This program was designed with excerpts from

presentations by the following :• Sue Wesner, RN, MSN, CS

Service for teens at RiskWestern Psychiatric Institute and Clinic

• Mrs. Debra McDermott• The Grieving Process-Elizabeth Kubler-Ross• The Healing Process-William Worden (1982)

Grief from LossThere are various things that occur where we

experience grief associated with some kind of loss.

1 Brainstorm different examples from the movie

2 discuss-age related for death, divorce, disease, other losses (moving, college choice, sports, roles in play, musical, honors band, chorus, etc

THE HEALING PROCESSWilliam Worden (1982)

Is different for everyone -based on perception of the

situation (closeness) and you

William Worden (1982)

• 1. Accept the reality of the loss

– This is the coulda, woulda, shoulda phase – Yes - it did happen

May be different for everyone and completion of this step in healing may also vary in length

DENYING REALITY

• William Worden 1982

Denial is often the first reaction (review -our mental/emotional defense mechanisms

Sometimes affected by How they died or How our loss occurred.

DENYING REALITY

Examples of Denial:

“This can’t be happening”

Refusal to believe the loss has occurred.

????

Acts as a “buffer” to give you a chance to process the loss

BARGAINING FOR CHANGE OF REALITY

Bargaining

•“I’d do anything to have them back”.

•If I do this ______, then this ______

•Making promises to change if the loss is returned to them.

•The final attempt to avoid the TRUTH.

Accepting Reality

Acceptance

This doesn’t mean you have to be okay with the loss, just that you know it is reality and you are ready to heal from it.

William Worden (1982)

• 2. Experience the PAIN of the loss

People tend to suppress (defense mechanism) grief because it’s painful and not always “convenient”

May be different for everyone and, again, completion of this step in the healing process may also vary in length

How might this experience affect us?

Experiencing Grief/Loss-ANGER

Anger

Why?

Fairness

Blame yourself or even others for the loss.

Effects -different ways and to different degrees for everyone

• Physical reactions

• Cognitive - “Brain Drain”

• Behavior

• Emotions

Physical Reactions to Grief/Trauma•Appetite changes•Feeling of choking•Dry mouth•Shortness of breath/yawning•Chest tightness

•Weakness•Fatigue•Exhaustion

•GI Disturbances

•Headaches/dizziness•Panic Attacks•Sleep disturbances ??

Cognitive (brain drain) reactions ?????????

– Trauma re-wires the brain. Why?

– The mind is so distracted that it’s difficult to focus on details.

– Preoccupation with images and thoughts of the loss/person

– Concentration is at a minimum.• Weakened memory skills• Difficulty in decision-making

Behavior - Reactions to GriefBehavior - Reactions to Grief

Disruptions of perceived “normalcy” Disruptions of perceived “normalcy” Difficulty following daily patterns/habitsDifficulty following daily patterns/habits DisorganizedDisorganized RestlessRestless Difficulty in decision-makingDifficulty in decision-making

Old life and patterns lose meaningOld life and patterns lose meaning

Emotions- Reactions to GriefEmotions- Reactions to Grief

Sadness, anger, anxiety, Sadness, anger, anxiety, loneliness, and guiltloneliness, and guilt

Grief can be overwhelmingGrief can be overwhelming

Function vs. dysfunctionFunction vs. dysfunction Very similar to an anxiety Very similar to an anxiety

disorderdisorder May need help to deal with itMay need help to deal with it

Coming out of loss/griefComing out of loss/grief

Emotional roller coaster can Emotional roller coaster can eventually turn into a new eventually turn into a new equilibrium for functioning. equilibrium for functioning.

May ride this coaster multiple timesMay ride this coaster multiple times Age-related/ maturity relatedAge-related/ maturity related

May need help to deal with itMay need help to deal with it you learn to deal/cope with it and…> you learn to deal/cope with it and…>

EMOTIONSSituational Depression/Sadness

PERCEPTION OF THE WORLD CHANGES!

•There is no hope, I just want to be left alone.

•A natural and important emotion(sadness) to cope.

May look for help from our personal support group ( who would YOU go to first?) or from a professional counselor.

Crisis Intervention TipsCrisis Intervention Tips(for self and others)(for self and others)

FUNCTIION VS DYSFUNCTIONFUNCTIION VS DYSFUNCTION We cannot be responsible for others We cannot be responsible for others

behaviors.behaviors.

However, we can be aware, supportive, and However, we can be aware, supportive, and positive in our efforts to develop and protect positive in our efforts to develop and protect good Mental Health in ourselves and others.good Mental Health in ourselves and others.

GET HELP from professionals.GET HELP from professionals.

William Worden (1982)

3. Readjust the environment

•Figure out who/what is important to you

•Choices about your

• thoughts and actions

William Worden (1982)

4. Reinvest emotional energy in other relationships (or things)

Examples: ??•This not that•“The broken road that led me straight to you”

Focus on what we Focus on what we CanCan DoDo

RecognizeRecognize and manage and manage negativenegative thoughts and emotions thoughts and emotions

Understand Understand stressstress and and identifyidentify stressors stressors

Develop Develop copingcoping skills skills

Make healthier choices in both your Make healthier choices in both your thoughts and actionsthoughts and actions

Focus on what we Focus on what we CanCan DoDo

It’s YOUR life, YOUR bookIt’s YOUR life, YOUR book - -

chapter by chapterchapter by chapter