Friday, October 31, 2008

College Notes for today (October 15th)

Well its all fun and frolics for me lately... Heavy on the sarcasm...seriously....well not really.
The topic today is Grief
In class we had to do some quick research to answer to some questions posed by our tutor, using the net, journal articles and textbooks.

1.What is Grief?
Grief is the normal, natural, emotional reaction to a significant loss. Those back in the ye olde days of France got it right when they defined it as a heavy burden. People often suffer emotional pain in response to loss of anything significant to them ( job, friendship, relationship, home etc), grief usually refers to the loss of a loved one through death.

2.What is bereavement?
Bereavement is the state or condition caused by loss through death. It is the entire period after loss during which grief is experienced and mourning occurs.

3.What is Mourning?
This the way that we express our grief and it heavily influenced by cultural norms. This is another reason why awareness and understanding of other cultures is so important to counselling. As opposed to grief, which refers to how someone may feel the loss of a loved one, mourning is the outward expression of that loss. Mourning usually involves culturally determined rituals that help the bereaved individuals make sense of the end of their loved ones life. This is everything from preparing the body for burial or cremation, to clothes you wear ( black for example).

Trying to define Grief, Bereavement and Mourning proved trickier than I thought, so I hope I have not confused anyone (other than myself)?

4.What is normal grief?
Normal grief is quite frankly a horrid way of putting it, but here we go.
Normal grief is the process of grieving in which a person must acknowledge the reality of the loss, work through the emotional turmoil, adjust to the environment where the deceased is absent and loosen ties to the deceased. How these things are accomplished is an individual matter. Also the amount of time to deal with death is highly individual, but one year is mentioned the most ( That doesn't mean its not normal if it takes a longer or shorter time to grieve).

5.What are the signs that a person may need grief counselling?
I think because grief is such a difficult painful time, its hard for friends and family to see a loved one go through it. This may lead to them suggesting counselling when its not needed. That's not to say you wouldn't benefit from it at all, its just up to the individual.Of course there are some signs that are worth considering after the months have gone by. Physical symptoms such as trouble with sleeping and/or eating and your emotional state impairing your ability to go about your daily routine. Also if you have turned to drugs or alcohol as a way to cope with your grief. (More signs to look out for in Q7)

6.What are some types of loss and grief?
The way that you lose someone can also impact on your grieving process. Unanticipated death- a sudden heart attack, an accident, am act of violence, suicide. Anticipated death- the person may of been suffering from illness for a long time time, so you may experience Anticipatory grief. So the types of loss are, Anticipatory Mourning, Sudden Loss and Complicated grief (more about this below).

7.Are there any links between depression and grief?
There are links between depression and grief, as you are grieving you may experience many depressive symptoms. Such as frequent crying, profound sadness, and depressed mood. Although its painful, normal grief is not a psychological disorder which major depression is. Antidepressants are not usually prescribed for grief as these are thought to inhibit the mourning process, this again is a highly individual thing.
Some syptoms can suggest that a bereaved person is also depressed are: Intense feelings of guilt, thoughts of suicide or preoccupation woth death, feelings of worthlessness, slow speech and body movements, hallucinations of the dead.

8.What are the phases or stages of grief/loss?
This is where things get a little sticky. Grief is definitely a process that you have to work through, but it doesn't just flow neatly through stages. Its worth looking at Elisabeth Kubler-Ross and the five stages of grief, otherwise known as DABDA (Denial, Anger, Bargaining, Depression and Acceptance). But also be aware that everyone is different and will grieve in different ways.
Read this article

9.What is the difference between grief counselling and grief therapy?
In the book Grief Counselling and Grief Therapy (1991), William J.Wolden. says:
"Grief counselling involves helping people facilitate uncomplicated, or normal, grief to a healthy completion of the tasks of grieving within a reasonable time frame. Grief therapy, on the other hand, utilizes specialized techniques that help people with abnormal or complicated grief reactions and helps them resolve conflicts of separation."

10.What are some techniques that may be effective in grief counselling?
Every counsellor and therapist is different and will have their own techniques. Here is a long list of things that you may expect: Art therapy, Music therapy, meditation, creation of personalised rituals, bibliotherapy (books), journalling, communication with the deceased (through writing, conversations, etc.), bringing in photos or possessions that belonged to the person that died, role playing, bearing witness to the story of the loved one, confiding in close friends/family and participating in support groups.

11.What is abnormal or complicated grief?
Abnormal or complicated grief is when it is accompanied with thoughts of suicide, or of there are psychotic symptoms, such as a loss of contact with reality, or there is significant weight loss or gain.
Someone is grieving in a normal manner may "hear" the voice of the dead person, but the episode is brief and fleeting. Someone with abnormal grieving may continually "hear" that voice. That's just a quick example. This is another subject I am going to have to read more about.
Any questions? Titbits of wisdom from yourselves?


Book recommendations:
1.A special scar by Alison Wertheimer. This is a book that deals with the experiences of people bereaved by suicide.

Things I need to read up on:
1.Multicultural counselling and the importance of symbols surrounding death.
2.Psychosomatic pains in relation to grief.

What else we covered: Just highlighted another chapter to look into, in the world of textbooks, which was the skills and qualities of an effective counsellor.
( Chapter 18 in the An Introduction to Counselling By John McLeod).
That inspired the following doodle

Personal Journal Entry
This was a hard topic for quite a few of the group and its on days like this that its almost a relief to do book/research type work. I think I was especially glad of this, after the intensity of the circle on Monday. There are just some days you don't want to be vulnerable and to seeing other people vulnerable is just as tough.
I don't believe in God, Jesus, heaven or angels, but when talking about grief I doodled myself as an angel. Not sure what that is really about, other than maybe its a nice way to draw death? Of course when training to be a counsellor, you have to keep your heart and mind open to whatever your patients beliefs maybe. So it doesn't mean that you can't work with someone of a particular faith, as its about them and not you. When I tackle the dreaded 'Who am I' project I will be looking my own relationship with religion in greater detail.
Next up for 'College Notes' is :
Art Therapy for Positive and Negative emotions (Oct 20th notes).
Group Process and then back to the topic of grief (Oct 22nd notes).
These will be up in quick succession before Monday, which is my next class.

I also want to say that I love the fact that people are reading my notes, even though it scares me a little bit. I am getting a lot out of it, but wish I could learn things faster. Even though its just a brief glimpse at the topics I cover on my diploma, I hope its not putting anyone off counselling.

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