3-D MODEL OF GRIEF PROCESS
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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
III. To adjust to a world without the deceased A. External adjustments: Living daily without the person
B. Internal adjustments: Who am I now?
C. Spiritual adjustments Reframe assumptive world
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)
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
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
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) (4th Edn) Grief Counselling and Grief Therapy. Hove, East Sussex, UK: Routledge