Exam 3 (Psychosocial Aspects of Death & Dying Ch. 8,9 and 13

Question 1

Raphael defines mourning as

Answer 1

The process whereby the bereaved gradually undoes the psychological bonds the bound him to the deceased

Question 2

places grief in the context of the “overarching process of mourning” and calls it a “transitional phase”. Implies that grief is a normal continuous condition

Answer 2

Rando

Question 3

According to Rando, both grief and mourning are processes, although mourning is driven by…

Answer 3

the social and cultural influences to which the griever is exposed

Question 4

States that grief is the process that allows us to let go of that which was and be ready for that which is to come

Answer 4

Rando

Question 5

Lindemann’s five characteristics of grief

Answer 5

1) somatic or bodily distress
2) preoccupation with the image of the deceased
3) guilt
4) hostile reactions
5) inability to function as one had before the death

Question 6

The uniqueness of the persons grief will be influenced by…

Answer 6

1) how the bereaved perceives the loss
2) The bereaved’s age
3) The age of the person who died
4) The degree to which the bereaved was prepared for the death
5) The bereaved’s inner strength and outer resources
6) The nature of the relationship with the person who died

Question 7

Worden arranged Lindemann’s five normal grief characteristics into four major categories…

Answer 7

1) feelings
2) physical sensations
3) cognitions
4) behaviors

Question 8

The feelings that may be present in normal grief

Answer 8

• Anger
• sadness
• guilt
• self-reproach
• anxiety
• loneliness
• fatigue
• helplessness
• shock
• yearning
• emancipation
• relief
• numbness

Question 9

Physical sensations that may be present in normal grief

Answer 9

• hollowness in the stomach
• tightness in the chest or throat
• shortness of breath
• over sensitivity to noise
• weakness of the muscles
• lack of energy
• dry mouth
• sense of depersonalization

Question 10

Normal cognitive responses in grieving

Answer 10

• Disbelief
• confusion
• preoccupation with thoughts of the deceased
• deeply felt presence of the deceased

Question 11

Normal behavioral responses to grief in the American culture

Answer 11

• sleep/appetite disturbances
• social withdrawal
• absent-minded behavior
• restless overactivity
• crying
• sighing
• searching and calling out
• dreaming of the deceased
• visiting places or carrying objects that reminds survivor of the deceased
• avoiding reminders of the deceased
• treasuring objects that once belonged to the deceased

Question 12

How long these feelings of grief persist will depend on

Answer 12

• nature and length of the relationship with the deceased
• how they died
• The amount of social and cultural support the griever receives

Question 13

Engel cautions that grief is a..

Answer 13

Healing process that can be interfered with by unsound interventions, sub optimal conditions or a lack of individual coping mechanisms

Question 14

Engel’s six step model of the stages of grief

Answer 14

1) shock and disbelief
2) developing awareness
3) restitution
4) resolving the loss
5) idealization
6) The outcome

Question 15

Stroebe suggests that grief work involves….

Answer 15

Reliving, thinking through, and breaking down each item of the shared relationship between the bereaved in the deceased.

Question 16

The difference between stages of grief and tasks of mourning

Answer 16

There are no guarantees that individuals will move in some natural fashion through the stages of grief neatly accomplishing the tasks along the way

Question 17

Worden’s four primary requirements for successful completion of grief work (tasks of mourning)

Answer 17

1) accept the reality of the loss
2) experience the pain of grief
3) adjust to environment in which the deceased is missing
4) withdraw emotional energy and reinvest it in another relationship

Question 18

Avoidance strategies

Answer 18

• buying into societal discomfort with outward displays of mourning
• taking a “geographic cure”
• postponing the grief in hopes that it will go away
• overwork
• over socializing
• over investment in the lives of others
• becoming romantically involved in another relationship prematurely

Question 19

Consequences of avoidance strategies

Answer 19

Depression, physical reactions, substance abuse, delayed expressions of pain, or experiencing the avoided pain in response to a subsequent loss

Question 20

Lindemann constructed three tasks of grief which parallel Worden’s and consist of

Answer 20

1) emancipation from the bondage of the deceased
2) readjustment to the environment in which the deceased is missing
3) formation of new relationships

Question 21

The only universal agreement among grief experts regarding timetables for recovery

Answer 21

Is that there isn’t one.

Question 22

Raphael grouped the psychological determinants of grief into three “umbrella” categories:

Answer 22

1) pre-existing relationship between the bereaved and the deceased
2) The type of death
3) previous losses

Question 23

Worden suggest that when considering the nature of the relationship three factors should be addressed

Answer 23

1) The strength of the attachment
2) The security of the attachment
3) The ambivalence of the attachment

Question 24

Rando identified 20 separate factors that impact the psychological component of bereavement:

Answer 24

1) meaning of the loss
2) qualities of the relationship
3) Roles of the deceased
4) age of the griever
5) grievers sex-role conditioning
6) deceased’s unique characteristics
7) Griever’s mental state
8) Griever’s maturity and intelligence
9) Previous experience with loss
10) cultural elements affecting the griever
11) Fulfillment of the deceased’s life
12) context of the death
13) preventability of the death
14) timelessness of the death
15) expectation of death
16) length of illness
17) involvement with dying person
18) secondary losses
19) additional stressors

Question 25

Sociogical factors

Answer 25

Outside the bereaved; would include the social structure of the family and the overall society around the bereaved which consists of any and all structures of which the bereaved is a member

Question 26

Payoff

Answer 26

Refers to certain bereaved individuals who derive such pleasure from the attention and sympathy they receive as mourners

Question 27

Different sociological factors of mourning

Answer 27

• available support systems
• cultural background and context
• socioeconomic status
• funerary rituals

Question 28

Different physiological factors in response to mourning

Answer 28

• drugs and sedatives
• nutrition
• rest and sleep
• exercise
• overall physical condition

Question 29

Strategies that can help the griever move toward resolution of the death

Answer 29

1) reaching out to the bereaved
2) Rituals of bereavement
3) Resolving complicated grief
4) expectations for closure

Question 30

Strategies involved in reaching out to the bereaved

Answer 30

• must be physically present and emotionally available
• encourage the griever to actualize the loss
• giving permission to grieve
• encourage the griever to be realistic

Question 31

Some unhealthy issues surrounding grief that can be resolved by taking a realistic approach include

Answer 31

• feeling an obligation to stop grieving and go on with life to please someone else
• taking little time to grieve
• conflicting emotions about the death
• The need for continuous grieving
• The fear of talking about the death
• exposing personal defenses
• pain
• sitting in thinking about the death
• unfinished business

Question 32

If the griever believes there is meaning in them rituals can provide

Answer 32

Healing, continuity, and balance

Question 33

More specifically rituals permit the following:

Answer 33

• A well-defined acting out
• expression of feelings
• rehearsal of the entire grief process
• healthy interaction with the deceased
• Full acceptance of the loss

Question 34

The following guidelines can be used to assist those suffering from complicated grief

Answer 34

• be aware of the difference between normal grief and complicated grief
• before assisting the bereaved, confirm the desire for help
• encourage the griever to talk about the deceased
• encourage the griever to consult a physician
• suggest an evaluation of incomplete or complicated grief
• offer assistance in overcoming complicated grief

Question 35

The death care professional can assist individuals with complicated grief with the following actions

Answer 35

• encourage the griever to accept the death
• explore the grievers relationship with the deceased
• encourage the griever to try new skills
• overwhelming emotions of anger and anxiety need to be identified and expressed
• assist the griever in giving up linking objects
• When the time is right encourage the griever to say goodbye

Question 36

Four behaviors that the bereaved experience as the grief process comes to a close

Answer 36

• acceptance of feelings
• detachment from the deceased
• reestablishment of relationships
• restoration of wholeness in one’s life

Question 37

the three C’s of reconnecting with others

Answer 37

Companionship, commonality, and commitment

Question 38

Restoration

Answer 38

Closeure placed on the past life with the deceased and a positive outlook for one’s future life

Question 39

To enhance the future the death care professional can offer these guidelines to the bereaved

Answer 39

• be responsible for your own future
• Believe in yourself
• maintain a balance in caring for yourself and others
• identify resources for creating a healthy future
• view problems and mistakes as learning experiences
• look for the silver lining
• empower yourself to complete the grieving process
• develop an awareness of your progress
• rebuild your life
• actively engage in living

Question 40

Raphael defines grief as

Answer 40

The emotional response to loss; the complex amalgam of painful effects including sadness, anger, helplessness, guilt, and despair