Treating Death and Loss From COVID – 19 continued from page 16
DEATH — THE ULTIMATE DISCONNECTION
The loss of a loved one is one of the top stressors in our lives , according to The Social Readjustment Rating Scale developed by Thomas Holmes , MD , and Richard Rahe , MD . ( Take the stress test they developed using the link in the box on this page , below .) Death-related conversations are not among the most common in U . S . society , where the grief experienced after losing someone is typically viewed as a pathological state that needs to be addressed by mental health professionals . The prevalence of COVID-19 deaths is challenging such perceptions .
Death permanently separates us , thus disconnecting the attachment we formed with the deceased person . When disconnection occurs , such as through the death of a loved one , certainty and predictability are disrupted , and our brains need to recalibrate or adjust to the resulting “ empty spots .” Recalibration is a painful process , and , if not addressed , it can lead to additional suffering .
After a sudden disconnection , our coping mechanisms may be compromised , and when resources and support systems to handle such loss are limited , as they were for many people during the pandemic , an inability to adapt to the loss occurs . The grieving individual is thrust into emotional turmoil of shock , disbelief , anger , sadness , depression , and other symptoms .
Psychologist George Bonanno , PhD , points out that the intensity and severity of grief may vary depending on the circumstances of the loss . For example , people caring for a loved one with a terminal illness might experience gradual loss differently than those who experienced a sudden loss of a loved one . COVID-19 losses are unexpected , and when compounded with other primary and secondary losses , family survivors were often left to experience grief when typical coping mechanisms were unavailable .
Score your stress using the original stress scale developed by Drs . Tomas H . Holmes and Richard H . Rahe , at :
www . mindtools . com / pages / article / newTCS _ 82 . htm .
The study first appeared in the Journal of Psychosomatic Research , Vol . 11 , Issue 2 , August 1967 , pages 213 – 218 .
LOSS IS UNIVERSAL ; GRIEF IS UNIQUE TO EVERY INDIVIDUAL
People experience finite losses through death and nonfinite losses , such as when someone loses a job , a couple goes through a divorce , or someone is diagnosed with a chronic illness or disability . Robert Neimeyer , PhD , director of the Portland Institute for Loss and Transition , defined a third category of loss — ambiguous loss , which refers to a loss that lacks clarity and makes it hard to move forward . COVID-19 pandemic times are filled with ambiguous losses , and many have reported losing motivation , freedom , certainty , and control as a result of these losses .
It is important to remember that grief after any loss is a normal , natural process that can provoke stress , anxiety , sadness , and anger . A dynamic process , grief changes over time and does not always require treatment . Keren M . Humphrey , EdD , NCC , LPC , LCPC , a professional counselor and counselor educator , defines grief as an emotional response generated by an experience of loss characterized by sorrow and / or distress . Grief can be debilitating , whether or not it occurs related to death , and it prompts several types of challenges , all of which are normal responses to disconnected times as individuals struggle with adjusting to a new reality :
• Emotional challenges : Symptoms include sadness , guilt , anger , anxiety , loneliness , helplessness , numbness , and shock .
• Physical challenges : These present as sleep disturbances , tightness in the chest , fatigue , exhaustion , headaches , loss of appetite , and general agitation .
• Cognitive challenges : Symptoms may surface as confusion , images of a deceased person , flashbacks , dreams , inability to concentrate , and memory problems .
• Behavioral challenges : These can include social withdrawal , avoidance of places , and changes in activity level .
When such symptoms persevere for a long time , with the same intensity and frequency , a person might experience prolonged grief ( i . e ., unresolved grief ), as coined by the International Classification of Diseases , 11th Revision . Those experiencing prolonged grief typically cannot make sense of their loss or losses , are preoccupied with their losses , experience intense emotional pain , isolate themselves , and avoid social and other activities . These symptoms exceed social , cultural , or religious norms for the individual ’ s cultural context .
continued on page 18 The Advocate Magazine Spring 2021 American Mental Health Counselors Association ( AMHCA )
www . amhca . org
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