THE PHASES AND TASKS OF GRIEF WORK

by Laura Slap-Shelton, Psy.D.

"To me, and I know to several in the group, it seems a cruel and bitter irony that the broad view, the insight cannot be known until everything is too late. Irrevocably too late, if it's to be with those we have loved who are now dead. But the pain at this very thing conceals the challenge that it is not too late with those who are left behind. There is a strength of life to be lived. Something good and something bad will happen to all of us here, but we have the potential to relate to our destiny in a different way from before."

(Quote from a grief therapy group member cited in: Leick and Davidsen-Nielsen, Healing Pain: Attachment, Grief and Loss Therapy. Routledge, 1991, p.63)

How one travels the road from the intense, often paralyzing pain of initial bereavement to a recognition that there is an opportunity to "relate to our destiny" in a new way has been the subject of study for those involved in helping the bereaved. Over the past decades many have attempted to understand and describe this path so as to better help the bereaved.

Until recently models of the path were based on the idea that everyone goes through the same sequence of stages in the recovery from grief, and at relatively the same speed. Departure from these stages in either type of mourning behavior or length of mourning were taken to be indications of pathological grief. The idea that the bereaved person would eventually strike out on a new life different from the previous life was not highlighted in these models. Nevertheless they did capture the challenges that the bereaved face, and a sequence of development that is shared to some degree by many. One stage model based on Kubler-Ross's stages of accepting death is as follows:

1-Numbness:

This reaction often follows the death of a loved one and may last for seven to ten days. A sense of being paralyzed, distant, and removed from one's feelings of grief is present. Some have referred to numbing as the body's mechanism for protecting itself from being overwhelmed by the shock of the loss.

2-Denial and Isolation:

Here the bereaved individual has significant difficulty accepting the reality of their loss. This may be expressed in more severe forms as a complete denial of the death or in less severe forms in lapses of thinking and behaving as if the person had really died. While complete acceptance is part of the work of the entire grief process, the initial more acute difficulties with acceptance are included in this phase.

3-Anger:

In this phase the bereaved person feels anger with the world, fate, God, or people in their lives. A sense of "Why me?" and/or "Why not someone else?" give a flavor of this phase. Bargaining with God for the return of the dead person may be part of this phase

4-Depression:

As acknowledgement and acceptance of the loss and the reality of life after the loss grow, sadness and depression become more present.

5-Acceptance:

The bereaved person comes to terms with the loss, and is able to move on to re-invest in the new life that lies ahead. An absence of the extremes of emotion previously experienced is present.

More recently, mental health professionals, with the help of the bereaved, have come to understand that there are tasks involved in grief work that may occur in varied sequence and often simultaneously as the work of one task will move along the work in other tasks. Drawing on the work of Worden, Leick and Davidsen-Nielson (1991) describe four basic tasks that the bereaved individual needs to achieve in order to integrate their experience of loss into their life and move toward investing in a new life without the lost loved one. These four basic tasks are as follows:

Recognizing the Loss:

Accepting the reality of the loss is the difficult work here. Initially the loss may be denied or minimized. Then it may be intellectually processed. The emotional recognition and acceptance of the loss is the most difficult to achieve, and involves a full recognition that the lost person will not return.

Releasing the Emotions of Grief:

The pain experienced at the loss of a loved one is composed of many intense emotions including sadness, despair, anger, guilt, fear, loneliness, shame, jealousy. When a person who is integral to one's life dies there are other losses which also follow. Being able to weep over the losses and to express anger and other uncomfortable feelings is part of the healing process. Initially, these painful feelings may be omnipresent. Eventually they become more periodic, surfacing at unexpected and expected times during the day. Their unpredictable nature can create as sense of being out of control and often the leave the sufferer with the experience of being on an "emotional roller coaster." Eventually they become less frequent and may become intense mostly during anniversaries, holidays, and special events.

Developing New Skills:

This work involves the need to take on new roles and make new kinds of contacts in the world. Making a new set of friends, finding a support network, relating to others in a new way, taking on new roles in the family, and becoming more independent may all be part of this process. Underlying this work is the work of incorporating the experience of the loss into one's identity. The opportunity for personal growth and development is perhaps most clearly seen in this part of the grief work.

Reinvesting Emotional Energy in the Present:

As the other types of grief work are achieved more energy is available to be released into the new life that the bereaved person has created. This may result in new relationships, closer relationships, investment in work, or even in investment in an activity that is in honor of the dead person, or stems from the experience of loss. Leick and Davidsen-Nielsen describe the work of this phase as being able to say a final farewell to the dead person. They stress that this does not mean a giving up of memories, but rather a release from a central attachment to the dead person so that there is more room and energy for engaging in life in the present.

For some this will mean integrating their experience of loss into a larger acceptance of human mortality. Individuals at this point in their grief work will sometimes report feeling increased energy and better ability to enjoy their present lives without guilt and fear.

These phases and tasks are indications of the kind of process that the bereaved individual will go through, but not of the unique and specific process of the individual. There are in reality no rights and wrongs and no deadlines. While individual paths share in the types of processes described above, each person's path will still be uniquely influenced by the bereaved person's personality and history, their relationship to the dead person, the manner in which the person died, and other factors as well. However, there are some universal aspects to grief work which Bob Deits (Deits, B., Life After Loss, p.61) nicely summarizes as:

1) The way out of grief is through it.

2) The very worst kind of grief is yours.

3) Grief is hard work.

4) Effective grief work is not done alone.

For the bereaved, the models of grief work can serve both as compasses which show the direction of your path at a particular time, and as topographical maps revealing the landscape of grief's highs and lows. For the counselor, therapist, and friend they can provide useful insights into the process of bereavement. For further reading on this subject the following references used in this article are highly recommended.

References:
Deits, Bob (1992) Life After Loss: A Personal Guide Dealing with Death, Divorce, Job Change, and Relocation. Fisher Books, Tucson, Arizona.

Fitzgerald, Helen (1994) The Mourning Handbook. Simon and Schuster, New York, N.Y.

Leick, N. and Davidsen-Nielsen (1991) Healing Pain. Routledge, New York, N.Y.

5/28/98

Laura Slap-Shelton, Psy.D. is a licensed psychologist with a private practice in Biddeford, Maine. She has a specialty in neuropsychology and has published in the field of psychology. In her work, she addresses the needs of individuals who are grieving and also focuses on helping widows in developing countries where tradition has denied them basic human rights. You can reach her by fax at: (207) 282-5895.

 

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