The Dual Process Model Of Grief: An Alternative Approach
The process of mourning a certain loss becomes a very complex event for the individual, both from an emotional, cognitive and behavioral point of view.
It seems obvious to differentiate the difficulty that this process entails taking into account the external circumstances surrounding said loss, such as the particularities in which it took place (whether it was abrupt or gradual), the type of link between the object of mourning and the surviving person or the skills that such individual has to manage this type of situation, etc.
In this article We will focus on the Dual Process Model of Grief and its implications.
The first approaches: the stages in the process of mourning
In a more traditional way, on the one hand, a certain consensus has been established among various expert authors in the area, a set of stages through which people must go through throughout the psychological elaboration of the grieving process. Even so, the idea that Not all individuals follow the same pattern in experiencing these phases
For example, the renowned Elisabeth Kübler-Ross Model (1969) assumes the following five stages: denial, anger, negotiation, depression and acceptance; while Robert A. Neimeyer (2000) refers to the “grief cycle” as a highly variable and particular process where permanent life adjustments occur during avoidance (absence of awareness of the loss), assimilation (acceptance of the loss with predominance of feelings of sadness and loneliness and isolation from the social environment) and accommodation (adaptation to the new situation in the absence of the object of mourning).
Despite such discrepancies regarding the number of stages or the conceptual label given to them, it seems like a nuclear phenomenon to understand grief as a transition period that goes from non-acceptance to assimilation, where feelings of sadness, longing, anger, apathy, loneliness, guilt, etc. come together. with a progressive return to obligations, responsibilities and personal vital projects.
At first it has a higher weight the first set of emotional reactions, but little by little the second element related to behavioral activation becomes more relevant, until it is balanced with respect to those. This allows the person to evaluate said loss from a more global perspective, since the fact of resuming the routine allows the person to connect in a more realistic way with the world around them and to somewhat distance their focus of attention, transferring it from the object of the loss to the vital re-adaptation of the different personal areas.
The dual process model of grief
This idea is what Margaret Stroebe defends in her “Dual Process of Grief” Model (1999), where the researcher explains that the assumption of grief involves the person moving continuously between the realms of “loss-oriented functioning” and “loss-oriented functioning.” reconstruction.”
Loss-oriented functioning
In this first process, the person focuses their emotional burden on experiencing, exploring and expressing in different ways (verbally or behaviorally) in order to understand the meaning that the loss brings to their own life.
So, the survivor is in a period of introspection, which could be understood metaphorically as a process of “behavioral energy saving” in order to consolidate this primary objective. The most characteristic manifestations in this first cycle are: being in contact with the loss, concentrating on one’s own pain, crying, talking about it, maintaining a passive behavior, presenting feelings of depression, isolation, having the need to discharge emotionally, promoting the memory or finally, denying the possibility of recovery.
At this stage, small episodes of “reconstruction-oriented functioning” appear in the individual, which increase in frequency and duration with the passage of time. Thus, it is observed in the person as invests his effort and concentration in the adjustments he has to make in the different vital areas: family, work, social. This has the purpose of being able to channel outwards the affectation experienced in the most acute stage of grief.
This functioning is based on actions such as: disconnecting from the loss, tending to deny the situation, distracting oneself, minimizing the affectation, rationalizing the experience, avoiding crying or talking about the loss, focusing on redirecting vital areas, adopt a more active attitude or focus on fostering interpersonal relationships.
The denial of loss as a central element of the model
In this model it is proposed, as can be seen in the previous paragraph, that denial of loss takes place throughout the process of mourning, being present in both types of functioning, and not found exclusively in the initial phases, as other more traditional theoretical models proposed.
This denial, It is understood as an adaptive response which allows the individual not to constantly focus on the reality of the loss, but rather to get used to it more gradually. This gradation avoids the experience of too intense (and unaffordable) pain that would be implied by abruptly confronting the assumption of the loss.
Among many others, some experts such as Shear et al. (2005) have designed a psychological intervention program according to Stroebe’s postulates. These studies have focused on working with patients on the indicated component of anxious denial (or loss-oriented functioning) and depressive denial (or reconstruction-oriented functioning) of loss. The central elements of this type of therapy have included components of gradual and personalized behavioral exposure and cognitive restructuring
Shear and his team obtained very promising results in terms of the effectiveness of the interventions carried out, while at the same time they had a sufficient level of scientific rigor when designing and controlling the different experimental situations. In summary, it seems to have been observed that cognitive-behavioral approaches provide an adequate level of effectiveness in this type of patient.
Conclusion
The model presented in this text aims to offer a conceptualization of grief focused on the process and aims to move away from a more “phase” perspective as defended by previous proposals. The low level of uniformity in the experience of personal grief does seem to be contrasted, assuming the particularity with which this phenomenon operates in each individual.
This is explained by differences in coping skills and psychological or emotional resources available to each individual. Thus, although the general effectiveness of psychological interventions linked to this objective has been growing in recent decades, they still have a limited and improvable effectiveness index, which must be linked to the continuation of research in this area of knowledge.
