Grief, Loss, and Trauma Notes

Grief, Loss, & Trauma Overview

• Focus on understanding grief, loss, trauma, and their psychological impacts.

Death & Death Anxiety

• Death: Permanent and irreversible cessation of life.

• Death Anxiety: Emotional response characterized by feelings of insecurity and anxiety when considering death, serving as a reminder of one's mortality.

Understanding Grief

• Grief: Anguish following significant loss, especially the death of a loved one.

Types of Grief

Normal/Uncomplicated Grief: Typical reaction allowing time for adaptation; acceptance may occur by 6 months post-loss

• Anticipatory Grief: Emotional preparation for loss, can occur before the death happens.

• Complicated Grief: Persistent and intense sorrow that disrupts daily life, can present late or appear distorted.

• Delayed/Inhibited Grief: Symptoms may be suppressed and emerge years later.

• Distorted/Exaggerated Grief: Symptoms become exaggerated and may not resolve appropriately.

• Chronic/Prolonged Grief: Persistent and intense grief that disrupts functioning.

• Disenfranchised Grief: Grief not acknowledged by societal norms, leading to feelings of isolation.

Complicated Grief

• Risk Factors: Dependence on the deceased, violent death, inadequate coping mechanisms, previous mental health issues.

• Prolonged Grief Disorder: Characterized by separation distress and disruption in everyday life.

Traumatic Grief and Loss

• Severe distress after sudden loss, such as death from accidents or violence, often leads to heightened grief responses such as shock and self-blame.

Coping Strategies

• Problem-focused Coping: Active approach to manage stressors.

• Active or Emotional Coping: Engaging directly with feelings.

• Avoidant Emotional Coping: Trying to divert attention from the distressing feelings.

Interventions

• Recognizing Loss: Acceptance of grief as a normal experience.

• Client-Centered Care: Engage clients in discussing their loss and life changes since the death.

• Cognitive Behavioral Therapy: Focus on conditioning thoughts and behaviors around grief.

Assessment Components

• Consider mental and physical health history, psychosocial background, and cultural factors.

• Mental Status Examination (MSE): Evaluate current psychological state.

Analyzing Grief's Impact

• Look for distress signs and ability to perform daily activities or revisit interests.

• Address any avoidance behaviors related to the loss.

Prioritize and Plan

• Address immediate client needs, emphasizing safety and supportive care.

• Facilitate ongoing bereavement support within a safe, confidential environment.

Implementation Strategies

• Develop therapeutic relationships, ensuring culturally sensitive and individualized care processes.

Evaluation of Care

• Assess the effectiveness of created environments and care strategies on daily functioning and symptom management.

Occupational Stress Related to Death & Grief

• Risk Factors: Frequent exposure to death and grief leads to burnout and secondary trauma.

• Burnout: Resulting from emotional exhaustion, detrimental to nursing performance and client satisfaction.

Understanding Trauma

• Trauma: Disturbing experiences causing mental, physical, and emotional disruption.

Types of Trauma

• Acute Trauma: Singular, time-limited event.

• Chronic Trauma: Exposure to multiple events over time, such as neglect or abuse.

• Vicarious Trauma: Secondary trauma resulting from engagement with trauma victims.

Effects of Trauma

• Can lead to alterations in functioning, significant emotional disturbances, and issues in well-being.

Toxic Stress

• Prolonged stress responses lead to biological changes in individuals impacting health.

Manifestations of Toxic Stress

• Can result in developmental and behavioral issues in children and diverse health risks in adults.

Adverse Childhood Experiences

• Negative childhood experiences affect brain development and long-term health outcomes.

Crisis Intervention

• Aimed at restoring pre-crisis functioning, employing directive strategies.

Considerations for Crisis Situations

• Recognize symptoms requiring further assistance, including severe emotional distress and suicidal thoughts.

Addressing Anger and Violence

• Understand cycles of violence, emphasizing non-judgmental approaches to management.

Self-Injury Mechanisms

• Intentional self-harm may manifest through various forms such as cutting or burning.

• Warning Signs: Observe for infections, scarring, and shame.

Interventions for Non-Suicidal Self-Injury

• Immediate outreach to trusted support, exploring creative emotion expression, and establishing actionable coping plans.