The TIME Approach to Grief Support (BOOK EXCERPT, PT 11)

Freitag, 6. Juli 2012

The TIME Approach to Grief Support (BOOK EXCERPT, PT 11)

The Book Stop Blog is featuring excerpts from The TIME Approach to Grief Support by Edmund Ng and WinePress Publishing.

The Mourning Process

Each of us grieves differently, and the mourning process is unique to the individual. However, researchers have described the progressive stages most people go through in their mourning. The better-known models are Elizabeth Kubler- Ross’ five stages of dying and John Bowlby’s four phases of grief. Here is a summary of their models:

Kubler-Ross’ Model

1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance

John Bowlby’s Model

1. Numbness and Disbelief
2. Yearning and Searching
3. Disorganization and Despair
4. Reorganization

Under Kubler-Ross’ model, the bereaved first undergoes a period of Denial, being paralyzed by shock and numbness. A new widow may say, “I cannot believe he’s dead. I think I’m only dreaming.” Next, the person is likely to erupt in Anger, but underneath the anger are other hidden emotions like fear, guilt, and so on. Then the grieving person may make Bargains such as wanting to be united with the deceased. As reality begins to sink in, emptiness takes its toll, and the Depression stage can last for some time. It is important to understand that this depression is not a sign of mental illness. Eventually, the person will learn to live with the new reality, accepting that his or her loved one is physically gone and things never will be the same again (Acceptance).

Bowlby’s model talks of Numbness and Disbelief in the initial denial phase, while anxiety and anger are expressed in the Yearning and Searching phase. During the Disorganization and Despair phase, there is depression and apathy that comes before healing and adjustment take place in the Reorganization phase.

In yet another model, Rando (1993) talks of an initial Avoidance phase, where the process involves the need to recognize and accept the loss. Next comes a Confrontation phase. This involves reacting to the separation, recollecting and re-experiencing the deceased and the relationship, and relinquishing the old attachments to the deceased. Finally, there is the Accommodation phase, where there is adaptive readjustment and reinvestment into the new world without forgetting the old.

To fall in line with Freud’s concept of grief work, Worden proposed another model, consisting of four tasks of mourning where the processes can be influenced by external intervention, such as emotional and practical support and counseling. Task 1 is to accept the reality of the loss, Task 2 is to work through the pain of grief, Task 3 is to adjust to an environment in which the deceased is missing, and Task 4 is to emotionally relocate the deceased and move on with life.

It is important to understand that all of these models are only descriptive and not prescriptive. The stages, phases, processes, or tasks are neither linear nor consecutive, but they overlap one another. In fact, a grieving person alternates between confronting and avoiding thoughts and feelings about the loss. Like the sea, sometimes he or she is calm, and at other times, the person is stormy for no apparent reason.

Not only is the mourning process unique to each individual, but also people in different cultures mourn differently. Therefore the practices, values, and beliefs of each person in relation to bereavement, grief, and mourning must be explored as part of the counseling and support process.

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