Grief is not experienced during a specific age, period, or time but rather, it can come during any stage of life from childhood all the way to late adulthood. People who have in the past experienced grief have a crystal clear understanding of what it is and to what extent it affects individuals and the society in entirety. Death is an unavoidable experience that at one point in life must be encountered by every individual. In respect of this perspective, grief is experienced by every individual and the argument that grief counseling is one of the subjects in which many counselors are ill prepared and untrained is worrisome. The difficulty experienced in counseling grieved individuals is underscored by the fact that every individual grieves differently and the levels of grief differ from one individual to another. Multiculturalism plays an integral role in enhancing the competence of a counselor in helping individuals.
One of the key aspects that counselors must possess when handling grieved clients is the knowledge about how the grieving process works and how various cultures respond to incidences of death. This research gives a clear and extensive definition of what grief counseling is, what it should entail, and its significance to an individual mourning a deceased loved one. In this research paper, multiculturalism from the perspective of grief counseling is divided or rather broken down based on the understanding of cultures, understanding the background of individuals, and different losses experienced by individuals. One of the key considerations in this research paper is the understanding of the different cultural coping strategies, which are seen to affect how clients mourn the loss of their close relatives or friends. If left untreated or undertreated, grief could lead to physical or physiological complications that could result in death over the long-term.
Definition of grief counseling
There are terms that are often used interchangeably in defining grief yet this should not be the case. These terms include mourning, bereavement and grief, which have different meanings, and thus, should not be used interchangeably. First, grief refers to the response that individuals give to situations of loss, and it can have cognitive, emotional, physical, spiritual, behavioral, or social dimensions. Second, mourning refers to the situation where individuals actively express grief, and this is often noticed by other individuals. It is argued that mourning is one of the strategies for coping with or settling grief. On the other hand, bereavement refers to the period or duration after a person, losses his or her loved one, and it is a period in which both mourning and grief occur. Bereavement is an individual’s state of having suffered a loss of a close relative or friend. To handle clients with the distress of grief and mourning especially after the death of a loved one, grief counselors give preference to the use of psychotherapy (Ober, Granello, & Wheaton, 2012).
On some occasions, grief counselors deal with clients who experience challenges in life which may trigger feelings of grief. Some of the problems that could lead to an individual experiencing grief include a family or societal member transitioning from male to female and vice versa or even divorce. The latter often results in depression and extreme cases grief, which if not treated or is undertreated, results in worse complications that jeopardize the survival of individuals. Moreover, there are individuals who experience grief when their family members and friends stop checking on them, and it is during such moments that grief counselors should step in. Grief counselors’ role is to ensure that clients are supported and allowed to work pro-actively through the emotions or stages accompanying grief.
Multiculturalism in Grief Counseling
The meaning of culture varies from one social setting to another and from the perspective of people from diverse cultural backgrounds. The concept of culture gives reference to the totality of the human experience for social contexts (Hays & Erford, 2014). The human experience referred to in the cultural context is mediated through political, biological, historical, or psychological events (Hays & Erford, 2014). A reference to culture sees the focus shift on perspectives such as behaviors, feelings, attitudes, and cognitions, which are related to people’s identities within the world. Thus, the broadness of the perspective of culture cannot be ignored, which is why it is imperative for competent counselors always to be very open-minded and have knowledge of several different cultures. Despite not knowing the specifics and other perspectives that accompany every culture, counselors can exhibit effectiveness when it comes to handling people from diverse cultural backgrounds when they have an understanding of different cultures. Other key perspectives that play an integral role in counseling are religiosity and spirituality, which are often intertwined and prompt counselors to consider keenly the religious beliefs of clients from various cultural backgrounds; when analyzing the coping strategies that should be used by people striving to cope with the demise of their loved one.
The thoughts, traditions, and behaviors of individuals exhibit significant differences when the focus is on culture. Nevertheless, cultural similarities do exist in the conduct, traditions, and thoughts of individuals. One of the similarities among cultures is the history that all of them have. Culture could be oral, written, or communicated through past generations. There is no doubt that history is pivotal to the shaping of past culture and also has influence or impact on present cultures. Cultures usually have a dominant religion that gives “meaning and legitimacy” to each of their rituals and rites; which include particular ceremonies, rites, rituals and traditions concerning grief (Klienman, 2012). Another similar feature that cultures share is each of them upholds their traditions and values. However, these traditions and values do vary from culture to culture. Lastly, cultures are sustained and structured by a routine of communication networks and social norms that set personal and social conduct standards (Altamaier, 2011).
Other than cultural differences, it is essential that grief counselors consider the relationship between the grieved person and the deceased, and how the death that resulted in the grief came about. When it comes to grief counseling, counselors should not take anything lightly or make assumptions about the situation of grief. To understand the relationship between the grieved persons and the deceased, and how the death came about, counselors are advised to come up with relevant questions such as “how close were you to the deceased” or “what influence or role did the deceased play in your life?” it should be noted that the different losses experienced by individuals could or could not affect them. For example, an individual who loses a cousin may not be affected as much as he or she will be in the case of the loss of a close sibling or parent. For others, the loss of a cousin may affect them more than the loss of a close sibling or parent, and thus, taking the different losses into consideration during grief counseling is essential.
Similarly, the ability of a client to put up with the bereavement process could be affected by inner factors such as security or strength. The inner traits such as strength that enable an individual to cope with the bereavement process are developed through experiences such as having loving relationships with family and societal members from childhood to adulthood (Anderson, 2010). The conditions or factors that led to a person’s death have an influence on the grieving process. In the case of sudden deaths, bereaved persons are often emotional and seriously grieved because they might not have had an opportunity to talk to the deceased for the final time. As such, sudden or unexpected deaths result in shocks and grief that could continue for a long time and grief counseling for such clients could an uphill task (Shear, Simon, & Wall, 2011).
Conversely, the situation and experience with expected deaths could be different. On several occasions, expected death brings relief to family or societal members, and this could also play an integral role in grief counseling. Primarily, delicate exploration of the situations, factors, and circumstances surrounding death can influence how a counselor carries out grief counseling. Most individual often exhibit noticeable grief when they the loss of a young one, a perspective that may not be shown in the case of death of an older person. Furthermore, the grieving process is often influenced by where a person died. Put simply, death from accidents results in more grief than that which occurs at home with hospice, and this underscores how the place of death affects the grieving process.
Background History of Individuals
Having an understanding of the background history of a grieved person could also play an integral role in grief counseling or process. For instance, should the client have a history of substance abuse this type of loss could be something to trigger their habit to start up again. Also, knowing to what extent they have experienced grief in the past. Is this the first loved one they have lost that has had an effect on them? Or do they have multiple losses and if so how have they handled their grief in the past? The professional should also find out what type of support system he or she has and what their current lifestyle was like before and after the loss. These kinds of questions are important to find out during the first session of therapy so that the counselor knows how to proceed in helping the client.
The Role of Culture in Bereavement and Loss
The role of culture in the way people view or perceive death and how they respond to it cannot be overlooked. Although death is a process that every person has to encounter at one point in life, it can be culturally embedded and recognized through various cultural norms, traditions, and beliefs (Prieto, 2011). Certain cultures associate death with specific prescriptions of religiosities and this influences the grieving process. There is no doubt that every culture has a unique approach and perception of death, and these, result in the embrace of various interventions that are in accordance with cultural beliefs, rituals, religions, and values when handling or dealing with the grief process. That is, every counselor must understand or look through the cultural lenses of the clients they are dealing with, as this enables them to understand how the clients will cope with the grief strategies and process in entirety. Through understanding and appreciating norms and cultural diversities associated with death, counselors often have the opportunity to understand what the loss of the clients’ close relatives means, and thus, they could handle the grief process without compromise (Ober, Granello, & Wheaton, 2012).
It should be noted that the primary purpose of having the counselors understand the cultural aspect of grief is to enable them to provide the much-needed type of support and therapy that could pave the way for resonation with the clients. There is the likelihood that if a counselor leverages on strategies that the client does not recognize or connect with, the entire grief counseling process will be meaningless. The failure of grief counselors to notice or identify cultural aspects when dealing with clients could result in miscommunication and misunderstanding, which could pave the way for the mere disregard of practices, values, and beliefs that are cherished by the client as well as create insensitivity (Klienman, 2012).
Cultural Coping Strategies
As mentioned earlier, there are various cultural coping strategies for grief including having a perception of death as a transition, maintaining bonds after death, experiencing grief in different stages, viewing death as a community event, and celebrating the life of the deceased.
Death as a transition
In myriads of cultures, there is the belief that death is a transition from one phase of life to another rather than it signifying the end of life. With this belief, several people have accepted death and embraced the challenges such as grief that accompany its occurrence. In fact, it has been viewed as a transition to another plane or phase of existence (Amelang, 2010). The religious beliefs and values in various cultures have prompted the embrace of the perception that death is a transition from one stage or phase of life to another. In myriads of Asian cultures, where Buddhism is dominant, there is an emphasis that death is just but a step in the journey of life. Several Asian cultures believe firmly in the concept of reincarnation, which refers to the ceaseless transmutation or impermanence of human beings as well as other existing beings and forces.
In addition, reincarnation insists on the endless cycle of death, birth, and rebirth (Hardy-Bougere, 2008). Buddhists believe that when an individual dies, he or she could be brought back into the universe in a different form, either a human being or animal and thus, there is continuity in the cycle. It is not only Buddhism that sees life as a transitory process but other religions including Christianity, Islam, and Judaism, which all believe in the resurrection of the dead, or in simple terms, life after death. Thus, when death is viewed as a transition, grief counseling is made easier as affected persons can overcome the death of their loved ones.
Maintaining bonds after death
Maintaining bonds with loved ones after their death is one of the modern-day therapies that have been proven to help develop beneficial and constructive techniques and resiliency. In most cultures, there is the belief that after the death of a person, the grieving individuals can overcome the grief through having a communicative bond (Zafar &Mubashir, 2012). People from different cultures have the belief that dead people will always continue to have an influence on those who are still living. The identification of this coping strategy could enable the counselor to perform an evaluation of whether it is healthy to have a continuous bond between the deceased or release the loved one and accept the fact that their loved one has died. This can be a sensitive area to touch because the counselor does not want to upset and offend a grieving person, and yet at the same time if it is becoming unhealthy there is a definite need to redirect the client into better coping strategies. Freud argued that the energy that a bereaved person invests into the demise of the deceased should be withdrawn and invested in another person (Strobe, Abakoumkin, &Schut, 2011, p. 255).
Freud also came up with the suggestion that people should detach themselves from the deceased person and redirect their lives to focus on other people and things around them. With time things have changed, and modern grief models suggest preserving the memories and connections with the loved ones who have passed is a good coping strategy. Historical and cultural perspectives go on to demonstrate that continuing bonds with the deceased can be beneficial to bereaved people by giving meaning to ongoing life. This allows meaningful connections to the past and allows the individual to retain identity and a sense of self by using the loved one as a continued example or completing the wishes of the loved one who has passed (Amelang, 2010).
Based on the cultural beliefs and practices, people may differ on how strong or real that the bond between those alive and the deceased may be and how communication occurs between them. In certain cultures, offering or sacrifice is made with the aim of reinforcing the bond between the living and the deceased. In some cultures, sacrifices are made out of respect for the deceased loved ones, and this includes placing flowers on a grave. It is argued that through offering and sacrifice, communication between the dead and the living is enhanced, and this paves the way for effective grief counseling processes.
Experiencing Grief in Different Stages
Another common strategy for coping with grief is to experience it in concrete stages. Through this strategy, the bereaved person is offered support and assisted in the conceptualization of his or her loss. The creation of the different grief stages sets the framework or lays a platform for the grieving process as well as the process of dying. This kind of coping strategy appeals to people because it gives an order to chaos in which otherwise would be unpredictable. One of the purposes of this approach is that it will remind the individual that grieving the loss of someone is a type of transition or even a process that must be worked through. For Jewish, death is viewed as a type of transition from being alive in the present to a life that is yet to come (Hardy-Bougere, 2008).
Another reason this coping strategy is used is that it gives the grieving person permission to grieve for a considerable amount of time and permits them to express his or her grief when it is most intensely felt (Klienman, 2012). There are individuals who argue that there is no time limit on how long people should grieve. This strategy is also of significance to individuals who would like to see grief broken up into more manageable experiences. The Jewish community is known for using this strategy, and its impact on grief counseling has been positive. In the community, after someone dies, the family of the deceased begins a six stage process in grieving (Bugless, 2010).
The first stage called Aninut is the point in time between the passing of the loved one and the actual burial. The second stage is three days after the burial in which the family spends most of their time at home, to grieve privately (Bugless, 2010). In the third stage, the family takes seven days to grieve and reflect which is considered to them a significant step in the direction of moving forwards from the feeling of grief that is debilitating to a state of grief where the person can accept help and support from others and learn to talk about the deceased person (Bugless, 2010), and this state is called sitting Shiva. In the fourth stage known as Sheloshim, individuals, and the affected families use thirty days after the burial of the decease to migrate to the previous lives. The fifth stage takes ten months, and it happens after Sheloshim allowing the affected family to get slowly back into their regular lifestyle, and the family members can go to the synagogue for religious services as well as reciting Kaddish more frequently (Bugless, 2010).
At the end of one year, the tombstone of the deceased is revealed and at this point, it is believed that the mourning process is complete, and there is no longer a responsibility to carry on the mourning process (Bugless, 2010). The final stage is the sixth stage, which experiences a complete return to normal life. At this stage, the family may still attend services of remembrance and have some rituals, but normal life should be in full swing. In the Jewish culture, more than one year of mourning is discouraged because their main focus is not on death but rather on life (Bugless, 2010). These six stages have created the framework or have provided a platform for the grieving process in the Jewish culture.
Grief stages can also be experienced through the Kubler-Ross model of denial, bargaining, anger, acceptance, and depression. It should be noted that not every individual goes through the mentioned stages, and not every person will go through them in the order they are. This means that other people could begin with either the second or third stage before proceeding to the first stage. According to the Kubler-Ross model, the first stage is denial, and this is where everything around people becomes meaningless and overwhelming. At this stage, the body begins to go through shock and denial which helps pace the feelings of grief (Zafar &Mubashir, 2012). This unique stage is one of nature’s ways of only letting the mourner take in as much as he or she can handle at that time, and thus, the grief process is enhanced. As denial begins to wear off, anger will start to fill in. This anger comes about at a time when most individuals are not ready, but it is when reality and its pain have come to the surface. This emotion is deflected from the individual’s vulnerability and comes out as anger (Zafar &Mubashir, 2012). Often, due to the anger towards the one who has passed away, the feeling of guilt may sink in which in return makes the griever even angrier jeopardizing the grieving process and how a counselor manages the grieved individual.
Following the denial stage is the bargaining stage which is dominated by the “what if” types of questions. At this stage, the bereaved persons are seen to question most of the things that take place through this stage, and come up with bargaining arguments to find their way out of the grief or pain that they feel. The arguments at this stage go to show that the person dealing with the pain is remaining in the past and is trying to bargain their way out of the immense pain, and this makes grief counseling a difficult task for counselors. After bargaining, the bereaved person proceeds to live in the present, although this can be lonely and can leave feelings of emptiness. Individuals at this stage often grieve deeper in a way that is unexpected.
However, depression which is considered as one of the stages of grieving may not be seen as a sign of mental health illness. In fact, experiencing depression is seen as a suitable response to the death of a loved member of a family or society. Intense sadness and withdrawing from life is normal during this stage for a brief time (Zafar &Mubashir, 2012). However, should the depression linger on, become severe, or cause thoughts of suicide this could be a sign of complicated grief and the individual should seek additional help.
The last stage to experience is acceptance, which should not be confused with happiness, and is a stage that involves accepting the fact that the deceased is no longer physical and cannot be seen again. At this stage, the fact that is worth recognizing is that life without the deceased is the new normal, and a continuation of life is necessary. Moreover, at this stage, people strive to maintain life as it was before the demise of the deceased. However, in many circumstances maintaining that life is not possible and trying to find a new normal and a new routine will have to come. Reorganizing roles and re-assigning them to other people in the family may have to take place during this stage. During this stage, the griever no longer denies his or her feelings but rather listens to their needs. They also begin to make new meaningful relationships, make new connections, and begin to reach out and connect with the people around them (Zafar &Mubashir, 2012). Understanding the cultural coping strategy of the clients is paramount, because as seen each culture can be very different.
Death as a community event
Another key strategy for the grieving process is having the perception of death as a community event. With this perception, the members of the community have the opportunity of participating in the grieving process and offer the support need by the grieved family members. One of the cultures that leverage on this strategy is the Hispanic culture, which encourages the bereaved to share their loss with the extended family and the community in entirety. Through sharing, part of the grief is taken away, and this is of great significance to the grieving process.
Celebration of Life
There is no doubt that celebration of life of the deceased can help take away grief rather than focusing on the issue of loss or death. This strategy or approach to coping with grief is most recognizable through Dia de losMuertos or Day of the Dead, which is celebrated by the Mexican heritage mostly but can also be seen in other Latin America areas (Klienman, 2012). This is one of the annual holidays for honoring the dead through celebrations and festivals. The celebration of life helps recognize that death is a natural part of the human experience and not a reason for continuous mourning and sadness. It also helps take away grief from the bereaved individuals, and thus, its significance to the grieving process cannot be ignored.
There are different factors that counselors have to take into consideration while dealing with multicultural grief counseling. Irrefutably, grief has neither boundary nor does it know cultures; anyone can suffer from grief at any time or stage in life. As such, it is the duty of the counselor to identify the role played by cultural practices or beliefs in the life of a grieving individual. It is also essential for the grief counselor to identify which coping strategy that should be incorporated into the grieving process, as this could have crucial impact on the helping a client overcome grief. Counselors should strive to retrieve the background information of clients to see how they have coped with death-related issues in the past, and this could play an integral role in such individuals’ healing processes.
Altmaier, E. (2011). Best practices in counseling grief and loss: Finding benefit from trauma. Journal of Mental Health Counseling, 33(1), 33-45. Retrieved from http://search.proquest.com/docview/851298138?accountid=12085
Amelang, J. (2010). Grieving. History Workshop Journal, 69(1), 239-245. Retrieved from http://muse.jhu.edu/
Anderson, H. (2010). Common grief, complex grief. Pastoral Psychology, 59(2), 127-136. doi:http://dx.doi.org/10.1007/s11089-009-0243-5
Bugless, E. (2010). Grief and bereavement theories. Nursing Standards, 24(41), 44-47.
Hardy-Bougere, M. (2008). Cultural manifestations of grief and bereavement: A Clinical Perspective. Journal of Cultural Diversity, 15(2), 66-69. Retrieved from http://search.proquest.com/docview/219371552?accountid=12085
Klienman, A. (2012). Culture, bereavement, psychiatry. The Lancet, 379(9816), 608-609. doi:http://dx.doi.org/10.1016/S0140-6736(12)60258-X
Ober, A. M., Granello, D. H., & Wheaton, J. E. (2012). Grief Counseling: An investigation of counselors’ training, experience, and competencies. Journal of Counseling and Development, 90(2), 150-159. Retrieved from http://p2048-www.liberty.edu.ezproxy.liberty.edu:2048/login?url=http://search.proquest.com.ezproxy.liberty.edu:2048/docview/963768950?accountid=12085
Prieto, L. R. (2011). Introduction to the special section on grief, loss, and bereavement. Journal of Mental Health Counseling, 33(1), 1-3. Retrieved from http://search.proquest.com/docview/851297996?accountid=12085
Shear, M. K., Simon, N., & Wall, M. (2011). Complicated grief and related bereavement issues for DMS-5. Depression and Anxiety, 28(2), 103-117. doi:10.1002/da.20780
Zafar, N., &Mubashir, T. (2012). Emotional distress and coping strategies. Journal of Behavioural Sciences, 22(3), 90-103. Retrieved from http://search.proquest.com/docview/1372088503?accountid=12085