How would you define death

Sadness

1. The most important things in a nutshell

Grief is a natural and normal process. The feeling of sadness is one of the first basic emotions that children experience and learn in kindergarten. Nevertheless, grief is an often repressed emotional state in our society. Knowledge about grief gives confidence in dealing with those who grieve and helps to avoid additional stress and injuries to those affected.

2. What is grief?

The loss of things, circumstances or loved ones triggers grief. The loss of a loved one is a decisive event that massively imbalances the emotional equilibrium of the bereaved. The way to restore this balance is called grief. Grief affects people emotionally, spiritually, socially, and physically. Grief can be expressed in a variety of ways, such as facial expression, posture, and behavior.

2.1. Who mourns

When you're grieving, you usually just think about it Relatives after death. But even an impending loss, e.g. of a seriously ill person, lets the grief begin. The path of acute grief begins with the onset of death.

Also Seriously ill and dying people mourn. From the diagnosis "terminally ill" they say goodbye to everything.

Professional and volunteer helper accompany and support the patient. They too grieve and should therefore consciously deal with their own grief and the grief in the team (self care).

2.2. Not knowing and making wrong assumptions about grief

Not knowing how grief works is widespread, so most people are unsure how to deal with grief and those who mourn.

Knowledge of grief protects all those involved from allegedly "protecting" the pain of those directly affected. However, it must be clearly stated here that grief is a strong feeling, usually stronger than anything that those directly affected have experienced up to then. Even "knowledge" cannot alleviate this. But knowledge reduces the fear of those affected ("Am I still normal at all?") ​​And it gives the environment the chance to help on the one hand (because they know what the affected person might need) and, on the other hand, to avoid additional pain (because they know what hurts).

In general, mourning is only granted to a limited extent and in certain forms. Family members and companions should not be influenced by the following common, but incorrect, assumptions about grief:

The worst times are the first few weeks

This may be true for people who are not very close, but those most directly affected usually take months to realize the full extent of the loss and change.
For more information, see Dealing with Mourners.

The mourning lasts for a year

There are no general rules about how long mourning lasts, but it lasts longer than most, including those who mourn, think. Sometimes the grief catches up with you years later - often through an experience, a detail that awakens the memory. But: In addition to grief, life will take its place again.

Grief comes in phases

Phases are a tool to structure grief scientifically. But grief does not run in phases, but in a circular, spiral shape. Some things repeat themselves, which is particularly difficult for those affected and their relatives to endure. And not every mourner goes through the same thing. It is important to admit to those who mourn that there is also something unresolved, that something remains open. For some mourners, it is helpful to be "somewhere else" in between, to forget the grief for a while (a kind of emotional commuting). See also below under mourning models.

Grief can be worked off, and then it's gone

There is no end to grief, the pain changes. You learn to live with pain. A new bereavement can also bring out old grief.

3. Forms of grief

Relatives show physical, psychological, social and spiritual reactions to the loss of a person.

Acute grief: Is triggered by a current loss or a current event of parting.

Old (unresolved) grief: There is something long lasting or unresolved in grief.

3.1. Normal grief

Grief is a complex and very emotional phenomenon for which there are no rules. The term "normal grief" is used in specialist circles to distinguish this phenomenon from "crisis" (pathological) grief.

Normal grief can last for months to years, and any "remaining" grief is considered normal. As a rule, medication and therapy are not necessary for normal grief. Normal grief does not mean that it is painless. The transitions between normal and critical grief are mostly fluid.

3.1.1. Loss responses

The reactions to the loss of a loved one can be very different and occur on different levels. All of these reactions can vary in their occurrence, strength and duration.

Reactions on a social level

The bereaved withdraws from their social environment. He no longer takes part in any activities, avoids memories of the deceased and does not want to talk about them.

 

Reactions on a psychological level

  • Cry, scream
  • Anger, anger, aggression
  • Apathy, confusion, hallucinations
  • Fear, loneliness, disinterest

 

Physical level reactions

  • Loss of appetite, weight loss
  • sleep disorders
  • Nausea, vomiting
  • Shivering, shivering, trembling
  • a headache

 

Responses on a spiritual level

  • To quarrel with fate
  • Doubting God
  • Constant prayer
  • Looking for a stronger hold in faith

3.1.2. Mourning models

The mourning process of every single person is individual. Grief models can help to better understand the process of grief and to recognize the phase in which the person concerned is. Models should not mislead people into believing that there is a certain sequence of events. They are explanatory models that were developed from observing and accompanying dying and grieving people. Various grief researchers have presented and subdivided recurring reactions into grief models, which do not always run linearly, but are variable in the order or can mix.

The most famous models are those after:

  • John Bowlby and Colin Murray Parkes
    Numbness - longing / consumption - demolition / despair - rebuilding / reorganization
  • Verena Kast
    Not wanting to be true - breaking up chaotic emotions - searching, finding, sight racing - new relation to self and world
  • Elisabeth Kübler-Ross
    Not wanting to believe - anger - negotiating - depression - consent
  • Ruthmarijke Smeding
    Lock time - Janus time - labyrinth time - rainbow time
  • Yorick Spiegel
    Shock - control - regression - adaptation
  • William Worden
    Accepting the reality of loss - Experiencing and working through the pain of grief - Adjusting to an environment in which the deceased is absent - Emotionally assigning the deceased a new place. Learning to take the memory of the relationship with you and move on

3.2. Crisis or aggravated (pathological) grief

In some cases, various factors can complicate the course of grief and lead to illness. The transition from normal to more difficult grief is fluid. Difficult grief process means that normal grief reactions persist, intensify or persistently express themselves in physical complaints. The duration, intensity and quality of the grief differ from normal grief. The following forms are typical:

  • Delayed or avoided grief
    This is mostly the case with unexpected deaths. The initial shock and denial of reality can delay an emotional response.
  • Somatization
    Basically, mourners are more susceptible to illness. In addition, those affected may develop excessive fears about the illness that caused the death of the loved one.
  • Chronic grief
    The mourning lasts longer and is expressed very intensely. An adaptation of the bereaved to the new, changed situation does not take place or does not take place over a longer period of time. However, it is difficult to specify "longer". What is certain is that one to two years is completely normal for intense grief for a close relative.

3.2.1. Factors that make grief difficult

The circumstances of death

  • Sudden death
  • Violent death
  • suicide
  • Death is not certain (e.g. plane crash)
  • Several losses in a short period of time
  • Loss of a child
  • Early loss of a parent or a similarly close caregiver

 

Relationship with the deceased

  • Characterized by strong dependency
  • Narcissistic shaped

 

Family and environment

  • Missing social network
  • Disputes within the family
  • Financial difficulties
  • Further crises or losses regardless of death

3.2.2. Help with critical grief

It is not easy to tell the difference between normal and critical grief. Those affected can get help from many contact points:

 

If the mourner cannot cope with the grief alone in the long term, psychotherapeutic treatment is sensible and unavoidable. The aim of therapy can be to make up for grief work that has not been done before, to convert aggravated grief into normal grief reactions and then to process it. For more information, see psychotherapy.

4. Other aspects of grief

4.1. Initial reactions to the death of close relatives

Not all people have tears: Knowing about the 4 typical initial reactions (feel, do, think, avoid) to the death of close relatives promotes understanding for the behavior of those affected and prevents misjudgments in dealing with them. For more information, see initial reactions to the death of close relatives.

4.2. Effects of Grief

At some point, many mourners fear that they are no longer normal, that the loss has driven them crazy. Everyone reacts differently, but certain problems such as insomnia, loss of appetite, or hearing voices are common and normal. In addition, there are many physical reactions. Knowing the effects of grief prevents misdiagnosis and unnecessary therapies. For more information, see Grief> Effects.

4.3. Dealing with mourners

How do you really help mourners, especially in the first year and deliberately beyond the anniversary of their death? What are you pressuring and burdening them with additionally? For more information, see Dealing with Mourners.

4.4. Child grief

When relatives or even their peers die, children are affected twice: through the grief of their parents and their own loss. But children are usually kept away from funeral services and burials in order to protect them and because "the little ones" don't understand that anyway. When do children understand death? How can they be included in an age-appropriate manner? For more information, see Death and Mourning> Children.

5. Related links

End-of-life care facilities

Palliative care

Palliative phase> death and grief

Death and Sorrow> Children

Grief> dying

Grief> effects

Grief> Help and contact points

Dying phases according to Kübler-Ross

Dealing with those who mourn