For the Practitioner and Supporter
Within the realm of loss and grief lies the dual fear of the unknown and the fear of the known. Anxiety and its reduction serve as the professional’s primary objectives during the journey through the five stages of grief or seven stages, depending on one's preference. The core purpose behind traversing these stages is to alleviate this anxiety, evident at every step, from anger and denial to bargaining until reaching acceptance. Anxiety often registers at its peak when measured on a scale of 0 to 100, especially when individuals receive news of a loved one's hospitalization, ranging between 90 and 100.
If the prognosis is grim and the realization that their loved one might not survive takes hold, it's natural to experience shock and denial. These reactions stem from the fear of confronting the unknown and the uncertainty of what life would look like without that person. Anger, arising from the desire to change the inevitable outcome, is rooted in the fear of an uncertain future, as it's difficult to envision a life without the presence of a loved one.
Depression, another stage in the process, is marked by apprehension about the unknown and fear of the future. It's challenging to fathom how one can navigate life without the person in question or manage the impending changes. Bargaining, in its own way, represents an attempt to quell anxieties about the future, often involving thoughts on altering the past to prevent similar catastrophes. This sense of responsibility, believing one can change the past, ultimately leads to anxiety about the future and a person's perceived abilities.
As we examine each stage of grief, anxiety remains a constant presence. Shock and denial serve as the minds initial attempts to manage this anxiety, which often resurfaces, particularly when it reaches anger. Bargaining ensnares individuals in ruminations about the past, making it difficult to confront the future—a vast unknown territory.
For professionals guiding individuals through the stages of grief, anxiety reduction and providing tools to manage anxiety are essential goals. By helping individuals reduce anxiety, professionals can expedite the journey toward acceptance. In the realm of acceptance, individuals begin to envision a future and the possibility of moving forward. This transition becomes viable when they believe they possess the necessary resources to navigate life's practical aspects and emotional processing tools to cope with their feelings. With these resources in hand and a sense that their loved one's presence is with them, acceptance becomes attainable, anxiety recedes, and a new chapter can unfold.
Anxiety Reduction Tools For The Professional By Grief Stage
Denial/Shock
Compassion/empathy towards surreal experience
“I can’t imagine what this experience must be like for you”, “it must feel like a nightmare”, “you’ve been through so much”, “anyone going through this would feel the same”
These statements serve multiple Purposes
the survivor feels seen and that they are no longer alone. They might feel as if they are losing their mind, the affirmation of their experience normalizes their grief and helps them feel they are part of a larger community. This calls on 5e humans natural instinct to be a part of a group and to find comfort in the idea of being a part of something larger. - Good for isolation
the survivor is pulled out of the frozen state of shock to the present reality where you are with them. As a result they, in a safe environment, are able to slowly reintegrate back to present reality with a lower level of anxiety than facing the situation by themselves. They are able to identify you as the expert guide to assist them in the emotional and information overload. - good for high anxiety
the survivor is able to begin processing the overwhelming weight of the loss through first identifying with the statements that were made by the professional instead of being frozen and unable to begin processing for not knowing where to being and feeling overwhelmed.
the professional is able to gain further trust with the individual as someone who is understanding and willing to listen to their perspective. This creates a sense of comradery and ethos
Experience review/overview
“Can you tell me what has happened?”, “It seems like it’s been an exhausting journey for you. What did you experience?”, “Your loved one has been on a long journey and it seems like you’ve been present throughout this experience.“
Life Review
A life review is defined as a journey through key moments in the deceased/grieving individuals experience.
Life review helps to frame and set the emotional stage for the survivor. They are able to relieve important moments in their relationship with the deceased. These moments assist the individual in shock in several ways
The survivor is able to verbally process painful moments with the assistance and guidance of a trained professional, easing anxiety and allowing the individual to process experiences that may be too uncomfortable to address by themselves.
The survivor is able through life review to time travel to a moment where things were better in life showing the survivor they can do this at will whenever they wish to interact with the deceased. Through life review they are able to see their loved one will always be with them.
The survivor is able to relieve the final moments of the deceased which typically leads to a survivor feeling gratitude that the deceased is no longer suffering. As they identify painful moments in their experience, they also see from the patients perspective and who they truly are. They see they’ve lived multiple beautiful experiences with the deceased and that the deceased body was no longer functioning in agreement with who the deceased truly was. The survivor is able to see that the ending of suffering is for the best.
Trauma Review
Presence/silence
Anger
Bargaining
Depression
Acceptance
Items to take note of
is room hot - water, ice, hydrating drink
is room cold - blanket tea coffee
is person seated - chair, ensure adequate seating
is person standing - ensure space to move
identifying which stage each individual is at.
identify the individual who primarily takes lead role in navigating crises for their family - ensure they have all the support they need including tools and resources for later.
Physiological items to notice
shaking leg
trembling voice
unstable gait/stance
crying
attempting not to cry
Anxiety Measurement (0-100)
With 0 being no anxiety and 100 being the most anxiety one can experience, where do you rank yourself on scale from 0-100 related to your anxiety level. *Anxiety defined as fear/apprehended of the future*
The professional can use this measurement when assessing the level of anxiety one has in different stages of grief while guiding the survivor towards acceptance and decreased manage of their anxiety. The goal is to get survivor to baseline or lower than baseline level of anxiety. Once they are substantially close enough the individual will no longer feel they are in emotional crisis and will be able to navigate utilizing tools they have already have grown accustomed with.
Sam Williams, MDiv, BCC
Professional Crisis Support Chaplain
Connecting Humans Mobile Chaplaincy
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