Diploma of Holistic Integrated Creative Arts Therapies

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Mind Body Education Diploma in Holistic Integrated Creative Arts Therapy – Module Twelve Author: Kerry Doolan & Isabelle Cunningham © 2019

Mind Body Education

Diploma of Holistic Integrated Creative Arts Therapies.

Online training course.

Module Twelve

Theory

Unit 25 – Working with Anxiety Disorder

Unit 26- Working with Grief and Loss

Unit 27 Working with Depression

Practical

Meditation/Mindfulness

Meditation with Music and Movement

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Depression, Stress and Anxiety in our Modern World

When we talk about depression, we are usually referring to the mental and emotional condition of being

unhappy. The feeling of unhappiness can vary in intensity depending on different individuals, different times and

different circumstances.

For many sufferers, depression involves recurrent and persistent feelings of sadness, hopelessness, lack of

motivation, sometimes fear and even self-loathing, along with a wide range of other similar feelings.

Depression can also mean feelings of poor emotional condition which might include feelings on a spectrum from

just feeling a bit out of sorts or down all the way through to having suicidal thoughts and actual death by suicide.

DESCRIPTION OF DEPRESSION

All people go through challenging periods at different times in their lives, where they feel down or sad. The term

depression is sometimes, wrongly used to describe what is really just normal sadness, which people experience

because of stressful situations, personal problem, death of a loved one, job loss, financial issues or the end of a

relationship.

Depression is also the term used to describe an illness that is a more severe and long-lasting than normal

sadness. This kind of depression interferes with other areas of the sufferer’s life, seems impossible to shake and

can cause serious physical illness.

According to its clinical description, depression can begin with no apparent cause or obvious reason, and it may

also be caused by a specific event or a number of different factors, including:

• Biochemical – When the brain functions normally, neurotransmitters (which regulate mood) hop from nerve

cell to nerve cell. The signal remains just as strong in each cell it hits as it was in the first cell. When people

are suffering from depression, the mood-regulating neurotransmitters signal is depleted or disrupted before

it passes on to the next nerve cell, so the mood is lowered. It is not yet known if the interrupted functioning

causes the lowered mood or if the mental pattern and continuing flight or fight response associated with this

mindset cause the neurotransmitters signal to become weak.

• Genetics or a history of depression within your family. From a holistic viewpoint, we may also consider that

genetics may include learned behaviour. When we grow up with a parent that handles their own experiences

in a particular way, we often learn to handle our experiences in the same way.

• A stressful event or series of events like a relationship break-up, financial problems, abuse or bullying, a

death, family conflict and a range of other normal life incidences. Encountering conflict and problems is a

normal part of being alive along with feeling sad, distressed or grieving. The problem begins when these

normal emotional reactions are suppressed, not dealt with properly or denied. Often when people have had a

traumatic experience and feel sad or depressed, they are given medication rather than tools to help them

work through and overcome their feelings. This does not help them heal and grow but further buries the root

of the problem.

• Having a baby (post-natal depression). This is part of the widely accepted clinical description of depression.

The only thing having a baby causes is a baby! The depression part is caused through the sudden extreme life

change (extra responsibility, body changes, fear for the baby’s wellbeing, extra pressure on the relationship

with a partner, other existing children, lack of sleep, etc.) and not having the positive tools required to

manage those changes in a stress-free way.

Experiencing feelings associated with depression is a normal part of life. When the cause of these feelings is not

addressed, the person does not have the tools and skills required to work through the depression in a reasonable

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timeframe, or the depression has become prolonged and the root cause is not being identified - there is a

problem.

Feelings (or states of mind) commonly associated with depression

• Feeling sad and/or moody

• Feeling hopeless or helpless

• Feeling numb or empty

• Feeling anxious

• Feeling guilty and blaming yourself

• Unable to feel good

• Unable to enjoy normal or usual activities

• Feeling angry at others or victimized

• Being overly self-critical

• Believing you can't cope

• Feeling that ‘things’ are out of your control

• Difficulty making decisions

• Difficulty thinking clearly

• Poor concentration and memory

• Thinking about suicide

• Loss of motivation and energy

• Frequent crying

• Withdrawing from friends and family or being

overly dependent on others

• Increased use of alcohol and/or other drugs

• Rage, burst of anger or losing temper more than

usual

• Lack of appetite or over-eating

• Disturbed sleep patterns - difficulty getting to

sleep, waking through the night or sleeping for

longer

• Headaches

• Stomach pain

• Nausea

• Low libido

• Nervous stomach- Butterflies

Consider for a moment, the effects the fight or flight response has when it is maintained for a longer than a

useful period of time. Do you see any similarities to the list above?

A brief history of depression

Throughout history, a number of creative ways have been used to treat depression, including:

• leaches to suck the madness out

• removal of the spleen as it was believed to hold the madness

• lobotomy to cut out the part of the brain thought to be causing the madness

• electric shock treatment to rewire the neurological pathways

More recently, anti-depressant drugs have been the standard medical answer in an attempt to correct the

chemical imbalance perceived to cause depression. Throughout history, dating back to pagan times, herbs have

also been used with high success rates.

In psychology, people suffering from depression are often taken back through their childhood memories in search

of an event or a series of events that may have caused the depression. There are, of course, many psychological

theories on what causes depression and how it should be treated.

If we go back and look at the signs or symptoms of depression and compare them with the effects of fight or

flight, we can see clear similarities.

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Qualities of the Fight or Flight

Response

Diseases known to be caused by

prolonged stress response

Known symptoms of depression

Increased heart rate

Increased blood pressure

Increased respiratory rate

Higher pulse rate

Increased oxygen consumption

Increased blood lactate

Increased muscle tension

Rapid production of cortisol

Production of noradrenaline

Unconsciously elicited

Stress-inducing

Outer focus of attention

Eyes wide open (straining)

Involuntary

External stimulus

Unpredicted stimulus

Unplanned

High-speed internal dialogue

Narrowing or focusing of attention

Sensory

Physical activity

Physical movement

From non-movement towards rapid movement

Unlearned

Elicited by loud noise

Builds unhappiness

Increases rate of ageing

Helps the individual survive and evolve

Excitation of consciousness

Prepared for most effort

Experience of being at odds with environment

Attitude of resistance

Alcohol and drug dependencies

Anorexia

Anxiety and panic disorders

Asthma, allergies, skin diseases

Cancer

Chronic fatigue syndrome

Chronic pain

Depressed immune system, increased likelihood of colds and infections

Depression and suicide

Diabetes

Difficulty maintaining sexual arousal, loss of libido

Erectile dysfunction

Difficulty urinating, bladder infection, bladder disease

Fibromyalgia

Headaches (and migraines)

Heart disease /heart attack

High blood pressure

High cholesterol

Hypertension

Joint Pain

Multiple Sclerosis

Muscle stiffness, backaches, neck pain

Sleep disturbances

Stroke

Ulcers and digestive disorders

Constipation, colitis, irritable bowel syndrome

Fuzzy thinking

Increased use of alcohol or other drugs

Lack of appetite or over-eating

Feeling anxious

Feeling that ‘things’ are out of your control

Loss of motivation and energy

Frequent crying

Rage; burst of anger or losing temper more than usual.

Thinking about suicide

Low libido

Headaches

Disturbed sleep patterns - difficulty getting to sleep, waking through the night or sleeping for longer

Nervous stomach- Butterflies

Stomach pain

Nausea

Difficulty making decisions

Difficulty thinking clearly

Poor concentrating and memory

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A Theory of Depression

When an event or experience occurs in our lives, our brain responds to any perceived threat by initiating the fight

or flight response (or stress response.) We know this is a healthy response designed to ensure our survival. We

also know the response occurs when there is a perceived danger and not only when the danger is physical and

requires a physical response from us (fleeing or fighting).

We also know that when a human enters the stress response and does nothing to disengage the condition, they

remain in the stress response for a prolonged and possibly indefinite period, causing serious damage to both

body and mind.

Most conventional practices for treating (or attempting to cure) depression are focused on correcting a chemical

imbalance theorised to be occurring in the brain and/or a psychological imbalance thought to be causing

irrational or abnormal thinking.

Some clinical depression is also considered to have begun for no apparent reason; fuelling the theory that

depression is caused through a chemical imbalance which may even be hereditary.

The use of pharmaceuticals for the treatment of depression and anxiety

WARNING: As holistic healthcare professionals, it is imperative, we understand that we cannot advise our

students and clients not to take anti-depressants, nor can we advise them to stop taking medication.

Treating Depression

There is a great deal of medical-based information available from many different organisations, and basically,

they all agree: No one really has a definitive answer to what depression actually is, what causes it and how it is

best treated.

The conclusion of years of research from all over the world from all types of theories and ideologies is that:

• Depression is indiscriminate (it can happen to people of both sexes, any age, any cultural or socioeconomic

background).

• Depression may or may not begin with a definable event (grief over the death of a loved one, job loss, etc.).

• Depression may or may not be hereditary.

• Depression may or may not be caused by a chemical malfunction in the brain.

• Depression may or may not be caused by a chemical abnormality on the body.

• Depression may or may not be ‘cured’ with medication.

Fundamentally speaking, medicine has so far been unable to clearly identify the cause or offer a successful

treatment to depression.

When a person is diagnosed as suffering from Clinical Depression, there is no blood test conducted to establish a

chemical imbalance. Yet, the medication prescribed is intended to correct a suspected chemical imbalance which

is assumed to be causing the depression.

However, there is no evidence anywhere that suggests taking medication cures depression. There is, however,

plenty of evidence to confirm that taking anti-depressants does not cure depression and does cause serious side

effects, including psychosis.

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Here are questions we can suggest people ask their doctor before taking anti-depressants:

1. How do anti-depressants work to cure my depression?

2. How long will it take for this medication to cure my depression?

3. What are the most common side effects associated with this medication?

4. What are the less common but possible side effects associated with this medication?

5. What are the results of the clinical research on the success rate of anti-depressants in curing depression?

Here are some answers:

1. The truth is anti-depressants do not cure depression. They are designed to basically numb the feelings so that

the person taking them doesn’t feel their emotional lows to the same extent, or the highs for that matter.

How is the body or the subconscious mind supposed to get any messages through to our conscious mind

now?

2. Forever! It will take forever. Anti-depressants do not cure depression. They simply take the edge off and

provide the sufferer with a false sense of security to give some other therapy an opportunity to heal the

depression. This other therapy is seldom provided along with the medication, and the success of the other

therapy is inhibited because the sufferer is ‘zoned out’ or not receiving clear messages from their body or

subconscious mind because of the medication.

3. Nausea, headaches, dizziness, constipation, stomach upsets, vertigo, fuzzy thinking, dry mouth, lowered

immune system, sexual dysfunction, tiredness, just to name a few.

4. Too many to mention with psychosis and suicidal thoughts being most reported.

5. We will let you know if any ever show up.

We can’t tell people not to take drugs. Mostly because if we do, we will become liable for and responsible for

what happens next. If that person commits suicide, you could be considered by law to have been instrumental in

causing their death by providing professional advice that you were not qualified to give.

What we can do is to provide our clients and students with a wide range of tools that will empower them to begin

to overcome the depression. We can also encourage them to discuss cutting down on the medication with a view

to eventually getting off it all together with their doctor; so the doctor is supervising our client or student to

move away from the use of anti-depressants.

Understanding Panic Attacks

Panic attacks are a terrifying and debilitating experience.

Usually, when a person first experiences a panic attack (also referred to as a panic/anxiety attack), they do not

understand what is happening to them. Many people think they are seriously ill and sometimes even believe they

are dying. Many sufferers will go to hospital emergency rooms or doctor’s surgery believing they are in mortal

danger, only to be told nothing can be found to be wrong with them.

A panic attack is a massive overreaction of the fight or flight response. All the physiological and psychological

changes that occur in a person who is experiencing the fight or flight response occur during a panic attack but in a

more extreme way. For example:

• the heart rate will increase and feel as if it is pounding at an incredible rate

• breathing will become shallow, often to the point of hyperventilation

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• the pores on the skin will open to where there is a sensation of chills on the skin

• Pupils can dilate until vision is blurry and even obscured

• Butterfly’s in the stomach feel like drums beating very quickly

Basically, all the symptoms of the fight or flight response are present in varying degrees of extremity. This is

because the person suffering a panic attack is, in fact, experiencing an extreme and elevated fight or flight

reaction. The more symptoms they experience, the more their fear increases (as they think they are in serious

danger or severely ill). This pushes them even more rigorously into fight or flight, increasing the symptoms even

more.

Panic attacks can occur at any time. A person who suffers from panic attacks can be triggered into a full-blown

attack by the slightest disturbance to their life or environment. The fear of experiencing another attack is ever-

present, and this can be debilitating to the point where the sufferer becomes afraid to leave their home.

A cycle is created: Something initially pushes the nervous system into full-blown a fight or flight response. The

experience is confusing and terrifying. The fear of it happening again keeps the sufferer in the fight or flight

response (because they are fearful) and then when something else happens (which can be PERCEIVED as danger)

the fight or flight response it causes is extreme.

Think of the person as being like a beaker filled with water. The water represents the level of stress or anxiety

they are holding in their body (and mind) or the level of the fight or flight response they are already experiencing.

If the beaker is already full, it only takes a little drop to make it overflow.

We know that in the long term, being in the fight or flight response for prolonged periods cause serious illness.

Panic attacks are an acute, sudden and extreme fight or flight response.

The Treatment of Depression, Stress and Anxiety

Whenever a person suffers from depression, stress, anxiety or panic attacks, they are suffering from being

trapped in the fight or flight response.

The cause may be due to some long-standing emotional problem they are still reacting to from childhood

(adverse childhood trauma), or it could be a direct response to their current situation (financial issues, job loss,

relationship difficulties - life!) It could be because they were taught to respond in this way by a parent

(hereditary).

It will take some time to discover the root cause and provide the appropriate self-empowering tools to heal them.

But before anything can be done to begin real and lasting healing, the sufferer must free themselves from the

fight or flight response and return to the relaxed response. This is likely to be a state they have not visited for a

long time, maybe even years, and their brains may have completely forgotten it existed or how to get there.

Anti-depressants and sedatives prescribed to treat panic attacks are intended to calm everything down so the

person suffering from depression or panic attacks can have some space or peace to begin dealing with the root

cause and thereby overcome the problem. The idea is sound, but it rarely works. This is because the medication

doesn’t stop the body or the brain’s response to the fight or flight response. It just dulls the messages. The body

is still in the fight or flight response; the brain is just restricted from feeling or understanding the messages the

nervous system is sending it. This causes a sense of disconnection and the cure to the problem is in feeling

connected, not strengthening the sense of disconnection.

When the fight or flight response is disengaged, and the relaxation response is achieved, the sufferer is released

from the frightening sensations the body has been experiencing. They start to feel connected again. They feel

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healthier, able to breathe, muscle tension clears, their appetite normalizes, even vision can improve. They also

begin to be able to think more clearly and (most importantly) gain a sense of hope and optimism about healing.

Teaching People Who Are Suffering from Depression, Stress and Anxiety.

When you run classes or see private clients for the management of depression and anxiety, you will be working

with a diverse group of people. They will all be individual and have different problems, different symptoms,

different attitudes and different abilities to manage their situation.

Two things they will all have in common:

1. They will all be afraid of what is happening to them.

2. They will all be perpetually trapped in the fight or flight response.

The process for providing quality care and correct guidance for people suffering from depression, stress-related

disorders, anxiety and panic disorders, is as follows:

1. Safety - Provide a safe environment which is respectful and confidential.

2. Hope - Provide an optimistic vision for the achievement of complete recovery. Hope heals!

3. Educate- Provide substantiated information on what they are experiencing (the fight or flight response: what

it is, why we have it and how it works along with its symptoms and long-term effects).

4. Empower – Provide tools that allow people to manage their symptoms (the fight or flight response).

5. Equip – Provide tools that empower people to gain control over their own thought processes and develop

more positive mindsets.

6. Support – Provide ongoing support and guidance. Assist students and clients in growing and developing at

their own pace in the direction they choose for themselves.

Creating Class Plans

Class plans that are specifically aimed at overcoming depression, stress, anxiety and panic attacks are the same

for general classes. Both a beginner and advanced class could be available; you can use your existing class plans

and combine many different tools and activities.

People attending your classes to overcome depression, stress, anxiety and panic attacks still need to learn about

the fight or flight response and how it affects them from a psychological and a physiological viewpoint.

Once we help people recognise how stress affects them and what the physical body does in response to stress

(fight or flight response) we alleviate a great deal of stress, because people who suffer from depression, stress,

anxiety and panic attacks often are very afraid and believe there is something seriously medically wrong with

them. This is because they are feeling all the physical effects of the fight or flight response, and they don’t

understand why.

They may frequently feel their heart racing or have trouble getting a deep breath. They may experience hot

flushes or sweating or have muscle pain or an upset stomach or any number of the other physical symptoms of

the fight or flight response. As a result, they are fearful that they may be seriously ill. It is a Catch 22 situation,

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where they are in the fight or flight response because they are afraid of the feeling of being in the fight or flight

response!

The first thing we can do for our students in these classes is to show them what the fight or flight response is and

how it affects them. This will bring them great relief fairly quickly and show them how our classes and workshops

can assist them, giving them hope for a brighter future.

Designing Meditations

It is important when teaching meditation that you create sanctuary first; before guiding people into any other

meditation or visualisation. This is especially true when teaching students who are suffering from depression,

stress, anxiety and panic attacks.

Providing your students with a sanctuary in which to practice their meditations gives them a safe place they can

always go to. It provides them with a familiar routine, making it easier to achieve success in their meditations. It

also provides an alternative experience for anyone who cannot get into or is not enjoying the meditation you are

offering. They can simply play around in their sanctuary.

Students who are not visual and have difficulty ‘seeing’ or creating a sanctuary can be asked to remember a

favourite place: ask them to recall how it looked, felt, smelt, sounded, etc. You can ask them to remember how it

felt being there and to imagine they are back there right now.

The full-body relaxation exercise is also an essential prelude to any meditation. This exercise not only prepares

people to enter a deeper state of meditation, it helps their brain to relearn what a relaxed muscle feels like by

tensing and releasing tension from muscles. This exercise retrains the brain to know how to relax muscles that

may have been held tensed for years.

If you do not guide your students through the muscle relaxation exercise every time you guide them into

meditation and impress upon them the value of the exercise, they will not receive half of the benefit they could

receive during their contact with you.

People who suffer from depression, stress, anxiety and panic attacks are best suited to Zen meditation above all

other styles. This is because most cases of depression, stress, anxiety and panic attacks are caused by the person

not living in the present moment but being absorbed in negative feelings about the past or fear of the future. The

best we can offer them is teaching them how to live in the now.

We know the practice of Zen is a powerful method for training the brain to focus on the present. Practising Zen is

not only beneficial at the time of practice, but it has the ability to rewire the brain patterns in a way that allows

the person to easily reach a Zen state (being in the now) at other times in their lives.

Another great advantage of teaching Zen is that it is suitable for all people regardless of their individual learning

style. While some people are visual or auditory or tactile learners and won’t enjoy all styles of meditation, we are

all in the NOW, and so Zen is the one meditation style that suits every learning style.

When designing meditations specifically for people who suffer from depression, stress, anxiety and panic attacks,

the focus should be on lightness, enjoyment and fun!

It is our task to guide our students toward finding happiness and joy inside of themselves. We want to expose

them to the self-acceptance and desire to embrace life again that will lead them back into a space where they can

begin to overcome their depression, stress, anxiety and panic attacks. It is our job to turn on the light! It is not

our job to take them on any deep traumatic adventures to face their demons.

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Once some joy, happiness and relief from the symptoms of the fight or flight response has been achieved, the

tools we can provide our students from our holistic counselling toolbox will assist them -in choosing new mental

patterns and ways of thinking and looking at life.

In holistic counselling, we do not spend time revisiting the traumas of the past. The ethos of holistic counselling

and creative arts therapy is to develop new living skills and ways of thinking that will allow them to choose how

they want their lives to be and not continue to let the events of the past have any power in the present or their

future.

The natural state for any human being is happiness and good health. Different experiences and traumas have

separated your students who suffer from depression, stress, anxiety and panic attacks from their natural state of

happiness. Often the original cause of their current situation is not even in their lives anymore. Their depression,

stress, anxiety and panic attacks are caused by reliving the past and holding on to old hurts or fear of the future:

fear of it all happening again. Their depression, stress, anxiety and panic attacks are not usually caused by what is

happening in the now. So, if we can assist them to live in the now, we can assist them in overcoming their

depression, stress, anxiety and panic attacks.

If their depression or panic attacks are caused by something which is in the now, then it is not clinical depression

or a stress disorder they are suffering from. In that case, it is a natural response to a current situation that needs

to be addressed. People who are living in trauma in the present cannot be considered to be suffering from clinical

depression or any stress or anxiety disorder.

In designing meditations, we need to remember that people have different learning styles and try to incorporate

as many learning styles as possible or make your meditation adaptable to accommodate the different learning

styles. Not all people, for example, are visual learners (some cannot create pictures in their minds).

The best meditations to take to your classes are those that suit all people regardless of their individual learning

styles because they are based on what every human has in common.

What all people have in common regardless of their individual learning styles are:

• We are all here in the NOW!

• Movement - We all have bodies

• Breath - We are all breathing

• Senses (with the exception of teaching blind, deaf or disabled students) we can all look and see, feel,

smell, hear, taste and touch.

Regardless of our respective upbringings, histories, cultural backgrounds, religious or spiritual beliefs, financial

situations, skin colour or age, there are certain aspects about being alive that we all (every human) share, such as

a desire to experience peace and happiness.

Choosing Positive Thinking Tools

We have many positive thinking tools at our disposal that many of your students may not have heard of or may

have attempted to use without clear guidance and not had success with, in the past.

It is important to remember when working with people who suffer from depression, stress, anxiety and panic

attacks, that part of their condition is feeling trapped, stuck, not able to be helped, a victim. They can often be

unreceptive at first to accept tools that can change their situation. The keyword in that last sentence is CHANGE.

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Often people who suffer from depression, stress, anxiety and panic attacks have become used to their situation,

and though they are in pain, they are also afraid of making changes. They may have an attitude of ‘better the

devil you know’.

Therefore, when we present people who suffer from depression, stress, anxiety and panic attacks with positive

thinking tools, it is common to have some resistance from them at first. We need to ensure the first tools we

present them with are easy for them to incorporate into their everyday lives and that those tools can have a

noticeable positive impact on them as quickly as possible.

Most people find the full-body relaxation exercise makes a noticeable positive difference quickly. This is because

they are discovering (or relearning) how to stop holding tension in their muscles and to some extent at least,

disengaging from the fight or flight response.

When choosing positive thinking (or holistic counselling) tools for people suffering from depression, stress,

anxiety and panic attacks, we must consider that they are in fight or flight mode and probably have been for a

long time.

Counselling Clients Who Suffer from Depression, Anxiety and Panic Attacks

Counselling clients who suffer from depression, anxiety and panic attacks is the same as counselling any other

client in many respects. Except that your clients who suffer from depression, anxiety and panic attacks are further

“in the illusion”. They have come to a point where their fight or flight response and the physical and mental

effects of being trapped in the fight or flight response have become overwhelming to the point of being

debilitating.

They may also be at a point where their lack of control over their thinking (monkey mind chatter) is non-existent,

making them feel like a victim of their own brain; continually worrying about the future and fretting about the

past. Mostly these people feel out of control and desperate. They have lost their footing and with that, their

personal power and self-confidence.

Powerful Tools We Can Offer Our Clients Who Suffer from Depression, Anxiety and Panic Attacks

1. Hope – We cannot support their idea of hopelessness.

They may have created a picture of themselves and their lives that might be hopeless, where they are the victim.

We must show them that while we are empathetic to their situation and value their experience, we are confident

they can overcome their situation and move forward into a happier and healthier life in a reasonably short

timeframe.

Bear in mind the steps these people may have already taken to attempt to recover from their depression, anxiety

and panic attacks. Most specialists they might have seen would have either tried to drag them back over the

horrors of their past, tried to analyse them and/or prescribed drugs. The main reason for this is that most medical

professionals really don’t know what depression is or the most effective way of treating it. That is because it is

not a disease to be treated; it is a symptom of being caught in the fight or flight response for a prolonged period,

the original cause of the fight or flight response may or may not still be evident in the person’s life.

If it is gone (past), then we must let it be gone and assist our client to stop giving it more of their life. If it is

current, then we can provide our client with the tools that will help them to make positive choices and take

affirmative action in changing their situation.

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2. Acceptance – Non-judgement

People who suffer from depression, anxiety and panic attacks benefit greatly from realising they are not alone (a

failure, a freak, weak, etc.). Talking to your clients about how common depression, anxiety and panic attacks are

in our modern society can give them an enormous sense of relief and hope for healing.

3. Education – Knowledge is power

Often (in fact almost always) people who suffer from depression, anxiety and panic attacks are afraid for their

health and wellbeing. They are usually not educated about what is happening to them. They do not realise they

are experiencing the fight or flight response, and they often think there is something seriously physically wrong

with them. Panic attacks, in particular, can make people think they are about to die. They could fear they are

having a heart attack, for example.

This fear perpetuates the fight or flight response, making symptoms worse. Teaching people about the fight or

flight response and how it affects the body (and the mind) can significantly alleviate the frequency and the

intensity of panic attacks. Just the understanding of what is happening (e.g., I am not having a heart attack, I am

having a panic attack) can reduce the intensity of a panic attack and sometimes even allow the person to avert it

altogether.

CAUTION: It is important that your clients who suffer from depression, anxiety and panic attacks have recently

had a full medical check-up; you need to know they are not actually having a heart attack! If your clients who

suffer from depression, anxiety and panic attacks have not recently had a physical check-up, ask them to do so,

simply for the purpose of eliminating any underlying physical issues.

4. Tools – If you give a man a fish, you feed him for a day. If you teach a man to fish, you feed him for a lifetime.

Empowering our clients to confidently manage their lives in positive and healthy ways is the essence of providing

effective holistic therapy.

• We do not give advice.

• We do not pass judgement.

• We do not enter the drama and support a victim attitude.

• We provide highly effective positive life skills along with connection ad encouragement that supports our

clients need to implement those skills into their lives.

Working with Grief and Loss

Grief and Loss counselling becomes necessary when a person is so disabled by their grief; and, so overwhelmed

by their loss, that their normal coping processes are disabled or shut down.

People may require Grief and Loss Counselling after the death of a loved one after a long-term relationship ends

or even after losing their job. All people experience grief and loss differently. Grief counselling facilitates the

expression of emotion and thought about the loss, including feeling sad, anxious, angry, lonely, guilty, relieved,

isolated, confused, or numb.

It includes thinking creatively about the challenges that follow loss and coping with concurrent changes in their

lives. Often people feel disorganized, tired, have trouble concentrating, sleep poorly and have vivid dreams. They

may experience a change in appetite or in their own health.

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Grief counselling may be called upon when a person suffers anticipatory grief, for example, an intrusive and

frequent worry about a loved one whose death is not imminent.

Anticipatory mourning also occurs when a loved one has a terminal illness. This can handicap that person's ability

to stay present whilst simultaneously holding onto, letting go of, and drawing closer to the dying person.

Holistic Grief and Loss Counsellors are able to provide clients with coping skills, emotional support and resources

(and sometimes referrals) to help support them through the normal grieving process and also through what is

known as 'complicated grief, which occurs when the client gets stuck in, or does not progress through, the

natural process of grief on their own.

Healing the Wounds of Grief

Eventually, everyone gets acquainted with grief.

The grief syndrome is now seen to be the most common cause of hospitalisation of around one-third of all

patients who enter hospitals. This is because many people in the community are living with unhealed grief

wounds. It is vital that we recognise that grieving is a normal and necessary response to significant losses in our

lives.

When we consider the physical and physiological effects of long-term stress (remaining for elongated periods of

time in the fight or flight response) has on a person, we can see how illness, accidents, addiction, psychosis and

serious disease can result from unresolved grief.

Unresolved grief keeps a person trapped in the emotions and thought cycles that are closely related to the cause

of the grief. This may include constantly wishing things were different, continually going over details of the event

that caused the loss and repeatedly blaming oneself for the event or becoming fixated on what should have or

could have happened to prevent the event.

These types of mental patterns keep the person trapped in the stress response which (A) can have a serious

effect on the person’s physical health, (B) cause the person to make poor choices and decisions leading to a lack

of self-care, accidents and reckless or dangerous behaviours and (C) compound and cause the grief to become

stuck or feel worse as the mind becomes entrenched in thoughts about the cause of the grief to the point where

it may feel impossible to escape from or even survive.

What is Grief?

• Grief is the normal response of the whole person to any significant loss. Its intensity will depend on the

importance of the loss to the person concerned.

• Grief happens with any significant loss. We tend to underestimate the variety of situations, apart from

death, which precipitates grief. There are many common experiences which involve significant losses.

They include:

Losses involving people: such as changes in a significant relationship or a breakup.

Moving away from people we love or having a loved one move away.

Death of a person or a pet.

The inability to have children.

Miscarriage, abortion or stillbirth.

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Unplanned pregnancies can also require us to sacrifice other plans or possibilities for our lives.

So, the grief is for lost freedom or plans we had made for our life.

Vocational changes or disappointments. The inability to find satisfactory work, retrenchment,

failure to secure a desired career or retirement.

Frustrated hopes and aspirations for ourselves, our families or our children.

The loss of roles or responsibilities that have been important to us, loss of potential, hope, trust,

self-esteem or confidence.

The impairment of health or bodily functions through accident, illness or because of ageing.

A change in circumstances which separates us from familiar places and people.

Transition associated with the life cycle. We sometimes find it difficult to leave behind stages of

life which have been especially fulfilling for us.

Many of these situations overlap. For example, a health problem may involve loss of certain aspirations we had as

well as affecting our relationships or vocational prospects.

Some griefs are harder to put behind us because they are ongoing. People living with a permanent disability,

disappointments over their children or dissatisfactions with marriage, for example, face daily reminders of their

loss.

Grief affects the whole person. Grief engages our feelings and stimulates physical reactions in our bodies.

Our life patterns change in the wake of loss. There are often concerns surrounding guilt, forgiveness and

suffering.

People are faced with spiritual questions about the meaning of life. We also find that when we are helping others

who are dealing with loss and grief, our own feelings about mortality, fragility and the losses in our own lives are

frequently aroused.

Some particularly shocking situations, where there has been an accident and/or the person has witnessed or

played some part in the cause of the grief, can also bring the additional challenges of Post-Traumatic Stress for

the grieving person. So, they may be dealing with horrific and frightening memories, be haunted by graphic

images and feel responsible, on top of their loss.

People Grow through their Encounter with Loss

Working through grief is essential if we are to avoid being crippled by the losses, which are an inevitable part of

life. There are no short cuts. Unresolved grief issues tend to fester like an unhealed wound.

Working through the feelings associated with loss does not mean that we forget the person or situation. But it

can take some of the pain out of remembering. Sometimes people are afraid to begin moving out of the initial,

agonizing pain of grief because they feel doing so means letting go of the person (or relationship, pet or situation)

they are grieving for. As if by not hurting anymore, they would be saying it is OK with them that the person they

are grieving is gone.

When people are parted by divorce or death from someone they love, they must face the pain of saying goodbye

and undoing the bonds that joined them before they will be emotionally ready for new relationships or to move

forward in their lives.

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Eventually, our grief work frees us to be creatively involved with life again. Painful as the experience has been,

there is a new depth which comes to our lives because of it, and we are better able to empathise with others

who experience suffering.

Grief Takes Time

Many people underestimate the time it takes to work through significant losses. We hear statements like “it’s

been three years; shouldn’t he be over it by now?”

There is no correct time frame for dealing with or moving beyond grief. Grief takes time partially because the full

impact is too great to deal with all at once. We tend to face it in manageable or at least survivable chunks. We

alternate between experiencing the pain and avoiding it; between thinking about all that, it means and pushing it

out of our minds. Then, too, there are many smaller losses which come with any separation.

When someone close to us dies, we are continually finding some additional thing about them to miss. Familiar

events (such as birthdays or anniversaries) along with the return to places we shared with them can restore

memories which are, at the same time, helpful and painful to recall.

When someone close to us dies, it is generally considered normal for the grief process to last two years (approx.)

Children tend to need much longer because of their inability to face the intensity of feelings most adults can

handle. This calls for patience from those experiencing the loss and a willingness on the part of the caregivers to

sustain their support over the long haul

The Journey Through Grief Individuals experience grief differently, and while grief does not really have stages that are defined like

steppingstone that lead neatly through the process, there are

chapters in the grieving process that may be referred to as stages.

However, they do not necessarily follow one from the other in a

well-ordered sequence. A person could stay in one stage of grief

for a long time and stay only briefly in another stage. Stages that

are often associated with the beginning of the grieving process

can return, even years later.

If the griever can thoroughly work through each stage of grief,

they may begin their own healing process in a shorter space of

time. However, things like the griever’s emotional maturity, past

experiences, personal and spiritual belief systems, support

network, responsibilities, and depth of connection to the person

(or situation) they are grieving, along with any unresolved issues

or sense of guilt they may have, can cause the grieving person to

stay in or return to any stage of the grieving process. When this

happens repeatedly and for a long period of time or when the

intensity of pain associated with the loss does not begin to

slowly diminish (or even if the griever appears to suddenly

recover and get over it too fast), there is a likelihood that they

are experiencing complicated grief.

One view of the different stages of grief is provided here

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In my own experience, both personally and through many years as a holistic counsellor, I have developed the

following format for the stages of grief. This format applies mostly to the grief caused by the death of someone

close. Again, this will vary from individual to individual and according to the circumstances surrounding the grief

experience.

Factors like how close the person who has died was to the griever, how significant in their lives, how the person

died and whether the griever had any involvement in the death (like being the driver in a car accident or being a

parent of a child where a sense of responsibility for the death is immediate).

It is not so much about expecting the grief process to happen in this order as it is about being able to recognize

what stage the griever is experiencing in order to provide the most appropriate support and resources.

Stage 1 – Shock / Horror

Absolute overwhelm - Terror

A massive fight-or-flight response – either allowing the person to fight or flee for their own survival, run for help

or to share the news. Or, causing them to be overcome by the chemical rush and associated physical responses,

making them weak or even causing them to collapse. They may also respond to this with a physical outburst like

screaming or wailing or even hitting out at others or punching a wall.

Stage 2 – Disbelief

This stage is usually following close behind stage one. The mind is unable to fathom or categorise the new reality.

This could be partly because the change is so massive (as in the death of a loved one) and also partly because the

fight-or-flight response limits logical thought, making processing the information difficult and seemingly surreal.

Stage 3 – Overwhelming Sadness (Pain)

As the news begins to sink in, there is an overwhelming sense of sadness which can even cause physical pain. The

griever may feel they are at risk themselves, experience chest pains, dizziness, shortness of breath and abdominal

pain. They may experience vomiting or diarrhoea or feel like they will pass out. This stage is deeply painful and

often involves a lot of crying and sometimes screaming.

Stage 4 – Denial and Blame (Seeking Control)

This is where the griever refuses to go on trying to process or accept the new situation. They feel it is not

acceptable and it can’t be real. They may go over all the things that could have happened to have changed the

outcome (like if I had done this or if only she had done that). They may also be looking for someone or something

to blame (like the hospital, the other driver, the hospital staff or even God). They start to think about all the

things that could have prevented this from happening, all the things they should have said or done and wishing

things were different. They want to rewind.

Stage 5 – Exhaustion and a Sense of Loss (Emptiness)

The disbelief begins to dissolve into a feeling of hopelessness. The griever is exhausted and confused. They feel

powerless as their rational mind begins to process the reality of the situation, and they are forced to face that

they can’t change anything from the past. It is beyond their power to control what has happened, and they have

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a deep sense of loss. They may feel like a victim. They may feel cheated, or that life is unfair. They may fall into a

depression where they believe that life will never be good again, and they will never recover from this loss. They

may have a sense of not wanting to or not being able to go on.

Stage 6 – Fear

At this stage, the griever may develop fears associated with mortality, death and that what has happened to their

lost loved one may also happen to them or to someone else they love. They may be afraid to drive (if the loss was

through a traffic accident, for example). They may become disconnected and afraid to feel loved or loving, in case

they lose that person too. They may feel destined to ‘go the same way’ if it was a parent who died from an illness.

Stage 7 – Anger and/or Guilt and Regret

At this stage, anger or guilt takes over from powerlessness. The anger may be directed at someone or something

the griever blames for the death, or they may be angry at a system or at life or at God. They may be angry with

themselves, and they may even be angry with the person who has died.

They may express this anger in what appears to be inappropriate ways. Usually, this is because the anger is

irrational, and they are having trouble directing it appropriately. It’s not the sort of thing one can sit down and

write a letter of complaint about and so there may be a lot of frustration and confusion mixed in with the anger.

There may also be a new wave of guilt and regret associated with anything that had occurred in the relationship

when their lost loved one was alive (I should have visited more; I wasn’t a good enough partner, etc.).

Guilt can also show up in this stage as the griever begins to feel the need to feel better. When they can no longer

sustain the deep level of grief, and there is a vague desire to experience happiness again. This guilt can be

because the griever may feel that allowing themselves to begin accepting the loss and start healing means they

are letting go of their lost loved one; that somehow their recovery will symbolize that they are OK with the loss.

Stage 8 – Tribute

Tribute is often our way of saying, ‘I am going to start healing now, but I am not leaving you behind, you and your

passing are still big in my life’. We are making a mark or creating something with a level of permanence to

represent the lost loved one.

Some people pay tribute by getting tattoos with the lost loved one’s name on their body, or by writing a poem or

composing a song. Some people plant a tree or make a pledge to live their lives a certain way from now on.

Some people even change their lives and start new careers or end other significant relationships in order to feel

they have made some permanent and relevant mark on the world, their body or their lives that will continue to

represent their lost loved one.

Provided it is not harmful or extremely irrational; making tribute is a very healthy sign in the grieving process.

Often, what looks like tribute is done very early, like when flowers and crosses are erected on the roadside where

people have lost their lives. This is not true tribute; in the very early days, this type of tribute is a part of the

overwhelming sadness stage.

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Stage 9 – Acceptance

Accepting the loss of a loved one can take many years and may not ever be completely accepted. For example, an

elderly person who loses a spouse they have spent most of their lives with or a parent who loses a child may be

able to accept their loved one is no longer here on the planet with them. They may be able to live a version of

normal life and experience happiness and fun again, but they may never move beyond the loss completely. Their

level of acceptance may be to where they can think about their lost loved one, without being overwhelmed with

pain or it may be they live a normal life but pray to or talk to their loved one frequently. They may live with some

connection to the loved one who is gone. Acceptance will be different for everyone and in the context of being a

holistic counsellor who is supporting someone through grief, acceptance means they have reached a point where

they can function in the world again.

Stage 10 – Recovery / Healing

Recovery and healing, like acceptance, will happen in different degrees for different people. Again, where an

elderly person loses their lifelong companion, they may never fully recover, however they may be able to live a

happy life, but they may be living that life with a longing to be reunited with their loved one.

A mother who has lost a child may never recover in the way one might recover from losing a friend. She may be

capable of living a happy life but may always carry the memory (and in her mind the essence) of that child with

her. Some people might continue to converse to some degree with their lost loved one for the rest of their lives.

While some strains of psychology may view this is as a failure to recover, many cultures and spiritual paths

consider this to be normal and acceptable.

What recovery and healing mean is what the griever wants or needs it to mean. Healing will look different for

different people. We will gain more insight from looking at what indicates that recovery or healing has not yet

been achieved.

Your client has not yet recovered or reached the healing stage if;

• They cannot discuss the loss without crying or choking up.

• They still blame themselves, or the lost loved one or someone else for the death.

• They are afraid of dying in a similar way or afraid of it happening to another loved one.

• They feel unable to become fully engaged in life.

• They are unable to start or maintain close relationships for fear of losing the other person.

• They cannot go to certain places or do certain things that remind them of the lost loved one without

becoming distressed.

Working as a Holistic Grief and Loss Counsellor

For the most part, when people choose to specialize in a particular area of counselling, it has something to do

with their own personal experiences. The areas we are drawn to guide and support others through are often

related to the journeys we have survived ourselves, which have had the greatest impact on our own lives.

Something inside us wants to go back in, with what we have learned to help others, who are in a place of

suffering (like we once were) to get out.

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The path I walked was long and dark, and many times seemed endless.

But sometimes there, I saw a light to follow in the blackness.

Then, at last, I spied the sun faintly in the distance, showing me the way.

I rushed into the open air so glad to see the light of day.

Once I caught my breath, and the sun rays warmed my skin and bone

I came back in to find and lead you out, so you would not have to walk alone.

In grief and loss counselling, as with all other areas, we may sometimes find ourselves working with clients and

listening to stories that come a little too close to home. That is to say, you are human, and we have had many

experiences and have probably also experienced grief and loss. There may be times when the situation makes

you feel overwhelmed with emotion. This could be because it is too close to your own experience, and you feel

your own grief or sense of loss, or it could be because you are overcome with empathy for your client’s situation.

The bottom line here is, it is Ok for you, the holistic counsellor, to express emotions of sadness that naturally

arise for you. I have sat and cried with many clients, and doing this actually provides them with a sense of safety.

It tells them it is fine to express emotion. It shows them that you are a real person and that they don’t need to

hide their feelings from you. At the same time, it is important that your own emotions do not become so strong

that your client ends up needing to comfort you. Never apologise for tears, if you do, it suggests to your client

that tears are not acceptable for them either.

The Pitfalls to Avoid

To be sure that your presence is most effective, avoid the pitfalls of would-be helpers, who think they can actually

talk someone out of their sadness. Well-intentioned as they may be, in reality, all they do is put up roadblocks

that stop the grief from coming out.

The Critic: You should be over it by now. You’re not the only one who’s ever been through it.

The Labeller I think you’re weak. It’s selfish to talk that way. You are blaming yourself.

The Analyst: You’re going through the angry stage. It will soon pass. Now, look at it logically. There must be

a reason for all this.

The Bully: You’ve got to snap out of it. Now promise me you’ll make a real effort to get out of the house.

The Moralist: God would not have sent you this if he thought you couldn’t handle it. You’ll be stronger

when all this is over.

The Advice Giver: If I were you, I wouldn’t take the children to the funeral. If you want my opinion, I’d join a

social club and start meeting people.

The Dodger: Let’s not talk about all this morbid stuff. Did I tell you what happened to me the other day?

Don’t talk about what has happened. Just remember all the good times.

The Cliché kid: Every cloud has a silver lining. Time heals all wounds.

The Talker: Now that reminds me of the time when… Did I tell you about my cousin who…

The Rock: Be brave, be strong. Crying won’t bring him back, you know.

Most people who use these unhelpful methods when talking with someone who is suffering from grief or loss, do

it because they don’t know what else to do. They are making a desperate attempt to fix the other person.

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Both humans and animals grieve when they lose someone or something, they are attached to emotionally. In

“Grief Counselling & Grief Therapy”, J William Worden cites stories of dolphins, geese and ostriches who have

shown all the signs of grief we associate with human mourning.

When a loved one dies or leaves, it is usually necessary for the bereaved to mourn. Worden suggests there are

four tasks of mourning that must be accomplished so that equilibrium is re-established.

Task 1. Accept the reality of the loss

• When someone dies or leaves, usually the first reaction is one that denied it has happened.

• The first task of grieving is to learn to accept the reality that the person is dead or gone.

• During this time, people may believe they see the dead person, misidentify other people or pretend the

dead person is still alive.

• Denial may involve:

1. The fact of the loss – a person might actually behave as if love one is still around, e.g. keep their

room as it was before, set them a place at the table.

2. The meaning of the loss – playing down the significance, e.g. “We weren’t that close.”

3. The irreversibility of the loss – some people refuse to accept that the person will not return.

Task 2. Experience the pain of grief

The pain may actually be physical as well as emotional.

Society may send the message to the individual – “You don’t need to grieve” and subtly steer the person away

from fully experiencing their pain.

If this happens, the person may simply “not feel” and avoid painful thoughts. They may think only pleasant

thoughts of the deceased and idealise them.

If there is anger towards the person for any reason, this may be pushed aside too.

Task 3. Adjust to an environment in which the deceased is missing

This, of course, may strongly depend on what the relationship was with the deceased, e.g. a widow may take a

long time to realise what life is like without her husband.

When someone dies, a lot is lost, e.g. a partner, lover, gardener, housekeeper, child-minder, money-earner etc.

Suddenly the survivor may have to learn to deal with all these things.

Someone who is not adapting may promote their own helplessness, refuse to develop the skills they need to cope

or withdraw from the world.

Task 4. Withdraw emotional energy and reinvest it in another relationship

This is not dishonouring the memory of the deceased but may be resisted for this reason or due to fear of

another loss.

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A person may decide to hold on to the past attachment, rather than go on and form new ones. Most counsellors

agree that the most important thing for people to do in the mourning/grieving process is to be able to show their

feelings and express their grief. The intensity of the feeling often makes friends and family react negatively

causing the grieving person to bottle it all up inside, which is not healthy.

Influencing Factors on Grieving

PSYCHOLOGICAL AND SOCIAL FACTORS

• The individual meaning that is attached to the loss

• The centrality of the relationship in the life of the bereaved

• The quality of the relationship lost

• Unfinished business or ambivalence in the relationship with the lost person

• The circumstances of the loss

• The secondary losses experienced

• The concurrent stressors

• Past loss experience

• Availability and quality of support

• Ability and willingness to use available supports

• Accessibility to and acceptance of mourning rituals

PHYSICAL SYMPTOMS OF GRIEF

These may include:

• Difficulties associated with under-eating or overeating, digestive difficulties

• Weight loss or gain

• Crying

• Sleep disturbance

• Fatigue and lack of energy or strength

• Feelings of heaviness or emptiness

• Tendency to sigh

• Anxiety symptoms - heart palpitations, breathlessness, associated with irrational fears

• Restlessness and searching for distractions

• Loss of sexual desire or hypersexuality

In the early stages of grief, the most we can offer our clients is a safe environment in which to share their

feelings, and practical resources if their loss has left them in physical, financial or material need or in danger of

some kind.

No amount of affirmations or life bubbles exercise can take away the pain. We cannot even reassure our clients

that they will recover. It is a painful journey, and the best we can offer them is compassion and understanding.

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The use of Holistic Integrated Creative Arts Therapy can be very useful in helping them connect with and express

their feelings.

In the later stages when we are working with clients who are seeking assistance to move beyond the disabling

stages of grief and loss or who may be experiencing and wish to overcome complicated grief, we can assist them

in exploring the psychological and social factors around their grief. We can also explore with them how the

following belief systems and their physical status impacts their ability to work through their grief.

Belief System Physical Status

Religious beliefs Physical Health

Philosophical outlook Nutritional intake

Beliefs about life after death Exercise and rest

Meaning attached to the loss Medication or drugs

What this means is, when our clients feel lost at sea and have come to us for help, we can shine a light on the

islands. We can remind them of, or help them discover, the constants in their lives (like their spiritual beliefs). We

can also guide them in taking the basic steps toward their physical recovery.

The art therapy exercised we explored at the beginning of this course where the client draws a tree representing

themselves can be very helpful. The roots of the tree represent the constants and foundations while the leaves

represent the things that can change and pass.

The belief systems and physical status listed above can provide us with topics for discussion, exploration and

creative action.

Complicated Grief

Other terms commonly used: pathological grief, unresolved grief, abnormal grief.

Complicated grief is grief, which is intense, prolonged, unresolved, delayed, exaggerated or unexpressed. The loss

is not integrated or resolved. Relatively few people experience complicated grief.

Certain factors may contribute to the vulnerability of complicated grief:

• The circumstances of the loss - violent, sudden, unexpected or untimely

• The attachment to the lost relationship - excessive dependency or ambivalence

• The intensity of feelings about the loss - intense anger at the lost person or thing or self-blame

• Number and intensity of stressors - where there are concurrent and numerous other stressors or losses

• Support network limited, absent or punitive

• Belief systems - rigidly held negative and fear-based beliefs

Symptoms of complicated grief:

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• Symptoms that are common in early staged of grief may persist – depression, unwillingness to part with

possessions related to the loss, repeated reviewing of the loss, self-destructive thoughts, hopelessness

and lack of meaning

• Preoccupation with thoughts of the loss, or unable to talk about the loss without excessive distress long

after the initial loss experience

• Intense fresh grief long after the initial loss, triggered by a minor event

• Talking about or acting as if the deceased person is still alive, or the lost object or relationship is still alive

• Talking about the loss as if it has just happened

• Uncharacteristic behaviours, e.g. substance abuse, sexual acting out, hyperactivity

• Delayed onset of grief reactions – the later the onset, the more likely the complications

• Extreme views of the lost relationship from saint-like view to intense bitterness

• Hypochondria or phobias about illnesses that are related to the illness of the deceased

• Taking on characteristics of the lost person

• Grief interfering with the person’s ability to function in daily life

Complicated grief is most likely when there is a combination of the above symptoms and when they occur or

persist long after the initial loss experience.

Grief, Complicated Grief and Clinical Depression

Normal Grief Complicated Grief and Clinical Depression

Both may exhibit classic symptoms of sleep and appetite disturbance, intense sadness and longing

Responds well to comfort and support Does not respond to or accept support

Gets openly angry Is visibly moody or upset but does not express anger

Sees the connection between their depressed feelings

and the loss they have experienced

May not see the connection between their depressed

feelings and the loss they have experienced

Is still able to experience moments of enjoyment or

lightness

Exhibits a consistent and constant air of gloom.

Shows and shares feelings of sadness and loss Seems hopeless and consumed by their loss

May have transient physical complaints like pain or

feeling unwell

Has chronic physical complaints, lasting pain and is

frequently unwell

Might express feelings of guilt over some specific aspect

of the loss

Has generalised or all-prevailing feelings of guilt

Can have a temporary negative impact on self-esteem Morbidly self-loathing with a feeling worthlessness

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Grief counselling is particularly challenging because unlike almost every other of type of counselling, we cannot

assist our client to recover or escape from their situation by changing the way they think. No amount of

affirmations, positive life bubbles exercises, painting trees or meditation sessions will bring back the thing they

are grieving for.

It can seem an almost impossible task to support a person through grief, especially complicated grief because

they are in, what seems to be, unresolvable pain. The thing they most want (the return of the thing or person

they are grieving for to return) is never coming back. So, there is a huge sense of powerlessness along with the

sadness and all the other various emotions involved.

Grief takes time. It is not something we can just decide not to think about or ‘buck up’ and get over. It’s deep. It’s

the biggest and hardest experience humans ever go through, and it is associated with every major, irreversible

and unwanted change in our lives. It is even involved in some wanted changes.

We can’t make the grief go away, and we do damage to the person we want to support if we try to make their

grief be gone and finished. There are times when deep grief can even seem life-threatening to the person

experiencing it. They can feel like their body, or their mind just can’t take it anymore, and they can fear dying

themselves, from the grief they are feeling. Their heart may be racing; they may find it hard to breathe or be

hyperventilating; they may have blurred vision; they could feel dizzy or faint; they could have chest pains,

stomach pain, even vomiting.

These are all extreme physical reactions to the stress response (fight-or-flight). These physical responses usually

cause genuine fear that works like a catch 22 situation to perpetuate a heightened level of stress that serves to

intensify the stress levels and cause more stress responses and more frightening feelings…and on it goes. The

person can be trapped in a terrifying physical and emotional spiral. In this state, healing from grief cannot even

begin.

It is important that you encourage your clients, who are experiencing frightening or unusual physical sensations,

to have a medical check-up to illuminate the possibility of any illness.

It is common for people who are experiencing grief to experience exaggerated anxiety over seemingly unrelated

or insignificant things like having visitors, being in public, making decisions, etc. They can experience panic attacks

and have a real sense of being out of control. Depending on how they have learned to deal with anxiety in the

past, this may perpetuate excessive use of alcohol or drugs or overeating. These types of coping mechanisms are

not truly helpful and quickly compound the person’s problems.

So, How Do We Help?

The most important thing we can do as Holistic Therapists is to remember that we can’t save our clients. We have

to go in knowing that we can’t make the thing they are grieving over better. We must accept that our client must

walk through this terrible phase in their lives, and they inevitably must do it for themselves. We can’t do it for

them, and nothing we say or do can make the reality of their experience different.

BUT and it’s a BIG BUT, we can provide them with the tools and skills to make their journey so much more

bearable. We can provide them with the unconditional and nonjudgmental support and guidance they need to

begin and negotiate their own healing journey.

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Dealing with Acute Emergency Situations (AES)

Acute emergency situations in grief counselling, are likely to arise immediately or very soon after the event,

which has caused the grief. Soon after the death, the diagnosis, the retrenchment, the relationship ending, or

whatever catastrophic event has occurred.

You may be called to attend someone’s home or a place of business or even a social group or other places where

you will be providing grief support for one person, a few people or a group of people. Or you may have someone

make an appointment to come and see you because they need help immediately. You could also have someone

brought to you by a friend or family member who doesn’t know what else to do with them. If you choose to work

in some type of medical facility or health care environment, your role might be supporting people who have just

received very bad news either about a loved one or about themselves.

Some funeral directors engage counsellors to help support their clients who are making funeral arrangements for

their loved ones.

The main points to remember in Acute Emergency Situations are…

1/ Be prepared. Be present and work on staying calm. Keep yourself apart from the event as much as you can.

That is to say, try not to over relate. Do whatever it is that you need to do to feel protected and safe. Most

healers are very empathetic, so it is important you make sure your hull is watertight before you dive into what

could be an ocean of very strong and distressing emotions. If it’s white light, or prayer, or meditation or deep

breathing, do it before you step into the situation and keep doing it as often as you can during and then again

afterwards.

2/ AES usually means you will be dealing with people who are deep in the fight-or-flight response and may also

be in shock. They will not be in their normal, logical mind. They will probably be experiencing great anxiety and

the very frightening physical effects of a massive stress response.

Meditation is not usually the best tool to use when people are in shock or trauma. However, breathing exercises

are important for regulating the stress response. Do not try to create diversions or distractions.

We must let the person have the full experience. Do not try to make them talk about what has just happened.

They will probably need time for the situation to fully sink in.

The best thing you can do is to provide tools for reducing the effects of the stress response (breathing) and

provide a safe space for them to talk if they wish to. By safe space, I mean one where they are safe from the

“pitfalls”. It’s all about listening, just listening and acknowledging them with your attention (nods, aha’s, yes, etc.)

not very many people can sit and listen and allow someone in distress to really speak without trying to interject

and make them feel better. This is what your role should be in any fresh, acute situation where grief is involved.

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The Grief Counsellor’s Role in an AES is to ensure everyone involved is SAFE

Support

Anxiety

Feelings

Environment

Support

To provide support to a person or people who are in the initial stages of shock and grief. This must be done

without an underlying intent or desire to make them better, cheer things up or divert attention away from

whatever the event that has caused the grief is.

The counsellor needs to refrain from giving their own take or opinion on what has happened and also from using

any of the “pitfalls” listed above. This is a time for listening if the grieving person wishes to speak or just being

present if they do not.

The counsellor should not try to tell the grieving person about their own comparable experiences or tell the

grieving person they know how they feel.

Anxiety

The anxiety levels that can be present at the onset of grief, that is when the person first knows, hears or realize

that the thing they are grieving over has occurred, can be massive, overwhelming and even dangerous if not

managed correctly.

If the client is able to participate in some breathing exercises, this will help to lower their stress response to some

degree. Do not try to force them to eat something as their digestive system has probably stopped functioning

due to the Fight-or-Flight response.

Non-caffeinated, non-alcoholic beverages are best to keep the client hydrated.

Crying and screaming are natural responses in traumatic situations and are healthy provided the client does not

become hysterical.

If you ever feel that a situation is out of your ability to manage, call for help from suitably qualified healthcare

professionals. This may include calling an ambulance.

Feelings

Allow your clients to talk about their feelings if they wish. But refrain from asking them questions about how they

are feeling. At times of great anxiety and in the midst of trauma, being asked how we feel can seem incredulous.

It is important not to correct them or contradict; just listen. If you hear them saying things that are unrealistic or

concerning, gently ask them to explain what they mean. If they are saying the death or other tragic event is

somehow their fault or are overwhelmed with guilt, ask them to explain why and ask them gentle questions

about why they believe that.

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Mostly they will need to be acknowledged and to be in a space where they are safe and allowed to have their

experience. This may require you to discretely ask others who could be using the “pitfalls” to refrain from doing

so.

Environment

Ensure your AES client is in a safe environment. Depending on the location and situation you find yourself in, this

may involve contacting friends or family to come to collect or be with your client. It could mean taking your client

home from a hospital or scene of the event. It could also mean contacting a community organization or

emergency services.

Before you leave your client, ensure they are in a safe environment with someone who can support and watch

over them.

Supporting the Support Team

The friends and family of the grieving person may need guidance on how to best provide support for the grieving

person.

The support person, or people, may also be grieving to some extent. They may have also experienced the same

loss on a personal level. They may find themselves in the support role because they are the one who is coping

better or because they were not as close to or as affected by the loss.

Most people simply do not know how to provide support for their loved ones when they are grieving. They mostly

just want to make their loved one feel better or make things get back too normal as quickly as possible. They can

feel helpless or powerless and find themselves using many of the “pitfalls’ discussed earlier.

We can provide guidance for people who are supporting others through grief in the following ways.

1/ Help them to recognize their own stress levels and to understand how the fight or flight response affects their

own ability to think clearly.

2/ Show them ways to reduce the effects that stress is having on them. They cannot help anyone else if they are

trapped in the stress response themselves.

3/ Help them identify their own motives for wanting to support the grieving person.

(A) They may have inadvertently, or even unwillingly found themselves in the role. In which case,

they may be overwhelmed and unprepared. They may even feel over-burdened and robbed

of the opportunity to fully experience or express their own grief around the same situation or

event.

(B) They may be the logical person to provide support (being the grieving person’s closest

relative, partner or best friend). In which case, they may be willing to provide support and

committed to ‘being there’ for the grieving person, but they may not feel sure of how to best

assist.

(C) They may be motivated to provide support for the grieving person through a deep sense of

love and attachment to the grieving person and be desperate to learn all they can about how

to do that.

(D) They might have had a similar experience themselves at some point in their lives and feel

compelled to provide the things they themselves needed during their own grief. This can be a

powerful drive, but it can also be hindered by the fact that they may have needed or wanted

different things to the person they are now supporting. Therefore, their own ideas and

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expectations may lead them to provide what they needed and not what the grieving person

they are supporting is really needing.

4/ Provide them with information about grief, how it works, and the methods for supporting people in grief, we

have discussed. Talk to them about the “pitfalls” and help them understand that they can’t make the grieving

person feel better. They can only provide a loving, safe space for the person to walk their own journey through

grief in.

5/ Make sure the support person knows where they can get help if they are feeling overburdened. Help them

make plans for dealing with the incidentals of life. Like food preparation, shopping, paying bills. They may need to

be referred to special agencies or community organizations to seek assistance with coping financially or

accommodation, depending on the circumstances.

6/ Provide a sounding board and allow the support person to express their thoughts and feeling in a

nonjudgmental environment. They may be angry with or fed up with the grieving person. They may have negative

feelings about the person who has died. They may have some guilt around a death or loss of their own. They may

feel the grief has gone on long enough and feel trapped that they can’t return to their own lives, due to needing

to support the grieving person.

Supporting people through grief is about holding space. It requires a level of detachment as we can’t be attached

to when, how or for how long the person we are supporting grieves. Support people still need to keep one foot in

their own lives, or they will become ‘burned out’ very quickly.

It is important to encourage the support person to be taking proper care of themselves. It is also important to

guide them toward engaging help from others to build a support team to share the responsibility of supporting

the grieving person. Other friends and family members may feel they are not needed or wanted and maybe

willing to share the support role if they were invited.

Some Guidelines

Dealing with tears.

As mentioned earlier, it is completely natural, if not absolutely guaranteed there will be tears in a grief

counselling session, unless your client is bottling up their emotions. Always have a box of tissues in easy reach of

your client and ensure they have a glass of water.

It is useful to let your grief counselling clients know what to expect from the counselling session as well as asking

them what they hope to gain from it, at the start of your session, just as you would with any other style of

counselling. At that time, you can tell your client that it’s fine with you if they cry or feel overwhelmed with

emotion.

If your client does start to cry or become very emotional, try not to react too much. You could pass or gently push

the box of tissues toward them. You might take a silent moment to acknowledge their experience but do not

make a big deal out of it. Don’t rush over and try to hug them or start talking about the fact that they are crying.

Do not start quizzing them about why they started crying. Just let them have their experience in the gentlest,

non-intrusive and non-judgmental way you possibly can.

If they become hysterical, start hyperventilating, or it seems to be going on way too long, you could start

encouraging them to breath. Get them to slowly inhale through their nose (like deeply smelling a flower) and

slowly blowing out through their mouth (blowing out a flame) maybe don’t use this analogy if their grief is

because their florist shop burned down. Ah! Yes, humour! It may seem that grief counselling is the most

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inappropriate place to use humour, and it is if you initiate it. But humour is a coping mechanism, and there may

be times when your client uses what could seem to be untimely, ironic or even distasteful humour. It may really

be funny, and it might crack you up. Or it might not, so just smile and try not to look shocked.

Counselling the Dying

One of the most challenging roles for the Holistic Grief and Loss Counsellor is in supporting terminally ill clients.

While the stages of grief and the strategies for working through them are very similar, the difference is the dying

person is not expecting to heal from the grief and get back to living a normal life. What the goal is in this

situation, is to support the dying client into a peaceful state.

The first task is to discover what the dying client is hoping to gain from the counselling sessions. Usually, their

goal will be to find acceptance of their situation. Apart from providing a safe space for the client to express their

thoughts and emotions, we can offer them the benefit of meditation and guide them into being in the present

moment through Zen. We can help them play, experience moments of joy and express their creativity.

Dying clients may want to talk about their spiritual beliefs and where they expect to go after they die. These

beliefs may be very different from your own. They may be comforting or disturbing for your client. If they, for

example, have a concept of hell and fear they will end up there, or if they believe that death means eternal

nothingness, they could be very scared of the journey they may feel condemned too.

You will need to identify whether or not your client wishes to explore their spiritual beliefs in order to develop a

belief system that brings them a greater sense of peace or whether they simply wish to learn the skills, through

meditation, to stop the frightening thoughts they may be having.

In this role, it is not your job to just listen to fear and negative beliefs. As with clients who are not dying, your role

is to help your client achieve their goals, not just be a sounding board for negative mindsets or fear-based

expression. It is always important to have a clear picture of what your client wishes to achieve through your

sessions together, but it is especially important with dying clients.

Sometimes your client may want to use Holistic Creative Art Therapies, Holistic Counselling and Meditation to

help them work through, understand, overcome, make peace with or get closure on their life experiences.

This course is non-sectarian, and we always endeavour to keep our personal belief systems and spiritual ideas out

of counselling sessions. However, this area of counselling can provide the space for you to share your own beliefs

about life, death and spirituality, provided that stream of support has been made very clear to the client before

the session. For example, you might advertise or explain that you offer spiritual, or Christian or Buddhist palliative

counselling.

This requires three things:

1/ Certainty that your client wants to hear about your theories or beliefs. They may be looking for spiritual

guidance, or they may find your beliefs overly confronting.

2/ Congruency from you. If you share your spiritual beliefs with your clients, you must do it from your most

authentic self. You must be unattached to outcomes, so as not to be preaching.

3/ Only share positive beliefs that will support your client in a positive way and not fear-based beliefs that revolve

around hell, punishment and repentance.

It is useful to have a list of referrals you can offer to the dying client.

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Taking Care of Yourself

Grief and loss counselling can be very taxing on the energy and emotions of the counsellor, but it can also be

incredibly rewarding. Most people who want to specialize in the area of grief and loss are drawn to it because

they have personally experienced massive loss and enormous grief themselves.

As human beings, we can consider what it was that we needed ourselves during a time of grief, but we also need

to remember that our clients’ needs may be very different from our own. We can’t assume to know how our

client is feeling. As we have discussed, people experience grief in very different ways and go through a variety of

different stages in an order that is different and unpredictable.

Grief and loss counselling really require the counsellor to be absolutely present…. right in the NOW moment. You

will need to be very tuned into your client and listening to everything they say in order to feel your way toward

your own responses.

Most importantly, never take on more than you know you can handle. If your clients' story is too close to home

for you, too upsetting or makes you feel frightened or overwhelmed, refer the client on to someone else. This is

not failure. It is professionalism. Failure is when you knowingly jump in over your head because then both you

and your client will suffer. Be willing to self-assess and know your own limits.

Debrief

There are several ways you can debrief after a challenging or emotional counselling session.

It’s great to establish a routine that might include some type of personal ritual where you consciously ‘let go’ of

the energy, thoughts and feelings associated with the session you have just finished. This would possibly include

meditation and/or affirmation. It might involve movement and/or chanting. It could even include something

more in line with your own spiritual beliefs…whatever it takes to make you feel closure.

It is also useful to have an associate you can talk to when you need to unload. However, remember that a

debriefing session is not about passing on terrible news or sad stories like a hot potato! It is not about focusing on

how bad the experience was and thinking you feel better because you have handed the story over to someone

else. A debriefing session should be more about you getting support to develop your ability to let go or ‘be OK

with” what you have experienced during the counselling session. If you choose the right person to debrief with,

they will be able to support you in regaining your equilibrium. The person you debrief with should be a

professional, with appropriate skills and not a friend or family member.

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Practical

Meditation/Mindfulness

Meditation with Music and Movement

Activity One

Returning to Sanctuary

You will need to make a recording of the following visualization and then practice it.

*Start recording*

Now relax and gently close your eyes.

(Full Body Relaxation Exercise)

To begin, gently rest your hands in your lap. Just focus on them for a moment.

Now clench your fists while all your other muscles stay relaxed.

Focus on the feelings of tension in your forearms and hands.

And, now all at once, relax your hands completely.

Focus now on how your hands feel and how your forearms feel, as you relax those muscles further and further.

Now, slowly raise your eyebrows.

Feel the muscles tense in your forehead and around your eyes.

Now try to let go about half the tension in your forehead.

Now, let half of that remaining tension go.

Now gently release half of that tension.

Try to hold on to just a tiny level of tension.

Now relax. Let all that tension float away and enjoy how good it feels, and your forehead relaxes.

Close your eyes tightly now and feel the muscles around your eyes tense.

Now gently relax those muscles.

Allow your eyelids to rest and your eyes to remain gently closed.

Now, while your eyes are closed, slowly roll your eyes to the right in a large circle.

Feel the tension in the muscles that move your eyes.

Now, roll your eyes back around to your left.

Really try to feel the tension in those muscles.

Then, relax your eyes completely.

Be aware of how softly your eyes are resting as you let all the tension flow out of these

muscles.

Now, pucker your lips tightly in a kiss. Feel the muscles around your mouth and in your chin tighten. Relax.

While your lips remain relaxed, clench your teeth, feel the tightness running through your jaw

and up into your temples. Feel the tension in your temples.

Now relax. Just let your jaw hang loose. Let all the tension slip away.

Very softly start humming a very low restful note that vibrates throughout your whole body.

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Slowly move your head back and feel the muscles tensing in your neck. While keeping those

muscles tight, slowly move your head forward, so you are tensing one set of muscles against

the other. Now, very gently move your head to the right. Very slowly and now to the left. Feel

the tension in the tiny muscles in your neck and at the top of your spine.

Now, gently relax the muscles in your neck. Feel them softening and smoothing out.

Stretch your shoulders forward and together as if you were trying to touch your shoulders together in

front of you. Feel where the tension is as you hold this position for a moment.

Now stretch your shoulders back as if you were trying to touch your shoulder blades together behind you.

Feel where in your body the tension is.

Now slowly lift your shoulders as if to touch them on your ears.

Feel the tensions.

And now, gently allow your shoulders to relax.

Let them slide down as far as they comfortably want to go,

Feel the tension flowing out of your body as the sensation of relaxation spreads across your shoulders and upper

back.

Press your knees together and notice where the muscles tighten.

Now tense the muscle in your thighs.

At the same time, tense the muscles in your calves.

Study all the feelings of tension in your legs for a moment.

Now gently Relax and let those muscles become heavy, lengthen and smooth out.

Feel the muscles become soft and lengthen as they relax more and more deeply.

Point your toes downward like a ballet dancer.

Feel which muscles tense.

Pull your toes upward now as if to touch your shins with your big toe.

Feel which muscles are tense.

Relax now, just let go.

Let all the tension slide out of your body from the top of your head, all the way through your

body and out your toes, leaving you feeling completely relaxed.

(Floating down)

Now, imagine yourself as a leaf or a feather high in the top of a very tall tree.

As I count backwards from 10, imagine yourself floating very gently down toward the ground and when I

reach ‘one’, imagine yourself landing gently in the grass - peaceful and completely relaxed. Ten

Nine

Eight

Seven

Six

Five

Four

Three

Two

One

Imagine you are now resting peacefully on the soft, cool grass...completely relaxed. As you lay there, totally

relaxed, repeat these words in your head after me.

I am safe

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I am relaxed

I am healthy

I am happy

I am blessed

I am love

Visualize, imagine or picture yourself walking along a winding path that is stretching out in front of you, as you

walk along, the path winds into a beautiful lush forest. You know this place, you have been here before. Imagine

now that up ahead is a huge solid wooden gate blocking the pathway and, on either side of the gate, ancient

stone walls stretch upwards and outwards as far as you can see. You know this place. This is the gate to your

sanctuary.

You see the big old chest by the gate, and you imagine opening the chest and placing all your worries, problems

or concerns into it. Shut the chest and turn back toward the gate. When you return, the chest will have vanished,

taking all of those worries with it. You can see the large iron bolt keeping the gate locked shut. You reach out

your hand and turn the bolt, and the huge old latch lifts with amazing ease. The gate swings open and you step in.

Yours is the only hand that can ever open this gate and enter this secret garden. Nothing and no one can ever

enter this beautiful sanctuary without your permission. This place is safe and sacred, and yours alone. This is your

sanctuary.

You close the gate behind you and continue to walk along the path.

Look down at the path and notice what it is made of. Are there trees? Are there plants? Are there flowers? Notice

the things that surround you as you walk. Are there any birds or animals in your sanctuary?

Remember everything within these walls is safe and friendly. Nothing can ever harm you here; this is your

sanctuary. You are always safe here.

What scents can you smell floating in the air? What sounds can you hear? What is the temperature like in your

sanctuary? Is it warm? Can you feel a gentle breeze on your face as you walk through this perfectly beautiful

place? Can you feel the gentle warmth of the sun? Picture the beauty of nature unfolding before you as you

wander along the pathway. Notice the colours. Notice the textures. Up ahead of you is a very special place. The

heart of your sanctuary. The place you can sit and relax and enjoy being in this beautiful, peaceful, safe place. See

yourself exploring the heart of your sanctuary.

This is your space… Make it as lovely and comfortable and welcoming as you wish. You can add things and

remove things and change things whenever you want to. Remember nothing and no one else can ever get into

your sanctuary without your permission, and you are always safe here. Just sit for a while now and enjoy the

beauty that surrounds you

Now, as you sit comfortably in the heart of your sanctuary, turn your attention to your breathing, just notice how

slowly the air is entering your body filling your lungs and then gently leaving your body. Just gently observe it. As

you exhale, imagine all of the muscles in your body relaxing more and more deeply with every outward breath. As

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you inhale, imagine good health, peace and happiness entering your body with the air and filling every part of

your being and enriching every cell.

Imagine yourself feeling completely relaxed and at peace in your beautiful sanctuary, just look around for a

moment and appreciate the beauty of this amazing place that you have created.

Allow your mind to be completely relaxed. Allow your awareness to be only in this moment.

Listen to all the sounds you can hear right now. First close by, and then further off in the distance...and further

away until you are listening to the sound that is the furthest away.

When you notice thoughts about the past or the future forming in your mind, simply acknowledge them and

return your attention to your breathing for a while.

Just allow yourself to be present in this very moment. Listen to the sounds in this moment.

Feel the sensations in this moment.

Be here right in this little space between the past and the future; this little shaft of warm sunlight that is the now.

Focus your attention on the way your body feels right now.

Notice how calm and relaxed your heartbeat is.

Notice how calm and relaxed your breathing is.

Notice how relaxed you are feeling right now

It is time to leave your sanctuary for now but remember, you can return to it any time you wish, simply by closing

your eyes and walking along the pathway and through the big gate, which only you can open.

Imagine yourself getting up now and beginning to walk back along the path. Take in the beauty and peacefulness

and know this beautiful place is always safe for you and it is always there for you, waiting for you to return. See

the gate ahead of you now and imagine yourself opening it and stepping through back on to the forest path. The

gate swings shut and locks behind you.

Imagine yourself walking back through the beautiful forest now along the pathway. Notice the sounds of the

forest, feel the soft breeze on your face. Now, as you move along the path, start to become aware of the sounds

beyond the forest. Start to become aware of the sound of my voice. Start to become aware of your breathing and

how slow and relaxed it is. Become aware of your body. Notice how deeply relaxed your body feels. Start to

become aware of the room around you. Slowly wiggle your fingers and when you are completely ready, slowly

open your eyes.

Butterfly Breathing

Let your hands hang down by your sides.

Feel your feet firmly rooted on the floor.

Exhale. As you inhale raise your arms slowly and bring them together above your head.

As you exhale slowly bring your arms down to rest at your sides again. As you inhale slowly again, bring your arms

up and together above your head. As you exhale slowly bring your arms down to rest at your sides again.

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Now inhale, raising your arms to the count of six, slowly breathing to the count of six.

1, 2, 3, 4, 5, 6.

Now slowly exhale, slowly putting your arms back down to to the count of six.

1, 2, 3, 4, 5, 6.

Continue to slowly inhale to the count of six as you raise your arms and slowly exhale to the count of six, as you

gently drop your arms.

1, 2, 3, 4, 5, 6.

1, 2, 3, 4, 5, 6.

1, 2, 3, 4, 5, 6.

Grow your roots

Bring your attention to your feet. Imagine that with each breath, you are growing a beautiful, healthy root or

roots that wind down, deep into the Earth.

Feel your roots go through the surface of wood, grass or cement. Further and deeper into the rich, dark soil that

blankets the planet. Feel the coolness of the Earth as your roots go deeper, deeper, moving away from air and

light. Into the cool, rich, nurturing Earth.

Just observe any thoughts, sensations or images that come to you as you travel on this inner journey. Try not to

hold on to, or judge these, just witness them and let them pass.

With each breath, imagine your roots growing deeper and deeper into the earth.

Imagine your roots gently pushing through fresh, underground springs and deep-water tables.

Now you come to the Earth's core.

Imagine your roots reach out and entangle themselves around the very heart of the earth.

As you breath feel the warmth of the Earths heart flowing gently through your roots, up into your feet and softly

through your body. Feel your heartbeat slowly rhythmically, in time with the rhythm of the Earth.

Feel how grounded and centred you are. Give gratitude for your body and the body of the planet.

When you're ready, begin drawing energy from your heart centre into your root.

With each breath, draw up the power of stability, grounding and love.

See the energy rise through the earth's layers - slowly with each breath - until it reaches your physical body and

begins to gently flow through you. Notice any colours or sensations, observing and allowing them without

judgment.

Reach for the sky

As the energy reaches the top of your head, imagine it softly stretching out like branches of a tree.

Feel your branches reaching up and outwards.

Allow yourself to draw in the energy and vitality of life through your leaves and branches.

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Feel the warmth and radiance of the universe, moving through your branches and flowing into your body and

filling every cell with warmth, joy and radiance. Feel it mingling with the earth energy. Notice the way your body

feels.

When you're ready, take a few slow, deep breaths and softly open your eyes.

Letting go and movement

Imagine you are a tiny seed. Very small and still waiting beneath the soil for your time to come into the sunshine.

You are breathing very slowly and conserving your energy.

Now you are feeling compelled to gently stretch out and poke your head out into the daylight. You breathe in the

crisp fresh air and feel the gentle sunlight on your face. You are growing. Feel free to stand up and move in any

way that feels right for you. Stretching upward and growing.

You feel the gentle wind blowing you and causing you to sway and move. You have branches that are growing,

reaching outward and upward. They dance in the wind. You emerge as if from an ancient dream to realize you

have taken the form of a bird. Your branches are strong graceful wings and where you once had roots, you are

now free to fly and dance and move across the sky.

Feel the sense of freedom rising up into your belly.

Feel the excitement of all the endless possibilities that stretch out before you.

Express your gratitude… your joy…your excitement in any way that feels right for you.

Please return to your chair now and sit quietly for a moment.

Feel your feet firmly rooted on the floor.

With your eyes open…exhale.

As you inhale raise your arms slowly and bring them together above your head.

As you exhale slowly bring your arms down to rest at your sides again. As you inhale slowly again, bring your arms

up and together above your head. As you exhale slowly bring your arms down to rest at your sides again.

Now inhale, raising your arms to the count of six, slowly breathing to the count of six.

1, 2, 3, 4, 5, 6.

Now slowly exhale, slowly putting your arms back down to the count of six.

1, 2, 3, 4, 5, 6.

Continue to slowly inhale to the count of six as you raise your arms and slowly exhale to the count of six, as you

gently drop your arms.

*End recording*

Activity Two

Now listen to and follow the recording you have made. Please sit in straight backed chair and get into a

comfortable position with your spine straight. Stretch your arms out to your side to make sure you have plenty of

space to move.

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If you can see images in your mind then you can follow the recording. If you do not usually see images in your

minds-eye, you can just listen to the words and focus on the kinds of thoughts and feelings these words and

suggestions invoke for you.

Activity Three

Please write an essay on which tools and skills you think would be useful in working with clients who are wanting

to overcome Depression. Consider the tools and skills you have explored so far, including your Tools for Holistic

Counsellors Handbook, from module seven. (Maximum 1,000 words).

Activity Four

Make a list of resources and referrals for your clients.

Consider what their needs might be and try to create a list of service providers in your area who can assist them

with these needs.

Their needs might include:

• Emergency accommodation

• Financial assistance

• Home help

• Legal advice

• Medical assistance (doctor, naturopath, homeopath, etc.)

• Psychologist

• Social networks

• What else can you think of?

Lecture References:

• Counseling Strategies for Loss and Grief - by Keren M. Humphrey

• JOURNAL OF COUNSELING & DEVELOPMENT - DSM‐5 and Bereavement: The Loss of Normal Grief?

• Greenberg, G. (2010). Manufacturing depression: The secret history of a modern disease. New York: Simon & Schuster.

• Harris, R. (2008). The happiness trap: How to stop struggling and start living. Boston, MA: Shambhala Publications

• Healy, D. (1999). The antidepressant era. Cambridge, MA: Harvard University Press.

• Jamison, K. R. (1995). An unquiet mind: A memoir of moods and madness.

• Karp, D. A. (1997). Speaking of sadness: Depression, disconnection, and the meanings of illness. New York, US: Oxford University

Press.

• Kirsch, I. (2011). The emperor’s new drugs: Exploding the antidepressant myth.

• Maisel, E. (2012). Rethinking depression: How to shed mental health labels and create personal meaning. Novato, CA: New World

Library.

• Solomon, A. (2002). The noonday demon: An atlas of depression. New York: Scribner.

https://isgweb.counseling.org/ISGweb/Purchase/ProductDetail.aspx?Product_code=72887

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http://www.amazon.com/The-Happiness-Trap-Struggling-Living/dp/1590305841

http://www.amazon.com/The-Antidepressant-Era-David-Healy/dp/0674039580

http://www.amazon.com/An-Unquiet-Mind-Memoir-Madness/dp/0679763309

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Diploma of Holistic Integrated Creative Arts Therapies