Emotion and coping

What are emotions?

Emotions – complex patterns of change that include physiological
arousal, subjective feelings, cognitive processes, and behavioural
reactions- occur in response to situations we perceive to be
personally significant. Emotions have 4 components:
1. Physiological arousal
Emotions engage he nervous and endocrine systems so that ou
are emotionally aroused your body is aroused.
2. Subjective feelings
Emotions involve the subjective awareness of feelings, such as
joy, sorrow, anger, disgust, anxiety and fear.
3. Cognitive processes
Emotions include cognitive processes such as memories,
perceptions, expectations and interpretations.
4. Behavioural reactions
Emotions consist of behavioural reactions. Facial expressions,
gestures and tone of voice serve to communicate our feelings
others. Cries of distress and running for lives are also adaptive
responses that many enhance our chances for survival.

General category of emotions

Psychologists have identified 2 general categories of emotions:
primary and secondary. Primary emotions refer to the initial
and direct emotional response to an experience, such as being
frightened at the sound of thunder or the joy of seeing a loved
one. 88 primary emotions have been identified: joy,
acceptance, fear, surprise, sadness, disgust, anger, and
anticipation. These emotions can be experienced more or less
intensely to create other emotions.
Secondary emotions are emotional experiences that are
reflective, involve evaluation of the self and typically follow
primary emotions. 3 common secondary emotions are shame,
guilt and pride. The negative emotions of shame and guilt
follow a failure to meet an internalized social standard but
whereas shame occurs due to loss of social status, guilt is
typically evoked after a moral transgression.
People seem to place emotions along 2 dimensions pleasant
versus unpleasant and intensely versus weakly aroused. The
emotions of contentment, joy, and love would fall into the
category of pleasant or positive emotions, whereas anger,
disgust, and sadness fall into the category of unpleasant
emotions. On the intensity scale, rage is more intense than
anger, which in turn is more intense than annoyance. On the
other hand love is more intense than liking.

Specific emotions
1. Anxiety
Anxiety is the vague, unpleasant feeling that serves as an
emotional alarm signal, warning us of an impending threat
to danger. Anxiety may be evoked by natural disasters,
predators, or inter-clan hostilities; its arousing nature may
have been adaptive in that it helped human’s survive. Our
worries tend to be related less to survival and more too
everyday frustrations, bureaucracies, personal
achievements, and other non- life threatening issues.
When a threat is real and can be pinpointed, such as fear of
failing an examination, moderate levels of anxiety may
motivate us to take the necessary steps to avoid the gaffe.
People who ae prone to unusually high, chronic, free-
floating anxiety tend to overreact to stressful situations,
 frequently making the situations worse. High levs of anxiety
can distort our perception and thinking so much that our
performance is impaired.

2. Anger
Anger- feelings of displeasure or resentment over
mistreatment. Psychologist have been investigating whether
holding anger in or venting anger out- catharsis- is the best
way to deal with this type of negative emotion. Holding
anger in, goes the popular notion, leads to all kinds of
problems- high blood pressure, increased risk of heart
attacks, depression and suicide.
Deciding whether venting anger is healthful or hurtful
actually depends on how you vent your anger. Venting anger
through actions or words results in more anger and
aggression. Venting anger through expressive writing can
actually help lower blood pressure. At times doing nothing
or displacing anger onto a more productive project may be
an effective way to manage ager.
Anger issues often develop during childhood. Certain child
rearing practices can go a long way toward preventing
inappropriate forms of anger expression. Developmentally
appropriate strategies for encouraging children to
responsibly handle their anger include modelling by parents
of appropriate anger management avoiding shaming a
child’s anger and increasing the child’s understanding of
anger as well as the sense of control over anger arousing
events. There is so much evidence that watching television
violence, playing violent video games, and the like, increases
aggressive feelings, aggressive thoughts and aggressive
behaviours and desensitizes us to its effects. From childhood
through adulthood, increasing social support and providing
opportunities to discuss negative emotions often improves
 anger management. Training in social skills is another option.
Lessons in social skills can also help individuals find
alternative’s solutions to provocation. Therapy should
convey the sense that anger is destructive and that better
communication and problem solving skills and increased
empathy for the target to the anger all reduce anger.

3. Jealousy
Jealousy is a complex emotion that occurs when we fear
losing a close relationship with another person or have lost it
already. Jealousy is characterized by fear of loss, distrust,
anxiety, and anger. Jealousy is apt to occur in romantic and
sexual relationships so that it is popularly known as romantic
jealousy. Jealousy can be contrasted with envy, which is
distinguished by feelings of inferiority, longing, resentment
and disapproval. Some situations likely to trigger romantic
jealousy:
1. The person you like goes out with someone else.
2. Someone gets closer to a person whom you are attracted
to.
3. Your lover or spouse tells you how sexy a former
boyfriend/girlfriend was.
4. Your lover or spouse visits a person he or she used to go
out with.
5. You see that your partner is having an affair
6. You are the second spouse of your mat and he or she has
to support to the first spouse.
Jealousy in men and women is activated by different
types of situations. Men are more likely to get jealous
when their significant other is talking to potential suitor
that is physically imposing. Women tend to get jealousy
the most when their partners are interacting with
physically attractive and socially powerful rivals. Men are
 concerned with sexual fidelity while women are upset
over emotional betrayals. Some people with low self-
esteem, high levels of anxiety , a negative view towards
the world, low levels of life satisfaction, little control over
their lives, low threshold of emotional arousal, and a
greater sensitivity to threatening stimuli in social
environment. Those with pathological jealousy possess
repeated and unfounded, suspicion of a partner’s fidelity.
These suspicions modify thoughts, feelings and behaviour.

4. Happiness
Happiness or as psychologists refer to it, subjective well-
being, includes a prepondence of positive thoughts and
feelings about one’s life. People high in SWB have a global
sense that work, marriage and other life domains are
satisfactory. They experience and report pleasant rather
than anxious, angry or depressive emotions. Happy people
are less self- focused, less hostile and less vulnerable to
disease. They are more loving, forgiving, trusting, energetic,
decisive, creative, helpful and sociable than unhappy people.
Happiness does not discriminate between genders; across
cultures, both men and women have equal opportunities to
find happiness. The sources of happiness for each gender
often differ, with men’s SWB being predicted by self-esteem,
and women’s happiness resulting from both self-esteem and
relationship harmony. Aging does ‘not involve a decline in
happiness either.

Expressing emotions
Emotions not only motivate us to do certain things and to
approach or avoid particular situations thy also suffer a
primary means of communicating with others. Sharing our
feelings is risky and makes us vulnerable to the judgements
of others. Some people are so afraid of their inner feelings
that they are unable to experience, much less express, their
deeper emotions disclose emotions, such as in times of great
joy or profound sorrow. They are more in touch of their
emotions disclose their feelings freely, whether the emotion
be anger or love.
Emotional balance is all the more difficult because of some
of the individual differences in emotional experiences.
Across a wide variety of cultures, men more frequently
report powerful emotions while women are more likely to
report powerless feelings. Scientists have yet to test out
whether such differences are learned or biological. Other
studies that culture can influence the expressions of emotion
known as cultural display rules.

Recognizing emotions
1. Self-recognition of emotion
Men are more so than women to ruminate about upsetting
events and report more inhibition of hostile feelings. Across
adulthood, whereas older person think more about
upsetting events than their younger counterparts, they
express emotions less frequently than younger individuals.
The elderly are still highly capable of experiencing
profoundly positive emotions.

2. Facial and body expression

The ability to monitor and correctly identify facial
expression is a key component of social relationships. The
recognition is sadness may evoke comforting behaviour
and the identification of the fear may elicit protection.
The misidentification of anger may increase the likelihood
of a social interaction becoming aggressive. Positive
emotions ae more quickly identifies than negative
 emotions, a phenomenon known as the happy face
advantage. It may be that the distinctiveness of the visual
features of happy faces and the relative in distinctions of
negative facial expressions accounts for the findings.
There is little doubt that the face is important, body
postures, vocal changes and hand gestures also signals us
to what others are actually feeling. Research indicates
that deciphering these and other nonverbal information is
complicated.

3. Issues of diversity
In comparison to men, women decode emotions more
accurately. Everyone is a better decoder of emotions
expressed by members of their own culture, relative to
those displayed by people of a different one. Such
differences occur because same race faces and other race
faces activate different parts of the brains. Race appears to
influence emotion recognition in others.

4. Detecting deceit
Identifying deception in others is a difficult task with the
ability to accurately judge whether someone is lying
hovering around 50%. One helpful aid is micro-
expressions, or fleeting facial expressions that last only a
fraction of a second. Micro-expression may be
momentary but they are still detectable by the astute
observer. Many people try hard to control their outward
facial expressions because they believe we think the ace is
the primary clue to their secret deceivers may blink more
or smile more broadly in an effort to mislead and thus can
be exposed.
Some individuals are also good at monitoring and
controlling their faces that their true feelings are difficult
to detect. Watching for body leakage, where body
postures rather than the face leak the truth, can one just
as revealing of emotional deceit. While individuals are
concentrating on monitoring their words and their facial
expressions, they attend less to their bodies, which
consequently betray their true feelings.

Managing emotions
Emotional self-regulation refers to the process by which
one inhibits or moderates ones emotional responses in
order to remain engaged in thoughtful interaction. Areas
of emotional management needing improvement vary
somewhat from one person to another. Some people who
are very emotional and impulsive may blurt out their
feelings without much thought, they need to develop
better self-control. Those who keep their emotions under
tight control may need to loosen up to become more
aware of their feelings and more comfortable expressing
them appropriately to others.

Communication intense emotions

A technique that is particularly useful for expressing
intense emotions, especially negative ones, Is the use of
an “I” message. This message consists of saying what you
honestly feel in a way that encouraged others to listen
and cooperate. “I” messages consists of 4 stages:
1. Describe the other persons objectionable behaviour
In specific but non-judgemental terms. You might use
the phrase” when you fail to return my book on time”,
instead of “you are irresponsible”. Avoid using fuzzy
 and accusatory responses or guessing the persons
motives. Such communication only intensifies the
person’s resistance to changing the behaviour.
2. Point out the specific ways in which that person’s
behaviour affects you.
People are not deliberately trying to make life
miserable for you; they simply aren’t aware of the
consequences of their actions. Once a person becomes
more aware of how the behaviour has become a
problem for you, they may be willing to modify.
3. Tell the person how you feel about the behaviour in a
way that owns your emotions.
You should general start your sentences with the
pronoun I. say “I feel hurt” instead of “you hurt me”.
Avoid projecting your motions onto the other person.
4. Tell the person what you done to correct the situation.
If you object to the causal way telephone messages are
left for you, you might say something like this: I don’t
have the information I need and I feel frustrated when
you don’t write down my telephone messages. I’d
appreciate your writing down my telephone messages.

Emotions and personal growth

Emotions are a kind of a barometer of our inner world,
giving us an intuitive knowledge about ourselves and
our involvement with others at the moment. Intense
emotions tell us our live are strongly affected by some
person or event and prompt us to act accordingly.
When we feel little or no emotion in a given situation,
chances are our needs, goals, or values are not
affected, that is we are not emotionally involved.

Enhancing emotional intelligence

Emotional intelligence consists of the ability to
perceive and express emotion, assimilation of emotion
in thought, understand and reason with emotion and
regulate emotion. Emotional intelligence includes 4
essentials components first, people need to be able to
accurately perceive emotions in themselves and others
and have the ability to express their own emotions
effectively. Second, people need to be aware of how
their emotions shape their thinking, decision making,
and coping with stress. Third, people need to be able
to understand and analyse their emotions, which may
often be complex and contradictory. Fourth, people
need to be able to regulate their emotions so that they
can dampen negative emotions and make effective use
of positive emotions.

Releasing pent-up emotions

One interesting study looked at the repercussions of
“psychological inhibitions” n gay men who conceal
their homosexual identify. Many gay individuals inhibit
the public expression of their homosexuality to avoid
stigmatization, discrimination, and even physical
assault. Cole et al tracked the incidence of cancer,
pneumonia, bronchitis, sinusitis and tuberculosis in a
sample of 222 HIV negative gay and bisexual men over
a period of 5 years. They found that the overall
incidence of these disease was noticeably higher mang
the men who concealed their homosexuality. If
inhibition is bad, expression is good. James penne
baker and his colleagues have shown that talking or
writing about traumatic events can have beneficial
effects. If one can find a good listener, it may be wise
to let your secrets fears, misgivings and suspicions spill
out in a candid conversation. Confiding in others can be
awkward and difficult. Therein lies the beauty and
appeal of the writing approach, which can be kept
private.

Managing hostility and forgiving others

Scientists have compiled quite a bit of evidence that
hostility is related with increased risk for heart attacks
and other types of illness. Many experts assert that
people should strive to learn how to manage their
feelings of hostility more effectively. The goal of
hostility management is not merely to suppress the
overt expression of hostility that may continue to
seethe beneath the surface, but to actually reduce the
frequency and intensity of one’s hostile feelings. The
first step toward this goal is to learn to quickly
recognize ones anger. A variety of strategies can be
used to decrease hostility, including reinterpretation of
annoyance events, distraction and the kind of rational
self- talk advocated by Ellis. Efforts to increase
empathy and intolerance can also contribute to
hostility management, as forgiveness, which has
become the focus of a new line of research I
psychology.
We tend to experience hostility and other negative
emotions when we feel wronged that is when we
believe that the actions of another person were
harmful, immortal or unjust. Our natural inclination is
either to seek revenge or to avoid further contact with
the offender. Forgiving someone involves
counteracting these natural tendencies and releasing
the person from further liability for this or her
transgression.
Meditating
Meditation refers to a family of mental exercises in
which a conscious attempt is made to focus attention
in a non-analytical way. Meditation has been practiced
throughout history as an element of all religious and
spiritual traditions, including Judaism and Christianity.
The practice of meditation can be largely divorced from
religious beliefs.
In TM a person is supposed to sit in a comfortable
position with eyes closed and silently focus attention
on a mantra, a specially designed Sanskrit word that
creates a resonant sound. This exercise in mental self-
discipline is to be practiced twice daily for 20 minutes.
The technique has been described as diving from the
active surface of the mind to its quiet depths.
Advocates of meditation claim that it can improve
learning, energy levels, work productivity, physical
health, mental health, and general happiness while
reducing tension and anxiety caused by stress.
Most studies find decreases in participants’ heart rate,
respiration rate, oxygen consumption and carbon
dioxide elimination. Many researchers have also
observed increase in skin resistance and decrease in
blood lactate-physiological indicators associated with
relaxation.
Research suggest that meditation may have some
value in reducing the effects of stress. Regular
meditation is associated with lower levels of some
stress hormones. Research also suggest that
meditation can improve mental health while reducing
anxiety and drug abuse. Other studies report that
meditation may have beneficial effects on blood
pressure, self-esteem, mood and one’s sense of
control, happiness and overall physical health and well-
being.

Using relaxation procedures

The most prominent systems are Jacobson’s
progressive relaxation, Schultz and luthes autogenic
training and Benson’s relaxation response.
After studying various approaches to meditation,
Herbert Benson, a Harvard medical school cardiologist,
concluded that elaborate religious rituals and beliefs
are not necessary for someone to profit from
meditation. He also conducted that what makes
meditation beneficial is the relaxation it induces. After
“demystifying” meditation, Benson set out to devise a
simple, nonreligious procedure that could provide
similar benefits. He calls his procedure the “relaxation
response”. According to Benson, 4 factors are critical to
effective practice of the relaxation response:
1. A quiet environment
It is easiest to induce the relaxation response in a
distraction free environment. After you become
skilled at the relaxation response, you may be able
to accomplish it in a crowded subway. Initially
however, you should practice it I a quiet, calm place.
2. Mental device
To shift attention inward and keep it there, you need
to focus on a constant stimulus, such as a sound or
toward that you recite over and over. You may also
choose to gaze fixedly at a bland object, such as a
vase. Whatever the case, you need to focus your
attention on something.
3. A passive attitude
 It is important not to get upset when your attention
strays to distracting thoughts. You must realize that
such distractions are inevitable. Whenever your
mind wanders from your attentional focus, calmly
redirect attention to your mental device.
4. A comfortable position
Reasonable body comfort is essential to avoid a
major source of potential distraction. Simply sitting
up straight works well for most people. Some
people can practice the relaxation response lying
down, but for most people such a position is too
conducive to sleep.

Death and dying

Some approach death and dying with an open mind
and matter of fact attitude. Others rely on denial to
avoid thinking about the inevitable. Actually some
denial of death is necessary and normal to function
effectively. Death, especially the possibility of or
own demise, is such a harsh reality that may find
this issue difficult to face directly. Denial, therefore
helps to keep anxiety and despondency at low,
manageable levels. It can also help us avoid the
pain associated with being separated from loved
ones, in no longer being able to share with them in
joys and sorrows, and in the recognition of a future
without their presence.

Risks of dying
Health habits and lifestyles are especially important.
People who smoke a pack or more of cigarettes a
day can expect to die 6- 9 years sooner than those
who don’t smoke. Personality and stress
management are also important, as individuals who
are intense, hostile and easily angered tend to die
sooner than those who are relaxed and easy going.
Heredity also affects our life expectancy. It is well
known that people with long- lived parents and
grandparents tend to live longer than those close
relatives die young. If your relatives are not noted
for their longevity, you need not become fatalistic.

Awareness of death
National and international tragedies, accidents and
homicides, as well as the death of family members
and friends can increase our own mortality salience.
Being aware of our own mortality is one thing;
understanding what it means to be dead is quite
another.

Death anxiety
Simply thinking about death, at times people fear
death, a phenomenon called death anxiety.
Although death anxiety can occur at any age, people
in their 20s are typically the most fearful. This occurs
because young adults have their whole life ahead of
them and that the leading causes of death for this
age group- accidents, homicides, and suicide-
emphasize the cruel and tragic nature of death.
Similar to mortality salience, large scale disasters,
terrorist attacks and the deaths of those around us
can increase death anxiety for everyone. As
individuals reach late adulthood, they generally
think about death more often and talk about it
more.
The experience of dying
Death is a journey in life, and one that each person approached in
their own unique way. During the experience of dying- the physical
and psychological changes experienced by individuals nearing death-
nothing is set in stone. There are some common experiences shared
by many named coming to terms with mortality and the physical and
cognitive changes that occur at the very end of life.

Coming in terms with mortality

Elisabeth kubler Ross noted that individuals tend to go through
several stages.
1. The first stage consists of denial of death, with people
characteristically feeling, “no not me”; this cannot happen to
me”. Such denial protects them from the deep emotions
associated with the death and provides time to cope with the
disturbing facts. Individuals tend to show small signs that they
are now willing to talk to talk about death.
2. In the second stage, denial eventually gives way to the
emotions of anger and resentment, especially toward
individuals who are healthy. “Why me?” people ask. The sigh of
others enjoying their health can evoke feelings of en vy,
jealousy and anger. The dying often take their feelings out on
these closet to them mostly because of what these people
represent- life and health. It is important for those nearby not
to take these remarks personally, but to help ding individuals
express their feelings.
3. The third stage characteristically consists of attempts to bargain
for time in which the dying individual attempts to negotiate
with others who might help him or her love linger. Individuals
at this stage often say,” in know I’m dying but” then they
indulge is bit of magical thinking or negotiation. “If they
 cooperate with the doctor or my family, maybe god will let me
live until my daughter graduates or my son gets married.”
4. When individuals tend to drop the “but” and admit “yes I am
dying” they enter the fourth stage, depression, characterized
by intense and sometimes unrealistic sadness. This is a natural
process or response to the threat of losing one’s life, and it is
very important to allow the dying to grieve and express their
sadness. One of the worst things a friend or a family member
can do is deny these feelings and say, “cheer up”. This, it is
important for everyone to come to terms with their own
feelings about death so that they can help, dying people accept
their own mortality without dwelling on it unduly.
5. The final stage is the acceptance of death, though not all dying
persons reach this stage. By this time most people who are
dying have pretty much accepted death and have disengaged
themselves from others. They may ask for fewer visitors and ta
times are difficult to interact with. At the end of the life most
people do not want to die alone. Although most people prefer
to ide at home, they are more likely to die in a hospital. Most of
the pain comes from mental anguish, especially the fear of
being separated from loved ones.

Physical and mental changes at the end of life

Between 1-3 months prior to dah, the body begins to slow down,
requiring less energy from food. Appetite and thirst decrease, there
is a corresponding loss in weight. Changes in their body chemistry
produce a sense of euphoria. People who are dying also tend to
sleep more, and when they are awake, they rarely engage in
activities that they once enjoyed.
About 1-2 weeks prior to death, the dying person begins to spend
most their time sleeping. And when they are awake disorientation,
delusions and hallucinations, agitation are quite common. Speaking
decrease and even talking stops altogether. Body movements and
actions, such as hand waving, occur without permission. There are
numerous physiological changes as well:
1. Body temperature lowers by a degree or more.
2. Blood pressure decreases.
3. Pulse becomes irregular.
4. Person sweats a lot.
5. Circulation becomes poor resulting in changes in skin tone.
6. Congestion builds up, causing a rattling cough.
7. Breathing becomes more rapid and labored.
During the final days and hours of life, the physical changes intensify.
Breathing becomes more irregular, and at times the dying person will
engage in ‘Cheyne stokes” breathing, characterized by rapid breathes
followed by periods of no breathing at all. Congestion continues to
build. Hands and feet are cool to the touch and appear blotchy and
purplish. The lips and skin under the fingernails change colour as
well. There is also loss of bowel and bladder control. The person
becomes unresponsive to the environment. Hearing is usually the
last sense to go, so caregivers are encouraged to keep talking to their
loved ones. Breathing will cease the heart will stop and the brain will
no longer function; death has occurred.

Life and death in perspective

The average life expectancy in the US was 48 years of age, by 1995 it
was 65, and now it is 78. As the average life expectancy increases,
more people are apt to suffer from chronic illnesses, such as cancer,
heart disease and stroke. For sufferers of chronic disease, death
comes slowly, often occurring in hospitals, which are geared more to
the treatment of acute illnesses and prolonging of life. Although
improvements in medical acer and technological advances can
postpone death, they do not necessarily guarantee a life of quality.

The right to die

A terminally ill patient’s quality of life, or lack can create a ethical
dilemma with regard to treatment choices, both for the families
making the decisions and for the doctors administering care. Family
members of patients in irreversible comas are often torn between
their desire to be loyal to their loved ones, religious beliefs and the
emotional and financial realities of supporting someone in a
permanent vegetative state. Doctors too face the dilemma between
their duties to sustain life, their obligation to relieve suffering and
the legal consequences of doing otherwise. The American medical
associations council on ethical and judicial affairs has provided
guidelines for doctors to withhold or withdraw life sustaining
measures for patients who have decided to forgo such treatments,
when patient were incapacitated and therefore cannot express their
end of life wishes, physicians are told to honour the choices made by
the surrogate decision makers. The right to die is the legal and
ethical view that competent individuals who are able to understand
treatment choices and their consequences have the right to decide
their own fate, such as withholding of treatment that would delay
death.

Advanced directives
Advanced directives allow patients to communicate health care
preferences in advance in the event that they are no longer able to
make these decisions. The most comprehensive type of advanced
directive is the living will, which instructs doctors and the type of life
sustaining procedures that should be stopped or prevented in the
event of a terminal conditions. Living wills cover a wide range of
health care procedures, including those affecting brain, liver, kidney,
heart, and lung functioning, as well as the provision of food and
water. Another type of advance directive, but one that is far more
limited in scope, is a do not resuscitate order, which prohibits
doctors from using advanced cardiac life support and cardio
pulmonary resuscitation should the patient have a cardiac arrest or
stop breathing.

Hospice care
The term hospice refers to a place or method of taking care of those
approaching the end of their lives. Hospice is a system of a care that
integrates a physical facility for the terminally ill with the patient’s
family and home to enable the patient to die with dignity. Much of
the suffering of the terminally ill consists of the treatments, the
impersonal atmosphere and the sense of isolation experienced in
hospitals. The hospice is a community that helps people to live, not
merely exist, while they are dying. The aim throughout is to provide
a humane and supportive community in which the patient may die
with dignity.
Although beneficial for both patients and their families, hospice stays
are often too short. The recommended amount of time necessary to
provide adequate physical and psychological support in 3 months on
reason is that exact time of death is never clearly predictable in
terminal illness. Physicians may be reluctant to make early referrals
to hospice because the patient and their family have not fully
accepted that the illness is terminal.

Caregiving in numbers
Caregivers are frequently family members- typically women or grown
daughters. Caregivers might also be neighbours, friends, or other
members of the community. There are more unpaid caregivers than
paid or professional caregivers.in addition to providing 20 hours of
care per week around 60% of caregivers are also employed. Paying
jobs do not provide enough income to cover the financial expense of
caring for a loved one. Nearly 47% of caregivers use up all or most of
their lifesavings ending to a family member. Because the financial,
emotional and psychological stress of long term caregivers can be
enormous, individuals who have been caregivers for extended
periods of time report high levels of stress, depression, poor eating
habits, and hostility.

Caring for the caregiver

Caregivers often need help themselves, at the very least requiring a
break from their many responsibilities. Most caregivers could benefit
from emotional and social support, as well as from training in a
variety of medical procedures. To assist caregivers, local support
groups are springing up all around the country. These groups offer
advice, support and respite care in which another member takes
over their duties for a few hours a week.

Bereavement and grief

Bereavement is the process of adjusting to the experiences of loss,
especially to the death of friends or loved ones. It involves the
overall experience of loss. Grief refers to the intense emotional
suffering that accompanies our experience of loss, and mourning
refers to the out ward expression of bereavement and grief.
Mourning customs
Because death is one of the universal rites of passage, most societies
have mourning customs to facilitate the expression of grief.
American widows dressed in black and widowers wore black
armbands. Such clothing explained the show of grief on the part of
the bereaved and afforded them an opportunity to talk about their
loss and to receive the needed sympathy. Any of these customs have
been modified or replaced with new ones. In most societies, parting
with the dead is recognized by some kind of funeral- the ceremonies
and rituals associated with the burial or cremation of the dead- with
the particulars varying by ethnicity, cultural norms and religious
canons.

Grief work
Grief work consists of the healthy process of working through the
emotions associated with the loss, freeing ourselves emotionally
from the deceased, readjusting to life without that person, resuming
ordinary activities, and forming new relationships. The grief process
can parallel the experience of dying and involves many of the same
stages.
People may react to a person’s death with a sense of shock and
disbelief especially when death occurs unexpectantly. When death
has been anticipated, as is the case of terminal illness, the initial
response may be subdued and accompanied by a sense of relief,
which may then turn to guilt as a result of feeling relieved at the
loved ones passing. People undergo survivor guilt defined as feeling
guilty because on is still alive while others are not.
The emotional intensity of grief in the early stages often appears in
the disguise of physical symptoms such as crying, depressed feelings,
lack of appetite, and difficulty concentrating at work or at home.
Another common symptom of grief is lack of interaction with others.
In order to avoid the negative emotions and physical symptoms
associated with grief, some people rely on sleeping pills, tranquiller
and alcohol during their bereavement, also of which can pose health
risks of relied on too much or too often.
In the final stage of grief, we usually come to terms with our loss and
resume our everyday activities. This task may occur anytime from a
few months to a year or more after the initial loss, depending on
how close we were t the person and the circumstances surrounding
their death. About 1 year is the normal length of time required or
grief work, with the most intense and negative emotions peaking by
6 months. For many normal grief can be present for an extended
period of time intensifying on important dates, such as birthdays,
weddings and the death date of the loved one. Depression and other
emotional reactions generally to decline over the 1st year.

Unresolved grief
Unresolved grief is a psychological state in which a person’s
emotional reaction to loss remains repressed, often being
manifested in unexplained physical or psychological symptoms. It is
also called as complicated grief, this prolonged and impairing type of
grief may assume a variety of forms, from unexpected physical
complaints to psychological symptoms suh as anxiety and
depression. The psychological reactions are related to loss.
Some individuals do just the opposite. Instead of thinking to little
about their loved one or their death, they think too much about their
grief and the loss they have experienced. Rumination or
preoccupation with the death of a loved person can be detrimental
to well- being, though suh cases rarely occur, individuals who
ruminate or constantly rehash details of the death experience ore
depression and pessimism than those who don’t ruminate.
Bereavement experts suggest that this type of prolonged or complex
grieving is problematic for well- being and thus requires special
attention.

Good grief
Grief and personal growth
There are some positive aspects of grief. Grief can increase our
appreciation of loved ones and friends more fully, despite their
shortcomings. Grief also helps us value our relationships with hose
still living. Good grief means that we have learned and grown in our
bereavement. Bereavement, has the potential to contribute to
personal growth. Know that personal oriented theories of
bereavement contend that grief represents only a part of the self,
the emotional self. Grief doesn’t just involve mourning; it also
concludes reflecting on the person who died as well as the
anticipated changes for the bereaved. In this model this survivor
assimilates the reality that the deceased is gone, expresses the
emotional pain of the loss, cultivates new strategies for coping in a
world without the loved one, and develops new beliefs and attitudes
about life, death, love and compassion.