Living with Grief After Sudden Loss

Transcription

1 Living with Grief After Sudden Loss Kenneth J. Doka, PhD Professor of Gerontology, The College of New Rochelle Senior Consultant, The Hospice Foundation of America

2 An Inter-Cultural Dialog The United States and Great Britain are two countries separated by a common language. (attributed to G. B. Shaw) My context is American so you need to constantly ask Do the same conditions and factors apply in the UK?

3 Goals To briefly review factors common to sudden loss and delineate some factors unique to particular types of sudden loss To offer some comments on ways to assist survivors of sudden loss

4 When Grief Is Sudden The dual challenge The challenge of grief The challenge to our assumptive world benevolence, meaning and fairness, identity, and predictability

5 Sudden Loss Common Factors Loss of the assumptive world The issue of grief + trauma Suddenness, unfinished business ( and the role of ritual) Issues of preventability Powerlessness Missing or disfigured body Intense reactions (possibly including anger, rage, anxiety, and survivor guilt)

6 Rynearson s The 3 V s V s of Violent Dying 1. Violence injurious action 2. Violation transgressive 3. Volition someone is responsible (commission or omission)

7 Sudden Loss Unique Factors to Natural Sudden Deaths Can include heart, attacks, strokes, aneurisms etc. Issues of personal culpability Death situation did person witness, did person die alone, unhelped, failure to help etc.

8 Sudden Loss Unique Factors to Accidents Issues of culpability Legal after-effects and adversarial legal system

9 Sudden Loss Unique Factors to Homicide Stigma and disenfranchisement Often relationship with both victim and perpetrator Even if the survivor was not a witness, they may still have fantasized intrusive imagery strong imaged of the imagined event (Blakley, 2009) The media Criminal justice system

10 Secondary Victimization Homicide Refers to individual victims of homicide feeling an additional sense of being victimized after the homicide such as by the media which may denigrate the reputation of the deceased victim or the criminal justice system which might not capture the perpetrators, fail in prosecution, or besmirch the victim s reputation in court proceedings.

11 Conflict and ambivalence Sudden Loss Unique Factors to Suicide Stigma and disenfranchisement Family stigma and feelings of guilt and preventability Spiritual issues and suicide

12 Sudden Loss Unique Factors to Public Tragedy or Disaster Strained support Multiple loss Concurrent crises A process that likely includes significant disenchantment

13 Rynearson s Restorative Retelling Persons may often review and re-enact event May see themes of remorse ( I should have prevented this. ) Retaliation ( I will get someone for this. ) Over-protection ( This will not happen again. ) Finally restorative retelling allows one to find some sense of meaning in the loss.

14 What Can Help? Choices in grief Catherine Sanders Phases Shock Awareness of loss Conservation and Withdrawal The Turning Point Renewal Worden s Tasks

15 Accepting Reality The role of funeral and other rituals Talking about the loss freely

16 Experiencing Emotions No need to bottle feelings Understanding ambivalence and finishing business Planning for difficult times

17 Adjusting to Life without the Person Assessing change Coping (and assessing) with loneliness Drawing from strengths and avoiding past weaknesses Secondary losses Getting Support (D, L, R)

18 Continuing the Bond Building in moments to remember or reaffirm Sanders Questions 1. What do I wish to take from my old life into my new life? 2. What do I wish to leave behind? 3. What do I need to add?

19 Reviewing Faith and Meaning The challenge to our spirituality and assumptions How does your faith or philosophy speak to you? What resources does it offer (beliefs, practices, rituals, community)?

20 Resources for Your Struggle Books Counseling Self-Help Groups

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22 Support Groups Validation Ventilation Respite and Support Learn Coping Techniques Lund Helping others helps self

23 Support Groups Possible The Danger of Shared Anguish in a poorly led group The Need for an Intake Process Danger

24 Creating Rituals The Value of Rituals Types of Ritual Continuity Transition Reconciliation Affirmation

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26 Caregiver Stress The Role of Secondary Secondary traumatization refers to the trauma that results from helping traumatized individuals as their stories challenge the caregiver s assumptive world This can add to caregiver stress Traumatization

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