Death And Dying

Front 1

Children and Death:
Most report their 1st experience with death as:

Back 1

1. Death of a family member (grand parent, parent)
2. Death of a pet

Front 2

Dickinson's Study

Back 2

57% college students reported first death = family member
28% college students' first death = pet.

Front 3

Anthony's Child Death Studies

Back 3

1970's
12% of Moms of children 6 and under say their children were concerned about death
in reality, 45% of these children are concerned!

Front 4

Impediments to Child Studies

Back 4

1.) Adult Bias- we think they don't worry but they do.
2.) Difficulty with Research- we don't want to upset them
3.) Freud's Legacy- he was phobic about death and thus minimized the impact of death on kids. Decided they were incapable of mourning until reached self-concept at age 13.
4.) Children's Language isn ot sophisticated enough to express thoughts.
5.) What we as parents teach kids.- Socially accepted immortality myth (only old die, we dont die)
-idiosyncratic family myth

Front 5

Cognitive Skills Required to Fully Understand Death (6)

Back 5

The concepts of:
1. Time
2. Transformation of Matter (things/body changes)
3. Causality
4. Irreversibility (things can't be brought back)
5. Concrete Operations (logical thinking)
6. Universality- things happen to everyone

Front 6

Conrad Lorenz

Back 6

IMPRINTING!
-Baby geese imprint on their mothers, follow them everywhere.
-Critical period between mother and child.
-36-72nd hour of life

Front 7

Bowlby and Mahler

Back 7

SYMBIOSIS
-vague critical period in humans.
-mom and child are very close.
-emotional responses depend on this time.

Front 8

Stages of Understanding

Back 8

Piaget and Elkind
Preoperational (3-5)
Concrete Operational (6-9)
Formal Operational (10-11)

Front 9

Preoperational

Back 9

3-5yrs
-don't understand death correctly
-it is NOT seen as break with life.
-the dead person is asleep (still alive- Nagy)
-reversible
-magical thinking
-confuse animate with inanimate

Front 10

Concrete Operational

Back 10

6-9 yrs
-death is seen as break with life
-doesn't happen to everyone
-Reversible (if you act right and pray they will come back)
-discontinuous

Front 11

Formal Operational

Back 11

10-11yrs
-Death irreversible and universal
-medical event
-adult like understanding

Front 12

At what age do children give a reasonably accurate definition of death?

Back 12

Anthony Study
AGE 7- 100% of kids give accurate response
AGE 6- 67% give accurate response

Front 13

Grieving Process: Freud

Back 13

1st to talk about death, unhelpful
-griveing/mourning are normal processes, not important.
-loss = minimalized.
-intrapersonal

Front 14

Freud's 2 important contributions

Back 14

1.) Depression vs. Grieving
Grieving is normal
Depression is a significant loss of self esteem
2.) Cathexis vs. Decathexis
Cathexis- investment of emotional energy. you put a lot into a person the more you invest energy into them the harder it is when they die.
Decathexis!! withdraw this energy, detach.

Front 15

Pollack's Homeostatic Theory

Back 15

Biological we like to keep balance
-Death of someone close causes an imbalance requires stages to regain balance.
1. Shock- psychological, days.
2. Grief- realize the reality of the death without accepting it, weeks.
3. Separation- most difficult. not physically with the person but maintain an internal dialogue with them. months/yrs.
4. Chronic State- secondary losses, ripple effect. realize you won't have mom's pie. Eventually adapt and use experience as a growth opportunity.Years.

Front 16

John Bowlby Stages of Grief

Back 16

1.) Numbing
2.) Yearning and Searching- psychologically go to places you've been together.
3.) Disorganization and Despair
4.) Reorganization- incorporate loss into your new life

Front 17

Parkes!

Back 17

British Psychologist
-stages are really overlapping clinical pictures.
- no schedule of grief

1.) Numbness- adaptive bc it helps us to feel less intense amounts of pain
2.) Searching and Pining- people search for the dead person psychologically. Pangs of grief.
3.) Depression- apathy, despair.
4.) Recovering- giving up the old frames of thinking- the way we thought about the world without the person.

Front 18

What is Despair?

Back 18

no hope for the future!

Front 19

Catherine Sanders

Back 19

Integrated many theories
1.) Shock
2.) Awareness of loss
3.) Conservaton and Withdrawal
4.) Decision Point- consciously decide to keep going in life or give up. big issue with elders who lose a spouse.
5.) Healing
6.) Renewal

Front 20

BILL WORDEN TOO GREAT

Back 20

most influential approach to mourning.
-Saw other approaches as a passive approach.
-Grief is like a physical injury/illness.
- Departure from psych. well being. (Like an injury, sometimes you recover or you don't)
-Mourning- active process of trying to return to normal functioning

Front 21

What are the four tasks of mourning?

Back 21

Worden
1. Accept the Reality of the Loss
2. Experience the Pain of the Loss
3. Adjust to the Environment where the Deceased is Missing
4. Withdraw Emotional energy from the dead person and reinvest it in something else

Front 22

Worden
1st task of mourning

Back 22

Accept the Reality of the Loss:
1. Accept Physical Reality (shock)
2. Accept meaning of the loss- takes time to sink in
3. Accept irreversibility of the loss.

Fail this task: DENIAL

Front 23

Worden
2nd task of mourning

Back 23

Experience the Pain of the Loss

-lonely task-need to dwell a little on the loss.
-hard bc people help you avoid it-dont want to talk about it.

Fail this task: INABILITY TO FEEL

Front 24

Worden
3rd task of mourning

Back 24

Adjust to Environment where the deceased is missing:

-Experience the secondary losses
-take on the roles that the person played for you

Fail this Task: WITHDRAWAL (general and social)

Front 25

Worden
4th task of mourning

Back 25

Withdraw emotional energy from dead person and reinvest it in something else.

Fail this task: INABILITY TO LOVE

Front 26

Worden's Normal Grieving Behaviors
4 categories

Back 26

Feelings
Physical
Cognitions
Normal Behaviors

Front 27

Worden: Feelings

Back 27

most common= SADNESS
most important= ANGER @ ___
most universal= GUILT(form of anger at yourself)
other important feelings:
LONELINESS- closer you were the lonelier you are
ANXIETY
1. death makes anxious about our own death.
2. can i cope? can i get through this?

Front 28

Worden: Physical

Back 28

Reactions:
Tightness in throat, chest
Lack of energy
Depersonalization (nothing is real, including myself)
Hollowness

Front 29

Worden: Cognitions

Back 29

Thoughts:
1. disbelief (shock and numb)
2. preoccupation with dead person, obsessing, thoughts intrude on daily life
3. confusion- trouble concentrating and focusing
4. Sense of presence- dead person still around (DOVES)
- birds, butterflies, rainbow
5. Hallucinations

Front 30

Worden: Normal Behaviors

Back 30

1. sleep disturbance- trouble getting to sleep, staying asleep, too much sleep
2. appetite disturbance
3. social withdrawal- don't want to be with others
4. dreams of dead person
5. crying
6. seaching and crying out

Front 31

Harry Sullivan

Back 31

-grief= valuble and protective device also obsessional device.
-Repetitively admit loss of loved one.
-This obliterates the object of the obsession

Front 32

George Pollock

Back 32

acute and chronic grief stages

Acute: initial shock,
grief-(realize actuality of death)
separation- (decathexis)
- difficult bc griever may "maintain the introject"

Chronic- lasting adaptation, experience secondary losses

Front 33

Bluebond Langer

Back 33

1. Terminal Kids as young as 3 know they are dying and that death is final and irreversible
2. Personal experience
life circumstances
self concept
age
all have impact on how kids integrate info about death and come to understand it.

Front 34

Sood, Weller, Weller

Back 34

Beareved kids aged 5-12
Likely to experience somatic symptoms
Headach and stomach aches

Front 35

Silverman, Nickman and Worden

Back 35

Reaction to Death of Parent
Age 6-17
74% Believed parent in Heaven
87% Believe parent watching over them
Kids need to "locate" parent