1. Normal Grief Reactions

2. Grief Page 96 (PAD & D) “an emotion or set of emotions due to a loss”
Grief is a normal reaction to loss.
The absence of grief is abnormal in most cases.
Grief is based on the individual perceptions of the loss by the griever.

3. Mourning
“an adjustment process which involves grief or sorrow over a period of time and helps in the reorganization of the life of an individual following a loss or death or someone loved”
Mourning is the process of adjustment and adaptation to the loss.
Mourning is driven by the social and cultural influences to which the griever is exposed.

4. Characteristics of Grief
Page 97 (PAD & D)
Lindemann:
Somatic (bodily distress)
Preoccupation with the image of the deceased.
Guilt
Hostile reactions.
Loss of patterns of conduct (inability to function as before the loss)

5. Determinants of Grief How the bereaved perceives the loss.
The bereaved’s age.
The age of the person who died.
The degree to which the bereaved was prepared for the death.
The bereaved’s inner strength and outer resources.
The nature of the relationship with the person who died.

6. Worden’s Grief Characteristics
Feelings
Physical sensations
Cognitions
Behaviors

7. Worden’s Tasks of Mourning
Page 99 (PAD & D)
Accept the reality of the loss.
Experience the pain of grief.
Adjust to an environment in which the deceased is missing.
Withdraw emotional energy and reinvest in another relationship.

8. Psychological Factors Influencing Grief
Page 108 (PAD & D)
Raphael:
The preexisting relationship between the bereaved and the deceased.
The type of death.
Previous losses.

9. Rando’s Psychological Factors
Page 110 (PAD & D)
Meaning of the loss.
Qualities of the relationship.
Roles of the deceased.
Age of the griever.
Griever’s sex-role conditioning.
Deceased’s unique characteristics
Griever’s mental state
Griever’s maturity and intelligence.
Previous experience with loss.

10. Rando’s Psychological Factors (cont’d)
Cultural elements affecting the griever.
Fulfillment of the deceased’s life.
Context of the death.
Preventability of the death.
Timeliness of the death.
Expectation of death.
Length of illness.
Involvement with dying person.
Secondary losses.
Additional stressors.

11. Rando’s Sociological Factors
Page 118 (PAD & D)
Available support systems.
Cultural background and context.
Socioeconomic status.
Funerary rituals.

12. Physiological Factors
Page 120 (PAD & D)
Drugs and sedatives.
Nutrition.
Rest and sleep.
Exercise
Overall physical condition.

13. Theories of Grief Page 123 (PAD & D) Freud: psychoanalytic
Lindemann: physical
Bowlby: relational
Parkes: clinical

14. Freud
Page 124 (PAD & D)
“grief is a process by which libido (energy) is withdrawn from a love object
The grief process absorbs the energies of the ego.
Grief is normal, appropriate and necessary.
Grief is painful.

15. Lindemann “Grief Syndrome” Physical expressions of grief:
Somatic or bodily distress.
Preoccupation with the image of the deceased.
Guilt.
Hostile reactions.
Inability to function as one had before the loss.

16. Bowlby Page 126 (PAD & D) “Attachment Theory”: 4 aspects
Strength of attachment.
Security of attachment.
Reliance.
Involvement.

17. Parkes Page 127 (PAD & D) Clinical viewpoint
Describes the experience of grief as a normal reaction to overwhelming loss.
Describes somatic distress as “pangs”.
Resistance to change and a reluctance to give up possessions, people, status and expectations are the basis of grief.