Despelder8_ppt_ch09

Despelder8_ppt_ch09 - n Chapter NineC H Chapter H Survivors...

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Unformatted text preview: n Chapter NineC H Chapter H Survivors Understanding the Experience of Loss Understanding Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland The Experience of Loss s s s Bereavement Grief Mourning Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Bereavement s s s s The objective event of loss Disrupts survivor’s life “Shorn off or torn up” / “Being Shorn robbed” robbed” A normal event in human experience Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Grief: The Reaction to Loss s s s s s Thoughts (mental distress) Feelings (emotions) Physical responses Behavioral responses Spiritual responses Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Mental Aspects of Grief s s s s s Confusion, disbelief, anxiety Sense of disorganization Depression Sensory responses undependable and Sensory erratic erratic Paranormal experiences (e.g., Paranormal hallucinations, vague sense of deceased’s presence) deceased’s Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Emotional Aspects of Grief s s s s s Sadness, longing, loneliness Sorrow and anguish Guilt Frustration at being unable to control Frustration events events Anger and outrage at injustice of the Anger loss loss Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Physical (Somatic) Aspects of Grief s s s s s s Frequent sighing Sleep disruptions (e.g., insomnia) Changes in appetite Tightness of the throat, choking, Tightness shortness of breath shortness Feeling of emptiness in the abdomen Chills, tremors, hyperactivity Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Behavioral Aspects of Grief s s s s s Crying Searching for the deceased Incessant talk about the deceased and Incessant circumstances of death circumstances Avoidance of talk about the deceased Restlessness, irritability, hostility Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Spiritual Aspects of Grief s s s Questioning Reexamination of religious or spiritual Reexamination beliefs beliefs Struggle to make meaning of the loss Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Mourning s s Process by which a bereaved person Process integrates a loss into his or her ongoing life ongoing Determined partly by social and Determined cultural norms for expressing grief cultural Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Expressions of Mourning s s The bereaved are “different” for a The time time Abstaining from social occasions Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Expressions of Mourning: Visual Symbols s s s s Black armbands National flag at half-mast Seclusion Cutting long hair short (Native Cutting Americans) Americans) Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Models of Grief s s s “Working through grief” and “letting Working go” (attachment theory) go” Accomplishing the “tasks of Accomplishing mourning” mourning” “Maintaining bonds” with the Maintaining deceased (memories and linking objects) objects) Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Models of Grief (continued) s “Telling the story of grief” (narrative Telling s s and mutual support) and “Intuitive” versus “instrumental” Intuitive” grieving (gender issues and grieving styles) styles) “Loss-oriented” versus “restorationoriented” coping (dual-process model) Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright The Grief-Work Model s s s s Associated with attachment theory Associated attachment and the work of Sigmund Freud, Erich Lindemann, and John Bowlby Lindemann, Grief is an “adaptive response to loss” Reality of the loss must be Reality “confronted and accepted” “confronted Grieving is an “active process that Grieving occurs over time” occurs Copyright 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright The Tasks of Mourning (Worden) s s s s Accept the reality of the loss Work through the pain of grief Adjust to a changed environment in Adjust which the deceased is missing which Emotionally relocate the deceased and Emotionally move on with life and capacity to love others others Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright The Tasks of Mourning (Rando’s 6 R’s) s s s s s s Recognize React React Recollect Recollect Relinquish Readjust Readjust Reinvest Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright The Tasks of Mourning (Rando) s s s s Recognize the loss React to the separation Recollect the deceased and the Recollect relationship relationship Relinquish old attachments to the Relinquish deceased deceased Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright The Tasks of Mourning (Rando) s s Readjust adaptively into a new world Readjust without forgetting the old without Reinvest Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Maintaining Bonds s s Rather than severing ties with the Rather deceased, the bereaved person incorporates the loss of a loved one into his or her ongoing life into Maintain “inner representation” of the Maintain deceased deceased Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Maintaining Bonds (continued) s s Bonds sustained through memories Bonds and linking objects and The “ties that bind” are maintained by The “threads of connectedness” “threads Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright “Telling the Story of Grief”: The Narrative Approach s s Every death creates a story, or set of Every stories, to tell stories, Sharing the story provides emotional Sharing relief, promotes the search for meaning, and brings people together in mutual support of their loss in Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright “Telling the Story of Grief”: The Narrative Approach s Telling the story of grief helps the Telling bereaved revise and re-form their own life stories in ways that restore wholeness wholeness Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Intuitive versus Instrumental Grieving Patterns s Intuitive: x Grief experienced and expressed emotionally x Tends to be associated with women s Instrumental: x Grief experienced and expressed physically Grief or through mental activity or x Tends to be associated with men Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Intuitive versus Instrumental Grieving Patterns s s Both patterns are effective ways of coping with loss, and both men and both women use them women Although gender influences patterns Although of mourning, the phrase “Men don’t cry, women do” is misleading cry, Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright The Dual-Process Model s s s Grief is a dynamic process Bereaved people typically express Bereaved both “loss-oriented” and “restorationboth oriented” coping behaviors There is “oscillation” between the two There modes of coping modes Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright The Dual-Process Model (continued) s s At times, the bereaved confronts At his/her loss and at other times he/she tries to avoid the pain of grief tries Over time, alternation between these Over two modes of coping leads to optimal adjustment adjustment Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Coping with Grief s s s Identify concurrent changes or Identify “secondary losses” Minimize other life stresses while Minimize mourning mourning Integrate grieving into “bigger Integrate picture” of life and living (e.g., art, music, lobbying, etc.) music, Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Coping with Grief (continued) s s s Use social support Maintain coping potency similar to Maintain that used with smaller losses and stress stress Recognize that head and heart may Recognize not react the same to a significant loss not Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Coping with Grief (continued) s s Withhold judgment about whether Withhold particular emotions or thoughts are “right” or “wrong” “right” Allow permission to have and express Allow feelings feelings Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Coping with Grief (continued) s s Accept that the course of grief may Accept not follow a stereotypical pattern not If symptoms persist and are not If managed by other ways of coping, seek counseling support from a qualified individual or group qualified Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright The Course of Grief s s s s s Highly variable and individualistic Complex, evolving process Multiple dimensions Signs of grief may appear Signs immediately after the death or may be delayed or even absent delayed No predetermined timetable for No “completion” “completion” Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright The Course of Grief (continued) s s s Initial phase: Shock, numbness, Shock, disbelief, denial disbelief, Middle phase: Anxiety, despair, Anxiety, volatile emotions, yearning for deceased, feelings of abandonment deceased, Last phase: Sense of resolution, Sense reintegration, and transformation; turmoil subsides; balance regained turmoil Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Complicated Mourning s s s s s Persistence of signs of “acute” grief Severe, sustained depression Substance abuse or suicidal thoughts Attempts to deny, repress, avoid Attempts to avoid accepting the death Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Factors that May Complicate Grief s s s s Sudden, unanticipated death Sudden, (especially when traumatic, violent, mutilating, or random) mutilating, Loss of a child Bereaved’s perception that the death Bereaved’s was preventable was Death from overly lengthy illness Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Factors that May Complicate Grief (continued) s s s Relationship that was markedly angry, Relationship ambivalent, or dependent ambivalent, Mental health problems or Mental unaccommodated losses unaccommodated Perceived lack of social support Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Danger of “Medicalizing” Grief s Because circumstances and Because personalities differ, what is a pathological response for one mourner may be an appropriate response for another mourner another Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Danger of “Medicalizing” Grief (continued) s Many of the criteria suggested for Many making a diagnosis of traumatic grief appear virtually indistinguishable from the signs of normal grief from Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Danger of “Medicalizing” Grief (continued) s Label of “dysfunctionality” may be Label applied to normal expressions of grief and mourning. and Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Mortality/Morbidity of Grief: General s No direct cause-effect link established No between bereavement and onset of disease. disease. Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Mortality/Morbidity of Grief: Studies Reported... s Higher incidence of some chronic Higher diseases in recently bereaved individuals individuals Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Mortality/Morbidity of Grief: Studies Reported... s Diminished immune response has Diminished been found among widowers during first months following bereavement first Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Mortality/Morbidity of Grief: Studies Reported... s Death rate during first year of Death bereavement nearly seven times that of general population (small community in Wales) community Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Stress and Sudden Death (Engel) s s s s Impact of the death of a close person Stress of acute grief Stress that occurs with mourning Loss of status or self-esteem Loss following bereavement following Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Variables Influencing Grief s Survivor’s model of the world x Personality x Cultural context and social roles x Perceived relationship with the deceased x Values and beliefs Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Variables Influencing Grief (continued) s Mode of death x Anticipated x Sudden x Suicide x Homicide x Disaster Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Variables Influencing Grief (continued) s s s Multiple losses and bereavement Multiple burnout burnout Social support and disenfranchised Social grief grief Unfinished business Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Support for the Bereaved s s s “Simply listening” is helpful A hug may be more comforting than hug words words Avoid judging whether feelings Avoid expressed by the bereaved are “right” or “wrong” or Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Support for the Bereaved (continued) s s The bereaved may occasionally need The to be reassured that it’s okay to “take a break” from grieving break” Funerals and other leave-taking rituals Funerals provide a framework for coping with loss loss Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Support for the Bereaved (continued) s s Social support is as important during Social the later course of grief as it is during the initial period the Organized support groups give Organized similarly bereaved people opportunities to share their stories and encourage one another encourage Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Controversy − Benefits of Grief Counseling s s Scholarly and popular press articles Scholarly questioning benefit questioning Investigation reveals no empirical or Investigation statistical foundation for claims that grief counseling is “ineffective” or harmful harmful Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Bereavement as an Opportunity for Growth s When loss is transformed in a way When that places it within a context of growth, grief becomes a unifying rather than alienating human experience experience Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Bereavement as an Opportunity for Growth (continued) s The feelings that accompany grief The express “a keen awareness of shared express life grasped in its intimacy” life Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright Bereavement as an Opportunity for Growth (continued) s Bereavement, grief, and mourning are Bereavement, complementary threads in the fabric of life, part of the warp and weft of human experience. human Copyright © 2009 Lynne Ann DeSpelder and Albert Lee Strickland Copyright ...
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This note was uploaded on 03/02/2011 for the course SOC 353 taught by Professor Ibrahimnaim during the Spring '11 term at ASU.

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