DOCSLIB.ORG

Perinatal Grief – a Profound and Complex Process by Cathy Quinn

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Perinatal Grief – a Profound and Complex Process by Cathy Quinn IJCP Volume 20 • Issue 3 • Autumn 2020 Practitioner Perspective Perinatal Grief – A Profound and Complex Process By Cathy Quinn This article provides an overview of the multiple facets of perinatal grief and the grieving process. It explores the key concepts of continuing bonds and the complexity of disenfranchised grief. It also reflects briefly on the significance of creating a safe empathetic space. Perinatal death in perspective In the past, the predominant culture of maternity hospitals and society in general tended to minimise or even ignore the existence of perinatal grief. Today compassionate approaches to care are slowly but positively transforming the landscape and culture of how we care for this umerous studies demonstrate that grief following vulnerable group of parents, for Na baby’s death is frequently minimised and may example the introduction of the go unacknowledged by society. These findings challenge National Standards for Bereavement Care following Pregnancy Loss and us not only to grasp the significant impact of the Perinatal Death (Health Service sociocultural dynamics woven into perinatal grief but Executive (HSE), 2016). also to create an empathetic therapeutic relationship, In 2016, a total of 227 babies were stillborn and 124 babies wherein bereaved parents are truly understood died within the first week of life in Ireland (Healthcare Pricing “When you are understood, you are born alive but dies within the first Office & HSE, 2018). Miscarriage at home. Understanding nourishes week of life. The profound grief occurs in approximately one- belonging. When you really feel experienced by parents following fifth of pregnancies equating to understood, you feel free to miscarriage or the death of their approximately 14,000 miscarriages release your self into the trust and baby is considered a complex per year in Ireland (Poulose, shelter of the other person’s soul” emotional response (Fenstermacher Richardson, Ewings & Fox, 2006). (O’Donohue, 1997, p. 13-14) & Hupcey, 2013). However, the Concealed in these statistics are majority of bereaved parents will an enormous number of bereaved Introduction experience a normal grief reaction parents and their families who erinatal grief embraces the grief with the support of family and undeniably will require empathetic Pexperienced by parents following friends (McSpedden, Mullan, care and support. miscarriage, following a diagnosis Sharpe, Breen, & Lobb, 2017). during pregnancy of a baby with Additional support may be sought Multiple facets of perinatal grief a life-limiting condition, when a from advocacy groups, while some To empathise fully with bereaved baby is stillborn or when a baby is parents may attend counselling. parents’ experience of perinatal 14 Irish Association for Counselling and Psychotherapy Volume 20 • Issue 3 • Autumn 2020 IJCP grief, the counsellor needs to impact of their baby’s death recognise the multiple facets of nforming parents of the on their relationship; they may perinatal death that are woven Iindividuality of grief is struggle to find the emotional into the tapestry of grief and helpful; although they are resilience to help each other undoubtedly impact the parents’ both grieving as parents of while they are individually coping grief response. the same baby, each parent with their own grief. Studies have Perinatal grief is unique given may grieve differently and shown that parents who share that most mourning is retrospective and communicate their grief whereas perinatal grief is are rarely synchronised in report less severe grief reactions prospective mourning i.e. parents their grief and greater partner satisfaction have to relinquish hopes, wishes (Cacciatore et al. 2008; Buchi and dreams about a future together et al. 2009; Avelin, Radestad, with their anticipated baby (Leon, and anxiety symptoms following S¨aflund, Wredling, & Erlandsson, 1990). They grieve for what might perinatal death (Blackmore et al. 2013). In contrast, other studies have been, a future with their baby 2011; Cheung, Hoi-yan, & Hung-yu, have identified perinatal death suddenly vanishes when unfulfilled 2013; Christiansen, Elklit, & Olff, as a risk factor for relationship dreams and expectations are 2013; McSpedden et al. 2017). break-down (Gold, Sen, & Hayward, crushed. Seeing live healthy babies of 2010; Shreffler, Hill, & Cacciatore, A baby’s death goes against family and friends may be difficult 2012). Informing parents of the the natural sequence of life for parents; particularly in the early individuality of grief is helpful; events, is frequently unexpected stages of grief; they may struggle although they are both grieving as and the cause of death may be to cope with painful feelings or parents of the same baby, each unexplained. Furthermore, there are avoid situations, which can lead to parent may grieve differently and no formal funeral or burial rituals isolation. are rarely synchronised in their for babies usually associated with Parents may also be fearful and grief. Encouraging parents to share other deaths which may limit social doubt their ability to have a live their feelings may help them to acknowledgement and support. healthy baby in the future. Well- understand each other’s unique Consistent feelings of guilt, meaning family and friends and reactions and ultimately avert or shame and failure, combined society in general may sometimes lessen tensions that may develop with self-blame and low self- assume that a subsequent in their relationship. Open, honest, esteem, may dominate the pregnancy will instantly heal communication with their surviving parents’ landscape of grief (Barr the parents’ grief, resulting in children is also encouraged. & Cacciatore, 2007; Wonch Hill, diminished opportunities for Grieving the death of a baby of a Cacciatore, Shreffler, & Pritchard, parents to share their true feelings multiple birth is a complex process 2017). A study conducted by (Markin, 2016; Meaney et al. 2017) for families (Richards, Graham, Meaney, Everard, Gallagher and In the midst of the parents’ Embleton, Campbell, & Rankin, O’Donoghue, (2017) revealed that grief, the focus of support may 2015). Parents often experience bereaved parents experienced a be directed solely towards the a rollercoaster of conflicting sense of failure which battered mother’s needs which may emotions: grief for the baby who their self-esteem and mothers in lead to the father’s grief going has died, as well as hopes and particular felt guilty and blamed unacknowledged by society. Fathers fears for their vulnerable baby/ themselves for their baby’s death. may feel they have to be stoic babies who survive. Parents may These complex, intrusive feelings and society may dictate this. In keep their emotions on hold while of shame, failure and guilt may a study by Meaney et al. (2017) caring for the surviving baby and a impede the grieving process and fathers reported that they had to be strong grief reaction may emerge damage a vulnerable self-esteem, strong emotionally, at times putting weeks, months or even years later thereby increasing the risk of their own grief on hold in order to (Richards et al. 2015) complicated grief (Markin, 2017). support their partner. Validation Early and late miscarriage may be Counsellors should be alert to and acknowledgement of the experienced as a highly traumatic pathological symptoms of grief father’s grief experiences and his loss for many women, yet it may be that may arise as several studies fatherhood is essential (Cacciatore, minimised and go unacknowledged have reported elevated levels of DeFrain, Jones, & Jones, 2008). by society (Gerber-Epstein, complicated grief, post-traumatic Another challenge that bereaved Leichtentritt, & Benyamini, 2009; stress disorder, depression parents have to negotiate is the Murphy & Merrell, 2009; Sejourne, Irish Association for Counselling and Psychotherapy 15 IJCP Volume 20 • Issue 3 • Autumn 2020 Callahan, & Chabrol, 2010). Lack grief reaction and an obstacle to of tangible mementos, especially he deceased baby successful grief resolution (Klass, in early pregnancy loss, limited Tis both present and Silverman, & Nickman, 1996). The empathy and support from family absent; there is a physical general consensus among grief and friends with few opportunities letting go of the deceased theorists echoed a belief that in to engage in culturally recognised baby but at the same order to resolve their grief, it was mourning rituals, which may lead to time keeping hold of the necessary for the bereaved to sever social isolation and disenfranchised bonds by detaching themselves grief (Kersting, & Wagner, 2012; connection or the bond emotionally from the deceased Bellhouse, Temple-Smith, & Bilardi, person. 2018). with the changes that occur as a It was Klass (1988) who first Parents who decide to terminate consequence of the baby’s death. reported that bereaved parents their pregnancy when their baby They are faced with the challenges maintained a bond with their is diagnosed with a life-limiting of readjusting to their changed deceased baby. However, he condition may experience higher world without their baby; learning did caution that it may not be levels of self-blame, guilt, and to live with the death in the face of representative of all bereaved social isolation (Maguire, 2015). bereavement and rebuilding their parents (Klass, 2006). He They may seek counselling, feeling lives by creating a new normal. supported the theory that a baby’s unsupported or stigmatised and Oscillation between the two types
Load more

Recommended publications
  • Emotional Fortitude: the Inner Work of the CEO
    FEATURE Emotional fortitude The inner work of the CEO Benjamin Finzi, Mark Lipton, Kathy Lu, and Vincent Firth Emotional fortitude: The inner work of the CEO Emotional fortitude—the ability to stay clear-headed while exploring one’s emotional reactions to sources of tension—can improve a CEO’s resilience to the stressors of decision-making and lead to better decision outcomes. HETHER AT A large, established firm or a work” that effective CEOs perform as they journey fast-growing one, making decisions through the decision-making process and live with Wwhile staring disruption in the face may the consequences. be the most grueling element of being a CEO. Data feels insufficient. Assumptions feel tenuous. Options feel How can CEOs increase their constrained. Timing feels rushed. chances of making an optimal Outcomes feel binary: The decision either takes the organization in the right decision when all of the direction or the wrong one. alternatives may not be known, Yet executives—particularly CEOs—are when time is not on their side, expected to be the most qualified people in their organization to make decisions. and when emotions play a central CEOs, perhaps more than those in any role before, during, and after the other executive role, feel enormous pressure to get it “right.” Even the most decision is made? level-headed CEO is apt to experience sleepless nights and personal doubts about the choices they make and the consequences The intellectual and emotional that result. If the decision ultimately proves to be a tensions of perilous decisions poor one, there is no one else to blame.
    [Show full text]
  • The Effect of Anxiety and Emotional Intelligence on Students’ Learning Process
    Journal of Education & Social Policy ISSN 2375-0782 (Print) 2375-0790 (Online) Vol. 1, No. 2; December 2014 The Effect of Anxiety and Emotional Intelligence on Students’ Learning Process Sara Hashempour Faculty of Human Ecology Universiti Putra Malaysia Serdang, Selangor Darul Ehsan, 43400 Aida Mehrad Faculty of Human Ecology Universiti Putra Malaysia Serdang, Selangor Darul Ehsan, 43400 Abstract A lot of teachers don’t know what exactly anxiety and emotional intelligenceare and how they can impact on student’s learning. Academic Anxiety will be happened amongst students when they feel intense worry about upcoming and previous incidence, too much self-concern and high focus on acting proficiently or they motivate by various items. Students with high level of anxiety most of the time misinterpreted or overstated the importance of the situation. If the situation is not managed correctly negative consequences may happen. In addition, students that show emotional intelligence toward different items can growth their skills in educational situation. Various expressions have been used to describe experience of emotional intelligence and academic anxiety. This study, talk over the relation of those terms associated with characterizing and conceptualizing of working memory, emotional intelligence and learning process. Keywords:Anxiety, Emotional intelligence, Working Memory, Student’s learning 1.1. Introduction Anxiety is a natural human reaction, and it works as an important psychological function that is felt by many people regardless of age. All children experience anxiety as an alarm system that is activated whenever they perceive situation as dangerous, embarrassing or stressful, in these situations anxiety can help them to better manage the events, while low and controllable level of anxiety can be beneficial, high level of anxiety may negatively impact one’s social and personal relationships, and cause physical and emotional problems.
    [Show full text]
  • Effects of Worry on Physiological and Subjective Reactivity to Emotional Stimuli in Generalized Anxiety Disorder and Nonanxious Control Participants
    Emotion © 2010 American Psychological Association 2010, Vol. 10, No. 5, 640–650 1528-3542/10/$12.00 DOI: 10.1037/a0019351 Effects of Worry on Physiological and Subjective Reactivity to Emotional Stimuli in Generalized Anxiety Disorder and Nonanxious Control Participants Sandra J. Llera and Michelle G. Newman Pennsylvania State University The present study examined the effect of worry versus relaxation and neutral thought activity on both physiological and subjective responding to positive and negative emotional stimuli. Thirty-eight partic- ipants with generalized anxiety disorder (GAD) and 35 nonanxious control participants were randomly assigned to engage in worry, relaxation, or neutral inductions prior to sequential exposure to each of four emotion-inducing film clips. The clips were designed to elicit fear, sadness, happiness, and calm emotions. Self reported negative and positive affect was assessed following each induction and exposure, and vagal activity was measured throughout. Results indicate that worry (vs. relaxation) led to reduced vagal tone for the GAD group, as well as higher negative affect levels for both groups. Additionally, prior worry resulted in less physiological and subjective responding to the fearful film clip, and reduced negative affect in response to the sad clip. This suggests that worry may facilitate avoidance of processing negative emotions by way of preventing a negative emotional contrast. Implications for the role of worry in emotion avoidance are discussed. Keywords: generalized anxiety disorder,
    [Show full text]
  • A Confucian Defense of Shame: Morality, Self-Cultivation, and the Dangers of Shamelessness
    religions Article Article Article A ConfucianA Confucian Defense Defense of Shame: of Shame: Morality, Morality, Self-Cultivation, Self-Cultivation, A Confucian Defense of Shame: Morality, Self-Cultivation, and theand Dangers the Dangers of Shamelessness of Shamelessness and the Dangers of Shamelessness Mark BerksonMark Berkson Mark Berkson Department of Religion,Department Hamline of Religion, University, Hamline St. Paul, University, MN 55104, St. USA;Paul, [email protected] 55104, USA; [email protected] Department of Religion, Hamline University, St. Paul, MN 55104, USA; [email protected] Abstract: ManyAbstract: philosophers Many and philosophers scholars in and the scholars West have in the a negative West have view a negative of shame. view In muchof shame. In much of Abstract: Many philosophers and scholars in the West have a negative view of shame.of post-classical In much ofpost-classical Western ethical Western thought, ethical shame thought, is compared shame is negativelycompared negatively with guilt, with as shame guilt, isas shame is asso- post-classical Western ethical thought, shame is compared negatively with guilt, asassociated shame is asso- withciated the “outer”, with the how “outer”, one appears how one before appears others before (and othe thusrs is (and merely thus a is matter merely of a “face”), matter of “face”), and ciated with the “outer”, how one appears before others (and thus is merely a matterand of “face”), guilt is and associatedguilt is associated with the “inner”with the realm “inner” of therealm conscience of the conscience and soul. and Anthropologists soul. Anthropologists and and philoso- guilt is associated with the “inner” realm of the conscience and soul.
    [Show full text]
  • Term Toxic Shame Being Mirrored by One
    Donald Bradshaw Nathanson Coined the The compass of term toxic shame. shame Four universal Mark Epstein, Pema Chodron, Being behaviors to Kevin Griffin Karen Horney mirrored defend against Abiding difficult emotions to observe and learn . Four major by one shame. The Idea of PRACTICE and Right View being wise idea that when aempts of Gershen Kaufman non- or attuned. Led to Present with Self and Present with avoiding shame Find the entrances to shaming the neuro2c Others and Wise-Self you are bigger individual to governing scenes. person than or less than Whenever we are makes all come to others. Says, to soluon able to observe upon the learn from our our experience, we difference shame and "Just immediately detach love yourself." from it. Brene Brown Silvan Thomas Tony Webb Empathy opposite of Scheff/Helen Tomkins Virginia Satir The social aspects of shame; judge in Lewis Block Emotions the compass of Four coping areas most Disrupts bond are shame -- aggression, vulnerable to shame; motivators. stances: depression, isolation, Humiliated Placating, judging numbs-easier Affect and addiction. fury. Blame, Being than loss/grief; pre- Acknowledge theory: Alienation and Super- aggression broader frontal cortex off in shame then Scripts are shame. connection to begun as Reasonable, social results from Perfectionism. others soon as we Being Irrelevant avoiding shame. 'Good' shame as restored. are born. humility. Show deference to others. What does acknowledged shame look like? What is attunement? Shame-anger spirals. Governing Scenes Gershen
    [Show full text]
  • Guilt, Shame, and Grief: an Empirical Study of Perinatal Bereavement
    Guilt, Shame, and Grief: An Empirical Study of Perinatal Bereavement by Peter Barr 'Death in the sickroom', Edvard Munch 1893 A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy Centre for Behavioural Sciences Faculty of Medicine University of Sydney November, 2003 Preface All of the work described in this thesis was carried out personally by the author under the auspices of the Centre for Behavioural Sciences, Department of Medicine, Faculty of Medicine, University of Sydney. None of the work has been submitted previously for the purpose of obtaining any other degree. Peter Barr OAM, MB BS, FRACP ii The investigator cannot truthfully maintain his relationship with reality—a relationship without which all his work becomes a well-regulated game—if he does not again and again, whenever it is necessary, gaze beyond the limits into a sphere which is not his sphere of work, yet which he must contemplate with all his power of research in order to do justice to his own task. Buber, M. (1957). Guilt and guilt feelings. Psychiatry, 20, p. 114. iii Acknowledgements I am thankful to the Department of Obstetrics and Department of Neonatology of the following hospitals for giving me permission to approach parents bereaved by stillbirth or neonatal death: Royal Prince Alfred Hospital, Royal Hospital for Women, Royal North Shore Hospital and Westmead Hospital. I am most grateful to Associate Professor Susan Hayes and Dr Douglas Farnill for their insightful supervision and unstinting encouragement and support. Dr Andrew Martin and Dr Julie Pallant gave me sensible statistical advice.
    [Show full text]
  • Applying ACT to Cases of Complex Depression: New Clinical And
    ApplyingApplying ACTACT toto CasesCases ofof ComplexComplex Depression:Depression: NewNew ClinicalClinical andand ResearchResearch PerspectivesPerspectives PartPart I:I: DepressionDepression withwith PsychosisPsychosis andand SuicidalitySuicidality Brandon Gaudiano, Ph.D. Assistant Professor of Psychiatry Grant Support: NIH K23 MH076937 OutlineOutline ¾¾ ClinicalClinical FeaturesFeatures ofof PsychoticPsychotic DepressionDepression ¾¾ ACTACT forfor PsychosisPsychosis ResearchResearch ¾¾ TreatmentTreatment DevelopmentDevelopment ProjectProject ¾¾ ClinicalClinical ConsiderationsConsiderations ¾¾ CaseCase ExampleExample DepressionDepression withwith hallucinationshallucinations and/orand/or delusionsdelusions PsychoticPsychotic DepressionDepression ¾ PrevalencePrevalence ratesrates z 15-19% of individuals with depression have hallucinations or delusions (Ohayon and Schatzberg, 2002) z Up to 25% of depressed hospitalized patients (Coryell et al., 1984) ¾ PsychoticPsychotic depressiondepression cancan bebe difficultdifficult toto diagnosediagnose andand treat:treat: z psychotic features in mood disorders can be more subtle than those found in patients with primary psychotic disorders ¾ PsychoticPsychotic depressiondepression cancan bebe difficultdifficult toto diagnosediagnose andand treat:treat: z psychotic features in mood disorders can be more subtle than those found in patients with primary psychotic disorders z patients often underreport psychotic symptoms due to embarrassment or paranoia ¾ PsychoticPsychotic depressiondepression cancan
    [Show full text]
  • Emotional Doubt and Divine Hiddenness
    Eruditio Ardescens The Journal of Liberty Baptist Theological Seminary Volume 1 Issue 2 Volume 1, Issue 2 (Spring 2014) Article 1 5-2014 Emotional Doubt and Divine Hiddenness A. Chadwick Thornhill Liberty University Baptist Theological Seminary Follow this and additional works at: https://digitalcommons.liberty.edu/jlbts Part of the Practical Theology Commons, and the Religious Thought, Theology and Philosophy of Religion Commons Recommended Citation Thornhill, A. Chadwick (2014) "Emotional Doubt and Divine Hiddenness," Eruditio Ardescens: Vol. 1 : Iss. 2 , Article 1. Available at: https://digitalcommons.liberty.edu/jlbts/vol1/iss2/1 This Article is brought to you for free and open access by Scholars Crossing. It has been accepted for inclusion in Eruditio Ardescens by an authorized editor of Scholars Crossing. For more information, please contact [email protected]. Emotional Doubt and Divine Hiddenness A. Chadwick Thornhill* Emotionally motivated doubts concerning one’s religious faith can generate severe pain and anxiety in the life of a believer. These doubts may generate both emotional and physical problems that also significantly affect their health. Os Guinness in speaking of this type of doubt asserts, “no one is hurt more than the doubter. Afraid to believe what they want to believe, they fail to believe what they need to believe, and they alone are the losers.” 1 While recent Christian scholarship has begun to be more attentive to this issue as it pertains to addressing the emotional doubts of the church community, much more work needs to be done concerning this prevalent issue. One issue in particular which may motivate emotional doubt and permit it to fester is that of divine hiddenness, or the silence of God.
    [Show full text]
  • About Emotions There Are 8 Primary Emotions. You Are Born with These
    About Emotions There are 8 primary emotions. You are born with these emotions wired into your brain. That wiring causes your body to react in certain ways and for you to have certain urges when the emotion arises. Here is a list of primary emotions: Eight Primary Emotions Anger: fury, outrage, wrath, irritability, hostility, resentment and violence. Sadness: grief, sorrow, gloom, melancholy, despair, loneliness, and depression. Fear: anxiety, apprehension, nervousness, dread, fright, and panic. Joy: enjoyment, happiness, relief, bliss, delight, pride, thrill, and ecstasy. Interest: acceptance, friendliness, trust, kindness, affection, love, and devotion. Surprise: shock, astonishment, amazement, astound, and wonder. Disgust: contempt, disdain, scorn, aversion, distaste, and revulsion. Shame: guilt, embarrassment, chagrin, remorse, regret, and contrition. All other emotions are made up by combining these basic 8 emotions. Sometimes we have secondary emotions, an emotional reaction to an emotion. We learn these. Some examples of these are: o Feeling shame when you get angry. o Feeling angry when you have a shame response (e.g., hurt feelings). o Feeling fear when you get angry (maybe you’ve been punished for anger). There are many more. These are NOT wired into our bodies and brains, but are learned from our families, our culture, and others. When you have a secondary emotion, the key is to figure out what the primary emotion, the feeling at the root of your reaction is, so that you can take an action that is most helpful. .
    [Show full text]
  • Worry Is Rarely Helpful, and Is Often Counter- Productive
    BEHAVIOUR orry has become a ourselves to act responsibly. ‘People think modern-day epidemic, worry is helpful,’ he says. ‘They think “I need infecting our lives with to worry to be protected” – they look at it as a THERE’S NO different strains – from way of avoiding a problem.’ Yet worry is rar- SUCH THING AS A sweating the small stuff ely helpful, and is often counter-productive. BORN WORRIER W(did I lock the car?) to imagining the worst Leahy distinguishes between productive 1 ‘I worry about everything. I always (is this headache a brain tumour?). worry – the concerns that prompt us to act have,’ says Eileen, 42, a healthcare And it’s a habit we are teaching our children: – and unproductive ‘what-if’ worry, when we manager from Nottingham. But research shows that today, levels of anxiety imagine worst-case scenarios. ‘What-if’ wor- is there such a thing as a ‘born in high school students in the US are as high rying often occurs because we overthink worrier’? According to personal as those of psychiatric patients in the 1950s, situations and feel a need to control the uncon- construct psychology, worry is a while the UK’s Mental Health Foundation esti- trollable. The key is to isolate what we can behaviour, not a personality trait. mates that 10 per cent of us are likely to have a control and to rigorously question just how ‘What determines our behaviour disabling anxiety disorder at some point. Mean- plausible are our other concerns. Challenging is not what happens to us but while, research shows that women are more irrational worries in this way exposes just how we interpret it,’ explains likely than men to brood on their worries.
    [Show full text]
  • Acute Stress Disorder
    Trauma and Stress-Related Disorders: Developments for ICD-11 Andreas Maercker, MD PhD Professor of Psychopathology, University of Zurich and materials prepared and provided by Geoffrey Reed, PhD, WHO Department of Mental Health and Substance Abuse Connuing Medical Educaon Commercial Disclosure Requirement • I, Andreas Maercker, have the following commercial relaonships to disclose: – Aardorf Private Psychiatric Hospital, Switzerland, advisory board – Springer, book royales Members of the Working Group • Christopher Brewin (UK) Organizational representatives • Richard Bryant (AU) • Mark van Ommeren (WHO) • Marylene Cloitre (US) • Augusto E. Llosa (Médecins Sans Frontières) • Asma Humayun (PA) • Renato Olivero Souza (ICRC) • Lynne Myfanwy Jones (UK/KE) • Inka Weissbecker (Intern. Medical Corps) • Ashraf Kagee (ZA) • Andreas Maercker (chair) (CH) • Cecile Rousseau (CA) WHO scientists and consultant • Dayanandan Somasundaram (LK) • Geoffrey Reed • Yuriko Suzuki (JP) • Mark van Ommeren • Simon Wessely (UK) • Michael B. First WHO Constuencies 1. Member Countries – Required to report health stascs to WHO according to ICD – ICD categories used as basis for eligibility and payment of health care, social, and disability benefits and services 2. Health Workers – Mulple mental health professions – ICD must be useful for front-line providers of care in idenfying and treang mental disorders 3. Service Users – ‘Nothing about us without us!’ – Must provide opportunies for substanve, early, and connuing input ICD Revision Orienting Principles 1. Highest goal is to help WHO member countries reduce disease burden of mental and behavioural disorders: relevance of ICD to public health 2. Focus on clinical utility: facilitate identification and treatment by global front-line health workers 3. Must be undertaken in collaboration with stakeholders: countries, health professionals, service users/consumers and families 4.
    [Show full text]
  • The Evolution of Animal Play, Emotions, and Social Morality: on Science, Theology, Spirituality, Personhood, and Love
    WellBeing International WBI Studies Repository 12-2001 The Evolution of Animal Play, Emotions, and Social Morality: On Science, Theology, Spirituality, Personhood, and Love Marc Bekoff University of Colorado Follow this and additional works at: https://www.wellbeingintlstudiesrepository.org/acwp_sata Part of the Animal Studies Commons, Behavior and Ethology Commons, and the Comparative Psychology Commons Recommended Citation Bekoff, M. (2001). The evolution of animal play, emotions, and social morality: on science, theology, spirituality, personhood, and love. Zygon®, 36(4), 615-655. This material is brought to you for free and open access by WellBeing International. It has been accepted for inclusion by an authorized administrator of the WBI Studies Repository. For more information, please contact [email protected]. The Evolution of Animal Play, Emotions, and Social Morality: On Science, Theology, Spirituality, Personhood, and Love Marc Bekoff University of Colorado KEYWORDS animal emotions, animal play, biocentric anthropomorphism, critical anthropomorphism, personhood, social morality, spirituality ABSTRACT My essay first takes me into the arena in which science, spirituality, and theology meet. I comment on the enterprise of science and how scientists could well benefit from reciprocal interactions with theologians and religious leaders. Next, I discuss the evolution of social morality and the ways in which various aspects of social play behavior relate to the notion of “behaving fairly.” The contributions of spiritual and religious perspectives are important in our coming to a fuller understanding of the evolution of morality. I go on to discuss animal emotions, the concept of personhood, and how our special relationships with other animals, especially the companions with whom we share our homes, help us to define our place in nature, our humanness.
    [Show full text]