BEREAVEMENT AND GRIEF COUNSELLING
Slide 1 : Title
Slide 2: Personal Bereavements
It can be seen from this list of events that my life has been touched on many occasions by bereavement. Some of these times the bereavement has been on a very personal level e.g.anticipatory death of family due to chronic illness. I have also experienced bereavement in sudden circumstances in the case of the murder of my cousin and the suicide of a close friend. Bereavement has also been in an occupational environment where there have been the suicides of five Samaritan callers. I hope during this presentation to show that all of these different types of bereavement can have a common grieving framework.
Slide 3: What is Bereavement?
Bereavement is an experience which often brings people in for counselling and is also one which everyone is likely to have at some stage in life. Although many bereaved people would in the past have received help in the community, from family, friends or both, this is not automatically the case today. Even when bereaved people are supported by family and friends, there remain certain situations in which counselling has added benefits, and this is especially true when several members of a family have suffered the same loss.
Slide 4: What is Grief?
Based on the evolutionary theory, Bowlby stated that every individual is biologically programmed to rely on other members of the species to enable the best possible means for survival and perpetuation of the species. From an early age a baby will develop a secure bond with its main caretaker and will rely on this person to provide a safe environment for development. Humans are social beings so from this initial bond (monotropy) man will go on to make bonds with many other human beings during his life. These bonds forge strong emotional links throughout life and when such a link is broken, for example, with a bereavement, there is a strong feeling of loss which results in an outpouring of grief.
Slide 5: Common Grief Responses – Feelings
Slide 6: Common Grief Responses – Physical Symptoms
Slide 7: Common Grief Responses – Cognitions
Slide 8: Common Grief Responses – Behaviours
Slide 9: Common Grief Responses – Cultural and Gender
Slide 10: Differences between Grief and Depression
Slide 11: Assessing between Grief and Depression
Slide 12: Assessing between Grief and Depression
Slide 13: Assessing between Grief and Depression
Slide 14: Grief Assessment – William Worden (1982) Grief Counselling and Grief Therapy
Slide 15: Theories on Bereavement:
Slide 16: Elizabeth Kubler Ross
Slide 17: William Worden – Four Tasks of Grieving
J.William Worden, a well -known grief therapist, strongly believed that a person must mourn the death of someone who has been significant in his or her life. Based on interviews with the bereaved he developed his Four Tasks of Mourning. He saw this process as being essential for successful development of the individual. If the grieving didn’t take place then it could lead to conflict in later life. The four tasks can be worked through in order but in some cases a person will go back and forth before successful resolution.
Task One: To Accept the Reality of the Loss.
Initially when one hears of a death there is a feeling of shock and disbelief followed by a gradual realisation of the reality of what has happened. If a death has been anticipated e.g. In the case of a fatal illness, then there is likely to be less denial to the death. Denial can be characterised by the person still talking of the deceased in the present tense or even keeping the deceased belonging. Sometimes it may manifest by the person trivialises the strength of relationship held. When death is by suicide, it is often the case that denial will be apparent when the individual insists that the death was accidental.
It is necessary to accept the death and acknowledge that the deceased will never return – this will be on both an intellectual and emotional level. Rituals such as planning funerals do help with this process.
Task Two: To Work Through the Pain of Grief
The intensity of the pain varies between individuals. ‘Normal’ feelings of grief are sad and uncomfortable ones – sadness, anger, hurt, emptiness and loneliness accompany that loss. When the death is sudden or unexpected there may be a feeling of unresolved business. Homicide can cause great feeling of fear and concern.
It is impossible not to feel some amount of pain when someone close dies. Family and friends may be uncomfortable around someone going through this process but it does need to be experienced so that the person eventually moves on. Some people choose to mask their pain by use of tranquillisers, alcohol or drugs and by denial of the strong feelings for the deceased. This merely draws out the process and it will surface again later.
Task Three: To Adjust to an Environment in Which the Deceased is Missing.
When the deceased played a marginal role in a person’s life this can be quite easy. However, when he was central to everyday life this loss will be a lot more difficult. Grief work centres on coming to terms with living alone, doing everyday practicalities alone and caring completely for oneself. It is important that there is not a regression to a state of helplessness, inadequacy or incapacity. It will take time and patience to make sense of life with the loss of the deceased and his role in life.
Task Four: To Emotionally Relocate the Deceased and Move on With Life.
For many people, this task is the most difficult to complete. It is not that the deceased is forgotten; it is more a case of the bereaved individual finding enjoyment in life again. The relationship with the deceased does not cease to exist it is just that it takes an appropriate place in the emotional world whereby the individual can get on with his life. The process is hindered by hanging on to the past rather than moving on to the future and forming new attachments. The deceased will not be forgotten or replaced. With time the pain will lessen and the mourner will redefine himself.
Slide 18: Robert Neimeyer – Rebuiding Life and Search for Meaning
Slide 19: Summary of slides 16,17,18
Slide 20: Helping
Slide 21: Taking Care of Yourself
Slide 22: Counselling Approach
So far, I have shown how it is important for an individual to work through the bereavement in a way which is best for him. This is very much the way of the humanistic approach to counselling. It is
Slide 23: Support
Slide 24: Support