Understanding Professional Grief

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September 12, 2006 at 4:43 pm  •  Posted in Grief And Loss by  •  0 Comments

By Elizabeth J. Clark, PhD, ACSW, MPH

Introduction
High Loss Work Environments
How Professional Grief Differs from Personal Grief
Maintaining a Professional Balance

Introduction

Loss is a recurrent theme in life, and many professionals such as social workers have received training in helping clients learn how to adjust to a variety of losses and how to cope with the grief that accompanies the loss.

Facts About Loss and Grief 

A loss is being deprived of something
one has had, or hopes to have, but does
not attain, (i.e., parenthood, fertility,
marriage, or reconciled relationship).

Grief is a reaction to loss.

Every loss has an accompanying grief.

Grief is a process, not an event. 

Loss, like stress, can accumulate.

Grief cannot be postponed indefinitely;
it will reach expression in some way.

People grieve differently. 

Expressions of grief vary by age groups,
culture, geographic area, and type loss.

What too often is lacking in professional training programs is how to deal with one’s own grief response when clients die, what can be referred to as “professional grief.”

High Loss Work Environments

Many individuals reach adulthood without experiencing a loss by death, and they are unfamiliar with the normal grieving process. Yet some occupations deal with death on a regular and continuous basis. These numerous losses create a very stressful work environment. To function adequately during a loss or crisis situation, professionals are trained to set aside their personal emotions, but all experience is personal. The experience happens to a particular individual, and that individual has to respond personally.

Whether your occupation is a social worker, nurse, physician, clergy person, office assistant, or professional caregiver, if you confront multiple and continuous losses at your work site, you will experience a grief response. What many professionals don’t recognize is that their grief response will be dissimilar to that experienced by family and friends who lose a loved one to death.

Professional grief usually takes the form of hidden grief — grief that is internalized and not openly expressed. There is no natural outlet for it, and the demands of work overshadow it. This lack of expression may result in cumulative grief, or what sometimes is referred to as bereavement overload. This can further lead to a legacy of vulnerability, burnout, or post-traumatic stress reaction.

Bereavement Overload
Bereavement overload is grief
precipitated by the occurrence
of multiple losses with little time
allowed for separate grieving.

“Hiding grief” is not new to the helping professions. There has always been an expectation that professionals who work in high loss settings get used to dying and death. In fact, familiarity with death does not make it easier to accept loss or to manage professional grief more effectively.

Most persons in the helping professions do not enter their fields prepared to cope with death, and they often spend years trying to develop the right blend of compassion and involvement while protecting themselves as much as possible from personal hurt.

How Professional Grief  Differs From Personal Grief

The following characteristics differentiate professional grief from grief that follows the loss of a loved one or close friend:

  • Professional caregivers are distant mourners.
  • The effects of professional grief are hidden and subtle.
  • Professional losses accumulate.
  • Professional grief may be transformed into other emotions such as anger, anxiety, blame, helplessness, and guilt.
  • Professional grief may take the form of a chronic or delayed grief response — one that never seems to come to a satisfactory conclusion.
  • Professional grief is a significant cause of burnout.
Maintaining Professional Balance

Working in a high loss environment requires a balance between engagement and detachment, and the balance requires ongoing self-monitoring. If balance is lost, the detachment or engagement can become dysfunctional. This may result in the inability to meet your own needs or the inability to care for others.

Several things may happen if you are unable to maintain a healthy balance in a high-loss work environment. These include the following:

  • There may be a decrease in your tolerance or sensitivity, and you will be unable to adequately meet the demands of your work.
  • You may become overly cynical, and your sense of the world may become jaded. (Cynicism is one of the best clues to burnout.)
  • You may experience a post-traumatic stress reaction which could include sensory imprints or flashbacks — sights, sounds, or smells that bring back a certain situation.
  • You may find it difficult to maintain hope at work or in your personal life.

Working in high loss environments is stressful, but it also is rewarding. There is much to learn about the human spirit and human experience, how people maintain hope, and how people find strength and meaning through adversity. Professionals who spend years working in such settings often mention their feeling of making a positive difference in the lives of others. These individuals have found ways to maintain balance in their lives. They monitor their reaction to loss, recognize professional grief, and express it in appropriate ways. Instead of feeling overwhelmed or diminished by the multiple loss environments, they find their lives are enriched by working there.

As C. Murray Parkes, one of the foremost experts in bereavement has noted:

“With proper training and support, we shall find that repeated griefs, far from
undermining our humanity and care, enable us to cope more confidently and
more sensitively with each succeeding loss.”

Reference

Parkes, CM. “Orienteering the caregiver’s grief.” Journal of Palliative Care, 1986; 1:5-7.

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