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Grief
Macmillan Encyclopedia of Death and Dying, (2003) by ROBERT KASTENBAUM, KENNETH J. DOKA, JOAN BEDER, REIKO SCHWAB, KENNETH J. DOKA, REIKO SCHWAB, KENNETH J. DOKA, NORMAN L. FARBEROW, MARGARET STROEBE, WOLFGANG STROEBE, HENK SCHUT, LILLIAN M. RANGE
Another paradigm that attempts to offer insight to the nature of acute grief is the psychological trauma model. This model, based on the work of Sigmund Freud, views grief as a response to the psychological trauma brought on by the loss of a love object. According to this view, acute grief is a normal defense against the trauma of loss. To Freud, grief is a crisis, but one that will likely abate over time and that does not usually require psychiatric intervention.
Perhaps one of the more influential theories of grief is the attachment model developed by John Bowlby. This approach emphasizes that attachment or bonding is a functional survival mechanism, a needed instinct, found in many of the social animals. Given humans' prolonged periods of infancy and dependency, attachment is necessary for the survival of the species. When the object of that attachment is missing, certain behaviors are instinctual responses to that loss. These behaviors, including crying, clinging, and searching, were seen by Bowlby as biologically based responses that seek to restore the lost bond and maintain the detachment. When these bonds are permanently severed, as in death, these behaviors continue until the bond is divested of emotional meaning and significance. A secondary purpose of these behaviors is that by expressing distress, they engage the care, support, and protection of the larger social unit. This psychobiological model sees grief as a natural, instinctual response to a loss that continues until the bond is restored or the grieving person sheds the bond. These early approaches continue to influence understandings of acute grief, though more contemporary models emphasize that grief is a natural response to major transitions in life and that bonds between the grieving individual and the lost object continue, albeit in different forms, after the loss. In addition, approaches of the 1990s emphasize that a significant loss may shatter assumptions, causing grieving individuals to reconstruct their sense of self, spirituality, and relationship to others and the world. While this may be a painful process, it also may be a catalyst for growth.
Manifestations of Acute Grief
Individuals can experience acute grief in varied ways. Physical reactions are common. These include a range of physical responses such as headaches, other aches and pains, tightness, dizziness, exhaustion, menstrual irregularities, sexual impotence, breathlessness, tremors and shakes, and oversensitivity to noise.
Bereaved individuals, particularly widows, do have a higher rate of mortality in the first year of loss. The reasons for this may include the stress of bereavement, the change in lifestyle that accompanies a loss, and the fact that many chronic diseases have lifestyle factors that can be shared by both partners; hence both partners share similar stress and patterns making them prone to similar diseases. It is important that a physician monitor any physical responses to loss.
There are affective manifestations of grief as well. Individuals may experience a range of emotions such as anger, guilt, helplessness, sadness, shock, numbing, yearning, jealousy, and self-blame. Some bereaved experience a sense of relief or even a feeling of emancipation. This, however, can be followed by a sense of guilt. As in any emotional crisis, even contradictory feelings, such as sadness and relief, can occur simultaneously.
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