Grief Theories & Models

In the years since Kubler-Ross produced her seminal work, numerous psychologists and psychiatrists have developed new theories about how people move through grief. Although there are far too many to mention them all here, some of the most widely accepted include:

• The Dual Process Model
• Worden’s Four Tasks of Grieving
• Rando’s Six “R” Processes of Mourning
• Bonanno’s Theory of Psychological Resilience 
• Wolfelt’s Six Needs of Mourning

Below is a brief explanation of each.

The Dual Process Model 

Developed by Margaret Stroebe and Henk Schut during the mid-1990s, the Dual Process Model of Coping with Bereavement theorizes that grief is a dynamic process involving two competing needs: the need to confront the stressors associated with the loss (loss-oriented stressors) and the need to restore some semblance of order to a disrupted life (restoration-oriented stressors.) Examples of loss-oriented stressors include reminiscing, yearning, and imagining the person who died. Restoration-oriented stressors are circumstances that are secondary to the loss: for example, if the person who died paid the bills or did all the cooking, the bereaved person needs to find ways to accomplish those tasks

Central to the Dual Process model is the idea that people oscillate between coping with each of these competing needs as they seek to restore a sense of equilibrium to their lives.

Worden’s Four Tasks of Grieving

In 2008, psychologist William Worden published the 4th edition of his handbook “Grief Counseling and Grief Therapy” in which he outlined a task-oriented approach to healthy grieving. In this model, Worden proposed that mourners who actively engage in four specific tasks will adapt more quickly and more effectively after a loss. 

The four tasks are:

• Accept the reality of the loss
• Experience the pain of grief 
• Adjust to the “new normal” of life without the person who died
• Find an enduring connection with the person who died while still moving forward in new ways

As in the Dual Process model, people are expected to move back and forth between the four tasks as they mourn rather than march through them in an orderly progression. How long it takes any one individual to move through the tasks depends on many variables, including their degree of attachment to the person who died,  the manner of death, concurrent stressors (for example, financial woes after the primary wage-earner in a household dies, or raising children alone) and the psychological makeup of the griever. 

Rando’s Six “R” Processes of Mourning

Dr. Therese Rando is a world renowned expert in the field of loss and grief, with a particular emphasis on traumatic grief. The Clinical Director of the Institute for the Study and Treatment of Loss, Dr. Rando has worked in the field of thanatology and grief since the early 1970s. Her research has spanned decades, and, in 1993, resulted in her proposing a theory she calls the Six “R” Processes of Mourning. 

Similar to Worden’s four tasks of mourning, Rando’s model proposes that mourning is an active process that progresses in a series of phases, each of which requires the mourner to engage in certain tasks (each of which begins with an “R”). In her model, the phases of mourning are:

• The Avoidance Phase: There is only one task in this phase — to recognize the loss. According to Rando, the grieving person cannot move on to the other phases of mourning until they have accepted that the loss occurred. 

• The Confrontation Phase during which the grieving person must accomplish three processes or tasks:
  • React to the separation, both the loss itself and secondary losses, such as loss of a sense of security and identity. Rando says this is the process through which the mourner seeks to “feel, identify, accept, and give some form of expression to all the psychological reactions to the loss.” 
  • Recollect and re-experience the relationship with the person who died. During this process, the mourner thinks about the loved one who died, remembers their relationship and re-experiences emotions they felt when the loved one was alive. 
  • Relinquish old attachments and begin to accommodate the “new normal” of life without the person who died. This is the longest and often the most difficult of the processes in the Confrontation Phase. 
• The Accomodation Phase during which the mourner begins to integrate the loss into their life and worldview. This phase has two tasks:
  • Readjust to the new reality and accept new roles and responsibilities while staying aware of life as it was before the loss. This is also the process during which the mourner begins to define a new relationship to the person who died. 
  • Reinvest emotional energy and learn to live again. This is the final phase of mourning, during which the person can begin to find pleasure in new things. This is also the phase when many people find a way to give meaning to the loss, such as starting a foundation or a self-help group, 

Rando emphasized that these processes are not necessarily linear, and that people may oscillate back and forth between the Confrontation and Accommodation phases for some time. 

Wolfelt’s Six Needs of Mourning

Alan Wolfelt is a noted psychologist who founded the Center for Loss and Life Transition in 1984. Similar to the grief experts mentioned above, Wolfelt believes that grievers must move through a process of mourning before they can integrate and ultimately move forward from a significant loss. This process includes six tasks that grievers “need” to complete, which include:

• Accepting the reality that the loss occurred
• Embracing the pain of the loss
• Remembering the person who died
• Developing a new sense of self 
• Finding meaning in the loss
• Seeking and accepting support

Wolfelt theorizes that it is impossible to truly reconcile a death until one moves through a process of openly acknowledging and expressing the pain of grief. However, this conflicts with numerous studies that show most people are able to adapt to and move past traumatic events, including bereavement, without doing so. 

Bonanno’s Theory of Psychological Resilience

As the head of the Loss, Trauma and Emotions Lab at the Department of Counseling and Clinical Psychology at Columbia University, George Bonanno has led a team of researchers in exploring  the effects of grief and trauma for almost 30 years. His approach to grief is considered somewhat controversial, in that he believes that people exhibit a great deal of psychological resilience in the face of traumatic, even horrifying events. Nonetheless, decades of research support this theory, which is based on the concept that loss engenders deep feelings of sadness, regret, yearning, and psychological pain, yet the quality of human reliance allows most individuals to return to their normal state of psychological equilibrium relatively easily. Bonanno does not believe that grief must progress through stages or tasks, or that the bereaved need to “work through’ their pain. Rather, he holds that the majority of people who experience the death of a loved one or other trauma oscillate between periods of anguish and positivity and will gradually heal with the passage of time. 

In a 2016 interview, Bonanno explained it this way:

“People who are not showing grief symptoms, don’t do anything — they’re fine. In fact, they can be harmed by intruding on their lives. They don’t need to talk about it. But I think in this culture we have this sense that people need to talk about it — if they don’t talk about it, something is wrong — no, leave those people alone. In people who are showing moderate levels of grief symptoms, it is sometimes a matter of getting used to the pain, which passes with time.”

Again, these are not all or even most of the grief theories that have been put forth over the last 50 years. But they are a good representation of what the world of psychiatry and psychology believes about grief today. 

Sources

“The dual process model of coping with bereavement: rationale and description”. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/10848151/ 

“Worden’s Four Tasks of Grieving”. Therapy Changes. https://therapychanges.com/blog/2015/05/review-wordens-four-tasks-of-grieving/ 

“Grief and Mourning Basics”. Center for Loss and Life Transition. https://www.centerforloss.com/grief/grief-mourning-basics/ 

“Rethinking Trauma: George Bonanno on Resilience”. Cornell University. https://evidencebasedliving.human.cornell.edu/blog/rethinking-trauma-george-bonanno-on-resilience/ 

“Loss, Trauma, and Emotion Lab”. Columbia University. https://www.tc.columbia.edu/ltelab/

Continuing Bonds Theory refers to the ongoing connection or relationship that individuals maintain with the person who has died. The theory was formally introduced in 1996 by Dennis Klass, Phyllis Silverman, and Steven Nickman in their book Continuing Bonds: New Understandings of Grief. It challenged the long-dominant Freudian perspective that healthy grieving required “letting go” and breaking emotional ties to the deceased. Instead, the authors proposed that an enduring, transformed bond could be adaptive and healing. This bond is maintained by weaving the deceased into one’s ongoing life through memories, reflections, rituals, conversations, and other meaningful practices, rather than severing the relationship.

Research has shown that the quality of the bond matters greatly. When the connection provides comfort, calm, and a sense of support, it tends to aid healing. When it is marked by intense preoccupation, distressing yearning, or avoidance of the reality of the loss, it can become a feature of disordered grieving, such as prolonged grief disorder. Thus, while the theory normalizes enduring connections, mental health professionals sometimes need to help individuals shift toward bonds that are soothing rather than distressing.

People express continuing bonds in highly personal ways. Some maintain a daily sense of connection by keeping photographs visible, mentioning the loved one in conversation, or privately speaking to them. Others write, through journaling or structured grief writing that traces the story of the loss and its significance. Additional methods include continuing activities the loved one enjoyed, visiting places of significance, celebrating rituals on meaningful dates, or sensing the person’s presence in comforting ways. Many even sustain bonds without consciously labeling them: keeping a keepsake, wearing a piece of jewelry, or upholding a tradition are all natural expressions of the bond.

The continuing bonds theory also resonates with longstanding cultural and spiritual traditions worldwide, such as ancestor veneration, Día de los Muertos, or daily remembrance practices that have long normalized ongoing relationships with the dead. By framing these connections as a healthy part of the human experience, continuing bonds theory validates the natural impulse to remain connected to those we have lost, while also acknowledging that the form of the bond may need to evolve over time.

Sources

“Continuing Bonds: Your Evolving Relationship with Someone Who Died”. Grief Compass. https://griefcompass.com/continuing-bonds 

“The Beauty of Continuing Bonds: Remembering Through Journaling”. Heather Stang. https://heatherstang.com/continuing-bonds-journaling/#