The Dual Process Model of Grief: An Alternative Approach

Another way of understanding the grief that arises from the loss of a loved one.

The elaboration of grief in the face of 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 involved in this process according to the external circumstances surrounding the loss, such as the particularities in which it has taken place (whether it has been abrupt or gradual), the type of bond between the object of grief and the surviving person or the skills available to the individual 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 elaboration of grief

In a more traditional way, on the one hand, a certain consensus has been established among various authors who are experts in the field on a set of stages through which people must pass during the psychological elaboration of the mourning process. Even so, it is also accepted as considerably validated the idea that not all individuals follow the same pattern. not all individuals follow the same pattern in the experience of these stages..

For example, the well-known Elisabeth Kübler-Ross Model (1969) assumes the following five stages: denial, anger, bargaining, 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 (assimilation 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 grief).

Despite such discrepancies as to the number of stages or the conceptual label given to them, it seems to be a nuclear phenomenon to understand grief as a transition period that goes from non-acceptance to assimilationwhere feelings of sadness, longing, anger, apathy, loneliness, guilt, etc. are combined with a progressive return to obligations, responsibilities and personal life projects.

At first, the first set of emotional reactions the first set of emotional reactionsThe second element related to behavioral activation gradually takes on more relevance, until it becomes more balanced with respect to the first. This allows the person to evaluate the loss from a more global perspective, since the fact of resuming the routine allows the person to connect more realistically with the world around him/her and to move his/her focus of attention away from the object of the loss to the vital re-adaptation of the different personal areas.

The dual grief process model

This idea is the one advocated by Margaret Stroebe in her "Dual Process Model of Grief" (1999), where the researcher explains that coping with grief involves the person moving continuously between the realms of "loss-oriented functioning" and "reconstruction-oriented functioning".

Loss-oriented functioning

In this first process, the person focuses his or her emotional charge on experiencing, exploring and expressing in different ways (verbally or behaviorally) in order to understand the meaning of the loss in his or her own life.

Thus, the survivor finds him/herself in a period of introspectionwhich could be understood metaphorically as a process of "saving behavioral energy" 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 dejection, isolation, having the need to unburden oneself emotionally, promoting the memory or finally, denying the possibility of recovery.

Reconstruction-oriented functioning

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 how the person invests his effort and concentration in the adjustments to be made in the different areas of life: family, work, social, social.family, work, social. The purpose of this is to be able to channel outwardly 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 the vital areas, adopting a more active attitude or focusing on fostering interpersonal relationships.

Denial of loss as a central element of the model

In this model, as can be seen in the previous paragraph, it is proposed that the denial of the loss takes place during the entire process of grief process of grief elaboration, being present in both types of functioning, and not being found exclusively in the initial phases, as proposed by other more traditional theoretical models.

Such denial, is understood as an adaptive response that allows the individual not to focus constantly on the reality of the loss, but to gradually become accustomed to it. This gradation avoids the experience of an overly intense (and unbearable) Pain that would be implied by the fact of confronting the loss abruptly and abruptly.

Among many others, 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 anxious denial (or loss-oriented functioning) and depressive denial (or reconstruction-oriented functioning) component of the loss. The core elements of this type of therapy have included components of graded and personalized behavioral exposure and cognitive restructuring..

Shear and his team obtained very promising results in terms of the efficacy of the interventions carried out, while having a sufficient level of scientific rigor in designing and controlling the different experimental situations. In sum, it seems to have been observed that cognitive-behavioral approaches provide an adequate level of efficacy in this type of patients.

Conclusion

The model presented in this text aims to offer a conceptualization of grief centered on the process, and is intended to move away from a more "phased" perspective as advocated by previous proposals. It does seem to contrast the low level of uniformity in the experience of personal grief, assuming the particularity with which this phenomenon operates in each individual.

This is explained by the differences in coping skills and psychological or emotional resources available to each individual. available to each individual. Thus, although the general efficacy of psychological interventions linked to this objective has been growing in the last decades, they still have a limited and improvable effectiveness index, which should be linked to the continuation of research in this area of knowledge.

Bibliographical references:

• Neimeyer, R. A., & Ramírez, Y. G. (2007). Learning from loss: a guide for coping with grief. Paidós.
• Shear, K., Frank,E., Houck, P., & Reynolds, C. (2005). Treatment of complicated grief: A randomized controlled trial. JAMA, 293,2601–2608.
• Stroebe M., Schut H. & Boerner K. (2017) Modelos de afrontamiento en duelo: un resumen actualizado. Estudios de Psicología, 38:3, 582-607.
• Stroebe, M. S., & Schut, H. A. W. (1999). The dual process model of coping with bereavement: Rationale and description. Death Studies, 23,197–224.