For professionals working with women of child bearing years, it is inevitable that you will one day have a client walk through your door who has experienced some sort of loss. For these clients there are some specific tools that can encourage and support a therapeutic relationship and support them during the process of healing. In everyday life, these conversations can be uncomfortable and difficult, that is exactly why many of the conversations are avoided. However, as a therapist, the steps you take when supporting a parent who has experienced a loss needs to be handled with care. In some cases, clients may be extremely delicate and fragile. 

The following are a few ways that you can support a parent who is newly bereaved.

It is all about relationships. Clients who have experienced losses often need a safe and secure place to BE, not someone with all of the answers. Knowing that a client is coming to you to feel all of the scary or uncertain things means that your office or therapeutic setting should be one of safety and security. Clients need a place to say the uncomfortable things, or the scary things and it is of the most importance to make sure that you are that place for them. It is imperative that the relationship between client and therapist remain a healthy partnership. The therapist may feel a deep desire to rescue a client from the pain, however, it is imperative to support the client in resolving their own grief and processing their emotions and thoughts without influence of a therapist’s opinions. 

It’s about the logistics. Grief has no exact timeline. Encourage parents to experience the feelings. Validation and labeling emotions are often very valuable tools in processing the story of the loss. Making sure that clients have a clear path to safely experience grief or other emotions — allow yourself to feel sad during times in your bedroom, taking time to identify self care (bath, reading, resting, — supports- who are the people you can call on? Who can you call on for visits, coffee, company or support with other children in the home. 

Silence is Golden. Sitting in the uncomfortable silence can be difficult for clinicians who have not practiced this tool. Being able to maintain quiet strength and compassion can support a client who may not have anyone to really talk about how they feel down deep. They may be tearful or angry and the quiet space often is a place that clients are confronted with things that they have been avoiding. Strength does not mean stoic silence, and in cases it may be appropriate to share tears in a powerful story. Strength is the ability of a therapist to hold the pain and sit in the silence with their client, with no expectations for them to clean up the mess when they leave.

Use the name. It is important to use the baby’s name. Talk about the baby’s death. “Tell me about how you found out that Joey died.” Naming their baby will bring a reality and respect to the event. That no matter how far along the pregnancy was, it is important to value and validate the death of the baby. If a family has not named their baby, conversations about that can be had. Honoring and respecting decisions to name or not to name often gives permission through conversation for the client to talk with a spouse or partner about doing that if they didnt think about it before or wanted to but felt that they couldnt for a variety of reasons (“I wasn’t that far along.”, “We didn’t know the gender”. “I felt weird asking”). 

Words and phrases-to try to avoid. Oftentimes, clients are very sensitive to words or statements. In many cases, use of these can create opportunities for a therapeutic struggle or conflict risking the safety and security of the space. 

“It’s ok”, “It’ll be alright (or some deviation of this)- In the moment, it may feel like it will never be ok again. It isn’t ok that they had a loss. And for those struggling with the reality of infertility, it may never be ok because a pregnancy may not result in a living baby. 

“You have children, so be grateful that you have little ones to love at home”, “Now your body knows what to do next time” or “Your body knew something was wrong…”, or some other variation of minimizing the magnitude of the loss. This can increase the guilt felt for missing a baby that never was born. 

“I knew (insert relationship) and they lost a baby…what worked to get through it was…” or “(Insert relationship) had a miscarriage and they got pregnant and have a baby now”. Again these statements can lead to the interpretation that they are overreacting and that things will be ‘ok’. 

Things to use. Supportive empathy. “I hear you saying….tell me about that”, Validation is important to give power to feelings and the significance of the loss, especially using phrases that the client has used previously. Recognizing and supporting a client in labeling emotion. 

As a clinician working with a perinatal loss client, it is important to remember that you don’t have to have all the answers, or know the exact thing to say in the moment. The most important support for clients in this area is to be genuine, truly care about the process of healing and to appreciate that you are being let into the most intimate, scary and at times devastating moments in a person’s life, and it is truly an honor to be asked to join in their journey to healing. 

About Teresa M Eltrich-Auvil

Teresa M Eltrich-Auvil MS, NCC, LMHC Teresa is a perinatal mental health specialist, the WA state Climb Out of the Darkness Lead and has specialized training in infant mental health, infant loss, and equine assisted psychotherapy.