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The Use of Conceptual Models in Loss Counseling

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The Use of Conceptual Models in Loss Counseling Loyola University Chicago Loyola eCommons Master's Theses Theses and Dissertations 1980 The Use of Conceptual Models in Loss Counseling Jean Lawrence Loyola University Chicago Follow this and additional works at: https://ecommons.luc.edu/luc_theses Part of the Counseling Commons Recommended Citation Lawrence, Jean, "The Use of Conceptual Models in Loss Counseling" (1980). Master's Theses. 3256. https://ecommons.luc.edu/luc_theses/3256 This Thesis is brought to you for free and open access by the Theses and Dissertations at Loyola eCommons. It has been accepted for inclusion in Master's Theses by an authorized administrator of Loyola eCommons. For more information, please contact [email protected]. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. Copyright © 1980 Jean Lawrence 'L THE USE OF CONCEPl.UAL M::>DELS IN LOSS COUNSELING by Jean Lawrence A Thesis Submitted to the Faculty of the Graduate School of Loyola University of Chicago in Partial Fulfillment of the Requirements for the Degree of Master of Arts September 1980 ACKNOWLEDGEMENTS I would like to thank Dr. Judy Mayo for her assistance as the director of my thesis, and especially for her help in organizing the material. To Dr. Gloria Lewis goes my appreciation for providing through her classes the opportunity to explore some of the materials and concepts which have developed into the present paper, and for her support and stimulation during the writing process. I am grateful to Dr. Anne McCreary Juhasz for recognizing the potential in a term paper presented in her class, and for her encouragement to expand upon the topic for other types of presentation. To those separated, divorced, and bereaved persons who, through their personal experience, provided informal corroboration of the use of theoretical models in loss counseling, I extend deep gratitude. ii VITA The author, Jean Lawrence, was born June 2, 19 38, in Evanston, Illinois. She is the daughter of John Reiter and Jane (Engelbreth) Reiter. She attended Maine Township High School East, in Park Ridge, Illinois; graduating in 1956. In September, 1956, she entered Northern Illinois University as an art major, graduating in 1960 with a comprehensive major in fine arts and a Bachelor of Science in Education degree. She was a member of the honorary art fraternity, Kappa Pi. From 1960 until 1972, Jean worked at Little City in Palatine, Illinois; as Art Therapist and Director of Social Habilitation. Further study in psychology was continued at Northern Illinois University during the summers. From 1973 until 1977, she worked as an artist in watercolor and pastel while attending the School of the Art Institute of Chicago on a part time basis. From 1977 until the present, Jean has restored and managed vintage apartment buildings while attending Loyola University. iii LIST OF ILLUSTRATIONS Figure Page 1. Dying as the Last Stage of Growth . 97 2. Interaction of Closeness of Relationship and Percep- tion of Preventability as Predictors of Grief 101 3. Ideal of Normal Grief in Response to Loss . 107 4. Divorce as the Death of a Relationship. 110 5. Self Esteem Changes During Transitions. 115 6.. Meaning in Life . 120 7. Hierarchy of Needs . 123 8. Traditional View of Life Alternate View of Life. .. 129 9. Social Readjustment Rating Scale. 132 10. Conceptualization of the Pathway Between Stress and Illness . 136 11. The Coping Process. 140 12. The Three Phases of the General Adaptation Syndrome 143 13. Stress ........ 146 147 14.· Theoretical Model Relating Emotions, Ego Defenses, and Diagnostic Categories . 149 15. Guilt ... 153 16. The Gestalt of Anxiety. 156 17. Loneliness. 159 18. The Phases of Helping A Continued Spiral of Helpee Activity and Growth. 161 19. Concentric Circles of Need Satisfaction . 165 iv Figure Page 20. Cylinder of Counseling Process as Needs Satisfaction. 166 21. Loss of "Wife" Role . 170 22. A Conceptual Model for Resolving Personal Loss .. 175 23. The Preliminary Mbdel for Loss Counseling ...... 177 v TABLE OF CONTENTS Page ACKNOWLEDGEMENTS. ii VITA ••••••• . iii LIST OF ILLUSTRATIONS iv Chapter I. INTRODUCfiON • • • • • • • • • • • • • • • • • 1 II. AN INTERDISCIPLINARY APPROACH TO 1HE STUDY OF 1HE LOSS PROCESS • • •. • • • • • • • • • • • • 12 I I I • SELECTED CONCEPTUAL .MODELS RELATED 'ID TilE LOSS PROCESS. • • • • • • • • • • • • • • • 94 IV. PRELIMINARY MODEL FOR LOSS COUNSELING. • • • • • 176 V. SUGGESTED USES FOR THE PRELIMINARY MJDEL FOR LOSS COUNSELING. • • • • • • • • • • • • • 188 VI • SUPPORT FOR AND SPECULATIONS ON THE USE OF CONCEPTUAL MODELS IN LOSS COUNSELING • 201 REFERENCES. • • • • • . • • • • • • • • • • • • • • • 217 CHAPTER I INTRODUCTION The study of loss is a relatively recent phenomenon. Histori­ cally, loss was dealt with in western culture through religious and social rituals and social support. Loss resulting from bereavement was a part of everyone's experience; and as such, was universally understood. As western society changed, however, the rituals and social support changed, and death was no longer considered a suitable topic of discussion. Recently, as a response to the silence and to the resultant pathological grief responses, such as delayed or pro­ longed grief, the topic has been reopened and expanded to include all losses. Both professional and non-professional persons are becoming concerned with helping persons who are experiencing a loss. The present paper will attempt to explore the loss process from an inter­ disciplinary standpoint and to develop a preliminary model for loss counseling. The Changing Attitudes Toward Research on Death Every society has had its own particular taboos, with contem­ porary western society being no exception. The Victorian era taboos regarding sex have been supplanted in the present century by taboos surrounding death. As recently as 1960, Feifel wrote of his dif­ ficulties in setting up a research study to explore the relationship between mental illness and one's philosophy of life and death. 1 2 Physicians asked by Feifel to assist in providing subjects for the investigation were horrified: they considered that to discuss death with seriously or tenninally ill patients was cruel, sadistic, and traumatic. As a taboo topic, death is "surrounded by disapproval and shame" (Feifel, 1960). Illness and death are not considered to be normal occurrences, but are seen as being accidents. Such an attitude implies personal failure and loss of identity and status for the person who is dying. Medical personnel perceive the death of a patient as a professional failure. With such feelings being prevalent, it is little wonder that little research has been conducted on death and grief. During previous eras, religious concerns revolved around the fear of God's judgement. Such apprehension has generally been replaced by fear of "the infringement on the right of life, liberty, and the pursuit of happiness." The expectation of personal immor­ tality has been replaced with a concern for historical immortality and for the welfare of future generations (Feifel, 1960). Some writers perceived this new concern for historical immortality as now being threatened by the possibility of nuclear holocaust, which would make death even more horrible and unthinkable. To cope with the horror of death, euphemisms such as "passed on" or "demised" are used instead of "died," even by researchers on the topic. Funeral practices such as the cosmetic decoration of the body are common, with mourners routinely corronenting on how well or how lifelike the dead body looks. Research sponsored by the funeral 3 industry tends to support such behavior. Mourners are currently expected to behave in a restrained and dignified manner, and to rejoin society as soon as possible. It is not considered appropriate to make others feel uncomfortable. It is little wonder that such taboos and customs surrounding death have influenced the research on the topic of loss. Feifel reported in his essay, "Death," (1960), that a review of the then current psychological texts had uncovered not even a single para­ graph on death. The prohibitions against studying death remained strong, with a few exceptions (Lindemann, 1944; Marris, 1956; Engel, 1961; Bowlby, 1961; Gorer, 1965), until 1969, when Kubler-Ross interviewed terminally ill patients at the University of Chicago Hospitals, and published several books and articles about the experience. She developed a model of the stages of grief experienced by the dying patient which, although not revolutionary L~ explaL~i~g t~e process, appears to have been influential in breaking the taboo on studying death and dying. The Accusation of Faddism Following the publication of Kubler-Ross' (1969) book, On Death and Dying, a radical increase occurred in the number of books, articles, essays, editorials, and specialized journals dealing with the topic. At the popular level, films, television programs, books, articles, sermons, workshops, and classes suddenly appeared. The topic of death appeared to have both cathartic and educational value, according to Cohen (1976). 4 Cohen, in an article entitled "Is Dying Being Worked to Death?" in the American Journal of Psychiatry (1976), reacted to the protest of other professionals that the topic was being overworked. Accusa­ tions were being made that death had become a fad, that authors were merely jumping on the death bandwagon, and that the topic had long been exhausted. In response, Cohen defended the proliferation of materials on death and dying, pointing out
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