Grief as a Family Process: A Developmental Approach to Clinical Practice

Abstract

Shapiro, Ester R. (1994). Grief as a Family Process: A Developmental Approach to Clinical Practice. New York: Guilford. 307 pp. Hardcover ISBN 0-89862-196-8, price $30.00. Using a comfortable narrative style and pertinent case studies, Shapiro gives clinicians and grief counselors an excellent new resource. This book is a well written professional accounting of an integrative systems approach to supporting not only those facing death but also the important people in their lives. Acknowledging that a culturally based denial of death as an imminent and final phase in the cycle of life is an awkward base for grief work, Shapiro challenges the reader to first address her or his own personal loss issues before attempting to help others. Shapiro argues that grief is a deeply shared family developmental transition, involving a crisis of attachment and a crisis of identity for family members. Both the management of intense emotions and the organization of a personal identity are achieved through a collaborative, mutually responsive family developmental process throughout the family life cycle. She proposes that managing the crisis of grief involves reestablishing a stable equilibrium necessary to support ongoing family development and day-to-day functioning by creating new family structures. The greater the family's resources and supports from each individual, the family system, the community, and the society, the greater flexibility with which they can reestablish shared family functioning. Shapiro explores the process of grief from the experiences of differentaged individuals within a family system. Beginning with adulthood, she describes the initial sensations of grief as profoundly and simply physiological. Not only does depression often accompany these physical symptoms, but the bereaved individual has to regulate the emotional fluctuations and thoughts in daily responsive relating to others. She reports that mourners often enter a world of unreality characterized by divided consciousness-they are completely split from their former life. It may take many years to reconstruct one's adult life and reorganize one's sense of self. Clinicians report that it may take 2 to 3 years to successfully accomplish this initial external functioning and much longer to process the internal confusion and transition. Emotional availability to one another for social and emotional support seems greatly diminished as each member attempts to cope with the death. …

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