Loss And Coping Flashcards
Loss
The absence of something, actual or perceived, that was valued
Grief
An involuntary, but normal, emotional response to the loss
Mourning
Outward expression of the grief, an active process towards accommodation
Bereavement
Period of sadness after the loss
Coping
Cognitions and behaviours to manage demands felt to be difficult or intolerable to the person
Types of loss
A loved one
Mobility
Function
Independence
Limbs
Speech
Relationships
Role
Home
Career
Fertility
Sense of self
Future plans
Future image of self
Financial
Physical and emotional responses to loss
Tightness of chest
Breathlessness
Muscle weakness
Lack of energy
Fatigue
Difficulty concentrating
Intense sadness
Distress
Anxiety
Insomnia
Loss of appetite
Numbness
Fear
Regret or guilt
Theories of loss: Freud (1917)
Mourning and melancholia
Comparing normal emotion (mourning) against melancholia (depression)
Hyper-remembering
Comparing memories with reality
‘In mourning it is the world which had become poor and empty; in melancholia it is the ego itself’
Theories of loss: Lindemann (1944)
Sympotomatology and management of acute grief
Psychosomatic perspective on dealing with acute grief
Somatic distress - loss of appetites, fatigue, lack of motivation
Preoccupation of images of the deceased
Guilt
Hostile reactions
Loss of pattern and conduct
Adopting traits of the deceased
Grief work - emancipation form bondage to the deceased, readjustment to a new environment, formation of new relationships
Theories of loss: Kubler-Ross (1969)
Stages of grief
Denial - conscious or unconscious decision to refuse to admit it to be true
Anger - physical or emotional act of placing blame
Bargaining - negotiation process
Depression - feeling of loss of control or helplessness
Acceptance - feeling of stability and/or resignation
Theories of loss: Bowlby (1969)
Attachment and loss
Grief is the normal affective response when the affectional bond breaks
1. Shock and numbness - physical distress and not accepting it to be real
2. Yearning and searching - aware of what had been lost and the impact upon their life
3. Despair and disorganisation - acknowledge everything has changes
4. Reorganisation and recovery - rebuild after realisation, not fully restored
Theories of loss: Klass, Silverman and Nickman (1996)
Continuing bonds theory
Challenging the belief that ‘holding on’ is pathological
Continuing the bond can be normal, adaptive and comforting
Constructing new relationships
Theories of loss: Stroebe and Schut (1999)
Dual process model
Oscillation between loss orientation and attending to life chanches
Restoration orientation - descaling with everyday life
Dynamic process
Loss and emotions are revisited
Recognise the importance of fining meaning
Unique reaction to loss
Takes into account the effect of culture and religion
Problem with the stage/task driven models of loss and grieving
Freud, Lindemann, Kubler-Ross, Bowlby
Not a linear process
Stages might repeat
Might not fit all - unique
One desired outcome
Importance of finding meaning - moving forward in a way that honours our loved ones
Coping (more)
Stressful situations trigger cognitive appraisals (Cohen and Lazarus, 1983)
Dynamic process by which people try to manage the perceived discrepancy between demands and resources
Theories of coping: Lazarus and Folkman (1984)
Transactional model of stress and coping
Stressors - internal and external demands
Primary coping resources - personal attributes, stable environment attributes
Secondary coping responses - emotion or problem focused coping
Short-term outcomes - relaxation, mood
Long-term outcomes - physical and mental health, life satisfaction
Theories of coping: Shontz (1975)
Coping with a diagnosis
Shock - emergency response, stunned, bewildered, autopilot, detachment
Encounter - disorganised thinking, loss, grief, helplessness, despair, overwhelmed
Retreat - avoidance, denial
Theories of coping: Miller (1980)
Coping strategies
Monitoring - information seeking, adaptive if perceived as controllable
Blunting - information avoiding, shields the individual from an increase in arousal, useful in uncontrollable situations
Role of personality - stable individual differences in inclination to employ a monitoring or blunting style
Coping strategies: appraisal-focused
Logical analysis and mental preparation
Cognitive redefinition
Cognitive avoidance or denial
Coping strategies: problem-focused
Information gathering
Problem-solving
Identifying reward
Coping strategies: emotion-focused
Regulation of emotions
Emotional discharge (venting)
Resigned acceptance
Cognitive behavioural therapy (CBT)
Psychological problems are based on faulty or unhelpful thought processes, and in learned patterns of unhelpful behaviour
People can change their thinking and behaviour patterns
Problem-solving therapy
Identify and solve problems that arise from stressors
Aims - improve quality of life and reduce negative impacts of illness
Benefits - make effective decisions, systematic approach, confidence, toolbox of strategies, identify stressors and triggers
Acceptance and commitment therapy (ACT)
Psychological flexibility
Acceptance
Cognitive delusion
Contacting the present moment
Self as context
Values
Committed action
