The parents as well as three siblings of a twenty-
three-year-old woman came in for grief counseling. All were neat,
well dressed and fairly quiet. The parents were first to speak
about their daughter. They began with a description which
characterized her as a quality young woman, their first born in the
family. She was gifted in every area of her life and had a bright
future ahead of her.
Slide 12
The parents went into great detail about her abilities and
accomplishments, stopping every now and then because of their
inability to talk. Often all five were in tears. Two weeks prior
she and her seven-month old unborn child and her mother-in-law were
driving on a freeway when a truck struck and killed all of them.
Since that time every member of this family has been
struggling.
Slide 13
Questions 1. How would you begin this session? Describe your
exact words. 2. What would be your goal in this initial session? 3.
What would you say or ask to engage the three siblings?
Slide 14
4.What would you want them to take away from this session in a
tangible way? 5. Based on this information identify all the
possible grievers. 6. What are the factors which contribute to this
loss being a complicated grieving process?
Slide 15
1. After greeting each person I would validate the fact they
have experienced a great loss in their life. If I didnt know
already I would ask the name of the daughter as well as the mother-
in-law and whenever I made reference to either I would use their
name rather than refer to them in a general way. One of the first
questions I ask is, Tell me about (the daughter) and have each of
the family respond.
Slide 16
Too often children are left out of the interaction. After each
has responded my next question is, Would you describe for me what
the last two weeks has been like so each has a chance to tell their
story. Within this I often ask how they heard the news and to
describe their reaction.
Slide 17
2. My goal is to have them tell their story and then normalize
for them what they are experiencing and educate them about grief
and what to expect in the future (using the handout on the Crazy
Feelings of Grief). Id also want to find out about their support
system as well as giving some suggestions to eliminate the pressure
of other individuals.
Slide 18
I also mention that each of them may grieve in a different way
and with a different intensity. Thats all right and its not a sign
that the other person doesnt care if their grief is less intense. I
ask, How can the other family members support you at this
time?
Slide 19
3. Some of the questions directed toward the parents could be
asked of the siblings. I also let everyone know that I would be
willing to meet with each one individually. One reason for this is
the deceased was described as a special gifted individual but was
she in the eyes of the siblings? Sometimes even in the initial
session I ask for a favorite memory from siblings.
Slide 20
Some may have a mixture of feelings. At some point I would ask
the parents and siblings alike if there was any unfinished business
or issues between them and the deceased or if there was something
they wished they could have said to her before she died. If so, I
would suggest writing a detailed letter and reading it aloud at the
place of internment.
Slide 21
4. I would like each one to believe there will be help for all
of them during the months and years ahead of them. Any suggestions
or recommendations made need to be put in writing such as the list
of Crazy Feelings of Grief, etc. I would give each one a copy of
Experiencing Grief as well, and suggest they read it when theyre
ready. I also let them know that it is normal not to remember what
they read at this time. I send home a DVD called Tear Soup and ask
them to watch this together.
Slide 22
5. There are two other family members who were lost as well. It
would be easy to ignore them and gloss over this loss. I would ask
about them as well as the effect this loss is having. For the
parents, the loss is a grandchild which is major.
Slide 23
The possible grievers would include husband, aunts, uncles,
cousins, friends, fellow workers, pastors, church, ob gyn, husbands
family, grandparents, truck driver, first responders and similar
group of individuals. Its important to consider who will minister
to them and how. One of our tasks is to identify neglected grievers
and reach out to them as well. Sending or giving them Experiencing
Grief as well as making available copies of the Tear Soup DVD has
been helpful.
Slide 24
6. Not only was this a sudden death but it was multiple tragedy
involving someones child and unborn grandchild. There could be the
possibility of legal complications because it was a vehicular
accident. The way in which the notification was made could be a
factor as well. (Refer to the section on sudden death for
additional information).
Slide 25
Was it an anticipatory loss, crisis or trauma? Delayed Grief -
Because of children or work Support The Ten Day Syndrome Use the
Tear Soup DVD
Slide 26
Major Problems Secondary Losses Financial Holiday Significant
Dates Death of an ex-spouse
Slide 27
1. Finances 2. List the essentials and the non-essentials 3.
List what I know how to do and what I dont 4. Help them handle the
advice of others 5. Help them handle the holidays 6. Explanation
letter Change monthly or quarterly
Slide 28
7. Identify safe people 8. Set up a team of people Different
each month 9. Journaling 10. Handle the feelings
Slide 29
Slide 30
The crazy feelings of grief are actually a sane response to
grief. The following examples are all symptoms of normal grief:
distorted thinking patterns, crazy and/or irrational thoughts,
fearful thoughts feelings of despair and hopelessness out of
control or numbed emotions
Slide 31
changes in sensory perceptions (sight, taste, smell, etc.).
increased irritability may want to talk a lot or not at all memory
lags and mental short-circuits
Slide 32
inability to concentrate obsessive focus on the loved one
losing track of time increase or decrease of appetite and/or sexual
desire difficulty falling or staying asleep
Slide 33
dreams in which the deceased seems to visit the griever
nightmares in which death themes are repeated physical illness like
the flu, headaches or other maladies shattered beliefs about life,
the world, and even God
Slide 34
When you lie down you shall not be afraid; yes, you shall lie
down and your sleep shall be sweet. Be not afraid of sudden terror
and strong, nor of the stormy blast or the storm and ruin of the
wicked when it comes [for you will be guiltless], For the Lord
shall be your confidence, firm and strong, and shall keep you foot
from being caught [in a trap or hidden danger]. Proverbs 3:24-26,
AMP
Slide 35
You will not be afraid when you go to bed and you will sleep
soundly through the night. Psalm 3:5, Good News Bible If Im
sleepless at midnight, I spend the hours in grateful reflection.
Psalm 63:6, The Message
Slide 36
When my anxious thoughts multiply within me, Your consolations
delight my soul. Psalm 94:19 I will lie down and sleep in peace,
for you alone, O Lord, make me dwell in safety. Psalm 4:8
Slide 37
In a dream, a vision of the night When sound sleep falls on
men, Then He opens the ears of men, And seals their instruction.
(Job 33:15-16).
Slide 38
Dear God, We give thanks for the darkness of the night where
lies the world of dreams. Guide us closer to our dreams so that we
may be nourished by them. Give us good dreams and memory of them so
that we may carry their poetry and mystery into our daily lives
Grant us deep and restful sleep that we may wake refreshed with
strength enough to renew a world grown tired.
Slide 39
We give thanks for the inspiration of stars, the dignity of the
moon and the lullabies of crickets and frogs. Let us restore the
night and reclaim it as a sanctuary of peace, where silence shall
be music to our hearts and darkness shall throw light upon our
souls. Good night. Sweet dreams. Amen Michael Leuing A Common
Prayer
Slide 40
Deposits of unfinished grief reside in more American hearts
than I ever imagined. Until these pockets are opened and their
contents aired openly, they block unimagined amounts of human
growth and potential. They can give rise to bizarre and
unexplainable behavior which causes untold internal stress. Robert
Cavanaugh
Slide 41
Slide 42
Your Block Who is There? Working in the Community
Slide 43
Slide 44
What are the losses? Have you asked? What has been taught on
loss? What has been taught on grief? What has been taught on how to
help others?
Slide 45
Is the teaching incident or situation prompted or purposefully
done to prepare and equip the congregation to handle their losses
and be a caregiver on their block and at work. Is there a special
ministerial care team to provide ongoing two year support to
grieving families? Pastors need this help.
Slide 46
Churches Sermons Week One Loss Grief Loss History
Slide 47
Week Two What to Say and What Not to Say Conversations that
Count from San Joaquin Hospital What to Say and What Not to Say
printout for each member of the congregation download from web
always have books available
Slide 48
1. Develop Spiritual and Emotional Caregivers 2. First Response
Team in the Church 3. Grief Coaches 4. Classes 5. Grief Recovery
DVD series 6. Grief Share
Slide 49
7. Memorial Day or Remembrance Day 8. Your Calendar 9. Care
Partner MINISTRY 10. Help the Christian Schools Develop a Plan 11.
Cards to Families on Obituary Page 12. Let Others Tell Their
Stories from the pulpit and in the class
Slide 50
1. Real or Material First loss as a child Many are replaceable
which could mask the grief reaction
Slide 51
Slide 52
2. Abstract Love Hope Ambition Control Loss of Face 3. Imagined
We thinkthe other no longer loves us Elderly woman complains
children have abandoned her Expectations
Slide 53
4. Relationship Loss The end of an opportunity to relate death,
divorce, moving, end of friendship
Slide 54
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5. Intrapsychic Loss Losing an image of oneself Losing what
might have been Death of a dream Loss of Face - Shame
Slide 58
Slide 59
Questions to ask: Has the way in which you view yourself
changed recently? Could it be that a dream you had or some plans
have gone by the wayside?
Slide 60
6. Functional Loss Muscular or neurological function sight,
hearing, coordination, body part, memory, Diagnosis Disability
Chronic Illness
Slide 61
Sometimes good health is not a blessing but a curseWhat if
youre in good health and active and youre 80 and your wife is
deteriorating mentally with Alzheimers and what if most of your
friends, your siblings and others that you know that you used to do
things with are in deteriorating health or have died? Where does
that leave you?
Slide 62
God grant me the senility To forget the people I never liked
anyway, The good fortune to run into the ones I do, And the
eyesight to tell the difference.
Slide 63
Questions to ask: What physical changes may have occurred in
your life in the past five years that may have been a significant
loss for you?
Slide 64
7. Role Loss Retirement, transfer, promoted, demoted,
graduation Questions to ask: In what way have any of your roles in
life changed? How did this change your life and how you view
yourself?
Slide 65
8. Systemic Loss Child leaves home; fellow-worker; family from
your church; pastor leaves Questions to ask: Has any significant
person left your life or group recently?
Slide 66
9. Threatened Loss Biopsy Im thinking of divorcing you.
downscaling, lawsuit, terrorism, hurricane, tornado, floods
Slide 67
10. Ambiguous Variations - 2 Main Types Deployment, adoptees
search for parents, MIA, The World Trade Center, strike, Alzheimers
Abortion Childhood abandonment Physical & Emotional The loss of
childhood from physical and/or sexual abuse Family member in jail,
Chronic illness
Slide 68
Questions to ask: Is there any kind of loss that youve
experienced that doesnt make sense or you cant seem to get any
closure over?
Slide 69
Ambiguous loss is the most devastating Why? 1. The loss is
confusing doesnt make sense and you cant problem-solve. 2. You cant
adjust to the loss so the family freezes in place.
Slide 70
3. Family is denied the rituals that support a real loss. 4. It
reminds you that life isnt fair.
Slide 71
11. Disenfranchised Grief the grief that persons experience
when you incur a loss that is not or cannot be openly acknowledged,
publicly mourned, or socially supported.
Slide 72
Three types of Disenfranchised Grief: The relationship is not
recognized The loss is not recognized. The griever is not
recognized.
Slide 73
friend provider handyman cook lover bill payer gardener laundry
person companion confidante sports partner mentor checkbook
balancer prayer partner mechanic source of inspiration or insight
identity
Slide 74
teacher motivator counselor business partner protector errand
person organizer encourager in-law support couples class financial
adjustment social adjustment feeling of safety tax preparer couple
friends
Slide 75
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First Memory Disneyland 0 3 4 5 7 8 10 New School Grandpa
Hamster Died Died Broken Arm Couldnt Play Soccer
Slide 79
First Memory 0 3 4 5 10 Two Friends Stopped Calling Wasnt
Allowed To Attend Funeral Grandpa Died Couldnt Go To Grandpas Cabin
Lost Toys Grandpa Gave Her A Boy She Liked Doesnt Like Her New
School Broke Arm Hamster Died
Slide 80
Please forward to cat lovers everywhere who, like myself, are
very concerned about their hygiene. Thoroughly clean the toilet.
Add the required mount of shampoo to the toilet water, and have
both lids lifted. Obtain the cat and soothe him while you carry him
towards the bathroom.
Slide 81
In one smooth movement, put cat in the toilet and close both
lids (you may need to stand on the lid so he cannot escape).
CAUTION: Do not get any part of your body too close to the edge, as
his paws will be reaching out for any purchase they can find.
Slide 82
Flush the toilet three or four times. This provides a powerwash
and rinse which I have found to be quite effective. Have someone
open the door to the outside to ensure that there are no people
between the toilet and the outside door. Stand behind the toilet as
far as you can, and quickly lift both lids. The now-clean cat will
rocket out of the toilet, and run outside where he will dry
himself.
Slide 83
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Slide 86
Counselor: Ill let you begin where youre comfortable, Eve. Eve:
This is a bit of a recent loss. (pause) In November, November 5 th
I lost a very, very close friend. It was from the swine flu. It was
a very sudden loss, unexpected. And we had recently had a
disagreement. So I blame myself. Somehow I felt responsible, so
that made it harder, because I wasnt there to encourage proper
medical care and that sort of thing. (speaking slowly and
softly)
Slide 87
Counselor: So youre taking on some real responsibility for this
persons death. Eve: Yesyes Counselor: And what was this persons
name. Eve: His name was Warren. Counselor: Warren
Slide 88
Eve: And they didnt go to the doctor soon enough and I felt
like that was the reason that he died. So its been very difficult.
I cant I know logically Im not responsible, but internally I was
thinking, I keep telling myself, If only this I reenacted making
contact in time to say, Oh, are you sick? You should go to the
doctor.
Slide 89
Counselor: So your mind is telling you one thing, but your
heart seems to be overriding that and youre taking on that
responsibility? (tentative) Eve: I am Counselor: And when you
reenact this in your mind, how does that leave you?
Slide 90
Eve: Oh, I feel terrible. I feel so guilty, I feel lost and
sad. I started to get migraine headaches. I realized was punishing
myself each time Id think it. Counselor: How long did you know
Warren? Eve: Probably 32 years Counselor: So it was a long
relationship?
Slide 91
Eve: A long friendshipvery long friendship. Very long (voice
trails off) Counselor: And youre thinking if we havent had this
riff then I could have saved him.
Slide 92
Eve: Right, I had tried to get back in touch but by then I
didnt know he was sick. I actually heard about it accidentally.
Someone who knew I knew him said, You know Warrens in ICU hows he
doing? I said, Oh, I dont know. I was in shock, I couldnt believe
hed had been there for 17 days before I heard. And he was all alone
during his illness part. So, waited to go to the doctor to the last
minute to go to the doctor and it was too late.
Slide 93
Counselor: Youre thinking I could have prevented this from
happening. Eve: Yeah, I think that over and over and over. And I
know he probably wouldnt have ever listened to me. He was a very
stubborn person, very stubborn because his son was living with him
and he wouldnt listen to anybody.
Slide 94
Counselor: So there were other people who probably encouraged
him to go to the doctor. Eve: Probably Counselor: But he didnt
listen to them.
Slide 95
Eve: Well, actually just his son. He never let anyone at work
know how bad he was, how sick he was. They just kept thinking he
would be coming back next week. One of his co-workers felt guilty
too because she was with him when she dropped him off and she knew
how sick he was. But she didnt have the kind of connection with him
that she would call. Well, she got sick herself from the swine flu.
And its been since November, its a little better, but suddenly it
will come over me.
Slide 96
Counselor: Its still heavy on your heart. Eve: Its so heavy,
its so painful Counselor: But youre not certain he would have
listened to you. Eve: No, honestly I know he probably wouldnt have.
Hes very stubborn about going to the doctor about anything.
Counselor: Like many men Eve: Yes, like many men (smiles)
Slide 97
Counselor: But still because of that connection you just wish,
I could have done something to help him. Eve: I feel so helpless.
This is the worst part though. I never say anything to somebody. He
had sort of a sharp way of saying things. It was part of him,
everybody knew that. And I never said anything back. And this one
time it was over something stupid. He made a comment about my car.
I carry all my files. And he made some comment. And I said, I dont
ever want to talk to you. But it was a lot of things. I said, I
dont want to talk to you anymore. It hurt my feelings.
Slide 98
Counselor: It sounds like it was a build up, it wasnt just what
happened then. Eve: So I said, I never want to talk to you again. I
didnt really mean it because I never say that to anyone. But then I
thought he probably really believes it. So, then I was afraid to
call him back. We didnt speak ever again. It was so hard. I feel
like he left the earth thinking that I never wanted to talk to him
again. He was such a good friend.
Slide 99
Counselor: You had a lot of good times together. Eve: We worked
in a lot of different places together. He was a very great person.
Just didnt like to go to the doctor. I felt so helpless. Counselor:
It sounds like you still have some things youd like to say to him.
Have you written him a letter? Eve: No, I havent. Its an idea.
Slide 100
Counselor: Do you think it would help? Eve: Yeah, I think it
would. Counselor: If you were to write it, what would you do with
it? Eve: Oh, Id probably would read it out loud. That would
probably help. Counselor: Where would you read this?
Slide 101
Eve: I just heard they are getting ready to get his headstone
ready. Maybe I could read it at his grave. Its funny because Ive
been thinking about what to do to go there what would I do? In
Judaism you leave stones to show that you have been there. And I
was reading about it last night you know like an altar.
Slide 102
I have a stone from Israel. Its a tradition that comes from
many different places. And I have a stone that I have from when I
went to Israel. He always said he wanted to go to Israel for the
history. He didnt have any belief system at all, in God. (takes a
Kleenex) That would be a healing thing to read the letter.
Counselor: What would you like to say?
Slide 103
Eve: Just to thank him for being such a good friend. To tell
him I miss him and that a lot of people miss him. He such a beloved
person. To tell him I wish he hadnt been so stubborn, but we know
that was who he was. Just to put those feelings into words, give
words to those feelings. Counselor: Churning. Theyre churning
around a lot inside of you, arent they?
Slide 104
Eve: Just even talking I feel some relief. They come back. Its
seems that they come back all of a sudden. Counselor: You also
alluded to regrets. I wonder what you could do about the
regrets.
Slide 105
Eve: Well I think the one thing was the regret. I rarely even
speak to somebody if they have a bad temper - I think I wont talk
to them for a while. And I thought to make sure I never leave a
friend without making sure that were still connected. Never say I
wont ever talk to you again. I dont know why I said that.
Slide 106
Counselor: This is becoming sort of a learning experience? Eve:
To learn how important every moment is. And not to lose a chance to
do some healing. And to make sure we reconnect with each other even
when weve been upset in a moment. Never walk away from anyone
whether I care about them or not, like Warren. Every person is
important who comes in my path.
Slide 107
I dont want to ever regret the thing about words. Not to put
words out that are going to hurt. I do regret that. Because you
dont know if youre ever going to see that person again. You just
dont know!
Slide 108
Counselor: And you really dont fully know how he felt toward
you after that either. I guess we all tend to assume the worst.
Eve: Oh, yes. Counselor: Can you think of anything else you might
be able to do that can help you at this time?
Slide 109
Eve: I think talking about this here and writing the letter. I
need to reconnect with the woman who was with him when he got ill
because she carried so much guilt, too because she didnt go back
and reconnect with him.. Weve formed a bond and friendship together
and because of that we can both share together. Thats been very
helpful.
Slide 110
Counselor: The situation itself where you had the altercation
with him, does it play over sometimes in your mind? Eve: Yes.
Counselor: I imagine when that happens its still pretty upsetting.
Eve: It still hurts
Slide 111
Counselor: What do you think about writing that out in detail
in longhand? Eve: Oh, I hadnt thought of that. I have such rare
altercations Yeah, that would be good because its painful to think
about. Counselor: Sometimes those thoughts get stuck on a circular
loop and they keep playing. And one of the best ways is just best
to write it.
Slide 112
Eve: I like that idea. (pause) Yes, that would be good.
Counselor: Can you think of anything else you might be able to do?
Eve: Well, one of the things I am doing - thats why Im taking this
class because I want to be able to help others. Ive counseled for a
long time but feel like I went right through the fire with this
loss.
Slide 113
I lost my dad 11 years ago, that was hard and Ive had the
miscarriages, that was hard. Maybe part of this is Im feeling I
should have known. Im mad at myself as a counselor, I should have
known to do this differently. Just to give myself permission to be
human, not to expect myself to know everything when Im in a
situation like this.
Slide 114
Kind of feeling Sort of feeling As I get it, you felt that Sort
of a feeling that If Im hearing you correctly
Slide 115
To me its almost like you are saying, I Sort of hear you saying
that maybe you Im not sure Im with you, but I wonder if youre
expressing a concern that Your message seems to be, I So your world
is a place where you
Slide 116
A. Loss can strengthen our faith. B. Loss can produce maturity.
C. As we suffer we enter more into the suffering of our Lord and
become more Christ-like D. When you experience loss you will
discover the extent of the comfort of God.
Slide 117
But whatever things were gain to me, those things I have
counted as loss for the sake of Christ. More than that, I count all
things to be loss in view of the surpassing value of knowing Christ
Jesus my Lord, for whom I have suffered the loss of all things, and
count them but rubbish so that I may gain Christ, Philippians
3:7-8, NASB
Slide 118
Peter said, Beloved, do not think it strange concerning the
fiery trials which try you, as though some strange thing happened
to you (I Peter 4:12, NKJV) The Message translation puts it in a
unique way: Friends, when life gets really difficult, dont jump to
the conclusion that God isnt on the job. Instead, be glad that you
are in the very thick of what Christ experienced. This is a
spiritual refining process, with glory just around the corner.
Slide 119
A Biblical perspective Purpose of Loss Consider it all joy, my
brethren, when you encounter various trials, knowing that the
testing of your faith produces endurance, James 1:2,3
Slide 120
Grief will take longer than youve ever imagined. It tends to
intensify at three months, special dates and the one year
anniversary. Grief is a journey, a process and there is resolution.
Hear the words of Scripture:
Slide 121
I weep with grief; my heart is heavy with sorrow; encourage and
cheer me with your words, Psalm 119:28, TLB He heals the
brokenhearted and binds up their woundscuring their pains and their
sorrows, Psalm 147:3, AMP
Slide 122
I cried to the Lord in my suffering and he heard me, he set me
free from all my fears, Psalm 34:6, NLT For You have delivered me
from death, my eyes and tears, and my feet from stumbling and
falling. I will walk before the Lord in the land of the living,
Psalm 116:8-9, AMP
Slide 123
Then maidens will dance and be glad, young men and old as well,
I will turn their mourning into gladness; I will give them comfort
and joy instead of sorrow, Jeremiah 31:13 You will grieve but your
grief will turn to joy, John 16:6
Slide 124
3. The body and the mind grieve. It is a full time job. Often
the grief has symptoms erupt that imitate the cause of death of the
loved one.
Slide 125
4. Grief is a wound that needs attention in order to heal. The
mourning period is really a time of convalescence. 5. Grieving is
relearning your world. We have to reshape our lives, reinterpret
and redirect our life story and find our way back to purposeful,
meaningful and hopeful life again.
Slide 126
Understanding and using the tasks of grief as your primary
therapeutic approach Task #1: Recognize and accept that your loved
one has died and is unable to return. Task #2: Express all the
emotions associated with the death of your loved one.
Slide 127
Task #3: Identify, summarize, and find a place to store the
memories of your loved one which will honor the life of that person
and make room to move on. Task #4: Identify who you are now,
independent of your prior connection with your loved one.
Slide 128
Task #5: Reinvest in life as an individual without your
deceased loved one. You have a new normal.
Slide 129
1) Through grief you express your feelings about your loss. 2)
Through grief you express your protest at the loss 3) Through grief
you express the effects you have experienced from the loss.
Slide 130
1) The person in grief needs to find the words for the loss. 2)
Say the words aloud. 3) Know that the words have been heard.
Slide 131
Grieving is a journey that teaches us how to love in a new way
now that our loved one is no longer with us. Consciously
remembering those who have died is the key that opens our hearts,
that allows us to love them in new ways. Thomas Attig
Slide 132
The words of grief include without, amputation, longing The
disbelief of a loss causes us to look at everything like its a
gauze curtain. We learn in our life to do things with our hands and
our minds. But its not as easy to accomplish something with our
heart.
Slide 133
Grief is a demanding and overpowering intruder Its a form of
exhaustion and at first its like an internal emotional hemorrhage.
Grieving like so much else in life does not have to impoverish but
can be a learning experience.
Slide 134
There are many burdens to carry in grief, but one of the
greatest is educating others to the meaning of grief. The loss we
experience doesnt stay the same but changes daily, shrinking and
expanding as well as gathering other unattended losses of our life
and reactivating some which were dormant.
Slide 135
The words of grief are many and varied Apathy no energy and not
caring Yearning for many things including undoing what was done
Ache Its been Viewing your life in a time pattern based on how long
theyre gone.
Slide 136
I need some help. My cousins cat had kittens and he was able to
give away all but 3 of them. I told him I would help him find homes
for the last 3. I cant take any because Im allergic, but if 3 of
you could take just 1 it would be such a help and the kittens could
have a nice home.
Slide 137
Since he lives up by the San Mateo Nuclear Power Plan Ill go
pick them up for you. Ive attached pictures of the last 3 kittens.
Will you help?
Slide 138
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Some individuals are intuitive grievers. For them: 1. Feelings
are intensely experienced. They want and need to express them. 2.
Expressions such as crying and lamenting reflect their inner
experience.
Slide 142
3. These grievers need to express feelings in order to create
successful adaptive strategies. For them feelings are vibrant,
intense colors.
Slide 143
Some individuals are instrumental grievers. 1. They think of
their grief more than feel it: Feelings are less intense. 2. Theres
a general reluctance to talk about feelings 3. Instrumentals are
often identified by the absence of crying and seeking help.
Slide 144
Some individual are blended grievers. 1. They have both
elements but with a greater emphasis on one or the other. From Men
Dont CryWomen Do, Martin & Doka
Slide 145
Job, having lost all 10 of his children, laments, My days have
passed, my plans are shattered, and so are the desires of my heart
(17:11). He concludes, Where then is my hope? Who can see any hope
for me? (v.15)
Slide 146
Bildad, who probably had never had training in communications,
could not simply receive Jobs words (18:2). He had to correct Job.
Possibly while Job was lamenting, Bildad was composing a challenge:
When will you end these speeches? Be sensible, and then we can
talk. Bildad the Shuhite to Job, Job 18:2
Slide 147
What you can say Your words Death and life are in the power of
the tongue, and they who indulge it shall eat the fruit of it [for
death or life] Prov. 18:21, AMP A gentle tongue [with its healing
power] is a tree of life Prov. 15:4a, AMP
Slide 148
A man has joy in making an apt answer, and a word spoken at the
right moment, how good it is! Prov. 15:23, AMP A word fitly spoken
and in due season is like apples of gold in a setting of silver
Prov. 25:11, AMP Watch the way you talk Say only what helps, each
word is a gift Eph. 4:29, The Message
Slide 149
The three most important steps to take in helping a person: 1).
Listening with your eyes 2). Listening with your ears 3). Listening
with your heart James 1:19: Prov. 18:13
Slide 150
I am frightened inside; the terror of death has attacked me. I
am scared and shaking, and terror grips me. I said, I wish I had
wings like a dove. Then I would fly away and rest. I would wander
far away and stay in the desert. I would hurry to my place of
escape, far away from the wind and storm. Psalm 55:4-8 New Century
Version
Slide 151
How long must I wrestle with my thoughts and everyday have
sorrow in my heart? Psalm 13:2, NIV
Slide 152
It can strike anyone Trauma leaves us feeling unsafe It
involves a loss Trauma makes us feel overwhelmed It is often
unspeakable Trauma can change or challenge our view of God
Slide 153
Trauma produces hyper-arousal, hyper-alertness and hyper-
sensitivity. Those traumatized often re-experience the trauma It
leads to feelings of helplessness Trauma does not make sense
Slide 154
Trauma is the response to any event that shatters your world.
Its more than a state of crisis. Trauma leaves you feeling unsafe
because your place of refuge has been invaded The word trauma comes
from a Greek word that means wound. Its a condition characterized
by the phrase I just cant seem to get over it.
Slide 155
1. Traumas a separation from safety. Its invasive invades all
areas of our life It must be dealt with in a unique way for each
one 2. Its unpredictable You think youre dropping your child off at
daycare or high school or your spouse goes to work or a parent
boards a plane. 3. Every new trauma activates the old one. It taps
into all the old stuff
Slide 156
4. Trauma means that nothing will be the same again. 5. Pain
will not last forever it will diminish. 6. Half to two-thirds of
victims grow in a positive way. Develop a greater appreciation for
life Deepen spiritual beliefs Feel stronger Build closer
relationships
Slide 157
7. Those who recover They see the event as a challenge, not an
overwhelming problem. -Theyre optimistic. -They connect with
people. -They use their spiritual resources.
Exposure to trauma that is repeated is more disabling as is
those events that are unpredictable. Violation by another person is
always worse that an impersonal trauma. Complex trauma is
premeditated and caused by others, usually someone known Hidden
traumas occur when the trauma has been repressed, when you live in
an environment that is trauma blind.
Slide 162
In trauma there is two kinds of suffering, one is the trauma
caused by the suffering living with the experience and the
aftermath. And the second type of suffering is part of the healing
process. This is the pain that was too overwhelming to feel before.
Traumatic events are like thieves that takes something from
us.
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When we encounter something that we feel threatens our life, a
cascade of hormonal reactions is triggered.
Slide 169
Something happens deep inside our brains, too. Our right-brain
alarm goes off and drowns out the logical analysis of our left
brain. It screams, Less thinking, more action! It also starts
taking pictures like madthe nonadrenalin heightens the emotional
aspects of the situation making it more vivid and notable. Very
strong and clear memories are being recorded, probably so that we
will remember this event and avoid it in the future.
Slide 170
What you experienced during the incident was so traumatic that
your brain took special note of it, and anytime you approach a
person, place, thing or experience that is similar to your original
trauma, your right brain whips out its photo album and puts on an
intense presentation (sights, sounds, smells, tastes) attempting to
alert you of the danger that could be waiting there.
Slide 171
Remember, our left side is more like a computer, our right side
is more like a photo album. This side remembers faces and craves
rapport and relationship. Its our emotional side. It is intuitive,
spontaneous, experience- oriented, artistic, creative. It stores
emotions. We dream on this side of our brain. And very importantly,
this is the alarm side of our brain.
Slide 172
Your logical left brain gets muted, and the calming influence
of your hippocampus gets pinched off. Youre off on a
re-experiencing jaunt which, if your right brain would only listen,
your left brain could explain why you didnt need to take that
detour today.
Slide 173
Its important to invite Jesus Christ into the episodic memories
of your trauma, visualizing Him experiencing it with you.
Hopefully, youll be able to continue engaging in this spiritual
exercise, giving Him more and more access to your places of pain
and darkness and thereby bringing about some direct healing.
Slide 174
In this Step we want to encourage you with Jesus help to take
action concerning the things that trigger your re-experiencing
episodes. By now, you are probably well-aware of what your triggers
are. In the space following, write down any people, places, things
or experiences that trigger your re- experiencing episodes, and
what the typical effect is (use additional paper if needed).
Slide 175
Golden retriever: The sun is shining, the day is young, weve
got our whole lives ahead of us, and youre inside worrying about a
stupid burned-out light bulb? Border collie: Just one. And Ill
replace any wiring thats not up to code. Dachshund: I cant reach
the stupid lamp!
Slide 176
Toy poodle: Ill just blow in the Border collies ear, and hell
do it. By the time he finishes rewiring the house, my nails will be
dry. Lab: Oh, me, me!!! Pleeeeeze let me change the lightbulb. Can
I? Can I? Huh? Huh? Can I? Cocker spaniel: Why change it? I can
still pee on the carpet in the dark.
Slide 177
Australian shepherd: First put all the lightbulbs in a little
circle Old English sheep dog: Lightbulb? Lighbulb? That thing I
just ate was a lightbulb? Chihuahua: Yo Queiero Taco Bulb.
Slide 178
Begin by developing an atmosphere of safety, trust and
exploration. Just talking and listening with your eyes and ears is
more important than techniques. Tell me your story. Honor their way
of thinking and speaking. The more similar you appear to counselees
the greater comfort the client will experience.
Slide 179
Comfort is vital (commonalities create comfort, differences
produce distance, Schupp, 2003). If counselees are comfortable,
they are more likely to discuss the trauma.
Slide 180
Decondition harmful affective responses. This critical step is
much easier to state than to accomplish. Help them discover new
ways of responding to difficult responsesreframe and reinterpret.
Reframe symptoms as signs of coping and as protective and healing
mechanisms and normal part of the recovery process.
Slide 181
The problem with traumatic memories tend to be their intrusion
into the present, not an inability to recall them. When they
intrude, discussing them and understanding how they may
unconsciously influence our behavior can be helpful. At the same
time, some people heal by fighting their fears and never discussing
or explicitly recalling their painful memories at all. For people
whose memories dont negatively affect them in the present,
pressuring them to focus on them may actually harm.
Slide 182
A. Intrusive thoughts are an attempt to make sense of the
experience, the brains attempt to assimilate the experience. Not
just let the experience go, but rather make sense of it;
flashbacks/ nightmares are access routes to memory. Flashbacks is a
way the brain is attempting to heal itself. Its the minds attempt
to make sense of what happened. What can be done about intrusive
thoughts or flashbacks?
Slide 183
B. Denial/numbing are ways that the mind takes a time out, as a
way of dosing or of pacing oneself so you only have to deal with so
much stress at one time. C. Dissociation at the time of the event
was a potentially useful skill. Speak of the wisdom of the body,
e.g., mind is taking time out from overstimulation denial is one of
natures small mercies.
Slide 184
D. Convey that the survival skills that the client once used
and were adaptive at the time may no longer be appropriate. E.
Commend the counselee for being distressed. The counselor might say
something like the following: Given what you have been through, if
you didnt have stressful reactions, werent depressed, had a short
fuse at times, dwelled on what happened (use counselees symptoms),
then I would be really concerned.
Slide 185
F. Indicate that PTSD is definitely responsive to treatment and
that healing can be a lifelong process. Convey to the counselee
that symptomatology may not go away complete, nor forever. G.
Indicate that it is possible that symptoms may get worse before
they get better as we discuss and work through what happened and
why, as we begin to refocus on the trauma.
Slide 186
H. Finally, although this may be difficult to believe right
now, you may even find that there will be some positive benefits to
you and your life as a result of the experiences you have had and
your willingness now to face and work through what you must work
through.
Slide 187
Re-exposure to the trauma is critical, as is how and when the
person is re-exposed. Research with all trauma survivors indicates
a principle that the individual must mentally revisit the traumatic
experience againbut with the supportive assistance of someone who
can help them through their fear.
Slide 188
The person becomes less afraid of the memory. This is a process
by which anxiety comes down on its own. It changes a hot memory to
a bad memory. How do you do this? One way is TIR (Traumatic
Incident Reduction. It can either be by talking or writing. If we
dont want the person to relive the memory so we have them write it
down in detail repeatedly in order to drain it.
Slide 189
When they write longhand its a tactile memory. It involves
better hand/eye coordination and accesses all parts of the brain to
help bring it together.
Slide 190
Battling illness and pain with pen and paper may be unorthodox,
but it may also spell relief. People who write for twenty minutes a
day about traumatic events reduce their doctor visits, improve
their immune systems and, among arthritis sufferers, use less
medication and have greater mobility, James W. Pennebaker, Ph.D,
professor at the University of Texas at Austin.
Slide 191
Why the relief? Suppressing negative emotions can weaken the
immune system and arouse your fight-or-flight system, churning up
blood pressure and heart rateWriting about conflict or trauma helps
organize the experience. The net affect is that people can move
beyond the stressful event. How? Breathing Counting Radio Dial
Slide 192
Restructure the meaning of the trauma by having the person
change the ending of the trauma story. As the person is reexposed
to traumatic experiences, it is very important to add a component
that did not exist the first time aroundcontrol. Take the control
away from the event or the person. Youve survived until now. How
could this be worse? You told your story. How will you be different
next month, next year?
Slide 193
Replace problematic behavioral responses with adaptive
behaviors. Teach the person how to make positive changes. Remember
you can write the last chapter of your trauma. It hasnt been
written yet.
Slide 194
Build a new internal self-view. Understanding the meaning of
past trauma to the individual, which is Step 2, will help you
understand what the post trauma self-image is. Dont define yourself
permanently as a traumatized person. Teach them when to remember
the trauma instead of the traumatic memories being in charge.