Death Studies, 25: 5317548, 2001

Copyright # 2001 Brunner-Routledge

0748-1187/01 $12.00 + .00

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MAPPING GRIEF: AN ACTIVE APPROACH TO GRIEF

RESOLUTION
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SHEILA CLARK
University of Adelaide, NorthTerrace, South Australia, Australia

This article describes a clinical tool, the Grief Map, that isdesigned to assist those who are
grieving death and non-death losses.The map provides a constructive multidimensional
framework for dealing with the phenomena of the grieving process and for rebuilding life
following major loss.The method of developing the map and its various uses as an assess-
ment, educational, and therapeutic tool are detailed with illustrative case examples.The
underlying precepts on which the map is based and its correlates with current theory and
research are discussed.The limitations of the map and issues for further research are dis-
cussed.

Grieving people want to know how to deal with grief but Silverman and
Klass (1996) noted that they tend to refer to familiar models even if they
are not appropriate. This is problematic as older models provide limited
prescriptive frameworks and lack structure for rebuilding life again. Yet
a considerable amount of interest has been generated recently in how
people reconstruct their lives following major loss. Indeed, constructs of
the grieving process have moved on from passive models, such as the val-
ley (Psalm 23), disease (Engel, 1961), and stages (Kubler-Ross, 1970;
Westberg, 1966), to active approaches involving work (Freud, 1917=1934;
Lindemann, 1944; Parkes, 1988), tasks (Worden, 1991), dosing (Stroebe
& Schut, 1999), participation (Macnab, 1989), and challenge, personal
growth, and fulfillment (Attig,1991; Frankl,1963,1969).

Received 10 January 1998; accepted 26 November 2000.

I thank Mary Brownlow, Art Therapist, Te Omanga Hospice, Lower Hutt, New Zealand, for
her contributions from her experiences of using the map with teen groups.
Address correspondence to Sheila Clark, Grief and Palliative Care Counselling Unit, Depart-
ment of General Practice, University of Adelaide, NorthTerrace, South Australia, 5005, Australia.

531
532 S. Clark

This article describes a clinical tool, the Grief Map, which is simple to
use, provides a constructive multidimensional framework for the grief ex-
perience, and incorporates the concepts of the active models mentioned
above. The map adheres to additional recommendations for grief con-
structs (Corr, 1999; Shuchter & Zisook, 1993; Stroebe & Schut, 1999) by
being non-prescriptive and allowing for individual, gender and cultural
differences.Through its applicability to both death and non-death related
losses, it also encompasses disenfranchised grief, thereby also providing a
framework for a broad range of client issues found in clinical settings.

Method

The map was created using a stepwise clinical and consultative process.
The initial draft was the result of a study of grief, using field methodol-
ogy (Schatzmann & Strauss, 1973) in individuals attending a support
group for persons bereaved through suicide. The author acted as lead-
er= facilitator in the group discussion at 96 support meetings.These were
attended by 97 participants (74 women and 23 men) on a mean of 4.5 oc-
casions (range 1720). The mean time of entry was 2.3 months after the
death (SD ˆ 9.5, range 0.5760) and the majority of attendances oc-
curred during the first 2 years after bereavement. Grief phenomena ex-
perienced by participants were observed and recorded by the author
immediately after each meeting. The time interval since the death at
which these phenomena were experienced by individuals was also noted.
Phenomena were drawn as triangles to represent mountains, which were
placed under the most relevant section of a three-part timeline, repre-
senting early, middle, and late periods of grieving. At this stage, the
map included all the phenomena of ``Unreality,’’ the three top lines of
phenomena under ``Survival,’’ and all the phenomena of ``Reorganisa-
tion’’except ``New relationship with the deceased’’and ``Finding meaning
from the loss’’ of the final map shown in Figure 1. During the study, the
author noted the loss of self-esteem (Sëguin, Lesager & Kiely, 1995)
and lack of recognition by participants of their accomplishments in deal-
ing with their grief and their ongoing lives. In addition there was fre-
quent use of negative euphemisms, such as ``breaking down,’’ ``falling
down a pit,’’and ``victim.’’ The map with its mountains was conceived to
reframe the participants’ perceptions of their coping abilities in terms of
positive attributes and control over their situations.
 Mapping Grief 533

FIGURE 1

The map was then modified according to further trials. It was distrib-
uted by the researcher to participants, as a single event, at group meet-
ings for people experiencing various types of loss.The groups included 15
parents of children suffering chronic illness, Compassionate Friends (25
bereaved parents), 30 sufferers of motor neuron disease, and two sepa-
rate public ``healing’’ seminars of 50 and 80 attendees. The participants
were asked to rename, add to, or delete phenomena on the map and to
give feedback to the researcher in the plenary session of the meeting or to
return the map anonymously afterwards. The applicability of the exist-
ing phenomena on the map to the range of death and non-death losses
represented at these seminars was confirmed. No consistent changes
were suggested. However, a search of the literature identified additional
items,``New relationship with the deceased’’and ``Finding meaning from
the loss,’’ which were added to the map. Feedback was then obtained
through use in clinical settings by professionals from various health and
welfare disciplines who had learned about the map through professional
presentations or an earlier publication (Clark,1998). This process identi-
fied two further phenomena,``Tasks of daily living’’and ``Mental fatigue,’’
which were also incorporated.
534 S. Clark

The Grief Map

The map (Figure 1) is a diagram representing the grieving process

from the time of loss to the establishment of a new life. The overall
grieving process is represented as a three-part line. The downward
slope on the left side of the horizontal arm represents the acute distress
in the early weeks and months that accompanies the increasing reali-
zation of the reality of the loss, the falling off of support, and the phy-
siological mechanisms associated with stress. This is followed by
the middle period of grief, which involves the phenomena related to
the distress of separation and the secondary losses. The upturn of the
graph represents lessening of the distress as the loss is accommodated
and life is reorganized. The phenomena of bereavement are placed un-
der the section of the graph in which they are most prominent but are
not necessarily limited only to this area. So, for example, those phe-
nomena usually experienced early on in the grieving process are
placed toward the left and later ones toward the right. However some
phenomena may be experienced broadly over the grieving process.
An example is ``Quest for the positives,’’ which may include the early
experiences of realizing that the deceased did not suffer physically
and of others’ compassion and care, whereas recognizing a new sense
of freedom may be a later one. The diagram provides unmarked trian-
gles for additional phenomena particular to the individual. The map
is accompanied by a set of guidelines (See the Appendix), which are
explained under ``Clinical Uses.’’

The Metaphor of the Grief Map

The premise on which the map is based is the metaphor that the grieving
process is a journey. The grief map is the map of the possible territory
to be covered. The three-part line is the overall route. The area under
the line represents the terrain. In this, the triangles represent the com-
mon phenomena as mountains in the journey.
Grieving individuals are asked to conceptualize each phenomenon of
grief as a separate mountain and to visualize themselves climbing
upward as they progress through an issue. This provides a positive
construct for dealing with negative feelings and helps to counteract the
societal attitudes that the bereaved person is ``not coping’’ or ``breaking
 Mapping Grief 535

down.’’ This positive construct assists them to identify the positive attri-
butes that facilitated their progress.
Particularly difficult issues may be reinterpreted as ascending a steep
mountain face and so making progress in a vertical dimension. Grieving
people may feel``stuck’’or ``going backward’’ in their grief. People who see
themselves as not progressing upward can be likened to clinging to a
rock face, which in itself demands strength and courage. Sometimes be-
reaved people feel discouraged when they discover that there is more to
an emotional issue than they originally thought.This is similar to reach-
ing a summit and discovering that there is still another one ahead.
Progress, therefore, may be conceptualized not only along the hori-
zontal arm of the graph but also in a vertical direction up the mountains.
Like any journey, the distance travelled on a map slows down when ver-
tical assaults are made up the mountains. So the distance and speed tra-
velled along the horizontal arm will vary according to the nature of the
terrain covered.
The map is not prescriptive. Rather it provides individuals with a
means of describing their experience as well as a guide on what may lie
ahead. Each individual chooses his or her own particular route. They
may climb the mountains in their own chosen order and combinations.
They may track back and forth, return repeatedly, delete inappropriate
mountains, and add the names of personal phenomena to the unlabelled
triangles. The realization of choice may assist the return of feelings of
control.
Individuals are also free to choose their own route up a mountain. For
example, in answering the question why someone took his or her life,
they may prefer the no-blame medical model (TrÌskman-Bendz &
Mann, 2000) to the sociological one. Just as the south face of the Eiger
is easier than the north face, so a different approach to a phenomenon
may benefit the griever.
Further analogies may be drawn from the metaphor to explain the
grieving process. A common feature of grief is that people may feel lost
in the grieving process; they may not know where they are heading or
what sort of life may be possible in the future.This is similar to the top of
a mountain being obscured by cloud. It also can be painful to leave be-
hind the old familiar life and to move into new territory, that can seem
strange and foreign. The journey can seem too hard and the bereaved
may feel caught in the undergrowth. The climber here may need some
help to find a route, be assured that the sun is still shining over the top of
536 S. Clark

the mountain and benefit from a companion for the journey. Here a
map, counsellor, or support group may be helpful.
Just as climbers learn the skills of negotiating vertical rock faces, so
the bereaved acquire new skills. These may include expressing feelings,
using thought stoppage for intrusive thoughts and developing strategies
for sleep and self care. Similarly the bereaved will adopt new customs to
assist their survival. For example they may leave behind some of their
former friends who have difficulty accompanying them and may meet
new ones, in particular fellow travellers, who will journey with them
and with whom they can share expertise.
More important, like any climber, bereaved people need time out to
refresh themselves. Finally, when the summit is reached, the view from
the top may open up new aspects and understanding of life and demon-
strate the individual’s personal growth.

Mountains as Phenomena
Many of the phenomena on the left and central sections of the map are
described elsewhere (Parkes, 1986; Parkes & Weiss, 1983; Raphael,
1984). Some need specific mention. ``Mental fatigue’’ includes the tem-
porary loss of concentration and memory, and difficulty in problem
solving as grieving proceeds.``Daily tasks’’ refers to the everyday duties
and responsibilities, whether these are personal, such as washing and
dressing, work-related, or concerned with household duties or care of
others, including children. The term ``Mood swings’’ has been used
rather than the misnomer ``depression.’’ This better describes the labile
mood of grief and distinguishes it from the consistently low mood of
clinical depression.``Legacy of the past’’ refers to grief and traumatic is-
sues existing prior to the death as well as the recurrence of grief about
past losses.``Crisis of values’’ was a term used by Van der Wal (1989) to
imply loss of self-esteem together with a variety of changed beliefs
about self-image and existential issues, such as difficulty in decision
making, priorities and values.``Sense of loss’’ includes the void created
by the major loss and the losses secondary to it.
On the right side of the map ``New relationship with the deceased’’
corresponds to Walter’s (1996) biographical model, Worden’s (1991)
fourth task of emotionally relocating the deceased, and Rubin’s (1999)
``Relationship with the deceased’’ track of his two-track model of be-
reavement. A common fear of bereaved people, namely that the de-
 Mapping Grief 537

ceased must be left behind or forgotten, may be dispelled by the map,

which helps them to develop new concepts of integrating the influence
of the deceased person into their psychological and emotional worlds
(Marwit & Klass,1996).
``Creating a new life’’ refers to the various social, practical, work-re-
lated, and financial issues associated with structuring life without the
lost person, object, or situation.``Rebuilding self ’’ includes the increase
of self-esteem, skills, and confidence as well as the recognition and devel-
opment of personal and psychological attributes (Lund, et al. 1986).
``Finding meaning from the loss’’ may include new directions resulting
from the integration of the influence of the deceased person and from
changed priorities and values coming from the loss experience (Nei-
meyer,1998). For example, some people recognize their increased empa-
thy and sensitivity toward others and consequently take up a helping
role. Creating purpose refers to attitudes and actions adopted as a result
of the new meanings, new self, and new life.

Clinical Uses

The Grief Map may be used as an educational, assessment, and therapy

tool for individuals and groups. Use of the map complements, but does
not replace, traditional therapeutic approaches. It can be used entirely
within counselling sessions or, alternatively, can be commenced in ther-
apy and continued by the client or patient at home. In either case, the
therapist first needs to explain the purpose and metaphor of the map be-
fore instructing the client. The therapist also may need to explain the
meaning of some of the mountains, although, for most of these, the per-
sonal meaning will be obvious to the client. The patient’s written and
diagrammatic responses on the map provide means of assessment in ad-
dition to his or her verbal and nonverbal responses. From this, appropri-
ate education and therapy can be planned. It is important for the
therapist to pace the steps of the instructions according to the responses
of the patient. Homework can be planned around any of the steps and
followed up at the following session.
The various uses of the map are described below with reference to
observations made by the author while using the map for therapeutic
purposes with general practice patients.Two cases are presented that de-
monstrate its application to clinical practice.
538 S. Clark

The Map as an Assessment and EducationalTool

Initially the map is both an assessment and an educational tool of the cli-
ent’s grief for use by the therapist. By asking clients to underline the
mountains relevant to their journey, cross out those that do not apply to
them, rename mountains appropriate to their experience, and add the
names of personal grief issues not already on the map to the unnamed
mountains at the bottom (Steps 174 of guidelines in the Appendix), the
therapist can gain an impression of the issues facing them.When the cli-
ent is invited to draw the heights of the mountains to the scale of their per-
ceived difficulty (Step 5), the relative heights of the mountains can assist
in differentiating the most difficult issues. Finally, by asking clients to fill
in the mountains to the height they perceive they have dealt with them
(Step 6), the therapist can obtain a quick assessment of the client’s
achievements as well as issues that may need to be addressed.
An example of a map completed by a young widow in the early
months after the death of her husband is given in Figure 2. In this, the
filled triangles indicate she feels she has dealt with the shock and disbe-
lief, the partially filled triangles demonstrate she feels she has made some

FIGURE 2
 Mapping Grief 539

progress with these issues, and the underlined but empty triangles indi-
cate she is experiencing these issues but feels she has not made any
headway with them. The most difficult issues for her at that time were
isolation, loss of trust in others, anger and the daily tasks of caring for
the family alone as shown by the heights of these triangles.
Taking the client through this process can help to open discussion
about grief, particularly for clients who find it difficult to talk about their
feelings. Children, young people, males, those who have difficulty with
verbal expression, and those with low IQ respond well. The map can be
particularly useful for people who conceive things visually. Comments
from clients include ``It was good to see it all in front of me.’’A client
may identify his or her emotions and sort out the confusion resulting
from being ``lost in his or her own grief ’’ (Parkes,1988). At the same time
the map can help clients understand that their feelings are normal. For
example, a grieving mother commented that the map``showed me I was
normal.’’A 14-year-old girl whose mother had died, felt relieved at seeing
``Anger’’on the map, exclaiming:``So I’m not a bad girl because I’m angry
at my mother!’’
For therapists who may themselves feel lost in the story of distress, the
map can present a quick picture of the issues faced and clarify where to
start. For example, if ``Suicidal thoughts’’ or ``Mood swings’’ are under-
lined, the therapist can proceed to assess the severity of these.
Another approach, which can be used after leading clients through
this process, is to ask them to draw their own map. By inviting the client
to put personal labels on phenomena, to group related phenomena to-
gether, and to draw the height of the mountains to the scale of their in-
tensity, the map becomes a personalized record of the client’s grief on
that day.
The map also can be used as an educational tool by helping people
understand their grief. For example, explanation of ``Mental fatigue’’
may assist them in making sense of their difficulties in concentration,
decision making, and short-term memory. This will reassure them they
are not becoming demented and help them plan strategies for dealing
with these difficulties. It can also inform them that, in addition to deal-
ing with their emotions, there are the practical, social, behavioral, and
spiritual issues to deal with on the right side of the map.
The map can therefore be used to identify priority areas for the client,
alert the therapist to which new constructs the grieving person may ben-
efit from, and to form a plan of counselling and support.
540 S. Clark

Finally, the map has also been used as a self-help tool for grieving peo-
ple. By using the map with its guidelines (Clark,1998), they can normal-
ize their feelings, assess their progress, recognize their achievements and
prioritize their future actions.

The Map as aTherapyTool

Following from the assessment, the therapist can use the map to follow
through a program of counselling and support for the client. It can be
useful also for helping clients change their attitude toward themselves,
empowering them, and motivating them to change. Filling in the moun-
tains provides a record for the client of his or her achievements. Simi-
larly, when a second map is completed several months later, the
difference between the two maps is a record of their progress. Figure 3a
and 3b show two maps completed by the same widow at 8 and 19 months
following the death of her husband. It is interesting that in the first map
she pictured herself traversing the mountains from left to right. The sec-
ond map demonstrates, that compared with the first map, she has made
progress on issues already started on the first map, such as ``Why?’’ and
``Isolation.’’ It also indicates that issues that she had not previously dealt

FIGURE 3a
 Mapping Grief 541

FIGURE 3b

with, such as ``Guilt’’ and ``Unfinished business,’’ were being addressed

and that her grieving process was balanced by including several of the
mountains of reorganization.
By marking progress in this way, clients can recognize their successes
and be encouraged to identify which personal strengths enabled their
achievements. This, in turn, builds self-esteem, helps them reclaim their
control over the situation and empowers them.
If no progress is demonstrated between maps, the reason why can be
explored. This was the case with one young woman whose father had
died. On exploration it was found that her widowed mother had, since
the previous map, introduced more grief into this woman’s life by seem-
ing to displace her within the family hierarchy. A different therapeutic
approach was planned as a result: the client was assisted in understand-
ing her additional grief and her mother’s needs, and the mother was of-
fered counselling.

The Grief Map as aTool for Families and Groups

The map has also been used as a discussion tool within families and sup-
port groups.The mother of a family who had lost a teenage daughter used
542 S. Clark

the map to facilitate family discussions about grief with her husband and
the remaining four children. The husband discussed his feelings about
the ``Isolation’’ mountain, which led to both husband and wife recogniz-
ing the seriousness of the breakdown of their relationship since the death
of their daughter. In particular, the husband was able to identify from
the map a number of issues he was dealing with, such as guilt and blame,
and was able to explain to his wife how these issues made it difficult for
him to communicate with her. This also led the children, who ranged in
age from 13 to 22, to identify their feelings of aloneness. The family were
then able to put in place some strategies to draw them together.
The map has also been used by an art therapist for assessing young
people in the aftermath of a peer’s suicide. It was found easy to use in
therapeutic group work with teens as part of a program of activities
and discussion about their experiences with death and grief. Teens
warmed to the idea of a map and found it easy to check off and color in
the triangles that fitted self. The process helped to bring into the open
hallucinations, nightmares and other frightening thoughts and feelings
that individuals were reluctant to speak about. It became a reference
point to discuss shared experiences and open the way to specific topics,
such as beliefs, cultural norms and the extrasensory dimension.

Case Examples

Case 1
Mrs. X is a 59-year-old divorced woman who somatized her emotions.
She regularly frequented her general practitioner’s surgery with physical
complaints as a ticket-of-entry to talk about emotional issues. After a
new diagnosis of non-insulin-dependent diabetes was made she con-
sulted her general practitioner with grief due to her apparent loss of her
health.
She was introduced to the map at this point. The map was a catalyst
toward her identifying her feelings and enabled the emotional issues that
had previously been bottled up inside her to be brought to light. For
homework she drew each mountain on a separate sheet in proportion
to the size of her feelings and listed the causes and associated feelings
alongside. She returned with several pages of ``mountains’’on which she
had obviously spent considerable time and which led to some important
 Mapping Grief 543

revelations. Of significance was that from``Mood swings’’she recognized

that she felt depressed and tearful because knowledge of the diabetes
made her feel ``like trash’’ and ``rubbish.’’ She also blamed herself for the
diabetes and wondered ``Why me?’’ Feelings related to previous losses
also returned, which she identified under ``Legacy of the past.’’ These in-
cluded her divorce, the grown-up children leaving home, loss of a pre-
viously supportive church group, physical and sexual abuse as a child,
the death of a grandchild through sudden infant death syndrome, and
the threat of the breakdown of her son’s marriage. She recognized she
felt loss of trust in others because many of these losses had been caused
by those she had previously had faith in, and consequently perceived
herself to be isolated and unsupported. She identified anger because the
diabetes was yet another loss in her life, at her family past and present, at
her husband, and at the church leaders.
The map was useful in giving her a framework for legitimizing and
working through the grief that had built up over her life from the many
losses. The pictorial and written representation of these losses and asso-
ciated emotions not only assisted her catharsis but also helped the coun-
sellor to understand her perspective. For example, the issue of her
integrity relating to the diabetes could be addressed in relation to the
physical and sexual abuse and with education about the causes of dia-
betes. The various losses, many of which she had never previously
discussed with anyone, were addressed in turn.
The counsellor also challenged her to look at the mountains of reor-
ganization. As a result she found that learning to manage her diabetes
would equip her better to live a healthy life style for the rest of her life.
She also perceived she would have a better understanding of how to help
others through her own understanding of dealing with diabetes and this
also gave meaning to her experience of diabetes. After some months she
completed another map and, from the increased number of filled-in tri-
angles, recognized the progress she had made. Following this she was
able to list several pages of personal attributes that helped her see herself
as a whole person. Her somatized symptoms reduced with a program of
ongoing counselling and support.

Case 2
Mrs. Y was a 35-year-old widow with 10-year-old twins. She presented
for counselling following the suicide of her husband 8 months previously.
544 S. Clark

On assessment, she was foundto be agitated and confused as there were

``so many parts’’to her grief and, at the same time, she was struggling with
the many practical issues of the home and children. From her grief map
(Figure 2) she identified many of her feelings and could talk at length
about each in turn. After drawing the mountains to the height she per-
ceived them, the therapist asked her what the ``daily tasks’’entailed for
her.This resulted in her recognizing that she was indeed dealing success-
fully with many of the``daily tasks’’ issues.These included shopping, cook-
ing, cleaning, caring for the children on her own, and making decisions
about her house and car that previously had been done by her husband.
She appreciated she made progress and could identify her personal
strengths. Consultations on a monthly basis helped her work through the
various mountains and provided support and recommended strategies
for dealing with the mountains of reorganization. In a second map com-
pleted10 months later, she hadtotally filled in``daily tasks’’as wellas partly
accomplished some of the mountains of reorganization. At this point she
recognized she was``turning a corner,’’ talked proudly about her achieve-
ments and terminated her counselling. For her, the map was helpful in
helping her identify her strengths and in assisting her to move on.

Discussion

Limitations in the Method of Developing the Map

The map was developed and validated almost entirely using selected
samples of support group and clinical populations. The lack of control
group and structured assessment methodology can also be criticized,
but the naturalistic field and clinical methods used have the advantage
of allowing careful prospective observation of phenomena.The presence
of the observers=clinicians and their perception of phenomena could
also have biased the findings.

Limitations of the Diagrammatic Representation of the Map

It is difficult to represent phenomena in a two-dimensional format that
occur over a wide timespan and that may be experienced repeatedly
and in combinations. The three parts of the grieving process are artifi-
cial constructs and exist as guides only.
 Mapping Grief 545

Limitations to Uses of the Map

The map is not appropriate when clients are very distressed and need to
tell their story. It may also not be appropriate for trauma counselling or
when denial is an important coping mechanism. Those who are not vi-
sually minded may find it difficult to use. Initial trials show that re-
peated use of the map after the first year may not demonstrate progress
and must be used with caution. It is a provisional construct, based on ob-
servations and is open to revision and amendment. Further evaluation
of its use for grieving persons and counsellors is necessary.

Correlations of the Map with Current Concepts

The map incorporates the six domains of grief (Corr,1999).``Mental fati-
gue,’’ ``Disbelief ’’ and ``Why?’’ are examples of the cognitive domain;
``Isolation,’’ ``Blame from others’’and ``Shame’’are examples of the social;
and ``Daily tasks’’ and ``Creating a new life’’ are behavioral; whereas
``New relationship with the deceased’’and ``Finding meaning’’ are spiri-
tual. Physical reactions, for simplicity, are conceptualized within the
mountains. For example, palpitations, sweating, and nausea may be
associated with``Shock,’’and abdominal pain with``Sense of loss.’’
The three parts to the map correspond roughly to the three phases of
numbing, yearning=disorganisation, and acceptance=reorganisation de-
scribed by Bowlby (1980), Parkes (1988), and Raphael (1984).
The concept of journeying incorporates Freud’s (1917=1934) ideas of
work and effort being needed in the grieving process. Both macro- and
microtasks of grieving can be distinguished. The left-hand side is analo-
gous to the first two tasks of Worden (1991) (i.e., to accept the reality of
the loss and to experience the pain of grief) and the right-hand side to his
second two tasks (to adjust to a new environment in which the deceased
is missing and to relocate the deceased emotionally and move on with
life). However the map can also identify microtasks specific to the
individual. Charting the accomplishments of grieving ``begins to coun-
ter the helplessness’’according to Attig (1991) and has become a feature of
bereavement support programs (Murphy et al.,1998). Such evidence on
paper reinforces the positive qualities required for grieving at a time
when little else may seem positive and so may help to raise self esteem.
This in itself, according to Caplan (1990), is a requirement for successful
grief resolution.
546 S. Clark

Like Stroebe and Schut’s (1999) dual-process model of loss orientation

versus restoration orientation, the map integrates the two major adjust-
ments of dealing with the emotions and the reorganization of life. The
tasks of loss orientation (grief work, intrusion of grief, breaking bonds=
ties, denial=avoidance of restoration changes) are located on the left side
of the map and those of restoration (attending to life changes, doing new
things, distraction from grief, denial =avoidance of grief= new roles =
identity= relationships) on the right.The dual process concept of``dosing’’
each orientation according to the tolerance of the griever is conceptua-
lized in the grief map by the choice of route on the map.The metaphor of
the journey also provides the notion of resting from the journey, which
corresponds with the dual-process concept of ``time off from either cop-
ing orientation.’’
Central to the success of completing the journey are the concepts of
challenge, choice, and control, which Frankl (1963) and Attig (1991) de-
scribed. The map also accommodates both the psychological as well as
the social transitions (``Daily tasks’’; ``Creating a new life’’) of Parkes’
(1988) model and of Averill and Nunley’s ``Levels of Organization’’
(1993). Like Rubin’s (1999) model, the map provides for both tracks of
grieving: ``Functioning’’and ``Relationship to the deceased.’’

Conclusion

The concept of mountains is not foreign to the grieving or to those who

assist them. In 1997, Frank Campbell, Past President of the American As-
sociation of Suicidology, wrote of people bereaved through suicide: ``I
have had the privilege of working with survivors and watching them
climb out of canyons of pain in order to stand on mountaintops, forever
changed by this indescribable and complicated bereavement.’’
The Grief Map provides a map of the grieving process that comple-
ments accepted therapeutic approaches and is consistent with
contemporary frameworks. It has been found useful by a wide range of
people for dealing with grief resulting from death as well as from non-
death related losses. It may evolve even further to suit individual and
situational needs and further evaluation will elicit additional uses and
limitations. The Grief Map is offered in the hope it may help those
touched by grief climb out of canyons of pain and indeed stand on
mountaintops.
 Mapping Grief 547

References

Attig, T. (1991). Grief as an active process. Death Studies, 15, 3857394.

Averill, J. R., & Nunley, E. P. (1993). Grief as an emotion and as a disease: A social con-
structionist perspective. In M. S. Stroebe, W. Stroebe, & R. O. Hansson (Eds.),
Handbook of bereavement: Theory, research and intervention. Cambridge England: Cam-
bridge University Press. pp. 77790.
Bowlby, J. (1980). Attachment and loss (Vol. 3). In Loss, sadness and depression. London:
Hogarth. pp. 817111.
Campbell, F. R. (1997). Changing the legacy of suicide. Suicide and LifeThreatening Beha-
vior, 27, 3297338.
Caplan, G. (1990). Loss, stress, and mental health. Community Mental Health Journal,
26(1), 27748.
Clark, S. E. (1998). After suicide: Help for the bereaved. Melbourne: Australia, Hill of
Content.
Corr, C. A. (1999). Enhancing the concept of disenfranchised grief. Omega, 38,1720.
Engel, G. (1961). Is grief a disease? Psychosomatic Medicine, 23,18722.
Frankl,V. (1963). Man’s search for meaning. Boston: Simon & Schuster.
Frankl,V. (1969).The will to meaning. NewYork: New American Library Inc.
Freud, S. (1934). Mourning and melancholia. In S. Freud, Collected papers (Vol. 4,
pp.1527170). London: Leonard & Virginia. (originally published 1917.)
Kubler-Ross, E. (1970). On death and dying. London: Tavistock=Routledge.
Lindemann, E. (1944). Symptomatology and management of acute grief. American
Journal of Psychology, 101,1417148.
Lund, D. A., Caserta, M., & Dimond, M. F. (1986). Gender differences through two
years of bereavement among the elderly.The Gerontologist, 26, 3147320.
Macnab, F. (1989). Life after loss: Getting over grief, getting on with life. Sydney,
Australia: Millenium Books.
Marwit, S. J., & Klass, D. (1996). Grief and the role of the inner representation of the
deceased. In D. Klass, P. R. Silverman & S. L. Nickman (Eds.), Continuing bonds:
New understandings of grief. Philadelphia: Taylor and Francis. pp. 2977309.
Murphy, S. A., Johnson, C., Cain, K. C., Gupta, A. D., Dimond, M., & Lohan, J.
(1998). Broad-spectrum group treatment for parents bereaved by the violent deaths
of their 12728 year old children: a randomised controlled trial. Death Studies, 2,
2097235.
Neimeyer, R. (1998). Lessons of loss: A quide to coping: NewYork: McGraw-Hill.
Parkes, C. M. (1986). Bereavement: Studies of grief in adult life. London: Penguin.
Parkes, C. M. (1988). Bereavement as a psychosocial transition: Processes of adaption to
change. Journal of Social Studies, 44(3), 53765.
Parkes, C. M., & Weiss, R. S. (1983). Recovery from bereavement. NewYork: Basic Books.
Raphael, B. (1984).The anatomy of bereavement. London UK: Hutchinson.
Rubin, S. S. (1999). The two-track model of bereavement: overview, retrospect and
prospect. Death Studies, 23, 6817714.
Schatzmann, L., & Strauss, A. (1973). Field research strategies for a natural sociology.
Englewood Cliff NewJersey: Prentice Hall.
548 S. Clark

Sëguin, M., Lesage, A., & Kiely, M. C. (1995). Parental bereavement after suicide and
accident: A comparative study. Suicide and Life-Threatening Behavior, 25, 4897498.
Shuchter, S. R., & Zisook, S. (1993). The course of normal grief. In M. S. Stroebe,
W. Stroebe, & R. O. Hansson (Eds.), Handbook of bereavement:Theory, research and inter-
vention. Cambridge: Cambridge University Press. pp. 23743.
Silverman, P. R., & Klass, D. (1996). Introduction: What’s the problem? In D. Klass,
P. R. Silverman, & S. L. Nickman (Eds.), Continuing bonds: New understandings of grief.
London: Taylor and Francis. pp. 3727.
Stroebe, M., & Schut, H. (1999). The dual process model of coping with bereavement.
Death Studies, 23,1977224.
Tra«skman-Bendz, L., & Mann, J. J. (2000). Biological aspects of suicidal behaviour. In
K. Hawton & K. van Heeringen (Eds.), The international handbook of suicide and at-
tempted suicide. Chichester UK: Wiley. pp. 65777
Van derWal, J. (1989). The aftermath of suicide: a review of empirical evidence. Omega,
20,1497171.
Walter,T. (1996). A new model of grief: bereavement and biography. Mortality, 1(1),1725.
Westberg, G. (1966). Good grief. Melbourne: The Joint Board of Christian Education of
Australia and New Zealand.
Worden, J. W. (1991). Grief counselling and grief therapy. London: Routledge.

Appendix

Guidelines for Using the Grief Map

1. Underline the mountains relevant to your journey.

2. Cross out the mountains that do not apply to you.
3. Are there mountains that do not have the exact name you want? If so,
cross out the printed name and put in your own.
4. Are any of your grief issues not on the map? If so, name these under
the blank mountains.
5. If some mountains seem especially big or difficult for you, draw them
taller to the height you think they should be.
6. Fill in each mountain to the height you feel you have climbed. For
example, if you have done a little bit of a mountain, fill in a little at
the bottom, or if you feel you have half dealt with an issue, demonstrate
you have climbed that mountain half way by filling in the lower half.
7. Now look at the map. Ask yourself:
° What issues have I dealt with?
° What successes can I identify? Celebrate your progress!
° What issues do I still need to work on?
° Where do I need help? Where can I get this help?
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