Lecture 1b: Death and grief.
We tend to avoid dealing with tragedies like death.
When doctors get sick, they try to avoid the topic.
“I’m not afraid of dying I just don’t want to be there when it happens.”
Books what you can/cannot should/should not do when you’re dying. Also about how to build your
own coffin. There is also fascination about death. Every religion has an important place for death and
what happens after death.
To conquer, to try and prevent the world of becoming to an end.
Cryonic suspension: frozen persons with diseases to be unfrozen when there’s a cure for
the disease.
Biohacking; try to find a way of reliving.
Virtual reanimation; hologram
Memorialization of death
Gustav Viegland painting; Death separating man and woman 1906.
Dealing with bereave
How do we deal with that?
Colin Murray Parks: The Price of Love
The only way not to grieve about a person is not attaching to anyone.
Many people turn to the internet; Not empirical!
´Anger is a necessary stage of the healing process. Be willing to feel your anger,
even though it may seem endless. The more you truly feel it, the more it will
begin to dissipate and the more you will heal.” (Kubler-Ross & Kessler, 2006) NOT TRUE
The majority of the information resources [available to the bereaved-HS] draw on the five stages
of grief theory (Kubler-Ross, 1969) said by Petrus Consulting 2008;2016
Grief Task Model (Worden, 1991). This is true.
o Accepting the reality of loss
o Allowing yourself to experience (not the same as expressing it) the emotions
o Adjusting to life without the deceased
o Relocating the deceased emotionally and move on
,A (working) definition of grief:
The primary emotional reaction to the death of a significant other (loved one). It is
a complex emotional syndrome accompanied by physical changes and physical symptoms.
In addition, it involves a wide range of possible cognitive and behavioral reactions.
(Stroebe, Schut, Stroebe & van den Bout, 2013).
4 dimensions of grief
Emotional (sorrow, loneliness, numbness, anxiety, guilt, aggression, helplessness, pessimism,
relief).
Cognitive (loss of concentration, intrusive images, preoccupation of the deceased, lowered self-
esteem, hopelessness)
Physical (sleep-related problems, decreased appetite, stress, headaches, tension, low energy,
similar symptoms to the deceased)
Behavioral (agitated, withdrawn, seeking behavior, avoidance)
Major determinants: in detail in literature !
o Background bereaved person; gender, age, personality, attachment, health, history
o Characteristics of death; sudden, unexpected, premature death, traumatic circumstances
o Characteristics of the deceased; kinship relationship, quality of the relationship
o Situation after loss: lack of support, secondary losses (lose partner lose income), ways of
coping
Background bereaved person
Mortality ratio of widows and widowers compared to similar groups of married couples in terms of
age
Higher in younger age groups
Higher for men (widowers) than for women
Explanation for gender differences:
o Differences in social support
o Differences in coping strategies
(men are more problem focused, women more emotion focused; how to problem-solve death?)
o Differences in type of bereavement
Religion:
o Life Philosophy (systems of meaning):
Conflict results (opposing processes?). Losing faith in religion
o Religious social community:
A relationship between worship sessions attendance and social support, and a relationship
between social support and health (“social capital”)
,Characteristics of death
NASH classification: Natural, Accident, Suicide and Homicide
Sudden, untimely, intentional, painful and violent deaths leads to greater risks
Debilitating and exhausting (terminal) conditions are a risk factor too why? Checken!
Talking and about acting in preparation of imminent death predicts less intense grief
(Mori et al., 2018).
Characteristics of the deceased
o Kinship (parent = losing your past, partner = losing your present, child = losing your future)
o Nature of relationship
o Quality of relationship
Unacknowledged losses or “Disenfranchised grief”:
- Ex-partners
- In the past: miscarriage, perinatal deaths etc.
- In some circles: homosexual relationships
- Extramarital affairs
- Etc..
After the loss: aspects
- Coping
- Social support
- Secondary Losses
- Multiple bereavements
- Family dynamics
- Material resources (change)
Conclusions (#1):
From a societal perspective, the concepts of death and dying, and surviving relatives, are
surrounded by complicated context of denial and fascination
Death in most western societies becomes more normalized, more like it is in many countries
elsewhere
Conclusions (#2):
Death of a loved one is virtually inescapable and in most cultures has significant
consequences for others physical, psychological and social functioning
There is no such thing as the grieving process. There are tremendous individual and cultural
differences. Every model is a simplification and should be recognized as such.
Conclusions (#3):
There are factors that lead to a higher risk of problems in the grieving process, but the
predictive power of these factors is usually not very high, and hence sound explanations are
generally not available
, Conclusions (#4):
A small minority cannot cope by themselves and need professional help
A large majority of surviving relatives eventually succeed in overcoming the loss.
Lecture 2a.
What are traumatic experiences?
Traumatic events:
- War violence and destruction
- Combat (military stress)
- Long-term imprisonment
- Criminal violence (rape, robbery, hijacking)
- Disasters (natural, man-made and technological)
- Accidents (traffic accidents)
- Child abuse and family violence
- Sudden and traumatic loss of a loved one.
Characteristics of overwhelming events:
Extreme powerlessness
Profound disruption
Extreme discomfort
Often it’s a very sudden and acute event that totally disrupts your life.
Type I trauma: Single, intense, unanticipated events
Typt II trauma: Prolonged, repeated, extreme conditions (series of extreme events over time)
History of psychotrauma; roots in Vietnam war
The ‘early years’ – around 1980
Chronic difficulties of Vietnam War veterans in the USA
o 60.000 were killed, soldiers were in duty for one year
o Many veterans came back with depressive symptoms, marital problems, sleeping
problems, problems at work.
Hostage-taking incidents in NL (1975-1977)
Establishment of victim support programs in European countries
Introduction of the concept of PTSD (DSM-III)
1850-1870
French publications on child abuse (Briquet, 1859) as well on war
First train accidents (Erichsen, 1876)
American Civil War (1861, Da Costa’s ‘soldiers heart’ syndrome)
1880-1900
Concept of trauma neurosis (Opperheim)
Hysteria: after-effects of sexual abuse (Janet, Beuer & Freud)
We tend to avoid dealing with tragedies like death.
When doctors get sick, they try to avoid the topic.
“I’m not afraid of dying I just don’t want to be there when it happens.”
Books what you can/cannot should/should not do when you’re dying. Also about how to build your
own coffin. There is also fascination about death. Every religion has an important place for death and
what happens after death.
To conquer, to try and prevent the world of becoming to an end.
Cryonic suspension: frozen persons with diseases to be unfrozen when there’s a cure for
the disease.
Biohacking; try to find a way of reliving.
Virtual reanimation; hologram
Memorialization of death
Gustav Viegland painting; Death separating man and woman 1906.
Dealing with bereave
How do we deal with that?
Colin Murray Parks: The Price of Love
The only way not to grieve about a person is not attaching to anyone.
Many people turn to the internet; Not empirical!
´Anger is a necessary stage of the healing process. Be willing to feel your anger,
even though it may seem endless. The more you truly feel it, the more it will
begin to dissipate and the more you will heal.” (Kubler-Ross & Kessler, 2006) NOT TRUE
The majority of the information resources [available to the bereaved-HS] draw on the five stages
of grief theory (Kubler-Ross, 1969) said by Petrus Consulting 2008;2016
Grief Task Model (Worden, 1991). This is true.
o Accepting the reality of loss
o Allowing yourself to experience (not the same as expressing it) the emotions
o Adjusting to life without the deceased
o Relocating the deceased emotionally and move on
,A (working) definition of grief:
The primary emotional reaction to the death of a significant other (loved one). It is
a complex emotional syndrome accompanied by physical changes and physical symptoms.
In addition, it involves a wide range of possible cognitive and behavioral reactions.
(Stroebe, Schut, Stroebe & van den Bout, 2013).
4 dimensions of grief
Emotional (sorrow, loneliness, numbness, anxiety, guilt, aggression, helplessness, pessimism,
relief).
Cognitive (loss of concentration, intrusive images, preoccupation of the deceased, lowered self-
esteem, hopelessness)
Physical (sleep-related problems, decreased appetite, stress, headaches, tension, low energy,
similar symptoms to the deceased)
Behavioral (agitated, withdrawn, seeking behavior, avoidance)
Major determinants: in detail in literature !
o Background bereaved person; gender, age, personality, attachment, health, history
o Characteristics of death; sudden, unexpected, premature death, traumatic circumstances
o Characteristics of the deceased; kinship relationship, quality of the relationship
o Situation after loss: lack of support, secondary losses (lose partner lose income), ways of
coping
Background bereaved person
Mortality ratio of widows and widowers compared to similar groups of married couples in terms of
age
Higher in younger age groups
Higher for men (widowers) than for women
Explanation for gender differences:
o Differences in social support
o Differences in coping strategies
(men are more problem focused, women more emotion focused; how to problem-solve death?)
o Differences in type of bereavement
Religion:
o Life Philosophy (systems of meaning):
Conflict results (opposing processes?). Losing faith in religion
o Religious social community:
A relationship between worship sessions attendance and social support, and a relationship
between social support and health (“social capital”)
,Characteristics of death
NASH classification: Natural, Accident, Suicide and Homicide
Sudden, untimely, intentional, painful and violent deaths leads to greater risks
Debilitating and exhausting (terminal) conditions are a risk factor too why? Checken!
Talking and about acting in preparation of imminent death predicts less intense grief
(Mori et al., 2018).
Characteristics of the deceased
o Kinship (parent = losing your past, partner = losing your present, child = losing your future)
o Nature of relationship
o Quality of relationship
Unacknowledged losses or “Disenfranchised grief”:
- Ex-partners
- In the past: miscarriage, perinatal deaths etc.
- In some circles: homosexual relationships
- Extramarital affairs
- Etc..
After the loss: aspects
- Coping
- Social support
- Secondary Losses
- Multiple bereavements
- Family dynamics
- Material resources (change)
Conclusions (#1):
From a societal perspective, the concepts of death and dying, and surviving relatives, are
surrounded by complicated context of denial and fascination
Death in most western societies becomes more normalized, more like it is in many countries
elsewhere
Conclusions (#2):
Death of a loved one is virtually inescapable and in most cultures has significant
consequences for others physical, psychological and social functioning
There is no such thing as the grieving process. There are tremendous individual and cultural
differences. Every model is a simplification and should be recognized as such.
Conclusions (#3):
There are factors that lead to a higher risk of problems in the grieving process, but the
predictive power of these factors is usually not very high, and hence sound explanations are
generally not available
, Conclusions (#4):
A small minority cannot cope by themselves and need professional help
A large majority of surviving relatives eventually succeed in overcoming the loss.
Lecture 2a.
What are traumatic experiences?
Traumatic events:
- War violence and destruction
- Combat (military stress)
- Long-term imprisonment
- Criminal violence (rape, robbery, hijacking)
- Disasters (natural, man-made and technological)
- Accidents (traffic accidents)
- Child abuse and family violence
- Sudden and traumatic loss of a loved one.
Characteristics of overwhelming events:
Extreme powerlessness
Profound disruption
Extreme discomfort
Often it’s a very sudden and acute event that totally disrupts your life.
Type I trauma: Single, intense, unanticipated events
Typt II trauma: Prolonged, repeated, extreme conditions (series of extreme events over time)
History of psychotrauma; roots in Vietnam war
The ‘early years’ – around 1980
Chronic difficulties of Vietnam War veterans in the USA
o 60.000 were killed, soldiers were in duty for one year
o Many veterans came back with depressive symptoms, marital problems, sleeping
problems, problems at work.
Hostage-taking incidents in NL (1975-1977)
Establishment of victim support programs in European countries
Introduction of the concept of PTSD (DSM-III)
1850-1870
French publications on child abuse (Briquet, 1859) as well on war
First train accidents (Erichsen, 1876)
American Civil War (1861, Da Costa’s ‘soldiers heart’ syndrome)
1880-1900
Concept of trauma neurosis (Opperheim)
Hysteria: after-effects of sexual abuse (Janet, Beuer & Freud)
