Grief Theory

human need to form emotional bonds with others which begins as an infant between a baby and its parents (Buglass, 2010). Grief is described by Bowlby (1980) as the emotional reaction to the loss of attachments to a loved one he also discussed grief as a series of attachment behaviors which are performed after a loss (Small, 2001; Strada, 2013). The morning process is described in four phases; numbness and disbelief, yearning and searching, disorganisation and despair and reorganization (Archer, 1999). Parkes (1987) applied Bowlby’s theory on attachment to his own work on bereaved women and described the emotional, behavioral and physical manifisatations of grief (Mander, 2006). Parkes also discussed the importance of ‘grief work’ and believed

The model begins with passive phases of grief and moves onto to active tasks of morning (Buglass, 2010). The tasks include working through the experience of grief, adjusting to the environment without the deceased individual and withdrawing emotionally from the deceased and moving on (Worden, 2009). Stroebe at al. (1993) cautioned against the use of prescriptive models of grief as they do not allow for variations and can lead to judgments about a correct way to grief. The dual process theory was developed in an attempt to integrate existing theories and models of coping with bereavement (Stroebe and Schut, 2010). The theory suggests that bereaved individuals alternate between loss-orientated and restoration-orientated responses and the balance of emphasis changes over time (Small, 2001). This theory recognizes the individual, dynamic process of grieving and explains how the expression of grief can alternate between distress and reviewing the loss and periods of coping and integrating the loss in a meaningful way (Strada, 2013). Buglass (2010) believes that the dual process theory is a more flexible way of understanding of grief. Moreover, the dual process model also provides a framework for understanding complicated grief (Stroebe and Schut, 2010). According to Stroebe and Schut, (2010) when an individual is experiencing complicated

Grief can become complicated and the intensity and duration of symptoms can be increased (Glass, 2005). Complicated grief is an abnormal response to grief that occurs in a small number of individuals after the loss of a loved one (Shear et al., 2011). The incidence of complicated grief quoted in the literature varies between 5% and 20% (Love, 2007; Shear et al., 2011). While normal grief does not need professional intervention complicated grief requires professional assessment and intervention (Strada, 2013). Healthcare professionals need an awareness of complicated grief and the possible signs that an individual is experiencing complicated grief (Shear et al., 2011). Strada (2013) explains that there are a number of risk factors associated with complicated grief and recommend that health care professionals should focus on identifying those at risk for developing complicated grief. Risk factors include: history of depression or psychiatric illness, childhood abuse or neglect, a sudden traumatic death, prolonged deaths and lack of support after the loss (Strada, 2013). Shear et al. (2011) explains there are a number of signs of complicated grief six months following the death of a loved one including; frequent intense feelings of loneliness, feeling empty, preoccupying thoughts of the loved one who died, inability to accept the death and persistent feelings of shock, or feeling emotionally numb. Complicated grief