As a psychotherapist, I am constantly inspired by my clients’ courage and commitment to change, and their willingness to face their struggles with open eyes, minds and hearts. My clients have taught me that an essential ingredient in overcoming and healing from life’s difficulties is grieving what has been given up in the name of growth– even if it is something negative or dysfunctional like addiction or an abusive relationship.

My work with “Sally” beautifully illustrates the healing power of grief in growth. Sally came to see me regarding her difficult relationship with her mother. It became apparent to me early on that Sally was tethered to her mother and that her mother was controlling, narcissistic and manipulative. Sally clearly loved her mother, and it was understandably difficult for her to see how her life was enmeshed with her mother’s and controlled by her mother’s neediness. Despite being a “grown up” with a keen intellect, wonderful sense of humor and a successful career, Sally still lived with her mother. When declining health forced her mother to enter a nursing home, Sally lived alone for the first time in her forty years of life. At first, she was fearful of living alone, and was unclear about what she wanted in her living situation. Sally has gradually gained more confidence in her ability to live independently, and eventually bought the family home, which is now in her name alone.

More importantly, with the perspective of space and time, Sally was finally able to clearly see who her mother is and the impact she has had in Sally’s life. She has essentially gone through the stages of grief described by Dr. Elizabeth Kubler-Ross, a psychiatrist who delineated the process people in grief experience.

The first experience Dr. Kubler-Ross describes in the grief process is denial. Sally was in denial for many years about her mother’s manipulative and narcissistic nature. People consider denial a “bad” thing, but it is necessary to our survival until we are ready to move on. Sally’s denial allowed her to maintain the status quo, which included career success. It was only when the status quo became uncomfortable and no longer workable that Sally was able to move forward in her process of growth.

The second grief experience described by Kubler-Ross is anger. I was hopeful that at some point in our work together Sally would have the courage to be angry at her mother as a step on her path to separate and differentiate from her. As a deeply spiritual person, Sally believed that anger was “wrong.” It took a while for Sally to understand that there is an inherent wisdom in the energy of anger, simply telling us that something is not right. Sally was ultimately able to express anger about her mother’s manipulation and control. This was a huge factor in Sally’s emotional separation and differentiation from her mother. She was able to use the energy of her anger to make the wise decision to buy the family home.

The next stage in Kubler-Ross’s model, bargaining, played out in a number of ways in Sally’s journey to healing and growth. When her mother first moved to the nursing home, Sally visited her daily, at a great cost to her own health and emotional wellbeing. On the brink of exhaustion, Sally has made a “bargain” with herself to visit her mother less often. This has been a gradual process for her, and has become increasingly easier despite her mother’s protestations as Sally has come face to face with her mother’s control.

When I assess for depression in the grief process, I always listen to how the bereaved talks about the loss. If the focus is inward on what he or she “should” have done, it may indicate depression, whereas if the focus is outward toward what has been lost, it is a sign of healthy grief. Sally rarely presented as depressed in our sessions. However, in her process of healing and asserting her independence, Sally did have some moments of depression. For example, she would berate herself for allowing herself to be manipulated by her mother and not seeing how her mother controlled her. I assured her that she did the best she could at that time, given her mother’s narcissism.

The last stage in the Kubler-Ross model is acceptance. It has been inspiring and beautiful to watch Sally work with the process of acceptance. Acceptance necessarily includes forgiveness. Sally has come a long way in understanding who her mother is, and she now sees that her mother’s mental ills resulted in large part from being emotionally abused by her own mother. Sally has also come a long way in seeing that her mother’s actions toward her were also abusive. She is grieving the opportunities she has missed because of her enmeshment with her mother, and has developed self-understanding and self-forgiveness. In giving up what she considered an idyllic relationship with her mother, Sally has been grieving the loss of what was, while also rejoicing in her new wisdom, confidence and growth.