By Robert Lanz, LCSW
My boss, a sensitive woman, thought I might get quickly burned-out witnessing the amount of death and loss that I did at the busy ER where we worked. Too much crying. Too much hopelessness. Too much uncertainty about what happened next. She thought I needed help processing some of this stuff.
I’ve explained my philosophy on ER interventions: People get 100% of me when I am there, but not much of me when I’m not – worrying about our patients after they leave our care would be wasted energy.
Emotional energy, I think, works better in-person and has minimal value once the patient — or I — have gone home. My style allowed me to give my all during face-time, while saving my ‘me’ time for me. But, my boss was my boss. So I soon found myself a co-leader of the hospital’s structured grief group, with the other leader being a very competent and experienced social worker.
The literature seemed to indicate that the grief-group experience is most effective if it is brief and focused. The issues of focus and brevity were ones I was familiar with, so eight weeks of focus for ninety-minutes for each weekly session seemed reasonable to me. I didn’t decline the ‘invitation.’
I was a little nervous the first night, but covered it well enough — well enough that the eight women and one man in the group didn’t jump up and bolt out of the room. I mention ‘bolting’ because the only other guy present was not particularly adept at hiding his body language: he had that ‘ready-to-bolt’ look about him. No one was surprised he never showed up again.
Since I was the only guy in the social work department most of the time, I utilized my feeling that men and women think differently or act differently, even when they feel the same way. (Twenty years after my grief group experience there is ample data, thanks to better technological devices like CT and PET scans to show there actually is a difference, in general, between female and male brains.) Nowhere is that difference more obvious than in the expression of emotions. Women will tend toward the open expression of emotions as an effective way to work through them. For the most part, men prefer the opposite. Generalities at best, but in the eight weeks of my grief group experience, these generalities became very specific.
Women are obviously more involved in the processes of their emotions. They prefer to get them out, roll them around, take them apart, tweak them with friends and put them back together in a workable form. Men, I have observed, are the same. But they just prefer to do the ‘taking apart and tweaking’ on their cars or boats or motorcycles. There’s a lesson here, but I’ll get to that later.
The initial meeting of the structured grief group went like this: We all sat in a circle and the group leader started around the circle asking each woman to talk briefly about the circumstances that led them to join the group. Each woman got out no more than a sentence or two before breaking into tears. Each of the other women, close to crying too, immediately offered sympathy tears, and I’ll admit right off it was hard for me not to puddle up myself. I looked over at the other group leader and she was also puddling up, so we were all on the same page. At the end of the first session everyone was exhausted. I was, too. I could hardly wait to get back to the chaos of the ER to relax.
The group co-leader asked afterwards what I thought.
“Pretty cool.” (I didn’t feel the need for overstatement.)
The next week was pretty much the same. Everyone was refreshingly open, with tears flowing freely. Both social workers puddled up again. By the end of this session participants were already emotionally close and they made plans for the following session. Food plans. Comfort food plans. Liquid refreshment plans. Crying a lot seemed to have the desired effect and the group was already showing strong signs of cohesion. After the second group meeting, the leader asked me again what I thought.
“Really cool.” (I was starting to feel more comfortable.)
By the fourth group meeting everyone was openly friendly and trusting. No one appeared to have any issues about the male intrusion (me), but that could have been because I hadn’t said much. The female group leader hadn’t said much either. She didn’t have to, because the women had become so focused. (Oh — I did have to step up and be the official ‘guy’ when one of the women had a question about why her husband had acted one way or another. I gave as honest an answer as I could based on my own experiences and on research data.)
There was one time (sort of a guy epiphany moment) when a young widow in the group opened the session with, “Can we talk about loneliness and sex tonight? — There are no guys here, just Bob.”
And that’s the way the rest of the group sessions went,’ just Bob.’ Not Bob the guy, just Bob the person. Of all the insight I learned from the group, that was the best of it: These women weren’t objects and neither was I. The group was a real success for all of the women and I considered it a success for me. I’ll admit I was a little envious of the women who were so, well, feminine and caring and loving. I thought a group of guys would never do or say the things that these women had. But I didn’t want to make a lame assumption, so I went upstairs to talk to the other male social worker in our department. He also ran a kind of grief group: a support group for spouses of terminal cancer patients. I asked him what his experiences were with the guys in his group.
“Guys are more content focused. When their spouse dies, the content of that relationship is over and they grieve in a different way, most likely home alone. If you want to work with them, you need to get to them while the project is still ongoing. Afterwards, it’s almost impossible to get a bunch of men in a group to talk about their feelings.”
He was right, of course. Guys generally don’t do that. It would be like going shopping with another guy and asking him, “Do these Levis make my butt look big?” Not going to happen.
Maybe a better therapist than I could put together a group of grieving men: Round-up a bunch of widowers and take them to a widow’s run-down house and get them to fix it up. I think that could work. A project.
But I’m not the guy to do it. I’m the guy who will go back to the ER and do the ER work that has always been in my comfort zone, unusual as that is.
In the end, I realized that my boss was right: I did need to go and see that people do get past, grief, one way or the other.