Table 4.

Examples for the Category Normalization of Grief.

Expression of Acceptance of Negative Emotions	Framing Grief as a Normal Reaction, Validation of its Expression	Explanation of Adverse Effects of Avoidance	Restructuring of Unhelpful Assumptions
T: It is okay to be sad one evening, to cry, and to say to yourself “I will function again tomorrow, but today I allow myself some moments of sadness.” That is, I think, absolutely okay.	T: This sadness you are feeling is absolutely normal and it is important to allow yourself to grieve. These negative emotions are absolutely normal; they are a kind of signal […]—they mean that you had a wonderful time with your husband and it is very important to give them space and to admit them for a moment, okay? C: Yes, I am admitting them.	T: It is very important that you give this sadness some space in your life. And I’d like to encourage you that it is absolutely okay to cry from time to time. It is healthy to allow ourselves to grieve rather than trying to avoid it. What do you think could happen if we tried avoiding it? C: I can imagine that we would explode one day. T: Yes, or we could become physically ill, or wouldn’t sleep well. We could also become depressed.	T: I think that was an important session today. C: Definitely, yes, definitely. Now that you’ve said that I can admit grief and not instantly become depressed, I think that I should admit it more. It doesn’t mean that I have to cry for hours, but just to say “It is not bad, it is what it is,” right? T: Exactly. And it actually is a normal reaction. I think—even if you cried for a few hours—it would be normal and it does not mean that you would become depressed. It is a normal, healthy reaction to the goodbye you are living through, right? It is difficult and you have a right to be sad. That’s not bad.

Abbreviations: T, therapist; C, caregiver.