Death, Society, and Human Experience

January 23, 2018 | Author: Anonymous | Category: Science, Health Science, Immunology
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Death, Society, and Human Experience 9th Edition Robert Kastenbaum This multimedia product and its contents are protected under copyright law. The following are prohibited by law: •Any public performance or display, including transmission of any image over a network; •Preparation of any derivative work, including the extraction, in whole or in part, or any images; •Any rental, lease, or lending of the program. •

Copyright © Allyn & Bacon 2007

Chapter Eleven: Bereavement, Grief, and Mourning This multimedia product and its contents are protected under copyright law. The following are prohibited by law: •Any public performance or display, including transmission of any image over a network; •Preparation of any derivative work, including the extraction, in whole or in part, or any images; •Any rental, lease, or lending of the program. •

Copyright © Allyn & Bacon 2007

Defining Terms: Bereavement •

An objective fact: • We are bereaved when someone close to us dies • “Close” is not easily defined • A change in status: • Such as when a child becomes an orphan, a wife a widow, a husband a widower • An outcome of a large-scale social phenomena: • Those surviving a natural disaster or a war Copyright © Allyn & Bacon 2007

Defining Terms: Grief • •

Grief is one response to bereavement; how one survives Grief affects all spheres of life • On a physical level • Acute grief: tightness in throat, shortness of breath, lack of muscle power, empty feeling in abdomen • Prolonged stressor: Increased risk of cardiovascular, infectious, & inflammatory disorders, & weakened immune system • On a personal and interpersonal level • Confusion, attention, concentration, memory, anxiety, and rage which may repeatedly return in waves Copyright © Allyn & Bacon 2007

Defining Terms: Mourning •



Mourning is the culturally patterned expression of the bereaved person’s thoughts and feelings • Can reflect local, regional, national, ethnic, and religious cultures at particular points in history Examples: • During World War I widows dressed in black with veils covering their heads • During World War II families put a gold star in their window if they had lost a loved one

Copyright © Allyn & Bacon 2007

Types of Grief • •

• •

Normal Grief – stays within the bounds of a particular culture Complicated Grief – once called “pathological” or “abnormal,” the most common feature is that the bereaved person does not move from the shock and pain of loss toward a return to a fulfilling life Traumatic Grief – severe and disabling responses to sudden and often violent death Anticipatory Grief – how people cope with expected loss

Copyright © Allyn & Bacon 2007

Types of Grief • •

• •

Resolved Grief – movement toward recovery from the most debilitating effects of grief Unresolved Grief – the debilitating effects of grief have continued longer than would be expected (difficult to define) Hidden Grief – hiding any signs of grief in order to appear as “normal” as possible Disenfranchised Grief – occurs when society does not recognize a person’s right to grieve. Examples: health care professionals, foster parents, gay partner

Copyright © Allyn & Bacon 2007

Examples of Disenfranchised Grief •

The grieving individual is not regarded as having the right to grieve (at this time or under these circumstances) and must keep the sorrow hidden • • • • • •

When at work, school, or in public places Nurses and caregivers Lover or companion of an AIDS victim When the lost companion was an animal When the loss was a stillborn baby When the bereaved person or the individual who died is developmentally disabled Copyright © Allyn & Bacon 2007

Freud’s Grief-Work Theory • • •

• • •

Grief is an adaptive response to loss The work of grief is difficult and time-consuming The basic goal is to accept the reality of death and thereby liberate one’ self from the strong attachment one had to the “lost object” Grief-work is carried out through a long series of confrontations with the reality of the loss The process is complicated by the survivor’s resistance to letting go of the attachment Failure results in continued misery and dysfunction Copyright © Allyn & Bacon 2007

Interpersonal Applications of Grief-Work Theory •

Bowlby’s Attachment Theory • Our basic goal is to maintain the security provided by the significant relationship • Stress comes as we try to re-establish the lost relationship • In grief-work we must overcome our attachment



Parkes’ Three Basic Components of Grief-Work • Preoccupation with thoughts of the deceased person • Repeatedly going over the loss experience • Attempts to explain the loss Copyright © Allyn & Bacon 2007

Other Theoretical Approaches •

Rando’s Task Theory • Accept the loss • React to the separation • Remember and re-experience the lost person and relationship • Give up the attachment to the person and the life that used to be • Move into the new life but remember the old • Reinvest emotions and energies in other relationships and activities Copyright © Allyn & Bacon 2007

Other Theoretical Approaches •

Stage Theories (such as Kubler-Ross) • Most agree on the beginning and ending points, but the middle stages vary by theory • Little independent evidence to verify the application of universal stages to the grieving process



Dual-Process Model (Stroebe and Schut) • Must work on both: • Emotional working through the grief • Adapting to roles and situations in the altered world Copyright © Allyn & Bacon 2007

Other Theoretical Approaches •

Integrated Individual-Family Model (Moos) • Considers symptoms of family grief, such as family isolation, confusion in family roles, changes in who talks to whom, and cut-off, reconnection or overprotection of certain family members



Evolutionary Biology Model of Grief (Archer) • Views grief in all mammals and social birds • Views social bonds as advantageous for survival, but grief as maladaptive Copyright © Allyn & Bacon 2007

How Do People Recover? Spousal Bereavement •

Immediate Impact of Spousal Bereavement • Most women experienced anticipatory grief • After the death women felt a sense of abandonment • After the death men felt a sort of dismemberment • Emotional & Physical Reactions Soon After Bereavement • Physical symptoms lingered for weeks (pains, poor appetite, loss of stamina, headaches, dizziness) • Women had trouble at night, wanted someone to rely on, and felt the situation was “not fair” • Men felt guilty and were less likely to express emotions Copyright © Allyn & Bacon 2007

How Do People Recover? Spousal Bereavement •





Leave-Taking Ceremonies • Women found them important and helpful • Men found them less important and too expensive Grief and Recovery: The Widow’s Response • Obsessional reviews of the circumstances • Tendency to idealize the husband • Strong sense that he is still with her Grief and Recovery: The Widowers’ Response • Cuts off obsessional reviews quickly • Faster social recovery, slower emotional recovery Copyright © Allyn & Bacon 2007

How Do People Recover? Spousal Bereavement •

Types of Recovery • People who did not have the opportunity to prepare for the spouse’s death suffered more distress • Time by itself will not facilitate recuperation • Those who were most disturbed a few weeks after the death usually were the ones who continued to be disturbed a year later • The quality of the marital relationship influences the grief and recovery process

Copyright © Allyn & Bacon 2007

How Do People Recover? Spousal Bereavement •



Three Types of Unresolved Grief • The unexpected grief syndrome (when death comes without warning, leaving disbelief and intense anxiety) • The conflicted grief syndrome (when death occurs in a troubled relationship) • The chronic grief syndrome (marked by dependency on deceased spouse) Psychosocial Transition • Vulnerable place of change • Rites of passage can be helpful Copyright © Allyn & Bacon 2007

The Family That Has Lost a Child: Perinatal Death Perinatal death – 20 weeks after conception to one month after birth • Health care systems are more responsive • Shadow grief – stays with parents for years (like a shadow) • Contact the “inner representation” of the dead child may be experienced for years (keeps parents’ worldview intact) • Memories, hallucinations, a presence or incorporation of the child’s characteristics into their own personalities • Most surviving parents do not divorce • Grandparents grieve as well •

Copyright © Allyn & Bacon 2007

Bereavement in Later Life •

Most older adults cope as well as anyone • Some deal with bereavement overload • Accumulation of experience with many losses (family, friends, pets, lifestyle) • Risk of illness and death increases following the death of a loved one (often within 6 months) • Risk is greater for widowers than widows • Risk is greatest for young adult widowers • Higher risk for violent death and suicide • Stress of grief can weaken immune system Copyright © Allyn & Bacon 2007

Meaningful Help for Bereaved People •



Silverman established the Widow-To-Widow Program prior to the development of professional grief counselors or peer-support groups • Grief does not have a final outcome • Grief can most usefully be regarded as a life transition • People can help each other Helpful things to say to the bereaved • “He/she will always be alive in your memories.” • “I’m here if you need somebody to talk to” • “Tell me how you are feeling” Copyright © Allyn & Bacon 2007

Glossary: New Terms • • • • • • • •

Anticipatory Grief Attachment Behavior Bereavement Continuing Bonds Disenfranchised Grief Dissociative Flight Grief Grief-Work Theory

• • • • •

Intrapsychic Mourning Spontaneous Memorialization Stigmatized Grief Traumatic Grief

Copyright © Allyn & Bacon 2007

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