Personal Guidebook to Grief Recovery
As grief and its expression are influenced by the society in which a bereaved individual lives, and by attitudes and expectations in the immediate family, assessing grief is complex. The focus should be on understanding the individual and on recognising their strengths and resources as well as potential difficulties. The following should be taken into account
Research has identified several factors that influence the course of grief and are associated with ongoing poor health. There are three groups of factors situational, individual, and environmental. Situational is the circumstances surrounding the death and the impact of concurrent life events. Deaths that are untimely, unexpected, stigmatised, or unduly disturbing cause more severe and more prolonged grief. The death of someone with terminal illness can still be unexpected and distressing, and the strain of caring for a terminally ill person for more than six months also increases risk. People from minority cultural or ethnic groups may experience problems if they are not able to follow the rituals and customs they think are appropriate. Concurrent crises such as multiple losses and financial difficulties also strain coping resources. Environmental is the social and cultural context of risk. A perceived lack of support is the common factor. Bereavement may deprive people of their main...
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The traditional paradigm of surgical care is founded on the concept of physician autonomy and holds the individual surgeon accountable as the captain of the ship. Undoubtedly, this paradigm has enabled great achievements in surgical care however, it has also, in some cases, become associated with a dangerous sense of infallibility. With this paradigm as a conceptual backdrop, errors tend to be equated with negligence, and questions of professional liability tend to involve blaming individuals. Indeed, the very willingness of professionals to accept responsibility for their actions makes it convenient for lawyers to chase individual errors rather than collective ones.58 Moreover, an individual surgeon is a more satisfactory target for an individual's anger and grief than a faceless organization is. The point is not that surgeons should avoid responsibility but rather that focusing on individual errors does not address underlying system flaws.
The significance of this new relationship was complicated. Not only did the girl gain status among peers for being chosen by this popular older boy, she also was welcomed into his peer group and included in their frequent gatherings. Because she was bright, empathic, and articulate, she was someone her new boyfriend could confide in as he was struggling to cope with the recent death of his father. Repeatedly she was told by his mother and friends that her support had lifted him out of his grief she felt needed and valued by her boyfriend, his mother, and many of his friends. Their warmth and gratitude served as an antidote to her strong feelings of failure and shame it also intensified her resistance to her parents' continuing demands that she stay at home more and study harder to succeed at school. Another question that might be raised is Where might this girl have ended up if her ADD syndrome had not been identified and treated when it was She came for evaluation because she was...
It is now accepted by many resuscitation providers and institutions that the relatives of those who have suffered a cardiac arrest may wish to witness the resuscitation attempt. This applies particularly to the parents of children. Clear guidelines are available from the Resuscitation Council (UK) detailing how relatives should be supported during cardiopulmonary resuscitation procedures. Allowing relatives to witness resuscitation attempts seems, in many cases, to allow them to feel that everything possible has been done for their relative even if the attempt at resuscitation is unsuccessful, and may be a help in the grieving process.
Analgesia for labour should be discussed with the mother and her midwife before active labour begins. It is common for combinations of parenteral opioids (usually diamorphine) and phenothiazines (such as chlorpromazine or promazine) or benzodiazepines to be administered in relatively large doses, the aim being to sedate the mother heavily as well as providing her with analgesia. Whilst this may seem humane (and certainly renders the midwife's task less stressful), it is not necessarily the best analgesic option and may impede the grieving process. If opioid analgesia is used, consideration should be given to the use of patient-controlled analgesia.
Concerns about human mortality date back at least 20,000 years when Cro-Magnons, the first Homo sapiens, prepared one of their own for burial. Cro-Magnon funerals are taken as evidence by anthropologists that those people thought like us. They knew about death, and in their sorrow, they adorned the corpse with prized possessions, possibly thinking they would be of use in a spiritual afterlife. In grieving for their lost loved ones, Cro-Magnons were drawn to a quest for immortality, but one that dealt with the soul rather than the body.
It may be that your expression of a particular emotion might be inappropriate in the context. It might not be regarded as seemly, for example, to give open vent to your anger at a board meeting or to continue grieving too openly for too long over the death of your cat. But the experience of such anger or grief is simply the experience and there is little you can do about it other than to give it due attention. famine. Or think of your reactions when you lose some favourite object. Sadness might be described as somewhat purer than the other negative primary emotions. It is made up of a mixture of down-heartedness, being discouraged, loneliness and feelings of isolation. It tends to follow the loss of something that was dear to us, whether this is a job, a house, a loved one, a favourite car, or even something like time. Unlike fear, anxiety and anger, the main effect of sadness is to slow us down rather than speed us up. In the extreme, sadness takes the...
Hopefully, you don't wait for a fire to start before you make a plan for dealing with it. Fire drills save lives, as do rehearsals of how you'll deal with relapse. Approaching the potential of relapse as you would the potential for fire can save you a lot of grief and prevent relapse.
I have had many miscarriages and have no children. Before I was diagnosed with MS, I thought I felt good during pregnancy because of emotions ofjoy and anticipation, and badly after a miscarriage, again because of emotions, albeit ones of grief and loss. Although emotions certainly played a part, I now understand that, as is often the case with MS, I had flare-ups after pregnancy.
However, several surveys administered before observation of resuscitative efforts showed that the majority of family members wished to be present during a resuscitation at-tempt.45-49 Family members with no medical background have reported that being at a loved one's side and saying goodbye during the final moments of life was comforting. 45,46,50 Family members also have reported that it helped them adjust to the death of their loved one,50,51 and most indicated they would do so again.50 Several retrospective reports note positive reactions from family members,41-43 many of whom said that they felt a sense of having helped their loved one and of easing their own grieving.44 Most parents surveyed wanted to be given the option to decide whether they would want to be present at the resuscitation of their child.43,52
Identifying people whose grief may be more complex Many difficulties can be avoided by work before the death to minimise the effect of factors that increase the risks to health and wellbeing associated with bereavement. It is helpful to involve family members in decision making, provide information, check out what people understand, encourage questions, and offer opportunities after bereavement to talk to those who provided care at the end of life. If misunderstandings or disagreements about the care of the patient are ignored, family members may remain angry and distressed and find it harder to make sense of their situation. Providing information Information about how to register a death, common aspects of grief, and local and national support services should be provided through empathetic personal contact and easy to read leaflets. Bereavement support and counselling While grief is a normal reaction to loss, the general lack of understanding combined with social pressure to keep...
Grief after the death of a child is described as the most painful and enduring. Parents suffer multiple losses. Siblings suffer too and may have difficulty adjusting they often feel isolated and neglected, as their parents can spare little energy or emotion for them. Grief of siblings and grandparents
Between confronting grief (for example, thinking about the deceased, pining, holding on to memories, expressing feelings) and seeking distraction to manage everyday life (for example, suppressing memories and taking time off' from grief by keeping busy, regulating emotions). Neither pattern of coping is problematic and difficulties are likely only if the balance of behaviour is oriented exclusively on loss (chronic grief) or avoidance (absent grief). Although grief is universal, social norms vary and what is viewed as normal differs both within and across cultures. Personality factors, sex, and cultural background will influence the degree of individual oscillation for example, women may be more emotional and loss focused while men may be more inclined to cope by seeking information, thinking through problems, taking action, and seeking diversion.
So 12 months later there is cause for concern. Prolonged intense pining, self reproach, and anger are danger signals, as is prolonged withdrawal from social contact. Failure to show any grief may also be problematic, but people cope in different ways and some recover quickly, especially if they were well prepared for the death. Risk factors described above that may make grief more intense and prolonged.
Parents may be preoccupied with the practical challenges of caring for someone who is dying or overwhelmed with their own grief. It may be useful to involve family friends or teachers. Adolescents struggling to develop their individuality and independence may find members of their peer group to be helpful, particularly if they know someone who has also experienced bereavement.
Whatever the explanation of these paintings, ritual finger amputation has been confirmed in a number of societies and, indeed, still occurs in 2005 (see following), and was recorded in 1961 by cine-film among the Dugum Dani tribe, New Guinea, the amputations taking place to express family grief and to placate the ghost of a tribesman killed in battle. The sacrificial victims were little girls, linked to the dead man by blood, who had one or two lesser fingers amputated with a stone adze, without anaesthesia other than a
Elizabeth Kubler-Ross (1969) describes five stages of impending death, not dissimilar to her stages of grief. However, not everybody experiences these stages and those that do, do not necessarily go through them in the same order. They are denial, anger, bargaining, depression and acceptance.
Our expanded view of the limbic system now includes its extension to this prefrontal cortex, specifically the orbital and medial portions of the frontal lobe this has been called the limbic forebrain. Widespread areas of the limbic system and association cortex of the frontal lobe, particularly the medial and orbital portions, are involved with human reactions to pain, particularly to chronic pain, as well as the human experiences of grief and reactions to the tragedies of life.
Most narrative therapeutic approaches share the goal of weaving painful, negative, or other unexpected events into the client's dominant life narrative. That is, the client and therapist collaborate to help the person both live and author an active, integrated story. Here, the therapist functions as an editor or co-author in attempting revisions of the client's life narrative. For instance, treatment for the bereaved spouse might focus on grieving the loss of the partner by examining how the person dealt with previous losses and the way these were integrated or interpreted in the larger framework of meaning that informs the person's life. Emphasis also may be placed upon developing further roles with children, other family, and friends as a way to emplot a new life chapter without the deceased spouse. Given the goals of narrative repair and reconstruction, therapists working from this perspective may employ a variety of literary techniques. Developing metaphors to help clients more...
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