bereavement and grief. what is grief? grief is a natural response to loss. it’s the emotional...

48
BEREAVEMENT AND BEREAVEMENT AND GRIEF GRIEF

Upload: geraldine-atkinson

Post on 16-Dec-2015

214 views

Category:

Documents


1 download

TRANSCRIPT

Page 1: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

BEREAVEMENT AND GRIEFBEREAVEMENT AND GRIEF

Page 2: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

What is grief?Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you are attached, or when something you love or to which you are attached, is taken away.

Page 3: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

“Grief management” is a misnomerGrief is a natural process and happens gradually;

Many people go through the grief process with no help from anyone in a caretaking;

We grieve differently—there are no “steps”;

Grieving a significant loss is among the most difficult experiences we will face.

Page 4: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

•MYTH: The pain will go away faster if you ignore it. MYTH: It’s important to be “be strong” in the face of loss. MYTH: If you don’t cry, it means you aren’t sorry about the loss. MYTH: Grief should last about a year.

A Few Myth

s Abou

t Grief

:

Page 5: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

PART ONE: FIVE IMPORTANT CONSIDERATIONS FOR THOSE WHO ARE WITH OR WHO ARE SUPPORTING THOSE WHO ARE GRIEVING

Page 6: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

(1) LISTENING

(2) LISTENING AND TALKING

(3) THE REFUGE OF THE MOMENT

(4) SUPPORTING THE BEREAVED IN SELF-CARE(5) SUPPORTING THE BEREAVED TO BE ACTIVE

Page 7: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

(1) Listening:Listen with our whole beings to whatever the bereaved are saying.

This is perhaps the greatest support we can give to someone who is grieving.

Page 8: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

(2) Listening and TalkingThere is no problem you need to solve or advice you have to give. Listening is often enough. Three specific reflections about talking:

There are ways of talking which are helpful;There are comments which are extremely unhelpful;There are also a few overall pointers.

Page 9: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Ways of talking that are helpfulAcknowledge that someone died—using the

word ‘died’ can show you are open to talk about how the person really feels if they want to.

Be genuine and don’t hide feelings.Ask how the bereaved person feels—never

assume since these feelings change. Asking is a good way to invite talking and a release of energy.

There is no reason to talk in hushed tones.Offer support—”Tell me what I can do for

you.”

Page 10: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Comments to Avoid"I know how you feel." "It's part of God's plan." "He's in a better place now.”"This is behind you now; it's time to get on

with your life”

Page 11: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Overall PointersAccept and acknowledge all feelings.

Be willing to be silent and in silence.

Let the bereaved talk about how their loved one died.

Offer comfort and reassurance without minimizing the loss.

Page 12: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

(3) The importance of refuge in the momentThe future is just too painful to think about and the past is equally too painful. In the case of those in intense grief, “now” is also the only refuge. •not denial •Allows the the loss to sink in at a rate the bereaved can handle. •living the “here and now”

Page 13: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

(4) Supporting the bereaved in self-care

encouraging the bereaved to take care of himself or herself physically.

Eating, sleeping, exercising, going for walks are important for a healthy body.

important for healthy grieving process.

Ways of being in the moment.

Page 14: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

(5) Supporting the bereaved to be activeExample: my own grief, surprise I could do it, passing time which felt frozen, was in the moment

Page 15: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Part One SUMMARY: Five Part One SUMMARY: Five Important ConsiderationsImportant Considerations

(1) Listening(2) Listening and Talking(3) The Importance of Refuge in the

Moment(4) Supporting the Bereaved in Self-Care(5) Supporting the Bereaved to be Active

Page 16: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

PART TWO: REFLECTIONS TO HELP UNDERSTAND THE GRIEF PROCESS

Page 17: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

REFLECTIONS TO HELP UNDERSTAND THE GRIEF PROCESSMost, even including Kubler-Ross, say there are no steps. Rather what follows are two items:(1) A Roadmap of the Grieving Process(2) The Tasks Involved in Grieving

Page 18: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

(1) A Roadmap of the Grieving ProcessReaction to the First Awareness of the

LossThe Loss sinks inThe Bottom—”this will never end” “I’m

always going to feel this way”Glimpses of Change—just glimpsesComing Back into the WorldAdaption

Page 19: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

a) Reaction to the first awareness of the loss. This varies from person to person: numbness, shock, breaking heart, disbelief, denial are typical.

Page 20: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

b) The loss sinks in. Yearning for the deceased, anger, sadness, broken heart, despair, whatever the person feels is legitimate. There is no “condition” that will tell you what another person might go through. And unless you have been mindful of your own losses, you may not even know what happens to you.

As the loss sinks in, our view of the world changes and we may question if life has a purpose or even any meaning. We may be angered that the magnitude of our own loss doesn’t make a ripple in the greater world.

b) The loss sinks in. Yearning for the deceased, anger, sadness, broken heart, despair, whatever the person feels is legitimate. There is no “condition” that will tell you what another person might go through. And unless you have been mindful of your own losses, you may not even know what happens to you.

As the loss sinks in, our view of the world changes and we may question if life has a purpose or even any meaning. We may be angered that the magnitude of our own loss doesn’t make a ripple in the greater world.

Page 21: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

c) The bottom. What happens here also varies but this is where the sense that “this will never end” or “I’ll always feel this way” can become dominant. Other typical responses: despair, listlessness, and disorganization.

c) The bottom. What happens here also varies but this is where the sense that “this will never end” or “I’ll always feel this way” can become dominant. Other typical responses: despair, listlessness, and disorganization.

Page 22: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

d) Glimpses of change. These are brief moments that indicate a change is happening, however slowly. They often catch a person by surprise. They may generate guilt: how can I enjoy this when so-and-so has died? They may generate an unrealistic hope for a quick recovery. They are just what they are—indications of a change beginning.

d) Glimpses of change. These are brief moments that indicate a change is happening, however slowly. They often catch a person by surprise. They may generate guilt: how can I enjoy this when so-and-so has died? They may generate an unrealistic hope for a quick recovery. They are just what they are—indications of a change beginning.

Page 23: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

e) Coming back into the world. There are good days and an ability to reconnect to old friends and old engagements.

e) Coming back into the world. There are good days and an ability to reconnect to old friends and old engagements.

Page 24: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

f) Adaptation. The person has completed what can be completed. It does not mean that there will not always be moments of sadness or that the bereaved is content or happy with the loss. It’s just that the bereaved can re-engage in life and has many more good days than bad.

Page 25: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

(2) THE FOUR TASKS INVOLVED IN GRIEVING

(1) To Accept the Fact of the Loss(2) To Process the Pain of Grief(3) To Adjust to a World without the Deceased(4) To find an Enduring Connection with the

Deceased in the Midst of Embarking on a New Life

Page 26: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Task One: Making Real the Fact of Loss

Those about to suffer a death lossMaking real the fact of loss after a death

Page 27: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Making real the fact of loss for Making real the fact of loss for those about to suffer a death loss those about to suffer a death loss

How to tell patients about their condition and discover if they want to know.The great advantage of people openly knowing they are dying when they are dying:dying and family members can be present, complete major unfinished business and say goodbye;those at a distance can return to be with dying;ends dance of pretence and irrelevant conversation;in any culture of not telling, very sick patients with positive prognosis may be unnecessarily stressed.

Page 28: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Making real the fact of loss after a deathIntellectual and emotional componentsHelpful actions: Viewing the body (unless disfigured by explosion, etc) Engagement in process between death and completion (personal examples)More difficult losses: The lack of a corpse (war, drowning) Disenfranchised grieving (miscarriage, abortion, secret lover)

Page 29: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

TASK TWO: PROCESSING THE PAIN OF GRIEF 1. Completing unfinished business—one important

reason to tell condition to dying if he or she wants to know

2. Taking time off for grief3. Journal, memorial book, painting the colours of

loss4. Joining a group for those who are grieving5. Mindfulness6. Difficulties:

guilt—rational guilt, irrational guilt, irrational guilt with staying power

loss through suicide

Page 30: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Irrational guilt and rational guilt.Irrational guilt and rational guilt.

Page 31: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

TASK THREE: ADJUSTING TO A WORLD WITHOUT THE DECEASED

External Adjustments—loss of a companion, sexual partner, accountant, baby-sitter, gardener, audience, bed warmer and/or many more.

Internal Adjustments—the internal task is to ask “Who am I now?” Over time negative images tend to give way to more positive ones.

Spiritual Adjustments—the bereaved may initially lose all direction in life and may consider himself/herself without value. The world may seem to make no sense.

Page 32: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Either the bereaved person makes progress toward a recognition of changed circumstances—aims, goals, perception of self without deceased--—

Or else remains in a state of suspended growth in which she or he is held prisoner by a dilemma that cannot be solved.

Either the bereaved person makes progress toward a recognition of changed circumstances—aims, goals, perception of self without deceased--—

Or else remains in a state of suspended growth in which she or he is held prisoner by a dilemma that cannot be solved.

Page 33: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

TASK FOUR: FINDING AN ENDURING CONNECTION WITH THE DECEASED IN THE MIDST OF EMBARKING ON A NEW LIFELove continues and may appear as

sadness;Continue work of deceased, completing a

project, volunteer work, helping with a condition the death brought to ones attention (diet, smoking, suicide prevention, alcoholism, becoming a hospice pioneer).

Page 34: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

PART THREE: THE COMPLEXITY AND INPUT FROM UNRESOLVED LOSSES

Page 35: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Changes that may be significant losses for many or some peopleDivorce or relationship breakupLoss of healthLosing a jobGraduationLoss of financial security Leaving home (for college, marriage)Loss of a friendshipSexual abuseA miscarriage Loss of a cherished dream

Page 36: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

More Changes that may be significant losses for someoneLosing money (including bad investments)Loss of mobility/capabilityBeing robbed or muggedRetirementChildren leave homeLoss of faith or religious beliefA loved one’s serious illnessAn abortionLoss of virginityLoss of a petLeaving a familiar hated work environment

Page 37: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Exploring and working with Exploring and working with past unresolved lossespast unresolved losses

Grief history All recent deaths or significant lossesAll significant losses beginning with first

death loss or first remembered significant loss

This takes an hour or so and the person may add to the list later as other losses are recalled

The list above may help a person recall losses that were not death losses

Page 38: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Exploring and working with past Exploring and working with past unresolved losses (continued)unresolved losses (continued)Take three of these losses and describe the experiences of how you went through the phases of grieving:a) reaction to the first awareness of the loss; b) the loss sinks in; c) the bottom; d) glimpses of change; e) coming back into the world; f) adaptation

Page 39: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Exploring and working with past Exploring and working with past unresolved losses (concluded)unresolved losses (concluded)By reviewing three significant losses, a pattern or

profile of how a person grieves may arise. The person can then assess what was helpful, what was not, and any changes that might help complete the four tasks of grieving

The work here is the same as the work in going through the four tasks of grieving: making real the fact of loss, processing the pain of grief, adjusting to a world without the deceased, and finding an enduring relationship with the deceased in the midst of embarking on a new life.

The practice of mindfulness meditation is a useful way of staying in the moment and allowing memories, images, pain and joy to arise and cease.

Page 40: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

The form of meditation here is often called vipassana. The aim is simply to be in the moment and to experience the pain and grief and anger and torment, not to become it.

These are all natural human conditions—the “mistake,” which most of us make, is to take them personally.

Rather than “I am angry” the ancient Irish language said “the anger is on me.”

The form of meditation here is often called vipassana. The aim is simply to be in the moment and to experience the pain and grief and anger and torment, not to become it.

These are all natural human conditions—the “mistake,” which most of us make, is to take them personally.

Rather than “I am angry” the ancient Irish language said “the anger is on me.”

Page 41: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

The Guest House– by Rumi

This being human is a guest house.Every morning a new arrival.A joy, a depression, a meanness,some momentary awareness comesas an unexpected visitor.Welcome and entertain them all!Even if they are a crowd of sorrows,who violently sweep your houseempty of its furniture,still, treat each guest honorably.He may be clearing you outfor some new delight.The dark thought, the shame, the malice.meet them at the door laughing and invite them in.Be grateful for whatever comes.because each has been sentas a guide from beyond.

Page 42: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

In closing…Two deeply mistaken myths:MYTH: The pain will go away faster if you ignore it MYTH: It is far better to avoid uncomfortable events and tasks than to acknowledge that a family member or friend is dying or has died.

Rather, take time off to grieve, allow the energy of the loss to express itself and flow through, TAKE TIME OFF TO GRIEVE.

Page 43: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

One way of bringing this home the importance of these “tasks” : looking ahead five years and asking what would I prefer to look back upon in five years?

Would I prefer to remember that I said goodbye to my dying parent?

Would I prefer to remember that I thanked the person for all that they had given me? That I asked forgiveness for mistakes I had made?

Would I prefer to help prepare the body of a loved one?

The five-year tool is a useful one and someone who is bereaved will recognize it being useful such as soon as they are asked.

Page 44: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Some important lessons….

Keeping relationships current (for example, telling people you love that you love them);

Keeping what is important current.

Some important lessons….

Keeping relationships current (for example, telling people you love that you love them);

Keeping what is important current.

Page 45: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

In my first grief lecture in Thailand, I was asked only one question: what can we do to prepare ourselves for loss and grieving? In addition to keeping our lives current, there is another practical answer:

In my first grief lecture in Thailand, I was asked only one question: what can we do to prepare ourselves for loss and grieving? In addition to keeping our lives current, there is another practical answer:

Page 46: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

By practicing meditation that quiets the mind and brings us into the “here and now” moment, including being mindful of touches and tastes and sights. This has nothing to do with religion but everything to do practical concerns.That is an indispensable important way of preparing ourselves for loss, grief and our own deaths.

By practicing meditation that quiets the mind and brings us into the “here and now” moment, including being mindful of touches and tastes and sights. This has nothing to do with religion but everything to do practical concerns.That is an indispensable important way of preparing ourselves for loss, grief and our own deaths.

Page 47: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

1) It helps us to process the pain of grief;2) By practicing daily, we develop an important tool that will be ready when we need it;3) Meditation actually changes our brain to abide with physical and psychological pain

1) It helps us to process the pain of grief;2) By practicing daily, we develop an important tool that will be ready when we need it;3) Meditation actually changes our brain to abide with physical and psychological pain

Page 48: BEREAVEMENT AND GRIEF. What is grief? Grief is a natural response to loss. It’s the emotional suffering you feel when someone you love or to whom you

Grieving for significant losses is one of the most difficult things we human beings experience.

I wish all of us well.

Grieving for significant losses is one of the most difficult things we human beings experience.

I wish all of us well.