The parents as well as three siblings of a twenty-three-year-old woman came in for grief counseling. All were neat, well dressed and fairly quiet. The parents were first to speak about their daughter. They began with a description which characterized her as a quality young woman, their first born in the family. She was gifted in every area of her life and had a bright future ahead of her.
The parents went into great detail about her abilities and accomplishments, stopping every now and then because of their inability to talk. Often all five were in tears. Two weeks prior she and her seven-month old unborn child and her mother-in-law were driving on a freeway when a truck struck and killed all of them. Since that time every member of this family has been struggling.
1. After greeting each person I would validate the fact they have experienced a great loss in their life. If I didn’t know already I would ask the name of the daughter as well as the mother-in-law and whenever I made reference to either I would use their name rather than refer to them in a general way. One of the first questions I ask is, “Tell me about (the daughter) and have each of the family respond.
Too often children are left out of the interaction. After each has responded my next question is, “Would you describe for me what the last two weeks has been like” so each has a chance to tell their story. Within this I often ask how they heard the news and to describe their reaction.
2. My goal is to have them tell their story and then normalize for them what they are experiencing and educate them about grief and what to expect in the future (using the handout on the “Crazy Feelings of Grief”). I’d also want to find out about their support system as well as giving some suggestions to eliminate the pressure of other individuals.
I also mention that each of them may grieve in a different way and with a different intensity. That’s all right and it’s not a sign that the other person doesn’t care if their grief is less intense. I ask, “How can the other family members support you at this time?”
3. Some of the questions directed toward the parents could be asked of the siblings. I also let everyone know that I would be willing to meet with each one individually. One reason for this is the deceased was described as a “special gifted” individual but was she in the eyes of the siblings? Sometimes even in the initial session I ask for a favorite memory from siblings.
Some may have a mixture of feelings. At some point I would ask the parents and siblings alike if there was any unfinished business or issues between them and the deceased or if there was something they wished they could have said to her before she died. If so, I would suggest writing a detailed letter and reading it aloud at the place of internment.
4. I would like each one to believe there will be help for all of them during the months and years ahead of them. Any suggestions or recommendations made need to be put in writing such as the list of “Crazy Feelings of Grief,” etc. I would give each one a copy of Experiencing Grief as well, and suggest they read it when they’re ready. I also let them know that it is normal not to remember what they read at this time. I send home a DVD called Tear Soup and ask them to watch this together.
5. There are two other family members who were lost as well. It would be easy to ignore them and gloss over this loss. I would ask about them as well as the effect this loss is having. For the parents, the loss is a grandchild which is major.
Other and possible grievers would include husband, aunts, uncles, cousins, friends, fellow workers, pastors, church, ob gyn, husband’s family, grandparents, truck driver, and similar group of individuals. It’s important to consider who will minister to them and how.
One of our tasks is to identify neglected grievers and reach out to them as well. Sending or giving them Experiencing Grief as well as making available copies of Tear Soup has been helpful.
6. Not only was this a sudden death but it was multiple tragedy involving someone’s child and unborn grandchild. There could be the possibility of legal complications because it was a vehicular accident. The way in which the notification was made could be a factor as well. (Refer to the section on sudden death for additional information).
First Memory Disneyland 0 3 4 5 7 8 10 New School Grandpa Hamster Died Died Broken Arm Couldn’t Play Soccer
First Memory 0 3 4 5 10 Two Friends Stopped Calling Wasn’t Allowed To Attend Funeral Grandpa Died Couldn’t Go To Grandpa’s Cabin Lost Toys Grandpa Gave Her A Boy She Liked Doesn’t’ Like Her New School Broke Arm Hamster Died
The “crazy” feelings of grief are actually a sane response to grief. The following examples are all symptoms of normal grief: distorted thinking patterns, “crazy” and/or irrational thoughts, fearful thoughts feelings of despair and hopelessness out of control or numbed emotions
changes in sensory perceptions (sight, taste, smell, etc.). increased irritability may want to talk a lot or not at all memory lags and mental “short-circuits”
inability to concentrate obsessive focus on the loved one losing track of time increase or decrease of appetite and/or sexual desire difficulty falling or staying asleep
dreams in which the deceased seems to visit the griever nightmares in which death themes are repeated physical illness like the flu, headaches or other maladies shattered beliefs about life, the world, and even God
When you lie down you shall not be afraid; yes, you shall lie down and your sleep shall be sweet. Be not afraid of sudden terror and strong, nor of the stormy blast or the storm and ruin of the wicked when it comes [for you will be guiltless], For the Lord shall be your confidence, firm and strong, and shall keep you foot from being caught [in a trap or hidden danger]. Proverbs 3:24-26, AMP
You will not be afraid when you go to bed and you will sleep soundly through the night. Psalm 3:5, Good News Bible If I’m sleepless at midnight, I spend the hours in grateful reflection. Psalm 63:6, The Message
When my anxious thoughts multiply within me, Your consolations delight my soul. Psalm 94:19 I will lie down and sleep in peace, for you alone, O Lord, make me dwell in safety. Psalm 4:8
In a dream, a vision of the night When sound sleep falls on men, Then He opens the ears of men, And seals their instruction. (Job 33:15-16).
Dear God, We give thanks for the darkness of the night where lies the world of dreams. Guide us closer to our dreams so that we may be nourished by them. Give us good dreams and memory of them so that we may carry their poetry and mystery into our daily lives Grant us deep and restful sleep that we may wake refreshed with strength enough to renew a world grown tired.
We give thanks for the inspiration of stars, the dignity of the moon and the lullabies of crickets and frogs. Let us restore the night and reclaim it as a sanctuary of peace, where silence shall be music to our hearts and darkness shall throw light upon our souls. Good night. Sweet dreams. Amen Michael Leuing A Common Prayer
Anticipation can be a great part of life. For many it’s something that adds excitement to existence and an eagerness within. The word actually mans “to feel or realize beforehand: foresee. To look forward to or to foresee and fulfill in advance.
One of the most difficult times of life is when what we anticipate is the inevitability of someone’s death. We tend to think of grief as after the fact rather than beforehand. Many of the people you will minister to will experience this type of grief. It can also mean “to act in advance, to prevent, forestall.”
One wife said, “When all that remained was hope for my husband’s survival, and he continued to decline, I felt absolutely helpless. My arsenal was depleted. There was nothing to do but surrender and redefine hope to be much greater than whether he lived or died. In the end, the effort ‘to forestall’ seemed to cause everyone involved suffering. At the same time, it was an integral part of the journey.”
Trepidation—”trepidatory grief” would be a closer fit for the kind of grief people with a life-threatening illness and their loved ones go through up until the point where bad days outnumber good ones.
Each day can bring new losses. If the person is slowly changing, is debilitated or losing control, there is grief over what is currently being lost and for the future that will never come. Sometimes family members begin pulling away from the dying person too soon and engage in premature detachment. They withdraw their emotional investment in the person prior to their death.
Here are some possible losses: Loss of control Loss of independence Loss of being productive Loss of security Loss of personal abilities (physical, psychological and cognitive)
Loss of life experiences Loss of future earthly existence Loss of pleasure Loss of plans, dreams and hopes Loss of other loved ones Loss of family’s involvement Loss of identity Loss of meaning
Terminally ill individuals experience and struggle with many of the same feelings as the mourners.
1. The capacity to cope is diminished as the shock overwhelms the person at the same time additional stressors are added. 2. The loss doesn’t make sense, and can’t be understood or absorbed. 3. Sudden loss or sudden death usually leaves the survivor with a sense of unreality that may last a long time.
4. Symptoms of acute grief and of physical and emotional shock persist for a prolonged period of time. 5. Sudden loss or death fosters a stronger- than-normal sense of guilt expressed in “if only…” statements. 6. In sudden loss or death, the need to blame someone for what happened is extremely strong.
7. There’s a profound loss of security and confidence in the world which affects all areas of life and increases many kinds of anxiety. 8. Sudden loss or death often involves medical and legal authorities. 9. Sudden loss or death often elicits a sense of helplessness on the part of the survivor.
10. The loss cuts across experience in the relationship and ends to highlight what was happening at the time of death, often causing these last-minute situations to be out of proportion with the rest of the relationship and predisposing of problems with realistic recollection and guilt.
11. Sudden loss or death leaves the survivors with many regrets a sense of unfinished business. 12. In the event of sudden loss or death there is the need to understand why it happened. Along with this is the need to ascribe not only the cause but the blame. Sometimes God is the only available target and it is not uncommon to hear someone say, “I hate God.”
13. The death tends to be followed by a number of major secondary losses because of the consequences of lack of anticipation. 14. The death can provoke posttraumatic stress responses.
I am not sure exactly how it works, but this is amazingly accurate. Read the full description before looking at the picture. The picture below has 2 identical dolphins in it. It was used in a case study on stress levels at St. Mary’s Hospital.
Look at both dolphins jumping out of the water. The dolphins are identical. A closely monitored scientific study revealed that, in spite of the fact that the dolphins are identical, a person under stress would find differences in the two dolphins.
The more differences a person finds between the dolphins, the more stress that person is experiencing. Look at the photograph and if you find more than one or two differences you may want to take a vacation.
Multiple Deaths: One death is sufficiently devastating; dealing with a set of losses overloads your emotional circuits.
Violent Death from Accident, Suicide, or Murder: These events are additionally weighted with overriding concerns about the possibility of the persons suffering, guilt over your inability to prevent the death, and shame about the way it occurred. You may also have to deal with distractions from law enforcement and other official agencies.
Questionable Deaths: Not knowing or being sure about the circumstances can lead to intense anger and frustration. Witnessing the Death: While seeing a peaceful, tranquil death may be of some comfort, watching a person die leaves a permanent imprint. The last impression may be all the more horrific if the death were under difficult or unusual circumstances.
Discovering the Body: Finding the body is shocking enough; having to break the news adds additional trauma. Hearing the News: Learning of the person’s death in a callous manner or getting confusing or dishonest information primes us for problematic mourning. Notoriety: Having a loved one die in a way that generates news coverage means putting a public face on private grief.
A Body That’s Not Presentable or No Body: Dealing with a badly damaged body may be particularly traumatic for a child or teen. Not being able to view or positively identify the remains can also produce lingering doubts. Secrets Discovered After the Death: Discovering that the person mourned as mother was actually grandmother.
1. A history of extended or prolonged grief that reflects an already existing difficulty with grief. 2. A wide variety of symptoms such as guilt, self-blame, panic attacks, feelings of choking and fears. 3. Physical symptoms similar to those of the deceased person’s terminal illness due to over-identification with the individual.
4. A restless searching for what was lost with a lot of purposeless, random behavior and moving about. 5. Recurring depression that is triggered on specific dates such as anniversary of the loss, birthday of the deceased person, holidays and even becoming the same age as the person who died. When these reactions are more extreme than normal responses, it can be indicative of unresolved grief.
6. Feelings that the loss occurred yesterday, even though months or years have passed. 7. Enshrinement or unwillingness to remove the belongings of a deceased person after a reasonable period of time. 8. Changes in personal relationships with other significant people following the death.
9. Withdrawal from normal religious activities and avoidance of usual mourning activities that are part of the person’s culture. 10. Inability to talk about the loss without breaking down especially when it occurred over a year before. 11. Extensive thinking about and noticing themes of loss in life.
12. Minor losses that trigger major grief reactions. 13. Phobias about death or illness. 14. Excluding anything or anyone who used to associated with a significant loss or deceased person. 15. A compulsion to imitate the deceased person due to over-identification with him or her.
The three most important steps to take in helping a person: 1). Listening with your eyes 2). Listening with your ears 3). Listening with your heart James 1:19: Prov. 18:13
Listen for emotions as well as body complaints. Listen for the times when their grief returns after moving forward. Listen for what they can’t put into words.
Assess: Part of your involvement is to determine what the person’s psychological, physical and behavioral needs are and how well they are meeting these needs and functioning. Normalize: This is one of the most supportive steps you can take. This may need to occur verbally againa dn again but also by sharing with them the “Ball of Grief”. They need your validation again and again that what they’re experiencing is normal. It’s vital to be realistic, positive and informative.
Reassure: Let the person know that he or she will be able to survive their grief journey although at times they may not believe this. You will need to lend them your faith and hope until theirs returns. You may need to remind them that support and help will be available. The phrase “You will get through this” is helpful. Remember, you can’t give them a time or how their world will be a year or two from now. Let them know that you ad countless others they’re not even aware of will be praying for them as well.
Support: Help the griever discover or develop a supportive network of family, friends, neighbors and professionals. Help tem to identify how they need and would like to be supported. Positive support reinforces their ability to express their feelings and concerns.
Plan: Planning is the heart of any type of counseling and coaching. This is a procedure that involves small, realistic and attainable steps. Plans need to be short-term initially. Everything decided on needs to be in writing so they can remember. Plans need to be adjusted and customized for each person. Co- design and plans with the grievers and encourage them to suggest the plans.
Clarify: Identify the griever’s goals and purpose in the counseling sessions. Intervene: There will be times when you may need to correct beliefs or even behaviors or plans. The way in which this is done should be general and supportive.
Educate: You will constantly be teaching in a direct or indirect manner. Printed material is necessary. Visual charts and graphs to plot progress will be beneficial at this time.
Monitor: Look for signs and symptoms of the griever being stuck, overly distressed or in serious depression, which may need additional assistance such as additional support, medical help, hospitalization, group support and so on. As you learn these guidelines, they’ll become a regular pattern to follow as you minister.
A four step process in ministering to a mourner. Remembering is the first step. Remembering realistically involves complete review of all recollections about the deceased and the mutual relationship.
All means precisely what it says: the full range of memories, of needs, feelings, thoughts, behavior and interaction patterns, hopes, wishes, fantasies, dreams, assumptions, expectations and beliefs. It also means all of the aspects of each of these memories and all of the feelings about them – good and bad, happy and sad, fulfilling and unfulfilling, comfortable and uncomfortable and so forth.
Recalling the significant and perhaps insignificant events and occasions helps in relearning the world without the person. We’re back to having people tell their story in their own way and timing. Telling their story has two places. At first the telling is accompanied by pain. You can ask helpful questions to help direct the person:
What are the stories you can tell about that bring a smile to your face? What are the stories that bring the greatest pain? Who would like to hear your stories about, and how could we make that happen?
When do you find yourself longing for the most? How do you handle that? One of the goals and something to encourage the griever with is that someday the stories will be told without pain. That’s the second place for the story.
A next step: reaffirm their values. Questions to Ask: 1. Can you describe how ’s death has affected what you believe about life? 2. Has this experience drawn you away from or closer to God? 3. Since the death, how has your faith been impacted?
A third step: Realize Others have different words for it, but it is accepting or realizing that a death has occurred. The last step: Release. It’s another way of saying goodbye. It’s a process of taking a step into our newly unfolding world. Releasing and saying goodbye may take awhile and may have to be repetitive.
Bereavement is not a malady from which we recoil. To recover implies a return to the kind of life we previously knew, and such is not the case with those grieving death loss. The following is an example of the first few minutes of a counseling session that incorporates some of the steps of the four-step process.
June: It’s important that I start back 23 years ago and tell you what I’ve been through, since it reflects on my currant situations. Maybe it will help you understand why I’m feeling the way I am and feel so isolated. Others don’t really want to hear my story since they don’t see how it relates to how I feel now and where I’m at.
Counselor: I’d like you to tell your story. This will help me understand more about you and who you are, as well as the present situation. Take your time, and if you need to stop at any time, just let me know. June: I was married at 25 to what I thought was a godly man, and everything went well at first. A few years later, I discovered gay port on our computer and confronted him, which he denied.
We stayed for several years, then one day I “discovered” him, and we divorced. At first I thought I had arrived with the man of my dreams, but those dreams died. I was single for three years and then remarried a quality man, or so I thought. Then the verbal abuse began. It continued.
Three years ago, my first ex died, and I discovered it was from a sexual disease. Last year, I began losing energy. I don’t’ know what’s wrong. I fear the worst. I can’t believe how much I miss my ex… I don’t know… my life seems over.
Counselor: What you have shared with me says that many of your dreams have died. It’s almost like a part of you has died, like you’re experiencing the death of yourself while you’re still living, and the ability to handle everything is not working…?
June: It’s true. I never thought about this as a type of death. I saw it as one loss, upon another loss, another dream shattered. I’ve tried to handle everything; and the 23 years have not turned out the way I thought they would. I think of me then and then now, and it doesn’t make sense.
Counselor: Perhaps you could think about this as a series of losses—of who you were in the past, and grieve over each one. I’d guess there are a number of these losses that you’ve never grieved over…is that a possibility? June: It’s more than a possibility. It’s a fact. I haven’t. I’m not sure where to begin.
Counselor: I wonder if it would help to begin by identifying each loss and then look at what hasn’t died with you and use this to move ahead. What are your thoughts about that? June: I guess we could. I appreciate nay help at this time. In this case, June needed someone to listen, to care, to clarify and to believe that she could move ahead.
Trauma is the response to any event that shatters your world. It’s more than a state of crisis. Trauma leaves you feeling unsafe because your place of refuge has been invaded The word trauma comes from a Greek word that means “wound.” It’s a condition characterized by the phrase “I just can’t seem to get over it.”
In a physical trauma the word has two meanings. Some part of the body is impacted with such a powerful force that the body’s natural protections such as the skin or bones can’t prevent the injury. And then the body’s normal natural healing capabilities can’t mend the injury without some assistance
Emotionally you can be wounded in the same manner. You can be assaulted so much emotionally that your beliefs about yourself and life, your will to grow, your spirit, your dignity, and your sense of security are all damaged. You end up feeling helpless. You can experience this for a degree in a crisis and bounce back. In a trauma you have difficulty bouncing back because you feel depersonalized.
In a trauma something happens in your brain that affects the way you process information. It affects how you interpret and store the event you experience.
The wound of trauma can create a condition called PTSD, or post-traumatic stress disorder. It is not just an emotional response to troubling events; it’s the expression of a persistent deregulation of body and brain chemistry. And brain chemistry can be altered for decades. Trauma creates chaos in our brain and causes emotional as well as cognitive concussion. Entering the world of trauma is like looking into a fractured looking glass. The familiar appears disjointed and disturbing; a strange new world unfolds.
Traumatization is about being trapped in the uncompleted act of escape – Our task is to help tem escape and find a safe haven. A traumatized event produces chronic inescapable stress or a permanent imbalance.
1. Trauma’s a separation from safety. —It’s invasive – invades all areas of our life —It must be dealt with in a unique way for each one
2. It’s unpredictable – You think you’re dropping your child off at daycare or high school or your spouse goes to work or a parent boards a plane. 3. Every new trauma activates the old one. It taps into all the old stuff
4. Trauma means that nothing will be the same again. 5. Pain will not last forever – it will diminish.
6. Half to two-thirds of victims grow in a positive way. —Develop a greater appreciation for life —Deepen spiritual beliefs —Feel stronger —Build closer relationships
7. Those who recover – They see the event as a challenge, not an overwhelming problem. They’re optimistic. They connect with people.