Grief: the continuing theoretical journey

Continuing our chronological journey through grief theories, we have now reached the late 1980s and into the1990s, when lots of changes in approaches were occurring.

Worden 1988

Worden, in his book Grief Counselling and Grief Therapy introduced the notion that the bereaved can take action during the process of grieving, and so feel less helpless. He wrote that there is individuality, autonomy and choice in grieving and that grief is not a linear process, and he also introduced the concept of uncomplicated and complicated grief (a concept that is still being debated today).

He is best known for introducing the 4 tasks of mourning, and they are:

1. To accept the reality of the loss (which can take quite some time)
2. To work through the pain of grief
3. To adjust to an environment where the deceased is missing (e.g. take on new roles and skills and a new identity)
4. To emotionally relocate the deceased and move on with life (e.g. love other people without loving the deceased any less)

Note that these are tasks, not stages, so do not occur in a lineal fashion.

Doka 1989

The concept of Disenfranchised Grief was discussed by Doka, and he defined this as grief from a loss that cannot be openly acknowledged or socially supported (e.g. abortion, suicide). He said that this will impact on the experience of grief, the meaning attached to it and the process of integrating the loss.

He also identified that both males and females show aspects of feminine (later changed to intuitive) grief (intense feelings, sharing with others, seeking help) and masculine (later changed to instrumental) grief (intellectualisation, anger, guilt about not protecting a loved one, self-reliance), and instrumental grieving is less understood (or accepted) than intuitive grieving, although it is just as legitimate.

Rando 1993

Rando built on Worden’s ideas and the concept of assumptive worlds. The major processes of grief were defined as:

• Recognising the loss
• Reacting to the separation
• Recollecting the deceased and the relationship
• Relinquishing old attachments to the deceased and the old assumptive world
• Readjusting to move adaptively into a new world without forgetting the old
• Reinvesting in new relationships and pursuits

Moos 1995

Moos highlighted the social context of grief and said that the social context will impact on the meaning of the loss for the individual. External factors (society, culture and religion) have an impact on the internal experience of loss.

Attig 1996

In How we Grieve: Relearning the World Attig talked about grief being an active process with choices and said it is about re-learning the world. The web of familiar relationships with self, with others and with the environment is temporarily shattered, although the bereaved person previously found meaning in these things. The process of grieving is about re-learning the world in a way that is right for them (e.g. ways of going on, their relationship with the deceased, aspects of themselves and their surroundings). Bereaved people engage in active participation in their grieving rather than remaining helplessly passive – they have no choice about the event, but they can choose how to respond to it.

 In the next post we will look at the late 1990s, but it is worth considering how the theories outlined in today's post might impact on working with grief.