Why We Should Normalize Therapy for Grieving Caregivers

Losing a partner can leave you feeling lonely, depressed and heartbroken. Don’t try to go it alone

Jessica Blatt Press,

AARP

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Published October 15, 2024

one hand covers another, surrounded by pink flowers

Illustration: Marine Bufford

For centuries, social norms in our country dictated that it was impolite, abnormal even, to talk about things that are uncomfortable; previous generations were urged to manage feelings on their own — and made to feel that, if they struggled, it must be because of their own shortcomings. Our culture has come a long way — but it’s understandable if, after losing someone you love, some part of you, even unconsciously, holds on to those notions.

“We live in a fairly mourning-avoidant, emotion-phobic culture that has fairly short social norms,” says Alan Wolfelt, Ph.D., an author, grief counselor and death educator at the Center for Loss & Life Transition. “People who would benefit from support often become their potential own worst enemy by not understanding the value of reaching out and seeking the support that they need and deserve.”

And therapy — be it individual psychotherapy, support groups, peer groups — can be particularly beneficial for spousal caregivers who’ve lost their partner.

“The paradox of losing a spouse is that you’ve lost the person you’d normally turn to for support in a crisis,” explains author Dale G. Larson, Ph.D., a professor in the Department of Counseling Psychology at Santa Clara University. “We have so many feelings in grief, and a counselor, support group, or even online experience can normalize your feelings for you, so you’re not beating yourself up about the ‘what ifs’ or feeling as totally isolated.” Bereavement outcomes, Larson says, are “very positively related with talking about the experiences we have.”

“Grief is a horribly lonely experience,” says Lauren Rhodewalt, a medical oncology social worker at Perelman School of Medicine at the Hospital of the University of Pennsylvania. “Just knowing that you’re not alone, that you’re having natural responses to things, is incredibly helpful,” Rhodewalt says.

Grief changes us, Larson says. “Especially when you’re a spousal caregiver and your life becomes so extremely different,” he notes. “We know that grief counseling works. A lot of us are tough individualists who don’t want to rely on others, but we have to reframe that thinking and see the process of mourning as sharing our human condition with others, and receiving the care we need. Spousal caregivers need to focus on themselves, so that they can go on in a healthy fashion and have the rich life they deserve.”

Here, Rhodewalt, Larson, Wolfelt and other experts share what spousal caregivers facing a loss need to know about getting help to navigate a path forward when the future feels impossible to imagine.

Therapy won’t rush you

Gone is the old thinking that grief is linear and that there are discrete “stages” one needs to work through to “resolve” their loss. Instead, as Larson explains, we now know that most people oscillate between reflecting on their loss and moving in the direction of restoration — toward building a new life, with their grief. “Processing things takes time, and it takes focus. You can’t just do it on the side,” Larson says.

Therapy can help spouses reclaim their identities, set new goals, and move adaptably forward without forgetting the past. The beauty of therapy, says Nicole Alston, a social worker at the Center for Prolonged Grief, is that “it’s a dedicated time just for you to share, without any restrictions holding you back.”

Therapists are objective

Maybe you have friends or family reaching out to talk — but you don’t feel comfortable unloading on them. Perhaps you have shame, or guilt, or resentment, feelings you’ve been conditioned to be embarrassed about, and wouldn’t want anyone else to know. Or maybe your loved ones are desperate to make you “better,” when what you really need is to feel and sit with your feelings. The beauty of a one-on-one therapeutic relationship, Rhodewalt says, is that “This is somebody in your life who isn’t enmeshed with, and doesn’t have any biases about, the people you may really need to talk about.” Trained counselors do not expect you to rehash your life story; they don’t put any pressure on you to share more than you’re ready to. “You don’t have to dive into everything,” Rhodewalt says. “A trained psychotherapist or counseling professional will go where you go, with you.”

Talking to a trained professional can offer what Rhodewalt calls a “release valve.” It can also improve relationships in your personal life. If you know you have someone dedicated to working through your feelings and experiences in a scheduled, structured setting, you can spend your time with others feeling more present and less preoccupied.

Therapists can help you rediscover how to use your days, and years, ahead

As a spousal caregiver, chances are that the days leading up to your loved one’s death were filled with doctor appointments and paperwork, the kinds of to-do lists you might not have enjoyed but that gave your life structure and meaning. “Now, you’re left to rediscover who you are without that person,” Rhodewalt says. A trained professional can help you reimagine what your future can look like — and how to get there, realistically.

The Cost of Care

Aker acknowledges that there’s no one-size-fits all fee. Many support groups and some therapists, like those run by community centers, hospitals, and religious organizations, offer free or low-cost programs. If you’re medically insured, you can call your insurance provider (or go to its website) to request a list of in-network providers in your area, and ask what your co-pay would be. If you find someone out-of-network who piques your interest, you can ask if they offer sliding-scale options. Psychology Today’s website also offers a searchable directory of therapy providers.

It’s true that private therapy can range in price, up to several hundred dollars per session, but don’t let that deter you — there are plenty of low-cost options available in communities nationwide, and a burgeoning number of online treatment options as well.

Bereavement support can validate and comfort

Caring for a loved one at the end of their life can be a beautiful gift — but it can also be traumatic. Some spousal caregivers express having flashbacks, feeling haunted by the experience. “That is real trauma — it’s not fake, and it’s not ‘drama,’” Rhodewalt says. At a time when our society doesn’t have the kind of strong community structures it used to, a grief support group can offer catharsis, comfort, and company, when all you might want to do is shut out the world.

Buddies count

Wolfelt is adamant that after experiencing a death, people must not only grieve but mourn — let grief “go public.” If you grieve but don’t mourn, he believes, you can get stuck. “It’s through active, authentic mourning that you’re transformed or changed. We don’t get over grief; we live with it, we’re changed by it,” he says.

Still, many people Wolfelt encounters are less motivated to seek out traditional therapy or support groups, and more amenable to finding a “grief buddy” and that can be just as beneficial.

Wolfelt strives to pair up individuals who recently lost a partner with those who are further along in their mourning. “They get the benefits of the shared response to loss, and there's no substitute for that common bond,” he says. “There’s nothing wrong with you — you’ve loved someone, and now you need to mourn — let’s hook you up with some people who’ve walked the same walk, who can bring you hope that during your darkness, you can come to light.”

Therapy can help you get further help

Jaime Aker, a social worker at Memorial Sloan Kettering Cancer Center (MSKCC), acknowledges that “humans are very resilient and adaptive, and we learn to move with grief.” But given how many symptoms of grief overlap with clinical depression, sometimes it can be helpful, if you’re struggling, to see a therapist to help differentiate between the two.

“It’s hard to know what’s adaptive and what’s problematic,” says Aker’s colleague at MSKCC, Susan Glaser, senior clinical social worker. “Some people can be sleeping more or not sleeping; eating more or not eating; staying home with the shades closed or filling their time with millions of activities.”

What’s more, if you’ve had depression prior to loss, then you are at increased risk of being depressed in grief. Either way, talking to a trained expert, even if it's just once, can provide a frame of reference, reassurance and, if needed, referrals for further support.

There can be a stigma, Wolfelt says, that grieving is some kind of a disorder. “It’s not,” he says. It’s in our capacity to give and receive love — and that requires the necessity to mourn.”

Getting Started

Convinced that therapy might be a good path for you, but not sure where to begin? Jaime Aker, a clinical social worker who supports patients, caregivers, and families at Memorial Sloan Kettering Cancer Center, offers these tips to make the process less daunting.

Start with your doctor.

Reach out to your primary care provider — not only are primary care providers trained to assess patients for issues like anxiety and depression, they’re often able to refer patients to local behavioral health providers and resources.

Lean on community members.

Whatever your religious affiliation or beliefs, many religious organizations can steer you to local therapists and support groups.

Call the county.

Your county social services department likely maintains a list of local nonprofits and organizations targeted at different demographics, from seniors and caregivers to family and children.

Turn to your loved one’s clinical team.

If your loved one died in hospice, was treated by a hospital team, or lived in a continuing care retirement community (CCRC), their caretaking team likely included a social worker or case manager; don't hesitate to call them. Many hospice and hospital teams provide free grief counseling or support groups for bereft caregivers and family.

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Jessica Blatt Press is an award-winning journalist whose work has appeared in The New York Times, O: The Oprah Magazine, Parents, Redbook, Glamour, and more.