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Ministry During a Time of Major or Sudden Loss. H. Norman Wright. Mozart. Misty Blue. Shadow. Aspen. Shaelyn. Norm and Tess. Princess, James and Tristen. Jacob and Alex. Case Study.

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Presentation Transcript
case study
Case Study

The parents as well as three siblings of a twenty-three-year-old woman came in for grief counseling. All were neat, well dressed and fairly quiet. The parents were first to speak about their daughter. They began with a description which characterized her as a quality young woman, their first born in the family. She was gifted in every area of her life and had a bright future ahead of her.

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Case Study

The parents went into great detail about her abilities and accomplishments, stopping every now and then because of their inability to talk. Often all five were in tears. Two weeks prior she and her seven-month old unborn child and her mother-in-law were driving on a freeway when a truck struck and killed all of them. Since that time every member of this family has been struggling.

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Case Study

Questions

1. How would you begin this session? Describe your exact words.

2. What would be your goal in this initial session?

3. What would you say or ask to engage the three siblings?

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Case Study

4.What would you want them to take away from this session in a tangible way?

5. Based on this information identify all the possible grievers.

6. What are the factors which contribute to this loss being a complicated grieving process?

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Case Study

1. After greeting each person I would validate the fact they have experienced a great loss in their life. If I didn’t know already I would ask the name of the daughter as well as the mother-in-law and whenever I made reference to either I would use their name rather than refer to them in a general way. One of the first questions I ask is, “Tell me about (the daughter) and have each of the family respond.

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Case Study

Too often children are left out of the interaction. After each has responded my next question is, “Would you describe for me what the last two weeks has been like” so each has a chance to tell their story. Within this I often ask how they heard the news and to describe their reaction.

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Case Study

2. My goal is to have them tell their story and then normalize for them what they are experiencing and educate them about grief and what to expect in the future (using the handout on the “Crazy Feelings of Grief”). I’d also want to find out about their support system as well as giving some suggestions to eliminate the pressure of other individuals.

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Case Study

I also mention that each of them may grieve in a different way and with a different intensity. That’s all right and it’s not a sign that the other person doesn’t care if their grief is less intense. I ask, “How can the other family members support you at this time?”

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Case Study

3. Some of the questions directed toward the parents could be asked of the siblings. I also let everyone know that I would be willing to meet with each one individually. One reason for this is the deceased was described as a “special gifted” individual but was she in the eyes of the siblings? Sometimes even in the initial session I ask for a favorite memory from siblings.

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Case Study

Some may have a mixture of feelings. At some point I would ask the parents and siblings alike if there was any unfinished business or issues between them and the deceased or if there was something they wished they could have said to her before she died. If so, I would suggest writing a detailed letter and reading it aloud at the place of internment.

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Case Study

4. I would like each one to believe there will be help for all of them during the months and years ahead of them. Any suggestions or recommendations made need to be put in writing such as the list of “Crazy Feelings of Grief,” etc. I would give each one a copy of Experiencing Grief as well, and suggest they read it when they’re ready. I also let them know that it is normal not to remember what they read at this time. I send home a DVD called Tear Soup and ask them to watch this together.

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Case Study

5. There are two other family members who were lost as well. It would be easy to ignore them and gloss over this loss. I would ask about them as well as the effect this loss is having. For the parents, the loss is a grandchild which is major.

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Case Study

The possible grievers would include husband, aunts, uncles, cousins, friends, fellow workers, pastors, church, ob gyn, husband’s family, grandparents, truck driver, first responders and similar group of individuals. It’s important to consider who will minister to them and how. One of our tasks is to identify neglected grievers and reach out to them as well. Sending or giving them Experiencing Grief as well as making available copies of the Tear Soup DVD has been helpful.

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Case Study

6. Not only was this a sudden death but it was multiple tragedy involving someone’s child and unborn grandchild. There could be the possibility of legal complications because it was a vehicular accident. The way in which the notification was made could be a factor as well. (Refer to the section on sudden death for additional information).

death of a spouse
Death of a Spouse
  • Was it an anticipatory loss, crisis or trauma?
  • Delayed Grief - Because of children or work 
  • Support – The Ten Day Syndrome
  • Use the Tear Soup DVD
death of a spouse1
Death of a Spouse

Major Problems

Secondary Losses

Financial

Holiday

Significant Dates

Death of an ex-spouse

what to do
What to Do

1. Finances

2. List the essentials and the non-essentials

3. List what I know how to do and what I don’t

4. Help them handle the advice of others

5. Help them handle the holidays

6. Explanation letter – Change monthly or quarterly

what to do1
What to Do

7. Identify safe people 

8. Set up a team of people – Different each month 

9. Journaling

10. Handle the feelings

the crazy feelings of grief
The Crazy Feelings of Grief

The “crazy” feelings of grief are actually a sane response to grief. The following examples are all symptoms of normal grief:

  • distorted thinking patterns, “crazy” and/or irrational thoughts, fearful thoughts
  • feelings of despair and hopelessness
  • out of control or numbed emotions
the crazy feelings of grief1
The Crazy Feelings of Grief
  • changes in sensory perceptions (sight, taste, smell, etc.).
  • increased irritability
  • may want to talk a lot or not at all
  • memory lags and mental “short-circuits”
the crazy feelings of grief2
The Crazy Feelings of Grief
  • inability to concentrate
  • obsessive focus on the loved one
  • losing track of time
  • increase or decrease of appetite and/or sexual desire
  • difficulty falling or staying asleep
the crazy feelings of grief3
The Crazy Feelings of Grief
  • dreams in which the deceased seems to visit the griever
  • nightmares in which death themes are repeated
  • physical illness like the flu, headaches or other maladies
  • shattered beliefs about life, the world, and even God
sleep
Sleep

When you lie down you shall not be afraid; yes, you shall lie down and your sleep shall be sweet. Be not afraid of sudden terror and strong, nor of the stormy blast or the storm and ruin of the wicked when it comes [for you will be guiltless], For the Lord shall be your confidence, firm and strong, and shall keep you foot from being caught [in a trap or hidden danger]. Proverbs 3:24-26, AMP

sleep1
Sleep

You will not be afraid when you go to bed and you will sleep soundly through the night. Psalm 3:5, Good News Bible

If I’m sleepless at midnight, I spend the hours in grateful reflection. Psalm 63:6, The Message

sleep2
Sleep

When my anxious thoughts multiply within me, Your consolations delight my soul. Psalm 94:19

I will lie down and sleep in peace, for you alone, O Lord, make me dwell in safety. Psalm 4:8

sleep3
Sleep

In a dream, a vision of the night

When sound sleep falls on men,

Then He opens the ears of men,

And seals their instruction. (Job 33:15-16).

slide38

Dear God,

We give thanks for the darkness of the night where lies the world of dreams. Guide us closer to our dreams so that we may be nourished by them. Give us good dreams and memory of them so that we may carry their poetry and mystery into our daily lives

Grant us deep and restful sleep that we may wake refreshed with strength enough to renew a world grown tired.

slide39

We give thanks for the inspiration of stars, the dignity of the moon and the lullabies of crickets and frogs.

 Let us restore the night and reclaim it as a sanctuary of peace, where silence shall be music to our hearts and darkness shall throw light upon our souls. Good night. Sweet dreams. Amen

Michael LeuingA Common Prayer

slide40

“Deposits of unfinished grief reside in more American hearts than I ever imagined. Until these pockets are opened and their contents aired openly, they block unimagined amounts of human growth and potential. They can give rise to bizarre and unexplainable behavior which causes untold internal stress.” Robert Cavanaugh

your community
Your Community

Your Block – Who is There?

Working in the Community

congregation
Congregation

What are the losses? Have you asked? What has been taught on loss?

What has been taught on grief?

What has been taught on how to help others?

congregation1
Congregation

Is the teaching incident or situation prompted or purposefully done to prepare and equip the congregation to handle their losses and be a caregiver on their block and at work.

Is there a special ministerial care team to provide ongoing two year support to grieving families? Pastors need this help.

a model of ministry educate and equip
A Model of Ministry Educate and Equip

Churches

  • Sermons

Week One

  • Loss
  • Grief
  • Loss History
a model of ministry educate and equip1
A Model of MinistryEducate and Equip

Week Two

What to Say and What Not to Say

“Conversations that Count” from San Joaquin Hospital

What to Say and What Not to Say –

printout for each member of the congregation

download from web

always have books available

a model of ministry educate and equip2
A Model of MinistryEducate and Equip

1. Develop Spiritual and Emotional Caregivers

2. First Response Team in the Church

3. Grief Coaches

4. Classes

5. Grief Recovery DVD series

6. Grief Share

a model of ministry educate and equip3
A Model of MinistryEducate and Equip

7. Memorial Day or Remembrance Day

8. Your Calendar

9. Care Partner MINISTRY

10. Help the Christian Schools Develop a Plan

11. Cards to Families on Obituary Page

12. Let Others Tell Their Stories— from the pulpit and in the class

the losses of life
The Losses of Life

1. Real or Material

First loss as a child

Many are replaceable which could mask the grief reaction

the losses of life1
The Losses of Life

2. Abstract

—Love —Hope —Ambition —Control – Loss of Face

3. Imagined

We think…the other no longer loves us

Elderly woman complains children have abandoned her – Expectations

the losses of life2
The Losses of Life

4. Relationship Loss

The end of an opportunity to relate—death, divorce, moving, end of friendship

the losses of life3
The Losses of Life

5. Intrapsychic Loss

Losing an image of oneself

Losing what “might have been”

Death of a dream

Loss of Face - Shame

the losses of life4
The Losses of Life

Questions to ask:

“Has the way in which you view yourself changed recently?”

“Could it be that a dream you had or some plans have gone by the wayside?”

the losses of life5
The Losses of Life

6. Functional Loss

  • Muscular or neurological function – sight, hearing, coordination, body part, memory,
  • Diagnosis
  • Disability – Chronic Illness
the losses of life6
The Losses of Life

Sometimes good health is not a blessing but a curse—What if you’re in good health and active and you’re 80 and your wife is deteriorating mentally with Alzheimer’s and what if most of your friends, your siblings and others that you know that you used to do things with are in deteriorating health or have died? Where does that leave you?

the senility prayer
The Senility Prayer

God grant me the senility

To forget the people

I never liked anyway,

The good fortune to run into the ones I do,

And the eyesight to tell the difference.

the losses of life7
The Losses of Life

Questions to ask:

“What physical changes may have occurred in your life in the past five years that may have been a significant loss for you?”

the losses of life8
The Losses of Life

7. Role Loss

  • Retirement, transfer, promoted, demoted, graduation

Questions to ask:

  • “In what way have any of your roles in life changed?”
  • “How did this change your life and how you view yourself?”
the losses of life9
The Losses of Life

8. Systemic Loss – Child leaves home; fellow-worker;

family from your church; pastor leaves

Questions to ask:

  • “Has any significant person left your life or group recently?”
the losses of life10
The Losses of Life

9. Threatened Loss

  • Biopsy “I’m thinking of divorcing you.” downscaling, lawsuit, terrorism, hurricane, tornado, floods
the losses of life11
The Losses of Life

10. Ambiguous – Variations - 2 Main Types

Deployment, adoptee’s search for parents, MIA, The World Trade Center, strike, Alzheimer’s – Abortion

Childhood abandonment – Physical & Emotional – The loss of childhood from physical and/or sexual abuse – Family member in jail, Chronic illness

the losses of life12
The Losses of Life

Questions to ask:

“Is there any kind of loss that you’ve experienced that doesn’t make sense or you can’t seem to get any closure over?”

the losses of life13
The Losses of Life

Ambiguous loss is the most devastating – Why?

1. The loss is confusing – doesn’t make sense and you can’t problem-solve.

2. You can’t adjust to the loss so the family freezes in place.

the losses of life14
The Losses of Life

3. Family is denied the rituals that support a real loss.

4. It reminds you that life isn’t fair.

the losses of life15
The Losses of Life

11. Disenfranchised Grief

…the grief that persons experience when you incur a loss that is not or cannot be openly acknowledged, publicly mourned, or socially supported.

the losses of life16
The Losses of Life

Three types of Disenfranchised Grief:

The relationship is not recognized

The loss is not recognized.

The griever is not recognized.

secondary losses
Secondary Losses
  • confidante
  • sports partner
  • mentor
  • checkbook balancer
  • prayer partner
  • mechanic
  • source of inspiration or insight
  • identity

friend

provider

handyman

cook

lover

bill payer

gardener

laundry person

companion

secondary losses1
Secondary Losses
  • in-law support
  • couple’s class
  • financial adjustment
  • social adjustment
  • feeling of safety
  • tax preparer
  • couple friends

teacher

motivator

counselor

business partner

protector

errand person

organizer

encourager

janice s graph for ten year old jean
Janice’s Graph for Ten-Year-Old Jean

First Memory

Disneyland

0 3 4 5 7 8 10

New

School

Grandpa Hamster

Died Died Broken Arm

Couldn’t Play Soccer

jean s graph
Jean’s Graph

Hamster

Died

New

School

Broke

Arm

Couldn’t Go

To Grandpa’s

Cabin

Grandpa

Died

Lost Toys

Grandpa

Gave Her

  • A Boy She
  • Liked Doesn’t’
  • Like Her

Wasn’t Allowed

To Attend Funeral

Two Friends

Stopped Calling

First

Memory

0 3 4 5 10

how to bathe a cat
How To Bathe A Cat
  • Please forward to cat lovers everywhere who, like myself, are very concerned about their hygiene.
  • Thoroughly clean the toilet. 
  • Add the required mount of shampoo to the toilet water, and have both lids lifted.
  • Obtain the cat and soothe him while you carry him towards the bathroom.
how to bathe a cat1
How to Bathe A Cat
  • In one smooth movement, put cat in the toilet and close both lids (you may need to stand on the lid so he cannot escape).
  • CAUTION: Do not get any part of your body too close to the edge, as his paws will be reaching out for any purchase they can find.
how to bathe a cat2
How To Bathe A Cat
  • Flush the toilet three or four times. This provides a “powerwash and rinse” which I have found to be quite effective.
  • Have someone open the door to the outside to ensure that there are no people between the toilet and the outside door.
  • Stand behind the toilet as far as you can, and quickly lift both lids.
  • The now-clean cat will rocket out of the toilet, and run outside where he will dry himself.
slide86
Eve

Counselor: I’ll let you begin where you’re comfortable, Eve.

Eve: This is a bit of a recent loss. (pause) In November, November 5th I lost a very, very close friend. It was from the swine flu. It was a very sudden loss, unexpected. And we had recently had a disagreement. So I blame myself. Somehow I felt responsible, so that made it harder, because I wasn’t there to encourage proper medical care and that sort of thing. (speaking slowly and softly)

slide87
Eve

Counselor: So you’re taking on some real responsibility for this person’s death.

Eve: Yes…yes

Counselor: And what was this person’s name.

   Eve: His name was Warren.

Counselor: Warren

slide88
Eve

Eve: And they didn’t go to the doctor soon enough and I felt like that was the reason that he died. So it’s been very difficult. I can’t… I know logically I’m not responsible, but internally I was thinking, I keep telling myself, “If only this…” I reenacted making contact in time to say, “Oh, are you sick? You should go to the doctor.”

slide89
Eve

Counselor: So your mind is telling you one thing, but your heart seems to be overriding that and you’re taking on that responsibility? (tentative)

Eve: I am

Counselor: And when you reenact this in your mind, how does that leave you?

slide90
Eve

Eve: Oh, I feel terrible. I feel so guilty, I feel lost and sad. I started to get migraine headaches. I realized was punishing myself each time I’d think it.

Counselor: How long did you know Warren?

Eve: Probably 32 years

Counselor: So it was a long relationship?

slide91
Eve

Eve: A long friendship…very long friendship. Very long (voice trails off)

Counselor: And you’re thinking if we haven’t had this riff then I could have saved him.

slide92
Eve

Eve: Right, I had tried to get back in touch but by then I didn’t know he was sick. I actually heard about it accidentally. Someone who knew I knew him said, “You know Warren’s in ICU how’s he doing?” I said, “Oh, I don’t know.” I was in shock, I couldn’t believe he’d had been there for 17 days before I heard. And he was all alone during his illness part. So, waited to go to the doctor to the last minute to go to the doctor and it was too late.

slide93
Eve

Counselor: You’re thinking I could have prevented this from happening.

Eve: Yeah, I think that over and over and over. And I know he probably wouldn’t have ever listened to me. He was a very stubborn person, very stubborn because his son was living with him and he wouldn’t listen to anybody.

slide94
Eve

Counselor: So there were other people who probably encouraged him to go to the doctor.

Eve: Probably

Counselor: But he didn’t listen to them.

slide95
Eve

Eve: Well, actually just his son. He never let anyone at work know how bad he was, how sick he was. They just kept thinking he would be coming back next week. One of his co-workers felt guilty too because she was with him when she dropped him off and she knew how sick he was. But she didn’t have the kind of connection with him that she would call. Well, she got sick herself from the swine flu. And it’s been since November, it’s a little better, but suddenly it will come over me.

slide96
Eve

Counselor: It’s still heavy on your heart.

Eve: It’s so heavy, it’s so painful

Counselor: But you’re not certain he would have listened to you.

Eve: No, honestly I know he probably wouldn’t have. He’s very stubborn about going to the doctor about anything.

 Counselor: Like many men

Eve: Yes, like many men (smiles)

slide97
Eve

Counselor: But still because of that connection you just wish, “I could have done something to help him.”

Eve: I feel so helpless. This is the worst part though. I never say anything to somebody. He had sort of a sharp way of saying things. It was part of him, everybody knew that. And I never said anything back. And this one time it was over something stupid. He made a comment about my car. I carry all my files. And he made some comment. And I said, “I don’t ever want to talk to you.” But it was a lot of things. I said, “I don’t want to talk to you anymore.” It hurt my feelings. 

slide98
Eve

Counselor: It sounds like it was a build up, it wasn’t just what happened then.

Eve: So I said, “I never want to talk to you again.” I didn’t really mean it because I never say that to anyone. But then I thought he probably really believes it. So, then I was afraid to call him back. We didn’t speak ever again. It was so hard. I feel like he left the earth thinking that I never wanted to talk to him again. He was such a good friend.

slide99
Eve

Counselor: You had a lot of good times together.

Eve: We worked in a lot of different places together. He was a very great person. Just didn’t like to go to the doctor. I felt so helpless.

Counselor: It sounds like you still have some things you’d like to say to him. Have you written him a letter?

Eve: No, I haven’t. It’s an idea.

slide100
Eve

Counselor: Do you think it would help?

Eve: Yeah, I think it would.

Counselor: If you were to write it, what would you do with it?

Eve: Oh, I’d probably would read it out loud. That would probably help.

Counselor: Where would you read this?

slide101
Eve

Eve: I just heard they are getting ready to get his headstone ready. Maybe I could read it at his grave. It’s funny because I’ve been thinking about what to do to go there what would I do? In Judaism you leave stones to show that you have been there. And I was reading about it last night you know like an altar.

slide102
Eve

I have a stone from Israel. It’s a tradition that comes from many different places. And I have a stone that I have from when I went to Israel. He always said he wanted to go to Israel for the history. He didn’t have any belief system at all, in God. (takes a Kleenex) That would be a healing thing to read the letter.

Counselor: What would you like to say?

slide103
Eve

Eve: Just to thank him for being such a good friend. To tell him I miss him and that a lot of people miss him. He such a beloved person. To tell him I wish he hadn’t been so stubborn, but we know that was who he was. Just to put those feelings into words, give words to those feelings.

Counselor: Churning. They’re churning around a lot inside of you, aren’t they?

slide104
Eve

Eve: Just even talking I feel some relief. They come back. It’s seems that they come back all of a sudden.

Counselor: You also alluded to regrets. I wonder what you could do about the regrets.

slide105
Eve

Eve: Well I think the one thing was the regret. I rarely even speak to somebody if they have a bad temper - I think I won’t talk to them for a while. And I thought to make sure I never leave a friend without making sure that we’re still connected. Never say I won’t ever talk to you again. I don’t know why I said that.

slide106
Eve

Counselor: This is becoming sort of a learning experience? 

Eve: To learn how important every moment is. And not to lose a chance to do some healing. And to make sure we reconnect with each other even when we’ve been upset in a moment. Never walk away from anyone whether I care about them or not, like Warren. Every person is important who comes in my path.

slide107
Eve

I don’t want to ever regret the thing about words. Not to put words out that are going to hurt. I do regret that. Because you don’t know if you’re ever going to see that person again. You just don’t know! 

slide108
Eve

Counselor: And you really don’t fully know how he felt toward you after that either. I guess we all tend to assume the worst. 

Eve: Oh, yes.

Counselor: Can you think of anything else you might be able to do that can help you at this time?

slide109
Eve

Eve: I think talking about this here and writing the letter. I need to reconnect with the woman who was with him when he got ill because she carried so much guilt, too because she didn’t go back and reconnect with him.. We’ve formed a bond and friendship together and because of that we can both share together. That’s been very helpful.

slide110
Eve

Counselor: The situation itself where you had the altercation with him, does it play over sometimes in your mind?

Eve: Yes. 

Counselor: I imagine when that happens it’s still pretty upsetting.

Eve: It still hurts

slide111
Eve

Counselor: What do you think about writing that out in detail in longhand?

Eve: Oh, I hadn’t thought of that. I have such rare altercations… Yeah, that would be good because it’s painful to think about.  

Counselor: Sometimes those thoughts get stuck on a circular loop and they keep playing. And one of the best ways is just best to write it.

slide112
Eve

Eve: I like that idea. (pause) Yes, that would be good.

Counselor: Can you think of anything else you might be able to do?

Eve: Well, one of the things I am doing - that’s why I’m taking this class because I want to be able to help others. I’ve counseled for a long time but feel like I went right through the fire with this loss.

slide113
Eve

I lost my dad 11 years ago, that was hard and I’ve had the miscarriages, that was hard. Maybe part of this is I’m feeling I should have known. I’m mad at myself as a counselor, I should have known to do this differently. Just to give myself permission to be human, not to expect myself to know everything when I’m in a situation like this.

empathic response leads
Empathic Response Leads

“Kind of feeling…”

“Sort of feeling…”

“As I get it, you felt that…”

“Sort of a feeling that…”

“If I’m hearing you correctly…”

empathic response leads1
Empathic Response Leads

“To me it’s almost like you are saying, I…”

“Sort of hear you saying that maybe you…”

“I’m not sure I’m with you, but…

“I wonder if you’re expressing a concern that…”

“Your message seems to be, I…”

“So your world is a place where you…”

the purpose of loss
The Purpose of Loss

A. Loss can strengthen our faith.

B. Loss can produce maturity.

C. As we suffer we enter more into the suffering of our Lord and become more Christ-like

D. When you experience loss you will discover the extent of the comfort of God.

a biblical perspective
A Biblical Perspective

But whatever things were gain to me, those things I have counted as loss for the sake of Christ. More than that, I count all things to be loss in view of the surpassing value of knowing Christ Jesus my Lord, for whom I have suffered the loss of all things, and count them but rubbish so that I may gain Christ, Philippians 3:7-8, NASB

a biblical perspective1
A Biblical Perspective

Peter said, “Beloved, do not think it strange concerning the fiery trials which try you, as though some strange thing happened to you”

(I Peter 4:12, NKJV)

The Message translation puts it in a unique way: “Friends, when life gets really difficult, don’t jump to the conclusion that God isn’t on the job. Instead, be glad that you are in the very thick of what Christ experienced. This is a spiritual refining process, with glory just around the corner.”

a biblical perspective2
A Biblical Perspective

A Biblical perspective – Purpose of Loss

“Consider it all joy, my brethren, when you encounter various trials, knowing that the testing of your faith produces endurance, “ James 1:2,3

grief
Grief

Grief will take longer than you’ve ever imagined. It tends to intensify at three months, special dates and the one year anniversary.

Grief is a journey, a process and there is resolution. Hear the words of Scripture:

grief1
Grief

“I weep with grief; my heart is heavy with sorrow; encourage and cheer me with your words,” Psalm 119:28, TLB

“He heals the brokenhearted and binds up their wounds—curing their pains and their sorrows,” Psalm 147:3, AMP

grief2
Grief

“I cried to the Lord in my suffering and he heard me, he set me free from all my fears,” Psalm 34:6, NLT

“For You have delivered me from death, my eyes and tears, and my feet from stumbling and falling. I will walk before the Lord in the land of the living,” Psalm 116:8-9, AMP

grief3
Grief

“Then maidens will dance and be glad, young men and old as well, I will turn their mourning into gladness; I will give them comfort and joy instead of sorrow,” Jeremiah 31:13

“ ‘You will grieve but your grief will turn to joy,’” John 16:6

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3. The body and the mind grieve. It is a full time job. Often the grief has symptoms erupt that imitate the cause of death of the loved one.

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4. Grief is a wound that needs attention in order to heal. The mourning period is really a time of convalescence.

5. Grieving is relearning your world. We have to reshape our lives, reinterpret and redirect our life story and find our way back to purposeful, meaningful and hopeful life again.

the five tasks of grief
The Five Tasks of Grief

Understanding and using the tasks of grief as your primary therapeutic approach

  • Task #1: Recognize and accept that your loved one has died and is unable to return.
  • Task #2: Express all the emotions associated with the death of your loved one.
the five tasks of grief1
The Five Tasks of Grief
  • Task #3: Identify, summarize, and find a place to store the memories of your loved one which will honor the life of that person and make room to move on.
  • Task #4: Identify who you are now, independent of your prior connection with your loved one.
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The Five Tasks of Grief
  • Task #5: Reinvest in life as an individual without your deceased loved one. You have a new normal.
the messages of grief
The Messages of Grief

1) Through grief you express your feelings about your loss.

2) Through grief you express your protest at the loss

3) Through grief you express the effects you have experienced from the loss.

three essential things to remember
Three Essential Things to Remember

1) The person in grief needs to find the words for the loss.

2) Say the words aloud.

3) Know that the words have been heard.

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“Grieving is a journey that teaches us how to love in a new way now that our loved one is no longer with us.”

“Consciously remembering those who have died is the key that opens our hearts, that allows us to love them in new ways.”

Thomas Attig

grief and loss
Grief and Loss
  • The words of grief include “without,” “amputation,” “longing”
  • The disbelief of a loss causes us to look at everything like it’s a gauze curtain.
  • We learn in our life to do things with our hands and our minds. But it’s not as easy to accomplish something with our heart.
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Grief and Loss
  • Grief is a demanding and overpowering intruder – It’s a form of exhaustion and at first it’s like an internal emotional hemorrhage.
  • Grieving like so much else in life does not have to impoverish but can be a learning experience.
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Grief and Loss
  • There are many burdens to carry in grief, but one of the greatest is educating others to the meaning of grief.
  • The loss we experience doesn’t stay the same but changes daily, shrinking and expanding as well as gathering other unattended losses of our life and reactivating some which were dormant.
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Grief and Loss

The words of grief are many and varied –

  • Apathy – no energy and not caring
  • Yearning – for many things including undoing what was done
  • Ache
  • It’s been… “Viewing your life in a time pattern based on how long they’re gone.”
kittens
Kittens

I need some help. My cousin’s cat had kittens and he was able to give away all but 3 of them. I told him I would help him find homes for the last 3. I can’t take any because I’m allergic, but if 3 of you could take just 1 it would be such a help and the kittens could have a nice home.

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Kittens

Since he lives up by the San Mateo Nuclear Power Plan I’ll go pick them up for you. I’ve attached pictures of the last 3 kittens. Will you help?

patterns of grief
Patterns of Grief

Some individuals are intuitive grievers. For them:

1. Feelingsare intensely experienced. They want and need to express them.

2. Expressions such as crying and lamenting reflect their inner experience.

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Patterns of Grief

3. These grievers need to express feelings in order to create successful adaptive strategies. For them feelings are vibrant, intense “colors.”

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Patterns of Grief

Some individuals are instrumental grievers.

1. They thinkof their grief more than feel it: Feelings are less intense.

2. There’s a general reluctance to talk about feelings

3. Instrumentals are often identified by the absence of crying and seeking help.

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Patterns of Grief

Some individual are blended grievers.

1. They have both elements but with a greater emphasis on one or the other.

From — Men Don’t Cry…Women Do, Martin & Doka

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Job

Job, having lost all 10 of his children, laments, “My days have passed, my plans are shattered, and so are the desires of my heart” (17:11). He concludes, “Where then is my hope? Who can see any hope for me?” (v.15)

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Job

Bildad, who probably had never had training in communications, could not simply receive Job’s words (18:2). He had to “correct” Job. Possibly while Job was lamenting, Bildad was composing a challenge:

When will you end these speeches? Be sensible, and then we can talk.

Bildad the Shuhite to Job, Job 18:2

how we can help others
How We Can Help Others

What you can say

  • Your words
  • “Death and life are in the power of the tongue, and they who indulge it shall eat the fruit of it [for death or life] Prov. 18:21, AMP
  • “A gentle tongue [with its healing power] is a tree of life” Prov. 15:4a, AMP
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How We Can Help Others

“A man has joy in making an apt answer, and a word spoken at the right moment, how good it is!” Prov. 15:23, AMP

“A word fitly spoken and in due season is like apples of gold in a setting of silver” Prov. 25:11, AMP

“Watch the way you talk… Say only what helps, each word is a gift” Eph. 4:29, The Message

how we can help
How We Can Help

The three most important steps to take in helping a person:

1). Listening with your eyes

2). Listening with your ears

3). Listening with your heart

James 1:19: Prov. 18:13

trauma
Trauma

I am frightened inside; the terror of death has attacked me. I am scared and shaking, and terror grips me. I said, “I wish I had wings like a dove. Then I would fly away and rest. I would wander far away and stay in the desert. I would hurry to my place of escape, far away from the wind and storm.”

Psalm 55:4-8 New Century Version

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Trauma

How long must I wrestle with my thoughts and everyday have sorrow in my heart?

Psalm 13:2, NIV

the common themes of trauma
The Common Themes of Trauma

It can strike anyone

Trauma leaves us feeling unsafe

It involves a loss

Trauma makes us feel overwhelmed

It is often unspeakable

Trauma can change or challenge our view of God

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The Common Themes of Trauma

Trauma produces “hyper-arousal,” “hyper-alertness” and “hyper-sensitivity.”

Those traumatized often re-experience the trauma

It leads to feelings of helplessness

Trauma does not make sense

what is trauma
What Is Trauma?

Trauma is the response to any event that shatters your world.

It’s more than a state of crisis. Trauma leaves you feeling unsafe because your place of refuge has been invaded

The word trauma comes from a Greek word that means “wound.” It’s a condition characterized by the phrase “I just can’t seem to get over it.”

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Trauma

1. Trauma’s a separation from safety.

—It’s invasive – invades all areas of our life

—It must be dealt with in a unique way for each one

2. It’s unpredictable – You think you’re dropping your child off at daycare or high school or your spouse goes to work or a parent boards a plane.

3. Every new trauma activates the old one. It taps into all the old stuff

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Trauma

4. Trauma means that nothing will be the same again.

5. Pain will not last forever – it will diminish.

6. Half to two-thirds of victims grow in a positive way.

—Develop a greater appreciation for life

—Deepen spiritual beliefs

—Feel stronger

—Build closer relationships

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Trauma

7. Those who recover

–They see the event as a challenge, not an overwhelming problem.

-They’re optimistic.

-They connect with people.

-They use their spiritual resources.

characteristics of ptsd
Characteristics Of PTSD

PTSD Symptoms:

Flashbacks

Traumatic Dreams

Memory Disturbance

Persistent Intrusive Recollections

Self Medication – Substance Abuse

Anger Irritability

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PTSD

PTSD Symptoms:

Dazed or Numb Appearance

Panic Attacks

Phobia Formation

Startle Response

Hyper-Vigilance

reflections on trauma
Reflections on Trauma

Exposure to trauma that is repeated is more disabling as is those events that are unpredictable.

Violation by another person is always worse that an impersonal trauma. Complex trauma is premeditated and caused by others, usually someone known

Hidden traumas occur when the trauma has been repressed, when you live in an environment that is trauma blind.

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Reflections on Trauma

In trauma there is two kinds of suffering, one is the trauma caused by the suffering living with the experience and the aftermath. And the second type of suffering is part of the healing process. This is the pain that was too overwhelming to feel before.

Traumatic events are like thieves that takes something from us.

what to say facing your fears
What to Say Facing Your Fears

When we encounter something that we feel threatens our life, a cascade of hormonal reactions is triggered.

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What to Say Facing Your Fears

Something happens deep inside our brains, too. Our right-brain alarm goes off and drowns out the logical analysis of our left brain. It screams, “Less thinking, more action!” It also starts taking pictures like mad—the nonadrenalin heightens the emotional aspects of the situation making it more vivid and notable. Very strong and clear memories are being recorded, probably so that we will remember this event and avoid it in the future.

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What to Say Facing Your Fears

What you experienced during the incident was so traumatic that your brain took special note of it, and anytime you approach a person, place, thing or experience that is similar to your original trauma, your right brain whips out its “photo album” and puts on an intense presentation (sights, sounds, smells, tastes) attempting to alert you of the danger that could be waiting there.

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What to Say Facing Your Fears

Remember, our left side is more like a “computer,” our right side is more like a “photo album.” This side remembers faces and craves rapport and relationship. It’s our emotional side. It is intuitive, spontaneous, experience-oriented, artistic, creative. It stores emotions. We dream on this side of our brain. And very importantly, this is the “alarm” side of our brain.

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What to Say Facing Your Fears

Your logical left brain gets muted, and the calming influence of your hippocampus gets pinched off. You’re off on a “re-experiencing” jaunt which, if your right brain would only listen, your left brain could explain why you didn’t need to take that detour today. 

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What to Say Facing Your Fears

It’s important to invite Jesus Christ into the episodic memories of your trauma, visualizing Him experiencing it with you. Hopefully, you’ll be able to continue engaging in this spiritual exercise, giving Him more and more access to your places of pain and darkness and thereby bringing about some direct healing.

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What to Say Facing Your Fears

In this Step we want to encourage you – with Jesus’ help – to take action concerning the things that trigger your re-experiencing episodes. By now, you are probably well-aware of what your triggers are. In the space following, write down any people, places, things or experiences that trigger your re-experiencing episodes, and what the typical effect is (use additional paper if needed).

how many dogs does it take to change a light bulb
How Many Dogs Does it Take to Change a Light Bulb?

Golden retriever: “The sun is shining, the day is young, we’ve got our whole lives ahead of us, and you’re inside worrying about a stupid burned-out light bulb?”

Border collie: “Just one. And I’ll replace any wiring that’s not up to code.”

Dachshund: “I can’t reach the stupid lamp!”

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How Many Dogs Does it Take to Change a Light Bulb?

Toy poodle: “I’ll just blow in the Border collie’s ear, and he’ll do it. By the time he finishes rewiring the house, my nails will be dry.”

Lab: “Oh, me, me!!! Pleeeeeze let me change the lightbulb. Can I? Can I? Huh? Huh? Can I?”

Cocker spaniel: “Why change it? I can still pee on the carpet in the dark.”

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How Many Dogs Does it Take to Change a Light Bulb?

Australian shepherd: “First put all the lightbulbs in a little circle…”

Old English sheep dog: “Lightbulb? Lighbulb? That thing I just ate was a lightbulb?”

Chihuahua: “YoQueiero Taco Bulb.”

suggested steps of helping those in trauma
Suggested Steps Of Helping Those In Trauma

Begin by developing an atmosphere of safety, trust and exploration. Just talking and listening with your eyes and ears is more important than techniques. “Tell me your story.” Honor their way of thinking and speaking. The more similar you appear to counselees the greater comfort the client will experience.

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Suggested Steps Of Helping Those In Trauma

Comfort is vital (commonalities create comfort, differences produce distance, Schupp, 2003). If counselees are comfortable, they are more likely to discuss the trauma.

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Suggested Steps Of Helping Those In Trauma

Decondition harmful affective responses. This critical step is much easier to state than to accomplish. Help them discover new ways of responding to difficult responses—reframe and reinterpret.

Reframe symptoms as “signs of coping ” and as “protective and healing mechanisms” and “normal” part of the recovery process.

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Suggested Steps Of Helping Those In Trauma

The problem with traumatic memories tend to be their intrusion into the present, not an inability to recall them. When they intrude, discussing them and understanding how they may unconsciously influence our behavior can be helpful. At the same time, some people heal by fighting their fears and never discussing or explicitly recalling their painful memories at all. For people whose memories don’t negatively affect them in the present, pressuring them to focus on them may actually harm.

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Suggested Steps Of Helping Those In Trauma

A. Intrusive thoughts are an attempt to make sense of the experience, the brain’s attempt to assimilate the experience. Not just let the experience go, but rather make sense of it; flashbacks/ nightmares are access routes to memory. Flashbacks is a way the brain is attempting to heal itself. It’s the mind’s attempt to make sense of what happened. What can be done about intrusive thoughts or flashbacks?

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Suggested Steps Of Helping Those In Trauma

B. Denial/numbing are ways that the mind takes a “time out,” as a way of “dosing” or of “pacing” oneself so you only have to deal with so much stress at one time.

C. Dissociation at the time of the event was a potentially useful skill. Speak of the “wisdom of the body,” e.g., “mind is taking time out from overstimulation”’ “denial is one of nature’s small mercies.”

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Suggested Steps Of Helping Those In Trauma

D. Convey that the “survival skills” that the client once used and were adaptive at the time may no longer be appropriate.

E. Commend the counselee for being distressed. The counselor might say something like the following: “Given what you have been through, if you didn’t have stressful reactions, weren’t depressed, had a short fuse at times, dwelled on what happened (use counselee’s symptoms), then I would be really concerned.

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Suggested Steps Of Helping Those In Trauma

F. Indicate that PTSD is definitely responsive to treatment and that healing can be a lifelong process. Convey to the counselee that symptomatology may not go away complete, nor forever.

G. Indicate that it is possible that symptoms “may get worse before they get better” as we discuss and work through what happened and why, as we begin to refocus on the trauma.

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Suggested Steps Of Helping Those In Trauma

H. Finally, “although this may be difficult to believe right now, you may even find that there will be some positive benefits to you and your life as a result of the experiences you have had and your willingness now to face and work through what you must work through.”

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Suggested Steps Of Helping Those In Trauma

Re-exposure to the trauma is critical, as is how and when the person is re-exposed. Research with all trauma survivors indicates a principle that the individual must mentally revisit the traumatic experience again—but with the supportive assistance of someone who can help them through their fear.

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Suggested Steps Of Helping Those In Trauma
  • The person becomes less afraid of the memory.
  • This is a process by which anxiety comes down on its own. It changes a “hot memory” to a bad memory.
  • How do you do this? One way is TIR (Traumatic Incident Reduction. It can either be by talking or writing.
  • If we don’t want the person to relive the memory so we have them write it down in detail repeatedly in order to drain it.
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Suggested Steps Of Helping Those In Trauma

When they write longhand it’s a tactile memory. It involves better hand/eye coordination and accesses all parts of the brain to help bring it together.

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Suggested Steps Of Helping Those In Trauma

Battling illness and pain with pen and paper may be unorthodox, but it may also spell relief. “People who write for twenty minutes a day about traumatic events reduce their doctor visits, improve their immune systems and, among arthritis sufferers, use less medication and have greater mobility,” James W. Pennebaker, Ph.D, professor at the University of Texas at Austin.

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Suggested Steps Of Helping Those In Trauma

Why the relief? Suppressing negative emotions can weaken the immune system and arouse your fight-or-flight system, churning up blood pressure and heart rate…Writing about conflict or trauma helps organize the experience. The net affect is that people can move beyond the stressful event. How?

Breathing –

Counting –

Radio Dial

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Suggested Steps Of Helping Those In Trauma
  • Restructure the meaning of the trauma by having the person change the ending of the trauma story. As the person is reexposed to traumatic experiences, it is very important to add a component that did not exist the first time around—control. Take the control away from the event or the person. You’ve survived until now. How could this be worse? You told your story. How will you be different next month, next year?
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Suggested Steps Of Helping Those In Trauma

Replace problematic behavioral responses with adaptive behaviors. Teach the person how to make positive changes. “Remember you can write the last chapter of your trauma. It hasn’t been written yet.”

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Suggested Steps Of Helping Those In Trauma

Build a new internal self-view. Understanding the meaning of past trauma to the individual, which is Step 2, will help you understand what the post trauma self-image is. “Don’t define yourself permanently as a traumatized person. Teach them when to remember the trauma instead of the traumatic memories being in charge.”