Transcript Chapter 8

Chapter 8
Crisis of Loss
Loss
By Rita Moran
PLEASE, don't ask me if I'm
over it yet.
I'll never be over it.
PLEASE, don't tell me she's in
a better place.
She isn't here with me.
PLEASE, don't say at least she
isn't suffering.
I haven't come to terms with
why she had to suffer at all.
PLEASE, don't tell me you
know how I feel.
Unless you have lost a child.
PLEASE, don't ask me if I feel
better.
Bereavement isn't a condition
that clears up.
PLEASE, don't tell me at least
you had her for so many years.
What year would you choose for
your child to die?
PLEASE, don't tell me God
Never gives us more than we can
bear.
PLEASE, just say you are sorry.
PLEASE, just say you
remember my child, if you do.
PLEASE, just let me talk about
my child.
PLEASE, mention my child's
name.
PLEASE, just let me cry.
Types of Loss
A. The death of a spouse is one of the
most emotionally stressful and disruptive
events in life. Many other problems are
faced such as economic, career, and family
etc..
B. Every parent suffers the loss of a child
somewhat differently. And it is traumatic for
parents of children of all ages. There is no
pattern that your mind can connect the
death of a child to so one adjusts their
thinking. The bond to that child is forever.
C. The loss of a loved one by suicide is doubly
stressful. The victim of suicide is often the ones left
behind, and can be more vulnerable to physical and
mental health problems than are grievers from other
causes of death. Support groups have been
recommended to help people cope with loss following
a suicide.
D. Children who experience the death of a parent or
sibling may show overt signs of bereavement, but
some may be covert. Preschool and school aged
children show different signs of grief. Older children
show more anxiety, depression, and somatic
symptoms, while younger children exhibitsadness,
anger, crying, feelings of remorse and guilt, and
separation anxiety.
E. Children’s cognitive, affective,
and behavioral responses must be
approached not in terms of adult
perspectives but in terms of each
child’s understanding and
developmental stage. They can
misinterpret the event and lack the
grieving process. They need to hear
over and over again that they are
safe and someone needs to listen to
their feelings. Honesty about the loss
should be shared and they should be
allowed to grieve at their own level.
F. Adolescence who are in bereavement
need to be included in the family’s grief,
while at the same time need privacy. They
need opportunities to be included in
discussions, planning, mourning, and
funeral and commemorative activities.
Teenagers may benefit from counseling
as long as three years following the
sibling death. Do not put a time limit on
the grieving process.
G. Divorce can place children in untenable
positions, causing them to feel confused,
insecure, fearful, trapped, angry, unloved and
guilty. It is a loss.
H. Elderly people generally experience more
losses than do their younger counterparts.
The most devastating is the loss of a spouse.
They respond in three ways
(1) they totally ignore death,
(2) excessive thoughts about dying,
(3) a healthy balance. Allowing them to share
their past will help an elderly persons selfesteem.
Stages and Tasks of Mourning
Kubler-Ross’s 5 Stages of Death and Dying:
1.
2.
3.
4.
5.
Denial and shock
Anger
Bargaining
Depression
Acceptance
Worden’s 4 Tasks of Mourning:
1.
2.
3.
4.
Acceptance that the death is real.
Grieving the loss, expressing feelings about loss.
Adjusting to life without the deceased party.
Withdrawing energy from the lost person and re-investing in
someone or something else.
The Schneider model deals with eightstages of grieving. It is a growth-promoting
model designed to nurture as much
personal growth as possible within a
context of stress, loss, and grief. It
includes internal events, systems of belief,
and the processes of growth and aging as
well as the easily recognized losses, such
as death and divorce. The stages are as
follows:
1. Initial Awareness-shock, confusion,
numbness, detachment, disbelief, and
disorientation
2. Attempts at Limiting Awareness by
Holding On-using coping mechanisms to
stave off immobility and disequilibrium
3. Attempts of Limiting Awareness by
Letting Go-recognizing one’s personal limits
with regard to the loss
4. Awareness of the Extent of the Loss-most
painful, lonely, helpless, and hopeless phase
5. Gaining Perspective on the Lossreaching a point of accepting that what is
done is done and providing the bereaved
people with a time to make peace with their
past
6. Resolving the Lost-when they can see
and pursue activities unconnected with the
loss without it being a reaction against or
identifying with the lost person or object
7. Reformulating Loss in a Context of
growth-discovering potential rather than
limits, seeing problems as challenges, being
curious again, and seeking a balance
between the different aspects of self
8. Transforming Loss into New
Levels of Attachment-approach life
with greater openness and the
willingness to surrender more readily
the necessity of structure in life,
reformulation that produces a greater
capacity for growth than before
Interventions
Help talk about the loss, don’t be
afraid to ask what happened.
Help identify and express feelings
Help live without the deceased or lost
loved object. Problem solving works
Facilitate emotional withdrawal from
deceased. Encourage to move on
Provide time to grieve actively.
Prepare for holidays and
anniversaries
Educate about customary grieving
reactions of others
Allow for individual differences
Provide for continuing support.
Groups are great!
Divorce and Separation
About 50% of marriages end in
divorce.
Each partner must complete tasks of
mourning
Children need not suffer if parents
manage feelings appropriately
Rage and frustration are common
Custody arrangements are
complicated
Other issues
Financial loss
Social loss
Family loss
At risk for increase substance use
Feelings of guilt and resentment
Interventions
Referrals to support groups, 12 step
groups and the use of church, school
and athletic organizations, as are
books.
Help clients grieve: they need to cry a
lot, write, read, pray and talk.
Be optimistic, the pain will end
eventually, support how difficult it is.
Children and Divorce
26% of children under the age of 18
live with a divorced parent.
39% of divorced women with children
live in poverty
Civility among parents and assurance
that both still love the children is
helpful
Some need brief individual play
therapy, others need family
counseling
Blended family issues
Loyalty is a problem
May feel guilty for bonding with a step
parent
Children often act out, won’t even try
to like a step parent.
Family must incorporate new parent’s
style and rules.