Repair & Reattachment Grief Therapy
The Resolution of Grief by Repair & Reattachment Grief Therapy
by R. Craig Hogan, Ph.D., Director, The Center for Spiritual Understanding
Jordan and Neimeyer’s review of studies measuring the effectiveness of grief counseling concluded, “. . . perhaps the central finding of these reviews is that grief counseling does not appear to be very effective, most probably because many of the people who received it would do just as well (and perhaps in some cases better) without it.” Five years later, in 2008, Neimeyer presented the results of his continued research into the effectiveness of grief counseling in a paper with Joseph Currier at the Association for Death Education and Counseling annual conference, with a similar conclusion: grief counseling has only a slightly helpful effect, and the effect is sustained for only a short time after the intervention ends.
A study of the effectiveness of physicians in helping people suffering grief came to the same conclusion. Physicians were taught to use a method of bereavement counseling named PBC (Primary Bereavement Care). Evaluation of the effects of the counseling on their grieving patients found that this physician intervention method “does not significantly improve the intensity of bereavement measured by GEI (Grief Experience Inventory) and TRIG (Texas Revised Inventory of Grief).”
Grief is persistent, defying interventions by counselors or physicians to help the grieving person.
However, positive effects have resulted from encounters grieving people have with their loved ones after the passing. In a study reported in OMEGA—Journal of Death and Dying, researchers examined subjects’ accounts of post-death encounters and their positive effects on the bereaved. Their findings were that, “The encounters profoundly affected the participants’ beliefs in an afterlife and attitudes toward life and death, and had a significant effect on their grief. Finally, post-death encounters had a healing effect on the participants by contributing to a sense of connectedness with the deceased. We conclude that health care professionals and counselors should be educated about post-death encounters so that the bereaved can share their experiences in a supportive and understanding atmosphere.”
The authors of that study were referring to spontaneous after-death contacts, such as encounters in dreams. However, in 2010, Rochelle Wright, M.S., a Washington-state licensed psychotherapist, developed a procedure using bilateral stimulation to help clients have afterlife connections with their deceased loved ones at will during psychotherapy sessions. She named it Repair & Reattachment Grief Therapy.
Her method focuses on allowing those in the afterlife to guide the experience, does not interrupt the unfolding process to redirect the client to focuses other than those being brought to the client naturally, and places no time limits on the duration of the experience. The Repair & Reattachment Grief Therapy method has resulted in afterlife connections in 95% to 98% of the sessions in which it has been used to date. The connections may last for an hour or more and usually consist of active encounters with the deceased, such as receiving messages, having conversations, walking together, hugging, and even kissing. The clients report that their grief dramatically diminishes or is extinguished by the connections, and their lives are changed.
Knowing that this form of grief therapy has such a dramatic effect on the clients’ grief, we wanted to evaluate formally the degree to which the clients’ grief is diminished by the Repair & Reattachment Grief Therapy experience. As a result, a study was performed using the Subjective Units of Distress scale (SUDS) commonly employed in EMDR psychotherapy to evaluate how disturbing a memory is for the client. The study used 45 subjects who participated in Repair & Reattachment Grief Therapy procedures with Rochelle Wright, M.S., originator of the Repair & Reattachment Grief Therapy procedure. It compared SUDS scale ratings at the beginning of the Repair & Reattachment Grief Therapy procedure with SUDS scale ratings of the same memories during or after the procedure. This report describes the methods used in the study and results.
The study used 45 clients who had Repair & Reattachment Grief Therapy experiences. It was limited to those subjects for whom SUDS ratings for specific memories were gathered before the session and during or after the session. For this study, only memories with pre-session ratings of 8 or higher were included in the sample. The result was 189 memories among the 45 clients. All of the sessions were facilitated by Rochelle Wright. All of the afterlife connections happened in one session. The median time was four hours. Longer sessions usually involved some psychotherapy work along with the Repair & Reattachment Grief Therapy.
The SUDS scale is a 10-point scale commonly used in EMDR psychotherapy. The client is asked to bring a distressing memory to mind and assess the strength of the disturbance it engenders by assigning a number to it. A 0 indicates no disturbance. A 10 indicates that it is highly disturbing. It may bring on any of a variety of feelings and body sensations: depression, sadness, grief, guilt, anxiety, feeling of loss of control, pain, dizziness, and any of the other negative emotions or bodily sensations associated with trauma and bereavement. Although the scale goes from 0 to 10, clients create their own scales to describe their disturbance, adding as many as four plusses (10++++) and even describing a memory as 100, 150, or 200. Clients add the plusses or use higher scores spontaneously as an expression of the depth of their profound grief.
The SUDS instrument is useful in providing a scale on which clients can assign their own evaluations of the disturbance using their own criteria for each number. The SUDS scale has great value in giving the client a method of expressing the subjective level of disturbance that cannot easily be expressed in words.
At the outset of the Repair & Reattachment Grief Therapy procedure, the client puts on a headset playing barely audible sounds or music that alternate in volume between the left and right ears to provide audio bilateral stimulation. The psychotherapist then asks the client to describe the person for whom they are grieving, focusing especially on the death and period after the death. The psychotherapist records every memory as the client describes it. This open-ended description of the memories may take an hour or more. The result is that the psychotherapist has an extensive list of as many as 100 or more memories.
The psychotherapist then explains the SUDS scale to the client and goes through the entire list of memories, repeating the words the client used to describe each memory, asking the client to rate how disturbing the memory is on the 0 to 10 SUDS scale. The psychotherapist writes the rating beside each memory. The result is a carefully recorded set of ratings for the client’s memories before the Repair & Reattachment Grief Therapy experience. These we call pre-session SUDS ratings.
The psychotherapist and client agree on the memory that is most disturbing, and that memory becomes the target to begin the Repair & Reattachment Grief Therapy procedure. Most often, the entire session unfolds from that initial disturbing image. However, in some instances, the psychotherapist may take the client to another disturbing image on which to focus if the first image’s disturbing quality seems to have diminished. In a small number of cases, the psychotherapist may take the client to three or more memories. To evaluate the reduction in disturbance of a memory before going on to another memory, the psychotherapist asks the client to recall the memory and assign a SUDS scale rating to it. If the rating has reduced to a level of 0 to 4, the psychotherapist goes on to another memory to use as the target. Nearly always, one memory unfolds the entire Repair & Reattachment Grief Therapy. The psychotherapist asks the client to go on to another memory in perhaps 10 percent of the sessions.
At the end of the session, the psychotherapist assesses the level of disturbance for those memories that were rated highest on the SUDS scale at the beginning of the session. The result is a record of the pre-session SUDS scale ratings for the memories, mid-session ratings for some of the memories, and post-session ratings for all of the most disturbing memories.
For this study, the pre-session SUDS scale ratings were compared with the mid-session and post-session ratings to determine the magnitude of the reduction in the client’s assessments of how much the memories disturbed him or her. That, then, is an indication of the effect the Repair & Reattachment Grief Therapy has had on the clients’ grief.
Degree of Disturbance by Memories at the Beginning of the Session
The SUDS scale uses numbers 0 to 10 for the client to rate the degree to which a memory is disturbing. A 0 indicates that it has no disturbing effect. A 10 indicates that it is very disturbing. Table 1 shows the range of pre-session SUDS ratings for the 189 memories. For this study, only memories with pre-session ratings of 8 or above were included in the sample.
Table 1: Range of Pre-session SUDS Ratings for the 189 Memories
Of the 189 pre-session SUDS ratings, 179 (95%) were 10 and above, with 95 (50%) above 10.
Degree of Disturbance During or at the End of the Session
When the same memories were evaluated during or at the end of the session, the SUDS ratings had reduced dramatically. The ratings for the memories measured during the session (mid-session) and at the end of the session (post-session) are presented in Table 2.
Table 2: Range of Mid-session and Post-session
SUDS Ratings for the 189 Memories
Of the 189 mid-session and post-session SUDS ratings, 172 (89.6%) had reduced to 0, 1, 2, or 3.
Magnitude of the Reduction in Disturbance
If the ratings that were over 10 are reduced to 10, the average pre-session SUDS rating for all of the memories was 9.91 on the 10-point scale. After the Repair & Reattachment Grief Therapy procedure, the average mid-session and post-session SUDS rating for all of the memories was 1.42. The average reduction between the pre-session SUDS ratings and the mid- and post-session ratings was 8.5 points on the 10-point scale.
There is no basis on which to give the ratings above 10 values that could be used in the results. However, if the ratings that were above 10 were given incremental values so 10+ became 11, 10++ became 12, 10+++ became 13, 10++++ became 14, and ratings above that became 15, the average pre-session rating would be 12.13. It is higher than the upper limit of 10 on the SUDS scale because clients assigned ratings above 10 for 50% of the memories. They were in profound grief. If the ratings above 10 were given these values, the reduction between the pre-session ratings for memories and the mid-session or post-session ratings for the same memories would be 10.71 points.
All of the participants made spontaneous comments about their state of mind after the sessions. These comments are indications of the reduction in grief and impact on the clients’ lives of the Repair & Reattachment Grief Therapy. A sample of the comments follows:
“It doesn’t seem to matter anymore.”
“Before, it seemed like his thing was the worst thing in the world. Now it feels like seeing him so joyous and at peace has lifted a weight off of me.”
“Freedom, peacefulness. I’m free now. I’m free now.”
“It doesn’t bother me anymore. I can do what I need to do.”
“I feel peaceful. I feel calm.”
“I feel energized.”
“I’m feeling peaceful. I’m happy.”
“I feel light as a feather.”
“I feel kind of like laughing. I feel very light hearted.”
“The Repair & Reattachment Grief Therapy took the pain of it away. When I think of him, it doesn’t really bother me anymore.”
“There’s this peace, and you know you’re still connected.”
“I’m so, so happy.”
“I’m in a state of bliss. Thank you.”
“I feel calm and relaxed. I felt her saying the words. I felt her presence like when I’m dreaming.”
“This was the most profound experience of my life.”
“It literally, literally changed my memory.”
“The memory doesn’t register. It doesn’t even register.”
Written in a note to Rochelle a month after the session: “I see the sun and can feel the breezes once more. I have a knowing my new leaves will dance and give nutrients to my new roots. Thank you.”
“I feel like my mom is always around now.”
In a note to Rochelle several days after the session: “For all you’ve done: Blessings to you for creating sacred space for me to connect with my mother! It is a gift I will be forever grateful for receiving.”
“Rochelle, I have become a powerful and self-assured woman.”
(A few weeks after the session) “I’m not upset anymore. I feel my mom’s presence and I’m not sad anymore. I feel OK.”
(Four weeks after the session) “I’m doing good! I’m laughing a lot more. I have a connection! and I feel good!”
“I don’t have any issues. I feel great. I have peace around his death.”
(A few days after the session) “I still feel really good for the first time in my life. I am not depressed. Half of my adult life, since my 20s, I’ve been on Zoloft, Lexapro, Prozac, and all the rest, but now, the whole depression thing has been lifted from me.”
The Repair & Reattachment Grief Therapy procedure dramatically reduces the disturbance of memories that initially were very disturbing. The SUDS ratings decreased from a pre-session average score of 8.5 or 10.71 (depending on the scores assigned to ratings above 10) to a mid- and post-session average rating of 1.42. All of the Repair & Reattachment Grief Therapy in the study resulted in connections in one session. It is clear that the Repair & Reattachment Grief Therapy procedure has a dramatic effect on grief with virtually all clients, regardless of the level of grief at the beginning of the session.
Considering the fact that evaluations of conventional grief therapy show it has little or no effect on clients’ grief, the highly effective Repair & Reattachment Grief Therapy procedure should be used as the standard treatment for people suffering from bereavement over the passing of a loved one.
 Jordan, J. & Neimeyer, R. (2003). Does grief counseling work? Death Studies, 27, 765-786.
 Currier, J., & Neimeyer, R. (2008). The Effectiveness of Psychotherapeutic Interventions for the Bereaved: A Comprehensive Quantitative Review. Paper presented at the 30th Annual Association for Death Education and Counseling (ADEC) Conference in Montreal, Canada, April 30-May 3, 2008.
 Garcia-Garcia J., Landa Patralanda V., Grandes Odriozola G., Mauriz Etxabe A., Andollo Hervas I. (2005). A Randomized Controlled Bereavement Intervention Study in Primary Care: Preliminary Results. Presented at the 7th International Conference on Grief and Bereavement in Contemporary Society, Kings College, London, July 12-15, 2005.
 Nowatzki, N., & Kalischuk, R. (2009). Post-Death Encounters: Grieving, Mourning, and Healing. OMEGA Journal of Death and Dying, 59(2), 91-111.