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.