Grief And Bereavement Tasks Of Mourning †Myassignmenthelp.Com

Question: Discuss About The Grief And Bereavement Palliative Care Practice? Answer: Introducation Grief is said to be a normal reaction to bereavement. From this statement questions like what exactly is grief and what is bereavement may arise. Bereavement is defined to be the losing of someone closely attached to you and is characterized by feelings of loneliness, emptiness, frustration, deprivation, yearning and longing(Sabar, 2000). Grief on the other hand is the subjective experience of loss. It is multifaceted as it can affect us on all levels of experience i.e. physically, emotionally, cognitively, socially and spiritually(Sabar, 2000). Another term that is always used in association with grief and bereavement is mourning which is defined as socially, culturally and religiously accepted expressions of grief (Sabar, 2000). The manner in which one grieves, the duration taken in the grieving process differs from one individual to another. This is typical situation that reflects the one shoe doesnt fit all philosophy. Theories like Wordens four tasks of morning, the dual process model by Stroebe Schutt, Parkes four phases of mourning model seek to explain grief, bereavement and mourning. We shall focus on Wordens four task of mourning as we seek to better explain and understand the grieving process and factors that affect this process. Worden Four Tasks of Mourning Other theorists like to view the grieving process in forms of stages and phases but not Worden. He prefers to view it as a series of tasks(Morrell, n.d). This means that the bereaved has to be active as adaptation cannot just happen but requires effort. Accounting to Worden, grief is a back and forth process involving overlapping tasks that one has to work through the physical, emotional and pain of their loss while adopting to changes that come with the loss such as roles, responsibilities and identity(Webster, n.d). The grieving process is considered complete when the bereaved person gone through the four tasks and has accepted the loss and adjusted to the new life brought about by the loss(Miller, 2014). To Accept the Reality of the Loss The first task in this process is to come face to face with the reality that the person is dead. This is one of the hardest tasks to accomplish as it involves in lay mans tongue accepting in your mind and in your heart i.e. intellectual and emotional acceptance (Worden, 2009). There are three forms of acceptance that need to take place for the successful completion of this task. They include; the acceptance the facts revolving the loss, the meaning attributed to the loss and the finality of the loss(Almeida, 2004). One needs to accept the fact that death has occurred, what the loss means to him/her in terms of responsibilities, roles even situation at home and in the society and that the deceased is gone and not coming back. It has been found that traditional rituals such as the funeral help many bereaved people move toward acceptance(Worden, 2009). The negative reaction that happens here is that one does not believe simply put being in denial. This is very common as death is usually first faced with shock and disbelief. Denial takes place in many forms. First it can occur in the form of denying the facts of the loss which varies in degree. It can be a minor distortion or a complete and advanced delusion(Worden, 2009). An example of full blown delusions was coined by Geoffrey Gorer which is mummification, a grief reaction in which the bereaved retains the deceaseds possessions and belongings and in extreme cases his/her corpse in an unchanging condition ready for use when the deceased returns(Leung So, 2013). This is very common for parents who a child as they usually retain the childs room without moving a thing or reorganizing. Another form of denial is to deny the meaning of the loss. This has been seen by actions that remove any reminders of the deceased in the aim of reducing the significance of the loss. This has been done in various ways like throwing away of belongings of the deceased, making statements that disregard the attachment or relationship with the deceased and in extreme cases, practicing selective forgetting whereby the image of the deceased disappears from consciousness(Parkes Prigerson, 2010). This behavior is commonly seen in cases of conflicting relationships between the bereaved and the deceased. Denial in the irreversibility of death is the other form of denial. This has been evidenced by people out rightly denying finality of death and through religion spiritualism(Worden, 2009). People participate in sances and attending of spiritualist churches so as to seek a form of communication or bond with the deceased. Overall, denial is very common in sudden deaths like accidents, fire outbreak, suicide, homicide etc. especially where the bereaved were not able to view the body of the deceased To Process the Pain of Grief This task involves opening oneself to experience the deep and intense feelings and thoughts that accompany a loss(Sabar, 2000). The pain experienced can be physical, emotional and behavioral. The physical reactions experienced include: tiredness, increased noise sensitivity, appetite gain or loss, headaches, neck and shoulder pain, increase in colds, infections and allergic reactions, chest tightness, bowel and bladder disturbances, stomach bloating, ulcers, and nausea. Females can experience menstrual irregularities(Rubel, 2004). Emotional reactions experienced include shock, numbness, sadness, fear, anxiety, loneliness, aggression, yearning, withdrawal, guilt, self reproach, fatigue, helplessness, emancipation and relief. Anger and rage can be directed at healthcare providers, the deceased, God, and themselves(Rubel, 2004). This should be noted as it can lead to them hurting others or engaging in self mutilating behaviors so as to relieve the pain. Thought process alterations or cognitive changes that occur include disorientation, confusion and an inability to concentrate(Rubel, 2004). Other common thought patterns include; preoccupation, disbelief, hallucination and sense of presence(Worden, 2009). Behavioral reactions are not uncommon in grieving individuals. Some of the common behaviors seen include insomnia or hypersomnia, loss or gain of appetite, absentmindedness, social withdrawal and isolation, dreaming of the deceased, avoidance behavior, sighing, increased hyperactivity and crying(Worden, 2009). Aggressive behavior, hoarding, increased drug use, increased sexual activity may also be seen(Rubel, 2004). The intensity and duration of the pain experience varies from one individual to another. This difference in feeling is mediated by a number of factors. These factors include; the person that died, type of attachment, manner of death, personality characteristics, social factors and concurrent stressors(Worden, 2009). The way one mourns for a child is not the same way one would mourn for a spouse or a mother. The way one mourns those who they had close attachment is found to be more intense and for a longer duration. The negation of this task is not feeling and it is demonstrated by cutting off feelings and denial of the pain one is experiencing, avoidance of painful thoughts, thought-stopping procedures, stimulating pleasant thoughts of the deceased and not hurtful, idealizing the dead, avoidance of reminders of the dead, and drugs and alcohol use. The consequence of this negation is usually depression. Due to this, this is a very important aspect that is considered during grief counseling. Adjusting to a World without the Deceased According to Worden, 2009 the three areas that need adjustment during the grieving process include the external, internal and spiritual adjustments. External Adjustments This involves coming to terms to an environment without the loved one. Adjusting to an environment without the loved one means different things to different people(Worden, 2009). Many bereaved individuals have to learn new skills in order to take on the roles performed by the deceased. For this to happen successfully, one to needs to challenge their beliefs by deriving meaning of the loss. What one thought he/ she could not accomplish, now he/she has to believe he/ she can. A wife who used to believe that she didnt have the strength to mow the lawns may challenge this belief after the death of the husband as she cannot delegate to him. Internal Adjustments Loss of loved one affects ones self definition, self esteem and self efficacy. People who derive their identification and self worth from relationships and marriages have lowered self esteem and decreased sense of the self when their loved one dies. This is the case especially for people who had rough backgrounds then found someone who makes them feel wanted, cherished and loved. When that person dies, the bereaved feels like there is no one who would love them like the deceased did. Bereavement can also affect a persons sense of self-efficacy(Worden, 2009). This can lead to feelings of helplessness, inadequacy and hopelessness. This worsens when one fails in taking on the responsibilities that used to be carried out by the deceased. This makes them feel like failures and lowers their self esteem further. Spiritual Adjustments Through death ones values and beliefs are always challenged or reinforced depending on the situation (Worden, 2009). Usually due to this challenge on ones beliefs and values, the bereaved feel like they have lost direction in life. They go through a journey to try and rediscover the meaning of the loss and the life changes in order to be able to control their lives again. As it was said earlier death can also reinforce or confirm our beliefs and assumptions. The death of an elderly person who had a well lived life is an example of this. The negation of this task is failure to adapt to the loss. You may find people who promote their inadequacy and helplessness by not developing the skills needed for the new responsibilities or withdrawing from the world and not facing up to the new requirements(Worden, 2009). To Find an Enduring Connection with the Deceased in the Midst of Embarking on a New Life This task includes finding an adaptive and ongoing connection in our lives with the deceased while allowing ourselves to reinvest our energies into new relationships(Perper, 2015). People believe that one needs to forget the deceased in order for them to move on with their lives. This tasks encourages us not to forget the deceased but reconnect and enjoy life by engaging in activities that give you pleasure while cherishing the memories and remembering the thoughts and feelings experienced with the loved one(Kelly Lees-Oakes, n.d). According to Worden, the negative aspect of this task is not living. This happens when one holds on too much to the past attachments are refuses to form new ones. They forget that life did not stop moving when their loved one died. Wordens four tasks of mourning have had great impact in the counseling and psychotherapy world as it has formed basis for many techniques and objectives for grief counseling and grief therapy. One thing that is clear is that the negation of the four tasks can facilitate the development of complicated grief. Through the four tasks of mourning, techniques that help one to accept the reality, evoke ones emotions and allow them to feel, that promote adjustment and facilitate reconnection and continuing bonds are found to be very crucial. These techniques include writing, use of evocative language, role playing, cognitive restructuring and directed imagery among others. Conclusion Wordens four tasks theory of mourning brought a new way to view the grieving process as it did not believe on the steps or phases model but tasks which have to be complicated not on a linear basis as believed by the previous theories. These tasks are important for one to go through the grieving process adaptively and successfully. This theory has had great impact as it not only helped us understand the grieving process but also informs grief counseling and grief therapy through streamlining the goals and the techniques so as to help the bereaved to fully adapt to the loss. References Almeida, R. (2004). The Politics of Mourning: Grief Management in Cross-cultural Fiction. New Jersey: Fairleigh Dickinson Univ Press. Kelly, K., Lees-Oakes, R. (n.d). The 4 Tasks of Grieving. Retrieved from Counseling Tutor: https://counsellingtutor.com/the-4-tasks-of-grieving/ Leung, C. M., So, J. (2013). Mummification in a Chinese Patient with Grief: A Morbid Symptom or a Cultural Practice? East Asian Archives of Psychiatry, 23(4), 164-167. Miller, K. E. (2014). Review of Grief Counseling and Grief Therapy by J. William Worden. Retrieved from Kirk Miller Blog: https://kirkmillerblog.com/2015/01/26/review-of-grief-counseling-and-grief-therapy-by-j-william-worden/amp/ Morrell, L. (n.d). Tasks of Grief. Retrieved from Linda Morrell: https://www.lindamorrell.com/?page_id=179 Parkes, C. M., Prigerson, H. G. (2010). Bereavement: Studies of Grief in Adult Life (4th ed.). New York: Routledge. Perper, R. (2015). Worden's Four Tasks of Grieving. Retrieved from Therapy Changes: https://therapychanges.com/blog/2015/05/review-wordens-four-tasks-of-grieving Rubel, B. (2004). Death, Dying, and Bereavement: Providing Compassion During a Time of Need. Massachusetts: Western Schools. Sabar, S. (2000). Bereavement, Grief, and Mourning:A Gestalt Perspective. Gestalt Review, 152-168. Webster, B. (n.d). Theories of Grief. Retrieved from Grief Journeu: https://griefjourney.com/startjourney/for-professionals-and-caregivers/articles-forprofessionals-and-caregivers/theories-of-grief/ Worden, W. J. (2009). Grief Counseling and Grief Therapy A Handbook for the Mental Health Practitioner (4th ed.). New York: Springer Publishing Company.