Timeliness of support is also important, and here too, the Bereavement During COVID study showed that people faced difficulties and long waiting times to get help, exacerbating their isolation and potentially impeding their ability to process their loss. What helps is revisiting and talking about the death, the loss, again and again – whether that is with a therapist, a volunteer supporter, or with peers. Says psychotherapist Juliet Rosenfeld: ‘Freud is so clear about the difference – depression is when you don’t know what is lost; with death, the person you loved most in the world has gone. In the work with depression, you are trying to work out what got lost; with bereavement, you know what is gone, but the work still takes a long time because it is so hard to believe it at the level that is necessary to accept it. The person has to relentlessly reality test.’ It can be painful when you have trained in an approach and someone comes along and says “actually, the evidence challenges that”,’ Cooper agrees. ‘It may not feel great. But I don’t think the evidence says “abandon person-centred practices”. It is saying some clients maybe would benefit from more of something else. Of course, we can only offer what we are trained in, but having the skills and willingness to refer on may be an important element of a therapist’s work.’ The supreme compendium of data on the effectiveness of relational factors in the talking therapies is Psychotherapy Relationships That Work, 3 which is based on the findings of the Third Interdivisional APA (American Psychological Association) Task Force on Evidence-based Relationships and Responsiveness. Now in its third edition, it is in two volumes: Evidence-based Therapist Contributions, edited by John Norcross and Michael Lambert, and Evidence-based Therapist Responsiveness, edited by John Norcross and Bruce Wampold. The book brings together findings from 18 vast meta-analyses of data on what makes talking therapies effective. Bluhm R, Jacobson J, Maibom L (eds). Neurofeminism: issues at the intersection of feminist theory and cognitive science. Basingstoke: Palgrave Macmillan; 2012.

If you include material about individuals (clients, colleagues or participants in any research or study), please provide written confirmation that you have their permission to publish the material in a print and online journal and that you have anonymised all identifying details. Depending on the nature and detail of the material, we may also ask you to confirm that they've read the article. Conversations and correspondence He has found worryingly high levels of PGD among the COVID bereaved. Using the Pandemic Grief Scale, which he developed and validated with his colleague Sherman Lee, he found that more than two-thirds of a sample of some 850 people in the US who were bereaved by COVID were experiencing what he calls ‘the shadow pandemic of dysfunctional grief’ and would benefit from specialist interventions to help them make meaning of their loss, both of the death itself and the surrounding circumstances, including the mourning and funeral rituals.I have since recommended it to a number of clients – co-written by a US psychiatrist and a psychologist, it’s an accessible and well-written introduction to attachment styles. And it seems that thanks to this book, and TikTok, young people are growing up with awareness, curiosity and understanding of the unconscious dynamics that can influence relationships. Often, the focus on understanding dementia, providing treatment and engaging in communication can emphasise verbal interaction, and the value of non-verbal communication can be ignored. As Julia states, continued connection is important, and, as such, attention to kinaesthetic engagement is key – not only when people’s cognitive faculties are impaired but more so within/in dementia relationships where meaning making through language as we ‘know it’ is changed and challenged. To sum up: ‘... a pluralistic perspective of good practice that is inclusive of all modalities is essential. The therapeutic relationship is key to effective therapy, and a focus on ingredients such as collaboration, empathy, and responding to client preferences is vital to ensuring ethical and effective therapeutic practice. The recognition that different clients need different things promotes a more pluralistic provision of therapy services.’ Bearing witness to dementia and holding an embodied awareness in dementia relationships is a political call – we are summoned both personally and professionally. In this last reflection on the film, Jonathan Wyatt, Director of Counselling and Psychotherapy at the School of Health in Social Science, University of Edinburgh, speaks of this kinaesthetic and affective call:

Dementia is under scrutiny: 850,000 people in the UK are living with the illness, and one in three people aged over 65 will have dementia by the time they die. 1 This is predicted to rise to over two million by 2051. There is an urgent socio-political call for action, 2 driving up research into causes and for a cure, looking towards prevention, improving treatment and raising care standards. 1

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Harrop E, Selman LE. Bereavement during the COVID-19 pandemic in the UK: What do we know so far? Bereavement, 2022; 1: https://doi.org/10.54210/bj.2022.18