Bereavement

Question 1

Describe grief.

What are the different ways in which grief reactions can be viewed?

Answer 1

• Grief is the primarily emotional / affective process of reacting to the loss of a loved one through death.
• The focus is on the internal, intraphsychic process of the individual.
• Normal or common grief reactions may include:
  
  • Numbness and disbelief
  • Anxiety from the distress of separation
  • A process of mourning often accompanied by symptoms of depression
  • Eventual recovery.
• Grief reactions can also be viewed as:
  
  • Abnormal
  • Traumatic
  • Pathlogic
  • Complicated

Question 2

Describe mourning.

Answer 2

• Mourning is the public display of grief.
• Mourning emphasises the external or public expressions of grief. Consequently, mourning is influenced by:
  
  • One’s beliefs
  • Religious practices
  • Cultural context
• Overlap between grief and mourning, with each influencing the other.
• The public expression (i.e. mourning) of the emotional distress over the loss of a loved one (i.e. grief) is influenced by culturally determined beliefs, mores and values.

Question 3

What is bereavement?

Answer 3

Bereavement is defined as the objective situation one faces after having lost an important person via death.

Question 4

What constitutes ‘bad news’?

Answer 4

• Includes situations where there is a threat to a person’s mental or physical wellbeing.
• A risk of upsetting an established lifestyle.
• Where a message is given which conveys to an individual fewer choices in his or her life.

Question 5

Describe anticipatory grief.

Answer 5

• Anticipatory grief refers to a grief reaction that occurs in anticipation of an impending loss.
• Defined as ‘the total set of cognitive, affective, cultural and social reactions to expected death felt by the patient and the family’.
• It is becoming increasingly recognised as an issue that can heighten distress for both patients and their social networks.
• The term ‘anticipatory grief’ is most often used when discussing the families of dying persons, although dying individuals themselves can experience anticipatory grief.
  
  • It includes many of the same symptoms of gried after a loss.

Question 6

Describe the stages of normal grief (one model).

Answer 6

1. Shock-numbness
2. Yearning-searching
3. Disorganisation-despair
4. Reorganisation

Question 7

Describe the difference between normal grief and depression.

Answer 7

• In grief:
  
  • Painful feelings come in waves
  • Lessen in intensity and frequency over time
  • Are often intermixed with positive memories of the deceased.
• In depression:
  
  • Mood and ideation are constantly negative.
• In grief:
  
  • The prevailing affect is one of emptiness.
• In major depression:
  
  • It is a long, sustained, depressed mood and an inability to expect pleasure or happiness.
• In grief:
  
  • Self-esteem is usually preserved.
• In major depression:
  
  • Feelings of worthlessness and self-loathing are common.
• In grief:
  
  • While symptoms such as suicidal ideation can occur, they are generally focussed on the deceased, such as a wish to join the deceased in death or feelings of guilt toward certain gaps or failures in the relationship with the deceased.
• In major depression:
  
  • Suicidal ideation is more likely directed at self only.