In counselling practice, there are a number of different contemporary models of the process of bereavement and grieving which are helpful when working with bereaved clients.
The models outlined here are drawn from well-established bereavement research commonly referenced within counselling and psychotherapy.
By taking a broader understanding of grief after a bereavement, my starting point is based on attachment theory which defines attachment as a ‘lasting psychological connectedness between human beings’ (Bowlby, 1969). When a person is bereaved, their life is overshadowed by the loss of an attachment figure resulting in anguish caused by this separation and they seek to re-establish the closeness they once had to the attachment figure (Mikulincer and Shaver, 2007).
Silverman and Klass (1996) suggest that bereavement never fully resolves as the bereaved person revisits their loss and its meaning in a cyclical manner over their lifetime through a continuing bond due to an ongoing attachment to the deceased person. This can lead to the natural question of how long does grief last?
Some models of bereavement identify phases or stages of mourning. These models are often criticised as they imply a linear, step-by-step grieving process:
- Bowlby and Parkes (1970) identify four phases of mourning: Numbing, Yearning and Searching, Disorganisation, Reorganisation.
- Kubler-Ross’ (2014) model has five stages of grieving: Denial, Anger, Bargaining, Depression, Acceptance.
Some people find that their grief does not show itself through obvious distress, but through emotional distance, delayed reactions, or a strong focus on coping. This more subtle pattern is explored further in when grief doesn’t look like grief: avoidant attachment and invisible mourning.
Bowlby’s and Parkes’ four phases
Each of Bowlby’s and Parkes’ four phases has a predominant feeling attached to it:
- Numbness – the predominant feelings are:
- Shock;
- Disbelief.
- Yearning – the predominant feelings are:
- Reminiscence;
- Searching;
- Anger;
- Guilt.
- Disorganisation and despair – the predominant feelings are:
- Anxiety;
- Loneliness;
- Ambivalence;
- Fear;
- Hopelessness;
- Helplessness;
- Reorganisation – the predominant feelings are:
- Acceptance;
- Relief.
However, these phases and feelings do not occur one after another, but mostly overlap as we can move from one phase to the next one and then back again. This is best captured in the dual process model of coping with loss.
Attachment theory
Attachment theory has moved contemporary bereavement research on from the limitations of psychoanalysts such as Freud who felt that successful adaptation to a death and completion of the mourning process required the bereaved person to abandon their attachment to the deceased person (Stroebe, 2002; Granek, 2010).
The Grief Work Hypothesis, which also works towards detachment from the deceased, has also been criticised for a lack of clarity in its work and the absence of sound evidence for it (Stroebe & Schut, 1999). For grief counselling that focusses on the client’s acceptance of separation, it also remains unclear how the mechanisms of bereavement counselling address the impacts of the loss (Schut & Stroebe, 2010; Beischel, et al., 2014; Klasen, et al., 2020).
Attachment is the relationship or bond that one person feels for another person (the attachment figure) even when the other is not present. Without this attachment there would be no grief, nor the emotional distress associated with loss that is intrinsic to the attachment process (Bowlby, 1997; Holmes, 2015).
The function of the attachment figure is to provide a secure base that enables exploration with the confident expectation that the attachment figure is physically available as a resource for coping whatever the present problem may be (Pickard & Nelson-Becker, 2011; Eagle, 2017). With the loss of an attachment figure and the secure base they provided, exploratory activity may no longer take place and may lead a bereaved person to withdraw from day-to-day activities due to feelings of vulnerability (Wayment & Vierthaler, 2011; Eagle, 2017).
The loss of a secure base may also result in overwhelming separation distress for the bereaved person (Bowlby, 1997; Pickard & Nelson-Becker, 2011; Eagle, 2017). This separation distress leads to an on-going search to re-establish the closeness once held with the attachment figure (Archer, 1999; Mikulincer & Shaver, 2007; Parkes, 2010) in the hope of relieving this distress by looking for answers to the following questions:
- About the person who has died: Where has that person gone and how are they?
- About their relationship with the person who has died: Will I be with them again?
- About their own life: How do I continue without them? (Holden, 2012).
The ongoing attachment expressed in these questions reflects a continuing bond by the bereaved person to the deceased person (Silverman & Klass, 1996; Schut, et al., 2006; Parkes, 2010). Bereavement theorists and practitioners (e.g., Silverman and Klass (1996), Schut, et al. (2006), and Root and Exline (2014)) suggest this continuing bond to the deceased is an important aspect of successful adaptation to a bereavement in which both the bereaved and the deceased remain involved and connected (Field, 2006; Root & Exline, 2014).
A bereavement may also undermine a person’s self-narrative by questioning the validity of their core beliefs about life, death, and the existence of an afterlife as they search for meaning and purpose about the nature of life and living (Nelson-Becker & Canda, 2008; Neimeyer, et al., 2010; Loetz, et al., 2013). Searching for answers to these questions provides a meaning-making approach for how grief is understood after bereavement to become a process of reconstructing a world of meaning to re-establish a coherent self-narrative that integrates the loss (Neimeyer & Wogrin, 2008; Neimeyer, 2016).
The dual process model of coping with loss
The dual process model of coping with loss (Stroebe, 2002) explains how grieving is an adaptive process caused by oscillating between restoration-orientation (attending to life changes, distraction from grief etc.) and loss-orientation (grief work, avoidance of restoration etc.)
The dual-process and continuing bonds models suggest a person does not grieve in a linear manner, as in Kubler-Ross’ Five Stage model of loss or Bowlby’s four phases of mourning, but in a cyclical manner by re-visiting and re-negotiating the loss and the associated feelings.
This also suggests that at times a grieving person may actively refuse to make any changes to their pattern of living in the hope their loss will not become real. At other times they be more actively engaged in activities related to the adjustment, re-organisation and recovery of their relationship with the deceased (Bayliss, 2008).
In a similar way, these phases and oscillations of coping are experienced differently by each individual, and timescales also vary. In general, the numbness wears off within around a month, the yearning phase reduces over about six months and the feelings of disorganisation and despair can take up most of the first year after a bereavement.
Summary
For many people, their grieving proceeds gradually as acceptance occurs, alongside which reorganisation of one’s life and beliefs takes place. As a result of this gradual process, by the end of two years a majority of bereaved people will talk of feeling more settled and able to take part in the ongoing highs and lows of living.
