Bereavement

An objective fact of the loss of a loved one who has died.
A change of status
An outcome of large-scale social phenomena
September 11

Grieving

The process of feeling distress or sorrow.
How you think, eat, sleep, make it through the day

Grief

The emotional responses of heartbreak, anger, or relief to the death of a loved one
Reactions and responses to a loss.
These are very individual and can occur on emotional, physical, cognitive, spiritual and behavioral levels

Erich Lindemann

Three primary tasks for successfully managing grief
letting go
adjusting to life without the deceased
forming new
relationships

Lindemann: Symptoms of Acute Grief

Feeling a tightness in the throat
Choking and shortness of breath
Feeling a painful tension
Muscular weakness
Empty feeling in abdomen

Neuroendocrine: Chronic Stress Theory

Increased production of cortisol in people who have high levels of separation anxiety
Young monkeys show less behavioral and physiological stress during maternal separation if they can remain in a familiar environment.

Personal Responses to Grief

Rosenblatt's study of nineteenth century diaries found that grief experiences seemed to come back in waves, even years after the death.

Mourning Behavior

Culturally and socially sanctioned ways that individuals convey that they have experienced a loss.
In modern society there are no strict social definitions of what is appropriate mourning behavior.

Hmong Mourning Practices

A guide to the spirit world
Music for safe passage of the soul
A symbolic horse to carry the body of the deceased

In Alice Walker's To Hell with Dying

Mr. Sweet did all of the following:
Come close to death several times, to be rescued by children's kisses and tickles.
Instruct and delight the neighbor children.
Represented those whose career hopes had been blocked by poverty and prejudice.

Yoruba of Western Nigeria

Bereaved people among the are greeted regularly by every member of the community with expressions of concern, support, and encouragement.

Grief-work Theory

"Accept the reality of the death in order to liberate one's self from the strong attachment one had to the lost object."

Freud's Griefwork Theory

Grief is an adaptive response to loss, not just an expression of emotional pain.
It is a mistake to insist that one's self or others should quickly snap back to normal life after a loved one has died.
The recovery process is complicated by the survivor's resistance to letting go of the attachment.

Bowlby

Explains the intensity of persistence of grief responses on the basis of attachment theory
connection between biological need for survival and grief

Parkes’ Grief-work

Preoccupation with thoughts of the deceased person.
Repeatedly going over the loss experience in one's mind.
Attempting to explain the loss.

Stroebe

Very little scientific evidence on the grief-work hypothesis
Cultural differences
Bereaved persons in Bali are expected to be cheerful.
Bereaved persons in Egypt are expected to share their pain and sorrow with others.

Lindemann, Worden, Rando

All the theories firmly agree of the need to accept the loss.

Family Grief

Moos found role confusion
Change in communication patterns

Harvard Bereavement Study

Differences between widows and widowers
The men more often reported a sense of dismemberment.
The women found more comfort in leave-taking ceremonies and the funeral services.
The men were more likely to blame themselves.
The women were more comfortable with direct expression of their feelings.

Lindemann: Anticipatory Grief

Woman expressed relief that her husband’s long period of suffering has ended.
still felt pain and desolate and abandoned by protector
not as much suffering as those suddenly transformed into widows
Men felt "like both my arms are cut off."

Funeral Ritual

It provides a sense of closure to the deceased's life.
They provide important social support for the bereaved.

Harvard Study: Unresolved Grief

Unexpected grief syndrome
Conflicted grief syndrome
Chronic grief syndrome

Obsessional Review

Thinking about the dead person and/or the circumstances of the death over and over again.

Shadow Grief

Sorrow over a perinatal death.
Years later parents still feel anguish.

Klass

Inner representation of the dead child
Often is a comforting part of the normal grief process

Traumatic and Stigmatized Deaths

Traumatic those that suddenly and unexpectedly end a life in a violent manner
murder, suicide, war,accident, or natural disaster
Stigmatized are seen as immoral, shameful, and discrediting
AIDS and suicides

Sprang and McNeil

Stress on family members
family members not kept in communication loop
forced to relive the trauma in the courtroom
defense attorneys attach the character of the murder victim
seeing the accused killer

High-grief Death

The death of a teenager in a car accident

Bereavement Overload

The burden of experiencing and coping with still another loss that is added to the many that had already been experienced.

Aiding the Grief Process

A high level of purpose in life
A religious orientation emphasizing the hereafter
A high self-esteem

Bereaved People

People who are most disturbed a few weeks after the death usually are the ones who continue to be disturbed a year later.
Those with a difficult time in recovering from grief were likely to be engaging more often in using tranquilizers, smoking, and drinking.

Grief Different in a Suicide

Grief from suicide is more complicated and prolonged for survivors.
Suicide produces a tremendous sense of anger and outrage.
Suicide produces strong feelings of guilt for survivors.

Differential Mortality Rate

Bereaved people have a higher death rate than other people.
Younger adults have a relatively higher excessive mortality rate after bereavement as compared with the elderly.
The single greatest cause of excessive mortality among bereaved people is some sort of heart disease.
The suicide rates for bereaved people are much higher for men than women.

Disenfranchised Grief

Among nurses and care-givers
AIDS survivors
Developmentally disabled people

Phyllis Silverman: Widow-to-Widow Program

Grief does not have a final outcome: it is a life transition, a human experience.

Time for Grief

Lois Pratt found a new trend regarding bereavement leave in her studies of management and labor negotiations in a large number of corporations of three days after the death of specified people.
As a formal agreement