The driver whose heart was full of sand: Leigh's story - a play therapy case study of a bereaved child

This paper describes the therapeutic journey of Leigh (not his real name), a nine-year-old boy who was referred for play therapy due to the death of his 15-year-old brother. The play therapy was offered through a joint project called 'Playing through Loss' and run jointly between a UK university and the local branch of a national bereavement organisation. The project was set up to offer play therapy to bereaved children in the local area. Leigh had eight sessions of therapy and this paper describes the major themes of his play and makes some preliminary explorations of the meaning the play may have had for him. Interestingly some of his play focused on a computer game called 'Zelda' and an exploration of the powerfulness of this as a therapeutic tool is also explored. The therapist's theoretic orientation is described along with her perceived role as 'loyal companion'. Finally, the process by which Leigh worked with his loss is discussed.     

Loss and human resilience

In this article we argue that humans are more resilient in the face of loss than has been previously believed. We begin by showing that historically the bereavement literature has tended to pathologize what are otherwise normal and natural reactions to loss. We then introduce a characterization of resilience during bereavement as the ability to maintain continuity in identity from pre- to postloss. We review various types of evidence consistent with this proposal, with a particular emphasis on the relationship between resilience and continuity in social identity. We then explore four possible mechanisms by which resilient individuals achieve identity continuity. We also attempt to extend the resilience-as-continuity link to the recent literature on continued bonds with the deceased and explore how this link manifests across different cultures. Finally, we review some implications of these formulations for psychotherapy with bereaved individuals.     

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.     

Cultural conceptions of a bereavement-related illness in a South African indigenous community

This study explored cultural conceptions of a bereavement-related illness among elderly (aged 34–85yrs) Northern Sotho-speaking people in Limpopo province. The participants (n = 14, females = 50%, mean age = 59 years, SD: 13.7 years) were purposively selected and interviewed using in-depth interviews. Data were analysed using Hycner’s adapted phenomenological method. Three themes emerged from the analysis: debilitating and life-threatening symptoms of the illness; aetiology explained by ritual taboo violations; and management of the illness through ritual cleansing. The cleansing process incorporates the administration of traditional herbs. The findings suggest bereavement-related illness in an African cultural community to be explained by their cultural concept of distress understandings.     

Eternal Connection: An Exploratory Study of the Effects of Learning About Near-Death Experiences on Adult Grief

We examined the effectiveness of a near-death experience (NDE) psychoeducational group bereavement intervention in reducing distressing aspects and enhancing a growth aspect of grief among bereaved adults. Participants were 22 females and 2 males (2 African American, 3 Asian, 2 Latina/o, and 17 White non-Latina/o) ranging in age from 20 to 71, with a mean age of 35.3 years. In this experimental design, we randomly assigned 12 participants to the experimental group and 12 participants to the waitlist control group. Effect size findings based on Hogan Grief Reaction Checklist scores indicated modest to substantial benefits of the NDE learning module intervention for bereaved adults in the form of decreased panic behavior, blame and anger, and detachment and increased personal growth. Conclusions include that further research into the effectiveness of NDE-related psychoeducational programs with bereaved individuals is warranted.     

Inferiority and bereavement: Implicit psychological commitments in the cultural history of Scottish psychotherapy

Abstract

The author has argued that psychoanalytic psychotherapy was seen in Scotland as a way to purify Christianity of supernaturalism and moralism, and to propel the faith in a scientifically rational and socially progressive direction. In making this historiographic claim, certain disciplinary protocols are followed, such as the symmetry postulate and a deprecation of reductive psychohistorical explanation. Nonetheless, the contemporary historian of psychotherapy is a psychologized subject whose historical practice rests upon a complex, prereflective background of psychological presuppositions.     

Irrational Beliefs and Basic Assumptions in Bereaved University Students: A Comparison Study

Several authors have argued that the loss of a loved one triggers changes in people's beliefs and assumptions, and that these changes play a role in emotional problems after bereavement. The present study was an attempt to investigate these hypotheses. Thirty students who had been confronted with the death of a parent or sibling, on average nearly 3 years ago, were compared with 30 nonbereaved matched control subjects on different measures assessing basic assumptions and irrational beliefs as defined in REBT. In line with the notion that bereavement has an impact on people's basic assumptions, results showed that bereaved students had a less positive view of the meaningfulness of the world and the worthiness of the self than their nonbereaved counterparts. Also, in accord with the notion that the tendency to think irrationally is likely to increase after a stressful life event, the bereaved were found to have higher levels of irrational thinking. Furthermore, it was found that the degree to which bereaved individuals endorsed general as well as bereavement-specific irrational beliefs was significantly associated with the intensity of symptoms of traumatic grief. Conversely, none of the basic assumptions was associated with traumatic grief. Beliefs reflecting low frustration tolerance explained most variance in traumatic grief. Clinical and theoretical implications of these findings are discussed.     

Mapping grief: A study in practice using a quantitative and qualitative approach to exploring and addressing the range of responses to loss

The Adult Attitude to Grief (AAG) scale was devised for an earlier study (Machin, 2001) to test the validity of a concept of loss, which proposed that grief reactions fall broadly into three categories — ‘overwhelmed’, ‘balanced’ and ‘controlled’. There was statistical support for the proposed differences but the AAG scale, more importantly, provided insight into the diverse reactions taking place in individual bereaved respondents. This paper describes a second study undertaken to examine the clinical usefulness of the AAG scale with clients receiving help within the Psychological Services Operating Unit of the North Staffordshire Combined Healthcare (NHS) Trust. The scale has been used both in its original form with bereaved clients and in a modified form with clients having distress symptoms associated with other losses, such as relationship breakdown or the onset of chronic illness. The use of the AAG scale in this clinical setting suggests that, both as an assessment tool and as a cue for therapeutic dialogue, it provides a promising way of mapping the general and particular characteristics of response to loss in individual clients. Consideration is also given to varying therapeutic approaches needed to help clients regain the equilibrium disturbed by their grief.     

How do loss- and restoration-oriented coping change across time? A prospective study on adjustment following spousal bereavement

Background and objectives: According to the Dual Process Model (DPM), shifting between loss-oriented (LO) and restoration-oriented (RO) coping is essential for adjustment following bereavement. Knowledge about how LO and RO coping change over time and how such changes are related to adjustment is missing. With a prospective design this study investigated (1) relations between levels of LO/RO coping and selected outcomes and (2) changes in LO/RO coping across time and their relations to adjustment.

Methods: A sample of 145 spousal bereaved individuals completed questionnaires measuring LO and RO coping, grief symptoms, positive affect, and attachment orientation approximately 2–3 months (baseline) and 7 months (follow-up) post-loss.

Results: High usage of LO coping was associated with poorer outcomes and high usage of RO coping was associated with better outcomes at both baseline and follow-up. Individuals generally shifted towards more RO coping across time and those who exhibited this shift showed lower levels of grief at follow-up compared to individuals who changed towards more LO coping across time.

Conclusions: Individuals showing more RO coping reported better adjustment both early and later in the bereavement process. Changes in coping orientation over time might be useful for understanding complicated grief reactions following loss.