Grief & Loss inAddiction & Recovery    Theory, Personal Awareness,   Grief Reactions, & What Helps
Overview   Why Talk About Grief?   Personal Awareness   Grief Theories   Grief Reactions   What Helps09/28/12        ...
What’s the first thing you think  of when I say the word “grief”?09/28/12     Janice Firn, L.M.S.W., Clinical   3         ...
“Grief”    Loss?                                                        Stages?    Sadness?                            ...
Grief is an…   Emotional   Mental   Social   Spiritual   Physical    …response to loss09/28/12            Janice Firn...
Why talk about Grief?   Change happens!   To live is to experience loss   “Little deaths”   “Change is Inevitable—Grow...
Why do we feel Grief?   Attachment Theory   Types of Attachments          Secure          Avoidant          Anxious  ...
Why talk about Grief?             “Working through our endings               allows us to redefine our               relat...
Personal Awareness of Grief & Loss                                        Perception is Key                              ...
Myths About Grief   Myth: The pain of the loss will go away faster    if you ignore it.   Myth: It’s important to be “be...
Facts About Grief    Fact: Trying to ignore your pain or keep it from     surfacing will only make it worse in the long r...
Kubler-RossThe five stages of grief:1. Denial/Shock: “This can’t be happening to me.”2.     Anger: “Why is this happening?...
Stroebe & Schut    Dual Process Model    Oscillating between a ‘Loss-     oriented’ state and a     ‘Restoration-oriente...
Martin & Doka   Grieving Styles: contrasting patterns of grieving and    mourning   Patterns which are not related solel...
J. William Worden   Physiological healing is needed to bring the    body back into physical health – this type of    heal...
The 4 Tasks of Mourning                      1.      Accept the reality of the                              loss          ...
Accept the Reality   To come full face with the fact that your loss is real    and will not return, i.e. that immediate r...
Experience & Work            Through the Pain It is impossible to lose something or someone you  have been deeply attache...
The New “Normal” Coming to terms with being without (maybe raising children  alone, facing future unemployment or handica...
Moving Forward   To find a place for what was lost that will enable us to remain    connected with them/it but in a way t...
When is Grieving Over? When a person can think of what was lost without      acute pain. When the tasks of mourning have...
Grieving is Necessary!  “Man, when he does       not grieve,    hardly exists.”    - Antonio Porchia09/28/12          Jani...
Normal Grief Reactions                                    Emotional                                    Physical         ...
Grief vs. Depression              Grief is a roller coaster.              Depression is dead end.09/28/12          Janice ...
Tensions for FamiliesHope                                  DespairDenial                                AcceptanceMeaningl...
When Grief Isn’t Healing   Relational Factors   Circumstantial Factors   Historical Factors   Personality Factors   S...
When Grief Isn’t Healing                                 Chronic grief                                 Delayed grief rea...
Grief WORK   Grief therapy: goal is not about forgetting but    remembering with less pain.   Developing adaptive coping...
Getting Support When                   You Are Grieving   Do not grieve alone        Turn to friends and family members ...
Helping Someone who is Grieving                            Listen                            Acknowledge the            ...
“Grief heals when it is received by09/28/12      Janice Firn, L.M.S.W., Clinical   31              Social Worker, UofM Hos...
Resources   J. William Worden, Grief Counseling & Grief Therapy, 2008.   Judith Viorst, Necessary Losses, 2002.   Holme...
Grief and Loss inAddiction and RecoveryMatt Statman, LLMSW, CADCDawn FarmEducation          September  Series             ...
"To spare oneself from grief at allcost can be achieved only at the price of total detachment, whichexcludes the ability t...
o Unresolved grief, loss & trauma often  predate useo Compounded in addictiono Complicated by use
Loss in AddictionoMinimizedoNormalizedoNumb / disassociate
Grief in addictiono Use AOD to copeo Lack healthy supporto Medicate / Avoid / Minimize feelingso Grief not processedo Loss...
Examples of Losses in          Addictiono Experiences and eventso Relationships with family/friendso Parenting timeo Famil...
Losses in moving from addiction to           recovery… “What are you leaving behind?”
Loss of drug (s) …
o Relationship with substance is  primaryo Constant reminders of this loss in  early recoveryo Important loss that can eas...
Loss of self…
o Early onset - identity formed around AOD –  You have to give up who you are to become  who you can beo Addiction forces ...
Loss of rituals etc…
o Loss over rituals “ The lifestyle”o Loss of coping mechanisms and  survival techniqueso Loss of culture of addictiono Lo...
In early recovery peoplebegin to realize that theyhave lost a lot…
Barriers to Grievingo Lack of safety/ trusto Unable to feel / identify feelingso Feelings unfreeze - feel  overwhelmingo S...
Feelings - Early Recoveryo Unable to verbalizeo Lack healthy coping skillso May seek relief through compulsive  behaviors/...
AvoidanceInability or unwillingnessto grieve can be a barrierto recovery/getting well/building relationships
“… If youre an addict on the road to recovery, be prepared to experience emotions in a new way – the good and bad; and be ...
“The best therapy for grief is   time and community.”       -Michael S. Logan
Recovery is a ProcessGrief recovery, like addictionrecovery, is not a linear process
In recovery people acknowledge, understand,and accept losses and move        through grief
o Safe and supportive environmento Communityo Additional support
Some Taskso Develop skills to cope with feelingso Open up, identify and talk about  losseso Learn to identify feelingso Le...
Grief recovery …o Healthy grieving enables the  recovering person to confront and  accept the reality of the loss, and  fi...
“Have You A Sufficient    Substitute?”         AA Page 152
New Rituals
Recovery offers:Opportunity to grieve lostrelationships, heal old ones,build new ones and makemeaning of past by helpingot...
Opportunity to connect / reconnect with one’s spiritual self and to grow spiritually
The Most Satisfying Years ofYour Existence Lie Ahead”           AA Page 152
What About Loved Ones?
“The reaction to loss that is widely experienced by friends and family members of persons who are addicted to mind alterin...
Losses may includeo   Relationshipso   Financial securityo   Hopes and dreamso   Self-esteemo   Emotional support, “presen...
Complicatedo Painful experiences/memorieso Complex feelings (resentment,  anger)o Stigma, secrecy , shameo Loss of contact...
Grief feels lonely for family and friends and circumstances may be especially challenging - but help, support and understa...
Grief recovery is hard work for family and friends too –  but it is worth the effort!
Grief triggers
Being triggered is normal          and OK   Grief recovery, like  addiction recovery, is          ongoing
Triggering Eventso Anniversarieso National tragedieso Others having a similar experienceo Holidayso ___________o _________...
Take Actiono Identify sources of supporto Talk about ito Plan ahead (more meetings, more social  contact, more service wor...
Social supportHelp from community …
o A safe placed to be open about feelings  and experiences, without shameo Step work helps people express grief,  gain per...
Support from  family/friends/others …
Helperso It’s ok / important to just be there  / sit / listeno Avoid trying to fix - It’s ok to say  “This sucks!” or “I a...
Grieverso Let family/friends/coworkers/others  know what you needo Support dissipates over time - continue  to ask for sup...
Spiritual support
o Participation in faith community  activities/ritualso Faith-based support groups or prayer  groupso Prayer, mindfulness,...
Rituals … Grief rituals and ceremonies acknowledge the pain of loss while offering social support and a reaffirmation of l...
Tributes …o Creating a tribute, legacy  or memorial to honor and  remember a loved one  can provide comforto People often ...
Experiential techniques …- experiential therapies (art, writing,  music) engage areas of the brain music) engage areas of ...
Self care …
o Participation in mutual aid groups / social  supporto Nutritiono Exerciseo Adequate rest and sleepo Activities to engage...
Professional Help• Complicated grief may require extra help• Resources are available
Barb SmithAuthor of “Brent’s World”
Grief and Loss in Addiction and Recovery - September 2012
Upcoming SlideShare
Loading in …5
×

Grief and Loss in Addiction and Recovery - September 2012

13,270 views

Published on

“Grief and Loss in Addiction and Recovery” was presented on September 25, 2012; by Janice Firn, LMSW, Clinical Social Worker, University of Michigan Hospital; Matthew Statman, LLMSW, CADC, Dawn Farm therapist and Education Series Coordinator; and Barb Smith, author of “Brent’s World” (http://compassionhearts.com.) The culture of addiction is rife with experiences of grief and loss for the person with addiction and for family and friends. The nature of these experiences combined with the stigma, shame and general lack of understanding of addiction can make grief and loss associated with addiction exceptionally lonely and difficult to heal from. This program will describe Worden's and Kubler-Ross' theories of grief and grief recovery, losses that the chemically dependent individual and his/her family experience throughout the addiction and recovery processes, and how recovery program tools can help individuals cope with grief and loss. It will include a personal account of addiction-related grief, loss and recovery from a mother who lost her son to addiction-related causes. This program is part of the Dawn Farm Education Series, a FREE, annual workshop series developed to provide accurate, helpful, hopeful, practical, current information about chemical dependency, recovery, family and related issues. The Education Series is organized by Dawn Farm, a non-profit community of programs providing a continuum of chemical dependency services. For information, please see http://www.dawnfarm.org/programs/education-series.

0 Comments
22 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
13,270
On SlideShare
0
From Embeds
0
Number of Embeds
4,430
Actions
Shares
0
Downloads
347
Comments
0
Likes
22
Embeds 0
No embeds

No notes for slide
  • It is how we integrate the losses we experience into our lives, how we adapt to the changes that move us forward into new definitions of ourselves, growth happens from living through the loss and redefining ourselves. Any time there is a change a loss is experienced whether one realizes it or not.
  • Attachment theory describes the dynamics of long-term relationships between humans. Attachments to people, animals, things, rituals, etc. The more avoidant, anxious, or ambivalent the relationship the more complex and conflicted the grief reaction
  • The goal of grief work is to more fully engage in life and to be open to the future.
  • No relationship is like another. How a loss impacts us will depend on the unique relationship we had with what is lost. If one perceives the loss as important or life altering than that is what it is. Additionally, the impact of the loss can be magnified by the number of losses experienced over time, our reserve for coping with the loss can be depleted if there are too many within a short time period. Life Events Scale Handout
  • Dual processing model addresses the balance between focusing on feelings and focusing on the practical tasks that move you through loss
  • The type of loss, the situation surrounding the loss, your personality, and the characteristics of the unique relationship with what was lost/how significant the loss is to you, etc. will all impact how grief looks and how long it lasts. For very significant losses the grief may never go away altogether, it may ease for a while only to resurface at key anniversaries or holidays.
  • Kubler-Ross has said that these are not linear and do not have to be completed in order, one can vacillate between them over time. Often immediately after a loss feelings of denial/shock and depression can surface, over time as denial and shock wear off, acceptance grows. Maciejewski, Zhang, Block, Prigerson, “An Empirical Examination of the Stage Theory of Grief”, JAMA, January 11, 2010
  • his model identifies two types of stressors, loss- and restoration-oriented, and a dynamic, regulatory coping process of oscillation, whereby the grieving individual at times confronts, at other times avoids, the different tasks of grieving. This model proposes that adaptive coping is composed of confrontation--avoidance of loss and restoration stressors. It also argues the need for dosage of grieving, that is, the need to take respite from dealing with either of these stressors, as an integral part of adaptive coping.
  • Men Don’t Cry . . . Women Do: Transcending Gender Stereotypes of Grief , by Martin and Doka
  • Just like after an injury heals we sometimes are reminded of the old injury so too with grief. The would gets better, the grief heals but sometimes there is a twinge. Tasks implies WORK
  • “ let it be Tuesday” syndrome Substance use can prevent someone from working through this task, prevents one from having to face reality.
  • Substance abuse numbs the pain and prevents someone from working through this task. Recovery can be a time of facing a number of losses, providing a safe, supportive place to allow you to feel your feelings and work through the pain of the loss – it seems an impossible task but it can be done.
  • Recovery helps to build new coping skills and to redefine who you are so that you can engage the world differently. Recovery helps you see yourself and the world differently.
  • Working through recovery allows us to be at peace with the past, to be vulnerable to life in a health way, to form new attachments, to forgive and to ask forgiveness.
  • Is it ever really over? No. It does get easier though.
  • The type of life we live depends on how we work through our grieving. Good grieving engages us more fully into life.
  • Grieving is an Emotional, Mental, Social, Spiritual, and Physical response to a loss. Behavioral – crying, listlessness, sleeplessness, sleepiness Spiritual – wondering about meaning and purpose Emotional – shock, sadness, anger, relief, release, guilt Physical – numbness, empty feeling, tight chest, shortness of breath Cognitive – reviewing what occurred, thinking about what was lost
  • Grief: the way I am feeling makes sense in light of what happened, these losses are the source for what I am going through, others have validated my losses. I am distracted easily, I wish I looked better – sometimes I feel better than I look, sometimes I look better than I feel. Some people have avoided me or been insensitive since the loss. At times I prefer to be alone and it’s an effort to do things. I am more aware of the fragility of life as a result of what has happened. It’s hard to concentrate but I can if I have to, I’m often preoccupied by thoughts of what I have lost. My heart feels broken. I am very angry, then I am very sad. I yearn to love again. At times I forget and am happy, then I remember again. I pray for strength to get through this. Sometimes I lose sight of my faith but I am sustained by other’s belief in me. I feel comforted when I am with sympathetic people. Depression: I don’t understand why I feel like this. Nothing makes sense. I am preoccupied and lose days or weeks. I don’t care how I look. I am worthless and to blame for this situation. I don’t cry, don’t feel sad. I feel nothing. I have no energy. I am always in a fog. I don’t care about my health. My life is hopeless. I am a broken person. I can find no comfort. I don’t care what happens. I can’t snap out of it. Other’s don’t care. I have nothing to live for.
  • As we navigate the changes we experience and the sense of loss we have about those changes we move along a continuum, from chaos after the change/loss occurs to a new “normal” or homeostasis. Letting go of what was and accepting what coming into being.
  • Relationship – if the attachment was complicated or ambivalent then the loss will be more difficult to work through Circumstantial – if the circumstances are not know, suicide, death related to substance use Historical – if you have experienced a number of losses over time or the current loss reminds you of a previous loss Personality – some of us have a greater capacity than others for intense emotions Social – some of us have more extensive support systems, less support is more difficult
  • Chronic – sometimes when one loss happens after another we do not have time to recover or heal before the next occurs, makes healing harder (ex bone keeps being broken before it has time to heal) Delayed – because of circumstances or personal factors we are not able to experience or work through the loss at the time it occurred, bottling it up and putting it aside for later can complicate our ability to work through it (ex wound has scab over it, hides the infection but it’s still infected) Avoiding – pretending that the loss did not occur, distracting ourselves from grieving, filling the hole left by what was lost in order to avoid the pain (ex pretending the wound doesn’t exist, child’s peek-a-boo game: if I cover my eyes you’re not there).
  • We are not meant to grieve alone.
  • Grief and Loss in Addiction and Recovery - September 2012

    1. 1. Grief & Loss inAddiction & Recovery Theory, Personal Awareness, Grief Reactions, & What Helps
    2. 2. Overview Why Talk About Grief? Personal Awareness Grief Theories Grief Reactions What Helps09/28/12 Janice Firn, L.M.S.W., Clinical 2 Social Worker, UofM Hospital
    3. 3. What’s the first thing you think of when I say the word “grief”?09/28/12 Janice Firn, L.M.S.W., Clinical 3 Social Worker, UofM Hospital
    4. 4. “Grief” Loss?  Stages? Sadness?  Tasks? Separation?  Symptoms? Anguish?  Adaptive? Change?  Normal? Ache?  Complicated? Hurt?  Pathological?09/28/12 Janice Firn, L.M.S.W., Clinical 4 Social Worker, UofM Hospital
    5. 5. Grief is an… Emotional Mental Social Spiritual Physical …response to loss09/28/12 Janice Firn, L.M.S.W., Clinical 5 Social Worker, UofM Hospital
    6. 6. Why talk about Grief? Change happens! To live is to experience loss “Little deaths” “Change is Inevitable—Growth is Optional.” - Walt Disney09/28/12 Janice Firn, L.M.S.W., Clinical 6 Social Worker, UofM Hospital
    7. 7. Why do we feel Grief? Attachment Theory Types of Attachments  Secure  Avoidant  Anxious  Ambivalent09/28/12 Janice Firn, L.M.S.W., Clinical 7 Social Worker, UofM Hospital
    8. 8. Why talk about Grief? “Working through our endings allows us to redefine our relationships, to surrender what is dead and to accept what is alive, and to be in the world more fully to face the new situation. - Stanley Keleman (from Living Your Dying)09/28/12 Janice Firn, L.M.S.W., Clinical 8 Social Worker, UofM Hospital
    9. 9. Personal Awareness of Grief & Loss  Perception is Key  Individual Response  Frequency of Exposure09/28/12 Janice Firn, L.M.S.W., Clinical 9 Social Worker, UofM Hospital
    10. 10. Myths About Grief Myth: The pain of the loss will go away faster if you ignore it. Myth: It’s important to be “be strong” in the face of loss. Myth: If you don’t cry, it means you aren’t sorry about the loss. Myth: Grief should last about a year.09/28/12 Janice Firn, L.M.S.W., Clinical 10 Social Worker, UofM Hospital
    11. 11. Facts About Grief Fact: Trying to ignore your pain or keep it from surfacing will only make it worse in the long run. Fact: Feeling sad, frightened, or lonely is a normal reaction to loss. Showing your true feelings can help you and others deal with the grief. Fact: Crying is a normal response to sadness, but it’s not the only one. Fact: There is no right or wrong time frame for grieving. 09/28/12 Janice Firn, L.M.S.W., Clinical 11 Social Worker, UofM Hospital
    12. 12. Kubler-RossThe five stages of grief:1. Denial/Shock: “This can’t be happening to me.”2. Anger: “Why is this happening? Who is to blame? What should have been done differently…”3. Bargaining: “Make this not happen, and in return I will ____.”4. Depression: “I’m too sad to do anything.”5. Acceptance: “I’m able to exist with what happened.”09/28/12 Janice Firn, L.M.S.W., Clinical 12 Social Worker, UofM Hospital
    13. 13. Stroebe & Schut Dual Process Model Oscillating between a ‘Loss- oriented’ state and a ‘Restoration-oriented’ state Loss-oriented: more emotional work of grief Restoration-oriented: more task-focused grief work Adaptive denial and distraction from the emotional work of grief 09/28/12 Janice Firn, L.M.S.W., Clinical 13 Social Worker, UofM Hospital
    14. 14. Martin & Doka Grieving Styles: contrasting patterns of grieving and mourning Patterns which are not related solely to gender, but to ‘style’ of mourning  Intuitive – emphasizing the experiencing and expression of emotion  Instrumental – focuses on practical matters and problem solving These contrasting styles are poles on a spectrum or continuum Related more to socialization and personality types than to gender09/28/12 Janice Firn, L.M.S.W., Clinical 14 Social Worker, UofM Hospital
    15. 15. J. William Worden Physiological healing is needed to bring the body back into physical health – this type of healing takes time. Similarly, after a loss it takes time to return to an emotional state of well-being. The 4 tasks of mourning are an essential part of the healing process. No specific order, but still must be worked through during the time of grieving.09/28/12 Janice Firn, L.M.S.W., Clinical 15 Social Worker, UofM Hospital
    16. 16. The 4 Tasks of Mourning 1. Accept the reality of the loss 2. Experience and work through the pain of grief 3. Adjust to the new “normal”; life without what was lost 4. Emotionally relocate the loss and move forward in life09/28/12 Janice Firn, L.M.S.W., Clinical 16 Social Worker, UofM Hospital
    17. 17. Accept the Reality To come full face with the fact that your loss is real and will not return, i.e. that immediate reunion or regaining it is impossible. Obstacles: Denying the facts of loss. Denying the meaning of the loss, e.g. “It wasn’t a good job anyway”, or “I don’t miss him,” or “I’m just as healthy as I ever was.” Minimizing the loss. “It’s not that big of a deal.”09/28/12 Janice Firn, L.M.S.W., Clinical 17 Social Worker, UofM Hospital
    18. 18. Experience & Work Through the Pain It is impossible to lose something or someone you have been deeply attached to without experiencing some level of pain. Obstacles:  Not allowing yourself to feel.  Cutting off your feelings and denying that pain is present.  Avoiding reminders of the loss – e.g., trying to find a ‘geographic cure’ by moving to another location, or travelling09/28/12 Janice Firn, L.M.S.W., Clinical 18 Social Worker, UofM Hospital
    19. 19. The New “Normal” Coming to terms with being without (maybe raising children alone, facing future unemployment or handicap, redefinition of self, etc.). A. External Adjustments : how the loss affects your everyday functioning in the world B. Internal Adjustments: how the loss affects your sense of self C. Spiritual Adjustments: how the loss affects your beliefs, values and assumptions about the world Obstacles:  Promoting your own helplessness.  Not developing the skills you need to cope or to function in new roles.  Withdrawing from the world. Refusing to see yourself or the world differently. 09/28/12 Janice Firn, L.M.S.W., Clinical 19 Social Worker, UofM Hospital
    20. 20. Moving Forward To find a place for what was lost that will enable us to remain connected with them/it but in a way that will not keep us from going on with life. Obstacles:  Withdrawal from others and life. Unwillingness to love.  Unwillingness to risk; making a vow to never invest yourself again.  Holding on so tight to the past that you’re unable to form new relationships or develop new skills.09/28/12 Janice Firn, L.M.S.W., Clinical 20 Social Worker, UofM Hospital
    21. 21. When is Grieving Over? When a person can think of what was lost without acute pain. When the tasks of mourning have been accomplished. When one can think of the what was lost without physical manifestations such as crying or feeling tightness in the chest. When one can reinvest his/her emotions into life and the living. When one can regain an interest in life, feel more hopeful, experience gratification again, and adapt to new roles. Is there a time limit? 1 year? 4 seasons? 2 years? It depends.09/28/12 Janice Firn, L.M.S.W., Clinical 21 Social Worker, UofM Hospital
    22. 22. Grieving is Necessary! “Man, when he does not grieve, hardly exists.” - Antonio Porchia09/28/12 Janice Firn, L.M.S.W., Clinical 22 Social Worker, UofM Hospital
    23. 23. Normal Grief Reactions  Emotional  Physical  Cognitive  Behavioral  Spiritual09/28/12 Janice Firn, L.M.S.W., Clinical 23 Social Worker, UofM Hospital
    24. 24. Grief vs. Depression Grief is a roller coaster. Depression is dead end.09/28/12 Janice Firn, L.M.S.W., Clinical 24 Social Worker, UofM Hospital
    25. 25. Tensions for FamiliesHope DespairDenial AcceptanceMeaninglessness MeaningfulnessIndependence Accepting InterdependenceAmbiguity Certainty of OutcomeMaking Plans Experiencing EmotionsHolding On Letting GoSpeaking Openly Not TalkingFamily as it Was Family as it is Becoming 09/28/12 Janice Firn, L.M.S.W., Clinical 25 Social Worker, UofM Hospital
    26. 26. When Grief Isn’t Healing Relational Factors Circumstantial Factors Historical Factors Personality Factors Social Factors09/28/12 Janice Firn, L.M.S.W., Clinical 26 Social Worker, UofM Hospital
    27. 27. When Grief Isn’t Healing  Chronic grief  Delayed grief reactions  Avoiding grieving09/28/12 Janice Firn, L.M.S.W., Clinical 27 Social Worker, UofM Hospital
    28. 28. Grief WORK Grief therapy: goal is not about forgetting but remembering with less pain. Developing adaptive coping mechanisms. Finding meaning. AA and Al-Anon, NA and Nar-Anon = grief work09/28/12 Janice Firn, L.M.S.W., Clinical 28 Social Worker, UofM Hospital
    29. 29. Getting Support When You Are Grieving Do not grieve alone  Turn to friends and family members  Join a support group  Talk to a therapist or grief counselor Face your feelings Express your feelings in a tangible or creative way. Look after your physical health. Plan ahead for grief “triggers”. 09/28/12 Janice Firn, L.M.S.W., Clinical 29 Social Worker, UofM Hospital
    30. 30. Helping Someone who is Grieving  Listen  Acknowledge the uniqueness of grief  Offer practical help  Make contact, write a personal note  Be aware of holidays and anniversaries09/28/12 Janice Firn, L.M.S.W., Clinical 30 Social Worker, UofM Hospital
    31. 31. “Grief heals when it is received by09/28/12 Janice Firn, L.M.S.W., Clinical 31 Social Worker, UofM Hospital
    32. 32. Resources J. William Worden, Grief Counseling & Grief Therapy, 2008. Judith Viorst, Necessary Losses, 2002. Holmes-Rahe Social Readjustment Rating Scale. Journal of Psychosomatic Research, (1967). Vol. 11, pp. 213-218. Lynn, J. and Harrold, J. (1999). Handbook for Mortals: Guidance for People Facing Serious Illness, p.41. Al-Anon Dist. 5, http://www.hvcn.org/info/afg5/griefloss.htm HelpGuide.org, http://71.6.131.182/mental/grief_loss.htm Dennis C. Daley & G. Alan Marlatt, Overcoming your Alcohol or Drug Problem, 2006. Wolfet, A. (2009). The Handbook for Companioning the Mourner. Companion Press: Colorado. Abbot, A., Alcohol, Tobacco, and Other Drugs. NASW, 2010. http://www.hospicenet.org Maciejewski, Zhang, Block, Prigerson, (2010) “An Empirical Examination of the Stage Theory of Grief”, JAMA Stroebe, M., & Schut, H., (1999). The dual process model of coping with bereavement: rationale and description. Death Studies,197-224. Doka, K., & Martin, T. (1999). Men Dont Cry, Women Do: Transcending Gender Stereotypes of Grief.09/28/12 Janice Firn, L.M.S.W., Clinical 32 Social Worker, UofM Hospital
    33. 33. Grief and Loss inAddiction and RecoveryMatt Statman, LLMSW, CADCDawn FarmEducation September Series 2012
    34. 34. "To spare oneself from grief at allcost can be achieved only at the price of total detachment, whichexcludes the ability to experience happiness." Dr. Erich Fromm
    35. 35. o Unresolved grief, loss & trauma often predate useo Compounded in addictiono Complicated by use
    36. 36. Loss in AddictionoMinimizedoNormalizedoNumb / disassociate
    37. 37. Grief in addictiono Use AOD to copeo Lack healthy supporto Medicate / Avoid / Minimize feelingso Grief not processedo Losses not fully grieved
    38. 38. Examples of Losses in Addictiono Experiences and eventso Relationships with family/friendso Parenting timeo Family milestoneso Deathso Timeo Opportunitieso Perinatalo Spiritual
    39. 39. Losses in moving from addiction to recovery… “What are you leaving behind?”
    40. 40. Loss of drug (s) …
    41. 41. o Relationship with substance is primaryo Constant reminders of this loss in early recoveryo Important loss that can easily be minimized
    42. 42. Loss of self…
    43. 43. o Early onset - identity formed around AOD – You have to give up who you are to become who you can beo Addiction forces people to live outside their values - guilt and shameo Loss of hopes, plans, aspirations and dreamso Loss of innocence, dignity, self-esteem, choice, control of one’s body
    44. 44. Loss of rituals etc…
    45. 45. o Loss over rituals “ The lifestyle”o Loss of coping mechanisms and survival techniqueso Loss of culture of addictiono Loss of using friends / relativeso Etc…
    46. 46. In early recovery peoplebegin to realize that theyhave lost a lot…
    47. 47. Barriers to Grievingo Lack of safety/ trusto Unable to feel / identify feelingso Feelings unfreeze - feel overwhelmingo Seemingly unrelated feelings may arise (anger, depression, anxiety)o Complicated by guilt/shame/ stigma/ trauma
    48. 48. Feelings - Early Recoveryo Unable to verbalizeo Lack healthy coping skillso May seek relief through compulsive behaviors/ other addictions / relapse
    49. 49. AvoidanceInability or unwillingnessto grieve can be a barrierto recovery/getting well/building relationships
    50. 50. “… If youre an addict on the road to recovery, be prepared to experience emotions in a new way – the good and bad; and be sure to have a plan in place to fight off the cravings while youre in that vulnerable state.”–Michael Bloch
    51. 51. “The best therapy for grief is time and community.” -Michael S. Logan
    52. 52. Recovery is a ProcessGrief recovery, like addictionrecovery, is not a linear process
    53. 53. In recovery people acknowledge, understand,and accept losses and move through grief
    54. 54. o Safe and supportive environmento Communityo Additional support
    55. 55. Some Taskso Develop skills to cope with feelingso Open up, identify and talk about losseso Learn to identify feelingso Learn to verbalize feelingso Learn to tolerate “negative” feelings
    56. 56. Grief recovery …o Healthy grieving enables the recovering person to confront and accept the reality of the loss, and find purpose and meaning for lifeo Losses are eventually remembered with less pain. Things will get better
    57. 57. “Have You A Sufficient Substitute?” AA Page 152
    58. 58. New Rituals
    59. 59. Recovery offers:Opportunity to grieve lostrelationships, heal old ones,build new ones and makemeaning of past by helpingothers .
    60. 60. Opportunity to connect / reconnect with one’s spiritual self and to grow spiritually
    61. 61. The Most Satisfying Years ofYour Existence Lie Ahead” AA Page 152
    62. 62. What About Loved Ones?
    63. 63. “The reaction to loss that is widely experienced by friends and family members of persons who are addicted to mind altering substances is profound grief. It has characteristics of flawed interactional patterns because the loss is ambiguous. If a person dies, the grief is unambiguous: the social role the deceased played is no longer occupied and the deceased cannot fulfill obligations or promises. The spouse who becomes addicted to mind altering substances often ceases to fulfill obligations or promises, but physically the social role is still occupied.”-Vicki Loyer-Carlson, Ph.D., LMFT
    64. 64. Losses may includeo Relationshipso Financial securityo Hopes and dreamso Self-esteemo Emotional support, “presence”o Other important tangible and intangible things
    65. 65. Complicatedo Painful experiences/memorieso Complex feelings (resentment, anger)o Stigma, secrecy , shameo Loss of contact by choiceo Incarcerationo Death
    66. 66. Grief feels lonely for family and friends and circumstances may be especially challenging - but help, support and understanding is available, and healing is possible
    67. 67. Grief recovery is hard work for family and friends too – but it is worth the effort!
    68. 68. Grief triggers
    69. 69. Being triggered is normal and OK Grief recovery, like addiction recovery, is ongoing
    70. 70. Triggering Eventso Anniversarieso National tragedieso Others having a similar experienceo Holidayso ___________o ___________o ___________
    71. 71. Take Actiono Identify sources of supporto Talk about ito Plan ahead (more meetings, more social contact, more service work, more spiritual practice etc…)
    72. 72. Social supportHelp from community …
    73. 73. o A safe placed to be open about feelings and experiences, without shameo Step work helps people express grief, gain perspective and acceptance, forgive and move on with their liveso Provides opportunities to give back to others and make meaningo Peer grief support groups can be helpful
    74. 74. Support from family/friends/others …
    75. 75. Helperso It’s ok / important to just be there / sit / listeno Avoid trying to fix - It’s ok to say “This sucks!” or “I am so sorry!”o If it is out of your league refer to professionals
    76. 76. Grieverso Let family/friends/coworkers/others know what you needo Support dissipates over time - continue to ask for supporto If family/friends are unavailable or unsupportive (including well-intentioned but misguided efforts to be supportive) –seek support elsewhere
    77. 77. Spiritual support
    78. 78. o Participation in faith community activities/ritualso Faith-based support groups or prayer groupso Prayer, mindfulness, meditationo One’s chosen spiritual practices and rituals
    79. 79. Rituals … Grief rituals and ceremonies acknowledge the pain of loss while offering social support and a reaffirmation of life …
    80. 80. Tributes …o Creating a tribute, legacy or memorial to honor and remember a loved one can provide comforto People often find comfort in donating to a related cause and/or becoming involved in volunteer or service work, or other ways of helping others
    81. 81. Experiential techniques …- experiential therapies (art, writing, music) engage areas of the brain music) engage areas of the brain involved in grief, memory, healing, recovery
    82. 82. Self care …
    83. 83. o Participation in mutual aid groups / social supporto Nutritiono Exerciseo Adequate rest and sleepo Activities to engage in that help with healing and regaining a feeling of purposeo Internet resourceso Literature
    84. 84. Professional Help• Complicated grief may require extra help• Resources are available
    85. 85. Barb SmithAuthor of “Brent’s World”

    ×