It has been argued that psychodynamic theories proposed by Freud, Bowlby and others have that it has been argued (, especially . Furthermore, friefFreud and post-Freudians presented his seminal work on grief the psychodynamic approach Ambivalence could be experienced by bereaved individuals whose child or partner commits suicide The psychodynamic approach has been beneficial in identifying the role of ambivalence, working through one’s grief, the children may be too young to achieve the necessary insight to reduce their ambivalence, ambivalence may actually be post-traumatic stress symptoms, . the criteria for clinical depression has been used with respect to grief in an attempt to distinguish “normal” grief from “pathological grief (Murray, 2003, p.102-103)
A person who experiences ambivalence woman could experience ambivalence with three young children whose husband commits suicide. Although she loved him very much she is angry at him for taking his own life and for leaving her with three small children to raise alone. hat she sees as a selfish acthowever he died suddenly of a heart attack before she could From a psychoanalytic perspectiveThe ambivalent feelings could arise where the sudden death According to the psychoanalytic theory in the area of grief and loss has remained strong, not only on contemporary classifications of pathological forms of grief, due to the work of Lindemann (1944), but also as the conceptual basis of counseling and therapy interventions that focus on grief work (Middleton, Raphael, Martinek, & Misso, 1993) and crisis intervention formats (Raphael, Middleton, Martinek & Misso, 1993).
Psychoanalytic theory focuses on the individual emotional response to loss, it pays little or no attention to larger social forces or interactions with others, it also does not apply well to losses other than those of bereavement, such as those stemming from illness or social situations (Miller & Omarzu, 1998).
Like psychoanalytic theory, which focuses on the importance of relinquishing ties, Bowlby’s work suggests that bonds with the deceased need to be broken for the bereaved to adjust and recover (Stroebe, Gergen, Gergen, & Stroebe, 1995). Freud (1957), in the case of death,
Attachment theory
In Bowlby’s view, grief is conceptualized as a form of separation anxiety, the motivation for which is to restore proximity to the lost object (Stroebe, Gergen, Gergen, & Stroebe, 1995). Like psychoanalytic theory, which focuses on the importance of relinquishing ties, Bowlby’s work suggests that bonds with the deceased need to be broken for the bereaved to adjust and recover and those who retain ties are considered maladjusted (Stroebe, Gergen, Gerhgen, & Stroebe, 1995). Attachment theory is based on the premise that children form different types of bonds with their parents, depending on the reliability and nurturing abilities of their parents, these bonds become attachment “styles” that children carry with them into childhood, ultimately, attachment style affects how an individual interacts and develops relationships with other adults, parenting styles that are characterized by ambivalence or neglect can result in children who may grow up to be anxious about relationships and have difficulty establishing intimacy or coping with separation and loss, the poor or unstable attachment style is presumed to cause prolonged or debilitating grief reactions in the case of a loss event. both these models assume that intense or prolonged grief is pathological in nature, stemming from flaws in emotional development and tends to treat to view loss as a transient state that demands recovery in order to be normal or healthy (Miller & Omarzu, 1998)
The reality that the love object is no longer available helps the person sever their attachment however when the object is remembered and longed for, reality intrudes with information that the object is longed gone (Jennings, 1991). Freud saw the psychological function of grief as freeing the individual of their ties to the deceased, achieving gradual detachment through a process whereby referred to as hypercathecting by means of reviewing the past and dwelling on memories of the deceased, the process is complete when most of the energy is withdrawn from the lost object and transferred to a new one, those who fail to hypercathect remain emotionally stunted (Stroebe, Gergen, Gergen, & Stroebe, 1995). Normal mourning was considered not to involve
According to Freud (1917) there were three specific phases in the mourning process: the loss of the loved object with the consequent loss of the capacity to invest attachment or energy in the loved person who has gone, the withdrawal of that energy into the self where a reorganization can take place, and a gradual reinvestment of that energy in new objects, people or activities (Macnab, 1989). Grief, in effect, attempts to hold onto the lost person until the psyche has had time and space to reorganize the grieving person’s view of the world (Macnab, 1989).
The personal experience of grief is a heterogeneous phenomenon and (Murphy et al., 1995) and every individual’s way of expressing grief is different and may be affected by many individual variables such as personality, past and present experiences, the circumstances of the death, the age and gender of both the deceased and the survivor, one’s role in the family system, and the dependency and depth of the relationship (Ross, 1997).
. quate to personal experience, on its own, being sufficient for working in the area of loss and grief, despite evidence to suggest that the personal experience of grief does not always follow the precepts of the theoretical models, as loss is a subjective experience and grief is influenced by various factors ( ).
Furthermore, that
These models have tended to focus primarily on the individual and their response to the loss however “families and family grief processes are inextricably linked to the individual’s grief and recovery” (Moos, 1995, p.337). Walsh and McGoldrick (1998) argue that a systems perspective is necessary to recognize the chain of influences that reverberates throughout the family network of relationships in relation to a significant loss. However, grief doesn’t occur within a vacuum and cultural and ethnic values surrounding death have moulded forms of verbal and emotional expressions of grief, grieving conditions, communal support systems and many other related issues (Ata, 1994). The purpose of this paper is to
In addition to the argument that the and it could be argued that these models merely provide an explanation of different facets of the individual’s reaction to their loss.
Each culture has its own approaches to dealing with loss (Parkes, 1997).
The argument as to whether grief and loss is a reaction to the individuals inability to accept change or due to the emotional attachment the individual has to the object that is lost is indeed a contention issue, and one that is beyond the scope of this paper. Moos, 1995). it has been pointed out that Furthermore, grief processes are inextricably linked to individual grief and recovery models of grief and bereavement have focused primarily on individuals with little attention paid to the role of family processes and models of family grief , families and family grief processes are (Moos, 1995). human response to grief. interestingly, there is no model for what needs to be considered however is that the individual’s response to loss and their ensuing grief is influenced by
The theoretical perspectives on grief and loss suggests that the individual’s perception of a loss is significantly influenced by their attachment (as in their emotional energy invested) to the
such as their existential anxiety, the anxiety of early separations, and the anxiety of the actual death event (Macnab, 1989).
it could be argued that the bereaved had been the primary focus of these models has been on the bereaved individual The bereaved individual is the primary focus of these models however However the primary focus of these approaches to grief do not . Whereas descriptive theories such as Descriptive theories include stage and task approaches such as stage and task approaches to grief areDescriptive theories are, in the main, acontextual. Whereas descriptive theories depict the phenomenology of the grief process in a basic descriptive way process theories of grief re are the descriptive theories of grief which depict the and process theories of grief. theoretical approaches to grief The conceptual models Stage and task approaches although Conjugal bereavement, the loss of loved ones ). In the late 1960s and early 1970s there were a number of The primary focus of however has been on the loss of a spouse and loved ones. The basis for much of the early research into loss and grief focused on bereavement and the loss of lovetheoretical perspectives for loss and grief have focused on why and how it occurs. Psychoanalytic models such as Freud and Bowlby’s attachment theory The primary focus on loss and grief were the bereaved ( ), terminally ill patients,
Engel (1964, cited in Kelly, 1995) states that “for the mourner…..the main work of grief goes on intrapsychically” One cannot deal with a loss without first recognizing what is lost and loss is a personal experience (Kelly, 1995).
The experience of grief, in response to loss, is known to all human beings regardless of age, sex, creed and culture (McKissock & McKissock, 1995), and “it [loss] can truly have a dramatic, everlasting impact on the lives of people” (Miller & Omarzu, 1998, p.6). The purpose of this paper is to The pre-dominant Euro-American view has been that successful grieving means breaking emotional ties between the bereaved and the deceased, which frees the bereaved person’s emotional or psychic energy to be reinvested in new relationships and activities ( DeSpelder & Strickland, 1995). However, theoretical approaches to grief tend to fall into two broad groups comprised of descriptive theories and process theories (Barbato & Irwin, 1992). .
Descriptive theories of grief However, while various theoretical perspectives Suffice to say however that the experience of grief, in response to loss, is known to all human beings regardless of age, sex, creed and culture (McKissock & McKissock, 1995), and “it [loss] can truly have a dramatic, everlasting impact on the lives of people” (Miller & Omarzu, 1998, p.6). Although it has been found that two or more individuals who have the same personal experience may not react to that experience in a similar fashion ( ) it is well noted that loss, and the grief that ensues
have all been show to .. , research in the area of grief and loss has found that no two individuals experience It has been suggested that it is loss is a reactive equates to change According to Barbato and Irwin (1992) “the fundamental substrate of grief is the emotional response to loss” (p. 169) While there appears to be a lack of consensus in the literature on grief and loss as to whether According to Barbato and Irwin (1992) “the fundamental substrate of grief is the emotional response to loss” (p. 169) However, in contrast to the early romanticist perspective on grief and mourning the modernist (20th century) view has been that successful grieving means breaking emotional ties between the bereaved and the deceased, which frees the bereaved person’s emotional or psychic energy to be reinvested in new relationships and activities (DeSpelder & Strickland, 1995). The post-modernist view on grief and morning would tend to However, there is a growing body of evidence it is becoming increasingly
According to Barbato and Irwin (1992) “the fundamental substrate of grief is the emotional response to loss” (p. 169), and loss events can be the most personal and emotional happenings that humans experience (Miller & Omarzu, 1998). However, although it is well noted throughout the literature on grief and loss that although we may all experience some form of loss in our lives, albeit tangible or intangible, not everyone will experience grief. It has been suggested that loss is a subjective experience and individuals may experience a broad range of cognitive, emotional, and behavioural reactions associated with the loss.
a broad range of factors have been shown to influence whether the , albeit positively or negatively, the individual’s reaction to the loss. The purpose of this paper is to discuss the
Studies of people who have suffered multiple losses (do they become desensitized to loss or do they tend to not invest as much love knowing that the object will eventually be lost.). Can people anticipate or prepare themselves for the inevitable. For example, does the parent whose son or daughter dies from a heroin overdose is using a highly addictive drug such as heroin, a drug where there is a high possibility of death through overdose may in some way prepare themselves for the worst case scenario.
For example, The focus of early literature on grief and loss tended to be on death and dying however loss, and the ensuing grief, is a subjective experience and grief and loss issues in current literature identify broad range of grief, the current literature on grief and loss that issues of grief and loss are associated with . However, while advances in medical science have proven successful in reducing the individual’s level of physical suffering it has been less effective towards alleviating their emotional suffering (Kubler-Ross, 1969). What also needs to be considered is that people become more susceptible to loss due to their increased , and the ensuing grief, due to Furthermore, as people live longer they become more susceptible to encountering somelikely to experience the same cannot be said for suffering . the literature on grief and loss process of grief . And although individuals however it has been suggested that although individuals experience share similarities because it could be suggested the no two individuals with process their grief the human . In contrast to the romanticist
Although there appears to be a emphasis on adopting an eclectic approach The development of a practice framework for professionals working in the area of human services
and although the individual may not necessarily have control over whether they will experience loss throughout their life, they can control how they respond to them. However,
Reactions to traumatic events seem to be determined by a number of variables such as the nature of the event, the character, personality, previous and present experiences, beliefs, attitudes and expectations, beliefs of the individual involved (Parkinson, 1997).
Positives and negatives of various theoretical approaches
What difference does their approach have in relation to grief and loss
Some people work purely from theory while others work predominantly from personal experience. whereas sympathy seeks to console, empathy works to understand - empathy requires a certain emotional distance - you have to step away from grief, fear, and anger to create a space in which your thoughts can exert a calming influence on your feelings (Ciaramicoli & Ketcham, 2000).Empathy
Traditional forms of mutilation for bereavement were, and in some instances still are, practiced among the indigenous people of Australia. For example, in Queensland many aboriginal tribes slashed their bodies or foreheads to show sorrow at the death or injury of a kin (Wilson, 1982).
Many Westerners who work at assisting the bereaved have notions of grief pathology such as grief that is never expressed, grief that goes on to intensely for too long, grief that is delayed, grief that involves delusions, grief that involves threat to others, and grief that involves self-injury (Parkes, 1997). Professionals who work with people who have suffered loss must prepare themselves psychologically and philosophically for this work, and a key aspect of this is to be able to accept suffering as endemic to life (Kennedy, 1990). Grief can be expressed through such masked appearances as school absenteeism and bed wetting in children, delinquency and drug abuse in adolescents (and adults), and promiscuity, suicide, and diverse physical and mental illnesses in adults (Fiefel, 1995). Stroebe and Stroebe (19 ) state that “grief is a normal affective response to the loss of a loved one which, if it runs an uncomplicated course does not require therapeutic intervention (p. 8). However, the focus of the majority of early research into grief and loss has been in relation to conjugal bereavement ( ) and the terminally ill patient ( ). Research into the area of grief and loss during the latter part of the 20th has identified a broad range of losses, albeit tangible or intangible, that can initiate a grief response.
Furthermore, the literature on grief and loss has recognized the impact of traumatic events and a broad range of factors that include the individual’s interpretation of the event ( ), the nature of the event (Parkinson, 2000; Davidson & Baum, 1990), gender (Kritsberg, 1993), age (Rosenthal, 2000), level of maturity, previous experience and coping strategies (Davies & Holden, 1997), support networks (Figley, 1988; Miller, 1994), and cultural display rules (Moos, 1995; Atkinson, 1997).is not yet a fully recognized academic discipline (Miller & Omarzu, 1998). Unlike trauma which is acknowledged Loss is a subjective experience and, for this very reason, two or more people encounter the same the person’s reaction “In psychology, modernism has given rise to the machine metaphor of human functionality. When applied to grief, this view suggests that people need to recover from their state of intense emotionality and return to normal functioning and effectiveness as quickly and efficiently as possible “ (Stroebe, Gergen, Gergen & Stroebe, 1995, p.233). 1995, 226). However,
Beginning with Freud, theorists have understood the purpose of grief as relinquishing the lost object so that new attachments in the present can be formed and that failure to sever the bond has been defined as pathological or complicated grief (Klass, 1995).
Theoretical approaches based on psychodynamics, attachment theory, social construction of loss, cognitive theories and constructivist psychology constitute the major movements that have evolved over the twentieth century with respect to our knowledge about loss and grief (Murray, 2003). Answers perhaps as to why people do not go through a normal grieving process.
According to the romanticist concept of grief the death of a beloved person was a defining event in the life of the bereaved, signaling the beginning of what was often a lifelong memorialisation of the deceased (DeSpelder & Strickland, 1995).
Since mourning is a process and not a state, incompleted tasks can impair further growth and development, although the tasks do not necessarily follow a specific order, there is some ordering suggested in the definitions, you cannot handle the emotional impact of a loss until you first come to terms with the fact that the loss has happened (Worden, 1991). Grieving does not proceed in a linear fashion, it may reappear to be reworked (Worden, 1991). There is not definitive time for when mourning is finished - four months, one year, never (Worden, 1991).
Only when the lost person has been internalized and become a part of the bereaved is the mourning process complete (Parkinson, 2000). The process of psychological debriefing should be an essential component in our response to survivors of traumatic events (Parkinson, 2000)
As with adults, children follow different paths through their grief experiencing different reactions at different times (Fitzgerald, 1992).
The most significant variable contributing to response to bereavement was having a history of psychological disturbance and those having a history were more likely to describe themselves as anxious and depressed, socioeconomic status was a significant contributor to depression and state and chronic anxiety levels in the bereaved individuals (Bartrop, Hancock, Craig, & Porritt, 1992).
A number of risk factors that have the potential to complicate “normal” grief reactions include sudden, unexpected death, traumatic events, ambivalence in a relationship, pre-existing psychopathology, concurrent crises, perceived preventability, lack of social support (McKissock, 1998). Of all the risk factors, centrality, the degree of significance the person who has died has in our everyday life, to our identity or our sense of well being, is the most likely to indicate the intensity of grief we experience (McKissock, 1998). Bereaved people don’t let go, the reconnect through memories and changing perceptions to form a new relationship with the person who has died (McKissock, 1998). Men and women grieve differently, men tend to seek solace in the warmth of familiar sexual intimacy with their partners whereas women long for emotional closeness, or hugs that don’t demand a response (McKissock, 1998).
Grief syndromes
Disenfranchised grief (frozen grief Hicks, 1996). Two major causes of pathological grief, which stem from problematic marital bonds, are referred to as the ambivalent grief syndrome (a relationship in which elements of love and hate coexist, conflicts were frequent, and divorce or separation may have been contemplated), after the loss the bereaved may still be attached to the deceased: chronic grief syndrome, follows the termination of a relationship characterized as highly dependent or clinging (Stroebe, Gergen, Gergen, & Stroebe, 1995).
Grief is at once physical, emotional, psychological, social, and spiritual (Attig, 1995).
Health professionals distinguish between two forms of abnormal grief, the distorted and the delayed (Ata, 1994). An obvious symptom of distorted grief is one whereby the bereaved has little or no sense of loss, an ongoing passion for life and preoccupation with events and activities (Ata, 1994).
Traditionally, an individual can experience feelings of anger, guilt, sadness, desperation, loneliness, hopelessness, and numbness in response to a loss in the case of disenfranchised losses the grief can become intensified as the feelings are not being expressed and the individual’s loss is not being acknowledged (Lenhardt, 1997).
The diagnostic criteria for post traumatic stress disorder include three groups of symptoms: evidence of reexperiencing the drama, numbing of responsiveness to or reduced involvement with the external world following the traumatic event, and a variety of stress reactions, the event is sudden, dangerous, and overwhelming (Figley, 1988).
Stage models
The concept of stages tends to suggest a clear progression from one step to the next, whereas reality is more likely to be one step forward and two steps back, stage models don’t allow for individual differences (children versus adults) and may encourage those of us in a caretaking role to have unrealistic expectations, or to analyse and label inappropriately what we consider “normal’ or “abnormal” (McKissock, 1998).
A stage-based approach, especially when used in ways not in accord with its authors intentions, can erect obstacles to individualisation, risking stereotyping vulnerable individuals who are coping with dying Corr, 1995). Stage-based models often take on a sense of directedness or obligation in the hands of those who use them (Corr, 1995). A model that is content to identify reactions to the threat of dying confines itself mainly to recognition and understanding (Corr, 1995). A stage-based model provides no guidance as to how the person should deal with it “bargaining” and the person, and helpers, are left in a passive state (Corr, 1995). Clinicians turned to examining how best to facilitate this recovery, from these investigations came various stages of grieving models, Kubler-Ross (1969) whose stages of grief include denial, anger, bargaining, depression, and acceptance, the idea behind these models is that the individual experiencing loss or bereavement must successfully “pass through” the stages, eventually reaching “acceptance” or recovery stage, not surprisingly, the idea of passing successfully through stages echoes the psychoanalytic model of individual emotional development, which inspired the first theories of grief and loss (Miller & Omarzu, 1998)
Task models
Grief task are never completed, nor can they be accomplished neatly and sequentially like a list of jobs to be ticked at the end of the day, task models can provide direction, encouragement, and empowerment (McKissock, 1998). Each of these four dimensions (physical, psychological, social, and spiritual) defines an area of task work, not a list of individual tasks (Corr, 1995). A task-based approach takes into account not only feelings or psychosocial responses but all the dimensions of human life, rejects broad generalizations that have an initial and superficial attractiveness, explicitly recognizes coping undertaken by all of the individuals-the dying person, family members or friends, and care providers-involved in a particular experience of dying (Corr, 1995). A task-based approach does not concentrate upon that which is obligatory (must) or normative/prescriptive (should or ought), instead it emphasizes choices among possible tasks and in this way it avoids the twin pitfalls of linearity and directedness that are prominent risks in any stage based approach (Corr, 1995).
Constructivists
In the psychological literature, constructivism refers to a theoretical position that regards persons or systems as constituting or constructing their reality, the process of adaption and change in the post-death relationship and the construction and reconstruction of new connections (Gergen, 1985, cited in Silverman, Nickman, & Worden, 1995).
Family systems
Figley (1988) posits that the family is a critical support system to human beings before, during, and after stressful times and that the system and its members are also affected, sometimes even more than the victim. The first task, accepting that the death has occurred, occurs on a intrapersonal level and a interpersonal level (Moos, 1995). The basis of family systems approaches is that a family consists of a number of individuals who, based upon their own interpretation of the death, interact with one another in ways that are qualitatively different from prior experiences, the interactions in turn determine how the family grieves and copes with the loss of the family member (Moos, 1995). How well children deal with death is closely bound up with how the family deals with it, the child’s experience of death is mediated by many factors including age, developmental stage and family dynamics (Cavanagh, 1997). The age of the child can influence whether they understand the permanence of death (Baker, Sedney, & Gross, 1992).
with It is becoming increasing evident Furthermore, semantics has
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