FS Counseling Exam- 9/24

John Bowlby

created attachment theory

Attachment theory

gives a way to understand the tendency for human beings to create strong affectional bonds with other s and a way to understand the strong emotional reaction that occurs when those bonds are threatened or broken

Engel

states that mourning is similar to the process of healing

Normal Grief

aka uncomplicated grief. Encompassed a broad range of feelings and behaviors that are common after loss.

Normal grief feelings

sadness, anger, guilt, anxiety, guilt, anxiety, loneliness, fatigue, helplessness, shock, yearning, emancipation, relief, numbness

Sadness

most common feeling. Not necessarily manifested by crying but often is.

Anger

can be confusing to the survivor. Frequently expressed after loss, can become the root of problems during the grieving process

Guilt and self-reproach

Can be over things related to the deceased death or about the deceased while they were living. Common experience of survivors over not doing something for the deceased

Anxiety

can range from a light sense of insecurity to a strong panic attack. Comes from fear of not being able to take care of oneself or from a heightened sense of personal awareness.

Loneliness

social can be lessened by socializing. emotional is broken hearted. Particularly expressed by those who have lost a spouse

Fatigue

an be apathy or listlessness. Can lead to clinical depression. For someone active this can be surprising of even distressing

helplessness

closely related to anxiety and loss of help from the deceased

Shock

usually occurs related to sudden death

yearning

usually a normal reaction in widows. AKA 'Pining'. When it diminishes is usually a sign mourning is coming to an end

emancipation

can be a positive feeling after the death of someone that was controlling or was a burden

relief

after a long or painful illness of the deceased

numbness

lack of feelings, early on in mourning

Disbelief

Cognition. "It didn't happen"

Confusion

cognition. Difficulty concentrating, can't order thoughts

Preoccupation

cognition. obsessive thoughts about the deceased. How to recover the lost person

Sense of presence

cognitive counterpart of yearning

Hallucinations

cognition. Visual and auditory. Experience in the first few weeks after loss

Sleep disturbances

Behaviors. difficulty going to sleep or waking up early morning

Appetite distrubances

behaviors. over or under eating

Absentminded behaviors

behvaiors. cause inconvenience

Social Withdrawal

Behaviors. Usually short-lived and corrects itself

Dreams of the deceased

behaviors. Can be of the dead person, normal dreams and nightmares

Avoiding reminders of the dead

behaviors. avoid triggers that remind them of that person

Searching and calling out

behaviors. can be done verbally or internally

Sighing

behavior. Closely related to the physical sensation of breathlessness

Restless Hyperactivity

behavior. Getting out to avoid the thoughts

Crying

Behavior. tears can have a healing value

Visiting places or carrying objects that remind that of the deceased

Behavior. Opposite of avoiding reminders

Treasuring objects that belonged to the deceased

behavior. Can't part with the belonging of the deceased

Grief

in waves, diminishes over time, healthy self image, hopelessness, response to support, overt expression of anger, preoccupation with the deceased

Depression

Moods and feelings static, consistent sense of depletion, sense of worthlessness and disturbed self-image, pervasive hopelessness, unresponsive to support. Preoccupation with self

Mourning

outward expression of grief. Process of adjustment and adaption to a loss. A process.

Stages of mourning

9-12

Phases

used to describe mourning by Bowlby, Sanders, and Parkes.

Parkes Phases

numbness, yearning, disorganization and despair, reorganized behavior

Sanders phases

shock, awareness, conservation withdrawal, healing, renewal

Worden's 1st task of mourning

accept the reality of the death

Worden 2nd task of mourning

experience to pain of the death

Worden's 3rd task of mourning

Adjusting to an environment from which the deceased is missing

Worden's 4th task

to find an enduring connection with the deceased in the midst of embarking on a new life

J. William Worden

created the mediators of mourning

Who the person died was

Mediator 1. Relationship to the deceased and survivor

The nature of the attachment

Mediator 2. Strength, security, ambivalence, conflicts, and dependency of attachment to the death.

How the person died

Mediator 3. Suddenness, violent, preventable, ambiguous, and stigmatized

Historical Antecedents

Mediator 4. Helps to understand how people grieve when you find out how they have experienced loss in the past and ho they dealt with the loss

Personality Variables

Mediator 5. Age and gender, coping style, attatchment style, Cognitive style, Opimisitc.pessimistic, ego strength, Assumptive world,

Age and Gender

women and men grieve differently and usually older survivors greive better than younger.

Coping style

the changing thoughts and acts that an individual uses to manage the external and internal demands of stressful situations

Problem solving coping

change to a method that works or ineffectively quit when that one method used doesn't work

Active emotional coping

redefinition of the ability to find something positive in a bad situation (using humor, venting, accepting support)

Avoidant emotional coping

least effective, includes blaming, distraction and social withdrawal

Attatchment style

usually developed as a child, a healthy adaptation is to internalize the deceased into themselves

secure attachment style

developed through good parenting and other early health relationships. When a loss is experienced, the pain of sorrow is processed and develop continuing bonds with the lost loved one

Insecure attachment style

when parenting/ early relationship is not secure.

anxious-preoccupied attachment

super sensitive to slights and other neglect in a relationship. Show high levels of stress at the time of a death and coping is difficult

Anxious/ambivalent attachment

Love and hate coexist in a relationship. Usually only the love comes out when the person dies and makes them larger than life

Avoidant/dismissing attatchement

behavior is organized around the goal of self-reliance and independence. Show minimal emotions to death

Avoidant/ fearful attachment

have long histories of tentative attachments and can go into depression when an attachment is severed due to death

Assumptive world

beliefs and values-death can create a spiritual crisis

Social variables

Mediator 6. Greiving is a social pheneomenon. Perceived emotional support inside and out is very important.

Social mediators

support satisfaction, social role involvement, religion and ethnic expectations.

Concurrent stress

mediator 7. experiencing high levels of disruption following a death can create higher levels of depression

7

How many mediating factors are there

Redefinition/ Reframing

the ability to find something positive in a bad situation

Exaggerated Grief

reactions that are excessive in duration and never comes to a satisfactory conclusion