The dual grieving process model: an alternative approach

The development of the duel in the face of a certain loss becomes a very complex event for the individual, at the same time from an emotional, cognitive and behavioral point of view.

It seems obvious the differentiation on the difficulty of this process given the external circumstances surrounding this loss, such as the peculiarities in which it occurred (whether it was abrupt or progressive), the type of link between the object of mourning. and the survivor or the skills that such a person has to deal with such situations, and so on.

In this article we will focus on the double grieving process model and its implications.

    The first approaches: the stages of the development of the duel

    More traditionally, on the one hand, a certain consensus has been established between the various expert authors in the field, a set of stages that people must go through during the psychological development of the grieving process. However, it is also accepted as considerably validated the idea that not all individuals follow the same pattern to experience these phases.

    For example, the recognized model of Elisabeth Kübler-Ross (1969) assumes the five stages: denial, anger, negotiation, depression and acceptance; while Robert A. Neimeyer (2000) refers to the “grieving cycle” as an extremely variable and peculiar process where permanent vital adjustments occur during avoidance (lack of awareness of loss), assimilation, assumption of the predominant loss 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 these discrepancies in terms of the number of steps or the conceptual label given to them, it seems to be a nuclear phenomenon to understand mourning as a transition period from non-acceptance to assimilation, Where are combined the feelings of sadness, desire, anger, apathy, loneliness, guilt, etc. with a gradual return to obligations, responsibilities and personal life projects.

    At first he has a heavier weight the first set of emotional reactionsBut little by little, the second element linked to behavioral activation becomes more and more relevant, to be balanced against these. This allows the person to assess this loss from a more holistic perspective, as resuming the routine allows the person to more realistically connect with the world around them and move away in a certain way. of his concentration. vital rehabilitation of different personal areas.

    The model of the double grieving process

    This idea is what Margaret Stroebe stands for in her Model of “Dual Process of Grief” (1999), where the researcher explains that the mourning hypothesis implies that the person continually moves between the fields of a “loss-oriented operation” and a “reconstruction-oriented operation “.

    Loss-oriented operation

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

    like that, the survivor is in a period of introspection, Which could be metaphorically understood as a process of “behavioral energy saving” in order to consolidate this primary objective. The most characteristic manifestations of this first cycle are: being in touch with the loss, focusing on your own pain, crying, talking about it, maintaining a passive behavior, having feelings of hopelessness, isolation, the need to emotionally discharge, promote memory, or finally, deny the possibility of recovery.

    Operation focused on reconstruction

    At this stage, small episodes appear in the individual of a “reconstruction-oriented operation”, the frequency and duration of which increase over time. Thus, it is observed in the person as invest your efforts and concentration in the adjustments you need to make in the different vital areas: Family, work, social. This presents the goal of being able to channel outward the affectation felt at the most acute stage of mourning.

    This operation relies on actions such as: disconnecting from the loss, tending to deny the situation, distracting, minimizing the impact, rationalizing the experience, avoiding crying or talking about the loss, focusing on redirecting people. vital areas, adopt a more active attitude or focus on promoting interpersonal relationships.

    The negation of loss as a central element of the model

    In this model, it is posed, as can be seen in the previous paragraph, that denial of loss takes place throughout the process development of the duel, being present in both types of operations, and not being exclusively in the initial phases, as posed by other more traditional theoretical models.

    This denial, it is understood as an adaptive response which allows the individual not to constantly focus on the reality of the loss, but to get used to it more gradually. This gradation avoids the experience of too intense (and unbearable) pain that would lead to the fact of immediately and suddenly confronting the hypothesis of loss.

    Among many others, some experts such as Shear et al. (2005) designed a psychological intervention program in accordance with Stroebe’s postulates. These studies focused on working with patients on the indicated component of anxiety denial (or loss-oriented functioning) and depressive denial (or reconstruction-oriented functioning) of loss. The core elements of this type of therapy have been included components of progressive and personalized behavioral exposure and cognitive restructuring.

    Shear and his team have obtained very promising results in terms of the effectiveness of the interventions carried out, while having a sufficient level of scientific rigor in the design and control of the different experimental situations. In short, it seems to have been observed that cognitive-behavioral approaches provide an adequate level of effectiveness in these patients.

      conclusion

      The model presented in this text seeks to offer a conceptualization of the duel centered on the process and seeks to move away from a more “phased” perspective as advocated by previous proposals. It seems to contrast well with the low level of uniformity in the experience of personal grief, assuming the peculiarity with which this phenomenon operates in each individual.

      This is explained by differences in coping skills and psychological or emotional resources. what each individual has. Thus, while the overall effectiveness of psychological interventions related to this goal has increased over the past decades, they still have a limited and improved efficacy index, which should be linked to further research in this area of ​​knowledge.

      Bibliographical references:

      • Neimeyer, RA and Ramírez, YG (2007). Learning from Loss: A Guide to Dealing with Grief. Paidós.
      • Shear, K., Frank, E., Houck, P. and Reynolds, C. (2005). Treatment of complicated pain: a randomized controlled trial. JAMA, 293.2601-2608.
      • Stroebe M., Schut H. & Boerner K. (2017) Duel adaptation models: an updated summary. Studies in Psychology, 38: 3, 582-607.
      • Stroebe, MS and Schut, HAW (1999). The dual process model for managing bereavement: justification and description. Death Studies, 23.197-224.

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