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Grief

COMMON REACTIONS TO GRIEF 

Physical
Reactions

Affective
Reactions

Cognitive
Reactions

Behavioral
Reactions

  • headaches 
  • muscle aches
  • nausea
  • tiredness
  • loss of appetite
  • pains
  • insomnia
  • tenseness
  • sadness
  • anger
  • guilt
  • jealousy
  • anxiety and fear
  • shame
  • powerlessness
  • relief
  • emancipation
  • searching for
         meaning
  • change in spiritual
         feelings or
         beliefs
  • obsessive
          thinking
  • inability to
         concentrate
  • fantasizing
  • apathy
  • dreams
  • confusion
  • continued
         thoughts about
         the loss
  • sense of
         deceased's
         presence
  • attempts to
         understand the
         loss
  • crying/ inability to
         cry
  • illness-related
         behaviors
  • outward
         expression of
         emotion
  • avoiding or
         seeking 
         reminders
         of loss
  • social withdrawal
  • physical activities
  • increase in
         alcohol, smoking
         or other drug
         use
  • Be careful about
         assuming the
         meaning of any
         specific behavior
  • FACTORS THAT CONTRIBUTE TO COPING

    • Type and timing of loss
    • Quality of relationship with the deceased
    • Social support
    • Pre-existing factors

    FIRST, SOME DEFINITIONS

    • Loss refers to being deprived of someone or something to which one was attached or previously possessed.
    • Secondary loss follows as a consequence of the primary loss (e.g., loss of income, hopes, and sometimes even faith)
    • Bereavement refers to the basic fact or objective reality of loss
    • Grief refers to the response and reactions to the loss. Involves the tension created by the conflict between the world that was, what it cannot be, and how it may become. Includes physical, affective, cognitive, and spiritual domains

    FEAR AND ANXIETY ABOUT DEATH

    • The view of death as loss is linked to fear and anxiety about death
    • Middle-aged adults show greatest fear of death. Older adults the least fear of death. Young adults' level of fear is somewhere in between
    • Concern about death and dying increases across aging. Therefore, although death is highly salient in late adulthood; it is not as frightening as it was in middle-age
    • Numerous personal qualities are predictive of fear of death (e.g., religiosity, neuroticism, personal competence, etc)

    THE PROCESS OF DYING

    • Kübler-Ross has developed a model of coming to term with death: Denial, Anger, Bargaining, Depression, and Acceptance
    • Kübler-Ross's conception has been enormously influential; however, it is weakened by methodological flaws
    • Some controversy as to whether there truly are universal stages of dying
    • One aspect of dying which is missing from Kübler-Ross's stages is the process of saying farewell to loved ones. This process is important for the dying and the grieving
    • Significant individual differences in emotional and physical process of death
    • Positive avoidance, fighting spirit, stoic acceptance, helplessness/hopelessness, anxious preoccupation
    • Studies link these psychological differences to immune system functioning
    • Social support is another important factor in a person's response to imminent death

    AFTER DEATH: RITUALS AND GRIEVING

    • Every culture has rituals associated with death that help people apply meaning to death and the life of the person who has died
    • The process of grief can be viewed through Kübler-Ross's stage theory
    • Recent research suggests personality and coping influences how one deals with grief
    • Bowlby describes four stages of grief: shock, yearning, despair, reorganization
    • Wortman and Silver identify patterns of grief: normal grieving, chronic grieving, delayed grieving, and absent grieving
    • Loss can also lead to growth
    • Awareness of death can help define and give meaning to daily life

    National Institute of Health Grief Information