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Loss and psychotrauma summary - lecture + literature
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LOSS AND PSYCHOTRAUMA 2021-2022Week 1 Lecture 1 Death and grief: A societal scientific positioning
What we usually do when we talk/think about large numbers of deaths: avoidance.
"A single death is a tragedy; a million deaths is a statistic."
Holocaust museum with a personal ID card, and you look for that one person individual, a
way that you try to make a larg number into something small and personal.
Avoidance: push it away is what we normally do. Doctors are the same, they deal with dying
every day. Once they get ill themselves they try to avoid it. People who are professional,
avoid the topic of death.
Just so you know ... : Talking about the Netherlands, approximately 4,200 people under the
age of 30 die every year -> That is almost 12 per day -> That is almost 1 every 2 hours
- How long does it take to watch this lecture?
Fascination:
- Fascination to concur it
- Prevention from it happening. Procreation-> having children, the most obvious way to
live on.
- Signs on the street like: I am now deceased. It has brought in a lot of money. There
are even death magazines. The book: sand about it? A book about making choices
about burial, was a bestseller.
- By faith, art, cryonic suspension (freeze and keep), or something we try to live
forever, biotech, virtual reanimation
● When freezing, the thought is: if a person has died of a disease that later
medicine, they can be thawed again. There's a little bit of hope that you'll
someday lives, even if it's just a tiny bit of hope, it's more than buried.
Normalisation:
- In addition to fascination and avoidance, there is also a kind of normalisation going
on. There are now even funeral shops or a museum. Funeral messages used to be in
a certain format.
- These days these messages are much more personal. There is now more freedom in
this. There are also online death cafes where you can talk to people about death.
- Children's books have also been made about the death, “I get tears in my eyes when
I think of you” for adolescents, but also Miffy for children. Public raw has also been
normalised. E.g. silent marches, memorials to the road
How do we deal with it?
- It is part of life and necessary. Book: The price of Love.
- Now -> If you want to get a good idea of what is available to people who are grieving,
you must first look on the internet. Because that is what a person most quickly goes
to when he is grieving. Only later maybe to the doctor or etc.
,On grief and grieving
‘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.’
- Stages of grief are bullshit. Outdated, not empirical, not scientific information. They
are often described in books, but no one is able to identify invented phases. Thinking
in phases leads to problems. Some people think they need help when nothing
actually goes wrong. They think they have to go through all the phases, while this is
not so at all. It seems to be prescribed by society.
- Some statements about phases or stages in the grieving process. The first one is still
okay, the rest is increasingly prescribed. At number 3 they start about healthy and
unhealthy grieving.
- Some sources write that you have to go through the anger phase per se, but a lot
people don't feel this anger at all. The phases are a myth.
One definition of grief is:
- an initial emotional response to the death of a “significant other”.
- It is a complex emotional syndrome associated with physical changes.
along with a wide range of possible cognitive and behavioural responses.
- You can't agree. Everyone may think differently. It's not a clear cut subject.
What is death?
- Is it the end, or is it the next phase, is it the ultimate problem? Is it the Ultimate
solution? What does it mean for me? How do we deal with grief? I'd rather not be in a
relationship than be abandoned. If you never want to mourn, you have no
connections with other people. But that's not real. So we have to deal with it. It's
harder to deal with people around you dying than to die yourself. Because you are
simply not here anymore.
- It's not just a psychological thing. There are also medical and other aspects.
Different dimensions of grief:
- Emotional (loneliness, fear, guilt, sorrow, numbness, anxiety, aggression etc.)
- Cognitive (loss of concentration, confusion, intrusive images, preoccupation with the
deceased, hopelessness,etc.)
- Physical (sleep-related problems, loss of appetite, stress, headache, decreased
energy, tension etc)
- Behavioural (withdrawn behaviour, seeking behaviour not that you look for things,
but you seek, agitated, deceased)
- suddenly things that remind you of the deceased person), avoidance behaviour,
excitement.
People need some kind of structure, of what's normal or not. So they can ask: Is it normal for
me to sleep with my dead husband's shirt? Or that I am the voice of my deceased child does
not know.
,“The majority of the information resources [available to the bereaved - HS] draw on the five
stages of grief theory (Kübler-Ross, 1969).” : Look for the right type of information, try to find
some order and information in this chaos and feelings.
Grief Task Model: (Worden, 1991)
- Accepting the reality of the loss
- Allowing yourself to experience the emotions that are related of that, the acceptance
any emotions (anger, grief, not necessarily express, just experience)
- Adjusting to life without the deceased
- Relocating the deceased emotionally and move on
With a phase it is more: I sit here and wait for the next phase.
With tasks: then you have to perform tasks to process. Grieving is hard work. People have
some sort of control/structure is needed.
Freud: mourning labour. The work must be done.
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 behavioural
reactions. Stroebe, Schut, Stroebe & Van den Bout (2013)
Dimensions of grief:
- Emotional (sorrow, loneliness, numbness, anxiety, guilt, aggression, helplessness,
pessimism, relief, etc.)
- Cognitive (loss of concentration, lowered self-esteem, confusion, intrusive images,
preoccupation with the deceased, hopelessness, etc.)
- Physical (sleep-related problems, decreased appetite, stress headaches, tension,
low energy, similar symptoms to the deceased, etc.)
- Behavioural (agitated, withdrawn, seeking behaviour, avoidance, etc.)
Major determinants:
- Background bereaved person: gender, age, personality, attachment, health, history
etc.
- Characteristics of death: sudden, unexpected, premature death, traumatic
circumstances etc.
- Characteristics of the deceased: kinship relationship, quality of the relationship
with the deceased etc.
- Situation after loss: lack of support, secondary losses, ways of coping etc.
Background of the bereaved person:
Mortality ratio of widows and widowers compared to similar groups of married couples in
terms of age and gender
- Widow and widowers
- First year after losing a partner was different from dying from a married man who still
has his partner. Gender difference, men had a higher risk of dying than women do.
, - Risk of dying is 8 x higher for a widower for man -> it is much higher to die after the
loss of your partner
- Higher in the early age group to die-> rare occasion to die in the early age
- Overall man run a higher risk of dying than women do
Explanations for gender differences (theoretical explanation):
- Differences in social support, women keep their social support to rely on, they
keep more friendships, but itś a suggestion
- In coping strategies men are problem focused, women emotional focused->better fit
in this situation
- Differences in types of bereavement: marriage is different for men than women,
men have more to gain then women from a marriage, so men lose more and bigger
the impact
Religion:
- Life philosophy (systems of meaning): Conflicting results (opposing processes?)
- Religious social community: A relationship between worship session attendance and
social support, and a relationship between social support and health (“social capital”)
Characteristics of death
1. Cause of death
- NASH classification: Natural, Accident, Suicide and Homicide
- Sudden, untimely, intentional, painful and violent death leads to greater risks
- Debilitating and exhausting (terminal) conditions are a risk factor too
- Exhausting (terminal) conditions are a risk factor too (like in grandma who has
to take care of grandpa atm).
- Talking about and acting in preparation of imminent death predicts less
intense grief (Mori et al., 2018)
2. The deceased
2.1 Who is deceased? Can't compare losses
- Kinship loose you parent (loses your past) , partner (lose your present) , child
(loose your future) etc.
- Nature of the relationship
- Quality of the relationship more ambivalent relationships are more difficult to
deal with
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