How Do You Cope with Complicated Grief? An Interview with Daniel Clifford, Part One

In part one of a two-part interview, SevenPonds speaks with marriage and family therapist Daniel Clifford. Through his work as a counselor and yoga instructor, Daniel has expertise in coping with complicated grief mentally and physically. He began his work as a counselor in 2010 and has since operated his family counseling office in San Francisco. He works with adults and children to heal after significant losses. 

Credit: Daniel Clifford

Marissa: What got you interested in the counseling world?

Daniel: It was a calling that I had. I was going through lots of what I’ll call grief in some ways about not having a fulfilling life and always wondering why. I started in my mid- to late 20s, and over the course of time I got really involved in reading about psyche, and I actually started seeing a therapist myself and started studying aspects of Plato and Aristotle with regard to the soul. I found myself eventually looking for graduate schools. That journey started about 10 years ago.

Marissa: Since then, you’ve focused a lot of your work on complicated grief. What exactly is complicated grief? 

Daniel: I feel it’s really sort of a subjective thing. Particularly there’s a lot of conversation about including it in the recent release of the next DSM 5. They’ve tabled it to be in consideration for the next volume because it’s really a subjective construct. What my experience has been in working with the bereaved and those in grief, we culturally at this point do not give a whole lot of permission to be sad or depressed. The reality is it is an emotional state. And so what we do is do everything we can to push people into happiness and joy through various aspects, including medications, and never getting into that space and suggesting that’s a bad place to be.

And what’s complicated about it is that there’s a mixed bag of emotion…

My experience has been that people never actually go there to grieve and actually feel the loss, that broken heart of someone passing, whether that’s a grandparent or a sibling or even a spouse. You get into a place in midlife or later in life never having to actually grieve your losses. So when you get into a complicated grief state, you’re grieving — typically I see a client who is grieving for one specific loss, and the next thing you know it unravels to every person that they lost in their life. And what’s complicated about it is that there’s a mixed bag of emotion, and it usually runs the whole gamut of emotions teetering back and forth between anger and sadness and depression and loss, and you’re not quite sure at what point who you’re grieving and why. This feels uncomfortable because you think, “I shouldn’t feel angry toward my spouse,” but you might actually feel an anger toward your parents, or whatever it may be, and then all of the sudden that gets repressed again. From my experience, it’s been an unraveling of a lifespan of grief that occurs in a complicated way.

Marissa: What’s the difference between someone experiencing a complicated grief compared to someone who experiences a simpler grief? 

Daniel: If it’s not a “complicated grief scenario,” working with one specific loss is fairly simple on paper. I don’t want to make it sound like grief and working with bereavement is simple in any way. It’s simple on paper because you can reconstruct that relationship: What was good; what was uncomfortable. From that, how do you honor the loved one that has passed? When you get into a complicated state, there are several traits that you have incorporated into your life over time from the many losses that you’ve had. To actually focus in on one, like I said, is an unraveling, and really a taking apart of every single relationship you’ve ever had in your life. And for someone who has not really processed or grieved and felt that experience emotionally, it’s a scary, scary place.

You find that you end up doing a lot of trauma work with them.

What you end up doing and end up finding is that it gets into a trauma place. You find that you end up doing a lot of trauma work with them. This moves directly into the somatic work and whatnot, which is with the yoga stuff that I’ve been doing. How do you experience your body in those states and know where you feel it, and what sort of emotion speaks to you if you work with that pain in your back, or shoulder, or arm or chest?

Credit: Jean Henrique Wichinoski

Marissa: Do you incorporate a lot of yoga into your counseling? 

Daniel: I suggest to people in a very broad way and work with them in the room to experience their body. It starts out with mindfulness, usually doing some breath work, and really focusing on where your body’s at and understanding where your breath is. Is it short? Is it long? Is it shallow? Is it deep? Is it quick breath or long breath? Really what your breath is trying to do is balance out your system. Your body is designed to bring balance into life, and understanding where your body’s at at any given moment is a huge step moving forward with understanding your emotional body. In that space and in that understanding of your emotional body, then you can say, “OK, I’m feeling a pain in my shoulder, or my hip, or my leg. Let’s see if we can stretch it out.”

And that’s where the yoga starts to come into play. If that happened and the client is feeling safe in the room to move their body, that’s great and it works out pretty well. I would suggest to them maybe starting some yoga classes or starting to do some physical exercise to really work with some of this stuff. And all of that being based in a mindful way, not necessarily a “go for a run” type thing.

Marissa: How do you overcome complicated grief?

Daniel: Slowing down. It’s very easy to say, and really, really hard to do. We are, in my opinion, designed educationally to sit at a desk and push a button. In pushing things, we never really release anything. We never really think for ourselves, and we get caught up in this whirlwind of very fast-paced living. Whether it’s driving in a car for six hours a day at your commute, meanwhile being in front of your computer 12 hours per day, you’re never really processing anything. To get someone to sit in their own space without anything in front of them, even with their eyes closed, takes a good deal of time for the average person. It’s being able to slow down and hear yourself and understand what you’re feeling, where you’re feeling it and why.

The three step process I go through with my client is: Where am I feeling it? Why am I being triggered at this point? What do I want to do with that information?

The three step process I go through with my client is: Where am I feeling it? Why am I being triggered at this point? What do I want to do with that information? The first step is pretty easy and most people can get to. The second step takes some good time to slow down. It might take anywhere from half a year to even a year for some folks to understand what their trigger is and why. And then the third step is a transitional space into a new way of living. Now that I understand this information, and I have this power of emotion within me, what do I want to use with my power, and how do I want to shape my life with it? Rather than ignoring that it exists and taking some medication for it.

Marissa: Do you think this process is better than taking medication for grief?

Daniel: Medication works in one context from my experience. It works in the immediacy. And medication without counseling is a recipe for failure. Medication, from my experience, for most of them has a six month lifespan. Your body will essentially get used to anything you inject into it or eat. If you eat carrots for six months, your body is going to be able to process carrots like it’s never been before. If you start ingesting something, your body will find a way to balance itself out again.

Credit: TheOpenMind.com

So you’ve got about a six-month span for most medications. If you’re not continually experiencing those emotions and working with them, you’re gonna need to constantly change medications. What you have now is a pharmaceutical industry that suggests, “Here are six different ways to cure anxiety. Pick one and we’ll put you on another, then another, then another until you’re all better, which doesn’t necessarily happen.”

To bring it back to a grief space, I know lots of clients who come in, and they’re on sleeping pills because they can’t sleep at night since they’re so upset with this. And that’s great. Sleep is a huge thing, and I would encourage people in a grief state to sleep as much as their body will want or allow. There’s been lots of different studies that sleep cures just about anything. Up to 16 or 20 hours a day sometimes cures large complicated emotions, and even injuries physically, whether it’s muscle or bone.

We’ve trained ourselves culturally that we only need six to seven hours of sleep a night. Anything more than that and we’re in some sort of psychotic or mental state that is not productive or successful. One of the remedies I would suggest in any regard to grief or even emotional discomfort is to allow your body to slow down and begin to process. When it’s at its slowest is when we’re asleep.

Marissa: What would you say to someone experiencing any type of grief?

Daniel: The human experience is like a heartbeat. If you hooked up your heartbeat to an EKG machine, it goes up and down in that circadian rhythm. To be alive, you experience the highs and the lows. If you’re flatlining, that means you’re dead. In order to experience life and have a human experience, you need to be comfortable in both of those, the high and the low. That’s the best way I would suggest anyone to come at any emotional experience if they need a process. Both the high and the low are good experiences. Neither of them is bad and neither of them is going to end your life in any way.

Please come back next week for part two of our interview with Daniel next week.