Thoughts for walking the

road through

grief and loss

Margaret Alve

If you have questions there

will be time at the end or you can

ask as we go through

What you hear here

What is said here

When you leave here

Let it stay here

1917 Freud – Mourning & melancholia

1960’s Bowlby –Attachment, Separation & Loss Theory

1970’s Parker & Kubler-Ross – Stage Model Theory

Maslow – Hierarchy of Need

1980’s Doka – Disenfranchised Grief

Worden – Tasks of Mourning

1990’s Tonkin – Growing around Grief

Stroebe & Schut – Dual Process Model

White – Saying Hello

Silverman –

Continuing Bonds

2000’s Wolfelt –

Companioning Neimeyer – Meaning Reconstruction

Bonaano & Kaltman

Michael White - Saying hello

Re-Membering conversations

http://www.dulwichcentre.com.au/michael-white-archive.html

sciencedirect.com downloaded images Google

The Dual Process Model of Coping with Bereavement (DPM) Stroebe and Schut (1999)

“If you can make meaning,

then you can accommodate;

if you can accommodate

then you can adjust;

when you adjust

you can go on and live

a reconciled life.”

Robert Neimeyer (abridged)

Our modern understanding of grief all too often uses

a "recovery" or "resolution“ which suggests a

return to "normalcy”

“Companioning" versus "treating”

Companioning the Bereaved by Alan D. Wolfelt, Ph.D.

Life long process “one does not get ‘over’ it”

Quietness and emptiness invite the heart to observe

signs of sacredness, regain purpose, rediscover

love, that life goes on

Companioning the Bereaved by Alan D. Wolfelt, Ph.D.

However we each get through our loss,

all of us - whatever our gender -

need the respect, understanding and

patience of others

to grieve in our own way,

without guilt or disapproval,

for as long as we need to.

Simon, 38, a bereaved father Skylight© skylight 2007

Liminality

Honouring the in-betweens in lives

Betwixt and Between

Situations and conditions that are

characterised by the

dislocation of established structures,

reversal of hierarchies,

and uncertainty regarding future outcomes

Characterised by ambiguity, openness,

sense of identity dissolves to some

extent, can included disorientation,

self understanding and behaviour can be

relaxed, opening the way to something

new.

Fear and denial

Support

Contact with the Sacred

Solitude & Soul Work

Adjustment & Acceptance

Grieving the old

Accommodating the new

Gifts of Liminality

Gender

Differences

Instrumental Intuitive

Thoughts are more dominant Emotions are more dominant

Feelings are tempered Grief consists primarily of profoundly

painful feelings

Energy is put into activity Feeling are expressed through tears that

range from weeping, sobbing

Prefer to discuss problems Tend to share feelings with others

May view their adaptation to loss as a

challenge instead of a threat

May experience feeling directly or

vicariously from listening to another’s

expression of grief

Other features may include: confusion,

disorientation, disorganised thought,

difficulty crying, often sit quietly,

restlessness, rote behaviours, pacing,

insomnia, may express anger than

other feelings

Other features may include: depression,

low mood, confusion, anxiety, loss of

appetite, inability, fatigue, increased

arousal/anxieties…

Adaptation from: Men Don’t Cry…….Women Do: Transcending Gender stereotypes of Grief. Martin T.L. & Doka K.J.

Instrumental Intuitive

THINKING is predominant to feeling as an experience; feelings are less intense. There is a general reluctance to talk specifically about feelings

FEELINGS are intensely experienced

Mastery of oneself & the environment are most important

Expressions such as crying and suffering mirror the inner experience

Problem-solving as a strategy enables mastery of feelings & control of the environment in creating the new normal

Successful adaptive strategies facilitate the experience & expression of feelings

GRIEF STYLES: Transcending Gender - AIDS Bereavement Project of Ontario

Instrumental Intuitive

Brief periods of cognitive dysfunction are common- confusion, forgetfulness, obsessiveness

Prolonged periods of confusion, inability to concentrate, disorganization & disorientation

Energy levels are enhanced, and symptoms of general grief reactions to the loss go unnoticed

Physical exhaustion & anxiety may result

GRIEF STYLES: Transcending Gender - AIDS Bereavement Project of Ontario

Talk to a person beside or in front of you

• When listening what stood out for you?

• What style of grieving do you resonate more

with?

How do children respond?

Are ego centric

Magical thinking

Process loss and grieve in bursts

Possible regression

Need honesty and updates

Respond best with routines

Have questions

Reassurance

Information – age appropriate

Inclusion and involvement

Look for/need comfort from those they trust

Anxieties and fears can build up

And Teens?

Want to be near you

Want to be alone or away with friends

Want comfort - don’t

Want information – don’t

Want to be involved –

don’t seem to care – seem disengaged

But always need?

attention, care and practical support

good information and updates – honesty

their needs acknowledged and taken into account

to be involved, consulted and included

respect

WORDS THAT CAN HELP

• What have you been doing?

• How’s ....sport, dancing, music...

• Ask them about them...

• What are the hardest things for you?

• Let me know if I can do anything for you..

Words that Hurt

• I know how you feel

• It will be okay

• Don’t cry

• You are the man/woman of the house now.

• You should feel ….(proud, relieved, happy, sad, etc.)

Watching family members, of all ages, coping

you’ll see patterns such as:

• Distancing themselves

• Confrontation – fighting for what they think

is needed/wanted

• Self control/lack of- thoughts and feelings

• Seeking social support – someone to talk to

• Accepting responsibilities – or not - to do

better/be better/take on roles or tasks

• Escaping - sleeping more, eating more,

drinking, drugs and other risk taking

behaviours

• Problem solving – making action plans to

do things to provide help or comfort

• Positive re appraisal of life – finding

new meanings and ways of

understanding what’s happening

Family members – of all ages and stages

Can have a role in caring, supporting or

can be ambivalent, or even active in avoiding it

What can help? What will maximise the

possibility that family coping will be effective?

• Understanding and respecting different coping

styles and needs

• Family routines kept up – including family time

• Reassurance of normality of reactions/grief

• Good communication

• Assistance in tangible support

• Empathy

Communication

Waiho i te toipoto, kaua i te toiroa

Let us keep close together,

not far apart

By understanding how we are using

our bodies/words to communicate

with other people, we can also

understand how other people are

nonverbally & verbally

communicating with us

Kité

Listen

Reflect

Be curious

www.becauseumatter.co.nz

S ignals

F - freaked out

I - insecure

N - neurotic (nervous)

E - emotional

Italian Job (2003) movie

Judging: by attitude, praise to soon, too often can have a detrimental effect

Giving/suggestions or solutions

Avoidance: changing the subject, logical statements

Barriers

• Phrases like – “I don't know what to say”

• ‘Hi what have you been doing’

• Please use ‘their’ name

• Don’t avoid me. Be the friend you have

always been

• A simple squeeze of the hand can tell

me you care

It’s helpful if people say

•Cry with me; laugh with me

• I will have myriads of feelings and that is ok

• Ring and ask if it is okay to visit but don’t be

afraid to visit, and don’t be offended if I say

not today

• Do one step at a time, day or moment….

• Listen to me, I know what I need

• Believe me

• Don’t tell me what to do

• I may need someone just to listen

• Write in a journal

• Digital coffee

• Walks, exercise

Things others have found helpful

Ma te wa– everything in its own time

Look at the list on the wall

1. Choose 2 -3 qualities that you have and

share about these in your group

2. Choose 2 others that you would like to

develop – how might you do that?

Look at your finger print… you are unique

“You can’t be anything for anyone else

unless you take care of yourself”

Tools for the

tool kit

For professional/friends

False Expectations Appearing Real

F E A R

For bereaved

Feelings Expressed Allows Relief

Conrad David: The Cost of Caring: Secondary Traumatic Stress , LCSW, Coordinator,

The Secondary Trauma Prevention Project

If you feel stuck and can’t think clearly –

STOPP

Stand still

Take a Breath

Observe

Pull Back

Practise what works

• Detect icebergs

Movies The Help, Big Fish Nemo,Despicable Me, Up Marley & Me A Good Day to Die Hard The Notebook Warhorse, Wolverine, Man of Steel

Some families find this a time of closeness,

reflection and special interaction together

Others find it a time of communication

difficulties, conflict or unhelpful old

family patterns

Most will find a blend of both.

Exercise

• Everything I do is futile and useless

• I can’t cope

• I feel like giving up

• All my efforts have been wasted

• I’m so slow

• Nothing is working

(negative Velten) from Pascal Saker the Brain Clinic

Exercise

• I am doing well

• My thinking is clear

• Everything is going well for me

• I’m enthusiastic and confident right now

• Things are easy at the moment

• People really appreciate me

(Positive Velten) from Pascal Saker the Brain Clinic

“The most authentic thing about us is

the capacity to create, to overcome,

to endure, to transform, to love and

to be greater than our suffering and

our grief”

Criminal Minds Wednesday 12 October 2011 8.30pm

Final thoughts......

The bottom line is "BE".

Be you, be authentic,

be real, be whole,

be the best you can be

in this moment,

be loving, be kind, just BE!

.

“Sometimes the questions are complicated and the answers are

simple.”

Hutia te o te harahkeke

Kei hea to kömako e kö kï mai ki ahau?

He aha te mea nui o te ao?

Mku e kï atu, he tängata, he tängata, he tängata.

If you remove the heart of the flax bush,

From where will the bell bird sing to me?

What is the most important thing in this world?

I say to you, it is people, people, people.

www.skylight.org.nz

0800 299 100

5 patterns of symptomatic adjustment to loss

Prospective study of 276 older bereaved couples across first 18 months

(Bonanno, Wortman & Nesse, 2004):

1. “Common” grief (16%): depression increases, then

decreases; associated with good coping, positive

memories

2.Resilient (46%): low depression throughout; little

search for meaning; low avoidance, good adjustment

overall

4. Chronic grief (16%): depression peaks after death and

remains high; intense search for meaning, regret,

history of dependency

5. Chronic depression (8%): depression precedes loss

and continues; high avoidance, many life difficulties,

low comfort, poor coping

6. Depressed-improved (10%): prior depression remits

after loss; low avoidance, good coping, benefits of

widowhood

5 different identity types

when people are grieving

Nomads are characterized by a range of

emotions, including denial, anger, and

confusion about what to do with their lives

Memorialists want to preserve the memory of

their loved ones. They do this by memorials

and rituals to honour them

Normalizers place primary emphasis on their

family, friends, and community

Activists create meaning from their loss through

activities or careers that give them a purpose

Seekers look outward to the universe and ask

existential questions about their relationship to

others and the world.

Adapted from: The Five Ways We Grieve: Finding Your Personal Path to Healing after the Loss of a Loved One - Susan A. Berger

http://psychcentral.com/blog/archives/2011/11/13/the-5-ways-we-grieve/

References Christ, C. Spirited Exchanges, Issues 10 August – September 2009. Hillenbrand, C. The Quest for the soul at midlife. http://www.aplaceinspace.net/Pages/CandyMidlife.html Neimeyer, R.A. Grief, Loss and the Quest for Meaning . The University of Memphis, USA (neimeyer@memphis.edu) West, M.G (1997) Don’t Get Over it: Honouring the In-betweens In Our Lives.

Berger, S.A. (2009). The Five Ways We Grieve.

http://psychcentral.com/blog/archives/2011/11/13/the-5-ways-we-grieve/

Bolton, R. (1986). People Skills. How to Assert Yourself, Listen to

Others & Resolve Conflicts. Simon & Schuster Inc.

Bond, J. (2005). Bereavement Theory – an Overview. Dorothy House

Hospice Care Bereavement Service

Grief Styles: Transcending Gender - AIDS Bereavement Project of

Ontario transcending_gender.doc‎.

www.abrpo.org/images/uploads/GRIEF_Styles-_Downloaded Nov 2013

Jacob. J.S. (9.11.2013). An Evolving Faith: True to who I am http://evolvingfaith.blogspot.co.nz/ Jade: http://griefandmourning.com/grief-and-mourning-distinguishe Lyes, .Mary,M. (2004). Words that Help and Hurt. Children’s Grief Education. Mathers, Charlotte M. Psychoanalyst member of American Association of Marriage & Family Therapists Martin T.L. & Doka K.J. Adaptation from: Men Don’t Cry…….Women Do: Transcending Gender stereotypes of Grief.

Quote: There is a sacredness in tears: Downloaded 9th Nov 2013

http://quotespictures.net/there-is-a-sacredness-in-tears-washington-irving/

Stroebe and Schut. (1999). The Dual Process Model of Coping with

Bereavement (DPM) sciencedirect.com downloaded images Google

Sheehy, G. (2003, p. 366) moving account of the aftermath of September, 11.

Timmins., A. (2012).5 Classic Body Language Tips (Are You Forgetting

These?). http://kingpinlifestyle.com/5-classic-body-language-tips-are-you-forgetting-these/

White, M. http://www.dulwichcentre.com.au/michael-white-archive.html

Wolfelt. D. PhD. (2006) Companioning the Bereaved.

http://www.centerforloss.com/companioning