Bereavement Theory Research Articles

Between the idea and the reality: A study of the counselling experiences of bereaved people who sense the presence of the deceased

There have been many theories of the process of loss and bereavement, from Freud, to the present day. Early theories of bereavement described a process which, following various stages and associated tasks, ended at the relinquishment of the bond to the deceased. In more recent years theories have taken different directions, identifying how bereaved people re-learn life, recreate biographies, and continue relationships to the deceased. Some research studies of bereavement have investigated the counsellors’ perspective, but there are very few studies of the client's experience and most studies have focussed on outcomes of counselling. This qualitative study, using semi-structured interviews, provides an insight into the bereaved client's perspective on the content and process of their counselling experiences. Taking as its focus the client's sense of the presence of the deceased, this study aimed to identify whether or how counsellors facilitate exploration of this experience and which theories they use in ...

Absence, loss and misappropriation

Bereavement and loss have a significant impact on health of older people, and are often part of the emotional distress that brings them to seek help from a therapist. This personal reflection, from an integrative perspective, considers three themes of absence, loss and misappropriation in relation to theories of bereavement and grief, and the practice of therapy with older people.

Sudden bereavement in acute care settings

This literature review examines best practice in caring for those who have been bereaved suddenly in acute care settings. Theories of bereavement are outlined in relation to sudden death. The evidence base for best practice is presented and the role of the nurse in this situation is examined. There are common psychological, physical and behavioural manifestations of grief, but people experiencing the sudden death of a loved one are at risk of more pronounced and prolonged grief reactions than those who had been expecting death. Nurses have an important role in facilitating bereavement in acute care settings. Preparation for bereavement care begins before an individual has died and continues through to identifying the appropriate person to provide follow-up care. Those who are unexpectedly and suddenly bereaved should receive practical and considerate evidence-based care.

Why nurses need to understand the principles of bereavement theory.

This article considers the value of bereavement theory to nurses. The contexts in which nurses care for the bereaved are identified and the terms "bereavement", "grief"and "mourning" are defined. A selection of psychological and sociological bereavement theory and models are considered in relation to their value in nursing practice. The increasing richness of bereavement theory strengthens potential understanding of the process of grief. Critical and creative use of this theory can offer valuable guidance to nurses caring for the bereaved and can help promote confidence, thus enabling them to provide appropriate support.

Death and people with learning disabilities: empowering carers

SummaryThis study investigates the provision of loss and bereavement education to carers of people with learning disabilities within a small community home. The literature that informs this study reviews the history of care of people with learning disabilities, theories of education and theories of loss and bereavement. The research approach is a micro ethnographic one. It considers the results of an evaluation of an educational session based on 12 individual needs assessment interviews. Results show increased personal insight as a result of the educational session with carers being able to identify areas of change to care provision as an outcome. In conclusion, this study shows the place and value of a ‘small scale approach to training’ and promotes proactive care provision around loss and bereavement to people with learning disabilities.

Pathos, paradox, and poetics: Grounded theory and the experience of bereavement

Too often in the professional community, the clinician's personal experience with loss and grief is viewed through a negative lens as a counter‐transference that must be carefully monitored, rather than as a positive, integral, and invaluable asset in working with the dying and bereaved. This article proposes an approach to theory in bereavement and end‐of‐life care that integrates a focus on the lived experience of dying and bereaved clients with the clinician's reflective awareness of the meaning and impact of suffering and loss in his/her own life. Using an auto‐ethnographic approach, the author connects his personal narrative as both client and clinician with the cultural construction of bereavement theory and practice over the past several decades.

The meaning of being a Muslim: An aftermath of the twin towers episode

The bombing of the twin towers on September 11th, 2001, invoked public outcry. As the Americans have tried slowly to come to terms with the annihilation of one of the utmost symbols of their dominance, at the same time Muslims all over the world have had to face their own twin disaster. The destruction of their current understanding of what it means to be a Muslim and the need to grieve as human beings for the tragic loss of human life, for which they are by implication responsible. This research depicts the journey of five individuals who sought counselling in an effort to come to terms with these phenomena. Discourse analysis of their conversations highlights their struggle. A number of common themes emerge: loss (both of life and of the current meaning of Islam), confusion, a need to be different from the perpetuators and, for some, a need to reflect on other injustices committed in the name of Islam. These themes are considered in the light of the theory of psychosocial transitions and bereavement theory.

"Broken Idols": Mark Twain's Elegies for Susy and a Critique of Freudian Grief Theory

The tragic death of his daughter Susy became a crucial event of the final fourteen years of Mark Twain's life—as a parent, as an author, and as a public persona. I make this claim based on an analysis of recent theories of parental bereavement and "continuing bonds" with the dead put forth by researchers, such as Dennis Klass, Margaret S. Stroebe, Paul C. Rosenblatt, and Robert A. Neimeyer, who are providing the vanguard of contemporary opinion in grief theory. As Stroebe notes, "contemporary opinions tend to agree . . . that bonds [with the dead] can be continued without the detrimental effects that were originally claimed and that [continued bonds with the dead] play a role in . . . the 'resolution' of grief." As such, today's leading grief theorists focus on a constructivist model of bereavement, clearly eschewing much contained in the modernist theories of grief of the early and middle twentieth century (dominated by Freud), especially their tendency to label extended and grueling patterns of mourning as "pathological." In this essay I analyze Mark Twain's two elegies for Susy, "In Memoriam" (written 1897) and "Broken Idols" (written 1898), with the latest and most influential recent research on parental bereavement in mind. This essay also marks the first publication of the entire poem "Broken Idols."

Referrals for bereavement counselling in primary care: a qualitative study

The growth in the provision of counselling services in British primary care offers an opportunity for general practitioners (GPs) to refer patients to counsellors following bereavement. This study explores the factors that influence GPs referral decisions. Qualitative interviews were conducted with 50 GPs from two cities in southern UK. The study found that GPs draw on notions of abnormal bereavement in making referral decisions. Indicators of bereavement problems related to: the nature of the death; level of social support; and reaction to the death. GPs views about the types of patients likely to benefit from counselling were further criteria employed in referral decisions. The study indicated that consideration of these factors may discriminate against certain types of patients being referred. Further education in the range of psychological theories of bereavement may assist GPs in understanding their bereaved patients’ experiences and in developing their skills in recognising abnormal reactions and making appropriate referrals.

Attachment Theory, Loss and Trauma: A Case Study

This article discusses applications of attachment theory and theories of bereavement to the treatment of trauma with loss of the mother in young children. The article suggests guidelines that may be useful in clinical work with these difficult cases. Clinical application of the guidelines is illustrated by discussion of the therapeutic work with a 3-year-old boy who at the age of 21/2years survived an automobile accident in which his mother died.

Attachment Theory, Loss and Trauma: A Case Study

This article discusses applications of attachment theory and theories of bereavement to the treatment of trauma with loss of the mother in young children. The article suggests guidelines that may be useful in clinical work with these difficult cases. Clinical application of the guidelines is illustrated by discussion of the therapeutic work with a 3-year-old boy who at the age of 21/2years survived an automobile accident in which his mother died.

Introduction: New Directions in Bereavement Research and Theory

Introduction: New Directions in Bereavement Research and Theory

Bereavement Research and Theory: Retrospective and Prospective

Bereavement Research and Theory: Retrospective and Prospective

No such thing as 'uncomplicated bereavement' for patients in rehabilitation

Purpose : This review aims to: (1) discuss the reasons for the limited focus in the literature on the loss experiences of patients in rehabilitation; (2) highlight the importance of increasing our understanding of the loss reactions of these patients; and (3) offer suggestions for appropriate incorporation of bereavement issues into clinical practice and research. Method : The authors review articles and books from several disciplines to reveal and provide suggestions for overcoming limitations in application of current bereavement theory and practice with disabled populations. Results : The paper identifies problems with the descriptive and diagnostic 'language' of bereavement, a lack of empirical support for popular theory and assumptions about the grieving process and bereaved persons, disagreement among bereavement and rehabilitation clinicians on most appropriate interventions for facilitating adjustment, and compelling reasons to focus on bereavement issues with the disabled patient. Conclusions : The review reveals the need to clarify loss issues and terminology, develop appropriate measures of the loss experiences of patients with disability, identify variables affecting the process and outcome of grieving in this population, develop guiding theory and select interventions that meet the needs of these patients.

Examining the Delayed Grief Hypothesis Across 5 Years of Bereavement

Traditional bereavement theories emphasize that it is crucial to work through the emotional meanings of a loss and that the failure to do so typically results in delayed grief symptoms. This article reports data examining these assumptions prospectively across the first 5 years of bereavement. Based on previous validity data, elevated symptoms were defined in terms of 6-month median scores for each measure. Delayed elevations were observed on isolated measures for 3 (7%) participants. However, these elevations were more parsimoniously explained by random measurement error. Furthermore, when a weighted grief-depression composite score was used to maximize the probability of capturing the true (latent) grief variable, not a single case of delayed symptom elevations was observed. Finally, data on emotional processing of the loss at 6 months failed to support the traditional assumption that minimal emotional processing of the loss would lead to delayed grief.

Loss and Meaning

People who have lost a loved one often try to make some meaning of their loss. The authors explore the ways people try to make meaning of loss, the factors that predict difficulty in making meaning, and the emotional outcomes of finding meaning. They also contrast the process of finding meaning with finding some benefit in the loss, even if meaning cannot be found. Our discussion centers on a study of 205 bereaved people who were interviewed before their loss and 1, 6, 13, and 18 months after their loss. The authors draw conclusions from this work not only for bereavement theories but also for general theories of adjustment in social and personality psychology.

The crucial importance of empirical evidence in the development of bereavement theory: Reply to Archer (2001).

In his commentary, J. Archer (2001a) argued that G. A. Bonanno and S. Kaltman's (1999) review and integration of the bereavement literature failed to consider evolutionary theory or other approaches to the origins of grief. Archer also argued that Bonanno and Kaltman had merely replaced the traditional grief work perspective with cognitive restructuring, thereby ignoring the processes related to avoidance and distancing from the loss. In this reply, the author first explains that although it was compelling to do so, Bonanno and Kaltman did not emphasize an evolutionary approach to the origins of grief reactions because in their current form these theories lack empirical and theoretical clarity. Second, the author shows that, contrary to Archer's reading, Bonanno and Kaltman's article viewed cognitive restructuring as a mechanism used primarily by extremely grieved persons and only in some cognitive domains. Last, the author shows that Bonanno and Kaltman have championed rather than ignored avoidant or distancing processes.

The crucial importance of empirical evidence in the development of bereavement theory: Reply to Archer (2001).

The crucial importance of empirical evidence in the development of bereavement theory: Reply to Archer (2001).

Narrating Bereavement: Thematic and Grammatical Predictors of Adjustment to Loss

Traditional bereavement theories advocate thinking and talking about painful loss-related experiences. This study examined bereavement narratives of 44 individuals as predictors of adjustment over time. Narratives were solicited 6 months postloss, in a semistructured, 6-min interview. Bereaved individuals who more often recounted negative thoughts and feelings and referred to themselves in diminished agentive roles suffered more persistent grief-related symptoms 2-year postloss, as indicated by self-report and clinician ratings. Diminished self-agency predicted outcome beyond negative content. Additionally, readers presented with transcripts of the narratives reported feeling more inclined to avoid and less inclined to comfort individuals whose narratives more frequently manifest such negativity and agentive structuring. Discussion emphasizes the importance of analyzing grammatical structuring of distressed persons' narratives to illuminate the construction of debilitating identities and world views, the potential of others' evaluations of narrative to illuminate relevant interpersonal dynamics, and possible strategies for intervention.

A synthesis of psychological interventions for the bereaved

Several interventions have been implemented to address the adverse psychological and physical consequences associated with bereavement. In this review, we summarize four major theories of bereavement, present a qualitative review of bereavement intervention studies, and assess the overall effectiveness of bereavement intervention studies in a quantitative meta-analysis. Summaries of the theories are drawn from published theoretical works. The qualitative and quantitative reviews were based on searches of Medline, PsychINFO, and Dissertation Abstracts International databases using the keywords “bereaved” and “bereavement.” Overall, the interventions were largely methodologically flawed, rarely specified what theory of bereavement they were testing, and showed surprisingly weak effect sizes. Possible interpretations for the small effect sizes are discussed, and future directions are outlined.