Lecture 1: Loss and psychotrauma
Division of course content
- Grief (reactions to the death of a significant other/job/limb/animal)
- Post-traumatic reactions (reactions to impactful events)
- Post-traumatic reactions
Conceptual overlap
Traumatic loss
Death and grief: a societal and scientific positioning
How do we deal with death?
Necessary pain
Anger is necessary for the healing process. Be willing to feel your anger, even though it may
seem endless. The more you truly feel it, the more it will begin to dissipate and the more you
will heal.
Grief task model (Worden, 1991):
- Accepting the reality of the loss
- Allowing yourself to experience the emotions
- Adjusting to the life without the deceased
- Relocating the deceased emotionally and move on (not just detaching, it is part of the
moving on to a new chapter).
A working definition of grief:
The primary emotional to the death of a significant other (loved one). It is a complex
emotional syndrome accompanied by physical changes and physical symptoms. In addition,
it involves a wide range of possible cognitive and behavioral reactions.
Dimensions of grief:
- Emotional (sorrow, loneliness, numbness, anxiety, guilt, aggression, helplessness,
pessimism, relief)
- Cognitive (loss of concentration, lowered self-esteem, confusion, intrusive images,
preoccupation with the deceased, hopelessness)
- Physical (sleep problems, decreased appetite, stress, headaches, tension, low energy)
- Behavioral (agitated, withdrawn, seeking behaviour, avoidance
Major determinants
Background person: gender, age, personality, attachment, health
Characteristics of death: sudden, unexpected, premature death, traumatic circumstances
Characteristics of the deceased: kinship relationship, quality of the relationship
Situation after loss: lack of support, secondary losses, ways of coping
Background
Gender: widows, more men die after loss of their partner than woman
Differences in social support: men have less social support (a few good friends)
,Differences in coping: men are more problem-focused, woman are more emotional-focused
(better fit for loss)
Differences in types of bereavement: marriage might be a different thing for men than for
woman, maybe men have more to it, they lose more
still unresolved
Religion:
- Life philosophy (systems of meaning): Conflicting results (opposing processes?)
- religious social community: A relationship between worship session attendance and
social support, and a relationship between social support and health (social capital)
Cause of death
NASH classification: Natural, Accident, Suicide and homicide
- Talking about and acting in preparation of imminent death predicts less intense grief
(mori et al., 2018)
The deceased
- Kinship (parent (past), partner (present), child(future))
- Nature of the relationship
Unacknowledged losses
- ex-partners
- In the past: miscarriage, perinatal deaths
- In some circles: homosexual relationships
- Extramarital affairs
After the loss aspects
- Coping
- Social support
- Secondary losses
- Multiple bereavements
- Family dynamics
- Material resources
Conclusion
#1 From a societal perspective, the concepts of death and dying, and surviving relatives, are
surrounded by acomplicated context of denial and fascination. Death in most western
societies becomes more normalized, more like it is in many countries elsewhere
#2 The death of loved ones is virtually inescapable and, in most cultures, has significant
consequences for others' physical, psychological and social functioning. There is no such
thing as the grieving process. There are tremendous individual and cultural differences.
Every model is a simplification and should be recognized as such
#3 There are factors that lead to a higher risk of problems in the grieving process, but the
predictive power of these factors is usually not very high, and hence sound explanations are
generally not available
,#4 A small minority cannot cope by themselves and need professional help. A large majority
of surviving relatives eventually succeed in overcoming the loss
, Lecture 3: Do we need theoretical approaches to grief and grieving?
Coping: The changing thoughts and acts that an individual uses to manage to external or
internal demands of stressful situations. > Processes, strategies or styles of managing the
situation.
Bereavement:
Mourning: The social expressions or acts expressive of grief, which are shaped by the
practices of a given society or cultural group. (e.g., mourning rituals).
Grief: The primarily emotional reaction to the loss of a loved one through death, which
incorporates diverse psychological and physical symptoms and is sometimes associated with
detrimental health consequences.
DABDA Model:
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
Concerns about stages of grief
1. No set pattern of specific reactions in adapting to loss.
2. No necessary progression through specific stages.
3. No sound empirical research supportive of stages.
4. Expectation regarding stages is harmful to those not experiencing them (Most
harmful)
5. Alternative perspectives better represent grieving processes.
How harmful is it that bereaved people can’t do the mourning rituals.
Division of course content
- Grief (reactions to the death of a significant other/job/limb/animal)
- Post-traumatic reactions (reactions to impactful events)
- Post-traumatic reactions
Conceptual overlap
Traumatic loss
Death and grief: a societal and scientific positioning
How do we deal with death?
Necessary pain
Anger is necessary for the healing process. Be willing to feel your anger, even though it may
seem endless. The more you truly feel it, the more it will begin to dissipate and the more you
will heal.
Grief task model (Worden, 1991):
- Accepting the reality of the loss
- Allowing yourself to experience the emotions
- Adjusting to the life without the deceased
- Relocating the deceased emotionally and move on (not just detaching, it is part of the
moving on to a new chapter).
A working definition of grief:
The primary emotional to the death of a significant other (loved one). It is a complex
emotional syndrome accompanied by physical changes and physical symptoms. In addition,
it involves a wide range of possible cognitive and behavioral reactions.
Dimensions of grief:
- Emotional (sorrow, loneliness, numbness, anxiety, guilt, aggression, helplessness,
pessimism, relief)
- Cognitive (loss of concentration, lowered self-esteem, confusion, intrusive images,
preoccupation with the deceased, hopelessness)
- Physical (sleep problems, decreased appetite, stress, headaches, tension, low energy)
- Behavioral (agitated, withdrawn, seeking behaviour, avoidance
Major determinants
Background person: gender, age, personality, attachment, health
Characteristics of death: sudden, unexpected, premature death, traumatic circumstances
Characteristics of the deceased: kinship relationship, quality of the relationship
Situation after loss: lack of support, secondary losses, ways of coping
Background
Gender: widows, more men die after loss of their partner than woman
Differences in social support: men have less social support (a few good friends)
,Differences in coping: men are more problem-focused, woman are more emotional-focused
(better fit for loss)
Differences in types of bereavement: marriage might be a different thing for men than for
woman, maybe men have more to it, they lose more
still unresolved
Religion:
- Life philosophy (systems of meaning): Conflicting results (opposing processes?)
- religious social community: A relationship between worship session attendance and
social support, and a relationship between social support and health (social capital)
Cause of death
NASH classification: Natural, Accident, Suicide and homicide
- Talking about and acting in preparation of imminent death predicts less intense grief
(mori et al., 2018)
The deceased
- Kinship (parent (past), partner (present), child(future))
- Nature of the relationship
Unacknowledged losses
- ex-partners
- In the past: miscarriage, perinatal deaths
- In some circles: homosexual relationships
- Extramarital affairs
After the loss aspects
- Coping
- Social support
- Secondary losses
- Multiple bereavements
- Family dynamics
- Material resources
Conclusion
#1 From a societal perspective, the concepts of death and dying, and surviving relatives, are
surrounded by acomplicated context of denial and fascination. Death in most western
societies becomes more normalized, more like it is in many countries elsewhere
#2 The death of loved ones is virtually inescapable and, in most cultures, has significant
consequences for others' physical, psychological and social functioning. There is no such
thing as the grieving process. There are tremendous individual and cultural differences.
Every model is a simplification and should be recognized as such
#3 There are factors that lead to a higher risk of problems in the grieving process, but the
predictive power of these factors is usually not very high, and hence sound explanations are
generally not available
,#4 A small minority cannot cope by themselves and need professional help. A large majority
of surviving relatives eventually succeed in overcoming the loss
, Lecture 3: Do we need theoretical approaches to grief and grieving?
Coping: The changing thoughts and acts that an individual uses to manage to external or
internal demands of stressful situations. > Processes, strategies or styles of managing the
situation.
Bereavement:
Mourning: The social expressions or acts expressive of grief, which are shaped by the
practices of a given society or cultural group. (e.g., mourning rituals).
Grief: The primarily emotional reaction to the loss of a loved one through death, which
incorporates diverse psychological and physical symptoms and is sometimes associated with
detrimental health consequences.
DABDA Model:
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
Concerns about stages of grief
1. No set pattern of specific reactions in adapting to loss.
2. No necessary progression through specific stages.
3. No sound empirical research supportive of stages.
4. Expectation regarding stages is harmful to those not experiencing them (Most
harmful)
5. Alternative perspectives better represent grieving processes.
How harmful is it that bereaved people can’t do the mourning rituals.
