Coping with loss of ability: ''Good grief'' or episodic stress responses?

Traditional grief models, which tend to prescribe ''good grief'' responses, are often applied to responses to loss of ability (loss of sensory, motor, intellectual or reproductive functioning). A brief review of relevant research concludes that the assumptions of grief models lack empirical support, both in the bereavement and the loss of ability contexts. It is argued that stress provides an appropriate framework for conceptualising loss of ability responses, especially the frequently observed recurrent pattern of stress (chronic sorrow). An Episodic Stress Response Model is proposed which avoids prescriptions and notions of pathology. It distinguishes between primary and secondary stress episodes and different types of stress demands (recognition, adjustment, comfort, and stress reduction). (C) 1997 Elsevier Science Ltd.