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GRIEF WORK VERSUSCONTINUING BONDS:A CALL FOR PARADIGMINTEGRATION ORREPLACEMENT?R.J. Russac , Nina S. Steighner & AngelaI. CantoPublished online: 11 Nov 2010.

To cite this article: R.J. Russac , Nina S. Steighner & Angela I. Canto(2002) GRIEF WORK VERSUS CONTINUING BONDS: A CALL FOR PARADIGMINTEGRATION OR REPLACEMENT?, Death Studies, 26:6, 463-478, DOI:10.1080/074811802760138996

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GRIEF WORK VERSUS CONTINUING BONDS: A CALLFOR PARADIGM INTEGRATION OR REPLACEMENT?

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R. J. RUSSAC, NINA S. STEIGHNER, and ANGELA I. CANTO

University of North Florida, Jacksonville, Florida

In this paper we compare grief work and continuing bond models of grief to determine ifone explains the data better than the other. Sixty individuals in active grief completed aquestionnaire in which they were asked to rate theirgrief status, perceived similarity to thedeceased along 7 dimensions, and closeness of relationship to the deceased. A matched con-trol group was also asked to rate the closeness of relationship and perceived similarity to aliving person of the same relationship as the deceased to the griever. In line with grief work,we found that perceived similarity was directly related to severity of grief and that per-ceived closeness of relationship declined over time. In support ofcontinuingbonds, however,perceived similarity did not decline over time, nor was overall perception of similarityamong grievers different from their matched controls.

In his influential 1973 book,The Structure of Scientific Revolutions,ThomasKuhn described scientific progress, not as a smooth and relatively con-tinuous path that leads inevitably toward a better understanding ofnature, but rather as a series of discontinuous steps consisting of increas-ingly comprehensive models of the world. Each model, or paradigm,represents a particular way of `̀doing science.’’ It prescribes what ques-tions can be asked, how research is conducted, what analyses are mostappropriately applied to the data, and what conclusions can reasonablybe drawn. A widely accepted paradigm constitutes `̀ normal science,’’defining the status quo for a field of inquiry and the precepts by whichthe next generation of scientists is taught.

Received16 July 2000; accepted 5 September 2001.Address correspondence to R. J. Russac, Department of Psychology, University of North

Florida,4567 St. Johns Bluff Road, SouthJacksonville, FL 32224-26450. E-mail: rrussac@unf.edu

463

Death Studies, 26: 4637478, 2002Copyright # 2002 Brunner-Routledge0748-1187/02 $12.00 + .00DOI:10.1080/0748118029008826 6

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However, every worldviewhas its limitations. Embeddedwithin it arequestions that cannot be answered, leading inevitably to cracks andinconsistencies in even the most robust paradigm. At first, discrepanciesare dealt with through elaborations of the theory: Corollaries are added.Exceptions are noted or ignored. Eventually, however, the paradigmitself is called into question and a new way to understand the world isfound to replace it. Kuhn calls the replacement of one paradigm withanother a `̀ paradigm shift.’’ On a grand scale, paradigm shifts are thescientific revolutions thatchange forever the way wecomprehend nature.Thereplacementofa geocentric modelof the universewith aheliocentricmodel of the solar system is one example of a major scientific revolution.

It would be difficult to contend that anything quite so dramatic as aCopernican revolution is occurring in the field of thanatology. Still thereare indications that a paradigm shift is presently taking place in ourunderstanding of the grief process. For most of the 20th century, theguiding paradigm was Freud’s grief work model. In Mourning and Mel-ancholia (1917/1949), Freud outlined a two-phase model of grief: Initiallythe griever experiences a strong desire to maintain ties to the deceased.Unwilling to abandon the lost object, the mourner repeatedly tests thereality of the loss by seeking to include the individual as part of his orher ongoing life structure (hyper-cathexis). Failing in these attempts,the survivor inevitably comes to the realization that maintaining anongoing relationship with the deceased is impossible.This leads to with-drawal of libidinous energy from the lost object (decathexis) and even-tual reinvestment of that energy in other objects and relationships. Freud(1917/1949) described the process as follows:

The task [of mourning] is now carried throughbit by bit, under great expense oftime and cathectic energy, while all the time the existence of the lost object iscontinued in the mind. Each single one of the memories and hopes whichboundthe libido to the object isbrought up and hyper-cathected, and the detachment ofthe libido from it accomplished. (p.154)

Whereas Freud emphasized the obsessive nature of early grief,Abraham (1927) was one of the first to focus on the tendency of grieversto internalize aspects of the deceased into their personality structure as away to preserve the ongoing relationship. Schafer (1968,1976) distin-guished between two types of internalization: identification, where traitsof the deceased are incorporated by the person as though they were his/her own, and introjection, where a representation of the deceased is

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incorporated into the personality structure that is both separate from,and foreign to, the self. Hinsie and Campbell (1974), however, claimedthat the two represent aspects of the same phenomenon. `̀ Prolongedintrojection, as in depressed states, may eventually bring about the qual-ity of identification. It would be technically more correct to say thatintrojection (incorporation) is the mechanism whereby identificationtakes place’’ (p. 374).To avoid confusion, the more inclusive term interna-lization will be used throughout this article to denote the tendency ofgrievers to incorporate aspects of the deceased into their own thoughtsand behavior.

In grief work, then, internalization is viewed as a normal reactionduring the early acute phase of grief, where it represents a vain attemptto maintain ties to a person whose physical presence is no longer avail-able. Over time, however, internalization is expected to wane as the sur-vivor withdraws the libido and reinvests it in new relationships.Continued internalization, from a grief work perspective, can be viewedas a sign of failure to complete the mourning process and thus in somesense pathological.

For 85 years the grief work model has constituted `̀normal science’’ inthe field of thanatology, focusing our attention on hyper-cathexis/deca-thexis at the expense of other important aspects of mourning. Manywould argue that the time is ripe for a fundamental change in the waywe conceptualize the mourning process. Already, several contemporarytheories of mourning are poised to assume the mantle worn for so longby the grief work model. Assuming that a paradigm shift is occurring, itseems important to ask what role grief work will play in the future.Will itbecome merely a footnote in the history of our field, as in the case ofPtolemaic (geocentric) astronomy after the Copernican (heliocentric)revolution? Or will it instead be integrated into a more comprehensivetheory, as Newtonian physics was subsumed under Einstein’s more inclu-sive theory of relativity?

Among the most vociferous critics of grief work are the proponents ofcontinuing bonds. Continuing bonds represents not so much a theory ofgrief as it does a reaction against the grief work assumptions of detach-ment and reinvestment (e.g., Silverman & Klass, 1996). Central to thecontinuing bonds approach is the belief that the bereaved continue toincorporate the deceased into their life structures through the construc-tion of mental representations that are both rich and vital. Death of aloved one does not end a relationship, but rather restructures and

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redefines it in ways that emphasize symbolic interaction over physicalpresence. Silverman & Klass (1996) quoted Anderson (1974), who stated`̀ Deathends a life, but it does not end a relationship, which struggles on inthe survivor’s mind toward some resolution which it never finds’’ (p.77).

Surprisingly, few empirical studies have addressed the relative meritsof these seemingly adversarial positions. In this article, we attempt tocompare the grief work and continuing bonds models directly to deter-mine whether one explains the data better than the other, or alterna-tively, whether the two can coexist within the field.

Two testable assumptions can be derived from the grief work model:(a) during early grief the survivor will internalize (hyper-cathect) manyaspects of the lost object; and (b) as grief progresses these internaliza-tions, unsupported by reality, will gradually be relinquished (de-cathexis) and the libido reinvested in other objects and relationships.Totest these assumptions, we asked grievers to rate their perceived similar-ity to the deceased along seven dimensions as a measure of internaliza-tion, then compared the ratings to time since death. We also felt it wasimportant to distinguish between changes in internalization that occurover time from changes associated with the severity of grief (or `̀griefstatus’’). Although grief is usually felt most acutely during the first fewweeks or months following the loss, the two are not necessarily identical.Strong grief reactions may persist indefinitely. Or they may reappearduring later `̀grief spikes’’ such as anniversary reactions. To test theassumption that internalization is most pronounced during times ofacute grief, we also asked grievers to rate their current grief status, whichwas then compared with perceived similarity.

What prediction should be drawn from continuing bonds with regardto internalization as a function of grief status is unclear. However, thereappears to be some common ground on which to base a comparisonbetweenthe two modelswith regard to the relationshipbetween internal-ization and time since death. Continuing bonds advocates also acceptinternalization as `̀ precisely the kind of psychological transformation ofthe bondwith the deadthat seems tobeusefulwith ourown data’’ (Silver-man & Klass, 1996, p. 8). These authors, however, presented a view ofinternalizationthat is somewhatdifferent fromthatof the psychoanalysts:

`̀ Internalization’’as used by the psychoanalytic school of thought does not accu-rately describe the process occurring in the experiences reportedon in thisbook.What we observe is more colorful, dynamic and interactive than the word

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`̀ internalization’’ suggests. For example, among bereaved children the innerrepresentation of the parent was neither buried in the unconscious nor stableover time.The child was aware of the inner representation and that representa-tion seemed to change with time as the child developed. (p.16)

This description seems to imply the following: (a) internalizationmay continue indefinitely and is not necessarily unique to early grief,(b) internalization is more varied and complex than grief work propo-nents suggest, and (c) the type of internalization used may either changeover time or evolve into other forms of symbolic representation.The firstof these assumptions provides the most direct comparison between griefwork and continuing bonds with regard to internalization. Although theformer predicts a decline in perceived similarity over time, the latterleads us to expect internalization to continue in some form.

However, even if internalization is foundto decline over time,continu-ing bonds advocates might argue that this does not necessarily indicatedetachment. Rather internalization has simply given way to other typesof symbolic interaction (the third assumption in the preceding para-graph). A more direct test of continuing bonds was therefore made byasking survivors to rate the perceived closeness of their relationship tothe deceased and then comparing these ratings to time since death.Thisallows the griever to judge the relationship on a more personalbasis.Thecontinuing bonds model clearly predicts that an ongoing relationshipbetween deceased and survivor, in some form, will endure over time. Bycontrast, grief work proponents would argue that with the passage oftime and the withdrawal and reinvestment of libido, the relationshipbetween deceased and survivor will attenuate, if not disappear entirely.To provide a baseline against which to compare the survivor’s relation-ship to the deceased, a control group matched to the grievers was alsoasked to rate closeness of their relationship and perceived similarity to aliving person of the same relationshipas the deceased heldto the survivor.

Method

Participants

Participants were recruited from undergraduate and graduate courses inpsychology at a southeastern university. The experimental group wascomposed of 60 individuals who indicated they were currently in `̀active

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grief’’over the death of a loved one. A control group was also assembledthat matched grievers on (a) ageö < 20 years, 20729 years, 30739years, 40749 years, 50759 years, and 60769 years; (b) gender; and (c)relationship of the deceased to the survivor. For the latter, if the grieverhad lost a grandmother, then the matched control was required to have aclose and ongoing relationship with his or her living grandmother.Whilecontrols were not screened for past losses, they were asked specificallyif they were currently grieving or feeling the effects of a personal loss.The characteristics of both groups are provided inTable 1.

Procedure

Participants were given one of two forms of a questionnaire. Grieverswere asked to think of the person who had died, whereas the controlgroup was asked to think of the person on which they were matched.Both groups then described the closeness of their relationship to thedeceased/matched individual by responding to the following item: `̀Ona scale of one (extremely close) to five (not very close), how would youdescribe your relationship to the deceased/[matched individual]?’’Grievers, but not the controls, were also asked to evaluate their currentgrief status as follows,`̀Realizing that the loss of someone dear remains apart of you for the rest of your life, how would you characterize yourpresent grief on a scale of one (Iam completely overwhelmed by the loss)to five (I have been able to come to terms with my loss and go on with mylife)?’’ Both groups received the same seven similarity questions, whichwere presented in the following format: `̀On a scale of one (extremelysimilar) to five (not very similar), how similar [Physically, in Mannerisms,

TABLE 1 Demographics for Participants in the Grief and Matched Control Groups

DemographicGrievers(n = 60)

Matched controls(n = 60)

Age (in years)M 27.84 27.19SD 8.54 8.28Range 19.20765.45 17.82763.78

SexMales 12 (20%) 12 (20%)Females 48 (80%) 48 (80%)

468 R. J. Russac et al.

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Emotionally, in Beliefs, in Lifestyle, in Interests, Overall] would you say you areto the deceased/matched individual?’’

Although use of a single Likert scale to assess grief might be consid-ered simplistic, it is not without rationale or precedent. First, when com-mon questions concerning grief reactions are incorporated into a singlequestionnaire, they typically show a high coefficient alpha, a measure ofinternal consistency (Archer, 1999). This gives credence to the notion ofan overall intensity of grief. Second, a single grief dimension has beenused in previous research with some success (e.g., Littlefield & Rushton,1986). Third, Archer (1999) concluded that, `̀ Despite the simplificationinvolved, the assumption that grief canbe treated as an intervening vari-able, implicit in this approach, may be useful for providing a shorthanddescription of differences between individuals and under different cir-cumstances’’ (p. 93).

Results

No differences in perceived similarity or closeness of relationship werefound for gender among either grievers or controls, nor was genderrelated to grief status among grievers. The data were therefore col-lapsed across this variable. The most common relationships betweengriever and deceased were as follows: grandmother (13), grandfather(11), father (7), brother/sister (6), female friend (5), male friend (4),aunt/uncle (4), and mother (4). Six other relationships were reportedby one participant each. A total of 17 different causes of death werereported. Most frequent among these were cancer (20), heart disease/stroke (16), pneumonia (4), suicide (2), general illness (2), natural causes(2), and automobile accidents (2). Two deaths were from unknowncauses, eight deaths by other unique causes, and two by unreportedcauses. Our sample was not large enough to make meaningful compar-isons based on either relationship or cause of death. The average age atthe time of death was 23.77 years (range = 4.97 to 63.41 years), whereasthe average time since the death was 4.37 years (range = .02 to 25.52years).

Perceived Similarity

We began our analysis by comparing similarity ratings for both griev-ers and controls. Among grievers, similarity ratings from highest to

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lowest (with smaller means indicating greater perceived similarity)were Beliefs (M = 2.18, SD = 1.23), Emotions (M = 2.57, SD = 1.17),Overall Similarity (M = 2.75, SD = .90), Interests (M = 2.88,SD = 1.18), Mannerisms (M = 2.98, SD = 1.26), Lifestyle (M = 3.10,SD = 1.32), and Physical Attributes (M = 3.47, SD = 1.35). When theratings were examined by frequency of response, it was found thatmost similarity dimensions displayed relatively normal frequency dis-tributions, somewhat skewed toward the high end of the scale. Thus,the majority of respondents provided similarity ratings of two orthree on the 5-point scale. However, two interesting exceptions tonormality were noted only among grievers. First, similarity ratingsfor Beliefs displayed steadily decreasing frequencies across the scale,with `̀extremely similar’’ being the most common response (n = 19).Second, similarity ratings for Physical Attributes among grieversexhibited the opposite relationship, with frequencies steadily increas-ing across the scale and the most frequent response being `̀not verysimilar’’ (n = 17).

Similarity rankings for controls closely paralleled those of grievers.From highest to lowest ratings, they were Beliefs (M = 2.47, SD = .96),Emotions (M = 2.52, SD = 1.11), Overall Similarity (M = 2.63,SD = .78), Interests (M = 2.92, SD = 1.03), Lifestyle (M = 2.92,SD = 1.24), Mannerisms (M = 3.05, SD = 1.13), and Physical Attributes(M = 3.08, SD = 1.17). Unlike grievers, frequency curves on all similarityitems were distributed in a relatively normal fashion by the controlgroup. No significant differences between grievers and controls werefound for any specific similarity dimension, with the two groups provid-ing virtually identical similarity ratings when the seven items werecombined.

For reasons discussed below, we were also interested in knowingwhether participants responded differently to the six individual similar-ity dimensions (excluding Overall Similarity). As shown in Table 2,which provides a correlation matrix for all variables, considerable over-lap exists among similarity items for both grievers and controls. More-over, coefficient alphas were high for both groups (.765 for grievers and.692 for controls, with Overall Similarity excluded from the analyses).Following Nunnaly’s (1978) suggestion that .70 provides a useful criterionfor acceptable inter-item reliability (i.e., for considering a set of items tobe unidimensional), the similarity questions, particularly for grievers,seem to converge on a single similarity factor.

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Similarity as a Function of Time Since Death and Grief Status

In line with the continuing bonds model, significant changes over timewere found neither for any of the seven similarity dimensions, nor for thesix specific similarity items combined (excluding Overall Similarity).However, perceived similarity for the six specific similarity dimensionscombined (again excluding Overall Similarity) did increase signifi-cantly as a function of grief status, F (1, 4) = 3.06, p = .024. Two specificsimilarity dimensions also reached levels of significance, Emotions,F(1, 4) = 2.68, p = .041, and Interests, F (1, 4) = 3.00, p = .026; whereastwo others approached significance, Mannerisms, F(1, 4) = .860,p = .059, and Overall Similarity, F(1, 4) = 2.36, p = .065. Severity of griefdeclined significantly over time, F(1, 5) = 3.04, p = .018, although theamount of decline was relatively modest (M = 3.18 within the first yearand M = 4.38 after10 or more years).

Closeness of Relationship as a Function of Time Since Death

Analyses indicated that for the 57 grievers for whom data were available,closeness of relationship was significantly related to time since death,F(1, 4) = 5.131, p = .001.Yet despite the overall decline in relationship rat-ings over time, most grievers did in fact rate the closeness of their rela-tionship as high. Moreover, some participants who had suffered theirloss many years in the past continued to describe their relationship tothe deceased as `̀extremely close.’’

Further analysis of the data revealed an interaction between close-ness of relationship and time since death that is more complex thaneither grief work or continuing bonds suggest. Using curve estimationprocedures, it was discovered that the data were best modeled quadra-tically, F(2, 54) = 9.02, p < .000. Those for whom the loss had occurredbetween approximately 1 and 4 years earlier reported the closest rela-tionship to the deceased (these values are necessarily approximatebecause of the lack of a continuous set of data points for time sincedeath). For the first year following death closeness of relationship wasrated somewhat lower, while after 5 years the ratings were consider-ably loweröproducing a J-shaped distribution. To give one exampleof this trend, among those grievers who responded with the lowest rat-ing, `̀not very close,’’ the loss had occurred, on the average, 17.66 yearsearlier.

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When compared with their matched controls, no overall differencebetween the groups on closeness of relationship were found (M = 1.77,SD = 1.14 for the grievers; M = 2.00, SD = .99 for the controls). However,grievers were more likely to describe their relationship to the deceased as`̀extremely close’’ than the matched controls.

Discussion

The findings presented here provide some support for both grief workand continuing bonds and argue persuasively for further refinement ofkey variables associated with each perspective. Our data indicate thatinternalization is a function of severity of grief, but not time since death.When grief is most acute, participants perceived the greatest similaritybetween themselves and the deceased. Perhaps, as Pincus (1976) sug-gested, internalization `̀gives comfort to the mourner, makes him feelclose to the deceased, and thus mitigates somewhat the pain of loss’’(p. 121). Grief work advocates often associate severe grief reactions withhyper-cathexis during early grief. As the survivor moves on with his orher life, the need for reliance on an internal representation of thedeceased is expected to diminish. Prolonged internalization may there-fore be considered a sign of unresolved or complicated grief. Thus Lin-demann (1944) described `̀ patients who border on pathologicalreactions,’’as follows:

[There] is the appearance of traits of the deceased in the behavior of thebereaved, especially symptoms shown during the last illness, or behavior whichmay have been shown at the time of the tragedy. A bereaved is observed or findshimself walking in the manner of his deceased father. He looks in the mirrorand believes that his face appears just like that of the deceased. He may show achange of interests in the direction of the former activities of the deceased andmay start enterprises entirely different from his former pursuits . . . . It seems aregular observation in these patients that the painful preoccupation with theimage of the deceased . . . [is] transformed into preoccupation with symptomsor personality traits of the lost person, but now displaced to their ownbodies andactivities by identification.(pp.1427143)

The fact that we found no relationship between perceived similarityand time since death suggests that many of our participants continued tofeel a strong sense of loss (with concomitant internalization) long after

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the death itself.The data seemto bear this out. Althoughthe two grieverswho gave the highest grief ratings hadboth experienced the death withinthe past year, among those who gave the next highest grief rating, twohad suffered the loss within the past year while three others continued tofeel strong grief after more than 3 to 10 years.Was this a sign of compli-cated mourning in the latter group? We did not attempt to assess the clin-ical status of the participants. However, we observed no obvious signs ofpathology among the grievers, nor did any of them indicate to us thatproblems existed. Thus although continued internalization may wellindicate complications in some people, it may also represent the sort ofstrong persistent feelings of loss describedbycontinuingbonds advocates.

Internalization may also reappear later during `̀grief spikes,’’ such asanniversaries, births, marriages, and other significant occasions. Zisookand DeVaul (1976) described a woman who displayed a`̀ facsimile illness’’on the anniversary of her husband’s death. She complained of chestpains identical to those sustained by her husband during his fatal heartattack. The woman presented no organic pathology and the symptomswere alleviated by grief therapy. Likewise,Worden (1991) recounted thecase of a woman who suffered chest pains identical to those suffered byher husband during a fatal heart attack. The symptoms appearedaround the anniversary of the death.

Another finding in support of continuing bonds was that similarityratings, assessed apart from their relationship to any other variable, werevirtually identical for both grievers and their matched controls. Weshould note one methodological limitation of the study, however.Whereas internalization was equated to the griever’s perception of simi-larity, it may well be that the former is a mostly unconscious processbetter assessed by observing the survivor’s behavior rather than by ask-ing for a conscious evaluation.This is the approach taken by psychoana-lytically oriented clinicians such as Lindemann (1944).The most that canbe said here is that grievers’verbal reports indicate they continue to viewthemselves as similar to the deceased as controls do to the living.

Our analyses of closeness of relationship provides somewhat moresupport for a grief work interpretation. The same caution given earlierconcerning the use of a single question to assess grief status also applies tothe single item used in this study to measure closeness of relationship. Itshould also be noted that, although the question concerning closeness ofrelationship was asked in the present tense, it is possible that some griev-ers may have interpreted it to mean,`̀How close was your relationship to

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the deceased when he/she was alive?’’Even if participants were respond-ing to their former relationship with the deceased, however, it is stillimportant to ask why survivors remember their relationship as beingmore distant both for the first year, and then again after 5 years, follow-ing the death.

The fading perception of closeness that occurs after 5 years is not dif-ficult to understand. It seems reasonable that although some survivorsare affected by the death of a loved one over extended periods, perhapsfor a lifetime, others are not.The latter group, although they may retainfond memories of the deceased, no longer find it necessary to include theloss or its object as an integral component of their ongoing life structure.In fact, the claim that grievers invariably maintain strong continuingbonds to the deceased seems as dubious as the grief work claim thatdetachment is inevitable. Rather, in the name of integration, the twoperspectives might be viewed more constructively as opposite ends of asingle continuum. Further research is needed to determine the types ofrelationships between survivor and deceased, the intervening experi-ences, and the personality structures that produce the strong enduringties envisioned by continuing bonds theorists and the detachmentdescribed by grief work advocates.

The lower closeness of relationship ratings for the first year followingthe death were not unanticipated when we began our research. Ourexpectation was based on a `̀ defensive distancing’’ that results fromincreased death anxiety immediately following the death of a lovedone. When someone dies we not only mourn the loss but must face thereality of our own mortality as well.This creates an approach-avoidancesituation in which the griever seeks both to maintain a relationship with,and to differentiate him- or herself from, the deceased. This dilemmashould be felt most acutely during the early phases of grief before ade-quate protective defenses can be erected.

In his classic,The Death of Ivan Ilyich,Tolstoy (1981) described Peter Iva-novich’s reaction to the death of his childhood friend:

Peter Ivanovich was overcome with horror as he thought of the suffering ofsomeone he had known so well, first as a carefree boy, then as a schoolmate, lateras a grown man, his colleague . . . . `̀ Three days of terrible suffering and death.Why, the same thing could happen to me at any time now,’’ he thought and for amoment felt panic-stricken. But at once . . . he was rescued by the customaryreflection that all this had happened to Ivan Ilyich, not to him, that it could notand should not happen to him . . . . With this line of reasoning Peter Ivanovich

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set his mind at rest and began to press for details about Ivan Ilyich’s death, asthough it were a chance experience that could happen only to Ivan Ilyich, neverto himself. (p. 44)

Discussing the passage fromTolstoy cited above, Kastenbaum (1998)noted that

Peter Ivanovich’s basic evasive technique here is the effort to differentiate himselffrom Ivan Ilyich . . . We witness Peter Ivanovich, then, stretching and torment-ing his logic in the hope of arriving at an anxiety-reducing conclusion . . . OncePeter Ivanovich has quelled his momentary panic, he is able to discuss IvanIlyich’s death. Even so, he is far more interested in factual details than in feelingsand meanings. He has started to rebuild the barriers between himself and death.Whatever he learns about how his friend died will strengthen this barrier: allthat was true of Ivan obviously is not applicable to him. (p.15)

Following this line of reasoning, the six similarity items (excludingOverall Similarity) were chosen to include three `̀external’’dimensions(Physical Attributes, Mannerisms, & Lifestyle) and three `̀ internal’’dimensions (Emotions, Beliefs, and Interests).We had hoped to show thatgrievers will attempt to differentiate themselves from the deceased onexternaldimensionstobolsterthefeelingthatthiscouldn’thappentothem.For example, one can imagine a survivor saying,̀ `He and I were a lot alike,buthe smokedtwopacksofcigarettes adayand it killed him. Idon’t smoke[a Lifestyle difference].’’Likewise, we expected perceived similarity to begreatest for the internal items,whichcanserve asamore personaland less-threateningbasis for maintaininganongoing relationship.

Unfortunately, asTable 2 indicates, the six similarity dimensions werenot independent of one another, nor was there a clear distinctionbetween internal and external items. One tantalizing finding, however,should be noted. Two similarity dimensions displayed relationships dif-ferent from the others. In line with our expectations, the most commonrating for beliefs (an internal dimension) was `̀extremely close,’’ wher-ever the most common perception of physical similarity (an externaldimension) was `̀ not very similar.’’ The effect was only seen amongthe grievers. This finding, along with the lower ratings for closeness ofrelationship over the first year following the loss, may therefore repre-sent a conflict between the need to maintain bonds with the deceasedand the need to differentiate onself brought about by increased deathanxiety. The fact that no overall differences in similarity ratings werefound between grievers and controls may be the result of the off-setting

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effects of the two vectors, and/or the fact that few of our grievers dis-played the severity of grief that might be expected to exacerbate theapproach-avoidance conflict.

Severalweaknesses inthis studyshouldbenoted inasmuchastheylimitthe scope of the findings.They include the following: (a) Fewof our parti-cipants reported experiencing overwhelming levels of grief. Only twogave ratings of `̀ 1’’, whereas five gave ratings of `̀ 2’’on the 5-point scale.Examin ing people in more acute gr ief may clar i fy the roleof internalization in general, and defensive distancing in particular.(b) The sample of grievers was relatively young (M = 27.84 years) andpredominantly female (80%). (c) Our sample of grievers was relativelysmall. A larger group of grievers would allow generalization of the find-ings to other grief variables, such as type of death and relationship to thesurvivor. (d) Internalization mightproductivelybe examinedusingmea-sures other than personal perceptions of similarity. Specifically, theunconscious aspect of internalization, which has important implicationsfor both grief models, should be assessed more directly. (e) Both grief sta-tus and closeness or relationship were assessed using a single self-reportitem. Reliable instruments for both variables exist and might be used tofurtherclarifytherelationshipsbetweengriefworkandcontinuingbonds.

In conclusion, our data suggest that both detachment and continuingbonds play a role in the resolution of grief.The two may actually repre-sent opposite ends of a single dimension.The time appears ripe to exam-ine this possibility, and many others, within the context of a moreinclusive model of grief. Presently several candidates are vying for ourattention as possible replacements for the venerable grief work perspec-tive. Among the most important of these are meaning reconstruction(e.g., Neimeyer,1998) and the dualprocess model (e.g., Stroebe & Schut,1994). It is encouraging thatboth models are seeminglyable toaccommo-date aspects of grief work into the broader perspectives they offer. As ourunderstanding of grief increases, we are forced to rethink the paradigmsthat havebrought us towhereweare today. But in the process let usnot, asWilliam James once cautioned,`̀ throw the baby out with the bathwater.’’

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