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(c) Copyright Community Training
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Strategies for assisting those
suffering from a loss(unit CHCCS426A)
Learning about Grief and Loss
(c) Copyright Community Training
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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.
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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.
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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.
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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
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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”.
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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.
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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.
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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.
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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.
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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.
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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
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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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!
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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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.
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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
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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….
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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.
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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.
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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
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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.
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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]
