1 Session Five Ministering in Crisis & Grief Situations 5.1 The Nature of Crisis 5.2 The Nature of Grief 5.3 The Phases of Grief 5.4 Guidelines for Ministry

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Session FiveMinistering in Crisis & Grief Situations

•5.1 The Nature of Crisis•5.2 The Nature of Grief•5.3 The Phases of Grief•5.4 Guidelines for Ministry

© Copyright 2001 Al Henager. Use only with written permission and with proper credit.

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5.1 The Nature of Crisis• Definitions of Crisis

– A turning point for better or for worse– A decisive or critical moment– Any event that changes the course or

direction of one’s life• Examples of Crisis

– Car wreck– New baby– Death of a loved one– Surgery– Hospitalization– Job promotion– Moving to a new city– Marriage– Conflict in relationship


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5.1 The Nature of Crisis• Hospitalization as an example of

Crisis– Illness as a crisis itself– Moved from home to an institution– Freedom is restricted– Diet is restricted– Clothes taken away– Mad to wear a “gown with a split

down the back– Schedule controlled by someone

else– Dignity taken away

• Bed pan• Sponge bath• Privacy invaded


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5.1 The Nature of Crisis• Intensity of Crisis

– Intensities of crises vary - some are more intense than others

– What seems insignificant to one person may be earth shaking for another

– Many times a person’s fears, anxiety, and hysteria are out of proportion to the reality of the situation

– “Fear of the unknown”


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5.2 The Nature of Grief• Definitions

– Grief• Emotional suffering caused by loss of

something important or held dear• A process of emotionally working

through the adjustments necessary as a result of loss.

– Bereavement• Suffering the loss of a loved on

through death• A specific type of grief related to the

death of a significant other

– Sorrow• The various displays of grief• The emotional outlet of grief or

bereavement


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5.2 The Nature of Grief• Grief comes from loss of anything important.

Examples:– Divorce– Retirement - especially if forced– Illness - loss of control– Surgery - mastectomy, hysterectomy, amputation,

etc.– Mobility - moving to another city, your neighbors

move, etc.– Empty nest syndrome– Birth– Loss of valued object– Loss of status or respect– Destruction of hopes & dreams - e.g. rebellious

child, denied entry to medical school– Mid-life crisis - loss of feeling productive– Going to a nursing home– Rape– Unemployment– Promotion


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5.2 The Nature of Grief

• The Purposes of Grief*– To enable over a period of

time to . . .• Adapt to what has happened• “Bring us back to life”• Renew all the purposes of our

lives• Draw to a close that part of

“their life” that was shared with us

*Tony Lake, Living with Grief, (London: Sheldon Press, 1984)

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• The Four Tasks of Grief– To accept the finality and

reality of the loss– To do the emotional work

of grief– To adapt to a world

without that which was lost– To emotionally re-invest in

someone or something else

From:

J. William Worden, Counseling and Grief Therapy, 1992.

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• Grief axiom:

– Anytime there is a loss, there is a gain

– Anytime there is a gain, there is a loss


--As quoted by Al Henager in a sermon delivered at the First Presbyterian Church of Pine Bluff, Arkansas, 1993.

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5.3 The Phases of Grief• The “Stages of Grief” (from

Granger Westburg)

– Shock & Denial– Emotional Release– Depressed and Lonely– Physical Symptoms of Distress– Panic– Guilt– Anger & Resentment– Resisting Returning– Hope– Affirming of Reality

Note, many writers express the grieving process in terms of “stages.” That seems to imply that the process is done in a neat “one, two, three . . .” order. Grief is messier than that. I prefer to use the term “phases.” The themes of the grief process seem to actually “phase” in and out, with one of them perhaps being dominant at a time, but cropping up again and again over time.

-Al Henager


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5.3 The Phases of Grief• Stages in the Process of Grief (From

Wayne E. Oates, Anxiety in Christian Experience, (Waco, Word Books Inc., 1971)

– Shock - Unwelcome reality assaults a person in such an overpowering way that he or she cannot accept it. He or she may be stunned, angry, guilt-stricken, or may act temporarily as though nothing serious has taken place.

– Numbness - The person may “freeze” and feel nothing. Numbness is nature’s way of helping him or her accept reality as fast as he or she can assimilate the facts. He or she may feel that family, friends, and even God are distant and indifferent. He or she my be tempted to withdraw excessively.

– Alternating between fantasy and reality -The grief-stricken person struggles between reality and the fantasy that nothing has happened. If he or she “steels” him/herself against the unwelcome reality, he or she will experience an increase of such destructive emotions as anxiety, hostility, and guilt.

– Flooding of emotions and grief - The wall of fantasy breaks and a flood of grief rolls over the person. Depression, loss of meaning in life, bitterness, or hostility may accompany this stage.

– Selective memory and stabbing pain - After the out-pouring of severe grief, the process levels off to a more drawn-out and less intense day to day re-association of memories. Such memories usually bring brief stabbing pain. Grief-work continues through daytime fantasies or bereavement dreams which relieve anxiety. Guilt feelings may continue during this stage.

– The acceptance of loss and the reaffirmation of life - The grieved person by now has gone through a sort of death, burial, and resurrection. He or she experiences a reaffirmation of goals, values, meaning, and life itself. He or she is capable of establishing new, meaningful relationships and of re-entering old ones with new meaning.

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5.3 The Phases of Grief

Shock

Numbness

Alternating

Flooding

Remembering

Reaffirming

Note: As a person works through grief, her or she experiences the developmental process described above. He or she must remember that the “steps” in the process are not like stairs. To move to one is not necessarily to have completely left the other behind.

He or she may be primarily on one step and yet experience the emotions related to another step. Also, the person may be intellectually ahead of where he or she is emotionally.

Furthermore, the process is not like an escalator. If a person fails to do the grief-work required at a particular step, he or she may get “hung” there, thus delaying the final freedom.

(From RTS BereavementServices)

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Denial

Anger

Bargaining

Depression

Acceptance

Many people have used Dr. Elizabeth Kübler-Ross’ “Stages of Death & Dying” to describe the grief process as well. While this can be helpful to an extent, in research in later life, Dr. Kübler-Ross herself admitted that this model was not adequate to describe the process of grief. While the process of grieving will have some of the same elements as the process of emotionally adjusting to death & dying, it is also substantially different. It is similar, but different. The process of death & dying involves “letting go.” The process of grief involves both “letting go” and “embracing.”

Kübler-Ross’Stages of Death& Dying

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• Four Key Facts About Grief*

– The way out of grief is through it.

– The very worst kind of grief is yours.

– Grief is hard work.

– Effective grief work is not done alone.*Bob Deits, Life After Loss, (Tucson: Fisher Books, 1988)

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• Four Phases of Bereavement*– 1. Shock & Numbness

• Duration - Characteristics most intense during first 2 weeks

• Characteristics -– Attention span is short– Concentration is difficult– Decision making impaired– Stunned, disbelief– Functioning impeded– Denial– Time Confusion– Failure to accept reality

*Glen Davidson, Understanding Mourning, (1984)

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• Four Phases of Bereavement . . . continued– 2. Searching & Yearning

• Duration - Characteristics dominant 2nd week to 4th month

• Characteristics -– Sensitive to stimuli– Anger, guilt, dreams– Restless, impatient– Double meaning– Testing what is real– Irritability, resentment, bitterness– Weight gain or loss– Sleep difficulties– “Aching arms” (perinatal loss)– Obsession with getting pregnant

(perinatal loss)– Preoccupation with the deceased– Time confusion– Palpitations, headaches, blurred vision– Sighing– Lack of strength– Perception confirmation is the “key”*Glen Davidson, Understanding Mourning, (1984)

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• Four Phases of Bereavement . . . continued– 3. Disorientation

• Duration - Characteristics dominant 5th to 9th month

• Characteristics -– Think “I’m going crazy”– Social withdrawal– Disorganized– Forgetful– Awareness of reality– Depressed– Guilt– Insomnia– Anorexia– Weight gain or loss– Sense of failure– Sadness– Exhaustion– Difficulty in concentration– Feels ill– Lack of energy


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• Four Phases of Bereavement . . . Continued– 4. Reorganization/Resolution

• Duration - Characteristics dominant 18th to 24th month

• Characteristics -– Sense of release– Renewed energy– Able to make decisions easier– Eating and sleeping habits re-

established– Able to laugh and smile again– Re-investing emotionally


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5.4 Guidelines for Ministering

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A Year’s Picture of the Grief Process


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5.4 Guidelines for Ministering

• Remember - “Story Listening”

• “Sitting with the other”– Remember - “Ministry of

presence”– Remember - The Fourth

Friend of Job

• If crisis is too great - REFER


Documents

1 Session Five Ministering in Crisis & Grief Situations 5.1 The Nature of Crisis 5.2 The Nature of Grief 5.3 The Phases of Grief 5.4 Guidelines for Ministry