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![Maladaptive Grief
Responses
Maladaptive grief responses to loss occur when an
individual is not able to satisfactorily progress
through the stages of grieving to achieve
resolution.
Several types to grief responses have been
identified as pathological [Lindemann (1944),
Parkes (1972)].
These are prolonged, delayed/inhibited, and
distorted responses.](https://image.slidesharecdn.com/grief-230618104512-1c74c06f/85/Grief-pptx-30-320.jpg)
Uploaded byABHIJIT BHOYAR
Grief.pptx
Grief is a natural emotional response to loss, characterized by feelings such as shock, anger, and depression. Various types of grief exist, including anticipatory, abbreviated, and cumulative grief, and individuals may experience unique symptoms both emotionally and physically. The grieving process can vary significantly in duration and depth, influenced by factors such as the nature of the loss and the individual's coping mechanisms.
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Grief.pptx
- 1.
- 2. What is grief? Grief is a natural response to loss. It's the emotional suffering feel when something or someone you love is taken away. Grief is a reaction of an individual to a significant loss. Shock, disbelief, anger, resentment and depression are common features in affected individuals.
- 4. Grief isdefined as the emotional process of coping with a loss. The reality of loss can be applied to the absence of anything that is significant or meaningful to our existence. This can include death of a loved one, a separation or divorce, loss of a body part, loss of a job and losses that result from a natural or imposed disaster.
- 5. There are multipleways to experience grief. Different types of grief describe how varied and complex grief can be. TYPES Anticipatory grief Abbreviated grief OF Delayed grief Inhibited grief GRIEF Cumulative grief Collective grief
- 6. Anticipatory griefinvolves grieving before the actual loss. For example, you may begin grieving when you learn that you or a loved one has a terminal illness. Processing grief beforehand can prepare you to face the loss when the time comes. Still, it’s important not to allow grieving to distract you from enjoying the precious time you do have. Anticipatory grief
- 7. Sometimes, you’reable to move through the grieving process quickly. This is the case with abbreviated grief. Abbreviated grief may follow anticipatory grief. You can grieve a loss quickly because you’ve already done a lot of emotional labor while anticipating that loss. Grieving for a short time doesn’t mean you never truly cared about what you lost. When it comes to grief, we’re all on different timelines. Abbreviated grief
- 8. Instead ofexperiencing the emotions that accompany grief immediately after a loss, you feel them days, weeks or even months later. In some instances, the shock of the loss pauses your body’s ability to work through these emotions. Or you may be so busy handling the practical matters that accompany loss (like funerals and wills) that your body can’t grieve until you’ve handled these responsibilities. Delayed grief
- 9. Inhibited griefinvolves repressing emotions. Most of us haven’t been taught how to process — or even how to recognize — the confusing emotions that can arise when we’re grieving. As a result, many people who repress their emotions don’t realize they’re doing so. Unfortunately, when you don’t allow yourself to pause and feel these emotions, grief often shows up as physical symptoms like an upset stomach, insomnia, anxiety or even panic attacks. Inhibited grief
- 11. With cumulative grief,you’re working through multiple losses at once. For example, you’re not only grieving the loss of a child. You’re grieving the ending of a marriage that followed that loss. Grieving multiple losses
- 12. Most ofus think of grief as personal, but collectives (groups) grieve, too. Major events like wars, natural disasters, school shootings and pandemics create far-reaching losses. They change what counts as “normal” life. As a group, we grieve the shared experiences we’ve lost as we struggle to imagine a changed future Collective grief
- 13. symptoms of grief Emotionalsymptoms Sadness that a loved one’s gone but relief that they’re at peace. Yearning for a spouse after a divorce but also excitement that you get another shot at love. Guilt for feeling grateful that you no longer have to provide exhausting around-the-clock care for a dying relative. Competing feelings of apathy, anger, sadness and regret as you grieve the loss of a friend or family member with whom you had a strained or hostile relationship.
- 14. Physical symptoms Fatigue. Headaches. Nausea. Restlessness. Upset stomach. Heart palpitations. Weak muscles or joint pain. Tightness in your chest or throat. Having reduced or increased appetite. Trouble sleeping (insomnia) or sleeping too much.
- 15. Behavioral changes Confusion. Trouble thinking or making decisions. Feeling as if you’ve lost a sense of hope or direction. Difficulty focusing on anything other than your loss. Difficulty remembering or keeping track of your responsibilities.
- 17. THEORIES OF GRIEF Kubler-Ross(1969) having done extensive research with terminally ill patients identified five stages of feelings and behaviour that individuals experience in response to a real, perceived or anticipated loss
- 18.
- 19. Stage I-Denial:This is a stage of shock and disbelief. The response may be one of "No, it can't be true!" Denial is a protective mechanism that allows the individual to cope within an immediate time-frame while organizing more effective defence strategies.
- 20. Stage II-Anger: "Why me?"and "It is not fair!" are comments often expressed during the anger stage. Anger may be directed at self or displaced on loved ones, caregivers, and even God. There may be a preoccupation with an
- 21. Stage III-Bargaining:"If God will help me through this, I promise I will go to Temple every and volunteer my time to help others". During this stage, which is generally not visible or evident to others, a bargain is made with God in an attempt to reverse or postpone the loss.
- 23. Stage V-Acceptance: The finalstage brings a feeling of peace regarding the loss that has occurred. Focus is on the reality of the loss and its meaning for the individuals
- 24. All individualsdo not experience each of these stages in response to a loss, nor do they necessarily experience them in this order. Some individuals grieving behaviour may fluctuate, and even overlap between stages.
- 25. GRIEF PROCESS Thegrieving process describes a series of occurrences in the resolution of loss. This process provides support as an individual works through the feelings of anger, hopelessness and futility that accompany loss. It provides time to put things into perspective, to place into memory that which is gone, and to embrace life.
- 26. Growth occursas the bereaved person comes to the point of letting off the past. This does not reduce the importance of the loss but allows the person to continue living with a new perspective. This acceptance indicates that the grief process is coming to a close.
- 27. Resolution of Grief Resolution of the process of mourning is thought to have occurred when an individual can look back on the relationship with the lost entity and accept both the pleasure and the disappointments (both the positive and negative aspects) of the association. Pre-occupation with the lost entity is replaced with energy and desire to pursue new situations and relationships.
- 28. The length ofthe grief process may be prolonged by a number of factors: If the relationship with the lost entity had been marked by ambivalence, reaction to the loss may be burdened with guilt, which lengthens the grief reaction. In anticipatory grief where a loss is anticipated, individuals often begin the work of grieving before the actual loss occurs.
- 29. Most peopleexperience the grieving behaviour once the actual loss occurs, but having this time to prepare for the loss can facilitate the process of mourning, actually decreasing the length and intensity of the response. The number of recent losses experienced by an individual also affects the length of the grieving process and whether he is able to complete one grieving process before another loss occurs.
- 30. Maladaptive Grief Responses Maladaptivegrief responses to loss occur when an individual is not able to satisfactorily progress through the stages of grieving to achieve resolution. Several types to grief responses have been identified as pathological [Lindemann (1944), Parkes (1972)]. These are prolonged, delayed/inhibited, and distorted responses.
- 31. Prolonged Response It ischaracterized by an intense preoccupation with memories of the lost entity for many years after the loss has
- 32. Delayed or Inhibited Response The individual becomes fixed in the denial stage of the grieving process. The emotional pain associated with loss is not experienced, but there may be evidence of anxiety disorders or sleeping disorders. The individual may remain in denial for many years until the grief response is triggered by a reminder of the loss or even by another unrelated loss.
- 33. Distorted Response The individualwho experiences a distorted response is fixed in the anger stage of grieving. The normal behaviours associated with grieving, such as helplessness, hopelessness, sadness, anger and guilt are exaggerated out of proportion to the situation. The individual turns the anger inward on the self and is unable to function in normal activities of daily living. Pathological depression is a distorted grief response.
- 34. Management and Treatment Evaluationto find out any primary psychiatric disorder Patient is encouraged to talk about his feelings concerning the deceased in a private room Reassurance is given that this is a normal process and will subside on its own If necessary, refer to psychiatric services
- 35. Treatment Normal griefdoes not require any treatment while complicated grief requires medication depending on the prevailing behaviour responses.
- 36. Nursing Intervention Providean open accepting environment. Encourage ventilation of feelings and listen actively. Provide various diversional activities. Provide teaching about common symptoms of grief. Reinforce goal-directed activities. Bring together similar aggrieved persons, to encourage communication, share experiences of the loss and to offer companionship, social and emotional support.
- 37. Assist patientto identify ambivalent feelings of guilt or anger towards loss of object. Assist in developing positive methods of coping with the loss. Provide positive feedback for use of effective coping strategies. Encourage patient to utilize family, religious or cultural supports that provide a meaning for the patient. Encourage participation in group activities.