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Concept of Guiding and Counseling in Grief and Loss

In today’s society losing someone or something, you love is quite painful yet it occurs frequently in human life. It is such an aspect of life that almost everyone will experience at some point in their lives in this world full of dynamism. The concern is not the occurrence but the prevention of the impact in the event of a loss that goes unattended to as such can result in the disorder in the human behaviors and mental functioning which may translate to physical damage and greater loss to the society. Therefore, this dissertation shall focus on the concept of loss and grief, its effect on the life of human beings, and the possible measures to manage the damages that may come as a result of the loss suffered. But most importantly is the application of the skills to sudden or shocking losses in the life of a bereaved person in connection with Stanley’s statement living with dying is learning about the transformation arising from your turning points (Keleman, 1985, p.65) in life encounters.

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In the concept of guiding and counseling, the phenomenon of loss can be referred to as an inevitable part of life while grief is a natural part of the healing process in that respect. In human life, there are many reasons which justify grief as the loss of a loved one (Smal, 2001, p.21), dealing with a significant loss can be one of the most difficult times in a person’s life both socially and psychologically (Klass, Silverman &Nickman, 1996, p.69). There are different kinds of losses that may be experienced by human beings in their living environment whereby persons may associate certain losses with strong feelings of grief in their life experiences. Sometimes, the feelings of loss are personal and only the affected individual knows what is significant to him or her (Kutner & Abraham, 2001, p.87). These may include; death of a partner or a colleague or classmate or parent or child, relationship breakup with beloved one, loss of health through illness, loss of physical ability, loss of mental ability, loss of financial security, as well as graduation from school and moving to a new home (Smal, 2001, p.49). It is important to note that, the occurrences of sudden or shocking losses as a result of events like accidents, crimes, prove to be traumatic and regarding the humanistic perspective there is no way to prepare for there happening. Therefore, they can challenge a person’s sense of security and confidence (Keleman, 1985, p.164). This can lead one to experience symptoms like social isolation, nightmares, sleep disturbance, distressing thoughts, or sometimes severe anxiety to the individual experiencing the loss.

Grief is the term that encompasses the emotions and sensations that accompany the loss of someone or something dear to a person (Smal, 2001, p.93). In this regard, grief in most cases weighs an individual down with sorrows and emotions which have both psychological and physical consequences to that person. Therefore, grief can refer to a normal process of reacting both internally and externally to the perception of loss to physical or psycho-social losses in human experience that may lead to influence the change in his or her behavior (Klass, Silverman & Nickman, 1996, p.75). In this respect, each type of loss implies an experience of some type of deprivation that is unique and needs different approaches to manage.

Like any other phenomenon, grief has such characteristics as; somatic distress, preoccupation with the image of the deceased or the occurred loss, guilt and hostile reactions, and loss of the usual patterns of conduct. For instance, in case of a family losing their member, the family undergoes a cancer illness of which in the event many losses are experienced, whereby each of the losses necessitates its grief reaction in response to the nature, perception, and scope of loss (Kutner & Abraham, 2001, p.143). In this connection, grief reactions can be social, emotional, physical, or psychological. For example, the psychological-emotional reactions may include; sadness, despair, guilt, anxiety, and anger. While the physical may include sleep difficulties, appetite changes, and somatic complaints. In addition, the social reactions may include such feelings that concern taking care of others in the family, the desire to return to work, and the desire to see or not to see family or friends (Lindeman, 1944, p.37). However, as with bereavement, the grief processes vary from one individual to the other depending on ones’ attachment, nature of the relationship, and the situation surrounding the loss of the deceased. In this regard, when an individual is experiencing grief, he or she may feel like going crazy, unable to concentrate, angry, frustrated, anxious, guilt or remorseful, ambivalent, or for others numbness (Wolfelt, 1997, p.108).

In some cases, however, it is important to note that, grief tends to be mixed with trauma when a loss is sudden or unexpected that can result in a fatal heart attack to the person experiencing it, or even committing suicide. This can be demonstrated in an example whereby an individual who nurses a spouse or relative for a long-term illness will grieve if the spouse passes away but an individual who witnesses the sudden death of a spouse in a car crash that is sudden is likely to be traumatized (Wolfelt, 1997, p.79). Even though trauma always incorporates grieving, the two states are quite different in the way a person experiences them and the effect they can have on a person in the entire scenario. The distinction is the fact that grief is a normal reaction to loss with its symptoms diminishing over time (Wolfelt, 1997p.91). While trauma is a disabling reaction that can block the grieving process, in severe cases, it can disrupt a person’s life and leave an individual psychologically vulnerable. Therefore, it can be seen that sudden loss can be difficult to deal with if a person does not have a socially recognized outlet for mourning such a loss that occurs to him or her. In this respect, therefore, psychiatrists or counselors should adopt a model that will enhance a social outlet for mourning (Keleman, 1985, p.108) in an occurrence of an expected loss to persons.

The work of psychiatrist Elisabeth Kübler Ross in 1969 which is attributed to her working with terminal cancer patients in her profession came up with a useful model known as the five stages of grief in handling loss experiences to individuals. In her model, she captured five main steps as; Denial as an individual may try to deny reality for instance denouncing the loss to herself or himself, Anger in the sense that a person searches as to where to direct blame to, Bargaining whereby the individual deliberates on the loss to find a solution, Depression in which a person may exhibit emotional imbalance and lastly is the Acceptance stage whereby a person comes to terms with the reality of what has happened or shall happen. These stages are not a rigid framework that applies to everyone who mourns (Smal, 2001, p.54) since grief is more often experienced in cycles and not a linear process. Therefore, this varies across the individuals and hence patience can help a great deal (Smal, 2001, p.91).

These five stages of the grief model are based on the assumption that everyone goes through the same sequence of stages in the recovery from grief. Therefore, a departure from these stages in either type of mourning behavior is taken to be an indication of pathological grief in suffered loss to a person (Kutner & Abraham, 2001, p.104). It should be pointed out that, the fact that the bereaved person would eventually strike out on a new life different from the previous life was not highlighted in these model of five stages and does not guarantee the results. But so far, it is the promising model that is relevant to use as it captures the challenges that the bereaved face and a sequence of development that is shared to some degree by many individuals (Lindeman, 1944, p.24). This model has steps such as Numbness which comes immediately after the loss occurrence that is normally characterized by a sense of being distant and paralyzed (Klass, Silverman & Nickman, 1996, p.254). For instance, this normally follows after the death of a loved one and may last for seven to ten days depending on the individual’s strength. This leads to some biological theories explaining numbing as the body mechanism for protecting itself against being overwhelmed by the shock of the loss during its occurrence.

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The following stage is Denial and Isolation whereby the individual has significant difficulty accepting the reality of their loss within himself or herself. The extend varies with the situation from less to more severe forms as a complete denial of the loss or partial lapses of thinking about the loss occurrence. For example, a person may refuse to accept the loss of a relative completely or continue to think that he can not die for a long time. Therefore, total acceptance is part of the work of the whole grief process which should be gradual (Lindeman, 1944, p.71) although sometimes it is accompanied by more acute difficulties with acceptance of reality as it may appear (Kutner & Abraham, 2001, p.65). After the bereaved person goes through the denial and isolation stage when one enters into the Anger stage whereby the individual feels anger with the deity, the world, as well as other people in their life believed as the main cause of the loss suffered. In this stage, it is where most people often develop personal interrogative questions like ‘why it happened to me and not someone else’. In a situation of the loss of financial security or the death of a close relative, a person may engage in a sort of bargaining with the deity (Lindeman, 1944, p.52) for the restoration of the lost status. It becomes increasingly important for the bereaved person to be counseled well at this stage as the excesses of the bargaining may lead to the person’s mental abnormalities if not contained.

Then the fourth stage in the model is resultant Depression as a consequence of the experience of the person in the event of loss suffered. Depression usually comes as a result of the unfolding reality of the occurrence of the loss and the individual responds to it, through acknowledgment and acceptance of that reality of life after the loss (Klass Silverman Nickman 1996). In this case, the acceptance of reality grows into sadness and depression for the bereaved person. At this moment some psychiatrists insist on the use of counseling techniques as the therapeutic counter-measure to the patient rather than the use of anti-depressant drugs. This is because, the anti-depressants may increase the negative consequence as it does not affect the behavioral part of an individual but rather the pain realized from the condition in the event the problem will not be solved (Kutner & Abraham, 2001, p.98).

After the bereaved person undergoes the stages above, successfully then the final stage will be to accept the reality (Wolfelt, 1997, p.60). In this regard, the individual comes to terms with reality and moves on with other normal life activities. Here, the bereaved person comes to terms with the loss that occurred by accepting it, after which he or she can be able to move on to re-invest in the new life that lies ahead of him or her without being troubled by the past experiences (Wolfelt, 1997, p.95). In this case, the person can look for another means to adapt to the new environment that is different from what he or she was initially used to in the past. If the previous stages have gone on successfully, the evidence is observable in terms of the absence of the extremes of emotions and behavior trends (Klass, Silverman & Nickman, 1996, p.198). In this respect, the concept is the clear understanding of the entire process of the bereaved person so that as a counselor, one can be able to diagnose the behavior of the individual and help the patient to contain and manage the ailment (Cope with a severe loss, 2003, ch.4).

To sum up the discussion, the concept of loss and grief is core in counseling as it has a bearing on the individual’s behavior. This is as a result of the societal dynamism that is experienced in today’s changing world and the surrounding environs which are catalyzed by the ever-growing technology. However, the major issue is to induce in the concept the aspect of accepting the reality, as the emotional recognition and acceptance of the loss is the most difficult to achieve in the whole scenario of loss and grief. Once it is achieved, then the other therapeutic measures can be successfully be implemented and the problem will be easy to solve. This must be done in consideration of the cultural, social, physical, and psychological balance. However, people should aim at developing healthy coping skills in resolving a loss suffered by being a good listener, sharing feelings, acknowledging the pain, talking about losses freely, never minimizing grief, and a habit of sit and share with others who have undergone the same experience would prove useful. In this regard, the universal aspect to grief is the fact that that the way out of grief is through it, the very worst kind of grief is yours, grief is hard work, effective grief work is not done alone, hence the solution should be patient-centered that is, involving the patient in the active roles of the solution.

Reference

Cope with a severe loss, 2003, Web.

Keleman S, 1985, Living Your Dying, Center Press, Berkeley Calif.

Klass D, Silverman P, Nickman S, 1996, New understandings of grief, Taylor and Francis, London.

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Kutner J, Abraham J, 2001, Practical approach to grief and bereavement, Ann Intern Med, Boston.

Lindemann E, 1944, Symptomatology and management of acute grief, Am J Psychiatry, vol 6 Suppl pp. 145

Smal, N, 2001, Theories of grief, Open University Press, Buckingham.

Wolfelt A, 1997, The Journey through grief, Companion Press, Ft. Collins.

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