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Living with Grief Living with Grief – – After After Sudden Loss Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle Senior Consultant, The Hospice Foundation of America

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Page 1: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Living with Grief Living with Grief –– After After Sudden LossSudden LossKenneth J. Doka, PhD

Professor of Gerontology, The College of New Rochelle

Senior Consultant, The Hospice Foundation of America

Page 2: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

An InterAn Inter--Cultural DialogCultural Dialog

“The United States and Great Britain are two countries separated by a common language.” (attributed to G. B. Shaw)

My context is American – so you need to constantly ask – Do the same conditions and factors apply in the UK?

Page 3: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

GoalsGoals

To briefly review factors common to sudden loss and delineate some factors unique to particular types of sudden loss

To offer some comments on ways to assist survivors of sudden loss

Page 4: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

When Grief Is SuddenWhen Grief Is Sudden

The dual challenge

The challenge of grief

The challenge to our assumptive world – benevolence, meaning and fairness, identity, and predictability

Page 5: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Sudden LossSudden Loss Common FactorsCommon Factors

Loss of the assumptive world

The issue of grief + trauma

Suddenness, unfinished business ( and the role of ritual)

Issues of preventability

Powerlessness

Missing or disfigured body

Intense reactions (possibly including anger, rage, anxiety, and survivor guilt)

Page 6: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

RynearsonRynearson’’ss The 3 VThe 3 V’’s of Violent s of Violent DyingDying

1. Violence – injurious action

2. Violation – transgressive

3. Volition – someone is responsible (commission or omission)

Page 7: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Sudden LossSudden Loss Unique Factors to Natural Sudden DeathsUnique Factors to Natural Sudden Deaths

Can include heart, attacks, strokes, aneurisms etc.

Issues of personal culpability

Death situation – did person witness, did person die alone, un- helped, failure to help etc.

Page 8: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Sudden LossSudden Loss Unique Factors to AccidentsUnique Factors to Accidents

Issues of culpability

Legal after-effects and adversarial legal system

Page 9: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Sudden LossSudden Loss Unique Factors to Homicide Unique Factors to Homicide

Stigma and disenfranchisement

Often relationship with both victim and perpetrator

Even if the survivor was not a witness, they may still have fantasized intrusive imagery – strong imaged of the imagined event (Blakley, 2009)

The media

Criminal justice system

Page 10: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Secondary Victimization Secondary Victimization HomicideHomicide

Refers to individual victims of homicide feeling an additional sense of being victimized after the homicide such as by the media which may denigrate the reputation of the deceased victim or the criminal justice system which might not capture the perpetrators, fail in prosecution, or besmirch the victim’s reputation in court proceedings.

Page 11: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Sudden LossSudden Loss Unique Factors to SuicideUnique Factors to Suicide

Conflict and ambivalence

Stigma and disenfranchisement

Family stigma and feelings of guilt and preventability

Spiritual issues and suicide

Page 12: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Strained support

Multiple loss

Concurrent crises

A process that likely includes significant disenchantment

Sudden LossSudden Loss Unique Factors to Public Tragedy or DisasterUnique Factors to Public Tragedy or Disaster

Page 13: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

RynearsonRynearson’’ss Restorative Restorative RetellingRetelling

Persons may often review and re-enact event

May see themes of remorse (“I should have prevented this.”)

Retaliation (“I will get someone for this.”)

Over-protection (“This will not happen again.”)

Finally restorative retelling allows one to find some sense of meaning in the loss.

Page 14: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

What Can Help?What Can Help?

Choices in grief

Catherine Sanders Phases– Shock– Awareness of loss– Conservation and

Withdrawal– The Turning Point– Renewal

Worden’s Tasks

Page 15: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Accepting RealityAccepting Reality

The role of funeral and other rituals

Talking about the loss freely

Page 16: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Experiencing EmotionsExperiencing Emotions

No need to bottle feelings

Understanding ambivalence and finishing business

Planning for difficult times

Page 17: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Adjusting to Life without the Adjusting to Life without the PersonPerson

Assessing change

Coping (and assessing) with loneliness

Drawing from strengths – and avoiding past weaknesses

Secondary losses

Getting Support (D, L, R)

Page 18: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Continuing the BondContinuing the Bond

Building in moments to remember or reaffirmSanders’ Questions

1. What do I wish to take from my old life into my new life?

2. What do I wish to leave behind?

3. What do I need to add?

Page 19: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Reviewing Faith and Meaning Reviewing Faith and Meaning

The challenge to our spirituality and assumptions

How does your faith or philosophy speak to you?

What resources does it offer (beliefs, practices, rituals, community)?

Page 20: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Resources for Your StruggleResources for Your Struggle

Books

Counseling

Self-Help Groups

Page 21: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,
Page 22: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Support GroupsSupport Groups

Validation

Ventilation

Respite and Support

Learn Coping Techniques

Lund – Helping others helps self

Page 23: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Support Groups Support Groups –– Possible Possible DangerDanger

The Danger of Shared Anguish in a poorly led group

The Need for an IntakeProcess

Page 24: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Creating RitualsCreating Rituals

The Value of Rituals

Types of Ritual– Continuity– Transition– Reconciliation– Affirmation

Page 25: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,
Page 26: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

Caregiver StressCaregiver Stress The Role of The Role of Secondary Secondary

TraumatizationTraumatization

Secondary traumatization refers to the trauma that results from helping traumatized individuals as their stories challenge the caregiver’s assumptive world

This can add to caregiver stress

Page 27: Living with Grief – After Sudden Loss · Living with Grief – – After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle. Senior Consultant,

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