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Stages in the Mourning Process

Stage theories are extremely common in developmental psychology. However, they are often inaccurate when applied to individual cases. This generalization applies to "stages of mourning" as well. Several stage theories of mourning exist, but no one theory applies to every case, and all have been criticized as simplistic.

The classic work on stages of grief came from Erich Lindemann, a psychiatrist at Massachusetts General Hospital who studied 101 bereaved people. He wrote an article, published in 1944, titled "Symptomology and Management of Acute Grief." In this article he described a set pattern:

What was Lindemann's classic proposal?

—After an unexpected death, there is initial shock that lasts 10-14 days.

—After the initial shock comes a period of intense sadness, and the grieving person may withdraw from social contact.

—Next comes anger, as the grieving person seems to "protest" the unexpected death.

—Finally, within a year or so, the grief is resolved and the person returns to normal.

Criticisms of this scheme are much the same as criticisms of other stage theories. First, not everybody reacts the same way; actual data show wide variations in the time course and emotional phases of grief. Second, if doctors and counselors expect a predictable series of stages, they may become impatient or presumptuous in their relations with grieving people.

What are criticisms of Lindemann's scheme?

One expert on mourning, Dr. Mardi Horowitz of the University of California Medical School at San Francisco, said mourning is often incomplete, as if the surviving person is "frozen" at some point in the normal mourning process and cannot get it to pass. Horowitz believed the following stages represent a normal mourning process:

What is Mardi Horowitz's theory of grieving stages?

—Immediately after the death, survivors may experience a wish to "do something" for the sake of the dead person, which Horowitz interprets as a sign the mourner has not begun to grasp the loss. An elaborate funeral, or even a simple service held "the way he would have wanted it" often satisfies this need.

—Next, mourners may turn away from all reminders of death. "Yet the dead person may seem alive in dreams."

—The mourner may feel numb in all emotions.

—After regaining their emotional equilibrium, mourners typically engage in a review of their life with the deceased. To those without close ties to the deceased, this phase may occur immediately, and they may be full of memories of the deceased while at the funeral. "For those most upset by the death, though, it is usually weeks or months later that the vivid memories begin to flow." At that point, sadness or intrusive memories may make it hard to concentrate on anything else. Horowitz found that such emotional floods tend to alternate with periods of putting such feelings out of the mind, "so the mourning proceeds in manageable doses."

—Feelings of intense grief fade with time. Yet, paradoxically, the survivor may experience a persistent longing for the deceased person at the same time life seems to get back to normal. Horowitz interprets this as a last attempt at denial. "This yearning gradually yields to an emotional acceptance of death." (Goleman, 1988)

About a third of all people seeking psychotherapy are there because they are having difficulty getting over the death of a loved one. Signs of incomplete mourning may include anxiety, depression, difficulty concentrating or doing creative projects, or an inability to feel pleasure. Unexpected deaths are especially likely to leave scars, with many people lingering in one of the phases listed above for two to four years after the death.

How does Volkan help his clients "activate the mourning they have not completed"?

Therapy aimed at moving the mourning process ahead may be helpful for people who seem stuck at a stage of denial, perpetually hoping the dead person will return. Dr. Vamik Volkan at the University of Virginia has clients bring in an object linked in some special way to the departed person. Volkan says, "These links are more than just treasured keepsakes; they are jealously guarded and hold an eerie fascination for the mourner." Volkan asks the mourner to explore the symbolic meanings of such an object, in order to "activate the mourning they have not completed" (Goleman, 1988).

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Copyright © 2007-2011 Russ Dewey