One session my client, grieving a personal tragedy, admitted: "Outside this office it feels like nothing happened. No one asks me about it. The world just moved on." She was right. We often treat other people's tragedies—whether the loss of a loved one, a miscarriage, or global catastrophes—as topics for intellectual discussion. But for those who live in that pain, every day is a struggle.
In recent months my clients and community have faced various losses: from everyday ones, like ill relatives, to world-scale events—the explosions in Iran and Gaza, brutality by immigration authorities, and laws that curtail transgender rights. Some people discuss these things at a distance, while others live in constant fear for their lives. The gap between those "inside" a tragedy and those "outside" it becomes unbearable. In Seattle, for example, many confront this issue, but there is a strong support system. Organizations like Crisis Connections, with a 24/7 hotline and referrals to therapists, The Grief Center, NAMI Seattle, and The Center for Grief & Loss, offer help to those who feel their pain has gone unnoticed. The Open Path Collective program provides low-cost therapy at $30–$60 per session for uninsured people.
I understand we can't hold all the world's suffering in our minds. But the isolation that comes when it seems everyone has forgotten your pain adds another layer of torment. Even I, as a therapist, sometimes hesitate: "Would reminding them only make it worse?" Yet silence out of fear of saying the wrong thing is even worse. How do you find words when there simply are none?
I asked my client what she would have liked to hear. Her answer struck me with its simplicity: "Just someone saying they are thinking of me and know how horrible this is." So little—and so much. We often try to "fix" someone else's grief, give advice, or distract. But people actually want presence, not solutions. Someone who won't avoid the awkwardness but will simply stay nearby. In Seattle, traditions of mutual aid run deep, rooted in the Coast Salish Indigenous cultures, including collective healing ceremonies—potlatches. In modern neighborhoods like Capitol Hill, Fremont, and the Central District, Buddhist support groups (sanghas), grief circles, and neighborhood mutual-aid cells are active. For example, during the pandemic the Covid-19 Mutual Aid Seattle community organized food deliveries and emotional support, helping combat isolation for those grieving alone.
"On the anniversary of the tragedy," she added, "I didn't want to talk. I just wanted someone to be there." Sometimes the best support is a silent cup of tea together or a hug. Healing doesn't fit into a 55-minute therapy session. It happens in community: when we share both joy and pain without hiding from discomfort. Seattle's healthcare system also works to expand access to help. Washington Apple Health (Medicaid) covers up to 20 therapy sessions per year with no copay for people under a certain income threshold, although wait times to get an appointment can be 2–6 months due to a shortage of providers. Crisis Connections at 988 operates 24/7, requires no insurance, and can refer to a therapist accepting new patients within a week, including via telemedicine. After global crises, city clinics like Neighborcare Health have added slots for emergency crisis therapy without an appointment. For low-income people, programs like Molina Healthcare have social workers who help find a therapist even if the patient lacks documentation.
"How would you feel about telling loved ones you're disappointed and need more care?" I asked. After a pause my client replied, "It will be hard. But it's what I need." Her courage reminded me: asking for support is also an act of vulnerability. And perhaps it's the only way to keep someone else's grief from going unnoticed.
Based on: What do you say when there are no words? | The therapist is in in