Disenfranchised grief (frozen grief Hicks, 1996). Two major causes of pathological grief, which stem from problematic marital bonds, are referred to as the ambivalent grief syndrome (a relationship in which elements of love and hate coexist, conflicts were frequent, and divorce or separation may have been contemplated), after the loss the bereaved may still be attached to the deceased: chronic grief syndrome, follows the termination of a relationship characterized as highly dependent or clinging (Stroebe, Gergen, Gergen, & Stroebe, 1995). Grief is at once physical, emotional, psychological, social, and spiritual (Attig, 1995).
Health professionals distinguish between two forms of abnormal grief, the distorted and the delayed (Ata, 1994). An obvious symptom of distorted grief is one whereby the bereaved has little or no sense of loss, an ongoing passion for life and preoccupation with events and activities (Ata, 1994). Traditionally, an individual can experience feelings of anger, guilt, sadness, desperation, loneliness, hopelessness, and numbness in response to a loss in the case of disenfranchised losses the grief can become intensified as the feelings are not being expressed and the individual’s loss is not being acknowledged (Lenhardt, 1997).
The diagnostic criteria for post traumatic stress disorder include three groups of symptoms: evidence of reexperiencing the drama, numbing of responsiveness to or reduced involvement with the external world following the traumatic event, and a variety of stress reactions, the event is sudden, dangerous, and overwhelming (Figley, 1988).
The concept of stages tends to suggest a clear progression from one step to the next, whereas reality is more likely to be one step forward and two steps back, stage models don’t allow for individual differences (children versus adults) and may encourage those of us in a caretaking role to have unrealistic expectations, or to analyse and label inappropriately what we consider “normal’ or “abnormal” (McKissock, 1998). A stage-based approach, especially when used in ways not in accord with its authors intentions, can erect obstacles to individualisation, risking stereotyping vulnerable individuals who are coping with dying Corr, 1995).
Stage-based models often take on a sense of directedness or obligation in the hands of those who use them (Corr, 1995). A model that is content to identify reactions to the threat of dying confines itself mainly to recognition and understanding (Corr, 1995). A stage-based model provides no guidance as to how the person should deal with it “bargaining” and the person, and helpers, are left in a passive state (Corr, 1995).
Clinicians turned to examining how best to facilitate this recovery, from these investigations came various stages of grieving models, Kubler-Ross (1969) whose stages of grief include denial, anger, bargaining, depression, and acceptance, the idea behind these models is that the individual experiencing loss or bereavement must successfully “pass through” the stages, eventually reaching “acceptance” or recovery stage, not surprisingly, the idea of passing successfully through stages echoes the psychoanalytic model of individual emotional development, which inspired the first theories of grief and loss (Miller & Omarzu, 1998)
Task models Grief task are never completed, nor can they be accomplished neatly and sequentially like a list of jobs to be ticked at the end of the day, task models can provide direction, encouragement, and empowerment (McKissock, 1998). Each of these four dimensions (physical, psychological, social, and spiritual) defines an area of task work, not a list of individual tasks (Corr, 1995).
A task-based approach takes into account not only feelings or psychosocial responses but all the dimensions of human life, rejects broad generalizations that have an initial and superficial attractiveness, explicitly recognizes coping undertaken by all of the individuals-the dying person, family members or friends, and care providers-involved in a particular experience of dying (Corr, 1995).
A task-based approach does not concentrate upon that which is obligatory (must) or normative/prescriptive (should or ought), instead it emphasizes choices among possible tasks and in this way it avoids the twin pitfalls of linearity and directedness that are prominent risks in any stage based approach (Corr, 1995). Constructivists
In the psychological literature, constructivism refers to a theoretical position that regards persons or systems as constituting or constructing their reality, the process of adaption and change in the post-death relationship and the construction and reconstruction of new connections (Gergen, 1985, cited in Silverman, Nickman, & Worden, 1995). Family systems Figley (1988) posits that the family is a critical support system to human beings before, during, and after stressful times and that the system and its members are also affected, sometimes even more than the victim.
The first task, accepting that the death has occurred, occurs on a intrapersonal level and a interpersonal level (Moos, 1995). The basis of family systems approaches is that a family consists of a number of individuals who, based upon their own interpretation of the death, interact with one another in ways that are qualitatively different from prior experiences, the interactions in turn determine how the family grieves and copes with the loss of the family member (Moos, 1995).
How well children deal with death is closely bound up with how the family deals with it, the child’s experience of death is mediated by many factors including age, developmental stage and family dynamics (Cavanagh, 1997). The age of the child can influence whether they understand the permanence of death (Baker, Sedney, & Gross, 1992). with It is becoming increasing evident Furthermore, semantics has
References
Ata, A. (1994). Bereavement & health in Australia: Gender, psychological, religious and cross-culture. Melbourne, Australia: David Lovell Publishing. Doka, K. (1995). Disenfranchised grief. In L. DeSpelder & A. Strickland (Eds. ). The path ahead: Readings in death and dying (pp. 271-280). Mountain View, CA: Mayfield Publishing Company. Herman, J. (1997). Trauma and recovery. London: BasicBooks.