Hope Leads to Transformation from Grief

For the last two years, the world has lived amid a crisis. More than five million people around the globe have died from complications related to COVID-19, the disease caused by the novel coronavirus, SARS-CoV-2. In the U.S., nearly 800,000 lives have been lost to the virus. In parallel, drug-use-related deaths have risen dramatically, increasing by nearly 30 percent in 2020.

Millions of survivors are grieving. Adverse events such as the death of a loved one can produce psychological distress and mental health concerns. Jefferson’s Katharine Sperandio, PhD, LPC, ACS, NCC, assistant professor in the department of counseling and behavioral health, studies how individuals can adapt to these difficult circumstances in positive ways.

More than just cope, or get by, Sperandio wanted to explore how counselors can help their clients grow from the experience of loss and grief. Post-traumatic growth, defined as experiencing a significant psychological change as a result of the struggle with a highly challenging life circumstance, is the process of making meaning out of trauma and growing from that trauma. That meaning becomes a catalyst to move forward despite what has happened. Individuals who experience post-traumatic growth do not return to baseline but become a new person as a result of that traumatic event.

She and her team looked at how self-compassion and hope might impact post-traumatic growth following the death of a loved one from a drug-related cause such as a substance use disorder.

The researchers used a crowdsourcing platform called Mechanical Turk to reach nearly 300 participants from around the world who had lost a loved one to a drug-related death. Participants completed questionnaires that assessed measures of self-compassion, hope, and post-traumatic growth.

Their analysis revealed that self-compassion was a major predictor of post-traumatic growth. But an even bigger catalyst was hope. The impact of self-compassion fell when hope was added into the analysis. Instead, Sperandio and her colleagues found that hope acts as a powerful mediator, amplifying the post-traumatic growth process.

Jefferson’s Health Nexus spoke with Sperandio about the research published online October 30, 2021 in The Family Journal: Counseling and Therapy for Couples and Families about hope, self-compassion, and how counselors can help clients move through grief to growth.

This interview has been edited for length and clarity.

What do survivors need in order to accept the death of a loved one?

When a loved one dies, regardless of whether or not it's an addiction, there's a grieving process that takes place among the survivors. They have to make meaning out of that person's death, in order to figure out how they're going to move forward, how are they going to continue life without their loved one.

In counseling, we say that when a loved one dies, that doesn’t mean your relationship with them has to end, it means the relationship changes because of that person’s physical absence.

How does losing a loved one to a drug-related death differ?

When someone loses a loved one due to a drug-related death, there’s stigma associated with that because our society often views addiction as something that someone brings on themselves, that it’s a choice as opposed to a mental health disorder.

Family members often experience self-blame because they didn’t intervene or weren’t aware that their loved one had an addiction. Then they also face a level of judgement from greater society because there is this generalized assumption that the family members could have done more to save the person.

As a counselor, how do you approach post-traumatic growth with grieving clients?

We take a strengths-based approach. Instead of looking at what's wrong with people, we look at what's right with people.

We communicate that these events have happened, they’re part of their story, but they’re not their entire story. Then we ask clients things like, what can you do now with this having occurred? What does this event mean to you? What do you think happens to the person now that they are deceased? How can you utilize your strengths to continue moving forward and promote your own mental health outcomes?

What can help clients move forward?

Hope has been a very promising construct throughout the mental health literature and specifically within the addictions literature because of its power to contribute to promoting adaptive and positive therapeutic outcomes.

Hope is not only an emotion, but there’s also a cognitive aspect to it. When you lose somebody, sometimes it can be difficult to look forward. The cognitive aspect of hope helps people look towards the future, set goals, and to see that there is a horizon beyond the current situation.

What are some things that people hope for? Can you provide a few examples of what has helped them get through?

Hope can look totally different to various people. For some people, hope looks like their willingness to get up in the morning and carry on with their day. For others, it’s setting short- and long-term goals and talking about the future. Hope can also look like partaking in therapy or engaging in other forms of self-care. Hope is future-oriented and consists of individuals striving towards something and sustaining that momentum.

What else can help grieving clients?

We also looked at self-compassion. In this population of survivors, losing a loved one to a drug-related death, the stigma around this issue can significantly impact how a person feels about themselves.

People who are dealing with addiction, or have loved ones with addiction, internalize a lot of negative societal messages. Then the question becomes, when that internalization is occurring, are they able to really have compassion for themselves? Are they able to look at themselves with care and with kindness, and turn their empathy inwards, so that they can be comforted?

We wanted to examine, if somebody has self-compassion, does that enable them to move forward?

What did you find?

We indeed found that self-compassion was a predictor for post-traumatic growth. In order for post-traumatic growth to occur, self-compassion has to be present. It had a significant impact on the development of post-traumatic growth in this population.

But when we put hope into the equation, the significance of self-compassion actually dwindled. Hope was the bigger contributor.

Hope is very future and goal-oriented, so it makes sense that hope and post-traumatic growth could potentially have a relationship because they are both very future focused, very much about continuing to push forward.

What can counselors take away from this research and incorporate into their practice?

The study reveals that self-compassion alone can be a powerful contributor to post-traumatic growth, but hope actually amplifies this process.

According to our findings, it would behoove counselors to actually not necessarily focus on self-compassion first, but rather go to hope, because hope is such a powerful force.

How can counselors help clients cultivate hope?

Because the cognitive aspects of hope are goal-oriented, counselors can help clients identify goals, and help clients think about how they’re going to achieve those goals, even with the physical absence of their loved one. It’s not about negating the fact that this death has occurred, but thinking about how they are going to incorporate this death into their goals and continue to move forward.

Agency, the motivation to pursue an identified goal, and pathways, perceived abilities to meet those goals, make up hope. Counselors can help clients by helping them to increase their motivation to move towards their goals, and providing them or helping them find solutions or pathways to accomplish their goals.

Then, if they want to add in self-compassion, they can utilize different interventions to promote aspects of self-compassion such as mindfulness exercises, self-kindness through the utilization of self-affirmations, and what we call common humanity or helping the individual to recognize themselves as part of the universal human experience.

Through self-compassion clients can accept themselves as interconnected human beings who share humanity in all its flaws and wonders, and this care is an important contributor to growth and change.