1. Presented by Deirdre Anderson, LCSW The Solutions Group EAP
Grief and Loss
Presented by
Deirdre Anderson, LCSW
The Solutions Group EAP

2. Death- a Major Loss Spouse Sibling
Child- can be a child or adult child
Parent
Close Friend
Co-worker or supervisor
The type of relationship and closeness factor into the grieving process as well as circumstances of the death

3. Other Types of Loss These changes are also grieving events: Moving
Major Health changes
Retirement
Legal problems
Empty Nest
Financial changes- positive or negative
Death of pet

4. Stages of Grief
People often think of the stages as lasting weeks or months. They forget that the stages are responses to feelings that can last for minutes or hours as we flip in and out of one and then another. We do not enter and leave each individual stage in a linear fashion. We may feel one, then another and back again to the first one.

5. 5 stages of grief
Denial
Anger
Bargaining
Depression
Acceptance

6. Stages of Grief
grief
denial
anger
bargaining
depression
acceptance

7. Denial A state of shock and denial, numbness.
Helps us to survive the loss. Nature’s way of letting in only as much as we can handle.
World feels meaningless and overwhelming.
Denial helps us to pace our feelings of grief.

8. Anger a necessary stage of the healing process
can extend not only to your friends, the doctors, your family, yourself and your loved one who died, but also to God. You may ask, "Where is God in this?
anger is the emotion we are most used to managing and is less painful to feel than sadness.
underneath anger is pain.
gives temporary structure to the nothingness of loss.

9. Bargaining “What if” and “if only……” Efforts to make sense of the loss
Looking at the particulars of the loss may help to bring out hidden feelings that could otherwise be overlooked
We remain in the past, trying to negotiate our way out of the hurt.
Guilt, remorse can be a feature here

10. Depression
empty feelings present themselves, feeling lost, without purpose
feels as though it will last forever.
this depression is the appropriate response to a great loss.
withdraw from life, left in a fog of intense sadness, wondering, perhaps, if there is any point in going on alone? Why go on at all?

11. Depression after a loss is too often seen as unnatural: a state to be fixed, something to snap out of. The first question to ask yourself is whether or not the situation you're in is actually depressing.
The loss of a loved one is a very depressing situation, and depression is a normal and appropriate response. To not experience depression after a loved one dies would be unusual.

12. Grief vs. Depression
Depression and grief can look the same as they have some similar characteristics such as lowered state of feeling or energy. This is normal part of grieving.
Clinical depression involves “ vegetative signs” such as diminished sleep and poor appetite as well as low energy and motivation.
Grief can cause sleep disturbance as well, especially complicated grief
One question to ask yourself: can you function? Get through the day? Some days will be difficult depending on the loss, but not everyday…

13. Acceptance
Often confused with the notion of being “all right” or “OK” with what has happened. It is not synonymous with “ approval”
Accepting the reality that our loved one is physically gone and recognizing that this new reality is the permanent reality.
Live now in a world where our loved one is missing.
Learn to reorganize roles, re-assign them to others or take them on ourselves. Finding acceptance may be just having more good days than bad ones.

14. Tasks of Grief Experience the emotions of grief
Adjusting to an environment in which the deceased is missing, or the loss is real.
Restoration- restoring enthusiasm and creating plans for the future
Finding a way to think about the loss without evoking intense feelings of anxiety, anger or guilt.

15. The authors of “The Grief Recovery Handbook” define recovery as:
Finding new meaning for living without the fear of future abandonment.
Enjoying fond memories without having them precipitate painful feelings of loss, guilt, regret, or remorse.
Acknowledging that it is perfectly all right to feel bad from time to time and to talk about those feelings no matter how those around you react.
Forgiving others when they say or do things that you know are based on their lack of knowledge about grief.
Realizing that your ability to talk about the loss you experienced is in fact helping another person get through his or her loss.

16. Anticipatory grief the “beginning of the end” in our minds.
May operate in two worlds; the safe world that we are used to and the unsafe world where a loss might occur.
feel the unconscious need to prepare our psyche.
may or may not make the grieving process easier.
- may experience all fives stages of loss (denial, anger, bargaining, depression and acceptance) before the actual death.

17. When grief doesn’t heal
Conflicted grief occurs when your relationship with the deceased was ambivalent (you had both love and hate for the person). Initially, the bereaved person may not show a lot of pain, but later can feel a great deal of sadness and guilt about the hate part of the relationship.

18. Complicated Grief Grief that is unusually severe and prolonged
It impairs function
Affects 2-3% of the population worldwide
More common when the loss is the loss of a child or the death is sudden or violent
Associated with other health problems such as sleep disturbance, suicidal thoughts, substance abuse, impairment in immune function.

19. Delayed grief
Delayed grief is fairly common, because there are many reasons grief might be delayed. People will delay their grief for purposes of survival. Fore example, mothers may put their grief process on hold in order to protect and care for their children.

20. Coping skills Self-care (Exercise, good nutrition) Shrine
Journal, Letter writing
Social Support
Counseling
Distress tolerance skills
Behavioral activation:
( Posistive, pleasants events)

21. Anniversaries/ Holidays
When grieving you may not feel the celebratory qualities of holidays.
Holidays can magnify feelings of loss. The contrast between how you’re feeling and general holiday moods may hurt.
Need for support may be the greatest during the holidays.
Pretending doesn't help. Rather then avoiding the feelings of grief, acknowledge them. Remember your grief is the best memorial to your loved one.

22. Tips to deal with Anniversaries/Holidays
Light a candle
Say a prayer
Donate time or money in your loved one’s name.
Do something you loved to do together on that day.
Have a Plan A/Plan B - Plan A is you go to the Thanksgiving, Christmas day or Christmas Eve dinner with family and friends. If it doesn't feel right have your plane B ready. Plan B may be a movie you both like or a photo album to look through or a special place you went to together. Many people find that when they have plan B in place, just knowing it is there is enough.

23. Tips to deal with Holidays cont.
Cancel the holiday all together. Yes, you can cancel the holiday. If you are going through the motions and feeling nothing, cancel them. Take a year off. They will come around again.
Don’t pretend the loss didn’t happen. Give the loss a place. Have everyone share a story about the lost loved one at the dinner table. It doesn’t have to be a sad story. It can be a funny story of a loved one.

24. Impact of grief on co-workers
They may feel:
so much discomfort of saying the wrong thing that they become immobilized
a desire to avoid the bereaved coworker because he or she represents their own worst fears actually happening
empathy and sadness for their bereaved coworker, especially if they are close and have a bird’s eye view of their colleague’s suffering
an intense and sometimes disturbing re-triggering of their own losses

25. Best Things to say to someone in Grief
I am so sorry for your loss.
I wish I had the right words, just know I care.
I don't know how you feel, but I am here If can help in anyway.
You and your loved one will be in my thoughts and prayers.
My favorite memory of your loved one is...
I am always just a phone call away
Give a hug instead of saying something
We all need help at times like this, I am here for you
I am usually up early or late, if you need anything
Saying nothing, just be with the person

26. Worst Things to say someone in Grief
At least she lived a long life, many people die young
He is in a better place
She brought this on herself
There is a reason for everything
Aren't you over him yet, he has been dead for a while now
You can have another child still
She was such a good person God wanted her to be with him
I know how you feel
She did what she came here to do and it was her time to go
Be strong

27. Traits
Traits of the worst ones want to fix the loss discomfort around grief directive in nature rationalize or try to explain loss may be judgmental may minimize the loss put a time line on grief
Traits of the Best ones supportive, but not trying to fix about feelings
not telling anyone what to do admitting can't make it better not asking for something or someone to change feelings validate loss not time limited

28. Final Thoughts “ Grief can be a garden of compassion
Final Thoughts “ Grief can be a garden of compassion. If you keep your heart open through everything, your pain can become your greatest ally in your life’s search for love and wisdom.” Rumi “Grief does not change you, it reveals you”. John Greene from “ The Fault in Our Stars”.