1. Grief Recovery – Public Health Connections By Lois Hall, MS Certified Grief Recovery Specialist Executive Director, Ohio Public Health Association

2. Grief defined: Grief is the normal and natural reaction to loss or change of any kind. Grief is about mixed emotions

3. What causes grief? We go through life picking up “rocks.” Starts early Not taught well how to deal with them They keep coming They pile up We don’t take time to empty our back pack Our rocks include:

4. Our “rocks” include - Pet losses Moves Abuse Divorces Deaths Graduation Job loss Financial loss Illnesses Aging Incarceration Infertility Estrangements Violence Loss of addictions Loss of “stuff”

5. What else causes grief? The “intangibles” Safety Security Trust Respect Faith Expectations Dreams HOPE “NORMAL”

6. Public Tragedy Loss of “tangibles” Loss of “intangibles” The immensity of public tragedy – not just my grief, but “our” grief. Who will help us as individuals? Who will help us as families? Who will help our community?

7. This is how they come into tragedy - How did we get here? Born natural – able to “deal” Intuition Emotion Intellect

8. Our Belief System About Grief Don’t feel bad Replace the loss Just takes time Grieve alone Keep busy Be strong for….

9. Argh!!! This doesn’t help! Energy and anxiety build up Something’s gotta give! We need to “manage” that energy

10. We Learn to Use STERBS Short-term Energy-relieving Behaviors What are common STERBS?

11. We Learn to Use STERBS Short-Term Energy Relieving Behaviors Food tobaccoalcohol drugs Rx shopping violence risk taking Sex exercise sleep anorexia/bulimia cutting isolating church cleaning porn video games “picking” anger looting running away suicide

12. The PUBLIC HEALTH Connection How many STERBS are PH concerns? STERBS often lead to health issues such as: obesity, addictions, high blood pressure, heart problems, glucose irregularities, infectious diseases, shaken baby, violence, injuries, aches/pains, depression, hair loss, skin problems, panic attacks, anxiety, cancer???, suicide

13. I’m not mentally ill… I’m just grieving… Op-Ed Contributor Good Grief By ALLEN FRANCES Published: August 14, 2010, NY Times Coronado, Calif. A startling suggestion is buried in the fine print describing proposed changes for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders — perhaps better known as the D.S.M. 5, the book that will set the new boundary between mental disorder and normality. If this suggestion is adopted, many people who experience completely normal grief could be mislabeled as having a psychiatric problem. Suppose your spouse or child died two weeks ago and now you feel sad, take less interest and pleasure in things, have little appetite or energy, can’t sleep well and don’t feel like going to work. In the proposal for the D.S.M. 5, your condition would be diagnosed as a major depressive disorder. This would be a wholesale medicalization of normal emotion, and it would result in the overdiagnosis and overtreatment of people who would do just fine if left alone to grieve with family and friends, as people always have. It is also a safe bet that the drug companies would quickly and greedily pounce on the opportunity to mount a marketing blitz targeted to the bereaved and a campaign to “teach” physicians how to treat mourning with a magic pill………

14. Let’s Review Back packs come full Loss of life, and “stuff” Loss of intangibles - hope, safety, “normal” Myths don’t help STERBS kick in overdrive “Medication” side effects/complications Health effects add to the weight

15. Grief Recovery Recovery means “getting better” not necessarily “healed;” an ongoing process; will be reminded of the injury periodically Recovery comes sooner with positive actions – individual and community-wide Recovery comes easier when you realize you have choices – even if small ones; getting “control” back

16. Community Leader Roles Validate and acknowledge grief Avoid the “myth” statements “I can’t imagine….” Identify the loss – tangibles and intangibles Name the feelings - Give them voice – Listen for feeling words or help them find feeling words to describe their experience

17. Community Leader Roles Help them identify their choices…. Think outside the box… maybe way outside the box! So much will be out of their control – many of the “big” things Even small choices will help them regain normalcy

18. KABB Knowledge, Attitudes, Beliefs, Behaviors Help them understand – Knowledge Show them you understand – Attitudes Empower them to make choices – Beliefs Determine next steps – Behaviors Choices will lead to a new normal

19. You’re gonna be a griever too! This is also YOUR community Your back pack comes full too Your family and normal are also impacted What myths are in your BS? What are your STERBS???? What choices will you need to make? Any you can make ahead of time?

20. A Couple Grief First Aid Tips FINE = Feelings Inside Not Expressed What else might you say? Model for others that feelings are normal, natural and therefore – OK! Debrief the Emotional as well as the Practical – the airline folks are right! Have a plan; care for the caregivers!

21. Grief Recovery GR as a Public Health tool! The Grief Recovery Institute www.grief.net 4-day training GR Programs; When Children Grieve Lois Hall, MS lhall@eachmatters.com ohiopha@gmail.com www.ohiopha.org