Grief & Bereavement Counselling Models Part 2

Hello Everyone,

This is the second part of the article about Grief and Bereavement Counselling Models from Neil Morrison. This article was published in the Institute of Counselling’s journal ‘The Living Document’ Spring 2010 edition. Please enjoy.

Murray Parkes moved from stages to phases and cycles, which were fluid in their construction. He worked with Bowlby (l6), the father of attachment theory, and so began to understand the dynamics of attachment and separation and the pain that this dynamic caused. Dr. Parkes presented a lecture to Cruse Bereavement Care (17) which included the following powerpoint slide:

ATTACHMENT THEORY

(John Bowlby)

 

All social animals become attached to each other.

  • The main function of attachment is to provide security.
  • The function of crying and searching following separation is to provide reunion.
  • The nuclear source of security is the family.

The above illustration of social attachment shows how security, reunion and the family are all impacted by death and bereavement. That is, “the ideas that Colin Murray Parkes shared together go beyond description to propose an explanation, rooted in attachment theory, for the nature of complicated responses to bereavement. The thinking expounded here is destined to become part of the accepted fabric of those working in this field and will undoubtedly prompt continuing debate and further research.” The key word here is complicated – no matter whether it is ‘stages’, ‘cycles’ or ‘tasks’ of grieving and mourning.

Stages of Grief –

 

A Cyclical Model (ColinMurray Parkes)

 By describing different stages, Murray Parkes (18) implied that grief was a journey. It has various landmarks and the route will meander and change direction along the way. The final destination or end point of the journey is the healthy resolution of the loss.

Four stages are identified. These include:

1.     Shock versus Reality –

–         Characterised by numbness, denial and a sense of unreality.

2.  Protest versus Experience

–         Characterised by yearning and longing for what is lost.

3.  Disorganization versus Adjustment

–          Slowly realizing the full impact of the loss and finding a way of coming to terms with the changes death precipitates.

4.  Attachment versus Reorganization

–          Accepting that life has changed forever. Reattaching and forming new relationships. Establishing a new and fulfilling life separate from the deceased.

Colin Murray Parkes emphasized that these stages manifested in cycles which could reoccur during the grief journey.

William Worden – The Tasks of Mourning

William Worden (19) introduced the ‘Tasks of Mourning’. This not only observed what happened to grieving clients but was also proactive in that it suggested ‘tasks’ that clients could work through in order to facilitate the grieving experience. These are summarised below:

Task 1: To Accept the Reality of the Loss.

Task 2: To Work Through the Pain of Grief.

Task 3: To Adjust to the Environment in Which the Deceased is Missing.

Task 4: To Emotionally Relocate the Deceased and Move on With Life.

When a grieving client cannot work through each task successfully, they may experience complicated mourning.

This can be described as follows:

Task 1 not tackled: This is where the person does not acknowledge the reality of the loss.

Task 2 not tackled: This is where the person has not allowed himself or herself to experience the pain of grief.

Task 3 not tackled: This is where the bereaved person is unable to adjust to living without the person who has died.

Task 4 not tackled: This is where the person is unable to move on and does not, therefore, have the energy to adjust to the environment without the deceased(20),(21)Worden’s Task 4 has received some criticism, as is highlighted by the following quote from a University paper on ‘Holding on and letting go: The resolution of grief in relation to two Xhosarituals in South Africa’:

“While the dominant emphasis in contemporary bereavement literature is on the need for the bereaved to sever their ties with the deceased, this is not a straightforward issue … (It is possible that) some ties are not easily severed. Maintaining the polarity between the ‘holding on’ versus ‘letting go’ distinction is thus not always helpful, as this ignores the references within contemporary literature to holding on and disregards a multiplicity of meanings of what holding on and letting go entails”.

Worden himself has moved on from ‘letting go’ to ‘relocating’ the deceased in the mind of the bereaved. This is viewed as being a more humane way of counselling the person.

 

(16) Bowlby J. (1988). A Secure Base: Clinical Applications of Attachment Theory. Routledge: Hove.

(17) w w w.crusebereavementcare .org ,uk

(18) Parkes C.M. (2006). Love and Loss: The Roots of Grief and its Complications. Routledge: Hove.

(19)        Worden, J.W (2001). Grief Counselling and Grief Therapy. (3rd Ed). Routledge: Hove.

(20)        http://www.heron.nhs,uk

(21)        www.uel.ac.uk

 

References

Bowlby J. (1988). A Secure Base: Clinical Applications of Attachment Theory. Routledge: Hove.

Parkes C.M. (2006). Love and Loss: The Roots of Grief and its Complications. Routledge: Hove.

Worden, J.W. (2001). Grief Counselling and Grief Therapy. (3rd Ed). Routledge: Hove.

http ://bjp .rcpsvch .org

http://www.businessballs.com/elisabeth kubler ross five stagesof grief.htm

w w w.crusebereavementcare .org ,uk

www.grief.net/Articles

http://www.heron.nhs.uk

www.uel.ac.uk

 

I hope you enjoyed the second part of this article about Grief and Bereavement Counselling Models from Neil Morrison.

Please “Like and Share” it.

If you have any comments then you can post these in the comments section below.

Thanks.

Best Wishes

Ian

Institute of Counselling.
www.instituteofcounselling.org.uk

Online Graduate Centre

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Grief & Bereavement Counselling Models Part 1.

Hello Everyone,

 

This is an article about Grief and Bereavement Counselling Models from Neil Morrison. This article was originally published in The Living Document Spring 2010. I hope you enjoy.

 GRIEF AND BEREAVEMENT COUNSELLING MODELS

By Neil Morrison

Introduction

Historically, counsellors will look to the work of Dr Elisabeth Kubler-Ross (13) the pioneer of support to personal trauma, grief and grieving, associated with death and dying. Her work dramatically improved the understanding and practices in relation to bereavement and hospice care.

 

Kubler-Ross’ ideas, notably the Five Stages of Grief Model (denial, anger, bargaining, depression, acceptance), are also transferable to personal change and emotional upset resulting from factors other than death and dying.

 

Dr. Kubler-Ross was at pains to stop practitioners thinking of her Five Stages of Grief Model as linear. However, it seems that this has been the thinking of many practitioners. (Worden (14), Parkes (15)). A common criticism was that not all clients come to the acceptance stage and may seem to be ‘stuck’ in the grieving experience at anger or depression. That was certainly my experience whilst in clinical training as a hospital chaplain. Many patients were stuck in their grieving experience and acceptance was by no means universal.

 

The concept that people in bereavement go through a grieving process is now also being challenged.

Is there a universal grieving process?

What seems to be developing is the view that people go through a grieving experience which is different for different people. This would, then, suggest that the Stages of Grief model is somewhat out of date.

Other theorists, while accepting the value of Dr. Kubler-Ross’ work, have moved on to phases and cycles, rather than stages, of the grieving experience (for example, Worden, Parkes and Ainsworth-Smith).

Russell Friedman and John W. James of The Grief Recovery Institute state: “We hesitate to name stages for grief. It is our experience that given ideas on how to respond, grievers will cater their feelings to the ideas presented to them. After all, a griever is often in a very suggestible condition: dazed, numb, walking in quicksand. It is often suggested to grievers that they are in denial. In all of our years of experience, working with tens of thousands of grievers, we have rarely met anyone in denial that a loss has occurred.

http://www.businessballs.com/elisabeth_kubler_ross_five_stages_of_grief.htm

 

 Worden, J.W. (2001). Grief Counselling and Grief Therapy. (3rded). Routledge: Hove.

Parkes C.M. (2006). Love and Loss: The Roots of Grief and its Complications. Routledge: Hove.

 

I hope you enjoyed the first part of this article. 

You can post your comments in the comments sections below.

Please Like and Share it.

Thanks.

Best Wishes

Ian Morrison

www.instituteofcounselling.org.uk                       

http://www.onlinegraduatecentre.com/

Counselling and Therapy Facebook
Institute of Counselling Facebook Degree Study Page https://www.facebook.com/Institute-of-Counselling-Degree-Study-108962466542697/