1. DEATH & GRIEF DSM category (v62.82 Bereavement

2. What Is Grief?
“Grief is the emotion people feel when they experience a loss. There are many different types of loss, and not all of them are related to death. For example, a person can also grieve over the breakup of an intimate relationship or after a parent moves away from home.”
The Nemours Foundation.

3. “Grief is a natural reaction to the loss of someone important to you
“Grief is a natural reaction to the loss of someone important to you. Grief is also the name for the healing process that a person goes through after someone close has died. The grieving process takes time, and the healing usually happens gradually.”
ｩ The Nemours Foundation.

4. *Depends on relationship with person.
*“Although everyone experiences grief when they lose someone, grieving affects people in different ways.”
*Depends on relationship with person.
*Circumstances under which they died.
ｩ The Nemours Foundation.
“How it affects you, partly depends on your situation and relationship with the person who died. The circumstances under which a person dies can influence grief feelings. For example, if someone has been sick for a long time or is very old, you may have expected that person's death.”

5. Cont. *Knowing someone is going to die can give us time to prepare.
*If they were suffering, it can mean a sense of relief.
*If the person that died was young, we may feel it was unfair.
ｩ The Nemours Foundation.

6. “Losing someone suddenly can be extremely traumatic, though, no matter how old that person is. Maybe someone you know died unexpectedly - as a result of violence or a car accident, for example. It can take a long time to overcome a sudden loss because you may feel caught off guard by the event and the intense feelings that are associated with it.”
ｩ The Nemours Foundation.

7. *Grief can make us feel guilty.
*Some people might blame themselves or think they could have done something to stop the death.
ｩ The Nemours Foundation.

8. “Others might think if only they had been better people, than their loved ones might not have died. These things aren't true, of course - but sometimes feelings and ideas like this are just a way of trying to make sense of something that's difficult to understand.”
ｩ The Nemours Foundation.

9. Coping With Grief
“The grieving process is very personal and individual - each person goes through his or her grief differently. Some people reach out for support from others and find comfort in good memories.”
ｩ The Nemours Foundation.

10. Coping cont. *Throw selves into activities to take mind off loss.
*Become depressed and withdraw from activities, peers, family.
*Everyone handles grief in different ways.
ｩ The Nemours Foundation.

11. “For some people, it may help to talk about the loss with others
“For some people, it may help to talk about the loss with others. Some do this naturally and easily with friends and family, others talk to a professional therapist.”
ｩ The Nemours Foundation.

12. Do children experience grief?
“Yes, if children are old enough to love, they are old enough to grieve. Many times in our society children are the forgotten grievers. For instance, when a parent dies, whom do we expect to help the child with their grief? The surviving parent. That parent not only has their own grief to deal with but they are learning for the first time how to be a single parent. They, like their child, can use support in their grieving.”
DAVID KESSLER
Excerpt from David Kessler’s website “On Grief & Grieving”
By Elisabeth Kübler-Ross & David Kessler

13. Example
“Joey's friends expected he'd be really upset at his mom's funeral, so they were surprised that he was smiling and talking with people as if nothing had happened. When they asked him about it, Joey said that seeing his friends at the funeral cheered him up because it reminded him that some things would still be the same. Joey was able to cry and talk about how he felt when he was alone with his dad after the funeral.”
Reviewed by: D'Arcy Lyness, PhD
Date reviewed: April 2004
KIDS/TEEEN.ORG

14. What are the Five Stages of Grief and Do They Always Occur in the Same Order?

15. The five stages: Denial Anger Bargaining Depression Acceptance
Elisabeth Kübler-Ross

16. Stage 1: Denial
It is hard for our minds to accept that such a loss has taken place.
“I can’t believe he’s gone”

17. Stage 2: Anger
Having no control over our loss we react to our vulnerability with anger.
“They should have been able to do something!”

18. Stage 3: Bargaining
We want to trade something we can do for the reversal of the loss.
“I’d do anything if only this didn’t happen”

19. Stage 4: Depression
A feeling of hopelessness about the situation takes over.
“I miss him”

20. Stage 5: Acceptance
We accept the reality of the situation and are able to move on with our lives.
“Yes, but we’ll be o.k.”

21. Youtube video clip
Summer expresses her grieving for Marissa in five stages. From episode 4x04 "The Metamorphosis".

22. Stages (cont.)
The stages are tools to help us frame and identify what we may be feeling.
Different for everyone.
Doesn’t always happen in exact order, may revert before moving forward.
KESSLER

23. Typical Physical Symptoms of Grief
difficulty going to sleep, or waking in the middle of the night
weight loss or gain; over- or under-eating
low energy or fatigue
headaches, chest pain, or racing heart
upset stomach or digestive problems
hair loss

24. Grief or Depression? Grief Depression Experienced in waves
Diminishes in intensity over time
Healthy self-image
Hopelessness
Response to support
Overt expression of anger
Preoccupation with deceased
Depression
Moods and feelings are static
Consistent sense of depletion
Sense of worthlessness and disturbed self-image
Pervasive hopelessness
Unresponsive to support
Anger not as pronounced
Preoccupation with self

25. There are many ways people who are grieving can help themselves:
Attending support groups
Therapy with a psychologist or other licensed mental health professional
Journaling
Eating Well
Exercising
Getting enough rest
Antidepressants such as Zoloft, Paxil, Wellbutrin, Lexapro, Celexa, Prozac and can be very effective to those who become clinically depressed

26. (continued) Reading and learning about death-related grief responses
Seeking comforting rituals
Avoiding major changes in residence, jobs, or marital status
Allowing emotions
Seeking solace in the faith community

27. Factors that may hinder the healing process
Avoiding or minimizing emotions
Using alcohol or drugs to self-medicate
Using work to avoid feelings

28. Gender Differences Women Men express their feelings early after loss
reach out for social support
are seen to express more sorrow, depression, and guilt
more willing to talk about loss
Men
more likely to take on a managerial role
intellectualize their emotions
indicate that they feel more anger, fear, and loss of control
use denial more
more private about grief