GRIEF WORK
No matter what the origin of distress, a common theme observed in people in crisis is that of loss, including loss of
Spouse, child, or other loved one
Health, property, and physical security
Job, home, and country
A familiar social role
Freedom, safety, and bodily integrity
The opportunity to live beyond youth
Active goal directed behavior
Major coping task: reconcile oneself to situation which cannot be changed
Permanent loss
A pivotal aspect of successful crisis resolution is grief work.
Bereavement is the response to any acute loss.
Grief work takes time
Main features of bereavement reactions:
1. A process of realization
2. An alarm reaction
3. The bereaved has an urge to search for and find the lost person or object in some form.
4. Anger
5. Guilt about perceived neglect is typical – neglect by self or others.
6. Feelings of internal loss or mutilation
7. Recreating a world that has been lost.
8. A pathological variant of normal grief may emerge.
Normal grief work consists of the following:
Acceptance of the pain of loss
Open expression of pain, sorrow, hostility, and guilt
Understanding of the intense feelings associated with loss
Resumption of normal activities and social relationships without the person lost
THEORIES OF REACTIONS TO LOSS
FREUD (1917) Mourning and melancholia
Resolved grief
Childhood losses
Bowery (1961)
Normal development – individuals form attachments – instinctive.
When bonds threatened – powerful attachment behaviors – clinging, crying, anger, protest.
Four phases of mourning:
1. Numbness/ stunned
2. Yearning and searching
3. Giving up attempts to recover the deceased
4. Reorganization or recovery
Kubler -Ross – On Death and Dying
Denial, anger, bargaining, depression, acceptance
ASSUMPTIONS ABOUT REACTIONS TO LOSS – All models share common assumptions:
1. Phase of distress/depression inevitable
2. Positive emotions are not present during grief
3. Failure to experience distress/depression = pathology
4. Those who go through depression ultimately better adjusted
5. Individuals work through, break attachment to loved one.
6. Individual will recover to normal role functioning
7. State of resolution must be reached
THREE NORMAL PATTERNS OF LOSS:
1. Stages from high to low distress over time
2. Failure to resolve or recover from loss ,longer distress, variability in
time
3. Failure to become depressed early after loss or later
Treatment implications