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Death & Dying Ch 9
"The Last Dance" Chapter 9
| Question | Answer |
|---|---|
| In what ways is grief manifested? | Mentally Emotionally Physically Behaviorally Spiritually |
| How does mourning differ from grief? | It refers not so much to the reaction to loss, but to the process by which a bereaved person integrates the loss into that person's ongoing life. |
| Among some Native American tribes, what is a way of showing that one is in mourning? | Shearing one's hair. |
| What is a theme common to mourning behaviors cross-culturally? | That the bereaved are different and that this difference diminishes with time. |
| What two purposes does seclusion during mourning serve? | It allows survivors to shelter their grief from the world. It prevents survivors from forgetting the deceased too quickly. |
| The concept of working through grief has been an important theoretical perspective at least since what? | Sigmund Freud's 1917 paper, "Mourning and Melancholia." |
| What does attachment theory state? | Recognition of loss of an attached object results in grief & defensive withdrawal of energy, then resistance & clinging, then detachment from object. |
| Lindemann noted that what is the main obstacle to successful grief work? | Many people try to avoid the intense distress connected with the grief experience and to avoid the expression of emotion necessary for it. |
| What 3 points does the grief-work model incorporate? | Grief = an adaptive response to loss. The reality of the loss must be confronted and accepted. Grieving is an active process that occurs over time. |
| What has been accepted as the standard formulation for understanding and helping people accommodate to loss? | The grief-work model |
| What has been questioned about the grief-work model? | The apparent emphasis on the need for bereaved individuals to break their relational bonds with the deceased. |
| The idea that there is some standard method of grieving is being replaced with what idea? | Grief is both highly individualistic and influenced by a variety of situation factors, such as the type of death, circumstances of the loss... |
| In the newly developing view regarding healthy grief, what does grief include? | An enduring connection with the deceased. |
| The death of a child challenges a parent's worldviews in what way? | How the universe functions and that person's place in the world. |
| How do children maintain connections with deceased parents? | Memories and linking objects. |
| What traditions maintain bonds with the deceased? | African - celebrate relationships with the "living-dead." Japanese - household shrine for ancestors American - visits to cemeteries |
| Jerome Bruner says that narratives reflect what? | How we organize our experience and our memory of human happenings. |
| In telling the story of loss, Carolyn Ellis says what? | We can make true a plot in which we play the part of, and become in the playing, actual survivors. |
| Sharing the story of a loss provides what? | Emotional relief, search for meaning, bringing of people together in support of one another. |
| According to the dual-process model of coping, the bereaved person expresses what? | Loss-oriented and restoration-oriented coping behaviors. |
| Define bereavement. | The objective event of loss. |
| Define grief. | The reaction to loss. |
| How might mental or cognitive distress in grief manifest? | Disbelief, confusion, anxiety, tension, pain, pervasive sense of disorganization, depression. |
| A heightened perceptual and emotional sensitivity to people and events among bereaved is a manifestation of what? | Grief |
| Name some of the emotions in grief. | Sadness, longing, loneliness, sorrow, self-pity, anguish, guilt anger, relief. |
| Name some physical manifestations of grief. | Frequent sighing, shortness of breath, tightness of the throat, a feeling of emptiness in the abdomen, muscle weakness, chills, tremors, nervous system hyperactivity, insomnia, changes in appetite. |
| What is psychomotor agitation? | Aimless wandering - a physical manifestation of grief. |
| What behaviors are associated with grief? | Crying, searching for the deceased, talking incessantly about the deceased, avoiding talking about the loss, irritability, hostility, frenetic over-activity. |
| What is the mater dolorosa? | A veiled woman in black clothing, represented as the socially prescribed way of mourning. |
| What is the central message of grief work? | The bereaved must let go. |
| What important points does the grief work model incorporate? | Grief as an adaptive response to loss; Reality of the loss must be confronted and accepted; Grieving as an active process that occurs over time. |
| Whether maintaining continuing bonds with the deceased reflects a healthy adjustment to loss may depend on what two criteria? | 1. Does the mourner truly recognize the person is dead and understand the implications of the death? 2. Is the mourner moving adaptively into his/her new life? |
| In emphasizing the personal meaning of loss, Stephen Fleming and Paul Robinson observe that most don't find meaning in a death, but in what? | In the life that was lived. |
| Loss oriented coping includes what from traditional theories? | Grief work |
| Mastering tasks that had been handled by the deceased, reorganazing one's life, and developing a new identity are types of which coping? | Restoration-oriented coping |
| What is central to the dual-process model of coping? | Understanding that grief is a dynamic process. |
| Does the dual-process model of coping help explain patterns of grief in diverse cultures or at different times within the same person? | Yes |
| What are the 2 tracks of the two-track model of bereavement? | I - Biopsychosocial functioning in the wake of the loss. II - The bereaved's ongoing or continuing relationship to the deceased. |
| The terms recovery, growth, continuing difficulties or inadequate adaptation may apply to what aspect of which model of coping/bereavement? | The biopsychosocial functioning, first track of the two-track model of bereavement. |
| Anxiety, depressive affect, health concerns, behaviors & symptoms associated with psychiatric problems, emotional difficulties, quality of relationships, self-esteem & self-worth are parts of which track in the two-track model of bereavement? | General biopsychosocial functioning |
| Narrative construction of the relationship, imagery & memory, emotional distance, positive/negative affect vis-a-vis deceased, preoccupation with the loss & lost, idealization are part of which track of the two-track model of bereavement? | Ongoing relationship to the deceased |
| What are the 4 major points in the two-track model of bereavement that serve to orient the observer to the bereavement process? | The loss of a close relationship has a major impact on the bereaved. Bereaved must accept the reality that death has occurred. As time passes, the acuteness of the response to loss subsides. After lots of time new organization in life is achieved. |
| Which bereavement/coping model has application to the shifting relationship between the bereavement and trauma fields, and to cross-cultural approaches to loss? | Two-track model of bereavement. |
| What is the first task in the task of mourning? | Accept the reality of the loss. |
| What is significant in accepting the reality of the loss in the tasks of mourning? | Transition from present to past tense in referring to the deceased. |
| What is the second task in the tasks of mourning? | Process the pain of grief. |
| What is the third task in the tasks of mourning? | Adjust to a world without the deceased. |
| What is the fourth task in the tasks of mourning? | Find an enduring connection with the deceased in the midst of embarking on a new life. |
| What are the "Six R's" that Therese Rando offers in conjunction with the tasks of mourning? | Recognize the loss. React to the separation. Recollect and reexperience. Relinquish old attachments. Readjust. Reinvest emotional energy. |
| What is often a crucial determinant of whether grief is dealt with in a healthy or dysfunctional manner? | The family and its patterns of interaction. |
| What are the three main influences on a person's course of grieving? | The urge to look back, cry and search for what was lost. The urge to look forward. The social and cultural pressures that influence how the 1st two urges are inhibited or expressed. |
| What is the result of expecting a survivor's emotional and mental responses to death not to be different? | Conflict |
| Is the course of grief linear? | No |
| What characterizes grief the first hours or days following a death? | Shock and numbness, feelings of being stunned or disbelief. |
| What characterizes the middle period of grief? | Despair - the realization that there will be no reprieve. Intense yearning and volatile emotions. Sadness and longing/loneliness are predominant. |
| What characterizes the last phase of active grief? | A sense of resolution. |
| What may reactivate grief for an earlier loss? | New losses |
| How long do professionals who work with grieving people subscribe to the axiom that grief should last? | There is no absolute end point or timetable. |
| When is help warranted in grieving? | When it puts bereaved individuals at risk. |
| Intense grief years after a loss in response to a new loss may be mistaken as what? | Abnormal |
| What is the ripple effect in regard to grief? | Grief stimulated by a public death. |
| What is a more appropriate term than "life crisis" in regard to the effects of loss sustained over an extended period of time or the rest of one's life? | "Life transition" |
| What are 7 risks of complicated mourning? | Sudden & unanticipated death. Death from overly lengthy illness. Death of a child. Perception that death was preventable. Angry, ambivalent or dependent relationship to deceased. Prior/concurrent mental health problems. Perceived lack of social support. |
| A mode of bereavement that is inherently complicated does not necessarily lead to grief that is what? | Dysfunctional |
| What sets the stage for a poor adjustment to a loved one's death? | Suppressed grief, absent or diminished emotional engagement with the loss, boundless grief that is overwhelming. |
| Complicated grief involves attempts to do what two things? | Deny, repress or avoid aspects of the loss. Hold onto the lost loved one. |
| Why, according to Rando, is the prevalence of complicated grief increasing? | Urbanization, secularization, deritualization, violence, availability of guns, social alienation, substance abuse, sense of hopelessness. |
| What does the internal working model of primary attachment relationships function as? | A basic pattern for viewing the world and guiding future relationships. |
| What is at the core of the prolonged grief disorder experts have been working to add to the DSM? | Separation distress - a cluster of symptoms such as yearning, searching, ruminative thoughts, excessive loneliness. |
| In prolonged grief disorder, what is the cluster of symptoms known as that includes efforts to avoid reminders of the deceased, feelings of purposelessness & futility about the future, numbness and detachment? | Traumatic distress |
| When separation distress and traumatic distress persist for how long in combination with impaired functioning in family, work and social roles do researches indicate a diagnosis of prolonged grief disorder? | More than 6 months |
| Why is it important to have a diagnosis for complicated grief? | There are mourning responses that do not head for mending and that might be helped by diagnosis, formulation and treatment covered by insurance. |
| During what century was grief a legal cause of death on death certificates? | 15th century |
| Unresolved mental stress can do what to a heart? | Throw it into an irregular and fatal heartbeat. |
| What does the brain's insular cortex do? | Controls breathing and heartbeat and links up with the limbic system. |
| What does the limbic system do? | Deals with anger, fear, sadness, and other emotions. |
| Damage to the insular cortex may render a person susceptible to what? | A chaotic heartbeat called ventricular fibrillation, leading to cardiac arrest. |
| An early study in Wales found that he death rate among bereaved individuals during the first year of bereavement was nearly what rate that of the general population? | 7 times |
| What are the 4 stressful categories possibly related to sudden death that are a component of grief and mourning? | 1. The impact of the death of a close person. 2. The stress of acute grief. 3. The stress that occurs with mourning. 4. The loss of status or self-esteem following bereavement. |
| How a person copes with loss tends to be consistent with how that person copes with what? | Everyday stresses and small losses of daily living. |
| What are the 4 factors identified by Edgar Jackson that are especially important in considering how a person's model of the world applies to bereavement? | Personality Social roles Perception of the deceased's importance Values |
| What part of personality is an important determinant of how a person responds to death? | Self-concept. |
| Studies indicate that human response to loss is culturally learned. True or False | True |
| The perceived similarity hypothesis suggests that grief is what depending on the more similar to the deceased one believes one is? | Greater |
| What are the two patterns of grieving identified by Terry Martin and Kenneth Doka? | Intuitive and instrumental. |
| In the linear and systemic model, the linear style is about what? | Doing |
| In the linear and systemic model, the systemic style is about what? | Being |
| Explain secondary morbidity. | Difficulties in the physical, emotional or social spheres of functioning that may be experienced by those closely involved with a terminally ill person. the strain of caring for the dying relative may cause the caregiver to become sick or run down. |
| Survivors are likely to be held responsible in what form of death? | Suicide |
| Name some of the trigger events that can re-stimulate grief in response to a homicide. | Identification of the assailant. Sensing something associated with the traumatic event. Anniversaries of the event. Holidays. Hearings. Media reports about the event. |
| What is survivor guilt? | Feeling guilty at being alive while others died. |
| Bereavement burnout can occur because of what? | Multiple losses, such as in genocide. |
| In Jewish customs, what is aninut? | The period between death and internment. |
| In Jewish customs, what is keriah? | The rending of the garment by the bereaved. |
| In Jewish customs, what is hesped? | The eulogy in which the virtues of the deceased are recounted in a way that elicits the natural expression of grief. |
| In Jewish customs, what is seudat havraah? | The meal of condolence, which recognizes that the first meal after the interment should be provided by friends or neighbors. |
| In Jewish customs, what is the kaddish prayer? | A prayer that subliminally transfers the focus from the deceased to the living. |
| In Jewish customs, what is shiva? | Seven days of mourning that give structure to the early period of grief. |
| What is disenfranchised grief? | Grief experienced in connection with a loss that is not socially supported or acknowledged through the usual rituals. |
| What can cause disenfranchised grief? | The significance of the loss is not recognized; the relationship between the deceased and the bereaved is not socially sanctioned; the bereaved's qualities, such as mental impairment. |
| In western Nigeria, what custom complicates grieving for widows? | Widows have no rights of inheritance to her deceased husband's estate. |
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