test 2 Flashcards
what are mediators of mourning
how people grieve is determined by many factors, and these tasks are mediated by various factors
a mediator of grief - who the person who died was
- the sort of relationship between the deceased and the survivor
- closer the relationship the more intense grief
- who the person was to someone else
a mediator of grief - nature of the attachment
- strength of attachment
- greater the love greater the grief
- security of attachment (sense of well being had from deceased)
- ambivalence in relationship (really mixed feelings in relationship can = guilt and anger)
- conflict with deceased (leave unfinished business)
- dependent relationships (stronger grief when survivor was dependent on deceased)
a mediator of grief - how the person died
- natural, accidental, suicidal, homicidal
- proximity
- suddenness
- violent/traumatic death (lead to complicated grief)
- multiple losses (too many deaths can be unmanageable)
- preventable death (guilt, blame, culpability)
- ambiguous death (not knowing for sure)
- stigmatized deaths (suicide/aids/miscarriage)
a mediator of grief - historical antecedents
- if the person has experienced grief before and how they dealt with it
- unresolved loss can transcend generations and affect current mourning process
a mediator of grief - personality variables
- age and gender
- coping style
- attachment style
- cognitive style
- ego strength (better self esteem better adjustment)
- assumptive world (possible spiritual crisis/people who believe in god plan adjust better)
problem solving coping
change to a method that works or ineffectively quite when that one method used doesn’t work
active emotional coping
redefinition, or the ability to find something positive in a bad situation (using humor, venting, accepting support)
avoidant emotional coping
least effective, includes blaming, distraction, and social withdrawal
secure attachment style
developed through good parenting and other early healthy relationships
- when there is loss, pain of sorrow is processed and develops continuing bond with the lost loved one
insecure attachment style
when parenting/early relationships are not secure
anxious/preoccupied attachment
super sensitive to slights and other negative neglect in a relationship. shows high levels of stress at the time of death and coping is difficult
anxious/ambivalent attachment
love and hate coexist in relationship. usually only the love comes out when the person dies and makes them larger than life
avoidant/dismissing attachment
behavior is organized around the goal of self reliance and independence. show minimal emotions to a death
avoidant/fearful attachment
have long histories of tentative attachments and can go into depression when an attachment is severed due to a death
rumination
focus on the negative without taking action to relieve these emotions
a mediator of grief - social variables
- grieving is a social phenomenon
- support can lessen after time due to need to move on
a mediator of grief - concurrent stress
- high levels of disruption (secondary loss) following death can create higher levels of depression
- economic factors of a spouse dying effecting the whole family etc
when is mourning finished
- when person completes the final mourning phase/task completed
- when person is able to think of deceased without pain
- when person can reinvest their emotions back in their life
grief counseling vs therapy
- counseling = help people facilitate uncomplicated grief, or normal grief, to a healthy adaptation to the tasks of mourning within a reasonable time frame
- therapy = specialized techniques, that are used to help people with abnormal or complicated grief reactions
goals of grief counseling
help survivor adapt to the loss of a loved one and be able to adjust to a new reality without that person
Specific goals of counseling
- Increasing the reality of the loss
- Help deal with emotional and behavioral pain
- Helping overcome impediments to readjustment after the loss
who does grief counseling
- Professional services by trained doctors, nurses, psychologists, social workers, etc
- Volunteers are selected and trained (ex. Widow to widow programs)
- Self help groups like compassionate friends (like bereaved people helping other bereaved people)
when to do grief counseling
- Usually within a week following the death
- not too soon
- If the family has contacted a counselor beforehand, the counselor may contact them at the time of death (ex. hospice)
where should grief counseling be done
- Grief counseling can be done in an office, hospital, or home
- Grief therapy should only be in a professional office
who receives grief counseling
- All individuals - anyone who has experienced a death related loss
- People wait to experience difficulty and then seek counseling
- Preventive model for mental health, predict in advance who will have difficulty coping
Significant predictors for person who would not do well 1-2 years following the death
- high level of perceived non supportiveness in the bereaved social network
- moderate level of perceived non supportiveness occurring together with particularly traumatic circumstance of the death
- previously highly contradiction marital relationship with the deceased, traumatic circumstances of the death, and any unmet needs
- presence of a concurrent life crisis
Other dimensions that could contribute to a need for intervention at the 4 week post death assessment
- Young children at home
- Lower social class
- Employment little, if any at all
- High anger
- Pining
- Lacking current relationships
Counseling procedures
- Help the survivor actualize the loss
- Help the survivor to identify and express feelings
- Help living without the deceased
- Help find meaning in the loss
- Facilitate emotional relocation of the deceased
- Provide time to grieve
- Interpret “normal” behavior
- Allow for individual differences
- Examine defenses and coping styles
- Identify pathology and refer
facilitating grief through the funeral ritual
- a funeral service can aid and abet the healthy resolution of grief
- Can help make real the fact of the loss
- Can give people an opportunity to express thoughts and feelings about the deceased
- Drawing a social support network close to the bereaved shortly after the loss
- Continued contact with the family helps facilitate grief
why people fail to grieve
- relational factors
- circumstantial factors
- historical factors
- personality factors
- social factors
narcissistic relationship
when the deceased was an extension of oneself, to admit the loss would necessitate confronting a loss of part of oneself
how does grief go wrong
grief without progression of the mourning process
- an increase in intensity and duration
chronic grief reaction
excessive in duration and never comes to a satisfactory conclusion
delayed grief reaction
inhibited, suppressed, or postponed grief reaction
exaggerated grief reaction
clinical depression, anxiety, phobias, alcoholism, and substance abuse, PTSD
masked grief reaction
experience symptoms and behaviors that cause them difficulty, but they do not recognize the fact that the symptoms or behaviors are related to the loss
