Personal Guidebook to Grief Recovery
Grief Grief is an involuntary, complicated, emotional, and psychological response to loss or extreme trauma. It is a process of movement through the pain of loss and simultaneously of healing and learning. Grief is the process that allows us to let go of intense emotional attachments and carry on with our lives. The experience of grief is personal and subjective. With regard to aids, those who have HIV or AIDS will frequently be experiencing loss of health, jobs, homes, friends, finances, and independence and are having to face in the near future the loss of their lives. Their family members will be grieving for them and for the loss of their own future expectations. Medical personnel grieve their loss as well, along with the failure of their expectations of themselves their inability to cure, letting another person die. Grief produces both emotional and physical manifestations. The initial reaction may include somatic symptoms such as easy fatigability, hollow or empty feeling in the...
Not surprisingly, patients have also changed. They are sicker, confined only during the most crucial hours of their recovery. Because patients are sent home so quickly, planning for discharge begins during the admitting process. Patients are expected to independently accomplish in hours what convalescents of the past would have been led through over days or even weeks. They are wheeled in, wheeled through, and wheeled out amid an array of scans, pokes, prods, opinions, discharge instructions, and multiple staff. They are anxious. Their families are anxious. The fact is that patients and their families bring fear, apprehension, anger, and grief to the hospital, just as they did forty years ago. What has changed is nurses' opportunity to deal with these emotions. The environment in which the emotions are experienced has changed as well.
American SIDS Institute A national, nonprofit health care organization founded in 1983 that is dedicated to preventing sudden infant death syndrome (SIDS) and promoting infant health through an aggressive, comprehensive nationwide program. The institute promotes research about the cause of sIDs and methods of prevention, offers clinical services to help pediatricians in the medical management of high risk infants, provides information about prevention methods aimed at the public and medical community, and offers family support providing crisis phone counseling, grief literature, and referrals. (For contact information, see Appendix I.)
Today, ACT-UP is a shadow of its former self. This reflects, in part, the deaths of many of its leaders, the infighting that fractured the group, the seemingly inevitable mellowing of any radical movement, and the degree to which the armies that amassed to battle AIDS traveled a spectrum of grief from anger to acceptance. It also is because ACT-UP's energy did not so much dissipate as disperse, with members marching off in different, more specialized directions and with an array of other AIDS-related organizations spun off from or inspired by it. Most interestingly, and perhaps most significantly, it also reflects the extent to which the protesters once clamoring at the dining room door have gained a place at the table. See
As the consultation progressed, I asked a routine question regarding how he'd been faring emotionally. For Michael, this question triggered a pained expression, which darkened his face, and caused him to shift uncomfortably in his chair. He told me he'd been depressed for more than a year, since the death of his grandson in a car accident. Although he received spiritual counseling from his minister, he had not been able to shake the grief, which waited for him every time he sought sleep and each morning upon awakening. He had also become prone to awakening in the early hours of the morning, unable to resume sleep. He felt as if he had been dragging himself out of bed, beginning each day with a sense of exhaustion. Michael began psychotherapy to work through his grief over his grandson's death he also started taking an antidepressant. His depression began to lift and his sleep improved the medication was discontinued after five months. His neuropsychological examination was entirely...
The goal of hospice care for children is enhancement of the quality of life each day. The child and family are included to the fullest degree possible in the decision process about treatment and choices. CHI ensures continuity and consistency of care through the coordination of a team of volunteer support professionals from medical, nursing, psychological, and spiritual fields, along with other services as appropriate. CHI's hospice care for children and their families is also attentive to needs related to loss and grieving.
Acerbate these social problems (Carrillo 1991). In working with Latino psychiatric patients, it is at times difficult to distinguish appropriate reactions to overwhelming life stressors from reactions that are beyond the realm of normal grief or response (L pez 1991). In making psychiatric diagnoses it is important to use the criteria set forth in DSM-IV (American Psychiatric Association 1994) while at the same time taking into consideration cultural responses to stress and cultural expression of symptoms. As with any patient, a detailed history and, when available, collateral information help to clarify the diagnoses. The specificity of a detailed history helps the clinician get beyond the description Latinos often use as to what is going on with them as being merely nervios, or nerves, a term that is used to encompass symptoms ranging from everyday blues to severe psychotic disorders (L pez 1991).
Greek clinical notes on the psychology of severe illness depicted the desire to end one's life as a sign of delirium or depression and not as a rational choice to die.10 Depression was correctly seen as a bad prognostic sign A n over-sad countenance bodes ill. 11 Timochareus' male servant, after what appeared melancholic affection during the epidemic , died. 12 For trembling to come on in patients that are out of their wits with melancholy is a malignant sign. 15 Morbid dreams, for example, dreaming of dead people, naked or clothed in black, or not clean, or taking something or bringing something out the house, the sign is unfavorable as it indicates disease. 14 Such distressing dreams merited distinctive treatments (emetics, rest, comic diversions, a light diet, and walks). These recommendations were among the earliest proposals for palliative care of the suffering caused by disease. Ancient Greek medical texts correctly described delirium as an ominous prognostic sign. For example,...
Migration may cause grief, depression, nostalgia, distress, and, for some, trauma. Shame and guilt, two characteristics that tend to be common among Colombians, may contribute to complicating their psychological status, especially for those who have to perform work-related activities considered to be inferior in nature.
The unambiguous regularities of harmony theory (Tables 3-2 and 3-3) suggest a similar psychology for musical pitch changes minor mode as inherently associated with a resolved inferior social status and a submissive mentality, and major mode as associated with a resolved superior social status and an established dominance.5 This psychological dichotomy is reflected in Cooke's (1959) characterization of the affective quality of commonly-used melodic sequences in Western classical music. As summarized by Kaminska and Woolf (2000), specific melodic lines in a minor key typically express inescapable doom, pain and acceptance, pure tragedy, yielding to grief, never-ending despair and assertion of sorrow. Specific major key melodies, in contrast, express joy and triumph. Their experimental work with musically untrained subjects did not reveal an ability to differentiate among various forms of grief and joy in response to the melodic lines, but their results strongly supported a...
One must visit a wise man from time to time to discover what one already knows. 3 Patients may already have figured out that their symptoms are not serious, but they need the reassurance from someone with a credential, the wise man called Doctor. A patient may be grieving over the loss of a spouse and need to be reassured by his physician that he is not going crazy. Even though a patient may be expert in the care of her diabetes, she still needs reassurance that she is doing the right thing. You didn't minimize, one patient told me. You believed in me, said another.
In a book review of Martha Nussbaum's (2001) book Upheavals of Thought The Intelligence of Emotions, Hoffmaster (2003) points out that emotions are more than just happenings that overtake us and sweep us toward particular thoughts or actions. Rather, they are responses that can be rationally assessed, contrary to the metaphors we are so accustomed to hearing swamped by grief, paralyzed by fear, blinded by love, and the like.
Since Darwin's seminal work on the expression of emotions, the question of the universality of facial emotional expressions has appeared in the art literature and especially in the literature of social psychology and anthropology, with one camp contending that facial expressions are universal to the species, the other camp that facial expressions are the result of socialization. Preparing his work during the height of the British Empire, Darwin sent out questionnaires to British subjects in eight parts of the world Africa, America, Australia, Borneo, China, India, Malaysia, and New Zealand, querying how natives expressed astonishment, shame, indignation, concentration, grief, good spirits, contempt, obstinacy, disgust, fear, resignation, sulkiness, guilt, slyness, jealousy, and yes no. The answers he got back from his correspondents indicated that the same expressions of emotions were seen in these
Critical care medicine is the perfect fit for pediatricians who prefer an acute fix-it-now-type setting. These subspecialists perform lots of procedures like placing chest tubes, central lines, and endotracheal tubes. They are the experts of physiology and medicine as managers of the ventilators, ventriculostomies, and invasive heart monitors. The ability to think quickly is of paramount importance as they assess and treat patients suffering from head trauma, postoperative cardiac surgery with complex physiology, sepsis, severe asthma, end-stage cancer, and more. Critical care pediatricians also must have a great deal of compassion, sympathy, and the ability to speak with families when their child is dying. The death of a child is especially sad, and parents cope with this tragedy with fear, anger, and frustration. Your empathy and patience help serve as the foundation for their process of grieving, healing, and coming to terms with the loss they are about to experience.
Could these, or any other mergers, have been managed differently Looking back the answer is almost certainly a grudging Yes . A shorter timescale for the decision, a definite timescale for the grieving, and then much more forceful efforts to get on with normal life would undoubtedly improve the process for the participants. Doctors who spend their lives dealing with mortal illness ought to know about these things. However, I confess that it was only in the midst of the Guy's and St Thomas' merger that I came to realise how like a death it seemed for many at Guy's, how important is the management of grieving, and how important it is to understand that the behaviour of some was akin to that of those close to a dying person inappropriately focused anger, denial, and inability to function effectively.
Ciated with greater gains in expressive language (Mus-selman and Churchill, 1991). At present, studies of causality have been insufficient to determine the efficacy or superiority of various intervention strategies. However, some interventions that are theoretically grounded and are characteristic of programs that demonstrate optimal language development are parent-centered, provide objective developmental data, assist parental decisions about methodology, based on the developmental progress of the individual child, include a strong counseling component aimed at reducing parental stress and assisting parents in the resolution of their grief, and provide guidance in parent-child interaction strategies. In addition to an analysis of communication skills, cognitive development, and age at identification, assessments should include information about the social-emotional development of both parents and children. Relationships have been found between language development and parental stress...
How has Jesse's family reacted, beyond their grief and their efforts to understand what happened Not surprisingly, once they realized that what happened to Jesse might not have been some uncontrollable biological luck of the draw but at least partly the result of mistakes in judgment or mistakes in the system of fail-safes, a lawsuit was filed against the doctors and the university. Since the suit was settled out of court, we cannot comment on the outcome of it, other than to indicate that Jesse's father plans to apply money from the settlement towards improving oversight of gene therapy research. Interestingly, this represents one of the most effective ways to further Jesse's dream of making gene therapy for OTC into a reality. The more safely and effectively the research is conducted, the more likely it is to continue and to eventually succeed in Jesse's goal of providing a cure, or at least an effective
However carefully you deal with complaints the outcome often seems to be unsatisfactory for complainants rarely fall on the complaints officers' necks thanking them for resolving the problem. The complainant who only wants to find out what happened may be content simply with the information, but the aggrieved complainant often wants more and the mollifying tone of the letter from the complaints officer or chief executive who acts as an intermediary between those involved and the complainant may be the very agent that further irritates the complainant who becomes more angry rather than less. Such complainants may not even understand their own motives for example, when the complainant is the relative of someone who has died the complaint may be an expression of the anger of grief inappropriately expressed. Not infrequently the complainant wants not an explanation but somehow to punish the system for a real or imaginary hurt sustained. A sanitised apology does not suffice, they want...
The human voice is acutely responsive to changes in emotional state, and the larynx plays a prominent role as an instrument for the expression of intense emotions such as fear, anger, grief, and joy. Consequently, many regard the voice as a sensitive barometer of emotions and the larynx as the control valve that regulates the release of these emotions (Aronson, 1990). Furthermore, the voice is one of the most individual and characteristic expressions of a person a mirror of personality. Thus, when the voice becomes disordered, it is not uncommon for clinicians to suggest personality traits, psychological factors, or emotional or inhibitory processes as primary causal mechanisms. This is especially true in the case of functional dysphonia or aphonia, in which no visible structural or neurological laryngeal pathology exists to explain the partial or complete loss of voice.
The sense of self can be radically threatened by the loss of a significant other. When a loved one dies, the relationship with that object (person) and one's own sense of self as defined by that relationship are disrupted. To work through the grief, the mourner must give up or transform the relationship with the loved one (Baker, 2001). This may take a variety of forms, including reminiscences, talking with the one who has died, thinking of the person as a ghost, and other forms.
The emergence of buried feelings from the unconscious is called catharsis. These feelings, including fear and grief, often accompany the recall of forgotten memories. Like the removal of infectious material when a wound is lanced, catharsis frees the unconscious of troublesome repressions.
Grief sadness for which emotions remain open questions, but there is wide agreement on the idea that prosody is a second channel through which people understand one another - often in spite of the contrary linguistic message in the first channel. For decades, linguists have focused on the fundamental frequency of the voice (F0) - not only because it is intuitively the most important carrier of information, but also because most of the physical energy in the voice lies there. Technical developments have meant, however, that many other acoustical features can also be measured and correlated with emotions. As seen in Table 4-2, some rough distinctions can be made among various emotions on the basis of voice acoustics, but there is no simple answer concerning which acoustic fac-tor(s) convey information concerning which emotion(s). In other words, the link between pitch characteristics and specific emotions is quite approximate. Unlike a typical human listener, the psychoacoustician will...
The news of a potential abnormality in what was thought to be a normal pregnancy is a crisis for the unsuspecting parents. The parents usually experience shock, worry, grief, guilt, even emotional detachment from the pregnancy, when confronted by this turn of events. They are likely to have little tolerance for the probing questions required for taking an exhaustive three-generation pedigree. The parents, through their fog of grief and worry, may even feel the health professional is asking questions to assign blame (especially with questions about teratogens and consanguinity). Other family members may not know about the pregnancy inquiring about the extended family may be viewed as a threat to privacy, further compounding the difficulties in obtaining an extensive pedigree.
Hospice staff had also begun to question their practice of keeping dying patients in communal wards after two patients in quick succession had requested a discharge as a result of witnessing the death of another patient in the same room as them. They had also received a letter of complaint from a widower who felt strongly that his wife should have been placed in a side room when she was dying. He suggested that he had felt unable to express his grief at the time of his wife's death because he did not want to upset the other patients and visitors present in the ward. Staff thus hoped that I would be able to befriend patients and obtain their views on whether they found it helpful or unhelpful to see other patients
Finally, both clinicians and researchers seek a method for revealing unconscious material upon their request so that they may diagnose individuals and test psychoanalytic hypotheses. For this purpose, they have developed projective tests. Among the most widely used projective tests in clinical practice are the Rorschach inkblot test and the Thematic Apperception Test (Butcher & Rouse, 1996). Most (nonprojective) tests ask explicit questions. For example, a test may ask, Do you feel happy most of the time In contrast, a projective test presents the client or research subject with an ambiguous stimulus, such as an inkblot or a picture, and gives only minimal directions for responding. What do you see in this inkblot Tell me a stoiy about this picture. The assumption is that responses in such minimally constrained conditions will reveal unconscious material, unknown even to the respondent. On the nonprojective test a person may say that he or she is happy most of the time, yet make up a...
Buddy Generally, a volunteer caregiver who works with a person with HIV or AIDS, providing or arranging for an array of services, such as home care, daily living needs (personal hygiene, clothing, bed linens, etc.), transportation, and personal or social support. A buddy provides comfort and assistance and helps a person afflicted with HIV AIDS maintain as much personal dignity as is possible with this disease. Many AIDS service organizations support some form of buddy system. Buddies often begin working with persons with HIV or AIDS that they do not know. Often, more than one buddy will be assigned to a patient. A patient's needs, capabilities, and limitations from one day to the next generally determine the care and support that are provided. Buddy training and ongoing buddy education are often required of all persons who volunteer as caregivers. Most AIDS service organizations offer buddy support meetings to help buddies deal with stress and burnout, as well as their own grief.
In our scientific era, we sometimes misinterpret myth as merely primitive science. A myth of the sun rising, for example, is dismissed as an outdated statement before people knew that the earth revolved around the sun. Fertility rites are, from this view, outdated by our increased understanding of natural science. For Jung, however, myths are far more than primitive science because they deal with human experience of the events of nature. A myth of the sun setting not only describes the sun going deep into the earth but also expresses people's grief of seeing the departure of the sun and their fear of the dangers that come with the night. Science, which is intentionally neutral in the emotional sphere, cannot replace this emotional function of myth. Perhaps a sense of this loss has contributed to antiscience tendencies in our modern era.
Friendship and understanding to bereaved parents, grandparents, and siblings. There is no religious affiliation and there are no membership dues or fees. The mission of the Compassionate Friends is to help families toward the positive resolution of grief following the death of a child of any age and to provide information to help others be supportive. As seasoned grievers reach out to the newly bereaved, energy that has been directed inward begins to flow outward and both are helped to heal. There are now Compassionate Friends chapters in every state in the United States almost 600 altogether and hundreds of chapters in Canada, Great Britain, and other countries throughout the world. In the United States, chapters are open to all bereaved parents, siblings, grandparents, and other family members who are grieving the death of a child of any age, from any cause. (For contact information, see Appendix I.)
Immigrants have additional levels of stress. Many are forced to immigrate by the political situations in their homelands or by poor economic conditions. They have often left important family members behind and miss them tremendously. People who come from war-torn countries may experience delayed grief reactions for persons who died years ago but whom they have not had the opportunity to mourn. Some immigrants are unable to adjust to life in the United States because their intention is to return to their country of origin whenever the political or economic situation improves as a result, their lives are in limbo. Some people are forced to immigrate against their will for example, children, adolescents, and elderly persons which creates family conflict. Professionals who immigrate often experience a loss of status because they are unable to practice their professions in the United States. For example, many Nicaraguan physicians who left their country during the revolution now earn their...
Some view depression accompanying aphasia within the framework of the grief model (Tanner and Ger-stenberger, 1988). In this view, individuals grieve for the loss of communication, moving through the stages of denial, anger, bargaining, depression, and acceptance. Whether people do in fact go through these stages has not been investigated, but it has served as a framework for counseling. Determining denial, bargaining, acceptance, and so on is problematic but has been investigated interpretively with personal construct therapy techniques by Brumfitt (1985), who argues that aphasia affects a person's core role constructs, with grief for the essential element of self as a speaker.
Hospice A facility that provides palliative and supportive services for the terminally ill. Hospice care is an interdisciplinary approach to providing for the terminally ill. The hospice concept emphasizes alleviating a patient's discomfort and supporting the family in the grieving process. Supportive care may include financial, physical, social, and spiritual services. Covered by medicare, medicaid, and some private health insurance plans, hospice care may be provided at a hospice facility, at a patient's home, or both. Care is generally provided by a team of health care professionals.
The team provides medical, nursing, psychosocial, and spiritual care as core services, along with trained volunteer and other services as appropriate. Hospice care for children is also attentive to needs related to loss and grieving for all concerned both prior to and following a death. Nursing services are available 24 hours a day as needed in any setting in which care is provided. Services are systematically evaluated for appropriateness and effectiveness.
This ethics question looks at the moral underpinnings of the profession, the identities of its practitioners, and their duties to secure the profession's future. The Oath's Apollonian opening refers to a rich set of moral stories about the foundation of medicine. These stories say that being a healer is a heroic enterprise. They tell of how the passion to heal is grounded on love and grief and teach that physicians must not pretend to contest the fact of human mortality. Asclepius, Unceasingly gentle, and Epione, Soothing, passed a common spirit to the diverse branches of healing. Physicians swore by the entire family of Asclepius and Epione. The Oath explicitly mentioned Hygieia (goddess of health or preventive health care) and Panacea (All-Heal, goddess of remedies) and called on their siblings, all the gods as well as goddesses as well. In this way, physicians embraced Iaso (goddess of medicine), Aigle (radiance) and Telesphorus (god of convalescence). In opening medical...
The birth of a deaf child to hearing parents with no experience or understanding of deafness can be perceived as devastating to the parents and their extended family (Luterman & Ross, 1991, in Israel, 1995). There are many factors that may influence the grieving process as parents try to make sense of their situation. Eventual acceptance of the child as deaf may be influenced by these factors prior perceptions of deafness, expectations and attitudes of friends and relatives, economic issues, stress factors in the family, previous coping strategies and relationships with health professionals and education network (Calderon & Greenberg, 1993, in Israel, 1995).
The year was 1988, the place was the small community of Alturas, and the family that was causing 39-year-old Trepal so much grief was the somewhat dysfunctional Carr family. This consisted of husband Pye, who spent most of his time with his girlfriend Laura Ervin, his wife Peggy, their children, and a number of dogs. Peggy was the person who drank most of the doctored Coca-Cola and within a few days she was displaying the classic first symptoms of thallium poisoning her fingers tingled and the soles of her feet were extremely painful. She slowly became worse and eventually she went into Winter Haven Hospital where her hair fell out. She sank into a coma, and within a few weeks she was dead. Meanwhile Pye Carr and son Travis were
In German, Adler used the term Gemeinschafsgefiihl, which has been translated as social interest, social feeling, community feeling, and so forth. Perhaps feeling of community is the best description for social interest (Stein & Edwards, 1998). It should not be confused with extraversion. Nor is it simply the need for affection, although Adler did use that concept earlier in the development of his theory (Ansbacher & Ansbacher, 1956, p. 40). Social interest is the innate potential to live cooperatively with other people. It enables the person to value the common good above personal welfare. It is not a matter of sacrificing self for other, though. Social connections with others and individual development each enhance the other (Guisinger & Blatt, 1994 Stein & Edwards, 1998). Although social interest is an inborn potential, it must be fostered. In early life, the mother selves as the first bridge to social life (p. 372) by being trustworthy and loving, but not possessive, and by...
Apollo was passionate about humans.5 He fell in love with the human woman Coronis and they made love. He went off and left a white crow to watch over her in his absence. The crow came to Apollo and told him that Coronis had fallen in love with another his rage blackened the crow. He told his sister, Artemis, to shoot Coronis with an arrow. The dying Coronis whispered that she was carrying his son. Grief stricken, Apollo the Physician plied his medical skill in vain. As the pyre's flames consumed her body, Apollo reached into her and pulled forth Asclepius. Apollo asked the wise centaur, Chiron, to raise and instruct him. Chiron taught Asclepius medicine and, like other humans with a divine parent, Asclepius excelled.4
Dealing With Sorrow
Within this audio series and guide Dealing With Sorrow you will be learning all about Hypnotherapy For Overcoming Grief, Failure And Sadness Quickly.