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This article is based on personal experience, an experience of grief and now, years later, an understanding of its transformative power in one's life. It is a true story and began some 25 years ago. As those who have gone through grief themselves know, it never ceases, it only changes, moves through its own cycles and permeates one's life. It almost has a life of its own within one's daily tasks. Eventually, grief can become a subtle and profound force in the act of living that is no longer felt as loss but as gain. In this story, I wish to present the idea that the relationship between the grieved and the person who has died continues to evolve and grow after the death process.     

Do Patients With Psychosis Experience Loss and Grief As a Result of Their Illness?

BACKGROUND: Depression and suicidality are frequently reported in patients with psychosis and schizophrenia, but the grief process that may be associated with this illness has not been systematically studied. In this study, we examined whether patients diagnosed with psychosis identify, grieve, and mourn losses engendered by the illness. METHOD: 24 patients diagnosed with psychosis in the past five years were surveyed to indicate whether their illness led to losses, and to describe their responses to the losses. Psychosis-related perceived losses were surveyed using three subscales of a loss and grief questionnaire (loss of self, self-care, and roles). Their relationship with beliefs about the illness, symptomatology, coping style, and self-efficacy and insight was studied. RESULTS: 23 (96%) patients named specific losses, and 16 patients (67%) reported feelings associated with grief and mourning. More than half reported loss of self-esteem at the onset of illness and only half saw themselves as having improved in the past month. Patients reported more loss within the past month than at the onset of illness. In the past month, patients with an intact sense of self experienced greater self-efficacy (r = .568, p < .004) while those with loss of self reported feelings of shame (r = ?.582, p < .003). Only patients with insight associated the onset of illness with loss. In the past month, most patients saw themselves as experiencing loss. DISCUSSION: The study results suggest that at some distance from diagnosis, patients still experience themselves as having much loss due to their illness. These unresolved feelings may indicate complicated mourning. Insight appears to be associated with the ability to look back at the onset of the illness and recognize that it engendered losses. Further study of the process of and barriers to grief and mourning is recommended. In clinical practice, the assessment of grief as a part of post-psychotic recovery could lead to providing more appropriate treatment and lead to a positive outcome.     

Beyond Broken Bonds and Broken Hearts: The Bonding of Theories of Attachment and Grief

Attachment theory describes the establishment and long-term impact of infants' early relationships. Theories of grief and mourning have acknowledged that the disruption of attachment bonds is loss and grief, but the attachment literature shows little development toward a conceptual linkage with these theories. The connection is important given the current discussion of whether bonds with the deceased are broken or continued. The purpose of this article is to link the strengths of each perspective to inform us about the process of grief as mourners work through the reconstruction of their relationships. It presents a developmental model integrating attachment theory and cognitive developmental approaches in order to further our understanding of the processes involved in loss and grief.     

Ongoing: On grief’s open-ended rehearsal

Peter Goldie’s account of grief as a narrative process that unfolds over time allow us to address the structure of self-understanding in the experience of loss. Taking up the Goldie’s idea that narrativity plays a crucial role in grief, I will argue that the experience of desynchronization and an altered relation to language disrupt even of our ability to compose narratives and to think narratively. Further, I will argue that Goldie’s account of grief as a narratively structured process focus on the process having come to an end. By contrast, I will propose the idea that grief can be understood as an open-ended rehearsal of our capacity to be alone in the company of an absent other. This makes grief a relational activity that differs from composing narratives about one’s past and about one’s process of grieving. Thus, grief is not primarily a process of recollecting our past narratively; rather, it can be seen as a dedicational activity which involves a future-oriented and open-ended rehearsal of relatedness despite irrevocable absence.     

The Clergy,the Clinician,and the Narrative of Violent Death

When death of a loved one occurs, humans use stories as a way of processing their grief and releasing their emotional attachment. In the case of traumatic and violent death, the story telling process is distorted, and focuses intensely and sometimes obsessively, on a often fantasized reenactment of the dying. Violent dying grief is often complicated further by the public and legal processes that surround violent death. The bereaved who get stuck in this dynamic may constitute a new psychiatric diagnosis called “prolonged grief disorder” and the author describes the criteria for this disorder. Clergy can play a key role in stabilizing and meditating the effects of trauma by inviting the bereaved to refocus their story telling, to a story of the loved one’s life. In a case the author illustrates many of the techniques used in this process of working with a prolonged grief disorder.     

“We Hardly Ever Talk about It”: Emotional Responsive Attunement in Couples after a Child's Death

Within Western cultural traditions, the idea that parents should talk about the death of their child with each other is deeply rooted. However, across bereaved parent couples there are wide variations in communication about their grief with each other. In this study, we explored the experiences of bereaved couples related to the process of talking and not talking. We used a thematic coding approach to analyze 20 interviews with 26 bereaved parents (11 interviewed as couples, four as individuals). Four main meanings emerged out of our analysis: not talking because of the inadequacy and pointlessness of words in grief, not talking as a way to regulate emotions in daily life, not talking as an expression of a personal, intimate process, and not talking because the partner has the same loss but a different grief process. In addition, we found that the process of talking and not talking can partly be understood as an emotional responsive process on an intrapersonal and interpersonal level. In this process partners search for a bearable distance from their own grief and their partner's, and attune with their relational context. A better understanding of this process is sought in a dialectical approach, emphasizing the value of both talking and not talking in a tense relationship with each other. Implications for clinical work are described.     

Observing a client's grieving process: bringing logical positivism into qualitative grief counselling research

This positional paper originates from our need as researcher/practitioners to establish a meaningful epistemological framework for research into bereaved people's journey through loss and grief over time. We describe how the field of grief research has a long and established biological basis, in keeping with a positivist epistemology. However, there has been a diminution of the influence of logical positivism in twenty-first-century counselling research. We argue that in grief counselling research, naturalistic observation of the grieving process within a logical positivist paradigm, remains a valid and valuable construct. We posit an observational protocol for the grief counselling process which minimises the intrusion of research method into the therapeutic process. We offer this as a means of conducting qualitative research within a bereavement counselling service. Further, we suggest that the development of an observational protocol for a client's grieving process has potential implications for developing good practice in grief work.     

“Partial Deaths”: A Buried Resource

This article addresses the reluctance that many professional counselors and other caregivers feel when faced with the task of working with dying patients or others facing losses and grief. Although working with the dying is not an easy task, many caregivers inappropriately label themselves unqualified. They tend to play down the variety of losses they themselves have experienced. These caregivers can get in touch with their own encounters with grief and loss and benefit personally and professionally by exploring these partial deaths.     

Mental ghosts and the process of grief

Abstract

Grieving the death of a loved one is an experience that many people will face at least once in their lifetime, but the lack of widely accepted guidelines as to what constitutes “normal” grieving results in mourning being a common experience with little universality. Memories may keep the deceased alive in the minds of the survivor and may even interfere with the formation of new relationships. This article considers the process of grieving the loss of a spouse and some of the individual factors, such as age, sex, and personal beliefs, that may account for variability in grief experiences. While several modeh detailing the grief process are discussed, the inappropriateness of establishing expectations for the nature and duration of grief is argued for.     

Conceptualizing an HIV Diagnosis Through a Model of Grief and Bereavement

For people living with HIV/AIDS, grief and bereavement typically refer to the loss of life felt in the HIV community. However, changes in HIV treatments allow care providers to view HIV grief in a way that considers physical, social, and emotional loss, as well as a loss of the life they had previously pictured for themselves. Kübler‐Ross's ( 1969 ) model of bereavement is presented as a way to conceptualize clients living with HIV who are dealing with grief and bereavement. In addition, popular bereavement counseling approaches relevant to clients with HIV are discussed, and a case illustration is provided.     

Broad and narrow perspectives in grief theory: comment on Bonanno and Kaltman (1999).

G. A. Bonanno and S. Kaltman's (1999) concentration on the grief work hypothesis in their review of perspectives on bereavement is only 1 aspect required for a comprehensive theory of grief, which should cover the following: the origin and adaptive significance of grief; the mechanism that initiates the grief response; the mechanism that leads to the resolution of grief; and sources of individual variation. Bonanno and Kaltman's replacement for grief work also emphasized cognitive restructuring, which can be contrasted with 2 alternative mechanisms, forgetting and engaging in new activities and relationships. M. S. Stroebe and H. A. W. Schut's (1994) dual process model, which involves cognitive restructuring and engaging in new activities, provides a broader alternative to grief work than that advocated by Bonanno and Kaltman.     

Goodbye,Daddy: An Autoethnographic Journey Through the Grief and Mourning Process

The purpose of this article is to present an autoethonographic study in how I experienced and communicated parts of the mourning process when my father died at the age of 73. The article highlights the stages of grief experienced during the first year. Autoethnographic means are used chronologically to explore how the loss of a family member impacts the stages of grief that are present and how they overlap. In particular, I highlight the events that carried meaning or provided an outlet to express one of the stages of grief. It is hoped that this article can be used to understand why grieving is not an overnight process, but rather is drawn out through the highs and lows of remembering a loved one.     

Neither Bereavement nor Grief: Coping with the Death of a Cherished Person in the Cunda-sutta

Though bereavement and grief have been common human experience throughout recorded history, how bereavement is viewed and grief coped with varies from one philosophical tradition to another. By examining features running throughout the Cunda-sutta, this paper demonstrates a shift from the ordinary conception of bereavement to an insightful understanding of not-bereavement. If one possesses insight into how worldly convention shapes ordinary conceptions of bereavement, then one need not associate bereavement with loss and grief. For ordinary people, grief may be regarded as a natural response to loss. However, in light of the emptiness of bereavement, the emphasis can be shifted from coping with grief to the understanding of not-grief and to the cultivation of mental abilities conducive to moving forward on the right path. By examining the reasoning of neither bereavement nor grief, this paper sheds new light on a rarely acknowledged perspective on coping with the death of a cherished person.     

On the Reclaiming of Denied Affects in Family therapy

A central developmental task of the family is to help its members develop the capacity to cope with the grief attendant on separation and loss. In order to work through such feelings, each member must first be able to acknowledge the affect as present, internal, and belonging to the self. Depending on the degree of intrapsychic differentiation, and the dread of abandonment, family members may seek to avoid awareness of such feelings within themselves. The disclaimed emotions remain powerful unconscious motivators of behavior, exerting their influence despite their denial. Some typical clinical illustrations of this are provided. Excerpts from conjoint family therapy are then presented to illustrate the therapeutic interventions made in assisting a family to acknowledge denied grief over the separation of one of its members along with unspoken tender feelings within the family. This paper affirms the continued relevance of a psychodynamic, interpretative approach for families struggling with unresolved grief.     

The Role of Avoidance in Complicated Grief: A Detailed Examination of the Grief-Related Avoidance Questionnaire (GRAQ) in a Large Sample of Individuals with Complicated Grief

Grief-related avoidance is a significant component of complicated grief, yet has rarely been formally measured in a validated fashion. Further, more work is needed to understand the impact of grief-related avoidance on symptom severity and functional impairment among individuals with complicated grief (CG). The Grief-Related Avoidance Questionnaire (GRAQ; Shear, Monk et al. 2007) was created to assess grief-related avoidance and the present analysis aimed to further develop this measure and construct by confirming the GRAQ’s psychometric properties and examining loss-related predictors of avoidance. In a sample of 393 adults with CG, we found the GRAQ had high internal consistency, with a Cronbach’s alpha of 0.89 and good convergent validity. While the EFA results suggest that the GRAQ may be unidimensional, a 3-factor model generally corresponded with the findings by (Shear, Monk et al. 2007), which suggested the presence of 3 subscales. Loss-related variables age, relationship to the deceased, and cause of death were all significant predictors of GRAQ scores. Our findings support that among individuals with complicated grief, avoidance is common, measurable and an important contributor to impairment.     

Grief's Rationality,Backward and Forward

Grief is our emotional response to the deaths of intimates, and so like many other emotional conditions, it can be appraised in terms of its rationality. A philosophical account of grief's rationality should satisfy a contingency constraint, wherein grief is neither intrinsically rational nor intrinsically irrational. Here I provide an account of grief and its rationality that satisfies this constraint, while also being faithful to the phenomenology of grief experience. I begin by arguing against the best known account of grief's rationality, Gustafson's strategic or forward‐looking account, according to which the practical rationality of grief depends on the internal coherence of the component attitudes that explain the behaviors caused by grief, and more exactly, on how these attitudes enable the individual to realize states of affairs that she desires. While I do not deny that episodes of grief can be appraised in terms of their strategic rationality, I deny that strategic rationality is the essential or fundamental basis on which grief's rationality should be appraised. In contrast, the heart of grief's rationality is backward‐looking. That is, what primarily makes an episode of grief rational qua grief is the fittingness of the attitudes individuals take toward the experience of a lost relationship, attitudes which in turn generate the desires and behaviors that constitute bereavement. Grief thus derives its essential rationality from the objects it responds to, not from the attitudes causally downstream from that response, and is necessarily irrational when the behaviors that constitute an individual's grieving are inappropriate to the object of that grief. So while the strategic rationality of an episode of grief contributes to whether it is on the whole rational, no episode of grief can be rational unless the actions that constitute grieving accurately gauge the change in a person's normative situation wrought by the loss of her relationship with the deceased.     

Family Bereavement and Cultural Diversity: A Social Developmental Perspective

This article offers an integrative, interdisciplinary model of bereavement as a family developmental process that unfolds in cultural context. A critique of cultural assumptions highlights the culture-bound nature of prevailing North American practices, which view grief as an isolated individual experience and emphasize detachment from the dead as a way to promote recovery. Death and grief precipitate two kinds of family change, both guided by culture yet uniquely experienced and interpreted by individual families: 1) recreating the family without a key family member; but capable of coping with both existing and new tasks; and 2) incorporating the death into an ongoing but irrevocably altered family life-cycle developmental process. In supporting family change after a death, family therapists need to collaborate with grieving families in examining the goodness of fit between their unique circumstances and the bereavement expectations of their community and culture. Four case examples are presented, two of which will apply this social developmental model to emphasize transformations of attachment to the deceased — rather than detachment — that will support the ongoing family development of grieving families.     

Grief as a Transcendent Function and Teacher of Spiritual Growth

Death is an inevitable phase of life, so is grief. This paper attempts to pinpoint the enormous potential of grief in advancing our spiritual growth. Jung states that when encountering a crisis such as loss, the unconscious often breaks through to help us with new adjustments, whereby a transcendent function takes place (Jung, 1971). Instead of becoming an emotional trauma, grief can transcend our everyday experiences and awaken us to our spiritual essence.