Complicated Grief

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Complicated Grief
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The Grief Wheel
Loss
Life Function
Shock
Protest
Reorganization
Disorganization
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Normal Grief

• Sadness
• Anger
• Guilt
• Anxiety
• Loneliness
• Yearning
• Relief
• Numbness

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• Kubler Ross 5 Stages
• Denial, Anger, Bargaining, Depression,
  Acceptance.
• C M Parkes 4 Stages
• Numbness,Yearning, Disorganisation Despair,
  Re-organised behaviour.

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• J W Worden 4 Tasks of Mourning
• To accept reality of the loss.
• To work through the pain grief
• To adjust to an environment in which deceased
  missing
• To relocate the deceased and move on.

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Acknowledged reality of loss

• By keeping all reminders the same
• By making everything different
• By denying the meaning of loss
• By selective forgetting

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• Work through pain grief
• Adjust to the environment
• Avoid reminders
• Change roles
• Relocate move on

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Complicated Grief

• Can you think of any factors which may make grief
  more complicated?

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Factors which effect out come of bereavement

• The Nature of the death
• Nature of relationship
• Nature circumstances of bereaved
• Life history of bereaved
• Personality of bereaved
• Social Factors

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Indication to Complicated Grief

• Avoidance of grief process
• Self Blame
• Identification problems
• Preserving the environment
• Hypochondria

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Pointers to Complicated grief

• Seems like a recent loss
• Emotion out of proportion to loss
• Refusal to talk about loss
• Did they really exist?
• Radical lifestyle change
• illness Phobias
• Repeated relationship difficulties

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Pointers to complicated grief

• Cant speak of loss without intense fresh grief
• Imitation of the deceased

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Complicated Grief

• Absent Grief
• Delayed Grief
• Inhibited Grief
• Unbalanced Grief
• Chronic Grief
• Exaggerated Grief
• Masked Grief

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Case Studies

• Consider
• What Further questions would you like to ask?
• Why are they experiencing difficulty in grieving
• Where do you think they are on the grief wheel?

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References/ Resources

• Parkes C M (1972) Bereavement Studies of grief
  in adult life. PenguinHarmondsworth.
• Parkes C M (1980) Bereavement Counselling does
  it work? British Medical Journal 281 Page 3-6
• Raphael B (1984) The Anatomy of Bereavement A
  handbook for the caring professional. Hutchinson
  london
• Stroebe, M, and Schutt, H. (1999) The Dual
  Process Model of Coping with Bereavement. Death
  Studies. 23, 197-224.

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• Worden, W. (1991) Grief Counselling and Grief
  Therapy (2nd ed) Routledge. London