The background contours of bereavement: Part 2

Continuing on with the background contours of mourning, here are some more to consider.

Loss orientation vs. Restoration orientation

Some bereaved alternate between feeling intense emotional upset and cognitively containing emotional upset through taking action on something to substitute for thinking about the loss. (Goodrum  S (2005) The interaction between thoughts and emotions following the news of a loved one’s murder. Omega: Journal of Death and Dying Vol 5 (2))

When working with loss orientation we need to explore the client’s experiences, feelings, hopes and fears and help them to release emotions without any pressure to move quickly beyond their pain or to find quick fixes. We need to normalise reactions, explore the significance of the loss for the client’s life and explore for related losses.

There can be multiple approaches to the expression of grief – verbal, written and artistic, and drawing and storytelling may allow trauma to be approached in the relative safety of symbolism and metaphor. Research suggests that the ability to share our feelings and stories with others is healing.

Harding says that Allowing oneself to go through the emotions that happen and accepting those emotions as part of a normal and natural process is affirming and helpful to those who grieve. (Harding D (2005) Spiritual guidance for grief: one piece of the puzzle. PsycCRITQUES  Vol 50 (51))

In Restoration orientation there is a focus on tasks and an exploration of options and possibilities. This is about external adjustment and tuning out to grief.

Meaning making/ reconstruction/ re-learning the world

On this contour we need to work at the pace of the person and pick up when they are ready to begin reconstruction (they need to be thinking beyond intense loss). We need to begin where the client is, allow the story to be heard and uncover the meanings attributed to their lives and the losses they have encountered. Our role is to act as collaborator and catalyst in the process of meaning reconstruction.

Malkinson and Bar Tur write that Grief along the life cycle is an unpatterned process with emotional and cognitive ups and downs involving a continuous search for a meaning to life. 

There are three areas of meaning-making: sense making (via communication and storytelling), benefit finding, and identity change, and we can use tools like journaling, biographies, letters, poetry and metaphoric stories to assist with meaning-making. (Malkinson & Bar Tur (2004) Long term bereavement processes of older persons: the three phases of grief. Omega: Journal of Death and Dying Vol 20 (2))

Continuing bonds

Patson and Marwit have observed that Continued contact with a loved one who has died is common in bereavement. 60% reported sensing a presence (visual, auditory or tactile) and of these, 85% found this comforting. (Patson & Marwit (1997) – but I have lost any further details, sorry)

When working on this contour we need to first explore the nature of the relationship and attachment to the deceased (some people may not want a continuing relationship with the deceased). Then, if appropriate, we may encourage the client to develop rituals that support memories, honour the dead and keep the presence/ spirit. Memories promote healing by validating grief, facilitating ritual, providing mementos and letting the bereaved tell their stories.

Some of the ways to continue bonds are to treasure objects which link to the person who has died (jewellery, clothes, photos, mementos and/or a box of memories), go to the cemetery, create memorials, continue to have thoughts of the deceased, have a relationship with them in one’s heart, have conversations with the deceased (and maybe seek guidance from them) and to write to them in letters or journals.

Music can be used to create connectedness and to facilitate rituals, and we need to encourage talk about the person who has died, as well as the observance of anniversary days.

Neimeyer’s tasks

I will elaborate on these in the next post.

Remember: All of these contours are ideas that may or may not be relevant to the individual grief journeys of our clients, and it is only appropriate to use them if they are meaningful for the client. Not every journey will follow all, or even any, of these contours, but they do give us a theoretical framework to draw on.