There are different therapeutic approaches used in the treatment of grief, and because people react differently in these difficult situations, treatment isn’t a one-size-fits-all.

As we know, DBT focuses on change and acceptance.

• if we can change the way we think, we can change the way we feel and act
• we must accept the things we cannot change

Mindfulness

In 2015, Marsha Linehan described mindfulness as

“…the act of consciously focusing your mind in the present moment without judgment and without attachment to the moment.”

Grief and mindfulness may feel like opposites, but that’s not necessarily the case. When we grieve, we are living in the past or the future, but not right now. We may ask ourselves ‘what if i had said or done something?’ or ‘when I will be able to move on?’.

DBT asks us to stop, and focus on the present, to accept things just as they are without judgment. In terms of grief, we have to have self-compassion, and using mindfulness is a good way to do that. Remember that two things can be true at the same time – you may think ‘I can’t do this, I’ll never get through it’ or you could think ‘this is awful, AND I’m doing my best right now’. The word ‘and’ is very important in DBT, we will come onto that in the mindfulness lesson later in the course. 

Interpersonal effectiveness

In DBT there are many acronyms that are used in various exercises and skills sessions, but one of those was invented to help you express your needs to others.

It’s called DEAR MAN, and it’s especially useful for those who are grieving.

• Describe – let people know what the situation is, in clear terms
• Express your feelings
• Assert your wishes
• Reinforce what you have said
• (Stay) Mindful of your feelings, remain present, focus on the sitation
• Appear confident – don’t waver in your requests, stand firm

Emotion Regulation

Grief affects our emotions, and it can be difficult to get them under control. In everyday life, we can’t be in control of our emotions all the time, but grief makes this harder.

‘Check the facts’ is a DBT exercise that helps us change our interpretations and in turn change our emotions. For example, you may feel guilty following the death of an elderly parent who was living in assisted care. You may think ‘I wish I had done more, I wish I had been there, I feel so guilty’.

Check the facts – you didn’t see any cause for concern, you ensured your parent had good around-the-clock care, and you did everything you could.

Checking the facts is a good way to take emotions out of the equation, even if just for a little while, so you can look at the situation logically.

Distress tolerance

This is possibly the most useful module of DBT, in respect of grievers. Distress tolerance, in the words of Marsha Linehan, is:

“the ability to perceive one’s environment without putting demands on it to be different; to experience one’s current emotional state without attempting to change it; and to observe one’s own thoughts and action patterns without attempting to stop or control them.”

You can see why this is important in grief, because we can’t change things – we can’t undo the loss or take away the pain, we can’t change the situation. The only thing left is to accept it for what it is, which means accepting that, even in times of pain, life can be worth living.