• It is a normal response of an individual to the loss of a loved object.
Theories of grief
I. According to Kubler Ross
Stage I: Denial:
• In this stage the individual does not acknowledge that the loss has occurred.
• He or she may say, “No, it can’t be true!” or “It’s just not possible.”
• May protect the individual against the psychological pain of reality.
Stage II: Anger
• Sadness, guilt, shame, helplessness, and hopelessness.
• Self-blame or blaming of others leading to anger.
• The anxiety level may be elevated,
• Confusion and a decreased ability to function independently.
• Preoccupied with an idealized image of what has been lost.
Stage III: Bargaining
• The individual attempts to strike a bargain with God for a second chance, or for more time.
• The person acknowledges the loss, or impending loss, but holds out hope for additional alternatives
Stage IV: Depression
• Mourns for that which has been or will be lost.
• Individual must confront feelings associated with having lost.
Stage V: Acceptance
• Worked through the behaviors associated with the other stages
• Accepts or has become resigned to the loss.
• Anxiety decreases, and methods for coping with the loss have been established.
II. According to John Bowlby
Stage I: Numbness or Protest
This stage is characterized
• A feeling of shock
• A disbelief that the loss has occurred.
• The reality of the loss is not acknowledged.
Stage II: Disequilibrium
• Desire to recover what has been lost.
• A preoccupation with the loss
• Intense weeping and expressions of anger toward the self and others
• Feelings of ambivalence and guilt associated with the loss.
Stage III: Disorganization and Despair
• Despair occur in response to the realization that the loss has occurred.
• Activities of daily living become disorganized
• Restlessness and aimlessness
Stage IV: Reorganization
• The individual accepts the loss.
• New goals and patterns of organization are established.
• The individual begins new relationships
• A readiness to move forward by accepting the loss
Techniques used in grief counseling
• Cognitive restructuring- By this technique person’s irrational thought related to grief is being clarified and thoughts are being restructured.
• Expressive writing- This method uses the writing skill of the patient in releasing his feeling towards the grief process. Person freely writes about the incidences and feelings associated with it.
• Role playing- Helps in recreating the situation and makes the person to accept the reality and to choose adaptive coping to the situation.
• Memory book- In this the person writes down all the events in a book and recollects the events. Later person analyses the situation and finds out the better way to resolve the emotions associated with it.
Maladaptive responses to grief
• Prolonged response-Intense pre occupation with the loss for many years after loss.
• Delayed or inhibited-During delayed response person will become stagnated in the denial stage of grief response. This will result in not accepting the reality that loss had occurred.
• Distorted- In this person gets fixed up in the anger stage which may be turned towards self. All the emotions experienced are exaggerated than normal.
• Assess client’s stage in the grief process.
• Develop trust.
• Help the client actualize the loss by talking about it.
• Help the client identify and express feelings
• Provide client with adequate time to grieve.
• Be accepting and nonjudgmental when client expresses anger.
• Contact spiritual leader of client’s choice, if needed.