Loss integration: A grounded theory of returning to work after perinatal loss

Date of Award


Document Type


Degree Name

Doctor of Organization Development & Change (D.O.D.C.)


Organization Development

First Advisor

Deborah O'Neil (Committee Chair)

Second Advisor

Sherri Horner (Other)

Third Advisor

Debra Ball (Committee Member)

Fourth Advisor

Lisa Hanasono (Committee Member)


Loss Integration theory proposes that an individual integrates a traumatic loss into the 'self' while integrating the 'self' back into the social context. It adds to a growing body of research concerned with understanding trauma and loss. The theory was derived from a qualitative, grounded theory study of parents returning to work after child loss, the first study of return to work after perinatal loss to elucidate the impact on fathers. Implications for organizational practice and for bereaved parents are explored. The interview transcripts from twenty participants (11 men and 9 women) were analyzed using the constant comparative method and synthesized through a recursive coding process. Utilization of the Gioia method (Gioia, et al., 2012) generated an exhaustive data structure, supporting the construction of three process models that are nested within the over-arching theory of Loss Integration. The first model accounts for the Loss Integration Process, the second represents the process of Integrating Loss into Identity, and the third is an emergent model of adaptive grieving termed Bimodal Grieving. The Loss Integration Process model accounts for the recursive nature of the grieving process and delineates what is needed from others and from the workplace for successful integration, while proposing requisite skills for the bereaved like neurophysiological self-care and self-compassion. The model accounts for the trauma inherent in perinatal loss and the potential for posttraumatic growth. The Integrating Loss into Identity model represents the process of assimilating the loss into one's identity over time and involves the key processes of meaning making and parenting the lost child. This model builds upon the theory of continuing bonds (Klass, et al., 1996) and logotherapy (Frankl, 1959), while challenging the causal roles of sense making and benefit finding (Davis, et al., 1998; Holland, et al., 2006). The Bimodal Grieving model makes central the flexible shifting of one's mental focus toward and away from the loss at regular intervals. It connects with the neuroscientific theory of grieving as learning (O'Connor & Seeley, 2022) and challenges the assumption that men and women grieve in fundamentally different ways.