Bereavement and loss – Part two

The Dual Process Model

Continuing on from my first blog about bereavement and loss, today I would like to focus on The Dual Process Model.

This model is one of my favourites to use when thinking about the process of grieving, coping with and adjusting to a loss. The dual process model was developed by two researchers called Stroebe and Schut, who researched into the experiences of bereaved people and is shown below:

The-dual-process-model-of-coping-with-bereavement

I particularly like this model of coping with a bereavement, as it focuses not only on the experiences of the loss, the thoughts, feelings and behaviours that we might experience when bereaved, but it also focuses on the aspects of what we can do in order to adjust to the loss of a loved one.

Loss orientation

The loss orientation side of the dual model focuses on what the bereaved person does when processing some aspect of the  loss.

Traditional theories of grief work will sit in this side of the model. It is interesting when looking up the meaning of grief work that I came across the following account of Erich Lindemann’s work at: https://whatsyourgrief.com/grief-work-grief-theory-erich-lindemann/

I am including more details of grief work here because chances are, even if you know nothing about grief theory, that somewhere along the way you may have heard someone talk about ‘grief work’, ‘the work of grief’ or something similar. This term was coined by Erich Lindemann, dating way back in the 1940s.  Lindemann was a psychiatrist who studied grief, doing research working with grieving survivors of the Coconut Grove tragedy.

Lindemann’s understanding of how people progress through grief and ultimately reduce the symptoms of grief, is by doing ‘grief work’.  Lindemann explains that grief work will take different times for different people, but ultimately will require the same three tasks, as shown by the following picture:

lindemann-grief-3 1. Emancipation from bondage to the deceased  

Basically this means that we have strong attachments to the person we lost and those connections are linked to our incredible pain and negative reactions.  Lindemann explains that we need to move on (“emancipate from bondage”) in order to proceed with ‘normal’ grief and go on to form new relationships.

Lindemann does clarify that this is different than forgetting about the person we lost. However, the wording does suggest that we need to be released, or freed from the bond with our loved one.  A later grief theory called continuing bonds talks about being able to cherish the bonds with our loved one that has died and being able to continue with them as part of our lives and maybe develop this bond further after the person has died.  This has certainly been my experience of bereavement, I was able to further develop the bond I had with a significant person in my life that died. This process was facilitated through counselling.

2. Readjusting to a new environment in which the deceased is missing.

This stage is a bit more straightforward, and is one that you see in other grief theories.  After you lose someone the world is completely different, yet utterly the same.  We have to find a way to make sense of a world that our loved one is no longer physically a part of.

3. Form new relationships.

building-relationships

For Lindemann, letting go of the attachments in the first task is an important part of opening up to new relationships.

I am sure many grievers would agree that, as continuing bonds theory suggests, we can create a new type of relationship with the person who died, while forming new and meaningful relationships with others.

It is interesting to consider the term ‘grief work’.  Despite the fact that many people have heard the phrase, society generally does not want to give us the time and space we need to engage in ‘grief work’. Grieving is ‘work’ and we need to give it time and attention in order to cope. Counselling can give you the space that you need to process the grief and do the work of grief.

 

Coming back to the loss orientated side of the model. Intrusion of grief may involve yearning for the deceased – thinking about them continuously, looking at old pictures, or videos. Thinking about what the deceased may have said, or done in a certain situation and experiencing the sadness and the pain of the death of a loved one. Many may describe the hole that the loved one has left in their lives, or a feeling of emptiness, or of feeling lost.

Restoration Orientation

The loss of a loved one also brings changes to the life of the bereaved individual. These changes may involve having to learn to do tasks which the deceased used to do, which could include learning to pay bills and having to manage the household chores (DIY, cooking, cleaning etc…).

The bereaved individual may have a change in roles and relationships.

The bereaved person may try new things, or do things in memory of the loved one that they lost. This could include fundraising for charity in memory of their loved one, trying out a new hobby, changing careers. The list is endless…

derbyshire-peaks-charity-run-4-0

Dual process

The model is a dual process, as the bereaved person must work through both the loss orientation side and the restoration orientation side of the model. They cannot attend to both sides of the model simultaneously, so it is normal for them to oscillate between the two dimensions.

Different cultures may vary on how much the individual directly focuses on the experience of being bereaved and how much they avoid the memories of the bereaved person and distract themselves.

In my experience people will show signs of both loss orientation and restoration orientation in their thoughts, feelings and behaviours and move between the two.

Moving from loss orientated behaviours to restoration orientation behaviours may allow the bereaved individual to take a ‘break’ from confronting their grief, thereby helping them to enhance mental and physical well-being. As the bereaved individual has ‘doses’ of confronting and avoiding the death that can be managed healthily.

The dual process model suggests that counselling, or other interventions needs to support booth loss orientation and restoration orientation work, rather than solely focusing on grief work.

According to what I learnt on the Awareness in Bereavement course for Cruse Bereavement Care, if there is no oscillation between loss orientation and restoration orientation, there is a risk of pathology. Chronic grief is an example here there is no oscillation and the entire focus of the bereaved person is loss orientated. Similarly, when a person denies the reality of a death, there is no oscillation, but the entire focus is on restoration.

A complex, chronic grief may result in the grieving process being prolonged and the bereaved person may have difficulties re-engaging with their life.

 

I would welcome your thoughts on the Dual Process Model and as ever if you have any questions please don’t hesitate to get in contact.

Best wishes,

Mary

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