The treatment of bereavement according to William Worden

The death of a loved one it is an event that we all go through at some point in life, which is associated with difficult ailments and which can mark a before and after. A new chapter. A point and a part.

The losses of our parents, grandparents or older siblings are part of a natural order dominated by time. So this is something that we have to face and be ready to live. Other times, however, there are unforeseen, immeasurably painful losses (like that of a child).

It is essential to consider that a passive attitude in the face of these circumstances usually leads nowhere, as there are a number of tasks that we must face in order to continue living and to preserve the loving memory of those who are gone.

In this article we will discuss the treatment of bereavement according to William Worden, Prestigious doctor of psychology, his contribution to this field has elevated him as an essential reference for understanding the process to which we are alluding: transcending death (and life) while retaining the capacity to be happy.

    The treatment of bereavement according to William Worden

    Many traditional descriptions of the duel have understood those who pass through it as a passive entity, subject to outside forces that will forge a path through which it will simply wander without a compass or a goal. Such a way of perceiving this stage of life adds even more pain, As it adds an uncontrollable component to a sometimes arid and barren landscape.

    The truth is that this is a vital process that has enormous individuality, being difficult to distinguish a linear succession of universal stages that each survivor will necessarily pass. like that, it is not possible to establish a time criterion by which pain becomes clinically relevant. It is a complex experience, irreducible in objective terms and applicable to all.

    The treatment of bereavement according to William Worden he seeks, for all this, to be sensitive and aware of this reality. The author proposes a four-phase model in which an extensive individuality is welcomed, and in which the person must perform a series of functions aimed at moving forward on his path to emotionally integrate the memory of the absent loved one. From this perspective, anyone who survives a loss plays an active and proactive role, unlike the classical view.

    The tasks to be accomplished would include: accepting the loss, protecting the emotion felt, restoring the balance by assigning roles and integrating the memory of the loved one into their own life. Let’s take a closer look at the phases offered by Worden, Which are an approach frequently used in cases where the suffering becomes intense and prolonged.

    1. Accept the reality of the loss

    One of the first emotional reactions that comes after learning of the loss of a loved one is shock. This is a response in which very intense emotions emerge, which even compromises the attention and / or memory of the episode (so you cannot later remember exactly when the fact was certain) . Although this condition makes emotional processing difficult at first, it allows you to gradually come to terms with the situation over time.

    As the person begins to orient themselves, it is common for him to remain in a position of denial or disbelief. This can last for several days; in which he thinks, feels and acts as if the parent is present. All this is more likely in cases where death occurs completely unexpectedly, because when it has been traversed by a lasting illness there is a tendency to observe early bereavement (for which at least one has already been used). at the time of death).

    The integration of the loss must be done at two levels, and always in a progressive way: rational (by assuming the awareness of the facts as they occurred, giving more precise coordinates to the situation and its consequences) and emotional (contact with the affections which follow one another as a result of what has happened).

    At this point, limited recognition may be given to the intellectual, Without the accompanying ailments (feeling that the person would “stay here” if they visited their home). This situation usually surprises the survivor, who does not understand why “he is not feeling as bad as expected”.

    The practice of funeral rituals, Which have existed since the dawn of humanity and depend on cultural reality (or the victim’s beliefs on a spiritual level), have a basic function in this whole process: they allow to record what has happened past and facilitate the meeting of those who suffer from shared pain. This is one of the points where the first gestures of any real thing (condolences, tears, etc.) are most often observed. And this is the moment when a tangible and formal farewell takes place.

    In the days following this event, the grieving process can take many different forms. In some cases the person must harbor the accompanying pain in the background (so their appearance is taciturn and distant), while in others the desire to share their feelings about the lost loved one is evident. The way we communicate is unique to everyone, private and intimate. It is also the first station on the way to overcome the duel.

      2. Elaboration of the evil of the duel

      Grieving the loss of a loved one is not a simple or daunting process. Despite several weeks or months, it is very possible that thoughts about it generate severe pain and extremely difficult to bear, so it is common for many people to try to distract themselves in order to get around their suffering.

      Thus, they can devote more time to their work or other activities, relegate what goes on inside to a second order of importance.

      It is not uncommon for families to do their utmost to avoid what reminds them of the dead (removing photos or building taboos about them) or those who do the opposite (as if the silence on the issue banished them in obliterates cruel). This is all natural in the context of the effort to put together a puzzle that is too many pieces missing, and in which each of the afflicted has a unique way of approaching it. In all, sometimes conflicts may arise because of such discrepancy, Which we will need to resolve correctly to avoid further discomfort.

      The truth is, this is an emotional issue that we will have to deal with sooner or later. Dealing with him means recognizing and assuming that he will go through disparate and confused internal states.; like anger, sadness or fear. These are all legitimate ailments that are part of the baggage we have to overcome adversity, so it is essential to stop and listen to them in a position of acceptance and with the disposition necessary to tolerate their presence.

      This part of the process is one that requires the investment of more emotional effort, as during its development there are personally relevant levels of sadness and anxiety, and even organic issues (such as headaches). , digestive disorders, etc.). too much it is very common to run with difficulty sleeping and changes in appetite (From inappetence to voracious hunger). For all of this, it is essential to take care of yourself and to maintain your own health.

      At this point in the process, it is essential to seek the support of people you trust, And understand that sometimes they too can get frustrated trying (unsuccessfully) to alleviate the grief of someone they consider important.

      We need to make connections that allow us to communicate and organize the inner life, which is possible when the interlocutor maintains active and patient listening. This help reduces the risk of suffering from mental health problems associated with such a delicate period.

      To finish, the person should be aware of two situations that can exacerbate their grief: Go to places where there is met the deceased and where the dates set (birthdays, Christmas, etc.) are respected. When the anniversary of the death arrives, a spontaneous increase in pain may also occur. These are well-known circumstances, for which one must be properly prepared.

      3. Adapt to a new world without being loved

      All the families function as a system, so that each of its gears fulfills a specific task but nested in the activity of the group. You could say that its members have complementary roles compared to those of others, So that the dynamics which hold them together are subjected to a balance or “social homeostasis”. When one of the pieces is missing, adjustments must be made to allow continuity of life together.

      Thus, the death of a loved one not only leaves an emotional void, but it becomes extensible to everyday acts and customs. The responsibilities assigned to him are now neglected and will have to be resolved by other elements of the family unit. This process is by no means straightforward, especially when the deceased was in charge of the financial support or acted as a beacon that directed relationship tensions to the placid limits of consensus.

      Additionally, although it is easy to redistribute tasks among family members, feelings of anxiety or grief can sometimes arise as they are carried out. This is due to the fact the action sharpens the feeling of absence of the loved one, And at the same time shifts the contributions he has made in life to a new dimension. That is why difficulties arise despite the skills or the possibility of successfully completing all the tasks.

      This situation is often experienced as a substantial adaptation challenge, although it also offers satisfactions and learning that help to improve the emotional state in times of difficulty.

      As you move through the successive stages of grieving, involvement in these new activities will no longer be seen as a kind of substitution, Integrate the role of the victim in all the family dynamics that emerge from shared adversity.

      4. Emotionally moving with a deceased loved one

      The death of a loved one is a break in the line of continuity on which we write the book of our existence, which makes it difficult to integrate into the narrative we make of our own story.

      This is why we mean by “overcoming” a grieving process. when the person is able to attribute a harmonious meaning to the life of the one who is no longer. For the truth is that the bonds between human beings do not dilute with death, but remain in force, transforming and acquiring new meanings.

      The integration of the loved one into his own life involves the reorganization of everything that has been shared with him within our individuality; reconcile all memories in the house full of personal history. The agonizing void of the first months, Experienced as a break in the fabric of one’s own existence, acquires a recognizable form and allows one to move forward. This is why in the last stage the person redirects his gaze “towards the outside”, towards a life whose course never stops.

      And it is that forgetting what has been lost never happens. So when one life touches another life, it changes it forever. Even despite death.

      Bibliographical references:

      • Drenth, CM, Glaudina, A. and Strydom, H. (2010). A complicated grieving intervention model. Health SA Health, 15 (1), 1-8.
      • Simon, NM (2013). Treatment of complicated bereavement. Journal of the American Journal Association, 310 (4), 416-423.

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