A Thematic Analysis of Men's Experience With a Partner's Elective Abortion

Research concerning men's experience with a partner's abortion is limited. To foster understanding of this topic, the authors used online surveys to gather data from men whose partners underwent induced abortion. A thematic analysis of men's comments about their experience revealed 3 salient themes: loss and grief, helplessness and/or victimization, and spiritual healing. Findings are discussed in terms of future research and counseling practices as they relate to pregnancy outcome decisions.     

Emotional response to abortion: a critical review of the literature

Anti-abortion groups in the US cite the existence of a post-abortion syndrome--a sense of loss, emptiness, and grief similar to that reported by trauma survivors. Although research on the longterm effects of induced abortion is marred by methodological errors, most studies have found no adverse psychological sequelae; rather, there appears to be a sense of relief and opportunity for personal growth. Nevertheless, there is a small group of women who do experience emotional distress after abortion and it is important to identify the demographic, social, and psychological factors that place women at risk of such a reaction. In terms of demographic factors, young age (adolescence), low or nulliparity, 2nd-trimester procedures, and Catholicism have been characteristics of women who suffered post-abortion depression. Of the social variables that have been examined, a lack of support from significant others (parents or partner) has been linked in some studies to emotional distress after abortion. A relatively consistent finding is that women who feel coerced to abort or are ambivalent about their decision at the time of the procedure are most likely to experience regret, depression, and anger. Women whose coping style involves avoiding responsibility are also prone to post-abortion distress. As noted, the literature does not support the contention that abortion causes longterm trauma. On the other hand, given the fact that 1.5 million abortions take place each year in the US, the existence of some post-abortion distress in even as small percentage of acceptors is enough to indicate a need for pre- and post-abortion counseling to help women determine the meaning of the experience and own their decisions.     

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.     

They that mourn

Summary Grief is a universal phenomenon. It most notably occurs following a loss by death, but may occur following any separation. It is a definite psychiatric syndrome with a characteristic onset, course, duration, and termination. The normal period of acute grief is from six to twelve weeks, and the normal grief reaction is completed within two years. The process by which the bereaved comes to accept the separation from the loved one and to readjust to the environment in which the deceased is missing is called the grief work. The more actively one engages in the grief work, the shorter the period of grief. The physican and the minister should help the bereaved to engage actively in the grief work; the principles of doing this are presented.     

Suicide,Loss, and Mourning

ABSTRACT: The intensive treatment of six suicidal patients has been used to explore the relationships among object loss, the mourning process, and suicide. These relationships may be condensed in two propositions: (a) suicidal behavior stems from an arrested grief reaction in which the subject is unable to complete the process of mourning for a lost object; and (b) the suicide's pathological loss reaction is brought about by developmental defects, primarily deficiencies in self-love and individuation. The suicidal subject's mournïng reaction is arrested in one or more of the first three stages of grief: shock, protest, or detachment from the lost object.     

Behavioural approaches to bereavement

Persons who get “hung up” in an unresolved grief reaction appear to be similar in many ways to those who develop phobias. As behaviour therapy approaches to phobias have been highly successful, similar tactics have been tried out with persons involved in pathological grief, with gratifying success. The characteristics of grief reactions are briefly described, as is Eysenck's theory on the development and maintenance of phobias. This theory is applied to explain how and why some people develop pathological grief reactions. A modified flooding technique of confrontation with pain-evoking stimuli is described and some results are presented. The psychoanalytic literature gives indications as to what kinds of emotional reactions the therapist can expect.     

Addressing the Chronic Sorrow of Long‐Term Spousal Caregivers: A Primer for Counselors

Chronic sorrow is described as a distinct grief reaction that occurs when loss is not final but continues to be present in the life of the griever. It is characteristic of a growing number of older individuals who are providing long‐term care at home for a spouse or primary partner with progressive disability. The unique presentations of grief, depression, and anxiety associated with the chronic sorrow of long‐term spousal caregivers require specialized counseling approaches.     

THE SURVIVING SIBLING: THE EFFECTS OF SIBLING DEATH IN CHILDHOOD

This paper considers the case of childhood mourning in which there is an increased possibility of a pathological grief reaction, due to an incapacity to sustain mourning and an inability to comprehend death. The death of a sibling in childhood is a complex loss to manage, the outcome of which is inextricably linked with parental grief. Maladaptive parental mourning processes, including the phenomenon of the ‘replacement child’, are explored. The effects of this loss on the surviving sibling can give rise to a variety of symptoms that may impair emotional development. Amongst the main responses experienced by the surviving sibling is that of a guilt reaction, not only for having survived when the sibling did not, but also a fear that harboured death wishes may have caused the tragedy. Premature death anxiety and distorted concepts of illness are further possible outcomes of this event. It is suggested that the primary deprivation a child may experience when their sibling dies is the emotional absence of their parents who are preoccupied with their own grief.     

Cognitive behavioral grief therapy

From a REBT perspective, loss through death is viewed as an intense negative and traumatic Activating event which effects the Belief system and related emotional and behavioral Consequences. Grief, then, is seen as a normal reaction and the process that follows is a necessary one characterized by the bereaved attempting to reorganize a shattered belief system. In the present paper a distinction between functional and dysfunctional grief is made. Based on Ellis' differentiation between iB's and RB's, typical irrational grief-related beliefs are identified (with specific focus on pain related ones). Various REBT interventions aimed at facilitating a more functional, healthier course of grief are suggested.     

A study of abortion and problems in decision-making

This paper is directed to those individuals who are sufficiently disturbed by the complex realities of problem pregnancies and who are prepared to think beyond the confines of ideology. Rigid ideological positions tend to create distance from the hard complexities surrounding concrete human situations and to limit the realities of pain and helplessness that may exist for each of the parties to an unwanted pregnancy. Pregnancy is more than a biological condition or an isolated emotional entity giving rise to joy or grief. Pregnancy introduces a new relational component to an already existing relational network, and, conversely, abortion is neither simply the evacuation of the products of conception nor an endpoint to emotional stress. It is, in actuality, a broken relationship. In the clinical experience of these authors a sense of sadness frequently accompanies a woman's choice to undergo an abortion. Some problem pregnancy counselors maintain that they have never known a woman who terminated pregnancy without sadness. This information reinforces these authors' observations that facing a decision to have an abortion is not easy, often stressful, and an occasion when a woman should feel entitled to obtain the help of her total relationship system in arriving at a decision. The decision to continue or to terminate a problem pregnancy is rooted in a complex network of relationship factors that have an effect on the decision-making process. Repeated occurrences of unwanted pregnancies in the family are more than individual and disconnected events. Relational strategies that effect decision-making in problem pregnancies are effective in the hands of helping agents who value conjoint, intergenerational reciprocity as a therapeutic paradigm.     

Impact of current grief on memory for past grief in spousal bereavement

This study examined the impact of changes in level of current grief over time on changes in memory for past grief. Following from previous work on the impact of current affective state on memory for past affectively salient events, bereaved individuals who underwent a greater reduction in grief over time were expected to show a similar pattern of changes in memory for past grief. A sample of conjugally bereaved participants completed measures of current grief and memory for past grief at the time of the loss of their spouse at each of the 2, 6, 13, and 30 month post-loss time periods. As predicted, those who reported greater reduction in grief over the course of the study were more likely to remember their past grief as progressively less severe relative to those who underwent less reduction in grief over time. A nonrecursive causal model analysis verified that changes in memory for past grief were explained by changes in current grief. These results were discussed in terms of contemporary reconstructive memory accounts of the effect of affective state on memory.     

Impact of current grief on memory for past grief in spousal bereavement

This study examined the impact of changes in level of current grief over time on changes in memory for past grief. Following from previous work on the impact of current affective state on memory for past affectively salient events, bereaved individuals who underwent a greater reduction in grief over time were expected to show a similar pattern of changes in memory for past grief. A sample of conjugally bereaved participants completed measures of current grief and memory for past grief at the time of the loss of their spouse at each of the 2, 6, 13, and 30 month post-loss time periods. As predicted, those who reported greater reduction in grief over the course of the study were more likely to remember their past grief as progressively less severe relative to those who underwent less reduction in grief over time. A nonrecursive causal model analysis verified that changes in memory for past grief were explained by changes in current grief. These results were discussed in terms of contemporary reconstructive memory accounts of the effect of affective state on memory.     

Cross-Lagged Analyses of Prolonged Grief and Depression Symptoms With Insomnia Symptoms

Prolonged grief disorder, characterized by severe, persistent and disabling grief, has recently been added to the DSM-5-TR and ICD-11. Treatment for prolonged grief symptoms shows limited effectiveness. It has been suggested that prolonged grief symptoms exacerbate insomnia symptoms, whereas insomnia symptoms, in turn, may fuel prolonged grief symptoms. To help clarify if treating sleep disturbances may be a viable treatment option for prolonged grief disorder, we examined the proposed reciprocal relationship between symptoms of prolonged grief and insomnia. On three time points across 6-month intervals, 343 bereaved adults (88% female) completed questionnaires to assess prolonged grief, depression, and insomnia symptoms. We applied random intercept cross-lagged panel models (RICLPMs) to assess reciprocal within-person effects between prolonged grief and insomnia symptoms and, as a secondary aim, between depression and insomnia symptoms. Changes in insomnia symptoms predicted changes in prolonged grief symptoms but not vice versa. Additionally, changes in depression and insomnia symptoms showed a reciprocal relationship. Our results suggest that targeting insomnia symptoms after bereavement is a viable option for improving current treatments for prolonged grief disorder.     

Consulting With Teachers in Two Areas: Grief and Mourning: Relaxation Techniques

Consultation with teachers remains untried by many counselors despite mandates, role definitions, and models for consultation. Barriers include the preference for the status quo and the lack of information and preparation. Involvement and training can help overcome these barriers. Two possible consultation areas are grief management and relaxation training. Grief is the normal reaction to any kind of loss. Being aware of the various stages is the first step in helping someone through the grief process. Relaxation techniques can be learned with proper guidance. Before tying any new ideas, however, counselors and teachers must have sufficient information and training.     

Parallel Process

Summary

This article addresses parallel processes between the author (a therapist) and client when each are mourning the death of their mother. Similarities and differences in their experience and reaction are discussed. The effect of the client's unexpressed grief from her early childhood loss is explored. The author also examines her own, more recent loss and develops a new perspective on its consequences. Tools are presented to help the client work on her grief, especially when the issue is “motherloss.” The impact of the therapeutic process on the client and author is delineated, and the client's reactions to ending her therapy are analyzed.     

Traumatische Trauer – ein eigenständiges Krankheitsbild?

Grief is a highly individualized process influenced by intrapsychic, interpersonal and social factors. The definition of normal and pathological grief is complicated by the variety of grief reactions. Empirical research indicates that pathological grief may be concerned considered as a separate entity. Two research groups developed empirically validated criteria with a special focus on the traumatic aspect of grief. The current state of research allows, however, in our opinion not the conclusion, that the proposed diagnostic criteria for complicated (Horowitz et al. 1997) or traumatic grief (Prigerson et al. 1999b) do not enclose all types of grief. Further empirical research on representative samples is necessary to validate previous findings and to differentiate specific subgroups of pathological grief.     

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.     

A longitudinal study of job loss in relation to the grief process

This study extended a previous assessment of the applicability of the grief process to job-loss, using a longitudinal sample. A sample of 38 unemployed men were interviewed shortly after job loss (t₁), and at four times over the following year (t₂–t₅), using a structured interview, a personal scaling technique [PQRST: Mulhall (1978), Manual for Personal Questionnaire Scaling Technique. NFER], and standard questionnaires of attachment to the former job, anxiety and depression. Of the sample, 24% fulfilled a criterion for a grief-like response at t₁. Factor analysis of the PQRST showed evidence for a general grief factor. A composite grief score from the interview was associated with two measures of job attachment (at t₁), and with questionnaire measures of depression and anxiety at t₁–t₁. There was a gradual decline over time in the grief reaction.     

Emotion Regulatory Strategies in Complicated Grief: A Systematic Review

Prolonged grief disorder, characterized by severe, persistent, and disabling grief, has recently been included in the International Classification of Diseases-11 (ICD-11). Emotional disturbances are central to such complicated grief responses. Accordingly, emotion regulation is assumed critical in the development, persistence, and treatment of complicated grief. Yet, a comprehensive review on this topic is lacking. We conducted a systematic review (PROSPERO: CRD42017076061) searching PsycInfo, Web of Science, and PubMed to identify quantitative research examining relationships between emotion regulation and complicated grief. Sixty-four studies on 7,715 bereaved people were identified, focusing on a variety of emotion regulation strategies (i.e., experiential avoidance, behavioral avoidance, expressive suppression, rumination, worry, problem solving, cognitive reappraisal, positive thought, and mindfulness). Our synthesis showed strong evidence that experiential avoidance and rumination play a role in the persistence of complicated grief. More generally, surveys support positive associations between putative maladaptive emotion regulation strategies and complicated grief, and negative associations between putative adaptive emotion regulation strategies and complicated grief. Laboratory research yielded mixed results. Emotion regulation is critical in complicated grief, and in particular experiential avoidance and rumination form important targets in complicated grief treatments. We advise expanding current knowledge, by employing more advanced, intensive data collection methods and experiments across diverse samples. Increasing knowledge in this domain will improve clinical practice.