Avoidant Grief: Is it Useful?

Grieving the loss of a loved one can be one of the most difficult experiences of our lives. We may struggle with intrusive memories, difficulty concentrating, and prolonged feelings of emptiness. We may also desperately try to block out any memories of our loved one to spare ourselves the painful feelings, also known as avoidant grief.

Avoidant Grief

However, blocking out feelings, according to a new collaborative study between Columbia Engineering and Columbia University Irving Medical Center, may ultimately exhaust our ability to cope effectively.

Using a machine-learning approach to functional magnetic resonance imaging (fMRI) called “neural decoding,” which establishes a neural pattern or fingerprint that can be used to determine when a given mental process is happening, researchers tracked the ongoing processes of mental control as loss-related thoughts came in and out of conscious awareness during a 10-minute period of mind-wandering in 29 subjects.

“The major challenge of our study was to be able ‘look under the hood’ of a person’s natural mind-wandering state to see what underlying processes were actually controlling their experience,” explains Noam Schneck, lead author of the study (Schneck, 2018).

All of the subjects in the study had lost a first-degree relative (a spouse or partner) within the last 14 months. While spontaneous fluctuations in their mental processes were monitored using fMRI, subjects performed a modified Stroop task, a test widely used in psychology to measure a person’s ability to control the contents of attention, and a separate task presenting pictures and stories of the deceased.

Schneck and his team discovered that those with more avoidant grief engaged their attentional control process to block representations of the deceased from conscious awareness (Schneck et al., 2018). Schneck explains, “Our findings show that avoidant grief involves attentional control to reduce the likelihood that deceased-related representations reach full conscious awareness. Even though they are not aware of it, avoidant grievers actively control their mental state so that spontaneous thoughts of loss do not enter their consciousness. This kind of tailoring of mind-wandering likely exhausts mental energy and leads to time periods when the thoughts actually do break through” (Schneck, 2018).

Schneck likens the process to an “ineffective pop-up blocker” that runs in the background of your computer. He says, “You might not be aware that it’s there but it slows down the overall operating speed and eventually breaks down and the pop ups get through” (Schneck, 2018).

“What we’ve shown is that outside of our conscious awareness, we are constantly editing our own mental experiences to control what does and does not get in. And this process of editing is not always helpful” (Schneck, 2018).

It is understandable that we may seek to avoid painful feelings, however, the point Schneck and his team make is that, ultimately, we cannot avoid painful feelings. As they say, “they do break through.” A better goal is perhaps to relax our conscious and unconscious mental controls of painful feelings and learn to accept them into our awareness.

Related Online Continuing Education (CE) Courses:

Grief: The Reaction to Loss is a 2-hour online continuing education (CE/CEU) course that teaches healthcare professionals how to recognize and respond to grief. Click here to learn more.

Caregiver Help: Depression and Grief is a 2-hour online video-based continuing education (CE/CEU) course that addresses caregiver depression and grief and provides strategies to help the caregiver cope. Click here to learn more.

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Georgia State Board of Occupational Therapy; the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors (#MHC-0135); the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Professional Development Resources is approved by the American Psychological Association to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for this program and its content.

PDR offers over 150 accredited online CE courses for healthcare professionals. 

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Rethinking Grief

Grief

Grief, say researchers, deserves a second look.

While we commonly associate the condition with obvious losses, the course of grief does not always follow a pattern or predictable timeline, as we might think.

Sometimes grief is complicated, and sometimes it is prolonged. For this reason, the diagnosis of persistent complex bereavement disorder (PCBD), was recently added as a condition for further study in the Diagnostic Statistical Manual of Mental Disorders, fifth edition (DSM-5).

Also referred to as prolonged grief disorder or complicated grief, PCBD is associated with long-term intense distress and suffering. It affects about seven to 15 percent of those grieving the loss of a loved one, and is typically diagnosed when persistent and severe grief continues beyond twelve months after the death of a loved one, resulting in functional impairment.

In looking to assess these criteria, Dr. Stephen Cozza and his team examined responses of study participants from USU’s National Military Family Bereavement Study, which is examining the impact of military service member death on family members. Participants included surviving family members of military members who died, by any cause, since Sept. 11, 2001.

What the researchers found should have us all reconsidering grief: even with the proposed DSM-5 criteria for PCBD, the individual’s actual experiences of clinically impairing grief were not accurately captured (Cozza et al., 2016).

What Dr. Cozza suggests is that when assessing grief, and a diagnosis of PCBD, symptoms such as prolonged distress and disability associated with the death of a loved one, persistent yearning or sorrow, and preoccupation with the deceased should be considered.

However, where a diagnosis of PCBD requires that six of twelve additional symptom criteria be required as currently proposed by DSM-5, we should be requiring a much less stringent criteria – such as meeting only one criteria. Further, the researchers encourage clinicians to remain vigilant to suicidal thinking, which is prevalent in those with persistent and impairing grief.

“It is imperative for clinicians to have reliable criteria to accurately identify and diagnose those individuals suffering from prolonged and impairing grief,” notes Dr. Cozza.

Related Online Continuing Education (CE) Courses:

Grief: The Reaction to LossGrief: The Reaction to Loss is a 2-hour online continuing education (CE/CEU) course that teaches healthcare professionals how to recognize and respond to grief.

Grief is the reaction to loss, and any kind of loss can trigger grief. People grieve for the loss of someone they love, but they also grieve for the loss of independence, usefulness, cognitive functioning, and physical abilities. Grief is also a lifelong process: a journey rather than a disease that is cured. It changes over time to deal with different kinds of losses. It is an experience that is intellectual, physical, spiritual, and emotional. It is affected by the person’s culture, support system, religious beliefs, and a host of other factors.

Grief is often not recognized by healthcare professionals, in patients or themselves. This course will teach healthcare professionals to recognize grief, as well as how to respond appropriately to the grieving person. The progression of aging and dying will be discussed in order to normalize the process, one of the most important aspects of working with a grieving person. Screening guidelines for depression, suicide risk, and grief are included, as are treatment strategies for anticipatory and complicated grief. A final section on compassion fatigue, burnout, and secondary stress includes strategies for professional self-care. Course #21-25 | 2018 | 35 pages | 15 posttest questions

Caregiver Help: Depression and GriefCaregiver Help: Depression and Grief is a 2-hour online video-based continuing education (CE/CEU) course that addresses caregiver depression and grief and provides strategies to help the caregiver cope.

The emotional stress of caring for persons who are aging, chronically ill or disabled can be debilitating for family members as well as professional caregivers. This course addresses caregiver depression and grief and provides a three-step process that can help develop an attitude of creative indifference toward the people, situations and events that cause emotional stress. It offers suggestions for dealing with preparatory grief, an experience shared by families and professionals as they cope with the stress of caring for someone who will never get well. In the process, it also explains the differences between reactionary depression and clinical depression. By gaining insights into the process of losing someone over an extended period of time, the mental health professional will be in a better position to understand the caregiver’s experience with depression and grief and provide both empathy and strategies for implementing a self-care plan. This course includes downloadable worksheets that you can use (on a limited basis) in your clinical practice. The course video is split into 3 segments for your convenience. Closeout course #20-92 | 2014 | 20 posttest questions

The Grieving SelfThe Grieving Self is a 3-hour online continuing education (CE) course that looks at stories of the bereaved to determine the major issues to address to reconnect those who grieve to a stable sense of self.
The annual number of deaths reported in the United States in the early part of this century was 2.4 million, about four per minute. This course looks at the stories of a few of those who are recently bereaved to determine the major issues for those who grieve: aloneness, loss of self, social connections, anniversaries and holidays, self and others’ expectations, the need to continue living, ambivalence of recovery, grief dreams, medical problems. Studies are reviewed which indicate some researchers’ conclusions as to: 1) Gender differences between men and women who grieve; there are important questions regarding the recruitment of subjects and the data gathering process for gender differences research. 2) And, who among the grief survivors are best served by counseling and psychotherapy. This author, while agreeing with much of the research, challenges the belief that the emotional loneliness suffered by the bereaved is the single, major dynamic of the bereaved, and can only be alleviated through passage of time. It is felt that an effort to reconnect those who grieve to a stable sense of self can help the bereaved regain better function and reduce the length of the time they are consigned to painfully distressing lives. Course #30-49 | 2010 | 34 pages | 20 posttest questions

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Our online courses provide instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

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Probiotics To Treat Depression?

By

What you eat can have a major impact on how you feel emotionally.

Probiotics to Treat DepressionA diet rich in probiotics — which support the growth of “healthy” bacteria in the gut — is known to boost digestive health and can even improve a person’s immune system. But now an increasingly robust body of evidence suggests that gut bacteria may exert a significant effect on brain function and mental health.

Probiotics are live bacteria and yeast that can be found in your body, as well as in supplements and foods fermented with live active cultures such as some yogurts, kombucha, sauerkraut, kimchi, and kefir. These “good” bacteria are known to promote digestive and immune health, and researchers are discovering that they may support mental health as well.

Once considered a fringe idea, a growing number of scientists have become interested in probiotics and prebiotics as potential treatments for anxiety, depression and other mental health problems. And in a small, new study at Leiden University, researchers found additional support for the idea: they report that among 40 healthy subjects, those who underwent four weeks of probiotic treatment showed a decrease in negative thoughts and feelings.

For the study, the researchers administered multistrain probiotics — meaning that they contained different types of bacteria — to 20 healthy participants every day for four weeks. The other 20 participants received a placebo. At the outset of the study and then again after the month had gone by, the participants filled out a questionnaire assessing sensitivity to depression.

Participants who took the probiotics were significantly less reactive to sad moods. Improving the balance of healthy bacteria in the gut seemed to have a protective effect against rumination, the type of obsessive negative thinking that often predicts depression.

The researchers don’t yet know how probiotics reduce sad mood, but it’s possible that they increase levels of plasma tryptophan, a key neurochemical involved in mood, which can be found in the gut.

“Unquestionably, further research needs to be carried out,” the study’s lead author, Dr. Lorenza Colzato of Leiden University, told The Huffington Post in an email. “But the hope is that probiotics supplementation may work as a potential and effective preventive strategy for depression.”

Boosting healthy bacteria in the gut may also be an effective way to treat anxiety. In a recent study, neuroscientists at Cambridge University found a short course ofprebiotics — non-digestible dietary fiber that act as food for good bacteria — to have an anti-anxiety effect, lessening study subjects’ emotional responses to negative stimuli.

“It is likely that these compounds will help to manage mental illness,” the study’s lead author, Oxford neurobiologist Dr. Philip Burnet, told The Huffington Post in January. “They may also be used when there are metabolic and/or nutritional complications in mental illness, which may be caused by long-term use of current drugs.”

Leiden University’s findings were published in the journal Brain, Behavior and Immunity.

Source: http://www.huffingtonpost.com/2015/04/17/probiotics-depression_n_7064030.html?ncid=newsltushpmg00000003

Related Online Continuing Education (CE/CEU) Courses:

Depression is a 1-hour online continuing education (CE/CEU) course that provides an overview to the various forms of depression, including signs and symptoms, co-existing conditions, causes, gender and age differences, and diagnosis and treatment options.

Depression: What You Must Know is a 2-hour online continuing education (CE/CEU) course that provides in depth information about the diagnosis and treatment of depression in a simple, straightforward way.

Clergy Stress and Depression is a 4-hour online CEU course that provides clinicians with an understanding of the complex factors that cause stress and depression in clergy, along with recommendations for prevention and treatment.

Caregiver Help: Depression and Grief is a 2-hour online video-based continuing education (CE/CEU) course that addresses caregiver depression and grief and provides a three-step process that can help develop an attitude of creative indifference toward the people, situations and events that cause emotional stress.

Nutrition in Mental Health & Substance Abuse is a 3-hour online continuing education (CE/CEU) course that discusses how good nutrition impacts a person’s mental health and well being.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for all programs and content. Professional Development Resources is also approved by the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the California Board of Behavioral Sciences; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board; the South Carolina Board of Professional Counselors & MFTs; and by theTexas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.

Caregiver Help: Depression and Grief

By: Elaine K. Sanchez and Alex A. Sanchez, EdD

The emotional stress of caring for persons who are aging, chronically ill or disabled can be debilitating for family members as well as professional caregivers.

Caregiver Help: Depression and GriefCaregiver Help: Depression and Grief is a new 2-hour online video-based continuing education (CE/CEU) course that addresses caregiver depression and grief and provides a three-step process that can help develop an attitude of creative indifference toward the people, situations and events that cause emotional stress. It offers suggestions for dealing with preparatory grief, an experience shared by families and professionals as they cope with the stress of caring for someone who will never get well. In the process, it also explains the differences between reactionary depression and clinical depression. By gaining insights into the process of losing someone over an extended period of time, the mental health professional will be in a better position to understand the caregiver’s experience with depression and grief and provide both empathy and strategies for implementing a self-care plan. This course includes downloadable worksheets that you can use (on a limited basis) in your clinical practice. Course #20-92 | 2014 | 20 posttest questions

This online video streaming course provides instant access to the course video, course handout and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. You can print the test (download test from My Courses tab of your account) and mark your answers on while viewing the video. Then submit online when ready to receive credit.

CE INFORMATION:

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the California Board of Behavioral Sciences (#PCE1625); the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

ABOUT THE AUTHORS:

Elaine K. Sanchez is an author, speaker and co-founder of CaregiverHelp.com. She co-teaches “Gero 407- Caregiving” at Western Oregon University with her husband Alex, and she writes the daily blog, “Caregiver Help Word of the Day.” She is the author of four books, including Letters from Madelyn, Chronicles of a Caregiver and contributes articles regularly to CaringTimes, Griswold Home Care’s blog.

Alex A. Sanchez, EdD, is the co-founder of CaregiverHelp.com, a video-based caregiver support program, and currently co-teaches “Gero 407- Caregiving” with Elaine at Western Oregon University. He earned his Master’s in Counseling and his Doctorate in Educational Psychology at New Mexico State University. He retired from Oregon State University in 2012, after teaching a doctoral program in Community College Leadership for 15 years. Previously he served as President of Central New Mexico Community College in Albuquerque, NM, President of Rio Hondo College in Whittier, CA, Vice President for Community and International Programs at the University of New Mexico, Academic Dean at New Mexico Military Institute, and Founding Director of Dona Ana Community College in Las Cruces, NM.