PBC Perinatal Loss & Bereavement Theories 3 — Questions and Answers
Question 1: Bowlby described which phase of attachment-based grief as characterized by intense yearning and searching for the lost person?
- Numbness
- Yearning and searching (Correct answer)
- Disorganization and despair
- Reorganization
Correct answer: Yearning and searching
Bowlby's second phase of grief is marked by persistent yearning for the deceased and behavioral searching, driven by the biological attachment system.
Question 2: A nurse notes that a father whose baby died two weeks ago appears numb and in disbelief. According to Bowlby's phases of grief, this is consistent with which phase?
- Yearning and searching
- Disorganization and despair
- Numbness (Correct answer)
- Reorganization
Correct answer: Numbness
Bowlby's first phase of grief — numbness — typically lasts hours to weeks after loss and serves as a psychological buffer against overwhelming pain.
Question 3: The 'assumptive world' concept, central to understanding traumatic grief, was developed by which theorist?
- Colin Murray Parkes (Correct answer)
- Elisabeth Kübler-Ross
- Dennis Klass
- William Worden
Correct answer: Colin Murray Parkes
Parkes introduced the concept of the assumptive world — the set of beliefs about life, safety, and meaning that are shattered by traumatic loss.
Question 4: Which of the following best describes Worden's Task IV: 'Finding an enduring connection with the deceased while embarking on a new life'?
- Forgetting the deceased to move forward
- Relocating the emotional place of the deceased so new relationships are possible (Correct answer)
- Avoiding all reminders of the loss
- Returning to pre-loss functioning without changes
Correct answer: Relocating the emotional place of the deceased so new relationships are possible
Task IV was revised by Worden to reflect continuing bonds theory — the goal is not to detach but to reposition the relationship so life can be re-engaged.
Question 5: In Stroebe and Schut's Dual Process Model, 'restoration orientation' refers to:
- Focusing solely on the emotional pain of losing the baby
- Confronting and processing the grief directly
- Attending to secondary losses and life changes resulting from the bereavement (Correct answer)
- Returning to the hospital for follow-up appointments
Correct answer: Attending to secondary losses and life changes resulting from the bereavement
Restoration orientation addresses the secondary stressors generated by the loss — identity changes, new roles, and rebuilding life — rather than the grief emotions themselves.
Question 6: Which statement BEST reflects how the Dual Process Model applies to perinatal bereavement counseling?
- Parents should remain in loss-orientation to honor their baby
- Oscillating between grieving the baby and engaging in day-to-day restoration is adaptive (Correct answer)
- Restoration-orientation means the parent has not properly grieved
- Loss-orientation should be discouraged after the first month
Correct answer: Oscillating between grieving the baby and engaging in day-to-day restoration is adaptive
The DPM supports that healthy coping involves both confronting grief and taking restorative breaks — both are necessary and normal parts of adapting.
Question 7: A bereaved parent experiencing 'chronic grief' — intense grief that remains unresolved years after perinatal loss — would be best classified according to which framework?
- Kübler-Ross's anger stage
- Prolonged Grief Disorder (formerly Complicated Grief) (Correct answer)
- Worden's Task I incomplete
- Normal grief variation within the DPM
Correct answer: Prolonged Grief Disorder (formerly Complicated Grief)
Prolonged Grief Disorder (PGD), now recognized in DSM-5-TR and ICD-11, describes grief that remains persistently severe and impairing well beyond the expected period.
PBC Perinatal Loss & Bereavement Theories 3
Bowlby described which phase of attachment-based grief as characterized by intense yearning and searching for the lost person?