crises of loss. kubler-ross five stages of death and dying denial and isolation- denial is a healthy...
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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.
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.
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
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 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