Bereavement & Grief

Definitions
Bereavement = the state of being deprived of
someone by death and refers to being in the
state of mourning.
Kaplan and Sadock's Synopsis of Psychiatry 10th edition; Page-62)

Broad term that encompasses the entire

experience of family members and friends in
the anticipation, death and subsequent
adjustment to living following the death of a
loved one.
Report on Grief and Bereavement Research, Center for the Advancement of
Health, 2004)
Definitions

Grief = the subjective feeling precipitated by the

death of a loved one.
Kaplan and Sadock's Synopsis of Psychiatry 10th edition; Page-62)

Subjective experience of loss.

(Sabar :

Complex set of cognitive, emotional, and social

difficulties that follow the death of a loved
one.
Report on Grief and Bereavement Research, Center for the Advancement of
Health, 2004)
Definitions
Mourning = the process by which grief is
resolved; it is the societal expression of post-
bereavement behavior and practices.
Kaplan and Sadock's Synopsis of Psychiatry 10th edition; Page-62)

A public process involving recognition by

others support and social, cultural and religious
customs and rituals
Root meaning: “remembering with care and
sorrow”
Sabar :
Normal Grief Reaction
Stage -1 : Denial
Hours to days Disbelief
Numbness
Sadness, weeping, waves of grief.
Somatic symptoms of anxiety
Stage -2 : Poor sleep, Guilt, Blame of others,
Weeks to 6 Illusions, hallucinations
months Preoccupation with memories of the
deceased
Social withdrawal

Stage-3: Symptoms resolve

Weeks Social activities resumed
to Memories of good times
months

(Shorter Oxford Textbook of Psychiatry, 6th Edition, Page-172)

 Primary Loss: Secondary Losses: Arise as a chain of
events from primary loss
-Death of spouse: loss of
› Significant loss event, such as death companionship, financial security,
sexual intimacy, family role, social status
-Job loss: self-esteem, identity, financial
security, sense of future
-Childhood sexual abuse: loss of
innocence, trust, sense of control, etc.
-Mental illness: loss of control over
emotions, thoughts, family role, loss of
occupation

Ambiguous Loss (AL):

Physically absent /psychologically present: (e.g. kidnapping, people missing
from natural disaster, divorce situations, baby put up for adoption)
Physically present / psychologically absent: person is emotionally and
cognitively missing (Alzheimer’s, traumatic brain injury, addictions)
 Wordon’s Tasks of Mourning

THE FOUR TASKS OF MOURNING.

Task 1: Accept the reality of the loss.
Task 2: Process your grief and pain.
Task 3: Adjust to the world without your loved
one in it.
Task 4: Find a way to maintain a connection to
the person who died while embarking on your
own life.
Addressing these 4 Task to adjust and assimilate
to grief.
 Counseling:

 Help maybe needed to

- accept that the loss is real.
- work through the stages of grief
- adjust to life without the deceased.

 Parents who are grieving for

stillborn child need special help.

(Shorter Oxford Textbook of Psychiatry, 6th Edition, Page-173)

 Psychotherapy:
 For adults experiencing normal grief,
interventions are likely to be unnecessary
and largely unproductive, may even be
harmful.

 For adults at risk, may provide some

benefit (esp in short term),

 Complicated grief likely to provide benefit.

(Report on Grief and Bereavement Research, 2004.)

 Management:

 Counseling

 Medication

 Support Groups

 Psychotherapy

(Shorter Oxford Textbook of Psychiatry, 6th Edition, Page-173)

Grief Therapies

Basic thing is a supportive-expressive

intervention causing shift in cognitive
appraisal of the reality that is forever altered.

Variation influenced by age, perception of

support, nature of the death, personal
health/co-morbidities of the bereaved.
Key Technique in Working With
Loss, Grief, and Bereaved Clients

 Master the Art of Silence

 Respectful silence is bearing witness
 Silence punctuates moments, prompts reflection, provides
support, deepens process, and is healing

 Create a space for coping, holding,

adapting

 Do not solve grief

 Do not rescue grief
Thank You!