1 Introduction 3
positive regard and is no longer viewed as “cute” for misbehavior, but is held
accountable; or when a young adult marries and must give up the freedom of
single living. We believe maturational losses to be a form of “disenfranchised
grief” (Doka, 2002). In this volume we name such losses, recognizing that until
named they cannot be acknowledged and mourned. We also sound a note of
caution that while recognition of the loss is necessary, overt mourning is not
always required.
Objectives
After reading this chapter the reader will be able to:
■ Review biological impacts, psychological experiences, and social contexts of grief.
■ Trace the evolution of classical grief theory to the task- and stage-based grief theories
of the modern era.
■ Describe postmodern grief theories including the dual process model (DPM),
meaning-making, continuing bonds, disenfranchised loss, ambiguous and nonfi-
nite loss.
■ Explore cultural impacts and the role of ritual in coping with loss.
■ Provide social and historical context for grief therapeutics, including recent changes
in the DSM-5.
■ Discuss concepts of mindfulness, attachment, and cultural humility and their
intersection with grief work.
■ Utilize the perspective that loss is a normal and necessary part of life.
Biopsychosocial Aspects of Grief
As our title indicates, we take a biopsychosocial perspective on grief and loss
across the life course. This requires that biological aspects of human devel-
opment, including neurobiological and other physical changes, be incorpo-
rated into our thinking as well as the more typical psychological and social
aspects of development. Much of this material will be new to many clini-
cians, yet practice in the 21st century requires that mental health practitioners
of all stripes understand immunological, hormonal, and other biochemical
responses humans have to stressful events; genetic and epigenetic influences
on psychosocial behavior (and vice versa); and the neurobiological impacts of
grief and trauma. We provide ample citation so that readers may explore this
material in more depth.
Biological Effects of Grief
The association of higher mortality with bereavement has been strong,
long-lasting, and significant (Parkes, Benjamin, & Fitzgerald, 1969; Stroebe,
Stroebe, Gergen, & Gergen, 1981). Although some older studies found no
