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Dream Work and Grief Work

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... the deceased and the loss experience, and adapting to life without the deceased' ... schemas are 'activated by events of waking life, experiences are assimilated ... – PowerPoint PPT presentation

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Title: Dream Work and Grief Work


1
Dream Work and Grief Work
  • Rochelle Perper, Ph.D.
  • November 3, 2008

2
  • "Needed 
  • A strong, deep person wise enough to allow me to
    grieve in the depth of who I am,
  • and strong enough to hear my pain
  • without turning away. 
  • I need someone
  • who believes that the sun will rise again,
  • but who does not fear my darkness. 
  • Someone who can point out the rocks in my way
  • without making me a child by carrying me. 
  • Someone who can stand in thunder
  • and watch the lightning,
  • and believe in a rainbow.
  • -Fr. Joe Mahoney

3
Reactions Following a Loss
  • Affective reactions
  • Depression, anxiety, loneliness, guilt, anger
  • Cognitive manifestations
  • Disbelief, confusion, hallucinations, lowered SE,
    helplessness
  • Physiological/somatic reactions
  • Changes in sleep and appetite, fatigue, physical
    complaints
  • Behavioral manifestations
  • Social withdrawal, restlessness, crying

4
Dreams of the BereavedPrevalence
  • Strongest predictor of recurrent dreams
  • Bereaved individuals are particularly inclined to
    reminisce about these dreams when awake (Kuiken,
    1993)
  • Dreams of the bereaved are typically vivid,
    filled with emotion, and affect the world of the
    dreamer in meaningful ways (Garfield, 1997)
  • However, clients may feel that they are going
    crazy or abnormal when confronted with dreams

5
Dreams of the BereavedThe Function of Dreaming
  • When a person is unable to tolerate the emotional
    and psychological reactions that come with the
    death of a loved one in their conscious lives,
    they may revert to the dream world (Barret, 1992
    Cookson, 1990).
  • Dreams offer alternative realities in which the
    dreamer has the opportunity to explore feelings
    surrounding the loss in a safe place (Hartmann,
    1995)
  • Dream Messengers Dreamer receives visits from
    the deceased through their dreams (Garfield,
    1997)

6
  • Trust the dreams, for in them is hidden the gate
    to eternity
  • Kahlil Gibran (1883-1931),
  • On Death, The Prophet, 1923

7
Dreams of the BereavedResearch
  • Hill (2000) Participants who had recently
    experienced a loss by death, loss of employment,
    or loss of relationship received brief therapy
    either with or without a focus on dream
    interpretation
  • Decrease in the impact of their loss utilizing
    the Impacts of Events Scale.
  • Participants who engaged in the dream
    interpretation intervention gained more insight
    and understanding and overall higher levels of
    satisfaction with therapy

8
The Effect of Dream Interpretation
Intervention on Grief for Bereaved
IndividualsParticipants
  • 63 bereaved adult individuals from the San Diego
    County area who voluntarily seeking bereavement
    therapy services at the Center for Grief Care and
    Education at SDHPC
  • Time since death 1-129 months (M 10 months)
  • Actively grieving (Average TRIG score 47.83)
    and more distressed than normative counterparts
  • Non-distressed families (Average FES scores)

9
The Effect of Dream InterpretationProcedure
  • 37 Participating Therapists
  • Randomized sequence by which to assign
    participants to treatment condition
  • Control Condition without focus on dream
    interpretation
  • Experimental Condition focus on dream
    interpretation
  • Intervention period included eight 50-min therapy
    sessions, ranging from 8 to 33 weeks
  • (M 11.78).

10
The Effect of Dream InterpretationMethods
  • Confidential Information Sheet
  • Texas Revised Inventory of Grief
  • Past Behavior past adjustment to the loss
  • Present Feelings degree of grief
  • Family Environment Scale
  • Therapeutic Realization Scale- Revised
  • Gains from Dream Interpretation
  • Therapist Adherence Measure

11
The Effect of Dream InterpretationFindings
  • Overall significant decrease in participants
    current distressful grief symptoms and past
    adjustment to the loss over time
  • No noted improvement on measures of family
    environment
  • Overall significant increase in therapeutic
    realizations over time
  • Participants in experimental condition reported
    overall higher ratings of Unburdening and
    Present-Focused Insights
  • Medium correlation noted between Therapeutic
    Realization scores at post-treatment and grief at
    post-treatment
  • No relationship between DIQ scores and grief at
    post-treatment in experimental condition

12
Dreams of the Bereaved Dream Content
  • Dream content has been found to mimic waking life
    struggles
  • The content of bereaved individuals dreams does
    not always include images of the deceased

13
Dreams of the BereavedCommon Dream Themes
(Barret, 1992)
14
Dreams of the BereavedDream Content
  • Dream content been correlated to phases of
    mourning (Barret, 1992 Garfield, 1996 Hill,
    1996)
  • Dreaming of the deceased may be the minds way
    of validating the reality of the death, through
    the sharp contrast that occurs when one awakes
    from such a dream Worden (2002) p. 30

15
Dreams of the BereavedConceptual Framework
  • Working with bereaved persons dreams is grounded
    in Wordens (2002) tasks of mourning and Hills
    (1996) cognitive-experiential model of working
    with dreams

16
Grief Work and Dream Work
  • Grief Work A cognitive process of confronting
    the loss, restructuring thoughts about the
    deceased and the loss experience, and adapting to
    life without the deceased
  • Dream Work Relevant schemas are activated by
    events of waking life, experiences are
    assimilated into existing schemas, and schemas
    are reorganized to accommodate the new
    information

17
Wordens (2002) Tasks of Mourning
  • Accepting the reality of the loss
  • Working through the pain and grief
  • Adjusting to the environment without the deceased
  • Emotionally relocating the deceased and moving
    on with life
  • Worden asserted that tasks imply an active
    process by which the bereaved persons can take
    action and therapists can more effectively
    intervene in the
  • grief process

18
Wordens (2002) Tasks of Mourning Task 1
Accepting the reality of the loss
  • After the loss of a loved one, a bereaved person
    often may find themselves enacting searching
    behaviors (Parkes, 2001)
  • The first task includes helping the bereaved
    individual realize that the deceased is really
    dead, and will not be coming back
  • This also includes adjusting to the change in
    their assumptive world, that is, the world as
    they once knew it

19
Wordens (2002) Tasks of Mourning Task 2 Work
through the pain and grief
  • Following the loss of a loved one, the bereaved
    experience emotional and physical pain
  • If the bereaved avoid or suppress the pain in
    their waking lives, such feelings may confront
    them in their dreams

20
Wordens (2002) Tasks of Mourning Task 2 Work
through the pain and grief
  • People must be given the opportunity to
  • hurt out loud
  • -Lady Bird Johnson
  • In a society which is much more included to
    help you hide your pain rather than to grow
    through it, it is necessary to make a very
    conscious effort to mourn.
  • -Henri Nouwen

21
Wordens (2002) Tasks of Mourning Task 3
Adjust to the environment
  • Three areas of adjustment often encountered by
    grieving individuals
  • External how the death affects ones everyday
    functioning in the world
  • Internal how the death affects ones sense of
    self
  • Spiritual how the death affects ones beliefs,
    values, and assumptions about the world

22
Wordens (2002) Tasks of Mourning Task 3
Adjust to the environment
  • People do not get over grief. My personal and
    professional experience tells me that a total
    return to normalcy after the death of someone
    loved is not possible we are forever changed by
    the experience of grief.
  • -Alan D. Wolfelt

23
Wordens (2002) Tasks of Mourning Task 4
Emotionally Relocating
  • Moving on vs. Going on
  • Worden (2002) stated that people do not give up
    the relationship they find an appropriate place
    for the dead in our emotional lives (p.36)

24
Wordens (2002) Tasks of Mourning Task 4
Emotionally Relocating
  • One benchmark of a completed grief reaction is
    when the person is able to think of the deceased
    without pain. There is always a sense of sadness
    when you think of someone that you have loved and
    lost, but it is a different kind of sadness it
    lacks the wrenching quality it previously had.
  • - J. William Worden

25
Losing a loved one
  • "Where there is pain, let there be softening.
    Where there is bitterness, let there be
    acceptance. Where there is silence, let there be
    communication. Where there is loneliness, let
    there be friendships. Where there is Grief, let
    there be Hope."
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