Stages of grief. Five stages of grief and psychological help to the suffering. The last step is acceptance

The ability to manage your emotions is an important condition for achieving your desired goals. Strong experiences experienced, for example, in the event of the loss of loved ones, are a serious test for everyone. From the point of view of psychology, there are 5 stages of grief that must be passed in order to return to the old life. Everyone independently gets out of a difficult state, spending the required amount of time on one or another stage, and from the first (denial) to the last (acceptance) there is a big gap. Row psychological methods will help restore a full perception of reality.

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    Stages of grief

    It is necessary to identify the stages that have to be overcome on the way to restoring peace of mind after parting, loss, or terrible news of an incurable disease. Experts distinguish the following 5 stages of grief experience:

    1. 1. Denial and shock.
    2. 2. Anger.
    3. 3. Guilt.
    4. 4. Depression.
    5. 5. Acceptance.

    Some psychologists have added the 5 stages of grief to the 6th: "development". As a result of passing through all stages of experiences, a person receives the potential for development, acquires maturity.

    Denial and shock

    A person does not believe in what happened, especially if he finds out about it unexpectedly. Subconscious fear opposes the acceptance of reality. This stage is characterized by a violent reaction in the form of a scream, excitement, inhibition due to protection from shock, denial of the inevitable, but it does not drag on for a long time, because sooner or later one has to admit the facts. A person is trying with all his might to clarify the truth, hoping that the news is erroneous.

    The sufferer avoids reality, interrupts interaction with the outside world and himself. The decisions he makes are inadequate, and his behavior inspires doubts about his mental usefulness. For example, someone who learns about the death of a relative may continue to act as if he is still alive.

    Anger

    The next stage of experiencing grief is aggression, anger or resentment. negative emotions may appear rapidly or increase gradually. In a constructive version, the negative is concentrated on working with the cause that caused the loss. This behavior serves as a form of protection: the punishment of enemies who have done evil. Aggression is not a constructive means of experiencing grief and is directed at oneself, others, fate, the deceased.

    The manifestation of anger brings temporary relief: the psyche is freed from the surging pressure, and the person feels better. There are known cases of self-torture, moral or physical - this is anger directed inward.

    Guilt

    At this stage, a person tries to put the blame for what happened on himself. He seems to be fighting fate, begging from higher powers different outcome of events. There is a need to go into the world of illusory salvation, to wait for a miracle, an exception, a gift of fate. As a result, a person is inclined to engage in spiritual practices, seeking help in the church.

    If loved ones are in danger, the person believes that his behavior has something to do with what happened. In the event of the death of a dear person, he punishes himself and "for the sake of expiation" is ready for actions unusual for him - increased attention to others, charity work, going to a monastery, and the like.

    Depression

    At this stage, a person realizes the inevitability of loss. In a state of grief, interest in what is happening disappears, there is no energy to take care of oneself and loved ones, everyday affairs are ignored. Depression is characterized by a decrease in social activity, apathy, irritability. Life loses its meaning, there is a need for antidepressants, decisions are made under the influence of destructive emotions. A suicide attempt cannot be ruled out.

    Depression is the longest stage of grief.

    Acceptance of loss

    Regardless of the severity of suffering, acceptance is inevitable. Awareness of the inevitability of loss occurs suddenly. A person's thinking becomes clearer, he becomes able to look back and analyze the course of life, discuss the problem with others. The overcoming of grief does not yet come, but thanks to acceptance, a person is close to a normal state.

    The usual way of life is restored, which again begins to make sense. The person becomes receptive to joy and returns to everyday activities, restores social contacts.

    For the terminally ill, there comes a period of quiet enjoyment of the blessings that life leaves them. They direct their resources to the completion of cases, communication with people who are significant to them. Survivors of death or separation remember the traumatic event without acute pain. Grief is replaced by sadness, gratitude to the departed for the good that was with his participation.

    Help the Suffering

    The specified sequence of stages of experiencing grief is conditional. Not everyone goes through it in the described order, someone stops at a certain phase, and in order to improve his condition, he needs qualified help from a specialist. And the first step in this direction is open heart-to-heart communication, a manifestation of trust, the ability to listen, and not lead a person away from grief: before letting go of pain, you need to live it.

    At the initial stage of grief, psychologists recommend surrendering to surging feelings, allowing yourself to be sad, instead of being ashamed, and showing visible courage. Both solitude and meeting with a friend who will listen will help: speaking out loud helps to understand and get rid of stress and difficult emotions.

    At the stage of compromise, the sufferer is looking for ways to influence the situation, and specialists for good purposes can hide the true state of things, but this cannot be overdone: the time will come when strength will be needed to work on oneself, to restore instead of believing in a miracle.

    At the stage of depression, allowing a person to speak out, to realize that he is not alone, it is important to bring new meaning into his life. Depression is an integral part of the experience of grief, but loved ones can make sure that it does not become pathological. If a person begins to contemplate suicide, one should seek psychological help and medication, which can only be prescribed by a doctor.

    The physiological consequences for the body should not be ignored: insomnia, loss of appetite, dysfunction of the gastrointestinal tract and the cardiovascular system are possible, which reduces immunity.

    Conclusion

    When a strong surge of emotions nevertheless occurred, you can’t close yourself off from the outside world again - you have to go towards the new, stay in nature, communicate with people and animals. Then grief will gradually begin to disappear from the life of a suffering person, giving way to creative processes.

    Pain is a natural emotion, and sometimes only after severe trials a person accepts what happened, refuses unnecessary things and realizes that he was wasting time and energy when he could continue to live.

Stages of grief

1. Shock and numbness.

The first stage is denial associated with confusion. The psychological defense mechanism actively rejects what has happened. At the first stage, the emotional shock is accompanied by an attempt to deny the reality of the situation. A shock reaction sometimes manifests itself in the sudden disappearance of feelings, "cooling", as if feelings fall somewhere deeper. This happens even if death loved one was not sudden, but expected for a long time.

The mourner may think that everything that happened is a nightmare, nothing more.

Duration - from a few seconds to several weeks, on average, by the 7-9th day, gradually changing to another picture. It is characterized by loss of appetite and sexual desire, muscle weakness, little or complete immobility, which are sometimes replaced by minutes of fussy activity, amimicity, depersonalization phenomena (“It can’t be!”, “It didn’t happen to me!”), A feeling of unreality of what is happening. Loss denial can range from mild distress to severe psychotic forms, where the person spends several days in an apartment with the deceased before noticing that the deceased has died.

A more common and less pathological form of manifestation of denial has been called mummification. In such cases, a person keeps everything as it was with the deceased, in order to be ready for his return all the time. For example, parents keep the rooms of dead children. According to V.Yu. Sidorova, it’s normal if it doesn’t last long, thus creating a kind of “buffer” that should soften the most difficult stage of experiencing and adapting to loss. But if such behavior drags on for years, the experience of grief stops and the person refuses to recognize the changes that have occurred in his life, “keeping everything as it was” and not moving from his place in his mourning, this is a manifestation of denial.

Another way people avoid the reality of loss is by denying the significance of the loss. In this case, they say things like "we weren't close," "He was a bad dad," or "I don't miss him." Sometimes people hastily remove anything that might remind them of the object of loss, thus exhibiting the opposite behavior of mummification. Bereaved individuals protect themselves from coming face to face with the reality of loss and are at risk of developing pathological grief reactions.

Another manifestation of denial is "selective forgetting", in this case a person forgets something related to the object of loss.

The third way to avoid awareness of the loss is to deny the irreversibility of the loss. This is when, after the death of a child, parents console each other - "we will have other children and everything will be fine." It is understood that we will give birth to a dead child again, and everything will be as it was.

Numbness is the most noticeable feature of this condition. The mourner is constrained, tense. His breathing is difficult, irregular, a frequent desire to take a deep breath leads to intermittent, convulsive (like steps) incomplete inspiration.

Often, outward calmness, the inability to cry are often regarded by people around as selfishness and cause reproaches. Such experiences can suddenly give way to an acute reactive state.

A feeling of unreality of what is happening, mental numbness, insensitivity, deafness appears in the human mind.

How to explain all these phenomena? Usually, the shock reaction complex is interpreted as a defensive denial of the fact or meaning of death, preventing the mourner from facing the loss in its entirety at once.

Assistance at this stage consists in silent accompaniment of a person, establishing tactile contact that helps a person to cry, i.e. “move” to the next stage of living the process of mourning and loss, verbalizing his inner experiences.

In my opinion, the longer this period lasts, the more severe the consequences.

2. Phase of acute grief.

After the first reaction to the death of a loved one - shock, denial, anger, there is an awareness of the loss and humility with it. This is the phase of search or despair, which lasts from three days to 6-7 weeks (the same 40 days of mourning). It is considered the most painful phase, since it is necessary to accept the loss as a reality, to say “yes” to life in an already changed life.

The picture of acute grief is very similar in different people. Common to all is the unrealistic desire to return the lost and the denial of not so much the fact of death as the permanence of loss. There are periodic attacks of physical suffering lasting from twenty minutes to one hour, spasms in the throat, fits of choking with rapid breathing, a constant need to breathe, a feeling of emptiness in the abdomen, loss of muscle strength and intense subjective suffering, described as tension or mental pain. State of acute anxiety, insomnia, amnesia, withdrawal reaction, numbness; somatic symptoms appear. Common to all are complaints of loss of strength and exhaustion: “it is almost impossible to climb stairs”, “everything that I lift seems so heavy”, “from the slightest effort I feel completely exhausted”.

At this time, it can be difficult for a person to keep his attention in outside world. There may be some changes in consciousness. Common to all is a slight sense of unreality, a feeling of increasing emotional distance separating the grieving person from other people (sometimes they look ghostly or seem small). Reality is, as it were, covered with a transparent muslin, a veil, through which the sensations of the presence of the deceased break through quite often.

A person who has suffered a loss tries to find evidence in the events preceding death that he did not do what he could for the deceased, he accuses himself of inattention and exaggerates the significance of his slightest missteps, for this reason many are overcome by guilt.

Often there is such an obsessive phenomenon as - "if". “If he were alive…”, “If I didn’t send him to such and such a school, then…”. Then comes the chain of events: “he wouldn’t get sick and wouldn’t die…”. Constantly there is a study of one's guilt, although objectively this guilt is not there. Where does this feeling come from?

According to F. Vasilyuk, in Western psychotherapy, guilt is treated as a symptom of grief, which must be quickly eliminated. This shows the desire to comfort a person. “The mourner does not believe in this, he sincerely believes that he is guilty. So we have to accept this illusion, this feeling of guilt as a reality. That is, we must take the position of the grieving and not dissuade him that he is not to blame.

In addition, a person who has lost a loved one often has a loss of warmth in relations with other people, a tendency to talk to them with irritation and anger, a desire not to be disturbed at all, and all this persists despite the increased efforts of friends and relatives to support with him friendly relations.

These feelings of hostility, surprising and inexplicable for the people themselves, greatly disturb them and are taken as signs of the coming madness. Patients try to contain their hostility, and as a result they often develop an artificial, forced manner of communication.

Freud called the process of adapting to adversity the "work" of mourning. Modern researchers characterize the "work of mourning" as a cognitive process that includes changing thoughts about the deceased. This process is not some kind of inadequate reaction, from which a person must be protected, from a humanistic point of view it is acceptable and necessary. This refers to a very heavy mental load that makes you suffer. The consultant is able to deliver relief, but his intervention is not always appropriate. Grief cannot be suspended, it must continue for as long as necessary.

3. Stage of obsession.

The third phase of acute grief is “residual shocks”, lasting up to 6-7 weeks from the moment of the tragic event. According to others, this period can last a year. The metaphor "residual shocks" is taken from the earthquake in Armenia. Otherwise, this phase is called a period of despair, suffering and disorganization and - not very accurately - a period of reactive depression.

Preserved, and at first may even intensify, various bodily reactions - labored shortened breathing, asthenia, muscle weakness, loss of energy, a feeling of heaviness of any action; feeling of emptiness in the stomach, tightness in the chest, lump in the throat; increased sensitivity to odors; decreased or unusual increase in appetite, sexual dysfunction. There are explosive reactions, emotional lability, constant arousal, sleep disturbance.

This is the period of greatest suffering, acute heartache. There are many difficult, sometimes strange and frightening feelings and thoughts. These are feelings of emptiness and meaninglessness, despair, a feeling of abandonment, loneliness, anger, guilt, fear and anxiety, helplessness. Unusual preoccupation with the image of the deceased and his idealization are typical - emphasizing extraordinary virtues, avoiding memories of bad features and deeds. For the first time, the New Year is celebrated "without it"; vacation without it… For the first time, the usual cycle of life is broken. These are short-term, but very painful situations.

Grief leaves its mark on relationships with others. Here there may be a loss of warmth, irritability, a desire to retire. Daily activities change. It can be difficult for a person to concentrate on what he is doing, it is difficult to bring the matter to the end, and a complexly organized activity can become completely inaccessible for some time. Sometimes there is an unconscious identification with the deceased, manifested in involuntary imitation of his gait, gestures, facial expressions.

The loss of a loved one is the most difficult event affecting all aspects of life, all levels of a person's bodily, mental and social existence. Grief is unique, it depends on a one-of-a-kind relationship with him, on the specific circumstances of life and death, on the whole unique picture of mutual plans and hopes, insults and joys, deeds and memories.

4. The stage of working out the problem.

During this period, the most important and difficult emotional events for a person occur: understanding, awareness of the causes of trauma and grief, mourning the loss. The peculiar motto of this stage is “forgive and say goodbye”, the last “farewell” is said.

The attitude toward the loss of an object depends decisively on the nature of the lost relationship and on the level of development of the subject's personality. The methods and mechanisms used in the situation of loss, and its consequences, are different depending on the proportion of functional and individual elements of the object relationship included in the lost relationship.

At this phase, life gets back on track, sleep, appetite, professional activity are restored, the object of loss ceases to be the main focus of life. The experience of grief is no longer a leading activity, it proceeds in the form of frequent at first, and then more rare individual shocks, such as occur after the main earthquake. Such residual attacks of grief can be as acute as in the previous phase, and subjectively perceived as even more acute against the background of normal existence. The reason for them most often are some dates, traditional events (“spring for the first time without him”) or events Everyday life(“offended, there is no one to complain to”, “a letter addressed to him”).

The fourth phase, as a rule, lasts for a year: during this time, almost all ordinary life events occur and then begin to repeat themselves. The death anniversary is the last date in this series. Perhaps it is no coincidence that most cultures and religions set aside one year for mourning.

During this period, the loss gradually enters into life. A person has to solve many new tasks related to material and social changes, and these practical tasks intertwined with the experience itself. He very often compares his actions with the moral standards of the deceased, with his expectations, with "what he would say." The mother thinks she has no right to look after her appearance, as before, until the death of the daughter, since the deceased daughter cannot do the same. But gradually more and more memories appear, freed from pain, guilt, resentment, abandonment.

If this phase does not pass successfully, then the grief becomes chronic. Sometimes it is a neurotic experience, sometimes it is a dedication of one's life to selfless service, charity.

5. Completion emotional work grief.

The work is considered to be coming to an end when the patient gains hope and the ability to plan for the future.

The normal experience of grief that we are describing enters its last phase, “completion,” about a year later. Here, the mourner sometimes has to overcome some cultural barriers that make the act of completion difficult (for example, the notion that the duration of grief is a measure of our love for the deceased).

The meaning and task of the work of grief in this phase is to ensure that the image of the deceased takes its permanent place in the ongoing semantic whole of my life (it can, for example, become a symbol of kindness) and be fixed in the timeless, value dimension of being.

With the end of the “work of grief”, adaptation to the reality of what happened takes place, and mental pain decreases. During the last stage of experiencing the loss of a person, more and more begin to occupy the people around him and new events. The dependence on loss decreases, but this does not mean forgetfulness.

It can be said that in the case of experiencing a loss, trials not only bring mental pain and suffering, but also, as it were, purify the soul, contribute to a person’s personal growth, open up new aspects of life for him, enrich him with life experience for possible transmission to his relatives in the future.

The process of mourning can be singled out as a separate item, since it is given great attention. It is usually believed that in this case, the subject of the loss must perform certain psychological tasks.

Burning process.

Is it necessary to grieve? Do sadness and mental suffering serve any useful function?

Mental anguish, as the brightest component of mourning, is presented as a process rather than a state. A person is faced with the question of identity again, the answer to which comes not as an instant act, but after a certain time in the context of human relations.

Many experts doubt the usefulness of separating certain phases in the process of mourning, as this may encourage people to grieve according to a prescribed pattern.

Of course, the intensity and duration of grief in various people are not the same. It all depends on the nature of the relationship lost man, on the severity of guilt, on the duration of the mourning period in a particular culture. In addition, some factors can contribute to the restoration of a normal state. For example, in the event of a prolonged illness or incapacity of the deceased, his relatives have the opportunity to prepare themselves for his death. It is likely that they are experiencing anticipatory grief. It is even possible that in such a situation, feelings of loss, guilt, or missed opportunities are discussed with the dying person. Anticipatory grief, however, does not eliminate grief after the death of a loved one. It may not even make him weaker. But still, in the case of a long-term illness of the deceased, his death is not so difficult for those around him, because they had the opportunity to prepare for it, and it is easier for them to cope with their grief.

The Kubler-Ross (1969) model is often used to describe the mourning process. It involves the alternation of stages of denial, anger, compromise, depression, adaptation. It is believed that a normal grief reaction can last up to a year.

The normal process of mourning sometimes develops into a chronic crisis called pathological mourning. According to Freud, mourning becomes pathological when the "work of mourning" is unsuccessful or incomplete. There are several types of pathological grief:

"Blocking" emotions to avoid intensifying the grieving process.

Transformation of grief into identification with the dead person. In this case, there is a refusal of any activity that can divert attention from thoughts about the deceased.

Stretching the process of mourning in time with exacerbations, for example, on the days of the anniversaries of death.

An overly acute sense of guilt, accompanied by a need to punish oneself. Sometimes such punishment is realized through suicide.

A typical manifestation of grief is longing for a lost object. A person who has experienced a loss wants to return what was lost. Usually this irrational desire is not sufficiently realized, which makes it even deeper. The counselor should understand the symbolic nature of longing. There is no need to resist the symbolic efforts of the mourner, because in this way he tries to overcome the loss. On the other hand, the reaction of grief is exaggerated, and then a cult of the lost object is created. In the case of pathological grief, the help of a psychotherapist is needed.

In the process of mourning, bitterness inevitably sets in. The bereaved person tends to blame someone for what happened. A widow may blame her dead husband for leaving her, or God for not listening to her prayers. Doctors and other people are accused who are capable of actually or only in the imagination of the sufferer to prevent the situation that has arisen. It's about real anger. If it remains inside a person, it “feeds” depression. Therefore, the consultant should not discuss with the client and not correct his anger, but help it pour out. Only in this case will the probability of its discharge on random objects decrease.

During mourning, they experience a significant change in identity, for example, a sharp change in self-image of the implementation of the marital role. Therefore, an important component of the "work of grief" is to learn a new look at yourself, the search for a new identity.

Rituals are very important in mourning. The mourner needs them like air and water. It is psychologically essential to have a public and sanctioned way of expressing complex and deep feelings of grief.

The "work of mourning" is sometimes hindered or made more difficult by sympathetic people who do not understand the importance of gradually moving out of adversity. The difficult spiritual process of separation from the object of loss takes place in the subjective world of the grieving, and the interference of others in it is inappropriate. From the point of view of R. Kociunas, the consultant should not drown out the process of grief. If he destroys the psychological protection of the client, he will not be able to provide effective assistance. The client needs defense mechanisms, especially in the early stages of mourning, when they are not ready to accept the loss and think realistically about it. In conditions of rationality deficiency, protective mechanisms are activated. In the process of mourning, their role is functional and boils down to buying time and re-evaluating themselves and the world. Therefore, the counselor must allow the client to use denial and other psychological defense mechanisms.

With the end of the "work of grief" there is an adaptation to the reality of unhappiness, and mental pain decreases.

The bereaved person begins to be occupied with new people and events. The desire to connect with the object of loss disappears, dependence on it decreases. In a sense, we can say that the process of mourning is a slow weakening of the connection with the object of loss. This does not mean oblivion, it’s just that the departed person already appears not in physical sense, but integrates into inner world. The issue of relations with him is now resolved in a symbolic way - the departed with his inconspicuous presence in the soul of the bereaved helps him in life. Thus the sense of identity is successfully modified.

During the period of loss, suffering is alleviated by the presence of relatives and friends, and it is not their effective help that is essential, but easy accessibility during several weeks, when grief is most intense. The bereaved should not be left alone, but he should not be “overloaded” with care - great grief is overcome only with time. A grieving person needs constant but not intrusive visits and good listeners.

The role of the listener in some cases can be performed by a consultant. Being with the grieving person and listening properly is the main thing that can be done. The more the counselor empathizes with grief and the more adequately he perceives his own emotional reactions associated with help, the more effective the healing effect. You should not superficially soothe a grieving person. Confusion and formal phrases only create an uncomfortable situation. The client must be given the opportunity to express any feelings, and all of them must be perceived without prejudice.

In some circumstances, grief can be overwhelming. For example, older people who have lost several friends or relatives within a year or two may experience bereavement overload. A serious threat, especially for men, is the development of depression in the period following the death of a loved one. No less dangerous, again for men, is the abuse of alcohol or drugs in order to forget from painful thoughts. Others use the "geographical way" - continuous travel or continuous work with great tension, which does not allow you to think about anything other than everyday affairs.

Thus, there is no universal or correct way to grieve, although the expectations of society have a tangible effect on people in this matter.

A person constantly loses something in his life - things, time, opportunities, relationships, people. Probably, there is not a single day when something would not be lost. And perhaps not a single hour or even a minute. Loss is the norm of human life and, accordingly, there must be some kind of “normal” emotional reaction to the loss.

One of the first to study such an emotional reaction to bereavement was the psychologist Elisabeth Kübler-Ros. She observed the reactions of terminally ill patients to her diagnosis and identified five stages of experience:

1. Denial. The person cannot believe in his diagnosis.
2. Aggression. Claims against doctors, anger at healthy people.
3. Bidding. Bargaining with fate, "Oh, if only I...".
4. Depression. Despair, loss of interest in life.
5. Acceptance. “I did not live in vain and now I can die…”.

Later, this model was transferred to the experience of any loss, including the smallest ones. The passage of these five (six) stages is considered the “norm” of experiencing loss.

The speed of their passage depends on the severity of the loss and on the level of "maturity" of the individual. The lighter the losses, the faster they are experienced. The “norm” for the most severe losses (for example, the loss of a loved one) is no more than a year or two. On the contrary, failure to pass these stages, hanging on any of them, can be considered a deviation from the norm.

This model was also supplemented by some psychologists with the sixth stage - "Development". In this case, when a person loses, he goes through certain stages, as a result of which his personality receives the potential for development, becomes more mature. Or these stages may not be passed (there was a hang at a certain stage), and the development of the personality, on the contrary, slowed down. Therefore, with such an addition, any loss can be viewed from the positive side - it is the potential for development. Without losing anything, a person cannot develop (similar to the thesis of Soviet psychology “personality develops in conflict”).

In the direction of Transactional Analysis psychotherapy, it is customary to depict this model through the "loop of loss", which clearly shows the movement of a person through the passage of the "loop of loss" upwards. Then, a person who has a broken cycle of experiencing loss, in this case, is not only unable to experience them and suffers because of this, but his personality development is blocked as such. Then, the particular task of the psychologist will be to help in experiencing the loss, and the general task will be to restore the cycle of passing losses as such (therefore, often with a focal consultative request for help, grief experiences go to the psychotherapeutic request to remove blocks and prohibitions in the emotional sphere).

The same model can be represented as a sequence of emotions that are experienced at each stage:

1. fear;
2. anger;
3. wine;
4. sadness;
5. acceptance;
6. hope.

This makes it easier to explain the psychological function of each stage. Normally, a person experiences a sequence of these emotions with any loss.

1. Stage of Fear. Fear is a protective emotion. It helps to anticipate and evaluate threats, to prepare for meeting with them (or fleeing from them). People in whom the experience of fear is underdeveloped or even blocked are unable to adequately assess threats and prepare for them. It is quite logical that nature put the stage of fear first in the cycle of experiencing the loss - after all, it is here that the threat to further life from this loss is assessed and the search for resources to survive it takes place.
Accordingly, the greatest difficulty in experiencing this stage occurs in people with impaired ability to experience fear. In this case, a person reacts to the loss with one level or another of its denial (from a neurotic feeling that nothing really happened, to a psychotic complete non-recognition of the loss that has occurred). Also, instead of the forbidden true emotion of fear, scenario (racket, blackmail - the terminology of transactional analysis) emotions may arise at this stage.
The task of the psychologist , when "stuck" at this stage, is to help in experiencing the fear of loss. In a consultative vein, this is a search and filling with resources that will help to live without the object of loss (it is highly not recommended to “break the denial”, as, for example, inexperienced specialists “like” to do in the case of addictions - the addict therefore denies his addiction problem, because that he has no resources to live without her). In a psychotherapeutic vein (it is similar at all other stages, so I will skip its description for other stages) - work with blackmailing emotions, access to children's prohibitions of fear and insufficiently resourceful parental figures (the child did not receive empathy and protection in response to his emotions of fear).
As self-help you can write an essay “How can I live without ... (an object of loss)!”, conclude an agreement with yourself to take care of yourself, plan a search for supporting and “protecting” resources.

2. Stage of Anger. Anger is an emotion aimed at changing the world (situation). From this point of view, following the stage of anger after the stage of fear, again, is completely logical. At the previous stage, there was a threat assessment and a search for resources. At this stage, there is an attempt to change the situation in their favor. Indeed, in many situations, before it is too late, the loss can be prevented by active actions (for example, catching up with a pickpocket when stealing a wallet), and it is anger that helps to take them. In addition, if fear helped to assess the level of threat to oneself, then anger helps to assess what is unacceptable in the very situation that causes the loss. Problems with the passage of this stage may be in people with the forbidden emotion of anger. Instead of experiencing natural anger, such people can "hang" in aggression, claims and accusations, as well as in a sense of powerlessness and injustice. In addition, instead of experiencing true anger, blackmailing emotions may appear.
As in the stage of fear, psychologist's task in this case, help in experiencing anger and moving on to the next stage of experiencing loss. In a consultative vein, this is the removal of cultural prohibitions on anger (for example, one cannot be angry that a person has died), the search for moments that are unacceptable in a situation and the search for resources for experiencing anger towards them.
self help : “Letter of anger” (what I did not like in the situation, what makes me angry, what is unacceptable for me, etc. - it is important not to turn into accusations and aggression), “Letter of forgiveness”.

3. Stage of Guilt. Guilt is an emotion that helps you find mistakes in your behavior and correct them. At this stage, guilt helps a person evaluate what could have been done differently and: 1.) either correct their behavior in time; 2.) or draw conclusions for the future for similar situations. A person with an inability to adequately experience guilt can “hang” at this stage in self-accusations, self-flagellation and other auto-aggressive emotions.
Principle psychologist's work here is similar to work at other stages. It is also important here to teach a person to distinguish between the position of responsibility (“I am responsible for correcting / accepting my mistakes”) and guilt (“I must be punished for my mistakes”).
Self Help: analysis of my mistakes, "Letter of anger to myself" (what I did not like about my behavior, it is important not to turn into auto-aggression), "Letter of forgiveness to myself", a contract for new behavior in similar situations in the future.

4. Stage of Sorrow. Sadness performs the function of breaking emotional ties with the object of affection. With problems of experiencing sadness, a person is unable to “let go” of the loss and “freezes” in “depressive” emotions.
Peculiarities psychologist's work at this stage: to show the "restoring" function of sad emotions.
Self Help: analysis of the “+” of what was lost (how good it was with this / him / her), “Letter of gratitude” (where one remembers and expresses gratitude for all the good things that happened before with the object of loss, and without which we will now have to live).

5. Stage of Acceptance. Acceptance performs the function of restoration and search for resources for life without the object of loss. At the end of this stage, an emotional point is put: “Yes, I can live without ...!”. Features of the work of a psychologist: expanding the perspectives of time (transferring from the past and present to the future), searching for resources and replacing the object of loss. Self-help: “Letter of support to myself” (how will I live and support myself without the object of loss).

6. Hope. Hope is an emotion of development and striving forward. At this stage, the loss situation is transformed into a resource situation. There is an understanding that in this loss there was actually an acquisition that can be used in the future.
The task of the psychologist: assistance in finding acquisitions in a situation of loss, how these resources can be used in the future.
Self Help: analysis of acquisitions in a situation of loss, "Letter of gratitude to the loss", setting goals for the future.

A few more words about the work of a psychologist with the experience of loss. Although this is a well-known and common topic in the work of psychologists, there are points that are rarely mentioned and many psychologists miss these points.

In the case of a forbidden true emotion (as mentioned above), a person can experience a blackmail emotion instead. So, for example, if the blackmailing emotion of true anger is guilt (the child was taught to feel guilty for his anger), then in the second stage, instead of anger, guilt will be activated. The psychologist in this case may make the mistake of taking this stage for the third and assisting in the experience of guilt, which, in the end, will be ineffectual. At the same time, work is needed here not just to experience guilt, but to remove it, to subsequently unblock anger and help in experiencing exactly it (anger).

The same principle applies to other stages: understanding is important, a person does not have enough resources to experience true emotion at this stage, or we are dealing with blackmail emotions. True emotions must be helped to experience (in the best traditions of Gestalt therapy), scenario ones should be “removed” and the true ones lying behind them should be revealed.

I would also like to reiterate that losses are not only large, but also small daily. And a person may be unable to experience them as well. As a result, a negative emotional life background and blocked emotional development.
In this case psychologist's work will consist in increasing the emotional literacy and culture of a person (or, as it is fashionable to say today, emotional intelligence): explaining the functions of emotions, working out cultural prohibitions, working with the system of emotional racket and children's prohibitions, etc.

And finally, the slogan: appreciate the losses, only in them we gain!

The role of experiences in crisis and extreme situations

The overall goal of the work of experiencing is to increase the meaningfulness of life, “re-creation”, reconstruction by a person of his own image of the world, which allows rethinking a new life situation and ensuring the construction of a new version. life path, provide further development personality.

Experience is a kind of restorative work that allows you to overcome the inner gap of life, helps to gain the psychological opportunity to live, this is also a “rebirth” (from pain, from insensibility, from a state of hopelessness, meaninglessness, despair). The psychological content of the recovery process and the main task of psychological assistance is the reconstruction of the subjective image of the world of the individual (first of all, re-identification, the creation of a new image of the Self, the acceptance of being and oneself in it).

It should be noted that although the experience can also be realized by external actions (often of a ritual and symbolic nature, for example, rereading the letters of a deceased loved one, erecting a monument on his grave, etc.), the main changes occur primarily in the mind of a person, in his inner space(mourning, revision of life and awareness of the contribution of the deceased to his life, etc.) (N.G. Osukhova, 2005).

Thus, it can be argued that a person resorts to experiencing (experiencing becomes the leading and most productive strategy for a person) in special life situations, which are unsolvable by the processes of subject-practical and cognitive activity, when transformations in the outside world are impossible, in situations that cannot be overcome and from which a person cannot escape. Mourning is a natural process, and in most cases a person experiences it without professional help. Due to the relative frequency of experiencing the crisis of loss and insufficient knowledge of the stages of its experience by people, it is violations during this crisis that are the most frequent reason for seeking psychological help.

Grief symptom complexes :

Emotional complex - sadness, depression, anger, irritability, anxiety, helplessness, guilt, indifference;

Cognitive complex - deterioration in concentration, obsessive thoughts, disbelief, illusions;

Behavioral complex - sleep disturbances, meaningless behavior, avoidance of things and places associated with loss, fetishism, hyperactivity, withdrawal from social contacts, loss of interests;

Complexes of physical sensations, weight loss or gain, alcoholism as a search for comfort are possible (E.I. Krukovich, 2004).

The normal process of mourning sometimes develops into a chronic crisis called pathological mourning. Grieving becomes pathological when the "work of mourning" is unsuccessful or incomplete. Painful grief reactions are distortions of normal grief. Transforming into normal reactions, they find their resolution.

I will briefly present the manifestations of the dynamics of experiencing loss (grief) in a schematic form (6 stages).

Features of the dynamics of experiences in case of loss (loss)

Loss Crisis Stage 1: Shock - Numbness

Typical manifestations of grief:

Feeling of the unreality of what is happening, mental numbness, insensitivity, stunnedness: "as if it were happening in a movie." The speech is inexpressive, low intonation. Muscle weakness, slow reactions, complete detachment from what is happening. The state of insensibility lasts from a few seconds to several days, on average - nine days

:

"Anesthesia of feelings": the inability to emotionally respond to what happened for a long period of time - more than two weeks from the moment of loss

Loss Crisis Stage 2: Denial

"It's not happening to me", "It can't be!" The person cannot accept what is happening.

Atypical signs of grief (pathological symptoms):

Loss denial lasts more than one to two months from the date of loss

3 Stage of the crisis of loss: Acute experiences

(acute grief phase)

This is the period of greatest suffering, acute mental pain, the most difficult period. Many difficult, sometimes strange and frightening thoughts and feelings. Feelings of emptiness and meaninglessness, despair, a sense of abandonment, anger, guilt, fear and anxiety, helplessness, irritability, a desire to retire. Grief work becomes the leading activity. Creating an image of memory, an image of the past is the main content of the “work of grief.” The main experience is a feeling of guilt. Severe impairment of memory for current events. A person is ready to cry at any moment.

Atypical signs of grief (pathological symptoms):

Prolonged intense experience of grief (several years).

The appearance of psychosomatic diseases, such as ulcerative colitis, rheumatoid arthritis, asthma.

Suicidal intent, suicide planning, suicide talk

Violent hostility directed against specific people, often accompanied by threats.

4 Stage of the crisis of loss: Sadness - depression

Typical manifestations of grief:

Depressed mood, there is an "emotional farewell" to the lost, mourning, mourning.

Deep depression, accompanied by insomnia, feelings of worthlessness, tension, self-flagellation.

5 Stage of loss crisis: Reconciliation

Typical manifestations of grief:

are recovering physiological functions, professional activity. A person gradually comes to terms with the fact of loss, accepts it. The pain becomes more tolerable, the person gradually returns to his former life. Gradually, more and more memories appear, freed from pain, guilt, resentment. A person gets the opportunity to escape from the past and turns to the future - begins to plan his life without loss.

Atypical signs of grief (pathological symptoms):

Overactivity: Abrupt withdrawal into work or other activities. Sudden and radical change in lifestyle.

Change in attitude towards friends and relatives, progressive self-isolation.

6 Bereavement Crisis Stage: Adaptation

Typical manifestations of grief:

Life is getting back on track, sleep, appetite, daily activities are restored. Loss gradually enters into life. A person, remembering the lost, no longer experiences grief, but sadness. There is a realization that there is no need to fill the pain of loss all your life. New meanings appear.

Atypical signs of grief (pathological symptoms):

Persistent lack of initiative or motivation; immobility.

Helping a bereaved person in most cases does not involve professional intervention. It is enough to inform relatives how to behave with him, what mistakes not to make.

Although loss is an integral part of life, bereavement threatens personal boundaries and can shatter illusions of control and security. Therefore, the process of experiencing grief can be transformed into a disease: a person, as it were, “gets stuck” at a certain stage of grief.

Most often, such stops occur at the stage of acute grief. A person, feeling fear of intense experiences that seem uncontrollable and endless to him, does not believe in his ability to overcome them and tries to avoid experiences, thereby disrupting the work of grief, and the crisis deepens.

In order for painful reactions of grief, being distortions of normal grief, to transform into normal reactions and find their resolution, a person needs knowledge about the stages of experiencing grief, about the importance of emotional response, about ways of expressing experiences.

This is where a psychologist can help: to determine where a person has stalled in his experiences, to help find internal resources to cope with grief, to accompany a person in his experiences.