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Posts Tagged ‘
grief ’
Sally had been a soldier's wife for all twelve years of their marriage. She endured separations while her husband, Tom, was called to duty, and she toughed out raising twin boys alone. Sally said Tom loved her because, in his words, she was a "team player." But ever since Sally learned that Tom was killed in a roadside bomb in Iraq, Sally doubts whether she can be a team of one. "I'm really not that strong," Sally said. "It's just a good act."
When Rolanda was shot out of her helicopter, her husband Ray said he had no choice but to "pull himself together." He had to focus on his job and raising his stepdaughter. "I only cry at night, and then only for a second or two. We were practically newlyweds. I don't even know what I'll be missing."
"At least the kids are grown." It was the first thing that came to Linda's mind when she heard that her husband was killed in an ambush. But the relief was short—depression set in, and Linda felt "ashamed" for falling apart.
These stories provide a glimpse into the plight of many of the American families of downed warriors in Iraq. Each family's grief is unique, but most share issues that are familiar to mental health professionals–adjustment, loss, grief, and anger.
Some families rely on friends, the Armed Forces community, and supportive family for help. But one of the issues that many (certainly not all) of these families also share is their reluctance to use the mental health services available to them.
Why? What makes providing counseling to these families so different from non-military families in mourning? And how can mental health professionals serve these families' needs?
Let's start with learning a little more about some of these families. Bear in mind, that there are many reactions to the loss of a family member and that not all families of downed warriors react the same. Yet, a constellation of beliefs, fears and adjustment issues does exist amongst many of these families, and it is important to become familiar with them.
At first, it seems that the most common issues of military families do not differ from the problems of families not in the military. People are people, as some say. After all, humans share common problems. Yet, military families often add elements to these issues that are unique to them.
Many families worry about being seen in counselors' halls and waiting rooms and about being judged and "found out." They also worry about confidentiality. They believe that no matter what the organization, if it's affiliated with the armed forces, it will keep records that could easily be shared with other branches and departments.
Non-military families may have similar feelings, but military families carry with them an extra dose of shame of being "found flawed." They also say they "have had it" with the power of military and government rules. They long for privacy, and they have far higher doubts that their insurance can protect them.
When the emotional and behavioral problems become too great, families might reach out to the mental health services of their insurance plans. Many families experience uneven quality of services, problems of continuity of care, restrictions on the number of mental health sessions or lack of freedom to choose they want.
Yet, non-military families experience these same issues. The difference is what one of my clients called "reaching the end of her rope" with her insurance. These families have higher expectations of the quality of their care. They believe that serving and sacrificing for their country permits them better treatment.
These families feel hurt and disrespected. When these feelings become too painful, the families often avoid seeking help.
The latest information about the unacceptable quality at Walter Reed Veterans Hospital reinforces their lack of trust in all services. However, there are many excellent Veterans Administration hospitals. When frustration peaks, it is easy to toss all hospitals and services into the "not good" pile.
Unfortunately, traveling to a quality Veterans Administration hospital is not easy. Military families may not have the financial ability or the family resources of a grandmother or aunt to assist with child-care. As one of my clients said, the families get "jaded and just give up."
Since these families have now experienced both the anguish of not being able to control their grief reactions and also the shock of seeing what they perceive as a weak and shameful self, their trust in most military mental health services finally erodes. They believe that if they can't trust themselves any longer, then they certainly aren't going to trust the institution that let them down.
Like many American soldiers who fought in Viet Nam, the American soldiers of Iraq and their families risk experiencing negative judgments from the public because of the civil and military difficulties, length of time of the war and loss of lives.
Families often worry about being accepted as well as valued for their patriotic contribution and sacrifice. One wife and mother said, "In the beginning, everyone clamored to wear a 9/11 pin. Now, no one wears one anymore."
Military spouses are usually viewed as hardy, "salt-of-the-earth" type of people who raise resilient children to withstand relocations, absent parents and emotional pain. When the death of a spouse and parent occurs, these families often experience shame in feeling weak, out of control, and emotional.
The comments of one daughter speak for many: "I feel like I'm a disappointment to my father's legacy. He would be furious if he saw me crying and just being a basket case right now."
Military personnel often choose spouses whom they think can manage the anxiety of military life. The spouses often fit along a range from "independent and capable" to "can carry out orders." Imagine, then, the shock when some spouses find that after the death of their husband or wife, their life, household and financial management abilities crumble.
"I thought I had everything under control. I guess I've just been a soldier, not an officer," one wife said. She was fine as long as her husband provided a script, but she faltered at making new decisions.
Like trauma survivors of the Holocaust and childhood sexual abuse, many surviving military spouses and family members describe themselves as "living on two tracks." One track takes them through daily life and the image they present to the world.
But the other track leads to their darker world inside, filled with anxiety, anger and depression. Even worse, some feel like imposters. "If you can fake it, you can make it," becomes their rally call.
Unresolved grief is one the biggest issues that military families report. As a result of their difficulties in handling grief, the families experience several "disconnections" between:
a) what was—and still is—expected of their coping skills,
b) their previous view of themselves as hardy, tough and sturdy,
c) normal grief and adjustment reactions, and
d) their struggle to view these reactions as normal and not weak or shameful. Families often
say things such as "I always saw myself as strong." Shame and confusion replace confidence.
To deal with their grief, families frequently rely on the same ineffective and often damaging coping mechanisms of non-military families. For example, depression, substance abuse or difficulty in working and parenting might occur.
What makes these grief responses of military families so different is that their unique burden of shame of not coping better, disappointment and anger in the quality of their mental health services and lack of perceived national support heightens the emotional intensity, duration, frequency and resistance to changing their ineffective coping tools.
Grief is already a lonely experience. This extra burden makes it even heavier. Soon, the families are caught in a shame-grief-shame cycle that eats away at their ability to change their behavior and negative self-view.
Finally, like many widows and widowers, the spouses often reassess their marriages. For example, wives might discover that they are "relieved" to be out of a bad marriage. Children also may see the deceased parent differently.
The difference in military families is the perceived pressure from the military community to maintain positive views of the deceased partner or parent. For example, serious flaws, such as domestic violence or child abuse might get overlooked. Children may have to work extra hard to conceal their anger at the living parent for having chosen a bad partner.
Military families often flip-flop internally between seeing the truth and glorifying the deceased. The family members sense a heightened taboo against saying anything negative about the deceased and keep secrets about their real feelings.
One of the surviving spouses described the difficulty of "keeping up appearances" that her husband and the father of her children was a "good man." "I don't know who I am anymore," she said. Over time, family tensions increased. The children sensed the lie, and the truth came out only after one of the children arrived at school drunk.
1. Renew your trust in mental health professionals. Try them out—just as you might try out a family physician. Find a person who makes you feel comfortable. Many professionals are willing to speak to you on the phone or provide a free consultation. Some people "Interview" several therapists. Ask openly about their willingness to work with military families. Ask if they have expertise with your specific issue.
2. Rethink your views of seeking help. You deserve to be happy and in charge of your life. Seeking help does not mean you are weak or ineffective. There is no shame in using therapists, pastors and other mental health professionals. In fact, most professionals know that the strong are often the ones most likely to ask for help.
3. Before you go to your appointment, make a list of the topics you want to discuss. Include information such as: a) when the problem began, b) what measures you've taken to solve the problem, c) why you think your efforts didn't work and d) what do you think might work.
4. If you don't like your therapist, speak up about what's not working. Consider trying the therapist for another visit before you select another one. Keep up the momentum of seeking help. If you thought you needed help, follow through on that instinct. Problems sometimes have a way of losing their urgency, but don't let this lull fool you. They tend to crop up again if you don't make effective changes.
5. Contact the Counseling Network of the Special Operations Warrior Foundation Counseling Network., www.specialops.org, a select network of therapists who are providing mental health services for free to families of downed warriors of the Iraq war.
The Warrior Foundation's initial mission was to guarantee college educations to all the children of downed special operations warriors. Over time, however, these families expressed their strong desire to receive counseling from outside their insurance company and the military establishment. Right now, there are over 600 children whose college education will be paid for by the monies that the Foundation raised.
The main office of the Foundation is in Tampa, Florida. Carolyn Becker is the Counseling Director. My husband and I have worked with Carolyn in setting up a free counseling network of volunteer counselors. If you are a family in need of help, you can contact Carolyn Becker at
beckerc@specialops.org
Or you may call Dr. L.B. Wish at 941-363-0505 in Sarasota, Florida or reach her by e-mail at dr.l.b.wish@comcast.net.
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Tags: families, grief, grieving, Iraq, mental health, social worker, veterans, war, widow
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Introduction
For every loss there is a grief reaction. Some losses are minor and the grief is manageable. Other losses, though, will have a significant impact and may lead to depression or an extended grief response.
Usually, the most difficult loss is the death of a loved one. Many persons reach adulthood without having experienced a loss by death, and they are unfamiliar with the grieving process.
In fact, American society is uncomfortable with death and with open expressions of grief, and prefers that people hide their feelings and emotions. Added to this is the organizational approach to grief that often allows an employee only a week to bury a loved one and mourn the loss before returning to work. As a result, bereaved persons are forced to hide their grief in public and act as though they have completed grieving and are "back to normal." This is the opposite of what we now know about grief, about how important it is to talk about the loss and to experience the grief.
Denying the significance of the loss can make grief harder and can extend the grief process. Another concern is that most individuals and their families don’t know what to expect with acute grief. They become concerned that what they or family members are experiencing isn’t normal.
It is important to note here that grief may be different depending on the age of the person experiencing the loss. Childhood and adult grief are not generally experienced in the same way. This article deals with adult grief.
The characteristics of normal or natural grief were first documented in 1944 when psychiatrist Erich Lindemann studied families who had lost a loved one in a nightclub fire. His findings have been called "the symptomatology of acute grief." That means there are certain symptoms or behaviors that are expected during the first six weeks or so after the death of a loved one, the time that is referred to as the acute grief process.
Depending on whether a death was expected, or sudden and tragic, grief may begin with the inability to fully grasp what has happened. This is a state of shock or numbness, and usually happens for the first week or two after the death. Acute grief also includes intense emotional and bodily distress occurring in waves lasting from 20 to 60 minutes. People often describe this as a sensation of grief "washing over them." It includes a feeling of tightness in the throat, a choking feeling with shortness of breath, an empty feeling in the stomach, and weakness in muscles. It also includes what is described as intense "mental pain."
In addition, acute grief includes crying and sobbing, restlessness (a person can’t sit still or paces back and forth), excessive sighing, a loss of appetite and a loss of sexual drive. Sleep problems are also common. These physical symptoms can be combined with depression, deep sadness, and being unable to concentrate.
There are two more aspects of normal grief that should be mentioned. The first is what is called "searching behavior." The grieving person is preoccupied with thoughts of the dead loved one. They simply can’t stop thinking about them. These thoughts may include responses that are like auditory or visual hallucinations. They think they see their loved one on a bus or on a crowded street, or they think they hear his or her voice or hear the car pull into the garage at the usual time each night. These thoughts are caused by psychological cues (instances that mentally trigger thoughts of the deceased loved one) and will decrease in time. Persons who are grieving are often frightened when this occurs, and fear that they are going crazy. It is helpful to note that these instances are common and normal during acute grief.
The second factor that people sometimes worry about is the use of linking objects that help the grieving person feel connected to their loved one. Wearing or sleeping with a piece of clothing or item belonging to their loved one may bring great comfort. Frequently, people note that the article still has the scent of the person who has died. Perhaps they can still smell their loved one’s perfume or cologne or shampoo. Perhaps it was a clothing item that was frequently worn, or a possession such as a necklace or ring that had special meaning for their loved one. The items may vary, but the idea is the same — that the items help to keep a person linked to the loved one who is gone. This, too, is normal grieving behavior, and the need for the linking object will decrease over time.
Many people ask how long grief lasts. Others ask if it will ever end. Death ends a life; it does not end a relationship. However, after the death, that relationship must change to deal with the grief and loss. This change involves four major tasks.
First is accepting the reality of the loss. The person comes to realize that their loved one is gone and nothing can bring him or her back.
The second task is experiencing the pain of grief. People sometimes think they can avoid the feelings of grief, or they may try and postpone it in some way. They may return to work in a day or two, and their behavior — often described as "how well they are handling it" — may be rewarded by people noting how strong or stoic they are. However, a person can’t move on in life by denying the death or the feelings that the loss has evoked.
Adjusting to a changed environment in which the loved one is missing is the third task. How a person does this depends on many things. Some individuals want to dispose of their loved one’s clothes and belongings immediately. Others leave things as they were before the death and ease into change. It is up to the grieving individual to make this decision and others should not try to impose what they think is best. Experts suggest that major decisions, like moving or selling the house, be put off for several months or even a year so that there is time to make a thoughtful decision.
The final task is going forward emotionally. This doesn’t mean forgetting about the loved one who has died, but it means thinking differently about the emotional tie to that person. The person who has died will always be a part of an individual's life, but they can’t be a part of their day-to-day life going forward. Their memory can, their love can, but their physical presence can’t be.
Grief experts estimate that it takes at least one year to move through the grief process. (Note, they do not use terms like "finish grieving," "resolve the loss," or "get over the loss.") Two to three years may be a more realistic estimate.
A full year is considered a minimum, because it takes a year to experience all of the anniversary dates and holidays with the loved one gone. During these special times, symptoms of acute grief may come back for awhile. This, too, is normal and will lessen with time.
The support of family and friends is important in the grief process. Sometimes, however, this may not be enough, or all family members are trying to manage their own grief and don’t have much emotional support to give to one another. At other times, especially when the death was expected, family and friends might think a person should be able to manage the loss and "get back to normal" quickly. Or they may say unhelpful things. Usually they simply don’t know how to help. They don’t know what to say. In fact, no matter what they say, it won’t change the fact that a loved one has died and that this is the cause of pain and great sadness. But it does help to know that they are caring and are trying to be supportive during a very difficult time.
Some people who are grieving feel better talking to someone outside the family or outside their circle of close friends. If a person needs help in dealing with grief, is seriously depressed, cannot cope with everyday life, or feels that their grief is getting worse, professional help should be sought. Social workers, clergy, or funeral directors are excellent places to begin. They frequently have lists of support groups and therapists who specialize in grief counseling. Also, many hospice programs offer support programs, and these frequently are open to all persons regardless of whether or not the dying person was cared for by that particular hospice.
Little by little, and day by day, grief becomes more manageable. People may think that their life can never be normal again, and in a way, they are right. It can never be exactly like it was when their loved one was alive. But eventually the acute pain of grief recedes somewhat, and a "new, normal" takes the place of old patterns and ways of doing things.
The person who has suffered the loss can still get in touch with their grief at any time, and it may often appear unbidden, but it is no longer all-consuming. When that happens, the bereaved person has moved out of the acute phase of grief and is moving forward with life.
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| A Grieving Young Person Might Ask |
"When is Daddy coming back?"
"Can I go to heaven to see Grandma?"
"Why did Mommy have to go?"
"Are you going to die, too?"
"How did he die? Was it something I did?" |
A strong response to the death of a loved one is a universal phenomenon that exists for people of all ages. Children and adolescents, however, may experience grief differently from adults. Knowledge of how children of different ages have experienced a loss is essential to helping children and adolescents who are grieving.
The loss of an important caregiver or adult can impact the infant's sense of security and well-being in the world. Children of this age are sensitive to changes in routine and stress in their environment. The child may display excessive crying, writhing, rocking, biting and other anxiety related behaviors.
Children at this age may have feelings of sadness, anxiety, insecurity, irritability and anger. They believe that death is a temporary state that can be reversed. They may equate death with sleeping or being away on a trip, or believe their thoughts or behaviors caused the death of their loved one. Some children may act as if nothing happened, while others may exhibit regressive behaviors, such as bedwetting or excessive clinging.
At this age, children are able to consider the biology of death and grasp its finality. They may develop fears associated with their own death or the death of a surviving parent. Feelings of insecurity may be expressed in a reluctance to separate from caregivers. Some children may be hyperactive, aggressive and disruptive, while others are withdrawn, sad and. Children may have nightmares, difficulty sleeping through the night, or display regressive behaviors.
Children this age understand that death is final and that it happens to everyone. Fears and worries associated with the loss may be heightened by the physical occurring within their own bodies. Ironically, they may have a strong need to control their feelings while at the same time they have great difficulty doing so. Because friends are so important to this age group, preteens may feel socially isolated, lonely, confused, scared, guilty and self-conscious.
Teens may have a need to feel "strong", in control of their emotions and "indistinguishable" from their friends. They may hide (or numb?) their emotions of grief by engaging in risk-taking behaviors, such as reckless driving, alcohol and drug use, sexual promiscuity and defiance of authority. They may be reluctant (or unable?) to Express their feelings with others…The death can cause strong feelings of sadness, loneliness, confusion, fear, guilt and anxiety for the grieving adolescent. They may become more easily distracted, experience sleeping and eating disturbances, perform better or worse in school, and display strong emotional mood changes. Like adults, adolescents may have difficulty coping the loss for months or years following the death.
Children of all ages may develop fears associated with a death. These fears can lead to other problems if neglected. Common childhood fears that result from the death of a loved one include: Fear for their own death or the death of a caregiver
- "When will I die?"
- "Is mommy going to die, too?"
Fears about being alone at night or in an empty house, the house being robbed, being in a car accident, or having nightmares
- "The monster/stranger might come."
- "I'm scared to go upstairs."
- "I need you to stay with me."
Concerns about the intensity of their grief related emotions and those of their caregivers
- "If I cry, I won't stop."
- "I can't stand to see my mother crying."
Fears that their friends and family members will treat them differently or that they will be isolated due to the death
- "No one will talk to me at school."
- "They act like I'm weird."
Safety related fears that revolve around who will attend to their needs
- "Who will take care of me?
Depression is a common outcome of extended grief among children and adolescents. Caregivers should be alert for any changes in the child's physical well-being and behavior. Typical signs of childhood depression include the general appearance of discontent, low frustration tolerance, needs for comfort but is unsatisfied when comfort is given, acting out behavior, bedwetting, decline in school performance, moodiness.
If a youth's grief reactions put them at risk of hurting themselves or others, caregivers should promptly seek the support of a mental health professional. For example, if a child or adolescent makes self-destructive behaviors or expresses feelings of hopelessness, it may indicate that there are more serious problems that should be promptly addressed by either a physician or a professional counselor.
While these signs are important indicators of how the child is faring with their grief, caregivers should be aware that most children do not sustain intense emotions for long periods of time (Landreth et al., 2005). A child may be crying about his/her deceased parent one minute and abruptly switch to joyful playing and laughing the next minute. It is OK for children to have "time off" from their grief experience, though this does not mean that the child has resolved all of his/her feelings about the death. Caregivers should also know that children often re-experience grief at different developmental stages.
Grief has different meanings depending on the family's background, spiritual orientation and culture. Rituals surrounding the death are often family specific as well as culturally grounded. In some families, for example, it is believed that children should be protected from the negative experiences associated with death and grief and therefore, children are excluded from rituals and discussions concerning the deceased. In other families, children are encouraged to be involved in all aspects of the death and memorialization of the deceased. Balancing these two extremes are the families that involve children in age appropriate ways. These families expose their children to some aspects of the grieving process while protecting them from other aspects that may overwhelm the child's coping abilities.
Parents and children may need to mourn a family loss individually as well as together as a family. Parents often feel uncomfortable expressing their grief in front of their children, fearing that too much emotion will scare them. Grieving parents should try to strike a balance between modeling the healthy expression of emotions while maintaining a sense of security in the home. Children and adolescents tend to weather the pain of grief more easily when family members:
- Communicate their emotions and their needs concerning the death
- Understand and respect the individuality of each member's grieving experience
- Recognize and cope with their own grief while assisting their children
- Reassure their children that despite the sadness of losing a family member, they will continue to be cared for and they will remain a family unit.
In addition, research has found that adolescents may benefit from:
- Good health habits such as good diet, nutrition, rest and exercise to combat emotional stress related to grief.
- A return to their normal routine including activities outside of school.
- Participating in activities of interest, such as sports teams and student clubs
- Obtaining professional counseling if necessary (Rask, Kaunonen, Paunonen-Illmonen, 2002).
Collaboration among family, school and professional services is essential to identify grieving adolescents who might not otherwise ask for help. Caregivers should notify school personnel when a death occurs. Teachers and school counselors can be watching for changes in the adolescent's mood and behavior. Significant changes in the adolescent may suggest that additional help is needed.
Social workers knowledgeable about grief and children can help caregivers:
- Learn how to explain death to children
- Provide information on how children understand and express grief
- Learn to tolerate and moderate emotions and behaviors exhibited by children
- Communicate to children that they are not at fault or responsible for the death
- Provide assistance for coping with a grieving child or multiple grieving children when the caregiver is also grieving.
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Tags: Adolescents, age range, caregivers, children, Danielle Parrish, Elizabeth C. Pomeroy, fears, grief, help, loss, Renee Garcia, social workers
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Introduction
When life is suddenly interrupted by a tragic or traumatic event, it can seem that the world has come to a screeching halt. Murders, assaults, and tragic accidents that occur without warning are particularly disturbing and difficult to manage emotionally. How individuals recover from such situations often depends on the prior psychological functioning of the individual, the exact nature of the trauma, and the individual's ability to regain some sense of safety and control over his or her world. There are, however, striking similarities in the ways in which we humans attempt to regain our composure and resume our lives after such an event.
While grief or sympathy is an expected reaction, another feeling is also tapped following a tragedy: a frightening sense of helplessness. Disasters, accidents, and traumatic events can invoke significant feelings of vulnerability and a loss of control in all of us. While each day brings countless threats and potential dangers to every human being, we have evolved to psychologically "insulate" ourselves from these fears and to proceed through our lives as if we, and everyone around us, have been somehow guaranteed another day. We dismiss the chance of death or loss, and we find comfort in predictability. We create a bubble around ourselves, enabling us to happily overlook our own mortality and the potential for life to suddenly and irreversibly change course. When that bubble is suddenly burst, it can leave us feeling helpless and vulnerable. Life suddenly becomes scary and unpredictable, and those feelings can be paralyzing.
To regain some feeling of control and to again make sense of life after a seemingly senseless occurrence, we may begin to search for both meaning and often blame. We may replay the specifics of the tragedy and the events leading up to it over and over to try and restore a sense of predictability. We may search all of the available information to find something, anything, that could have been done to prevent it: "If only I had taken another road…If only the airports had screened more carefully…If only the levees had been built better…"
If we decide that someone could have intervened and prevented the tragedy, or that some sequence of events could have been recognized as a prelude to the disaster, then we may feel that it is within our capability to prevent such a disturbance to our predictable world from ever happening again. If we begin to believe that it actually wasn't inevitable or unforeseeable, then no matter whom or what is to blame, we believe we can insure that the same mistakes are never repeated. The awful randomness of tragedy is thereby erased, and our impenetrable bubble is once again restored. Life returns to its normal, predictable patterns, and the demons return to the shadows.
While these maneuvers to restore a sense of mastery over our world are natural and usually benign coping strategies, they can also be the catalyst for a disaster of another kind. If, in our attempt to make sense out of the senseless, we misplace blame on either ourselves or on another, then we create culpability or responsibility where there is none. This results in essentially restoring our own sanity by sacrificing our humanity.
While we cannot be expected to completely avoid these tragic tendencies, we can be expected to constantly question our own motives and reactions. Anger, grief, sadness, confusion are all valid and understandable emotions in response to life's sudden attempt to exert its own will. But they are emotions that we, as individuals, must process and resolve for ourselves. It is important to recognize that a sense of helplessness may be complicating recovery. We must be able to look to life-affirming activities to help restore a sense of peace and balance.
If we are able to keep in mind that our own responses to tragedy and loss are often based in fear and a false sense of omnipotence, then we may be able to resist the desire to throw our neighbor into the volcano to deter the next eruption. Then, once we begin to accept that in many ways our lives are unpredictable and our days fleeting, we can begin to live more fully and cherish each moment that we are given.
In the aftermath of a tragedy, social workers are often "first responders" who provide services both on-site and in the subsequent days and months. Whether the situation involves only a handful of individuals such as in a shooting or an entire region such as with Hurricane Katrina, social workers are involved in the task of getting people's lives back to normal as quickly as possible.
- Social workers help connect victims and their families with critical services and provide mental health interventions for emergency personnel.
- Social workers provide ongoing psychological services for those directly impacted by a tragedy and help individuals move through their grief and fear related to the trauma.
- Social workers normalize feelings which create a greater sense of control.
- In situations where children are displaced, state social workers often assist them in finding temporary or long-term placement.
- When the tragedy involves the loss of a home or income, social workers help locate things like food, clothing, and shelter for the affected individuals. Social workers also help with job placement and the application for state or federal funds for which the individual might qualify.
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Tags: blaming, death, event, grief, help, Lesa Warren, loss, meaning, social workers, tragedy, tragic
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Introduction
Grief. It’s one of the most basic and universal of human emotions. If you are alive, you either have experienced or will experience grief. Grief can occur when someone experiences a loss…any loss. People generally expect grief to follow a death, but it can also occur after a life-altering illness, after the end of a relationship, losing a pet, or because of giving-up of a dream. But even though grief is a common and universal emotion, it can take on very different forms from one individual to the next.
There is no "appropriate" bereavement period for someone who has experienced a loss. Grief is a very individual experience and can vary in length and intensity from person to person, and even from one loss to another. Grief is the natural and healthy task of processing a loss and it can include significant mental, physical, social, and/or emotional reactions. With support from friends and family, however, most individuals are able to grieve their losses and successfully leave the mourning period in their own time. These individuals are generally able to move into the next stage of life with an emotional and spiritual renewal. Time is also a natural healer of intense pain and emotions which are a part of grief.
How does someone know if their grieving becomes unhealthy? Grief can sometimes become what is called complicated grief: grief, which is identified by a significantly extended period of symptoms, an inability to function in daily activities, and/or the presence of very intense symptoms such as violent or prolonged anger or suicidal thoughts and feelings.
Complicated grief can appear as a major depression or even post-traumatic stress disorder, both of which can seriously interfere with functioning. Individuals who are experiencing complicated grief seem unable to move forward and find resolution. At that point, grief stops being a healthy and necessary vehicle for growth and becomes a dark and menacing adversary.
If someone is suffering from complicated grief, the best approach is to seek psychological help, perhaps with medication support. While complicated grief like other mental health needs disorders can’t simply be wished away, individuals can usually be assisted through the grief process by a professional and return to a more stable level of functioning.
There are many highly trained social workers available to help those whose suffering is unnaturally prolonged or considered complicated. Many individuals experiencing grief receive support from loved ones, friends, clergy, support groups, online information. They may also receive support from printed materials and sometimes short-term counseling. Temporary medication assistance may help get some individuals through difficult times like the funeral or related events which trigger memories and emotions about their loss.
Many people who experience grief are resilient but they may need formal or informal support of some kind.
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Introduction
You might have thought you were in the wrong place if you stepped inside Sol Levinson & Bros. Funeral Home on Wednesday night, May 10. The chapel filled with bouts of laughter from the approximately 400 guests inside.
Projected on a screen were dozens of cartoons — all about grief. The cartoons punctuated two PowerPoint presentations given by Dr. Kenneth J. Doka and Dr. Ellen S. Zinner at the eighth annual Irvin B. Levinson Memorial Lecture Series on Death, Dying and Bereavement, sponsored by the funeral home and Jewish Family Services, an agency of the Associated: Jewish Community Federation of Baltimore.
Click here to read the entire story.
Tags: cartoons, death, Dr. Ellen S. Zinner, Dr. Kenneth J. Doka, dying, grief, how to, Irvin B. Levinson Memorial Lecture Series, jewish times, Laura Berg, loss, mourn, Sol Levinson & Bros
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Introduction
Bereavement support groups are increasingly being recognized as an effective way to promote healing through education and support after the loss of a loved one or close friend. While the debate may still be ongoing regarding scientific research supporting the benefits of such groups, bereavement group members report a strong positive impact based on both the psycho-educational aspects of groups and the safe haven setting they provide for emotional expression and release of feelings.
Bereavement groups come in many shapes and sizes. Group participants may express a desire for narrowly defined groups where everyone has had the same type of loss, (spouse, parent, child, sibling, etc). Comfort levels may be increased if the losses are similar, but this is not a prerequisite for a successful group. The commonality of loss is a common denominator and learning comes from sharing among different age groups and perspectives.
Traumatic losses, such as loss of a child or suicides generally are better served in groups where all members share the same type of loss. Age separation by young widows or widowers from older widows or widowers is important since many of the issues they face are different due to where they are in the life cycle.
Groups are either time-limited or open-ended. A time-limited group may meet weekly for six to ten weeks. Open-ended groups often have a drop-in format, where the membership may vary from session to session and the time between meetings may be longer, bi-weekly, or monthly. Many grieving individuals find it useful to begin with an intensive, closed group, and then move on to the less structured format of a drop-in group, where there is less commitment and investment needed.
Social workers can offer and encourage grieving individuals to join a bereavement group when the following conditions are present:
- When the grieving individual finds a lack of support or empathy among the usual base of family and friends, or feels isolated or geographically remote from family or close friends. The grieving individual may feel he or she is “not doing as well as everyone else” and may feel self-conscious and uncomfortable in their presence.
- When the grieving individual is facing his first grief experience and wants to learn more about typical patterns of grief. Many grieving individuals do not understand the many ways that grief affects us physically, mentally, and emotionally. They may be disturbed by their behaviors and recurrent feelings that often include anger, guilt, sadness, and fear.
- When the grieving individual is able to talk and wants validation of feelings and emotional support from others who are experiencing similar feelings. “I feel like I’m going crazy” is often noted by grieving individuals who don’t fully understand the wide range of reactions that grief can cause.
Support groups work most effectively when they offer participants:
- A safe environment where one can tell his or her story and express feelings freely, knowing that others will be understanding, non-judgmental, and supportive.
- A place for establishing a connection with others to decrease the isolation that grief brings.
- A forum for understanding common myths about grief and typical grief patterns. There are different stages of grief which include feelings of denial, depression, anger, bargaining, and acceptance. In reality, grief is better understood and more readily accepted when seen as a spiral pattern that spins round and round between resilience and grief reactions.
- A community that validates and normalizes one’s emotional reactions.
- A place for learning that there are many different ways to grieve, all equally natural and acceptable.
- A resource base for gathering articles, poetry, and reading lists to further one’s awareness of the many aspects of grief and to learn from examples of how others have faced their losses. Discussion of articles can serve as a springboard for identifying important meanings in one’s own loss.
- A place for learning new coping skills, relaxation techniques, stress management skills, and daily survival skills that others in the group have found effective. The opportunity for members to help each other brings strength, confidence, and a new sense of purpose and value.
- An opportunity for personal writing and/or journaling that promote self examination and encourage exploration of the many aspects of loss over time. It is healthy to re-examine the loss at different times in the life cycle, (such as young, middle age, or older adulthood), in order to recognize self-change and growth and feel good about these changes.
- A sounding board where members can present on-going or new concerns, report on progress or concerns, and safely come back for help when they experience setbacks or backslides in their grief journeys.
Support groups do not fully resolve grief, particularly when they are time-limited. These groups can promote acceptance that life will be different now, but that life will be okay and even hopeful. Participants report that groups serve as a major stepping stone along the path of learning how to live with loss. A sure sign of their value is that often groups continue informally after they have ended or provide the basis for new friendships that continue to grow as members transition from becoming past-oriented to present and future-oriented.
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Tags: articles, bereavement, grief, Margo W. Steinberg, open ended, support groups, time-limited
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