Bereavement/Grief

1. “Grief cannot be hurried or prevented or bypassed, even with the help of therapy. Above all, patience is required in this work, which is the work of bearing the pain of loss and change, not avoiding or eliminating it. And it is work that often takes longer than either the patient or the therapist can imagine.” John E.Baker

2. Bereavement/Grief Karen Schultz

3. Overview • Tasks of grieving • Factors influencing a grief reaction • Grief counselling

4. Grief Counseling and Grief Therapy. A Handbook for the Mental Health Practitioner by J.W. Worden, Springer Publishing Company.

5. Tasks of Grieving • Acknowledgement • Working through the pain • Accommodation • Task reassignment • Day to day • Emotional • Redefinition of self • Resumption of life cycle tasks

6. Working Through the Pain • Emotions: sadness, anger, guilt, anxiety, helplessness, yearning, emancipation, numbness • Physical Symptoms: chest tightness, stomach hollowness, heightened sensitivity to noise, shortness of breath, weakness, fatigue, dry mouth • Altered Thought Patterns: disbelief, confusion, forgetfulness, decreased concentration, hallucinations, preoccupation, depersonalization • Behavioural Changes: sleep disturbances, appetite changes, withdrawal, searching, sighing, restlessness, crying

7. Tasks of Grieving • Acknowledgement • Working through the pain • Accommodation • Task reassignment • Day to day • Emotional • Redefinition of self • Resumption of life cycle tasks

8. Factors Influencing the Grief Reaction Circumstances around the death Bereaved’s personal history Grief rxn Expected, Social stigma Personality, Psychiatric illness, Previous losses Relationship with the deceased Strength/security, Ambivalence, Dependency Social Context Supports, Cultural, Religious, SES

9. Grief Counselling

10. Who? • Those who ask • Those who are not coping • Those who you anticipate will have difficulty coping

11. Factors Influencing the Grief Reaction Pathological Grief Predisposition Circumstances around the death Bereaved’s personal history Grief rxn Social stigma, Uncertainty, Multiple losses Psychiatric ds., Previous losses Relationship with the deceased Ambivalence, Dependency Social Context Isolation, drop in SES

12. Principles of Grief Counselling • Self-awareness • Interpretation of the range of normal grief behaviours • Allowance of individual differences • Awareness of the cyclical nature of grief • Awareness of the need for repetition • Identification of pathological grief

13. Assisting with the Tasks of Grief • Acknowledgement of the death/impending death • Language • Discussion of the deceased • Repetition,repetition,repetition,repetition--you get the idea! • Working through the pain • Identification and expression of feelings • Problematic feelings • Anger, guilt, anxiety, helplessness • Accommodation • Role reassignment • Redefinition of self • “Permission” to resume life cycle tasks

14. Questions?