Bereavement: A D.I.S.C. Analysis
Dillenburger, Karola, Keenan, Mickey, Behavior and Social Issues
Theories of bereavement abound. The endeavour to understand this complex process has moved from intra-psychic explanations and stage theories to cognitive rationalizations and, most recently, process orientated explorations of bereavement. What has been missing in most of the literature to date is a detailed analysis of the context within which bereavement behaviours occur. This paper outlines a contingency analysis that includes consideration for the context of Death itself, Individual factors of the bereaved, Social factors, and influences of Cultural norms and systems (D.I.S.C.). The paper concludes by proposing that a comprehensive D.I.S.C. analysis might lead to whole person evidence-based practice in helping those who are experiencing bereavement.
KEYWORDS: bereavement, behavior analysis, trauma, death
It is a myth to think death is just for the old. Death is there from the very beginning. (Herman Feifel, in Cassingham, 2004).
Human reaction to bereavement and loss is widely discussed in the psychological literature. Generally speaking it is thought that, "The death of someone close is, for many, the most devastating experience in life. Most people find ways of adjusting to their loss; for others it may be too difficult without additional support."(Strang, 2001). Holmes and Rahe (1967) rated death of a spouse as the most stressful life event people experience. Commonly, a range of theories is employed in an effort to understand and explain the human experience of bereavement, loss, and separation. In this paper, the evolution of theories of bereavement is very briefly described and critically assessed in the context of newly emerging data from long-term studies of traumatic bereavement. Then a contingency analysis of the context and process of bereavement is offered based on recent thinking in behaviour analytic research. Finally, implications for working with the bereaved are explored.
EVOLVING THEORIES OF BEREAVEMENT
For the past decade or so, the controversy has grown about the utility of existing theories related to grief and mourning (Fulton, 2003). Before having a look at what the science of behaviour analysis can offer to the topic, a brief overview of the evolution of theories of bereavement to date is outlined. Given the amount of writing in the field such a brief visit obviously cannot cover all the ground. Therefore, some general trends are outlined. The writers and thinkers to whom we refer to are by no means exhaustive of the available literature. They are to be viewed merely as representative of main trends in the evolution of theories of bereavement.
In Western scientific literature Freud's (1963) ideas of an inevitable grieving process or "grief work" that serves to end emotional and internal attachments to a love object, and the necessarily detrimental effects of not going through the natural path of grieving, have had a massive and extremely long lasting influence on thinking in the area (Worden, 1991). For centuries bereavement and grieving was understood in terms of stages that the bereaved has to go through in order to adjust to the loss (Stroebe, 2002). Although in the main these stages were considered not to be static, often they were described as following a relatively uniform sequence of shock, denial, depression, anger, regaining equilibrium or homeostasis, and recovery or resolution. Intriguingly, there was no agreement on the number of stages that the bereaved person had to go through. For example, Rubin (1977) and Tatelbaum (1981) stated that there are three stages, while Conroy (1977) and Bowlby (1980) described four; Kuebler-Ross (1969) and Littlewood (1986) outlined five stages, and Calhoun, Selby, and King (1976) used six categories, while Lipinski (1980) depicted seven stages of grief (cf. Dillenburger, 1992).
In the early 1990's professionals who worked with the bereaved became increasingly dissatisfied with the restrictive nature of stage theories and fresh approaches were called for (Greally, 1993; Stroebe & Stroebe, 1991). …