Death, Society, and
Human Experience
9th Edition
Robert Kastenbaum
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Copyright © Allyn & Bacon 2007
Chapter Eleven:
Bereavement, Grief, and
Mourning
This multimedia product and its contents are protected under copyright law. The following are prohibited by law:
•Any public performance or display, including transmission of any image over a network;
•Preparation of any derivative work, including the extraction, in whole or in part, or any images;
•Any rental, lease, or lending of the program.
•
Copyright © Allyn & Bacon 2007
Defining Terms: Bereavement
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An objective fact:
• We are bereaved when someone close to us
dies
• “Close” is not easily defined
• A change in status:
• Such as when a child becomes an orphan, a
wife a widow, a husband a widower
• An outcome of a large-scale social phenomena:
• Those surviving a natural disaster or a war
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Defining Terms: Grief
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Grief is one response to bereavement; how one survives
Grief affects all spheres of life
• On a physical level
• Acute grief: tightness in throat, shortness of breath,
lack of muscle power, empty feeling in abdomen
• Prolonged stressor: Increased risk of cardiovascular,
infectious, & inflammatory disorders, & weakened
immune system
• On a personal and interpersonal level
• Confusion, attention, concentration, memory, anxiety,
and rage which may repeatedly return in waves
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Defining Terms: Mourning
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Mourning is the culturally patterned expression of the
bereaved person’s thoughts and feelings
• Can reflect local, regional, national, ethnic, and religious
cultures at particular points in history
Examples:
• During World War I widows dressed in black with veils
covering their heads
• During World War II families put a gold star in their
window if they had lost a loved one
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Types of Grief
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Normal Grief – stays within the bounds of a particular
culture
Complicated Grief – once called “pathological” or
“abnormal,” the most common feature is that the bereaved
person does not move from the shock and pain of loss
toward a return to a fulfilling life
Traumatic Grief – severe and disabling responses to
sudden and often violent death
Anticipatory Grief – how people cope with expected loss
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Types of Grief
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Resolved Grief – movement toward recovery from the most
debilitating effects of grief
Unresolved Grief – the debilitating effects of grief have
continued longer than would be expected (difficult to
define)
Hidden Grief – hiding any signs of grief in order to appear
as “normal” as possible
Disenfranchised Grief – occurs when society does not
recognize a person’s right to grieve. Examples: health care
professionals, foster parents, gay partner
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Examples of Disenfranchised Grief
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The grieving individual is not regarded as having
the right to grieve (at this time or under these
circumstances) and must keep the sorrow hidden
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When at work, school, or in public places
Nurses and caregivers
Lover or companion of an AIDS victim
When the lost companion was an animal
When the loss was a stillborn baby
When the bereaved person or the individual who died is
developmentally disabled
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Freud’s Grief-Work Theory
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Grief is an adaptive response to loss
The work of grief is difficult and time-consuming
The basic goal is to accept the reality of death and thereby
liberate one’ self from the strong attachment one had to the
“lost object”
Grief-work is carried out through a long series of
confrontations with the reality of the loss
The process is complicated by the survivor’s resistance to
letting go of the attachment
Failure results in continued misery and dysfunction
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Interpersonal Applications of
Grief-Work Theory
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Bowlby’s Attachment Theory
• Our basic goal is to maintain the security provided by
the significant relationship
• Stress comes as we try to re-establish the lost
relationship
• In grief-work we must overcome our attachment
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Parkes’ Three Basic Components of Grief-Work
• Preoccupation with thoughts of the deceased person
• Repeatedly going over the loss experience
• Attempts to explain the loss
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Other Theoretical Approaches
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Rando’s Task Theory
• Accept the loss
• React to the separation
• Remember and re-experience the lost person and
relationship
• Give up the attachment to the person and the life that
used to be
• Move into the new life but remember the old
• Reinvest emotions and energies in other relationships
and activities
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Other Theoretical Approaches
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Stage Theories (such as Kubler-Ross)
• Most agree on the beginning and ending points, but the
middle stages vary by theory
• Little independent evidence to verify the application of
universal stages to the grieving process
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Dual-Process Model (Stroebe and Schut)
• Must work on both:
• Emotional working through the grief
• Adapting to roles and situations in the altered world
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Other Theoretical Approaches
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Integrated Individual-Family Model (Moos)
• Considers symptoms of family grief, such as family
isolation, confusion in family roles, changes in who talks
to whom, and cut-off, reconnection or overprotection of
certain family members
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Evolutionary Biology Model of Grief (Archer)
• Views grief in all mammals and social birds
• Views social bonds as advantageous for survival, but
grief as maladaptive
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How Do People Recover?
Spousal Bereavement
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Immediate Impact of Spousal Bereavement
• Most women experienced anticipatory grief
• After the death women felt a sense of abandonment
• After the death men felt a sort of dismemberment
• Emotional & Physical Reactions Soon After Bereavement
• Physical symptoms lingered for weeks (pains, poor
appetite, loss of stamina, headaches, dizziness)
• Women had trouble at night, wanted someone to rely
on, and felt the situation was “not fair”
• Men felt guilty and were less likely to express emotions
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How Do People Recover?
Spousal Bereavement
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Leave-Taking Ceremonies
• Women found them important and helpful
• Men found them less important and too expensive
Grief and Recovery: The Widow’s Response
• Obsessional reviews of the circumstances
• Tendency to idealize the husband
• Strong sense that he is still with her
Grief and Recovery: The Widowers’ Response
• Cuts off obsessional reviews quickly
• Faster social recovery, slower emotional recovery
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How Do People Recover?
Spousal Bereavement
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Types of Recovery
• People who did not have the opportunity to prepare for
the spouse’s death suffered more distress
• Time by itself will not facilitate recuperation
• Those who were most disturbed a few weeks after the
death usually were the ones who continued to be
disturbed a year later
• The quality of the marital relationship influences the
grief and recovery process
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How Do People Recover?
Spousal Bereavement
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Three Types of Unresolved Grief
• The unexpected grief syndrome (when death comes
without warning, leaving disbelief and intense anxiety)
• The conflicted grief syndrome (when death occurs in a
troubled relationship)
• The chronic grief syndrome (marked by dependency on
deceased spouse)
Psychosocial Transition
• Vulnerable place of change
• Rites of passage can be helpful
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The Family That Has Lost a Child:
Perinatal Death
Perinatal death – 20 weeks after conception to one month
after birth
• Health care systems are more responsive
• Shadow grief – stays with parents for years (like a shadow)
• Contact the “inner representation” of the dead child may be
experienced for years (keeps parents’ worldview intact)
• Memories, hallucinations, a presence or incorporation of
the child’s characteristics into their own personalities
• Most surviving parents do not divorce
• Grandparents grieve as well
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Bereavement in Later Life
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Most older adults cope as well as anyone
• Some deal with bereavement overload
• Accumulation of experience with many losses (family,
friends, pets, lifestyle)
• Risk of illness and death increases following the death of a
loved one (often within 6 months)
• Risk is greater for widowers than widows
• Risk is greatest for young adult widowers
• Higher risk for violent death and suicide
• Stress of grief can weaken immune system
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Meaningful Help for
Bereaved People
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Silverman established the Widow-To-Widow Program prior
to the development of professional grief counselors or
peer-support groups
• Grief does not have a final outcome
• Grief can most usefully be regarded as a life transition
• People can help each other
Helpful things to say to the bereaved
• “He/she will always be alive in your memories.”
• “I’m here if you need somebody to talk to”
• “Tell me how you are feeling”
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Glossary: New Terms
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Anticipatory Grief
Attachment Behavior
Bereavement
Continuing Bonds
Disenfranchised Grief
Dissociative Flight
Grief
Grief-Work Theory
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Intrapsychic
Mourning
Spontaneous
Memorialization
Stigmatized Grief
Traumatic Grief
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