Continuing bonds in adjustment to bereavement: Impact of abrupt versus gradual separation

There is debate whether continuing bonds with a deceased person help or hinder adaptation to bereavement. This longitudinal study examined causal relationships between continuing bonds and symptoms over time. Following attachment theory predictions, suddenness of separation was examined as a moderator. Data were obtained from 60 bereaved spouses at 3 points across the first 2 years of bereavement. Measures included expectedness of death, grief and depression measures, and a continuing bonds index. Persons with unexpected loss who retained strong bonds were the least well adapted and remained so over time. Those with expected loss and strong ties suffered initially but improved. Those with weaker ties had lower scores on maladaptation, regardless of (un)expectedness of death. Theoretical and applied implications are discussed.     

Child mortality and parental grief: An evolutionary analysis

Across most of human history, infant and child mortality rates were very high, suggesting the death of a child was a challenge faced by many ancestral parents. Prolonged grief likely harmed grievers’ fitness, yet grief is ubiquitous and often protracted, thereby presenting a puzzle for evolutionary arguments. We integrate existing theories of grief with patterns of parental bereavement to examine how human psychology has been shaped to respond to the death of a child. We contend that variation in life history strategy may explain the relative difficulty with which individuals recover from losing a child. We propose that the same physiological mechanisms underlying detachment and grief during dissolved romantic relationships may also underlie the intensity of parental attachment and bereavement. This theoretical review thus integrates evolutionary theory with extant grief research to provide a functional analysis of the immense suffering associated with the loss of a child.     

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.     

Identity continuity and loss after death,divorce, and job loss

This paper examined the relationship of constructs identified by identity continuity and attachment theories of grief to adjustment to loss from the framework of identity theory. Connections between loss salience, identity construal, and balance of identity construal on grief intensity via their association with post-loss identity disruption were examined across three types of self-relevant losses; death of a family member, job loss, or divorce. We hypothesized that lower salience, higher endorsement of identity attributes represented by relational and individualistic self-construals, and an overall balance across identity attributes would be related to decreased grief severity across all types of loss. Results supported hypotheses with the exception that the hypothesized ameliorative effect of increases in relational self-construal was only seen in the bereaved group.     

Repercussions of Mortgage Foreclosure: Loss of Place Attachment,Adult Roles,and Trust

Clients coping with mortgage foreclosure suffer from multiple losses, including the loss of placement attachment, neighborhood, and trust in organizations. These losses can result in depression, anxiety, suicidal ideation, and complicated grief. Counselors can enhance treatment by integrating organizational role and attachment theory.     

Bereaved African American Adults: The Role of Social Support,Religious Coping,and Continuing Bonds

The present study identified relationships between social support, religious coping, continuing bonds, prolonged grief disorder (PGD) symptoms, and the quality of life among bereaved African American adults (N = 154). Perceived social support and less use of negative religious coping strategies predicted a higher quality of life and fewer PGD symptoms. Also, greater perceived social support, less use of negative religious coping strategies, and less use of continuing bonds significantly predicted fewer PGD symptoms. Implications suggest that the conceptualization of grief and loss for African Americans might include social support, religious coping, and continuing bonds.     

Circumstances of Death and Complicated Grief: Indirect Associations Through Meaning Made of Loss

Losses by violent means and the loss of primary attachment figures may increase the likelihood of developing a chronic and severe grief response (referred to as complicated grief, or CG). Path analysis was used to examine the relationships between these risk factors and CG symptoms. College student participants filled out online questionnaires relating to their bereavement. Analyses provided support for statistical models whereby meaning made of the loss fully mediated the association between cause of death and CG symptoms and partially mediated the association between relationship to the deceased and CG symptoms. Although based on cross-sectional data, these findings provide additional support for meaning-oriented understandings of adaptation to loss.     

Family and social networks after bereavement: experiences of support,change and isolation

The role of family and social support networks on grief experiences following the death of a family member in a road traffic accident is explored. Twenty‐one bereaved informants were interviewed and the data analysed using grounded theory methodology. We outline the ways in which a crash fatality impacts upon familial and social relationships. The data clearly demonstrate that although the death of a loved one precipitated closer familial and social bonds in some instances, it was more common that those relationships deteriorated and collapsed. Implications for service delivery, grief education and research are discussed.     

Anatomy of Regret: A Developmental View of the Depressive Position and a Critical Turn Toward Love and Creativity in the Transforming Schizoid Personality

This article deals with critical psychic transformation in a schizoid personality disorder that evolves in an object relations psychoanalysis in which "developmental mourning" plays a central role. Within a mourning process that allows for the grieving of loss related to arrested separation-individuation development, the analysand confronts the existential grief of regret that had always unconsciously haunted her. The unconscious guilt related to the existential grief of regret had caused much dissociation of self-experience and affect states. The analysand acknowledges her own part in the destruction of primal and current relationships after the traumatic impact of her early life is understood. This allows her to repair current relationships, both within her internal and external worlds so that she can open to capacities for love and creativity. The analysand's courage to consciously grapple with her regret (loss and guilt combined) allows her to relinquish self-sabotaging character defenses such as contempt and emotional withdrawl. Consequently, a second marriage is salvaged and enriched, and the analysand's relationship with her two children is dramatically improved.     

Grief and attachment

Loss and grief are universal phenomena with serious potential psychological and physical consequences. Loss results in various reactions that have been identified in a variety of ways. Attachment theory provides a conceptual scheme to understand these processes and consequences. Clergy are in a strategic position to respond to loss, and attachment theory helps inform pastoral intervention. Several program and research issues are posed that emerge from the author's clinical experience.     

Patterns of attachment and parents' adjustment to the death of their child

The impact of adult attachment on psychological adjustment among bereaved parents and the mediating effect of relationship satisfaction were examined among a sample of 219 couples of parents. Data collection took place 6, 13, and 20 months after loss. Use of the actor partner interdependence model in multilevel regression analysis enabled exploration of both individual as well as partner attachment as predictors of grief and depression. Results indicated that the more insecurely attached parents were (on both avoidance and anxiety attachment), the higher the symptoms of grief and depression. Neither the attachment pattern of the partner nor similarity of attachment within the couple had any influence on psychological adjustment of the parent. Marital satisfaction partially mediated the association of anxious attachment with symptomatology. Contrary to previous research findings, avoidant attachment was associated with high grief intensity. These findings challenge the notion that the avoidantly attached are resilient.     

An Attachment-Theory Approach Psychology of Religion

The purpose of this essay is to demonstrate that attachment theory, as origi- nally proposed by John Bowlby and subsequently refined by a host of other researchers, provides a powerful framework for integrating research and theory concerning the psychology of religion. The essay begins with a brief over- view of contemporary models of attachment, with particular emphasis on adult attachment relationships. Selected literature is reviewed concerning a variety of topics in the psychology of religion, including research on images of God, conversion, and prayer, and attachment theory is shown to provide a useful conceptual framework for integrating these findings. It is argued that extending attachment theory in this direction may benefit religion researchers as well as social and developmental psychologists interested in such topics as interpersonal relationships, stress and coping, and loneliness.     

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.     

Religion and emotional compensation: results from a prospective study of widowhood

Based on recent applications of attachment theory to religion, the authors predicted that the loss of a spouse would cause widowed individuals to increase the importance of their religious/spiritual beliefs. This hypothesis was examined using the Changing Lives of Older Couples sample from which preloss measures of religiosity were available for widowed individuals and matched controls. A total of 103 widowed individuals provided follow-up data, including reports of religious beliefs and grief, at 6 months, 24 months, and 48 months after the loss. Results indicated that widowed individuals were more likely than controls to increase their religious/spiritual beliefs. This increase was associated with decreased grief but did not influence other indicators of adjustment such as depression. Finally, insecure individuals were most likely to benefit from increasing the importance of their beliefs. Results are discussed in terms of the potential value of applying psychological theory to the study of religion.     

Introduction to the Special Issue on Grief

In the Introduction I present an overview of the changes that take place in conceptualizing the psychological purpose of the grief process following death of a loved one, and their effect on defining adaptive and maladaptive outcomes of grief. One of the most significant ones is the shift from breaking bonds to continuing bonds—the process of reorganizing the inner relationship with the deceased. New models of developmental grief have evolved. These are empirically-based and evidenced-based studies within which Cognitive Behavior Grief Therapy has gained significant reputation and the collection of articles in this special issue are representative of these changes. Also, a URL link of my article “Cognitive Behavioral Grief Therapy”, published in this journal in 1996 is provided for interested readers.     

Group psychotherapy and neuro-plasticity: an attachment theory perspective

This article selectively highlights relevant areas of neuroscience research which have direct application for attachment theory and group psychotherapy. Emerging evidence from the neurosciences is revealing that the developing brain of the infant, sculpted by the earliest attachment relationships, continues to be malleable in adulthood and can be profoundly influenced by ongoing relationships throughout one's lifespan. Advances in the neurosciences are also supporting the idea that strong attachment bonds and external interpersonal interactions that arise within the context of these attachments are registered as a person's neurophysiology and neurobiology. Attachment theory in particular provides a common language and conceptual framework from which the contributions from the neurosciences can be made applicable to group psychotherapy.     

Somatoforme Störungen und Bindungstheorie

Somatoform disorders are not only marked by somatic symptoms, but also by significant disturbances in interpersonal relationships. Interpersonal difficulties – including the maladaptive pattern of illness behavior and the resulting difficult doctor-patient-relationship – are an important field of therapeutic intervention (Nickel u. Egle 1999). The interpersonal problems which are characteristic in patients with somatoform disorders draw attention to the developmental aspects of these conditions. Attachment theory provides a promising framework for understanding these developmental features. In the paper presented we therefore apply concepts and observations from attachment theory to somatoform disorders. After a brief review of attachment theory we specifically discuss the developmental aspects of representation formation in somatization. As next, empirical evidence is reviewed that link attachment insecurity to the development of somatoform disorders. Finally a vulnerability model of somatoform disorders is outlined.     

Romantic love conceptualized as an attachment process

This article explores the possibility that romantic love is an attachment process--a biosocial process by which affectional bonds are formed between adult lovers, just as affectional bonds are formed earlier in life between human infants and their parents. Key components of attachment theory, developed by Bowlby, Ainsworth, and others to explain the development of affectional bonds in infancy, were translated into terms appropriate to adult romantic love. The translation centered on the three major styles of attachment in infancy--secure, avoidant, and anxious/ambivalent--and on the notion that continuity of relationship style is due in part to mental models (Bowlby's "inner working models") of self and social life. These models, and hence a person's attachment style, are seen as determined in part by childhood relationships with parents. Two questionnaire studies indicated that relative prevalence of the three attachment styles is roughly the same in adulthood as in infancy, the three kinds of adults differ predictably in the way they experience romantic love, and attachment style is related in theoretically meaningful ways to mental models of self and social relationships and to relationship experiences with parents. Implications for theories of romantic love are discussed, as are measurement problems and other issues related to future tests of the attachment perspective.     

Locating Ruptures Encrypted in Gender: Developmental and Clinical Considerations

The purpose of this article is to encourage reflection about children and adolescents who are expanding gender expression in this contemporary cultural moment. More specifically, to consider how relational rupture and its affective counterpart, grief, may become encrypted in gender. Attachment theory’s articulation of the intricacies of loss, in combination with psychoanalytic and systems theories, will serve to parse out the complex and paradoxical communications within this potentiality. Toward this end, my clinical process with five gender nonconforming children and adolescents will be discussed. The clinical section forms a tapestry weaving between similarities and differences in the expression of gender within the fabric of an attachment relationship. To link the clinical process to a larger cultural discourse, this article brings literary voices into the conversation, including Carson McCullers’s in Member of the Wedding and Jennifer Boylan’s memoirs of life in two genders and other writings. These sources crisscross/queer developmental time lines, disciplinary mediums, culture, and family dynamics to open up an inclusive conversation about gender subjectivity. The therapeutic process, with particular emphasis on the importance of play, is linked to advances in developmental science. Thinking with the children who vary the expression of gender can potentially inform our conceptualization of gender development, more generally.     

A Multicultural Application of Attachment Theory with Immigrant Families: Contextual and Developmental Adaptations

This article explores attachment theory from a multicultural perspective to highlight adaptive considerations for immigrant families. The specific considerations of the theory reviewed are (1) attachment sensitivity based on social and cultural context and (2) the effect of maturation on families’ developmental needs and how this can be integrated within context. A case conceptualization of a Bosnian immigrant family living within the United States will highlight potential variations in the adaptation process. How therapists can support in providing culturally-sensitive applications of attachment theory to promote family relationships will be discussed.