Models of Grief
If there is anything you need to know about models of grief, it is that there is no single model that works for all bereaved people. Many popular models of grief are based on an individual's observations of people's reactions to bereavement, rather than on any scientific research and are too rigid to reflect the complex emotions and processes of grief. One size does not fit all when it comes to bereavement.
People also say that there is no hierarchy of grief – and that's not true either. Some losses are undoubtedly more tragic and more painful than others. You cannot simply flatten the landscape of grief and say that everything is equal, it isn't. What is true to say, however, is that every loss is valid. Every loss is unique and at a time of bereavement, the worse kind of loss is yours.
Many people still talk about the ‘stages of grief’, which have unfortunately been ingrained into our cultural beliefs about loss. Thinking about grief has moved on considerably since Elizabeth Kubler Ross’s famous book On Death and Dying (1969) popularised the model.
These stages were developed to reflect the experiences of dying patients, not of bereaved people and describe a linear process for bereavement that simply does not exist. Kubler Ross herself later expressed regret that her description of the so-called stages of denial, anger, bargaining, depression and acceptance had been interpreted as a simple way to “tuck messy emotions into neat packages”. Indeed, there is no empirical evidence that people experience dying or bereavement in this way.
Other well-known models of grief include the Dual Process Model, Worden's Tasks of Mourning and Tonkins' ‘Growing Around Grief'. All have some value for explaining grief to the bereaved person, but should be used with caution - not every grief fits into any or all models.
Dual Process Model
The Dual Process Model of coping with bereavement. Source: Stroebe and Schut (2001).
The Dual Process Model describes grief as a process of moving between two modes of functioning – the ‘loss orientation’, where people focus on the emotions (usually sad or difficult) associated with their loss and the ‘restoration orientation’, where people focus on the demands of reorganising their lives and returning to more everyday tasks and issues.
The model demonstrates that it is normal for people to move between the two modes, sometimes paying attention to their grief emotions and sometimes paying attention (or being distracted by) other life issues. It is only when people get stuck in either one mode or the other (i.e. they are either constantly stuck in the sadness of grieving, or they do not focus at all on the grief and instead attend only to moving forward), that problems can arise.
Worden’s Tasks of Mourning
William Worden developed the tasks of mourning in 2008. While they may sound similar to the stages of mourning (or stages of grief), they are not a linear process and do not suggest that bereaved people should be at a certain stage in any given timeframe.
The Tasks of Mourning presents grief as an active process, whereby bereaved people need to:
- Accept the reality of their loss
- Feel and process the pain of their grief
- Adjust to a world without the person who has died
- Maintain an enduring connection with the person who has died, even when moving forward with their life.
Worden also highlights that every person's grief is unique and their response to bereavement is shaped by the nature of the death, their individual psychological makeup, life experiences, concurrent stressors and attachment to the person who has died.
Tonkin’s Model: Growing Around Grief
Tonkin’s model of grief from 1996 challenges the idea that ‘time heals all wounds’, or that grief disappears with time even though it never goes away completely.
Instead, this visual model describes a world where rather than expecting the grief to reduce (or trying to shrink it), the life of the bereaved person actually grows around the grief. Making new friends, having new experiences and beginning to look forward to new possibilities are all examples of ‘growing around grief'.
There are many other models of grief, including those which look to explain how people find meaning after a loss and also how they continue their bonds with the person who has died.
In his research, George Bonnano (2002) found that most people ultimately adapt well to bereavement, typically regaining their psychological balance after some weeks or months of acute mourning, even though they continue to miss their loved one for a long period of time afterwards.
A small number of people experience chronic grieving, or Persistent Complex Bereavement Disorder (PCBD). It is estimated that around 10-15% of bereaved people might experience PCBD and it most commonly affects people who have experienced unexpected, untimely or violent bereavements. PCBD might be an issue for bereaved people whose grief has significantly affected their ability to function for a considerable period of time (over six months) and can be supported by professional grief support.
A layperson’s guide to models of grief:
- The stages of grief (whether it's five stages, seven stages or any other number)
- ‘Closure’ – it doesn’t exist in bereavement. You don’t simply decide to move on after the death of someone important to you; grief takes its own course and its own time. You always carry your losses with you throughout life, but in time they should become more bearable
- Working through your grief – it really isn’t as simple as that, although taking positive steps to recognise your grief, taking good care of yourself and reaching out for support if you feel that you need it are always helpful
- The idea that bereavement is always associated with depression, anxiety or other mental health problems – for most people it isn’t. Only a small percentage of people need professional support, most people cope with grief with the help of family, friends and community.
- The Tasks of Grief – accepting the reality of your loss, processing the pain of your grief, adjusting to the world without the person who has died and finding ways to keep the memory of the person who has died, while at the same time moving forward with your life are all important things to do
- Moving between grieving and getting on with life is normal - ups and downs on a daily basis are common for a period of weeks and months after a significant loss
- Continuing bonds with the person who has died – death ends a life, not a relationship. Studies show that approximately half of bereaved people experience a sense of the presence of the person who has died
- Resilience – most people are much more resilient than they imagine and the majority of people get through the difficult times of grief without any professional support or long-term negative consequences on their physical or mental health
- Post-traumatic growth – personal growth is common (and scientifically proven) even after the most unimaginable and painful losses.
Contributed by Catherine Betley, Managing Director of Professional Help Limited & GriefChat®
Catherine has over 20 years experience of managing counselling and therapy organisations, starting and developing new projects and ventures and delivering training and support to a huge range of organisations.
She has worked in business and across the voluntary and community sector at local, regional and national levels, including a serving as Director of Services for Cruse Bereavement Care, the world’s largest bereavement charity.
Catherine is currently Managing Director of Professional Help Limited, which delivers confidential and impartial support and counselling including employee support, critical incident response and bereavement counselling. In 2017, Catherine set up GriefChat® which enables bereaved people to chat instantly online to a qualified bereavement counsellor. GriefChat won the ‘Best Bereavement Support Website’ category at the 2018 Good Funeral Awards.
We know that no-one can understand exactly what your loss feels like to you. But we do understand that it’s sometimes easier to talk to someone outside of your friends and family about grief and the impact bereavement has on your life. This is why we offer the GriefChat service.
GriefChat was created by bereavement experts and allows you to chat directly to a specially trained bereavement counsellor. GriefChat counsellors are experienced in supporting bereaved people and will listen to your story, explore how your grief is affecting you and help you to find any additional support you might need.