and suicide Spiritual Care Association 2020 Annual Meeting Santa Fe New Mexico Presented by G Jay Westbrook Advanced Grief Recovery Specialist Clinical Director Compassionate Journey Author ID: 908271
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Slide1
Grief Recovery’s Role in Preventing Elder Substance Abuse and suicide
Spiritual Care Association
2020 Annual Meeting
Santa Fe, New Mexico
Slide2Presented by
G Jay Westbrook Advanced Grief Recovery Specialist Clinical Director, Compassionate JourneyAuthor:
Compassionate Journeys: Lessons From My Work with the Dying
www.CompassionateJourney.com
Calista
Anderson
Advanced Grief Recovery Specialist
www.LivingBeyondGrief.net
Slide3introduction
Knock Knock CD/DC Buddhists say …Intention: Grief in general/Grief Recovery specifically
Case Studies:
Frank & Betty – know God
Three Generations of Dying – no God
Slide4Substance use disorder
[Substance Abuse/Addiction/Alcoholism]Questions – who drinks more? priests, ministers, rabbis, or chaplains
physicians or nurses
general population or mature adults
country w greatest per capita liquor consumption?
Slide5Substance use disorder
Definition-a primary disease, a bio-psycho-social-spiritual progressive and incurable brain disorder terminal, but
…
d
isease without blame, but not …
Characterized by-
obsession and cravings
impaired control over use
compulsive use
continued use despite harm
Slide6Substance use disorder
Causes- In mature adults, late-onset SUD associated with GRIEF isolation
loneliness
Slide7Substance use disorder
Costs- multi-dimensionalhealth emotional social financialbehavioral functional spiritual
destroys
…
i
ndividuals families communities
Slide8Substance use disorder
Myths – re: the older adultappearance her only pleasurehelps her sleep
can’t teach an old dog new tricks
not hurting anyone but herself
she’s earned the right
impotence
bottle of red wine/day is good for the heart
Slide9Substance use disorder
Characteristics:dishonest immature grandiosedefiant arrogant entitledimpulsive rigid denying
manipulative sneaky close-minded
Self:
sabotaging loathing pitying
justifying seeking righteous
Slide10substance use disorder
Why SUD goes Undiagnosed: Invisible R/T isolation3 Ms: masked/mistaken/misidentified
falling/slurring/seizures/inability to remember
Lack of screening
Slide11substance use disorder
Huge Complicating IssueRemoval of solution (substance) without intervention for: GRIEF/loneliness/isolation
Slide12Substance use disorder
Perspective: Judgment vs. Mercy Head vs. Heart Separates vs. Unites
Wounds vs. Heals
Touching Pain w Fear vs. Touching Pain w Love
Slide13Substance use disorder
Approaches:Contracting, with patients12-StepHarm reduction
Intervention - ultimatum-driven or eulogy-driven
Detox
Treatment
Sober living
But
…
Slide14suicide
Definitionthe act of intentionally causing one’s own death not as clear as it might seem
Slide15suicide
U.S. Stats: 130-150/day females attempt 3X as often as males males are 4X as successful as females
success: young – 4% elderly – 25%
White 85+ males suicide at 4X general population
Whites & Native Americans @ 14.7 & 10.9/100K
Hispanics/Asians/Blacks @ 6.3 - 5.9 - 5.5/100K
people w SMI die of S at 12X general population rate
rural rate > urban rate (19.7 – 16.7 – 12.7)
Slide16suicide
Methods Internationally: hanging intentional pesticide ingestion
US:
firearms
Slide17Suicide
Perspectives:not hurting anyone but me sinpermanent solution to temporary problem
9/11
we’re all
gonna
die – just want it on my terms
wouldn’t let my dog
sufffer
, so why should I have to?
-survivor: selfish, weak, cowardly
person who took their life: selfless, strong, courageous
how could they do that to their family?
Slide18suicide
Types – less likely in the elderly (8):mass SS pactscopy-cat S – (first provides implicit permission)
honor S –
Harakiri
(avoid dishonor) Kamikaze (honor)
S by cop
martyr S
punishment S
attentional
S
Slide19suicide
Types – more likely in the elderly (6): traditional Sassisted S
homicide/suicide
altruistic S
joining or re-uniting S
rx
-driven S
Slide20suicide
Factors associated with S:MI (Tx & 0 TX) grief prior attempts
substance abuse vanity hopelessness
suffering humiliation avoidance
impatience impulsivity 0 support sys.
meaninglessness identity crisis S as honorable
being/avoiding burden v
QoL
/FI 0 resilience
invisible/impotent they’ll be better off without me
unwilling to ask for help
pain that exceeds one’s coping resources
Slide21suicide
Cultural Mixed Messagesdenigrate person who took their life, butchampion Thelma & Louise and Dr. Jack Kevorkian
Pro life and pro death penalty
Pro pet euthanasia and anti medical aid in dying
Slide22suicide
Interventions: therapy w/wo
rx
evolution of hope
SUD recovery $100 teach coping skills
normalizing reframing peer counseling
provide
opps
for creating meaning & connection
“Zero Suicide” - systemic
Crisis line – no crisis if I’ve already found solution (S)
Help line – may not want help
spiritual principles w/
wo
God
Grief Recovery
Slide23bridge
So, if Grief is a primary driver of late-onset Substance Abuse, with or without Suicide, let’s talk about Grief in general, and Grief Recovery specifically
Slide24Grief
Definitionnormal & natural reaction to lossdeath-related, including behaviors around the death non-death-related
…
Distinguish from mourning
the expression of grief
Slide25grief
Costs of unresolved grief: healthcognitivesocial
emotional
behavioral
spiritual
Slide26grief
Barriers to healing into wholeness: asynchronicity (of depth, timing, pace, expression): between losses
between people
Slide27grief
Barriers to healing into wholeness:fear of: who I’ll become if I recover what others will think if I recover
Slide28grief
Barriers to healing into wholeness:The words of others(well-intended, but hurtful, enraging, or frightening)
that dismiss or minimize my loss
that impose a silver lining
intellectual response to a broken heart
examples
Slide29grief
Barriers to healing into wholeness:what we’re taughtto acquire, but not to cherish or lose
responsibility for and/or guilt over the death
you make me so mad/proud/etc.
you’re going to be the death of me
Jackson
Slide30grief
Barriers to healing into wholeness:Kubler-Ross DABDA Stages
Slide31grief
Barriers to healing into wholeness:Myths:don’t feel bad – replace the lossgrieve alone
be strong for others
stay busy
time heals all wounds – just give it time
compare the loss
Slide32grief
Approaches: just give it timetherapygrief support groups
Grief Recovery
Slide33Grief support groups
What are they?scheduled gatherings - ongoing or time-limited professionally facilitated, or not
grievers support one another as they discuss:
feelings & experiences of grief
tools & techniques for self-care & rejoining life
Slide34Grief support groups
Positivescan provide community can normalize early grief experiences usually free or low-cost
“safe” - don’t require much of the griever
can be a springboard for new relationships
Slide35Grief support groups
Negativescan keep the griever stuckcan reinforce Stages & Myths don’t provide meaningful & lasting transformation
provide identification, but little recovery
reinforce & reward the griever identity
Slide36Grief recovery
What is it?an evidence-based method comprised of a set of action-based steps by which trained & certified GR Specialists
guide a griever to completion of their loss
leading to meaningful & lasting transformation
and unencumbered re-engagement with life
Slide37Grief recovery
Heals the griever’s wishes: that a relationship had been better, different or more of hopes/dreams/expectations for a future that won’t be
about words left unspoken
to heal relationships they thought would keep them in pain for the rest of their lives
Slide38Grief recovery
Negativesdoesn’t provide community if engaged in 1:1requires work by the griever results are dependent on completion of the work
requires a financial investment (similar to therapy)
Slide39Grief recovery
Positivescan provide community if engaged in via a group time-limitedleads to meaningful & lasting transformation
fosters full re-engagement with life
deals with loss directly
completes the relationship
opens door to completing other life-long losses
evidence-based
replaces overwhelming grief w sweet sadness & fondness
Slide40Grief recovery
For more info: if you’re a griever seeking healing & recovery: www.CompassionateJourney.com
www.LivingBeyondGrief.net
if you’re interested in becoming a trained & certified Grief Recovery Specialist:
www.GriefRecoveryMethod.com
Slide41resources
Suicide Prevention Line – 800/273-8255 Friendship Line – 800/971-0016
Text Line – 741741
G Jay Westbrook – 818/458-8929
www.CompassionateJourney.com
Compassionate Journeys: Lessons From My Work with the Dying
Calista
Anderson – 323/475-1080
www.LivingBeyondGrief.net
www.GriefRecoveryMethod.com
- training & certification
Slide42questions
Questions & Answers Thank You