Crises of Loss

Kubler-Ross Five Stages of Death and Dying• Denial and Isolation- Denial is a healthy and

common reaction to loss. It helps with the initial shock, and allows you to deal with both their hope and despair.

• Anger- Helps with the acceptance of the reality of death. You may feel rage, envy, resentment, etc.

• Bargaining- Are secret packs with God. Even if parents were not religious earlier in life.

• Depression- When death is accepted the feelings of loss are overwhelming and depression sets in. You may feel sadness, feeling of guilt, worthlessness, etc.

• Acceptance- Work though your mourning and depression of loss and comes to accept the loss.

Other Theories of Loss

• Sigmund Freud- defined mourning as a period of gradual withdrawal of libido from now-missed loved object.

• Reactions- dejection, disinterest with surrounding, and detachment from others.

• Self-limiting• The libido has completed its

withdrawal form the loved object and is reinvested in a new object.

Other theories

John Bowlby- Proposed four phases of mourning:

Numbing Yearning and Searching for the

lost figure Disorganization and despair Reorganization

Other Theories

Charles Darwin- Separation reaction results from the loss of a loved one were innate. There are similar body movements in grieving individuals regardless of cultural background.

Worden’s Tasks of Mourning

Task I: Accepting the Reality of the Loss The person grieving needs to accept

that the loss is real Denial can become pathological Permanent loss must be replaced by

realization that loss has happened and that the person can survive the loss

Anger shows there is some acceptance that the loss is real

Task II: Experiencing the Pain of Grief

Next step: fully experience the feelings associated with the loss

Ways of showing grief: crying, yelling, or meditations

Pain may be more intense for some then others

Everyone needs to experience the pain left in his/her life from a loss

Task III: Adjusting to an Environment from Which the Deceased is Missing• Widows and widowers take several months

to cope on their own• About 3 months after the loss they realize

that they can manage their new environment

• Must find ways to cope with new roles that once were their loved one’s role

• At first they often resist developing new skills, but eventually become proud of their newfound abilities…new self-esteem!!

Task IV: Withdrawing Emotional Energy from the Deceased and Reinvesting It in Another Relationship and Reinvesting It in Another Relationship Withdrawing their emotional energy

from the dead loved one is often seen as betrayal

Guilt must be overcome Mourning can be considered finished

when the tasks of mourning are over Mourning is an individual process Usually takes a year to pass by

before the loss is fully resolved

Task IV Continued

At least a year is needed to let go of old memories and begin to build new ones

Holidays, seasons, and family events all must come and go during the mourning period before resolution is complete

Does not mean the expression of grief will be strong for the entire year

How might you know the mourning has come to an end???

The person is able to think and talk about the deceased without pain.

The sadness at this point lacks the tearing quality of loss

Studies show widows often need 3-4 years to find stability in life again

MOURNING IS A LONG TERM PROCESS!

Manifestations of Normal Grief

Sadness, anger, guilt, anxiety, including death awareness and phobia; loneliness, fatigue, helplessness; shock-particularly with sudden death; yearning and pining; emancipation, which can be a positive response; relief, particularly from suffering; and numbness

Manifestations of Normal Grief

• Physical Sensations: Hollowness in the stomach, tightness in the chest and throat, sense of depersonalization, breathlessness, weakness in the muscles

• Cognitions: Disbelief, confusion, preoccupation, sense of presence, hallucinations

• Behaviors: sleep disturbances, appetite disturbances, social withdrawal, dreams of the deceased; sighing or crying; fear of losing memories; treasuring objects

Determinants of Grief

Relation to the one loss Nature of the attachment Mode of death; Natural, accidental,

suicide, or murder Prior grief experiences and mental

health Religious beliefs

Intervention

If worker is on alert because of symptoms they must refer client to a physician if symptoms cause moderate to severe dysfunction.

Counseling Principles and Procedures 1. Help survivor actualize the loss. Talk

about the loss. What happened? Ask.2. Help them identify and express feelings.3. Help survivor live without the deceased. 4. Facilitate emotional withdrawal from the

deceased. Encourage survivors to go on.5. Provide time to grieve. Crucial time

include 3 months and 1 year after the death, anniversaries of the death and holidays. Help client prepare in advance.

Procedures continued

6. Educate clients about customary grieving reactions of the other individuals to help normalize the experience.

7. Allow for individuals differences. Be sensitive to individual styles.

8. Provide for continuing support. Encourage clients to join support group.

Separation and Divorce

Approximately 50% of American marriages end in divorce.

The split of a relationship is often seen as a loss, even if wanted initially.

Divorce can be seen as a “failure”.

If children are involved, the loss becomes more complex.

Rage is a common reaction when arranging custody matters – crisis workers often act as mediators.

Children and Divorce

Approx. 26% of children under 18 live with a divorced parent in the U.S.

In 1991, 39% of divorced women with children lived in poverty.

Intervention may be child or family oriented; the goal is to alleviate emotional/behavioral problems connected with divorce.

Crises in Blended Families

Many crises occur when one or the other divorced parent moves on and starts dating again.

In some situations, the person who is dating the divorced person has never had children.

Loyalty issues often come into play when children are presented with a divorced parent’s new partner.

Losing a Child

The affects of losing a Child Parents who are married at the time

of lost of a child. Their relationship is usually weakened.

Most couples have troubles getting along with each other, as well as their other children.

They no longer feel like the same people before the tragedy

Work

Employment allows only 3 days of leave for a death

Not enough time considering the attention span of a grieving parent is about a minute and a half

Most parents lose their jobs, making their crisis state even higher

The outcome of Receiving no Help

Suicide Divorce

The outcome of Receiving no Help

Ninety percent of couples who don’t receive some kind of help, usually ends in divorce

Extreme depression Suicide thoughts come into play

The outcome of Receiving Help

According to Nancy Ludt, she said that of the 1,500 people who attended her support group over the last 16 years, only two couples had later divorced.

When the depression and suicide thoughts are strong, a support group gives some hope and help to the grieving parents

Why Attend Support Groups Gives couples the chance to say things

that they usually wouldn’t say at home Father gets to express his feelings as

openly as the mother In our society, the man is supposed to

be strong. He can’t cry but instead must be

strong and go to work even after the death of a child.

Some Reasons why Parents prefer Support Groups

It’s a place of safety, where it is all right to say anything.

It fills that need to be with people who understand.

It’s their child’s space It has no time frame

Continued

It allows the parents to laugh or cry and not hurt anyone’s feelings

They can express their thoughts with no need to explain them

It can save a parents life

Crisis Worker

What can a crisis worker do to help?

Crisis Worker continued

Crisis worker can ease the pain by listening

Let the grieving parent do most of the talking

This where we use our educational and supportive comments

What a Crisis Worker Shouldn’t do Structure is not good Parents have changing needs, which

can shift from one minute to another No guest speakers Same on an individual basis

Video

http://www.youtube.com/watch?v=19mLHDQ68wE

Outside sources for Loss

The Compassionate FriendsFor loss of a child http://www.compassionatefriends.org/

Grief Sharehttp://www.griefshare.org/