Grief and Bereavement: Analyzing Worden's Four Tasks of Mourning

This essay provides a detailed exploration of grief and bereavement, focusing on Worden's Four Tasks of Mourning. It begins by defining bereavement, grief, and mourning, and then delves into Worden's framework, which views the grieving process as a series of tasks rather than stages. The essay examines each of the four tasks: accepting the reality of the loss, processing the pain of grief, adjusting to a world without the deceased, and finding an enduring connection with the deceased while embarking on a new life. It discusses the challenges and potential negative reactions associated with each task, such as denial and failure to adapt. The essay highlights the importance of these tasks in grief counseling and therapy, emphasizing techniques that facilitate acceptance, emotional expression, adjustment, and reconnection. The conclusion underscores the impact of Worden's theory on understanding and supporting individuals through the grieving process, and how the negation of the four tasks can lead to complicated grief.

Running head: GRIEF AND BEREAVEMENT: TASKS OF MOURNING 1
Grief and Bereavement: Tasks of Mourning
Author:
Course Name: Palliative Care Practice
Institution:

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Grief is said to be a normal reaction to bereavement. From this statement questions like what
exactly is grief and what is bereavement may arise. Bereavement is defined to be the losing of
someone closely attached to you and is characterized by feelings of loneliness, emptiness,
frustration, deprivation, yearning and longing (Sabar, 2000). Grief on the other hand is the
subjective experience of loss. It is multifaceted as it can affect us on all levels of experience i.e.
physically, emotionally, cognitively, socially and spiritually (Sabar, 2000). Another term that is
always used in association with grief and bereavement is mourning which is defined as socially,
culturally and religiously accepted expressions of grief (Sabar, 2000). The manner in which one
grieves, the duration taken in the grieving process differs from one individual to another. This is
typical situation that reflects the one shoe doesn’t fit all philosophy. Theories like Worden’s four
tasks of morning, the dual process model by Stroebe & Schutt, Parkes’ four phases of mourning
model seek to explain grief, bereavement and mourning. We shall focus on Worden’s four task
of mourning as we seek to better explain and understand the grieving process and factors that
affect this process.
Worden Four Tasks of Mourning
Other theorists like to view the grieving process in forms of stages and phases but not Worden.
He prefers to view it as a series of tasks (Morrell, n.d). This means that the bereaved has to be
active as adaptation cannot just happen but requires effort. According to Worden, grief is a back
and forth process involving overlapping tasks that one has to work through the physical,
emotional and pain of their loss while adopting to changes that come with the loss such as roles,
responsibilities and identity (Webster, n.d). The grieving process is considered complete when

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the bereaved person gone through the four tasks and has accepted the loss and adjusted to the
new life brought about by the loss (Miller, 2014).
Task I: To Accept the Reality of the Loss
The first task in this process is to come face to face with the reality that the person is dead. This
is one of the hardest tasks to accomplish as it involves in lay man’s tongue accepting in your
mind and in your heart i.e. intellectual and emotional acceptance (Worden, 2009). There are
three forms of acceptance that need to take place for the successful completion of this task. They
include; the acceptance the facts revolving the loss, the meaning attributed to the loss and the
finality of the loss (Almeida, 2004). One needs to accept the fact that death has occurred, what
the loss means to him/her in terms of responsibilities, roles even situation at home and in the
society and that the deceased is gone and not coming back. It has been found that traditional
rituals such as the funeral help many bereaved people move toward acceptance (Worden, 2009).
The negative reaction that happens here is that one does not believe simply put being in denial.
This is very common as death is usually first faced with shock and disbelief. Denial takes place
in many forms. First it can occur in the form of denying the facts of the loss which varies in
degree. It can be a minor distortion or a complete and advanced delusion (Worden, 2009). An
example of full blown delusions was coined by Geoffrey Gorer which is mummification, a grief
reaction in which the bereaved retains the deceased’s possessions and belongings and in extreme
cases his/her corpse in an unchanging condition ready for use when the deceased returns (Leung
& So, 2013). This is very common for parents who a child as they usually retain the child’s room
without moving a thing or reorganizing.

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Another form of denial is to deny the meaning of the loss. This has been seen by actions that
remove any reminders of the deceased in the aim of reducing the significance of the loss. This
has been done in various ways like throwing away of belongings of the deceased, making
statements that disregard the attachment or relationship with the deceased and in extreme cases,
practicing selective forgetting whereby the image of the deceased disappears from consciousness
(Parkes & Prigerson, 2010). This behavior is commonly seen in cases of conflicting relationships
between the bereaved and the deceased.
Denial in the irreversibility of death is the other form of denial. This has been evidenced by
people out rightly denying finality of death and through religion spiritualism (Worden, 2009).
People participate in séances and attending of spiritualist churches so as to seek a form of
communication or bond with the deceased. Overall, denial is very common in sudden deaths like
accidents, fire outbreak, suicide, homicide etc. especially where the bereaved were not able to
view the body of the deceased
Task II: To Process the Pain of Grief
This task involves opening oneself to experience the deep and intense feelings and thoughts that
accompany a loss (Sabar, 2000). The pain experienced can be physical, emotional and
behavioral.
The physical reactions experienced include: tiredness, increased noise sensitivity, appetite gain
or loss, headaches, neck and shoulder pain, increase in colds, infections and allergic reactions,
chest tightness, bowel and bladder disturbances, stomach bloating, ulcers, and nausea. Females
can experience menstrual irregularities (Rubel, 2004).

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Emotional reactions experienced include shock, numbness, sadness, fear, anxiety, loneliness,
aggression, yearning, withdrawal, guilt, self reproach, fatigue, helplessness, emancipation and
relief. Anger and rage can be directed at healthcare providers, the deceased, God, and themselves
(Rubel, 2004). This should be noted as it can lead to them hurting others or engaging in self
mutilating behaviors so as to relieve the pain.
Thought process alterations or cognitive changes that occur include disorientation, confusion and
an inability to concentrate (Rubel, 2004). Other common thought patterns include;
preoccupation, disbelief, hallucination and sense of presence (Worden, 2009).
Behavioral reactions are not uncommon in grieving individuals. Some of the common behaviors
seen include insomnia or hypersomnia, loss or gain of appetite, absentmindedness, social
withdrawal and isolation, dreaming of the deceased, avoidance behavior, sighing, increased
hyperactivity and crying (Worden, 2009). Aggressive behavior, hoarding, increased drug use,
increased sexual activity may also be seen (Rubel, 2004).
The intensity and duration of the pain experience varies from one individual to another. This
difference in feeling is mediated by a number of factors. These factors include; the person that
died, type of attachment, manner of death, personality characteristics, social factors and
concurrent stressors (Worden, 2009). The way one mourns for a child is not the same way one
would mourn for a spouse or a mother. The way one mourns those who they had close
attachment is found to be more intense and for a longer duration.
The negation of this task is not feeling and it is demonstrated by cutting off feelings and denial of
the pain one is experiencing, avoidance of painful thoughts, thought-stopping procedures,
stimulating pleasant thoughts of the deceased and not hurtful, idealizing the dead, avoidance of

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reminders of the dead, and drugs and alcohol use. The consequence of this negation is usually
depression. Due to this, this is a very important aspect that is considered during grief counseling.
Task III: Adjusting to a World without the Deceased
According to Worden, 2009 the three areas that need adjustment during the grieving process
include the external, internal and spiritual adjustments.
External Adjustments
This involves coming to terms to an environment without the loved one. Adjusting to an
environment without the loved one means different things to different people (Worden, 2009).
Many bereaved individuals have to learn new skills in order to take on the roles performed by the
deceased. For this to happen successfully, one to needs to challenge their beliefs by deriving
meaning of the loss. What one thought he/ she could not accomplish, now he/she has to believe
he/ she can. A wife who used to believe that she didn’t have the strength to mow the lawns may
challenge this belief after the death of the husband as she cannot delegate to him.
Internal Adjustments
Loss of loved one affects one’s self definition, self esteem and self efficacy. People who derive
their identification and self worth from relationships and marriages have lowered self esteem and
decreased sense of the self when their loved one dies. This is the case especially for people who
had rough backgrounds then found someone who makes them feel wanted, cherished and loved.
When that person dies, the bereaved feels like there is no one who would love them like the
deceased did. Bereavement can also affect a person’s sense of self-efficacy (Worden, 2009). This
can lead to feelings of helplessness, inadequacy and hopelessness. This worsens when one fails

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in taking on the responsibilities that used to be carried out by the deceased. This makes them feel
like failures and lowers their self esteem further.
Spiritual Adjustments
Through death one’s values and beliefs are always challenged or reinforced depending on the
situation (Worden, 2009). Usually due to this challenge on one’s beliefs and values, the
bereaved feel like they have lost direction in life. They go through a journey to try and rediscover
the meaning of the loss and the life changes in order to be able to control their lives again. As it
was said earlier death can also reinforce or confirm our beliefs and assumptions. The death of an
elderly person who had a well lived life is an example of this.
The negation of this task is failure to adapt to the loss. You may find people who promote their
inadequacy and helplessness by not developing the skills needed for the new responsibilities or
withdrawing from the world and not facing up to the new requirements (Worden, 2009).
Task IV: To Find an Enduring Connection with the Deceased in the Midst of Embarking
on a New Life
This task includes finding an adaptive and ongoing connection in our lives with the deceased
while allowing ourselves to reinvest our energies into new relationships (Perper, 2015). People
believe that one needs to forget the deceased in order for them to move on with their lives. This
tasks encourages us not to forget the deceased but reconnect and enjoy life by engaging in
activities that give you pleasure while cherishing the memories and remembering the thoughts
and feelings experienced with the loved one (Kelly & Lees-Oakes, n.d).

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According to Worden, the negative aspect of this task is not living. This happens when one holds
on too much to the past attachments are refuses to form new ones. They forget that life did not
stop moving when their loved one died.
Worden’s four tasks of mourning have had great impact in the counseling and psychotherapy
world as it has formed basis for many techniques and objectives for grief counseling and grief
therapy. One thing that is clear is that the negation of the four tasks can facilitate the
development of complicated grief. Through the four tasks of mourning, techniques that help one
to accept the reality, evoke one’s emotions and allow them to feel, that promote adjustment and
facilitate reconnection and continuing bonds are found to be very crucial. These techniques
include writing, use of evocative language, role playing, cognitive restructuring and directed
imagery among others.
Conclusion
Worden’s four tasks theory of mourning brought a new way to view the grieving process as it did
not believe on the steps or phases model but tasks which have to be complicated not on a linear
basis as believed by the previous theories. These tasks are important for one to go through the
grieving process adaptively and successfully. This theory has had great impact as it not only
helped us understand the grieving process but also informs grief counseling and grief therapy
through streamlining the goals and the techniques so as to help the bereaved to fully adapt to the
loss.

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