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 Relationship Between Momentary States of Therapist Self-Awareness and Perceptions of the Counseling Process

To investigate the role of momentary self-awareness, beginning therapists and their volunteer clients participated in a postsession process recall in which therapist helpfulness and momentary self-awareness were assessed along with client reactions. Therapist anxiety levels and strategies used to manage hindering self-awareness were also examined. Results suggest that momentary states of heightened therapist self-awareness may be hindering. Specifically, when therapists rated themselves as more self-aware from moment to moment during counseling sessions, they also rated themselves as more anxious before the session and their clients rated them as less helpful during the session. In addition, therapists reported using a variety of strategies to manage distracting self-awareness, including focusing on intervention planning and focusing on the client. Implications for therapist training are discussed.     

Friend or foe? Evidence that anxious people are better at distinguishing targets from non‐targets

Armed conflict necessitates the ability to quickly distinguish friend from foe. Failure to make accurate shooting decisions may result in harm either to oneself or to innocent others. The factors that predict such rapid decision making, however, remain unclear. Based on social defense theory, we contend that people high on attachment anxiety possess characteristics that are particularly advantageous in this domain such that anxiously attached individuals will show greater vigilance and accuracy in a realistic shooting paradigm in which they must quickly distinguish between militants (people holding a gun) and innocents (people holding an item with the same color and shape as a gun—Coca‐Cola bottle, black wallet, and black mobile phone). Using signal detection theory algorithms, we calculated sensitivity in performing the behavioral shooting task [D_(prime)]. Results indicate that as expected, anxious people demonstrated significantly better shooting accuracy. Implication for contemporary violent conflict is discussed.     

Does worry affect adjustment to bereavement? A longitudinal investigation

Background and objectives: Repetitive thought is a trans-diagnostic risk-factor for development of psychopathology. Research on repetitive thought in bereaved individuals has focused primarily on clarifying the role of rumination, repetitive thinking about past negative events and/or negative emotions. While detrimental effects of rumination have been demonstrated following bereavement, surprisingly few studies have aimed to clarify the role of worry, repetitive thinking about potential future negative events, in adjustment to loss. This study sought to fill this gap in knowledge. Methods/Design: One hundred eighty-three bereaved individuals (85.3% women) filled out questionnaires on sociodemographic and loss-related characteristics, worry, and symptom measures of depression, anxiety, and prolonged grief. After six months, 155 participants completed worry and symptom measures again. Using multiple regression analyses, concurrent and longitudinal associations between loss-related variables, worry, and symptoms of psychopathology were examined. Results: Main results were that worry was strongly positively associated with symptoms of anxiety, depression and prolonged grief concurrently and also predicted higher levels of anxiety, depression and prolonged grief longitudinally. Conclusions: Findings suggest that worry influences adjustment to bereavement negatively and may be a potential target in grief therapy, especially when aiming to reduce anxiety.     

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.     

A Poetic Path from Melancholy to Mourning: Robert Lowell's Elegies as Case Study

This essay builds on a previous one in this journal (Cole, 2005) that details how reading elegiac poetry, the poetry of mourning, may be a pastoral resource for complicated grief or what is classically termed melancholia. A study of elegies by poet Robert Lowell (1917–1977), which depict a progression from melancholia to more “typical” mourning, demonstrates how thinking and writing in elegiac terms may offer a similar resource, whether for one's own melancholia or that of persons in one's care. Allan Hugh Cole, Jr. is Assistant Professor of Pastoral Care at Austin Presbyterian Theological Seminary.     

情感强度不同负性生活事件对个体情感反应和行为选择的影响

采用系列实验方法探讨不同情感强度负性生活事件对个体情感反应和行为选择的影响。结果发现：（1）复合生活事件（1高负性+1低负性）为异类时,个体对复合事件的负性感受比单独1高负性事件更低,选择经历前者,出现平均效应;（2）复合生活事件为同类时,其负性感受比单独1高负性事件更高,选择经历后者,出现累加效应;（3）复合事件有明显的时间特点时,其情感和行为选择受事件发生时间影响,符合峰-终定律。结论：人们对负性生活事件的加工受其特点的影响,加工方式不同。     

Guilt in bereavement: Its relationship with complicated grief and depression

This study investigated the relationship between guilt and well‐being of bereaved persons, and explored potential differences in the associations between guilt‐complicated grief (CG) and guilt‐depression. In total, 1358 Chinese bereaved adults were recruited to fill out questionnaires. Participants (N = 194) who had been bereaved within 2 years of the first survey, filled out the same questionnaires 1 year later. Higher guilt was associated with higher degrees of both CG and depression. The level of guilt predicted CG and depression symptoms 1 year later. Bereavement‐related guilt has a closer association with CG than depression. Responsibility guilt, indebtedness guilt and degree of guilt feeling are more prominent aspects of guilt in CG than in depression. These findings demonstrate the significant role of guilt (perhaps a core symptom) in mental health of the bereaved, having implications for identifying persons with grief complications and depression.     

The New York Inferno: Taking Solace from the Stories

The sudden destruction of the World Trade Center on 9/11 created an instant scenario of panic and horror. It was followed by post-traumatic shock that spread across New York. Psychoanalysts and other therapists were mobilized to provide emergency counseling for survivors, families of victims, firemen, police, rescue workers and others who had been scarred. One of the most effective techniques was to encourage the telling of personal stories as a method of working through trauma. It emerged as the most powerful tool in our therapeutic arsenal.