Today’s scan of grief research led me to some studies of restorative retelling. It’s a kind of talk therapy for people like me who lost loved ones violently and as a result are suffering from things like PTSD, depression and prolonged grief. When my only son Brady died of suicide at 16 in 2016, I was first on the scene and suffice to say I have experienced a lot of distress connected with that.
This 2014 article from the Death Studies journal described the restorative retelling therapy as “an exercise in which participants draw the scene of the dying and share the drawing and the story of the dying with other group members.” They do this in groups of six to 10 people and the treatment, in this case, consisted of 10 weekly sessions.
It sounds a little like the repeated slow-motion reenactments I did with a therapist after Brady died, and which helped quite a bit to reduce the PTSD symptoms like intrusive images and overwhelming feelings of anxiety and panic. The slow-mo reenactments of doing CPR on my son were excruciating, especially on the first couple of run-throughs. But they got easier and I could feel the horror and terror leaking away as soon as in the middle of the first session. They were worth it, I think.
What happened with Brady is obviously not a happy memory for me, and of course I don’t expect it ever will be. But nowadays I can usually think of it without feeling like my heart and head just exploded. It’s more like, say, my heart and head are being squeezed in a huge vise. Still, a significant improvement, which is something.
Does RR Work?
Restorative retelling makes a sort of intuitive sense. The idea seems to be that by recounting what happened, you gain some mastery over it and make some sense of it. But I’m not all that interested in whether something sounds like it ought to work. Grieve Well reports evidence for coping strategies’ effectiveness in the real world, to the extent that’s available. Whether it’s counter-intuitive or not is less important to me than whether it has been shown to work.
So, does RR work? The researchers summed up their results like this: “Findings from this study suggest that RR is associated with decreased depression symptoms, diminished avoidance, and less prolonged grief reactions.” It looked like it was particularly good with relieving depression. They suggested it worked best with people who had more severe symptoms to start with.
Findings from this study suggest that RR is associated with decreased depression symptoms, diminished avoidance, and less prolonged grief reactions.
The researchers based this conclusion on scores on pre- and post-therapy assessments that the participants took. The assessments included the Beck Depression Inventory, the Impact of Events Scale and the Inventory of Traumatic Grief. (You can read more about some of these assessments at this Grieve Well post.)
I’m no statistician, but it does appear to me based on the visual graphs depicting outcomes that the scores the participants had on these standard assessments improved significantly after the 10 weekly treatments. So, yes, for the most part it appears to work, with some caveats I’ll address in a minute.
Other Restorative Retelling Research
There hasn’t been a ton of research into restorative retelling. The first reference I found was from 2006, in a chapter of a scholarly book called “Violent Death: Resilience and Intervention Beyond the Crisis.” It describes the therapy in detail along with results of a small study on how well it seemed to work.
The lead author of this chapter, Edward Rynearson, also wrote a book called “Retelling Violent Death” that discusses the therapy for an audience of ordinary bereaved people as well as therapists. That might be worth looking into if you want to know more.
The study Rynearson and his co-authors of the Violent Death chapter did closely resembled the later study from 2014 in Death Studies. This study used a couple of additional assessments and was slightly larger in terms of number of participants. But generally the results were similar and it appeared that the therapy was helpful.
Those two studies provided the best evidence I could find on restorative retelling. In 2017, Robert Neimeyer, a prominent University of Memphis grief researcher and the editor of Death Studies, contributed a chapter that discussing restorative retelling to a book called Alleviating World Suffering.
Neimeyer’s research has consistently upheld meaning-making as an important grief coping strategy, so restorative retelling – in which a grieving person forces some meaning on a loss so they can make a comprehensible story out of it – is a natural fit for him. It’s not the only way to find meaning, however. In addition to restorative retelling, Neimeyer mentions directed journaling Here’s a link to an abstract of a scholarly article that briefly describes directed journaling.
You can find lots of popular press references to directed journaling with an internet search. Note that it’s supposed to be done with a therapist’s oversight and, as the name suggests, direction. So it’s not ideally a form of self-therapy, I assume.
A very recent article – January 2018 – describes a variation of restorative retelling therapy that compresses the usual 10-week schedule into just three days. I haven’t been able to obtain a complete copy of this just-published study, so I can’t say much more about it. However, it could be helpful for evaluating whether restorative retelling is really any good.
It’s hard to tell whether the therapy was more helpful than the passage of time.
As Rynearson notes in the 2006 original book chapter, without an un-treated control group for comparison, it’s hard to tell whether the therapy was more helpful than the passage of time. As far as I can tell, time is probably the single most broadly effective factor in reducing grieving symptoms. And this therapy takes about three months. Grieving people may experience noticeable improvement in grief symptoms over that time, with or without therapy. But if a compressed three-day therapy produces similar improvements, that might be more meaningful.
Keep This In Mind
This 2014 study was really just a pilot study with only 51 participants and, like the one from 2006, no control group. A majority of the participants had lost loved ones to homicide, with smaller numbers losing loved ones to suicide and accidental death.
Also, like almost all psychological studies, subjects were overwhelmingly female and white. Ideally, we’ll eventually see larger studies of more diverse populations assigned randomly to treatment or control group. Bottom line: Your mileage may vary, especially if you’re not a white female who lost a loved one to homicide.
But if you lost a loved one violently, you’re hurting and looking for relief, this is something that some people do to help with PTSD and prolonged grief and other problems that sometimes go with this sort of traumatic experience. It might help.
I’m sorry for the losses that brought you here and hope you get at least a moment of peace today. Thanks for reading, liking, commenting, sharing and re-posting Grieve Well.