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Article Excerpt
Phenomenological methods were used to explore the experience of grief after bereavement. Nine bereaved adults volunteered to participate in open-ended interviews in which they were asked to discuss their experience of grief after the death of a loved one. An analysis of the interviews revealed the following themes in the experience of grief after bereavement: Coping, Affect, Change, Relationship, and Details. Implications for the practice of mental health counseling are discussed.
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Grief over the death of a loved one presents one of the most frequent and challenging problems mental health counselors face with their clients. Death of loved ones is possibly the most penetrating loss individuals experience: it is a physical, emotional, and spiritual loss (James & Friedman, 1998). Grief, our emotional response to loss, is the entire range of naturally occurring human emotions that accompany loss. The authors' position is that mental health counselors could improve their grief counseling skills from reading first person accounts of the experience of grief.
Few would disagree with Parkes' (1996) contention that bereavement results in emotional, cognitive, physical, and behavioral responses. The impact of loss through death is noted on the Social Readjustment Rating Scale (Holmes & Holmes, 1970), which was designed to measure cumulative stress over a given period of time. The norm group which was used in developing the scale, although almost exclusively composed of men, contained all major cultural groups in the United States. On the scale, the death of a spouse ranks first out of 43 stressful events followed by the death of a family member which ranks 5th and the death of a close friend ranking 17th. Clearly, mental health counselors need to be prepared to work with clients on their adjustment to the loss of their loved ones through death.
FACTORS INFLUENCING THE GRIEVING PROCESS
A variety of factors affect the bereavement experience, including how one is related to the deceased (e.g., parent, child, partner, or friend; Bonanno, 1999; Leahy, 1993; Meshot & Leitner, 1993), the type of death (Drenovsky, 1994; Ginzburg, Geron, & Solomon, 2002; Levy, Martinkowski, & Derby, 1994; Stamm, 1999), historical approaches to bereavement (Leming & Dickinson, 1994; Smart, 1993), societal influences (Leming & Dickinson), cultural norms (Klapper, Moss, Moss, & Rubinstein, 1994; Stroebe, 1992), the quality of relationship with the deceased (Meshot & Leitner; Rubin, 1992), and the age of the deceased (Klapper et al.; Moss, Moss, Rubinstein, & Resch, 1993). In addition, various aspects of bereaved individuals influence their reaction to loss such as personal vulnerability (Bonanno, 1999; Van Baarsen, Van Duijn, Smit, Snijders, & Knipscheer, 2002), personality traits (Goodman, Black, & Rubinstein, 1996), their age (Gilbar & Dagan, 1995; Levy et al.; Meshot & Leitner), social behavior (Van Baarsen et al.) and familial patterns in dealing with grief (Book, 1996; McGoldrick, 1995). Some have suggested that certain variables have differential effects depending on the stage of bereavement (Richardson & Balaswamy, 2001). For example, loss-oriented variables such as circumstances of death (e.g., type of death) have been found to be more crucial in the early stages of loss whereas restoration variables such as investing in social activities are more relevant in later stages.
When considering the variables which impact the experience of bereavement, it is no surprise that one's relationship with the deceased greatly influences an individual's emotional response to the loss (Meshot & Leitner, 1993; Rubin, 1992). For instance, one's association (i.e., kinship tie) to the deceased has a notable effect on one's reaction to a loss. Reactions vary depending on whether one has lost a parent, sibling, child, partner, co-worker, or friend; different relationships evoke different responses. Losing a spouse is different from losing a parent. The death of a twin is a loss that involves its own unique issues. Losing a friend is likely very different from losing a sibling. The quality of the emotional attachment to the deceased acts as an additional variable in one's response to death. The nature of the bond influences the intensity of one's grief and one's adjustment to a loss (Levy et al., 1994; Meshot & Leitner; Moss, Resch, & Moss, 1997; Rubin).The role of the deceased, whether that of family scapegoat, hero, or main provider, has a notable effect on the grieving process. Bereaved individuals who had a more positive relationship with the deceased reported more intense grief than do those with a less positive one (Bonanno, 1999; Moss, Rubinstein, & Moss, 1997).
Regarding type of death, one's reaction to a death is greatly influenced by the manner in which the death occurs. Deaths can be categorized as natural anticipated (e.g., cancer), natural unanticipated (e.g., heart attack), accidental, homicidal, or suicidal (Range, Walston, & Pollard, 1992; Silverman, Range, & Overholser, 1994). Although there is some evidence that type of death is unrelated to resolution of grief (Campbell, Swank, & Vincent, 1991), there is much evidence that type of death does influence the grief experience or reaction (Drenovsky, 1994; Ginzburg et al., 2002; Levy et al., 1994; Silverman et al.).
The aforementioned variables may account for some of the incongruencies found in the literature on grief and bereavement. For example, researchers have found that the duration of grief varies widely (Levy et al., 1994). There are also divergent views on which grief responses are most adaptive. Although some researchers have found that talking about their feelings and reactions to a loss is necessary for a healthy adjustment (Lindemann, 1944; Worden, 1982), other professionals contend that this is unnecessary for (Bonanno, 1999; Stroebe, 1992) or even detrimental to a healthy adjustment (Wortman & Silver, 1989). Some researchers advocate for stage-based approaches to grief (Kavanaugh, 1972; Kubler-Ross, 1969, 1975; Parkes, 1996), while others favor task-based approaches (Attig, 1996; Corr, 1992; Lindemann, 1944; Rando, 1993; Worden, 1982).
Most of the research on bereavement has been done using quantitative methods (Henschen & Heil, 1992; Hogan, Morse, & Tason, 1996). Edmonds and Hooker (1992) suggested that a qualitative approach would "more clearly articulate the voices of the bereaved respondents without the framework imposed by the researchers" (p. 315). Therefore, the present study was designed to use phenomenological methods to provide a deeper and clearer understanding of the general bereavement experience. With a goal to understand better what it is like for an individual to experience the death of a loved one, particularly what the experience of grief is like, the research question for the study invited bereaved participants to describe their experience of grief after the death of a loved one. A thematic structure of the experience of grief was used to identify the common patterns that emerged from such an experience.
METHOD
Participants
Participants were individuals who volunteered to be interviewed after hearing a brief description of the study. In accordance with Polkinghorne's (1989) recommendation, the researcher attempted to select volunteers with diverse experiences regarding variables such as period of time since the death, relationship to deceased, and type of death in hopes that these variables would increase the richness of the data. Nine Caucasian adults, five females and four males, who had experienced the death of a family member or loved one volunteered for the study. They ranged from 44 to 77 years of age. The period of time since their loved one's death ranged from one week to 28 years prior to the interview. The deceased individuals were spouses, parents, siblings, children, and friends of the participants. The deceased person's age at the time of their death ranged from 3 years and 10 months to 89 years of age. Causes of death included various forms of cancer, a heart attack, an aortal aneurysm, an auto accident, a rare disease, heart conditions, stroke/pneumonia, AIDS, and drowning.
Phenomenological Interviews
Open-ended and unstructured interviews were conducted by the senior author. Each interview began with the following statement: "Tell me about your experience of grief after the death of a loved one." Subsequent statements or questions represented attempts to obtain clarification or elaboration regarding the participant's experience. Interviews were participant-centered in the sense that participants controlled the direction of the interview, including the subject matter and range of topics discussed. The interviewer, prior to the study, participated in a bracketing interview on the same topic to identify her experiences, reactions, and thoughts regarding the experience of grief after the death of a loved one. The interviewer's responsibility was to avoid injecting her experiences into the interview content shared by the participants. Likewise, the interviewer's responses were limited to minimal encouragers, summaries of content, clarifications, and requests for elaboration on the content shared by the participants. Thus, there was no preplanned agenda of questions to be covered in the interview. Interviews were discontinued...
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