Group Facilitation of the Grieving Process With Those Bereaved by Suicide

People bereaved by suicide receive less sympathy and support from society than do those bereaved by other causes. By using Yalom's curative factors, Parkes's stages of grief, and Worden's tasks of grief resolution, a structured group model can be constructed to facilitate movement through the grieving process of participants bereaved by suicide.     

A short-term grief and loss therapy group: Group members' experiences

Abstract

This article is an evaluative study of a short-term grief and loss therapy group conducted at a large Midwestern university's counseling center. The group was held for students who had experienced loss through death of a significant person. The author examines brief group psychotherapy, special considerations of the college student's grief experience, an adaptation of the brief group model for grieving students, and data gathered from the members of the therapy group. Students' scores on a grief instrument showed mixed results. Group members made journal entries at four times during the group experience. They reported that the group was a supportive and helpful experience; five of Yalom's (1995) eleven therapeutic factors could be discerned. Recommendations regarding the treatment of grieving students in a group setting are made.     

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.     

Pastoral Theological Reflection on Grief: Contemporary Theory and the Practice of Ministry by Melissa Kelley

This article highlights four of Melissa Kelley’s contributions in her book Grief: Contemporary Theory and Practice. The author identifies these as: 1) Kelley’s capacity to distill and synthesize the most important areas of contemporary grief theory; 2) her work on attachment theory and its relationship to people’s ways of coping with grief; 3) the focus on the research of Bonanno et al. (Journal of Gerontology Series B: Psychological Sciences and Social Sciences 60:67–73, 2005) and showing us who is most vulnerable and in need of pastoral care during grief; 4) her emphasis on meaning making as the core of the grieving process. The article also lifts up questions concerning communal practices for grieving loss born of injustice and the need for prevention and fostering coping mechanisms so that the worst effects of grief might be mitigated.     

Can parental responses to adult children with schizophrenia be conceptualized in terms of loss and grief? A case study analysis

It has been suggested that parental responses to adult children with schizophrenia may involve feelings of loss and grief, centred around loss of the pre-morbid version of their child. In this exploratory study, an in-depth case study analysis of four parental accounts of their responses was undertaken in order to obtain insights into whether these responses can be conceptualized in terms of loss and grief, with the aim of informing therapeutic practice with parents in this position. Information was also obtained on how parents coped with the reactions that their child's condition elicited in them. Data were analysed using Interpretative Phenomenological Analysis. In relation to the central research question, it was found that the perception of loss was not uniform amongst participants. Three acknowledged a sense of loss, at least to some extent, but one parent resisted such an interpretation because she perceived a continuity over time in her son's behaviour and she also challenged her son's diagnosis. One parent acknowledged a loss of his daughter's pre-morbid self but qualified this by pointing to her continued physical presence. The usefulness of existing models of grief is examined in light of the findings. The implications for the practice of counselling psychology are discussed.     

The Effectiveness of Mindfulness Training on the Grieving Process and Emotional Well-Being of Chronic Pain Patients

Losses in relationships, work, and other areas of life often accompany the physical discomfort of chronic pain. Often the depth and intensity of the grief associated with chronic pain are overlooked or possibly misdiagnosed and treated as depression. We used an 8-week mindfulness meditation program to determine its effectiveness in addressing the grieving process among 39 patients diagnosed with chronic pain. Eighteen patients volunteered to be in a comparison group. The study was conducted in a regional hospital's pain clinic and patients completed the Response to Loss Scale (measuring grief), the Beck Depression Inventory, and the State Trait Anxiety Inventory. Results indicated that the treatment group advanced significantly more quickly through the initial stages of grieving than the comparison group. In addition, the treatment group demonstrated significant reductions in depression and state anxiety, but no significant differences emerged when comparing groups on the final stages of grieving or trait anxiety.     

The Myth of Closure

Therapies for grief and loss have traditionally focused on the work of grieving. The goal was to reach an endpoint, now popularly called closure. There are, however, many people who, through no fault of their own, find a loss so unclear that there can be no end to grief. They have not failed in the work of grieving, but rather have suffered ambiguous loss, a type of loss that is inherently open ended. Instead of closure, the therapeutic goal is to help people find meaning despite the lack of definitive information and finality. Hope lies in increasing a family's tolerance for ambiguity, but first, professionals must increase their own comfort with unanswered questions. In this article, the authors, one a poet, the other a family therapist and theorist, offer a unique blending of theory, reflection, and poetry to experientially deepen the process of self‐reflection about a kind of loss that defies closure.     

Review of <Emphasis Type="Italic">Principles and Practice of Grief Counseling</Emphasis> by Darcy L. Harris and Howard R. Winokuer

This is an extended book review of the second edition of the book by Harris and Winokuer (2016). They describe what is currently known about grief counseling, bringing us up to date about the latest research and what has been successful in working with clients. They seamlessly fit the theoretical foundation of grief counseling with its practice and process. This helps the reader to understand the relationship between grief counseling and other kinds of counseling. The book includes chapters that help counselors reflect on the quality of their own work. The book’s style is easy to read and filled with examples, yet also a resource for further study. It does not have explicit references for grief counseling in religious settings, though its principles are applicable to religious settings. Moreover, the book provides a social-historical context of grief counseling, helping the reader understand how far the science has advanced since the 1960s. This resource is valuable for pastoral counselors, care-givers, and others that minister to people in grieving situations.     

Acknowledging the Archetypal Elements of Grief

The universality of grief as a soul-aching experience within the human condition is evident in even the oldest recorded stories and myths around the world. Theories and scientific studies in the past few decades have attempted to understand the phenomenon of grief, forming a significant body of research and a myriad of ideas and guidelines for the grieving process. Acknowledgment and appreciation of the archetypal elements of grief broadens our understanding of the painful emotions that arise as part of a natural reaction in the aftermath of loss and can assist helping professionals to make wise choices for therapeutic interventions in clinical practice.     

Researching Grief: Cultural,Relational, and Individual Possibilities

This review of the author’s writings on grief focuses on cross-cultural research, research with 19th-century diaries, and qualitative interview studies of couples and families. The cross-cultural studies show that there are strong cultural differences in how people grieve. The diary data show that some people cycle into and out of intense grieving, even for years after a death, and the cycling is governed partly by what they do to control emotions and what they encounter that reminds them of their loss. The interview studies make clear that grieving is, for many people, relational, so looking only at individual grieving we miss much of the relational dynamics that are central to the experience of grieving for many people.     

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.     

Dreaming and bereavement

Bereavement dreams provide an important, though seldom mentioned or recognized, component of the grief process. As the unconscious presses for recognition of the pain and extent of the loss, dream material is presented to help the bereft move to a new and integrative life position. Religious symbols present themselves to give the grieving a new sense of themselves as individuals and an expanding view of the world. Grief therapists have generally ignored this important component of the grief process, and as a result, little significant clinical research has been done. A comprehensive picture of bereavement will not be developed until increased attention is given to this important area.     

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.     

Fracturing drive or fracturing connections—relational considerations commentary on paper by Paul Williams

We tend to conceive of mourning primarily in intrapsychic terms. In this commentary I highlight how Harvey Peskin’s paper (this issue) helps us to appreciate that grief is not only the product of the individual mind but is also constituted relationally. Both what we experience in our grieving and how we express it is shaped by and through those around us whose grief we bear witness to, as we ourselves grieve and are witnessed by them.

I elaborate further on Peskin’s view of the role of witnessing during grieving and mine another profound implication in his discourse by pointing to the bidirectional influence between mourning and relationality. Not only is mourning fostered through relational engagement, but our grieving together can provide the mortar for the building and sustaining of community.     

“Making things better”: Personal construct counselling for young children

A personal construct counselling approach that we are using with young children is presented here, an approach based on the construct of “wellness”, a medium to promote the well-being of troubled children and their families. The case study we share with you shows a counselling intervention based on play, with experiments drawn from self-related construct systems of “making things better” rather than construct systems of “fixing things up”. We present a case study of a young girl grieving over the death of her father. Emphasis is placed on the relationship of trust between the child and the counsellor, to encourage experimentation with relationship experiences to help the child to reconstrue events outside the counselling context. Working hypotheses drawn from cognitive and emotional developmental research into young children are provided, and the subsequent investigations which guide our intervention. Suggestions for process and outcome research in this area are finally made.     

Grief counselling in context: Multiple roles and professional compromise

The issues involved in the use of counselling skills and approaches by members of professions such as nursing and social work have received relatively little research attention. Grief counselling represents an appropriate area in which to explore these issues, since members of many diverse professional groups may be called on to work therapeutically or supportively with the bereaved. This paper explores the use of grief counselling in a variety of professional and voluntary contexts, through an analysis of the experience of students who had undertaken a bereavement counselling course. The aim of the study was to explore the level of awareness shown by employing organisations to the 'loss' element of client experience, and the implications of organisational context for the role of counsellor as a worker responding to client grief. A range of practice characteristics emerged. At one end of the spectrum was clearly focused and contracted grief counselling, usually within the context of specialist voluntary agencies. By contrast, there were practitioners whose counselling response to grief was concealed within a multi-professional perspective characterised by compromise, usually working in complex organisational contexts in the statutory sector. It is argued that the range of practitioner activity cannot be understood simply by describing some activities as counselling and others as the use of counselling skills; it seems that there is a real and sometimes subtle middle ground which lies between the two. This is territory which is determined by the context of practice and needs to be understood and defined as such     

Working with differences: Issues for research and counselling practice

This paper considers our experience within a group researching domestic violence in minoritised groups and the implications for counselling practice. Issues of race, gender and power were significant within the research team. These issues are intrinsic to minoritised women's experiences of service responses and are also a powerful, yet often unexplored, dynamic in counselling practice. We reflect on issues of ‘outsiders’ and ‘insiders’ in terms of the research process and findings, and the impact and influence of these power roles on counselling practice. We acknowledge that it is only by retrospectively engaging with each other and our differences that we have been able to explore our parallel processes and consider their implications for counselling practice.     

Use of Bibliotherapy in the Treatment of Grief and Loss: A Guide to Current Counseling Practices

Grief is a complex and dynamic process influencing individuals of all ages. This article provides an overview of historical and contemporary constructs of grief counseling. Bibliotherapy, a creative counseling tool, is presented as an appropriate intervention when counseling grieving clients. Guidelines for using bibliotherapy with grieving clients are considered.     

Adapting Strauss and Corbin's grounded theory in clinical case study research in the field of counselling

Case study can be adopted when aiming to understand an individual's lived experience. Such experience produces rich and complex qualitative data for analysis, conducive to counselling and psychotherapy research. Furthermore, grounded theory (GT) can be adopted to produce a theory from qualitative data, fitting well with case study research that explores complex experiences regarding social, psychological and phenomenological processes. This paper aims to guide the counselling researcher to incorporate Strauss and Corbin's model into the main arena of qualitative counselling research. In addition, this paper draws on a multiple case study that adopted Strauss and Corbin's method and identified various phases in the GT process. The aim is to inform the reader how to put the iterative process and pragmatic theoretical sampling into practice to produce a robust theory from clinical case study data.     

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.