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Chapter 11

Chapter 11

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PSYC 3570
Erin Allard

PSYC*3570 Chapter 11 – Grief and Bereavement SOME RESPONSES TO LOSS  People who have been through the same thing are the most helpful.  If a spouse was unhappy with their marriage, they’ll still grieve, but not as long as people who were happy.  Sometimes people avoid the grieving individual… perhaps they’re unsure what to say to them, or simply don’t want to deal with their drama.  “Attack of the nerves” may occur  loss of consciousness from shock  Some people think death is friendly and believe they can communicate with the dead.  Los Madres de la Plaza  after these mothers had their children kidnapped, they marched around the plaza… rebelling not only against the constricted role of women in their society, but also against the militaristic regime to which force and violence were systematically employed against the public at large. o Discovered new self – one of courage, dignity, and worth. DEFINITONS Bereavement (an objective fact) – We are bereaved when someone dies. We often have had a relationship with that person. It’s sad to lose something we once had. It is also defined as a change in status (become widow, widower, orphan, etc).  More widows than ever, social isolation and loneliness have become recognized as a major source of stress and vulnerability. Grief (a painful response) – Response to bereavement. Effects how the person feels, thinks, eats, sleeps, and makes it through the day. This is not the only response to bereavement (some people are angry or indifferent), but most common. Dissociative flight can occur, leaving the person in extreme, even psychotic denial. Some people delay their emotions. Other people have insomnia, failures of memory, problems concentrating, tendency to repeat things over and over, shortness of breath, tight throat, lack of muscular power, etc. Neuroendocrine Changes in Grief  Grief is a stressor  People become inactive and withdrawn and increase their vulnerability to infection because of lowered muscle tone.  Homeostatic mechanisms of the body try to moderate the stress as the first shock of the loss, followed by a period of active grieving.  Difficult to “get over” because our central nervous system has dedicated itself so effectively to moderating the effect of the stress.  Internal wear and tear leads to cardiovascular, infectious, and inflammatory disorders.  Higher levels of cortisol, epinephrine, and nonrephrine are signs that people are undergoing a destabilization of their physiological systems that place their health and survival at higher risk.  “Killer cells” in our immune system people come fewer and less active in grieving women.  In a study, monkeys who were most agitated, slouching and withdrawn were those whose immune systems were most affected by the stress of separation.  Stress in the monkeys was less when they were left in a familiar environment.  Other health concerns: not eating well, neglecting self, alcohol, medications, etc.  Often feel like things are getting worse, and feel like they’re going crazy.  Pangs of distress can come up again throughout life.  Half-masting – hanging flag half way to indicate a loss. First occurred in 1612 with Heart’s Ease (a ship that had an altercation with Eskimos).  In WWII, there was more support for the losses than the Vietnam War. Why It Was Important to Have Memorial Services for 9/11 1. Individuals were recognized at every opportunity (reading names, showing photos). 2. NYC itself was treated as a victim (losing their towers, etc). Hmoung Grieving Traditions  Believe there is a spiritual world that the deceased needs to be guided to  Guide will read Qhuah Ke verses from memory with mention of every place in which the deceased lived. Placcenta was buried in their birthplace, so it’s important to know where that is.  Reed pipe player and drummer play music  Counselor to the family (an elder)  Personal director and assistant  Shoemaker  special shoes for the deceased to cross over to the spiritual world  Stretcher maker  bamboo, 2 long wooden poles… deceased stay there until burial… horse  Food server who can communicate with the dead  Warrior – shoots arrows or fires his gun in the air to protect deceased  Coffin maker – specific tree cut down and used – not metal or anything other than this wood  Sacrificial ox slayers Problems with this in the USA  Sometimes autopsies will throw off plans  No opportunity for Hmoungs to wash, dress, lay out stuff or put the deceased on the stretcher (horse)  Pipers and guns may not be permitted  Some of these people become Christians APPRECIATING UNIVERSALITY AND DIVERSITY IN THE RESPONSE TO BEREAVEMENT 1. Racism and Grief: Dying was his Specialty  Children’s book called To Hell with Dying, tells a story of Mr. Sweet who was an African American alcoholic guitar player that lived down the road from a cotton farm. Dying was one of “specialties” – he was close to death in several situations and was always saved by the Walker children.  This book told a story of African American grief, love, and bereavement. 2. Yoruba Compassion  An example of the instructive way that Africans cope with grief in the homelands is displayed by the Yoruba from Nigeria.  Strong support – mourning person greeted daily with concerns and support.  Acknowledge the pain of the loss, and let them know how courageous they are… The bereaved person is reminded to take care of themselves. 3, AIDS, Multiple Deaths, and Grief  AIDS continues to be responsible for such stressful situations, although less pervasive in the news.  In Zimbabwe, the mourning rituals are partially Christian-based, and partially the traditional/folk way.  A grieving person in one society probably has much in common with grieving people in other societies. However, tradition and ongoing circumstance can exercise powerful influence over the nature and effectiveness of the morning process. WHAT KIND OF GRIEF?  Since grief isn’t the same for everyone, researchers and clinicians make useful distinctions among types of grief.  7 types of grief: normal, pathological, complicated, traumatic, resolved, unresolved, and anticipatory. Normal and Complicated Grief  Human nature… not a weak or pathological response to loss – different than what we previously thought  Normal – when grief stays in within the bounds of a particular culture tradition.  Abnormal and pathological – Neglect the interpersonal side of the situation and unnecessarily stigmatize the distraught person.  Complicated grief – can be complicated in several ways… commonly the person doesn’t move from shock and pain of loss toward a substantial return to an active life.  Traumatic grief – severe and disabling response to sudden, unexpected, and often violent death. Example: families of terrorist attacks. Anticipatory Grief  Grieving before death occurs  Common in recent years as people live longer with life-threatening conditions.  More time to worry, more time to plan, more time to experience stress.  Also more time to make decisions, clarify values, and strengthen relationships.  People who prepare themselves for the loss feel less grief.  Doesn’t seem to be the case with situations like Alzheimer’s when death is expected, but not imminent (pending/looming). Resolved and Unresolved Grief  Some experts think it should be resolved within a reasonable period of time, whereas others believe that think people will never heal completely from the loss.  Author doesn’t think people should be pushed to resolve grief in a certain amount of time. Hidden or Disenfranchised Grief  Grief may be intensified and it’s resolution delayed when the bereaved are denied the opportunity to express their feelings.  In some cases (like a teacher going into a class), grief may be hidden because they don’t feel “entitled” to those feelings.  Caregivers in hospitals or nursing homes often get attached to their patients and grieve their loss, however this isn’t seen as acceptable in society… thus they hide their grief – not suppose to be “too involved” with patients.  Emotionally close healthcare workers who repress their grief are more likely to be involved in single car accidents, and experience illness (requiring more sick days) after the death of a patient – these effects are greatly reduced when staff were allowed support groups that they can love and mourn their patients.  Lover-companions of people with AIDS may not have feel they have the right to mourn. o Lovers are often excluded from supportive interactions because they’re not considered “family”. o However, as times are changing, it’s become more acceptable for lovers to mourn.  Parents of stillborn babies often have forced to keep their grief inside.  Disabled children are sheltered longer, thus take grief harder. THEORIES OF GRIEF Freud’s Grief-Work Theory 1. Grief is an adaptive response to loss. Not just an expression of emotional pain. 2. The work of grief is difficult and time-consuming. 3. The purpose of grief work is to accept the reality of the death and thereby become liberate from the strong attachment one had to the “lost object”. 4. Grief work is carried out through a long series of confrontations with the reality of the loss. 5. The process is complicated by our resistance to letting go of the attachment. 6. The failure of grief work results in continued misery and dysfunction. From Grief-Work to Attachment  More recent theories have studied how a loss affects our relationships.  Attachment behaviour – current interest in which connects the biological need for survival with grief and mourning.  People show need for attachment when there is danger… All humans at all ages have separation anxiety. Under what conditions does grief work fail? 3 Basic Components of Grief Work:  Preoccupation with thoughts of the deceased person.  Repeatedly going over the loss experience in one’s mind.  Attempts to explain the loss. How Useful is Grief-Work Theory?  Some people get back to functioning normally without grief work – widows often distract themselves.  But there are individual differences – some people prefer counseling, others don’t.  Although Freud was fascinated by cultural differences, he did not take them into account in his grief-work theory.  Bereaved persons in Bali are expected to distract themselves and participate in cheerful interactions, whereas those in Egypt are encouraged to share their pain and sorrow with others. From Attachment to Continuing Bonds  In many cultures, grief kept the lost loved one somehow alive to the survivor over the years.  Grievers must sever the bonds with the lost loved ones, and make new attachments.  It doesn’t make a person pathological if they keep the bond.  Doesn’t deny all grief-work theory, but is considered an alternative  A continuing bond doesn’t necessarily mean that a person is living in the past… This is human nature… People don’t just get over a loss or find closure.  Continuing bonds are often an adaptive part of adjustment to loss, but can also contribute to difficulties in adjustment in certain circumstances.  Researchers are not likely to have positive or negative effects on the grieving person’s adaptation. Other Theoretical Approaches Stage Theory  The first response is shock, numbness, and disbelief.  The final phase is the reestablishment of physical and mental balance.  The middle points vary from person to person and researcher to researcher. The Dual-Process Model  May different responses – “normal” responses can take many different forms
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