1. GRIEF COUNSELLING
JUNISE VAZHAYIL
AL SHIFA COLLEGE OF PHARMACY
KIZHATTUR – PERINTHALMANNA-
KERALA
junisevazhayil20@gmail.com
Cope with Grief & Loss
2. limited time on earth –
we will then begin to live each day to the
fullest, as if it was the only one we had.
3. an emotion/ natural reaction people feel
when they experience a loss
Grief is also the name for the healing
4. Grief
is the process of spiritual, psychological, social &
somatic reactions, to the perception of loss.
Mourning
is the cultural response to grief.
Bereavement
is the state of having suffered a loss.
5. • divorce,
• death
• separation from children,
• break-up of boyfriend/girlfriend,
• losing a job/unemployment,
Feeling “dead” in our job,
in our relationship,
is a reality with many people.
6. o If the person that died was young, we
may feel it was unfair.
There is no right or wrong way to experience
grief.
Grief can make us feel guilty.
8. Grief
Experienced in waves
Diminishes in intensity
over time
Healthy self-image
Hopelessness
Response to support
Overt expression of
anger
Preoccupation with
deceased
Depression
⚫ Moods and feelings are static
⚫ Consistent sense of depletion
⚫ Sense of worthlessness and
disturbed self-image
⚫ Pervasive hopelessness
⚫ Unresponsive to support
⚫ Anger not as pronounced
⚫ Preoccupation with self
9. Women
express their feelings
early after loss
reach out for social
support
are seen to express
more sorrow,
depression, and guilt
more willing to talk
about the loss of a
child
Men
⚫ more likely to take on a
managerial role
⚫ intellectualize their
emotions
⚫ indicate that they feel
more anger, fear, and loss
of control
⚫ use denial more
⚫ more private about grief
11. Disruptive behaviors
Aggressive behaviors
Non-compliance
Increase in risk taking
“Hyperactive – like”
behavior
Withdrawal
Regressive behaviors
Lying
Separation anxiety
Refusal to return
to school or
daycare
Rage and anger
High need for
attention
12. Insecurity
Concern about being
treated differently
“I don’t care” attitude
Depression
Overly sensitive,
frequently tearful
Mood swings
Trouble concentrating
Nightmares
Irritable
Appears unaffected by
the loss
Suicidal thoughts or
ideations
Increase in fears
Guilt, confusion,
regret, anger
Withdrawn or spending
a lot of time alone
13. Stomachaches,
headaches, heartaches
Frequent accidents or
injuries
Sleep disturbances
Loss of appetite or
increased eating
Low energy, weakness
Increased illnesses
and infections
Rapid heart beat
Acne
New habits or
regression in behavior
14. Inability to focus
Decline in grades
Incomplete work,
or poor quality
Increase in
absences
Over achievement,
trying to be
perfect
Inattentiveness
Daydreaming
Increase in
behavior
problems at
school
Lack of interest
15. Withdrawal from
friends
Withdrawal from
activities and sports
Use of drugs or
alcohol
Changes in
relationships with
peers
Change in family
roles
Stealing,
shoplifting
Difficulty being in
social situations
that were once
comfortable
Wanting to be
physically close to
safe adults
16. Anger at God
Questions of “Why
me?” or “Why now?”
Questions of the
meaning of life
Confusion about what
happens after death
Doubting or questioning
previous beliefs
Sense of despair
about the future
Change in values,
questioning of what is
important
17. Age Understanding Common Behaviors
0-2
Cannot understand death/loss.
All knows is that someone who
cared for him is no longer
present
o sleep problems,
o stomach
problems,
o separation
anxiety,
o crying
3-5
“Magical thinking” leads them to
believe that they somehow caused
the loss, or somehow can bring
the person back.
They will repeatedly ask
questions about the loss
o Regression in
behavior,
confusion,
o concerns about
their own safety
18. 6-10 If loss is due to a death, they begin to
suspect that they might die.
Develop interest in causes of the loss.
Start asking for reasons &
connect what is happening to others may
happen to them
Anger,
difficulty in paying
attention and
concentrating,
not completing
schoolwork,
withdrawal
11-14 Comprehend loss as final and unavoidable.
May start to show concern for future and
impact on others
Anger, risk-taking,
lack of
concentration,
unpredictable ups
and downs or
moodiness
15-18 Essentially adult views of loss. Withdrawal for
parents, pushing
limits or rules,
inability to focus,
increased risk-
taking, wanting to
spend lots of time
with friends
19. Kind and understanding tone of voice
Encouragement to talk about how she feels
in whatever way she can express it
Open and direct manner that says
“I’m with you and you are with me.
There are no secrets.”
20. Clear answers in simple terms to the questions that
they ask,
An accepting listener to the memories he has of
the deceased
Explanations to refute the magical beliefs that
feed their fears
Acceptance of play, artwork, songs, etc.
21. To be taken seriously, no matter how
shallow his concerns seem
To be included in family discussions about
the changes brought about by the death
To have his/her ways of grieving accepted
While this age-group may understand
death intellectually, they may have great
difficulty understanding it emotionally.
22. To be included in planning & decision making
To be informed of what to expect in terms
of events, ceremonies, rituals, etc.
To know what to expect from various
relatives
To know what is expected of them
To witness adults grieving so they can learn
adult ways to grieve
23. Act natural
Show genuine care and concern
Make it clear that you are there to listen
Talk openly and directly about the person
who died
It is better for the child to learn about the
loss from a parent or family member
24. Find a way to help children symbolize
and represent the death
Pay attention to the way a child plays;
this is one of the main ways that
children communicate
Say that you are sorry about the loss
Sit next to a child that wants closeness
25. Provide lots of hugs, holding, physical contact, and nurturing
Explore your religious beliefs and explain to your child
Reassure child that all emotions (sadness, anger, relief,
guilt) are normal responses to loss
If possible, teach your child about death
26. Try to shelter children from the reality of death;
Give false or confusing messages
(“Grandma is sleeping now.”)
Tell a child to stop crying because others might
get upset
Try to cheer the person up or distract from the
emotional intensity
(“At least he’s no longer in pain.”
“She’s in a better place now.”)
27. Offer advice or quick solutions
(“I know how you feel.”
“Time heals all wounds.”)
Pry into personal matters
Ask questions about the circumstances of
the death
28. DO NOT
suggest that the child has grieved long enough
DO NOT act as if nothing happened
DO NOT tell a child things that he will later
need to unlearn
DO NOT force them to go to the funeral
or deny them the opportunity to go to the
funeral
29. DO NOT
rely on your child for your own emotional support
DO NOT
burden your child with adult responsibilities
DO NOT
try to protect your child from your own sad feelings
DO NOT say things like:
“I know how you feel.”
“You’ll be stronger because of this.”
“It could be worse you still have…”
30. 1. Let yourself grieve:
Express & share sadness
We can delay grief for a while, but cannot avoid it.
It is a learning process-Teaches us how to deal with
it the next time around.
This is why it is so important to share our grief
with our children so that they learn & grow.
31. Not all of show grief by crying.
Immerse in physical activity.
Listening & playing music.
Story telling.
Writing.
Painting & drawing.
Talking about the loss.
Praying.
Meditating.
Ceremonies & memorials to say good bye.
Share our feeling
Rituals & ceremonies that are part of family,
cultural or religious heritage.
32. 2.Look after yourself
Eat healthy-easily digestible food
Back to your routine ASAP
Aim for regular meal /sleep time
Avoid alcohol /drugs – they numb the feelings
that need to be expressed.
Do something you enjoy / something new.
.
33. 3. Postpone major life decisions.
4. share your feelings Cultural traditions.
5. Let people know how they can help
6. Let yourself heal, - enjoy the happy memories by
laughing about the person.
Don't feel guilty about healing.
7. Know that you will come through this.
34.
35. Denial: The initial stage: “It can’t be happening.”
Anger: “ Why ME? It’s not fair?!”
(either referring to God, oneself, or anybody
perceived, rightly or wrongly as responsible)
Bargaining: “Just let me live to see my son
graduate.”
Depression: “I am so sad, why bother with
anything?”
Acceptance: “It’s going to be OK.”
36. Refusing to believe
a probable death will
occur.
You can available for
them to talk instead
of forcing them to
talk about it.
37. - Anger at God for not
allowing them to see
their kids grow up
- Anger at the doctors
- Anger at the family
- Try not to take it
personally. They have
a right to be angry so
allow them to express
themselves so they can
move on in the grieving
process.
38. They dying person may start to negotiate
with God i.e.
“I’ll live a healthier life,”
“I’ll be a nicer person,” “
I was angry so let me ask nicely to please let
me live.”
They may negotiate with the doctor by
saying, “How can I get more time so I can live
in my dream home, and so on.
39. When reality sets in about
their near death, bargaining
turns into depression.
Fear of the unknown
Guilt for demanding so much
attention and depleting the
family income occurs.
Be available to listen instead
of cheering them up, or
rambling, repetitive talk.
Distraction like talk about
sports, etc., is good but
don’t ignore the situation.
40. When the dying have
enough time and
support, they can
often move into
acceptance.
There is an inner
peace about the
upcoming death.
The dying person will
want someone caring,
and accepting by their
side.
41. By sharing feelings with one another,
children find out that they are not
alone and that others are also
struggling to rebuild shattered lives.
Open-ended
Walk-in
Time-limited:
42. Writing or drawing spontaneously
Creating a collage
Writing a poem or song
Constructing a memory book
Launching a balloon after writing messages
to the person who died
Going on a field trip to a funeral
home,cemetery
43. Important things to remember:
▪ Children feel the pain of loss—but do not have
the coping skills that adults have developed
▪ often express their feelings through behavior
▪ Grieving may not “show” on the out side
▪ They can not tolerate long periods of sadness.
