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The Chains of Grief


The Compassionate Friends Annual Grief and Loss Seminar 18 June 2011 Presenter: Associate Professor Judith Murray The University of Queensland What are we chained to? – PowerPoint PPT presentation

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Title: The Chains of Grief

The Chains of Grief
  • The Compassionate Friends
  • Annual Grief and Loss Seminar
  • 18 June 2011

Presenter Associate Professor Judith Murray
The University of Queensland
The Chains that BindReminiscence
  • I hear your whisper on the wind
  • I hear your voice just as it has always been
  • Your laughter fills the air around me
  • And I turn with a smile to laugh with you
  • But when I turn there is silence
  • There are only echoes in my mind
  • I know this, and yet, often they are so loud
  • So clear, so real, that I just cant believe
    youre not here
  • Karen Gerry in Words of Sorrow Words of Love

The Essence of Our Chains The EXPERIENCE of Loss
  • Experience is not an unstable irrational and
    emotive concept but rather it is the world, it is
  • Lumby (1994)

Understanding the experience. An Emic rather
than an Etic approach. It is also you have
shared with all humanity...
  • No one ever told me that grief felt so like fear.
  • C.S. Lewis 1898-1963 
  • Well has it been said that there is no grief like
    the grief which does not speak
  • Henry Wadsworth Longfellow 1819-1892
  • Our trials, our sorrows and our grieves develop
  • Orison Swett Marden 1850-1924
  • What right have I to grieve, who have not ceased
    to wonder?
  • Henry David Thoreau 1817-1862

  • Change
  • Loss is produced by an event which is perceived
    to be negative by the individuals involved and
    results in long-term changes to ones social
    situations, relationships, or cognitions. Miller
    and Omarzu (1998)
  • Bereavement is the loss through death of a
    significant other.
  • Grief is
  • the emotional response to loss the complex
    amalgam of painful affects including sadness,
    anger, helplessness, guilt and despair. Raphael
  • (Grief) incorporates diverse psychological
    (cognitive, social-behavioural) and physical
    (physiological-somatic) manifestations. Stroebe,
    Hansson Schut (2001)

Losses rarely exist aloneWhat did you lose?
Edvard Munch The Dead Mother 1899-1900
The Chains weigh us down in every aspect .........
Physical Reactions to Loss
  • Heart palpitations
  • Sighing, trouble breathing
  • Headaches
  • Appetite changes
  • Numbness, tingling of feeling of heaviness in
    the arms or legs
  • Stiff neck, jaw tenseness
  • Susceptibility to colds, allergies
  • Easily startled
  • Chills
  • Fatigue
  • Sweating
  • Backache
  • Rapid shallow breathing
  • Nausea, upset stomach, diarrhoea, constipation
  • Other gastrointestinal problems
  • Tremors of hands, lips etc.
  • Sleep disturbances
  • Muscle weakness or aches
  • Faintness, dizziness
  • Pains in chest (needs checking by doctor)
  • Sensation of lump in throat
  • Lack of coordination

Psychological Reactions
  • Irritability, anger or general agitation
  • Restlessness, excitability
  • Sadness, depression, crying
  • Feeling lost, isolated, abandoned
  • Wanting to be alone
  • Recurrent dreams, insomnia, night waking
  • Frustrated
  • Anxiety
  • Fears, worry
  • Apathy
  • Feeling overwhelmed.
  • Thoughts of cant go on, (even suicide) in some
  • Feeling powerless, hopeless
  • Moodiness, periods of highs and lows
    following closely one after the other
  • Guilt, blaming
  • Flashbacks of traumatic events
  • Numbness, shock, confusion, inability to feel
  • Loss of interest in sex

Behavioural Reactions to Loss
  • Difficulty in concentrating, slowness of thinking
    and decision making
  • Difficulty expressing oneself verbally
  • Withdrawing socially, reluctance to leave home
  • Frequent arguments, family difficulties
  • Forgetfulness
  • Disorientation
  • Hyperactivity/ Inability to carry out even the
    most minor tasks
  • Increase in use of alcohol, tobacco and other
  • Difficulty in organizing daily tasks
  • Avoidance of any reminder of the event
  • Preoccupation with memorabilia of lost person
  • Eating more or less
  • Loss of work efficiency

Other Reactions to Loss
  • Loss can shape and change families (e.g., family
    secrets), communities (indigenous loss),
    societies (Australia and Port Arthur, Effects of
    War, AIDS crisis and Uganda) and Global Trends
    (9/11 and the War on Terrorism).
  • Effects on larger groups can then have affects on
    individuals (eg., transgnerational transmission
    of loss, Oklahoma Bomber)
  • Loss makes people ask the big questions of life
  • Difference between spirituality and religion

  • Mourning is the the psychological processes that
    occur in bereavement whereby the bereaved
    gradually undoes the psychological bonds that
    bound him/her to the deceased (Beverley Raphael

Grieving the process of dealing with losses
other than bereavement
Suffering The width of the gap between reality
what is and what is desired
Suffering is not a question that demands an
answer It is not a problem that demands a
solution It is a mystery that demands a
presence. Unknown
The Journey Through Loss
  • What do we know about
  • Grief and Grieving???

Chains of grief are normal and hard-working.As
hard as it is, grieving is a normal, natural
Dual Process Model (Strobe Schut 2006)
The experience of loss is integrated into the
basis psychological functioning of a person even
from the earliest age.
Therefore there exist both the potential for
personal growth and personal deterioration.
Prototypical patterns of disruption in normal
functioning following loss or potential trauma
Bonanno 2008
1 year
2 year
Grief to Growth Model(Hogan Schmidt, 2002)
Different chains bind different peopleMany
factors will affect the journey through grief.
Grieving is a mostly private and even at times
lonely experience.
For a child in an adults world it can be even
more lonely
Internal Influences
  • Individual personality factors
  • Life Orientation / Purpose in Life
  • Spirituality / Religious beliefs
  • Death Anxiety
  • Coping Styles
  • Age
  • Gender
  • Individual culture
  • Attributional style
  • Vulnerability/Resilience
  • Previous mental health
  • Previous physical health
  • Mental capacity/Complicating disabilities

Circumstances Surrounding the Loss
  • The type of loss
  • Anticipation versus suddenness
  • The opportunity to say goodbye
  • The legal requirements of sudden death
  • Location of the loss
  • Perceived preventability/responsibility
  • Chronic sorrow

External Factors that Affect Grieving
  • Social context of the loss/Sanctions/Taboos.
    Disenfranchised grief
  • Family context
  • Concurrent stresses
  • Social support

Being Chained in Isolation
The Existential Aloneness
  • We were setting out on different roads. This
    cold truth, this terrible traffic regulation
    (You, Madam, to the right you, Sir, to the
    left) is just the beginning of the separation
    which is death itself. And this separation, I
    suppose, waits for all. I have been thinking of
    H. and myself as peculiarly unfortunate in being
    torn apart. Even if we both died at exactly the
    same moment, as we lie here side by side, it
    would just be as much a separation as the one
    youre so afraid of. Of course she didnt know,
    nay more than I do. But she was near death near
    enough to make a good shot. She used to quote
    Alone into the alone. She said it felt like
    that. And how immensely improbable that it
    should be likewise.
  • C.S. Lewis, 1961, A Grief Observed, p.14

Alone ..Lonely
  • Difference between being alone and being
  • Alone but not Lonely
  • Alone and Lonely

The Chains in our Heads
  • Messages given to a person during early losses,
    that may contribute to a sense of being
    overwhelmed by life and loss at a later time, may
  • My pain in not as important as that of some
  • My family falls apart under pressure. They cant
    care for me when the going gets tough
  • I am bad
  • I am responsible for others pain and comfort
  • Im hopeless. Im useless
  • You mustnt bother people with your problems
  • Bad things happen to me, no matter how hard I try
  • People cant be trusted
  • The world is a very scary place

The Chains in our Heads
  • Messages adopted by people as a result of
    previous losses, that may enhance growth,
  • In times of trouble, someone will always be there
    for you
  • My family can weather bad times
  • I am safe
  • My needs matter to others
  • I can cope with bad times
  • There are many things in life I have control over
  • The world is an exciting place just waiting for
    me to explore it
  • Other people need me
  • Im OK even if Im not perfect
  • Its OK to tell people how you feel
  • I know there are things you can do to help
    yourself feel better

Chains that Damage
Definition of Problem Grieving
  • Unresolved (problem) grief is grief
  • That is preoccupying, incapacitating and
    immobilizing for a prolonged period in a way that
    causes concern to the bereaved person and his/her
    family and friends.
  • McKissock McKissock (1991)

Complicated Grief
  • Complicated grief occurs when integration of the
    death does not occur.
  • People who suffer from complicated grief
    experience a sense of persistent and disturbing
    disbelief regarding the death and resistance to
    accepting the painful reality. Intense yearning
    and longing for the deceased continues, along
    with frequent pangs of intense, painful emotions.
    Thoughts of the loved one remain preoccupying
    often including distressing intrusive thoughts
    related to the death, and there is avoidance of a
    range of situations and activities that serve as
    a reminder of the painful loss. Interest and
    engagement in ongoing life is limited or absent
  • (Complicated Grief Review, Edith Cowan Uni and
    Australian Government).

Prigersons Criteria for Complicated Grief
Proposed for DSM-V
  • Criterion A
  • Chronic and persistent and disruptive yearning/
    longing/ heartache
  • Criteria B
  • 4 of 8 at least several times a day to
    distressing degree
  • Trouble accepting the death
  • Inability to trust others
  • Excessive bitterness or anger related to death
  • Uneasy about moving on
  • Numbness/Detachment
  • Feeling life is empty or meaningless without
  • Bleak future
  • Agitated
  • Criteria C
  • Marked and persistent dysfunction in social,
    occupational or other important domains

What are we chained to? What chains us?
(No Transcript)
Neurobiology and Complicated Grief
  • Neuroimaging (OConnor, 2005) has found a number
    of areas of the brain specifically active when
    grieving people (compared to viewing neutral
    similar forms of stimuli) are presented with
    picture and word stimuli of lost loved one or
    bereavement. Most active ones were

Posterior Cingulate Cortex Area activated during
autobiographical memory so memories being
recalled. Also deals with emotionally salient
stimuli Anterior Cingulate Cortex and Insula ACC
role in attention and Insula in processing
visceromotor information. Suggests strong somatic
element in reaction eg., broken heart, pangs
of grief
Neurobiology and Complicated Grief
  • OConnor et al.(2007)imaged the brains of 12
    women diagnosed by Prigerson Complicated Grief
    Scale as suffering complicated with 12 women not
    showing complicated grief.
  • Found difference in nucleus accumbens, that is
    the part that anticipates rewards ie., the part
    that knows you want something, so the longing
    becomes like a ppowerful craving. Much more
    research needed.

Grief and Depression
Normal Grief Clinical Depression
Responds to comfort and support Does not respond to support
Often openly angry Irritable and may complain but does not directly express anger
Related depressed feelings to loss experienced Does not relate experiences to a particular life event
Can still experience moments of enjoyment in life Exhibits an all pervading sense of doom
Exhibits feelings of sadness and emptiness Projects a sense of hopelessness and chronic emptiness
May have transient physical complaints Has chronic physical complaints
Expresses guilt over some specific aspect of the loss Has generalized feelings of guilt
Has temporary impact upon self-esteem Loss of self-esteem is of greater duration
The Powerful Chain FearLoss threatens a
persons sense of safety, mastery and control
Loss that never seems to end because IT DOESNT.
It simple changes
It can be so very scary having the world you know
totally turned upside down..
  • No one ever told me that grief felt so like fear
  • C.S. Lewis A Grief Observed

  • If fear is natural
  • Living with fear of the world as it now is
  • So loss of hope is natural..
  • Frustration, anger and sadness is natural.
  • Not pleasant, not what you want, bloody hard.
  • But NATURAL !!!!

Breaking the Chains that Bind
Finding The Weakest Links
The Weakest Links
  • Trusting in the healing power of grief and time
  • Saying goodbye in a meaningful way
  • Gaining and giving forgiveness
  • Calming the trauma
  • Rethinking our assumptions and our thoughts
  • Receiving and giving support
  • Finding a livable spot for them
  • Cherishing
  • Finding solace

I have been to the edge of the abyssAnd I have
looked into the depths.There I looked at
deathAnd I have returned to the living.There I
looked at madnessAnd have returned to the
sane.There I looked at destructionAnd I have
returned to create.For only creation and
loveCan answer destruction and madness and
death. Marjorie Pizer
  • HOPE.

Leaving Beautiful Chains
  • Maybe through..
  • Knowing we will never be the same
  • Knowledge of what is happening within and around
  • Companionship
  • Finding what our children/siblings/grandchildren
    have given us
  • Being assured of the parents we are now to our
    children who are no longer here for us to parent

The chains of love are never binding as when the
links are made of gold. Royale Tyrell
The Gold....Our Children
  • Some people come into our lives and quickly go.
    Some people move our souls to dance. They awaken
    us to new understanding with the passing whisper
    of their wisdom. Some people make the sky more
    beautiful to gaze upon. They stay in our lives
    for awhile, leave footprints on our hearts, and
    we are never ever the same.
  • Flavia Weedn