Death and Dying: Chapter 9
Experiencing the turmoil of grief
Permit grief- give yourself grief Allow expression of feelings Use of linking objects- pictures, objects, places, people Recognize the wide range of normal reactions and upsurges Permit respite from grief
Accepting the reality of the death problems
denying loss, denying the meaning of loss, hope for physical reunion
Behavioral Grief
Reactions to loss and feeling Behaviors toward the deceased Coping behaviors
Tasks of Mourning (6 R's)
Recognize the loss React to the separation Recollect and re-experience the deceased Relinquish the old attachments Readjust to the new world without forgetting the old Reinvest the emotion energy
Last Phase
Resolution, recovery, reintegration, transformation Physical and mental health is balanced/ restored Feelings recedes
Middle Period
Anxiety, longing for the deceases, despair, reliving the events, pain, loneliness Can last awhile- emotions may erupt Re-evaluate the Relationship that existed, new relationship emerges
Cognitive Grief
Denial, Disoriented cognitive functioning, yearning and searching: preoccupation with deceased, sense of presence of deceased, hallucinations, death review, struggle for meaning
Processing the pain of the grief problems
Short circuit thoughts- "every time I get sad I'll just think of something else" Drug use
Accepting the death
Funeral process: social validation, discussion about the death, sharing of memories, maintaining security and routine
Grief Styles
Grief and mourning are unique to each other We often need to normalize the process for bereaved Recognize the family dynamics in bereavement
Grief Counseling and Grief Therapy
Grieving is an adaptive process and not a form of pathology
Tasks of the Mourning Process
1. Accept the reality of the death 2. Process the pain of the grief 3. Adjust to the world without the deceased 4. Find an enduring connection with the deceased in the midst of embarking on a new life
Physical Grief
1. Stress 2. Physical sensations: aches and pains, general weakness, nausea 3. Illness: broken heart 4. Psychosomatic: caused or aggravated by a mental factor such as internal conflict or stress
The Course of Active Grief
Initial Period Middle Period Last Phase
Dual Process of Model of Coping
Loss-oriented coping Restoration- oriented coping Oscillation is typical : grief is dynamic
The process of grief is affected by many variables
Type of relationship- closeness, ambivalence Availability of social support Situation of death- sudden, violent
Grief Counseling vs. Grief Therapy
Some say grief counseling is more harmful than helpful Cybertherapy, e-therapy, web-based counseling Social support is important
General Considerations
Upsurges Linking objectsL special days, people, objects, places Length of time Recovery, Reconciliation or Accommodation: 18-36 months
Conventional Mourning
all the things we do when there is a death, set of rules that we follow, a certain process, certain thing we are suppose to do Example: wearing black at a funeral
Restoration- Oriented
attending to life changes, doing new things, distraction from grief, denial/ avoidance of grief, new roles/identities/ relationships
Initial Period
confusion, overwhelmed, shocked, withdrawal, make decisions
Mourning
coping with the loss
Reactions to loss and feeling
crying, irritability, social withdrawal, sleep and appetite disturbances, absentminded
Behaviors toward the deceased
dreams of the deceased, avoiding reminders or treasuring objects of the deceased, visiting places
Loss-Oriented
grief work, intrusion of grief, breaking bonds/ties/relocation, denial/avoidance of restoration changes
Adjusting to the world without the deceased
help to deal with problems, use of social support network, be alert to health changes, anticipate the need for reassurance, encourage new activities and traditions, new identity
Person loss and roll loss
lookout who you lose as a person and the role that you lose
Grief
manifestations, reactions or symptoms to loss
Emotion Grief
numbness, depression and sadness, loneliness, anger and hostility, guilt : survivor guilt, grief recovery guilt, causation guilt, anxiety and fear, relief (joy)
Moving on
reconciliation, challenge unrealistic or illogical beliefs, utilize belief systems, enhance old relationships or develop new relationships, further reconstruction of new identity, commemoration and connections which are appropriate
Loss
removal of or separation from something precious
Coping behaviors
restless overactivity, rituals, remembers
Adjusting to the world without the deceased problems
sense of helplessness and dependency; new problems
Anticipatory grief
the event doesn't occur, but the anticipation is there so the grieving may begin early Example: cancer patients
Bereavement
the event of the loss
Find an enduring connection with the deceased in the midst of embarking on a new life problems
unfinished business, conflicts, lack of identity
Disenfranchised grief
unrecognized and unsanctioned Example: AIDS epidemic: person died and their lover was not allowed to grieve because it is unspoken. Mistress grieves over the loss of her lover but can not openly cope because he is married.