Worden’s Four Tasks Of Mourning: An Overview

Grief

It is difficult for a person to cope with loss of a loved one and affect their lives in many ways. It is hard difficult time for a person to cope with someone’s death. The grieving process depends on the person’s personality and the relationship that the person shares with the deceased person (Worden J. W., 2014). The cultural, religious background, mental history, coping skills and support systems influence the way a person cope with the grief. Therefore, the bereavement, grief and mourning are the ways to express the pain of losing a loved one and the discussion explains the Worden’s Four Tasks of Mourning to overcome grief and loss of a loved one.

Grief is multifaceted and affects all aspects of life like psychological, spiritual, social, behavioral and physical. It is painful and hard to believe what and how life has changed. The loss of dear one with whom one has shared good moments of life that results in deep pain. It hurts tremendously and reflects the role of the deceased person that he plays in one’s life and huge void that is created after the person’s absence. On the other hand, bereavement is the time after the loss when a person mourns and grief being experienced by the person for longer time duration (Watanabe & Suwa, 2017).

Grieving is the external or outward expression of one’s loss and is normally expressed emotionally, physically and psychologically.  (Pattee, 2011).  Everyone has his own way of expressing and feeling grief but there are certain stages that are common to the mourning process.  (Kessler, 2016). Through mourning, people learn to adapt to a loss and is usually a factor of the cultural rituals, customs and the rules of the society regarding coping with losses (Worden J. W., 2010). It becomes very hard and at time unbelievable that the people we loved and cherished are living no more hence the need to cope up with a situation of their non-existence (Kessler, 2016).

Although grieving is the normal process in which a person reacts in response to the death of a loved or closed one. There are varying types of reactions that are experienced in grief like physical, mental, emotional or social reactions. Physical reactions include changes in eating habits, sleep disturbances, illness or other physical problems. Mental reactions include guilt, anger, sadness, anxiety and despair. Social reactions take place when a person tries to go back to work, taking care of other family members and meet family friends. Grief depends on the relationship the person had with the deceased, situations that surrounded death and degree of attachment with the deceased person. They might be physical problems, thoughts of the dead person, hostility, guilt and abnormal behaviour (Iliya, 2015).

Stages of Grief

There are five stages of grief that act as a framework to help one to learn to live without the loved one. The following stages help one to be better equipped to cope with loss and life.

Denial: Denial helps to live and survive the loss where the world becomes overwhelming and meaningless. It is the first stage of learning about a loss and in most cases a person feel it is an imagination rather than the reality (Kessler, 2016). Denial is used as a defence mechanism against coming to terms with a loss and the shock that comes with it. Shock and denial are the ways to cope with the loss and pace the feelings of grief. It is a natural way of letting a person handles grief as much as possible. In this stage, the person starts questioning to oneself and in accepting the loss and there begins the healing process (Young, 2017).

Anger: There is feeling of frustration and helpless that crops in when the reality dawns as individual experiences the pain of the loss. It is equally natural to be angry with the deceased and a feeling of being left alone (Strada, 2013). Anger is the way a person tried to gain strength and show the intensity of love the person had with the deceased person. The more anger one begin to dissipate, the more healed the person feels (Neimeyer, 2015).

Bargaining: At this stage, the bereaved tend to focus on what he could do in order to prevent the loss from occurring. Questions tend to strike the mind and leave the bereaved partly blaming self for the loss.  (Mallon, 2010). One tries to bargain with the pain and remain in the past where they try to negotiate with the way out.

Depression: As one begins to comprehend the loss and the effects it has come with in his life he experiences sadness. Depression occurs in two types and is usually associated with mourning. The initial depression is a response to the practical effects associated with the loss and is predominated by regret and sadness (Turner, 2017). Loss of or decrease in appetite, crying and even sleep issues are the signs of depression that the bereaved is likely to experience. There may be also feelings of loneliness, overwhelm and regrets. The second depression type is more private and subtle and involves a preparation to detach and bid our loved ones farewell.

Acceptance: This the final stage of grief, one comes to terms with the loss experienced and understands that the situation cannot be reversed (Worden J. W., 2013). At this stage, the individual is able to move forward with life despite sadness resulting from the loss. In this stage, a person tries to accept the reality that the loved one is lost and recognize that this is the permanent reality.

Bereavement

Bereavement is the grief process and letting go of a close and loved one who died. It is a state of loss when a dear person dies. The feelings of bereavement is accompanied by decline in health and disruption of relationships, however, grief is healthy and normal response to loss. One experiences social, physical, mental reaction as a part of bereavement and normal reaction to loss. Bereavement support is provided to the family and close relatives who have lost a loved one and suffering from grief and pain. It is very devastating for the person who has lost a loved one and was emotionally attached to that person. It refers to the grieving and acknowledging that a loved one is deceased (Worden J. W., 2013).  Bereavement is the time when grief is experienced and mourning begins. This bereavement time depends on the degree of attachment with the person who died and time spent for the anticipation of the loss.

There is extreme loss of emotional and physical energy during grieving not only because of the loss of the loved one, but also the unfulfilled plans and wishes for the relationship with that person. The death of the loved one reminds them of the separations or losses and people feel to bring back the dead person, express sadness or disorganization and eventually try to reorganize and gain resilience to lead a normal life (Ingles, J.; Spinks, C.; Yeates, L.; McGeechan, K.; Kasparian, N.; Semsarian, C, 2016).

Worden, while explaining on the Four Tasks of Mourning in his book, he claims that there are four tasks that an individual must accomplish in order to complete the mourning process and the reestablishment of the equilibrium to occur (Mallon, 2010). He states that there is no order of the four tasks but there exists a natural order of the completion such that the completion of one culminates into the beginning of another.  The four tasks include;

• Admitting the actual occurrence of the loss
• Understanding and accepting the pain of grief
• Adjusting or adapting to an environment of non-existence of the deceased
• Finding a long-lasting link with the dead person as one embarks on starting a new life(Strada, 2013)

Accepting the actual occurrence of the loss: The death of someone comes with a sense of disbelief that is literally defined as denial. Supporting the bereaved in achieving both the emotional and intellectual realization of the actual death of a loved one is important.  (Worden J. W., 2010). There is sense of unreality that prevails in the mind of the person thinking about what happened. Rationally, one knows that the person is gone, but on an emotional level, they are unable to accept it. Accepting the significance of the loss as well as the death mechanism makes accomplishing this task a bit of a challenge.  (Almeida, 2014). In this stage, a person tries to come with the terms of the death of the person. They experience shock and disbelief and feel that they are dwelling in surreal reality. Acceptance means that they are ready to mark the present moment and start with the process of healing (Cacciatore & DeFrain, 2015).

Worden’s Four Tasks of Mourning

Understanding and accepting the pain: The second task is about working through the pain brought by the grief. This encompasses identifying the emotions associated with the grief that one is likely to experience and work through them (Turner, 2017). This stage is considered the adaptive stage.

Through this task, Worden recognizes that each individual and each loss requires working through a range of emotions. Recognizing, talking about and fathoming the complex emotions that come with the grief are important in the accomplishment of this task. The only danger at this task is attempting to avoid and deny one’s feelings. This stage may cause such effects as loss of appetite, complete exhaustion, sore muscles and difficulty in decision making and hence it is important that one is patient and permit the feelings to wash over so as to process them. Proper self-care should be observed at this stage and such strategies as proper eating, sleeping well, engaging in physical exercises and spending time with other people should be deployed (Almeida, 2014).

Adjusting to an environment of the non-existence of the deceased: In task three, Worden acknowledges the roles affected by the loss and the relationship with the deceased. This task takes time to be accomplished and depends much on internal, external and spiritual adjustments. It would take quite long enough time to realize the roles that the loved ones were performing ranging from companionship, parenting, paying bills (William, 2012). There are also practical adjustments that need to be made without the deceased person in his or her life. Death greatly affects the one’s way of sense of self and the way one view the world. This stage takes time and adjustments are made accordingly (Schulz, Boerner, Klinger, & Rosen, 2015).

The task is achievable by developing the required skills to confidently move forward in the new spiritual, internal and external environment (Pattee, 2011). The non-existence of the loved one calls for an adjustment to a new spiritual environment caused by the demise of the loved one. To successfully accomplish this task, one may consider asking for help should there need be.

Enduring connection with the lost loved one in the midst of a new life:  This involves an everlasting connection with the deceased as one embarks on a new life. It means finding a link in the emotional lives with the deceased as we allow ourselves to continue with life. It entails allowing memories and thoughts, at the same time engaging in activities that bring pleasure, and comfort i.e. new relationships or new activities. According to Worden, failing to accomplish this task amounts to not living (William, 2012). Achieving this task takes a long time (Kessler, 2016). The relationship with a deceased loved one tends to change and evolves as the life of the bereaved is changing over time. A member of one’s spiritual or religious community may help in finding an everlasting connection with the deceased.

Conclusion

From the above discussion, it can be concluded that grieving is a challenging and unique process of recognizing the pain of a loss of loved one. It is difficult to understand the feelings accompanied by grief after the death of a loved one. The process of grief and the associated emotions helps one to come to the terms to live without the person and gain resilience to lead a normal life. .  Bereavement is the time when grief is experienced and mourning begins. Worden’s Four Tasks of Mourning help to accomplish the task of mourning and re-establish themselves to gain equilibrium and lead a normal life and integrate meaning of loss in their lives.

References

Almeida, R. (2014). The Politics of Mourning: Grief Management in Cross-cultural Fiction. New York: Fairleigh Dickinson Univ Press.

Cacciatore, J., & DeFrain, J. (2015). The world of bereavement: Cultural perspectives on death in families. Springer.

Iliya, Y. A. (2015). Music therapy as grief therapy for adults with mental illness and complicated grief: A pilot study. Death studies, 173-184.

Ingles, J., Spinks, C., Yeates, L., McGeechan, K., Kasparian, N., & Semsarian, C. (2016). Posttraumatic stress and prolonged grief after the sudden cardiac death of a young relative. JAMA internal medicine, 402-405.

Kessler, D. (2016). On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss. Chicago: Simon and Schuster.

Mallon, B. (2010). Dying, Death and Grief: Working with Adult Bereavement. Manchester: SAGE.

Neimeyer, R. A. (2015). Techniques of grief therapy: Assessment and intervention. Routledge.

Pattee, K. L. (2011). Helping to Facilitate Normal Grief: A Workbook for Psychotherapists Using Worden’s Four Tasks of Mourning. California: California State University, Northridge.

Schulz, R., Boerner, K., Klinger, J., & Rosen, J. (2015). Preparedness for death and adjustment to bereavement among caregivers of recently placed nursing home residents. Journal of palliative medicine, 127-133.

Strada, E. A. (2013). Grief and Bereavement in the Adult Palliative Care Setting. New York: OUP USA.

Turner, J. H. (2017). Handbook of the Sociology of Emotions. London: Springer Science & Business Media.

Watanabe, A., & Suwa, S. (2017). The mourning process of older people with dementia who lost their spouse. Journal of Advanced Nursing.

William, W. J. (2012). Grief Counselling and Grief Therapy: A Handbook for the Mental Health Practitioner. New York: Routledge.

Worden, J. W. (2010). Grief Counselling and Grief Therapy: A Handbook for the Mental Health Practitioner. New York: Routledge.

Worden, J. W. (2013). Grief Counseling and Grief Therapy, Fourth Edition: A Handbook for the Mental Health Practitioner. London: Springer Publishing Company.

Worden, J. W. (2014). Theoretical perspectives on loss and grief. Death, dying, and bereavement: Contemporary perspectives, institutions, and practices,. 91-104.

Young, H. (2017). Overcoming barriers to grief: supporting bereaved people with profound intellectual and multiple disabilities. International Journal of Developmental Disabilities, 131-137.