Ambiguous Loss • [Podcast for Student Counsellors]

Virtual Reality in Therapy – Vicarious Trauma

In Episode 326 of the Counselling Tutor Podcast, your hosts Rory Lees-Oakes and Ken Kelly take us through this week’s three topics:

First up in Ethical, Sustainable Practice: Understanding ambiguous loss, its complexities, and how it presents in therapy.
Then in Practice Matters: Rory speaks with Nina Solomons about the innovative use of virtual reality in therapy.
Lastly, in Student Services: Rory and Ken discuss a critique of the person-centred model, addressing its strengths and limitations.

Ambiguous Loss [starts at 03:07 mins]

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In this week’s Ethical, Sustainable Practice, Rory and Ken explore ambiguous loss – a type of grief where the person or thing is physically absent but psychologically present.

The main points from this section:

Examples of ambiguous loss are children leaving home for university, missing person cases, and emotional loss due to illness or addiction.
Grief in ambiguous loss can be difficult to process as there is no clear endpoint or closure.
Clients may experience unresolved emotional states such as yearning, self-blame, or confusion.
Ambiguous loss can be unseen both by the individual and by others.
Types of ambiguous loss:
- Physical absence without closure (e.g. a missing loved one).
- Emotional loss, such as the gradual loss of a person due to conditions like Alzheimer’s or addiction.
Clients may have difficulty coming to terms with the loss due to the lack of closure.
This emotional complexity requires thoughtful therapeutic approaches focusing on acceptance and resilience.
Working with ambiguous loss in therapy:
- Mastery: Helping clients regain control over their lives despite the absence.
- Acceptance: Encouraging acceptance of the loss.
- Resilience: Supporting clients in their healing journey through understanding and accepting their grief.
- Connection and Hope: Encouraging connections with others who have experienced similar losses and nurturing hope for emotional growth.

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Virtual Reality in Therapy [starts at 30:00 mins]

In this week’s Practice Matters, Rory speaks with Nina Solomons about how virtual reality (VR) is transforming therapy, offering clients a safe space to express their thoughts and emotions.

Key points from this conversation include:

VR allows clients to create a personal space where they can express emotions and process difficult topics.
Therapists can remotely observe and engage with what the client creates in VR, offering a dynamic approach to emotional expression.
Clients can use VR to build visual metaphors that help them externalise complex emotions, aiding in trauma processing or exploring relational issues.
Creative methods such as drawing or building in VR can help clients uncover hidden emotions or suppressed memories.
The therapist can control aspects of the session, ensuring safety and comfort for the client.
VR in therapy provides a creative outlet for clients to express their thoughts, especially those with difficulty articulating complex emotions.
VR can also support clients with PTSD, anxiety, and trauma by providing an environment that allows them to face their fears and work through emotions.

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Vicarious Trauma [starts at 52:16 mins]

In this section, Rory and Ken discuss vicarious trauma, how it can affect counsellors, and how to recognise and manage it.

Key points include:

Vicarious trauma occurs when a counsellor or helper is affected by the trauma they hear about from clients.
Even brief mentions of traumatic events can trigger strong emotional reactions or past experiences in the therapist.
It’s important to be aware of the signs of vicarious trauma, such as feeling emotionally overwhelmed, disconnected, or experiencing distress related to the trauma you hear about.
Therapists and helpers can also be vicariously traumatised when they imagine themselves in the client’s situation.
Coping with vicarious trauma:
- Use grounding techniques such as square breathing to steady the nervous system.
- Engage in physical movement to help the body release stress.
Supporting others with vicarious trauma:
- Recognise the signs in colleagues and offer support when necessary.
- Encourage self-care practices and professional development to mitigate the impact of vicarious trauma.

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