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
(not believing)
II. To process the pain of grief
(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
Kinship (who died)
Mediator 2
Nature of the attachment
strength/security
ambivalent/conflicted
dependency issues
Mediator 3
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
Historical antecedents
loss history
mental health history
Mediator 5
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
Social mediators
support availability
support satisfaction
social role involvement
religious resources
ethnic expectations
Mediator 7
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) (4th Edn) Grief Counselling and Grief
Therapy. Hove, East Sussex, UK: Routledge