Abstract
Bereavement following loss through death is a universal human experience, but how it is experienced and understood is mediated by many variables. In this article, we stress the importance of a bifocal approach to understanding, assessing and intervening following the loss of significant persons using the framework of the Two-Track Model of Bereavement. This model examines both biopsychosocial functioning as well as the nature of the ongoing relationship with the deceased and the death story in working with the bereaved. It is particularly suited to identify adaptive and maladaptive responses to loss and to optimally focus interventions where needed. Two case vignettes are presented to orient the discussion. Traumatic bereavements, a term indicating the interface between trauma and loss, increase the likelihood of complications following loss and these are considered. Bereavements that occur under external traumatic circumstances increase the risk for dysfunction, symptomatic difficulties and complicated grief. In addition, there are forms of traumatic bereavement that arise due to subjective elements related to aspects of the psychological relationship to the deceased and the relational bond with him or her. Clinically, there is a need to identify and understand the various aspects of the traumas of bereavement and to intervene appropriately. Interventions based on the Two-Track Model of Bereavement will be described.
Similar content being viewed by others
References
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association press.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association press.
Bar-Nadav, O., & Rubin, S. S. (2016). Love and bereavement: Life functioning and relationship to partner and spouse in bereaved and non-bereaved young women. Omega: Journal of Death and Dying, 74(1), 62–79.
Bowlby, J. (1980). Attachment and loss: Loss (Vol. 3). New York: Basic Books.
Herman, J. (1997). Trauma and recovery. New York: Basic Books.
Karniel-Laor, E. (2004). Post-traumatic stress disorder and grief response: Their interrelationship and the contribution of damage to the “world assumption” and “self perception”. A Thesis submitted for the Degree of Ph.D. Tel Aviv University.
Klass, D., Silverman, P., & Nickman, S. (Eds.). (1996). Continuing bonds: New understanding of grief. Washington, DC: Taylor and Francis.
Kosminsky, P., & Jordan, J. R. (2016). Attachment-informed grief therapy. New York: Routledge.
Malkinson, R. (1996). Cognitive behavioral grief therapy. Journal of Rational Emotive & Cognitive Behavior Therapy, 14(3), 155–172.
Malkinson, R. (2001). Cognitive behavioral therapy of grief: A review and application. Research on Social Work Practice, 11, 671–698.
Malkinson, R. (2007). Cognitive grief therapy. New York: W.W. Norton. Publishers.
Malkinson, R. (2012). The ABC of rational response to loss. In R. A. Niemeyer (Ed.), Technique’s of grief therapy: Creative principles for counseling the bereaved (pp. 129–132). New York: Routledge.
Malkinson, R., & Ellis, A. (2000). The application of Rational-Emotive Behavior Therapy (REBT) in traumatic and nontraumatic loss. In R. Malkinson, S. S. Rubin, & E. Witztum (Eds.), Traumatic and nontraumatic loss and bereavement: Clinical theory and practice. Madison, CT: Psychosocial Press/International Universities Press.
Malkinson, R., Rubin, S. S., & Witztum, E. (Eds.). (2000). Traumatic and nontraumatic loss and bereavement: Clinical theory and practice. Madison, CT: Psychosocial Press/International Universities Press.
Neria, Y., Gross, R., Litz, B., Maguen, S., Insel, B., et al. (2007). Prevalence and psychological correlates of complicated grief among bereaved adults 2.5–3.5 years after September 11th attacks. Journal of Traumatic Stress, 20, 251–262.
Prigerson, H. G. (2004). Complicated grief: When the path to adjustment leads to a dead-end. Bereavement Care, 23, 38–40.
Prigerson, H. G., Frank, E., Kasl, S. V., Reynolds, C. F., III, Anderson, B., Zunebko, G. S., et al. (1995). Complicated grief and bereavement-related depression as distinct disorder: Preliminary empirical validation in elderly bereaved spouses. American Journal of Psychiatry, 152, 22–30.
Rubin, S. (1981). A two-track model of bereavement: Theory and research. American Journal of Orthopsychiatry, 51(1), 101–109.
Rubin, S. S. (1984). Mourning distinct from melancholia: The resolution of bereavement. British Journal of Medical Psychology, 57, 339–345.
Rubin, S. S. (1999). The Two-Track Model of Bereavement: Overview, retrospect and prospect. Death Studies, 23(8), 681–714.
Rubin, S. S., & Bar-Nadav, O. (2016). The Two-Track Bereavement Questionnaire for complicated grief (TTBQ-CG31). In R. Neimeyer (Ed.), Techniques of grief therapy (Vol. 2, pp. 87–98). New York: Routledge.
Rubin, S. S., Bar-Nadav, O., Malkinson, R., Koren, D., Gofer-Shnarch, M., & Michaeli, E. (2009). The two-track model of bereavement questionnaire (TTBQ): Development and findings of a relational measure. Death Studies, 33, 1–29.
Rubin, S. S., & Malkinson, R. (2001). Parental response to child loss across the life-cycle: Clinical and research perspectives. In M. Stroebe, R. Hansson, W. Stroebe, & H. Schut (Eds.), Handbook of bereavement research: Consequences, coping and care (pp. 219–240). Washington, DC: American Psychological Association Press.
Rubin, S. S., Malkinson, R., & Witztum, E. (2003). Trauma and bereavement: Conceptual and clinical issues revolving around relationships. Death Studies, 27, 667–690.
Rubin, S. S., Malkinson, R., & Witztum, E. (2008). Clinical aspects of a DSM complicated grief diagnosis: Challenges, dilemmas, and opportunities. In M. S. Stroebe, R. O. Hansson, H. Schut, & W. Stroebe (Eds.), Handbook of bereavement research and practice: Advances in theory and intervention (pp. 187–206). Washington, DC: American Psychological Association Press.
Rubin, S. S., Malkinson, R., & Witztum, E. (2012). Working with the bereaved: Multiple lenses on loss and mourning. New York: Routledge.
Rubin, S. S., Malkinson, R., & Witztum, E. (2016). The Multiple faces of loss and bereavement: Theory and therapy. Haifa: University of Haifa/Pardess Press.
Shear, M. K., & Smith, K. (2002). Traumatic loss and the syndrome of complicated grief. PTSD Research Quarterly, 13, 1–6.
Silverman, P. R., & Rubin, S. S. (2015). Bereavement/grief interventions. The encyclopedia of clinical psychology. New York: Wiley.
Stroebe, M. S., Hansson, R. O., Schut, H., & Stroebe, W. (Eds.). (2008). Handbook of bereavement research and practice: Advances in theory and intervention. Washington, DC: American Psychological Association Press.
Stroebe, M. S., Schut, H., & Finkenauer, C. (2001). The traumatization of grief? A conceptual framework for understanding the trauma-bereavement interface. Israel Journal of Psychiatry, 38(3–4), 185–201.
Witztum, E., Malkinson, R., & Rubin, S. S. (2005). Traumatic grief and bereavement resulting from terrorism: Israeli and American perspectives. In S. C. Heilman (Ed.), Death, bereavement, and mourning. New York: Transaction Books.
Witztum, E., Malkinson, R., & Rubin, S. S. (2016). Loss, traumatic bereavement and mourning culture: The Israel example. In Y. Ataria, D. Gurevitch, H. Pedya, & Y. Neria (Eds.), International handbook of trauma and culture. New York: Springer.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Rubin, S.S., Witztum, E. & Malkinson, R. Bereavement and Traumatic Bereavement: Working with the Two-Track Model of Bereavement. J Rat-Emo Cognitive-Behav Ther 35, 78–87 (2017). https://doi.org/10.1007/s10942-016-0259-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10942-016-0259-6