# Chap 2 - Mental Health and Mental Illness: Theoretical Concepts - P3

Grief
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• Grief is a subjective feeling of sorrow and sadness accompanied by emotional, physical, and social responses to the loss of a loved person or thing.

• The loss or anticipated loss of anything of value to an individual can trigger the grief response. This period of characteristic emotions and behaviors is called mourning.

• The normal mourning process is adaptive and is characterized by feelings of sadness, guilt, anger, helplessness, hopelessness and despair.

• Absence of mourning after a loss may be considered maladaptive.
Stages of Grief: stage 1

• A stage of shock and disbelief.

• The response may be one of "No, it can't be true!" The reality of the loss is not acknowledged.

• Denial is a protective mechanism that allows the individual to cope in an immediate time frame while organizing more effective defence strategies.
Stages of Grief: stage 2

• "Why Me" and "it is not fair!" are comments often expressed during the anger stage. Envy and resentment toward individuals not affected by the loss are common.

• Anger may be directed at the self or displaced on loved ones, caregivers, and even God.

• There may be a preoccupation with an idealized image of the loss entity
Stages of Grief: Stage 3

• During this stage, which is usually not visible or evident to others, a "bargain" is made with God in an attempt to reverse or postpone the loss: "If God will help me through this, I promise I will go to church every Sunday and volunteer my time to help others."

• Sometimes the promise is associated with feelings of guilt for not having performed satisfactorily, appropriately, or sufficiently
Stages of Grief: Stage 4

• During this stage, the full impact of the loss is experienced. The sense of loss is intense, and feelings of sadness and depression prevail.

• This is a time of quiet desperation and disengagement from all association with the lost entity.

• It differs from pathological depression, which occurs when an individual becomes fixed in an earlier stage of the grief process. Rather, stage 4 of the grief response represents advancement toward resolution.