Episode 1 - The Dual Process Model by Stroebe and Schut

In this episode, we explore a key piece of grief theory: the Dual Process model. We'll discuss the meaning behind some of this model's key features and how the insights into the grieving process that it provides can inform our practice when supporting clients with grief and loss.

We created this work with Maggie and Henk's collaboration and blessing. Below is part of the email we received after presenting this pod and the accompanying movie, which you can view here.

Dear Martin and Trudie,

Thanks for sharing your DPM movie. We very much appreciate the clear way the essentials of the model are presented for a lay audience. It was a joy to watch. We feel it gives bereaved people a clear picture of what common grief is about and what they might want to expect: very different from person to person, it can be difficult, and it is hard work, but people do it and get there. We expect people to really appreciate the way you present that message. Thank you both for working in such a prudent and gentle way with the model.

We wish you all the best with your fabulous work!

Warm wishes,

Maggie and Henk

Transcript

Welcome to Grief in the Room. In this podcast, we do a deep dive into all things grief, so that when those themes of grief and loss show up in your client's story, you're prepared, with the insight, tools, and most importantly, confidence, to give them the kind of support they need. Grief in the Room is presented by Martin Ruddis and Trudie Bamford, grief trainers and advocates, and good friends.

We bring warmth, humanity, and humor to the subject. We're so glad you're joining our conversation today. Please do subscribe to and say hello to us in the comments.

Right. So can we just, can we start the story from the start?

So you were reading The Grieving Brain and you realized that the inference that was placed upon the dual process model when you were handed it during your creased brain Bereavement support training wasn't the same way that Mary Francis delivered it Which in the book which made you dig deeper and look deeper and you took it back to the original model And you discovered, what did you discover?

That both the loss oriented work and the restoration oriented work are both stressors. It is not that the restoration is the relief from the stressful work of grieving, it is a different type of work. Yes. So the inference that when I delivered it to you, when we were in the classroom back in the day was that, and even the graphics, I can recall the graphics in my mind because I see them still quite often, sunshine moving to the light, you know, and the way I coined it, when I, I reached out to Hank and Maggie was, Almost that everybody has, like it's a disnification of their original model.

Mm. But you brought this to me 'cause of our, our continued relationship outside of the classroom and, and as volunteers now as collaborators. You brought it to me and said it's just not sitting right. 'cause the inference is wrong. And then you made a, you made a movie, you made a, you made a new animation and you did a, a voiceover.

And that's what you released on LinkedIn a while ago. Yeah. Emphasizing that the loss orientated and the restoration orientated are both stressors. Okay. With that movie, I then sent it to Maggie and Hank or Strobey and shut and said, hello, how'd you feel about this? Which started as collaborating with them and lots of emails and lots of fantastic, amazing discussions.

And we, we got great insights into their character, uh, and, and how they collaborated and how they worked and they came back to us. And do you remember clearly what they said in that first email? No, I, I, I do remember them commenting that they felt that perhaps the use of the word restoration originally may have somewhat contributed to the way that it has gradually become misunderstood, which makes perfect sense, because we do think of restorative things as being lovely.

Yeah. And gentle and a relief. So the other thing that Maggie mentioned to us as well was our, our inference that we still placed on it as time as well, past and future, the single little movie that we released to the general public. I think it's still on our website at thefitsandrooms. co. uk. We mentioned the loss phase being past orientated, perhaps, and the restoration phase being future.

So, so yeah, when I was creating the video, that was my addition to it. I chose to add That the loss oriented work was more looking to the past and what's been lost Yeah, whereas the restoration oriented work is more about the rebuilding therefore is looking to the future, but they made the Extremely valid point.

Yeah that they are both actually present day Experiences and at that stage then they also said But what you've said is intriguing and interesting to us because we had not considered it and framed it like that So an actual fact they loved the simplicity they loved them the visuals and the and the explanation and but then as what happens with these Conversations with the grief greats the Giants that we stride on the backs of all the time More came in and what Maggie then and Hank brought in was something that they've not done in their model to date yet.

In fact, we need to have a chat with them about this podcast before we let it out because this is, this is our creative process almost to a degree, isn't it? They brought to us the overload and they brought to us about rumination as well. And then they explored the time, um, elements with us as well. So because of summer holidays, because of busyness and work, because of college, because of.

All sorts of stuff we have not put together that final clip to send back to them I know we sent another version back, but that was just a walk through but we haven't put together the Polished product have we no no, but what's been lovely is I think we spoke in a previous episode about us being responsible rebels Meaning that we won't just accept something without questioning it and, you know, looking for the inference and seeing does this work?

And that is very much the feeling I got in all of our interactions with them too. Yeah. You know, you know, this is, this is one of the absolute foundation stones of grief theory. And yet they were so Beautifully open to discussing it and exploring it and looking at it through different eyes and, and you know, what's your perspective on this?

And, you know, so we're still in that process, aren't we, of kind of bouncing that back and forth between us, which is, is a humbling thing. I love that that is their approach. I love that their approach is to collaborate. They'll be open. Yeah. Still be open. I mean, you're right. I mean, when they, when they presented this, I think it was 93, was it 93?

and then to 99 that it was launched to the, to the mass there. The novelty of this was the oscillation. Um, and it was just incredible in terms of, um, because they, they decided basically back in the day that between Bowlby who had the phase model, Shock, yearning, protest, despair, restitution, and then the task model from Bill Warden.

Again, you know, I mean, Bowlby was a student of Freud. I mean, you know, these are just, these are just building upon the work of and reinterpreting and that takes bravery, the pioneers. And then the task model, which was accept reality of loss, experience the pain of grief, adjust to life without deceased.

And relocate deceased emotionally and move on. That was the actual test model. Um, which we all recognize the words where they're come from and also how things have changed now, but what they brought in their key pivot for their model was the oscillation, the pendulum swing between these two spheres. And it's interesting when you say we're both responsible rebels, we actually, because of that word restoration, because I think Maggie gave us that little, you know, perhaps that wasn't the best word.

We came up with new words, didn't we? I can't actually remember what those new words were now. Rebuilding. Rebuilding. But I think we've, I think so far on the creative process, rebuilding is now stopped. Yeah. Yeah. That, that one's still, um, a work in progress. So, so we haven't really spoken about this, as you said, right at the very start, probably in a, in a bit of the clip that we're not going to use.

You said to me, you're still using your. Your video or your, the slides that you built that video from, because we haven't come to an agreement. We, not an agreement. We haven't signed anything off, have we, between ourselves? We haven't finalized it. No, we haven't finalized it because, you know, we've, we've, we've tried to incorporate the overload that they've, that we've talked about with them, but we haven't actually finalized how it's going to, to be.

And, um. So, Trudy, can I. Can I just take this opportunity because since then it's been a few months and I've delivered lots of grief awareness, lots of grief by suicide, lots of grief first aid training on behalf of crews and other stuff. And I've actually been, I've actually been using our work in progress slide deck.

To do the dual process model. So I've become quite used to it now in the way I'm describing it. And I know it's not been officially signed, so apologies, but if I go through that with you now, which makes me a little bit vulnerable because on this camera, you can say why, um, should we do that? Absolutely.

Before you even start, I'm going to say on the other one, you kept saying loss orientated, restoration orientated. But I think you, you, you hit me on that a while ago, didn't you? Yeah, it's just one of my bug bears, but you haven't put it on this one. So

yeah, yeah. I got herds of them. You are elephantine. It's like people saying ATM machines. Don't even get me started. But that's what they were back in the day. No, the M is machine. ATM. Oh, ATM machines. Yes. Yeah. It's also when, when writing my, um, when writing my stuff for college, I went into the habit of putting R E B T therapy.

The T is the therapy. My other, one of my other ones, uh, is people saying the proof is in the pudding. It's not proof of the pudding is in the eating. Ah, these things keep me awake at night I'm handing you this on a plate martin. I know, you know, I want to keep this in. Yeah I know you but I know you can keep it in.

No, we've made a promise. I will never I will never I will never publish I just gave you permission I like words to be right. This, this is, you know, people will learn this about me. But in truth, you're keeping me honest, more honest than I have been before because we, we do sometimes disagree on words, don't we?

Okay. But we always find an agreement, which is lovely. It is right. So if you are a grief counselor or trainee, or you're in the grief field, you're going to be familiar with the dual process. Model from Strobey and shut, but what we would say is that the version that you're familiar with even on the great grief charities and the great grief sites and, and, you know, if you follow people on LinkedIn, they're not posting it with the same inference that we're about to present to you.

So what I would say, and I'm truly, this is not script. I'm going to be shooting from the hip. And I just want to interject there, sorry, was I interrupting your sentence? No, no, interject. I just want to interject there, it really matters. Why? It really matters. Why? When we are using somebody else's work to understand what they were trying to say with it.

And it matters for that reason, but it also matters specifically in the context of this, as we're going to go through, it will become apparent why it matters. So just because something has been, has become understood a certain way, you know, it's not enough to accept that if that is not what the original researchers, psychologists, academics wanted it to say.

They worked incredibly hard on this. They, they would have been developing this for such a long time. So it really, really matters if we are learning grief theory, if we are teaching grief theory, if we are supporting the bereaved, it matters to get this right. So, How does that sit with, say, for example, Lois Tonkin and Growing Around Grief, which we'll do probably very soon as well.

Because people use that in so many different ways and put so many different inferences on it and depict it in so many ways. I suppose it doesn't matter. I think because that is a very much more simplistic, piece of grief understanding. You know, this, this is, this is quite an academic, academically solidly based piece of grief theory as it should be because it is one of the cornerstones.

Yeah. And it was groundbreaking in its time. So much has been built on it. So much has been built on it. Yeah. But I think because It came from academics. Sometimes people find that a little bit hard to get their heads around. So they try to simplify it and they try to soften the edges of it, but it's unnecessary as we're going to go through because the changes that have been made to it to make it seem more appealing, if you like, they're actually built into the model anyway.

And in actual fact, when you brought this to me and we started to have chats about this before you made your movie, I, because I always used to say to the trainees, the cruise volunteer trainees, you can hand this over to your bereaved clients. If that's the way that your conversations are going and you feel that your client will be receptive to hearing it.

But also what I really want you to do is to be able to know, understand it and have it yourself. So in the back of your mind, it's a framework. So when you're speaking to someone that's grieving, you can detect in your own mind. Are they oscillating and be able to relate to that? And I was worried that when you brought it to me, you're, you're, you know, the correct inference.

It wouldn't be something that's now as good to hand over to the bereaved, but I think now it's even better. Um, I, I, yeah. I think, I think that's a really valid point though. Some of the grief theory that is taught that we need to understand, we may think twice about sharing. Some of them, like Tonkin's, is much more.

You know, easy for somebody bereaved to understand, but that doesn't preclude this being used because this model, I, for me, this is the one that I use with people, this is the only one apart from the grieving brain that I use with bereaved clients, because it does two important things. Yeah. Are you telling me that you don't use the waterfall of grief?

No, I do not. Um, this model does two really important things. It gives people permission to grieve and it gives them hope of rebuilding, but permission to find that difficult too. So. You know And I have to say in the in since i've been using this version as well And i'll open it up to discussion afterwards after i've presented it It's been incredibly relatable and these are people that aren't looking to be Full time grief counselors or their grief first aiders So it's a pop up role to support someone in their grief along with their day jobs and their busy Accountabilities and they've said that is just so so Useful to know really has been Hello And after all, let's not forget this was in direct contrast at the time to the linear stages of grief model, which has lodged itself in the collective consciousness.

So when we present this or we present the principles of this to somebody bereaved or somebody who is supporting somebody bereaved, you know, this is, this is one of the main points of this model is that it is not point A to point B. So yeah, for that very reason alone, it's, it's a useful one to share.

Okay. So this is how we are or how I am framing this. So this is the dual process model from Strobey and Schutt as in my mind now, I cannot get away from Maggie and Hank because I sadly sign off their emails to us. And that's how we, me and Trudy, when we're doing this process, think about them. So back in 99, They had a couple of, there was lots of models now starting to evolve, you know, we certainly moved on from the Freudian days and Freudian thoughts, but we had all the metaphorical children of Freud, um, and, and the models were being built.

When Strabo and Schutt got together and started to look at this grief process, their biggest thing that they gave us was oscillation. So what they identified was There were two spheres, the loss orientated work and the restoration orientated work, and their biggest insight was that there was a pendulum swing, an oscillation between these two spheres, wrapped around as we're going through our everyday life experiences.

Now, whilst they are not time orientated, certainly when we are recently bereaved, we are facing acute grief, we become loss orientated. So we can become more inwards focused, but I'll unpack that. So we become loss orientated. So what does that mean? So when we become loss orientated, we're, we're into those morning rituals.

So if we've got a culture or a customer of faith, there's quite some good structure or quite some structure, not necessarily good wrapped around that. Day one, this day to that a week, that 30 days, that 12 days of morning that, so it all has different effects and that can be quite comforting, but we'll talk about that in general grief.

So. The sad men. So there is a natural withdrawal for others. And I used to describe this as, you know, literally we can withdraw into a room, a room of grief where we amplify that volume, we shut the door and we just, we become insular. So our loss is, um, focused inwards. We're shutting out the world around us.

We are not focused on that. We can get absorbed in reliving, remembering, yearning for what has gone. Also ruminating. Okay, and all this work pushes away the idea of rebuilding, reintegrating or growing around our grief, because we've got to figure it all out. We are now me or I as opposed to we. So the brain is literally in this phase of they're gone.

The conscious knowledge, they're gone, but they're everlasting, the implicit knowledge. So there's that dissonance. So, we are literally focused on our grief, we are grief orientated, doing this loss work, okay? And again, this is a point we'll build on later. This grief can intrude. So we have lots of invasive thoughts.

Now we have invasive thoughts all the time, but when we're in this acute grieving process, we can have lots more coming into us and they can have a negative effect, or they can have a negative inference, or they can be quite stressful because literally that mechanical rewiring process hasn't even thought about starting yet.

Hasn't even thought about it. Trudy, is there anything you'd like to add before I move on through the slides? That although this isn't time limited, it makes sense to us that in the acute early stages of grief, it is likely you will spend all if or most of your time in loss oriented work. Work's an interesting word and I think it was Maggie and Hank that actually coined that work concept as well.

Grief as work. Pretty sure they did, but they certainly use it and I know Mary Frances refers to it in her work and her book as well. So let's talk about. The restoration orientated work. Now this is where we start to engage with the work around us. Again, literally we are picking up the reins of our life, taking on new challenges and responsibilities and that rebuilding can evolve new relationships.

And I'm not talking about a romantic relationship, just new relationships. Now, as a, as a me, as an individual, as opposed to as a we, you know, we often hear people say, am I a parent if my child has died? Um, Am I still a son or a daughter if I've got no parents? I mean, they, you know, all these thoughts and cognitions are swirling around.

What am I? Who am I? If, if we're not talking about death, but we are certainly with this at the moment, even though you can apply this model to lots of different aspects, not just about bereavement and grief over the loss of a loved one, it may be status. So it may be, I'm not now that athlete I've had an injury.

It may be, I'm not now that Olympian. I'm not now that counselor. I'm not now that sergeant major or whoever or whatever. So, you know, it could be all the losses will still apply to this, to this model. So yeah, we've got changing relationships and although rebuilding may seem positive. Uh, in nature from an outside view, it can be stressful.

And that's the big thing, doing this work is stressful. So for example, in some of our training courses, we talk about Bob. Now, Bob had a relationship with his wife who died suddenly, and she had the responsibility for all the children because he was away as a traveling salesman. Okay. But when she died, he now has child responsibility.

So he is that phone call from school. He is that picking up when ill, staying at home. So you can't just go off. That was their division of labor. That's what we do when we're in a loving relationship, forming those bonds. We outsource so much to our partners. Um, And that's changed. I give the example quite often that if I was to die tomorrow, my wife, Fiona, who is a very functional globe trotting psychologist, would get on with life.

Of course she would. But she would soon realize that my instructions on how to clean the dishwasher filter really should have been paid attention to, because she will even, she won't even remember that there's a filter there. It will be a real struggle for her. And it will, it will cause her a lot of angst and challenges.

Feeding the cats at six o'clock in the morning, because she doesn't That's not her job, um, at all. But she'd have to adapt to that. Electrics in the house, DIY, the washing machines in the garage. That's my tasks, my responsibilities. So if there was electrical problems, these things are all restoration orientated work as she adapts and grows around her grief.

Um, there will be a challenge to her. There will be a struggle. They would cause real challenges. So that's the restoration orientated work and it is work. And, and those, those are all examples that yes, we can see quite clearly. Then that is going to be stressful, but restoration oriented work, rebuilding work, they can also be positive changes.

For example, having a change in goals or purpose, you know, regularly I follow some incredible people on LinkedIn, like Alice Hendy, Caroline would hope, I think her name is. They have dedicated their lives because of the grief they suffered. to helping other people. Now that change, from the outside, could look like it's nothing but positive.

Somebody takes on, takes on a new goal, uh, has a whole new meaning and purpose in life. You could look at that from the outside and think, oh they must be doing really, really well if they're able to do that. But, it will all come with a price. If you've lost your brother to suicide and you've dedicated the rest of your life to trying to prevent suicide, yes, you're achieving incredible things.

This is part of restoration oriented work, but it's going to be costing you. It's going to be creating stress and pain, even if it doesn't look like that from the outside. So all of this restoration oriented work, whether it's things that we might easily identify. are stressful. Like an elderly lady having to learn how to do the banking.

We, you know, we get that that would be stressful or very positive seeming changes. Like you go back to work or you take on a new project and people think, Oh, they must be getting over it. Cause you know, they've, they're able to move on a bit now. It is all whether it's positive. work or negative semen work, it will all be costing, it will all be creating stress.

So we have these two spheres, Strobey and Shutt suggested that we oscillate between the loss orientated work and the restoration orientated work

and we have that pendulum swing between them as we're going through life and life is growing around us. But what can happen because the nature of them are both stressors, we can reach a phase where it's just all too much. overload and we can just lose, you know, our ability to function. We can just crumple, uh, because it's just stressful, too stressful.

Why? Well, because at certain stages, as we carry on, because time doesn't stop, if we think about that waterfall and that river of life, it goes and keeps on going. As we carry on, everyday life experiences are still happening. We will still experience the loss and the restoration stresses, but at certain times, The loss stressors may be more in the house, more present.

So we may be bereaved again. Something may have happened that amplifies our loss, our grief. We may be cut off. COVID. COVID was a great example of that. It may be that it is an, um, an anniversary. You know, uh, um, any anniversary, a death day, a wedding day, a birthday. So these anniversaries that will come along and amplify our grief.

So we can choose to literally enter into that room of grieving again, become inwardly focused and go through that amplified grief process. Or it may be sometimes that it's not invited in. So it may be that scent in the air, that. that picture, that holiday, that food, that joke with friends or seeing particular friends, we may get drawn back in.

Okay. So that's where the loss can be amplified, or it may be the restoration. It may be in my house, for example, the, uh, the phones, not the phones, the electrics stop working. And all of a sudden Fiona has to deal with all my DIY budgets. I've been there over the last three or four years since we've been in the house.

So that could cause her huge challenges. Well, maybe, you know, not ours, but the cats or maybe dealing with the kids or dealing with, you know, necessary restoration events that may amplify the restoration stresses over time. As everyday life experiences and we carry to navigate and grow along with our grief, we are still going to oscillate between loss and restoration stresses because grief doesn't go away.

How we react to our grief on our grieving journey when that grief visits us in those moments, that does change and that we talk about more later. But it's still there, and we're still going to be oscillating. I know, Trudie, that we haven't spoken about being stuck in either sphere as well. And I also haven't talked about rumination, grief rumination.

Because I think that's going to be a part two to this as well. Because, um, Maggie took us down a line of the impact of rumination, and the two rumination, um, theories. Fascinating stuff. We know that. ruminating can amplify that loss orientated stressors. Again, another conversation. So Trudie, would you like to add something in or say something?

This is where the way that the restoration oriented work has become Misunderstood. This is where it clearly becomes unnecessary because they baked into the model the fact that there would be time when you would not be in either sphere, that you would just be experiencing everyday life. And that is the kind of thing that maybe is currently being taught of as restoration.

So you know, going to a spa for a day or having a lovely lunch with friends and laughing and just forgetting for a while. That is not restoration work, that is part of everyday life experience. And as time goes on and you spend less time in the loss work and the restoration work, you spend more time. In those everyday experiences in, if you don't, that is where the overload comes in that you were referring to earlier.

So if. You're either in the loss work or the restoration work all the time and time goes on and you know, you're, you're not spending more time in just everyday life. That's where that overload will hit. And I think that when they brought the overload to us, it just, and, and, and when we started to emphasize that the restoration and the, Uh, loss and the overload, it all made so much perfect sense to me, I have to say, and it makes perfect sense as I'm explaining it as well.

And the words will only get better because that's what happens with practice and with a deeper understanding. But when I, when I present it like that, uh, and give some examples, I find people in the room also start to relate to it. more and start to talk about it. It's certainly not some form of academic study about grief that's not relatable.

It is so relatable. Yeah. And it gives people permission. That's the point of it. It gives people permission to whatever state they are currently in. It's normal. It's normal to have days where you can't get out of bed. It's normal to Maybe struggle a little bit taking on new responsibilities and for that cause pangs and it's normal to forget It's normal to forget and find yourself laughing at something and then feeling guilty because you forgot for a moment It is all normal.

It is all valid. It's all acceptable, so I think You know, the understanding the inference as they originally intended it, it still gives people permission and it still gives people hope. For me, one of the key takeaways from this model that I want people to understand and remember whether they are the grieving or whether they are supporting the grieving is grieving is an active process of adaptation.

And as part of that adaptation, it involves tasks that are stressful, that are exhausting, that will take from you, even if, to the outside view, those might seem very positive, very forward looking tasks. Adaptation is hard, but thankfully we are capable of adaptation. That's one of the incredible things about humans.

We, we, we have that resilience. We are learning creatures and we have the capability no matter how tragic the loss. We have the capability of adaptation, but that is very rarely a straightforward process. Adaptation is usually. Two steps forward, one and a half steps back. That is normal. And I think that for me is, is one of the lovely things about this model, is that it is just really, really validating that.

But also leaving people with hope that as time goes on, yes, Because the grief is always going to be part of you, you are going to spend time in the loss work and the restoration work for the rest of your life. But you will have a little bit more control over that. And perhaps the turmoil, maybe, that that once evoked may change.

Diminish with time and life will grow around it so that you are spending less time Dealing with that and more time just living We know that you don't move on from grief. We know that this is not a time constrained disorder to recover from, but we also recognize that sometimes people can get stuck. We do know that.

So, you know, just reflecting on the lessons from this model, if you are working perhaps with a client and It feels to you like they are really, really stuck and they are in a huge amount of distress because of that. Come back to this model. Look at that person within the context of the lessons and the principles in the dual process model.

Are they not allowing themselves time in the loss work, or they are not allowing themselves time in the restoration work, maybe because it feels disloyal, or are they not allowing themselves time off so that they are in that overload state? Just kind of reframing, because what, you know, as therapists, When a client is stuck, we can absorb that stuckness and feel really stuck ourselves and feel frustrated.

So if that is your experience, if you're working with someone and you know, it does feel like, because you know, let's be realistic here in grief support, you are going to keep going around and around in circles with people. That's normal. That's to be expected. But if it maybe feels like it is worse than that, it's bigger than that.

And, you know, you can tell that this is literally all their life. That they really are deeply, deeply enmeshed in this. Go back to this model, see what, see what you can draw from it and, um, what, what you can use with them and to help you to deepen your empathy. With them as well. Very good. So yeah, and keep an eye out for the great work that I mean What we've not touched on here as well is all the work that they've done about rumination and they're the They were the scientific brains behind lots of studies into rumination with eye movement measurements and joysticks and moving pictures that Mary, Mary Francis kind of alludes to but references in the book but doesn't talk more about it's more in the papers that we've read since from Maggie and Hank.

So we're gonna have to cover that in another part.

 Thank you for joining our conversation today. This episode of grief in the room was presented by Martin Morris and Trudy Bamford. Join us next time when we'll be talking about bereavement by drugs and alcohol.

This is something that you have been passionate about for a long time. I have been kind of quietly campaigning behind the scenes for there to be more training on this topic because there is very little training available, certainly in the UK. for how to work with people bereaved by drugs and alcohol.

And yet those deaths are at an all time high. So as therapists, as counselors, as supporters, as volunteers, we are going to be encountering people with this kind of bereavement more and more regularly. And these Bereavements do need special handling. So, even if you don't currently have clients who are bereaved in this way, even if you think to yourself, well, I'm not sure that's something I want to work with, I really, really would encourage everybody, all counsellors, all therapists, all volunteers, all supporters of any description, to understand this topic, because you're going to encounter it.