Harnessing the power of metaphors in group-work with bereaved families more

Harnessing the Power of Metaphors in Group-Work with Bereaved Families Eleanor Pardess There is hope for a tree; If it is cut down it will renew itself; Its shoots will not cease. If its roots are old in the earth, And its stump dies in the ground, At the scent of water it will bud. And produce branches like sapling (JOB 14:7-9) 1. Introduction This paper describes a model for supporting families coping with traumatic loss. It focuses on the ways metaphors can be explored, elaborated, and harnessed as vehicles for communication and reconstruction of meaning in the wake of loss. The word “metaphor” is Greek in origin; the Greek etymology is from meta (change) and pherein (to bear or to carry). The word “amphora,” which has the same root, means an ancient Greek vessel for carrying and storing precious liquids. Metaphors can convey ideas and feelings that might otherwise be difficult to put into words. (Knopp, 1995; Seligman, 1990). The model that will be described converges with a constructivist approach to the reconstruction of meaning in the wake of loss (Neimeyer, 2001a) and with new trends in grief theory and research including: (a) an adoption of non-pathologizing models of transformation; (b) a shift away from traditional stage models of grieving that emphasize “closure” or “letting go” towards an acknowledgement of the importance of continuing bonds with the deceased (Klass, 1996; Rubin, 1999); (c) a search for culture-sensitive approaches (Malkinson, 2003); and (d) the adoption of concepts for “relearning” the world (Attig, 2000) and of re-authoring life narratives following loss (Neimeyer, 2001b). 2. A Model for Supporting Families Coping with Traumatic Loss Selah, the Israel Crisis Management Center, is a non-profit organization that has, in the past ten years, supported more than 11,000 2 Harnessing the Power of Metaphors immigrants coping with traumatic loss due to terror attack, car and work accidents, sudden illness, or other circumstances. It has a countrywide network of about 600 trained volunteers that is organized into multidisciplinary emergency teams providing: • Immediate on-site emergency practical assistance and emotional support from the initial hours after tragedy strikes – in hospitals, morgue, or homes – to the bereaved as well as to the wounded and their families. Long-term individual and group support. • Selah’s two or three day seminars are an integral part of its longterm support program. The seminars are held in different locations in Israel and are tailored to meet the needs of the different target groups which include bereaved parents, widows/widowers, grandparents raising orphaned grandchildren, and children and adolescents coping with sudden death or the severe wounding of a family member. The seminars for each of these groups deal with specific themes but all the programs share the common goal of creating a climate of support and validating grief while accepting and respecting individual and cultural differences in coping. The intersection of loss, trauma, and immigration generates multiple stresses. Immigrants are often isolated, lacking the language and the natural support systems provided by extended family and long-time friends. It is well known that isolation is a risk factor in the aftermath of trauma (Danieli et al, 2004; Malkinson et al, 2000; Rubin, 1999). Selah’s seminars weaves together mutual support, practical assistance, professional guidance, and the support of the volunteers, creating a kind of “safety net”. Most of the families who come together at the seminars would have been unwilling to do so if the way hadn’t been paved by the intensive one-on-one relationship and strong bonds of trust they formed with Selah volunteers from the first hours after tragedy struck. The families that attend a seminar for the first time return and participate in subsequent seminars that are held several times a year in different locations in Israel. Over the years, some of the bereaved parents and widows/widowers who received support have joined the ranks of the volunteers reaching out to help the newly bereaved. 3. Encounters in Nature Nature provides endless opportunities to learn about the cycles of change, life, and death, as well as about processes of regeneration. Eleanor Pardess 3 The seminars were originally based on the idea that they would enable bereaved families to support each other and get away from the stresses of everyday life, at least for a while. The group excursions were planned to offer an opportunity to get to know the country and to experience some sense of belonging to it through visiting places of historical significance and relevance. The workshops are planned and facilitated by a multi-disciplinary team of volunteers, including mental health professionals and volunteers from different professional backgrounds, each of whom bring unique strengths, perspectives, and experience. One of our leading volunteers, Dr. Zvia Shapira, is a botanist specializing in ethnic botany. Observing nature through her keen eyes adds a new dimension to the outdoor group experiences. Discussions on themes such as survival strategies in nature, the re-acclimatization of transplanted plants, and the regeneration of burnt trees resonate deeply with group members, enabling them to share their own feelings and thoughts. The botanical perspective uncovers hidden processes concealed from the untrained eye, underscoring the inter-connectedness of the web of life, the multiple ways life unfolds and interacts with death, and regenerative processes in nature. The creative activities – including painting, sculpture, music, drama, etc. – that are planned with the help of volunteer art therapists, complement the outdoor experiences. Introducing different art techniques enables participants to use alternative channels for expression. This intermodal approach, which includes both verbal and nonverbal techniques, offers group members tools that enable them to translate their feelings and experiences to themselves and to others. The workshops are usually held on the second or third day of each seminar after participants have already spent time together and shared various activities. Each workshop has the same structure though they focus on different themes. Each workshop has three parts: • Nature walks – with relaxation, guided imagery, and observations in “nature’s classroom,” followed by space for reflection. • Creative activity – painting, sculpture, collage, etc. • Sharing and processing of experiences. This sequence of experiential activities is designed to enable a gradual entry and engagement of participants in the process, which unfolds as it proceeds. There is a gradual shift from a more passive to a more active participation in the activities. 4 Harnessing the Power of Metaphors A. “How do These Trees Gather the Strength to go on Living?” To illustrate this process, let me take you to the Dead Sea. Imagine a circle of about fifteen men and women sitting on the ground in the cactus garden in Kibbutz Ein Gedi, an oasis with lush vegetation nestled between two mountain streams amidst the arid desert landscape. The participants were bereaved parents whose children were killed in a suicide bombing. The first time they participated in such a weekend seminar was five months after the bombing. It is November and it was quite hot outside; the sky was a deep blue and we were sitting in the shade. The group was very quiet. Most of the participants – of ages ranging from 33 to 57 – looked withdrawn and disconnected. Most of them were staring blankly into the air. The botanist, Dr. Zvia Shapiro, spoke about the survival of the plants in the desert, using short sentences because of their short attention span. Some of the group gradually seemed to become engaged in conversation, gradually “de-freezing”, expressing interest in the subject and sharing reflections as to what had caught their attention. A single mother, whose only daughter was killed in the suicide bombing, spontaneously shared her thoughts regarding the landscape she saw along the road from Masada the day before: I saw the trees in the desert near the Dead Sea all dry and paralyzed in such distorted positions. I feel that we are just like those trees. I asked myself: “How do these trees gather the strength to go on living?” B. Surviving in a Desert What can we learn from desert plants about survival in extremely harsh conditions? How do they protect themselves? How do they survive? Desert plants adapt to extremes of heat and aridity by using numerous and innovative physical and behavioral mechanisms: • • • Some grow extremely long roots so they can search deeply for resources. Others survive by remaining dormant during dry periods of the year and then springing to life when water becomes available. Many desert plants have a thick covering – a protective shield – coated with a waxy substance that seals in moisture. Eleanor Pardess 5 • Some trees and shrubs adapt through eliminating transpiration and minimizing loss of energy by completely replacing leaves with thorns or greatly reducing leaf size. Reducing the exposed area and shutting out the outside is part of the self-regulation that prevents unnecessary loss of energy. When working with people struggling with traumatic loss, this state of “shutting down” is evident. People in the first stages of acute grief often desperately need support but too much exposure can be overwhelming. That is why listening, and a non-intrusive indirect approach such as that provided by the use of metaphors, is so important. It has a third-person quality that helps provide a “holding environment” (Winnicot, 1972), which creates a safe space for sharing without imposing, without overwhelming, and without letting too many words get in the way. C. Trying to Put Together Fragmented Parts of Life As we returned from the outing to the second part of the workshop, the bereaved mother quoted above collected dry crumbling leaves and pieces of bark from the ground. Art materials had been spread out in advance in the room. She prepared a collage of scattered fragments loosely held together with a piece of rope. She then placed a fig in the middle and began to talk slowly, trying to find words: Until yesterday, I felt that everything was dead within me…empty…like the dry bark.…Everything was falling apart. Here you can see the shattered, scattered pieces.…This green fig is a sign of hope…maybe… “I was surprised to find strengths in me I never knew existed,” she said later. She was glad she had come in spite of her initial reluctance. She was very proud of her artwork. “I am the eyes through which my daughter can continue looking at the world,” she said. The search for meaning in face of desolation, emptiness, and fragmentation is expressed in multiple ways in the artworks created in these workshops. Trying to put together the scattered and shattered fragments of life is a recurrent theme. 6 Harnessing the Power of Metaphors D. Breaking through Isolation Metaphors can be used to break through isolation by creating a language that crosses cultural and language barriers. A bereaved father drew an isolated island in the middle of the sea with only three trees on it, representing himself; his wife, and his surviving son after his 19-year-old son was killed in the suicide bombing. He drew a ship far away from the island, at the edge of the page. “The island is us, after the terror attack. The faraway ship is the rest of the human race, going on with their lives. The ocean is wide. Maybe the ship will come nearer. Maybe not!” E. Making Room for Diversity Another bereaved mother drew a tree with flowers in different colors, representing her hope of “sticking together” in spite of differences between the group members: “I draw strength from being together as a group. It is important not to be left alone with the sorrow. Together we are like a tree with flowers in different colors”. Accepting individual ways of mourning is a central issue in the nature-based workshops. The diversity of the thousand different species of cacti in the botanical garden, with their many ways of self-protection and survival strategies (as mentioned before), is only one example of the diversity in nature. Individuals can be helped to identify their needs and to “re-learn” themselves in the aftermath of loss. The experiential activities in the workshops can help them identify when they feel a need to be alone or feel a need to be together with others and what kind of support suits them in different situations. Elaborating metaphors with the use of both nonverbal and verbal means can promote self-awareness so participants can let friends and family members know what feels right to them. Close listening to metaphors, that are spontaneously introduced by group members, as well as to the many different images of life and death, can guide us in creating a climate of empathy and acceptance validating grief and countering the isolation and alienation often experienced by the bereaved. F. The Experience of Being Uprooted “We don’t always have an opportunity to discover what goes on beneath the surface.” With these words we stopped by a tree, the Eleanor Pardess 7 underground roots of which had been exposed and were intertwining by the side of the path. This workshop was held in a forest in the north of Israel. One of the participants, a single mother who had lost her only son, aged 23, in a suicide bombing, was particularly attracted to a severed root. She was the only one who noticed it. She bent over and gently stroked the root, saying: “Just like my heart – broken in two.” Later on she drew a picture in black of the exact same tree with its severed roots. She said: I identified with the severed roots we saw on the way – split into two. On these roots I saw green sprouts pushing their way out. My roots are now like the roots of the tree I drew – only black. Yet who knows, maybe there will be some growth in the future. G. Keeping Roots Alive Plants that have been uprooted, transplanted, and forced to adjust to new surroundings seem to have an inner knowledge of how to survive the relocation. At first they invest all their energy in settling down and developing roots. During this stage they do not grow leaves or produce fruit, as that would be a waste of energy. The plant may seem to be “sick” or even “dead” on the outside, but the real story is what goes on under the surface. Underneath, roots are gradually developing and spreading out. It may be difficult to accept these periods in which there is no visible growth. However, it is important to realize that this is not a waste of time but part of the process of rooting and grounding. Acclimatization takes time! In another workshop for bereaved parents, a mother whose 14year-old daughter had been killed in a terrorist attack shortly after the family immigrated to Israel, told the group the story of a cherry tree. After her daughter’s death, she tried to plant a cherry tree in Israel using a sapling sent by her mother from the Ukraine, a tree like the one they had in their garden there. It looked very sick and so sad here. We waited and waited. Not one leaf, not one flower. It was so dry. We thought it had already perished. One day my husband saw this tiny shoot pushing its way out. He is usually quite reserved, yet he was so excited and even shouted in Hebrew (it was the first time he spoke a word of Hebrew at home) – “Here you are! Here you are!!” 8 Harnessing the Power of Metaphors The group participants resonated strongly to the struggle of the tree. “We also need care and nourishment just like the plants,” said one of them. “And so much patience…” said another. “I hate the word ‘savlanut,’ which means ‘patience’ in Hebrew, but I know deep deep inside that we have to be patient with all that is unresolved in ourselves.” Group members elaborated on the meaning of keeping one’s roots alive. They talked about the personal meanings of roots, which are essential for nutrition as well as for giving firm anchorage to help weather the storms of life. In the words of a bereaved father: “As long as the roots remain alive, there is hope for re-growth.” 4. Conclusion Nature provides endless opportunities for reflection and for learning about the cycles of change, life, and death. Being together in nature and engaging in creative activities – including verbal and nonverbal techniques – can open new channels of communication that can enable individuals to become more self aware, to understand themselves better and to feel understood by others. Sensitive use of metaphors can help break through isolation, cross language and cultural barriers, and create a safe space for sharing. The distance provided by the use of indirect communication can reduce the risk of re-retraumatization. While acknowledging the power of metaphors, it is important to stress that this power may be misused. We need to be aware of the danger in pitfalls like imposing metaphors, minimizing pain, or letting too many words get in the way. Metaphors play an important role in facilitating the interdisciplinary and multidisciplinary dialogue essential for the development and implementation of the support program described above. The perspectives and metaphors from different fields, such as psychology, social work, the expressive arts, and botany, have enriched the coming together and creation of a “community of support.” This coming together – de-professionalizing grief and making room for diversity – is a major tenet of this strength-based approach to validating individual ways of coping and searching for meaning in the wake of desolating loss. The combination of nature-based group experiences and the expressive arts can open creative ways for honoring memories, giving “life in the heart” (Kasher, 2003), and building bridges between the past, present, and future. Eleanor Pardess 9 References Attig, Thomas. The Heart of Grief. New York: Oxford, 2000. Danieli, Yael, Brom, Danny, and Sills, Joe (editors). The Trauma of Terrorism: Sharing Knowledge and Shared Care, An International Handbook. Binghamton, NY: Haworth Maltreatment and Trauma Press, 2004. Kasher, Asa. “Life in the Heart.” Journal of Loss & Trauma, 8 (2) (2003): 247-260. Klass, Dennis, Silverman, Phyllis, and Nickman, Steven. Continuing Bonds: New Understandings of Grief. Washington, DC: Taylor & Francis, 1996. Kopp, Richard. Metaphor Therapy: Using Client-Generated Metaphors in Psychotherapy. New York: BrunnerMazel, 1995. Ofra, Eylon and Muli, Lahad. Living on the Border: Toughening Up and Coping with Stressful Situations Involving Violence and Threats to Security. Haifa : Nord Press, 2000. Malkinson, Ruth. “Battling the Black Sea Despair: CrossCultural Consultation Following an Air Disaster. Journal of Loss & Trauma 8 (2) (2003): 99-113. Malkinson, Ruth, Rubin, Simon, and Witzum, Eliezer. Traumatic and Non Traumatic Loss and Bereavement – Clinical Theory and Practice, Madison, CN: Psychosocial Press, 2000. Neimeyer, Robert. Meaning Reconstruction and the Experience of Loss. Washington, DC: American Psychological Association, 2001a. Neimeyer, Robert. “Reauthoring Life Narratives: Grief Therapy as Meaning Reconstruction.” The Israel Journal of Psychiatry and Related Sciences 3 (2001b): 171-181. Rubin, Simon. “The Two-Track Model of Bereavement: Overview, Retrospect and Prospect.” Death Studies 23 (1999): 681-714. Siegelman, Ellen. Metaphor and Meaning in Psychotherapy. New York: Guildford Press, 1990. White, Michael and Epston, David. Narrative Means to Therapeutic Ends. New York: W. Norton Press, 1990. Winnicot, Donald. Playing and Reality, New York Basic Books, 1972. 10 Harnessing the Power of Metaphors Eleanor Pardess, Clinical Psychologist SELAH, Israel Crisis Management Center