Good Grief: How to understand and support the bereaved...Good Grief: How to understand and support...
Transcript of Good Grief: How to understand and support the bereaved...Good Grief: How to understand and support...
Good Grief: How to understand and support the bereaved
Marney Thompson, M.A., R.C.C.Bereavement Coordinator
Victoria Hospice
Victoria Hospice Bereavement Services
ObjectivesParticipants will:
1. Understand that grief does not
proceed in stages
2. Learn a pluralistic framework
for understanding grief
3. Be reminded of the highly undervalued skill of
deep listening and presence
What is grief?
• A natural response that helps us adjust to life after loss
• Characterized by: -Preoccupation -Yearning-Intense emotions-Isolation
How does grief impact us?xThoughtsxFeelingsxBodies
xBehaviorsxRelationshipsxPurpose/meaning & values
How does grief impact our thoughts and feelings?
Expected:• Preoccupied; mind is busy
processing loss
• Sad, lonely, depressed, fearful
Less expected, perhaps:• Counterfactual thinking;
“what if” and “if only”
• Angry, guilty, relieved, blaming
How does grief impact us physically?
Expected:• Nausea, loss of appetite• Difficulty with sleep• Fatigue• Breathlessness• Dizziness• Pain
Less expected, perhaps:• Weakened immune function• Broken heart syndrome
(Takotsubo cardiomyopathy)
• Acute episodic amnesia (transient global amnesia)
How does grief affect our behaviors?Expected:• Change in routines and
habits, such as¾ Eating, dressing, hygiene¾ Activities¾ Interests¾ Coping strategies
Less expected, perhaps:• Avoidance of reminders,
such as¾ Thoughts¾ Feelings¾ Places¾ People
• Proximity seeking, such as¾ Time spent with reminders
(photos, letters, grave)
How does grief impact our relationships?
Expected:• Brings us closer, through
¾ Funeral/memorials¾ Sharing expertise (with
financial or legal work)¾ Supportive visiting¾ Provision of meals & help
with daily life (chores and childcare)
Less expected, perhaps:• Creates distance, through¾ Unwanted advice giving¾ Insensitive comments¾ Differing needs re. physical
space, talk, emotion¾ Difficulty with strong emotion
How does grief affect our sense of purpose and values?
Expected:• Make the moments count• Don’t sweat the small stuff• Tell people you love them
(unfinished business)
Less expected, perhaps:• Life has no longer has
meaning/purpose
How does grief work?
The painful thoughts and feelings associated with loss, actually help us to adjust.
1. The intensity of the distress and disruption that we feel motivates us to want to ‘feel better’
2. The yearning and preoccupation we experience compels us to find ways to ‘feel connected’
An Instinctive Healing Process
The reality & consequences of the loss are fully understood. This includes:1. Finality of the death
2. Continued bond
3. Redefined purpose & meaning
ACUTE GRIEF
INTEGRATED GRIEF:
What is Complicated Grief?
A persistent and pervasive grief response, characterized by:• longing for the deceased, • preoccupation with the deceased
and/or the death,
• accompanied by intense emotional pain
How to know who’s having trouble with grief?
• Credulous questioning-“How are you doing with your grieving”
• Investigate integration-“Tell me about the person you lost? Tell me about the death?”
• Symptom snapshot-“What would I have seen or heard if I met you 3 months ago?”
How can we help?Consider these four models for understanding grief:
• Dual Process Model -Stroebe and Schut• Continuing Bonds -Klass, Silverman &
Nickman• 4 Tasks -Worden• Grieving Styles -Martin and Doka
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Oscillation
LOSS ORIENTATIONLOSS
ORIENTATION
Adjusting to the
reality and
consequences of
the loss
RESTORATION
ORIENTATION
Rebuilding a life of
meaning and
purpose
EVERYDAY LIFE EXPERIENCES
The Dual Process Model
Continuing Bonds• The attachment bond is not
relinquished but instead is recreated.
• The bond is a source of ongoing connection, comfort and solace.
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4 Tasks
1. To accept the reality of the loss
2. To learn to live with the pain of grief
3. To adjust to life without the deceased
4. To form an enduring connection
Intuitive Grieving Style
• Experienced as waves of emotion
• Expression mirrors inner feelings
• Focus on exploring and expressing emotions
Instrumental Grieving Style
• Experienced in more cognitive or physical ways
• Expressed in thoughts, actions & behavior
• Focus on doing
Tips for Welcoming Griefy Start conversations -about the deceased & the
death
yListen wholly -with patience, attention & presence
yBe open -suspend the tendency to prescribe or fix
y Identify resources -the person’s own and others
Grief Resources
• MyGrief.ca http://www.mygrief.ca/
• KidsGrief.ca http://kidsgrief.ca/
• BC Bereavement Helpline http://bcbereavementhelpline.com/
• The Centre for Complicated Grief https://complicatedgrief.columbia.edu/
“Beyond right and wrong is a field. I’ll meet you there.”-Rumi
Questions?