A Clinical Tool to Help Find Your Bearings after Loss

A big theme of my work as a perinatal therapist is helping folks navigate grief and loss. To honor pregnancy and infant loss awareness month, I want to share one of my most used clinical tools with you from the world of grief therapy.

‍

What does it mean to process grief?

While the idea of processing emotion is culturally familiar, I think we all make default assumptions about what it actually means to be in a grief process. Is it embracing all our emotions head on? Does it follow linear stages? How long should it take? 

‍

My favorite tool to understand the breadth and complexity of the grief process is Stroebe and Schut’s Dual Process Model. The model suggests our unfolding experience after loss will be shaped by one of two main categories; that of either loss-oriented experiences or restoration-oriented experiences. 

‍

Loss-oriented experiences include the thoughts, feelings, and activities that are primarily connected to the loss. Examples include sitting with grief related feelings, reflecting on the story of loss, leaning into an ongoing connection to who or what was lost (think going down memory lane, imagined dialogue with the deceased), and even avoidance or denial of the inevitable longer term impact of the loss. 

‍

Restoration-oriented experiences reflect the more outwards oriented thoughts, feelings, and activities that follow life after loss. Examples include engaging in continuing life administration (grocery shopping, paying bills, etc.), engaging distraction, pursuing old or new interests, and accepting the unavoidable personal and practical life changes brought on by loss. 

‍

In sessions I doodle this out with folks, but for current purposes you can see both categories pictured below. 

Schut, M. S., Henk. (1999). THE DUAL PROCESS MODEL OF COPING WITH BEREAVEMENT: RATIONALE AND DESCRIPTION. Death Studies, 23(3), 197–224. https://doi.org/10.1080/074811899201046

‍

By and far, the most important part of the model, the part I find resonates most with people, is the zigzagging arrow in the middle. The oscillating arrow reflects the reality that a healthy grief process will include a dynamic back and forth between loss and restoration oriented experiences over time. In a culture that values control, urgency, predictability, and simplicity, The Dual Process Model validates and permits that there is nothing simple, linear, or scheduled about grief. This may sound simple on its face, but there are many ways this model can be applied to help navigate common pain points of a grief journey. I’ll do my best at summarizing a few of those here. 

‍

How this tool benefits those who grieve

• It normalizes the ebb and flow of grief. You are not failing or regressing if you suddenly cannonball back into loss-orientation even months or years following loss. Alternatively, your love or connection to one lost is not diminished when you lose yourself in a task, distraction, or hobby. The model helps us make sense of what first feels disorienting, but is actually a natural psychological and physiological adjustment over time. 

‍

• It disentangles “shoulds”. I regularly hear “I should be over this by now, what am I doing wrong?”, or conversely “I should have thought about X more this week”. An oscillating grief model helps us get curious when our unfolding experience violates our grief rules. A helpful place to start is to listen for your “shoulds” and ask yourself 1)What is the implicit expectation underneath this feeling? and 2) Is that expectation fair or realistic? These expectations often try to force your experience to one side of the model or the other, and heap on additional shame, guilt, and fear to an already painful loss. But many grief rules do not stand up when filtered through this researched model, which can open the door for increased clarity and self-compassion.

‍

• It helps identify a default “leaning”. Many folks will lean towards one category or the other based on comfort, default coping patterns, and family history. By identifying your leaning, you can also consider what needs may unintentionally fall unmet on the other side. For example, some folks benefit from intentionally planned opportunities to authentically connect to their grief, while others may find it helpful to plan for small steps that re-engage an old hobby. 

‍

A note for couples 

• It's very unlikely that partners will share a default leaning or will travel between sides at the same pace. Naming this reality can be key in loosening expectations towards each other, diffusing conflict, and creating a shared language and model for connecting amidst grief. 

‍

For those walking alongside grievers

• Identify your own implicit grief rules and leaning. Many people who grieve feel an outside pressure to act a certain way or expedite healing. If you are walking alongside someone experiencing a loss, notice where a sense of “should” or agenda towards the griever creeps in (even if it's a desire for them to feel better!). Offering your supportive presence to wherever the griever finds themself is always the best starting point.

‍

• Don’t be afraid to check in…continually. Many people I work with share a wish that their community would continue to check in on their well being long after a loss occurs. Even after someone appears to be doing well from an outsider's perspective, this model helps us understand that a grief process is ongoing. 

‍

While one of my favorites, The Dual Process Model is just one of many tools at our disposal as perinatal and grief therapists to guide people experiencing loss. If you find yourself amidst disorienting grief, our therapists and psychiatrists are available to meet with you and support you on your journey. You can find more information about RPC here: https://www.rpcaustin.com/. 

‍