Long-Term Impact of Early Maternal Loss on Females
Anne Tracey and Conor Mc Guckin
School of Psychology
University of Ulster
Address for correspondence:
Anne Tracey
School of Psychology
University of Ulster, Magee Campus
Northland Road
Londonderry, BT48 7JL
Northern Ireland
Tel:
00 44 2871 375427
Fax:
00 44 2871 375493
ap.tracey@ulster.ac.uk
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Long-Term Impact of Early Maternal Loss on Females
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Introduction
Loss is a universal experience. While it remains a uniquely personal experience,
bereavement is often central to psychological distress in the lives of many people.
The present article presents a review of the theory and research around an area of
bereavement and distress that has, as yet, not been adequately addressed. The area in
question is early childhood loss and the long-term effects on the physical and mental
health of bereaved children – especially girls. From this, the state of current research
in this area within an Irish context is illuminated.
Bereavement and Adult Mental Illness
In Ireland, in recent years, there have been investigations into violent bereavement
(Dillenburger, 1992), spousal loss (Earls, 1994) and death through suicide (O’Connor,
1997). These studies have been helpful in providing knowledge and insight into how
bereaved people have experienced and dealt with their own specific type of loss. A
particular area of bereavement that has received little attention in Ireland and requires
much needed research is that of early childhood loss. This situation is, however,
being helped by the publication of papers such as that of McGovern and Barry (2000)
who examined the attitudes of parents and teachers in connection with death
education and childhood grief.
There have been many developments in our knowledge and understanding of
loss and bereavement since the early theoretical foundations provided by Freud
(1917) and Bowlby (1980). Their influential contributions paved the way for
subsequent studies investigating the effects of loss through death. As such, their
theories have permeated the scientific study of grief in the 20th Century and still
continue to do so in these first few years of the new millennium. One of the themes
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emerging from these early studies was that depression in adulthood is an inevitable
result of loss in early life. Much of the research that followed, set out to confirm or
dispute the link between early loss and psychopathology in later life.
Early clinical studies produced contradictory and inconclusive findings
regarding the link between early loss and the risk of adult mental illness. For
example, studies yielded mixed results about the age at which loss is most critical to
future mental health. Whilst some researchers argued that the age of four was the
most significant in relation to risk for psychopathology (Beck, Sethi, & Tuthill, 1963),
others found that the first nine years was the period most likely to be significantly
related to adult mental illness (Birtchnell, 1972, 1980). Despite the fact that one of
the main criticisms of such studies was the over-reliance on psychiatric samples
(Dilworth & Hildreth, 1998), they did nevertheless reveal and highlight the
importance of early parental death in the lives of females. More recent research
(Brown & Harris, 1977) has confirmed this finding in that whilst early parental death
predicts a higher likelihood of depression for females, males who lose a parent
through death before the age of seventeen are more likely to be autonomous and
responsible (Maier & Lachman, 2000). Depression in adult men has been found to
be more likely to occur as a result of parental divorce in childhood (Maier &
Lachman, 2000).
In explaining their findings that confirmed a higher incidence of depression in
adult females than adult males as a result of early parental loss, Brown and Harris
(1977) argued that, if the mother is the daughter’s primary source for learning how to
master or control the environment, then the loss of the mother before the age of 11
may permanently affect their feelings of personal control, thus leading to mental
health difficulties in later life. Thus, if it is the case that females are predisposed to
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psychopathology in adulthood as a result of losing a parent in early life and that,
specifically, the loss of a mother is a more significant loss in the life of a daughter,
attention needs to be given to finding out more about the specific impact of early
maternal loss on female survivors.
Research to date that has concentrated on female populations has uncovered
some interesting findings. For example, it has been found that the high risk of
depression in adult females as a result of maternal loss or separation in childhood
could be explained by other ‘vulnerability’ factors such as: the lack of adequate
parental care following the loss, premarital pregnancy, marital separation\divorce,
helplessness or low self-esteem (Bifulco, Brown, & Harris, 1987; Harris et al., 1986,
1990).
In looking at the relationship between the death of a parent and the
development of serious emotional problems in the surviving children, Silverman and
Worden (1993) and Worden and Silverman (1996) have reported data from the Child
Bereavement Study that demonstrates that a significant percentage of bereaved
children compared with non-bereaved children were identified as having such
problems. Non-clinical studies with children have demonstrated that in some cases,
responses to loss are determined by the child’s emotional condition before the loss
and the presence or absence of family conflict (Elizur & Kaffman, 1983). In one
study of acute parental bereavement in preschoolers, children, particularly girls as
young as three, express their emotions of grief (Kranzler, Shaffer, Wasserman, &
Davies, 1990). This helps to support the notion that the level and quality of support
available to children is influential in the years following the bereavement. The
influence of familial conditions is also evident from the findings of Hurd (1999). His
study showed that a ‘strong supportive family environment’ could help the child to
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resolve their grief, thus reducing the long-term risk of depression. The factors that
can determine a positive outcome for the child included a good relationship with the
parent prior to the death, continued emotional and psychological support from the
remaining parent and honest communication with the child about the death and its
impact on the family (Hurd, 1999). However, if these are the factors that are required
for the resolution of early loss, then the question is - are families suitably equipped,
emotionally, mentally and psychologically to provide children with the conditions
within which they can grieve in healthy ways? If not, what kind of help can be
provided? According to Mc Govern and Barry (2002), society is in a state of
transition and schools are playing an increasingly important role in dealing with issues
surrounding grief and bereavement. This is good news, but perhaps, it is not only
time to review how bereavement, grief and loss (particularly in early life) is managed
in Ireland, but that more education and training is provided for families, schools,
employers, and helping agencies. In this way, everyone has more knowledge and
understanding of loss and what it means and that the responsibility for our bereaved
population is shared, not attributed to one grouping or the other.
Current Research Perspectives and Future Directions
As previously highlighted, one criticism levelled at some research in the area is that it
has focussed upon psychiatric populations. Thus, research that has targeted those who
have required medical help for mental health problems may do little more than
confirm that adversity in early life leads to psychopathology in adulthood. Although
there has been an increased number of publications centring on normative
populations, the studies have, in the main, employed quantitative methodologies and
only a few have concentrated on daughters who have survived early loss.
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Whilst quantitative research in this area is welcome and is furnishing us with
interesting insights, nothing helps our understanding of the personal impact of loss
more than hearing someone tell their story. Whether it is spoken or written, the
individual’s account helps us to realise that each person’s response to bereavement is
a unique and personal grief experience. The qualitative study of adult daughters who
have lost a mother in childhood is a fruitful way of exploring how the event has
impacted on their lives. A qualitative study of early loss has not been done before in
Ireland. In fact, no study of maternally bereaved daughters who have lost their
mothers prior to eleven using only qualitative methods can be found. Current
research in an Irish setting is addressing this imbalance (Tracey, 2001, 2002).
Statistics provided by the Central Statistics Office (Dublin) and the Northern Ireland
Statistics and Research Agency (Belfast) (personal communications) for the northern
region or Ireland (taking in the six counties of Northern Ireland and the County of
Donegal) reveal that over the last decade (1990- 2000) an average of 347 women,
aged 20 - 49 died each year. In each of the same years, an average of 13,000 female
children were born. These figures alone indicate that there will be female children
every year who will face the loss of a mother.
Adopting a qualitative approach will ensure that those who participate in the
study are given a voice to share their experience of loss and that the meanings
extracted from their stories will be preserved in the process. In this way, it will be
possible to gain further insight and understanding of the impact of maternal loss on
the lives of daughters in Ireland. It may help to reveal how daughters perceive the
loss to have impacted on their lives in terms of health (mental, physical, emotional),
relationships, career, their role as parent/mother.
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The findings will help us to understand more about the plight of daughters
bereaved of a mother in childhood. They may also help to guide us on what might
need to be done in order to improve the quality of life for survivors. In particular,
there may be pointers for the bereaved population under study, for those who provide
them with therapeutic and medical help and it may alert families, communities and
employers to the needs of early loss survivors. More importantly, the study could
produce findings that will be helpful to those daughters who have lost a mother in
childhood and to those who will be maternally bereaved in the future.
Conclusion
If we accept that there is a risk of mental illness in later life for those who do not have
an opportunity to resolve their grief and that there is a need to address the issue of
how we, in Ireland, manage bereavement, grief and loss, particularly loss in early life,
then insights into the impact of early childhood loss are necessary. The fact that there
is a differential outcome in terms of later mental illness for females bereaved of a
mother in childhood suggests that interventions and follow-ups should differentiate
and distinguish between male and female survivors. The findings from research into
early childhood loss could contribute to the knowledge and understanding of this
phenomenon and help to formulate part of the training and education that is required
for the future. In a comprehensive review of the grief literature, Parkes (2002)
outlined his vision for the future. In his vision he refers to the need for appropriate
and effective help for those in grief and he hopes for a future “ … where parents as
well as children, leaders as well as followers, receive the cherishing and support that
they need; where the griefs that are a necessary part of life are recognised as such and
those who suffer them receive understanding and wise counsel” (p. 383).
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Anne Tracey, C. Psychol., is lecturer in psychology at the University of Ulster and is
a volunteer with Cruse Bereavement Care.
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