Hundreds of community-based grief support centers around the country follow a model developed by the Dougy Center for Grieving Children and Families, which was one of the first of its kind. Its grass-roots model is built on the premise that the common experience of grief from the death of a loved one can be lessened through peer support.

This approach is best appreciated by looking at the historical and social context in which it arose. Patriarchal medical practices became the norm in the 20th Century, characterized by physician-dominance. Doctors maintained their role as experts and power-holders in part by making medical information and knowledge mystical to patients, and medicalizing normal life events and conditions like grief. Coupled with a post-Victorian cultural discomfort with death and grief, these subjects were largely taboo in everyday life.

Several developments contributed to resistance against this cultural norm. First, Elizabeth Kubler-Ross’s influential book “On Death and Dying” was published in 1969. Although she developed her now-famous concept of “five stages of grief” from working with people who were dying of terminal illness, she brought attention to the topic. As death became less pathologized, grief began to follow suit. The Dougy Center, established in 1982, estimated that more that more than 500 grief support centers worldwide use their peer-support model.

There is a consistency to spatial layouts and environmental elements, such as objects, in many of the centers that are aligned with the overarching philosophy. These elements offer tangible examples of how the model is practiced, how objects and elements are assigned different meanings in a specific context, and, as I found, reveal tensions between some mental health practitioners and layperson administrators of the programs.