Theories and models that have been developed to explain how or why we feel what we do and ways of working through grief.
Many professionals have expanded on Freud’s model of bereavement, which emphasises that grief about personal attachments and the process of experiencing pain, detaching from the deceased and rebuilding a new life with them (Walsh, 2012).
Margaret Stroebe and Hank Schut’s model attempts to explain how people alternate from intense pining and normality for the dead person (Walsh, 2012). Psychologist J. William Worden’s stage-based model outlines four tasks of grief, to: accept, work through, adjust, maintain and move on (Worden & Winokuer, 2011).
Therese Rando’s model outlines how people proceed through six phases of mourning in order to work through grief; recognition; understanding/acknowledging loss; reacting to separation; recollect or re-experience relationships; readjust or reinvent (Rando, 1986).
John Bowlby stated that attachments develop early in life, if broken or lost, an individual will experience distress or emotional disturbance (Smith, 2004; Walsh, 2012; Windell 2012).
Bowlby’s theory of attachment explains how attachments influence the degree of grief experienced; why some people are affected more than others. Every infant will form an intense attachment to the significant people who provide their basic needs of shelter, food, protection and love, crucial in the development of infants (Smith, 2004; Walsh, 2012).
Bowlby’s expansion of Freud’s findings, discovered that attachments established by infants, either real or assumed, have important consequences throughout their entire life (Santrock, 2014). The fear of the unfamiliar, produces/aids a healthy attachment with the primary caregiver or mother, which can be perceived in two ways; being with the mother, the child shows contentment – if they cannot see her, the child is obviously upset (Weiten, 2001; Windell 2012). This separation occurrence is also determined as the first form of grief that a person learns to regard reactions to the loss of the significant other.
Elisabeth Kubler-Ross’s model to first explain the behaviour or thinking experiences of the terminally ill and encouraged the attention towards the quality of life for dying people or their families (Santrock, 2014; Walsh, 2012).
A person’s grief transitions through five stages: denial and isolation, anger, bargaining, sadness or depression and acceptance (Santrock, 2014; Walsh, 2012).
The first stage is a temporary defence of denial and isolation, the person does not believe that it is really happening, they feel very alone. Anger is the second stage, the person gets angry at the situation and the realisation that loss is major or why me?
Bargaining, the person questions what they could have done or do differently, wondering what they can do to stop or reverse the unavoidable. Sadness or depression begins when the person understands that they will die, and is their emotional response. Acceptance is considered, that the person comes to terms with death, often wishes to be left alone and they begin to plan for the end or their future.
Eric Lindemann’s model of outlines tasks to work through grief, such as emancipation, readjustment and formation (Walsh, 2012).
Lindemann’s model theorises grief as a process of simultaneous change through various loss dimensions; emotional, social, physical, spiritual, lifestyle, practical and identity losses (Walsh, 2012). His model helps those offering support to gain a better understanding their circumstances or grief outlined in the main areas that are affecting the individual to understand what resources are available to the bereaved.
Understanding grief reactions/responses and help/support
Everyone will die or lose loved ones, however, we still struggle with this reality by defending ourselves against it from a young age (Day, 2008). Infants do not have the cognitive ability to understand death of others or themselves, however they do experience the feelings of loss in reaction to separation from their main caregiver, the first step for them to develop an awareness of death (Walsh, 2012).
Children begin to test the reality of death as they reflect on the information received from others, they will struggle to understand what death means (Walsh, 2012). When children reach the age of 9 or 10 years old, they have learned that death becomes unavoidable, however, death is final or scary, but death happens mostly to old people, not them (Walsh, 2012).
Adolescents comprehend that death is permanent, irreversible, affects everyone and they may present with behaviour that indicates denial (Walsh, 2012). Adolescents become more thoughtful about death, as they are now capable of mature/thoughtful reflections on the meaning of life/death. When confronting their own death, adolescents may struggle with existential questions or the probing, philosophical questions that get down to the nature of who we are or why we are even here (Walsh, 2012). This carries on throughout adulthood, till their end or death.
All adults fully comprehend the impact of death and the full complex range of responses of different people in different situations increased sensitivity and openness to others and alternate ways of coping (Walsh, 2012). When adults are confronting their own death, they feel anxious and uncomfortable; some may seek assistance from their elders or spiritual/ pastoral leaders (Walsh, 2012).
Elderly people have gone through a life of change or adaption, which is the difference between old adults and those at earlier stages of development, they begin to expect loss as they age they must work through the grief of multiple deaths which provides some preparation for their own passing (Jeffrey’s, 2011).
Elderly spend a lot of time reminiscing, thinking of what they experienced or what they have done in their lives, often when others die they are left wondering why they are still there (Jeffrey’s, 2011). The world becomes lonely, sometimes unfriendly ‘ after loss of spouse. Elderly begin to anticipate their own death and contemplate the end of life, death becomes a bigger part of life during old age (Walsh, 2012).
A large part of aging is experiencing multiple and sequential non-death losses, including the physical changes in family, job, social roles, also working through shifts in their cognitive thinking (Jeffrey’s, 2011).
Common grief reactions An individual’s grief reaction is generally determined by the circumstances surrounding the loss, the social support, the cultural influences or the media intrusions; whether they are high-profile losses or the individual already has multiple stressors (Walsh, 2012).
Grief symptoms felt by individuals of all ages, can show in forms of physical pain or health issues; headaches, appetite or sleep disturbances, stomach upsets (Jeffrey’s, 2005). Pre-teens have a developed heightened sensitivity to others emotions (anger, stress, etc.) and an increased awareness of vulnerability and may present regressive and impulsive behaviours that indicate they under stress (Walsh, 2012).
Pre-teens, like younger children learn to reflect how others react around them. They are capable of empathy and expressing caring for the others who are grieving. Pre-teens may become especially anxious about the family and their safety or well-being, they tend to take on more adult responsibilities, try to please those around them and spend more time with friends for moral support. (Ewart, Neser & Hendry, 2008).
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