Grief Theory 101: The Dual Process Model of Grief

Those of you who love love LOVE WYG’s grief theory posts have probably been a little frustrated lately. After scouring the archives I’ve discovered it has been about 4 months since we last covered a grief theory. Whoops. This hiatus has in no way been intentional so today we’re getting back on track by talking about a more recent theory: Stroebe and Schut’s Dual Process Model of Grief.

Before we dive in I’d like to say that I truly believe learning about grief theory can be good for grievers. As a person with rational leanings, understanding my own grief really helped me make sense of what I was going through. Though some people get frustrated that grief theory feels abstract and that it isn’t practical for your average griever, I write about grief theory here on the blog because I believe at least a handful of you may feel the same way I do– you actually like reading about grief theory.

That being said, I should warn you that the Dual Process Model of Grief makes even my grief-theory-lovin’ head spin. If you thought grief was confusing, the Dual Process Model may make things seem even more complicated on first pass. But here’s the reward for sticking with it, this grief theory endorses watching mindless TV sometimes. Yes seriously. So I am going to do my best to break it down for you, although I’ll warn you that even WYG-style-cliff-notes might not save you.

Okay. Deep Breaths.

In 1995 Margaret Stoebe and Henk Schut presented a paper at the Meeting of the International Work Group on Death, Dying and Bereavement (OMG guys, can you imagine what their post-meeting happy hours are like?). The paper was called “The Dual Process Model of Coping with Bereavement” and outlined their theory. Their theory then gained traction after authors Stoebe and Schut published The Dual Process Model of Coping with Bereavement, Rationale and Description in the journal Death Studies; spurring grief-academics to put the theory to the test and look at its real life applications when working with grievers. I was in high school when the original paper came out so, like most people, not so much interested in papers about bereavement; but by the time I conducted my mental health and grief studies in the 2000s the Dual Process Model of Grief had sure enough made its way into the grief text books.

Stroebe and Schut started their 1999 paper with a direct critique of prevailing ‘grief work’ theories, saying…

“…there are shortcomings in traditional theorizing about effective ways of coping with bereavement, most notably, with respect to the so-called ‘grief work hypothesis.’ Criticisms include imprecise definition, failure to represent dynamic processing that is characteristic of grieving, lack of empirical evidence and validation across cultures and historical periods, and a limited focus on intrapersonal processes and on health outcomes.”

Dang…way hash, Tai. There’s no beating around the bush with this crew.clueless-way-harsh-tai

 

 

 

 

 

 

Now you may be asking yourself, “what the heck is ‘grief work’ and why are they so critical of it?” Though (as Stroebe and Schut point out) the definition is imprecise, ‘grief work’ is the general idea that a griever must work through their difficult and painful feelings around the loss. Those who subscribe to the ‘grief work’ theory argue that a griever will not recover from their loss if they do not go through this process, often tasks and stages, to confront their difficult emotions.

It is important to understand these criticisms, as the Dual Process Model is a direct response to some of the limitations and problems they identified in existing grief theory. One strong beef they have is with the way ‘grief-work’ theories deal with avoidance, denial and repression. Under the ‘grief work’ model, you must face the pain of the loss head-on. This is emotionally and physically exhausting, but it is crucial to healthy grieving. The DPM argues that to “avoid, deny, or suppress” certain aspects of grief is not only normal, but a healthy and important part of grieving. Sounds crazy, right?!

Stroebe and Schut also suggest that the ‘grief-work’ theory undervalues the male experience of grief, and is based on the female experience which is more expressive and willing to confront difficult emotion. They suggest the grief work’ definition of ‘healthy’ grief is largely based on a western, medical model and suggest that their own model is more inclusive.

When Stroebe and Schut transition from a review of other theories to introducing their own, they explain a final critique of ‘grief work’ theories, which is failing to specify the stressors of bereavement. In the DPM the authors suggest that there are two types of stressor that are associated with grieving: loss-oriented stressors and restoration-oriented stressors. Both types require coping, but Stroebe and Schut are quick to point out that we also must take important breaks from said coping.

Loss-oriented stressors, as DPM defines them, are stressors that come from focusing on and processing the loss of the person who has died and our relationship with that person. This includes everything from looking at old photos, yearning, remembering, imaging what a loved one would say about something, and reminiscing.

Restoration-oriented, on the other hand, has to do with secondary sources of stress and coping. Instead of just thinking about the grief for the person who died, this theory considers the stress of feelings of isolation, having to fulfill tasks that the person who died used to do (like cooking, cleaning, managing finances, etc). This is, as Stroebe and Schut point out, similar to the concept of coping with secondary losses that arise following a death, though the DPM is slightly more inclusive.

A crucial part of the Dual Process Model is the concept of oscillation. According to Stroebe and Schut, healthy grieving means engaging in a dynamic process of oscillating between loss-oriented and restoration-oriented coping. A griever will oscillate between confronting the loss and avoiding the loss. This is a dynamic process that is actually part of the healthy grief process under the DPM, coping with our grief at times and seeking respite at times (this is the part where we are all given permission to watch bad TV!).

If there is only one thing you take from the Dual Process Model of Grief it is this: it’s okay to experience grief in doses. At times you will face your loss head-on, others you’ll focus on fulfilling practical needs and life tasks, and once in a while you will need to take a break or find respite. This is partially why we talk so often about self-care.

If you find all of this clear as mud, perhaps this diagram provided by Stroebe and Schut will help:

dual process

Hmmmm . . . . yeah, that diagram didn’t really help me either. So, for now let’s all just toast to a grief theory that supports my love of TMZ and Game of Thrones and hope that some smart individual leaves a comment that sheds a little more light.

In the mean time, subscribe over to the right on the sidebar so you can get all our great posts straight to your email!

March 28, 2017

31 responses on "Grief Theory 101: The Dual Process Model of Grief"

  1. Hi
    I posted a comment on Grief Theory on 30th January 2016 following the death of my wife. Now, almost a year later, I still find solace in learning about grief theory and developing my own logic about the process of bereavement.
    My initial reactions to my loss were a sries of desperate questions: What is bereavement? What are the symptoms? How long would it last? How best to cope? Where was the handbook that would give me the answers to these questions?

    I soon discovered that there is no handbook as bereavement is personal and unique. However, by reading about the various theories, I was able to get an understanding of what I was going through at the time and, more importantly, what I could expect in the times ahead.
    I was able to describe my progression in terms of an emotional balance sheet akin to the Dual Process model of grief, negative emotions being ‘debits’ and positive ones ‘credits’. In these terms, two years after the death of Anne, I feel that my account is in credit but that there will always be an underlying debit which is bereavement.
    If the goal of the bereaved is to seek the state of ‘acceptance’ i.e. being able to look forward in a positive way and to being able to look back with fond memories rather than sadness and regret, then I have not yet reached this state. I am optimistic, however, and am currently learning about Acceptance and Commitment Therapy which is a relatively recent branch of Mindfulness. Its very name seems appropriate in the context of bereavement and grief.

    • Profile photo of Litsa Williams

      Thanks for sharing your update and perspective, John. It is amazing how grief changes and evolves, as does our perspective and reflection on our own grief. We both love ACT! I did my initially training in it in the VA’s PTSD program in and agree that there are many apt connections to grief.

  2. Is it possible to get stuck in loss, or restoration orientation, or is oscillation inevitable? What are the implication for someone with disorganised attachment or someone who has become emotionally detached from others?

  3. The DPM article seems to me an excellent grief theory, I lost my husband three weeks ago and have done a lot of swinging from one process to the other. I would like to say though that I’d prefer for my “time out” to be of my own choosing. I don’t want to be jollied along or cheered up by well-meaning friends and family. I also reserve the right to say “I’m fine” even when I’m not. This is less avoidance of the grief itself than avoidance of people telling me what I should be doing. I really don’t want to lose friends by unleashing my anger on them when they give me unwanted advice. I have a few trusted people who are supportive and empathic and those are the one I can tell how I really feel. Thank you so much for creating this website that I am finding so very helpful.

  4. I read the article and realized the DPM resembles the natural way children grieve…in bite size pieces. Working at a hospice that runs a grief camp for children ages 6-16 has afforded me the opportunity to talk to many families as well as working closely with our social worker and grief counselor. Children seem so resilient almost naturally and I have been told over and over that they sometimes do not even seem to miss their loved one but in the right setting that grief will surface. Then they go back to the appearance that the loss never even happened. I know that is not true for all children but I have seen it enough that I recognized it in this model, or at least it appears that way. Thanks for the article.

  5. Hi. I have come across the DPM almost in retrospect. Since my wife of 40 years died 10 months ago, I have taken a very introspective approach to my bereavement . From earlier experience of cognitive behavioural therapy, I had become familiar with evaluating my days in terms of ‘positives’ and ‘negatives’. With this mindset, I have tried to describe journey so far by using an analogy with an ’emotional’ bank account. Thus, for forty years my wife and I had a healthy joint account, with the balance always in credit; following a prognosis of terminal cancer, this balance began to decline but was still in credit; on Anne’s death, I became emotionally bankrupt overnight and remained in that state for several months; recently, I have sensed some improvements and, and occasionally I feel that my account is coming into credit, although now it is no longer a joint account.
    In this analogy, the emotional debts are the loss oriented factors whilst the credits are restorative factors. The progression over time represents the journey from grief to acceptance. The central transitional phase is where the counterplay or oscillation of both factors is more closely balanced.
    I have found some personal logic (and solace) in coming to this conclusion and, for me, it resonates very strongly with the Dual Process Model.
    Thank you for your excellent work.

  6. Thank you Litsa, and I’ll look up the links.

  7. Hi, thank you, I will be looking into DPM practices to help me (aged 62) cope with the loss of my father four years ago. Mine isn’t so much as grief over a ‘loved one’. I never thought of him as such, we didn’t have a loving father-daughter relationship; not because he wasn’t able/willing to, but because I was an angry, arrogant and surly young child. And a polite but repressed adult child, unable to emotionally connect with him due to my deep aversion and dislike for my mum, his main caregiver, whenever I visited him a couple of times a month. It hurts very badly that I was supposedly the favorite of his four children, and I remember the times he had tried to make conversation with me but met with unenthusiastic responses. I feel heartache over the fact he might have felt disappointment that he had ‘betted on a three-legged horse’. For years, we all knew he was dying and I had mechanically made a list of the things he had done for/with me, to remind me of his kindness for which I was grateful. But it was a mechanically process, done with the head but not with the heart. I failed to ask myself the things *I could do for him before he died, in reciprocation. I agonize that it’s too late and that he will never know how much love I have for him and that I weep for my loss. I did nothing, to make his remaining days happier, or to establish a tangible father-daughter bond, and I could have done so much more, even though he was reasonably well cared for with the basics. When he died, it was as if a veil lifted, and I cried, and I’ve not stopped crying, every single day. But when I went to his house upon his death and saw my mum and family, and at the funeral, I did not shed a single tear, I needed to keep my grief in check.

    I hope you will have an article on grief over a love that never was..or something like that.. due to repression, self-consciousness with other family members (shades of ‘disenfranchisement’?) and one’s lack of self-awareness of how they would react to the death.

    • Profile photo of Litsa Williams

      An, I don’t know that we have an article on exactly what you’re suggesting, but we will certainly consider writing one. I am so sorry for all of the emotions that have come up since your father’s death. Is not uncommon for people to struggle immensely with grief even when the relationship they had with the person was not a traditional relationship. It sounds like you are dealing with a lot of feelings of regret and guilt, so it may be helpful to read some articles about coping with those complex emotions. This may be a good place to start:
      http://www.whatsyourgrief.com/guilt-and-grief-2/

      and

      http://www.whatsyourgrief.com/grief-and-forgiveness-part-two-12-tips-for-self-forgiveness/

      I hope you find some support on this site.

      • Good Morning,

        From a personal and a professional perspective the DPM has been very beneficial in working through grief. It has two concepts that are worth taking a deeper look at. One is the concept of “oscillation”, that the client moves back and forth between two points of orientation during the grieving process. Second is the reference to two points of orientation: a loss orientation and a restorative orientation. One of the defining moments in moving forward in the loss of my father was when I realized I could give my self permission to shift from one orientation to the next. The theory and the practical application has been helpful to our bereaved clients as well.

  8. Hi, I’m just about to enter into Bereavement counselling training next January and I’ve found out today that the Dual Process Model is the desired theory for today’s students to learn. Lucky for me, I studied the DPM for my Certificate level and I’m wondering if there are any counsellor’s out there that can offer any advice or links that may help. Like I said, I studied DPM for a while and found out that loss takes a number of stages and whilst some theorists state that loss follows a pattern of behaviour, the DPM states that the grieving process can and will move along the line of process and may revert back to the start or to the middle or end of the process at any time, this may be different for each individual dealing with their loss but in time, the pain will level out over time with support. I mean support in the way of dealing with loneliness, money, moving on and being encouraged to speak with the deceased person as if they were there, this is a continuum of the relationship between the griever and deceased until a time that the griever can feel different and feel able to cope with that loss of the loved one. This is the Oscillation which is spoke about which allows the griever to take their time and to move back and forth into a place of process which suits them at that time. It is acknowledged that love, memory and pain will never leave you, but the pain will decrease and a coping mechanism will arrive into place when the griever allows it to.

  9. It is interesting for me to realize that 13 years after I lost my spouse, I have been going through what DPM is explaining. Many times I play avoidance but I find myself dealing with raw grief on and off. It has not been easy and am encouraged to hear IT IS OK .:)

  10. I realise I’m late to the party but I LOVE LOVE this theory (if that is even possible). It fits completely with what I’m going through at the time. Which is being late to the ‘party’ of my own grief for a father who killed himself fifteen years ago. As a child I decided two days after it happened (or, you know, maybe a few weeks) that I was ‘over it’. Other people had a dad, I simply didn’t. Ummm… that didn’t really work out.

    So now I’m dealing with all this leftover rage and sadness and despair and stuff, in therapy, looking at pictures for the first time etc. etc. etc… While at the same time having to reorient my life (made some not-so-intelligent studying choices and unfortunately no-one stopped me from getting two basically useless degrees), looking for work while trying to survive the grieving.

    I absolutely oscillate between the two aspects. With some mindless distraction in between to get a break from all the deep awareness I’m practising (computer games like ‘the sims’ come to mind)

    Sorry for the rambling post and anyway thank you so much, this was very helpful!

  11. I love this website! I am an aftercare provider (funny name) and a social worker. I’m also someone who has experienced a tremendous amount of loss, including my husband; both parents and two siblings. I know grieving… do I do it right? Well, I’m starting to understand that, yes, I’m doing it the best way I can. I love this theory and am intrigued and plan to read more. I love the notion of oscillation…. I continue to do that, as I continue to experience the aftermath of so many loved ones’ deaths. Years can go by and I find myself beginning again another layer of my grief. And, it’s ok. And, I so want to articulate that to the people I am honored to work with. It’s ok to take a breather from grief. Thanks so much for the great website!

    • Profile photo of Eleanor Haley

      Hey Rose,

      Sorry for the late response but I just wanted to say thanks for your comment. I used to be an aftercare worker as well! I agree it is kind of a funny name 🙂 I’m glad you find the theory helpful. Thanks for the work you do to support other grievers.

      Eleanor

  12. This is such a wonderful resource-my only concern is that the DPM is widely being used and applied only to those grieving the loss of a loved one when in fact many people go through the stages of grief and the DPM because of a personal loss such as a life threatening illness that has changed the path of their life dramatically or infertility that causes them to grieve over the life they imagined they would have with their spouse. As one who has grieved for loved ones gone too young in my life and also in the ways I described above I have found the DPM a helpful resource in working through my grief in all of these matters. I would encourage you to expand your grief topics to those of personal loss/loss of a dream in addition to the heartbreak of grieving for the loss of a loved one because the same formula applies and is invaluable. Thank you for your resources!

  13. The way I think of the DPM and the way I frame it to clients is that the oscillation of this model is the work of grief. That back and forth between loss orientation and restoration orientation, or between grief experience and moving forward experiences takes a huge amount of energy and effort and is truly work. How do I grieve while still finding joy in some things? How do I allow myself the time to process my feelings while still going to work/being engaged with others/etc? For some, it is easier to be all in the grief or all in the avoidance of grief, and the real work is how you do both.

    I have found looking at this helpful, both for me as a counsellor, but also for clients who wonder if they are doing grief the right way. (And we know there is no right way.)

  14. This makes sense to me….particularly the concept of ‘restoration oriented stressors’. This is where I am now, nine months after my partner’s death, adjusting to my life without him. Feeling incredibly isolated and lonely due to his absence, and overwhelmed by working plus all the household tasks. You don’t realize how much someone you love does for you until they aren’t there to do it any more. And I am back to anger…thanks Kubler Ross. So I have been known to bury myself in a book or binge watch some Netflix, just to give heart and mind a break. I have faced up to all the ‘difficult tasks of grieving’. But you can’t do that 24/7 without it breaking you.

  15. I really appreciate hearing about theories of grief. It makes me feel less crazy- I can say to myself “ohhh, so might be why I’m acting/feeling like that”. This theory does make sense to me- pretty much right where I’m at as I come up to the year anniversary of my mom’s death. Swinging between times of feeling ok, to times of avoidance, to times of feeling really sad. It helps to think of those things as stressors I am dealing with, and reasons sometimes I still get overwhelmed, tired etc.

  16. This is EXACTLY how I have handled the death of my son. We just passed the 4 year mark. I dove in “head first” to grieving, then realized that grieving 100% of the time is not healthy. My soul was tired of the darkness and needed small doses of sunlight. Great read, thanks.

    • Profile photo of Litsa Williams

      So glad this was helpful. The realization that it is okay and healthy to take breaks from grief can be so important! I am sure passing the anniversary was tough – no matter how many years, it always is. Take care.

  17. Hi…this article was so helpful! My mom died from brain cancer 6 months ago…and even though I had a grief coach by my side for about a month, now that the coaching is ended I was confused about my own post reactions: I was grieving that this tool ended, and I was also avoiding to think of my mom (plus…we just bought a new house, and that has been keeping me really busy)…Now I see it clearly: I have been avoiding to face the pain, because I am simply not ready / willing to feel so much pain exactly right now when I have to make an effort to get this move done in time. I do consider it is healthy because this just gives me time to heal those little injuries that grief causes in your soul, or life….and then we can move on to the next one. In doses, exactly! Thanks a lot for this information, I know every grief process is different but at least this one applies to my case.

    • Profile photo of Litsa Williams

      Alicia, I am so sorry about the loss of your mom and so glad this resonated with you. I think we sometimes have to be honest that the time and space to grieve is a luxury. When we have day-to-day needs that we have to get through (moving to a new house, etc) sometimes we have to take a break from the loss to manage the practicalities of life. As long as we keep that balance (oscillation) in our grief, it isn’t unhealthy to take breaks. Good luck with your move – I am sure that is a significant stress at a tough time!

  18. Well I’m not too sure about these grief work models personally. I’ve gone to a psychologist that specializes in grief & bereavement for a year now and whilst it was a safe place to share my grief, tears, anger & guilt, I can’t say I left an appointment in that year better equipped to cope with the ensuing emotions, intrusive thoughts and feelings of my loss. I felt raw and hung out after each session with no rope to latch onto in terms of coping and self care/preservation. So now $4k later I’m back to square one feeling the exact same way I did whilst in so much pain. I wonder daily how to go on with a shattered heart, a voided soul that lives an empty life of pain, and how long to endure that hopeless life? Maybe therapy works for some, but it is $$$ and doesn’t work for others.

  19. As a grief counselor, I’ve always worked from many of the grief theories. As someone who has been grieving over the past year (and knew the theories) I have to say I like the DPM. I’ve spent (and continue to) a large amount of my time creating a new life for myself which has meant I’ve been in Restoration Oriented Perspective but I’ve also faced my grief head on at times and had some avoidance (Criminal Minds/Orange is the New Black. I love reading about the different theories but also believe each has strengths and weakness. Thanks for this post.

    • Profile photo of Litsa Williams

      Ummm I LOVE Criminal Minds- I officially classify it as self-care 🙂 I am glad to hear the Dual Process Model had resonated with you – I am only sorry you have been coping with your own grief over the last year. Thanks for taking the time to comment!

  20. In dealing with grieving people and working with people who provide support to the grieving I have found the Dual Process Model very helpful.

    There are two components that have been the most helpful. First in dealing with those grieving it has been extremely helpful for initiating conversations on the two orientations. If you will note in the graph part of the restoration orientation is “distraction, denial, doing new things….” Grievers need to know that it is alright to take a break from the hard work of grief work. Even if it is just enough time to come up and catch their breath so that they have the mental, emotional, spiritual, and social support to continue the hard work. Second dealing with those who work with those grieving. We often assess clients and where they are in their grief process. Most assessment are driven by the time of the assessment and do not take into consideration “oscillation” or the clients current orientation. This leads to confusion on where the client may or may not be. When we take into consideration some of the components in the DPM model; we are likely to see the assessment as an ongoing process as opposed to a specific point of time. This theory also helps us to understand why their is often discrepancies in grief assessments.

    A history/relationship with the client, an understanding of oscillation, and orientations can help the client to cope as well as provide understanding to the one offering support. DPM is worth a second look and application for those providing grief support.

  21. It all seems to make sense but nothing works for me. I suffer from disenfranchised grief as the man I love was married to someone else. I couldn’t be a part of the natural grieving process. It’s been almost two years since he died and I’m as miserable today as I was then. I think I will have to carry this burden until the day I die. I cry every day and find myself talking to him as if he was in the room with me, which I believe he is. Talking about it is helpful but he has gone from this earth and he’s never coming back. Perhaps we will be reunited in Heaven.

Leave a Message

Your email address will not be published. Required fields are marked *

Disclaimer

WYG provides general educational information from mental health professionals, but you should not substitute information on the What’s Your Grief website for professional advice. Please check out terms and conditions here

National Suicide Prevention Hotline

National Suicide Prevention Hotline - 1-800-273-8255

PhotoGrief

Share Your Snapshot

Grief In 6 Words

Submit a Story to Us

What's Your Grief Podcast

Listen to our podcast

top
X