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Hi everyone, I'm Ainslee Coates from the Mental Health Education and Resource Centre.
We are a Christchurch-based organisation
that provide mental health education and information
for the community around mental health and mental illness.
My role is to coordinate the education professional development that we provide
for the non-government organisation mental health sector.
My previous experience has been as a teacher
and advisor to teachers in health education,
mainly in mental health and sexuality education.
That involved me providing professional development opportunities,
and in relation to mental health,
one of the key learning areas that we concentrated on very strongly
was that in relation to change, loss, and grief.
This is an area that we know a number of people struggle with
and it is something that we all experience within our lifetimes.
Therefore, education and support around this important context is really, really important.
I was also involved in writing a thesis
around the implementation of change, loss, and grief
within the New Zealand health curriculum
and that was an interesting experience
to discover how teachers actually put this very sensitive area
with into a teaching and learning context for children.
My interest and enthusiasm for this area has really come about through
an understanding and awareness of the different changes, loss, and grief as a result of that,
that occurs for most people at some point throughout their lives.
In fact, I don't think that anybody could say that
they haven't experienced a loss or change at some point.
But how they experience those losses is very individual and unique,
and of course, loss and change occurs in a variety of ways.
So some common examples of these are things like
separation and divorce, a loss of independence,
loss of cultural identity or belonging can be a huge one for a number of people,
illness, loss of youth and vitality, employment...
All of these issues contribute to people struggling with a sense of coping
with something they often don't have the skills or are equipped to cope with.
Change is something that occurs, as I said, to all of us.
It occurs often on a daily basis,
and sometimes, we can find change very difficult to deal with.
But change also has the potential for both loss and gain.
And sometimes, out of a loss can come the opportunity
for new growth, new experiences, and new opportunities.
So I think it's important to remember that
although change and loss can often, and sometimes, be very painful,
it can also be a positive experience as well.
Loss occurs in a variety of different ways
and we experience loss and change through grief.
Grief is a very personal thing to each of us.
And I guess, a good way of looking at grief is like it's a thumbprint:
it is unique to all of us.
When change and loss occurs, sometimes there can be a scar that occurs as a result of that
and that scab may form over that scar
but the scar will remain with us forever.
Sometimes that scar can be knocked
and that knock can result in some additional pain for us.
But I guess the way we can think about this is that
it's a way we can best learn to manage the loss that we've experienced
rather than something we will actually get over permanently.
It's something that we manage and live with,
as opposed to a complete resolution of the issue.
Previous ways of conceptualising grief have looked at the notion of
grief as being something that occurs in stages.
A common and very well-known theorist is Elisabeth Kübler-Ross
who looked at this idea with people that were dying in hospice situations
around their experiences and how they negotiated
the meaning of their impending death.
Now, Elisabeth's notion of stages has, in some ways,
been misconstrued into a sense of a linear approach,
which is actually not what she intended.
Instead, what Elizabeth found was that people move through stages
in different ways, in different times, and that they may vary between the stages.
So, they could start with one, then go on to a third or fourth stage, and then return to a second one.
A good example of this is starting off feeling very angry.
You might go through a stage of anger,
then denial of the situation, or bargaining,
and finally, the resolution of the loss that you've experienced.
Nowadays, we have used the learning from Elisabeth Kübler-Ross
to apply to our own situation, to recognise that
yes, there are stages that we progress through in grief,
usually taking one to two years,
but that, as I mentioned, they're not necessarily linear.
So, we may revert back to a previous stage, at any time.
One thing that is really unhelpful
is to expect people not to experience
some resulting emotion out of a grief situation.
And I guess in times gone past, some theorists
talked about this idea of severing the attachment
with the loved one that had moved on,
in order to overcome grief.
But what we know from that is actually
that doesn't help people to manage
and learn to live with the loss that they've suffered.
and that it's far more healthy to develop
a new form of attachment to that loss.
Keep the memories of that person or thing in your mind
in order to express that in a healthy way
and develop a new relationship with that
as opposed to a complete severing of that bond.
There are lots of ways that we can support ourselves and others
when we are grieving.
And I think, we can think of those
in terms of emotional and social support,
practical support, and informational support.
In relation to emotional and social support,
listening is critical.
To be able to feel heard, to share your experiences,
no matter how crazy they may seem, is incredibly important.
Being connected, being secure, and feeling valued
can enable you to be able to share what's going on
inside for you, inside your mind
inside your body, and inside your heart.
Having people around you that can empathise
as opposed to sympathy.
So, we talk about empathy being the ability
to put yourself in the shoes of the person
that is experiencing a grief or a loss.
As opposed to sympathy being dismissive of their feelings.
Keeping in touch with people is really important,
even if you are not sure how you might behave towards them,
it is really important that you keep in communication with them.
If they're not feeling comfortable or
if they're wanting some time and space on their own,
encourage them to tell you that that is what they need.
But keep inviting people to social occasions.
Invite them for walks, invite them for coffee.
Text them.
E-mail.
Send a card.
Include them in normal, everyday activities.
Practical support is really important as well.
Things like cooking,
walking the dog,
mowing the lawns,
cleaning the windows.
Just doing things that help that person
have the space and the time that they need
to process the emotions that they're feeling.
People will experience emotions differently.
Not only in their thoughts. They might be thinking,
"Why is this happening to me?", "I'm confused",
"I don't understand", "I'm angry".
They also may be feeling a variety of different feelings around
disappointment,
betrayal,
and those can be represented also in physical manifestations.
Things like butterflies in the stomach,
a racing heart,
dry mouth,
headaches,
eating too much or not enough,
and just generally feeling unwell.
In children, it's often difficult for them
to be able to explain and express their emotions.
And so, in some children, behaviour can be difficult.
Children can regress into more child-like behaviours
as a result of not having the language to express how they're feeling.
Parents can help children by talking with them
about some of the feelings that might be going on for them.
Helping them to name or draw what those feelings might be,
and giving them the space to, and the time to, just be in the moment.
Informational support is really important as well.
People need to understand where they can access support,
what organisations might be there to assist them,
and in relation to a funeral, knowing what the process might be
and what will happen, particularly for children.
The Mental Health Education and Resource Centre here in Christchurch
has an on-site library with books, DVDs, CDs,
and a variety of resource materials
to assist people that may be experiencing a loss and grief.
Also, the Skylight organisation in Wellington
specialise specifically in loss and grief
and have a variety of organisational resources and materials to support.
In addition to that, counsellors are a really good point of contact,
and it's important that people feel that
they're able to be honest with a counsellor,
and recognise that an interpreter is there
to help that person to express their feelings and needs
in a way that is confidential, and doesn't break any bounds of confidentiality or ethical boundaries.
Change and loss also involves
the loss and change that occurs as a result of a natural disaster.
And in Canterbury recently, we have experienced just that.
The 4th of September 2010 will be a date that not many people in this area will forget.
Out of that has come a lot of anxiety for a number of people,
and from that has come grief in terms of the loss of routine,
familiarity,
homes,
and those anxiety feelings that people have experienced
have contributed to a number of issues for them.
So it is important to remember that loss and grief
occurs for a variety of different ways.
So change and loss has potential for both loss and gain.
On the loss side can be a variety of negative and down feelings.
But on the positive side, there is the potential for new opportunities and new growth.
Sometimes, out of a very negative experience can come something very positive.
In relation to a relationship breakdown, for instance,
that sometimes can result
in the creation of a new relationship that brings new opportunities.
Also, in a situation where someone is terminally ill,
the stress and the emotional anxiety around caring for a loved one
can take its toll.
And so, out of a final outcome,
out of a death, out of a moving on,
there can be some gain
in terms of the opportunity to remember the person
for who they were and the contribution that they made
and for you, yourself, to experience some relief
from the all-consuming nature of caring for that particular loved one.
That can be a positive side, as well,
not less painful,
but certainly the opportunity for a positive outcome.
When we experience a loss in our lives,
often that will result in something which can be alikened to a cut on our skin.
Over time, that cut will heal and a scab will form.
But the cut is never really healed.
Sometimes it can be knocked and that pain will return.
It will be a constant reminder of the event that occured
when that cut was created.
So in a situation of loss or grief,
the cut is something we carry with us for the rest of our life.
There is a scab that will provide some partial healing
but it is something we will learn to live with.
Similarly, we can experience the carrying of a black box.
A black box that is heavy,
that is weighted down,
that is all encompassing.
And in that situation, at times we can feel like we can't cope;
it's too much, we don't know where to turn.
Through the support of friends, family, whānau,
the church, the community,
our partners, our family,
we can shed some of those
parts of the black box that weigh us down.
And through that process, our load will be lighter.