Chapter 8

Crisis of Loss

LossBy Rita Moran

PLEASE, don't ask me if I'm over it yet.I'll never be over it.PLEASE, don't tell me she's in a better place.She isn't here with me.PLEASE, don't say at least sheisn't suffering.I haven't come to terms withwhy she had to suffer at all.PLEASE, don't tell me youknow how I feel.Unless you have lost a child.PLEASE, don't ask me if I feelbetter.

Bereavement isn't a conditionthat clears up.PLEASE, don't tell me at leastyou had her for so many years.What year would you choose foryour child to die?PLEASE, don't tell me GodNever gives us more than we can bear.PLEASE, just say you are sorry.PLEASE, just say youremember my child, if you do.PLEASE, just let me talk aboutmy child.PLEASE, mention my child'sname.

PLEASE, just let me cry.

Types of Loss

A. The death of a spouse is one of the most emotionally stressful and disruptive events in life. Many other problems are faced such as economic, career, and family etc..B. Every parent suffers the loss of a child somewhat differently. And it is traumatic for parents of children of all ages. There is no pattern that your mind can connect the death of a child to so one adjusts their thinking. The bond to that child is forever.

C. The loss of a loved one by suicide is doubly stressful. The victim of suicide is often the ones left behind, and can be more vulnerable to physical and mental health problems than are grievers from other causes of death. Support groups have been recommended to help people cope with loss following a suicide.

D. Children who experience the death of a parent or sibling may show overt signs of bereavement, but some may be covert. Preschool and school aged children show different signs of grief. Older children show more anxiety, depression, and somatic symptoms, while younger children exhibitsadness, anger, crying, feelings of remorse and guilt, and separation anxiety.

E. Children’s cognitive, affective, and behavioral responses must be approached not in terms of adult perspectives but in terms of each child’s understanding and developmental stage. They can misinterpret the event and lack the grieving process. They need to hear over and over again that they are safe and someone needs to listen to their feelings. Honesty about the loss should be shared and they should be allowed to grieve at their own level.

F. Adolescence who are in bereavement need to be included in the family’s grief, while at the same time need privacy. They need opportunities to be included in discussions, planning, mourning, and funeral and commemorative activities. Teenagers may benefit from counseling as long as three years following the sibling death. Do not put a time limit on the grieving process.

G. Divorce can place children in untenable positions, causing them to feel confused, insecure, fearful, trapped, angry, unloved and guilty. It is a loss.

H. Elderly people generally experience more losses than do their younger counterparts. The most devastating is the loss of a spouse. They respond in three ways(1) they totally ignore death, (2) excessive thoughts about dying, (3) a healthy balance. Allowing them to share their past will help an elderly persons self-esteem.

Stages and Tasks of Mourning

Kubler-Ross’s 5 Stages of Death and Dying:1. Denial and shock2. Anger3. Bargaining4. Depression5. Acceptance

Worden’s 4 Tasks of Mourning:1. Acceptance that the death is real.2. Grieving the loss, expressing feelings about loss.3. Adjusting to life without the deceased party.4. Withdrawing energy from the lost person and re-investing in

someone or something else.

The Schneider model deals with eight-stages of grieving. It is a growth-promoting model designed to nurture as much personal growth as possible within a context of stress, loss, and grief. It includes internal events, systems of belief, and the processes of growth and aging as well as the easily recognized losses, such as death and divorce. The stages are as follows:

1. Initial Awareness-shock, confusion, numbness, detachment, disbelief, and disorientation

2. Attempts at Limiting Awareness by Holding On-using coping mechanisms to stave off immobility and disequilibrium3. Attempts of Limiting Awareness by Letting Go-recognizing one’s personal limits with regard to the loss4. Awareness of the Extent of the Loss-most painful, lonely, helpless, and hopeless phase

5. Gaining Perspective on the Loss-reaching a point of accepting that what is done is done and providing the bereaved people with a time to make peace with their past6. Resolving the Lost-when they can see and pursue activities unconnected with the loss without it being a reaction against or identifying with the lost person or object7. Reformulating Loss in a Context of growth-discovering potential rather than limits, seeing problems as challenges, being curious again, and seeking a balance between the different aspects of self

8. Transforming Loss into New Levels of Attachment-approach life with greater openness and the willingness to surrender more readily the necessity of structure in life, reformulation that produces a greater capacity for growth than before

Interventions

Help talk about the loss, don’t be afraid to ask what happened.

Help identify and express feelings

Help live without the deceased or lost loved object. Problem solving works

Facilitate emotional withdrawal from deceased. Encourage to move on

Provide time to grieve actively.

Prepare for holidays and anniversaries

Educate about customary grieving reactions of others

Allow for individual differences

Provide for continuing support. Groups are great!

Divorce and Separation

About 50% of marriages end in divorce.

Each partner must complete tasks of mourning

Children need not suffer if parents manage feelings appropriately

Rage and frustration are common

Custody arrangements are complicated

Other issues

Financial loss

Social loss

Family loss

At risk for increase substance use

Feelings of guilt and resentment

Interventions

Referrals to support groups, 12 step groups and the use of church, school and athletic organizations, as are books.

Help clients grieve: they need to cry a lot, write, read, pray and talk.

Be optimistic, the pain will end eventually, support how difficult it is.

Children and Divorce

26% of children under the age of 18 live with a divorced parent.39% of divorced women with children live in povertyCivility among parents and assurance that both still love the children is helpfulSome need brief individual play therapy, others need family counseling

Blended family issues

Loyalty is a problem

May feel guilty for bonding with a step parent

Children often act out, won’t even try to like a step parent.

Family must incorporate new parent’s style and rules.