Psychological and physical effects of loss and grief Essay Sample
Introduction
In this essay I will discourse what heartache is and the sort of heartache a client could see. We will travel onto fond regard theory and its nexus as to why we grieve. I will so look at what tools are available for counselors to back up their clients through a normal or unnatural grieving procedure.
Grief. Loss and Change
A grief procedure can be kicked off by anything that signals an stoping or alteration in someone’s life. We tend to believe of this as the decease or loss of person loved. However. it can besides be an stoping of other kinds. Below is a head map I created to see some of these things. The list is non thorough. but alternatively gives an apprehension of the extended topics to which the grieving procedure may use:
Diagram 1: Types of Loss that may take to grief ( via Coggle Tool )
An illustration may be a adolescent who has extreme acne and as a consequence their tegument or face has changed for good. This may take to a grieving procedure for how they looked or expected to look
Timelines may besides non needfully suit within a ‘social’ outlook. For illustration. whilst the heartache may so be related to the decease of a spouse. it may be that if the decease was expected due to a terminal unwellness that portion of the grieving procedure has been processed. This may take to surprise by others when a spouse finds they are traveling on to a new relationship earlier that others expect. Of class. this grieving procedure besides applies to the individual who is sick – grieving for the portion of their life that they will non populate. Grief comes in many signifiers.
Attachment Theory
The loss of an ‘attachment’ suggests a connexion in the first case. Attachment Theory has developed in support of this – proposing that we learn to do fond regards through childhood and this development affects our big relationships. ‘Bowlby ( 1977 ) developed his fond regard theory based on research in many countries ( cognitive. control theory. physiological psychology. biological ) . but concluded that the chief footing was non biological but due to a demand for trust. safety and security. This fond regard is distinguishable from feeding and sexual behaviour’ ( Worden. 1991 ) . This demand for trust. safety and security directs us straight to Maslow’s Hierarchy of Needs theoretical account.
Worden goes on to propose that Bowlby’s theory has a correlativity with Erikson’s Psychosocial Theory of kid development ‘through good parenting. the single sees himself as being both able to assist himself and worthy of being helped should difficulties arise ( Erikson. 1950 ) . ’ Worden besides says that conversely. pathological aberrances can develop in this form. unnatural state of affairss and/or rearing during development can take to unnatural fond regards.
There are four chief manners of fond regard ( Ainsworth & A ; Bell. 1971 ) :
Secure AttachmentCan go forth attachment state of affairs and return without utmost emotional response. Positive mentality of fond regard. trusting. seeking support and comfort when necessary from relationship. Able to portion feelings. Dismissive-AvoidantAvoids attachment state of affairss and familiarity. Avoids sharing emotions socially or romantically. Tend to stamp down and conceal feelings. Appears to demo small emotional penchant between fond regards and aliens. Deals with rejection by distancing themselves. Anxious-PreoccupiedExhibiting high degrees of emotional expressiveness. concern and impulsiveness in relationships. Concerns that they are non loved. Difficult to alleviate concern with comfort. Loath to organize initial bonds through misgiving.
An extra class was added by Ainsworth’s co-worker. Mary Main ( 1988 ) :
Disorganised-DisorientedShows avoidant and immune behavior. Looking dazed. confused or discerning. Contradictory interactions with those close to them. Observed in kids during Main’s ‘Strange Situation’ survey.
It must be noted at this point there are strong links between these attachment classs and development theories. I think it’s’ deserving briefly researching these as it may impact apprehension of how our client is believing:
BehaviouralConditioning by parent or those in functions of influence during the development old ages. Influencing security. insecurity. trust. misgiving. etc. PsychosocialAs referenced above via Worden. Various development stages whether Erikson. Piaget others with possible for struggle during these periods with altering the nature of fond regard to others. PersonalityIntrovert/extrovert. emotional stability/neuroticism/etc. Specific research environing personality and its consequence on normal or unnatural heartache. Proposing that certain personality types are more prone to unnatural heartache ( Prosser-Dodds ) Transactional AnalysisI’m O.K. . you’re O.K. would propose security. I’m O.K. . you’re non all right being would propose insecure avoidant. etc and the attendant arrested development provinces.
The logical position around fond regard suggests so that an single losing that fond regard may so travel through a procedure of grieving.
The Grief Curve. Circles and Waves
Many will hold heard of the ‘grief curve’ . Some may hold heard of similar theoretical accounts such as the Change Curve ‘S. A. R. A. H’ ( Shock. Anger. Revenge. Acceptance and Help ) . The phases outlined below were originally identified by Dr Elizabeth Kubler-Ross. Her engagement in mourning and hospice attention led to her making this theory ( businessballs. com ) . The Kubler-Ross theoretical account is seen as something that can be applied for any procedure of alteration assisting those regain the feeling of ‘control’ and making an apprehension of their experience.
Figure 2: From Focus Mediation Website – Adapted from Kubler-Ross theoretical account
There are alternate positions to that of a clip oriented theory. Debbie Messer Zlatin. besides working with terminally sick patients suggested that persons look to construe their ain individuality during such periods. Lisa Prosser-Dodds ( 2013 ) discusses both ‘linear’ and ‘circular’ grieving processes that are under treatment within the profession. She includes the suggestion of “waves of acutely painful emotions” being more of an on-going procedure in heartache.
Grief has besides been likened to a impermanent depression ; although some heartache may take to on-going depression. A counselor must be understand where heartache ends and longer term depression is now seated with the client. If person is sorrowing. anti-depressants may merely decelerate the journey through the heartache curve. Similarly. if person is enduring from depression and it’s clear the symptoms have been exacerbated by heartache. it may be of import to guarantee a GP referral to hold back uping medicine.
With all of these different positions. it’s of import to maintain in head that any research and theory done through observation extends our professional cognition and undending. Rather than sing theories as ‘competitive’ . certainly all observations are utile in understanding the changing experience of both client and counselor. Prosser-Dodds ( 2013 ) besides notes that Kubler-Ross’s last written words in 2005 stated “I am so much more than five
phases. And so are you. It is non merely about cognizing the phases. It is non merely about the life lost but besides about the life lived. ”
What does grief ‘Feel’ like?
One of the things that Kubler-Ross identified were the ‘feelings’ behind heartache. The stoping of any sort of fond regard can ensue in the feelings of heartache. Anyone who has experienced heartache will appreciate the feelings and esthesiss are multi-faceted. If we take Freud’s three elements that make up ‘human existence’ we can demo some illustrations of these changing experiences of heartache.
Soma
( Body )
Mind
( Mind )
Ethos
( Culture )
Bad Back
Anger
Expectations
Concerns
Daze
Distance
Stomach jobs
Fear
Percepts
Lapp Symptoms as Loss
Incredulity
Lack of Communication
Palpitations
Sadness
Reason for Loss ( Accepable )
Exhaustion/Fatigue
Hankering
Conforming ( Shoulds )
Aches
Helplessness
Duration of Grief
Joint Pain
Retaliation
Interfamily statements
Colds/Flu
Numb
Execution of Wills
Balance
Apathy
Rituals ( Funeral. Stating Goodbye )
Insomnia
Dispair
Belief
Fidgety
Confusion
Sing the organic structure
Nausea
Guilt
Heavy throat/Crying
Shame
Short on Breath
Hankering
Whilst the lists are non thorough they gives an thought of how the physical. emotional. cognitive. behavioral and societal affect our experience of heartache.
Complications of Grief Issues
When does heartache travel beyond the ‘normal’ ? It’s suggested that a ‘normal’ grieving procedure is 18months to 2 old ages. When does the injury of heartache create a long lasting depression? Solomon ( 2001 ) suggests ‘Grief is depression in proportion to circumstance ; depression is grief out of proportion of circumstance. ’ He quotes The New England Journal of Medicine as stating ‘Since normal mourning can take to major depression. sorrowing patients who have symptoms of depression lasting longer than two months should be offered antidepressant therapy. ’
Further illustrations of complications to heartache:
Accumulative GriefPersonal issues environing old losingss. similarities. types of relationship. multiple losingss Inability to decide heartache and feeling overwhelmed Nature of RelationshipDifficult relationship. unnatural relationship. loss where single deemed excessively immature. i. e. loss ‘before time’ . Nature of Death/LossHow the individual died or was lost in relation to individual sorrowing. such as unexpected decease. Denial/DelayedLack of emotional response. ridding of anything to make with them. Avoiding reminders of the dead or lost. Too busy to sorrow. Media AttentionDealing with extra factors such as media attending around the loss or single ( s ) involved. SocialIncomplete heartache when others believe ‘it’s clip to travel on’ . Affecting occupation. relationships. loss of position.
Children acquire into problem at school. Trying to carry through the function of the doomed. Family conflicts. MummificationKeeping a room the same. non altering modus operandis that should affect that individual. Puting that individual on a base or idealising them. InformationNew cognition of the individual after the loss that may alter original perceptual experience by those sorrowing. Such as sexual orientation. debt. matter. HealthDue to badness of heartache. Besides same symptoms to those of lost if lost through sick wellness. Over/under-eating as per depressive manner symptoms. Self-medicationOngoing usage of intoxicant or drugs.
Curative Approach to Grief
When would person see extra support when the ‘flags’ shown supra are non instantly obvious? The NHS ( 2014 ) suggests the followers:
•You don’t feel able to get by with overpowering emotions or day-to-day life.
•The intense emotions aren’t lessening.
•You’re non kiping.
•You have symptoms of depression or anxiousness.
•Your relationships are enduring.
•You’re holding sexual jobs.
•You’re going accident-prone.
•You’re caring for person who isn’t get bying good.
Worden ( 1991 ) steps off from any grief curve or circle and negotiations about ‘principles’ can be worked through with a client in order to ease the sorrowing procedure to a decision:
1. ‘Actualisation’ of the loss: Helping the client discuss the loss. the fortunes. Help the client explore and acknowledge the world of the loss. 2. Research feelings and emotions: Sing the ideas and how these are set uping them. Awareness of the emotions that drive a feelings of being ‘out of control’ . Identifying associated ‘phenomenon’ such as seeing the lost individual. hearing them. Still experiencing a leg that has been amputated. To normalising ( See below ) . 3. Adjusting to populating without: Identifying specific issues that are forestalling the client from come oning to a life ‘adjusted’ to this loss. Worden suggests that at this point. clients should be discouraged from doing major life alterations – for illustration selling a belongings. instead take clip to let yourself to work through your heartache in familiar milieus. Whilst I agree. in portion. where there has been major injury – doing such a alteration may in fact be a necessity for some.
4. ‘Emotional Resettlement of the Deceased’ : Memory or reconciling. Adjusting to the new life without the individual or state of affairs and how this new life looks to them. Detecting the joy of memory and the header schemes traveling frontward. What would the client like the hereafter to ‘look like’ ? What would they imagine for themselves? 5. Ongoing infinite to retrieve and sorrow: This is Worden’s nod. I think. to the cyclical theoretical accounts of heartache. Being cognizant of moving ridges of emotion that may return via a trigger ; be it a odor. anniversary or a familiar face. What would the client like to make at cardinal times – when they are reminded. how would they wish to accommodate such an experience? What would they wish to make on the day of remembrance of the decease of a loved one or their birthday?
6. Normalising: Understanding it’s normal to experience the emotions or feeling of ‘going mad’ . Of class. consciousness of anterior psychosis is cardinal every bit good as looking for cues diagnostic of any upset. 7. Individual Differences: Understanding and accepting the broad assortment of responses. behaviors. personalities. outlooks and methods of sorrowing. 8. Continuing Support: Worden suggests that heartache reding should non be contracted to a specific figure of Sessionss but available ongoing should the client require. Of class. the counselor needs to be cognizant of when the Sessionss become a crutch alternatively. 9. Coping Mechanisms: Positive or negative. Working with client to place get bying mechanisms as positive action and placing any that may finally go a self-defeating behavior. 10. Referral: When does a client demand to be referred? I have discussed this below.
It may go clear that there are longer term complications either around the heartache or secondary to the heartache that requires extra support and may necessitate GP referral. Drawn-out Grief Disorder would fall into this class. However. it is hard to name and non peculiarly good researched. There are besides many appraisals for heartache and understanding the badness of heartache. One such is called ‘PG-13’ which assesses all the symptoms of heartache and is designed to place Prolonged Greif Disorder.
Extra Tools to Support Clients
Empty ChairClient either imagines the individual in the chair or being the individual in the chair. So the client can either talk to the individual they have lost or be that individual ( counselor asks inquiries ) . Evocative LanguageUsing linguistic communication to convey frontward the world of the loss. illustration. utilizing word ‘death’ alternatively of ‘lost’ . Cognitions/BehaviourRecognising hot thoughts/cognitions and behaviors. Understanding how the client would wish to alter these. Items or SymbolsClient brings points or symbols to a session to discourse and retrieve. WritingTo the asleep or about the loss.
Memory Book/AlbumCreating a book with memories. letters. exposures to look at and to return to during hard ‘waves’ . Similarly could be a box of memories/items. Role-playWhen person demands to make something that possibly was done by the individual they lost. A safe topographic point to seek. The same can be said for other major alterations such as retirement. In MemorandumA trip. a tree. a bench in memory.
Group CounsellingWhen the loss is specific to something such as malignant neoplastic disease or a natural event. Talking to others who have similar experience. DrawingWhat does the grief expression like to the client? Or if they were to pull how they experience? Decisions
Grief is wholly dependent on the client’s fond regards. position. beliefs. personality and/or their mode. Chapman ( businessballs. com ) suggests ‘One person’s desperation ( a job-change. or exposure to put on the line or phobia. etc ) is to another individual non endangering at all. ’
A great trade is written on heartache theory. with many different decisions reached ; some proposing a additive procedure. some a cyclical. possibly even ageless procedure. Some suggest that heartache guidance may do more harm than benefit.
I believe from what I have read. all of the above is true. Reding isn’t ever appropriate. some people will ne’er to the full decide their heartache. However. with the tools available. those who are ‘stuck’ in some manner due to grief hold a strong tool available in reding to research. understand and place alterations or get bying mechanisms to experience safe. make new fond regards and be a portion of mundane life once more. Counselors need to guarantee they are good trained for heartache guidance and good supported through supervising to understand their ain wellness around such a familiar issue.
Bibliography
Ainsworth. M. D. S. . Bell. S. M. . & A ; Stayton. D. J. ( 1971 ) Individual differences in strange- state of affairs behaviour of one-year-olds. In H. R. Schaffer ( Ed. ) The beginnings of human societal dealingss. London and New York: Academic Press.
Chapman. Alan – Business Balls: Elisabeth Kubler-Ross – Five Stages of Grief [ Online ] Available from: hypertext transfer protocol: //www. businessballs. com/elisabeth_kubler_ross_five_stages_of_grief. htm [ Accessed: 10th February 2015 ]
Focus Mediation – The Grieving Cycle and Relationship Breakdown [ Online – Diagram Merely ] Available from: hypertext transfer protocol: //blog. focus-mediation. co. uk/2013/12/10/the_grieving_cycle_and_relationship_break_down/ [ Accessed 13th February 2015 ]
Main. M. . & A ; Solomon. J. ( 1990 ) . Procedures for placing babies as disorganized/disoriented during the Ainsworth Strange Situation. In M. T. Greenberg. D. Cicchetti & A ; E. M. Cummings ( Eds. ) . Attachment in the Preschool Years. Chicago. University of Chicago Press.
Maslow. A. H. ( 1943 ) Hierarchy of Needs [ Online ] Available from: hypertext transfer protocol: //figur8. net/baby/2014/11/06/maslows-hierarchy-of-needs-and-how-it-relates-to-your-childs-education/ [ Accessed: 13th February 2015 ]
NHS Choices: Covering with Loss [ Online ]
Available from: hypertext transfer protocol: //www. New Hampshire. uk/Livewell/emotionalhealth/Pages/Dealingwithloss. aspx [ Accessed: 20th February 2015 ]
Prosser-Dodds. L. ( 2013 ) THE RELATIONSHIP BETWEEN GRIEF AND PERSONALITY – A QUANTITATIVE STUDY [ Online ]
Available from: hypertext transfer protocol: //www. researchgate. net/profile/Lisa_Prosser-Dodds2/publication/260081247_THE_RELATIONSHIP_BETWEEN_GRIEF_AND_PERSONALITY__A_QUANTITATIVE_STUDY/links/0deec52f5e83729ef8000000. pdf [ Accessed: 13th February 2015 ]
Solomon. A ( 2001 ) The Noonday Demon: An Anatomy of Depression. London: Chatto and Windus
