Working with the Two Track Model of Bereavement: P erspectives on grief and loss

1. 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: rubin@psy.haifa.ac.il http://psy.haifa.ac.il/~rubin One-Day Symposium on Death, Dying & Bereavement Society for the Promotion of Hospice Care, Hong Kong 2005

2. 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. Simon Shimshon Rubin

3. 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. Simon Shimshon Rubin

4. 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 thebereaved. Simon Shimshon Rubin

5. The Two Track Model of BereavementASSESS BOTH TRACKS and DECIDE WHERE TO INTERVENE Track I: Function- Track II: Relationship to the Deceased Simon Shimshon Rubin

6. 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? Simon Shimshon Rubin

7. TRACK I: GENERAL FUNCTIONING- DOMAINS TO ASSESS The Two Track Model of Bereavement

8. For Example How does the bereaved person think about the deceased 1 week, 1 month, 1 year, 10 years, after the loss? Track II Relationship to the Deceased Simon Shimshon Rubin Nova Scotia memorial 05

9. TRACK II: RELATIONSHIP TO THE DECEASED– DOMAINS TO ASSESS The Two Track Model of Bereavement

10. 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. Simon Shimshon Rubin

11. 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! Simon Shimshon Rubin

12. THERAPEUTIC IMPLICATIONS of Two- Track Model of Bereavement Select your focus– Track I (and why) Track II (and why) Listening versus intervening – not same Continuing 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 !! Simon Shimshon Rubin

13. 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? Simon Shimshon Rubin

14. 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. Website: “Asaf Tzur (Blondi). Angel of 17. Born 27.4.86. Died 5.3.2003. Killed… in the Suicide bombing in Haifa.” Simon Shimshon Rubin

15. 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….” אסף אהב את הים וגלישת גליםהמצבה שעל קברו עוצבה כגלשן היוצא מתוך גלי הים, עיצוב שנבחר על ידי הוריו להנצחת אהבה זו. בדרך זו הוא יגלוש לנצח נצחים ... Simon Shimshon Rubin

16. 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. Simon Shimshon Rubin

17. 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/~rubin THANK YOU Simon Shimshon Rubin