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Ruminative coping as avoidance

A reinterpretation of its function in adjustment to bereavement

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Abstract

The paper argues for a reconceptualization of ruminative coping with the death of a loved one as an avoidant rather than a confrontational strategy. Ruminative coping has been characterized within the bereavement field as persistent, repetitive and passive focus on negative emotions and symptoms. It has been theoretically described and empirically shown to be a maladaptive process, being conceptually related to complicated/chronic/prolonged grief. Furthermore, it has been contrasted with denial and suppression processes—which, too, have been understood to be maladaptive and associated with major complications following bereavement. Here evidence is reviewed and the case made that rumination is not an opposite form of coping from suppression or denial, but that it is a similar phenomenon to these, and different from the types of confrontation that take place in so-called “grief work”. Implications with respect to intervention for complicated grief are discussed.

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Notes

  1. We use the term “complicated” in preference to “prolonged” grief, since the former term is still more familiar and more frequently used in the current scientific literature.

  2. There have been few methodologically sound empirical studies investigating the notion that grief work leads to adaptation to bereavement [9, 67]. Thus, the link with good adaptation is based more on theoretical than empirical research.

  3. See Treynor et al. [71] for discussion of issues to do with the potential conceptual overlap between rumination and depression.

  4. Scott and McIntosh [61] developed the so-called Scott-McIntosh rumination inventory, about people’s tendency to ruminate about failed goal pursuits. We do not describe this scale here, since it focuses, like Martin and Tesser [40], on engaging in thoughts about progress toward goals. Other rumination scales that are similar in some respects to the RSQ are the Negative Rumination Scale [33] and the more specific Anger Rumination Scale [68]—it is beyond current scope to describe these.

  5. Worden’s [77] Task Model of Mourning, notably the 1st 2 tasks.

  6. Although we have categorized rumination as an avoidance process, it must be remembered that there are also non-ruminative avoidance (suppression, denial, etc.) processes which may sometimes be related to poor mental health, sometimes not (see [28], for a scholarly analysis of the relationship of types of avoidance to complicated grief).

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  1. Research Institute for Psychology and Health, Faculty of Social Sciences, Utrecht University, Box 80140, 3508, TC, Utrecht, The Netherlands

    Margaret Stroebe, Paul A. Boelen, Marcel van den Hout, Wolfgang Stroebe, Elske Salemink & Jan van den Bout

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  1. Margaret Stroebe
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Correspondence to Margaret Stroebe.

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Stroebe, M., Boelen, P.A., van den Hout, M. et al. Ruminative coping as avoidance. Eur Arch Psychiatry Clin Neurosc 257, 462–472 (2007). https://doi.org/10.1007/s00406-007-0746-y

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