The Reality of Loss

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The Reality of Loss

• James Lynch, April 2007
• james.lynch_at_mailc.hse.ie

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Grief

• No one ever told me that grief felt so like
  fear. I am not afraid, but the sensation is like
  being afraid. The same fluttering, the same
  restlessness, yawning. I keep on swallowing.
  At other times it feels like being mildly drunk,
  or concussed. There is a sort of invisible
  blanket between the world and me. I find it hard
  to take in what anyone says. Or perhaps, hard to
  want to take it in it is so uninteresting. Yet
  I want the others to be about me. I dread the
  moments when the house is empty. If only they
  would talk to one another and not to me C.S.
  Lewis, A Grief Observed

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Grief

• Grief derived from the latin gravare, meaning
  to burden or cause distress.
• The Oxford English Dictionary defines grief as
  great sadness caused by trouble or loss and a
  heavy sorrow.
• Grief is defined as ones experiences after a
  loss (Worden, 2005)
• Grief is an emotional response to loss, and the
  intensity and duration of the grief response are
  relative to what is lost. (Parkes,
  1996)

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Grief

• Mourning is the behaviour that expresses grief at
  the loss (Hopkins, 2003),
  
  the process one goes through leading to an
  adaptation to the loss (Worden, 2005).
• Other terms such as loss and bereavement are
  also used when referring to grief.
• Loss is the action of losing or having lost
  something while bereavement relates to the loss
  of a person by death. (Dunne, 2004).

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Grief and loss

• Grief and loss can be said to be part of every
  human life although the meaning of this
  experience and responses to it are unique.
• Each of us will grieve in our own unique way for
  the unique loss that we have suffered. There is
  no right or wrong way to grieve.
• Each persons unique feelings of grief and loss
  will be influenced by the culture and society in
  which they live.

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Grief and loss

• While usually connected with death, grief and
  loss can occur in many other ways
• The end of a relationship without one of the
  partners dying
• Loss of a job
• Change in circumstances due to illness
• Loss of independence
• Not getting a promotion/passing an exam
• Break up of a family/ divorce
• Death of a pet
• Miscarriage/Infertility

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Purpose of Grief

• this is not a process which can be rushed.
• It is about integrating the changed circumstances
  into the survivors ongoing life.

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Ways of Grieving

• Personal grief
• Anomic grief
• Private grief
• Forbidden grief
• Time-limited grief
• Distracted grief
• Expressive grief (Walter 2001)

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Responses to Grief Loss

• Physical responses
• Weakness, loss of appetite/comfort eating,
  feelings of choking, shortness of breath,
  tightness in the chest, dry mouth,
  gastrointestinal disturbances
• Increased alcohol intake, smoking excessively
• Fatigue, exhaustion and insomnia
• Excessive tearfulness/not crying at all
• Increased vulnerability to physical mental
  illness

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Responses to Grief Loss

• Cognitive responses
• Preoccupation with the deceased
• Having conversations with the deceased
• Starting to prepare the dinner when deceased
  would usually come home
• Picking up the telephone to tell them something
• Difficulty concentrating
• complete lapses of focus or orientation to
  time/person/place
• Difficulty remembering (short term memory)
• Seeking or longing for the lost person/object
• Hallucinations
• Momentary glimpses of the deceased
• Auditory messages perceived to be spoken by the
  deceased

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Responses to Grief Loss

• Behavioural responses
• Inability to perform basic activities of daily
  living
• Washing dressing
• Communication
• Eating and drinking
• Disorganised behaviour
• Inability to cope with children
• Neglecting household chores
• Not paying bills
• Intense sense of isolation

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Responses to Grief Loss

• Affective Responses
• Sadness, loneliness, hopelessness
• Intense irritability, little tolerance
• Anger
• Anger at family friends, at the deceased, God,
  the world, yourself
• Guilt the starring role
• At what we did/didnt do
• Range of emotions are wide, everyone will
  experience different ones

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Theories of Bereavement Grief

• Parkes (1998) identified related stages in the
  grieving process
• Shock or numbness
• Yearning and pining (anger guilt)
• Disorganisation
• Beginning to pull life back together

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Theories of Bereavement Grief

• Kubler Ross (1970) described stages in the
  process of accepting the diagnosis of terminal
  illness.
• Denial and isolation
• Anger
• Bargaining
• Depression
• Acceptance
• Hope

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Theories of Bereavement Grief

• Worden (2005) concentrates on tasks of grieving
  that have to be worked through (grief work) if
  resolution of grief is to take place
• To accept the reality of the loss
• To experience the pain of grief
• To adjust to an environment in which the deceased
  is missing
• To emotionally relocate the deceased and move on
  with life

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• I finally understand what life is about it is
  about losing everything. Losing the baby who
  becomes a child, the child who becomes an adult,
  like the trees loose their leaves. So every
  morning we must celebrate what we have.
• Isabel Allende, 1995