Grief Notes 1 Flashcards
the science study of human behavior.
PSYCHOLOGY
Psyche=Mind
Logy=Study
the study of human behavior as related to funeral service
FUNERAL SERVICE PSYCHOLOGY
(Experience/Event) – the experience of the emotion of grief. A state of being deprived of something valuable. The experience or the event of losing something or someone.
BEREAVEMENT
(Process) – an adjustment process which involves grief and or sorrow over a period of time and helps in the reorganization of the life of an individual following a loss or death of someone loved
MOURNING
(Emotion) – an emotion or set of emotions due to a loss
GRIEF
study of death.
THANATOLOGY
Thanos=Death
Logy=Study
an irrational exaggerated fear of death.
THANATOPHOPIA
Thanos=Death
Phobia=Fear
NEEDS OF THE BERIEVED:
- To confirm reality
- To establish stability and security
- To receive emotional support
- To express emotions
- To modify emotional ties to deceased
- To provide a basis for building new inter-personal relationship
Why have funerals?
A funeral helps confirm reality by providing a face-to-face encounter with the deceased. Viewing the deceased leaves a final and lasting impression with the survivor. The opportunity to receive and express love
Funerals provides:
- The opportunity to receive and express love
- To show respect for the family, friends and deceased
- To provide an opportunity to express grief
- Provides for a face to face confrontation with death, Confirm the reality that death has occurred
- Opportunity for sharing. “Joy expressed is joy increased, grief shared is grief diminished.”
Funerals provides:
- Theological, psychological and social needs of those who mourn are nourished
- Provide an opportunity for farewell thru ritual
- Provides a dramatic presentation of the fact life has been lived by reflecting upon memories of deceased.
- Helps establish emotional stability thru a social support network
- Establishes a socially accepted climate for mourning and expression of feelings
Theories of Grief and Mourning
Kubler-Ross - 5 Stages of Death And Dying Lindemann –Grief Syndrome Bowlby – Attachment Theory Freud - Mourning and Melancholia Worden – 4 Tasks of Mourning Parkes – 4 Phases of Mourning
A physician who worked with hospice patients and identified “five stages” a terminally ill person and the family experiences. Based on interviews with dying patients wrote Book “On death and Dying” circa 1966
ELISABETH KUBLER-ROSS
5 Stages of Death and Dying
Do the five stages of death occur in exact order listed? NO
Does one experience ALL stages? Not necessarily!
- Denial and isolation
- Anger
- Bargaining
- Depression
- Acceptance
- He was Chief of Psychiatry at Massachusetts General Hospital in 1944.
- Worked with families who lost loved ones in the Coconut Grove fire.
- First professional to describe “anticipatory grief”.
- Wrote “Symptomatology and Management of Acute Grief”.
- Formulated the “Grief Syndrome”.
Lindemann
- A British psychiatrist who devoted much of his professional career to understanding attachment –what it is and how it develops?
- Noted for the “Attachment Theory”.
Bowlby
GRIEF SYNDROME
- Somatic or bodily distress of some type
- Preoccupation with image of deceased
- Guilt relating to deceased or circumstances of death
- Hostile reactions
- Inability to function as before loss
- May develop traits of the behavior of the deceased
ATTACHMENT THEORY
- Attachments come from need for security and safety
- Situations that endanger bond of attachment give rise to emotional reactions
- The greater the potential for loss, the more intense the reaction
A psychiatrist who wrote “Grief Counseling and Grief Therapy”.
Participated in the “Harvard Bereavement Study” which indicated the mourning is necessary for all who have experienced loss through death.
Identified the four “Tasks of Mourning”.
Worden
4 TASKS OF MOURNING
- Accept the reality of loss
- Work through pain of grief
- To adjust to an environment in which the deceased is missing
- To emotionally relocate the deceased and move on with life
Wrote early paper “Mourning and Melancholia” 1917, which he pointed out that depression which he called melancholia was a pathological form of normal grief.
He also came up with concept of “grief work” which implies that the mourner needs to take action
Freud
4 Phases of Mourning
Parkes
4 Phases of Mourning
- Period of numbness
- Phase of yearning
- Phase of disorganized and despair
- Phase of reorganized behavior
described as uncomplicated grief.
Normal grief
Factors That May Complicate Grief
Relational Factors: Circumstantial Factors: Historical Factors: Personality Factors: Social Factors:
Relational Factors:
- Highly ambivalent relationship with unexpressed hostility
- The death may reopen old wounds
- In highly dependent relationships the death may lead to a desperate sense of helplessness
Circumstantial Factors:
- The loss is uncertain (MIA’s, no remains found)
2. Multiple losses from plane crashes, natural disasters, fire may lead to bereavement overload
Historical Factors:
- People who have had complicated grief reactions in the past will have a higher probability of a complicated reaction in the present
- There is interest in the influence of early parental loss on the development of subsequent complicated grief reactions in other losses
Personality Factors:
- Some people are unable to tolerate extremes of emotional distress
- One’s self-concept such as being the “strong one” in the family may hinder grief
Social Factors:
- The death is socially unspeakable (suicide, homicide, AIDS)
- The loss is socially negated (abortion)
- The absence of a social support network may cause complications.
Sadness (most common feeling), anger, guilt, and self-reproach, anxiety, loneliness, fatigue, helplessness, shock, yearning, emancipation, relief, numbness.
FEELINGS
Hollowness in stomach, tightness in chest or throat, oversensitivity to noise, sense of depersonalization, feeling short of breath, weakness in the muscles, lack of energy, dry mouth
PHYSICAL SENSATIONS
(inside oneself)
Display confusion, preoccupation with thoughts of the deceased, sense of presence, hallucinations
COGNITIONS
Sleep disturbances, appetite disturbances, absentminded behavior, social withdrawal, dreams of deceased, avoiding reminders of deceased, searching and calling out, sighing, restless, over activity, visiting places or carrying objects that remind the survivor of the deceased, treasuring objects that belong to the deceased
BEHAVIORS
Severity of grief is determined by 8 key factors:
- WHO is the person that died
- NATURE OF THE ATTACHMENT:
- MODE OF DEATH:
- HISTORICAL ANTECEDENTS:
- PERSONALITY VARIABLES:
- SOCIAL VARIABLES:
- CONCURRENT STRESSES
- CIRCUMSTANTIAL FACTORS:
strength and security of the attachment, ambivalence in the relationship, conflicts with the deceased, dependent relationship
NATURE OF THE ATTACHMENT:
natural (long or short duration), accidental, suicide, homicide
MODE OF DEATH:
previous losses and how these were grieved
HISTORICAL ANTECEDENTS:
age & gender of the survivor, persons coping style, attachment style, cognitive style, self-esteem and self-efficacy, person’s beliefs and values
PERSONALITY VARIABLES:
support availability, support satisfaction social role involvements, religious resources and ethnic expectations
SOCIAL VARIABLES:
influencing grief: involvement of hospice, use of living will
CIRCUMSTANTIAL FACTORS:
COUNSELING – 3 definitions by source:
WEBSTER: - advise especially that given as a result of consolation
EDGAR JACKSON: - anytime someone helps someone else with a problem
CARL ROGERS: - good communication within and between men, or good (free) communication within or between men is always therapeutic
– an individual who provides assistance and guidance. *DO NOT confuse counseling with psychotherapy, which is treatment of mental or emotional disorder
COUNSELOR
– strong sudden emotional grief as awareness increases
ACUTE GRIEF
– blame directed toward another person
ANGER
– the experience of grief where mourning customs are unclear due to an inappropriate death and the absence of prior bereavement experience. Typical in society that has attempted to minimize the impact of death thru medicine
ANOMIC GRIEF
– presence of grief in anticipation of death or loss attachment theory (Bowlby) – human making strong affectional bonds
ANTICIPATORY GRIEF
– (unresolved, chronic) – grief extending over a long period of time without resolution
COMPLICATED GRIEF
– defense mechanism by which person is unable or refuses to see things as they are because such facts are threatening to the self
DENIAL
– defense mechanisms; anger is redirected toward a person or object other than the one who caused the anger originally
DISPLACED AGGRESSION
– the ability to enter into and share feelings of others
EMPATHY
– helping people facilitate uncomplicated grief to a healthy completion of the tasks of grieving within a reasonable time frame
GRIEF COUNSELING
– specialized techniques which are used to help people with complicated grief reactions
GRIEF THERAPY (WORDEN)
– blame directed toward one’s self
GUILT
– used to treat patients with a life-limiting condition
HOSPICE
– intervention with people whose needs are so specific that usually they can only be met by specially trained physicians or psychologists. The practitioners in this field need special training because they often work with deeper levels of consciousness
PSYCHOTHERAPY (JACKSON)
- assumption of blame directed toward one’s self by others
SHAME
– reaction of the body to an event often experienced emotionally
SHOCK
– guilt felt by the survivors
SURVIVOR GUILT
– sincere feelings for the person who is trying to adjust
SYMPATHY
What else is going on in the life of the person experiencing complicated grief?
Divorce?
Loss of job?
Problems with children?
- Concurrent Stresses
