The document discusses grief and bereavement, defining grief as the physical, emotional, cognitive, and spiritual response to loss. It outlines common grief responses including feelings, physical sensations, cognitions, and behaviors. The document also examines the differences between grief and depression and provides guidance on assessing and treating grief.

1. John C. “TC” Megahan, Sr.
President and Sr. Bereavement Counselor
The Journey of Hope, Inc
Bear, Delaware

3. Carl and Ellie: A Love Story

4. Defining and Understanding Grief?
 Grief can be defined as the physical, emotional, cognitive
and spiritual response to actual or threatened loss of a
person, thing or place to which individuals are emotionally
attached.
"Contrary to what social workers will tell you, when you lose a
loved one, we don't just forget, move on, and find closure. To
truly grief, we must learn to honor, to remember, and to
incorporate our deceased children, parents and siblings into our
lives in a new and different way. In fact, keeping memories of
your loved one alive in your mind and heart is an important part
of your healing journey." ~ John "TC" and Joanne Megahan
RESTORING HOPE.

5. Common Grief Responses
Feelings
 Numbness  Loneliness
 Shock  Fatigue
 Anger  Yearning
 Anxiety  Relief

6. Common Grief Responses
Physical Sensations
 Tightness in the chest
 Shortness of Breath
 Lack of Energy
 Panic Attack-like symptoms

7. Common Grief Responses
Cognitions
 Disbelief
 Confusion
 Sense of Presence
 Lack of Concentration

8. Common Grief Responses
Behaviors
 Sleep disturbances
 Appetite disturbances
 Social withdrawal
 Dreams of the deceased
 Absent-minded behavior

9. Common Grief Responses
Additional considerations
 Cultural Differences
 Religious Differences
 Gender Differences
 Grief experience and history

10. Differences between Grief and Depression
It is important to understand and recognize the
difference between Grief and Depression.
 Depression shares common features with grief.
Misdiagnosis can result in overlooking depression
when it is present and inappropriately treating grief.

11. Assessing between Grief and Depression
Grief Depression
 Experienced in waves  Moods and feelings are static
 Diminishes in intensity  Consistent sense of
over time depletion
 Healthy self-image  Sense of worthlessness and
disturbed self-image

12. Assessing between Grief and Depression
Grief Depression
 Anhedonia - Loss of the  Anhedonia - Loss of the
capacity to experience capacity to experience
pleasure. The inability to gain pleasure. The inability to gain
pleasure from normally pleasure from normally
pleasurable experiences. pleasurable experiences.
 Hopelessness  Pervasive hopelessness
 Response to support  Unresponsive to support
 Overt expression of anger  Anger not as pronounced

13. Assessing between Grief and Depression
Grief Depression
 Guilt is focused on aspect of loss
 Guilt is preoccupied with a negative
 Not demoralizing or humiliating
 Demoralizing and humiliating
 Preoccupation with deceased
 Preoccupation with self
 Suicidal gestures rare in
uncomplicated grief  Suicidal gestures are common
 Elicits sympathy, concern and desire  Elicits irritation, frustration and a
to embrace desire to avoid

14. Grief Assessment
 What was the relationship?
 Nature of the Attachment
 Mode of Death
 Historical Antecedents (preceding event, condition, causes, etc.)
 Personality Variables
 Social Variables

15. Theories on Bereavement
 Elizabeth Kubler-Ross: Stages of Grief
 William Worden: Four tasks of grieving
 Robert Neimeyer: Rebuilding life and search for
meaning
 Grief as a journey.

16. Treatment Planning
 Establish a relationship with the bereaved
 Be comfortable with their expression of grief
 Listen, listen, and then listen some more
 Normalize grief reactions
 Companion them in rebuilding their life

17. Taking Care of Myself
 Know your own strengths and limits
 Set boundaries, communicate those boundaries.
 Nurture yourself – read, watch, and listen positive and
supportive information.
 Surround yourself with supportive people.