Defining and Understanding Grief? Grief can be defined as the physical, emotional, cognitive and spiritual response to actual or threatened loss of a person, thing or place to which individuals are emotionally attached. "Contrary to what social workers will tell you, when you lose a loved one, we dont just forget, move on, and find closure. To truly grief, we must learn to honor, to remember, and to incorporate our deceased children, parents and siblings into our lives in a new and different way. In fact, keeping memories of your loved one alive in your mind and heart is an important part of your healing journey." ~ John "TC" and Joanne Megahan RESTORING HOPE.
Common Grief Responses Physical Sensations Tightness in the chest Shortness of Breath Lack of Energy Panic Attack-like symptoms
Common Grief Responses Cognitions Disbelief Confusion Sense of Presence Lack of Concentration
Common Grief Responses Behaviors Sleep disturbances Appetite disturbances Social withdrawal Dreams of the deceased Absent-minded behavior
Common Grief Responses Additional considerations Cultural Differences Religious Differences Gender Differences Grief experience and history
Differences between Grief and Depression It is important to understand and recognize the difference between Grief and Depression. Depression shares common features with grief. Misdiagnosis can result in overlooking depression when it is present and inappropriately treating grief.
Assessing between Grief and Depression Grief Depression Experienced in waves Moods and feelings are static Diminishes in intensity Consistent sense of over time depletion Healthy self-image Sense of worthlessness and disturbed self-image
Assessing between Grief and Depression Grief Depression Anhedonia - Loss of the Anhedonia - Loss of the capacity to experience capacity to experience pleasure. The inability to gain pleasure. The inability to gain pleasure from normally pleasure from normally pleasurable experiences. pleasurable experiences. Hopelessness Pervasive hopelessness Response to support Unresponsive to support Overt expression of anger Anger not as pronounced
Assessing between Grief and Depression Grief Depression Guilt is focused on aspect of loss Guilt is preoccupied with a negative Not demoralizing or humiliating Demoralizing and humiliating Preoccupation with deceased Preoccupation with self Suicidal gestures rare in uncomplicated grief Suicidal gestures are common Elicits sympathy, concern and desire Elicits irritation, frustration and a to embrace desire to avoid
Grief Assessment What was the relationship? Nature of the Attachment Mode of Death Historical Antecedents (preceding event, condition, causes, etc.) Personality Variables Social Variables
Theories on Bereavement Elizabeth Kubler-Ross: Stages of Grief William Worden: Four tasks of grieving Robert Neimeyer: Rebuilding life and search for meaning Grief as a journey.
Treatment Planning Establish a relationship with the bereaved Be comfortable with their expression of grief Listen, listen, and then listen some more Normalize grief reactions Companion them in rebuilding their life
Taking Care of Myself Know your own strengths and limits Set boundaries, communicate those boundaries. Nurture yourself – read, watch, and listen positive and supportive information. Surround yourself with supportive people.