Date of Award
Doctor of Philosophy in Psychology
James O. Prochaska
The 'cognitive model' in this treatise is proposed as an original method of understanding, describing and explaining the acute grief process and outcome. The model suggests that the primary impact of a sudden death event is upon the survivor's conceptual frame-of-reference. This differs from the traditional psychoanalytic view of mourning which emphasizes the emotional impact as being foremost.
Man's typical functioning is assumed to be dependent on the cognitive dimensions or categories by which he comprehends those events which he encounters. These dimensions are postulated as forming a cognitive structural matrix, in which dimensions relating to significant others are central or core elements. The development of such a matrix is believed to result from increased differentiation, organization and integration of the dimensions during growth. This process tends to increase the individual's adaptiveness and effectiveness and, therefore, increases his survival potential.
When the sudden death of a significant other occurs, the matrix is postulated as being traumatically disrupted, since a core dimension has been unexpectedly damaged by the loss. This disruption creates a state of cognitive inadequacy and initiates a process of cognitive regression to less refined and less adequate methods of understanding events. The regression is analyzed in the dissertation, along four principle criteria processes; (a) disjunction (the separation of cognition from affect and conation); (b) modification-absorption (the openness to change of the dimensions); (c) dilation-constriction (the variations of cognitive activity from matrix expansion to matrix compression, respectively) ands (d) subjectivity-objectivity (the extent to which understanding is channelled through self-reference).
Using changes in these cognitive developmental processes, the influence of cognitive disruption (following a sudden death event) upon cognitive. somatic, affective and behavioral functioning is discussed. The symptomology of acute grief that occurs in these spheres is reviewed, and then is described in terms of being postulated derivatives of cognitive disruption. The general symptom categories discussed include: (a) cognitive confusion, cognitive defenses (denial, distortion and depersonalization) and pre-occupation with the deceased; (b) somatic symptoms in respiratory, circulatory, digestive musculo-skeletal and neurological systems, as well as overall morbidity and mortality effects, (c) affective fear and anxiety, anger and hostility, guilt, depression; and (d) behaviorally, interpersonal changes, activity level changes and searching.
Finally, major determinants of healthy versus pathological grief outcome are reviewed, and their effects upon bereavement are explained from the perspective of the cognitive model. This is done with particular regard to the determinant's influence upon cognitive disruption, and the meaning attribution by the survivor to the death event. The determinant factors examined include (a) mode of death such as anticipated death, sudden death, suicide, accident and Sudden Infant Death Syndromes (b) the relationship of survivor to the deceased, such as spouse or parent of the deceased, and (c) characteristics of the survivor, such as age and sex.
Schor, Allen G., "Acute Grief in Adulthood: Toward a Cognitive Model of Normal and Pathological Mourning" (1974). Open Access Dissertations. Paper 1112.