some may never progress beyond the initial stage. been observed to warrant characterization of grief as a syndrome incomplete bereavement and thus impairing further growth and accomplish some of these tasks and not others, resulting in an as the subjective states that accompany mourning, or the emo-tional work involved in the mourning process. For purposes of this text, grief work and the process of mourning are collectively referred to as the the grief response. He suggests that it is possible for a person to Theoretical Perspectives on Loss and Bereavement (Symptomatology)Stages of GriefBehavior patterns associated with the grief response include many individual variations. However, suffi(2009), offers a set of tasks that must be processed to complete development.that has a predictable course with an expected resolution. Early theorists, including Kübler-Ross (1969), Bowlby (1961), and Engel (1964), described behavioral stages through which indi-viduals advance in their progression toward resolution. A num-ber of variables inflto an earlier stage; some may never complete the sequence; and process. Some individuals may reach acceptance, only to revert A more contemporary grief specialist, J. William Worden grief response. uence one’s progression through the grief Loss and Bereavement cient similarities have ●^391
ELISABETHKübler-Ross in her extensive work with dying patients. Behaviors associated with each of these stages can be observed in individuals experiencing the loss of any concept of personal value.These well-known stages of the grief process were identifiStage III: Bargaining.Stage I: Denial.Stage II: Anger.with an idealized image of what has been lost. Numerous bargain with God for a second chance or for more time. to function independently. He or she may be preoccupied dividual may experience confusion and a decreased ability the loss has occurred. He or she may say, “No, it can’t be true!” or “It’s just not possible.” This stage may protect the and others. The anxiety level may be elevated, and the in-somatic complaints are common.ing of others may lead to feelings of anger toward the self Feelings associated with this stage include sadness, guilt, shame, helplessness, and hopelessness. Self-blame or blam-individual against the psychological pain of reality. KÜBLER-ROSS The individual does not acknowledge that This is the stage when reality sets in. The individual attempts to strike a ed by
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