Loss and Grief

05-Jun-22 By Tadesse S. 1
 Loss
• Loss is any situation (either actual, potential, or
perceived) in which a valued object is changed or
is no longer accessible to the individual.
• Because change is a major constant in life,
everyone experiences losses.
• Loss can be actual (e.g., a spouse is lost through
divorce) or anticipated (a person is diagnosed
with a terminal illness and has only a short time
to live).

05-Jun-22 By Tadesse S. 2
 Loss
• A loss can be tangible or intangible. For example,
when a person is fired from a job, the tangible
loss is income, whereas the loss of self-esteem is
intangible.
• Losses occur as a result of moving from one
developmental stage to another.
• An example of such a maturational loss is the
adolescent who loses the younger child’s
freedom from responsibility.
• A situational loss occurs in response to external
events, usually beyond the individual’s control
(such as the death of a significant other).
05-Jun-22 By Tadesse S. 3
 Loss as Crisis
• Loss precipitates anxiety and a feeling of
vulnerability- which may lead to crisis.
• When a significant other dies, one’s sense of
safety and security is disrupted.
• Grieving is a mechanism for crisis resolution.
• When an individual feels overwhelmed by stress
and the usual coping mechanisms are no longer
effective, crisis occurs.
• Crisis intervention may be necessary to help the
person grieve successfully.
05-Jun-22 By Tadesse S. 4
 Types of Loss
• There are many types of loss, including:
– Actual loss: Death of a loved one, theft of one’s
property.
– Perceived loss: Occurs when a sense of loss is
felt by an individual but is not tangible to others.
– Physical loss: Loss of an extremity in an
accident, scarring from burns, permanent injury.
– Psychological loss: Such as a woman feeling
inadequate after menopause and resultant
infertility.
05-Jun-22 By Tadesse S. 5
 Types of Loss
• There are four major categories of loss:
– Loss of external objects,
– Loss of familiar environment,
– Loss of aspects of self, and
– Loss of significant other.

05-Jun-22 By Tadesse S. 6
 GRIEF
• Grief is a series of intense physical and
psychological responses that occur following a
loss.
• It is a normal, natural, necessary, and adaptive
response to a loss.
• “Grieving is a walk through unknown territory.
• Familiar internal and external stabilities
disappear in a whirlwind of changing thoughts,
feelings, and emotional flux”
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 GRIEF
• Loss leads to the adaptive process of
mourning(grief), the period of time during which
the grief is expressed and resolution and
integration of the loss occur.
• Bereavement (loss) is the period of grief
following the death of a loved one.

05-Jun-22 By Tadesse S. 8
 Lindemann’s Theory:
Reactions to Normal Grief
• Somatic Distress: Episodic waves of discomfort in
duration of 10–60 minutes; multiple somatic
complaints, fatigue, and extreme physical or
emotional pain.
• Preoccupation with the Image of the Deceased:
The bereaved experience a sense of unreality,
emotional detachment from others, and an
overwhelming preoccupation with visualizing the
deceased.

05-Jun-22 By Tadesse S. 9
 Lindemann’s Theory:
Reactions to Normal Grief
• Guilt: The bereaved consider the death to be a
result of their own negligence or lack of
attentiveness; they look for evidence of how they
could have contributed to the death.
• Hostile Reactions: Relationships with others
become impaired owing to the bereaved’s desire
to be left alone, irritability, and anger.
• Loss of Patterns of Conduct: The bereaved
exhibit an inability to sit still, generalized
restlessness and continually search for
something to do.
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 Engle’s Theory of Grief:
Three Stages of Mourning
Stage I: Shock and Disbelief
• can last from minutes to days
• Stage II: Developing Awareness
• may last from 6 to 12 months
• Stage III: Restitution and Resolution
• marks the beginning of the healing process and
may take up to several years

05-Jun-22 By Tadesse S. 11
 Types of Grief
• Grief is a universal, normal response to loss.
• Grief drains people, both emotionally and
physically.
• Because grief consumes so much emotional
energy, relationships may be impaired and health
status may become altered.
• There are different types of grief including
uncomplicated (“normal”), dysfunctional, and
anticipatory.
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 Kübler-Ross’s Five Stages of Dying
• Denial: “This cannot be true
• Anger: “Why me?” Feelings of rage,
resentment or envy directed at God, health
care professionals, family, others.
• Bargaining: “I just want to see my
grandchild’s birth, then I’ll be ready
• Depression: “I just don’t know how my kids
are going to get along after I’m gone.”
• Acceptance: “I’ve lived a good life, and I have
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no regrets