2. This program was designed with excerpts from presentations by the following : Sue Wesner, RN, MSN, CS Service for teens at Risk Western Psychiatric Institute and Clinic Mrs. Debra McDermott The Grieving Process- Elizabeth Kubler-Ross The Healing Process-William Worden (1982)

3. Grief from Loss There are various things that occur where we experience grief associated with some kind of loss. 1 Brainstorm different examples from the movie 2 discuss-age related for death, divorce, disease, other losses (moving, college choice, sports, roles in play, musical, honors band, chorus, etc

4. THE HEALING PROCESS William Worden (1982) Is different for everyone - based on perception of the situation (closeness) and you

5. William Worden (1982) 1. Accept the reality of the loss –This is the coulda, woulda, shoulda phase –Yes - it did happen May be different for everyone and completion of this step in healing may also vary in length

6. DENYING REALITY William Worden 1982 Denial is often the first reaction (review -our mental/emotional defense mechanisms Sometimes affected by How they died or How our loss occurred.

7. DENYING REALITY Examples of Denial: “This can’t be happening” Refusal to believe the loss has occurred. ???? Acts as a “buffer” to give you a chance to process the loss

8. BARGAINING FOR CHANGE OF REALITY Bargaining “I’d do anything to have them back”. If I do this ______, then this ______ Making promises to change if the loss is returned to them. The final attempt to avoid the TRUTH.

9. Accepting Reality Acceptance This doesn’t mean you have to be okay with the loss, just that you know it is reality and you are ready to heal from it.

10. William Worden (1982) 2. Experience the PAIN of the loss People tend to suppress (defense mechanism) grief because it’s painful and not always “convenient” May be different for everyone and, again, completion of this step in the healing process may also vary in length How might this experience affect us?

11. Experiencing Grief/Loss-ANGER Anger Why? Fairness Blame yourself or even others for the loss.

12. Effects -different ways and to different degrees for everyone Physical reactions Cognitive - “Brain Drain” Behavior Emotions

13. Physical Reactions to Grief/Trauma Appetite changes Feeling of choking Dry mouth Shortness of breath/yawning Chest tightness Weakness Fatigue Exhaustion GI Disturbances Headaches/dizziness Panic Attacks Sleep disturbances ??

14. Cognitive (brain drain) reactions ????????? –Trauma re-wires the brain. Why? –The mind is so distracted that it’s difficult to focus on details. –Preoccupation with images and thoughts of the loss/person –Concentration is at a minimum. Weakened memory skills Difficulty in decision-making

15. Behavior - Reactions to Grief Disruptions of perceived “normalcy” Disruptions of perceived “normalcy” Difficulty following daily patterns/habits Difficulty following daily patterns/habits Disorganized Disorganized Restless Restless Difficulty in decision-making Difficulty in decision-making Old life and patterns lose meaning Old life and patterns lose meaning

16. Emotions- Reactions to Grief Sadness, anger, anxiety, loneliness, and guilt Sadness, anger, anxiety, loneliness, and guilt Grief can be overwhelming Grief can be overwhelming Function vs. dysfunction Function vs. dysfunction Very similar to an anxiety disorder Very similar to an anxiety disorder May need help to deal with it May need help to deal with it

17. Coming out of loss/grief Emotional roller coaster can eventually turn into a new equilibrium for functioning. Emotional roller coaster can eventually turn into a new equilibrium for functioning. May ride this coaster multiple times May ride this coaster multiple times Age-related/ maturity related Age-related/ maturity related May need help to deal with it you learn to deal/cope with it and…> you learn to deal/cope with it and…>

18. EMOTIONS Situational Depression/Sadness PERCEPTION OF THE WORLD CHANGES! There is no hope, I just want to be left alone. A natural and important emotion(sadness) to cope. May look for help from our personal support group ( who would YOU go to first?) or from a professional counselor.

19. Crisis Intervention Tips (for self and others) FUNCTIION VS DYSFUNCTION We cannot be responsible for others behaviors. We cannot be responsible for others behaviors. However, we can be aware, supportive, and positive in our efforts to develop and protect good Mental Health in ourselves and others. However, we can be aware, supportive, and positive in our efforts to develop and protect good Mental Health in ourselves and others. GET HELP from professionals. GET HELP from professionals.

20. William Worden (1982) 3. Readjust the environment Figure out who/what is important to you Choices about your thoughts and actions

21. William Worden (1982) 4. Reinvest emotional energy in other relationships (or things) Examples: ?? This not that “The broken road that led me straight to you”

22. Focus on what we Can Do Recognize and manage negative thoughts and emotions Recognize and manage negative thoughts and emotions Understand stress and identify stressors Understand stress and identify stressors Develop coping skills Develop coping skills Make healthier choices in both your Make healthier choices in both your thoughts and actions

23. Focus on what we Can Do It’s YOUR life, YOUR book - chapter by chapter