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BEREAVEMENT AND GRIEF

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BEREAVEMENT AND GRIEF (5) SUPPORTING THE BEREAVED TO BE ACTIVE: The final consideration involves helping the bereaved to be able to remain engaged. – PowerPoint PPT presentation

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Title: BEREAVEMENT AND GRIEF


1
BEREAVEMENT AND GRIEF
2
What is grief?
Grief is a natural response to loss. Its the
emotional suffering you feel when someone you
love or to whom you are attached, or when
something you love or to which you are attached,
is taken away.
3
Grief management is a misnomer
4
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5
PART ONE FIVE IMPORTANT CONSIDERATIONS FOR THOSE
WHO ARE WITH OR WHO ARE SUPPORTING THOSE WHO ARE
GRIEVING
6
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7
(1) ListeningListen with our whole beings to
whatever the bereaved are saying. This is
perhaps the greatest support we can give to
someone who is grieving.
8
  • (2) Listening and Talking
  • There is no problem you need to solve or advice
    you have to give. Listening is often enough.
    Three specific reflections about talking
  • There are ways of talking which are helpful
  • There are comments which are extremely unhelpful
  • There are also a few overall pointers.

9
Ways of talking that are helpful
  • Acknowledge that someone diedusing the word
    died can show you are open to talk about how
    the person really feels if they want to.
  • Be genuine and dont hide feelings.
  • Ask how the bereaved person feelsnever assume
    since these feelings change. Asking is a good
    way to invite talking and a release of energy.
  • There is no reason to talk in hushed tones.
  • Offer supportTell me what I can do for you.

10
Comments to Avoid
  • "I know how you feel."
  • "It's part of God's plan."
  • "He's in a better place now.
  • "This is behind you now it's time to get on with
    your life

11
Overall Pointers
  • Accept and acknowledge all feelings.
  • Be willing to be silent and in silence.
  • Let the bereaved talk about how their loved one
    died.
  • Offer comfort and reassurance without minimizing
    the loss.

12
  • (3) The importance of refuge in the moment
  • The future is just too painful to think about and
    the past is equally too painful. In the case of
    those in intense grief, now is also the only
    refuge.
  • not denial
  • Allows the the loss to sink in at a rate the
    bereaved can handle.
  • living the here and now

13
(4) Supporting the bereaved in self-care encourag
ing the bereaved to take care of himself or
herself physically. Eating, sleeping,
exercising, going for walks are important for a
healthy body. important for healthy grieving
process. Ways of being in the moment.
14
(5) Supporting the bereaved to be active Example
my own grief, surprise I could do it, passing
time which felt frozen, was in the moment
15
Part One SUMMARY Five Important Considerations
  • (1) Listening
  • (2) Listening and Talking
  • (3) The Importance of Refuge in the Moment
  • (4) Supporting the Bereaved in Self-Care
  • (5) Supporting the Bereaved to be Active

16
  • PART TWO REFLECTIONS TO HELP UNDERSTAND THE
    GRIEF PROCESS

17
REFLECTIONS TO HELP UNDERSTAND THE GRIEF PROCESS
  • Most, even including Kubler-Ross, say there are
    no steps. Rather what follows are two items
  • (1) A Roadmap of the Grieving Process
  • (2) The Tasks Involved in Grieving

18
(1) A Roadmap of the Grieving Process
  • Reaction to the First Awareness of the Loss
  • The Loss sinks in
  • The Bottomthis will never end Im always
    going to feel this way
  • Glimpses of Changejust glimpses
  • Coming Back into the World
  • Adaption

19
  • a) Reaction to the first awareness of the loss.
    This varies from person to person numbness,
    shock, breaking heart, disbelief, denial are
    typical.

20
  • b) The loss sinks in. Yearning for the deceased,
    anger, sadness, broken heart, despair, whatever
    the person feels is legitimate. There is no
    condition that will tell you what another
    person might go through. And unless you have
    been mindful of your own losses, you may not even
    know what happens to you.
  • As the loss sinks in, our view of the world
    changes and we may question if life has a purpose
    or even any meaning. We may be angered that the
    magnitude of our own loss doesnt make a ripple
    in the greater world.

21
  • c) The bottom. What happens here also varies but
    this is where the sense that this will never
    end or Ill always feel this way can become
    dominant. Other typical responses despair,
    listlessness, and disorganization.

22
  • d) Glimpses of change. These are brief moments
    that indicate a change is happening, however
    slowly. They often catch a person by surprise.
    They may generate guilt how can I enjoy this
    when so-and-so has died? They may generate an
    unrealistic hope for a quick recovery. They are
    just what they areindications of a change
    beginning.

23
  • e) Coming back into the world. There are good
    days and an ability to reconnect to old friends
    and old engagements.

24
f) Adaptation. The person has completed what can
be completed. It does not mean that there will
not always be moments of sadness or that the
bereaved is content or happy with the loss. Its
just that the bereaved can re-engage in life and
has many more good days than bad.
25
(2) THE FOUR TASKS INVOLVED IN GRIEVING
  • (1) To Accept the Fact of the Loss
  • (2) To Process the Pain of Grief
  • (3) To Adjust to a World without the Deceased
  • (4) To find an Enduring Connection with the
    Deceased in the Midst of Embarking on a New Life

26
Task One Making Real the Fact of Loss
  • Those about to suffer a death loss
  • Making real the fact of loss after a death

27
Making real the fact of loss for those about to
suffer a death loss
  • How to tell patients about their condition and
    discover if they want to know.
  • The great advantage of people openly knowing they
    are dying when they are dying
  • dying and family members can be present, complete
    major unfinished business and say goodbye
  • those at a distance can return to be with dying
  • ends dance of pretence and irrelevant
    conversation
  • in any culture of not telling, very sick patients
    with positive prognosis may be unnecessarily
    stressed.

28
Making real the fact of loss after a death
  • Intellectual and emotional components
  • Helpful actions
  • Viewing the body (unless disfigured by
    explosion, etc)
  • Engagement in process between death and
    completion (personal examples)
  • More difficult losses
  • The lack of a corpse (war, drowning)
  • Disenfranchised grieving (miscarriage,
    abortion, secret lover)

29
TASK TWO PROCESSING THE PAIN OF GRIEF
  • Completing unfinished businessone important
    reason to tell condition to dying if he or she
    wants to know
  • Taking time off for grief
  • Journal, memorial book, painting the colours of
    loss
  • Joining a group for those who are grieving
  • Mindfulness
  • Difficulties
  • guiltrational guilt, irrational guilt,
    irrational guilt with staying power
  • loss through suicide

30
  • Irrational guilt and rational guilt.

31
TASK THREE ADJUSTING TO A WORLD WITHOUT THE
DECEASED
  • External Adjustmentsloss of a companion, sexual
    partner, accountant, baby-sitter, gardener,
    audience, bed warmer and/or many more.
  • Internal Adjustmentsthe internal task is to ask
    Who am I now? Over time negative images tend to
    give way to more positive ones.
  • Spiritual Adjustmentsthe bereaved may initially
    lose all direction in life and may consider
    himself/herself without value. The world may
    seem to make no sense.

32
  • Either the bereaved person makes progress toward
    a recognition of changed circumstancesaims,
    goals, perception of self without deceased--
  • Or else remains in a state of suspended growth
    in which she or he is held prisoner by a dilemma
    that cannot be solved.

33
TASK FOUR FINDING AN ENDURING CONNECTION WITH
THE DECEASED IN THE MIDST OF EMBARKING ON A NEW
LIFE
  • Love continues and may appear as sadness
  • Continue work of deceased, completing a project,
    volunteer work, helping with a condition the
    death brought to ones attention (diet, smoking,
    suicide prevention, alcoholism, becoming a
    hospice pioneer).

34
  • PART THREE THE COMPLEXITY AND INPUT FROM
    UNRESOLVED LOSSES

35
Changes that may be significant losses for many
or some people
  • Divorce or relationship breakup
  • Loss of health
  • Losing a job
  • Graduation
  • Loss of financial security
  • Leaving home (for college, marriage)
  • Loss of a friendship
  • Sexual abuse
  • A miscarriage
  • Loss of a cherished dream

36
More Changes that may be significant losses for
someone
  • Losing money (including bad investments)
  • Loss of mobility/capability
  • Being robbed or mugged
  • Retirement
  • Children leave home
  • Loss of faith or religious belief
  • A loved ones serious illness
  • An abortion
  • Loss of virginity
  • Loss of a pet
  • Leaving a familiar hated work environment

37
Exploring and working with past unresolved losses
  • Grief history
  • All recent deaths or significant losses
  • All significant losses beginning with first death
    loss or first remembered significant loss
  • This takes an hour or so and the person may add
    to the list later as other losses are recalled
  • The list above may help a person recall losses
    that were not death losses

38
Exploring and working with past unresolved losses
(continued)
  • Take three of these losses and describe the
    experiences of how you went through the phases of
    grieving
  • a) reaction to the first awareness of the loss
  • b) the loss sinks in
  • c) the bottom
  • d) glimpses of change
  • e) coming back into the world
  • f) adaptation

39
Exploring and working with past unresolved losses
(concluded)
  • By reviewing three significant losses, a pattern
    or profile of how a person grieves may arise.
    The person can then assess what was helpful, what
    was not, and any changes that might help complete
    the four tasks of grieving
  • The work here is the same as the work in going
    through the four tasks of grieving making real
    the fact of loss, processing the pain of grief,
    adjusting to a world without the deceased, and
    finding an enduring relationship with the
    deceased in the midst of embarking on a new life.
  • The practice of mindfulness meditation is a
    useful way of staying in the moment and allowing
    memories, images, pain and joy to arise and
    cease.

40
  • The form of meditation here is often called
    vipassana. The aim is simply to be in the moment
    and to experience the pain and grief and anger
    and torment, not to become it.
  • These are all natural human conditionsthe
    mistake, which most of us make, is to take them
    personally.
  • Rather than I am angry the ancient Irish
    language said the anger is on me.

41
The Guest House by RumiThis being human is a
guest house.Every morning a new arrival.A joy,
a depression, a meanness,some momentary
awareness comesas an unexpected visitor.Welcome
and entertain them all!Even if they are a crowd
of sorrows,who violently sweep your houseempty
of its furniture,still, treat each guest
honorably.He may be clearing you outfor some
new delight.The dark thought, the shame, the
malice.meet them at the door laughing and invite
them in.Be grateful for whatever comes.because
each has been sentas a guide from beyond.
42
In closing
  • Two deeply mistaken myths
  • MYTH The pain will go away faster if you ignore
    it
  • MYTH It is far better to avoid uncomfortable
    events and tasks than to acknowledge that a
    family member or friend is dying or has died.
  • Rather, take time off to grieve, allow the energy
    of the loss to express itself and flow through,
    TAKE TIME OFF TO GRIEVE.

43
One way of bringing this home the importance of
these tasks looking ahead five years and
asking what would I prefer to look back upon in
five years? Would I prefer to remember that I
said goodbye to my dying parent? Would I prefer
to remember that I thanked the person for all
that they had given me? That I asked forgiveness
for mistakes I had made? Would I prefer to help
prepare the body of a loved one? The five-year
tool is a useful one and someone who is bereaved
will recognize it being useful such as soon as
they are asked.
44
Some important lessons. Keeping
relationships current (for example, telling
people you love that you love them) Keeping
what is important current.
45
In my first grief lecture in Thailand, I was
asked only one question what can we do to
prepare ourselves for loss and grieving? In
addition to keeping our lives current, there is
another practical answer
46
By practicing meditation that quiets the mind and
brings us into the here and now moment,
including being mindful of touches and tastes and
sights. This has nothing to do with religion but
everything to do practical concerns.That is an
indispensable important way of preparing
ourselves for loss, grief and our own deaths.
47
1) It helps us to process the pain of grief2)
By practicing daily, we develop an important tool
that will be ready when we need it3) Meditation
actually changes our brain to abide with physical
and psychological pain
48
Grieving for significant losses is one of the
most difficult things we human beings
experience.I wish all of us well.
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