Grief And Bereavement: Understanding Reaction And Adaptation To Loss

Life Satisfaction and Affect in an Australian National Sample

Question:

Discuss about the Applied Counseling for Stability of Happiness.

As stated by Parkes et al. (2105), “Bereavement” caused on the occasion of a spouse death has been regarded as one of the most significant and stressful events of life. Grief is linked with feelings of sadness. Prolonged grief if exist for more than six months, might result in the psychological phenomenon which includes the searching for the deceased, preoccupation, yearning, disbelief about the loss, hallucination, survivor guilt, and bitterness. Emotions are often astonishing in their strengths, and these emotions often can be confusing especially in situations when a close person is being missed. The act of grieve varies from person to person. Some people recover from grief within few months, though this period of recovery might involve moments of sadness. Others may take a long time to get relief which might be temporary. During this period of stress and depression family support plays a vital role. When such grief related feelings and thoughts are extreme or distressing, it becomes important to concern with qualified “mental health professionals” who could provide the remedies to get relief. Certain counseling intervention strategies have shown to produce positive results.  Communication, assessment of the problem and clinical therapies could be a successful way of bringing about the change in the behavior and emotional status of the deceased’s spouse (Parkes & Prigerson, 2013).

Spousal mourning is a problem that commonly affects the women since women are generally younger than their husband, and they have more longevity. Moreover, their marriage rate is also lower than that of the widowers. As stated by Carr et al. (2014), a window experiences the feeling of loneliness, loss of camaraderie, need of physical attachment, comfort and also the support of a partner. In the case of dependent women, loss of her spouse might result in a decrease in financial income and also a scarcity of various requirements. In order to meet the needs, she might have to relocate to a different place which might lead to a relocation trauma. The most significant issue is that after a particular duration the family support fades out, relatives and friends instead of consoling the person observe the widowhood as a component of a stigma. Thus, without minimal support, it becomes hard to grow the children. Studies reveal that grieve is more prolonged in old age spouse due to the living together for a long time (Carr et al., 2014).

According to Parkes et al. (2015), a complementary factor other than social and psychological distress, bereavement constitutes chronic physical health deterioration and also causes survival risk. A study constituted on windows under the age of sixty-five revealed that during the first year of their widowhood consulted health physicians very frequently. Moreover, it was also noticed that they have more number of sedatives than the expected number of use, and they were observed more in bed and hospitals than non-widowed females (Schulz et al., 2015).

According to Schulz et al. (2015), the various phases of grief involve shock and numbness leading to yearning, weeping due to depression. The third phase involves attaining equilibrium to help life to achieve comfort. The fourth phase or the final stage involves identity reconstruction where an individual develops a new role in life or crystallization of fresh relationships. Identification of these phases is very important in order to undergo the diagnosis process (Schulz et al., 2015).

Lessons from the Hedonic Adaptation Prevention Model

As stated by Svenaeus (2014), aged people who suffer due to the loss of their spouse after living throughout the life with happiness, chronic and fatal illness of the spouse was reported to have “poor post bereavement medical adjustment.”   The grief is suppressed or delayed. As discussed by Asai et al. (2013), family members are a great support this point of time, especially when the family is close-knit. Outside support is not required. However, when families split, that support remains empty. In this case, the grief is suppressed and indicates a poor prognosis. Certain factors that operate to delay the grief are: (a) the loss might be socially stigmatized. (b) If there remains an uncertainty in the death like missing soldiers. (c) A grieving person whether it is a widow or widower becomes concern about their health or concerned about growing the children well. (d) Multiple losses might have made the grieving difficult. (e) Trivial factors such as overcrowded cemetery might inhibit grief (Yu et al., 2015).

Several types of research using “DSM – III” termed the diagnosis as “Uncomplicated Bereavement.” All the current researches reveal that there are comparable differences that exist between the normal and abnormal reactions. “As stated by Dayringer (2013), there are few proposed diagnoses for Complicated Bereavement disorder in the DSM – V.” There were four criterions that involve the abnormality in the client. The first criteria was yearning, the second criteria involved the experience of any four of the eight symptoms such as anger, trouble to accept the truth, excessive bitterness, inability to trust others, feeling uneasy to live life, feeling numbness due to emotions, feeling emptiness, feeling agitated and feeling future is meaningless (Svenaeus, 2014).

According to “Diagnostic and Statistical Manual of Mental Disorders,” bereavement diagnosis is associated with the death of a close person. This is the main key to the diagnosis, but other factors need to be given importance as well. According to Cameron & Green (2015), “Bereavement” is the only diagnosis that might lead to the delay of the “Major Depression Disorder.” “There are symptoms associated with this particular state which is characterized by feeling of loneliness, sadness, loss of interest in various activities, change in the weight, appetite and significantly insomnia. If the individual experience symptoms of guilt, preoccupation, feeling of worthlessness, suicidal thoughts, psychomotor retardation, hallucination, etc. then these relate to Major Depression Episode as contrasting to bereavement “(DSM-5 American Psychiatric Association. 2013).”

According to Gillies et al. (2014), “in assessing such a condition, more informal and less structured approach is generally used. Researchers and scientists have outlined different models on the phases of grief and bereavement. The first model was developed by Kubler-Ross which was used to illustrate the process of grief after the death of near ones. The developers of this model noted that every individual experience at least any two of the five stages of grief. Some people might revisit the phases over and over again.” A stage-based model known as “The Four Tasks of Mourning” was created by psychologist “J.W.Worden” for coping with the death of a close person. “The four task involved in this model were to accept the truth, to work through the grief, to adjust to life without the presence of the deceased and lastly, to maintain a connection with the person lost throughout the life (Wade et al., 2016).”

Mental Health Among the Bereaved Spouses of Cancer Patients

“Margaret Stroebe and Hank Schut” developed a “dual process model” of bereavement. They noted two tasks were associated with the loss. Firstly, “Loss-oriented activities and stressors” which are related directly to the death and secondly, “Restoration-oriented activities and stressors” relates to the secondary losses such as routine, lifestyle and relationships (Klass et al., 2014).

As discussed by Holland et al. (2013), the “Diagnostic and Statistical Manual do not define bereavement as a disorder rather a preexisting condition like depression, or repercussions linked with the trauma of a death of a closed one. These components can complicate the condition of bereavement.” As discussed by Litz et al. (2014), the difference between grief and depression is that depression is characterized in general terms of despair or lack of joy, while the feeling of grief is related to the loss or death. Presently several instruments have been designed used to evaluate bereavement. But no instrument has been developed yet to constantly monitor the phases of bereavement and the symptoms associated with it. The choice of instruments varies depending upon the population. “It is specific for every population such as the death of children, parents, spouses, and other loved ones (Cameron & Green, 2015).”

According to Litz et al. (2014), “the majority of the individuals are apparent as experiencing “normal” grief. It is very natural for a person to be depressed and it requires a short or long period to get adjusted or overcome the situation of grief.” “Certain researchers are recently focusing on the adaptive functioning so that they can understand the process how to protect individuals who are continuously experiencing maladaptive functioning has grown an interest in resilience and how the affected individuals function normally after a negative experience in life.” “According to psychology Resilience can be defined as the sense of recovery despite an encounter with the adverse situation in the life. Coping strategies differ completely from resilience since resilience relates to adaptation to certain adversities (Klass et al., 2014). “

Anusic & Lucas (2014), “Reconstruction model” on the fact that “bereaved individuals are faced with the task of reconstructing their understanding of how the world works and their personal identity without the presence of the loved one. As discussed by Gerson (2013), there are three core dimensions to the process of meaning reconstruction. The first dimension is sense-making, or the ability to find an explanation for the death and make sense of the occurrence.” This is predominantly important untimely in the grieving course, although it is a continuing procedure for the majority individuals. “The second aspect is benefited finding, where individuals can identify benefits to the bereavement in order to aid in their adjustment, whether the benefits are personal, spiritual, or philosophical.” “The last dimension is individuality reconstruction, which needs the bereaved individual to modify and adjust their intellect of personality after experiencing the loss of a near one (Klass et al., 2014).”

“Maximum research on “adaptation to widowhood” in later years has focused on a female since women inclined to live longer than their spouses. According to Tomer et al. (2013), both men and women who are widowed in later life account inferior life satisfaction and well-being than those who stay married, and widowhood is a risk factor for fading, while being wedded is not. Most result research with bereaved older persons has utilized formless group interventions, often led by friends or paraprofessionals, with achievement reported in dropping depression and mounting thoughts of support.” For example, in a study, it was discussed a nationalized program to assist recently widowed individuals that use “skilled paraprofessional counselors” for outreach and hold. “Follow-up questionnaires” finished by sixty two participants who attempted “bimonthly talk groups” exposed that most consideration that the crowd experience was positive (Anusic et al., 2014).

Clinical Wisdom: The Therapist as a Person Managing Life Crises

“Aging is a part of the life span rather than being apart from the life span. All persons who age experience common life transitions and developmental challenges, notably the search for ego integrity identified by (Armenta et al., 2014). The design of interventions to help older persons cope with these normative changes has focused on two primary and overlapping strategies: group counseling and life review therapy. Research on both options reveals almost universal support for their effectiveness in helping older persons to develop successful coping mechanisms for a variety of life problems and also to achieve life satisfaction despite the unwanted change.” “After completing their education and formal training, psychiatrists may not be fully prepared to handle some of the most common clinical challenges they will face in practice. Diagnosing and treating complicated grief and bereavement-related major depression will undoubtedly rank high on the list of such challenges. Both conditions overlap with symptoms found in ordinary, uncomplicated grief, and often are written off as normal with the assumption that time, the strength of character and the natural support system will heal.  This prolonged, complicated grief response tends to be chronic and persistent in the absence of targeted interventions, and may be life threatening. Complicated grief usually responds well to a specific psychotherapy, perhaps best when administered in combination with antidepressant medication” (Armenta et al., 2014).

Conclusion:

Grief is linked with feelings of sadness. Prolonged grief if exist for more than six months, might result in the psychological phenomenon which includes the searching for the deceased, preoccupation, yearning, disbelief about the loss, hallucination, survivor guilt, and bitterness.  “During this period of stress and depression family support plays a vital role. When such grief related feelings and thoughts are extreme or distressing, it becomes important to concern with qualified “mental health professionals” who could provide the remedies to get relief. Certain counseling intervention strategies have shown to produce positive results. “It is essential for them to recognize their own vulnerabilities to the personal assaults that often accompany such losses, not only for their own mental health and well-being, but also to provide the most sensitive and enlightened care to their patients.” The “Diagnostic and Statistical Manual” do not define bereavement as a disorder rather a preexisting condition like depression, or repercussions linked with the trauma of a death of a closed one. “Resilience” can be defined as the sense of recovery despite an encounter with the adverse situation in the life. “Reconstruction model on the fact that “bereaved individuals are faced with the task of reconstructing their understanding of how the world works and their personal identity without the presence of the loved one. Most result research with “bereaved older persons” has utilized the formless “group interventions,” often led by friends or paraprofessionals, with achievement reported in dropping depression and mounting thoughts of support.” Thus, it can be concluded that although mourning over the death of one’s spouse or grieve can have detrimental effects on physical and mental health, so needs to be counseled and treated.

Constructs of Continuing Bonds, Meaning of Loss, and Studies of Grief Across Cultures

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