The Dual Process Model

Grief is the act following the loss of a loved one. While grief and bereavement are normal occurrences, the grief process is a social construct of how someone should behave. The acceptable ways that people grieve change because of this construct. For a time it was not acceptable to grieve; today, however, it is seen as a necessary way to move on from death (Scheid, 2011).The grief process has been described as a multistage event, with each stage lasting for a suggested amount of time to be considered “normal” and reach resolution. The beginning stage of grief is the immediate shock, disbelief, and denial lasting from hours to weeks (Wambach, 1985). The middle stage is the acute mourning phase that can include somatic and emotional turmoil. This stage includes acknowledging the event and processing it on various levels, both mentally and physically. The final stage is a period of

Someone who is grieving will experience “major psychological, spiritual, social and physiological” changes throughout the grieving process (Hooyman & Kramer, 2006, p37). There are many theories and models that support these words. This essay will discuss Freud’s theory of grief work (Davies, 2004), Bowlby’s attachment theory (Walsh, 2012), and Worden’s tasks of grief (Worden & Winokuer, 2011). The major tasks of grief throughout the four different stages of life will be looked at, as well as common grief reactions, and ways to support people through these. In addition how children, adolescents, adults and the elderly understand and respond to grief will be examined. Finally how people at the various stages of life confront their own death will be looked at, including some personal examples.

According to Thomas Attig, who made an important distinction between grief and the grieving process, the grieving process is a complex coping process which gives and challenges and opportunities for the griever and also the choices to be made and tasks to be presented with a tremendous amount of energy to be invested. Most people have negative thoughts about grieving process and they believe that grieving process can render the individual passive and helpless. However, according to Attig, “It is misleading and dangerous to mistake grief for the whole of the experience of the bereaved. It is misleading because the experience is far more complex, entailing diverse emotional, physical, intellectual, spiritual and social

There are several models on grief, however this author believes that one of the most significant is William Worden’s four tasks of grieving model. According to Leming and Dickinson, 2010, mourning is necessary for all individuals who have experienced loss and there are four tasks of mourning one must accomplish before the mourning process can be completed. These four tasks are as follows: to accept the realty of loss, experience the pain of grief, adjust to an environment in which the person is absent, and to withdraw emotional energy and reinvest it in another relationship. Worden suggested that if the tasks are not completed, the individual will struggle to develop and grow (Worden, 1982). This model has a unique application to nursing because it suggests that certain actions can be done through the control of the mourner in order to facilitate the grieving process. Even more significant is that nurses with knowledge of this theory will be able to help guide grievers through this process.

The life transition of death and dying is inevitably one with which we will all be faced; we will all experience the death of people we hold close throughout our lifetime. This paper will explore the different processes of grief including the bereavement, mourning, and sorrow individuals go through after losing someone to death. Bereavement is a period of adaptation following a life changing loss. This period encompasses mourning, which includes behaviors and rituals following a death, and the wide range of emotions that go with it. Sorrow is the state of ongoing sadness not overcome in the grieving process; though not pathological, persistent

Grief is an inner sense of loss, feeling of emptiness and sadness every human being experience at some point of life and each person feels and handles it differently. But there are some common stages of grief which starts from recognizing a loss to the final acceptance. It is not necessary that grief should occur after the death of a beloved one. Grief is the multifaceted response to death and losses of all kinds, including emotional (affective), psychological (cognitive and behavioral), social, and physical reactions (Stroebe, Hansson, Stroebe, & Schut, 2001). Grief is a healthy response to a loss, which should not be prevented. But grief lasting more than two months and is severe enough to interfere with daily life may be a sign of

The loss of a loved one is one of the most difficult experiences to endure in a human lifetime. The grieving process often encompasses the survivors’ entire world and affects their emotional, cognitive, spiritual, and physical selves in unexpected ways. After a major loss, such as the death of a spouse or child, up to a third of the people most directly affected will suffer detrimental effects on their physical and/or mental health (Jacobs 1993).

Those stages are denial, anger, bargaining, depression, and acceptance. Kubler-Ross indicated that many of these stages may overlap, occur together, or some may not happen at all. Worden (2009) developed a similar model called the Tasks of Mourning Model. This model integrates four different tasks to complete the process of mourning. Task 1 is to accept the reality of the loss on an intellectual and emotional level. Task 2 is to process the pain and grief. This depends on the type of pain that is being experienced and the nature of the relationship with the deceased. Task 3 is to adjust to a world without the deceased. And Task 4 is to find a connection with the deceased while moving forward with life (Worden, 2009). Despite stages or tasks, the grief process is cyclical. Feelings of grief can be revisited, often many times over again. There is no time limit on when grief begins and when it ends. Anniversaries of the death, reminders of the loved one, or traumatic events can trigger sadness and depression. The cycle of grief will be experienced in different ways depending on the type of loss and emotional development of the

Death is a universally experienced phenomenon. In the United States alone, over 2.6 million people die each year (Center for Disease Control and Prevention [CDC], 2015). For practitioners, it is of utmost importance to better understand the process of grief to develop better interventions for bereaved individuals.

The Two-Track Model of Bereavement is a model that states loss is conceptualized along two axes. Track I pertains to the biopsychosocial functioning in the event of a loss and Track II pertains to the bereaved’s continued emotional attachment and relationship to whoever is deceased. The effect of Track I is seen through the bereaved’s functioning, including their anxiety, their self-esteem and self-worth, and their depressive affect and cognitions. Noting the ability of one to invest in life tasks after experiencing a loss indicates how they are responding to the loss of the deceased. This Track is seen as an expression similar to one of trauma, or crisis. Track II holds that the bereaved has difficulty physically separating from the deceased. This can be seen in emotional, interpersonal, or cognitive ways. It is shown through imagery and memories that the bereaved experiences surrounding the deceased, whether positive or negative, as well as the emotional distance from them. These pictures in the bereaved’s head explain both the cognitive and emotional view of the person who has died (Rubin, 1999).

Grief and loss are one of the most universal human experiences, though painful, and understandably causes distress. However, approximately 15 % experience a more problematic grieving process with elevated symptoms of depression and/or posttraumatic stress symptoms (Bonanno and Kaltman, 1999).There is no well-established model of the timeline for resolution of grief and the variance of its expression is wide. Many persons cope with the emotional pain of bereavement without any formal intervention. However, individuals who have experienced traumatic bereavement, such as deaths that are sudden, violent, or due to human actions (Green 2000), may face particular challenges. Researchers have tried to define a model for the treatment of traumatic bereavement that fully supports not only the client, but also those working with the clients around their trauma

Grief is a personal adaptive reaction to the loss of a relationship or a serious attachment and it’s a process that takes time. Nicholas Wolterstorff in his book, Lament for a Son, narrated this grief process as he reflected on his son’s death. Provoked by death, grief can impede a person’s thought process and can take a heavy toll as they become emotionally labile (Brosche, 2003). In a healthcare setting, a nurse may experience grief after the death of a patient and often this emotion is masked and kept private. It is crucial for healthcare providers to recognize and deal with emotions appropriately to competently function in the workplace. This paper will examine the five stages of grief as defined by Kübler-Ross and how these stages are in parallel to Nicholas Wolterstorff’s grief process and how he eventually finds joy in understanding the significance of death.

Grieving is a process the human mind goes through to stay healthy through a large loss. According to the American Psychology Association “Coping with the loss of a close friend or family member may be one of the hardest challenges that many of us face. When we lose a spouse, sibling or parent our grief can be particularly intense. Loss is understood as a natural part of life, but we can still be overcome by shock and confusion, leading to prolonged periods of sadness or depression. The sadness typically diminishes in intensity as time passes, but grieving is an important process in order to overcome these feelings and continue to embrace the time you had with your loved one.” The argument could even be made that grief is part of psychologist Abraham Maslow’s hierarchy of human needs (See Below), which is a pyramid shaped diagram used to explain the basic needs of humanity. In a brief explanation Simple Psychology puts is simply, “Maslow wanted to understand what motivates people. He believed that people possess a set of motivation systems unrelated to rewards or unconscious desires. Maslow (1943) stated that people are motivated to achieve certain needs. When one need is fulfilled a person seeks to fulfill the next one, and so on… This five stage model can be divided into basic (or deficiency) needs (e.g. physiological, safety,

A common struggle for many folks identify is trying to figure out how grieving is operationalized and whether they are doing it "right". "Doing it right" usually has two meanings for the person struggling with a loss. The first has to do with reaction - many folks spend a good deal of time trying to figure out whether how they are feeling in relation to the loss is normal. The second has to do with process - a desire for a blue print on how to go about grieving.

In her seminal work on grief and grieving, Elisabeth Kubler-Ross introduced the concept now very well known as the Five (5) Stages of Grief, enumerated chronologically as follows: denial, anger, bargaining, depression, and acceptance. In this concept, Kubler-Ross explored and discussed the normative stages that people go through when they experience the loss of a loved one and feel grief as result of this loss. It is also through these stages that people are now more aware of their feelings and thoughts when experiencing grief and the loss of a loved one. While the stages of loss are mainly developed for grief experienced with the death of a loved one, it is a generally accepted framework in understanding feelings of grief when an individual experiences the loss of a significant individual in his/her life. The discussions that follow center on the discussion of Kubler-Ross' 5 Stages of Grief, applied in the context of the Story of Job in the Bible.