2/7/2011. Help Me Understand: Exploring Grief. Through the Eyes of a Girl

Transcription

1 Help Me Understand: Exploring Grief and Loss Through the Eyes of a Girl NCCD Center for Girls and Young Women Dr. Lawanda Ravoira Director Experience of grief and loss wears many faces Death, sexual abuse, physical abuse, abandonment, pregnancy loss, incarcerated parent, miscarriage, divorce, foster home placement, moving to a new community I am struggling to cope with life My feelings from all the losses are intense and frightening I frequently feel depressed, anger I use drug and alcohol use, self mutilation, and eating disorders to cope Death affects when I get older (even in adulthood) because the loss was not given proper attention I have no support and opportunity to express my pain People tell me to move on and find ways to be happy I often must grieve alone When I feel pain, I "numb out" to avoid the pain and unfamiliar emotions I have sex because it makes me forget In the US alone, approximately 4.8 million children under 18 are grieving the death of a parent. 15million 1.5 children are grieving the loss of a parent to incarceration, sometimes for their entire childhood. Many others have siblings who have died or people significant in their lives. Grief is how we respond when we experience loss DSM IV TR Diagnostic Code: V62.82 Bereavement usually associated with severe depression or PTSD How they are different: Hypervigilance in traumatic grief refers to searching the environment for cues of the deceased, whereas in PTSD, it refers to fears that the traumatic event will be re experienced Sadness is the predominant effect in traumatic grief, whereas fear is foremost in PTSD While PTSD diagnostic criteria include sleep disturbance as one of the symptoms, no evidence of hyper aroused sleep is found among subjects with traumatic grief. 1

2 Physical symptoms (headaches, stomachaches, sleeping and eating disorders, hypochondria) Wide mood swings Able to verbally expresses emotions Feelings of helplessness and hopelessness Increase in risk taking ik ki and self destructive behaviors bh Anger; aggression; fighting; oppositional behavior Withdrawal from adults Depression; sadness Lack of concentration and attention Identity confusion; testing limits Everyone experiences grief in their own way. Grief has no timeline. Some people show grief only in private. Members of the same family can grieve differently. There is no right way to grieve. There is no set time for grief to be over. Grief can be re occurring at any time. Safety Matters Relationships Matter Emotions Matter Trauma Matters Identity Matters Social Supports Matter Choice Matters Power Matters Accept that they will experience mood swings and physical symptoms. Encourage them to honestly recognize their painful feelings and find positive outlets in physical and creative activities. Listen for the feelings behind their words and actions and respond with empathy. Be truthful and factual in explaining the loss. Help them develop and maintain their sense of identity. Allow preteens to make choices that are not harmful. Encourage safe expressions and experiences of beginning independence. The trauma that often comes with loss challenges children Their emotional, psychological & physical wellbeing is challenged. Their school performance is also challenged. Children tend dto move in & out of intense feeling, rather than sustaining high levels of one emotion for long periods of time. When adults see children playing or laughing, they often think the child is over it. Age Concepts and Beliefs Difficult Emotions Possible Behaviors How to Help Understands the Emotional turmoil Regressive behavior & Allow regressive finality of death heightened by fluctuating moods behavior & offer Denial physical changes Hides feelings comfort His/her words, Shock Acts like death never Expect & accept mood thoughts or actions Sad happened swings caused the death Anger Aggressive acting out Encourage expression Thinks about life s Confused Withdrawal of feelings through milestones without Lonely Nightmares & sleep writing, art, music, the deceased Vulnerable disturbances sports, etc Years (graduation, marriage, Fear Concentration Find peer support etc.) Worried difficulties groups High death awareness Guilty Changes in grades Be available to listen (death may happen Isolated Talks about physical & talk again) Abandoned aspects of illness or Answer questions What if my caregiver Anxious death truthfully dies? Offer physical contact Formulating spiritual Give choices about concepts involvement in death & mourning 2

3 Age Concepts and Beliefs Understands the finality and universality of death Denial His/her words, thoughts or actions caused the death Thinks about life s milestones without the deceased (graduation, marriage, etc.) High death awareness (death may happen again) 12 Years & up May sense own impending (teenagers) death I need to be in control of feelings If I show my feelings, I will be weak Internal conflict about dependence a& desiring independence May utilize spiritual concepts to cope Difficult Emotions Highly selfconscious about being different due to grief Shock Sad Anger Confused Lonely Vulnerable Fear Worried Guilty Isolated Abandoned Anxious Possible Behaviors Occasional regressive behavior Mood swings Hides feelings Acts like death never happened Aggressive acting out Withdrawal Nightmares & sleep disturbances Concentration difficulties Changes in grades Impulsive & high risk behavior Changes in peer groups Fighting, screaming, arguing Changes in eating patterns How to Help Allow regressive behavior & offer comfort Expect & accept mood swings Encourage expression of feelings through writing, art, music, sports, etc. Support relationships with understanding adults Be available to listen & talk Answer questions truthfully Share your grief Watch for high risk behavior Find peer support groups Offer physical contact Allow choices about involvement in death & mourning No one can take away the pain and sadness of grief, but knowing that people care is comforting and healing for grieving people. You cannot fix it, but you can help. Here are some suggestions for things that might help: keep in touch and be prepared to just listen be open in showing your concern and care help in practical ways express your sorrow about their loss talk about the person who has died use their name if culturally appropriate remember that many people in the family/household may be grieving make contact again, even if there was no response the first time sometimes people will want to talk and sometimes they won t share memories and stories Denial or Shock (This is not happening to me) Anger (Why is this happening to me?) Bargaining (I will be a better person, if.) Denial (This isn t happening to me) Acceptance & Hope (I am ready for whatever comes) Kubler Ross Safety (Present Tense) Remembrance and mourning (Past tense) Reconnection to Ordinary y Life (Future tense) Adolescents grief experience profoundly personal in nature. They grieve more intensely than adults, but the grief may be expressed in short outbursts, or there may be a concerted effort to control emotions. They may retreat into themselves by reading, writing, listening to music, or exercising, or to enact angry or antisocial behavior (Worden, 1996). Counselors can encourage adolescents to express their grief through creative arts, maintaining tangible connections with the person who has died, and engaging in rituals (Silverman and Nickman, 1999) 3

4 Counselors need to support the adolescent s needs for further independence and maturity. These needs can be encouraged by helping the adolescent set appropriate limits, aiding the adolescent in overcoming feelings of helplessness, and by connecting him or her with professionals when grief is prolonged and selfdestructive. Understanding Feeling Remembering Integrating Growing Understanding the cause of the loss if they are normal in what they are experiencing. Lyrics that pertained to the area of feeling allowed adolescents to express a variety of emotions related to their experience of their loss. Reflections for memories such as and times spent with their loved one, including the unique relationship with their loved one; memories before parent was incarcerated, before the move to a new community, before the tragic accident, etc. Lyrics describing a concern about how they would be able to go on with their lives while experiencing emotional pain and the changes that resulted from the loss. These lyrics also described how the adolescents is (or wants to) re define their relationship with their loved one and maintaining a connection with them as they continued with their lives or how they reconnect to ordinary life. 4

5 Lyrics describe adolescents concern with finding some sense of meaning or personal growth through the loss. It is important that girls have an opportunity to remember and honor their loss Balloon Release Butterfly Release Journaling Writing a Poem, Song, etc. Plant a tree or flower Music Lyrics Helps ease sense of isolation and creates a sense of belonging and identity. Grief Song Writing Process adolescents create music and write original lyrics to songs tuhat focused on five grief process areas: Understanding Feeling Remembering Integrating growing (Dalton and Krout, 2006) Simple test instrument that will tell them if a child is in a stage of grief. There are only 2 that we could find and neither have been fully vetted with youth The Hogan Sibling Inventory of Bereavement The W.T. Grant Consortium Grief Inventory Over time, healing will occur. There are things that a person can do to help speed up the process. 1. Give yourself permission to grieve. 2. Memorialize your loved one. 3. Get lots of rest, good nutrition and exercise. 4. Surround yourself with people who understand your loss. 5. Accept the feelings that come with grief. 6. Indulge yourself in small pleasures. 7. Be patient with yourself. DON'T let society dictate how long mourning should last. 8. Give yourself permission to backslide grief is like waves in the ocean: at first the waves come in fast and hard, but as time goes on, the waves become less intense and further apart. don't be surprised if holidays, smells, sounds, or words trigger a relapse. 9. Don't be afraid to get help. 10. Be sure to consult your own "Higher Power." either religious or spiritual. 5

6 Avoiding people who are grieving Taking anger personally often it is simply an expression of pain and grief Saying I know how you feel when everyone feels differently Telling them they should be grieving in a certain way Changing the subject or trying to cheer them up Not using the name of the person who has died for fear of reminding them they won t have forgotten Trying to find something positive in the death Making suggestions to replace the person who has died Lots of resources for teens us