Grieving a Variety of Losses over the Lifespan

Grieving a Variety of Losses over the Lifespan Katie Kostohryz, Ph. D, Licensed Professional Counselor Associate Teaching Professor at Penn State PSU Herr clinic supervisor at SCASD Counselor Education; Rehabilitation & Human Services kzk 18@psu. edu

Objectives & initial questions • Identify and acknowledge a variety of losses, death and non-death related. • Understand unique needs of of grieving individuals and families across the lifespan. • Explore creative ways to express grief in our home, community & schools. Questions submitted: • What are individual and group supports family members with illnesses or disability, pet loss, separation or divorce, death, etc. for my kids and for myself? • What role do sports or physical activities have in the grief process?

• Loss is the real or perceived deprivation of something (or someone) deemed meaningful. Grief & Loss Definition from: Humphrey, K. M. (2009). Counseling strategies for loss and grief. American Counseling Association. • Grief is unique for each person. It’s a multidimensional experience to a loss. Responses can be emotional, interpersonal, cognitive, physical, behavioral, social, cultural, spiritual, and/or historical.

• Natural/man made disasters/terrorism/pandemics • Trauma/illness/disability/addiction/mental health • Divorce/separation/relationship ending Different types of losses… • Estrangement, loss of contact with family, friends, partners • Infertility/miscarriage/abortion • Loss of freedom/independence/sense of safety/ security/control/hopes and dreams • Loss of community/connection/ competence/self esteem/peace of mind • Loss of job/career changes by choice/loss of title/status • Transitions/role changes/loss of friends/loss of daily routines • Loss of graduation, seasons, events, milestones, academics, school year • Immigration/relocation/Re-entry after war, travel, or school • Cultural loss, loss of language, loss of objects • Loss of normalcy, everyday routine, motivation • Loss of life as we knew it, loss of old world, old way of being • Pet loss • Loss of faith, in people, the world • Change is loss, not knowing

• Primary loss- initial loss Types of losses • Secondary losses • Follow the primary loss, often overlooked • Loss of identity, loss of trust, loss of support systems & friends, loss of faith, loss of hopes & dreams, loss of finances, loss of status, loss of communication. . • Can be as or more impactful as the primary • Anticipatory loss -what is to come • Obscured loss -unaddressed or unrecognized loss overlooked due to survival, not knowing it was a loss, or for other reasons

Types of losses • Ambiguous Loss • uncertain, intangible, lack of rituals and rites • loss or change in relationship with someone still living • Psychologically present yet physically absent • COVID, adoption, child or parent in divorce, incarceration, military, empty nest, cut off & estrangement, friends or partnerships ending. • Physically present yet psychologically absent • Alzheimer’s, mental health, substance use or addiction, primary caregiver consumed with their own grief or with work. . • Pauline Boss: https: //www. ambiguousloss. com/

• Hierarchy of losses • Stigmatized loss • labeled shameful because of societal norms • substance use related deaths, HIV/AIDS, suicide Types of losses • Disenfranchised loss & grief • loss that can not be openly grieved, supported or acknowledged, absence of a ritual or denial to one • Griever is not socially recognized • age (youth & aging adults), ability or disability • A relationship is not recognized as legitimate • LGBTQA, “just a” friend, not married or partnered for that long, didn’t know them “that” well • Not socially recognized as a legitimate loss • systemic oppression and marginalization, cultural losses, historical unresolved trauma, pet loss, infertility, abortion, adoption, foster care • Self-disenfranchisement of your own losses“shoulds”

● Beyond the 5 stages (Kubler-Ross, 1969) ● Denial, Anger, Bargaining, Depression, Acceptance ● Finding Meaning, The Sixth Stage of Grief-D. Kessler A few theories on grief. . ● Dual process: loss coping vs restoration coping ● Loss adaptation and strategies as opposed to “coping”: ● Affective (emotional expression, affective regulation) ● Cognitive (how we think, analyze, reframing) ● Behavioral (activity, problem solving, behavioral distraction, doing, giving) ● Spiritual (meditation, prayer, rituals) ● Meaning reconstruction as a critical aspect (beliefs, assumptions, values, truths about self and the world) ● Existential, Narrative, TF-CBT, depends on theory & agency • Grief Matters 2019: Grief Comes to Lunch Community Grief Model

*http: //wecandiebetter. com/stages-of-grief/

Culture & Grief ● How does culture influence grief and loss? ● How does one’s culture enhance resiliency? ● What influences your ideas, thoughts, emotions, behavior, practices surrounding grief and loss? ● Variety of healthy responses to grief.

R- Religious and Spiritual identity E- Ethnic/Cultural/Racial identity S- Sexual orientation, Gender identity P- Psychological Maturity RESPECTFUL model (D'Andrea & Judy Daniels, 2001) E- Economic Class Background C- Chronological-Developmental: Ability & Disability T-Threats to One’s Personal Well-Being F-Family History and Dynamics U-Unique Physical Characteristics L-Location of Residence and Language

Questions to explore about culture &our environment in grief • How do policies, media, government, education, COVID impact our grief? • What are your greatest sources of strength? • What is your belief of what happens after someone dies? • Can the necessary supports and rituals be afforded? • As a member of a marginalized group, how does that impact the grief process? • Is grief expressed privately or publicly and for how long? • Expected genders or ages to grieve a certain way. • What rituals do people in this group/family perform? • What works for you? What does not? • What do you wish your grief looked like? • Is it a stigmatized loss & are there disenfranchised grievers? • What other losses or traumas or crisis are happening now?

Developmental resources The Dougy Center: The National Center for Grieving Children & Families Developmental responses to grief • Sesame Street Grief • Coalition to Support Grieving Students • National Center for School Crisis and Bereavement • National Institute of Health, Talking to your children about death • American Academy of Pediatrics: After a Loved One Dies • • Hume, K. , Regan, T. , Megronigle, L. , & Rhinehalt, C. (2016). Supporting Students With Autism Spectrum Disorder Through Grief and Loss. Teaching Exceptional Children, 48(3), 128– 136. https: //doiorg. ezaccess. libraries. psu. edu/10. 1177/0040059915618196 • In play therapy, toys are like the child's words and play is the child's language (Landreth, 2002).

• Kids & teens & grief summary Changes in thinking, feeling, body, behavior and relationships: • What is their baseline? • Increased somatic complaints • Regression • Social withdrawal • Concerns and fears with other loved ones, fears of abandonment • Guilt & magical thinking (they might have caused the death or divorce) • Decreased academic performance and concentration • Behavioral problems/high risk behaviors • Depression and anxiety • • • How a caregiver grieves impacts them Invite conversations, talk to them & ask them Comfort & reassure Calming and expressing Routines-when possible, offer choices • Teens & suicide: https: //afsp. org/teens-andsuicide-what-parents-should-know Children, Teens and Suicide Loss booklet: https: //awsfetch. s 3. amazonaws. com/flipbooks/childrentee nssuicideloss/index. html? page=1 •

COVID links & resources • https: //developingchild. harvard. edu/resources/how-to-supportchildren-and-yourself-during-the-covid-19 -outbreak/ • https: //childmind. org/article/supporting-kids-during-the-covid-19 crisis/ • https: //www. healthychildren. org/English/healthissues/conditions/COVID-19/Pages/Parenting-in-a-Pandemic. aspx • https: //www. nasponline. org/resources-and-publications/resourcesand-podcasts/school-climate-safety-and-crisis/health-crisisresources/helping-children-cope-with-changes-resulting-from-covid 19

How to stay well while grieving • Sleep, exercise, nutrition, basic needs, emotional, social, financial, environmental, occupational, tending to cultural identities, etc. • Calming & breathing activities • Mindfulness • Connection & groups • Routines & structure • Gratitude & hope • Compassion & kindness • Active participant in your grieving process • What helped before during difficult times? • What did not? #nailedit • Humor-when appropriate

Social Media and Grief • How does social media help/hinder people across • • the lifespan who are grieving ? What is appropriate vs what is not differs between individuals in families/friends/strangers Unite and connect people: family, friends or strangers who are also grieving Maintain relationship with the deceased or others experiencing loss Exposure to losses on media Quotes, funny videos, blogs, articles, apps Etiquette/trolling/hierarchy/grief tourism Disconnect from social media, limit use if need be How are you and others in your family using social media now?

* * I Recreate My Late Father’s Photos To Reconnect And Accept His Passing http: //www. boredpanda. com/daughter-traveled-and-re-create-late-fathers-photos/

Social Media & Grief Pet Loss: Video, Denali: https: //vimeo. com/122375452 Anxiety Project & Drifting, art By Dr. Bill Doan: https: //williamjdoan. com/portfolio_page/my-anxiety/ Living with health challenges website: Option B: https: //optionb. org/category/health-illness-and-injury Life after Infant Loss, Father’s Vlog: https: //www. youtube. com/watch? v=qfrbjxdehn. A Mourningsongs: Son wrote 15 second songs for a year on IG after father died: https: //www. instagram. com/mourningsongs/ Video games and loss: https: //www. standard. co. uk/stayingin/tech-gaming/grief-in -video-games-how-gaming-can-help-us-confront-death-a 3640891. html Modern Loss: https: //modernloss. com/

What to say/what not to say • What’s been helpful for you all in your grief? Not helpful? • Grief can be incredibly lonely and isolating. • People don’t want to talk about it or don’t know how. Greeting cards: https: //emandfriends. com/collections/empathy-cards • Show up & be present. . in other ways in COVID • How are you? What do you need today? • It can change day by day & moment by moment • Supportive ideas, Speaking Grief: https: //speakinggrief. org/get-better-atgrief/supporting-grief/support-ideas • Dummy Book for Grieving: Top 10 clichés • What Not to Say, Coalition to Support Grieving Students: https: //grievingstudents. org/modulesection/what-not-to-say/

Books & Movies-watch your grief • What/who is your child or teen watching, reading, or following? • • Use that as an entry way to learn more about them and their loss Day to day conversations yet respect space & privacy Similar and different than the character or person, create different endings. . Inside Out, Soul, Coco, any Disney movie or short film Checking in-what’s your meme/GIF/song/photo? Tear Soup: A Recipe For Healing After Loss by Pat Schwiebert WPSU Speaking Grief documentary: https: //speakinggrief. org/documentary Crash Reel: http: //thecrashreel. com/about-the-film/ U. S. champion snowboarder Kevin Pearce filming a documentary for Olympics and has a training accident resulting in a TBI. Follows grief of his family and friends. • Brain on Fire by Susannah Cahalan, 24 -year-old with an auto immune disease • Tons of books out there on different losses… • •

Expressing & moving your grief • Movement & body • Dance; Animal Yoga • Physical activities and sports • Lost Codes by Ibrahim Quraishi: https: //www. youtube. com/watch? v=7 t. I 6 Eo. Nlg. GE • Musical chronology & grief lyrics • Alive Inside: https: //www. youtube. com/watch? v=Ia. B 5 Egej 0 TQ • Painting, coloring, creating, collages • Alternative medicines • Ecotherapy, aromatherapy, energy work, massages, tai chi, yoga, food • Grief recipes : https: //whatsyourgrief. com/connecting-with-deceased-lovedones-through-food-grief-recipe-stories/

Creative interventions-document your grief • Digital storytelling and photovoice • Journeys Through Life cards • Write or tell your story • Learning to Live: http: //learningtolivewhatsyourstory. org/about-us • What’s your Grief? What would you tell your younger self about your grief? • Poems & stories, creating or relating • Activities for kids, Dougy Center: • Museum of Broken Relationships: https: //brokenships. com

Ways to do something in grief or sometimes we need to do nothing • Memory boxes, life stories to ethical wills • Make together with children, adolescents, or others family memories. Include photos, clothes, audio recordings, videos, magazines, other tangible evidence of person, animal or thing-be creative! • Time Capsule (Pillay & Gibson, 2010) • Snapshot of current time; Put memory in for each family member; Write letters for individuals to read later; “Sending love to the future” • Create nature centerpieces, prepare a favorite meal, plant flowers or trees, light a candle, donate, give back, do something • Watch a movie, read a book or listen to music enjoyed by your loved one • Express your faith or self in a variety of ways (read, prayer, rituals, journal. . ) • Reach out, join a group, read something, talk to someone

The Boy, the Mole, the Fox & the Horse by Charlie Macksey

Local Resources • • • TIDES: www. tidesprogram. org Jana Marie foundation: www. janamariefoundation. org Learning to Live: http: //learningtolivewhatsyourstory. org Koch funeral home resources, groups, Death Café: https: //kochfuneralhome. com/97/Bereavement-Gatherings--Events. html Support groups in SC: https: //www. griefconnection. org/general What are our needs? What else can we do in our schools & community? How can we come together to best support one another in our grief?