Grief Therapy
It is important to understand that the theories described on this page are just that, theories. They help inform the work that I do with clients in grief therapy, but I also understand that each person is unique and grief is different for everyone. These are also just some of the many theories of grief and grief therapy, and there are other theories that are not listed here.
The Five Stages of Grief
The Tasks of Grief
To learn more about different types of grief and loss, please click here.
You may have heard of the “five stages of grief.” These stages (denial, anger, bargaining, depression and acceptance) were originally identified by Dr. Elisabeth Kübler-Ross to describe the way people come to terms with learning that they have a terminal illness, with facing their own death. This theory was then later generalized to also describe how people respond to various kinds of loss and move through grief.
In the more than 50 years since this theory was first developed, we have learned a lot about grief and how people respond to loss. We now understand that these five “stages” are actually just five different types of responses a person can have when grieving, not linear stages. You can experience them in any order, re-experience some or all of them again and may not experience some of them at all. You may also experience other reactions that are not among these five. For example, grieving people describe feeling shock, numbness, yearning, despair, guilt and many other things.
We have also learned that there is no set timeline or endpoint for grieving. People used to think that you would move through these five stages, and when you got to the last stage (acceptance) then you would be finished grieving. People would cite various timelines for “normal” grief to be “resolved,” typically anywhere from two months to two years. We now know, however, that each person grieves in their own way and in their own time, and for many people grief is an ongoing process with no real endpoint.
This does not mean the pain you feel after a new loss will necessarily continue forever. Your response to the loss and the intensity of your feelings will shift and change throughout your life. Your grief may feel different at different times and in different situations. In therapy, I can help you recognize and understand your responses and learn how to adjust to the new reality of living without whomever or whatever you have lost.
Two theories developed more recently identify tasks that you may need to work through in order to adjust to a loss. Dr. J. William Worden identified four tasks: accepting the reality of the loss, working through the pain and grief, adjusting to an environment in which the deceased is missing and finding an enduring connection with the deceased while embarking on a new life. Dr. Theresa Rando identified six tasks, which she calls “R processes” since they all start with the letter R: recognizing the loss, reacting to the separation, recollecting and reexperiencing the deceased and the relationship, relinquishing old attachments to the deceased and old beliefs about the world, readjusting to move through the new world without forgetting the old world, and reinvesting emotional energy in life (including relationships, activities, goals, etc.).
As you can probably see, there is a lot of overlap between Worden’s four tasks and Rando’s six R processes. In both theories, the idea is that working through these tasks of grieving can help you adjust to the loss and move forward while still maintaining a sense of connection with the loved one who died. It’s important to note that these theories can be applied to other types of losses, too, not only the death of a loved one.
The Dual Process Model
Another grief related theory that can be helpful to understand is the dual process model developed by Dr. Margaret Stroebe and Dr. Henk Schut. In this theory there are two different orientations, or ways of being, following a loss. The loss orientation involves being focused on the loss and your feelings and reactions related to the loss. For example, this might involve telling stories about a loved one who died, crying while going through their belongings, etc. The restoration orientation involves being focused on the tasks of your day-to-day life and also doing the things you need to do to move forward after a loss. For example, this might include cleaning your house, going to work, cooking for yourself, etc., and also something like selling your parents’ home after they have died.
The dual process model maintains that in healthy grief you should be continually moving back and forth between these two orientations. Sometimes you will be focused on the loss, and at other times you will be focused on the things you need to do to keep living and to move forward. This oscillation between loss orientation and restoration orientation seems to help people cope. The loss orientation allows you to feel and adjust to the loss, while the restoration orientation provides a distraction from grief and pain and helps you move forward.
When Grief Gets Stuck
You may feel like you are “stuck” in your grief and having trouble moving forward in your life after a loss. You may feel stuck if you have difficulty working through one of the tasks or R processes. You may also feel like you are stuck in the loss orientation and unable to engage in the restoration orientation. Sometimes the opposite may be true. You may feel like you are doing a great job focusing on the restoration orientation but cannot really feel your grief (loss orientation).
There seem to be three common explanations why people feel stuck like this after a loss. One reason is that there may be something about the loss that is traumatic for you. The type of death or loss may have been traumatic, or the loss itself of someone or something important to you may be traumatic. The second reason is that you may have a belief about the loss makes it hard for you to move forward. For example, you may feel responsible for a loved one’s death, or the loss may have altered your beliefs about the world in a way that feels overwhelming. The third reason is that you may feel like you had “unfinished business” with the loved one who died and their death prevents you from working through the issue directly with the person. Of course, there may be other reasons, too, in addition to these three.
How Therapy Can Help
You may have experienced a loss and want help in understanding and coping with that loss. You may feel that you are working through a “normal” grief process and could just benefit from some professional support, or you may feel “stuck” in your grief for any number of reasons. Your loss may be recent or it may have been decades ago. You may be grieving the death of a person, the loss of a place or object or the loss of an idea or other more abstract concept. These are some of the many grief-related issues that I can help you with in therapy. If you have questions about how I might be able to help you with your individual situation, please contact me to discuss it with me.