Introduction
Death is an inevitable part of life, and all human beings must experience it at one point. The people who lose a loved one tend to grieve and mourn as they come to terms with the fact that the person is gone and will never return to earth. Following the death of a loved one, a family is plunged into grief.
This paper examines the bereavement process of Ahmir and Bea, who lost their son Ezra during an accident caused by his father. The couple had struggled before getting the child, and Ezra was considered a miracle baby. After the loss, the parents are affected differently because of their backgrounds. Ahmir felt guilty as he thought he was responsible for the death. On the other hand, Bea was angry as her only child was snatched from her. Grief is a complex process that differs among individuals and requires a customized approach to overcome it.
Theoretical Perspectives of Grief
The theoretical grief model illustrates how the process of bereavement should be approached. After losing a loved one, a person may experience complicated grief, which requires counseling services. The theories explaining the grief process help counselors to customize the approach to meet the person’s unique needs. Elizabeth Kubler-Ross developed the five-stage theory, which stated that “the key stages of mourning are, denial, anger, bargaining, depression and acceptance of the loss” (as cited in Boelen et al., 2007, p. 231). Although it is expected that the stages are felt in a linear format, this may not be the case as some may move back and forth.
The connection between the living and the deceased may jeopardize the healing process after a loss. The continuing bond theory proposes that after the loss, the living maintains a bond with the deceased through memories and belonging (Boelen et al., 2007). The theory underscores the importance of holding on the memories as a person moves on in life.
The task-based model of grief proposes that four main stages must be followed for a person to come to terms with the loss. The tasks are accepting that the loss has occurred, experiencing the pain caused by the loss, trying to adjust to life without the deceased, and finally moving forward (Fitzgerald, 2023). John Bowlby coined the attachment theory by stating that “people are attached to their loved ones, and when the person leaves, they feel an immense reaction of grief which may be as intense as committing suicide” (as cited in Boelen et al., 2007, p. 263). The theories help counselors customize their approach to the situation of the grieving individual.
Consistency of the Bereavement Process with the Theoretical Perspectives
The bereavement process exhibited by Ahmir and Bea is inconsistent with the theoretical perspectives. Ahmir, for example, is in pain as he believes he is responsible for the death of his son. In the Kubler-Ross stages, he is in depression and cannot come, cannot cope with the loss, and has opted to be a drunkard. Alcohol is used as a coping mechanism to eliminate guilt while avoiding neighbors shows that he still suffers grief. Ahmir’s actions are consistent with the attachment theory, where a person does not accept the loss and has to embark on alternative actions to help get rid of the pain and guilt.
Bea, on the other hand, also experiences complicated grief, which is manifested by her anger and lack of sleep as she believes that her husband is responsible for the death of their miracle baby. Further, she has insomnia and longs for her dead son as she ponders about secondary infertility. Bea’s reaction is in tandem with the continuous bond theory because she still feels attached to her son. Further, her actions are consistent with the five stages of Kubler-Ross, where there is anger and resentment towards her husband. Bea has characteristics of complicated grief as she cannot come to terms with the loss. The loss significantly impacted the marriage was on the verge of breaking.
Risk Factors for Complicated Grief
There are behavioral and circumstantial risk factors that are associated with complicated grief. In the case of Ahmir, they include intense guilt as he thinks that he is to blame for Ezra’s death. The signs manifesting the risk factors include the fear of driving, excessive drinking, and avoiding neighbors (Lehman et al., 1989).
On the other hand, Bea also depicts some characteristics of complicated grief, such as insomnia and constant dreams about her child. She also shows extreme risk factors, such as the presence of dirty utensils, showing that she has not been able to cope with the loss. Both Ahmir and his wife, Bea, are suffering from symptoms of complicated grief.
One of the potential characteristics that may predispose Bea and Ahmir to complicated grief is the fact that the couple struggled with secondary infertility and that Ezra was a miracle child (Fitzgerald, 2023). Both individuals, therefore, were predisposed to complicated grief because of the circumstances under which they got the child, who was the only child. The loss of her only child and her perceived infertility may be the prerequisite to the complicated grief.
Signs of Complicated Grief
Both Bea and Ahmir have signs of complicated grief from the given case. The excessive use of alcohol and avoiding leaving the house was because of his guilt. On the other side, Bea’s inability to sleep and continuous thoughts and dreams about Ezra indicate that she is undergoing complicated grief. The action of the two people means that they are all suffering immensely from the loss, and they cannot process the child’s death. The specific examples to show that they have not moved on are connected to the attachment theory, where they experience behavioral change such as leaving their plates dirty and Ahmir’s fear of driving.
Social and Cultural Context
The case study presented involved two people of different socio-cultural backgrounds. Ahmir is a Saudi Arabian male and a Muslim, where masculine culture and religious beliefs affect the way people express their grief. Ahmir did not leave the house because he did not want people to see him cry. He also started taking alcohol as a defense mechanism because he could not contain the grief.
On the other hand, Bea is an African American whose culture shapes her reaction towards the loss. In the African American culture, social support is essential in supporting a grieving person (Loudin, 2021). Since her husband was also in the same pain, he could not support her, so her pain escalated. Social norms and views, therefore, play a crucial role in the expression and management of the grief process.
Counselling Process
The case study shows that the family needs help to adapt a life without Ezra. However, as a counselor, hearing the story from their mouth is essential because speaking out is an integral part of the healing process. The three critical questions that will be asked to start the conversation are:
- Kindly describe how you have been feeling since the day Ezra died.
- Have there been any changes in your daily routine since Ezra’s passing?
- Do your cultural or religious beliefs play any role in your grieving process?
The three key questions are essential to assist the counselor in determining the status of the grief and then determining the best approach to be used. For example, the first question helps to get an insight into the family’s state of healing. If a person speaks out, they are bound to come to terms with the loss and realize that the person is gone (Lehman et al., 1989). According to the task brief theory, speaking about pain helps a person to move from the stage of experiencing the pain to the stage of adapting (Lehman et al., 1989).
The second question assists in understanding the change in behavior and the coping mechanisms that have been embraced so far. Cognitive Behavioral therapy is vital in assisting people in changing their behavior (Fitzgerald, 2023); when the behavioral change is noted, it serves a vital role in determining what is needed for a person to change their behavior. Cognitive behavioral therapy can be recommended only when the changes in behavior can be witnessed in a person’s day-to-day activities.
Finally, the third question sets the pace on how the cultural behavior of the person may be implored to assist in the coping process to help in managing the grief. The coping mechanism may be affected by religious or cultural beliefs. The counselor must, therefore, understand the impact of the religious and cultural context to develop coping mechanisms in the religious and cultural context.
The primary lesson from the course that helped develop the questions was that the bereaving process differs from one person to another, and coping can be affected by other factors such as religious and cultural beliefs (Boelen et al., 2007). Finally, the cognitive behavioral theory is an antidote to complicated grief and must be implemented when the initial and current behaviors are known.
Further Assessments
As a bereavement counselor, there are further assessments to get adequate information to assist the family in coping with the loss of their son. One critical assessment is determining the communication patterns between Ahmir and his wife to determine whether they share a positive relationship. When the counselor determines how the couple understands and supports each other during the grief process, it becomes easy to assist them in coping better.
Another assessment is to be conducted on their coping strategies to observe any unhealed trauma. The assessment is essential because it helps the counselor understand their weakness and unique needs so as to customize the therapy for their healing (Boelen et al., 2007). Some of the questions include: what is unhealed trauma? What do you do when you are alone? What does the thought of Ezra make you do? The questions are based on the fact that people bereave differently and must be understood for the healing approach to be tailored.
Specific Interventions
Individual Counselling
Both Agmir and Bea express their loss in different ways, meaning no general method can help them. However, individual counseling gives room for the counselor to understand the specific issues affecting the individual and propose a more appealing coping strategy. This strategy is essential because it helps each individual to process their emotions effectively and find a way to overcome them (Fitzgerald, 2023). Through individual counseling, Bea’s anger may subside while Ahmir’s drinking behavior may end.
Family Therapy
Ahmir and Bea’s marriage is at stake because of the loss of their son. Since a support system and family care is one of the antidotes to overcoming grief, family therapy will be aimed at building the family relationship. When the husband and wife can understand and support each other, the grieving process will be made accessible, and healing will be attained. The intervention will be helpful for the whole family since the people because once the family is back together, the people can support each other and cope.
Grief Support for Groups
Bea’s condition is critical because of her infertility issues, and she must be taught that she is not the only one who has passed through such pain. The group support for grief is dedicated to helping Bea meet with other women who have been through similar losses or, even worse, to help her cope. The group support is beneficial to her because it allows her to share her experience with the other group members for a better understanding.
Conclusion
The bereavement process is unique for all individuals, and a counselor must speak to the people to determine the most effective therapies to help them cope. The case of Ahmir and Bea shows how people react differently to losses and must be allowed to undergo the mourning process for them to heal. However, in the case of a different approach, complicated grief like the one experienced by Ahmir and Bea, a different prerequisite is that each approach speaks out to ensure that the background of the grieving may be understood. The theoretical perspective offers a critical approach and stages that may be helpful for people to grieve and cope with the loss effectively.
References
Boelen, P. A., de Keijser, J., van den Hout, M. A., & van den Bout, J. (2007). Treatment of complicated grief: A c omparison between cognitive-behavioural therapy and supportive counselling. Journal of consulting and clinical psychology, 75(2), 277. Web.
Fitzgerald, H. C. (2023). You know you are getting better when…. American hospice foundation. Web.
Lehman, D. R., Lang, E. L., Wortman, C. B., & Sorenson, S. B. (1989). Long-term effects of sudden bereavement: Marital and parent-child relationships and children’s reactions. Journal of Family Psychology, 2(3), 344. Web.
Loudin, A. (2021). The profound sadness of prolonged grief” Long-term grief often goes undiagnosed even though treatment can be pivotal to overall well-being. The Magazine of Harvard Medical School. 36(2), 1-8. Web.