ROMANIAN ASSOCIATION OF COGNITIVE BEHAVIORAL THERAPIES

The death of a loved one ends physical relationship with the deceased and there begins an inner journey to reconstruct meaning to life without the person who died. Bereavements that occur under external traumatic circumstances increase the risk for dysfunction, trauma symptomatology, as well as disordered and prolonged grief. While the majority of individuals who have experienced traumatic bereavements do not meet formal criteria for posttraumatic stress disorder (PTSD), or prolonged grief disorder (PGD), the degree of distress and dysfunction for these bereaved can be quite significant.

The term traumatic bereavement incorporates elements of both trauma and bereavement, highlighting the interface that exists between the two experiences. It takes into consideration the interaction between the sudden traumatic circumstances of the event of the death and the bereaved person’s traumatic experience of grief(Malkinson et al., 2000; Stroebe et al., 2001; some traumatically bereaved individuals may develop complicated grief (Rubin, et, 2020). When grief goes awry with some difficulties in reorganizing inner relationship with the deceased, psychotherapy aims at facilitating a more adaptive process. The Two-Track Model of Bereavement (Rubin, 1981, 1999; Rubin, Malkinson & Witztum, 2012) assists in the specification of how to adapt interventions to the needs of the client. By separating biopsychosocial functioning such as under traumatic bereavement (Track I) and the nature of the ongoing relationship with the deceased and the death story (Track II) following loss, it is possible to assess and plan intervention based on one or both tracks in the intervention schema. 

Changes within the field of bereavement indicate that a successful grief therapy is no longer to sever ties with the deceased. A healthy psyche copes with the stress of loss by maintaining high functioning in daily life activities while constructing a balanced positive inner relationship with the deceased.

In the workshop we will focus and elaborate on the following themes:

1.  The state of the Arts of bereavement: From decathexis to continuing bond state of the arts of bereavement, and traumatic bereavement

2. Prolonged grief Disorder the newly added criteria in the DSM5-TR (March, 2022)

3. The Two Track Model of bereavement: Theory, research and application: By separating biopsychosocial functioning (Track I) and the nature of the ongoing relationship with the deceased and the death story (Track II) following loss. The clinical implications of these will be grounded in interventions tailored to facilitate an adaptive process when grief goes awry.

4. The ABC of grief therapy with specific focus on Healthy Negative Emotions (adaptive grief process), and Unhealthy Negative Emotions (maladaptive grief process).

5. Specific strategies to strengthen adaptive grief process of assimilating loss in the bereaved’s life: 

a. Grief Rational Emotive Body Imagery (GREBI), 

b. Letter-writing, 

d. The use of circular questions to explore the richness of the relationship with the deceased.

6. Traumatic bereavement from a systemic perspective: Socio-cultural and religious consideration in planning an intervention

Reading list:

• Malkinson, R. (2007). Cognitive Grief Therapy: Constructing a Rational Meaning to Life Following Loss. New York: WW.Norton
• Rubin, S,S,. Malkinson, R. &Witztim, E. (2020)Traumatic Bereavements: Rebalancing the Relationship to the Deceased and the Death Story Using the Two-Track Model of Bereavement. Front. Psychiatry, 15 September 2020 | https://doi.org/10.3389/fpsyt.2020.537596
• Rubin, S,S,. Malkinson, R. &Witztim, E. (2020)Traumatic Bereavements: Rebalancing the Relationship to the Deceased and the Death Story Using the Two-Track Model of Bereavement. Front. Psychiatry, 15 September 2020 | https://doi.org/10.3389/fpsyt.2020.537596