Normal Grief ReactionsNormal Grief Reactions

GriefGrief

““an emotion or set of emotions due to a an emotion or set of emotions due to a loss”loss”Grief is a normal reaction to loss.Grief is a normal reaction to loss.The absence of grief is abnormal in most The absence of grief is abnormal in most cases.cases.Grief is based on the individual Grief is based on the individual perceptions of the loss by the griever.perceptions of the loss by the griever.

MourningMourning

““an adjustment process which involves grief or an adjustment process which involves grief or sorrow over a period of time and helps in the sorrow over a period of time and helps in the reorganization of the life of an individual reorganization of the life of an individual following a loss or death or someone loved”following a loss or death or someone loved”Mourning is the process of adjustment and Mourning is the process of adjustment and adaptation to the loss.adaptation to the loss.Mourning is driven by the social and cultural Mourning is driven by the social and cultural influences to which the griever is exposed.influences to which the griever is exposed.

Characteristics of GriefCharacteristics of Grief

Lindemann:Lindemann: Somatic (bodily distress)Somatic (bodily distress) Preoccupation with the image of the Preoccupation with the image of the

deceased.deceased. GuiltGuilt Hostile reactions.Hostile reactions. Loss of patterns of conduct (inability to Loss of patterns of conduct (inability to

function as before the loss)function as before the loss)

Determinants of GriefDeterminants of Grief

How the bereaved perceives the loss.How the bereaved perceives the loss.The bereaved’s age.The bereaved’s age.The age of the person who died.The age of the person who died.The degree to which the bereaved was The degree to which the bereaved was prepared for the death.prepared for the death.The bereaved’s inner strength and outer The bereaved’s inner strength and outer resources.resources.The nature of the relationship with the The nature of the relationship with the person who died.person who died.

Worden’s Grief CharacteristicsWorden’s Grief Characteristics

FeelingsFeelingsPhysical sensationsPhysical sensationsCognitionsCognitionsBehaviorsBehaviors

Worden’s Tasks of MourningWorden’s Tasks of Mourning

Accept the reality of the loss.Accept the reality of the loss.Experience the pain of grief.Experience the pain of grief.Adjust to an environment in which the Adjust to an environment in which the deceased is missing.deceased is missing.Withdraw emotional energy and reinvest in Withdraw emotional energy and reinvest in another relationship.another relationship.

Psychological Factors Influencing Psychological Factors Influencing GriefGrief

Raphael:Raphael: The preexisting relationship between the The preexisting relationship between the

bereaved and the deceased.bereaved and the deceased. The type of death.The type of death. Previous losses.Previous losses.

Rando’s Psychological FactorsRando’s Psychological Factors

Meaning of the loss.Meaning of the loss.Qualities of the relationship.Qualities of the relationship.Roles of the deceased.Roles of the deceased.Age of the griever.Age of the griever.Griever’s sex-role conditioning.Griever’s sex-role conditioning.Deceased’s unique characteristicsDeceased’s unique characteristicsGriever’s mental stateGriever’s mental stateGriever’s maturity and intelligence.Griever’s maturity and intelligence.Previous experience with loss.Previous experience with loss.

Rando’s Psychological Factors Rando’s Psychological Factors (cont’d)(cont’d)

Cultural elements affecting the griever.Cultural elements affecting the griever.Fulfillment of the deceased’s life.Fulfillment of the deceased’s life.Context of the death.Context of the death.Preventability of the death.Preventability of the death.Timeliness of the death.Timeliness of the death.Expectation of death.Expectation of death.Length of illness.Length of illness.Involvement with dying person.Involvement with dying person.Secondary losses.Secondary losses.Additional stressors.Additional stressors.

Rando’s Sociological FactorsRando’s Sociological Factors

Available support systems.Available support systems.Cultural background and context.Cultural background and context.Socioeconomic status.Socioeconomic status.Funerary rituals.Funerary rituals.

Physiological FactorsPhysiological Factors

Drugs and sedatives.Drugs and sedatives.Nutrition.Nutrition.Rest and sleep.Rest and sleep.ExerciseExerciseOverall physical condition.Overall physical condition.

Theories of GriefTheories of Grief

Freud: psychoanalyticFreud: psychoanalyticLindemann: physicalLindemann: physicalBowlby: relationalBowlby: relationalParkes: clinicalParkes: clinical

FreudFreud

““grief is a process by which libido (energy) grief is a process by which libido (energy) is withdrawn from a love objectis withdrawn from a love objectThe grief process absorbs the energies of The grief process absorbs the energies of the ego.the ego.Grief is normal, appropriate and Grief is normal, appropriate and necessary.necessary.Grief is painful.Grief is painful.

LindemannLindemann

““Grief Syndrome”Grief Syndrome”Physical expressions of grief:Physical expressions of grief: Somatic or bodily distress.Somatic or bodily distress. Preoccupation with the image of the Preoccupation with the image of the

deceased.deceased. Guilt.Guilt. Hostile reactions.Hostile reactions. Inability to function as one had before the Inability to function as one had before the

loss.loss.

BowlbyBowlby

““Attachment Theory”: 4 aspectsAttachment Theory”: 4 aspects Strength of attachment.Strength of attachment. Security of attachment.Security of attachment. Reliance.Reliance. Involvement.Involvement.

ParkesParkes

Clinical viewpointClinical viewpointDescribes the experience of grief as a Describes the experience of grief as a normal reaction to overwhelming loss.normal reaction to overwhelming loss.Describes somatic distress as “pangs”.Describes somatic distress as “pangs”.Resistance to change and a reluctance to Resistance to change and a reluctance to give up possessions, people, status and give up possessions, people, status and expectations are the basis of grief.expectations are the basis of grief.

Complicated GriefComplicated Grief(Unresolved, Chronic)(Unresolved, Chronic)

Canine’s Variable That Can Canine’s Variable That Can Obstruct the Grief ProcessObstruct the Grief Process

Past Losses (Worden: Historical Factors)Past Losses (Worden: Historical Factors)Death Surround (Worden: circumstantial Death Surround (Worden: circumstantial Factors and Relational Factors)Factors and Relational Factors)Social Issues: (Worden: Social Factors Social Issues: (Worden: Social Factors And Personality Factors) (Lazare: 3 And Personality Factors) (Lazare: 3 conditions)conditions)Abnormal Grief Responses (Worden: Abnormal Grief Responses (Worden: Abnormal Grief Reactions)Abnormal Grief Reactions)

Worden’s Abnormal Grief Worden’s Abnormal Grief ReactionsReactions

Chronic Grief ReactionChronic Grief Reaction

Exaggerated Grief ResponseExaggerated Grief Response

Delayed Grief ResponseDelayed Grief Response

Masked Grief ResponseMasked Grief Response

Therapeutic StrategiesTherapeutic Strategies

Reaching out to the bereaved.Reaching out to the bereaved.Rituals of bereavement. (Funeral Rites)Rituals of bereavement. (Funeral Rites)Resolving complicated grief.Resolving complicated grief.Expectations for closure.Expectations for closure. 4 behaviors: acceptance of feelings4 behaviors: acceptance of feelings detachment from the deceaseddetachment from the deceased reestablishment of relationshipsreestablishment of relationships restoration of wholenessrestoration of wholeness