CHAPTER TWELVE: PERSONAL LOSS:

BEREAVEMENT AND GRIEF

Terms Critical to Understanding Loss

Bereavement (sorrow) Uncomplicated bereavement

Grief (mental anguish) Complicated grief/prolonged grief Traumatic grief Disenfranchised grief (a loss that one is unable to share)

Loss Primary loss (death) Secondary loss (resulting from the death) Ambiguous loss (physically or psychologically missing)

Mourning (social or cultural state or condition expressing grief)

Dynamics of Bereavement

Cultural DynamicsCulture3 patterns of response:

Death accepting Death defying (dreading/avoiding)

Death denying

Sociocultural Mores Spirituality and Religion

Conceptual Approaches to Bereavement

Stage/Phase ModelsKubler-Ross’s Stages (denial, anger, bargaining,

depression, and acceptance)

Assessment Tools

Texas Revised Inventory of Grief (TRIG)Current GriefPast Disruption

Grief Experience Inventory (GEI)Nine clinical scales

Hogan Grief Reaction Checklist (HGRC)Can discriminate variability in the grieving process as a

function of cause of death and time elapsed since death Inventory of Complicated Grief (ICG)

Targets symptoms of grief that are distinct from bereavement-related depression and anxiety, and predicts long-term functional impairments

Types of Loss

Death of a SpouseOne of the most emotionally stressful and disruptive

events in life More widows than widowers

Loss Due to Caregiving

Death of a ChildPerhaps the ultimate loss for a person to endure

regardless of the age of the child

Types of Loss Cont.

Bereavement in Childhood (age related) Bereavement in Adolescence

Value of connectedness Bereavement in the Elderly

Present more somatic problems than psychological problems No indication that the intensity of grief varies significantly with age Grief among older people may be more prolonged than among

younger people Tend to be lonelier and to have far longer periods of loneliness than

younger people

Types of Loss Cont.

HIV/AIDS (anticipatory, complex, page 430) Job Loss Separation and Divorce Death of a Pet Complicated Grief

Traumatic grief

Being There for Grievers

Empathic Presence Gentle Conversation Providing Available Space Eliciting Trust

The Crisis Worker's Own Grief

Emotional investment in the client Bereavement overload Countertransference Emotional replenishment Facing one’s own mortality Sense of power Tendency to rescue