Working with the Two Track Model of Bereavement: P erspectives on grief and loss Simon Shimshon Rubin, Ph.D. University of Haifa Department of Psychology

Working with the Two Track Model of Bereavement: Perspectives on

grief and loss

Simon Shimshon Rubin, Ph.D.University of Haifa

Department of Psychology

Haifa, Israel 31905

Email: [email protected]

http://psy.haifa.ac.il/~rubin One-Day Symposium on

Death, Dying & Bereavement

Society for the Promotion of Hospice Care, Hong Kong

2005

http://psy.haifa.ac.il/~rubin


Simon Shimshon Rubin2

How does one think about, measure, and if need be, intervene following loss and death?

Many laypersons and professionals consider how one is “managing”. This that can mean: health or illness; degree of sadness or depression; anxiety; ability to function at work; ability to find support in family, culture, or religion; meaning structures; etc.


What about the uniquely relational and interpersonal aspects of the death of a loved one? How and where do professionals and laypersons look at that?

This that can mean: How often one thinks of the loved one; whether one feels only sadness or also support from the memory; how strong is the yearning and what is yearned for; and many other aspects of the unique relationship between self and the deceased.


The TWO TRACK MODEL OF BEREAVEMENT (Rubin, 1981, 1984, 1991, 1996,

1998, 2000, etc.) focuses on both domains of response to loss: (Track I) The way people “manage” to live their lives following the death of a significant other and (Track II) the way in which the uniquely relational and interpersonal aspects of the connection with the deceased are maintained in the minds and hearts of the bereaved.


ConstrictionConflictIdealization"Stages" of LossRelationship to SelfPreoccupationDistanceNegative AffectPositive Affect

SomaticDepressionAnxietyMeaning StructurePsychiatric Symp.Investment in ?WorkSelf EsteemFamiialInterpersonal

The Two Track Model of BereavementASSESS BOTH TRACKS and DECIDE

WHERE TO INTERVENETrack I: Function -

Track II: Relationship to the Deceased


TRACK I assesses function– in bereaved and non-bereaved

For Example

How productive at work is the bereaved person 1 week, 1 month, 1 year, after

loss?

Somatic problemsDepressionAnxietyMeaning StructurePsychiatric Symp.Emotional Investment in ?WorkSelf EsteemFamily RelationsOther InterpersonalPost-trauma (PTSD)

TRACK I: GENERAL FUNCTIONING- DOMAINS TO ASSESS

The Two Track Model of Bereavement


Track II Relationship to the Deceased

For Example

How does the bereaved person think about the deceased 1 week, 1 month, 1 year, 10 years, after the loss?

Nova Scotia memorial 05

ConstrictionIdealizationConflictGrief "stagesSelf PreocupationPos affectNeg affectSoothingOther

TRACK II: RELATIONSHIP TO THE DECEASED– DOMAINS TO ASSESS

The Two Track Model of Bereavement


Relationship to the Deceased – Track II – emphasize continuing bonds: This means ongoing attachment that focuses us on questions of: the nature, the intensity, the predominance, the quality, the uniqueness, the quality of those ongoing bonds for the individual, family, and culture.


What are the factors that should concern us following interpersonal loss?

Q: Is it how one manages “life” tasks or is it how the person manages “reorganization”/(not detachment) vis a vis the deceased? Answer: BOTH!


THERAPEUTIC IMPLICATIONS of Two- Track Model of Bereavement

Select your focus– Track I (and why)Track II (and why)Listening versus intervening – not sameContinuing involvement with memories of deceased is normative for many cultures and traditions in East and West– but WHAT is the nature of the

involvement? EXPLORE THAT as TRACK II !!


THERAPEUTIC IMPLICATIONS of Two- Track Model of Bereavement

Help loosen what is frozen, for example:Is trauma blocking access to thoughts and

feelings?Is emotional conflict to the deceased blocking

access?Is intense focus on deceased blocking access

to life? Are gender differences, personality style

differences complicating things ?


Website: “Asaf Tzur (Blondi). Angel of 17. Born 27.4.86. Died 5.3.2003. Killed… in the Suicide bombing in

Haifa”.

Closing Remarks: Relationship to the deceased is all around us. This is one source, from the website of the Tzur family. Asaf was killed in 2003.

Simon Shimshon Rubin15 אסף אהב את הים וגלישת גליםהמצבה שעל קברו עוצבה כגלשן היוצא מתוך גלי הים, עיצוב שנבחר על

בדרך זו הוא יגלוש לנצח נצחים ... ידי הוריו להנצחת אהבה זו.

Website: From the inscription on the

gravestone: Asaf loved the sea, friends, music, and life .

Asaf, we love you, we will always remember you, and we

will miss you every day .The website contains these pictures and

explanation: “The monument on his grave was designed as a surfboard that goes out to the sea. The design was designed by his parents to keep alive this love. This way, he will

surf for all eternity”.…


Two Track Model of BereavementSelect References

• Rubin, S. (1981). A Two-Track Model of Bereavement: Theory and research. American Journal of Orthopsychiatry, 51(1), 101-109.

• Rubin, S. (1999). The Two-Track Model of Bereavement: Overview, retrospect and prospect. Death Studies, 23(8), 681-714.

• Rubin, S. & Shechter, N. (1997). Exploring the social construction of bereavement: Perceptions of adjustment and recovery for bereaved men. American Journal of Orthopsychiatry, 67(2), 279‑289.

• Rubin, S., Malkinson, R. & Witztum, E. (2003). Trauma and bereavement: Conceptual and clinical issues revolving around relationships. Death Studies, 27, 667-690.


Two Track Model of Bereavement Further Resources

• Questionnaire assessing Functioning, Relationship, History of Relationship, and Traumatic Elements. Clinical version and research version.

• Research studies• Theory• Clinical Material• WEBSITE HAS ARTICLES and MATERIALS:http://psy.haifa.ac.il/~rubinTHANK YOU


Documents

Working with the Two Track Model of Bereavement: P erspectives on grief and loss Simon Shimshon Rubin, Ph.D. University of Haifa Department of Psychology