PAOC BEREAVEMENT COURSE

1. PAOC BEREAVEMENT COURSE Rev. Bob Glasgow glasgowb@telus.net www.soulconsolation.com

2. Common societal myths about grief The grief experience has predictable, linear stages. One can “get over” the loss,accept it and return to normal .. there is (should be) an ending to grief Private process rather than a social/relational Grief “bursts” are a sign of weakness or indicate “not coping” Relinquishes ongoing attachment

3. Contemporary Grief Theory • Grief is varied and unique • To grieve means to relearn the world • Full range of affect • Continuing bonds • On-going process

4. WELL BEING Avoidance/Healing Model ADVOIDANCE ROUTE Resentment and Guilt (Secondary Emotions) Avoidance Behaviors: • Social Isolation • Drugs/Alcohol • Workaholic • Extensive Travel • Beliefs used as defense HEALING ROUTE Steps of Healing: • Acts of accommodation • Re-telling of loss • Exploring lost relationship in detail • Dealing with change in identity • Being aware of secondary losses • Working at emotional closure in what felt unexpressed with our loved one • Celebrate learning about self and life • New directions Result: Repress pain, avoid being vulnerable again Result: Pain expressed, vulnerability re-established LOSS developed by Bob Glasgow SAD HURT SCARED Sad Hurt Scared

5. Cycles of GriefTherese RandoTasks William Worden • Avoidance • Desire to avoid acknowledgment of the loss • Shock, denial, numbness, disorganization • Denial allows the person to absorb reality slowly • A need a to know why the death occurred may appear • Task: To recognize and acknowledge the loss Confrontation - Intense grief - Emotional extremes - Anger and guilt are common - Yearning and despair - Symptoms of depression may be evident - Waves of acute grief may occur - Repeated review of the loss experience is common Two Tasks: 1. Experiencing the pain 2. Beginning to integrate the loss • Integration • Waves of intensity get farther apart • Decline of grief • Beginning of emotional and social re-entry • Task: Re-investing energy in • relationships and pursuits

6. Doka

7. Empathetic Listening Empathy is the ability to understand another person’s ideas and feelings. It is gaining an understanding (through listening) and demonstrating that understanding (by responding).

8. The EISPU Response System E – Evaluation A response which indicates the counselor has made a judgment of relative goodness, appropriateness, effectiveness, rightness. He has in some way implied what the client MIGHT or OUGHT to do: grossly or subtly. I – Interpretive A response which indicates the counselor’s intent is to teach, to impart meaning to the client, to show him. He has in some way implied what the client MIGHT or OUGHT TO THINK: grossly or subtly. S – Supportive A response which indicates the counselor’s intent is to reassure, to reduce the client’s intensity of feeling, to pacify. He has in some way implied that the client NEED NOT FEEL AS ANXIOUS AS HE DOES. P - Probing A response which indicates the counselor’s intent is to seek further information, provoke further discussion along a certain line, to query. He has in some way implied that the client OUGHT or MIGHT PROFITABLY DEVLEOP OR DISCUSS A POINT FURTHER. U – Understanding A response which indicates the counselor’s intent is to so respond as in effect to ask the client whether the counselor understands correctly what the client is “saying”, how the client is “feeling” about it, how it “strikes” the client, how the client “sees” it.

9. Patient: “I could accept it when this disease cost me my eyesight and to be bedridden, but how can God possibly want me to live in an institution and away from my husband.” Response: Evaluative: You have adjusted to a lot of physical losses and now you need to make another difficult adjustment. Interpretive: Chronis illnesses have a way of forcing one to continually change dreams and expectations. Supportive: You have amazed me with your spiritual strength in accepting so many physical losses. I am pulling for you as you face this crisis. Probing: What do you think helped you with the other challenges you have faced in accepting physical losses? Understanding: Your husband has been so important to you. I would be questioning God as well.

10. Responding to Grief “I can’t stand the fact that people have withdrawn from me since my wife died. Some that I thought were really good friends haven't called once.” Caregiver might say…..

11. Responding to Grief I can’t seem to get over that night and the memory of the policeman coming to the door. The experience was horrible and I can hardly think of anything else. Caregiver might say….

12. Responding to Grief “I feel so bad about the last words I spoke to Jim. We fought over how much he used the car. I wish I had told him I loved him.” A caregiver might say….

13. Specific Circumstances of Death Sudden, Unanticipated Violent, Mutilation, Destructive Random and / or Preventable Multiple Deaths Mourners Personal Encounter with Death Death is Traumatic Higher Risk for Complicated Mourning

14. Capacity to Cope Diminished Assumptive World is Shattered No Sense to Loss No Chance for Good-byes Symptoms Persist Longer Obsessive Thoughts of Death Anxiety Replaces Security and Confidence Last Minute Involvements with Deceased Emphasized More More Tendency to Determine Blame and Affix Responsibility Sometimes More Secondary Losses Post Traumatic Stress Responses Therese Rando Eleven Issues of Traumatic Loss

15. Post Traumatic Stress Visual 58%, Smell 25%, Auditory 18% Mental and Emotional sides separated Very sensitive to stimuli Testing Traumatized person frozen in past

16. THERAPY • Create Safety (They set boundaries) • Ego Building – Strengthen Self • Widen Field of Perception • Relive Trauma • Have Safety Restored (Systematic Desensitization) Goal: Integrate all emotions, thoughts, and actions related to particular event with existing schema

17. Intense fresh grief long after the loss Intense grief triggered by a minor event Holding on to all possessions Radical lifestyle changes A history of depression Self-destructive thoughts and behaviors Physical symptoms or hypochondria Substance abuse Talking about as past loss as if it just happened Inability to talk about or remember the deceased Preoccupation with thoughts of the deceased Talking or acting as if the person were still alive Inability to form new relationships Feelings of helplessness and, or meaninglessness Signs of Complicated Grief

18. Assisting the Grieving Person • Reminisce: Explore meaning of loss in detail • Listen to the stories • Encourage expression of emotions (Validate, Normalize) 4. Give permission to take a break from their grief work 5. Encourage meaningful ritual 6. Gently challenge irrational perceptions 7. Be real and open with your own feelings

19. Assisting the Grieving Person Continued… • Address any prolonged social isolation • Honor physical and spiritual needs • Help complete unfinished business • Do not try to explain loss in philosophical or religious terms • Your challenge is to sit with the suffering not to try and take the pain away • As active grief subsides, help search for new directions

20. Ongoing Connections • Memories • Special dates, Holiday times • Special projects • Communicating from our heart • Spiritual experiences • Customs of loved one • Heritage of loved one’s qualities • Commitment to our own healing

21. Mourning Cloak Butterfly Large butterfly, with a wingspan of up to three and a half inches. It is easy to identify by its markings. No other butterfly looks like this one.

22. “Accepting suffering, disease and loss does not mean taking pleasure in them or hoping that distractions or the passage of time will make us forget them. It means offering our suffering up to God to that God can help bring forth something productive. One does not arrive at this through reasoning, nor is it understood through logic; it is an experience of the grace of God.” Paul Tournier