Sandtray Therapy With Bereaved Clients

Sandtray is the perfect intervention and expressive art modality for working with grief. Grief often involves remembering things from the past (sometimes the very recent past) and sandtray provides a visual and kinesthetic experience for clients as they create a scene that includes images and symbols of loss. Grief is also about experiencing feelings in the present.

The kinesthetic quality of sandtray provides clients with a powerful nonverbal means of experiencing grief. The figures, the sand, the arranging of miniatures into a meaningful configuration all allow clients to experience their feelings of grief without saying a word. Also, the visual aspect of sandtray provides a powerful external depiction of symbols that is meaningful to the client. Whenever the client chooses, she can look at the symbols and clusters of symbols in the tray.

Clients experience polarities when they experience deeper feelings, and feelings of loss, obviously, are among the deeper feelings that clients experience. Thus, as a sandtray therapist, you should expect a client to be reluctant to express feelings of grief and loss even though part of the client wants to and needs to grieve the loss. The polarity is fear of letting go and feeling pain versus experiencing the feelings of loss. Just knowing what to expect will save you some frustration when you’re working with clients who are grieving.

Denial of Death

Growing up in this country as a Euro-American, I have witnessed the tendencies of people from my cultural background when it comes to death and loss. For years, it has disturbed and concerned me that many Euro-Americans, compared to people from other cultural backgrounds, tend to grieve less, deny death, and avoid the grief process as much as possible. I have been to many funerals where people who have lost spouses were admired for not grieving. They are admired for not grieving. After the funeral, I’ve heard people say, “She held up really well.” This phenomenon has always puzzled and disturbed me. Why are people admired for not grieving? Wouldn’t anyone who really cared about the dead person feel pain? Why has my culture adopted attitudes toward death and dying that I consider phony?

Hope can even be a part of our denial of death. Have you even known someone who was hopeful for too long? When someone is nearing the end of a terminal illness, hope impedes the grief process. I have known people who wanted their spouses to accept the reality of their death but the spouses could not accept it. In these cases, hope is a hindrance. Some people who hope do it with their eyes closed.

Years ago, I had a client whose wife died of cancer. the client began to tell me his story, it became apparent that he had held out hope until the day his wife died. His wife had tried to talk to him about her death and his adult children had as well. I think that he believed that he was holding onto this hope for his wife but it was apparent that it was for him. He just could not face her death.

Intra-psychic issues, cultural differences and family of origin issues are other important factors that may affect the grief process. Families have styles of handling feelings of grief/loss and other emotions. In some families, feelings are expressed openly while in others feelings are suppressed and not expressed. In other families, anger is expressed by some members of the family, while feelings such as fear or sadness are expressed by other family members. Cultural differences make a huge difference in the grief process. As I mentioned earlier, many Euro-Americans tend to grieve less openly, whereas many African Americans are much more open in expressing feelings of grief and loss.


Clients who are dealing with the death of a loved one still have responsibilities in their lives that need their attention. Even if clients take bereavement leave, the leave will be over long before the grief process is completed. Therefore, it is important for clients who are grieving to find a balance between grieving and coping. In the first months of the grief process, this balance is hard to find; grieving will be in the foreground to such an extent that coping is elusive. But as the months pass, finding a balance between the two is possible even though it may be difficult. In my opinion, the therapist’s role is to support and encourage the grief process and coping. Sandtray therapy provides the perfect climate for clients to explore and express feelings of loss and receive the support they need.

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