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(c) Copyright Community Training Australia 2011 Strategies for assisting those suffering from a loss (unit CHCCS426A) Learning about Grief and Loss

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Page 1: Grief and loss power point 7.4.11

(c) Copyright Community Training

Australia 2011

Strategies for assisting those

suffering from a loss(unit CHCCS426A)

Learning about Grief and Loss

Page 2: Grief and loss power point 7.4.11

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Overview

Grief experiences

Strategies to support normal grief

Grief and personal growth

Exercises to relieve grievers distress

Complicated grief

Community support structures

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Onwards and

Upwards….

Impossible words when

you are struck with a major

loss in your life.

It‟s the last thing you feel like

doing, and the energy

required for even thinking

like this let alone the doing

can be overwhelming.

Page 4: Grief and loss power point 7.4.11

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The Grief Experience

Many people have tried to describe and

understand what happens to people when

they lose someone or something of great

value to them in their life. Grief is an

experience that we all know in varying

degrees and will know over a lifetime.

Page 5: Grief and loss power point 7.4.11

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What are some of the

things we can lose in life?

Family through separation and divorce

Friends

Girlfriends and boyfriends

Locations

Precious possessions

Hopes

Health

People through death

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What does grief feel

like?

Body sensations?

Feelings?

Thinking?

Behaviour?

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What are some of the body

sensations that may accompany

loss.

Stomach upset

Headaches

Dizziness

Tiredness

Palpitations

Nausea

Agitation

Tingles

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What are some of the feelings

which may accompany loss?

Sadness

Shock

Anger

Insecurity

Relief

Depression

Loneliness etc.

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What are some of the thoughts

that may accompany a loss?

It‟s my fault.

It‟s not fair.

I can‟t go on.

I have been abandoned.

Life sucks.

There is no God.

This always happens to me.

Page 10: Grief and loss power point 7.4.11

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Grief reactions are

individual and depend

upon;

Personality factors

Previous family history

– in reacting to loss

Previous losses,

multiple losses

Shock

Other complicating

factors

Page 11: Grief and loss power point 7.4.11

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People have theories about

the stages or ways people go

through a loss

Kubler Ross – stages theory

William Worden – task theory

Margaret Stroebe and Henk Schut

(1999)- Dual process model

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Loss Experience

What is clear from any model is that after the

shock, people tend to walk around in denial

for a bit before the reality hits and deep grief

envelopes them.

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The Dark Times

This dark period of time feels like it will never

end, and all desire for it to end sometimes

leaves as well.

“There is

a place so

dark, that

you can’t

see the

end”.

Page 14: Grief and loss power point 7.4.11

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Guilt

When people lose a partner or child or someone close through death, they may even feel guilty about having days when they feel good or happy. They are fearful that to be happy means that the person they have lost didn‟t count much, or they don‟t care anymore.

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Sometimes a “guilt trip”

is put on someone by

others.

Children can be especially vulnerable to this.

Kids move in and out of sad feelings and

cannot „stay‟ in depression for long periods of

time. It‟s God‟s design and not their fault.

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Trying to get out of the „pit of

despair‟.At other times people

are desperate to feel

normal again and try to

hasten its arrival by

feigning normality.

“I‟m alright, yes,

managing fine, thank

you”.

At night time the pain of

the façade catches up.

Page 17: Grief and loss power point 7.4.11

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Trying to „be strong for

others‟.

Many of us feel

responsible for young

children or other people

we consider to be more

vulnerable than

ourselves. We can

sometimes put on a

brave face in order to

„be strong for others‟.

Inside we may be

crumbling.

Page 18: Grief and loss power point 7.4.11

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Strategies to support

others in grief.

1. Education – the

framework.

2. Letting go, saying

goodbye… in ceremony.

3. Keeping connected in a

new way. Questioning

techniques.

4. Micro-losses as a way to

build a future.

5. Support search.

6. Introduce new supports.

7. Check for complications.

Page 19: Grief and loss power point 7.4.11

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1. Education – the

framework.

Providing a framework for someone

who is grieving is helpful. In the middle

of intense pain and misery to

understand that the process has been

lived through by others and what to

expect can give an individual bearings.

Page 20: Grief and loss power point 7.4.11

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A feminine framework

Elizabeth Kubler-Ross observed grief in

her patients and in their families. She

saw grief as a journey which had

stages. She felt that the griever was

pulled by an invisible thread through the

darkness of loss towards the light. This

„trusting‟ framework will be very helpful

for some individuals.

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Stages theory

The stages she observed were:

Stage 1: Shock and denial

Stage 2: Anger/bargaining

Stage 3: Depression and detachment

Stage 4: Dialogue

Stage 5: Acceptance

Elisabeth Kubler Ross - On Death and Dying

1969

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A fluid movement.

Her theory was not rigid however…it was understood that in moving forward at times people will move backwards and forwards, for example between anger and depression, but will eventually come out the other side.

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A male framework

William Worden had a task theory of

grief. He felt it was something that

people had to „do‟. This „power‟ model

which emphasises the need for action

will assist some individuals as they feel

more relaxed when they know the

experience as something that they can

control.

Page 24: Grief and loss power point 7.4.11

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The Task Theory

To accept the reality of the loss

To experience the pain of grief

To adjust to an environment in which the significant person is no longer present

To reinvest emotional energy

J.W. Worden, Grief Counselling and Grief Therapy 1982, pp 11-16

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Dual Process Model

Margaret Stroebe and Henk Schut

(1999)

This recent model of grief and loss

maintains that both grieving and

avoiding grief are necessary for a

successful resolution and pragmatic

coping with a loss.

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Page 26: Grief and loss power point 7.4.11

Dual Process

Active confrontation with loss may not be necessary for a positive

outcome. There may be times when denial and avoidance of reminders

are essential. Most individuals can expect to experience ongoing

oscillation between a loss orientation (coping with loss through grief

work, dealing with denial, and avoiding changes) and a restoration

orientation (adjusting to the many changes triggered by loss, changing

routines, and taking time off from grief). This reflects a movement

between coping with loss and moving forward, but the extent to which

one needs either of these dimensions differs for each individual.

Read more: Loss Grief and Bereavement - Coping With Loss - Theory,

Family, History, Development, Family, Emphasis, Individual, Model,

Grieving, and Illness http://family.jrank.org/pages/750/Grief-Loss-

Bereavement-Coping-with-Loss.html#ixzz1Iq7pcS00

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A framework for

children

Seasons of the year.

Autumn – losing leaves….losing someone

Winter – cold and dark….feeling sad

Spring – new little buds coming….feeling

hope, knowing change is happening

Summer – lovely colours, sun

shining….feeling happy again

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Visual symbols are

helpful for everyone….

Children need concrete tools to

understand concepts that are new to

them and which they can‟t directly

experience in the present.

The caterpillar/butterfly is also a great

analogy for children – but adults get it too!

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The Broken Leg analogy

A broken leg once set can heal beautifully.

However if it is broken and not set in the right

fashion it can get infected or heal in a warped

manner and a limp may result and at worst

death can happen.

Grief needs padding and support, cleaning of

the wound and time to heal without too much

pressure – just like a broken leg!

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Page 31: Grief and loss power point 7.4.11

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2. Letting go, saying

goodbye… in ceremony.

Since the beginning of time humans

have used ceremonies and symbolism

to help make sense of and work through

major life events. The funeral ceremony

is a way that we say goodbye and have

a marker for our memories. But

ceremonies can be encouraged to be

personal things for various losses.

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Saying Goodbye.

Building a garden bed or gazebo

Going for a walk on the beach and throwing a bottle out with a message.

Letting doves or balloons free

Writing a poem or letter

Even divorcees are having goodbye parties like a „wake‟.

Encourage people to „say goodbye‟ as many times as they need it in their own unique ways.

Saying goodbye to a body part and thanking it for the work it has done and promising never to forget it….can be amazingly freeing.

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3. Keeping connected in

a new way. Questioning

techniques.

Losing someone or something precious doesn‟t mean we have to cut them off….

Encourage people to find ways of staying connected…

When you think about „George‟ where do you like to imagine he is right now?

When do you feel closest to George…what are you doing when the pain eases?

Having a memory album that you go through can be helpful.

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4. Micro-losses as a way

to build a future.

Finding out all the things someone has lost when they lost a loved one or something special to them is validating and can give clues to the helper.

When you lost Katie what else did you lose Joe?

I lost, my best friend, my confidant, my house cleaner, my cook, my budgeter, my social planner, my lover, my cuddler.

Page 35: Grief and loss power point 7.4.11

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See what can be

done about some of

the micro-losses…

“Well Joe we can never replace Katie, she was so wonderful, but I am wondering about that cuddling…I have a friend who has a new puppy that needs a home, I think he will lick you to death…or… I have heard that full length body pillows can really help someone feel comforted at night when they feel alone in the bed and they miss their partner. Can I find out where you can get one of those for you?”

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5. Support

search.

Who or what is out there to help you?

Who has offered support?

What do you know about supports in the

community right now?

By questioning you are reminding a person of

their need for support and checking their own

resources and knowledge.

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6. Introduce new

supports

As a worker wanting to support someone through grief…get to know all the community supports available so that you can suggest other alternatives if the individual isn‟t aware of supports.

Grief and loss libraries, group programs, grief counsellors, grief buddies, associations, web sites etc.

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Seasons for Growth

This program is a four week program to help people who have had a loss in their life. It will give you the skills to cope and share with others who have been in a similar situation.

Many teenagers, children and adults have been helped with the Seasons for Growth Program.

If you feel you or someone you know would benefit, go to the Good Grief Website and find out more. www.goodgrief.org.au

Page 39: Grief and loss power point 7.4.11

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7. Check for

complications.

Sometimes people have really

unpleasant things which accompany

their loss which can infect the wound of

grief and make it really hard to

heal….check for these complicating

factors…

6 complications are presented later….

Page 40: Grief and loss power point 7.4.11

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Grief and personal

growth

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How can we help ourselves

feel better?

1. Be real about how you feel. Express it.

Even if you have no one you can tell, write down your thoughts, even your worst ones or speak these out loudon a beach. Tell God if you believe in him.

Better than this find a trusted friend or confidant that you can be real with.

If you don‟t have anyone you can be honest with, seek out a counsellor.

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Steps forward….

2. Don’t feel that you have to ‘cut off’ the past.When people do this it tends to make the healing process a lot longer.

You are who you are because of the past, the precious people in your life and all of your experiences both good and bad. To „cut it off‟ is to cut off part of yourself. It will make you feel empty.

Instead…face the pain of talking about the person or situation you have lost. This pain will lessen as a result.

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Steps forward

3. Keep a balance in your thought life.

While at the beginning of a loss we will be consumed

with past events – we will want to stay close in our

thoughts to the person or situation we have lost (this

is only natural), over time try to concentrate on the

moment you are in and plan a little for the future.

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Steps forward

4. Watch guilt or blame…get rid of it (its like a cancer that grows and consumes)When life lets you down, its easy to blame people, God or yourself. This is a natural stage and provides „some‟ relief for a time. But be careful of vows…‟I will never forgive them‟, „I will never forgive myself‟, even „no-one understands‟ is a form of blame of others, and „If there is a God, He‟s either making a lot of mistakes or is obviously disinterested!‟

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Steps forward

5. Be sensible with self careMake sure you eat well, get lots of sunlight, walk a

lot, keep routine sleep, reduce workload and laugh as

much as you can. The „looking after yourself‟ body

soul and spirit is really important.

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Steps forward

6. Drug UseWhen you experience a loss it is better to find natural ways to cope rather than use medication. Sometimes in extreme circumstances doctors do prescribe drugs for the depression or sleeplessness than can occur in grief.

It is really important to stay clear of alcohol or other non prescribed drugs if you are in grief. Individuals in grief are the most at risk with going too far with these things because they are trying to numb emotional pain. This is of course far more dangerous than carefully prescribed medication when legitimately in need.

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Steps forward

7. Find friendships and support

The friends you make in grief are incredibly special. They may be completely different from your normal friends.

Get out and get involved with new aspects of life.

Even if you don‟t feel like it, take baby steps forward.

Page 48: Grief and loss power point 7.4.11

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A step UP…

1. Grief can become a time of

spiritual awakening.

Many people find their limitations through

a significant loss. They can no longer do

what they once did, or protect themselves

in the same way. They will often say they

have found a „higher power‟ when all their

strength fails.

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A step UP

2. People can find new purpose for their

lives.

Many people experience a new found love of helping

others, and a sense of peace about material things.

They don‟t matter like they used to. We realise the

real value of life.

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A step UP

3. Becoming more grounded….helps you

fly

It is true. Smelling the roses, knowing what counts in

life, helps you prioritise and achieve greatness in this

life.

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A step UP

4. Suffering is everywhere…none of us have a monopoly

Unfortunately this planet is less than perfect. However the suffering we experience can make us greater people, with greater empathy with greater resourcefulness and a passion to extinguish pain wherever we see it.

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Lessons of life from

children

Author and lecturer Leo Buscaglia once talked about a contest he was asked to judge. The purpose of the contest was to find the most caring child.

The winner was: A four year old child whose next door neighbor was an elderly gentleman who had recently lost his wife. Upon seeing the man cry, the little boy went into the old gentleman's yard, climbed onto his lap, and just sat there. When his mother asked him what he had said to the neighbor, the little boy said, "Nothing, I just helped him cry."

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Lessons of life from

children

Whenever I'm disappointed with my spot in life, I stop and think about little Jamie Scott. Jamie was trying out for a part in a school play.His mother told me that he'd set his heart on being in it, though she feared he would not be chosen.

On the day the parts were awarded, I went with her to collect him after school. Jamie rushed up to her, eyes shining with pride and excitement."Guess what Mom," he shouted, and then said those words that will remain lesson to me............................

"I've been chosen to clap and cheer."

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Exercises for times of

grief

1. Map of Life

Goal setting is an important part of beating

depression.

Draw a map of your life – each separate domain.

Add one new goal for each area for the new year.

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Exercises

2. Write to the one you have lostConnectedness is central to emotional wellbeing.

Write a letter or journal to the one you have lost or the part of yourself that you have lost. Say goodbye, express your regrets and sadness and also your gratefulness.

End on a positive note about your goal for the future as a result of your loss.

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Exercises

3. Stretching and rocking

Stress and trauma which is part and parcel of grief

builds up tension in the body…the body keeps

bracing itself for disaster.

Do lots of stretching exercises and do rocking

exercises and cross lateral patterning to release off

tension.

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Exercises

4. LaughingLaughing has been shown in research to release serotonin…the happy hormone in the brain, it improves immune function, flushes the face, and provides a sense of wellbeing. We can fool our brain into thinking we are happy with fake laughing.

Make laughing noises, ha ha – hee hee- ho ho and make them loud, move up and down and smile widely while doing this…do it for 2 mins 3 times a day whether you feel like it or not.

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Exercises

5. Examine all your senses again.

Get in touch with the moment.

Have an excursion to particularly exercise your sense

of smell…

The same for hearing…

Sight

Touch

Taste….get adventurous.

Page 59: Grief and loss power point 7.4.11

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Page 60: Grief and loss power point 7.4.11

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Exercises

6. Try to enjoy people and

their differences

There are lots of different

types out there in the world.

Take a new perspective,

notice people, their

expressions, their features,

their voices.

In your appreciation of people,

you may find the favour is

returned yielding unexpected

friendships and joy.

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Exercises

7. Take a big pillow to bed.

Hold it close to your chest.

In loss we can feel like children again, needing

holding and comfort. If we have lost the one who held

us, it will be important to have as much touch as

possible. This doesn‟t always happen. Take a pillow

to bed an cuddle it. No matter how old you are….this

can feel great and relieve the internal ache.

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Exercises

8. Hold your forehead and

back of the head, and cross

your feet together.

This position brings a lot of comfort

quickly and provides a sense of

wellbeing. Maybe our parents did it

for us when we were babies…who

knows why it works…but it works.

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What happens when

people get „stuck‟ in their

grief?

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Complications to the

grief process

6 reasons for extended grief and what

to do about it

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1.

Denial of Grief This is when someone

doesn‟t get to

experience their

emotions as a result of

deliberate or

unintentional

avoidance. It can

postpone and cause

mayhem to our normal

grief reactions.

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What can be done to remedy

denial of grief?

Read more information

Attend a community

support group

Call someone from a

community support

group

Speak to a counsellor

Get help to deal with

past issues or present

energy stealers.

Design a ceremony.

Give permission to „feel‟. Emotions are not wrong.

Use debriefing strategies…. What happened, what were you thinking, what were you feeling. Drawing –Music – take opportunity to feel when it arises.

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2.Abuse of

grief This is when others do not allow grievers to express their distress and sorrow in loss. This can be from a selfish motivation or from a mistaken belief that it is best for everyone, not to talk or think of the „problem‟ of death or loss.

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What can be done to

support abuse of grief?

Actively not listen

Remove self from atmosphere of abuse

Educate „abusive‟ voices.

Read literature

Attend a support group

Seek help from a

counsellor

Find supportive

people

Journal the

experience

Be your own best

friend.

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3. No Good byes

This often accompanies

sudden death and is usual in

suicide situations. The

suicide victim may leave a

note or say goodbye, but

survivors rarely get the

chance.

Children may be particularly

vulnerable to this complication

to the grief process.

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What can be done to say

goodbye.

Emphasise that it is nevertoo late to say goodbye.

Find a way to say your goodbye – make an endpoint.

Ask a friend or relative to help in a simple „ceremony‟ of goodbye

Community opportunities… memorial services etc.

Talk to someone in a support group about how they said their good-byes.

Speak to a counsellor about ways to make a „goodbye‟ a personal and healing time.

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4.

Confusion

about

reasons.

We long to know why

something so

tumultuous happens. It

is important for us to

have a way to think

about a loss event so

that our „framework‟ for

meaning in life can stay

intact.

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What do you think you

could do to attend to this

complication?

Seek more information so that the event makes sense.(read books, speak to Drs etc)

Talk to other survivors whose loved one was in a similar situation –if there has been a death.

Speak to a counsellor.

Agree inside that while all answers may not be clear now… as time passes the answers may come.

Be clear in your mind that self blame is not a reasonable answer to „why‟.

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5.

Blame/shame Blame is related to our

need for reasons and

meaning. We blame

ourselves, others, the

situation, the system or

God. Blame keeps us

a prisoner of pain,

even though it is a

natural human

tendency.

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What can be done to

attend to this

complication?

Write a list of possible people, situations or things that we might have felt was to blame for our loss.

Check for body reactions or ruminations in the mind.

Talk to a professional.

Take a step back and think… they are (I am) only human… we all can make mistakes, none of us knows the future. God (life) is not out to get me. Release blame. Verbalise it. Assist people to understand that releasing blame, releases them, releases us from wasting emotional energy.

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6.

Trauma Trauma relates to a change in brain chemical reactions as a result of undue or prolonged stress. Trauma can be treated. Drug and trauma therapies are highly recommended for sufferers.

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What can be done to

support trauma?

Write a list of body sensations and body complaints that has been present since the loss..

Ask yourself, does this get better over time or worse? Does it constitute trauma?

Read about strategies to relieve trauma reactions in the body. Tapping, exercise, relaxation, laughing.

Seek professional help.

Talk to other sufferers.

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Antidotes for

complications

1. Denial of grief

2. Abuse of grief

3. No good byes

4. Confusion about

reasons.

5. Blame/shame

6. Trauma

Get permission

Don‟t listen, find kinder

voices.

Never too late……

Answers and meaning

will come… just rest.

Be aware - get help to

stop.

Get treatment

Page 78: Grief and loss power point 7.4.11

(c) Copyright Community Training

Australia 2011

Sensible emotional first

aid

Good education

Good friends

Good food

Good rest

Good work

Good exercise

Good fun

Good touch

Good drink

Good faith

These are the first

ports of call for any

emotional distress,

including any losses

including the death

of someone close to

us.

Page 79: Grief and loss power point 7.4.11

(c) Copyright Community Training

Australia 2011

Toni Mehigan

Psychologist/Grief and Loss

Educator

This presentation has been put together by

Toni Mehigan.

Toni can be contacted on 07 47724103 or by

email on [email protected]