What is Grief

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Kaylee, Nadia and Rahni

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Grief :

Grief

What is Grief?:

What is Grief? Greif is a natural reaction to loss or tragedy. It is natural, normal and inevitable. Grief is both a universal and a personal experience. Individual experiences of grief vary and are influenced by the nature of the cause . Although conventionally focused on the emotional response to loss, it also has physical, cognitive, behavioural , social, spiritual, and philosophical dimensions. “Grief is not an event, it’s a process” While the terms are often used interchangeably, bereavement refers to the state of loss, and grief is the reaction to loss In considering grief, it’s important to remember that it is a response to many different kinds of losses, that is individual, and that it is influenced by the person’s perception of the loss.

Emotions Involved With Grief :

Emotions Involved W ith G rief Exhaustion Distraction: Do not overburden yourself. Lower your expectations. Know that you will be able to function like you once did-but it takes time-it takes recovery. There may be times when you are in the midst of a normal, pleasant activity and suddenly a wash of grief comes over you. Know that this is common and that grief can surface at any time, without notice. Heightened fear of death Physical symptoms: Pain Sleep difficulties Poor appetite or overeating Shakiness or trembling Listlessness Disorientation Migraines or headaches Dizziness Dry mouth Crying Numbness Shortness of breath Exhaustion “We may experience intense feelings such as sadness, anger, anxiety, disbelief, panic, relief or even numbness. It can also affect our thinking, so that we may think we will never get over this, or we may think we are going crazy. We may think that this is all too hard and wish we were with the person who has died. This does not usually mean that we will take active steps to end life, but can simply be an expression of our pain and sadness. Sometimes grief can cause difficulty in sleeping and can lead to physical symptoms.”

Emotional responses:

Emotional responses Sadness may be observed in others in a variety of ways.  Crying is the most obvious indication that something is disturbing someone.  It can be a great relief for the griever to have an opportunity to share tears with another, or even solitude to release the tears.  Children report that there will be moments when in a classroom that they will feel overwhelmed with feelings of loss, but they don't want to cry in front of peers.  Providing an option for newly bereaved students to go to a quiet spot in the school to release their feelings creates a safer emotional environment.  Sadness may manifest in other ways, such as through deep sighing. Anger – Grief isn't just about crying.  Anger is common among those who have lost someone important in their life.  They may feel that it just isn't fair, that life is unjust.  The loss may be understood as preventable, giving rising to blaming and outrage.  There are many possibilities of carelessness, neglect, and deliberate intent to kill that bring tragedy into the lives of children and their families.  A child may be angry at the one who died.  Displaced anger arises when the energy of anger is directed at someone or something other than the true source of pain.  It may be easier for a child to express anger than sadness because there is less perceived emotional vulnerability in being angry verses being sad. Acknowledgement of anger can be an effective way of deescalating the intensity of anger. Irritable -  The bombardment of unpleasant feelings of loss can create a sense of irritation.  Feelings of anger over the loss may not come out in explosive ways, but in a general sense of irritation. Guilt and self-reproach - Because children are ego-centric (the cause and effect world revolves around them), they are likely to feel like they are the cause of the loss regardless of the circumstances around the death.  Children may believe that “if only I had” ….put my toys away, made better grades, helped around the house more, asked her to wait five minutes more, not talked back to my mom, etc , etc , etc. their loved one would still be alive.  There are times when these thoughts may be the only sense of power and control the child feels.  At other times, these beliefs may be carried into adulthood, contributing to difficulties in later life.   There are times when a child may be responsible for a death, such as the tragic stories of teen drivers who are involved in fatal accidents due to reckless driving, or road conditions for which they were unprepared, accidental shootings, falls, etc.  Under these circumstances, it is likely that these feelings may need to be addressed by a grief therapist.  Anxiety, Insecurity and Fear -  After the loss of a loved one, a child's world may feel unfamiliar and unsafe.  The question, “Who is going to take care of me?” is important to answer.  Family circumstances may have changed dramatically.  The remaining parent is required to take on the responsibilities left by the other parent.  This leaves less time for nurture and care of the children in the family.  This further destabilizes grieving children.  In these cases, we see either an overly parentified child, one who takes on adult mannerisms and responsibilities, or attention-seeking, often disruptive behavior .  Even negative attention is better than no attention at all. In addition, the loss of a loved one creates high loss awareness.  To the child this means that since this happened once, the reality of potential future losses is underscored.  Children express concern over what will happen to them if the remaining caregiver dies.  There are times when children lose both parents simultaneously, or within a brief period. 

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When a sibling dies, the child may wonder if he or she is next.  This further complicates feelings of anxiety. Abandoned - The absence of a loved one may contribute to a feeling of abandonment regardless of whether the loss appears to the child to be caused by the one lost, is accidental or the result of a lengthy illness.  This feeling may attack the child's sense of self-esteem.  The cry, “Why did you leave me?” is common in both children and adults. Worried -  Children have concerns about many things.  They may worry about other family members who are grieving, finances, and the overall welfare of the family.  These worries may be grounded in true difficulties facing the family.  Children will often hide their pain from family members to try to “protect” others.  One child reported pretending to be asleep when her surviving parent came in to say goodnight so that her tears would not disturb him.  Lonely -   When a significant loved one is removed from a child's life, a pervasive sense of loneliness often sets in.  The talks, emotional interactions, and activities once shared are also lost, leaving a void in the child's life.  Extended family members, aunts, uncles, cousins, grandparents, and friends may help by spending time with the child, but the special role of the one lost is still missing.  In today's society, many families are far from extended family, so the needed support is lacking. Yearning - Longing for and seeking the lost one is common in the first year or two following a loss.  Life adjustments are in progress, but aching and longing for the loved one remains.  During this time, children may talk with the deceased, have vivid dreams about interacting with the person, or think they see the person in a public place.  A scent, song, phrase or other sensory experience may throw the griever into a place of acute yearning and sense of loss. Helplessness and Powerlessness -  The child who cries out, “I WANT MY DADDY BACK!” is faced with the continued absence of Daddy.  No matter what she says or does, Daddy does not return.  She has no impact on engaging the return of her father.  She is powerless to change this critical issue so vital to her emotional and physical health.  It is important for the child to find areas that allow her to produce her desired outcome. Shock -  Shock may work as a defense against the loss, shutting down mental and emotional circuits that are overloaded with feelings and loss.  This is a time when feelings of numbness and being “out of body” may happen.  Shock is more likely to occur following an unexpected death, but happen even when a death is anticipated. Numbness - Absence of feeling can create a surreal sense for the child.  No feelings replace intense feelings about things and people before the loss.  This experience does not usually last more than a few months, but can be disconcerting and confusing while it lasts. Emancipation -  There are times when a relationship is so painful that there is relief when the person is gone.  There may have been physical, emotional, or sexual abuse.  While there may be conflicted emotions following a loss, the sense of freedom from the abuser can be exhilarating for the griever. Relief -  When someone has suffered through a lengthy illness, families may be relieved that the suffering is over for their loved one.  This feeling is most common in an anticipated death.  A child may be at peace about feeling relief, or may question his loyalty to the loved one and feel guilty for feeling relieved. Turmoil - A melting pot of emotions can create inner turmoil as children try to sort through the feelings.  A child is not likely to tell you, “I'm feeling inner turmoil.”  She, however, may demonstrate it through chaotic artwork, disorganization, forgetfulness, and disruptive behavior in the classroom.

Physical Sensations:

Physical Sensations Physical Sensations Grief is about more than emotions.  Feelings of loss have physical components as well.  These feelings may be frightening to a grieving child and his or her family. After medical causes have been ruled out, the following physical symptoms may be attributed to normal grief reactions: Fatigue Stomach pains Appetite changes Headaches Tightness in throat, chest Short of breath Weakness Low energy Dry mouth Sensitive to noise, light, alcohol

Thought patterns :

Thought patterns Thought patterns Denial -  “I can't believe it happened” is a defense that allows the unprepared bereaved person time to absorb the reality of the loss.  When someone first learns of an unexpected death, the first response is often “NO!”.  This response changes over time as a person is psychologically able to tolerate the loss without being completely overwhelmed.  One should not attempt to convince the bereaved of what they are denying.  Allow the natural process of grief to unfold this defensive thought. Confusion -  Short term and long term memory may be impacted for a period.  This can be disconcerting to students.  They may or may not have done their homework, and cannot remember anything about it.  This is frustrating to the teacher, parents, and disheartening to the student. Thoughts about deceased -  Shortly after a death, it is common to think about the deceased almost constantly.  It is also common for the bereaved unconsciously to adopt behavior characteristics of the deceased.   This will diminish over time.  If not, referral to a grief therapist is appropriate. Sense of presence of the deceased -  Children and adults alike may experience a sense that their loved one is watching over them.  One child said that his mom was in the walls of his room and would come out at night to visit him.  This sense of presence may help the bereaved cope or may be disturbing.  When a group of about 15 bereaved children was asked who had seen their loved one since the death, all but one responded that they had. Difficulty concentrating -  In the first few months, most bereaved individuals find that it is difficult to stay focused on a task.  Intrusive thoughts about the deceased and moments of overwhelming feelings contribute to these lapses of concentration.  Nightmares -  Nightmares are common for children.  When safety and security are threatened, thoughts and feelings are likely to be expressed in the form of frightening dreams.

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Behaviours Eating changes, more or less Absentmindedness Withdrawal from others Avoiding places or people who remind one of deceased Searching and crying out for the deceased Sighing Crying

Differences in Dealing with Grief:

Differences in Dealing with Grief There is no right or wrong way to grieve Many people will experience a state of numbness while moving through grief. The world may take on a dreamlike quality or seem to go on separate from them. Often experiences or people that once evoked joy and happiness evoke nothing at all. Activities once enjoyed seem foreign. Some people spend a relatively short time in this numb state, as short as a few days, while others find it lingers. This is part of how our bodies help to protect us from the overwhelming emotions caused by our loved one's death. We become numb and filter through information as we are able, instead of all at once. The feelings will come back, but it will take time. Impulsive Living While some grievers withdraw, others will compulsively pursue activities. The thought process often goes like this, "Life is short. I'd better do everything now that I always wanted to do…spend all the money, sell the house and move to Hawaii, write that book, divorce my wife, etc." Others will take unnecessary risks. It's imperative to carefully monitor your behaviour during the first year. Do not make impulsive decisions. Do not sell your house, change locations, divorce a partner, etc. Wait until the fog has lifted and you can clearly see the options available to you. http://www.funeralplan.com/griefsupport/griefsteps.html

Cultural Differences:

Cultural Differences Each culture specifies manners such as rituals, styles of dress, or other habits, as well as attitudes, in which the bereaved are encouraged or expected to take part. An analysis of non-Western cultures suggests that beliefs about continuing ties with the deceased varies. Cultural perspectives can shape people's reaction to a traumatic experience.  Specifically, culture: Influences what type of threat is perceived as traumatic Influences how individuals and communities interpret the meaning of a traumatic event and how they express their reactions to the event Forms a context through which traumatized individuals or communities view and judge their own response May help define healthy pathways to new lives after trauma

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Everyone grieves in different ways. Some people stoically plow through loss and essentially feel working is the best way to deal with it. Others need to cry or keep themselves away from other people for a time. Elizabeth Kubler -Ross did great work on the stages of grief, which can help people gain understanding as to the process of grief.

Grief in Children:

Grief in Children Children grieve too, for small things, like a friend moving away or having to change schools. One expects a child to perhaps grieve at the death of a pet, but parents may fail to recognize the grief children feel during transitional times. Most therapists recommend that parents not dismiss their children’s first grieving experiences, as this may shape the way in which children are able to recognize grief, mourn, and at the appropriate time move on from the first sad feelings that grip them. It is not necessary to encourage a child to grieve more, because again, children will respond in individual ways, as adults do. However, leaving open the opportunity for children to discuss their feelings, enabling them to express their feelings by giving them an emotional language, and practicing extra patience around a grieving child may be one of the best things one can do for such a child.

Developmental Phases in Understanding Death :

Developmental Phases in Understanding Death Infancy to Age 2 Concept of Death Babies do not have the cognitive capability to understand an abstract concept like death. They function very much in the present. When someone significant dies, babies are more acutely aware of loss and separation. They react to the emotions and behaviors of significant adults in their environment and to any disruptions in their nurturing routine and schedule. If there is a sudden change, they feel tremendous discomfort. Grief Response Babies may search for the deceased and become anxious as a result of the separation. Common reactions include: irritability and protest, constant crying, a change in sleeping and eating habits, decreased activity and weight loss .

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Preschool Age (2-4) Concept of Death “When will my mommy be home?”
“How does (the deceased) eat or breathe?” Preschool children do not comprehend the concept of “forever.” For this age group, death is seen as temporary and reversible. Even when a preschooler is told that Mommy is not coming back, for example, he or she may ask an hour later where mommy is. They do not usually visualize death as separate from life, nor as something that can happen to them. Preschool children love to play “peek-a-boo” games where adults in their life disappear and then reappear again. It is through these games that they slowly begin to understand the concept of “gone for good.” Grief Response  Because preschoolers tend to be present-oriented, their grief reactions are brief but can be very intense. This is the developmental stage where children are learning to trust and form basic attachments, so when a significant adult in their life dies, they become very concerned about separation and altered patterns of care. Children this age typically have a heightened sense of anxiety concerning separations and rejections because they don’t yet have the capacity to use fantasy to gain control over what is happening. [ i ] They also respond to the emotional reactions of adults in their life. If they sense their parents are worried or sad, they may cry or have a tantrum, either because they are concerned or as a way to distract their parents from difficult emotions. Typical grief responses of the preschool child include confusion, frightening dreams and night agitation, and regressive behaviors such as clinging, bed wetting, thumb sucking, inconsolable crying, temper tantrums and even withdrawal from others. They may search intensely for the deceased despite assurance that that person will not return. They may exhibit anxiety toward strangers.

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Early Childhood (4-7) Concept of Death  “It’s my fault. I was mad at my mother once and I told her I wish she would die and then she died.”
“The roadrunner in the cartoon always comes back to life, so I know Daddy will too.” As with preschoolers, this group views death as temporary and reversible. They sometimes feel responsible for the death because they believe that negative thoughts or feelings they have had about the deceased caused his/her demise. This “magical thinking” stems from the belief that everything in their environment revolves around them and that they can control what happens. Even when children at this age are exposed to death through the media or at school, they still may believe that if you are careful enough you can avoid death. Children at this age may also connect occurrences that do not have anything to do with each other. If a child bought a certain toy the day that her sister died, she may attribute the toy to causing the sister’s death, especially if the real cause of the death is not fully explained to her. Grief Response  As with preschoolers, this age group may repeatedly search for the deceased or ask where he/she is. Repetitive questioning about the death process is also common. “What happens when you die?” “How do dead people eat?” They will often express their grief feelings through play instead of verbally. Themes of family loss and death may surface as they play with dolls or action figures. They may play act the death itself or the funeral.[ii] Sometimes children at this age appear unaffected by the death and act as if nothing happened, but this doesn’t mean that they are oblivious OR that they have accepted the death. It may signify their inability in the moment to acknowledge very painful reality. They may model their grief reaction after adults in their lives who are feeling uncertain how to express grief feelings. Other typical responses include anger, sadness, confusion and difficulty eating and sleeping. As with preschoolers, this age group may regress as a way to receive more nurturance and attention during this difficult time. Children who have experienced a loss at this age tend to be fearful that other loved ones will leave them as well. Sometimes they form attachments to people who resemble the deceased in some way.

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Middle Years (7-10) Concept of Death  “Do your fingernails and hair keep growing when you die?”
“If I smoked cigarettes, would I die?” This age group may want to see death as reversible, but they begin to see it as both final and universal. Children in this age group sometimes visualize death in the form of a tangible being such as a ghost or boogeyman.[iii] They are very curious about the details of death, cremation and burial and may ask candid questions. Even though they know death can happen to anyone and that there are many things that cause death, they still do not typically think of death as something that can happen to them or their family members, but instead to only old or very sick people. They may believe that they can escape from death through their own efforts. They also might view death as a punishment, particularly before age nine. Sometimes they are unable to comprehend how the death will affect their life, which can become a source of anxiety. Grief Response Children in the middle years often become concerned with how others are responding to the death as they become less focused on themselves and more on others. They may fear that other loved ones will die as well. Sometimes they may become overly concerned about their own health and may fear bodily harm and death. Some children in this age group may act out their anger and sadness and experience difficulties in school due to a lack of concentration. On the other hand, they may have a jocular attitude about the death, appearing indifferent, or they may withdraw and hide their feelings. Other typical responses include shock, denial, depression, changes in eating and sleeping patterns, and regression to an earlier developmental stage. This age group tends to have more coping strategies available than younger children and may fantasize how they would prevent the death from happening again as a way to gain control over the situation. Death is also play acted in children at this age, for example, through war games, especially for those children who have difficulty expressing feelings verbally. Children in this age group may assume the role or the mannerisms of the deceased. They may also take on tasks or chores normally performed by the deceased, such as care for their siblings. They may idealize the deceased as a way of maintaining a bond with them.

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Pre-Adolescent (10-12) Concept of Death “None of my friends could ever relate to what it’s like losing their dad.”
“I know that Grandma is not coming back and I will miss her. I don’t understand why my mom is so upset about it.” Pre-adolescents conceive of death in much the same way as children in the middle years, with a few additions. Pre-adolescents are in the process of establishing their own identity, increasing their independence from their parents and other adults and increasing their dependence on their peer group. In understanding death, pre-adolescents attempt to understand both the biological AND emotional process of death. They are, however, more able to understand the facts surrounding the death of someone than they are the feelings surrounding the death.[iv] Grief Response It is common for pre-adolescents to want to cover up their feelings about their loss so as not to appear “different” from their peer group. They fear that expressing sad feelings may be seen as a sign of weakness (particularly for boys). For this reason, they may seem removed and indifferent. They also may express their grief feelings in uncharacteristic ways such as through anger outbursts, irritability and bullying behavior. Feelings may also be exhibited through physical complaints, moodiness, changes in sleeping and eating patterns, indifference toward schoolwork, or isolation from their peers. They may show concern for practical issues after the death, such as how the household will survive without the deceased or how they personally will be taken care of. They also might have questions regarding religious and cultural beliefs related to death.

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Suggestions on how to help a bereaved person in the first few days include: Contact the bereaved person as soon as possible after their loved one's death. This contact could be a personal visit, telephone call, text message, sympathy card or flowers. Attend the funeral or memorial service if you can. They need to know that you care enough to support them through this difficult event. Offer your support and ask them how they would like you to support them. Listen to them if they want to open up to you and try to suspend all judgement . How to help a bereaved person in the first few days

Comments to avoid :

Comments to avoid It is a natural reaction to want to ease the person's pain. However, well-meaning words that encourage the bereaved to 'look on the bright side' can be hurtful. The type of comments that should be avoided include: 'You'll get married again one day.' 'At least you have your other children.' 'She's lucky she lived to such a ripe old age.' 'It was God's will.' 'You can always try for another baby.' 'He's happy in heaven.' 'Be thankful they're not in pain anymore.' 'Try to remember the good times.' ' You'll feel better soon .' 'Time heals all wounds.' 'Count your blessings. You still have a lot to be grateful for.' 'You've got to pull yourself together and be strong.' 'I know exactly how you feel.' ‘Everything happens for a reason.’

Kids Matter :

Kids Matter Kids Matter is the Australian Governments mental health promotion, prevention and early intervention initiative for primary schools and early intervention initiative for primary schools and early childhood educations services. It focuses on the mental health needs of children and aims to contribute to: Improving the mental health and wellbeing of children Reducing mental health problems among children Greater support for children, and their families, experiencing mental health difficulties

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Kids Matter is a national collaboration between the education and health sectors. It was jointly developed by Beyond Blue, Principals Australia Institute, Early Childhood Australia and the Australia Psychological Society, with funding from the Australian Government Department of Health and Ageing and Beyond Blue.   Kids Matter Primary is a flexible, whole school approach that can be tailored to schools local needs. It is a ground breaking program. It involves a step by step planning process designed to assist primary schools to review, support and build upon their existing efforts to foster the mental health and well being of students.

It focuses on four components: :

It focuses on four components: A positive school community Social and emotional learning Working with parents and careers Helping children with mental health difficulties

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Kids Matter has been adopted by over 1300 schools. There is an aim to have 2000 schools participating by 2014. Kids Matter talk about how children deal with grief and can be offered assistance . Children learn from adult behaviour and seek permission from adults Children often express their feelings through behaviour It is important to acknowledge changes that have happened in the family as a result of loss Grieving children still need to experience being children When talking to children about death, it is important to avoid using euphemisms such as 'sleeping forever' or ' left us..' as these phrases can cause confusion Meet with your child's teacher and let them know what's happened

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NURSE -ON-CALL – expert health information and advice, 24 hours, 7 days Tel. 1300 606 024 Australian Centre for Grief and Bereavement – bereavement counselling and support services Tel. (03) 9265 2100 or 1300 664 786 (toll free VIC) Lifeline – crisis support and suicide prevention services, 24 hours, 7 days, 13 11 14 SuicideLine Victoria – for counselling, crisis intervention, information and referral (24 hours, 7 days) Tel. 1300 651 251 GriefLine Community and Family Services Inc. – loss and grief telephone counselling service, 12 noon to 3 am, seven days a week Tel. (03) 9935 7400 or 1300 845 745 Learning supports

Sites:

Sites http://www.griefjourney.com/pdfs/The%20Many%20Emotions.pdf http://www.griefspeaks.com/id90.html (culture) http://www.childgrief.org/howtohelp.htm http://www.fernside.org/resources/families / http :// www.strathmor.com/assets/pdf/0506-GenevaGriefInChildren.pdf https:// www.google.com/search?q=grieving+events+children http:// www.cancer.gov/cancertopics/pdq/supportivecare/bereavement/Patient/page1/AllPages http://www.vitas.com/hospice-care-services/bereavement-and-grief-resources/child-development-stages http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/ grief_how_to_support_the_bereaved http://www.helpguide.org/mental/grief_loss.htm https://www.lifeline.org.au/Get-Help/Facts---Information/Loss---Grief/Loss-and-Grief http://www.lifesupportscounselling.com.au/get-help/grief-counselling/ http://www.beyondblue.org.au/resources/schools-and-universities/early-childhood-and-primary-schools/kidsmatter-primary

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