1. Module 1: Bereavement Signs & Symptoms

2. A-Z Emotions Write down as many emotions as you can for each letter of the alphabet (the aim is to show you the difficulty of expressing emotion)

3. How difficult was the task? How would this impact you as a listener? How will this impact a bereaved person? Personal Reflections

4. Being able to understand and describe feelings is important when supporting a bereaved person. It is often difficult for the bereaved person to describe how they are feeling because so much is happening. Being able to offer suggestions i.e. “it sounds like you are lonely” is sometime helpful.

5. Some Feelings Associated with Grief sadnessguilt disbelief confusion worried lonelyinadequate powerlessness anxious depressed withdrawn preoccupied unsure deserted angry

6. Example In the course of bereavement, experiences of sadness, anger or perhaps even relief may be felt. There may be the feeling or urge to withdraw from other people or to seek social support. Many of these feelings are normal and can be experienced at any time.

7. What is Grief? “Grief is the physical, emotional, somatic (physical pain is felt instead of feelings), cognitive (thinking) and spiritual response to actual or threatened loss of a person, thing or place to which we are emotionally attached. We grieve because we are biologically willed to attach.” - John Bowlby, ‘Father of Attachment Theory.’

8. What is Grief? FeelingsCognitions SadnessLonelinessDisbelief AngerHelplessnessConfusion Guilt AnxietyPreoccupation YearningTirednessSense of Presence ShockWorthlessnessHallucinations JealousyEmancipation GRIEF Physical SensationsBehaviours Hollowness in stomachSleep disturbance Tightness in chestAppetite disturbance BreathlessnessAbsent Mindedness Lack of energyDreams/nightmares Dry MouthSearching Oversensitive to noiseSighing/crying A sense of depersonalisation (nothing seems real, Hyperactive including self)Treasuring objects Avoiding Reminders

9. Signs and Symptoms of Grief Mental & Emotional Quiet Sad Anxious Guilty Disbelief Depressed Confused Withdrawn Absent-minded Preoccupied Lonely Feelings of inadequacy Uncertainty Unsure what to do Hallucinating Sense of presence of dead person Powerlessness Deserted Worried Over-independent/independent Angry Rapid mood swings

10. Some Behaviours Associated with Grief Withdrawal Sarcasm Drinking Promiscuity Sleeping/Not sleeping Crying, Shouting, Screaming Joking Around

11. Complicated Grief People with “Complicated Grief” often need the help of a bereavement counsellor Signs include: Being stuck at phases such as shock, denial and disbelief Avoidance of grieving: feeling no emotions Obsessed with talking about loved one Extreme expression of self-blame Keeping shrine or obsession of loved one Eating disorder Poor sleeping Vivid dreams or thoughts involving the deceased Expressing feelings of extreme loneliness

12. Complicated Grief Hypochondria often with symptoms of deceased’s illness before death Guilty that enjoyment is betrayal to deceased’s memory Lack of interest in surroundings and friends Isolation Crying often and uncontrollably Deep depression often with suicidal feelings Refusing to acknowledge difficulties Prolonged anger about death Agitated Life feeling empty & meaningless

13. Visit Touchstones online for our events and blogs. www.ruralyorkshire.org.uk/project/Touchstones Call 0845 313 0270 for more information.