The Myths of Grief Management Mary Raymer, L.M.S.W., A.C.S.W. Copyright 2007

“Nobody knows enough, but many know too much.” Marie Von Ebner-Eschenbach, Aphormisms (1893)

Grief is an ongoing process that is a normal and necessary response to loss. Individuals need to be active participants in order to find their “new normal”.

Common Myths about Grief  Time heals  It takes one year after a loss to resolve grief  It is crucial to not make any major decisions during the first year

Common Myths about Grief  All losses are the same  The goal of grief is to forget and “let go”  Grief occurs in predictable stages

Common Myths about Grief  Everyone grieves in the same way  Expression of feelings is the main aspect of healing  Depression is an inevitable aspect of grief

Common Myths about Grief  Medication is never or always indicated for the bereaved  People require therapy to get through grief  Children do not grieve

Common Myths about Grief  Sudden death and anticipated death effect people in the same way  If you truly love someone, you will grieve more intensely

Crucial Questions of Grief  What have I lost?  What is still intact?  What really matters?

Crucial Questions of Grief  What have I learned?  What are the possibilities now?

Crucial Questions of Grief  What are the obstacles to these possibilities?  What do I need to achieve these possibilities?

Social Work Interventions  Validation  People who believe in our abilities  Connectedness

Social Work Interventions  Information/education  Support for healthy changes

Major Depressive Disorder and Grief Differentiation  Guilt about things other than actions taken or not taken by the survivor at the time of death

Major Depressive Disorder and Grief Differentiation  Thoughts of death other than the survivor feeling that he or she would be better off dead or should have died with the deceased person

Major Depressive Disorder and Grief Differentiation  Morbid preoccupation with worthlessness  Marked psychomotor retardation

Major Depressive Disorder and Grief Differentiation  Prolonged and marked functional impairment  Hallucinatory experiences other than thinking that he or she hears the voice of, or transiently sees the image of the deceased person (From -DSM-IV) (From -DSM-IV)

Grief Identifiable loss Identifiable loss Focus is on the loss Focus is on the loss Fluctuating ability to feel pleasure Fluctuating ability to feel pleasure

Grief Variable physical symptoms Variable physical symptoms Closeness of others is usually reassuring Closeness of others is usually reassuring Fluctuating emotions Fluctuating emotions

Depression  Loss may or may not be identifiable  Focus is on the self  Inability to feel pleasure

Depression  Persistent self-destructive response  Persistent isolation from others and self  Fixed emotions or feeling stuck

Social Work Intervention  Assess and screen for type of depression  Identify appropriate course of treatment plan  Intervene with appropriate treatment

Social Work Intervention  Refer to appropriate additional resources  When depression is alleviated, provide education and support to grieve

High Risk Factors  Multiple losses  Unsafe environment  History of substance abuse

High Risk Factors  Pre-existing mental disorder  Socially negated losses  Lack of social support

“I am the sum of many difficult acts of grace.” May Sarton