Clinical Theory

Clinical Theory Behind Unfinished Conversation’s Healing Process

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Marilynne Chöphel MFT

The Aftermath
Unprocessed grief blocks us from living and loving fully. All loss requires grieving, and any death can be traumatic. However, losing a loved one to suicide is especially traumatizing, and the bereavement complex. It overwhelms the ability to cope, and threatens physical, mental, emotional, and spiritual well-being. When faced with such distressing circumstances, the body is hard-wired to draw upon the most effective survival strategies available at the time—fight, flight, freeze, submit/collapse, or attach. Long after the events have ended, the intense responses in the mind and body are still felt and easily retriggered: emotional and physical distress, over- or under-activation, reliving the experience, sleep disturbance, self-limiting beliefs, self-destructive behavior, interpersonal challenges, emotional flooding, withdrawing and shutting down, and more.

It’s important to remember that the responses to loss are unique to each person, and all are quite normal reactions to an event as life altering as losing someone you love to suicide. Any unresolved grief or trauma from the past also compounds the complexity of the current loss. Distressing symptoms remain trapped in the mind and body, easily triggered by everyday reminders of the painful past—sometimes for months or years—unless resolved in some way. The traces of the trauma that remain in your nervous system and mind can be completed and released, freeing the pain and fostering a renewed relationship with your self, your lost loved one, and your life.

There Is a Way Through
You can’t change what happened in the past, but you can transform the mind’s and the body’s responses to the past. Modern neuroscience tells us that the way we respond to any experience causes neurons to fire, linking together various parts of the brain. Repeated firings of the same responses strengthen the neural pathways. This means that the more often we act and respond in a particular way, the more likely we are to continue doing so. This is how habits develop, and it’s true for both positive and negative behaviors. However, neuroscience has also revealed the inherent neuroplasticity of the brain—the lifelong capacity to change existing connections in the nervous system and even completely rewire them.

One of the main ways to alter old ineffective patterns of response, and cultivate more desirable behaviors and patterns of thinking, is through a process of “pairing” experiences. By activating the memory networks of the old unwanted patterns, while focusing attention on a new more desirable experience, the neural pathways of the old patterns are actually diminished. The new pathway can override the old, in effect “rewiring” it.

In Unfinished Conversation, after each brief chapter of Robert’s story revealing a particular stage or action in the aftermath of suicide, you are invited through a series of related questions, to reflect on your own experiences and memories in order to facilitate a transformative healing process. Robert’s journey through grief and loss activates your own memory networks, then the related Journal Exercises invite new experiences so that the old pathways can be responded to in new, more adaptive ways. Through reflection, writing, and creating new experiences, you are able to do now what wasn’t able to be done then. You can create safety, take the time to scan for new options, make empowered choices, respond in ways that weren’t possible at the time, and elicit a feeling of more competence or even triumph. As you repeatedly incline your mind toward what you want to create now, old ineffective patterns begin to be extinguished and are replaced with wiser choices. You begin to build a greater capacity for well-being.

The Goal is to Heal
The exercises in the book are intended to help you move through the stages of trauma recovery in progressive, achievable steps to release the traumatic traces of the past and create a more healthy present. You are guided to create safety and stability, affirm your emotions, release the traumatic activation, transform your relationship to the past, find greater perspective and meaning, honor the relationship with your lost loved one, create the conditions for personal and relational well-being, and begin to live the life you want to live.

Remember that the goal is to heal, not re-live or re-traumatize. To avert getting hijacked by unregulated emotions, stuck in avoidance, or overwhelmed by memories, you are encouraged to complete the exercises within your optimal “window of tolerance,” choosing a level of exploration and pacing that enables you to maintain safety and stability as you relate with the past in different ways.

The Tools of Transformation
The healing process of Unfinished Conversation invites you to cultivate three primary tools. The first tool is mindful observation—the quality of compassionate awareness that notices, without judgment, your moment-by-moment experience inside and around you, and helps you step back from overwhelming experience to study it. You can take the time to pause and bring curiosity to the thoughts, feelings, and body sensations that are arising in the here-and-now in response to recalling the past. This mindful attention activates the frontal lobes of the higher brain to develop internal awareness, regulate your emotions, and learn from your experience.

The second tool is dual-awareness—the capacity to relate to the past, in small manageable doses, as you remain aware and grounded in the safety and connection of the present. When you intentionally focus attention in an exercise, you activate the parts of the brain that can access the painful memories. You can begin to notice and uncouple the traumatic activation from the past—the distressing thoughts, emotions, impulses, physical sensations, self-limiting beliefs, incomplete actions—so that more adaptive responses can be discovered, restored, and used in the present.

The third tool is compassionate connection. A feeling of disconnection from not just your loved one but also from those around you and from yourself is natural after such sudden and tragic loss. And the journey to healing after suicide can feel very lonely, with the unfortunate stigma by many about suicide or mental illness. The exercises invite deepening awareness and compassionate connection with yourself, as you continue the conversation with your lost loved one. And they encourage you to communicate your feelings and needs with others— trusted individuals, a support group, and/or a mental health professional. (See Resources for Creating Support below.) As you begin to bring more understanding and compassion to yourself and your loved one, and reach out for support and connection with others who truly understand and care, shame and alienation can decrease, and a greater capacity for self-acceptance and supportive interpersonal connection can grow.

As your relationship to the old memory or pattern of responses is re-organized, you begin to come to terms with the traumatic past that is now over, as you create a more resourced, connected, and healthy present—to live fully and well.

Resources for Creating Support

Creating Support: See Appendix 2, “Creating Support” for ways to use Unfinished Conversation and help make your time with others supportive and healing.

Support Groups: See Appendix 4, “Resources for Survivors of Suicide” for websites of organizations with survivor’s support groups in your area, and its subsection Resources for Creating Survivor Support Groups that offers guidance for creating and facilitating suicide bereavement support groups.

Therapists: See Appendix 1, “Tool Kit for Your Journey to Healing” for Fellow Travelers and Guides that lists respected organizations that can help you find a therapist in your area who is licensed and trained in working with traumatic loss.