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Grief is the emotion people feel when they experience a loss. There are many different types of loss, and not all of them are related to death. – PowerPoint PPT presentation

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Title: DEATH

  • G505
  • Andrea Davasher
  • Kassy Franchville
  • Chris Kempf

What Is Grief?
  • Grief is the emotion people feel when they
    experience a loss. There are many different types
    of loss, and not all of them are related to
    death. For example, a person can also grieve
    over the breakup of an intimate relationship or
    after a parent moves away from home.
  • 1995-2007 The Nemours Foundation.
  • http//

  • Grief is a natural reaction to the loss of
    someone important to you. Grief is also the name
    for the healing process that a person goes
    through after someone close has died. The
    grieving process takes time, and the healing
    usually happens gradually.
  • 1995-2007 The Nemours Foundation.
  • http//

  • Although everyone experiences grief when they
    lose someone, grieving affects people in
    different ways.
  • Depends on relationship with person.
  • Circumstances under which they died.
  • 1995-2007 The Nemours Foundation.
  • http//

  • Knowing someone is going to die can give us time
    to prepare.
  • If they were suffering, it can mean a sense of
  • If the person that died was young, we may feel
    it was unfair.
  • 1995-2007 The Nemours Foundation.
  • http//

  • Losing someone suddenly can be extremely
    traumatic, though, no matter how old that person
    is. Maybe someone you know died unexpectedly - as
    a result of violence or a car accident, for
    example. It can take a long time to overcome a
    sudden loss because you may feel caught off guard
    by the event and the intense feelings that are
    associated with it.
  • 1995-2007 The Nemours Foundation.
  • http//

  • Grief can make us feel guilty.
  • Some people might blame themselves or think they
    could have done something to stop the death.
  • 1995-2007 The Nemours Foundation.
  • http//

  • Others might think if only they had been better
    people, than their loved ones might not have
    died. These things aren't true, of course - but
    sometimes feelings and ideas like this are just a
    way of trying to make sense of something that's
    difficult to understand.
  • 1995-2007 The Nemours Foundation.
  • http//

Coping With Grief
  • The grieving process is very personal and
    individual - each person goes through his or her
    grief differently. Some people reach out for
    support from others and find comfort in good
  • 1995-2007 The Nemours Foundation.
  • http//

Coping cont.
  • Throw selves into activities to take mind off
  • Become depressed and withdraw from activities,
    peers, family.
  • Everyone handles grief in different ways.
  • 1995-2007 The Nemours Foundation.
  • http//

  • For some people, it may help to talk about the
    loss with others. Some do this naturally and
    easily with friends and family, others talk to a
    professional therapist.
  • 1995-2007 The Nemours Foundation.
  • http//

Do children experience grief?
  • Yes, if children are old enough to love, they
    are old enough to grieve. Many times in our
    society children are the forgotten grievers. For
    instance, when a parent dies, whom do we expect
    to help the child with their grief? The surviving
    parent. That parent not only has their own grief
    to deal with but they are learning for the first
    time how to be a single parent. They, like their
    child, can use support in their grieving.
  • Excerpt from David Kesslers website On Grief
  • By Elisabeth Kübler-Ross David Kessler
  • http//

  • Joey's friends expected he'd be really upset at
    his mom's funeral, so they were surprised that he
    was smiling and talking with people as if nothing
    had happened. When they asked him about it, Joey
    said that seeing his friends at the funeral
    cheered him up because it reminded him that some
    things would still be the same. Joey was able to
    cry and talk about how he felt when he was alone
    with his dad after the funeral.
  • Reviewed by D'Arcy Lyness, PhD?Date reviewed
    April 2004

Counselors should keep in mind
  • Children dont grieve the way we do. They dont
    openly talk about how they are feeling. A death
    in their life usually causes them to feel even
    more different than usual.
  • Bereavement groups can be a helpful tool for

DSM IV V62.82 Bereavementalong w/diagnosis of
Major Depressive Disorder
  • This category can be used when the focus of
    clinical attention is a reaction to the death of
    a loved one.
  • Can be linked with a Major Depressive Episode
    (e.g., feelings of sadness and associated
    symptoms such as insomnia, poor appetite, and
    weight loss).
  • Symptoms must still be present 2 months after
  • Cant be considered normal grief reactions.
  • DSM IV, p 740-741, V62.82
  • Very limited information

What are the Five Stages of Grief and Do They
Always Occur in the Same Order?
The five stages
  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance
  • Elisabeth Kübler-Ross

Youtube video clip
  • Summer expresses her grieving for Marissa in five
    stages. From episode 4x04 "The Metamorphosis".
  • http//

Stages (cont.)
  • The stages are tools to help us frame and
    identify what we may be feeling.
  • Different for everyone.
  • Doesnt always happen in exact order, may revert
    before moving forward.

Typical Physical Symptoms of Grief
  • difficulty going to sleep, or waking in the
    middle of the night
  • weight loss or gain over- or under-eating
  • low energy or fatigue
  • headaches, chest pain, or racing heart
  • upset stomach or digestive problems
  • hair loss

Grief or Depression?
  • Grief
  • Experienced in waves
  • Diminishes in intensity over time
  • Healthy self-image
  • Hopelessness
  • Response to support
  • Overt expression of anger
  • Preoccupation with deceased
  • Depression
  • Moods and feelings are static
  • Consistent sense of depletion
  • Sense of worthlessness and disturbed self-image
  • Pervasive hopelessness
  • Unresponsive to support
  • Anger not as pronounced
  • Preoccupation with self
  • Excerpts from Therese A. Rando (1993).
    Treatment of Complicated Mourning. Research
    Press, Champaign, IL.

  • There are many ways people who are grieving can
    help themselves
  • Attending support groups
  • Therapy with a psychologist or other licensed
    mental health professional
  • Journaling
  • Eating Well
  • Exercising
  • Getting enough rest
  • Antidepressants such as Zoloft, Paxil,
    Wellbutrin, Lexapro, Celexa, Prozac and can be
    very effective to those who become clinically

  • Reading and learning about death-related grief
  • Seeking comforting rituals
  • Avoiding major changes in residence, jobs, or
    marital status
  • Allowing emotions
  • Seeking solace in the faith community

Factors that may hinder the healing process
  • Avoiding or minimizing emotions
  • Using alcohol or drugs to self-medicate
  • Using work to avoid feelings

Gender Differences
  • Women
  • express their feelings early after loss
  • reach out for social support
  • are seen to express more sorrow, depression, and
  • more willing to talk about the loss of a child
  • Men
  • more likely to take on a managerial role
  • intellectualize their emotions
  • indicate that they feel more anger, fear, and
    loss of control
  • use denial more
  • more private about grief

Developmental Grief Responses
  • Ages 2-4
  • Concept of Death
  • Death seen as reversible
  • Grief Response
  • Intensive response but brief
  • Very present oriented
  • Most aware of changes in patterns of care
  • Asking questions repeatedly

Developmental Grief Responses
  • Ages 4-7
  • Concept of Death
  • Death still seen as reversible
  • Feeling of responsibility because of wishes and
  • Grief Response
  • More verbalization
  • Great concern with process. How? Why?
  • May act as though nothing has happened
  • General distress and confusion

Developmental Grief Responses
  • Ages 7-11
  • Concept of Death
  • Still wanting to see death as reversible but
    beginning to see it as final
  • Death seen as punishment
  • Grief Response
  • Specific questions
  • Desire for complete detail
  • What is the right way to respond?
  • Starting to have ability to mourn and understand

Developmental Grief Responses
  • Ages 11-18
  • Concept of Death
  • Ability to abstract
  • Beginning to conceptualize death
  • Grief Response
  • Extreme sadness
  • Denial
  • Regression
  • More often willing to talk to people outside of
    family and peer support
  • Risk-taking

  • It's only when we truly know and understand that
    we have a limited time on earth -- and that we
    have no way of knowing when our time is up, we
    will then begin to live each day to the fullest,
    as if it was the only one we had.
  • Dr. Elisabeth Kübler-Ross

Needs of the 2 5 year old
  • Kind and understanding tone of voice and demeanor
  • Encouragement to talk about how s/he feels in
    whatever way s/he can express it
  • Permission to play about death and the events
    surrounding the experience
  • Open and direct manner that says Im with you
    and you are with me. There are no secrets.

Needs of the 2 5 year old(continued)
  • Sharing of how you feel or felt when a similar
    thing happened
  • Reassurance that remaining family members will
    take care of the child

Needs of the 5 9 year old
  • Clear answers in simple terms to the questions
    that they ask, no matter how improbable their
    fears seem
  • An accepting listener to the memories s/he has of
    the deceased
  • Explanations to refute the magical beliefs that
    feed their fears
  • Acceptance of play, artwork, songs, etc. about
    the events surrounding the death

Needs of the 9 12 year old
  • To be taken seriously, no matter how shallow
    his/her concerns seem
  • To be included in family discussions about the
    changes brought about by the death
  • To have his/her ways of grieving accepted
  • While this age-group may understand death
    intellectually, they may have great difficulty
    understanding it emotionally.

Needs of the Teenager
  • To be included in planning decision making
  • To be informed of what to expect in terms of
    events, ceremonies, rituals, etc.
  • To know what to expect from various relatives
  • To know what is expected of them
  • To witness adults grieving so they can learn
    adult ways to grieve

Needs of the Teenager(continued)
  • To be encouraged to talk about what they think
    and feel and have their thoughts and feelings

What to Do
  • Act natural
  • Show genuine care and concern
  • Make it clear that you are there to listen
  • Talk openly and directly about the person who
  • Keep in mind that evenings, weekends,
    anniversaries, and holidays can be extra
    challenging times

What to Do
  • Find a way to help children symbolize and
    represent the death
  • Pay attention to the way a child plays this is
    one of the main ways that children communicate
  • Say that you are sorry about the loss
  • Sit next to a child that wants closeness

What NOT to Do
  • Try to shelter children from the reality of
    death it can be a learning experience
  • Give false or confusing messages (Grandma is
    sleeping now.)
  • Tell a child to stop crying because others might
    get upset
  • Try to cheer the person up or distract from the
    emotional intensity (At least hes no longer in
    pain. Shes in a better place now.)

What NOT to Do
  • Offer advice or quick solutions (I know how you
    feel. Time heals all wounds.)
  • Pry into personal matters
  • Ask questions about the circumstances of the death

Grief Groups
  • By sharing feelings with one another, children
    find out that they are not alone and that others
    are also struggling to rebuild shattered lives.
    Grief groups help children feel understood,
    accepted, and supported.

How do you start a group?
  1. Open-ended new kids can arrive at any time, and
    group introductions will need to be made often.
    The advantage is that children will have more
    time to work on their grief, especially after
    sudden, violent, or traumatic deaths.
  2. Walk-in this format frees students from any
    commitment and fits into the busy routine of
    school life. The difficulty is not knowing who
    or how many kids will attend.

How do you start a group?
  • 3. Time-limited these groups work best in
    the school setting. School schedules often do
    not allow the flexibility for an on-going group.
    Students may also be more comfortable knowing
    there is a beginning and an end to the group.
    The number of sessions is usually 8 12, but
    shorter groups could be offered along with the
    opportunity for teens to request an additional
    session or sessions.

How do you select group members?
  • Group leaders have to decide on the parameters of
    the group. Is this going to be limited to
    students who have had a parent die, or will it be
    more general? Are there enough students to do a
    group focusing on parent loss? This type of
    focused group may work best, but grief groups
    that are broader in nature work well too.
  • Referrals may come from teachers, coaches,
    students, or parents.
  • The school newsletter or website can be a good
    place to advertise the group.

Group Activities
  • Writing or drawing spontaneously on mural paper
    taped to the wall
  • Creating a collage using pictures and words cut
    from old magazines
  • Writing a poem, eulogy, or song
  • Constructing a book that can be used as a journal
    or a memory book
  • Launching a balloon after writing messages to the
    person who died
  • Going on a field trip to a funeral home,
    cemetery, etc.

Signs that Bereavement in Young People Needs
Outside Intervention
  • If a young person pretends that absolutely
    nothing has happened
  • If school work takes a dramatic decline or the
    student develops a school phobia
  • If a young person threatens suicide
  • If a young person panics frequently
  • If a young person becomes involved with alcohol
    or drugs
  • If a young person begins committing serious
    socially delinquent acts

Signs that Bereavement in Young People Needs
Outside Intervention
  • If news of a death or other significant loss was
    kept from the young person for a long time or if
    the young person was told lies about the death
  • If a young person frequently physically assaults
    others or is cruel to animals
  • If a young person had a difficult relationship
    with the deceased or behaves poorly with family
  • If the young person is unwilling or unable to
    socialize with other young people