1. 1 Day #4 of 8 What is grief? Roster:Handouts: Please verify your information and put a checkmark next to your name or add your name. Please pick up a copy of today’s handouts. http://www.canyons.edu/faculty/rafterm

2. Grief varies based on the type of loss unexpected vs. anticipated Grief as a response to the loss of control that death represents Five stages of grief D.A.B.D.A. (Elizabeth Kübler-Ross) Four statements to say out loud that will increase acceptance

3. ABC Affect + Behavior + Cognitions (Emotions + Overt Behavior + Cognitions) “If we are fortunate enough to experience love, then we may also know grief.” “Everything is accomplished within the context of relationships.” THREE CENTRAL CONCEPTS:

4. Death represents a profound change in the nature of any relationship – both with others & with self. Many different types of death: PhysicalSocialPsychological Self Marital Familial Work & Play

5. The universal answer: “I won’t.” “How will I ever survive this?” A COMMON QUESTION: “How will I ever survive this?”

6. “I won’t survive.” “…but I will get through this.”

7. Unexpected or off-time loss Expected or on-time loss Do I have any sense of control? Grief – “It depends…”

8. Denial Anger Bargaining Depression Acceptance 5 Stages/Phases of Grief: D.A.B.D.A. Out of Control Relaxed

9. Conscious – “No!” Not true. I want a second opinion. Suppression – I don’t want to think about it right now. Repression – I forgot about it. No change in my thoughts, emotions or behavior. DENIAL

10. Frustration-Aggression I have no control, so I attack those who have control – and are responsible – in my mind. Attack the messenger. Attack God. Why me?! & Why now?! ANGER

11. A futile attempt to exert control. If I can live differently, then I’ll have a different outcome. What if I quit this behavior?! What if I start this behavior?! Eat. Pray. Love. BARGAINING

12. … FOR THE SURVIVOR : Counterfactual Thinking The fact: The person is dead The counterfactual thought: “The person would not be dead, if only…” BARGAINING

13. Counterfactual Thinking

14. 14 Mr. Crane and Mr. Tees were scheduled to leave the airport on different flights, at the same time. They traveled from town to the airport in the same limousine.

15. 15 They were caught in a bad traffic jam, and arrived at the airport 30 minutes after the scheduled departure time of their flights.

16. 16 Mr. Crane is told that his flight left on time, 30 minutes ago. Mr. Tees is told that his flight was delayed, and left just 5 minutes ago. Who is more upset, Mr. Crane or Mr. Tees?"

17. 17 Just missing the flight by a moment increases the counterfactual thoughts of having caught it.

18. All efforts are exhausted or seen to be futile. Still a high level of anxiety but helpless. Prone to anger and bargaining. Withdrawal from contact. DEPRESSION

19. A peaceful acknowledgement of the way things are. Relaxed and not withdrawn. May selectively withdraw from those who are in denial, are angry or still bargaining. May suppress the issue to focus mindfully on effective action. ACCEPTANCE

20. The person may appear to others to be in denial. ACCEPTANCE

21. Four statements to say out loud that help increase acceptance: 1.“I love you.” 2.“I know you love me.” 3.“We will be OK.” 4.“It is OK for you to go.” 21

22. For survivors, if the death occurred after a prolonged illness, then these stages may have been experienced well in advance of the final moment. This is true for divorce, too. D.A.B.D.A. D.A.B.D.A. …and an anticipated loss.

23. Not necessarily a linear process. Each is not necessarily experienced. Once experienced, a stage may be experienced again. One person’s acceptance may trigger another’s anger.D.A.B.D.A.

24. The relationship each of us has with any one human is unique. …and so the love within that relationship is unique, and the grief for the loss of that relationship is unique.D.A.B.D.A.

25. Review one year of your life in terms of Holmes & Rahe’s 43-item Social Readjustment Rating Scale (SRRS) Some “no homework” before our next class: Life Change Event# of times in the one yearX the LCU’s Retirement X 45 Change in health of family member X 44 Pregnancy X 40 Gain of a new family member X 39 Business readjustments X 39

26. 26 The End.