Abstract
This essay aims to highlight some of the main approaches in psychological theory that have contributed to our understanding of grief, loss and adjustment associated with death, dying and bereavement. Some of the main models that have influenced the work on this subject have been outlined briefly and then examined with respect to existing literary evidence. The research by Kubler-Ross (1969), Buckman (1993), Copp (1996), Maciejewski (2007) and Bonanno (2009) are among some of the main approaches that have been described. Criticisms and limitations within each perspective have been underscored and a cross-examination between theories has also been made wherever possible. Difficulties in investigating death have also been pointed out. The discussion primarily focuses on death caused by prolonged illness or chronic disease. Each approach has been examined from the point of view of the dying individual, their loved ones and their health care providers. The essay concludes that every model has its merits and demerits that have helped to evolve the understanding of death and bereavement. Current trajectories on the topic have however moved towards including a multi-faceted view of death and its characteristics. In doing so it has also paved the way for better and more comprehensive care for the dying and their needs, as well as those of the their healthcare providers and families.
Keywords: Death, Dying, Grief, Response to Loss, Stages of Dying, Bereavement
Word Count (excluding references and appendices): 3, 048
Introduction
Whether it is fear, uncertainty or unpreparedness, there is something that prevents people from discussing the subject of death openly. Despite the technological, spiritual and material advances in the world today, dying has been, and perhaps always will be, a distasteful topic to talk about (Kubler-Ross, 2009). But even with the often-frightened reaction that it receives, death is not something that can be avoided or pushed under the carpet. This is especially true for healthcare providers who are bound to come across death in some form or situation at their workplace. Death for them is in fact a reality as true as life itself.
For that reason, it is pertinent for practitioners working in healthcare settings to develop a deep understanding of death, not just its physical attributes but all the emotions, ideals and attitudes associated with the concept of dying (Lakhani, 2011). For the patients and their families, it is sometimes even more important to be able to face and understand their emotional reactions rather than gain a complete awareness of the physical changes that may be occurring inside them. Such a psychological insight into death can thus help the dying and their families comprehend their specific circumstances and deal with them in the most appropriate way. This in turn can build effective communication between health practitioners and their patients, thus allowing a better assessment of end-of-life needs.
This essay explores some of the approaches in psychological theory that have contributed to our understanding of responses to loss, death and grief. It will briefly outline these approaches first and then highlight their prevalence in empirical research. Strengths and limitations of each perspective have been pointed out and a cross examination between theories has been made wherever possible. It should be mentioned that the essay looks at death resulting from natural causes particularly a chronic, debilitating and/or terminal illness. Death that is caused by accidents, acute attacks or sudden unforeseen circumstances where the patient, family or carers have not had a chance to absorb and react to what is happening have not been included in the investigation. The essay aims to conclude that each approach has its own merits and has helped transform healthcare given to those at the end of their life. While different individuals and healthcare professionals may subscribe to different and even opposing perspectives, each one has helped in its own way to further our understanding of the subject. However the future of research in this subject aims to incorporate a wider multi-faceted view of the dying and bereavement process to enable affected individuals to cope better.
Deconstructing dying and grief
The advancement in modern healthcare has meant that more can now be done to keep a human being alive even if it is merely at a physiological level (Neuberger, 2004). This, combined with growing life expectancies in the developed world has pushed away the idea of death into the oblivion (Cohen & Kass, 2006). Ironically, an average individual will still be exposed to ‘thanatological themes in television, cinema and other forms of media’ (Durkin, 2003 p. 5) on an almos