MODELS OF GRIEF PROCESS

Lorelle Madden M Couns, Grad Dip Couns Studies, B.Ed, Dip Rel Couns, Cert IV TAA, MAARC, SCAPE, PACFA # 20412

• Virginia Satir - “Human experience is universal, but my experience is unique.” (Lecture notes) • Professor Gordon Allport (September 1957, lecture notes) “Each man is like all other men; each man is – like some other men; each man is like no other man.” (Worden, 2009, p.8)

Stages of Grief – Elisabeth Kubler-Ross 1. Shock and denial - “No, not me!” 2. Rage and anger - “Why me?” “Why now?” 3. Bargaining - “Yes, it is me, but…” 4. Depression - “Yes it is me!” 5. Acceptance - Inner and outer peace

Phases of Mourning – Parkes, C.M.

• Phase I – Period of Numbness – ignore the loss • Phase II – Phase of Yearning – deny permanency of loss • Phase III – Phase of Disorganization and Despair – difficult to function in the environment • Phase IV – Phase of Reorganised Behaviour – begin to pull his or her life back together

Tasks of Mourning – William J. Worden I.

To accept the reality of the loss II. To process the pain of grief (not believing) (not feeling) III. To adjust to a world without the deceased A. External adjustments: Living daily without the person (not adjusting) B. Internal adjustments: Who am I now?

(not growing) C. Spiritual adjustments Reframe assumptive world (not understanding) IV. To find an enduring connection (not moving forward) with the deceased while embarking on a new life.

The Mediators of Mourning - Worden

Mediator 1 Mediator 2 Mediator 3 Kinship (who died) Nature of the attachment

strength/security ambivalent/conflicted dependency issues

Death circumstances

proximity of death expectedness of death traumatic death multiple losses preventable death ambiguous death stigmatized death

The Mediators of Mourning – Worden (cont’d)

Mediator 4 Mediator 5 Historical antecedents

loss history mental health history

Personality mediators

age/gender coping style attachment style (secure, insecure) cognitive style ego strength (esteem, efficacy) assumptive world (beliefs, values)

The Mediators of Mourning – Worden (cont’d)

Mediator 6 Mediator 7 Social mediators

support availability support satisfaction social role involvement religious resources ethnic expectations

Concurrent stresses

life-change events

Levels of Loss – Patricia Weenolsen 1. Specific loss incident – primary loss 2. Associated losses – secondary loss 3. Abstract or holistic losses to the life or self 4. Losses to the self or self-concept 5. Metaphorical losses – idiosyncratic meaning of loss to individual

Normal Grief 1. Feelings * sadness * anger * guilt and self-reproach * anxiety * loneliness * fatigue * helplessness * shock * yearning *emancipation * numbness

Normal Grief (cont’d) 2. Physical Sensations * hollowness in the stomach * tightness in the chest * tightness in the throat * oversensitivity to noise * sense of depersonalisation * breathlessness, feeling short of breath * weak in the muscles * lack of energy * dry mouth

Normal Grief (cont’d) 3. Cognitions * disbelief * confusion * preoccupation * sense of presence * hallucinations

Normal Grief (cont’d) 4. Behaviours * sleep disturbances * appetite disturbances * absentminded behaviour * social withdrawal * dreams of the deceased * avoiding reminders of the deceased * searching and calling out * sighing * restless hyperactivity * crying * visiting places or carrying objects that remind the survivor of the deceased * treasuring objects that belonged to the deceased

We find a place for what we lose. Although we know that after such a loss the acute stage of mourning will subside, we also know that we shall remain inconsolable and will never find a substitute. No matter what may fill the gap, even if it be filled completely, it nevertheless remains something else.

Freud, to his friend Binswanger on the death of his son.

(1961, p.386)

References Freud, S. (1961) Letters of Sigmund Freud (E. L. Freud, Ed.). New York: Basic Books.

Kubler-Ross, E. (1997) Living with Death and Dying. New York: Touchstone.

Weenolsen, P. (1988) Transcendence of Loss over the Life Span. New York: Hemisphere Publishing Corporation. Worden, J. W. (2010) (4 th Edn) Grief Counselling and Grief Therapy. Hove, East Sussex, UK: Routledge