In-person in Houston, online across Texas • In-network with Aetna, BCBS, Cigna, UHC/Optum, Tricare, Curative, Oscar • Therapy in English, Spanish, Portuguese, Farsi
Grief & Loss
Grief and Loss Therapy in Houston, TX
Grief is not reducible to sadness. It may present as disorientation in time, as the hollowing out of routine, or as the sense that the world has shifted and will not shift back. Some people cannot stop crying; others cannot cry at all. Some become relentlessly active; others stop. Grief also does not always present as grief. It may present as depression, as anger, as an inability to concentrate or to care about anything.
Grief therapy at Real Talk addresses the loss of a person, a relationship, a role, one's health, a country, a version of oneself, or a future that was expected. Each requires mourning something that will not return, and each proceeds in its own way.
Mourning is work, and it cannot be accelerated by the person or by those around them. The treatment makes room for what has been lost to be spoken about at length, including what cannot be said elsewhere: ambivalence toward the deceased, relief mixed with devastation, anger at abandonment, guilt over what was left unsaid.
We do not use a stage model. We follow the person, and we attend to what the current loss has revealed about earlier ones and to what the relationship had been holding in place that is now unheld.
Presentations We See
Recent bereavement, including the death of a parent, partner, child, or sibling. Loss by suicide, which carries its own questions and its own silence. Sudden death without opportunity for leave-taking. Estrangement, in which the person remains alive and the loss is nonetheless a loss. Miscarriage and pregnancy loss, which are frequently grieved in isolation. Divorce and the end of long relationships. Loss of health and of an anticipated future. Migration, which is a loss even when chosen. And grief that was not mourned at the time and has surfaced years later, often presenting as depression.
What We Pay Attention To
We pay attention to the edges of what has been lost and to what continues to be missed, which is not always what one would predict. We attend to what remains unfinished or unsaid. We listen for the relationship as it actually was, since idealized losses resist mourning. And we hold in view earlier losses, which a current loss almost always reopens.
Why Doctoral Training Matters for Grief: Doctoral training matters most when loss is complicated by trauma, by ambivalence, or by circumstances that impede mourning, including suicide, sudden death, estrangement, and losses that others do not recognize as such. It matters when grief and depression have become difficult to distinguish, when functioning has broken down, and when a present loss has reopened earlier ones that were never worked through. Prolonged grief disorder, now a recognized diagnosis, is one point at which the difference between grief counseling and clinical psychology becomes apparent.
Our clinical director reads every inquiry and recommends a clinician within minutes on weekdays, hours on weekends.
Is grief therapy only for recent loss?
No. Many people seek treatment years later, when something else has returned the loss to view. It is neither too late nor unusual.
How long should grief take?
There is no honest answer that also respects the person. What can be said is that grief which has not moved in a long time usually has something in its way, and identifying that becomes the work.
What if the loss is not a death?
Divorce, diagnosis, migration, a lost future: these are mourned, and they also belong in treatment.
Joan Didion. After Life.
The New York Times Magazine, 2005. Read here.
C.S. Lewis. A Grief Observed.
HarperOne, 1961.
Susan Sontag. Regarding the Pain of Others.
Farrar, Straus and Giroux, 2003.
From Our Journal
Surfing the Wave of Grief During the Holidays.
Read here.