Below is a diagram showing the Models of Grief that have been developed by a range of theorists since the 1940 s. The 1964, 1972) Restitution

Transcription

1 Models of grief Below is a diagram showing the Models of Grief that have been developed by a range of theorists since the 1940 s. Models of grief Theorist Stage or Phase Lindemann Shock & Acute Mourning Resolution (1944) Disbelief Engel (1961, Shock & Developing Restitution Resolving the Idealisation The 1964, 1972) Disbelief Awareness Loss Outcome Pollock (1961) (Acute Stage) (Chronic Stage) Shock Grief Separation Reparation Averill(1968) Shock Despair Recovery Kubler-Ross (1969) Denial & Isolation Anger Bargaining Depression Acceptance Parkes (1971) Numbness Searching & Pining Depression Recovery Parkes (1974, 1986) Numbness Yearning & Searching Disorganisation & Despair Reorganisation Bowlby (1980) Numbness Yearning & Searching Disorganisation & Despair Reorganisation Rando (1984) Avoidance Confrontation Reestablishment Sanders (1989) Shock Awareness of Loss Conservation- Withdrawal Healing Renewal M. McCabe (2003)

2 Stroebe and Schut (1999) argue that grief can best be described as, A cognitive process of confronting a loss, of going over the events before and at the time of death, of focusing on memories and, working toward detachment. Fundamental to current conceptions is the view that one needs to bring the reality of loss into one s awareness as much as possible and that suppression is a pathological phenomenon. There are many models that represent established research in the psychology of loss and bereavement. Lindermann (1944) discusses the concept of the bereaved person moving through phases of shock and belief, acute mourning and resolution. Parkes (1971) presents the argument for stages of numbness, searching and pining, depression, and recovery. Similarly Bowlby (1980) promulgates the idea of the bereft moving through phases of numbness, yearning and searching, disorganisation and despair, and then finally reorganisation. The problem with staged models of bereavement is that they assume a linear progression through some distinct time line of grieving. For many people, especially children, loss and grief is interpreted and reinterpreted differently the further the time away from the initial loss and the more the child revisits their experiences at different stages of maturation and development. The established research of Bowlby and Ainsworth (1977) form some of the understandings about how infant and individual personal attachment is affected by loss, grief and bereavement and does not assume a linear progression. The model states that there are four interchangeable stages and does not overly specify distinct periods of time to be spent at each stage. Bowlby's four stages are: 1. Phase of numbing that usually lasts from a few hours to a week and may be interrupted by outbursts of extremely intense distress and/or anger. 2. Phase of yearning and searching for the lost figure lasting some months or sometimes for years. 3. Phase of disorganization and despair. 4. Phase of greater or less degree of organization. The strength of Bowlby s model lies in the idea that the bereft young person can move between lesser or greater degrees of despair, depending on varying factors contributing to their coping with their grief. This is similar to one of the most highly recognised models of coping with loss and grief developed by Stroebe and Schut (1999). The Dual Process Model of Coping and Bereavement (DPM) states that there is an oscillation between loss orientated behaviours, such as ruminating or negative event interpretation, and restoration orientated behaviours such as revising constructive goals and assigning new meaning to life experiences post lost. The model also allows for a moratorium from grief, or a holiday period from experiencing the feelings associated with loss and grief. The idea that a bereft child or young person can be assisted in developing the skills to attend to daily life functioning whilst simultaneously holding in mind the pain of their grief and loss, and that they can allow themselves breaks from grieving in order to further maximise their coping strategies, easily fits within the ethos of YMCA Children s Bereavement Service.

3 In its application to the area of loss and grief in children and young people the DPM could be applied in the following ways: 1. It explains how individuals can take time off from thinking about or having to deal with feelings and emotions associated with the experience of death, dying, grief and loss. This is a useful tool in talking to children about any guilt that might be expressed in relation to not thinking as much about the person who has died. 2. Children and young people can be educated about the idea of loss orientation and restoration orientation behaviours. This may encourage some individuals to feel as though they have some control over the overwhelming feelings often associated with bereavement. 3. Anyone involved in supporting a child through the process of loss and grief, such as teachers, youth workers or family members and friends can also be educated about the importance of the need to be able to oscillate between daily functioning, grieving and taking breaks from bereavement. 4. The Dual Process Model promotes meaning construction and reconstruction at varying points, which is particularly important in situations of childhood loss and grief, as it supports the individual in moving on and being able to express emotions such as joy and happiness, again without feeling guilty about the person who has died. 5. The model does not presume a linear progression and allows individuals to grieve at their own pace, and if needed to return to aspects of the loss at different points in the process of grieving. YMCA Children s Bereavement Service endeavours to allow children and young people to experience their grief from an individual perspective and does not assume that all children will grieve in a uniform way. However the service is focused on offering best practice at all times and therefore a thorough understanding of the psychology of grief and bereavement is important when working in a therapeutic setting.

4 Rubin s Two Track Model of Bereavement Track I Functioning Track II Relationship to the Deceased Anxiety Imagery & Memory Depressive Affect and Cognition Emotional Distance Somatic Concerns Positive Affect vis-à-vis Deceased Psychiatric Concerns Negative Affect vis-à-vis Deceased Familial Relationships Preoccupation with Loss & the Lost General Relations Idealisation Self Esteem & Self Worth Conflict Meaning Structure Features of Loss Process (Shock, Searching), Work Disorganisation & Reorganisation Investment in Life Tasks Impact upon Self Perception Memorialisation & Transformation of the Loss and the Deceased S.S. Rubin (1999)

5 Model of Meaning Reconstruction Pathways in Response to the Loss of a Loved One Gillies, J. & Neimeyer, R.A. (2006)

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