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helping the bereaved to accept the loss by helping him or her to talk about the loss
helping the bereaved to identify and express feelings related to the loss (for example, anger, guilt, anxiety, helplessness, and sadness)
helping the bereaved to live without the person who died and to make decisions alone
helping the bereaved to separate emotionally from the person who died and to begin new relationships
providing support and time to focus on grieving at important times such as birthdays and anniversaries
describing normal grieving and the differences in grieving among individuals
providing continuous support
helping the bereaved to understand his or her methods of coping
identifying coping problems the bereaved may have and making recommendations for professional grief therapy
Grief therapy is used with people who have complicated grief reactions. The
goal of grief therapy is to identify and solve problems the mourner may have in
separating from the person who died. When separation difficulties occur, they
may appear as physical or behavior problems, delayed or extreme mourning,
conflicted or extended grief, or unexpected mourning (although this is seldom
present with cancer deaths).
Grief therapy may be available as
individual or group therapy. A contract is set up with the individual that
establishes the time limit of the therapy, the fees, the goals, and the focus of
the therapy.
In grief therapy, the mourner talks about the deceased and
tries to recognize whether he or she is experiencing an expected amount of
emotion about the death. Grief therapy may allow the mourner to see that anger,
guilt, or other negative or uncomfortable feelings can exist at the same time as
more positive feelings about the person who died.
Human beings tend to
make strong bonds of affection or attachment with others. When these bonds are
broken, as in death, a strong emotional reaction occurs. After a loss occurs, a
person must accomplish certain tasks to complete the process of grief. These
basic tasks of mourning include accepting that the loss happened, living with
and feeling the physical and emotional pain of grief, adjusting to life without
the loved one, and emotionally separating from the loved one and going on with
life without him or her. It is important that these tasks are completed before
mourning can end.
In grief therapy, six tasks may be used to help a
mourner work through grief:
1) develop the ability to experience,
express, and adjust to painful grief- related changes,
2) find effective ways
to cope with painful changes,
3) establish a continuing relationship with
the person who died,
4) stay healthy and keep functioning,
5)
reestablish relationships and understand that others may have difficulty
empathizing with the grief they experience, and
6) develop a healthy image
of oneself and the world.
Complications in grief may come about due to
uncompleted grief from earlier losses. The grief for these earlier losses must
be managed in order to handle the current grief. Grief therapy includes dealing
with the blockages to the mourning process, identifying unfinished business with
the deceased, and identifying other losses that result from the death. The
bereaved is helped to see that the loss is final and to picture life after the
grief period.
Complicated Grief
Complicated grief reactions
require more complex therapies than uncomplicated grief reactions. Adjustment
disorders (especially depressed and anxious mood or disturbed emotions and
behavior), major depression, substance abuse, and even post-traumatic stress
disorder are some of the common problems of complicated bereavement. Complicated
grief is identified by the extended length of time of the symptoms, the
interference caused by the symptoms, or by the intensity of the symptoms (for
example, intense suicidal thoughts or acts).
Complicated or unresolved
grief may appear as a complete absence of grief and mourning, an ongoing
inability to experience normal grief reactions, delayed grief, conflicted grief,
or chronic grief. Factors that contribute to the chance that one may experience
complicated grief include the suddenness of the death, the gender of the person
in mourning, and the relationship to the deceased (for example, an intense,
extremely close, or very contradictory relationship). Grief reactions that turn
into major depression should be treated with both drug and psychological
therapy. One who avoids any reminders of the person who died, who constantly
thinks or dreams about the person who died, and who gets scared and panics
easily at any reminders of the person who died may be suffering from
post-traumatic stress disorder. Substance abuse may occur, frequently in an
attempt to avoid painful feelings about the loss and symptoms (such as
sleeplessness), and can also be treated with drugs and psychological therapy.
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