings of grief. Grievers often need to reflect and mourn at this time.