(c) Copyright Community TrainingAustralia 2011Strategies for assisting thosesuffering from a loss(unit CHCCS426A)Learning aboutGrief and Loss
(c) Copyright Community TrainingAustralia 2011OverviewGrief experiencesStrategies to support normal griefGrief and personal growthExercises to relieve grievers distressComplicated griefCommunity support structures
(c) Copyright Community TrainingAustralia 2011Onwards andUpwards….Impossible words whenyou are struck with a majorloss in your life.It‟s the last thing you feel likedoing, and the energyrequired for even thinkinglike this let alone the doingcan be overwhelming.
(c) Copyright Community TrainingAustralia 2011The Grief ExperienceMany people have tried to describe andunderstand what happens to people whenthey lose someone or something of greatvalue to them in their life. Grief is anexperience that we all know in varyingdegrees and will know over a lifetime.
(c) Copyright Community TrainingAustralia 2011What are some of thethings we can lose in life?Family through separation and divorceFriendsGirlfriends and boyfriendsLocationsPrecious possessionsHopesHealthPeople through death
(c) Copyright Community TrainingAustralia 2011What does grief feellike?Body sensations?Feelings?Thinking?Behaviour?
(c) Copyright Community TrainingAustralia 2011What are some of the bodysensations that may accompanyloss.Stomach upsetHeadachesDizzinessTirednessPalpitationsNauseaAgitationTingles
(c) Copyright Community TrainingAustralia 2011What are some of the feelingswhich may accompany loss?SadnessShockAngerInsecurityReliefDepressionLoneliness etc.
(c) Copyright Community TrainingAustralia 2011What are some of the thoughtsthat may accompany a loss?It‟s my fault.It‟s not fair.I can‟t go on.I have beenabandoned.Life sucks.There is no God.This alwayshappens to me.
(c) Copyright Community TrainingAustralia 2011Grief reactions areindividual and dependupon;Personality factorsPrevious family history– in reacting to lossPrevious losses,multiple lossesShockOther complicatingfactors
(c) Copyright Community TrainingAustralia 2011People have theories aboutthe stages or ways people gothrough a lossKubler Ross – stages theoryWilliam Worden – task theoryMargaret Stroebe and Henk Schut(1999)- Dual process model
(c) Copyright Community TrainingAustralia 2011Loss ExperienceWhat is clear from any model is that after theshock, people tend to walk around in denialfor a bit before the reality hits and deep griefenvelopes them.
(c) Copyright Community TrainingAustralia 2011The Dark TimesThis dark period of time feels like it will neverend, and all desire for it to end sometimesleaves as well.“There isa place sodark, thatyou can’tsee theend”.
(c) Copyright Community TrainingAustralia 2011GuiltWhen people lose apartner or child orsomeone close throughdeath, they may even feelguilty about having dayswhen they feel good orhappy. They are fearfulthat to be happy meansthat the person they havelost didn‟t count much, orthey don‟t care anymore.
(c) Copyright Community TrainingAustralia 2011Sometimes a “guilt trip”is put on someone byothers.Children can be especially vulnerable to this.Kids move in and out of sad feelings andcannot „stay‟ in depression for long periods oftime. It‟s God‟s design and not their fault.
(c) Copyright Community TrainingAustralia 2011Trying to get out of the „pit ofdespair‟.At other times peopleare desperate to feelnormal again and try tohasten its arrival byfeigning normality.“I‟m alright, yes,managing fine, thankyou”.At night time the pain ofthe façade catches up.
(c) Copyright Community TrainingAustralia 2011Trying to „be strong forothers‟.Many of us feelresponsible for youngchildren or other peoplewe consider to be morevulnerable thanourselves. We cansometimes put on abrave face in order to„be strong for others‟.Inside we may becrumbling.
(c) Copyright Community TrainingAustralia 2011Strategies to supportothers in grief.1. Education – theframework.2. Letting go, sayinggoodbye… in ceremony.3. Keeping connected in anew way. Questioningtechniques.4. Micro-losses as a way tobuild a future.5. Support search.6. Introduce new supports.7. Check for complications.
(c) Copyright Community TrainingAustralia 20111. Education – theframework.Providing a framework for someonewho is grieving is helpful. In the middleof intense pain and misery tounderstand that the process has beenlived through by others and what toexpect can give an individual bearings.
(c) Copyright Community TrainingAustralia 2011A feminine frameworkElizabeth Kubler-Ross observed grief inher patients and in their families. Shesaw grief as a journey which hadstages. She felt that the griever waspulled by an invisible thread through thedarkness of loss towards the light. This„trusting‟ framework will be very helpfulfor some individuals.
(c) Copyright Community TrainingAustralia 2011Stages theoryThe stages she observed were:Stage 1: Shock and denialStage 2: Anger/bargainingStage 3: Depression and detachmentStage 4: DialogueStage 5: AcceptanceElisabeth Kubler Ross - On Death and Dying1969
(c) Copyright Community TrainingAustralia 2011A fluid movement.Her theory was not rigidhowever…it was understoodthat in moving forward attimes people will movebackwards and forwards, forexample between anger anddepression, but willeventually come out the otherside.
(c) Copyright Community TrainingAustralia 2011A male frameworkWilliam Worden had a task theory ofgrief. He felt it was something thatpeople had to „do‟. This „power‟ modelwhich emphasises the need for actionwill assist some individuals as they feelmore relaxed when they know theexperience as something that they cancontrol.
(c) Copyright Community TrainingAustralia 2011The Task TheoryTo accept the reality of the lossTo experience the pain of griefTo adjust to an environment in whichthe significant person is no longerpresentTo reinvest emotional energyJ.W. Worden, Grief Counselling and GriefTherapy 1982, pp 11-16
Dual Process ModelMargaret Stroebe and Henk Schut(1999)This recent model of grief and lossmaintains that both grieving andavoiding grief are necessary for asuccessful resolution and pragmaticcoping with a loss.(c) Copyright Community TrainingAustralia 2011
Dual ProcessActive confrontation with loss may not be necessary for a positiveoutcome. There may be times when denial and avoidance of remindersare essential. Most individuals can expect to experience ongoingoscillation between a loss orientation (coping with loss through griefwork, dealing with denial, and avoiding changes) and a restorationorientation (adjusting to the many changes triggered by loss, changingroutines, and taking time off from grief). This reflects a movementbetween coping with loss and moving forward, but the extent to whichone needs either of these dimensions differs for each individual.Read more: Loss Grief and Bereavement - Coping With Loss - Theory,Family, History, Development, Family, Emphasis, Individual, Model,Grieving, and Illness http://family.jrank.org/pages/750/Grief-Loss-Bereavement-Coping-with-Loss.html#ixzz1Iq7pcS00(c) Copyright Community TrainingAustralia 2011
(c) Copyright Community TrainingAustralia 2011A framework forchildrenSeasons of the year.Autumn – losing leaves….losing someoneWinter – cold and dark….feeling sadSpring – new little buds coming….feelinghope, knowing change is happeningSummer – lovely colours, sunshining….feeling happy again
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(c) Copyright Community TrainingAustralia 2011Visual symbols arehelpful for everyone….Children need concrete tools tounderstand concepts that are new tothem and which they can‟t directlyexperience in the present.The caterpillar/butterfly is also a greatanalogy for children – but adults get it too!
The Broken Leg analogyA broken leg once set can heal beautifully.However if it is broken and not set in the rightfashion it can get infected or heal in a warpedmanner and a limp may result and at worstdeath can happen.Grief needs padding and support, cleaning ofthe wound and time to heal without too muchpressure – just like a broken leg!(c) Copyright Community TrainingAustralia 2011
(c) Copyright Community TrainingAustralia 20112. Letting go, sayinggoodbye… in ceremony.Since the beginning of time humanshave used ceremonies and symbolismto help make sense of and work throughmajor life events. The funeral ceremonyis a way that we say goodbye and havea marker for our memories. Butceremonies can be encouraged to bepersonal things for various losses.
(c) Copyright Community TrainingAustralia 2011Saying Goodbye.Building a garden bed or gazeboGoing for a walk on the beach and throwing abottle out with a message.Letting doves or balloons freeWriting a poem or letterEven divorcees are having goodbye parties likea „wake‟.Encourage people to „say goodbye‟ as manytimes as they need it in their own unique ways.Saying goodbye to a body part and thanking itfor the work it has done and promising never toforget it….can be amazingly freeing.
(c) Copyright Community TrainingAustralia 20113. Keeping connected ina new way. Questioningtechniques.Losing someone or something preciousdoesn‟t mean we have to cut them off….Encourage people to find ways of stayingconnected…When you think about „George‟ where doyou like to imagine he is right now?When do you feel closest to George…whatare you doing when the pain eases?Having a memory album that you gothrough can be helpful.
(c) Copyright Community TrainingAustralia 20114. Micro-losses as a wayto build a future.Finding out all the things someone haslost when they lost a loved one orsomething special to them is validatingand can give clues to the helper.When you lost Katie what else did youlose Joe?I lost, my best friend, my confidant, myhouse cleaner, my cook, my budgeter,my social planner, my lover, mycuddler.
(c) Copyright Community TrainingAustralia 2011See what can bedone about some ofthe micro-losses…“Well Joe we can never replace Katie, shewas so wonderful, but I am wondering aboutthat cuddling…I have a friend who has a newpuppy that needs a home, I think he will lickyou to death…or… I have heard that fulllength body pillows can really help someonefeel comforted at night when they feel alonein the bed and they miss their partner. Can Ifind out where you can get one of those foryou?”
(c) Copyright Community TrainingAustralia 20115. Supportsearch.Who or what is out there to help you?Who has offered support?What do you know about supports in thecommunity right now?By questioning you are reminding a person oftheir need for support and checking their ownresources and knowledge.
(c) Copyright Community TrainingAustralia 20116. Introduce newsupportsAs a worker wanting to supportsomeone through grief…get to knowall the community supports availableso that you can suggest otheralternatives if the individual isn‟taware of supports.Grief and loss libraries, groupprograms, grief counsellors, griefbuddies, associations, web sites etc.
(c) Copyright Community TrainingAustralia 2011Seasons for GrowthThis program is a four week program to helppeople who have had a loss in their life. It willgive you the skills to cope and share withothers who have been in a similar situation.Many teenagers, children and adults have beenhelped with the Seasons for Growth Program.If you feel you or someone you know wouldbenefit, go to the Good Grief Website and findout more. www.goodgrief.org.au
(c) Copyright Community TrainingAustralia 20117. Check forcomplications.Sometimes people have reallyunpleasant things which accompanytheir loss which can infect the wound ofgrief and make it really hard toheal….check for these complicatingfactors…6 complications are presented later….
(c) Copyright Community TrainingAustralia 2011Grief and personalgrowth
(c) Copyright Community TrainingAustralia 2011How can we help ourselvesfeel better?1. Be real about how you feel.Express it.Even if you have no one you can tell,write down your thoughts, even yourworst ones or speak these out loudon a beach. Tell God if you believe inhim.Better than this find a trusted friendor confidant that you can be real with.If you don‟t have anyone you can behonest with, seek out a counsellor.
(c) Copyright Community TrainingAustralia 2011Steps forward….2. Don’t feel that you have to ‘cut off’ the past.When people do this it tends to make the healing process alot longer.You are who you are because of the past, the preciouspeople in your life and all of your experiences both good andbad. To „cut it off‟ is to cut off part of yourself. It will makeyou feel empty.Instead…face the pain of talking about the person orsituation you have lost. This pain will lessen as a result.
(c) Copyright Community TrainingAustralia 2011Steps forward3. Keep a balance in your thought life.While at the beginning of a loss we will be consumedwith past events – we will want to stay close in ourthoughts to the person or situation we have lost (thisis only natural), over time try to concentrate on themoment you are in and plan a little for the future.
(c) Copyright Community TrainingAustralia 2011Steps forward4. Watch guilt or blame…get rid of it (its like acancer that grows and consumes)When life lets you down, its easy to blame people, God oryourself. This is a natural stage and provides „some‟ relieffor a time. But be careful of vows…‟I will never forgivethem‟, „I will never forgive myself‟, even „no-oneunderstands‟ is a form of blame of others, and „If there is aGod, He‟s either making a lot of mistakes or is obviouslydisinterested!‟
(c) Copyright Community TrainingAustralia 2011Steps forward5. Be sensible with self careMake sure you eat well, get lots of sunlight, walk alot, keep routine sleep, reduce workload and laugh asmuch as you can. The „looking after yourself‟ bodysoul and spirit is really important.
(c) Copyright Community TrainingAustralia 2011Steps forward6. Drug UseWhen you experience a loss it is better to find natural waysto cope rather than use medication. Sometimes in extremecircumstances doctors do prescribe drugs for thedepression or sleeplessness than can occur in grief.It is really important to stay clear of alcohol or other nonprescribed drugs if you are in grief. Individuals in grief arethe most at risk with going too far with these things becausethey are trying to numb emotional pain. This is of course farmore dangerous than carefully prescribed medication whenlegitimately in need.
(c) Copyright Community TrainingAustralia 2011Steps forward7. Find friendships and supportThe friends you make in grief are incredibly special.They may be completely different from your normalfriends.Get out and get involved with new aspects of life.Even if you don‟t feel like it, take baby steps forward.
(c) Copyright Community TrainingAustralia 2011A step UP…1. Grief can become a time ofspiritual awakening.Many people find their limitations througha significant loss. They can no longer dowhat they once did, or protect themselvesin the same way. They will often say theyhave found a „higher power‟ when all theirstrength fails.
(c) Copyright Community TrainingAustralia 2011A step UP2. People can find new purpose for theirlives.Many people experience a new found love of helpingothers, and a sense of peace about material things.They don‟t matter like they used to. We realise thereal value of life.
(c) Copyright Community TrainingAustralia 2011A step UP3. Becoming more grounded….helps youflyIt is true. Smelling the roses, knowing what counts inlife, helps you prioritise and achieve greatness in thislife.
(c) Copyright Community TrainingAustralia 2011A step UP4. Suffering is everywhere…none of us havea monopolyUnfortunately this planet is less than perfect.However the suffering we experience can makeus greater people, with greater empathy withgreater resourcefulness and a passion toextinguish pain wherever we see it.
(c) Copyright Community TrainingAustralia 2011Lessons of life fromchildrenAuthor and lecturer Leo Buscaglia once talkedabout a contest he was asked to judge. Thepurpose of the contest was to find the mostcaring child.The winner was: A four year old child whosenext door neighbor was an elderly gentlemanwho had recently lost his wife. Upon seeingthe man cry, the little boy went into the oldgentlemans yard, climbed onto his lap, andjust sat there. When his mother asked himwhat he had said to the neighbor, the little boysaid, "Nothing, I just helped him cry."
(c) Copyright Community TrainingAustralia 2011Lessons of life fromchildrenWhenever Im disappointed with my spot in life, I stopand think about little Jamie Scott. Jamie was trying outfor a part in a school play.His mother told me that hedset his heart on being in it, though she feared he wouldnot be chosen.On the day the parts were awarded, I went with her tocollect him after school. Jamie rushed up to her, eyesshining with pride and excitement."Guess what Mom," heshouted, and then said those words that will remainlesson to me............................"Ive been chosen to clap and cheer."
(c) Copyright Community TrainingAustralia 2011Exercises for times ofgrief1. Map of LifeGoal setting is an important part of beatingdepression.Draw a map of your life – each separate domain.Add one new goal for each area for the new year.
(c) Copyright Community TrainingAustralia 2011Exercises2. Write to the one you havelostConnectedness is central toemotional wellbeing.Write a letter or journal to the oneyou have lost or the part of yourselfthat you have lost. Say goodbye,express your regrets and sadnessand also your gratefulness.End on a positive note about yourgoal for the future as a result ofyour loss.
(c) Copyright Community TrainingAustralia 2011Exercises3. Stretching and rockingStress and trauma which is part and parcel of griefbuilds up tension in the body…the body keepsbracing itself for disaster.Do lots of stretching exercises and do rockingexercises and cross lateral patterning to release offtension.
(c) Copyright Community TrainingAustralia 2011Exercises4. LaughingLaughing has been shown in research to releaseserotonin…the happy hormone in the brain, itimproves immune function, flushes the face, andprovides a sense of wellbeing. We can fool our braininto thinking we are happy with fake laughing.Make laughing noises, ha ha – hee hee- ho ho andmake them loud, move up and down and smile widelywhile doing this…do it for 2 mins 3 times a daywhether you feel like it or not.
(c) Copyright Community TrainingAustralia 2011Exercises5. Examine all your senses again.Get in touch with the moment.Have an excursion to particularly exercise your senseof smell…The same for hearing…SightTouchTaste….get adventurous.
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(c) Copyright Community TrainingAustralia 2011Exercises6. Try to enjoy people andtheir differencesThere are lots of differenttypes out there in the world.Take a new perspective,notice people, theirexpressions, their features,their voices.In your appreciation of people,you may find the favour isreturned yielding unexpectedfriendships and joy.
(c) Copyright Community TrainingAustralia 2011Exercises7. Take a big pillow to bed.Hold it close to your chest.In loss we can feel like children again, needingholding and comfort. If we have lost the one who heldus, it will be important to have as much touch aspossible. This doesn‟t always happen. Take a pillowto bed an cuddle it. No matter how old you are….thiscan feel great and relieve the internal ache.
(c) Copyright Community TrainingAustralia 2011Exercises8. Hold your forehead andback of the head, and crossyour feet together.This position brings a lot of comfortquickly and provides a sense ofwellbeing. Maybe our parents did itfor us when we were babies…whoknows why it works…but it works.
(c) Copyright Community TrainingAustralia 2011What happens whenpeople get „stuck‟ in theirgrief?
(c) Copyright Community TrainingAustralia 2011Complications to thegrief process6 reasons for extended grief and whatto do about it
(c) Copyright Community TrainingAustralia 20111.Denial of Grief This is when someonedoesn‟t get toexperience theiremotions as a result ofdeliberate orunintentionalavoidance. It canpostpone and causemayhem to our normalgrief reactions.
(c) Copyright Community TrainingAustralia 2011What can be done to remedydenial of grief?Read more informationAttend a communitysupport groupCall someone from acommunity supportgroupSpeak to a counsellorGet help to deal withpast issues or presentenergy stealers.Design a ceremony.Give permission to„feel‟. Emotions are notwrong.Use debriefingstrategies…. Whathappened, what wereyou thinking, what wereyou feeling. Drawing –Music – takeopportunity to feel whenit arises.
(c) Copyright Community TrainingAustralia 20112.Abuse ofgrief This is when others donot allow grievers toexpress their distressand sorrow in loss.This can be from aselfish motivation orfrom a mistaken beliefthat it is best foreveryone, not to talk orthink of the „problem‟ ofdeath or loss.
(c) Copyright Community TrainingAustralia 2011What can be done tosupport abuse of grief?Actively not listenRemove self fromatmosphere ofabuseEducate „abusive‟voices.Read literatureAttend a supportgroupSeek help from acounsellorFind supportivepeopleJournal theexperienceBe your own bestfriend.
(c) Copyright Community TrainingAustralia 20113. No Good byesThis often accompaniessudden death and is usual insuicide situations. Thesuicide victim may leave anote or say goodbye, butsurvivors rarely get thechance.Children may be particularlyvulnerable to this complicationto the grief process.
(c) Copyright Community TrainingAustralia 2011What can be done to saygoodbye.Emphasise that it is nevertoo late to say goodbye.Find a way to say yourgoodbye – make anendpoint.Ask a friend or relative tohelp in a simple „ceremony‟of goodbyeCommunity opportunities…memorial services etc.Talk to someone ina support groupabout how theysaid their good-byes.Speak to acounsellor aboutways to make a„goodbye‟ apersonal andhealing time.
(c) Copyright Community TrainingAustralia 20114.Confusionaboutreasons.We long to know whysomething sotumultuous happens. Itis important for us tohave a way to thinkabout a loss event sothat our „framework‟ formeaning in life can stayintact.
(c) Copyright Community TrainingAustralia 2011What do you think youcould do to attend to thiscomplication?Seek more informationso that the eventmakes sense.(readbooks, speak to Drsetc)Talk to other survivorswhose loved one wasin a similar situation –if there has been adeath.Speak to a counsellor.Agree inside thatwhile all answersmay not be clearnow… as timepasses the answersmay come.Be clear in yourmind that self blameis not a reasonableanswer to „why‟.
(c) Copyright Community TrainingAustralia 20115.Blame/shame Blame is related to ourneed for reasons andmeaning. We blameourselves, others, thesituation, the system orGod. Blame keeps usa prisoner of pain,even though it is anatural humantendency.
(c) Copyright Community TrainingAustralia 2011What can be done toattend to thiscomplication?Write a list of possiblepeople, situations orthings that we might havefelt was to blame for ourloss.Check for body reactionsor ruminations in themind.Talk to a professional.Take a step back andthink… they are (I am)only human… we all canmake mistakes, none ofus knows the future. God(life) is not out to get me.Release blame. Verbaliseit. Assist people tounderstand that releasingblame, releases them,releases us from wastingemotional energy.
(c) Copyright Community TrainingAustralia 20116.Trauma Trauma relates to achange in brainchemical reactionsas a result of undueor prolonged stress.Trauma can betreated. Drug andtrauma therapiesare highlyrecommended forsufferers.
(c) Copyright Community TrainingAustralia 2011What can be done tosupport trauma?Write a list of bodysensations andbody complaintsthat has beenpresent since theloss..Ask yourself, doesthis get better overtime or worse?Does it constitutetrauma?Read aboutstrategies to relievetrauma reactions inthe body. Tapping,exercise, relaxation,laughing.Seek professionalhelp.Talk to othersufferers.
(c) Copyright Community TrainingAustralia 2011Antidotes forcomplications1. Denial of grief2. Abuse of grief3. No good byes4. Confusion aboutreasons.5. Blame/shame6. TraumaGet permissionDon‟t listen, find kindervoices.Never too late……Answers and meaningwill come… just rest.Be aware - get help tostop.Get treatment
(c) Copyright Community TrainingAustralia 2011Sensible emotional firstaidGood educationGood friendsGood foodGood restGood workGood exerciseGood funGood touchGood drinkGood faithThese are the firstports of call for anyemotional distress,including any lossesincluding the deathof someone close tous.
(c) Copyright Community TrainingAustralia 2011Toni MehiganPsychologist/Grief and LossEducatorThis presentation has been put together byToni Mehigan.Toni can be contacted on 07 47724103 or byemail on firstname.lastname@example.org