Psychology Chapter 17 Simple Ways Supportive Include Indicating Sorrow About

Unlock access to all the studying documents.

View Full Document

Chapter 17

2. Terminally ill children often not “models of bravery” that some suppose them to

be, but rather experience many emotions of dying adults

a. May demonstrate fear in play behavior through tantrums

C. The Bereaved Child

1. Children do grieve, however, their grief is expressed differently than an adult’s

2. Common reactions of bereaved child

a. Often misbehave or strike out at others

b. Ask endless questions about death and deceased

conjuring up mental representations of their lost parents

3. Common grief symptoms vary from person to person and by age

a. For preschoolers, common reactions include daily routine problems (e.g.,

sleeping, eating), negative moods, dependency, and temper tantrums

b. For older children, there is more direct expression of sadness, anger, fear, and

physical ailments

about and share their grief

Checking Mastery

1. What are two factors that might lead Jared develop a fuller understanding of death

concepts than Jeremy at age five?

➢ Answer: An advanced understanding of death concepts (that is, of death as a

Chapter 17

2. What three concepts of death are children likely to master by ages five to seven and

what concept might still be incomplete?

➢ Answer: By ages five to seven, children usually master the concepts that death is

3. What reactions on the part of bereaved children might irritate their caregivers?

➢ Answer: Bereaved children may upset adults by expressing anger and

V The Adolescent

A. Advanced Understandings of Death

1. Typically understand death as irreversible cessation of biological processes and

can think abstractly about death

B. Experiences with Death

1. Adolescent reaction to dying reflects advanced developmental capacities

a. Worry how illness might affect appearance (e.g., hair loss, amputation)

2. Reaction to loss of friend or family member reflect themes of adolescent period

a. May carry on internal dialogue with dead parent

b. Often devastated if loss involves a close friend

i. 32% of teens with friend who committed suicide experienced clinical

3. Adolescents are sometimes reluctant to express grief for fear of seeming abnormal

or losing control

a. Adolescents who yearn for dead parent may feel like they will be sucked back

into dependency of childhood

Checking Mastery

1. Why might someone conclude that adolescents “regress” to a less mature concept of

death, and why would this be incorrect?

➢ Answer: Because adolescents often acquire a belief in an afterlife, they may

Chapter 17

2. In David Brent’s study of bereavement after a parent’s death, what were two

differences between bereaved and nonbereaved youth?

➢ Answer: Differences between bereaved and nonbereaved youth in Brent’s study

3. Why might some bereaved adolescents have difficulty expressing their grief?

➢ Answer: Adolescents may bottle up their grief to avoid seeming abnormal, losing

VI The Adult

A. Death in the Family Context

1. The loss of a spouse or partner

a. Marital relationship is central one for most adults, and loss of marital partner

or other romantic attachment figure can mean a great deal

b. Precipitates other changes (e.g., changes in residence, job status)

i. Bereaved must redefine roles and identities

d. Five most prevalent patterns of widows and widowers adjustment:

i. A resilience pattern – distress at low levels all along

ii. Common grief – heightened then diminished distress after loss

iii. Chronic grief – loss brings distress and distress lingers

iv. Chronic depression – individuals depressed before loss remain so after

v. Depressed-improved pattern – depressed before loss, less depressed after

Chapter 17

a year or two

g. Depressed-improved individuals may have been experiencing caregiver

burden before the death and relief afterwards

h. Do partners of gay men who die of AIDS experience similar patterns of

bereavement?

j. Overall, most bereaved individuals experiencing significant loss begin to

show signs of recovery after a year or so

k. A minority of bereaved may experience complicated grief—less common

form involving prolonged or intense grief that impairs functioning

i. Often diagnosed with depression, or if death was traumatic, with

2. The loss of a child

a. No loss seems more difficult for an adult; even with forewarning, experienced

as unexpected, untimely, and unjust

i. Sense of failed role as parent

b. Death alters family system

i. Effects on marriage – strains relationships; strain worse in marriages

shaky before death

3. The loss of a parent

a. Not as difficult an adjustment as death of spouse or child, as it commonly

Chapter 17

B. The Grief Work Perspective and Challenges to It

1. Grief work perspective – in order to cope with death, the bereaved must confront

loss (model grew out of Freudian psychoanalytic theory)

b. Grief-work perspective under attack as many question the assumption that

there is a “right way” to grieve, that bereaved people must experience and

work through intense grief to recover, and that they must sever their bonds

with the deceased in order to move on with their lives

i. Cross-cultural research showing wide variety of successful grief patterns

(e.g., Egyptian mother conforms to norms by sitting alone and mute for

years after child’s death, Balinese mother is following her cultural norms

if she is seemingly cheerful after her child’s death)

c. Some forms of continuing attachment healthier than others

i. Sharing fond memories of deceased and feeling that loved one is watching

over and guiding experience means less distress

2. Flaws in traditional grief-work perspective

a. Norms for expressing grief vary by culture—no one normal and effective way

to grieve

experience positive emotions along with negative emotions

C. Who Copes and Who Succumbs?

Chapter 17

1. Personal resources influence an individual’s ability to cope with bereavement

a. Attachment style is an important resource (or liability)

i. Secure attachment associated with coping relatively well

ii. Resistant or preoccupied styles of attachment associated with over

unequipped to cope; may turn inward and harm self or abuse alcohol

b. Personality and coping style

i. Those with a low sense of self-esteem tend to have difficulty coping with

loss

2. Loss of someone with whom you have a close relationship (e.g., spouse) hits

people hardest

3. Cause of death influences bereavement; senseless or violent deaths are worse

(e.g., death of child)

4. Presence of strong social support systems and life stressors can positively impact

grief reaction

a. Social support (e.g., parents, siblings, friends) helps at all ages

i. Simple ways to be supportive include indicating sorrow about the loss,

D. Posttraumatic Growth

1. Although painful, grief has potential to foster growth in self, religiosity, family

relationships, and appreciation of life

a. Many widows may master new skills, become more independent, and emerge

Checking Mastery

1. What appears to be the most common pattern of adjustment observed in studies of

widows and widowers?

➢ Answer: The most common pattern of adjustment observed in many studies of

Chapter 17

2. What are two elements of the grief work perspective that are not well supported by

evidence?

➢ Answer: The elements of the grief work perspective that lack research support

3. How would individuals with a resistant (preoccupied) attachment style or orientation

and those with an avoidant (or dismissing) style be expected to differ in their grief

reactions?

➢ Answer: A resistant attachment style is associated with overdependence on others

VII Taking the Sting Out of Death

A. For the Dying

1. Hospice option – program to support dying individuals

a. Philosophy of “care” rather than “cure” founded at St. Christopher’s Hospital

in London and quickly spread to North America

b. Hospice care may take place at care facility or at home

2. Impact of hospice care different from medical care

a. Less interest in physician-assisted suicide

b. More emotional support (something often lacking in home healthcare

agencies, nursing homes, and hospitals)

B. For the Bereaved

1. Most bereaved individuals do not need psychological intervention, but options are

available

2. At-risk individuals (with depression, other psychological disorders, or lacking

Chapter 17

support) may benefit from counseling designed to reduce depression

3. Family therapies most effective

a. Family Bereavement Program – for children and adolescents (and surviving

C. Taking Our Leave

1. Reminders of these themes echoed throughout book

a. Nature and nurture truly interact in development (environment and biology

interact reciprocally)

b. We are whole people throughout the lifespan (advances in one area have

implications for other areas)

Checking Mastery

1. What are three key features of hospice care?

➢ Answer: In hospice care, the dying person and family make decisions, efforts to

2. What are two approaches used to help bereaved individuals cope?

SUGGESTIONS FOR CLASS DISCUSSIONS OR PROJECTS: To develop critical thinking skills

and enhance learning with exercises that support the course learning objectives.

1. Euthanasia: Have students discuss medical and moral concerns raised by euthanasia. They

will need to distinguish among passive euthanasia, active euthanasia, and assisted suicide.

Assisted suicide has gotten a great deal of media attention because of Dr. Jack Kevorkian’s role

Chapter 17

2. Understanding Death across the Life Span: Have students discuss the understanding of

death at different points in the lifespan. Compare a young child’s understanding of death to an

3. Student Killings: The last two decades saw numerous high-profile incidents of students

killing students and faculty members. In May 1998, a 15-year-old boy killed both his parents and

then opened fire on his fellow students in the school cafeteria in Springfield, Oregon, leaving one

4. Longevity: Jonathan Swift once commented that we all want to live long lives but none of us

wants to become old. Ask students to respond to this. How old do they want to become? What

factors or conditions are important to students when considering their longevity? What is the

optimal trade-off concerning the quantity of life (longevity) and the quality of life (mental and

physical heath)?

5. The Impact of Death: To encourage a deeper understanding of the impact of dying, have

students write a paper in which they describe what they would consider a “perfect” death. Do

students wish to have time to say good-bye, or would they rather die suddenly? Where would

6. Ceremonial Rituals: Chapter 17 introduces students to a wide variety of topics associated

with the processes of death and dying. The inclusion of such material reflects a growing societal

willingness to discuss death, something that was often taboo in the recent past. As a result of this

past attitude, most people were not only ignorant of biological and psychological aspects of

death and dying, but were also ignorant of practical issues associated with death, like information