Loss, Grief, and Healing: Presented by Ann Vernon, PH.D

LOSS, GRIEF, AND
HEALING
PRESENTED BY
ANN VERNON, Ph.D.
WHAT IS LOSS?
• INESCAPABLE
• MORE ENCOMPASSING THAN DEATH
• RESULTS IN A CHANGE OR
DISRUPTION
• TIED TO PAIN & GROWTH
• THE REAL OR PERCEIVED
DEPRIVATION OF SOMETHING
MEANINGFUL
MAJOR TYPES OF LOSS
• LOSS OF IMPORTANT
RELATIONSHIPS
• LOSS THAT DAMAGES SELF-
ESTEEM
• LOSS RESULTING FROM
VICTIMIZATION
OTHER TYPES OF LOSS
• EXPECTATIONS
• POWER
• ABILITIES
• FREEDOM
• NON-EVENTS—HOPES & DREAMS
THAT NEVER OCCURRED
• HEALTH, LOOKS
AMBIGUOUS LOSS
TWO TYPES:
• PERSON IS PHYSICALLY ABSENT
BUT PSYCHOLOGICALLY PRESENT
(CHILD BEING ABDUCTED)
• PERSON IS PHYSICALLY PRESENT
BUT PSYCHOLOGICALLY ABSENT
(PERSON WITH DEMENTIA)
PRIMARY AND SECONDARY LOSS
• PRIMARY LOSS—SIGNIFICANT
LOSS EVENT (DEATH, DIVORCE)
• SECONDARY LOSS—CONSEQUENCES
RESULTING FROM PRIMARY LOSS
• PRIMARY LOSSES ARE APPARENT,
WHEREAS SECONDARY LOSSES ARE
LESS OBVIOUS AND VARY BY
PERSON AND CONTEXT
IMPACT OF LOSS
THE GREATER THE ATTACHMENT OR

DEPENDENCY, THE GREATER THE
SENSE OF LOSS
IMPACT OF LOSS
• IS IT TEMPORARY OR PERMANENT?
• IS IT VISIBLE OR INVISIBLE?
• NATURE OF THE LOSS & HOW IT
OCCURRED
• PREVIOUS HISTORY OF SIGNIFICANT
LOSSES
• OTHER LIFE STRESSORS
• INDIVIDUAL’S PSYCHOLOGICAL MAKE-
UP
FACTORS TO CONSIDER
REGARDING LOSS
• WAS IT SUDDEN, EXPECTED, OR
GRADUAL?
• WAS IT A STIGMATIZED LOSS?
(SUICIDE, INFIDELITY)—RELATES
TO TRANSGRESSION OF SOCIETAL
NORMS
• WAS IT A CULTURAL LOSS?
IMMIGRATION, ASSOCIATED WITH
TRAUMA, OPPRESSION
EMOTIONAL REACTIONS
• MOOD SWINGS
• FRUSTRATION
• FEAR
• PANIC ATTACKS
• NUMBNESS
• ANGER
• ANXIETY
• SHOCK
MORE EMOTIONAL REACTIONS
• DISBELIEF
• GUILT
• SHAME
• BLUNTED EMOTIONS
• EXCESSIVE CRYING
• SADNESS, DEPRESSION
• HOPELESSNESS, HOPELESSNESS
BEHAVIORAL REACTIONS TO LOSS
• DETACHMENT
• CHANGES IN INTERESTS,
ACTIVITIES
• ISOLATION
• DECREASED SOCIALIZATION
• CHANGES IN SEXUAL ACTIVITY
• CHANGES IN RELATIONSHIPS
MORE BEHAVIORAL REACTIONS
• CHANGES IN WORK PRODUCTIVITY

• LOSS OF PLEASURE
• SHORT TEMPER
• LONELINESS
• CHANGE IN ACTIVITY LEVEL
COGNITIVE REACTIONS
• LACK OF CONCENTRATION
• DIFFICULTY MAKING DECISIONS
• PREOCCUPATION W/ THE LOSS
• BEING DISTRACTED
• SHORT TERM MEMORY LOSS
• CONFUSION
• LOWERED SELF-ESTEEM
• FEELING OVERWHELMED
PHYSICAL REACTIONS
• SLEEP DISTURBANCES
• CHANGES IN EATING
• CHANGE IN WEIGHT
• NAUSEA, INDIGESTION
• HEADACHES
• STOMACHACHES
• FATIGUE
MORE PHYSICAL REACTIONS
• LACK OF ENERGY
• UNEXPLAINED ACHES AND PAINS
• LUMP IN THE THROAT
• SLOWED MOVEMENT
• TIGHTNESS IN CHEST
• FREQENT ILLNESSES
• DIFFICULTY BREATHING
• RESTLESSNESS
SPIRITUAL REACTIONS
• CHANGE IN BELIEF SYSTEM
• CHANGE IN VALUES
• SENSE OF HOPELESSNESS
• QUESTIONING FAITH/GOD
• CHANGE IN DESIRE TO WORKSHIP
• SHIFT IN PRIORITIES
• CHANGE IN SUPPORT SYSTEM
WHAT IS GRIEF?
• A NORMAL REACTION TO ANY
TYPE OF LOSS
• THE CONFLICTING FEELINGS THAT
ARE CAUSED BY THE END OF A
CHANGE OR TRANSITION
• IT IS EMOTIONAL NOT
INTELLECTUAL
WHAT IS GRIEF?
• AN EMOTION GENERATED BY LOSS
• UNIQUE TO EACH PERSON
• MULTIDIMENSIONAL: COGNITIVE,
AFFECTIVE, PHYSICAL,
BEHAVIORAL
• A PROCESS, NOT ABNORMAL OR
DYSFUNCTIONAL
DISENFRANCHISED GRIEF
• GRIEVING A LOSS THAT CANNOT BE
OPENLY ACKNOWLEDGED OR
MOURNED BECAUSE:
A. THE RELATIONSHIP IS NOT
FORMALLY RECOGNIZED (AFFAIR)
B. LOSS ISN’T RECOGNIZED AS
LEGITIMATE (MISCARRIAGE)
C. GRIEVER ISN’T RECOGNIZED
(CHILD, COGNITIVE DISABILITY)
WHAT IS MOURNING?
• THE COURSES OF ACTION THAT
HELP INDIVIDUALS ADAPT TO THE
LOSS AND TO A NEW REALITY
• PSYCHOLOGICAL RESPONSE TO
LOSS AND ADJUSTING TO IT
• INFLUENCED BY CULTURE,
TRADITION, & CUSTOMS
6 “R” STEPS IN MOURNING
• RECOGNIZING THE LOSS AND
ACCEPTING THE REALITY OF IT
• REACT TO THE SEPARATION—
EXPERIENCING THE PAIN
• RECOLLECTING & RE-EXPERIENCING
THE LOSS/REALISTIC REMEMBERING
• RELINQUISHING OLD
ATTACHMENTS
6 STEPS--CONTINUED
• READJUSTING AND ADAPTING TO
THE NEW REALITY WITHOUT
FORGETTING THE OLD
• REINVESTING IN THE FUTURE;
WITHDRAWING FROM THE LOST
“RELATIONSHIP”—REMAINING
CONNECTED BUT IN A WAY THAT
DOESN’T PREVENT MOVING ON
MYTHS ABOUT DEALING WITH
GRIEF
• DON’T FEEL BAD

• GRIEVE ALONE
• JUST GIVE IT TIME
• BE STRONG
• KEEP BUSY
UNHELPFUL COMMENTS
• IT’S GOD’S WILL
• AT LEAST HE OR SHE IS IN A
BETTER PLACE
• TIME WILL HEAL
• ALL THINGS MUST PASS
• SHE/HE HAD A GOOD LIFE
• AT LEAST SHE/HE ISN’T
SUFFERING
MORE COMMENTS…
• IT WASN’T MEANT TO BE
• YOU’LL GET OVER IT
• AT LEAST YOU HAVE OTHER
(CHILDREN, PETS, ETC.)
• BE GRATEFUL YOU HAD HIM/HER
FOR SO LONG
• YOU CAN HAVE OTHER CHILDREN;
YOU CAN REMARRY…
S.T.E.R.B.S—SHORT TERM ENERGY
RELIEVERS
• THESE COVER THE PAIN BUT IN

THE LONG RUN THEY DISTRACT
THE GRIEVER FROM DEALING WITH
THE PAIN OF THE LOSS
• GRIEVING IS PAINFUL AND IT IS
SUPPOSED TO BE
EXAMPLES OF S.T.E.R.B.S
• OVEREATING, NOT EATING ENOUGH
• USING DRUGS AND ALCOHOL
• SLEEPING EXCESSIVELY
• SMOKING
• SHOPPING
• TOO MUCH COMPUTER OR T.V. TIME
• ISOLTATION
• WORKING TOO MUCH
SIGNS OF GRIEVING
• NOT BEING ABLE TO STAY IN THE
PRESENT MOMENT
• HIDE TRUE FEELINGS FOR FEAR OF
BEING JUDGED
• FEELING LETHARGIC…NO ENERGY
• “PROTECTING” BY NOT LOVING
AGAIN
• ISOLATIONISM
RECONCEPTUALIZING GRIEF
• IT IS NOT ABOUT STAGES

• IT IS A DYNAMIC PROCESS
OF UPS AND DOWNS
• IT IS NOT TIME LIMITED
• TIME DOESN’T HEAL—IT’S
WHAT YOU DO WITH THE TIME
• IT CAN’T BE AVOIDED AND THERE
ARE NO UNIVERSAL REACTIONS
WHAT IS GRIEF RECOVERY?
• TAKING AN ACTIVE ROLE (GRIEVER) IN
ADAPTING TO THE LOSS; MAKING
SMALL AND CORRECT CHOICES
• GRIEVER TAKING RESPONSIBILITY FOR
HIS/HER FEELINGS; THE LOSS ITSELF
DIDN’T “MAKE YOU FEEL”…BELIEFS
ABOUT LOSS CREATES FEELINGS
• ACKNOWLEDGING WHAT COULD HAVE
BEEN DIFFERENT, BETTER, OR MORE
GRIEF RECOVERY PROCESS
• CAN’T DO ANYTHING ABOUT THE
LOSS BUT CAN DO SOMETHING
ABOUT THE WAY GRIEVER REACTS
• COMPLETING THE GRIEVER’S
RELATIONSHIP TO THE PAIN &
LONELINESS CAUSED BY LOSS
• GETTING RID OF THE VICTIM
MENTALITY
FACTORS AFFECTING GRIEF
RECOVERY
• AN INDIVIDUAL’S COPING STYLE
• AN OPTIMISTIC VS. PESSIMISTIC
VIEW OF LIFE
• A STRONG SENSE OF SELF
• A SENSE OF PERSONAL CONTROL
• PREEXISTING VULNERABILITIES
• STRONG SUPPORT SYSTEM
• CURRENT LIFESTYLE, CIRCUMSTANCE
TECHNIQUES TO FACILITATE
RECOVERY
LOSS TIME LINE
BIBLIOTHERAPY
LETTER WRITING
JOURNALING
MEMORY MOBILE
SCRAPBOOK
TRANSITION ACTIVITY: CHANGES IN
ROLES, RELATIONSHIPS, ROUTINES,
RESPONSIBILITIES
MORE TECHNIQUES
• TOOL BOX
• EMOTIONAL PIE
• HELPING HAND
• VERTICAL ARROW TECHNIQUE
• BINOCULAR VISION
• ACT AS IF
MORE TECHNIQUES
• LET IT GO
• MOOD CHART
• MAPPING GRIEF & LOSS
• CHAIR DIALOGUES
• DECISIONAL BALANCE SHEET
• MIRACLE QUESTION
• TELLING AND RETELLING THE
STORY
MORE TECHNIQUES
• THOUGHT STOPPING
• CHALLENGING BELIEFS
• REFOCUSING
• DEFENSE ATTORNEY
• LETTERS OF ADVICE
• WRITE THE NEXT CHAPTER
• LIFE IMPRINT
MORE TECHNIQUES
• LISTS—WHAT GRIEF HAS TAUGHT
ME, THINGS I MISS MOST
ABOUT…HOW TO CARE FOR MYSELF
• WHAT REMAINS THE SAME
• 20 WAYS (I CAN RESUME MY LIFE)
• LOOKING FORWARD, LOOKING
BACKWARD
• CAPTURED MOMENTS
LOSS AND GRIEF IN CHILDREN
CHILDREN AND ADOLESCENTS

EXPERIENCE LOSS AND GRIEF
DIFFERENTLY THAN ADULTS
MYTHS ABOUT LOSS AND GRIEF
IN CHILDREN
• CHILDREN DON’T GRIEVE
• IT’S NOT OKAY TO FEEL BAD
• YOU’RE SUPPOSED TO FEEL BAD
• RFEPLACE THE LOSS
• DON’T TALK ABOUT IT
• BE A BRAVE LITTLE SOLDIER
• YOU’LL GET OVER IT
MORE MYTHS
• YOU’RE OVERREACTING
• JUST DON’T THINK ABOUT IT
• IT’S TIME TO MOVE ON
• IF YOU DON’T CRY, YOU DON’T
CARE
DO’S AND DON’T WITH GRIEVING
CHILDREN
• LISTEN WITH YOUR HEART

• LET THEM EXPRESS ALL FEELINGS
• BE PATIENT
• NEVER SAY “DON’T FEEL SAD”
• LOOK FOR BEHAVIORAL
REACTIONS
• DON’T ASK “WHAT’S WRONG”
OTHER CONSIDERATIONS
• DON’T SAY THAT EVERYTHING

WILL BE FINE
• DON’T HIDE THE TRUTH
HOW DO YOUNG CLIENTS
EXPERIENCE GRIEF?
• FEELING VOCABULARY IS MORE
LIMITED; MAY EXPRESS FEELINGS
BEHAVIORALLY
• MAY FEEL MORE FRIGHTENED AND
ALONE THAN ADULTS WHO GRIEVE
• MAY FEEL MORE GUILT AND
RESPONSIBILITY BECAUSE THEY
DON’T FULLY UNDERSTAND
COGNITIVE RESPONSES
• BIRTH-AGE 3; CAN’T DISTINGUISH
BETWEEN TEMPORARY LOSS AND
PERMANENT; NO COMPREHENSION
OF DEATH
• AGES 3-5; THINK DEATH IS
REVERSIBLE OR THAT THEY COULD
CHANGE THE COURSE OF EVENTS;
MAGICAL THINKING
COGNITIVE RESPONSES
• AGES 5-9; UNDERSTAND THAT
DEATH IS FINAL, MAY FEEL
RESPONSIBLE, CAN EXPRESS
FEELINGS BUT MAY ALSO ACT OUT
• AGES 9-12; “WHAT IF” QUESTIONS;
EXPRESS FEELINGS, MAY
WITHDRAW AND AVOID
• AGES 12+; CAN COMPREHEND/THINK
MORE ABSTRACTLY
EMOTIONAL RESPONSES
• ANGER
• FRUSTRATION
• ANXIETY
• GUILT
• ISOLATION
• RELIEF
• REVENGE, RAGE
• SADNESS, DEPRESSION
COMMON REACTIONS TO LOSS
• ACADEMIC PROBLEMS
• CRYING
• EATING DISORDERS, PROBLEMS
• NIGHTMARES AND DREAMS
• PHYSICAL REACTIONS: MORE
ILLNESS, DIZZY, CONSTIPATED,
SLEEP PROBLEMS
• REGRESSION: CLINGING, BED
WETTING, THUMB SUCKING,ETC.
TECHNIQUES TO HELP GRIEVING
CHILDREN
• PLAY THERAPY
• DRAWING PICTURES, MAKING
BOOKS
• MEMORY MOBILES
• BIBLIOTHERAPY
• TAKE A SAD SONG AND MAKE IT
BETTER
• EXERCISE
MORE TECHNIQUES
• JOURNALING
• LETTER WRITING
• MEMORY BOX
• TREE OF LIFE
• EMPTY CHAIR DIALOGUE
MORE TECHNIQUES
• BLANKET OF LOVE
• GOODBYE COOKIE JAR
• GOODBYE AND HELLO BOOK
• LOSS MAP

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Loss, Grief, and Healing: Presented by Ann Vernon, PH.D

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LOSS, GRIEF, AND

THE GREATER THE ATTACHMENT OR

• CHANGES IN WORK PRODUCTIVITY

• DON’T FEEL BAD

• THESE COVER THE PAIN BUT IN

• IT IS NOT ABOUT STAGES

CHILDREN AND ADOLESCENTS

• LISTEN WITH YOUR HEART

• DON’T SAY THAT EVERYTHING

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