Dr. Dawn-Elise Snipes PhD, LPC-MHSP

Podcast Host: Counselor Toolbox and Happiness Isn’t Brain Surgery

Objectives

~ Define Complicated Grief

~ Examine the impact of CG

~ Identify risk factors for CG

~ Explore tasks for successful grief resolution

Definitions:

~ Loss: Change that includes being without someone or something; physical loss of something tangible like a person, a car, a house, a breast; psychosocial loss of something intangible like a divorce, an illness, a job, a dream, a hope.

~ Bereavement: comes from the same Latin root word as “to have been robbed….” i.e. to have experienced loss.

~ Secondary loss: Other losses as a result of a primary loss. Example, loss of income when bread winner dies.

~ Grief: Reaction or response to loss; includes physical, social, emotional, intellectual and spiritual dimensions.

~ Mourning: Rituals or behaviors associated with grief; i.e. courses of action in response to loss. Rando, Complicated Mourning, p. 22.

~ Symptoms

~ Separation distress involving intrusive, distressing preoccupation with the deceased

~ Traumatic stress reflecting specific ways the person was traumatized by the death

~ Avoidance of reminders

~ Intrusive painful thoughts

~ Emotional numbing

~ Irritability

~ Feelings of hopelessness and purposelessness

~ Shattered self identity

~ Failure to assimilate the loss can create an identity crisis and problems with self-regulation

~ Who am I if I am not John’s wife/Sally’s mother?

~ Who is there to protect me now that both of my parents are gone?

Complicated Grief

~ Complicated grief can be reliably identified by administering the Inventory of Complicated Grief (ICG) more than 6 months after the death of a loved one.

What exactly are we talking about?

~ There is significant overlap between grief and trauma

~ In one study, 53% of participants had significant elevations in trauma symptoms

~ Losing a therapist or discharge could trigger past CG reactions

~ The first and most pressing question in a crisis is: What just happened?

~ Immediately following is the question: How can I manage right now?

~ Finally, the larger questions of grief and meaning are formulated.

Grief Takes Time

~ Whole first year is one loss after another

~ Beware of special occasions and holidays all year

~ Uncomplicated mourning is normally 2-3 years

~ Complicated mourning may be a 5-7 year process.

~ Grief continues for a lifetime through major life milestones.

Grief impacts us holistically…

Physical responses:

~ Appetite (eating) disturbances

~ Energy, fatigue, lethargy

~ Sleep disturbance

~ Cold (especially for children)

~ Anxiety (sweating, trembling, etc.)

~ Gastrointestinal disturbance

~ Compromised immune response; increased illness

~ Confusion; “What is real?”

~ Difficulty concentrating; ex. Read the same page several times

~ Short attention span; ex. Can’t finish a 30 minute TV program

~ Difficulty learning new material; short term memory loss; ex. Income taxes

~ Difficulty making decisions

~ Lack of a sense of purpose

~ Inability to find meaning in the events and life itself

~ Withdrawal

~ Isolation

~ Searching

~ Avoidance

~ Irritability

~ Self absorption

~ Clinging/dependence

Emotional…

~ Angry

~ Depressed

~ Sad

~ Crying

~ Irritable

~ Afraid

~ Can’t go on

~ Death anxiety

~ Lonely

~ Relieved/Guilty/Regretful

Spiritual beliefs are challenged…

~ The question “Why” reverberates

~ Where was God?

~ If God is all powerful, why allow this?

~ If God loves me,