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Grief & Loss
Transcript of Grief & Loss
E. All of the above
5. Which of the following would be considered as common feelings reaction to grief?
A. Effective grief work is done alone
B. Grief is hard work
C. The way out of grief is through denial
D. The very worst kind of grief is not yours
3. Which of the following is one of the key facts described by Diets?
A. Loss of a pet
B. Loss of important people
C. Job loss
D. Loss of health
E. All of the above
2.Identify examples of common losses
Sudden, unexpected loss for which no one was prepared
Occurrence of multiple losses
Death viewed as preventable
Witnessed violence or death
Grieving person unable to attend funeral/ritual
Death of a child
1. Nature of the Loss
Men may grieve by:
Engaging in solitary mourning or secret grief
Taking physical or legal actions
Becoming immersed in activity
Men in Grief cont’d.
Consider how you might respond to a male caller who is openly crying, expressing need for affection, losing control of self, or being passive.
Consider how you might respond to a female caller who is not expressing emotion, immersed in activity, or remaining solitary.
LOSS AND GENDER
Sleep and appetite disturbances
Restless, over activity
Crying, searching and calling out
Avoiding reminders of the lost person
Seeking out reminders of the person
Dreams of the deceased
Disconnection with faith community or practices
Searching for meaning by connecting with a new faith community or practices
POSSIBLE GRIEF REACTIONS
POSSIBLE GRIEF REACTIONS
YOUR OWN FEELINGS ABOUT LOSS
Learn to grieve fully so that you can live and love more fully.
Take what is inside-outside.
When words are inadequate have a ceremony.
Allow the hurt and pain to integrate the loss into life.
The grieving work softens the symptoms of loss over time.
Express it over time in small doses and find it’s way to meaning.
Grief : “Must feel it to heal it”
(i.e. How are you feeling?” “You sound sad to me “)
( i.e. “It makes sense you are feeling sad because you just lost your cat”)
FEELINGS ASSOCIATED WITH
GRIEF AND LOSS
A Historical Review -
Stages of Grief
No universal timeline for reconciling grief
There is no “right way” to grieve
Grief may be hard work – figuring out who you are now without that person/place/thing/status, etc.
Often we grieve old losses with new losses
We grieve when a loss has happened or is threatened
Companioning may help those in grief*
Grief has an ending point – “You should be over it by now”
Grief is like an illness, there is a known progression or “cure” (or end)
You should not speak (ill) of the dead
Not thinking about your loss helps you “get over it”
Grieving/Mourning is sign of a weakness
Hierarchy of loss – one type of loss is “worse” than another
Myths about Grief
In grief the greatest teachers are those that are grieving. We become witness and are awed by the intensity and depth of grief encountered by the human spirit and humbled by the lessons of those facing such tragedy.
A Final Thought...
A.Sense of Presence
D. All of the above
6. What thoughts we can expected as a reaction to grief?
4.What are the common stages of grief described by Elizabeth Kubler-Ross
A. Greif is hard work
B. Effective grief work is not done alone
C. Grief has ending point
D. Greif is a sing of weakness
1. What are the common myths about grief?
Aches and pains with no explanation
Frequent illness - decreased immunity
Weight gain or loss
Hollowness in the stomach or feeling like a part of them is missing
Tightness in chest and throat Oversensitivity to noise
Breathlessness or shortness of breath
Lack of energy
Dry mouth or lump in throat
PHYSICAL SIGNS ASSOCIATED
WITH GRIEF AND LOSS
POSSIBLE GRIEF REACTIONS
a first reaction to the awareness of the loss i.e. “No, not me, it cannot be true”
a stronger sense of awareness of the loss i.e." Yes it is me, it was not a mistake”
an attempt to postpone or to bargain for more time
reaction to letting go of anger is followed by a sense of intense loss
neither depressed or angry; an individual has found some peace
STAGES OF GRIEF Cont’d.
DIFFERENT TYPES OF LOSSES
How have you seen others (or yourself) react or respond to loss?
STAGE 2 – RAPPORT
Let them tell their story, having someone safe to talk to about their loss can be very healing and helpful.
If you do not know what to say… silence is alright.
Be careful of cliché as this can cause “secondary wounding”
Loss of identity
Loss of Status
Loss of Independence
Loss of Innocence
Loss of Health
Loss of Faith
Life stage losses
Loss of important
people in our lives
Loss of a pet
Loss of objects
( i.e. a house)
Nature or human
Examples of losses
STAGE 6 – PLAN
What the caller can do today to help themselves feel safe and more in control of the situation when they hang up the phone.
Get rid of means
Contact family and friends and make them aware of situation
SELF CARE: stress relief (walk, bath) physical relief (eat, sleep)
What resources are available for them longer term Remember: We need to provide options not advice, which means we must try to identify more than one resource so the caller can decide what will work best for them.
Counseling intake with DC or other counseling organization
Referral to MRT
Schedule appointment with physician or therapist
STAGE 4 – FEELINGS
Normalize feelings so caller does not feel that they are alone or that they are going “crazy”.
Loss of control
Try to understand what caller is feeling
Put feelings into words
Validate those feelings
Stage 5 Options
Short term plan
Counseling resources in the community (individual and group support)
STAGE 3 – IDENTIFY PROBLEMS
Clarify the problem-what concerns led them to call us today?
Prioritizing-what do we need to work on first?
What they usually do to cope with their loss or what they have tried
Ask the caller what type of assistance they would find helpful.
When we are talking about grief and loss, often times how the caller is feeling is the problem.
STAGE 1 – RISK ASSESSMENT
Suicide/homicide risk assessment:
is the caller at risk of harming him/herself or someone else?
Basic needs/Are they able to proved for their basic needs?
Socializing: Are they avoiding friends and family?
Physical needs: Have they been eating?
Mental health (depression and other mental health issues) how depressed are they? Is there history of depression ( or other mental health issues)personal/family?
Addictions : are there concerns about substance use and this would include everything from using tranquilizers or sleeping pills for too long to engaging alcohol or drug abuse?
STAGE 7 – FOLLOW UP
Is there a follow up call needed?
Would the caller benefit form the DC counseling?
Invite caller to call back and thank them for calling.
And Roberts’ Model
Stroebe & Schut (2013).
The dual process model of coping with
(pg. 213). Retrieved on May 21, 2017 from http://wendyvanmieghem.com/wp-content/uploads/2012/08/dual-process-model-by-M.-Stroebe-.pdf
The Dual Process Model of
Coping with Bereavement
Wolfelt, A.D. (2003).
Understanding your grief.
Colorado: Companion Press
Prolonged grief with severe symptoms that lead to significant dysfunction*
Four conditions that enhance the possibility of complicated grief
The real or perceived deprivation of something meaningful (both death and non-death)
The constellation of inner thoughts, feelings and experiences following a loss
Grief “gone public” or outwardly expressed
Types of Losses
Sense of presence
Intrusive thoughts about the loss
Sense of futility – “What’s the use?”
Uncertain of identify – “Who am I now without x?”
Responding sluggishly to questions*
– significant loss event
– the losses that are the consequence of a primary loss and vary according to the individual and the context of the loss
– grieving a loss that cannot or is not openly acknowledged
1. The relationship is not socially recognized
2. The loss is not socially recognized as a ‘legitimate’ loss
3. The griever is not socially recognized – idea that this person isn’t capable of grief
How do people navigate grief?
Consider your own feelings about loss
Sadness Gratitude Regret
Anger Joy Fear
Guilt Helplessness Panic
Shame Shock Disbelief
Anxiety Yearning Denial
Loneliness Numbness Release Emancipation Fatigue Relief...
1. The nature of the loss
2. The nature of the relationship with the person who has been lost (or the loss is threatened)
3. The psychological characteristics of the grieving person
4. Social issues associated with the loss
2. Nature of the Relationship
Difficult relationship – a history of abuse
Challenging attachment – ambivalent, dependent, insecure relationship
Unresolved issues with deceased
3. The psychological characteristics
of the grieving person
History of mental illness
Difficulty tolerating psychological pain
Previous complex grief response
Intense feelings of inadequacy or guilt towards deceased, especially during illness
View grief as being the only strategy to maintain connection with the deceased
4. Social issues associated
with the loss
Cause of death is stigmatized
Griever feels disenfranchised by society
Lack of adequate social support
Griever is socially isolated and hesitant to express self for fear of further isolation
Concurrent crises – financial, occupational, physical, familial, spiritual, etc.
How can we help…?
Express curiosity about their experience
Resist the urge to “fix” their situation
“Companioning is about going to the wilderness of the soul of another human being; it is not about thinking you are responsible for finding the way out” – Alan Wolfelt