An Interview with Phyllis Silverman, Ph.D.
Phyllis Silverman, who addressed the NHO Conference in Pittsburgh is a researcher, author, teacher and clinician. Her extensive work brings the spirit of inquiry to the field of bereavement, encouraging the bereaved to ask questions, make use of resources, and share information amongst themselves. As they do so they will discover a supportive community and will develop a set of skills that will be helpful to themselves and others in the future.
The spirit of research has taken Dr. Silverman in many interesting directions, one of which was to develop the concept of widow to widow support that has served as a model for bereavement groups in this country for years.
Phyllis is now working on the continuing bonds paradigm. Research has shown that the deceased continues to play a role in the lives of the bereaved. There is a continuing connection that is consoling and supportive. This relationship changes and grows as mourners move in time away from the time of death, but it is not severed. In her plenary speech, Phyllis gave examples relating to this and how the relationship to the deceased is constructed and changed.
We had a chance to talk with Phyllis and friend Gretchen Gaines-Lane after Phyllis’ speech. Much of the text of the interview refers to her work with mutual help and promoting competence, a concept which is briefly explained as follows:
When someone we care about dies, we are faced with strong and painful feelings and we quickly learn that our lives have changed forever. Since all of us will know this experience, we all need to be experts in managing this grief. This involves knowing how to mobilize appropriate help to ease our pain and facilitate our coping. None of us can or should have to deal with our grief by ourselves.
If we think of grief as something we get over, then we seek treatment that will cure us. The applicable metaphor is of an illness which we can contain and overcome. In an illness model the focus is on what’s wrong. We want to help make things “right” and focus on grieving correctly so that we can limit the discomfort or illness. If seen as a life cycle event then the responses of any mourner are seen as normative. We cannot avoid our feelings, we will never be the same again. Change and transformation are part of the grieving process and we will negotiate and renegotiate the meaning of the loss as we change over the rest of our lives. We need friendship, support, legitimization. Others who have been there have a special role as teacher of “tricks of the trade.” In this way we expand our repertoire of coping strategies to meet the vicissitudes this death has led into our lives. Thus we are empowered to cope competently. We need to create communities where we are there for each other. Faith communities, schools, mutual help organizations and the family itself are the sources for solace, comfort and places of learning. The role of the health professional or bereavement counselor is as partner, and facilitator.
.
TGA: You’re a researcher and have examined so many ideas…what does a good caregiver or companion bring to their work?
Phyllis: The thing that is most interesting to me is that “being there” for people is something that we in America don’t know how to do. To first assume that people haven’t got any capacity to cope on their own is the wrong way to go about this. Sometimes the impact of a loss is so trying that for the moment the mourner may lose the capacity to reflect. The counselor acts as a partner and facilitator but more than just that, he or she has to be an active educator. Its not that he or she has all the answers but that he or she can help teach people how to think, to step back from what’s happening to them and think about it.
One of the dilemmas for many bereaved people is that they don’t have this inner resource. When people have it instinctively then they can sit down and say: “What happened here? What am I going to do? I need to figure this out, and what do I need to learn?” But others may need help to focus on regaining the capacity to find some meaning in what’s happened to them in the new situation. In this case the bereavement counselor is a teacher but teaching to where people are developmentally and with a particular style of learning. This way the bereaved can discover how to begin to solve their problems this time, next time, and the time after. They now have not just solved today’s problem but they have acquired a whole new set of skills.
What you, (the counselor), have to do is think about is who it is you are talking to. That’s where a developmental view is helpful. You need to consider learning styles, family dynamics, and the like. For example, bereaved parents trying to deal with their other children are carrying a lot of burdens. They will have a lot of learning to do not only for themselves but also for their children in order to deal with the many changes in the world they are living in now.
Some people know how to do this and have done it all their lives. They collect information, go to the library, try to figure it out, and by the time they finish stirring up the storm they probably know more about it than the experts. You find this with bereaved parents all the time, or parents whose children have cancer or some chronic illness. They teach the doctors.
You don’t teach someone who knows how to think. You may just encourage them and support them and give them more information if they need it. You reinforce the parts of them that know how to do this.
One may not be able to change the fact that somebody died because none of us can do that, but he or she can change what he or she can do about it. Focusing on what one feels may not be the key issue. It may be more beneficial to focus on how one deals with change, what one is trying to do today and how he or she can do that. The feelings will get taken care of, not by ignoring them, but by putting some order into one’s life, as one begins to see that the kids are going to school and that the family is able to carry on in one way or another. It would seem that little by little as we effectively deal with change we can learn how to deal with our feelings.
Companionship and the kind of learning that one gets from peers is very important here. The intervenor, the helper, I don’t even want to call it the therapist or counselor, has to be there to help this process. It comes from anywhere, it doesn’t necessarily come from a professional. Some professionals have difficulties with peer related help and an opportunity for expanding resources can be lost.
TGA: I had a friend show up when I was grieving for my mother who gave just the right advice. He said, “Make sure that you grieve,” and it was correct advice. He didn’t tell me how to grieve, he was acknowledging that there was going to be pain associated with this…
Gretchen: People are surprised when I tell them that all they need to do before the next time that I see them is to drink a lot of water, take walks, get a lot of sleep and eat well…that’s all for now and then the grieving will come. But it is as you are saying Phyllis, they need help even to do these things.
Phyllis: Some people do and some know about it instinctively and sometimes we have to talk to the whole family. (Speaking to Gretchen) Do you remember the woman you referred to me, the child had died and the family was trying to be helpful but was driving her crazy with their idea of help? So we called a family meeting to negotiate how to be helpful. That was very important.
TGA: You describe yourself as a researcher however it sounds like you are loaded with common sense.
Phyllis: Thank you, it is nice to hear, but I do also have some clinical training. I am a CSW and clinician of sorts, I do a little bit of clinical practice, but mostly I’m a researcher and a teacher and a writer. My husband told me that you can’t do research unless you publish. Its not always easy for me to write but I have gotten better at it.
I think that all good clinicians are like researchers. Like a good researcher, a good clinician is always asking questions. Most clinicians come to a given situation with preconceived notions about what they should do to help and so they get stuck. You have to come with an open mind, “Now lets see what is going on here,” and hypothesize what might or might not work. You have to share that with the client and say “This is what I think, and let’s try this or lets see if this works for you.” If it does, you go on from there, if it doesn’t then you try something else. That is what a good researcher does.
TGA: Do you find that people are opening to a more flexible approach rather than the strict model of bereavement that we are used to?
Gretchen: Not much. What I am doing is educating. I like the teacher role because when I change someone’s paradigm, or way of looking at what’s going on, that really helps in itself. In many ways I’m teaching that there is another way to look at death rather than what they bring to it from the media and from what they have learned.
Phyllis: That’s what I said at the beginning of my talk today about the whole way we make meaning and the impact we as professionals have on the culture. We need to consider what we are selling people. For myself, I have found a lot of people get upset because I don’t have a formula and I don’t have recipes and I don’t have a list of “this is what you should do.”
Its not that I don’t have any thoughts about what grief looks like. I have learned a great deal from working in this field, mostly from the widowed and the bereaved. We are talking about a living situation to which people bring their own creativity and experience.
I talk about change. I talk about transition, about maintaining some connection to the deceased and the whole issue of changing roles and changing meaning as the bereaved deal over time with their grief. For a long time I have been working on a relational paradigm and it does seem that others are becoming more interested in this.
Phyllis will have a new book coming out in the summer of 1999 entitled, Never to Young to Know: Death in Children’s Lives, published by Oxford University Press. Her other books are: Helping Women Cope With Grief, Widow to Widow, Widower:When Men are Left Alone and Continuing Bonds: New Understanding of Grief (editor).
