Chapter: Psychiatric Mental Health Nursing : Grief and Loss

Types of Losses

One framework to examine different types of losses is Abraham Maslow’s hierarchy of human needs.

TYPES OF LOSSES

 

One framework to examine different types of losses is Abraham Maslow’s hierarchy of human needs. According to Maslow (1954), a hierarchy of needs motivates human actions. The hierarchy begins with physiologic needs (food, air, water, sleep), safety needs (a safe place to live and work), and security and belonging needs (satisfying relationships). The next set of needs includes self-esteem needs, which lead to feelings of adequacy and confidence. The last and final need is self-actualization, the ability to realize one’s full innate potential. When these human needs are taken away or not met for some reason, a person experiences loss. Examples of losses related to specific human needs in Maslow’s hierarchy are as follows:

 

·    Physiologic loss: Examples include amputation of a limb, a mastectomy or hysterectomy, or loss of mobility.

 

·    Safety loss: Loss of a safe environment is evident in do-mestic violence, child abuse, or public violence. A per-son’s home should be a safe haven with trust that family members will provide protection, not harm or violence. Some public institutions, such as schools and churches, are often associated with safety as well. That feeling of safety is shattered when public violence occurs on cam-pus or in a holy place.

 

·    Loss of security and a sense of belonging: The loss of a loved one affects the need to love and the feeling of being loved. Loss accompanies changes in relation-ships, such as birth, marriage, divorce, illness, and death; as the meaning of a relationship changes, a per-son may lose roles within a family or group.

 

·    Loss of self-esteem: Any change in how a person is val-ued at work or in relationships or by him or her self can threaten self-esteem. It may be an actual change or the person’s perception of a change in value. Death of a loved one, a broken relationship, loss of a job, and re-tirement are examples of change that represent loss and can result in a threat to self-esteem.

 

·    Loss related to self-actualization: An external or internal crisis that blocks or inhibits strivings toward fulfillment may threaten personal goals and individual potential. A person who wanted to go to college, write books, and teach at a university reaches a point in life when it be-comes evident that those plans will never materialize. Or a person loses hope that they will find a mate and have children. These are losses that the person will grieve.

 

The fulfillment of human needs requires dynamic movement throughout the various levels in Maslow’s hier-archy. The simultaneous maintenance of needs in the areas of physiologic integrity, safety, security and sense of belonging, self-esteem, and self-actualization is challeng-ing and demands flexibility and focus. At times, a focus on protection may take priority over professional or self-actualization goals. Likewise, human losses demand a grieving process that can challenge each level of need.

 

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Psychiatric Mental Health Nursing : Grief and Loss : Types of Losses |


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