Loss + coping

Question 1

Define loss

Answer 1

The absence of something, real or perceived that was valued

Question 2

Define coping

Answer 2

Cognitions or behaviours that manage demands that may feel intolerable to a person

Question 3

Define mourning

Answer 3

An outward expression of grief, an active process to be worked through

Question 4

Define bereavement

Answer 4

A period of sadness after loss

Question 5

Define Grief

Answer 5

A normal involuntary response to loss

Question 6

Give examples of types of losses

Answer 6

• Lost of a loved one
• relationships
• Job loss
• Financial loss
• home
• independance
• future

Question 7

Give examples of emotional as well as physical symptoms of loss

Answer 7

• Fatigue
  -Emotionally drained
• anger & frustration
• Numbness
  -Fear & regret
• Insomnia
• loss of appetite
• breathlessness & chest tightness

Question 8

Describe Freud’s theory of loss

Answer 8

Proposed the 1st grief theory involving breaking ties with the dead & adjusting to new relationships
2 components:
Mourning: an active finite transformative process, loss stimulates a change allowing a person to feel & accept change. Mourning is said to rebuild a persons inner world by experiencing extreme pain that reawakens love affect for lost one
Melancholia: Occurs when mourning lasts too long, a person may not understand their loss. There is a struggle to get over the deceased & ongoing depression. Grief is delegated to unconscious as is too painful for conscious to process, leading to a person feeling stuck in their pain

Question 9

Give a strength & limitation on Freud’s theory of loss

Answer 9

S: Freud’s distinction between mourning & melancholia helps identify between normal functional grief & pathological grief. This differentiation is valuable as they may require different treatment approaches to provide relief

L: Freuds theory does not apply to all types of loss, only loss of a loved one, it cannot be used as a full explanation on grief as detachment may not be an appropriate response.
- oversimplistic, detachment may not cause healing, people may feel better to stay emotionally connected to lost one after passing, continuing the bond, can be a vital factor in healing

Question 10

Describe Lindemanns theory on loss

Answer 10

Gives a psychosomatic perspective on grief, identified somatic grief symptoms: fatigue, loss of appetite, lack of motivation, hostile reactions, guilt, adopting traits of deceased, loss or routine
He presented evidence that grief has not just psychological impact, but also physical impact. He suggested that these symptoms can set in immediately, be delayed, be exaggerated, or may be absent.
Suggested to reduce grief, ‘grief work’ needs to be done, consisting of 3 times to remain on normal grief trajectory
Grief work involves 3 stages

Question 11

Describe Lindemanns 3 stages of grief

Answer 11

Emancipation: severing of the bond between us & dead, connection links to our emotional pain, to move on bond needs to be broken to form new relationships
Readjustment: we have to find a way of making sense of the world without the person we love in it
Formation: healthy normal grief results in us being able to form new relationships by being able to let go

Question 12

Give a strength & limitation on Lindemanns theory of loss

Answer 12

S: A key strength of normalizing grief, making it identifiable by providing symptoms, presents it as a universal process, reduces stigma around grieving by normalizing large emotional responses e.g., crying, allows people to see their grief as a shared part of the human condition
L: Lack of application to reality, grief is not a linear process for everyone, may be more cyclical e.g., at xmas time, therefore universal assumption may not apply to all suffering with grief
- does not take into account cultural differences, cultures may have rituals/traditions to follow, Lindemanns stages may not include these

Question 13

Describe Kubler ross theory on loss

Answer 13

Model is used to understand peoples emotional reactions to trauma & grief, Grief is seen as fluid & not linear
People undergo stages, but not necessarily in order
S1: Denial, refusal to accept facts relating to a circumstance, a natural defence mechanism, easy for people to become stuck in this stage
S2: Anger, can be directed to others or themself, anger can also be expressed to lost one
S3: Bargaining, with people facing death it can involve them trying to bargain with ‘some god’, does not provide a sustainable solution
S4: Depression, indicates beginning of some accepting of fate/loss, feelings of sadness & fear
S5: Acceptance, Symbolises emotional detachment, grieving individual begins to come to turn with loss, they begin to make an effort to move on

Question 14

Give a strength & limitation on Kubler Ross’ theory of loss

Answer 14

S: work also contributed to the establishment of hospital care, emphasis on the importance of providing emotional and psychological support for individuals facing terminal illness and their families. increased empathy and compassion for those who are grieving. The idea that individuals may experience a variety of emotions in the aftermath of loss has helped society better understand and support grieving people
- provides a clear framework
L: It assumes grief is linear process, people may skip or repeat stages
- an oversimplification, as condenses grief into 5 categories, grief is individual specific, people will experience grief differently
- does not account for gender difference or cultural differences

Question 15

Describe bowlby’s theory on loss & attachment

Answer 15

Suggests grief is a normal response to the breaking of an attachment. Bowlby suggests that four general phases of mourning include: Numbing: feelings of disbelief, providing temporary relief to a person from pain caused by loss, lasts for short period, followed by an outburst
Yearning & searching: realization of loss occurs when numbness fades, Anger & frustration felt, there is a search for someone to blame
Disorganization: accepts reality of loss, evaluation of life without lost one occurs
Reorganization: occurs after life after the deceased has been established, defined by gradual changes someone makes to move on with their life after loss

Question 16

Give a strength & limitation on Bowlby’s theory of loss

Answer 16

S: Bowlby defines grief as a dynamic process, not a quick fix e.g., not through grief work, suggests grief is not about detachment, but adjustment (contradicts freud & Lindemann) offering a useful framework to understand the stages of grieving, even though these stages may vary among individuals.

L: Bowlby OG theory was for infants & caregivers, may not apply to other relationship types, other types may be more complex. The theory may not fully capture the unique dynamics of adult attachment or the way grief manifests in adult relationships.
- Grief is not linear may be fluid or cyclical for some people, does not provide full explanation for grief

Question 17

What is the overall issues with stage driven models of loss & grieving

Answer 17

• Most models are linear, suggests grief is a staged process that may not apply to everyone, stages may repeat themselves or be skipped entirely
• Most focused on death of loved one, does not account for other types of loss
• Cultural difference
• Gender differences
• oversimplified, does not fit everyone’s personal grieving process, no model fits all

Question 18

Describe Klass, Silverman & Nickman’s theory on loss

Answer 18

Continuing bond theory, challenges idea of detachment needed for healing, Continuation of bond creates comfort & security. Grieving does not necessarily require “letting go” or “moving on” from the deceased. Instead, it can involve finding new ways to keep the bond alive in one’s life. E.g., ritual, keepsakes

The Continuing Bonds Theory is influenced by attachment theory, which focuses on the bonds between individuals and how they are maintained even after death. It contrasts with the idea that grief necessarily involves “separation” from the attachment figure. E.g., Lindemann

Question 19

Give a strength & limitation on Klass, Silverman & Nickmans theory of loss

Answer 19

S: Aware of cultural differences e.g., rituals after death, It acknowledges that there are many ways to grieve and that people have different ways of continuing their bond with the deceased

L: doesn’t provide a clear framework like other models
- it might prevent people from fully embracing new roles or life changes because they are still emotionally tethered to the deceased as some individuals might struggle with balancing this emotional connection with the need to embrace life and future relationships
- The concept of “continuing bonds” is somewhat abstract and can be difficult to measure empirically. Unlike other models that involve observable behaviors (e.g., stages of grief or specific emotional reactions), continuing bonds involve ongoing psychological connections that may not be easily quantified or tested through research.

Question 20

Describe the dual process model by Stroebe & schut

Answer 20

Theory suggests grief involves 2 processes of:
Loss-orientated coping: focusing on emotional pain, remembering lost one & dealing with grief
Restoration-oriented coping: This involves adjusting to life without the deceased, engaging in new roles, and developing a new identity after the loss.
The model suggests that grieving is not a linear process but involves oscillating between these two types of coping: focusing on the loss and managing the practical demands of life that result from the death.

Question 21

Give a strength & limitation on Stroebe & Schut’s theory of loss

Answer 21

S: recognises that grief is not a linear process, allowing a more realistic view of grief, this flexibility is more reflective of real-world situations. The model accounts for both the emotional and practical aspects of grieving. By recognizing the importance of both processing the loss (e.g., experiencing sadness, yearning, and emotional pain) and adjusting to the new reality (e.g., taking on new roles, restructuring life), the Dual Process Model offers a more holistic view of the grieving experience.

L: The Dual Process Model could be seen as oversimplifying the complex nature of grief. Grief is a multifaceted experience, and people may not always easily oscillate between two clear coping processes. In reality, grieving individuals may experience a range of emotions and coping mechanisms that are not neatly categorized into loss-oriented or restoration-oriented coping. Additionally, people might experience complicated grief or traumatic grief that does not fit into the framework of this model.

Question 22

Describe Lazarus & Folkman’s theory of coping

Answer 22

Lazarus and Folkman emphasize that stress is not just a result of external events but a transaction between the person and their environment. It depends on how an individual perceives and appraises a situation, and the resources available to cope with it.
In primary appraisal, individuals assess whether the stressor poses a risk to their well-being or if it is something they can handle or overcome, e.g., stressful, moderate or benign
secondary appraisal involves evaluating resources and options for coping with the stressor. This includes assessing what strategies or resources are available to deal with the stressor (e.g., social support, skills, financial resources).
Coping refers to the thoughts and behaviors individuals use to manage the demands of a stressful situation. Lazarus and Folkman identified two main types of coping strategies
Reappraisal—reassessing the situation and their coping responses based on new information or experiences. Reappraisal can lead to changes in how the stressor is viewed or how coping strategies are adjusted.
This dynamic process allows individuals to adapt to changing circumstances and refine their coping strategies over time

Question 23

Define the two types of coping in Lazarus & Folkmans theory

Answer 23

Problem-focused coping: This involves taking action to address or eliminate the source of stress. For example, tackling a problem head-on, seeking information, or taking steps to solve an issue.

Emotion-focused coping: This involves managing emotional responses to the stressor, rather than dealing with the problem itself. It may include strategies like seeking emotional support, using relaxation techniques, or avoiding the stressor.

Question 24

Give a strength & limitation on Lazarus & Folkman’s theory of coping

Answer 24

S: Recognize that coping & stress varies between individuals. It makes it clear that strategies should be personalized to be effective. Highlights the importance of SS, it focuses on the importance of resources available to individuals, shifts the stress as they have identified proper tools to manage effectively
L: Subjectivity, relies on individuals perception. People may not be able to describe their stress or identify stress effectively, which distorts appraisal, they may tend to catastrophize, making it difficult to assess their stress.
- refers to stress in specific situations does not take into account chronic stress, model is not applicable to use e.g., reappraisal

Question 25

Describe Shontz theory of coping

Answer 25

Shontz theory is used for people having received a recent medical diagnosis. Key components:
- Shock: experienced when learning of a new diagnosis, can suffer denial or difficulty accepting the diagnosis
- Adjustment: Person must adjust aftershock, which involves emotional reactions e.g., anger, sadness as well as efforts to understand illness e.g., seek out of information
- Coping: work through emotional responses, person begins to adjust their life to their illness, includes coping strategies that could be bad or good
- Social support: Shontz emphasizes importance of SS, includes support from family, HP, friends etc, HP’s help with adjusting to new life with illness
- Reappraisal: person reinterprets their diagnosis & their views on it. Vital for adapting to new circumstances and to maintain normality

Question 26

Give a strength & limitation on Shontz theory of coping

Answer 26

S: Acknowledges the importance of individual differences, that coping varies on personality. Shontz distinguishes between bad & good coping strategies, offers a clear framework of what people go through & how to manage diagnosis, This distinction helps in identifying potential areas of intervention for those who are using less effective coping mechanisms.
L: Shontz model is primarily used for acute illness & not for chronic conditions, which includes different challenges that may not be reflected in the model. It also does not explore the long-term psychological impact of diagnosis especially for MH sufferers over a while, coping therefore may be long-term.
People may skip stages of complete them in a different order

Question 27

Describe Miller’s theory of coping

Answer 27

Miller’s model emphasizes the dynamic relationship between the individual and the environment, and how individuals appraise stressors, how they use their cognitive resources, and the various coping strategies they employ.
Consisits of monitoring & blunting:
M: Monitoring is a coping strategy characterized by attending to and actively seeking out information about the stressor or threat. Monitors tend to experience more acute anxiety because they are constantly processing information and worrying about possible outcomes. Monitors feel more in control due to info seeking

B:Blunting, in contrast, involves avoiding or minimizing the information related to the stressor. People who use blunting as a coping strategy often distract themselves or deny the significance of the stressor, preferring not to think about it or seek additional information.

A person who blunts might try to distract themselves by engaging in other activities, such as watching TV. Blunters generally seek emotional relief by reducing emotional engagement with the stressful situation, often avoiding feelings of anxiety or fear. Blunters tend to have lower levels of emotional arousal in the short term, but this avoidance can result in unresolved stress that might manifest later.

Question 28

Give a strength & limitation on Miller’s theory of coping

Answer 28

S: Miller’s model recognises that people deal with stress differently (M&B), this allows coping mechanisms to be personalized to the individual as different strategies may work for different people
Practical application: Knowing about M & B can be useful for therapists allows effective treatment

L: M & B may be too simple, (reductionist), people may not fit into these 2 categories or be a mix of both, cannot account for all of the population dealing with loss
Also model does not indicate M & B influence on long-term stress, e.g., monitoring could lead to heightened anxiety over time

Question 29

How can we help with loss & coping

Answer 29

Through social support, therapies e.g., ACT, CBT & problem solving therapy

Question 30

How does CBT help coping & loss

Answer 30

CBT aims to challenge negative beliefs & thinking patterns. e.g., feelings of guilt leading to intense emotional pain. CBT recognizes bad thinking patterns & helps to replace/alter them with more constructive thoughts.
CBT helps normalize the grieving process. CBT can help people understand the range of emotions they go through during grief.

Question 31

Describe the techniques used in CBT that can help with loss & coping

Answer 31

Behavioral activation, a key technique in CBT, encourages individuals to gradually re-engage in activities that provide a sense of meaning or satisfaction. This can include spending time with family, pursuing hobbies, or engaging in self-care activities.

This step helps combat isolation and promotes healing by focusing on positive actions, despite emotional difficulties.

Question 32

Describe problem solving therapy

Answer 32

PST is a goal-oriented type of therapy method, to help people with grief solve their problems effectively
PST can help clarify & define grief and breakdown tasks into smaller more manageable ones that fit with their emotional needs
PST can help identify and manage triggers & find healthy coping stratergies

Question 33

Describe the strengths & limitations of problem-solving therapy

Answer 33

S: It builds a persons problem-solving skills, helping them feel more capable during grief/stress. PST reduces emotional burden by creating smaller tasks & supports adaptive coping mechanisms

L: PST requires active engagement, this may be too demanding. Active engagement may feel like a burden as they feel emotionally drained. PST may not be useful for all types of grief, emotional processing may be needed rather than problem solving

Question 34

Describe acceptance & commitment therapy

Answer 34

Is a form of psychotherapy that focuses on helping individuals accept their emotions, thoughts, and experiences, rather than trying to change or avoid them. ACT emphasizes mindfulness, acceptance, and values-based living to help people cope with difficult situations, including loss and grief. It encourages individuals to develop a flexible approach to their experiences, allowing them to live a meaningful life despite the pain associated with loss.

Question 35

Describe how acceptance & commitment therapy helps

Answer 35

Acceptance of difficult emotions: prevents avoiding of emotions leading to healthier emotional processing

Living in the present: prevents rumination or regret over the past, prevents people from feeling stuck

Emotional resilience

Building a fulfilling life after loss

Empowering action: ACT encourages individuals to take small, deliberate actions toward the things that matter most to them, such as staying connected to loved ones or pursuing hobbies, despite grief. This helps prevent isolation and loss of direction after a loved one’s death.

Question 36

Describe strengths & limitations of acceptance & commitment therapy

Answer 36

S: ACT emphasises on accepting grief rather than avoiding it leading to healthier emotional processing, the practicing of mindfulness prevents people being consumed by their grief leading to more balanced emotional responses

L: Some people may have trouble accepting, as it may conflict with their desire to fix their emotional pain, those who prefer to avoid distressing emotions may struggle with sitting with their feelings and accepting them