Grief

Two Integrative Models

George Bonanno's and Stacey Kaltman's four-component model is an example of contemporary attempts to synthesize current research into an integrative model. These investigators describe several components as fundamental in the grieving process and suggest ways in which they may interact during bereavement: (1) context of loss, risk factors such as type of death, gender, and cultural setting; (2) the continuum of subjective meanings associated with loss, appraisals of everyday matters as well as existential meanings; (3) the changing representations of the loss relationship across time, including the persisting bond with the deceased; and (4) the role of coping and emotion-regulation processes that can relief or aggravate the stress of the loss. Emotion-regulation research has provided a theoretical framework to understand how adjustment in bereavement could be enhanced. The general theory suggests how the regulation or even dissociation of negative emotions and enhancement of positive emotions may foster adjustment to bereavement and, likewise, enable identification of spontaneous or automatic processes in grieving.

Margaret Stroebe and Henk Schut have attempted a different type of integration in their dual-process model of coping with bereavement. The dual processes refer to two different types of stressors: those associated with the lost person, socalled loss orientation, and restoration orientation, those associated with the secondary upheavals that are also consequences of bereavement. The focus of attachment theory on the nature of the lost relationship is consistent with loss orientation. Similarly, cognitive stress theory's identification of a range of substressors suggests the need to include the additional tasks of restoration orientation in the model, because these too are associated with distress and anxiety. For example, it may be necessary to acquire new skills (e.g., cooking or dealing with finances) that had been the domain of a deceased spouse. The model suggests that coping with the two types of stressors is a dynamic and fluctuating process, labeled "oscillation," that incorporates confrontation and avoidance of different components at different times, and includes both positive and negative reappraisals. For example, at any one moment a bereaved person may be dealing with new tasks (restoration-oriented) and feeling good about mastering these, only to be interrupted by a piece of music, perhaps, that is a reminder of the deceased (loss-oriented) and that brings on feelings of sadness. This perspective integrates the processes identified by Folkman and Nolen-Hoeksema, and is also consistent with Bonanno's emotion-regulation component.

Conclusions

Theorizing in the field of bereavement is still marked by a pluralism of approaches, but attempts at integration have begun. Investigators are also looking more to related bodies of research such as emotion theory to derive sound theoretical and empirical hypotheses. Further probing of the biological bases of grief and grieving is needed. Likewise, broadening of theoretical interest from the single stressor of bereavement to a general psychology of loss, focusing on diverse phenomena, could encourage the formation of general principles. Nevertheless, the understanding of grief has deepened significantly during the past few decades, in part because of the theoretical grounding of fine-grained empirical research on social and cognitive processing.