prashant bhatt

Understanding Grief: Finding Meaning Through Narrative Therapy

30 August is Grief Awareness Day.

People who have lost someone have a certain look recognizable maybe only to those who have seen that look on their own faces. I have noticed it on my face and I notice it now on others. The look is one of extreme vulnerability, nakedness, openness.”

Didion, (2007, p.35)

The stages of grief model of Kubler Ross and David Kessler talks about Denial, Anger, Bargaining, Depression, Acceptance, Finding meaning.

Case scenario– The long term partner chose not to be with him when he went for MAID- Medical Assistance in Dying as she did not want to increase the conflicts in his family. The step sons, brothers do recognize her, but the ex-wife and related persons would be uneasy by her presence. As she struggled with feelings of guilt, shame, confusion we turned to Narrative therapy informed techniques to deepen the finding meaning.

Remembering Conversations- Discussing the contributions of a loved one to your life, your contributions to their life and how one would imbibe those lessons and memories going forward

Background: Re-membering is a Narrative Therapy (NT) intervention in which we dig deeper into the implication of one’s contribution to the person’s identity, that person’s contribution to our life, how one’s identity would be viewed through that person’s eyes and the implication of these contributions (White, 2007)

Finding meaning

The contribution to each other’s identity conversations led to how he had helped her process her loss when her ex-husband passed away, and she wanted to be there for the sake of her sons from that marriage. Her partner had helped her in that difficult stage and they found meaning in deeper conversations on the processes of family, parenting and life. Her own contribution to his identity was on finding renewed meaning in his connection with his step-sons, after his marriage dissolved. His step sons spoke at the funeral and mentioned how they had seen a different way of relating as their father (the only person they knew as their father- climbed upon him when they were children- as their own biological father had left when they were very small).

When one views one’s identity through that person’s eyes, reflects upon the implications of these contributions one can find go beyond day-to-day life and have a richer connection.

Exercise

Stop and try to remember a person who has physically passed, and remember the joint energy of that relationship.

An aid could be try to remember a shared moment and see how it felt to be together, what remains from that moment and how you would imbibe that energy in your life.

Share as comfortable.

What was the experience of re-membering and sharing like.

My example: Nature walks early in the morning were a gift my father gave to me. I remembered him on his 4th death anniversary on a walk up the Hills near Haridwar, Uttarakhand India in 2003. That moment of imbibing the joint energy has been imbibed into my life by many such nature walks over the decades. One of his other contributions in my life was to model what a flashcard and a checklist would do to one’s work. In my pre-school years, I saw him make flash cards of important drugs, how they would interact with other drugs and with body systems in different stages of disease (he was an anesthesiologist). Having such flashcards and checklists have been part of my professional identity.

Re-membering models could see these experiences (nature walks, checklists, flashcards) be revisited by seeing how these experiences contributed to each other’s meaning. As I went into hostel (medical school days-Delhi 1980s) we went for nature walks to the hills of Shimla, Himachal Pradesh, India and he talked about his younger childhood years, we prayed at the temples which he had visited as a child. Those pilgrimages, museum walks have imbibed in me the spirit of taking my own sons, nephews, nieces to museums, natural areas.

My grade 3 teachers in St Vincent’s High School Pune, Maharashtra, India- 1975-76, introduced me to Charles Dickens through the story of Oliver Twist. The love of the written word is a legacy my parents passed on to me. They started our Home Library even before I entered grade 1.

If his spirit would see/experience this, he would view it as an extension of our walks together in the Western Sahyadri ranges and Northern Himalayan ranges of India.

Key words

Grief, Finding Meaning, Identity, Definitional Ceremonies, Remembering, Narrative Therapy

Walks-New York Botanical Gardens; My parents instilled the love of the written word, nature and science in me. My mother, a botanist, created the first Rock Garden I knew, in Poona, Western India in 1970s. Looking at this Rock Garden at NYBG-June 2025-sent me down memory lane. What part of our identity is shaped by a loved one?

References White, M. (2007). Maps of narrative practice. WW Norton & Company.

Gendered Socialisation Navigating Alexithymia in Immigrant Families

Boys are taught to value and lead to certain parts of them. Girls are taught to do the same but with other parts.Boys were nurtured by their caretaker, till around 4-5 years, and then for fear of being “sissified” they were wrenched away and may even be shamed for showing emotions.

Schwartz, 2023

In the cultural context of immigrant families in North America, I found many men who are unable to express and explore their emotions.

Case scenario: Relationships, Un-Manliness and Cultural Messaging

Tanmay (a composite), a 27 year old graduate student, struggling after the break up of his second online relationship came to me feeling uncertain, confused and hesitant to restart another relationship. As we went into his family of origin to see for underlying patterns, he told of how his parents stayed in the Middle East before shifting the family to Canada, while the father continued to earn and support the Canadian journey. This is a common theme found in Subcontinent origin families. As we went into the way emotions were expressed (or suppressed) in the family, the dynamic of a long distance parent, the emotional instability with no proper economic roots in this society came forward.

Themes around “un-manliness” and what it is to be the “typical male” came up.

Terry Real, in his book, I don’t want to talk about (1998) talked about difficulty with intimacy, workaholism, alcoholism, abusive behaviour and rage as being failed solutions to escape depression.

The Toronto Alexithymia Scale can get one started on becoming aware of the patterns and messages which one has imbibed

Alexithymia and Immigrant journeys

Coined by Peter Sifneos in 1973, the term comes from Greek roots meaning “no words for emotions.” Alexithymia is often observed in various psychological, medical conditions and in the context of immigrant families can be experienced in varying degrees depending on the level of assimilation, marginalisation, integration and separation. (Akhtar, 2010; Sifneos, 1973)

Therapeutic Process: Third Wave-Cognitive-behavioral therapy (CBT) approaches like Acceptance and Commitment therapy (ACT) with focus on emotional awareness and expression can be useful in addressing these issues

For example

Journal of Emotions: T was encouraged to keep a journal where he noted daily events and attempted to label his feelings associated with those events.

The story of how emotions were expressed in his family of origin was started by making some jottings on how he remembers his own parents relating to his grandparents. These cultural messages can be more nuanced as we see the effect of immigration and the early years (first three to five years in Canadian society are very difficult, especially for de-credentialied professionals who try to make it through using labour market or delivery jobs)

Mindfulness Practices: Polyvagal theory informed approaches will help tune to one’s internal states, aiding in the recognition of subtle emotional cues.

The polyvagal journal will be aware of the dorsal vagal (freeze), sympathetic (fight , fright) and the ventral vagal (social, tend, befriend) and use this format to be more aware of one’s tendencies (Dana,2020)

Psychoeducation: Awareness of emotions, their importance, and how to recognize different emotional states in himself and others can lead us to a life of greater connection and fulfilment.

References

Akhtar, S. (2010). Immigration and acculturation: Mourning, adaptation, and the next generation. Jason Aronson.

Dana, D. (2020). Polyvagal exercises for safety and connection: 50 client-centered practices (Norton series on interpersonal neurobiology). WW Norton & Company.

Real, T. (1998). I don’t want to talk about it: Overcoming the secret legacy of male depression. Simon and Schuster.

Schwartz, R. (2023). You Are the One You’ve Been Waiting For: Applying Internal Family Systems to Intimate Relationships. Sounds True.

Sifneos, P. E. (1973). The prevalence of ‘alexithymic’ characteristics in psychosomatic patients. Psychotherapy and Psychosomatics, 22(2-6), 255-262.