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Can you imagine what it’s like to be betrayed by a loved one at the moment of their death? The combination of both loss and betrayal brings up intense emotions, which can become overwhelming. What twists the knife is that there is no possibility to have questions answered. Here, I will present two case studies whose names and identifying information have been changed to respect their confidentiality.

Helen

Helen was always close to her father. He started to become seriously unwell, so she knew the end was near. She tried her best to prepare herself for his death, yet nothing could have prepared her for what came next. After her father’s death, she went to his house with the intention of picking a suit for his funeral. Instead of a suit, she found numerous pictures of child pornography. She kept digging in a frenzy, trying to find some clues to explain it all and somehow absolve her father of the unspeakable. Unfortunately, the more she dug, the harsher reality became: her father was a paedophile. Helen was left with many painful questions: ‘Who was my father?’ ‘How did I never notice this?’ ‘How many lives did he ruin?’ ‘Did he love me in an inappropriate way too?’ ‘Are my memories of him real or am I remembering a man who never existed?’ ‘Why didn’t he throw it all away before he died? Did he want to burden me with it?’

Helen went through the many stages of grief with double intensity. Anger became rage. Depression became not wanting to exist. She tried to bargain with a divine power to take it all away for her, rewind and start again. She could not share this very heavy secret with anybody else. She started drinking heavily and binge eating, in a desperate attempt to numb the pain. Losing her sense of who her father was meant that she was losing her sense of self. On top of it all, she was also grieving for the father she had always known and loved. The contradicting emotions were overwhelming: ‘Is it OK to feel sad for him?’ ‘Can I grieve for him?’ ‘Am I allowed to miss him?’ And more questions: ‘Is it wrong to be angry at someone who just died?’

Paul

Paul was a married gay man. He looked at his life and felt happy: he had a good job and a good home he shared with his husband Simon. They were making plans for the future and had constructed a vision of growing old together. Life was good. Paul’s husband went on business trips once a month overnight. On one of those nights, Paul got a call: his husband had unexpectedly died. ‘How could it be? He was young and healthy!’ In the next few days, a completely different story unravelled. Simon engaged in unprotected group sex and drug taking when away on his business trips. This behaviour is commonly known as ‘chemsex’.

The precious story of his monogamous marriage that Paul once held dear in his mind – past, present and future – was suddenly shattered. Just like Helen, he asked himself: ‘What was real?’ ‘Who was that man? In his initial consultation, I suggested that Paul have an STD check-up in a sexual health clinic. My suggestion was painful for him; it made the new story all too real. It wasn’t as painful as the reality that came next: he had contracted syphilis. He was shocked. Fortunately, the infection was caught early and treatment was successful. Paul was lucky and all too aware that if he had caught the disease a long time ago, it would have had some serious health implications: Simon had put Paul’s life at risk.

Going through the gruelling process of being treated in a sexual health clinic, as well as dealing with the bereavement and the betrayal of his spouse, were intensely overwhelming. Paul had imagined growing old with Simon, and overnight he was faced with many questions with no answers. He couldn’t even begin to make sense of any of these emotions, so he medicated with recreational drugs and alcohol. Soon, he engaged in chemsex for the first time in his life. At the time, he didn’t know what was happening. Later, in my consulting room, it became clearer to him: he tried to recapture the last moments of Simon’s life so that he could make sense of it. Of course, his coping strategies were futile. He didn’t find any answers in his own chemsex behaviours. He only found more pain.

Disenfranchised grief

Both Helen and Paul felt multiple layers of anger: at the betrayal, at not being able to ask the betrayer questions, at the unfairness of life, and at death. They both felt multiple grief and loss at the same time: losing their loved ones, losing the story they thought they had with that person, their perception of the future, and their sense of self.

Helen and Paul suffered from disenfranchised grief, a rarely spoken-about grief in which the survivor is denied a chance to openly grieve their loss. Instead, they’re filled with shame, guilt, depression, anger, frustration and intense prolonged sadness. Helen felt incandescent rage at the funeral when people were saying how ‘lovely and wonderful’ her father was. The worst was when they praised him for being such a good citizen, doing much for local charities. She wanted to scream: ‘You don’t know him! He’s notÌýa good citizen! He harmed children! He ruined lives! He was a paedophile!’ Instead, she swallowed it all, along with vodka, and smiled.

Paul was just as furious at Simon’s funeral, for the same reasons. He couldn’t share the real cause of death to anybody. Friends and family paid their respects, feeling sorry for such a tragedy: a random heart attack at his age. Inside his mind, Paul was shouting at Simon: ‘You brought it on yourself! It wasn’t a random heart attack! You bastard!’ But, on the outside, he played the game and kept to the story of the unlucky loss.

The hallmark of disenfranchised grief is loneliness and isolation. How could Helen and Paul possibly talk about the real painful story that lives inside them? In addition to these, they also harboured feelings of disgust. Helen felt disgust about her father but also about herself – ‘I share his genes.’ Paul felt disgust at Simon’s behaviour and also because he infected him with syphilis.

People say that time is a great healer. In my experience, time doesn’t always heal if people are stuck in grief and betrayal. Clients can start to develop an unhelpful perception of themselves, others and the world around them: ‘The world is a bad place’, ‘All men are nasty’, ‘Nobody can be trusted.’ Occasionally, suicidal ideation creeps in: ‘I don’t want to be a part of this world.’

Feeling disgust and anger do not stop love. Both Helen and Paul also felt tremendous grief at the loss of their loved ones. ‘If only I could switch off my love for him, it would be much easier,’ I often heard, in a desperate attempt to bargain with a fantasy world, so that they could reduce their pain. What can we do to help such clients?

Reframing

Addressing the disenfranchised grief is paramount. One way to do this is to help the client reframe their present situation with affirmative statements: ‘It’s OK to grieve, no matter what your loved one has done. Although he has done terrible things and betrayed you, he also had a positive impact on your life: your positive memories are still yours.’ I emphasise this point because, in my experience, I see clients feeling relief from a great burden if they hear their memories are real. Memories are all they have to keep holding some pieces of reality among the mess.

‘It’s OK to be angry at someone who died.’ This statement provides relief for clients. It gives them permission not to conform to society’s rigid expectation: when one dies, we must feel sad and cry. ‘Betraying you does not take away the loss that you are feeling.’ This statement is a helpful attempt to address the disenfranchised grief by making it just as valid as other grief.

‘Feeling grief for your loss doesn’t mean you have to forget what he did.’ There’s a misconception that in order to forgive, we have to forget. But it’s not so. We can feel love, grief and sadness at losing someone without forgetting what they did. It’s another permission to give to clients: they don’t have to forget nor forgive in order to grieve.

Validating

We can address disenfranchised grief by normalising the client’s thoughts and feelings with appropriate self-disclosure: ‘Your mind is a lot like mine. If I had to go through this, I would probably think and feel the same as you do now.’ This intervention helps with the therapeutic relationship and invites collaboration between therapist and client, rather than the client feeling ‘broken’ or ‘crazy’ and waiting for the therapist to heal them.

Questions with no answers

As a therapist helping clients through secrets and death, one of the biggest tasks to address is to help them manage the questions for which there are no answers. The best place to start is to help reduce the sting of the questions by disengaging from them a little bit. ‘Your question is a thought. Is it a helpful or unhelpful thought right now?

What are the pros and cons of holding the question right now? Are there any other thoughts that exist next to this one?’ Combining this line of enquiry with mindfulness practice helps clients stay in the here and now.

Chairwork

Chairwork is another way to help address the unanswered questions. Helen placed her father in the empty chair. She was able to express to him all of her anger from the raw part of herself. The chairwork process is remarkable and transformative. I’m always impressed with this intervention, as it tends to tap into the deepest place of the client’s wisdom. When she sat in her father’s chair, she was able to hear from him that he was a sick man, and that he was ashamed and never stopped loving her. In her own way, Helen was able to integrate some of her unanswered questions.

Paul underwent a similar process. When he sat in Simon’s chair, he was able to hear that he had a sexual behaviour problem that was independent from Paul, and that he genuinely loved Paul. I observed him take a long breath out, one that he had been holding for a long time. He started to heal his broken heart.

Wisdom

The clients’ wisdom – helped by validation, reframing and chairwork, among other therapeutic interventions – is the only place where they can find some answers. The evidence to support their wisdom can be found in their memories that they validated as real. Paul said: ‘Of course, Simon loved me. I know that. I remember it clearly. It was real. It felt real. His sex problems were something else, not because of me. It’s clear to me now. He didn’t live long enough to seek help.’

Helen said: ‘I remember clearly how he loved me as a daughter; that love was appropriate. He raised me well, despite ruining the lives of other children. I will never love him for what he did to other children, but I will keep with me the happy moments he gave me and how he positively shaped me as a person.’

Saying goodbye

An important therapeutic conversation is to discuss how clients would like to say goodbye to their loved one. At the time of the actual funeral, they couldn’t do so, because of their disenfranchised grief. Now, in the presence of their therapist – often the only person who knows the whole story – they can identify a ritual or ceremony for how to say goodbye properly. Helen wanted to do it in the consulting room: she played some of her favourite music, talked about the most important memories she had with her father and how his presence in her life shaped her positively, and also acknowledged his paedophilia and how she felt disgusted by it: together, as an integrated story, she was able to say goodbye, validated by my witnessing.

Paul discussed his ritual with me but preferred to do it on his own, outside of the consulting room. He took Simon’s ashes and spread them in one of his favourite places. He said goodbye to him, feeling grateful to have been married to him, remembering the real memories of feeling loved by him, and also felt sorry that he had some unresolved demons that led him to his death.

This type of therapeutic process takes clients and therapists on a meaningful existential journey. Death is seldom discussed in our society. And betrayal is a hot topic, split into black-and-white thinking. Learning to live with the loss, with unanswered questions, and with gratitude in this imperfect world, are key to an elevated sense of self. Being courageous to face the most intense emotions one could feel, led both Helen and Paul to find a new life.

The ending and the beginning

Saying goodbye to their loved one wasn’t the end of their existential process. Such events are life changing. Helen and Paul knew their lives would never be the same again. Talking to clients about what happens next is an important part of the ending and new beginning. They decided to turn the energy of their anger into something useful for society. Helen became the trustee of a child sexual abuse charity. Paul volunteered in a chemsex service, helping other gay men reduce their risk of harm. For them, it was the last piece of their grief process, never forgetting, but a step towards the life they wanted for themselves and connecting with others.

Silva Neves is a psychosexual and relationship psychotherapist, trauma therapist and clinical supervisor. He also specialises in bereavement work and runs a busy private practice in Central London.Ìý

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