Academic journal article The Israel Journal of Psychiatry and Related Sciences

Reauthoring Life Narratives: Grief Therapy as Meaning Reconstruction

Academic journal article The Israel Journal of Psychiatry and Related Sciences

Reauthoring Life Narratives: Grief Therapy as Meaning Reconstruction

Article excerpt

Abstract. New conceptualizations of bereavement have begun to highlight the process of meaning reconstruction in the aftermath of loss, and the important role this plays in adaptation. This article summarizes theoretical and empirical contributions to this emerging perspective, and discusses several specific implications these carry for the practice of grief therapy.

Bereavement theory has evolved considerably in recent years. Gone is its unquestioning reliance on presumably universal stage models of recovery, its preemptive focus on emotional responses to loss in isolation from both cognition and action, and its penchant for quantifying grief only in terms of psychopathological symptomatology (1). In their place is a newfound sensitivity to different patterns of adaptation as a function of age, gender and ethnicity (2), concern with the disruption of life assumptions (3), and the quantitative and qualitative study of the transformations of self and world occasioned by loss (4, 5). My goal in the present article is to extend this latter effort by exploring the concepts and methods of one recent contribution to grief theory -- namely, a constructivist and narrative approach - as they pertain to the practice of grief counseling and psychotherapy. I therefore will begin with a brief recapitulation of emerging paradigms in grief theory that are more extensively summarized elsewhere (1, 6), noting their compatibility with a constructivist approach to psychotherapy, which focuses on the personal and collective processes by which people construct and reconstruct the meaning of significant life experiences (7). Finally, I will conclude by detailing seven strategic implications of these perspectives for the practice of grief therapy.

Toward a New Theory of Grieving

The past decade has witnessed the development of several new trends in grief theory and research. In this section I will highlight a few of these trends that have special relevance for clinical practice, and that converge with a constructivist model of meaning making in the face of adverse life experiences (8). These include (a) the shift toward idiographic approaches and away from stage models of grieving, (b) the growth of qualitative research, (c) notions of sense-making, benefit-finding, and identity reconstruction, (d) the adoption of non-pathologizing models of transformation, and (e) explicitly narrative models of grieving. Idiographic approaches. Despite the near hegemony of stage models of grief since the publication of Kubler-Ross's (9) On Death and Dying (10), the shortcomings of such models have been increasingly recognized. Corr (11), for example, notes the virtual absence of empirical support for a conception of bereavement as involving identifiable universal stages of adaptation, and both Worden (12) and Rando (13) have offered more active, task-based models of what the bereaved person needs to accomplish in order to reinvest in living. This critical effort has been supplemented by growing recognition of subtle ethnic and gender variations in grieving (2, 14), further undermining the presumed authority of a "one-size fits all" approach to post-loss adaptation.

With the critique of traditional models has come a call for more personal, idiographic approaches to loss, which do not so much seek to offer alternative models of human experience as to afford new windows on human complexity. Thus, Attig (15) depicts the many ways in which bereaved persons "relearn" the world following loss, and Gilbert (16) underscores the quite different fashion in which different family members, by dint of their different positions, accommodate the "same" loss. Constructivist theorists in particular have developed a range of methods for studying and facilitating individual processes of bereavement adaptation (6, 17), contributing to many of the remaining trends discussed below.

Qualitative research. Coinciding with the upsurge of interest in idiographic approaches has been a proliferation of qualitative studies of grief, supplementing the traditional emphasis on quantitative assessment of grief symptomatology (4). …

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