Alexandra begins her scheduled counseling session with the news that her sister suddenly passed away the day before. The counselor is caught off guard and begins to provide supportive therapy. The counselor learns that while Alexandra’s sister had been sick for some months, her sudden health turn was unexpected and rapid. Alexandra was at the hospital when her sister died and was charged with taking the lead on making funeral arrangements.
Alexandra appears numb and detached in session. The counselor attributes this to the initial shock of the loss and provides warmth and comfort to Alexandra. In the following sessions, the counselor notices that although Alexandra appears to be functioning well following what she endorses as a traumatic loss, she demonstrates a flat affect in sessions, states she has accepted the loss and resumes work immediately although she reports feeling little connection to her current life.
The counselor is concerned that Alexandra is avoiding her grief experience, which may lead to the development of pathological symptoms. However, Alexandra reports that she is functioning just as she was before her sister’s death, only with a lost sense of purpose or spirit. She redirects therapy topics to present stress management and adjustment issues in a new career. After exploration from the counselor, Alexandra acknowledges that without her sister, she finds little point in continuing to pursue her goals as every plan was something she would share with her sister.
As counselors, working with traumatic loss can be a difficult subject matter. Unfortunately, Eurocentric American society has generally promoted the avoidance of grief in subtle ways, which causes many people to be uncomfortable around people in pain. In addition, we often inadvertently provide the subtle message “it is time to move on” after a loss.
In Loss, Trauma, and Resilience: Therapeutic Work With Ambiguous Loss, Pauline Boss argued that traumatic grief — a grief “so great and unexpected that it cannot be defended against, coped with, or managed” — is significant, complex, and a diverse public and social health concern. The COVID-19 pandemic, along with a rise in social justice issues and a charged election in 2020, created difficult trials and mass grief that continues today. People experienced numerous losses at individual and community levels: loss of personal health, job security, identity, human rights security, mobility, physical safety and loved ones. Typical responses to traumatic loss may be fear, helplessness, illness, instability and even violence. As counselors, we help clients make sense of loss, redefine their lives and find meaning again. But understanding the multitude of factors needed to grieve traumatic loss is an advanced clinical skill, particularly with clients from minoritized backgrounds who have been systematically silenced.
As noted in Robert Neimeyer and colleagues’ Grief and Bereavement in Contemporary Society: Bridging Research and Practice and Darcy Harris and Tashel Bordere’s Handbook of Social Justice in Loss and Grief: Exploring Diversity, Equity, and Inclusion, cultural traditions often affect the way people respond to grief, whether that involves wearing a particular color or garment, crying or praying. Thus, understanding how trauma impacts mental health requires a broader view of identity, community, adaptation and resistance as forms of resilience. Cultural awareness, responsiveness and understanding are essential to increasing access and improving the standard of care for traumatized individuals. However, there are misconceptions about resilience encompassing an individual’s level of grit and fortitude when facing adversity. In reality, particular groups may risk developing traumatic grief because of repeated exposure to pain and suffering (e.g., the Black community, immigrants, members of the LGBTQ+ population). Also, these marginalized populations may not receive adequate treatment or community support for the causes of their grief and trauma because they may only be treated under the medical model, if they are treated at all. Taking a social justice approach, we as counselors can increase individuals’ feelings of meaning, connectedness and support following a traumatic loss. And by exploring the role and impact of cultural resiliency in navigating traumatic loss, we can consider how cultural strength can be utilized in treatment to decrease the vulnerability of disadvantaged communities.
When working with clients going through a traumatic loss, what are the perceptions we hold about the healing process? About resiliency? About treating historically harmed and excluded populations? When people and communities are overwhelmed and unsafe, they experience the world as dangerous. The rest of the world may not know about what our clients have been through, or they may have no appreciation for it. When this happens, traumatized people and communities may feel completely alone, forgotten or ignored. With traumatic loss, focusing on cultural sources for resiliency is paramount to supporting marginalized populations. This construct provides a focused way for counselors to engage with individual stories of suffering, locate causes, charge responsibility, validate the person’s struggle and activate more effective responses.
A cultural resilience approach
Utilizing resiliency soon after a traumatic event can prevent severe mental health concerns. As documented by the literature, resilience has been associated with several positive physical and mental health outcomes. However, as counselors, we must be mindful that most measures of resilience are still skewed toward Western, individualistic practices. Culture can buffer its members from the impact of trauma because it can create meaning systems and provide healing rituals where one can express their pain while remaining connected to a group. A cultural resilience approach to treating clients experiencing traumatic grief can offer a wide range of culturally responsive techniques to decrease client helplessness, hopelessness, self-blame, guilt, shame and worthlessness, especially for those with a poor clinical prognosis. In addition, a social justice approach to integrating cultural resiliency in therapy can be used to evaluate clients’ beliefs about loss, belonging, defeat, marginalization, honor and self-preservation.
Through cultural resiliency, our clients can have a pathway to express their pain in connection to their belonging group. We, as counselors, can increase our clients’ feelings of meaning, connectedness and support following a traumatic loss. We can consider how cultural strength can be utilized in treatment to decrease the vulnerability and oppression of disadvantaged and harmed communities. A social-ecological approach can incorporate cultural variables to activate resilience and acknowledge cultural components of the trauma and a client’s response.
When working with Alexandra, the case example mentioned previously, the counselor could conceptualize Alexandra’s loss from a multicultural and social justice lens, instead of focusing just on stress management. Alexandra is a Black, single, cisgender woman in her 20s who identifies as a Christian. She is in a professional role following her graduate program, and she says that she is close to her two parents and feels supported by them.
First, the counselor considers how Alexandra’s identified cultural and ethnic groups have historically demonstrated resilience. Next, the clinician asks, “How might I effectively integrate a cultural resiliency approach to my work with Alexandra?” The counselor then respectfully asks Alexandra, “What does the healing process look like within your culture as a Black person, a woman and a Christian?”
Alexandra sits and considers the counselor’s question for a minute. She then answers, “That is difficult to answer. As a Black woman, I recognize the expectation to be a strong Black woman. Emotions are a vulnerability that literally makes us less safe so we must push through no matter what. We prevail. As a woman, I also expect to take care of others before myself so my own healing will come with time, but the important thing is that my people are taken care of. As a Christian, healing looks like having faith in God and knowing that this is all a part of God’s master plan. However, I have been angry at God since my sister’s death, so I do not want to discuss faith and his master plan.”
Without identifying a client’s cultural or ethnic affiliation that guides navigating life’s circumstances, counselors may empathize personally with the client but miss the sociopolitical framework that influences the client’s traumatic loss experience. In a 2003 article published in Violence Against Women, Bonnie Burstow discussed how counseling requires both personal and political empathy to understand a client’s social location and how oppression has impacted their well-being. Society and systems are critical in clients’ trauma experiences, and a person’s group identity or identities and the historical trauma with which they are associated often underly their personal trauma history. Trauma occurs in layers, with each layer affecting every other layer.
The counselor considers Alexandra’s reply, and then says, “I hear multiple cultural influences shaping your understanding of healing. I wonder how these cultural components of healing inform your process of grieving the loss of your sister?” Alexandra sits for a moment in silence, with a thoughtful look on her face. “I feel conflicted,” Alexandra says. “I am prevailing, keeping on with my job, taking care of surviving family, and organizing my sister’s things. But I am confused and angry; everything feels unjust. How am I supposed to grieve something that should not have happened?”
The counselor validates Alexandra’s experience of injustice and her conflicted feelings. Alexandra’s question also opens the door for deeper conversations about how her cultural groups have responded to injustice and formed cultural resiliency strategies. But how can the counselor engage in the meaning-making process (the one taught in counseling programs and supervision) with Alexandra through a cultural lens?
Cultural healing and meaning making
For counselors working with clients navigating traumatic grief and loss, exploring historical and cultural healing can deepen the conversation around bereavement and mourning and aligns with our counselor identity of being strengths-based. Some of our clients come from ethnic and cultural groups that have overcome the most traumatic of trials. An intentional counselor can draw upon generations of resilience and attitudes of overcoming impossible odds despite injustices. When counselors focus only on an individual’s lived experiences without considering historical and cultural context, then beliefs about weakness, powerlessness, helplessness and worthlessness may abound because we think that we are entirely responsible for the quality of our life or lack thereof. However, when counselors explore a client’s identity and lived experience in relation to their identified groups, belief systems about belonging, strength and persistence in adversity come to the surface. In this latter scenario, healing can include considerations about how a client’s traumatic loss experience is part of a more significant social injustice that requires institutional and community remedy.
Healing involves a process of forming vulnerable narration about concepts that have been suppressed or silenced. In other words, it is important to narrate the concepts that have only been quietly discussed in the safety of within-group communities or within internal processing and self-talk. Such healing involves a therapeutic relationship of empathic witnessing and a commitment to deepening one’s understanding of the origins of the client’s pain and suffering that has often been pervasive through time and circumstance.
Returning to the example of Alexandra. If the counselor chooses to remain focused only on client functioning and symptom monitoring, they lose an opportunity to deepen the processing and healing of Alexandra’s pain that surrounds her traumatic loss. Prompting deeper reflection on the origins of Alexandra’s pain within her identities (i.e., a sister who was helpless to protect her sister from death, a Black woman who feels that she must make sure everyone else is OK before she allows herself space to grieve, and a religious woman who believes that her higher power wholly abandoned and betrayed her devoted family through this loss) can elicit more meaningful transformations in therapy. Instead of oversimplifying and focusing sessions on the pain of losing a sibling, the counselor can use deliberate Socratic questioning to probe into deeper associations of powerlessness and injustice. This exploration can help Alexandra gain the power to name her generational, historical and personal losses; feel equipped to protect herself through generational resilience; and combat alienation in her traumatic loss through cultural and ethnic identification and belonging.
Counselors can aid in this process by asking clients to tell their story of grief, not only for the immediate loss but throughout their life and previous generations. What has their identified group endured, and how pervasive are those histories in their lived experience? What and who contributes to our client’s grief story? How did they learn their expectations of what it means to suffer? By asking these questions, counselors can help grieving clients label their experiences and examine their beliefs about how their cultures factor into their feelings of traumatic loss.
The counselor decides to guide Alexandra to explore her anger with God gently. The counselor acknowledges that spirituality can be tricky to unpack because it may be perceived as unfaithful or sacrilegious to express doubts about one’s spiritual beliefs outwardly. Alexandra pauses and considers the counselor’s invitation to verbalize how her anger toward God feels. She is hesitant as she begins discussing an almost superstitious belief that if she and her family were faithful and devoted to their religious practices, they would be granted blessings and saved from the suffering others outside her religious faith might experience. She looks down, sheepish in her admission that she genuinely believes that good things happen to good people, and yet her good sister died regardless. Here, the counselor can help Alexandra not only examine her beliefs about being a strong woman of faith but also assess the intersectionality of her being a “good” woman and how that impacted her grief experience. Being a good woman means that Alexandra is outwardly stoic and strong and demonstrates resilience through continuing her responsibilities (e.g., checking in and cooking for her loved ones, managing her sister’s funeral arrangements) and by not becoming emotional around others or needing to be consoled by others.
Over several sessions, the counselor and Alexandra explore reclaiming her personal and community space. They acknowledge the outcomes of Alexandra’s labor to be resilient despite her suffering and implement rituals and ceremonies that express her grief and outrage in a way that is true to her identity as an angry woman, a betrayed woman and a woman who mourns for the generations of Black women who could not express their suffering openly and be met with warmth. The counselor then offers the client warmth and acknowledges the vulnerability it took for Alexandra to name these experiences in therapy and accept support as she not only reconnected with her historical strength and resilience as a Black woman but also rebuilt ties and traditions to being a religious woman who also historically overcame adversity.
The counselor also guides Alexandra to reconnect with nature in her grief processing, as nature has repeatedly demonstrated its resilience through catastrophic impacts. Through this, Alexandra can draw symbolic strengths and models of what resilience looks like. Her grief response changes over time; she no longer feels she must earn her right to be comforted or take up space in processing the traumatic loss. Instead, she resonates with the notion that, like in nature, she can just be and bend and transform as the circumstances require, while remaining rooted in the generations of strength and resiliency that shape her.
Through counseling, Alexandra realized that her grief of suddenly losing her sister would be ongoing and without end. However, she discovered parts of her cultural resiliency that would be beneficial to help her process this grief; using culturally resilient strategies to cope with the loss of her sister allowed Alexandra eventually to readily embrace the injustice and make meaning of the loss experience. Her bond with her sister will always remain, and her meaning-making journey will include how she continues to name and recognize how her sister shows up in her life and informs her cultural resiliency.
Often, to avoid superficial platitudes (e.g., “things happen for a reason”), individuals find themselves at a loss for words to support others going through traumatic loss. Exploring the role and impact of cultural resiliency to help clients grieve traumatic loss can metamorphize their process of bereavement and decrease counselor helplessness in the therapy room. When a horrific event occurs, we, as counselors, do not have words that will heal, and there is no cognitive reframe possible that can make a client’s suffering cease. Nevertheless, we can help clients explore their own histories of resilience and triumph in pain and adversity beyond their lived experience. This empowers a client to continue to fight to survive the unsurvivable and increases their connection and belonging with others in their identified groups and with us as the counselor.
Through a cultural resilience framework, counselors can guide clients through traumatic loss in a way that connects them to the dignity inherent to how their ancestors navigated and overcame suffering. An individual’s cultural groups may also hold generational pain because of oppression and abuse inflicted on the culture. Therefore, it is strongly recommended that counselors explore cultural identities with their clients and highlight helpful aspects of their identified groups that can activate resilience while leaving behind the aspects of the group the client finds unhelpful. The counselor can normalize that culture does not have to be all or nothing, and each person can write the story of how their identified groups activate and empower their group resilience.
Drawing on community connection, resources and rituals that encompass a sense of support and belonging can aid counselors and protect our clients from traumatic grief, which can lead to significant mental health concerns such as mood disorders or posttraumatic stress disorder. Learn about and emphasize the culture-based holistic strategies that clients bring into therapy. This serves to decolonize our counseling practices and enhance our current methods, while also amplifying the voices of generations who have survived and created meaning systems that can contribute to our healing through traumatic loss.
Jessica Meléndez Tyler is an associate professor of practice at Vanderbilt University and a private practitioner. She is a licensed professional counselor, a licensed counseling supervisor, a board-certified telemental health provider and a national board-certified counselor. Her professional interests include working with suicidal clients and crisis counseling, women’s issues, trauma-informed care, cultural resiliency, collegiality, and the intersection of these topics for counselor education. Contact her at email@example.com.
Nancy Thacker Darrow is an assistant professor of counseling at the University of Vermont. She specializes in grief counseling and LGBTQ+ mental health and development. Through research and practice, she aims to dismantle systemic barriers that influence these specialty areas and counselor education broadly. Contact her at firstname.lastname@example.org or through her website at nancythackerdarrow.com.
Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.
Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.