Grief is usually defined as a person’s constellation of responses to bereavement. These include thoughts, feelings, and behaviors that accompany coping with and adjusting to a loss. As a universal human phenomenon, grief has biological, cultural, and uniquely individual components.
Grief’s biological aspects can be seen as having roots in the behaviors of animals. Graylag geese were observed by ethologist Konrad Lorenz as having a pattern of restless searching for a lost mate. Bereaved primates such as rhesus monkeys exhibit patterns of depressed behavioral activity, lowered bodily temperature, and whimpering. Elephants have been reported to bury dead animals (including humans). Thus, grief may not be limited to the realm of the human.
Cultural determinants of grief can be seen in the answers to such questions as whether the work of grief should be to detach the person from the lost loved one and get on with a productive life or, conversely, whether grieving should foster a continuing relationship with the deceased. Modern Western cultural norms clearly favor moving on and not ruminating on a loss. Looking through a historical cultural lens, however, there have been many cultural instances in which the maintenance of a relationship with a deceased loved one is a normative grief response.
Individual aspects of grief are the result of many factors in addition to the cultural and biological. These include the personality and coping history of each griever, his or her relationship with the deceased, and the circumstances surrounding the loss. Both cultural and individual differences point to the fact that no single formula exists for successful resolution to grief.
John Bowlby ((1980)) demonstrated in his work the importance of affectional bonds or attachments. According to Bowlby, we form such bonds through repeated close contact with another. Many of our needs, especially needs for safety and security, are met through our attachments to intimate others. As a result, the death of someone to whom we have been attached is a painful experience. Drawing on the work of Bowlby, several theorists have described grief as occurring in stages or phases. Colin Murray Parkes ((1987)), for example, described four phases of grieving: shock and numbness (an initial reaction of feeling “dazed”); yearning and searching (protesting the reality of the loss); disorganization and despair (questioning one’s sense of self); and reorganization (making sense of one’s life and integrating the loss into one’s scheme of life).
The experience of losing someone to whom we have been attached occurs on at least four levels, according to thanatologist J. William Worden ((2001)). Thus grief is normally seen in ways that reflect these levels of experiencing, and knowing that these are “normal” reactions sometimes brings a measure of reassurance to the grieving person. Worden’s levels are (1) normal feelings, including sadness (the most common feeling), shock, numbness, yearning, loneliness, guilt, anxiety, helplessness, fatigue, and anger; (2) normal cognitions, including confusion, difficulty concentrating, disbelief, preoccupation, and hallucinations (thinking one has just seen or heard the deceased); (3) normal behaviors, including crying, sleep disturbance, eating disturbance, restlessness, and searching for, calling out to, or dreaming about the deceased; and (4) normal physical sensations, including oversensitivity to noise, a lump in the throat, tightness in the chest, shortness of breath, dry mouth, lack of energy, and muscle weakness.
Others, notably Corr, Nabe, and Corr ((2000)), have included two additional levels of normal grief response: (1) social disturbances, including withdrawal, problems in relationships, and problems working in groups (e.g., at work) and (2) spiritual disturbances, including anger with God, a search for meaning, and a sense that previous ways of making sense of life are now inadequate. Among other theorists describing grief and mourning according to a stage or phase model, Rando ((1995)) delineated a “six R” process consisting of recognizing the loss, reacting to the separation, recollecting the deceased, relinquishing the old attachments, readjusting to move into the new world, and reinventing.
Phase models have considerable face validity, because they describe experiences common to many people. However, their emphasis on sequence may not best describe the process of grieving. It may be more accurate to describe the “phases” as overlapping and often repeating events following a loss. According to research by Attig ((1996)) and others, for example it is important to recognize that grieving is a process of coping. It is a process that demands energy and presents the grieving person with tasks, choices, and even opportunity for growth. Stroebe and Shut ((2001)) have emphasized that there are actually two coping processes that constitute the experience of grief and mourning. They point out that bereavement involves two sorts of stressors, loss-oriented and restoration-oriented. Loss-oriented coping involves focusing on and processing aspects of the loss itself and includes such activities as visiting the grave and emoting about the death. Restoration-oriented coping involves focusing on stressors that are secondary to the loss. These may include dealing with diminished financial resources, added household responsibilities, and changes in familiar patterns of communication with family and friends.
The Stroebe and Shut model has come to be known as the Dual Process Model. At its heart is the idea that grieving is an oscillation between the two kinds of coping processes. Both processes are necessary for adaptive coping. An interesting finding of their research has been that men generally tend to cope in more restoration-oriented ways, whereas women tend to cope in more loss-oriented ways. Thus, counseling interventions are best when they are tailored to the type of coping with which an individual person needs help. Men tend to benefit from therapeutic interventions that focus on accepting and expressing their emotions (i.e., working on loss-oriented coping). Women, on the other hand, tend to benefit from interventions focused on problem-solving (i.e., helping them with restoration-oriented coping).
A widely accepted approach to grieving and grief therapy focuses on the individual’s reconstruction of meaning. Neimeyer ((2000)) has articulated this idiographic model, which emphasizes each individual’s unique experience of grieving. The revision of one’s life story is seen as the central process in grieving, and grief therapy as an opportunity for grieving persons to tell their life stories in ways that will help them make sense of loss and of life.
In this sense, human life can be seen as a process of telling one’s story. Through telling and revising their stories, people develop a sense of meaning, purpose, and self. Losses and deaths disrupt our stories. They can threaten assumptions that have given meaning and order to our lives. Significant losses can initiate a search for meaning. Recent studies indicate that at least 70–85% of bereaved persons engage in a search for meaning in their lives. Research by Davis, Nolen-Hoeksema, and Larson ((1998)) has found that this search usually centers on two kinds of questions. Early questions try to make sense of the loss, as in “Why did this happen?” and “What is the meaning of this loss (death)?” Later questions try to find benefits from the loss: “What can I learn from this experience?” or “What is the meaning of this experience in my life?” Neimeyer has said that such new meanings become part of the grieving person’s broad scheme of things. Thus, for most people bereavement can be a time for looking at such existential questions as “What is the purpose of my life?” and “Who am I?”
Grieving can be an active process with opportunities for growth and self-definition. Sanders ((1998)) has contributed the concept of a “decision point” that most people seem to reach after the early and perhaps more biologically influenced aspects of grieving. She points out that a grieving person makes a decision, sometimes unconsciously, to survive and go on with a new life or to remain in a state of bereavement. We learn about ourselves by observing our own behaviors following a loss, by listening to our own answers to existential questions, and by revising our life stories following the urgent experience of bereavement. A growth outcome of grieving can be increased self-perception and self-definition.
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