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Walking with the bereaved : a phenomenological investigation of the experience of the companion in grief 1990

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WALKING WITH THE BEREAVED: A PHENOMENOLOGICAL INVESTIGATION OF THE EXPERIENCE OF THE COMPANION IN GRIEF by KERRY MACFARLANE BELL B.S.R., Un i v e r s i t y of B r i t i s h Columbia, 1973 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE STUDIES (Department of Counselling Psychology) We accept t h i s t h e s i s as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA September, 1990 f c j Kerry Macfarlane B e l l , 1990 f T In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of Counseling Psychology The University of British Columbia Vancouver, Canada D a t e R p p l - p m y ^ r . iqqn DE-6 (2/88) - i i - ABSTRACT T h i s r e s e a r c h study sought to respond to the q u e s t i o n ; what i s the meaning of the experience of the companion to a g r i e v i n g person? T h i s was accomplished through u s i n g a phenomenological method of r e s e a r c h . The re s e a r c h e r was guided by dramatic form in c r e a t i n g a common s t o r y of the experience and i t s s t r u c t u r a l meanings. T h i s study i n c l u d e d three c o - r e s e a r c h e r s , who were s e l e c t e d on the b a s i s that they had each been a companion to a mother who had g r i e v e d the l o s s of her c h i l d through death. The c o - r e s e a r c h e r s were Interviewed and asked to give d e t a i l e d d e s c r i p t i o n s of t h e i r experience, which were taperecorded and t r a n s c r i b e d , and the t r a n s c r i p t s or p r o t o c o l s were analyzed by the r e s e a r c h e r . A Phenomenological p r o t o c o l a n a l y s i s was used to e x t r a c t meaning u n i t s and common themes from the three p r o t o c o l s . The themes were woven i n t o an i n t e g r a t e d n a r r a t i v e d e s c r i p t i o n , which was condensed i n t o the e s s e n t i a l s t r u c t u r e or meaning of the experience. At each stage of the a n a l y s i s , the re s e a r c h e r and c o - r e s e a r c h e r s cooperated so that a l l the r e s u l t s were v a l i d a t e d by the f i n a l i n terv i ew. The r e s u l t s of the study i n c l u d e d a l i s t of twenty-four themes, a n a r r a t i v e d e s c r i p t i o n of the experience b e i n g i n v e s t i g a t e d , and the e s s e n t i a l s t r u c t u r e , which presented the meaning of the experience as c o n c i s e l y as p o s s i b l e . It was p o s i t e d in the d i s c u s s i o n that the study had p a r t i c u l a r i m p l i c a t i o n s f o r p r a c t i c e . - i i i - TABLE OF CONTENTS page ABSTRACT i i TABLE OF CONTENTS i i i CHAPTER I INTRODUCTION 1 Personal E x p l i c a t i o n of Assumptions 7 CHAPTER II LITERATURE REVIEW 10 S i g n i f i c a n c e of the Companion 13 T h e o r e t i c a l Assumptions 37 Role of the Companion 40 Assumptions of the Companion's Role in G r i e f . . . 58 CHAPTER III METHOD 60 R a t i o n a l e 60 Overview of Research Method 61 Co-Researchers 63 Procedures 67 A n a l y s i s and I n t e r p r e t a t i o n of P r o t o c o l s 75 W r i t i n g a D e s c r i p t i o n 83 Issues 86 - i v - CHAPTER IV RESULTS 89 Summary of Co-Researchers' Experiences 89 C l u s t e r s of Themes 94 D e s c r i p t i o n s of the Themes 96 N a r r a t i v e D e s c r i p t i o n 128 The E s s e n t i a l S t r u c t u r e 142 CHAPTER V DISCUSSION 150 Q u a l i f i c a t i o n s 154 T h e o r e t i c a l I m p l i c a t i o n s 158 P r a c t i c a l I m p l i c a t i o n s 161 I m p l i c a t i o n s f o r Furth e r Research 166 Con c l u s i o n s 167 BIBLIOGRAPHY 170 -1- CHAPTER 1 INTRODUCTION What i s the experience of the companion to a g r i e v i n g person? The i n t e n t i o n of t h i s r e s e a r c h study i s to gain a deeper understanding of the meaning of the multidimensional aspects of the experience of the companion in g r i e f as i t i s 1 i v e d . For the purpose of t h i s study, the person who o f f e r s her presence and support to another g r i e v i n g person i s addressed by the s e l e c t e d t i t l e of /companion /. The person who i s g r i e v i n g the l o s s of a loved one, p a r t i c u l a r l y one g r i e v i n g the d e v a s t a t i n g and untimely l o s s of a c h i l d , i s e s s e n t i a l l y a person on a journey. For most, the journey i s a f e a r f u l one, i n t o unknown and p r e v i o u s l y unfathomed depths of p a i n . What bereaved parents most d e s i r e i s that t h i s unforeseen t h i n g should not be happening to them, that i t should turn out to be a bad dream. But s i n c e t h i s cannot be, what they need and d e s i r e from those who seek to o f f e r comfort i s someone to walk with them i n t o the unknown. To r e c e i v e comfort, they need a companion. It i s the r o l e - 2 - and experience of the companion In g r i e f that the res e a r c h e r seeks to explore by l i s t e n i n g to the s t o r i e s of three women who became companions to t h e i r three f r i e n d s , each of whom had l o s t a c h i l d through death. E x p l o r i n g the word 'companion'' o f f e r s a deeper i n s i g h t i n t o the r o l e and experience of the person who accompanies the bereaved on t h e i r journey of g r i e f . The Pocket Oxford D i c t i o n a r y i n c l u d e s in i t s d e f i n i t i o n of the word companion, "Person with whom one spends much time, comrade, mate, person with one on a journey "(Fowler & Fowler, 1973, p. 161). To be a companion i n g r i e f , one walks a l o n g s i d e , l i s t e n i n g , b e i n g present, w a t c h f u l , a v a i l a b l e , sometimes j u s t s i t t i n g empty handed when she would r a t h e r run away. Those who become companions to bereaved p a r e n t s , l i k e those who are companions to the dying, must enter i n t o t h e i r darkness, go with them at l e a s t p art way along t h e i r l o n e l y and f r i g h t e n i n g road. T h i s i s the meaning of compassion: to enter i n t o the s u f f e r i n g of another, to share in some small way in t h e i r -3- p a l n , c o n f u s i o n and d e s o l a t i o n ( C a s s l d y , 1988, p. 5 ) . In our present-day c u l t u r e which has become e x p e r i e n t i a l 1 y ignorant about dying and g r i e f , there are few r o l e models f o r the compassionate f r i e n d or companion in g r i e f . Although people have been e x p e r i e n c i n g l o s s f o r thousands of years, g r i e f and bereavement have t r a d i t i o n a l l y been worked out and r e s o l v e d w i t h i n the s u p p o r t i v e r e l i g i o u s and s o c i a l s t r u c t u r e s of f a m i l y , church and community networks. In today's s o c i e t y , however, e x c e s s i v e m o b i l i t y and the s e c u l a r i z a t i o n of the age have brought about an i n c r e a s i n g breakdown of these s t r u c t u r e s and the sense of community and shared v a l u e s they p r o v i d e . When f r i e n d s and f a m i l y are a v a i l a b l e to o f f e r comfort and support to the bereaved in t h e i r g r i e f , they o f t e n f e e l confused and u n c l e a r as to what may be expected of them, and i l l - e q u i p p e d to respond to the needs of t h e i r bereaved f r i e n d . The need f o r a resource or guide to equip companions to g r i e v i n g persons i s more p r e s s i n g in l i g h t of these c u l t u r a l changes. By s t u d y i n g the nature and meaning of the experience, i t s problems, -4- p l t f a l l s and rewards, p r o f e s s i o n a l s w i l l be In a b e t t e r p o s i t i o n to guide and t r a i n companions to g r i e v i n g persons in the f u t u r e . The search f o r the meaning <or e s s e n t i a l s t r u c t u r e ) of the experience of the companion in g r i e f i s accomplished by s t u d y i n g human experience. One method s u i t a b l e f o r i n v e s t i g a t i n g the experience of the companion w i t h i n the context of l i v e d experience i s phenomenology. The phenomenological r e s e a r c h e r i n t e r v i e w s those who have experienced the phenomenon under study, and through c a r e f u l a n a l y s i s c o n s t r u c t s a d e s c r i p t i v e account of the experience which i s true to each i n d i v i d u a l d e s c r i p t i o n . T h i s n a r r a t i v e d e s c r i p t i o n i s then condensed to i t s e s s e n t i a l s t r u c t u r e , which p r e s e n t s the meaning of the experience as i t i s l i v e d . By conducting a study with the aim of c a p t u r i n g the raw experience of laypersons who have become companions to g r i e v i n g persons, and doing so w i t h i n the context of dramatic form so as to capture the dramatic power and the nuances of the phenomenon, i t i s hoped that the r e s u l t s of t h i s study w i l l p e netrate to the core of the experience b e i n g i n v e s t i g a t e d . - 5 - The body of g r i e f l i t e r a t u r e has expanded over the past twenty years to cover formerly n e g l e c t e d a s p e c t s of the l o s s and g r i e f e x p e r i e n c e . While the present body of g r i e f l i t e r a t u r e i s a growing reso u r c e , there i s s t i l l very l i t t l e which d i r e c t l y addresses the phenomenon of the companion in g r i e f . There i s a need f o r w r i t t e n r e s o u r c e s r e f l e c t i n g the knowledge gained from the experience as i t was l i v e d by laypersons, without the i n t e r f e r e n c e of c l e a r l y devolped p r i o r assumptions about f a c i l i t a t i n g the g r i e f p r o c e s s , which i s o f t e n evident in the work of p r o f e s s i o n a l s in the f i e l d of bereavement c o u n s e l i n g . In the opening chapter of t h i s study, the re s e a r c h e r i n t r o d u c e s the reader to the o b j e c t i v e s and the o v e r a l l s i g n i f i c a n c e of the study. The second chapter i s a review of the l i t e r a t u r e which addresses the phenomenon of the p a r t i c i p a t o r y g r i e f of the companion to the bereaved and the e x p e r i e n t i a l p r o c e s s of the person who accompanies a bereaved person through t h e i r g r i e v i n g p r o c e s s . The s i g n i f i c a n c e of the r o l e of the companion to the bereaved i s c l e a r l y e s t a b l i s h e d by consensus - 6 - ln the l i t e r a t u r e to date. The qu e s t i o n s of what c o n s t i t u t e the q u a l i t i e s or common f e a t u r e s of the companion, and the components of the companion's experience in f a c i l i t a t i n g the g r i e f p rocess are addressed in the work of the major g r i e f t h e o r i s t s to v a r y i n g degrees. The t h i r d chapter o u t l i n e s the methods of phenomenological r e s e a r c h , which has been s e l e c t e d as the most a p p r o p r i a t e r e s e a r c h method to gain an understanding of human experience as l i v e d . A r a t i o n a l e i s presented which u n d e r l i n e s that the explanatory methods of e m p i r i c a l psychology, concerned as they are with laws of c a u s a l i t y and measurement, are inadquate to the task of understanding human experience and the q u a l i t i e s inherent in the i n d i v i d u a l s p a r t i c i p a t i n g in the experience b e i n g i n v e s t i g a t e d . The a n a l y s i s f o l l o w s the d e s c r i p t i v e methods o u t l i n e d by G i o r g l in Duguesne S t u d i e s in Phenomenoloalcal Psychology II ( G i o r g l , 1975) and by C o l a i z z i in E x i s t e n t i a l - P h e n o m e n o l o g i c a l A l t e r n a t i v e s f o r P s v c h o l o g v C C o l a i z z i . 1978) and The Meaning of G r i e f : A Dramaturgical Approach to Understanding Emot ion (Cochran & C l a s p e l l , 1987). Issues -7- a r i s i n g from the s e l e c t e d methodology are d i s c u s s e d . The f o u r t h chapter i s a d e s c i p t i o n of the r e s u l t s of the study; i t i n c l u d e s the l i s t of common themes, the n a r r a t i v e d e s c r i p t i o n and the e s s e n t i a l s t r u c t u r e of the experience. The f i f t h and f i n a l chapter i s a d i s c u s s i o n of the r e s u l t s . Included i s a b r i e f overview of what the study has produced, the p o s s i b l e q u a l i f i c a t i o n s which apply to the study, the t h e o r e t i c a l and p r a c t i c a l i m p l i c a t i o n s , and the i m p l i c a t i o n s f o r f u r t h e r r e s e a r c h . Researcher's Personal E x p l i c a t i o n of Assumptions In accordance with the phenomenological method, the r e s e a r c h e r makes her own p r e s u p p o s i t i o n s and assumptions e x p l i c i t about the phenomenon b e i n g i n v e s t i g a t e d . By making her own p r i o r thoughts, e x p e c t a t i o n s , and b e l i e f s known, i t then becomes p o s s i b l e to suspend Judgement so that the reader can see the phenomenon as presented by the c o - r e s e a r c h e r s in the study, without the i n t e r f e r e n c e of b i a s . T h i s process of making background ex p e c t a n c i e s e x p l i c i t a l s o c l a r i f i e s how preformu1ated q u e s t i o n s which have been posed by the r e s e a r c h e r at the end of the -8- c o - r e s e a r c h e r s ' d e s c r i p t i o n s of experience, have been d e r i v e d . T h i s process w i l l be e l a b o r a t e d upon in Chapter 3 . L i k e the c o - r e s e a r c h e r s in t h i s study, the r e s e a r c h e r has attempted to be a companion to g r i e v i n g persons. The process of l e a r n i n g through personal experience p r o v i d e s the e x i s t e n t i a l s t a r t i n g p o i n t f o r the i n i t i a l assumptions r e g a r d i n g the experience. Dialogue with o t h e r s , both p r o f e s s i o n a l c a r e g i v e r s and lay companions who have shared what they have learned from t h e i r experience, and the r e s e a r c h e r ' s r e a d i n g of l i t e r a t u r e about the phenomenon, have been a d d i t i o n a l sources which have c o n t r i b u t e d to i n i t i a l e x p e c t a t i o n s of the experience. The f i r s t assumption about the experience i s that becoming a companion in g r i e f r e q u i r e s commitment, that once made, cannot be withdrawn without c a u s i n g f u r t h e r pain and d i s t r e s s to an already v u l n e r a b l e bereaved person. The second assumption r e g a r d i n g the q u e s t i o n about length of the process, i s that the experience shared by the companion and bereaved i s intense and 1ong-1asting, longer than s o c i e t a l e x p e c t a t i o n s - 9 - set f o r t h . T h i r d l y , there are p a r t i c u l a r q u a l i t i e s inherent in the companion which w i l l f a c i l i t a t e the g r i e v i n g process of the bereaved, and a primary a t t r i b u t e i s the c a p a c i t y f o r empathy. F o u r t h l y , there are p a r t i c u l a r components to the experience which correspond to the beginning, middle, and end of the g r i e v i n g experience of the bereaved. And f i n a l l y , the r o l e of the companion, though demanding, i s an experience that has rewards and b e n e f i t s which exceed the c o s t l y nature of the commitment. - 1 0 - CHAPTER 2 LITERATURE REVIEW In t h i s chapter, various aspects of the experience of the companion to the bereaved, as presented in the works of the major grief theorists and in current research studies, are reviewed. The purpose of t h i s l i t e r a t u r e review is f i r s t l y , to establish the significance of the companion to the bereaved in the l i t e r a t u r e . Secondly, the intent i s to explore the role of the companion in accordance with needs assessments of the bereaved in f a c i l i t a t i n g the grief process. Inherent in t h i s exploration of the role of the companion i s the need to review how components of the companion's experience in f a c i l i t a t i n g the griever's journey towards healthy resolution of the gri e f process correspond to the various theories of the phases or components of the grief process. The p a r t i c u l a r focus of t h i s study of the experience of the companion in grief i s on the experience of the woman, who, by virtue of prior relationship, becomes the companion to a mother who has lost a c h i l d through death. The current -11- r e s e a r c h Into t h i s phenomenon Is very l i m i t e d . T h e r e f o r e , r e s e a r c h s t u d i e s that are r e l e v a n t to the wider t o p i c of the companion in g r i e f w i l l be Included. The l i t e r a t u r e review w i l l i n c l u d e an overview of those aspects about the experience that have been e x p l o r e d In the work of the major g r i e f t h e o r i s t s in t r e a t i n g the themes of l o s s and g r i e f , and bereavement c o u n s e l l i n g CLindemann, 1945; Bowl by, 1960-63; Kubler-Ross, 1969; Parkes, 1983; Raphael, 1982; Rando, 1984; Schneider, 1984; Worden, 1982). In accordance with the phenomenological method, the b a s i c t h e o r e t i c a l assumptions that emerge in the l i t e r a t u r e w i l l be made e x p l i c i t , as these assumptions in a d d i t i o n to assumptions emerging from personal experience, have guided t h i s study. The reason f o r making both t h e o r e t i c a l and personal assumptions e x p l i c i t i s to e l i m i n a t e p o t e n t i a l b i a s at the stage of i nterv i ewi ng. The bulk of the g r i e f l i t e r a t u r e c o n s i s t e n t l y s t r e s s e s the c r u c i a l r o l e that s o c i a l network p l a y s in g r i e f r e s o l u t i o n . "The process by which laypersons support one another in times of s t r e s s - 1 2 - i s a g e n e r a l l y r e c o g n i z e d phenomenon.... However, as a phenomenon, p a r t i c i p a t o r y g r i e f , that i s , the compassion that we experience when we empathize with a f r i e n d who has s u f f e r e d a l o s s , has not r e c e i v e d much a t t e n t i o n . Yet the f e e l i n g s of sadness are r e a l , and so i s the c o n f u s i o n that r e s u l t s from b e i n g p l a c e d in a p o s i t i o n in which i t i s u n c l e a r what i s (or may be) expected" (Schoenberg, 1970, p. 243). Because the r e s e a r c h i n t o the phenomenon remains l i m i t e d , the f o l l o w i n g two areas addressed in the l i t e r a t u r e which c o n t r i b u t e to an understanding of the experience of the companion to a bereaved person w i l l p r ovide the s t r u c t u r e f o r r e v i e w i n g the l i t e r a t u r e : 1. The s i g n i f i c a n c e of the companion in g r i e f , whether layperson, t r a i n e d v o l u n t e e r , or p r o f e s s i o n a l 2. The components of the companion's experience in f a c i l i t a t i n g r e s o l u t i o n of the g r i e f p rocess f o r the bereaved - 1 3 - S l a n i f i n a n c e of the Companion Two are b e t t e r than one... f o r If one f a l l s down, h i s f r i e n d can help him up. But p i t y the man who f a l l s and has no one to help him up C E c c l e s i a s t e s 4:9-10). Although the a c t u a l r o l e and experience of the companion remains to be e x p l o r e d in the growing body of g r i e f l i t e r a t u r e , the s i g n i f i c a n c e of a companion to a g r i e v i n g person i s c l e a r l y e s t a b l i s h e d . The evidence in the l i t e r a t u r e suggests that everyone needs support and reassurance f o l l o w i n g bereavement (Osterweiss, Solomon & Green, 1984). There are three general c a t e g o r i e s of care that are r e c o g n i z e d in the l i t e r a t u r e as p r o v i d i n g the bereaved with a companion in t h e i r g r i e f . F i r s t l y , informal support may be p r o v i d e d by f r i e n d s , r e l a t i v e s or c l e r g y or by laypeople in s i m i l a r circumstances. The companions in t h i s study are f r i e n d s of the bereaved and represent t h i s l e v e l of c a r e . Secondly, formal support may be p r o v i d e d by laypeople who r e c e i v e t r a i n i n g and s u p e r v i s i o n by a p r o f e s s i o n a l , and such support i s o f f e r e d on a -14- one-to-one b a s i s or in the context of a mutual s e l f - h e l p group. T h i r d l y , p r o f e s s i o n a l support i n c l u d e s g r i e f c o u n s e l i n g and g r i e f therapy. (Worden, 1982; Raphael, 1982; Parkes, 1983). The evidence in the l i t e r a t u r e i s i n d i s p u t a b l e that the presence of the person who i s equipped to support the bereaved i s of c r i t i c a l importance. The absence or i n a p p r o p r i a t e n e s s of some forms of support i s a l s o evident in s t u d i e s on p e r c e i v e d s o c i a l support. Therese Rando, one of the most cu r r e n t and r e l e v a n t g r i e f t h e o r i s t s to address the phenomenon of f a c i l i t a t i n g the g r i e f p rocess s t a t e s , S o c i a l support i s c r i t i c a l throughout the e n t i r e g r i e f p r o c e s s . It enables the bereaved person to t o l e r a t e the p a i n of l o s s and p r o v i d e s the acceptance and a s s i s t a n c e necessary f o r completion of g r i e f work and r e i n t e g r a t i o n back i n t o the s o c i a l community. Research r e p e a t e d l y confirms that one of the most s i g n i f i c a n t f a c t o r s c o n t r i b u t i n g to the f a i l u r e to a p p r o p r i a t e l y r e s o l v e g r i e f i s the absence and or i n a p p r o p r i a t e n e s s of s o c i a l support and i n t e r a c t i o n . Nothing i s more -15- t h e r a p e u t l c In the process of g r i e f than the presence of an a c c e p t i n g and non-Judgemental c a r i n g other (Rando, 1984, p. 82). The suggestion in the l i t e r a t u r e i s that where f a m i l y and c l o s e f r i e n d s are a v a i l a b l e , the support and i n t e r a c t i o n they p r o v i d e i s g e n e r a l l y s u f f i c i e n t in f a c i l i t a t i n g h e a l t h y g r i e v i n g , and i s c o u n t e r - p r o d u c t i v e only when such q u a l i t i e s as empathy and non-judgemental acceptance are s o r e l y l a c k i n g . Due to c u l t u r a l changes, people have turned i n c r e a s i n g l y in t h e i r bereavement to the p r o f e s s i o n a l c a r e g i v e r . There i s some con t r o v e r s y which i s addressed in t h i s review as to who i s best s u i t e d to the task; the layperson, the t r a i n e d and s u p e r v i s e d v o l u n t e e r , or the p r o f e s s i o n a l c a r e g i v e r . The work of each of the major g r i e f t h e o r i s t s emphasizes the s i g n i f i c a n c e of the companion in g r i e f . The f o l l o w i n g h i s t o r i c a l overview c l a r i f i e s t h e i r agreement that the s o c i a l support that a companion in g r i e f p r o v i d e s , i s a c r u c i a l f a c t o r c o n t r i b u t i n g to healthy g r i e v i n g . The proponents of the medical model view g r i e f as having d i s t i n c t c l i n i c a l f e a t u r e s - 1 6 - r e q u i r i n g treatment. E r i c h Lindemann, a p s y c h i a t r i s t , was one of the p i o n e e r i n g r e s e a r c h e r s in the study of c r i s i s i n t e r v e n t i o n with the bereaved and the e a r l i e s t g r i e f t h e o r i s t to look at normal g r i e f r e a c t i o n s in any s y s t e m a t i c way. In h i s c l a s s i c paper based upon h i s o b s e r v a t i o n s of the acute g r i e f r e a c t i o n s of 101 r e c e n t l y bereaved fam i l y members of the v i c t i m s of a f i r e , he p o i n t s to the s i g n i f i c a n c e of the p s y c h i a t r i s t whose r o l e he s p e c i f i e s i s to "share the p a t i e n t ' s work" (Lindemann, 1945, p. 74). He views the p s y c h i a t r i s t as the optimim choice of companion in ' t r e a t i n g the symptomatology of g r i e f with the aim of p r e v e n t i n g maladjustment and d i s e a s e . T h i s i s r e f l e c t e d In h i s c o n c l u s i o n that " p s y c h i a t r i c management of g r i e f r e a c t i o n s may prevent prolonged and s e r i o u s a l t e r a t i o n s in the p a t i e n t ' s s o c i a l adjustment, as well as p o t e n t i a l medical dise a s e " (Lindemann, 1945, p. 74). His personal view that the p r o f e s s i o n a l r a t h e r than lay companion i s b e t t e r s u i t e d to the task i s u n d e r l i n e d i n h i s statement t h a t , -17- Since It Is obvious that not a l l bereaved p e r s o n s . c a n have the b e n e f i t of expert p s y c h i a t r i c h e l p , much of t h i s knowledge w i l l have to be passed on to a u x i l i a r y workers. S o c i a l workers and m i n i s t e r s w i l l have to be on the lookout f o r the more ominous p i c t u r e s , r e f e r r i n g these to the p s y c h i a t r i s t w h ile a s s i s t i n g the more normal r e a c t i o n s themselves CLindemann, 1945, p. 75-76). T h i s view i s c h a l l e n g e d by l a t e r g r i e f t h e o r i s t s (Kubler-Ross, 1975; Raphael, 1983; Worden, 1982; Parkes, 1983). The s t r e n g t h of Lindemann's c o n t r i b u t i o n i s h i s s y s t e m a t i c study of normal g r i e f r e a c t i o n s , but i t i s the c l i n i c a l o r i e n t a t i o n in h i s medical model that causes him to discount what o t h e r s view as a v a l u a b l e c o n t r i b u t i o n of laypeople in p r o v i d i n g companions to g r i e v i n g people. E l i z a b e t h Kubler-Ross, a l s o a p s y c h i a t r i s t , but a proponent of the stage model of g r i e v i n g , s t i m u l a t e d popular i n t e r e s t in i s s u e s r e l a t e d to death and dying. Through her work with the dying, she o u t l i n e d stages common to g r i e v i n g one's own imminent l o s s of l i f e (Kubler-Ross, 1969). - 1 8 - Although the major focus and c o n t r i b u t i o n of her work has been to b r i n g to p u b l i c awareness the much avoided s u b j e c t of death and dying, she has a l s o c o n t r i b u t e d to an understanding of g r i e f and bereavement. In her book, Death; The F i n a l Stage of Growth. she p o i n t s to the s i g n i f i c a n c e of the companion in g r i e f , whether layperson or p r o f e s s i o n a l . She emphasizes the need of the bereaved to be accompanied r a t h e r than abandondoned, in s p i t e of her view that people in our s o c i e t y and age are o f t e n i l l equipped to do so. She s t a t e s , The r e a l i t y of what works i s the re v e r s e of what we expect. We r o u t i n e l y s h i e l d the bereaved from coming face to face with the r e a l i t y of the death of t h e i r loved one; we take over f o r them and i n v i t e them only to observe. And in doing t h i s , we f o r c e them to submerge t h e i r g r i e f , extending and expanding t h e i r p a i n and making i t i n c r e a s i n g l y d i f f i c u l t f o r them to come to g r i p s with the death. ... In the f o l l o w i n g s e l e c t i o n , the authors o f f e r an a l t e r n a t i v e to t h i s k i n d of well-meaning d e c e p t i o n . I only wish we c o u l d - 1 9 - al1 be f o r t u n a t e enough to f i n d such l o v i n g , understanding human beings to help us when death comes to our f a m i l i e s . (Kubler-Ross, 1975, p. 87). John Bowlby, a B r i t i s h p s y c h i a t r i s t and g r i e f t h e o r i s t , drawing from a b i o l o g i c a l p e r s p e c t i v e i n f l u e n c e d by p s y c h o a n a l y s i s , presented a developmental model of g r i e v i n g which emphasized the adaptive value of g r i e f . The focus of h i s work i s in the area of attachment and l o s s , and the s t r e n g t h of h i s work i s in h i s t h e o r e t i c a l o r i e n t a t i o n , which p r o v i d e d a p l a t f o r m f o r the work of such l a t e r t h e o r i s t s as Parkes and Raphael. Bowlby i n f e r r e d that a companion in g r i e f was s i g n i f i c a n t to the extent that the process of g r i e f that was o u t l i n e d in h i s theory was encouraged and not blocked. He viewed g r i e f as a b i o l o g i c a l phenomenon which began with the i n i t i a l shock of l o s s . He saw the companion as s i g n i f i c a n t i n encouraging the emotional e x p r e s s i o n of p r o t e s t and d e s p a i r which was a necessary and healthy p a r t of i n s t i n c t u a l behaviour r e q u i r e d to b r i n g about detachment from - 2 0 - the l o s s so that reattachment and reinvestment was p o s s i b l e . C o l i n Murray Parkes, a more recent proponent of the developmental model of g r i e f , p o i n t e d to the importance of s o c i a l support in d e c i d i n g the course of g r i e f and the l i k e l i h o o d that the i n d i v i d u a l would r e t u r n to e f f e c t i v e f u n c t i o n i n g . Parkes, i n h i s paper, "Bereavement Counseling: Does i t Work?", reviewed a number of r e s e a r c h s t u d i e s in an attempt to compare the three c a t e g o r i e s of companion r e f e r r e d to e a r l i e r in t h i s chapter. He concluded that support and c o u n s e l i n g f o r the bereaved was o f f e r e d as e f f e c t i v e l y by p r o p e r l y t r a i n e d v o l u n t e e r s as by p r o f e s s i o n a l workers. Parkes e v a l u a t e d that p r o f e s s i o n a l and p r o f e s s i o n a l l y supported s e r v i c e s and s e l f - h e l p s e r v i c e s were capable of r e d u c i n g the r i s k of post-bereavement m o r b i d i t y . A l a t e r study (Cameron & Parkes, 1983) confirmed these f i n d i n g s that c o u n s e l i n g c o u l d reduce the i n c i d e n c e of l a s t i n g maladjustment. His c r i t e r i a in e v a l u a t i n g the s i g n i f i c a n c e of v a r i o u s types of support was based on p r e v e n t i o n of d i s e a s e and s o c i a l maladjustment, l i k e Lindemann. He saw that - 2 1 - p r o f e s s I o n a l s should f u n c t i o n not as examples to be Imitated or as I n s t r u c t o r s of psychotherapy. Rather, they should encourage v o l u n t e e r s to develop t h e i r own l a t e n t s k i l l s in s u p p o r t i n g the bereaved. He suggested that such s e r v i c e s should not be seen as necessary f o r a l l people. He viewed g r i e f as a normal response not n e c e s s a r i l y r e g u i r i n g o u t s i d e i n t e r v e n t i o n , p r o v i d e d that bereaved i n d i v i d u a l s had s u p p o r t i v e people around them. His work confirmed that a l l three l e v e l s of care were s i g n i f i c a n t , but s e r v i c e s were most b e n e f i c i a l f o r those who p e r c e i v e d t h e i r f a m i l i e s and f r i e n d s as unsupportive or who, f o r other reasons were thought to be at s p e c i a l r i s k (Parkes, 1980, p. 9). Beverley Raphael, a p s y c h i a t r i s t and proponent of the p s y c h o a n a l y t i c model (which p r e s e n t s g r i e f as an i n t r a p s y c h i c process) s t r e s s e d the s i g n i f i c a n t r o l e that a companion in g r i e f p l a y e d in f a c i l i t a t i o n of the g r i e f p r o c e s s . She, l i k e Parkes, advocated that knowledge of bereavement p a t t e r n s and a s s o c i a t e d dynamics was very c r u c i a l in e d u c a t i n g v o l u n t e e r s and t r a i n i n g them in the s k i l l s r e q u i r e d to support bereaved -22- i n d l v l d u a l s who were s p e c i f i c a l l y i d e n t i f i e d as h i g h - r i s k . She confirmed in one study that p e r c e i v e d lack of s o c i a l support was a p r e d i c t o r of poor bereavement outcome (Raphael, 1977, p. 1454). She saw bereaved i n d i v i d u a l s i d e n t i f i e d as high r i s k r e q u i r i n g the s k i l l s of a w e l l - t r a i n e d v o l u n t e e r or p r o f e s s i o n a l c o u n s e l o r , but those c o n s i d e r e d low-risk as r e q u i r i n g support by one who demonstrated the core a t t r i b u t e of empathy. In the low r i s k bereaved, she found that the common f e a t u r e s of non-judgemental support, compassion, and a wish to help the bereaved to resume adequate f u n c t i o n i n g and a sense of w e l l - b e i n g , were s i g n i f i c a n t in f a c i l i t a t i n g r e s o l u t i o n of the g r i e f p r o c e s s . Raphael, u n l i k e Lindemann before her, emphasized that with uncomplicated g r i e f and with the low r i s k bereaved, r e g a r d l e s s of who p r o v i d e d the support, p e r c e i v e d s o c i a l support was s i g n i f i c a n t to the h e a l t h y r e s o l u t i o n of the g r i e f p r o c e s s . She i n f e r r e d that the presence and support that f r i e n d s and f a m i l y gave to the bereaved c o n t r i b u t e d to h e a l t h y g r i e v i n g , when she s t a t e d , - 2 3 - The comfort and consolation' human beings o f f e r to each other at such times (of bereavement) are powerful r e i n f o r c e r s of the bonds so e s s e n t i a l f o r f a m i l y and community l i f e . Much of the h e a l i n g of bereavement takes p l a c e in the warmth of f a m i l y l i f e and f r i e n d s h i p (Raphael, 1983, p. 352). Raphael a l s o focused upon the unique aspects of p a r e n t a l l o s s , and the p a r t i c u l a r need f o r support, when she s t a t e d , Through the c r i s i s of prolonged i l l n e s s and death, or sudden death, the f a m i l y i s l i k e l y to need not only one another's support but a l s o that of the extended f a m i l y and s o c i a l network. F r i e n d s are needed f o r t a n g i b l e p r a c t i c a l a s s i s t a n c e as well as emotional support. The g r e a t e s t support o f t e n comes from s h a r i n g with other parents e x p e r i e n c i n g the same c r i s i s (Raphael, 1983). She saw the parent l o s i n g not only the r e l a t i o n s h i p but a p a r t of the s e l f and a hope f o r the f u t u r e . She emphasized the need f o r support from o u t s i d e the m a r i t a l r e l a t i o n s h i p at a time - 2 4 - when both parents were simultaneously s t r u c k by overwhelming l o s s when she s t a t e d , O u t s i d e r s , be they t h e r a p i s t s , other members of the c a r e g i v i n g p r o f e s s i o n s , or simply f r i e n d s and neighbours, because they are not caught up in the f a m i l y , are sometimes able to give support at the very moment when the fa m i l y i s most i n c a p a c i t a t e d . . . . These o u t s i d e r s can r e i n t r o d u c e s a f e t y and order i n t o what has become f o r the f a m i l y , an unsafe and c h a o t i c world (Raphael, 1983, p. 245). Therese Rando, a p s y c h o l o g i s t , focused on the p a r t i c u l a r need f o r the support of the companion in p a r e n t a l l o s s of a c h i l d , given the emotional i m p l i c a t i o n s of such a l o s s . She p o i n t e d out some of the unique p s y c h o l o g i c a l and s o c i o l o g i c a l i s s u e s that made pa r e n t a l bereavement p a r t i c u l a r l y d i f f i c u l t to r e s o l v e ; the unexpectedness of a c h i l d ' s dying before a parent, negative s o c i a l r e a c t i o n s , l o s s of support from spouses, and the need f o r c a r i n g f o r s u r v i v i n g c h i 1 d r e n . She f e l t that the s i g n i f i c a n c e of a compassionate and understanding companion was heightened in a - 2 5 - s o c l e t y "which has a s t r a n g e l y c a l l o u s response to the bereaved parent, who o f t e n experiences avoidance, r e j e c t i o n and anger at a time when the person to whom one would normally turn f o r support i s a l s o deeply i n v o l v e d in h i s or her own gri e f " ( R a n d o , 1984, p. 167). She u n d e r l i n e s the p a r t i c u l a r need f o r a companion from o u t s i d e the m a r i t a l r e l a t i o n s h i p in pa r e n t a l l o s s as each person's most t h e r a p e u t i c resource i s removed with t h i s l o s s . She a l s o p o i n t s out that the c l o s e n e s s that c h a r a c t e r i z e s the marriage r e l a t i o n s h i p a l s o makes p a r t n e r s p a r t i c u l a r l y v u l n e r a b l e to the f e e l i n g s of blame and anger that g r i e v e r s o f t e n d i s p l a c e to those nearest them. Rando h i g h l i g h t e d the need f o r a companion to a bereaved parent to o f f e r support both p r a c t i c a l l y and e m o t i o n a l l y , but she addressed the p a r t i c u l a r d i f f i c u l t i e s in r e c e i v i n g that much needed support in her address to the bereaved parent; The problems that you as a bereaved parent have in g e t t i n g s o c i a l support from o t h e r s can i n t e n s i f y your d i f f i c u l t i e s . While s o c i e t y v a l u e s the p a r e n t - c h i l d r e l a t i o n s h i p above a l l o t h e r s , i t does l i t t l e to a s s i s t - 2 6 - you as bereaved parent.... T h i s i s because you represent the very worst f e a r s of every parent.... As a r e s u l t , bereaved p a r e n t s are avoided more than most other mourners and are v i c t i m s of s o c i a l o s t r a c i s m and u n r e a l i s t i c e x p e c t a t i o n s " (Rando, 1984, p. 169) John Schneider, a p s y c h o l o g i s t and advocate of a w h o l i s t i c stage model of g r i e v i n g , u n d e r l i n e d the s i g n i f i c a n c e of s u p p o r t i v e r e l a t i o n s h i p s f o r the f a c i l i t a t i o n of the g r i e f p r o c e s s . He t r a c e d the changing a t t i t u d e s toward f a c i l i t a t o r s in g r i e v i n g , when he s t a t e d , Although the p e r v a s i v e philosophy of many mental h e a l t h p r o f e s s i o n a l s was that g r i e f and the process of mourning was a na t u r a l process and t h e r e f o r e not amenable to t r a d i t i o n a l p s y c h o t h e r a p e u t i c i n t e r v e n t i o n ( A v e r i l l , 1969; Freud, 1917), i t i s now co n s i d e r e d to be a l e g i t i m a t e focus f o r those in h e l p i n g r o l e s . T h i s change in view i s at l e a s t in pa r t a t t r i b u t a b l e to the awareness that f a c i l i t a t i o n of h e a l t h and growth are as l e g i t i m a t e a f u n c t i o n f o r the h e a l t h p r o f e s s i o n a l as i n t e r v e n t i o n in pathology and - 2 7 - disease. In a d d i t i o n , those in h e l p i n g r o l e s are I n c r e a s i n g l y aware that people o f t e n have d i f f i c u l t y with aspects of the process of mourning. T h i s d i f f i c u l t y i s at l e a s t p a r t i a l l y a t t r i b u t a b l e to the absence of s u p p o r t i v e r e l a t i o n s h i p s or e f f e c t i v e r i t u a l s to f a c i l i t a t e the pro c e s s . C u l t u r a l changes, which have brought about i n c r e a s e d m o b i l i t y and l e s s r e l i a n c e on org a n i z e d r e l i g i o n , have c o n t r i b u t e d to these absences (Schneider, 1984, p. 60). W i l l i a m Worden, in h i s handbook on g r i e f c o u n s e l i n g and g r i e f therapy, s t r e s s e d that the companion in g r i e f i s sought by many bereaved people who acknowledge the s i g n i f i c a n t r o l e a companion can pl a y in f a c i l i t a t i n g the g r i e f p r o c e s s . He s t r e s s e d that people i n c r e a s i n g l y turn to the h e a l t h care system and the mental h e a l t h system, s e e k i n g from p r o f e s s i o n a l c a r e g i v e r s the support and care that p r e v i o u s l y would have come from a l t e r n a t e sources in a r e l i g i o u s l y based extended community network. He addressed h i s book to those in t r a d i t i o n a l p r o f e s s i o n s i n c l u d i n g the c l e r g y , f u n e r a l - 2 8 - d i r e c t o r s , f a m i l y t h e r a p i s t s , nurses, s o c i a l workers, and p h y s i c i a n s , who are a l r e a d y in a p o s i t i o n to extend care to the bereaved and who have the knowledge and s k i l l s r e q u i r e d to do e f f e c t i v e i n t e r v e n t i o n and in some cases, p r e v e n t i v e mental h e a l t h work. Worden emphasized the v a r y i n g degrees of need in the bereaved f o r support through t h e i r g r i e v i n g p r o c e s s . The l o s s of a s i g n i f i c a n t other causes a broad range of r e a c t i o n s which we have now seen are normal a f t e r such an experience. Most people are able to cope with these r e a c t i o n s and work through the four tasks of g r i e v i n g on t h e i r own, thereby s e e i n g g r i e f to i t s c o n c l u s i o n . Some people f i n d , however that they have t r o u b l e r e s o l v i n g t h e i r f e e l i n g s about the l o s s and t h i s can hinder t h e i r a b i l i t y to complete the g r i e f tasks and thus to resume a normal l i f e . In these cases, c o u n s e l i n g w i l l o f t e n help them b r i n g t h e i r g r i e f to an e f f e c t i v e c o n c l u s i o n . . . . C o u n s e l i n g i n v o l v e s h e l p i n g people f a c i l i t a t e uncomplicated or normal g r i e f to a h e a l t h y completion of the tasks of g r i e v i n g w i t h i n a - 2 9 - reasonable time frame. I r e s e r v e the term g r i e f therapy f o r those s p e c i a l i z e d techn1ques...used to help people with abnormal or complicated g r i e f r e a c t i o n s (Worden, 1982, p. 35). Although there i s a d i v e r s i t y of views about the nature of g r i e f and d i f f e r e n t p e r s p e c t i v e s f o r viewing the g r i e f p rocess r e p r e s e n t e d in the work of the major g r i e f t h e o r i s t s , there i s agreement that the r o l e of the companion Is a s i g n i f i c a n t one. The l i t e r a t u r e s t r o n g l y suggests that f o r people who experience normal r e a c t i o n s and who are not seen as b e i n g at p o t e n t i a l l y high r i s k f o r adverse consequences of bereavement, the support of f a m i l y and f r i e n d s , perhaps augmented by some type of mutual support i n t e r v e n t i o n i s both s i g n i f i c a n t and g e n e r a l l y s u f f i c i e n t . Current Research S t u d i e s Parkes r e p o r t e d on the s i g n i f i c a n t r o l e of the companion in a l o n g i t u d i n a l study he conducted at S t . C h r i s t o p h e r ' s Hospice in London. Lay v o l u n t e e r s were t r a i n e d to p r o v i d e support and p r a c t i c a l advice to a predetermined ' h i g h - r i s k ' group of s u r v i v o r s whose r e l a t i v e or c l o s e f r i e n d - 3 0 - d i e d at the Hospice. One hundred and eighty-one r e c e n t l y bereaved i n d i v i d u a l s were d i v i d e d i n t o three groups of imperative need, h i g h - r i s k , and low r i s k . The h i g h - r i s k group was then f u r t h e r d i v i d e d i n t o an i n t e r v e n t i o n or n o n - i n t e r v e n t i o n group by random assignment. At twenty months postbereavement, the groups were compared on a number of measures, i n c l u d i n g p h y s i c a l symptoms, de p r e s s i o n , h a b i t changes, an index of worry, and a general h e a l t h index. S i g n i f i c a n t d i f f e r e n c e s were found between the two h i g h - r i s k groups and those in the i n t e r v e n t i o n group of h i g h - r i s k s u r v i v o r s had become l i k e the low-risk i n d i v i d u a l s (Parkes, 1981). In the Harvard Bereavement Study, Parkes c o l l e c t e d data e a r l y in bereavement to e s t a b l i s h s i g n i f i c a n t p r e d i c t o r s of the h i g h - r i s k p o p u l a t i o n , which was d e f i n e d by absence of a support network. R e s u l t s of t h i s study confirmed Parkes' h y p o t h e s i s that t r a i n e d lay companions in g r i e f c o n t r i b u t e d in a s i g n i f i c a n t way to the h e a l t h y r e s o l u t i o n of the g r i e v i n g p rocess of bereaved persons. Raphael conducted a study s i m i l a r to the Parkes' study. She i n t e r v i e w e d widows and - 3 1 - wldowers at r e g u l a r I n t e r v a l s . She p r o v i d e d b r i e f s u p p o r t i v e p s y c h o t h e r a p e u t i c i n t e r v e n t i o n s f o r widows at high r i s k f o r m o r b i d i t y in the postbereavement p e r i o d . F a c t o r s c o n t r i b u t i n g to the ' h i g h - r i s k ' s t a t u s of these women were p e r c e i v e d lack of s o c i a l support and ambivalence in t h e i r m a r i t a l r e l a t i o n s h i p , both confirmed as p r e d i c t o r s of poor bereavement outcomes from a p r e v i o u s study (Raphael, 1977, p. 1454). T h i r t y - o n e h i g h - r i s k widows were randomly a l l o c a t e d to an i n t e r v e n t i o n group while t h i r t y - t h r e e r e c e i v e d no i n t e r v e n t i o n . Low-risk widows formed a c o n t r o l group. The i n t e r v i e w s o f f e r e d d u r i n g the f i r s t three months post-bereavement were designed to support and f a c i l i t a t e the g r i e v i n g p r o c e s s and review the m a r i t a l r e l a t i o n s h i p . R e s u l t s of a s e l f - a d m i n i s t e r e d general h e a l t h q u e s t i o n n a i r e i n d i c a t e d that s u p p o r t i v e i n t e r v e n t i o n s r e s u l t e d in a s i g n i f i c a n t r e d u c t i o n in the l e v e l of r i s k . S i g n i f i c a n t d i f f e r e n c e s were r e p o r t e d in h e a l t h s t a t u s between the experimental and c o n t r o l group in p h y s i c a l symptoms, p h y s i c i a n ' s v i s i t s , weight l o s s , smoking, d r i n k i n g , medications usage, - 3 2 - d e p r e s s i o n , and a b i l i t y to work. The h i g h - r i s k group, as i n Parkes' study, had s i m i l a r outcomes to the low-risk group (Raphael, 1977). The r e s u l t s of these two s t u d i e s suggest that bereavement i n t e r v e n t i o n , whether p r o v i d e d by t r a i n e d v o l u n t e e r s or by a p r o f e s s i o n a l , f a c i l i t a t e s h e a l t h y g r i e v i n g in a s i g n i f i c a n t way with bereaved i n d i v i d u a l s c o n s i d e r e d to be h i g h - r i s k f o r poor bereavement outcome. Gerber conducted a s i m i l a r study with one hundred and s i x t y - n i n e aged, bereaved spouses. The s u b j e c t s were randomly a s s i g n e d to a group where one-to-one support with emotional exp r e s s i o n and p r a c t i c a l a s s i s t a n c e was o f f e r e d by p s y c h i a t r i c s o c i a l workers and nurses, or to a c o n t r o l group. R e s u l t s showed s i g n i f i c a n t d i f f e r e n c e s at 5 and 8 months post-bereavement. By 15 months, the d i f f e r e n c e s were reduced to a n o n - s i g n i f i c a n t l e v e l . Vachon demonstrated s i m i l a r f i n d i n g s in a study in which one hundred and s i x t y - t w o newly bereaved widows were randomly a l l o c a t e d to an i n t e r v e n t i o n or n o n - i n t e r v e n t i o n group. The i n t e r v e n t i o n group r e c e i v e d one-to-one support and - 3 3 - p r a c t i e a l a s s i s t a n c e from t r a i n e d widow h e l p e r s which was f o l l o w e d by p a r t i c i p a t i o n in a mutual support group. P e r c e i v e d s o c i a l support was the key p r e d i c t o r in the s i g n i f i c a n t d i f f e r e n c e s in adjustment on a s e 1 f - a d m i n i s t e r e d h e a l t h q u e s t i o n n a i r e and on i n t e r v i e w at 6, 12 and 24 months post-bereavement (Vachon et al . , 1980). The r e s u l t s of these two s t u d i e s r e f l e c t s i m i l a r f i n d i n g s to the Gerber and Vachon study, which u n d e r l i n e that p e r c e i v e d s o c i a l support i s shown to be a s s o c i a t e d with emotional adjustment among the bereaved. R e s u l t s of other s t u d i e s demonstrate t h i s same c o r r e l a t i o n between emotional adjustment and p e r c e i v e d s o c i a l support, r e g a r d l e s s of the source of support o f f e r e d , whether by a t r a i n e d layperson or p r o f e s s i o n a l ( B o r s t e i n et a l . , 1973; Cary, 1974; C l a y t o n , H a l i k a s & Maurice, 1972; Jamison, W e l l i s h &Pasnov, 1978; Weisman, 1976). W e l l i s h , & Pasnov, 1978; Weisman, 1976). Yet r e s e a r c h f i n d i n g s a l s o suggest that the k i n d and q u a l i t y of support needed i s o f t e n not a v a i l a b l e . In one such study of p e r c e i v e d s o c i a l support of widows, l e s s than h a l f of the sample - 3 4 - were able to express t h e i r g r i e f f r e e l y with at l e a s t one other person ( G l i c k et a l . , 1974).In comparing bereavements f o r widows, Sheskin & Wallace concluded that there were few good l i s t e n e r s a v a i l a b l e to bereaved persons (Sheskin & Wallace, 1978). The degree and p a r t i c u l a r q u a l i t y of support o f f e r e d d u r i n g the bereavement was found to a f f e c t the extent to which the g r i e f process was s u c c e s s f u l l y completed. B a l l concluded in a study on what c o n s t i t u t e d support d u r i n g the bereavement of widows, that one's c h i l d r e n , f r i e n d s , and r e l a t i v e s were the most h e l p f u l support. The consensus of the widows' advice to o t h e r s to c o n t r i b u t e to t h e i r adjustment to l o s s was to maintain a s o c i a l l i f e with good, l o y a l and t r u s t i n g f r i e n d s ( B a l l , 1977). B a l l suggests f u r t h e r r e s e a r c h should i s o l a t e the s o c i a l and p s y c h o l o g i c a l f a c t o r s that produce s t r o n g , independent e m o t i o n a l l y s t a b l e s u r v i v o r s who c a r r y out g r i e f work and to e s t a b l i s h c r i t e r i a of how the layperson can a s s i s t f r i e n d s , and r e l a t i v e s . In these s t u d i e s of p e r c e i v e d s o c i a l support by widows, the c o n s i s t e n t theme i s that the most - 3 5 - h e l p f u l support was p r o v i d e d by those who were t r u s t i n g , a v a i l a b l e , and compassionate l i s t e n e r s , and that s o c i a l support f a c i l i t a t e s the c o p i n g p r o c e s s . Current S t u d i e s on Parental G r i e f Support The g r i e f of parents i s p a r t i c u l a r l y severe when compared with other bereaved i n d i v i d u a l s ( C l a y t o n et a l , 1968; Schwab et a l , 1975; Sanders, 1979-80). R e l a t i v e l y l i t t l e t h a n a t o l o g i c a l l i t e r a t u r e , however, i s devoted to the t o p i c of p a r e n t a l l o s s of a c h i l d as compared to other l o s s e s . P h y s i o l o g i c a l l y , p s y c h o l o g i c a l l y , and s o c i a l l y , the r e l a t i o n s h i p that e x i s t s between parents and t h e i r c h i l d r e n may well be the most intense that l i f e can generate. Obviously, then, v u l n e r a b i l i t y to l o s s through death i s most acute when one's c h i l d d i e s . In comparing a d u l t bereavement of a spouse, a c h i l d , and a parent, Sanders r e p o r t e d s i g n i f i c a n t l y higher i n t e n s i t i e s of g r i e f r e a c t i o n and the widest range of r e a c t i o n in p a r ents s u r v i v i n g the l o s s of t h e i r c h i l d . (Sanders, 1980, p. 303). Only two r e p o r t s were found of c o n t r o l l e d s t u d i e s on the e f f e c t s of p s y c h o t h e r a p e u t i c -36 - support f o r pa r e n t s whose c h i l d has d i e d or i s dying. The f i r s t was a study of s i x t y - f o u r f a m i l i e s with c h i l d r e n dying of leukemia, who were a l l o c a t e d to one of three groups; intense support, moderate, and no support ( o f f e r e d by s o c i a l workers and master's l e v e l c o u n s e l o r s ) . The v a r y i n g l e v e l s of support were o f f e r e d at v a r i o u s p e r i o d s p o s t - d i a g n o s i s , p r i o r to the a c t u a l death of t h e i r c h i l d d u r i n g the a n t i c i p a t o r y g r i e v i n g stage. No major d i f f e r e n c e s were found between the groups on s e l f - r e p o r t s or p r o f e s s i o n a l r a t i n g s at 3, 6, 12, or 24 months a f t e r the i n i t i a l d i a g n o s i s (Kupst et a l , 1982). The r e s u l t s suggest that support o f f e r e d to the f a m i l i e s had no s i g n i f i c a n t e f f e c t on adjustment. These r e s u l t s are gu e s t i o n a b l e given the absence of in f o r m a t i o n r e g a r d i n g the p r o g r e s s i o n of the c h i l d ' s i l l n e s s or p o s s i b l e death, a p o s s i b l e confounding v a r i a b l e in t h i s study. In order to be meaningful, i n t e r v e n t i o n r e s e a r c h must be s p e c i f i c to the age and sex of the s u r v i v o r , the nature and time of death, and consequent phase of bereavement. In a study conducted by F o r r e s t et a l . , immediate support and c o u n s e l i n g was o f f e r e d f o r -37- up to s i x weeks to parents who l o s t b a bies due to s t i l l b i r t h (which l e g a l l y r e f e r s to a baby of 28 or more weeks of g e s t a t i o n ) or p e r i n a t a l death (bab i e s who d i e d w i t h i n a week of b i r t h ) . F i f t y bereaved mothers were randomly a s s i g n e d to two groups, one that r e c e i v e d planned support and c o u n s e l i n g (up to four hours c o u n s e l i n g over s i x weeks) and one that r e c e i v e d r o u t i n e h o s p i t a l care immediately f o l l o w i n g the death of t h e i r i n f a n t . The s o c i a l and emotional f u n c t i o n i n g of the supported (experimental) group was s i g n i f i c a n t l y b e t t e r than that of the unsupported c o n t r o l group at s i x months post-bereavement. By fourteen months, there were no s i g n i f i c a n t d i f f e r e n c e s between the groups. Maternal g r i e f has been found to be the same f o r m i s c a r r i a g e as f o r a s t i l l b o r n c h i l d or the death of a neonate (Peppers and Knapp, 1980; Worden, 1982; Stack, 1980). T h e o r e t i c a l Assumptions: The S i g n i f i c a n c e of the Companion in G r i e f : 1. The presence and support that a companion in g r i e f o f f e r s to the bereaved i s s i g n i f i c a n t in f a c i l i t a t i n g t h e i r g r i e f -38- process, unless the support i s sorely lacking in the core q u a l i t i e s of empathy and compassionate l i s t e n i n g Everyone needs support and reassurance following bereavement. There are three general categories of care which are recognized in the l i t e r a t u r e as a potential source of support; informal support by untrained laypeople, formalized support by laypeople trained and supervised by a professional, and professional supportive counseling or grie f therapy For bereaved persons who perceive their family or friends as supportive, the informal support i s s u f f i c i e n t and s i g n i f i c a n t in f a c i l i t a t i n g healthy grieving. The most helpful support i s provided by those who are trustworthy, available, and compassionate l i s t e n e r s For bereaved persons who perceive their family or friends as unsupportive, formal support services offered by trained volunteers or by professionals are - 3 9 - b e n e f l c l a l to prevent poor bereavement outcomes T r a i n e d lay companions in g r i e f c o n t r i b u t e in a s i g n i f i c a n t way to the f a c i l i t a t i o n of the g r i e v i n g p r o c e s s of bereaved persons. V o l u n t e e r s educated in bereavement p a t t e r n s and a s s o c i a t e d dynamics and t r a i n e d in the s k i l l s r e q u i r e d to deal with them pr o v i d e j u s t as e f f e c t i v e support as p r o f e s s i o n a l p r a c t i t i o n e r s . A p o t e n t i a l r o l e f o r p r o f e s s i o n a l s i s to educate and equip s e l e c t e d v o l u n t e e r compan i ons The s i g n i f i c a n t l y higher i n t e n s i t i e s and wider range of g r i e f r e a c t i o n in the p a r e n t a l l o s s of a c h i l d heightens the need f o r a companion in g r i e f to p r o v i d e support. -40- Role of the Companion in F a c i l i t a t i o n of the G r i e v i n g Process; "Give sorrow words. The g r i e f that does not speak k n i t s up the o'erwrought heart and b i d s i t break." The r o l e of the companion in the work of the major g r i e f t h e o r i s t s i s e x p l i c i t l y addressed in some cases and i s otherwise i m p l i e d in accordance with needs assessments of the bereaved. The companion's r o l e i s s i m i l a r l y e x p l o r e d in c u r r e n t r e s e a r c h s t u d i e s on the f a c i l i t a t i o n of the g r i e f p r o c e s s . The suggested g u i d e l i n e s f o r f a c i l i t a t i n g h e a l t h y g r i e v i n g , e i t h e r as a means to prevent pathology or to promote growth, emerge in the l i t e r a t u r e and are presented in t h i s review. It i s assumed f o r the purpose of t h i s study that the r o l e and the experience of the companion in f a c i l i t a t i n g r e s o l u t i o n of the g r i e v i n g p r o c e s s , w i l l a r i s e as a composite p i c t u r e of a l l that i s c i t e d in the l i t e r a t u r e as c o n s t i t u t i n g the most a p p r o p r i a t e o v e r a l l response to the needs of the bereaved. -41- The major commonalities r e p r e s e n t e d in the g u i d e l i n e s f o r f a c i l i t a t i n g h e a lthy g r i e v i n g in the work of the major g r i e f t h e o r i s t s i n c l u d e : 1. g i v i n g concrete a s s i s t a n c e with necessary t a s k s e a r l y in the bereavement 2 . b e i n g present and c o n s i s t e n t l y a v a i l a b l e 3. l i s t e n i n g w i t h acceptance as the bereaved reviews t h e i r r e l a t i o n s h i p and the d e t a i l s and i m p l i c a t i o n s of the l o s s 4 . o f f e r i n g reassurance to normalize the i n t e n s i t y and f l u c t u a t i o n s of the f e e l i n g s a s s o c i a t e d with the l o s s 5. encouraging r e i n t e g r a t i o n and formation of new r e l a t i o n s h i p s The major d i f f e r e n c e s in p r e s u p p o s i t i o n s of the g r i e f t h e o r i s t s are in the o r i e n t a t i o n to h e a l t h or d i s e a s e . The g o a l s of a l l i n t e r v e n t i o n s i n c l u d e the f a c i l i t a t i o n of the g r i e v i n g p r o c e s s and, i m p l i c i t l y or e x p l i c i t l y , the p r e v e n t i o n or a l l e v i a t i o n of the detrimental consequences of bereavement. However, there i s a spectrum re p r e s e n t e d in the f o l l o w i n g overview that ranges -42- from Schneider's emphasis on the promotion of growth through l o s s to Lindemann's focus on p r e v e n t i n g medical d i s e a s e as a r e s u l t of l o s s . E r i c h Lindemann i d e n t i f i e s the needs of the bereaved i n h i s c l a s s i c paper on "Symptomatology and Management of Acute G r i e f " (Lindemann, 1945). He i m p l i e s that there are corre s p o n d i n g responses on the pa r t of the companion in g r i e f , whose r o l e i t i s to a s s i s t in the g r i e f work of the bereaved; He has to accept the pain of the bereavement. He has to review h i s r e l a t i o n s h i p s with the deceased, and he has to become acquainted with the a l t e r a t i o n s in h i s own modes of emotional r e a c t i o n . His f e a r of i n s a n i t y and h i s f e a r of a c c e p t i n g the s u r p r i s i n g changes in h i s f e e l i n g , e s p e c i a l l y the overflow of h o s t i l i t y , must be worked through. He w i l l have to express h i s sorrow and sense of l o s s . He w i l l have to f i n d an acce p t a b l e f o r m u l a t i o n of h i s f u t u r e r e l a t i o n s h i p to the deceased. He w i l l have to v e r b a l i z e h i s f e e l i n g s of g u i l t , and he w i l l have to f i n d persons around him whom he can use as -43- p r i m e r s £ or the acqu 1 s i t i on of n ew pa 11 e r ns of conduct (Lindemann, 1945, p. 75). Llndemann o u t l i n e d the main tasks of g r i e f as he viewed them: emancipation from the bondage of the deceased and f i n d i n g new p a t t e r n s of rewarding i n t e r a c t i o n with the formation of new r e l a t i o n s h i p s . He s t r e s s e d that r e l i g i o u s agencies had l e d i n p r o v i d i n g comfort f o r the bereaved, in d e v e l o p i n g s u p p o r t i v e and meaningful r i t u a l s , and in c o u n t e r a c t i n g g u i l t f e e l i n g s with the o f f e r of d i v i n e f o r g i v e n e s s , but he emphasized that a d d i t i o n a l a s s i s t a n c e was r e q u i r e d in f a c i l i t a t i n g the g r i e f work of the bereaved. Lindemann i m p l i e s that the companion's r o l e , in responding to these i d e n t i f i e d needs of the bereaved, c o n s i s t s of encouraging the e x p r e s s i o n of p a i n , l i s t e n i n g with acceptance as the bereaved reviews h i s r e l a t i o n s h i p with the deceased, of b e i n g present and o f f e r i n g reassurance as the bereaved comes to accept the n o r m a l i t y of the i n t e n s i t y and f l u c t u a t i o n s of h i s emotional s t a t e , and a s s i s t i n g with s o c i a l r e i n t e g r a t i o n i n encouraging the formation of new r e l a t i o n s h i p s . -44- John Bowl by presented a developmental model of g r i e f based on h i s theory that human beings develop s t r o n g a f f e c t i o n a l bonds or attachments, and they seek to maintain these bonds out of t h e i r need f o r s a f e t y and s e c u r i t y . S i t u a t i o n s of l o s s endanger these bonds and give r i s e to very s p e c i f i c r e a c t i o n s . Bowlby o u t l i n e d four major r e a c t i o n s or phases of the g r i e f p rocess. An i n i t i a l phase of shock and numbness i s f o l l o w e d by a second phase of angry p r o t e s t , and then a phase of d e s p a i r and d i s o r g a n i z a t i o n . The process culminates in a phase of r e o r g a n i z a t i o n with the r e c o n s t r u c t i o n of new attachments in l i f e . Bowlby's phases of the g r i e f process form the b a s i s f o r the g r i e f recovery mutual support groups begun by L a r r y Yeagley. Helpers have d e f i n i t e t a sks to perform d u r i n g each phase of g r i e f . During the numbness phase, when the bereaved needs emotional d i s t a n c e f o r p r o t e c t i o n from f e e l i n g the impact of l o s s , the companion can be present to be leaned upon and to o f f e r concrete a s s i s t a n c e with managing necessary chores. During the phase of angry p r o t e s t and d i s o r g a n i z a t i o n , c h a r a c t e r i z e d as i t i s by p a i n f u l f e e l i n g s of l o n e l i n e s s , - 4 5 - sorrow, anger and weeping, the h e l p e r must pr o v i d e s a n c t i o n when the bereaved needs intimacy and v e n t i l a t i o n of f e e l i n g s in order to acknowledge the r e a l i t y and impact of the l o s s . The companion can be present and l i s t e n with acceptance to permit the bereaved to express f e e l i n g s and d e t a i l s of the l o s s . During the f i n a l phase of r e o r g a n i z a t i o n , when the f e e l i n g s of the berreaved are l e s s intense and there i s a be g i n n i n g s h i f t i n d e s i r e to r e e n t e r l i f e ' s mainstream, the corresp o n d i n g h e l p i n g r o l e of the companion i s to encourage the bereaved to expand t h e i r s o c i a l network, and begin to r e i n t e g r a t e s o c i a l l y . In her stage model of g r i e f , E l i s a b e t h Kubler-Ross d e s c r i b e s the stages that persons t y p i c a l l y go through in a n t i c i p a t o r y g r i e v i n g (and a p p l i e s p a r a l l e l stages to the g r i e f p r o c e s s ) . I n d i v i d u a l s move from d e n i a l through rage and anger to b a r g a i n i n g , and then to de p r e s s i o n and on toward a f i n a l stage of acceptance. T h i s model, l i k e Bowlby's model, i s concerned with the adaptive value of g r i e f (Kubler-Ross, 1975). Kubler-Ross's great legacy to the f i e l d was her advocacy f o r open communication about g r i e f . - 4 6 - I m p l i c i t in her approach i s an understanding of the r o l e of the companion. Such a person i s to be s e n s i t i v e l y p r e s e n t , w i l l i n g to accept without judgement whatever r e l e a s e of f e e l i n g or verbal e x p r e s s i o n i s necessary to encourage them towards acceptance of the l o s s . C o l i n Murray Parkes d e s c r i b e s phases of g r i e f . He c h a r a c t e r i z e s the f i r s t phase of g r i e f as one of alarm and a high s t a t e of a r o u s a l , r e s t l e s s movement, preoccupation with thoughts of the l o s t person, l o s s of i n t e r e s t in personal appearance, and d i r e c t i n g of a t t e n t i o n towards those p a r t s of the environment in which the l o s t person i s l i k e l y to be and c a l l i n g f o r the l o s t .person. T h i s s e a r c h i n g behaviour occurs while the bereaved i n d i v i d u a l s t i l l cannot b e l i e v e what has happened. In t h i s i n i t i a l stage of bereavement, bereaved i n d i v i d u a l s need the companion's o f f e r of support and understanding and a r e f r a i n i n g from impressing the r e a l i t y of the s i t u a t i o n b efore the bereaved i s ready to begin to cope with i t . When the bereaved becomes aware of the r e a l i t y of the l o s s , a sense of d i s o r g a n i z a t i o n and meaninglessness r e s u l t . At -47- t h l s p o i n t , the companion can respond by h e l p i n g the bereaved t a l k about the begi n n i n g r e c o g n i t i o n and about her new s i t u a t i o n . It i s h e l p f u l f o r the companion to reco g n i z e the anger and h o s t i l i t y of the bereaved towards the anonymous s o c i a l world. The subsequent phase of r e o r g a n i z a t i o n f o l l o w s as the sense of c o n f u s i o n and meaninglessness d i m i n i s h e s . The companion h e l p s the bereaved to r e l i n q u i s h the l o s t person, and when there i s r e c o g n i t i o n that the former world has been destroyed, the companion can encourage the r e b u i l d i n g of a new world on the b a s i s of new r e l a t i o n s h i p s . T h i s can best be achieved when the i d l v 1 dual *'s i d e n t i t y i s confirmed and developed in i n t e r a c t i o n with the h e l p e r . John Schneider proposes a more w h o l i s t i c v e r s i o n of stage theory in which s i x d i s t i n c t phases are d e f i n e d to t r a c e the movement in g r i e f from awareness of the l o s s towards t r a n s f o r m a t i o n through the l o s s . H i s concern i s with growth r a t h e r than the p o t e n t i a l pathology in r e s o l v i n g l o s s . The s i x phases which Schneider o u t l i n e s f o r the bereaved to r e s o l v e t h e i r l o s s a r e : 1. awareness of l o s s - 4 8 - 2. l i m i t i n g awareness or focus on the l o s s 3. g a i n i n g p e r s p e c t i v e 4. r e s o l v i n g l o s s 5. r e f o r m u l a t i n g l o s s 6. t r a n s f o r m i n g l o s s He sees acceptance and r e s o l u t i o n of l o s s as phases of the process which become the means through which one i s enabled to go beyond g r i e f to new commitments and investments, and a g r e a t e r sense of balance and wholeness in l i f e . Schneider proposes the view that "growth occurs in the context of an ongoing, s u p p o r t i v e r e l a t i o n s h i p . Without such support and p e r m i s s i o n , g r i e f can be blocked" ( F r e a r s & Schneider, 1981, p. 341). He emphasizes t h e r e f o r e the importance of s o c i a l s a n c t i o n s in l o s s r e c o g n i t i o n and eventual r e s o l u t i o n . Schneider d i r e c t l y addresses the components of the companion's journey in f a c i l i t a t i n g the g r i e f p rocess as he views i t . He p r e f a c e s h i s chapter on f a c i l i t a t i n g the g r i e f p r ocess with the s o b e r i n g statement that " i t i s p r e t e n t i o u s to assume anyone can r e a l l y be the f a c i l i t a t o r of another's g r i e f , p a r t i c u l a r l y i f they are not i n v i t e d in some way or another by the -49- bereaved to do so" (Schneider, 1984, p. 251). He p r e s e n t s the view that there Is an u n d e r l y i n g process of h e a l i n g and growth inherent in g r i e v i n g , and f a c i l i t a t i n g g r i e f begins by r e s p e c t i n g t h i s n a t u r a l h e a l i n g p r o c e s s . For both the p r o f e s s i o n a l counselor and the lay companion, the n a t u r a l i n c l i n a t i o n to do something has to be turned to doing nothing, in Schneider's view; "nothing, perhaps other than l i s t e n i n g , b e i n g a v a i l a b l e , t u r n i n g o f f t h e i r c l i n i c a l r o l e , and simply f e e l i n g along with the bereaved i n d i v i d u a l s the p a i n , h e l p l e s s n e s s , and l o n e l i n e s s w hile knowing that f e e l i n g with them does not r e a l l y r e p l a c e t h e i r need to experience i t f o r themselves" (Schneider, 1987, p. 253). Schneider p r e s e n t s g u i d e l i n e s f o r a s s i s t i n g in the course of bereavement, which correspond to the phases in h i s model. Suggested g u i d e l i n e s i n c l u d e : 1. I n i t i a l l y o f f e r i n g p r a c t i c a l a s s i s t a n c e to a l l e v i a t e the exhaustion of g r i e v i n g 2. F a c i l i t a t i n g awareness of the l o s s by h e l p i n g the bereaved to i d e n t i f y the exact i m p l i c a t i o n s of the l o s s - 5 0 - 3. Reassuring the bereaved of t h e i r ongoing r e l a t i o n s h i p by b e i n g present and a v a i l a b l e and being an a c t i v e l i s t e n e r , a l l o w i n g the bereaved the s a f e t y to explore the l o s s and gain p e r s p e c t i v e 4. G i v i n g the bereaved the o p p o r t u n i t y to t e l l the s t o r y of the event to one who can be t r u s t e d to l i s t e n with u n q u e s t i o n i n g acceptance (which i s both a p r i v i l e g e and an entry i n t o deep l e v e l s of pain and awareness of the f r a g i l i t y of l i f e which may t r i g g e r personal i s s u e s ) 5. G i v i n g permission to g r i e v e and a s s i s t i n g the g r i e v e r i n d i s c o v e r i n g the extent of the l o s s and the subsequent process of d i s c o v e r i n g what was not l o s t and can then take p l a c e W i l l i a m Worden's model of g r i e f i s that g r i e v i n g c r e a t e s a s e r i e s of tasks that need to be accomplished. Whereas the stage t h e o r i s t s present a l i n e a r sequence of p r e d i c t a b l e stages that the g r i e v e r moves through, and o t h e r s l i k e Bowl by, Parkes and Schneider present phases of g r i e f that the g r i e v e r passes through, Worden's approach, -51- r e f l e c t i v e of Freud's concept of g r i e f work, i m p l i e s that the g r i e v e r needs to take a c t i o n and can do something. The four tasks of g r i e f as o u t l i n e d by Worden are: 1 . To accept the r e a l i t y of the l o s s 2. To experience the p a i n of g r i e f 3. To a d j u s t to an environment in which the deceased i s m i s s i n g 4. To withdraw emotional energy and r e i n v e s t i t i n another r e l a t i o n s h i p The c o r r e s p o n d i n g g o a l s of the companion, as o u t l i n e d by Worden, and the g u i d e l i n e s f o r f a c i l i t a t i n g the g r i e f p rocess i n c l u d e : 1. To increase the r e a l i t y of the l o s s , the companion can encourage the a c t u a l i z a t i o n of the l o s s by l i s t e n i n g as the bereaved t a l k s about the l o s s and circumstances surrounding the death, r e p e a t e d l y , i f necessary 2. To help the bereaved deal with both expressed and l a t e n t a f f e c t , the companion can help the bereaved i d e n t i f y and express t h e i r f e e l i n g s about the - 5 2 - l o s s ; t h e i r anger, g u i l t , a n x i e t y , and h e l p l e s s n e s s 3. To help the bereaved overcome v a r i o u s impediments to r e a d j u s t i n g to t h e i r l o s s , the companion can encourage the bereaved to i d e n t i f y the i m p l i c a t i o n s of the l o s s and use a p r o b l e m - s o l v i n g approach to a s s i s t in new r o l e s in l i v i n g without the deceased 4. To encourage a h e a l t h y emotional withdrawal from the deceased and a reinvestment of emotion in another r e l a t i o n s h i p , the companion can encourage r e i n t e g r a t i o n and formation of new r e l a t i o n s h i p s Other g u i d e l i n e s presented by Worden in c l u d e encouraging adequate time to g r i e v e and b e i n g s e n s i t i v e to c r i t i c a l p o i n t s l i k e a n n i v e r s a r i e s and b i r t h d a y s , o f f e r i n g reassurance by p r o v i d i n g understanding and i n t e r p r e t a t i o n of what c o n s t i t u t e s the wide range of normal g r i e f behaviour, a l l o w i n g f o r i n d i v i d u a l d i f f e r e n c e s , p r o v i d i n g c o n t i n u i n g support, h i g h l i g h t i n g c o p i n g s t y l e s and h e l p i n g the bereaved ev a l u a t e t h e i r - 5 3 - e f f e c t i v e n e s s . F i n a l l y , It Is important to i d e n t i f y , in the event of the l o s s having given r i s e to pathology, the need f o r p r o f e s s i o n a l r e f e r r a l . Raphael, in a book, Anatomy of Bereavement, o u t l i n e s a t h e r a p e u t i c assessment used with g r i e v e r s to p r o v i d e a framework f o r s p e c i f i c p r e v e n t i v e i n t e r v e n t i o n f o r those assessed to be at high r i s k of m a l r e s o l u t i o n . The format i s of short-term psychotherapy, o f f e r e d between two weeks postbereavement to e i g h t or twelve weeks. The g o a l s of i n t e r v e n t i o n a r e : 1. To encourage the e x p r e s s i o n of g r i e v i n g a f f e c t s and to promote the mourning process and the f u l l e x p r e s s i o n of sadness, rage, shame, and g u i l t 2. To encourage the v e n t i l a t i o n of anger at the d e s e r t i o n that the death and l o s s seems to represent 3. To encourage review of the l o s t r e l a t i o n s h i p with an opening up of negative f a c t o r s i f these are denied - 5 4 - Raphael emphasizes that i n t e r v e n t i o n , i f o f f e r e d at t h i s optimum time, w i l l a i d in the f a c i l i t a t i o n of the g r i e f p rocess l a t e r , when she s t a t e s ; With the c o u n s e l o r ' s communication of h i s r e c o g n i t i o n of the pain i n v o l v e d , with some o p p o r t u n i t i e s p r o v i d e d to express the a f f e c t s i n v o l v e d and the beginnings of review of the r e l a t i o n s h i p , the f i r s t s t e p s have been taken toward an adaptive as opposed to maladaptive r e s o l u t i o n . Much of the f u r t h e r work of r e l i n q u i s h i n g the r e l a t i o n s h i p w i l l continue beyond the e a r l y c r i s i s months, yet i t s ad a p t i v e course can be set at t h i s e a r l y time and a h i g h - r i s k maladaptive course a v e r t e d (Raphael, 1982, p. 377). Rando p r e s e n t s a model of g r i e f which, as in the f o r e g o i n g models, u n d e r l i n e s the importance of f a c i l i t a t i n g the a f f e c t i v e e x p r e s s i o n of g r i e f . She i d e n t i f i e s the primary needs of the bereaved as a need f o r acceptance and non-judgmental support which w i l l f a c i l i t a t e the , c a t h a r t i c e x p r e s s i o n of emotions. Rando, l i k e Raphael, a l s o s t r e s s e s the importance of the more n e g l e c t e d i n t r a p s y c h i c and c o g n i t i v e p r o cesses, the changes - 5 5 - ln the Inner world, which she b e l i e v e s deserve as much a t t e n t i o n as those very necessary emotional responses to the actual l o s s of the loved one in the e x t e r n a l world. She i d e n t i f i e s a primary need of the bereaved f o r d e c a t h e x i s or the withdrawal of energy from the l o s s of the loved one w i t h i n one's inner world. Rando draws upon the e a r l y p s y c h o a n a l y t i c t h e o r i s t s in e s t a b l i s h i n g t h i s as a c r u c i a l i n t r a p s y c h i c procedure that must be undertaken in order f o r the bereaved to s u c c e s s f u l l y r e s o l v e the l o s s and to subsequently r e i n v e s t in other r e l a t i o n s h i p s . Secondly, she s t r e s s e s the need f o r the c o g n i t i v e p r o c e s s of de v e l o p i n g a new r e l a t i o n s h i p with the deceased as the g r i e v e r ' s l i f e i s r e o r g a n i z e d in the absence of the deceased and a new r e l a t i o n s h i p i s s t r u c t u r e d , one based l a r g e l y on r e c o l l e c t i o n , memory, and past experience. T h i r d l y , Rando i d e n t i f i e s the need f o r the bereaved to form a new i d e n t i t y based on r e c o g n i z i n g what r o l e s and i n t e r a c t i o n a l p a r t s of the s e l f have changed and what needs to be a f f i r m e d and what i s new and needs to be accommodated. Rando, l i k e Schneider, - 5 6 - focuses upon the p o t e n t i a l growth inherent in gr i e f . Rando suggests g u i d e l i n e s f o r the companion in g r i e f to f a c i l i t a t e the process of g r i e f . She suggests that the c a r e g i v e r or companion encourage the bereaved to p a r t i c i p a t e a c t i v e l y in the work of mourning by: 1. T a k i n g i n i t i a t i v e to be present and o f f e r i n g concrete a s s i s t a n c e in accordance with the f e l t or expressed needs of the bereaved 2. Being c o n s i s t e n t l y a v a i l a b l e p h y s i c a l l y as well as e m o t i o n a l l y to render the g r i e v e r s e c u r i t y and support 3. G i v i n g the g r i e v e r p e r m i s s i o n to g r i e v e by demonstrating v e r b a l l y and through non-judgemental a t t i t u d e s and behaviours that e x p r e s s i n g g r i e f i s both a p p r o p r i a t e and e s s e n t i a l 4. M a i n t a i n i n g a f a m i l y systems p e r s p e c t i v e in d e a l i n g with the g r i e v e r by r e c o g n i z i n g her l o s s of the s p e c i a l r e l a t i o n s h i p through death and of the f a m i l y as she has known i t - 5 7 - 5. Making sure that the g r l e v e r has a p p r o p r i a t e medical e v a l u a t i o n and treatment when symptoms warrant 6. M a i n t a i n i n g a r e a l i s t i c and t h e r a p e u t i c p e r s p e c t i v e in acknowledging one's own r e a l i s t i c l i m i t a t i o n s 7. Encouraging v e r b a l i z a t i o n of f e e l i n g s and r e c o l l e c t i o n s of the deceased, by h e l p i n g the bereaved r e c o g n i z e , a c t u a l i z e and accept the l o s s 8. H e l p i n g the g r i e v e r i d e n t i f y and r e s o l v e secondary l o s s e s 9. Supporting the g r i e v e r i n coping with the g r i e f p r o c e s s by p r o v i d i n g normative data about the g r i e f p rocess 10. A s s i s t i n g the g r i e v e r to d i s c o v e r p s y c h o l o g i c a l and s o c i a l r o l e s that must be assumed or r e l i n q u i s h e d , and h e l p i n g her i d e n t i f y those b e l i e f s and a c t i o n s that w i l l p r ovide a renewed sense of purpose in l i f e 11. Working with the g r i e v e r to r e i n v e s t in a new l i f e , by b e i n g s e n s i t i v e to the - 5 8 - g r i e v e r ' s r e a d i n e s s to begin a p r o c e s s of r e i n t e g r a t i o n Rando h e l p f u l l y addresses the ending or r e s o l u t i o n of the g r i e f process by r e a s s u r i n g the g r i e v e r and the one who supports her, that g r i e f i s not u s u a l l y r e s o l v e d in the sense of b e i n g f i n i s h e d and completely s e t t l e d f o r e v e r . She o f f e r s assurance that c e r t a i n a spects of the l o s s w i l l continue throughout one's l i f e , and b r i e f upsurges of g r i e f w i l l be r e e x p e r i e n c e d . She d e s c r i b e s r e s o l u t i o n of g r i e f as a term i n d i c a t i n g that the processes of g r i e f have been addressed and completed as much as p o s s i b l e at a given p o i n t so that the l o s s i s a p p r o p r i a t e l y i n t e g r a t e d i n t o the r e s t of one's l i f e (Rando, 1984). Assumptions of the Companion's Role in G r i e f The assumptions which emerge in the l i t e r a t u r e of what c o n s t i t u t e s the most a p p r o p r i a t e o v e r a l l response of the companion in g r i e f i n c l u d e : 1. Taking i n i t i a t i v e to be present 2. G i v i n g concrete a s s i s t a n c e e a r l y in bereavement ( i n f o r m i n g d e s i g n a t e d f r i e n d s and r e l a t i v e s of the l o s s , a s s i s t i n g in - 5 9 - f u n e r a l p r e p a r a t i o n s , meals, and c h i l d c a r e ) 3. L i s t e n i n g wlth non-Judgemental acceptance to encourage r e l e a s e and v e r b a l i z a t i o n of the f u l l range of f e e l i n g s of the bereaved (sadness, rage, h o s t i l i t y , g u i 1 t , shame) 4. O f f e r i n g reassurance and s a n c t i o n f o r the bereaved, to a s s i s t in n o r m a l i z i n g the i n t e n s i t y of g r i e f r e a c t i o n s and f l u c t u a t i o n s of f e e l i n g 5. Encouraging repeated review of the l o s s and i t s i m p l i c a t i o n s in g i v i n g the bereaved the o p p o r t u n i t y to t e l l the s t o r y of the event and i t s c o n t i n u i n g impact 6. Working with the g r i e v e r to begin a process of reinvestment and r e i n t e g r a t i o n in new phases of l i f e - 6 0 - CHAPTER III METHOD Rat i ona1e In the phenomenological method of r e s e a r c h , the emphasis i s on the study of experience. Experience i s i n v e s t i g a t e d d e s c r i p t i v e l y r a t h e r than by the explanatory methods of e m p i r i c a l psychology. The methods of the n a t u r a l s c i e n c e s , based as they are on the laws of c a u s a l i t y , are inadequate to the task of s t u d y i n g l i f e as l i v e d . Phenomenological r e s e a r c h , "a method which a l l o w s us to contact phenomena as we a c t u a l l y l i v e them out and experience them" ( V a l l e & King, 1978, p. 7), has been s e l e c t e d as the most a p p r o p r i a t e re s e a r c h method to apply to t h i s study. T h i s method, drawn as i t i s from the p h i l o s o p h i c a l d i s c i p l i n e of phenomenology, i m p l i e s an e x i s t e n t i a l view of the phenomenon b e i n g i n v e s t i g a t e d i n that e x i s t e n t i a l i s m "seeks to understand the human c o n d i t i o n as i t m a n i f e s t s i t s e l f in our c o n c r e t e , l i v e d s i t u a t i o n s " ( V a l l e & King, 1978, p. 6 ) . It has become conventional to r e f e r to the psychology of e x i s t e n t i a l -61- phenomenology simply as phenomenologlcal psychology C C o l a i z z i , 1973, p. 4). Overview of Research Method The concern of the phenomenological r e s e a r c h e r in t h i s study i s to understand the meaning of the l i v e d experience of the companion in g r i e f . In t h i s method of r e s e a r c h , the re s e a r c h e r and s u b j e c t s are p a r t n e r s , and the s u b j e c t s w i l l be r e f e r r e d to as c o - r e s e a r c h e r s ( C o l a i z z i , 1978). The experience of each c o - r e s e a r c h e r i s e l i c i t e d in a di a l o g u e with the res e a r c h e r as together they seek to understand the experience as l i v e d . The re s e a r c h e r tape-records i n d i v i d u a l d e s c r i p t i o n s and c o n s t r u c t s a common account that i s f a i t h f u l to each i n d i v i d u a l one. By thoroughly s t u d y i n g the c o - r e s e a r c h e r s ' d e s c r i p t i o n s or p r o t o c o l s of t h e i r experience, and c r o s s - r e f e r e n c i n g them, the r e s e a r c h e r e x t r a c t s common themes which are interwoven to c r e a t e the phenomenol o g i c a l account-. T h i s phenomenol o g i c a l approach to understanding experience can be combined with a dramaturgical p e r s p e c t i v e , r e s u l t i n g in d e s c r i p t i o n s of experience as l i v e d , c o n t a i n e d w i t h i n the dramatic or n a r r a t i v e form. - 6 2 - Elements of the dramatic form can be a p p l i e d to phenomenological accounts of experience, to preserve the multidimensional aspects of the s t o r y . The r e s e a r c h e r , u s i n g t h i s combined approach, i s guided by dramatic form when e l i c i t i n g the s t o r y or i n d i v i d u a l d e s c r i p t i o n s of the companions to g r i e v i n g persons in the study, by a t t e n d i n g to and drawing f o r t h what c o n s t i t u t e s the beginning, middle, and end of the experience under study, and by c a p t u r i n g the p i v o t a l p o i n t s in the s t o r y . The dramatic form captures the dynamic d e s c r i p t i o n which i n v o l v e s change over time with an emergent understanding of r e l a t i o n s h i p between events and alignment of c h a r a c t e r s . The r e s e a r c h e r can a l s o be guided by dramatic form in the r e c o n s t r u c t i o n of the common account by making e x p l i c i t what i s i m p l i c i t l y present beyond the words in a d e s c r i p t i o n . It i s t h i s phenomenological method combined with a dramaturgical approach which i s capable of f o r m u l a t i n g a common s t r u c t u r e of experience drawing from d i v e r s e i n d i v i d u a l p a t t e r n s of experience (Cochran & C l a s p e l l , 1987). - 6 3 - Co-Researchers It was assumed f o r the purpose of t h i s study that those who were companions to a bereaved person through t h e i r g r i e v i n g p rocess were the source of knowledge f o r understanding the companioning experience under study. For t h i s reason, the companions p a r t i c i p a t i n g in t h i s study were r e f e r r e d to as c o - r e s e a r c h e r s r a t h e r than s u b j e c t s . By i n v i t i n g the f u l l p a r t i c i p a t i o n of the c o - r e s e a r c h e r s to share t h e i r experience, the r e s e a r c h e r c o l l a b o r a t e d with them in a combined attempt to a r r i v e at an emergent sense of meaning of the phenomenon. The r e s e a r c h e r i n t r o d u c e d to each of the c o - r e s e a r c h e r s the phenomenon under study, and the c o - r e s e a r c h e r s were i n v i t e d to share the meaning of t h i s phenomenon through d e t a i l e d d e s c r i p t i o n s of i n d i v i d u a l experience and t h e i r r e f l e c t i o n s on that experience. The dialog u e proceeded on the b a s i s of t r u s t , and the r e l a t i o n s h i p between the r e s e a r c h e r and co - r e s e a r c h e r was a r e s p e c t f u l and e g a l i t a r i a n one. The c r i t e r i a f o r s e l e c t i o n of the c o - r e s e a r c h e r s i n c l u d e d the f o l l o w i n g : - 6 4 - Th e c o - r e s e a r c h e r s were a d u l t s . Because the method of resea r c h i s based upon the a r t i c u l a t i o n , e l a b o r a t i o n , and r e f l e c t i o n of an experience of emotional depth, i t was necessary that the i n d i v i d u a l was able to communicate in a mature and c l e a r manner with the res e a r c h e r in a d e t a i l e d i n t e r v i e w . The c o - r e s e a r c h e r s were a l s o women. Because the phenomenon under study i s the experience of the companion to a bereaved mother, women companions were s e l e c t e d , as there were major gender d i f f e r e n c e s between male and female companions to the bereaved in the background l i t e r a t u r e . The c o - r e s e a r c h e r s were r e p r e s e n t a t i v e s of the Western c u l t u r e , with an adequate command of the E n g l i s h language so that language was not a b a r r i e r to a r t i c u l a t i n g the experience that they were asked to d e s c r i b e . Because the nature of the personal r e l a t i o n s h i p between companion and g r i e v i n g person i s a culture-bound experience, the study was - 6 5 - c o n f l n e d w i t h i n the bounds of the Western cu1ture. 3. The c o - r e s e a r c h e r s were s e l e c t e d from among those who were companions to a bereaved parent whose l o s s took p l a c e in the range of one to three years p r i o r to the time of i n t e r v i e w . T h i s d e s i g n a t e d time frame was in an attempt to ensure that the c o - r e s e a r c h e r was s u f f i c i e n t l y removed in time from the l o s s of the bereaved person so as not to be immersed in i t , but able to r e f l e c t upon i t , as meaning tends to emerge upon r e f l e c t i o n . It was a l s o important that the c o - r e s e a r c h e r s not be too removed from the experience as t h e i r r e f l e c t i o n would then be l a c k i n g in immediacy. It was assumed that t h i s optimum d i s t a n c i n g in time enabled the companions to r e f l e c t more f u l l y and i m p a c t f u l l y , and enabled them to p r o v i d e a more comprehensive p i c t u r e of the experience. The c o - r e s e a r c h e r s were i d e n t i f i e d and s e l e c t e d through a network of personal c o n t a c t s . By r a i s i n g the proposed r e s e a r c h t o p i c with people - 6 6 - in the personal and p r o f e s s i o n a l network of the re s e a r c h e r , three p o t e n t i a l c o - r e s e a r c h e r s were i d e n t i f i e d . One woman was i d e n t i f i e d by a s o c i a l worker who ran a Bereaved P a r e n t s ' group and was aware of the s u p p o r t i v e r o l e t h i s woman had pl a y e d f o r her f r i e n d . The second was i d e n t i f i e d by mutual f r i e n d s of the bereaved parents and the t h i r d woman was i d e n t i f i e d by bereaved parents who had r e c e i v e d c o u n s e l i n g from the r e s e a r c h e r . The three women were companions to bereaved mothers in that they made themselves a v a i l a b l e to a mother who had s u f f e r e d the l o s s of her c h i l d through death, one to two and a h a l f years before the time of the i n t e r v i e w . The ages of the women who p a r t i c i p a t e d in the study were 41, 42, and 31 years. T h e i r occupations i n c l u d e d a Community C o l l e g e P r o f e s s o r of Psychology, a High School Counselor, and a Tra v e l Agent. One woman was rema r r i e d with no c h i l d r e n , one was s i n g l e with no c h i l d r e n , and one was married with two c h i l d r e n , aged 5 years and 2.5 years. A l l assessed themselves as middle c l a s s . A l l became companions to a bereaved mother by v i r t u e of a p r e e x i s t i n g c l o s e f r i e n d s h i p with the bereaved mother. - 6 7 - Procedures : The Interview: Each of the three c o - r e s e a r c h e r s was inte r v i e w e d three times and the i n t e r v i e w s were audio-taped and t r a n s c r i b e d . The aim of the f i r s t i n t e r v i e w was to gain a d e t a i l e d d e s c r i p t i o n of the experience of be i n g a companion in g r i e f . The aim of the second i n t e r v i e w was to v a l i d a t e the themes d e r i v e d from the o r i g i n a l s t o r y . The purpose of the f i n a l i n t e r v i e w was f o r v a l i d a t i n g the n a r r a t i v e d e s c r i p t i o n or common s t o r y of the experience. The three i n t e r v i e w s were from three to nine months a p a r t . F i r s t Interview The f i r s t i n t e r v i e w took the form of a dia l o g u e with the re s e a r c h e r o r i e n t i n g each co- r e s e a r c h e r to the study and then u s i n g the sample format that f o l l o w s to begin e l i c i t i n g the experience of the companions in the study: I am t r y i n g to understand the experience of bei n g a companion to a g r i e v i n g person. I am i n t e r e s t e d in what your experience has been as you made y o u r s e l f a v a i l a b l e to your f r i e n d through her l o s s . I would a p p r e c i a t e i t i f - 6 8 - you would d e s c r i b e your experience in as much d e t a i l as p o s s i b l e as i f you were t e l l i n g me a s t o r y ; that i s , how your experience began, what o c c u r r e d in the midst of i t , and how i t ended, i f i t has. I w i l l be a s k i n g you some que s t i o n s of what i t was l i k e to be a companion to your f r i e n d in her g r i e f , but I ' l l r e s e r v e any qu e s t i o n s u n t i l l a t e r . Can you t e l l me about the beginning, how you got i n v o l v e d in b e i n g there f o r your f r i e n d when she l o s t her c h i l d ? The i n t e n t i o n at t h i s p o i n t in the i n i t i a l i n t e r v i e w was to encourage the co - r e s e a r c h e r to begin to recount the s t o r y of her experience, s t a r t i n g at what she p e r c e i v e d to be the be g i n n i n g of the s t o r y . By a c t i v e l i s t e n i n g and empathic responding with simple r e f l e c t i o n of content and of f e e l i n g , the i n t e n t of the r e s e a r c h e r was to encourage the u n i n t e r r u p t e d flow of the s t o r y . A l i s t of preformu1ated q u e s t i o n s was on hand to f u r t h e r i n v e s t i g a t e the assumptions u n d e r l y i n g the study. Included were the f o l l o w i n g : - 6 9 - 1. In what ways d i d you make y o u r s e l f a v a i l a b l e to your f r i e n d and what k i n d of t h i n g s d i d you do when you were together? 2. Did you do any formal c o n t r a c t i n g ? How d i d you make c l e a r to each other in what ways and f o r how long you would be able to be a v a i l a b l e to your f r i e n d ; what her needs were and perhaps yours as w e l l ? 3. What experiences of your own, i f any, d i d you f i n d y o u r s e l f drawing upon to g i v e you an understanding of what the g r i e v i n g p r o c e s s was l i k e or what you might expect? 4. Did you f i n d y o u r s e l f doing t h i n g s to set the,pace or would you say you tended to go with the flow? 5. Sometimes, when a bereaved person shares her p a i n , i t has a way of s t i r r i n g up your own pain or memories of your own l o s s e s or g r i e f or even your v u l n e r a b i l i t y to a p o t e n t i a l l o s s ? How was i t f o r you? 6. In the midst of your f r i e n d ' s g r i e v i n g p r o c e s s , in what ways, i f any, d i d you - 7 0 - f e e l she should change the way she was gr i ev ing? In what ways was your manner of be i n g with your f r i e n d through her g r i e v i n g p rocess congruent with the way you were before? What key moments, i f any, would you i d e n t i f y when you experienced changes in who i n i t i a t e d c o n t a c t , where you met or how o f t e n you were together, what you d i d when you were together, or what was t a l k e d about? How would you d e s c r i b e your r o l e ? I have d e s c r i b e d i t as companion. In what ways, i f any, has your r o l e as companion come to an end? (For example, was there a r i t u a l c l o s u r e ; a way of f o r m a l i z i n g that there had been c l o s u r e ? Or was there a s i g n i f i c a n t event?) Knowing what you know now, would you have s t a r t e d ? Can you t e l l me about some of the b e n e f i t s , i f any ? Can you tel1 me about some of the o b s t a c l e s ; some of the t h i n g s that might -71- have made you f e e l l i k e q u i t t i n g , when It Just seemed too much? 13. What awkward dynamics, i f any, d i d you experience with your f r i e n d ' s spouse? In what ways d i d you see your r o l e as h e l p f u l f o r the marriage? 14. As you r e f l e c t on your own experience now, can you d e s c r i b e what was h e l p f u l to you, and what might have helped you? 15. I don't have-any other s p e c i f i c g u e s t i o n s to ask you, but I wonder i f you have anything to add that I haven't asked or we haven't addressed? These g u e s t i o n s which r e l a t e d to the experience were only i n c l u d e d i f not touched upon in the r e c o u n t i n g of the s t o r y . They were r a i s e d only at a p p r o p r i a t e j u n c t u r e s to encourage the c o - r e s e a r c h e r to explore these aspects of the experience in more depth when they n a t u r a l l y seemed to touch upon the i s s u e s encompassed by the q u e s t i o n s . The i n t e r v i e w was i n t e n t i o n a l l y open-ended to allow f o r an u n i n t e r r u p t e d flow and a r e l i v i n g of experience. The establishment of rapport through a c t i v e l i s t e n i n g was c r u c i a l to - 7 2 - the c o - r e s e a r c h e r ' s r e c o u n t i n g of her experience. The d i a l o g u e c o u l d then proceed on the b a s i s of t r u s t . The primary concern of the r e s e a r c h e r was to be present to the person s h a r i n g her s t o r y . When r a i s e d s e n s i t i v e l y , the q u e s t i o n s seemed to s t i m u l a t e the d i a l o g u e and at times to add depth or f u l n e s s of meaning. Second Interview The second i n t e r v i e w was arranged w i t h i n one month of the f i r s t i n t e r v i e w . T h i s i n t e r v i e w was scheduled s e v e r a l days a f t e r the c o - r e s e a r c h e r s r e c e i v e d a typed t r a n s c r i p t of the f i r s t i n t e r v i e w f o r t h e i r perusal and r e f l e c t i o n . The aim of the second i n t e r v i e w was to continue e x p l o r i n g the experience of the companion, through d i s c u s s i n g general impressions of the t r a n s c r i p t . Co-researchers were asked f o r c l a r i f i c a t i o n and m o d i f i c a t i o n s to the t r a n s c r i p t , e l a b o r a t i o n s or necessary d e l e t i o n s , and f o r v a l i d a t i o n of the d i a l o g u e up to t h i s p o i n t . In a d d i t i o n , the c o - r e s e a r c h e r s were presented with f i n a l meaning u n i t s (see A n a l y s i s and I n t e r p r e t a t i o n of P r o t o c o l s ) and were asked to check, e l a b o r a t e , and - 7 3 - v e r i f y meaning u n i t s , and suggest any m o d i f i c a t i o n s . T h i r d Interview The t h i r d i n t e r v i e w was scheduled a f t e r the re s e a r c h e r had composed the phenomenological account in n a r r a t i v e form by weaving together the common themes. The aim of t h i s i n t e r v i e w was to present the c o - r e s e a r c h e r s with the common themes, and the n a r r a t i v e d e s c r i p t i o n of the experience of the companion in g r i e f f o r v a l i d a t i o n of accuracy and p o s s i b l e a d d i t i o n s . The c o - r e s e a r c h e r s were t o l d that t h i s phenomenological d e s c r i p t i o n was intended to r e f l e c t t h e i r experience as given in t h e i r i n d i v i d u a l d e s c r i p t i o n s . Procedure: The r e s e a r c h e r i n i t i a l l y i n v i t e d the p a r t i c i p a t i o n of the i d e n t i f i e d women i n f o r m a l l y through t h i r d person c o n t a c t s from the r e s e a r c h e r ' s network. In each case, i n t e r e s t was expressed in becoming a p a r t i c i p a n t in the study, and a d e s c r i p t i o n of the resea r c h study was given by m a i l . The i n t e r v i e w s were arranged at the convenience of the c o - r e s e a r c h e r s . They took p l a c e in the r e s e a r c h e r ' s home or desig n a t e d -74- o f f i c e . Both v e r b a l l y and by w r i t t e n consent, the c o - r e s e a r c h e r s were informed of the overview of the r e s e a r c h study, and that they would be asked to d e s c r i b e in d e t a i l t h e i r experience of b e i n g a companion to a g r i e v i n g person. In order not to i n t e r r u p t the flow of the s t o r y , the r e s e a r c h e r i n t e n t i o n a l l y kept most of her responses to r e f l e c t i o n of the c o - r e s e a r c h e r ' s f e e l i n g s and content of the account. The time of the i n t e r v i e w s v a r i e d in length between two and two and a h a l f hours. The i n i t i a l i n t e r v i e w s were s e m i - s t r u c t u r e d . Incorporated w i t h i n an open-ended approach were a l i s t of preformu1ated q u e s t i o n s , c r e a t e d to f u r t h e r explore the r e s e a r c h e r ' s assumptions about the experience. The phenomenological r e s e a r c h e r must give up the " " p o s i t i o n of d i s i n t e r e s t e d s p e c t a t o r and become a c t i v e l y and p e r s o n a l l y i n v o l v e d in the phenomenon. The phenomenological p s y c h o l o g i s t i s seen as s t a r t i n g out h i s i n v e s t i g a t i o n i n t o a phenomenon with a pre-comprehension of the meaning of the phenomenon... from h i s own e x i s t e n c e or p a r t i c i p a t i o n i n the everyday world" ( C o l a i z z i , 1973, p. 187). The i n t e r v i e w s were taperecorded - 7 5 - and then t r a n s c r i b e d , which y i e l d e d the d e s c r i p t i o n s or p r o t o c o l s of the experience of each companion. The a n a l y s i s of the data was done by means of a p r o t o c o l a n a l y s i s (see A n a l y s i s and I n t e r p r e t a t i o n of P r o t o c o l s ) . The second i n t e r v i e w s were scheduled and conducted. The c o - r e s e a r c h e r s were asked f o r v e r i f i c a t i o n of the r e s e a r c h e r ' s d e l i n e a t i o n of p r o t o c o l s i n t o coded meaning u n i t s . The t h i r d i n t e r v i e w s were scheduled a f t e r the r e s e a r c h e r had composed the phenomenological account in n a r r a t i v e form, and d u r i n g the i n t e r v i e w , the c o - r e s e a r c h e r s were asked to v a l i d a t e or introduce changes i n t o the d e s c r i p t i o n . The r e s e a r c h e r then rewrote the co n c i s e d e s c r i p t i o n or fundamental s t r u c t u r e of the experience i n c o r p o r a t i n g a l l necessary m o d i f i c a t i o n s . A n a l y s i s and I n t e r p r e t a t i o n of P r o t o c o l s The data, c o n s i s t i n g of the p r o t o c o l s or typed t r a n s c r i p t s of the c o - r e s e a r c h e r s ' d e s c r i p t i o n s of experience, were analyzed phenomenological1y u s i n g methods o u t l i n e d by C o l a i z z i ( C o l a i z z i , 1973, 1978) and G i o r g i ( G i o r g i , 1970, 1975), and Cochran & C l a s p e l l - 7 6 - (Cochran & C l a s p e l l , 1987). It was the task of the r e s e a r c h e r to transform the d e s c r i p t i v e p r o t o c o l s through a process of r e f l e c t i o n , d e s c r i p t i v e r e d u c t i o n and d e l i n e a t i o n i n t o t h e i r s t r u c t u r a l meaning. F i r s t , the p r o t o c o l s were read and r e r e a d in order f o r the re s e a r c h e r to r e f l e c t upon the d e s c r i p t i o n s of the experience and to gain a sense of the t o t a l i t y of experience. Secondly, the p r o t o c o l s were d e l i n e a t e d (by making a d i v i d i n g l i n e on the p r o t o c o l ) each time there was a t r a n s i t i o n in meaning i n t o n a t u r a l meaning u n i t s . Natural meaning u n i t s are statements w i t h i n the t r a n s c i p t which sum up or make known a p a r t i c u l a r idea, theme, concept or d e s c r i p t i o n without r e g a r d to the major ques t i o n posed w i t h i n the reasearch ( G i o r g i , 1975). For example, in one of the p r o t o c o l s , the f i r s t n a t u r a l meaning u n i t p o i n t s to W s e n t e r i n g i n t o the companion r o l e , through her s h a r i n g of the joy of the b i r t h of the son of her f r i e n d s before the g r i e f of h i s subsequent death. I was there at the b i r t h . I was there with them before they l o s t him. I think I can l i v e that p a r t , the happy part of that memory f o r -77- that l i t t l e b i t of time before the g r i e f came. So that was r e a l l y important. The f o l l o w i n g quote from the i n t e r v i e w i n d i c a t e s a s h i f t or t r a n s i t i o n in meaning from the companion's p a r t i c i p a t i o n i n the joy of the b i r t h of the f r i e n d s ' baby to p a r t i c i p a t i o n in the f e a r of l o s i n g him. The d e l i n e a t i o n to the next n a t u r a l meaning u n i t i s made when W. begins to d e s c r i b e the events which l e d to her be i n g present at the labour and d e l i v e r y of the baby, when the f e a r f o r h i s s u r v i v a l began. That morning, when A. went i n t o labour, I was at school so I l e f t shcool when A. c a l l e d . I was supposed to be able to go with them, then the doctor d i d n ' t think that was very smart. I don't think he t r u s t e d that I'd be able to be a support. But that morning, the doctor s a i d you can come i n , we'll give you a c a l l , so the hope we'd had, then no you can't, and then at the l a s t minute, yes, you can. So when he was born, h i s c o l o u r was b l u e . There was f e a r r i g h t away. In t h i s example, the co-r e s e a r c h e r i n i t i a l l y f ocuses on the f a c t that there was an element of - 7 8 - joy in her experience that was important to her, yet there i s a s h i f t to the experience of f e a r , which marks the t r a n s i t i o n in meaning. In one sense, these are not c l e a r l y separate, as the momentary r e f l e c t i o n on the joy i s accompanied by a foreshadowing of the g r i e f to come. The two Interdepend and i t i s l o g i c a l to i n c l u d e p a r t of one when t a l k i n g of the other. There i s a need on the p a r t of the r e s e a r c h e r to be a l e r t to s h i f t s in emphasis, and to i n f e r e n c e s , r a t h e r than to e x p l i c i t s h i f t s in t o p i c . The i n t e n t i o n here i s to capture what the c o - r e s e a r c h e r meant, and to d i s c r i m i n a t e between meaning s h i f t s in the r e l a t i n g of a t o t a l experience. Thus, the s h i f t in emphasis from p a r t i c i p a t i n g in a j o y f u l experience, to p a r t i c i p a t i n g in what has become a f e a r f u l experience i s the meaning s h i f t d e t e c t e d in t h i s i n s t a n c e . The f i r s t meaning u n i t c o n t a i n s an acknowledgement of the g r i e f to come, and the second meaning u n i t c o n t a i n s an acknowledgmenet of the p o t e n t i a l of b e i n g robbed of the j o y f u l focus of the p r e c e d i n g u n i t . The next t r a n s i t i o n in meaning comes with W.'s d e s c r i p t i o n of b e i n g present and a v a i l a b l e to her f r i e n d s in the - 7 9 - a n t i c l p a t o r y p e r i o d when C s c o n d i t i o n Is l i f e - t h r e a t e n i n g , u n t i l she r e c e i v e s the news c o n f i r m i n g h i s death. So he went i n t o I.C.U. r i g h t away. So I stuck with them that whole day; B. being even more a f r a i d f o r h i s death than A... I went i n t o the o f f i c e and D. was on the phone to t e l l me. T h i s method of d e l i n e a t i n g n a t u r a l meaning u n i t s , while c l e a r l y d e s c r i b e d by G i o r g i in theory, i s c h a l l e n g i n g in p r a c t i c e . People tend to speak c o n f i g u r a t i v e 1 y , o f t e n with a f r e e a s s o c i a t i o n of thoughts, memories and r e f l e c t i o n s , so that s t r a n d s of one u n i t of thought are p i c k e d up and woven i n t o a subsequent u n i t . The task of d e c i d i n g whether aspects have been i n t e g r a t e d i n t o a u n i t that would be b e t t e r separated, and i f aspects have been n e g l e c t e d and subsumed in a u n i t that i s too l a r g e ; these are the c h a l l e n g e s i n t e g r a l to a n a l y z i n g p r o t o c o l s . It i s p o s s i b l e to reduce some of t h i s u n c e r t a i n t y in three major ways: 1. People o f t e n r e f e r back to an aspect of meaning. It i s p o s s i b l e to r e f i n e meaning - 8 0 - by examining and reexamining the meaning u n i t s , by making note when a s t r a n d of meaning r e c u r s , and i n c l u d i n g those aspects of meaning which r e c u r , in one un i t . 2. Co-researchers can be d i r e c t l y asked to c l a r i f y and e l a b o r a t e intended meanings in order to r e f i n e meaning u n i t s . 3. C o l a i z z i ' s C C o l a i z z i , 1975) method of e x t r a c t i n g s i g n i f i c a n t or key statements can be used to f u r t h e r v e r i f y the r e s u l t s a r r i v e d at u s i n g G i o r g i ' s method. The second step of p r o t o c o l a n a l y s i s i s to code each n a t u r a l meaning u n i t a c c o r d i n g to s i m i l a r i t y of meaning, in order to a v o i d redundancies w i t h i n a p a r t i c u l a r p r o t o c o l . The next step of p r o t o c o l a n a l y s i s i s to formulate a s e r i e s of f i n a l meaning u n i t s . T h i s i s achieved by f i r s t s e p a r a t i n g n a t u r a l meaning u n i t s d i r e c t l y concerned with the experience of the companion in g r i e f from those that were i n c i d e n t a l . Then each of the r e l e v a n t coded na t u r a l meaning u n i t s i s r e f l e c t e d upon, and a statement of meaning i s c o n s t r u c t e d , u s i n g the c o - r e s e a r c h e r ' s words as much as p o s s i b l e . The -81- procedure o f t e n i n v o l v e s r e s t a t i n g in the t h i r d person what i s given In the p r o t o c o l . It a l s o i n v o l v e s some changes from what was a c t u a l l y s a i d to what was i n f e r r e d or presumably meant by the co-reseacher; that i s , a movement from what i s e x p l i c i t to what i s i m p l i c i t . These f i n a l meaning u n i t s are recorded on the 5" x 8" index c a r d s . It i s f o r t h i s reason that the second i n t e r v i e w i s so v i t a l to the process of v e r i f i c a t i o n , when the co- r e s e a r c h e r i s i n v i t e d to v a l i d a t e these formulated meanings. The next step i s to compare each of the three s e t s of f i n a l meaning u n i t s . The e s s e n t i a l task of the r e s e a r c h e r i s to go beyond i n d i v i d u a l meaning u n i t s in a set to a statement of t h e i r common meaning, which can be r e f e r r e d to as a theme. The task can be best imagined as one of l a y i n g out the three s e t s of index cards f o r each of the three c o - r e s e a r c h e r s in three columns. By p e r u s i n g the three s e t s of index cards, the s i m i l a r i t i e s between meaning u n i t s can be d i s c e r n e d . The r e s e a r c h e r ' s task i s to match cards so that each row c o n t a i n s s i m i l a r meaning u n i t s . As one co - r e s e a r c h e r might expand upon one - 8 2 - aspect of experiencce and another might only touch upon i t or ignore t h i s aspect a l t o g e t h e r , there may be some rows with a gap; that i s , with one person having no comparable u n i t to two other persons. The d i f f i c u l t i e s of a r r i v i n g at the common l i s t of themes can be reduced in three ways: 1. Each of the common themes are r e f e r r e d back to the p r o t o c o l s to v e r i f y that each theme r e f l e c t e d what was there and added nothing. 2. In the t h i r d i n t e r v i e w , the themes, along with a b r i e f d e s c r i p t i o n of each, are presented to the c o - r e s e a r c c h e r s f o r v a l i d a t i o n to determine whether they f i t t e d t h e i r a c t u a l experience. V a l i d a t i o n i s achieved by "asking whether there i s anything c o n t a i n e d in the o r i g i n a l p r o t o c o l s that i s n ' t accounted f o r in the c l u s t e r of themes and whether the c l u s t e r s of themes propose anything which i s n ' t i m p l i e d in the o r i g i n a l p r o t o c o l s " ( C o l a i z z i , 1978, p.59). - 8 3 - 3. If the common theme a c c u r a t e l y r e f l e c t s the meaning u n i t s on which i t i s based, the theme i s confirmed to be a g e n e r a l i z e d statement of the meaning of a set of d e s c r i p t i o n s . For each theme, a r e s e a r c h e r can r e f e r back to p o r t i o n s of a c t u a l p r o t o c o l s , the set of meaning u n i t s , and the c o n f i r m a t i o n by the c o - r e s e a r c h e r s . W r i t i n g a D e s c r i p t i o n In w r i t i n g a d e s c r i p t i o n of the experience of the companion in g r i e f , the i n t e n t i s to weave a l i s t of themes i n t o the exhaustive phenomenological d e s c r i p t i o n to be r e f e r r e d to as the n a r r a t i v e d e s c r i p t i o n . The aim of the n a r r a t i v e d e s c r i p t i o n i s to i l l u m i n a t e the experience of the companion in g r i e f in a way that i s f u l l y present to the phenomenon. By condensing the n a r r a t i v e d e s c r i p t i o n i n t o an i n t e g r a t e d s t r u c t u r e , the f i n a l aim i s achieved; i t i s t h i s e s s e n t i a l s t r u c t u r e of the experience of the companion in g r i e f which answers the q u e s t i o n : what i s the meaning of the experience of the companion in g r i e f ? The procedure f o r w r i t i n g - 8 4 - both the d e s c r i p t i o n and the s t r u c t u r e began with the r e s e a r c h e r ' s open-ended q u e s t i o n i n g of the co - r e s e a r c h e r s when they were asked to t e l l t h e i r s t o r y , as i t was in the beginning, in the middle, and at the end. The s t o r y form p r o v i d e d a v e h i c l e which i n turn formed the b a s i s f o r a n a l y s i s . Then, in the process of e x t r a c t i n g meaning u n i t s and f o r m u l a t i n g themes, i t was p o s s i b l e to separate f i n e r d i f f e r e n t i a t i o n s of the whole. The t h i r d step was to determine the sequence of themes; to d i s c e r n which themes r e f l e c t e d the beg i n n i n g of the s t o r y , which were in the middle or midst of the experience, and which were concerned with the end. T h i s o r d e r i n g of themes in terms of the way they i n t e r r e l a t e d over time, helped to determine the r o l e of the companion as i t would appear in s t o r y form. T h i s step was a very general attempt to order events in time, but i t was not intended to suggest that the s t o r y form reduced the experience to one of l i n e a r i t y . Rather, the i n t e n t of the re s e a r c h e r was to in c o r p o r a t e the c o n f i g u r a t i o n a l and multidimensional aspects of the experience w i t h i n the v e h i c l e of the s t o r y form. Some themes - 8 5 - d i m l n l s h e d and ended, taut o t h e r s d i d not. Some st r a n d s of a theme were int r o d u c e d i n t o the s t o r y and c ontinued throughout. Once the re s e a r c h e r had a sense of the comprehensive s t o r y , i t was necessary to r e t u r n to the o r i g i n a l p r o t o c o l s f o r c o n f i r m a t i o n and v a l i d a t i o n . In t h i s f o u r t h s t e p , the r e s e a r c h e r attempted to be s e n s i t i v e to whether the common s t o r y a c t u a l l y r e f l e c t e d the s t o r i e s t o l d . It was c r u c i a l that the r e s e a r c h e r become attuned to the complexity of the phenomenon be i n g e x p l o r e d , and a p p r e c i a t e the nuances of meaning in the d e s c r i p t i o n s . It was at t h i s p o i n t that the w r i t i n g of the s t o r y began. F i n a l l y , a f t e r w r i t i n g and r e v i s i n g the n a r r a t i v e d e s c r i p t i o n , i t was condensed to i t s e s s e n t i a l s t r u c t u r e . The s t o r y c o u l d then be checked in two ways. F i r s t l y , the re s e a r c h e r r e t u r n e d to the o r i g i n a l p r o t o c o l s to v e r i f y that i t was a true r e f l e c t i o n of the i n d i v i d u a l d e s c r i p t i o n s . Secondly, the c o - r e s e a r c h e r s were asked to read the n a r r a t i v e d e s c r i p t i o n and the e s s e n t i a l s t r u c t u r e of the experience. Each was asked to v e r i f y i f the d e s c r i p t i o n and the e s s e n t i a l s t r u c t u r e f i t her experience, to f i n d how the - 8 6 - s t o r y might be a l t e r e d to most a c c u r a t e l y r e f l e c t the experience. If changes were necessary, in that a s p e c t s d i d not f i t f o r one c o - r e s e a r c h e r , the other c o - r e s e a r c h e r s were c o n s u l t e d b e f o r e changes would be introduced. Issues The i s s u e s of r e l i a b i l i t y , v a l i d i t y , and g e n e r a l i z a b i 1 i t y must be viewed from the p e r s p e c t i v e of phenomenological r e s e a r c h , which concerns i t s e l f with understanding the meaning of l i v e d experience and behaviour and s t r u c t u r i n g that meaning in a d e s c r i p t i v e way. R e l i a b i l i t y , a c o n s t r u c t drawn from t r a d i t i o n a l e m p i r i c a l psychology, i n s t e a d takes on the meaning of t r u s t w o r t h i n e s s . That i s , how a c c u r a t e l y do the resear c h r e s u l t s r e f l e c t the i n d i v i d u a l s ' experience? Because t h i s r e s e a r c h method i s one in which the b i a s e s and assumptions of the res e a r c h e r are made e x p l i c i t , i t i s e s s e n t i a l that to understand and h o n e s t l y evaluate phenomenological r e s e a r c h , the a t t i t u d e s and c r i t e r i a which are made e x p l i c i t by the re s e a r c h e r must be taken i n t o account. - 8 7 - V a l i d i t y , another c o n s t r u c t drawn from t r a d i t i o n a l e m p i r i c a l r e s e a r c h , assumes the meaning of trueness to a person's experience as a companion in g r i e f . The v a r i o u s s t e p s l e a d i n g to o b t a i n i n g f i n a l r e s u l t s , i n c l u d e d v a l i d a t i o n by the c o - r e s e a r c h e r s throughout, to s u b s t a n t i a t e the accuracy of the i n t e r p r e t a t i o n of her experience. It was only through such d i a l o g u e that the e s s e n t i a l s t r u c t u r e of the experience was d e r i v e d . G e n e r a l i z a b i 1 i t y , takes on the meaning of a c o n t i n u i n g d i a l e c t i c on the experience of the companion in g r i e f as l i v e d . It i s assumed w i t h i n t h i s methodological approach, that the c o - r e s e a r c h e r s , or those who companion a bereaved person through t h e i r g r i e v i n g process are the source of knowledge f o r understanding the experience under study. It i s not the i n t e n t of t h i s r e s e a r c h method to g e n e r a l i z e to groups of people who companion another, but these p a r t i c u l a r c o - r e s e a r c h e r s s e l e c t e d u s i n g p a r t i c u l a r c r i t e r i a , are c o n s i d e r e d c u l t u r a l r e p r e s e n t a t i v e s of people who are companions in g r i e f . T h i s study, then, p r o v i d e s a d e f i n i t e s t a r t i n g p o i n t f o r understanding the phenomenon of the companion in - 8 8 - g r i e f , and i s intended as an i n v i t a t i o n f o r f u r t h e r refinement. - 8 9 - CHAPTER IV RESULTS To p r o v i d e a context f o r viewing the themes l i s t e d in t h i s chapter, a b r i e f s y n o p s i s of each c o - r e s e a r c h e r ' s experience i s presented. The l i s t of themes which are common to the three separate accounts are c a t e g o r i z e d in three c l u s t e r s ; Beginning, Middle, and Ending. Each theme i s then d e s c r i b e d b r i e f l y . The n a r r a t i v e d e s c r i p t i o n which weaves the themes together to form an exhaustive account of the experience of the companion in g r i e f i s presented. The c o n c i s e v e r s i o n of t h i s d e s c r i p t i o n r e v e a l s the e s s e n t i a l s t r u c t u r e of the experience, which concludes the chapter. Summary of the Co-Researchers' Experiences The f o l l o w i n g summaries provide the reader with an overview of three d i v e r s e experiences in the l i v e s of the women who became companions in g r i e f to a c l o s e f r i e n d . The s t o r i e s i l l u s t r a t e the i n d i v i d u a l i t y of the women, the v a r i a t i o n s in r e l a t i o n s h i p to the bereaved f r i e n d , and the p a r t i c u l a r l o s s i n c u r r e d . - 9 0 - Co-Researcher L L, a 41 year o l d woman, remar r i e d without c h i l d r e n , was completing her do c t o r a t e in S o c i a l Psychology when she became a companion in g r i e f to her f r i e n d . It was May, 1987, that her f r i e n d of many years gave b i r t h prematurely (at 23 weeks g e s t a t i o n ) to twin boys. One son d i e d a f t e r 17 hours and the second son s u r v i v e d in the S p e c i a l Care Nursery. He d i e d nine months l a t e r , never having r e t u r n e d home. L was c o n s i s t e n t l y a v a i l a b l e to her f r i e n d throughout the months of v i s i t i n g in h o s p i t a l and d u r i n g her f r i e n d ' s a n t i c i p a t o r y g r i e v i n g and f o r ten months a f t e r the l o s s . She a l s o accompanied the parents and t h e i r three year o l d daughter as they s a i d t h e i r f i n a l goodbyes before g i v i n g consent to removing t h e i r son from l i f e support. L was present to her f r i e n d p r a c t i c a l l y and em o t i o n a l l y whenever she was needed, and was given the o f f i c i a l t i t l e of support person, which granted her v i s i t i n g p r i v i l e g e s in the S p e c i a l Care Nursery d u r i n g the h o s p i t a l i z a t i o n . It was c l o s e to a year a f t e r the death of the second twin that the frequency and type of contact in t h e i r r e l a t i o n s h i p changed with -91- subsequent l i f e events, a demanding new t e a c h i n g p o s i t i o n f o r L, and the p r e p a r a t i o n f o r the b i r t h of a new c h i l d f o r her f r i e n d . L f e l t that the broad, al1-encompassing experience had resumed a manageable p o r t i o n in her l i f e . It was one p a r t of her r e l a t i o n s h i p to her f r i e n d but the experience had found i t s p l a c e . L and her f r i e n d mutually acknowledged they would always be able to t a l k about the l o s s and t h e i r shared experience would always remain a p a r t of them. Co-Researcher W W, a 42 year o l d s i n g l e woman with no c h i l d r e n , was employed as a high school c o u n s e l l o r when she accepted the i n v i t a t i o n of long-time f r i e n d s to be present at the b i r t h of t h e i r e a g e r l y awaited f i r s t c h i l d . It was January, 1989, that the joy of the b i r t h was turned to f e a r at the time of d e l i v e r y , and then to s h a r i n g i n the pain of the death of her f r i e n d s ' f i r s t b o r n son twenty-four hours l a t e r . W was present with her f r i e n d s at the b i r t h , was with them in h i s death, and then was i n v i t e d to l i v e with them f o r f i v e days while they together planned h i s f u n e r a l . She became a companion in g r i e f e q u a l l y to both - 9 2 - the bereaved parents as she shared a h i s t o r y of f r i e n d s h i p with each of them i n d i v i d u a l l y and as a couple. She was c o n s i s t e n t l y a v a i l a b l e to them f o r the f i v e months that her f r i e n d s remained in the same c i t y . She has remained open and a v a i l a b l e to them by phone, by m a i l , and by frequent v i s i t s in s p i t e of a one thousand m i l e d i s t a n c e between them imposed by a move. She has continued as a companion in g r i e f to the present time, and j o i n e d them in c e l e b r a t i n g the b i r t h of t h e i r daughter, her namesake, one and a h a l f years a f t e r the death of t h e i r son. Co-Researcher T T, a 31 year o l d married woman with two c h i l d r e n , aged one and three years at the time of her f r i e n d ' s l o s s , was employed p a r t - t i m e as a Travel Agent. T became a companion in g r i e f to her f r i e n d of twelve years. It was an A p r i l evening of 1989, when she was r e t u r n i n g with a mutual f r i e n d from an A e r o b i c s c l a s s . They came upon the scene of an a c c i d e n t near her f r i e n d ' s home to d i s c o v e r her f r i e n d ' s two year o l d son had been h i t by a truck and was en route to Emergency. T made h e r s e l f immediately a v a i l a b l e with the - 9 3 - mutual f r i e n d , g i v i n g p r a c t i c a l support, informing f r i e n d s and r e l a t i v e s and c a r i n g f o r her f r i e n d ' s f i v e year o l d daughter. The c h i l d never recovered from h i s coma and d i e d i n h o s p i t a l the f o l l o w i n g day. T's p h y s i c a l presence and emotional support was openly r e c e i v e d up to the time of the f u n e r a l . A f t e r the f u n e r a l , in s p i t e of her continued a v a i l a b i l i t y and o f f e r s of support, her f r i e n d shared with her that she found h e r s e l f needing to turn to the mutual f r i e n d in her g r i e f r a t h e r than to T. Although T was f e e l i n g hurt by the r e j e c t i o n of her o f f e r s of support, she p e r s i s t e d in making d a i l y phone c o n t a c t . Within s i x months, t h e i r r e l a t i o n s h i p began to grow c l o s e r and she became the primary companion in her f r i e n d ' s g r i e f , as the r e l a t i o n s h i p with the other woman had become s t r a i n e d due to the demands of the r o l e . The l o y a l support and the u n c o n d i t i o n a l acceptance that T o f f e r e d in s p i t e of i n i t i a l f e e l i n g s of personal r e j e c t i o n earned her the t r u s t i m p l i c i t in t h i s r o l e . T c o n t i n u e s to be a companion to her f r i e n d one and a h a l f years f o l l o w i n g t h i s t r a g i c death, as her f r i e n d moves i n t o the e a r l y stages of a subsequent pregnancy. T i s aware of markers - 9 4 - p o l n t i n g to s i g n i f i c a n t movement in the g r i e v i n g process although the pa i n of the l o s s c o n t i n u e s to be a consuming r e a l i t y . C l u s t e r s of Themes The common themes presented in t h i s chapter have been given s h o r t t i t l e s f o r convenience so that they can be l i s t e d in three c l u s t e r s or c a t e g o r i e s . The themes are d i v i d e d i n t o three c l u s t e r s ; Beginning, Middle, and Ending of the Experience. The Beginning i n c l u d e s a l l that s e t s the scene f o r becoming a companion and the i n i t i a l experience of s h a r i n g the l o s s . The Middle takes in the bulk of the experience of be i n g a companion, and i n c l u d e s the elements of the r o l e and the p a r t i c i p a t i o n with the bereaved in the midst of the g r i e f p r o c e s s . The Ending i n c l u d e s aspects of the experience i n d i c a t i n g movement toward c l o s u r e f o r the companion. There are 24 themes l i s t e d , and each w i l l be given a f u l l e r d e s c r i p t i o n in the f o l l o w i n g s e c t i o n . Beginning of the Experience 1. A P r e e x i s t i n g L o y a l t y of R e l a t i o n s h i p 2. Sha r i n g the A n t i c i p a t i o n of Loss 3. Being Moved by the News of Death - 9 5 - 4. P a r t i c i p a t i n g in the Pain of Loss Middle of the Experience 5. Being Present 6. P r a c t i c a l Support 7. L i s t e n i n g 8. M e d i a t i n g 9. F a c i 1 i t a t ing 10. Encouraging 11. S e l f - R e f l e c t i o n 12. P a r t i c i p a t i n g in R i t u a l Events 13. I d e n t i f y i n g With the Loss 14. Owning Personal Needs 15. Sense of Personal Support 16. Deeper Sense of the S p i r i t u a l Dimension of L i f e 17. Need f o r Normalcy 18. R e f l e c t i n g on the G r i e v i n g Process 19. Overcoming O b s t a c l e s to Companioning 20. Sense of Impact on the Marriage 21. Empathy f o r S u r v i v i n g or P r o s p e c t i v e Ch i1dren 22. R e c o g n i t i o n of the Changing S e l f Ending of the Experience - 9 6 - 23. R e s t o r i n g M u t u a l i t y in Changing Re 1 at i onsh ip 24. Looking to the Future I I I . D e s c r i p t i o n of the Themes Beginning of Experience 1. A P r e e x i s t i n g L o y a l t y of R e l a t i o n s h i p One's p r e e x i s t i n g f r i e n d s h i p with the bereaved has a h i s t o r y of mutual l o y a l t y , which has wi t h s t o o d a t e s t of time. The f r i e n d s h i p e x i s t s w i t h i n the context of a common c i r c l e of f r i e n d s . W i thin the p a r t i c u l a r f r i e n d s h i p , there i s r e g u l a r contact v a r y i n g from a d a i l y phonecal1 to at l e a s t a weekly encounter. For L, she i s par t of a c i r c l e of f r i e n d s who meet r e g u l a r l y f o r Saturday morning c o f f e e , and her f r i e n d s h i p i s rooted in that c i r c l e and weekly c o n t a c t . For W, she l i v e d and worked with her f r i e n d f o r four years before her marriage. She knew her f r i e n d ' s husband even longer, so they are a threesome who share a t r u s t i n g mutual openness. T and her f r i e n d knew each other twelve years before when t h e i r husbands were roommates in c o l l e g e . In the year p r e c e d i n g the l o s s , they weathered a c r i s i s in t h e i r f r i e n d s h i p a f t e r a breach of t r u s t - 9 7 - threatened to sever t h e i r bond. T acknowledges that without a deep commitment to r e c o n c i l i n g the r e l a t i o n s h i p and a perseverance that proved her l o y a l t y , the f r i e n d s h i p would not have been r e s t o r e d when her f r i e n d needed her to g r i e v e the death of her son. 2. S h a r i n g the A n t i c i p a t i o n of the Loss The experience of the companion in g r i e f begins with the f i r s t h i n t of f e a r that i n t r u d e s i n t o the l i f e of the f r i e n d when an unexpected turn of events o c c u r s . T h i s I n i t i a l f e a r and dread of p o t e n t i a l l o s s r e v e r b e r a t e s to the companion. L had been v i s i t i n g her f r i e n d i n h o s p i t a l d u r i n g a problem pregnancy and while on h o l i d a y , her f r i e n d gave b i r t h prematurely to twins. L r e t u r n e d from h o l i d a y to r e c e i v e the news of the death of one son, and she accompanied her f r i e n d through s e v e r a l months of a n t i c i p a t i n g the death of the second twin, who d i e d nine months l a t e r . When one i s given an extended time to a n t i c i p a t e the l o s s , there i s o p p o r t u n i t y f o r the companion to p a r t i c i p a t e in the a n t i c i p a t o r y g r i e v i n g of her f r i e n d as they together r e s i g n themselves to the i n e v i t a b i l i t y that t h i s c h i l d - 9 8 - w l l l d i e . R e s i g n i n g o n e s e l f to t h i s p o s s i b i l i t y happens in c o n j u n c t i o n with a w i l l i n g n e s s to remain open to a turn of events so as to share as f u l l y as p o s s i b l e in the v a c i l l a t i n g hopes and f e a r s of t h i s u n c e r t a i n time, u n t i l i t becomes c l e a r that death i s imminent. For W, a t t e n d i n g at the b i r t h of her f r i e n d ' s f i r s t baby, she f e l t the f i r s t pangs of f e a r when the baby showed s i g n s of being traumatized a f t e r the momentary e x h i l a r a t i o n of the d e l i v e r y . Her joy was r e p l a c e d with f e a r as the S p e c i a l Care Team whisked the baby to In t e n s i v e Care. He s u r v i v e d only one day. T f e l t f e a r and dread on approaching the scene of an a c c i d e n t when she heard a c h i l d had been h i t and knew i t c o u l d be her f r i e n d ' s c h i l d . Her f i r s t words were, "Oh God, please don't l e t i t be G", only to have her f e a r s confirmed. He was rushed to Emergency in a coma and he d i e d the next day. With sudden trauma, there i s no p r e p a r a t i o n . One i s g r i p p e d by f e a r and a s i c k f e e l i n g of dread that t h i s c o u l d go e i t h e r way. One j o i n s one's f r i e n d in a consuming sense of power 1essness in the r e a l i z a t i o n that a l l the hope and d e n i a l in -99- the world w i l l not change the p o s s i b i l i t y they are f a c i n g . 3. Being Moved by the News of Death When one r e c e i v e s the news of the death, most markedly in sudden death, one responds immediately with an o u t f l o w i n g of the deep f e e l i n g one has been h o l d i n g w i t h i n . For L, who had the op p o r t u n i t y to prepare f o r the death and p a r t i c i p a t e with the fa m i l y in s a y i n g t h e i r goodbyes, she was f l o o d e d with the f e e l i n g of r e l i e f and g r a t i t u d e with a sense that the death was t i m e l y , and that the baby d i e d in h i s p a r e n t s ' arms. She f e l t there was d i g n i t y in h i s death, and she never f e l t angry but r a t h e r g r a t e f u l f o r h i s short l i f e . For W and T, who had no such p r e p a r a t i o n , they each responded to the news over the phone with an immediate r e l e a s e of sobbing and t e a r s of anguish. One, who experiences the l o s s as sudden and unexpected, f e e l s numb and dazed. Then through the s u r f a c e numbness and daze, a r i s e s a p r e s s i n g , angry p r o t e s t , "No!, t h i s cannot be happening", a sense that t h i s t e r r i b l e nightmare cannot be r e a l . One has a p r e s s i n g need to see one's f r i e n d face to f a c e . -100- 4. P a r t i c i p a t i n g in the Pain of Loss One fe e l s one's own deep pain at how t h i s loss i s touching her, but fe e l s a deeper p a r t i c i p a t i o n in a l l that one's fri e n d must f e e l . For W, she went to her frie n d and her husband and a l l she could do was hug them as they held the baby who had died. As she held them and c r i e d with them, they were joined in the shock and d i s b e l i e f that t h i s baby they'd waited for with such expectation, was now dead. After a long time, her fr i e n d began to share her story. For T, she arrived at the home of her frie n d , who took her aside, and they just held each other, and cr i e d . After some time, her fr i e n d poured out her story, and T f e l t the pain and horror of the events leading to the death of her friend's son. One fe e l s the depth of one's own hurt, and imagines the ever deeper place of pain as she aches for the parents in t h i s unfathomable place. Middle of the Experience 5. Being Present Because of the empathic sharing of the sorrow, the hurt, the pain, one desires to be present to the bereaved friend. One makes clear -101- to one's f r i e n d one's ready a v a i l a b i l i t y and w i l l i n g n e s s to respond by her p h y s i c a l and emotional presence. One i s h e s i t a n t at times, unsure of when to be f u l l y p resent, and when to fade i n t o the background, in one's attempt to be s e n s i t i v e to the needs of the bereaved. L made h e r s e l f r e a d i l y a v a i l a b l e , i n i t i a l l y by phone and then in person. L knew that when her f r i e n d needed her, she would phone, and because L was a student, she was able to s t r u c t u r e her time to assure her f r i e n d she was welcome to c a l l at any time. L accompanied her f r i e n d on r e g u l a r h o s p i t a l v i s i t s , and f o r a year a f t e r the death, she and her f r i e n d t a l k e d d a i l y and d i d t h i n g s together. W went d i r e c t l y to the h o s p i t a l to be present to her f r i e n d in s h a r i n g her l o s s , and then r e t u r n e d home to be with the bereaved parents in p r e p a r i n g f o r the f u n e r a l . There were moments, as when her f r i e n d woke from a dream, h o l d i n g her baby and r o c k i n g him only to r e a l i z e he was gone, when W s e n s i t i v e l y d i s c e r n e d her need to enter i n and be present, to h o l d her f r i e n d and share the t e a r s . It was a p p r o p r i a t e at other times to al l o w her f r i e n d space. W rec o g n i z e d , a f t e r f i v e intense -102- day s of being present In her f r i e n d s ' home, her need f o r some s e p a r a t i o n to r e f o c u s f o r h e r s e l f on her Job and her l i f e . W remained present to her f r i e n d in a new p a t t e r n of frequent contact with mutual i n i t i a t i o n and t h i s p a t t e r n continued u n t i l her f r i e n d s moved f i v e months l a t e r . For T, she was c l e a r l y a v a i l a b l e to her f r i e n d and was openly r e l i e d upon at the outset but then her w i l l i n g n e s s to be present was r e j e c t e d , and her f r i e n d withdrew as in a p r e v i o u s time of c o n f l i c t between them. T's p e r s i s t a n c e in i n i t i a t i n g d a i l y phone contact won her f r i e n d ' s t r u s t and she began to respond to T's openness to b e i n g present f o r her. If T sensed her f r i e n d ' s need to t a l k , she made h e r s e l f present g i v i n g her permission to do so. And T was there f o r her f r i e n d , not on her own terms, but a v a i l a b l e whether the c a l l s came in the middle of dinner or the middle of the n i g h t . One's openness to being present, without e x p e c t a t i o n of m u t u a l i t y in the r e l a t i o n s h i p i s fundamental to the r o l e of the companion. 6. P r a c t i c a l Support In the e a r l y stages of the l o s s , a v i t a l r o l e one assumes i s a n t i c i p a t i n g what i s needed, and -103- s p e c i f i c a l l y o f f e r i n g to take on some of the p r a c t i c a l f u n c t i o n s . One takes on such d i f f i c u l t but p r e s s i n g t a s k s of phoning designated r e l a t i v e s and f r i e n d s to inform them that the death has occ u r r e d . When there are s u r v i v i n g s i b l i n g s , one s e n s i t i v e l y reaches out to care f o r them and t h e i r own needs. For both L and T, t h i s was a v i t a l l y important f u n c t i o n at the time of the death, and was an ongoing r o l e , p r o v i d i n g b a b y s i t t i n g and empathic a t t e n d i n g to the c h i l d ' s need to g r i e v e . One a l s o a s s i s t s in fun e r a l arrangements and with the everyday tasks of meals, management of the house, and as a resource f o r info r m a t i o n f o r such t h i n g s as the f u n e r a l , r e a d i n g m a t e r i a l to normalize the g r i e f process, and c o u n s e l i n g i n f o r m a t i o n . E s s e n t i a l as these tasks are, one re c o g n i z e s that i t i s more d i f f i c u l t but even more important to be r a t h e r than to do f o r her f r i e n d . 7. L i s t e n i n g One becomes aware of how v i t a l l y important i t i s f o r the f r i e n d to express what she i s f e e l i n g at any given time. One makes o n e s e l f a v a i l a b l e as a l i s t e n e r , day or n i g h t , to hear from her f r i e n d , whatever she may be f e e l i n g . By a c t i v e l y -104- l l s t e n i n g , one attempts to help the f r i e n d t e l l and r e t e l l her s t o r y . The f r i e n d can say the same t h i n g s a hundred times and the companion can be t r u s t e d not to r e j e c t her. One enables one's f r i e n d to t a l k as her need d i c t a t e s , which corresponds to the f r i e n d ' s r e a l i z a t i o n of her own need to connect with one who a l l o w s her to f r e e l y and r e p e t i t i v e l y express her g r i e f . One's r o l e as l i s t e n e r changes over time with changing circumstances from h e a r i n g the i n i t i a l o utpouring, to p r o v i d i n g a s a f e p l a c e f o r the f r i e n d to g i v e v o i c e to the a s p e c t s of the experience that she h e r s e l f f e a r s f a c i n g , f e e l i n g s of g u i l t , of anger, and of d e s p a i r . One attempts to set a s i d e competing demands wherever p o s s i b l e to r e a s s u r e the f r i e n d that she i s attempting to l i s t e n without i n t e r r u p t i o n . As the year p r o g r e s s e s , one becomes s e n s i t i v e to p a r t i c u l a r markers ( b i r t h d a y s , Christmas, a n n i v e r s a r y dates) which give r i s e to a heightened need f o r the f r i e n d to express h e r s e l f . The context f o r l i s t e n i n g a l s o changes with changing circumstances, from phone c o n v e r s a t i o n s , to shared mealtimes and a c t i v i t i e s . For W, who had to come to terms with the e f f e c t s 105- of her f r i e n d s ' move, easy access f o r b e i n g a l i s t e n e r was removed, and she had to r e l y on l e t t e r s , long d i s t a n c e c a l l s and v i s i t s . But once deep t r u s t i s e s t a b l i s h e d in the r e l a t i o n s h i p , the p a r t i c u l a r context i s secondary. Through the l e t t e r s and c a l l s , W continued to hear her f r i e n d ' s deepest sadnesses and longings and her own s t o r y of her d i f f i c u l t i e s a d j u s t i n g to her l o s s in a new s i t u a t i o n . 8. M e d i a t i n g One sees o n e s e l f as an approachable channel between the bereaved and those more p e r i p h e r a l l y i n v o l v e d ; the person through whom ot h e r s f e e l a sense of connection with the bereaved. In the e a r l y stages, t h i s r o l e takes the form of b e i n g a v a i l a b l e to be approached by those who f e e l unable to approach the bereaved person d i r e c t l y . It a l s o i n v o l v e s becoming a b u f f e r between the bereaved and the l a r g e r world as one screens p h o n e c a l l s , answers q u e s t i o n s , and r e l a y s i nformation in accordance with the f r i e n d ' s r e a d i n e s s to take over these f u n c t i o n s . T h i s conduit r o l e changes over time as i t becomes more important f o r o t h e r s to i n i t i a t e contact d i r e c t l y -106- and f o r the bereaved to begin the p a i n f u l r e i n t e g r a t i o n p rocess with l a r g e r networks of people. One f i n d s o n e s e l f o f f e r i n g p r o t e c t i o n to one's f r i e n d while most v u l n e r a b l e and subsequent freedom to widen c i r c l e s of contact c o r r e s p o n d i n g to personal r e a d i n e s s r a t h e r than s o c i e t a l e x p e c t a t i o n s . One f i n d s o t h e r s choosing t h i s channel of communication f o r months a f t e r the l o s s due to personal discomfort with the bereaved f r i e n d , or because of having c h i l d r e n who might be seen as p a i n f u l reminders. As time e l a p s e s and through d i a l o g u e with the bereaved f r i e n d , one p r o g r e s s i v e l y encourages o t h e r s to approach the f r i e n d d i r e c t l y , r e g a r d l e s s whether they have c h i l d r e n , in the i n t e r e s t s of the f r i e n d ' s need to r e i n t e g r a t e with the l a r g e r community. 9. F a c i 1 i t a t i n g One becomes a c a t a l y s t f o r the bereaved to help her to accept and v a l i d a t e her experience. One r e f l e c t s and names f o r the f r i e n d what one hears and observes, o f t e n u n d e r l y i n g her words and a c t i o n s , and seeks always to v a l i d a t e her f e e l i n g s . One t r i e s to d i s c e r n what her f r i e n d i s t r y i n g to express, and r e f r a i n s from s u g g e s t i n g - 1 0 7 - how she 'should'' f e e l . For L, she d i s c e r n e d that w i t h i n her f r i e n d was an i n t u i t i v e sense, "something Inside her that was more measured and knowing than her w i l d swings of mood would i n d i c a t e " , so she v a l i d a t e d that sense and the t r u s t she had in her f r i e n d ' s p r o c e s s . She normalized her f r i e n d ' s resentment toward her p a r e n t s , who showed no support or understanding and was a c a t a l y s t f o r the l e g i t i m a t e anger her f r i e n d f e l t and needed to acknowledge and express. For W, she would name and i d e n t i f y the unigue way she saw her f r i e n d e x p e r i e n c i n g her l o s s , and by spending time with her f r i e n d ' s husband, would i d e n t i f y t h e i r d i f f e r e n t ways of g r i e v i n g , thereby h e l p i n g her f r i e n d to accept those d i f f e r e n c e s . W saw her r o l e as c a t a l y s t as e n a b l i n g her f r i e n d and her husband to hear one another yet be f r e e d to g r i e v e in t h e i r own way. For T, i t meant r e f l e c t i n g the s t r e n g t h she saw and heard in her f r i e n d , who gave e x p r e s s i o n to her g r i e f , and in doing so, appeared to T as the h e a l t h i e s t person in her fami 1y. 1 0 . Encouraging -108- By u n c o n d i t i o n a l l y a c c e p t i n g one's f r i e n d ' s e x p r e s s i o n of sadness, longings, f e a r s , anger, of her need to work out personal meaning f o r h e r s e l f , and ambivalence at moving i n t o new phases of l i f e , one i m p l i c i t l y encourages the f r i e n d to g r i e v e . For L and W, by e x p l i c i t l y r e f e r r i n g to t h i s p r o c e s s , they o f f e r e d encouragement. For T, she a f f i r m e d her f r i e n d ' s e x p r e s s i o n of f e e l i n g s in a d a i l y way and p o i n t e d out the markers i n d i c a t i n g how f a r she'd come by t a k i n g one day at a time, and she encouraged her to take breaks o c c a s i o n a l l y as a way of c a r i n g f o r h e r s e l f . One i s h e s i t a n t at times to i n c l u d e the f r i e n d in former a c t i v i t i e s and o p p o r t u n i t e s to resume former s o c i a l avenues, but with time and s i g n s of r e a d i n e s s in the f r i e n d , one begins to i n v i t e the f r i e n d to r e i n t e g r a t e s o c i a l l y . 11. S e l f - R e f l e c t i o n One sees o n e s e l f on r e f l e c t i o n , as a v a i l a b l e in s p i t e of competing demands (of c h i l d r e n , s t u d i e s , and work), as u n c o n d i t i o n a l in one's support, a non-judgemental l i s t e n e r , and a s a f e and approachable conduit f o r o t h e r s to approach the bereaved f r i e n d . One accepts the p a r t one -109- p l a y s as i n t e g r a l to the process of accompanying one's f r i e n d on her journey. One p i c t u r e s one's r o l e not as a job or p r o f e s s i o n a l t h i n g , nor as an o b l i g a t i o n , but what l i e s dormant a w a i t i n g to be c a l l e d upon as p a r t of f r i e n d s h i p as determined by the needs of the moment. L imagined h e r s e l f as "the beanbag c h a i r , so i f her f r i e n d f e l l i n t o i t , she would take her shape, but she would be f i r m enough that her f r i e n d would never h i t the f l o o r " . L f e l t the r o l e was what a husband and wife are to one another in some emotional sense, l i k e a best f r i e n d in o f f e r i n g non-judgemental support, and l i k e a mother in one's concern that the bereaved make d e c i s i o n s that would not hurt her, and that she be p r o t e c t e d from those not s e n s i t i v e to her needs. W r e f l e c t e d on the r o l e as a s p i r i t u a l i t y of presence, of b e i n g present when the t e a r s needed s h a r i n g , the s t o r y needed t e l l i n g , and bei n g there to r e c e i v e and r e c o r d the u n f o l d i n g s t o r y . She p i c t u r e d h e r s e l f as another set of eyes and ears, and as a voice that l e t her f r i e n d ' s v o i c e be heard through her when a p p r o p r i a t e , as at the fune r a l and in her conduit r o l e . For T, " i f someone s a i d , what would you do, - n o - how would you do i t ; you've done i t , my advice would be; make no demands, s i t back, l i s t e n , t r y not to judge, take breaks, look a f t e r y o u r s e l f , and j u s t don't give up." 12 . P a r t i c i p a t i n g in R i t u a l Events One p a r t i c i p a t e s with the bereaved in the pain i n t e n s i f i e d in r i t u a l events and markers, b e g i n n i n g with the f u n e r a l or memorial and then throughout the months, marked as they are by s p e c i a l days such as b i r t h d a y s , Christmas, the a n n i v e r s a r y of the death. One who i s i n v i t e d to speak at the memorial or f u n e r a l j o i n s in g r i e v i n g anew, f o r the parents and the l o s s of t h e i r shared f u t u r e and dreams. For W, she experienced g r a t i t u d e in h e l p i n g to prepare the f u n e r a l s e r v i c e which she f e l t o f f e r e d s p i r i t u a l comfort as the community entered, through the words and the music, a time of c o n s o l a t i o n mingled with the p a i n . One i s aware of each marker as i t approaches and searches f o r ways to be e s p e c i a l l y s e n s i t i v e to the f r i e n d . L knew that her f r i e n d was very c o n s c i o u s of s p e c i a l days, not the p r e d i c t a b l e markers, but the a n n i v e r s a r y of the baby's co n c e p t i o n , or New Year's Day when the - i l l - b e g i n n i n g of the end was i n d i c a t e d by a s p i k e in temperature recorded in a memo book. L became r e c e p t i v e to her f r i e n d l i n k i n g her p e r i o d i c d e p r e s s i o n s with one of these markers, and she would l i s t e n with compassion as her f r i e n d r e l i v e d the event which r e t r i g g e r e d the l o s s . For W, she acknowledged the images she had as Christmas approached and by doing so, gave permis s i o n to her f r i e n d to share her own images and l o s s of dreams. For T, she learned by her f r i e n d ' s response s i x months a f t e r the l o s s , that Christmas was as p a i n f u l as her c h i l d ' s dying. L f e l t empathy as she d i s c o v e r e d that f o r her f r i e n d , Christmas, l i k e the b i r t h d a y , was a day that i n t e n s i f i e d her c h i l d ' s absence. It was a day that he too was m i s s i n g in c o n t r a s t to the a n n i v e r s a r y date of h i s death, which was a day on which one was not expected to be happy. So T's phonecall on the b i r t h d a y of her f r i e n d ' s son, t h i r t e e n months a f t e r h i s death, was r e c e i v e d with deep g r a t i t u d e . One becomes attuned to the p a r t i c u l a r s i g n i f i c a n c e of these s p e c i a l days, by remaining open and r e c e p t i v e , and s e n s i t i v e to the f r i e n d ' s exper i ence. -112- 13. I d e n t i f y i n g With the Loss One e n t e r s so f u l l y i n t o the f r i e n d ' s l o s s that one l i v e s the pain and experiences that one's own l i f e i s i r r e t r i e v a b l y changed as a r e s u l t of the l o s s . So intense i s the i d e n t i f i c a t i o n with the f r i e n d ' s l o s s that a s s o c i a t i o n s and c o nnections are made. To v a r y i n g degrees, one's own p a i n a s s o c i a t e d with memories of past l o s s e s of s i g n i f i c a n c e are t r i g g e r e d , as well as the f e a r f o r p o t e n t i a l l o s s e s . T h i s s t i r r i n g up of memories and f e a r s v a r i e s from a r e f l e c t i v e pondering to a consuming p r e o c c u p a t i o n . For L, the death of her f r i e n d ' s c h i l d s t i r r e d up memories of p r e v i o u s deaths from the expected l o s s of her grandmother to the intense experience of l o s i n g a c l o s e f r i e n d through s u i c i d e . For W too, there were memories of p r e v i o u s l o s s e s i n c l u d i n g another s t i l l b o r n c h i l d and the recent death of her mother, but her focus of a t t e n t i o n was so f i x e d on her f r i e n d in her l o s s that her own personal l o s s e s were as background ponderings. She was aware that i f she h e r s e l f had a c h i l d or p l a n s f o r c h i l d r e n , her f r i e n d ' s l o s s would have touched her p o t e n t i a l motherhood. She observed -113- that each new parent in t h e i r c i r c l e of f r i e n d s were i d e n t i f y i n g with the p o t e n t i a l l o s s of t h e i r own c h i l d r e n . For T, h e r s e l f a mother of two young c h i l d r e n , the impact of her f r i e n d ' s l o s s t r i g g e r e d f o r her an a l 1 - p e r v a s i v e f e a r and a s h a t t e r i n g of a l l that had seemed secure in her l i f e . She awoke each morning with t h i s "sunken b r i c k f e e l i n g " that a c h i l d had d i e d , and l i k e r i p p l e s in a pond, the f e a r evoked in her spread to a f e a r f o r the h e a l t h and s a f e t y of her own c h i l d r e n , her spouse, her own h e a l t h , her p a r e n t s , and her f r i e n d s i n ever widening c i r c l e s . For her, t h i s powerful sense of i d e n t i f i c a t i o n was a consuming r e a l i t y and the hardest part of the whole experience. T s a i d , " i t s c a r e s a l l of us. We a l l have c h i l d r e n around the same age. And f o r me, i t ' s the unknown. I t ' s going to happen. That t e r r i b l e heavy b r i c k s i c k f e e l i n g . I know I'm going to f e e l that way again. I don't want t o . I'm going to f e e l that sad and that h o r r i b l e , and i t ' s j u s t out there w a i t i n g and I don't l i k e i t " . 14. Owning Personal Needs One commits o n e s e l f , in t a k i n g on t h i s r o l e , to g i v i n g e n d l e s s l y from one's own g r a c i o u s but -114- a l b e i t l i m i t e d r e s o u r c e s . One e n t e r s i n t o an unspoken agreement with one's f r i e n d that a s h i f t has taken p l a c e ; that one's needs have been v o l u n t a r i l y s et a s i d e in favour of the needs of the bereaved who i s weathering personal c r i s i s and attempting to s u r v i v e . For L, she acknowledged her personal needs, f o r example, when she was aware that her f r i e n d had c a l l e d at an inopportune time and she was s e n s i t i v e not to cut her o f f but f e l t the need to acknowledge that she was in the middle of something but would c a l l r i g h t back. For W, when she was asked to speak at the Memorial, she was i n i t i a l l y u n c e r t a i n and f e a r f u l as to whether she would f i n d the emotional r e s o u r c e s to do j u s t i c e to f u l f i l l i n g t h i s request, as she had given her emotional r e s o u r c e s without r e s e r v a t i o n . A f t e r acknowledging her needs and personal l i m i t a t i o n s , she was then able to f u l f i l l the request. For T, she too acknowledged her own personal l i m i t s when asked to speak p u b l i c l y , and in so doing was able to i n v i t e the p a r t i c i p a t i o n of her husband, who she in turn supported. 15. Sense of Personal Support -115- One r e c o g n i z e s one's own need f o r support, someone to turn to when one needs to express a l l that has been suppressed in one's own experience, as the focus has been on the f r i e n d ' s e xperience. T h i s need dawns with the r e a l i z a t i o n that one has given up m u t u a l i t y i n r e l a t i o n to the f r i e n d s i n c e the time of the l o s s . But one's own needs remain. For L and T, t h e i r husbands were a primary source of support; they p r o v i d e d a p l a c e of refuge where one c o u l d be h e l d or c o u l d speak without r e s e r v a t i o n . For L and W, a c l o s e woman f r i e n d and c o n f i d a n t e o f f e r e d support. T was more r e t i c e n t to share openly with another woman f r i e n d because of a recent b r e a k i n g of a confidence that hurt her deeply. One tended to g r a v i t a t e to oth e r s whose comfort zone about death and l o s s and g r i e f was wider due to t h e i r own experience. There was a pas t o r and a male companion in g r i e f f o r W, a f r i e n d who worked in P a l l i a t i v e Care f o r L, and T's mother. For W, the f a i t h experience that she and her f r i e n d shared p r o v i d e d a source of support and comfort, and w i t h i n that shared f a i t h experience, she f e l t r e f r e s h e d and supported by the love of her f r i e n d and her f r i e n d ' s -116- husband. She acknowledged that f o r her, i t wasn't al1 one way. 16. Deeper Sense of the S p i r i t u a l Dimension Regardless of one's experience of r e l i g i o u s f a i t h , one experienced a deepened sense of goodness in the midst of t r a g i c circumstances, which lent c l a r i t y to one's own s p i r i t u a l e xperience. For L, she was touched by the experience of a v u l n e r a b l e dying c h i l d who had nothing to give to her and yet in some mysterious way c a l l e d f o r t h a sense of compassion in her, e n a b l i n g her to give to t h i s c h i l d who c o u l d never g i v e back, s t r e n g t h e n i n g her so that she c o u l d in turn strengthen h i s mother, and even f i n d anew the love f o r her own f a t h e r . For W, she had an i n c a r n a t i o n a l view of God present in her experience of events. She experienced a deepening of f a i t h i n God, and shared with her f r i e n d a sense of God's presence in the midst of the darkness that had come through the t r a g i c circumstances. She experienced a deeper sense of a c c e p t i n g the mystery of God s h a r i n g t h i s darkness, which strengthened her r e s o l v e to accept God's presence in her own p l a c e s of pa i n and -117- hard-heartedness, no longer a s k i n g , 'where are you or who are you to be a l l o w i n g t h i s ' as she might have done in the p a s t . Her words were, "You are indeed a powerful God when you can touch h e a r t s that are so, that are s h a t t e r e d , smushed i n t o the ground, and you can s t i l l touch them and love them and acknowledge the p a i n , you're not a God to be denied.... I t ' s more an acknowledging that there i s God's darkness, I mean he c r e a t e d n i g h t , there i s God's darkness but not that hasn't got God in i t " . T's experience was a l s o one of deepening personal f a i t h in God, with a g r e a t e r acceptance of the mystery of God which was humbling f o r her. She experienced a renewed sense of g r a t i t u d e f o r a l l that was p r e c i o u s in her own l i f e , a l l that was s t i l l untouched, s t i l l i n t a c t though imbued with a new f r a g i l i t y . Although t h i s seemed the worst and most s e n s e l e s s t h i n g to touch her l i f e , she accepted her own lack of understanding and was r e c e p t i v e to f i n d i n g the goodness in t h i s experience; she b e l i e v e d i t was not f o r naught. 17. Need f o r Normalcy One i s drawn i n t o an experience so intense in nature that one r e c o g n i z e s the need f o r glimpses -118- of normalcy. One f i n d s the need f o r comic r e l i e f , and f o r n o r m a l i z i n g and l i g h t e n i n g the experience with humour. L s a i d , "they d i d laugh together; I f e l t you j u s t can't go through l i f e b e i n g s e r i o u s about every s e r i o u s t h i n g " . L's f r i e n d and her husband r e l a t e d to her how they r e l e a s e d the c o n t a i n e r c o n t a i n i n g t h e i r son's ashes i n t o the r i v e r and how i t kept f l o a t i n g back. For T's f r i e n d and her f r i e n d ' s husband, they were able to laugh with T about the only t h i n g they had to look forward to, a c c o r d i n g to s t a t i s t i c s , was t h e i r marriage f a l l i n g apart in the f i r s t year a f t e r the l o s s . One sensed the need f o r glimpses of the fun s i d e of l i f e and r e l a t i o n s h i p , the o c c a s i o n a l f r i v o l i t y and s u p e r f i c i a l i t i e s . One d e a l s with the i n t e n s i t y , a l s o by s i t u a t i o n s of f a m i l i a r i t y . For W, she and a mutual f r i e n d went to the p l a c e where they were accustomed to b e g i n n i n g t h e i r morning j o g to t a l k over fu n e r a l arrangements. Glimpses of the former p a t t e r n s of b e i n g and doing t h i n g s are r e a s s u r i n g reminders that although an i r r e t r i e v a b l e change has taken p l a c e , that what i s f a m i l i a r in the r e l a t i o n s h i p w i l l one day r e t u r n . 18. R e f l e c t i n g on the G r i e v i n g Process -119- One a c q u i r e s b e l i e f s and n o t i o n s about the g r i e v i n g process and one's p l a c e in i t from s e v e r a l s ources. One's own experience of s i g n i f i c a n t l o s s e s leads one to r e a l i z e that every l o s s and one's response to l o s s i s unique. But one a l s o r e a l i z e s from experience that there are aspects of g r i e v i n g that are common; the need to t a l k and to express one's f e e l i n g s and to f i n d another who w i l l l i s t e n with acceptance, the need to set the pace, and the awareness that g r i e v i n g i s an intense and p o t e n t i a l l y consuming experience. L learned that the response to l o s s i s unique e a r l y in her l i f e when an understanding aunt accepted her h y s t e r i c a l laughter as a response to l o s s , w h ile en route to her grandmother's b u r i a l . W learned through her own experience of l o s i n g a parent and watching her f r i e n d s ' each lose a parent that l o s s i s unique and there are ac c e p t a b l e d i f f e r e n c e s in how one g r i e v e s . In s t u d y i n g Psychology, both L and W learned that l o s s and g r i e f are undeniable p a r t s of l i f e , and there i s a need to express the f e e l i n g s and t a l k about the proc e s s . L learned through her p r e v i o u s l o s s of a f r i e n d by s u i c i d e -120- that g r i e f c o u l d be ever-present, powerful and i n t e n s e , and c o u l d not be set a s i d e , and yet i t was a l s o necessary to take o c c a s i o n a l breaks because of i t s consuming nature. L learned through c o n s i d e r a b l e experience in s u p p o r t i n g o t h e r s in g r i e f that there are c e r t a i n components to doing so; that once committed, you don't withdraw, however p a i n f u l and time-consuming i s the p r o c e s s , and that in s e t t i n g a s i d e your own agenda to be a v a i l a b l e to your f r i e n d , you had the r e s o u r c e s and in f a c t your own " s p i r i t u a l r e s e r v o i r s were r e f i l l e d " , e n a b l i n g you to r e t u r n to your own agenda, r e f r e s h e d . T learned by being e m p a t h i c a l l y present to her f r i e n d , by p u t t i n g h e r s e l f in her f r i e n d ' s shoes, that h e a l t h y g r i e v i n g i n v o l v e d g e t t i n g i t out, e x p r e s s i n g one's f e e l i n g s , however unacceptable, whereas she observed that the s t o i c i s m of her f r i e n d ' s husband was p r o v i n g d e t r i m e n t a l to h i m s e l f and in h i s r e l a t i o n s h i p s . She learned e a r l y on, her own need f o r support as one means of t a k i n g care of h e r s e l f , and acknowledged that need as l e g i t i m a t e and h e a l t h y . -121- Each d i s c o v e r e d that there are some h e l p f u l w r i t t e n r e s o u r c e s , but the p a r t i c u l a r l y h e l p f u l r e s o u r c e s were d i s c o v e r e d in r e t r o s p e c t . L, f o r example found that her own experience d i d not f i t what she had read about stage models of g r i e f , "that there are emotions that you know w i l l be present, but they come in d i f f e r e n t p l a c e s and are manifested d i f f e r e n t l y " . One draws from one's own personal experience of having g r i e v e d , one's experience of having walked with o t h e r s who have g r i e v e d , and from one's own empathy f o r the needs of the f r i e n d who a c t s as a guide in the g r i e f p r o c e s s . 19. Overcoming O b s t a c l e s to Companioning One who v o l u n t a r i l y becomes a comapanion in g r i e f to another, i s c o n f r o n t e d by i n e v i t a b l e o b s t a c l e s which must be overcome i f one i s to remain committed. The major o b s t a c l e i s how demanding t h i s non-sanctioned r o l e i s in terms of time, energy, and commitment. For L and T, they found they w i l l i n g l y s et as i d e competing demands ( c h i l d r e n , husband, and d i s s e r t a t i o n s ) , and although t h e i r p r i o r i t i e s were to remain a v a i l a b l e , there were times when the task was -122- d r a i n i n g and they were t i r e d and abrupt with o t h e r s . In L/s words, "here was t h i s l a r g e chunk, t h i s l a r g e amount of energy and time and because i t wasn't my son dying or my f a m i l y , i t was o f t e n d i s c o u n t e d " . T found at the end of a year that she d e s p e r a t e l y needed a h o l i d a y ; that once she had a thorough b a t t e r y of medical t e s t s to a l l e v i a t e her f e a r s f o r her h e a l t h , she took the needed h o l i d a y on the recommendation of her doct o r . W f e l t the d r a i n i n g nature of the r o l e only at the outset when she r e a l i z e d her need to r e o r i e n t h e r s e l f to her own l i f e and work a f t e r the p a r t i c u l a r i n t e n s i t y of l i v i n g with her f r i e n d s f o r the week a f t e r the l o s s . One a l s o f e l t that one consequence of g i v i n g up m u t u a l i t y in the r e l a t i o n s h i p was a r e t i c e n c e to c h a l l e n g e or confront the f r i e n d on i s s u e s and concerns. One p e r c e i v e d the f r i e n d as f r a g i l e and avoided or was h e s i t a n t to explore aspects of the r e l a t i o n s h i p or concerns that might r a i s e c o n f l i c t . The degree to which one ventured to explore concerns depended upon the s e c u r i t y one f e l t in the r e l a t i o n s h i p . For example, W, who f e l t very secure with her f r i e n d , r i s k e d e x p l o r i n g -123- her f r i e n d ' s r e s i s t a n c e to bonding with the baby she was c a r r y i n g and the e f f e c t her understandable s e l f - p r o t e c t i v e n e s s was having on her marriage. L, whose r e l a t i o n s h i p with her f r i e n d was l e s s secure due to a p r e v i o u s misunderstanding, was more h e s i t a n t to explore her concerns about the e f f e c t of the l o s s on her f r i e n d ' s marriage. 20. Sense of Impact on the Marriage By becoming a companion in g r i e f to one parent, one by i m p l i c a t i o n i s a l s o s u p p o r t i n g the spouse. By b e a r i n g some of the pain with the bereaved mother, or as an accepted p a r t of a threesome with both bereaved p a r e n t s , the burden on the bereaved f a t h e r i s l i g h t e n e d . One f e e l s that the f r i e n d ' s spouse i s g r a t e f u l f o r one's presence. For L, she d i s c o v e r e d that she was viewed as t h i s s p e c i a l t h i r d p a r t y a d u l t , who had some r o l e and i t was important, and her f r i e n d ' s husband knew i t and her f r i e n d knew i t and she h e r s e l f knew i t . W, who was f r i e n d s e q u a l l y with both p a r t n e r s in the marriage, f e l t that her presence was h e l p f u l in encouraging t h e i r acceptance of t h e i r unique ways of g r i e v i n g , and in f a c i n g the f e a r s with each other that they'd -124- expressed Independently to her. Whether one was assured of the b e n e f i t s of one's presence e x p l i c i t l y , one f e l t welcome by both p a r t n e r s and that one's r o l e was a p p r e c i a t e d as h e l p f u l to the marr i age, 21. Empathy f o r S u r v i v i n g or P r o s p e c t i v e C h i l d r e n One i s p r i m a r i l y present to the bereaved mother, but there i s a s p e c i a l r o l e one p l a y s with the s u r v i v i n g c h i l d r e n and with the p r e p a r a t i o n f o r subsequent c h i l d r e n . For L, she was a s p e c i a l a d u l t f r i e n d to the three year o l d daughter of her f r i e n d , accompanying her on h o s p i t a l v i s i t s , and on the night of her f i n a l goodbye to her baby b r o t h e r . L, l i k e T, with the f i v e year o l d daughter of her f r i e n d , helped the s u r v i v i n g c h i l d to grapple with d y i n g and the l o s s of t h e i r younger s i b l i n g by b e i n g prepared and s e n s i t i v e to help the c h i l d express t h e i r f e e l i n g s and any f e a r s s u r r o u n d i n g the l o s s . 22. The Changing S e l f One i s s u r p r i s e d to gain unexpected b e n e f i t s through one's experience. One f e e l s a deeper bond with the f r i e n d , and d i s c o v e r s a deeper c a p a c i t y -125- to enter i n t o the pa i n of o t h e r s , to show love and develop more meaningful r e l a t i o n s h i p s g e n e r a l l y . One f i n d s o n e s e l f more w i l l i n g to r i s k openness in e x p r e s s i n g one's own f e e l i n g s and to be v u l n e r a b l e . W spoke of "opening up a p a r t i n s i d e h e r s e l f , a part that has broken, the pain of the p a i n " . She found that she had a wider comfort zone when fa c e d with the pain of o t h e r s . For L, her compassion f o r her f r i e n d and p r e v i o u s l y f o r her dying son, f r e e d her to c h e r i s h her own f a t h e r in a l l h i s i m p e r f e c t i o n . She d e s c r i b e d her experience as l e a r n i n g and a c c e p t i n g a g i f t of g i v i n g , which brought joy in knowing that she was l i g h t e n i n g the load of another. For T, she became more p a t i e n t l y a c c e p t i n g of ot h e r s and more s e l f - a c c e p t i n g and st r o n g e r w i t h i n h e r s e l f ; her experience matured her. 23. R e s t o r i n g M u t u a l i t y and Change in Re l a t i onsh ip One experiences changes in the r e l a t i o n s h i p to the bereaved f r i e n d because of the i n t e n s i t y of experience they have shared. Whereas one v o l u n t a r i l y g i v e s up any e x p e c t a t i o n of m u t u a l i t y in the r e l a t i o n s h i p in the begin n i n g with the -126- c r i s i s i n the f r i e n d ' s l i f e , the s i g n s of resuming aspects of the former r e l a t i o n s h i p i n d i c a t e a movement toward an ending of the experience of the companion. One f i n d s a gradual movement to other concerns b e s i d e s the l o s s , g i v i n g new focus f o r time spent together. I n e v i t a b l e l i f e changes, both p e r s o n a l l y and p r o f e s s i o n a l l y , c o n t r i b u t e to t h i s s h i f t i n g focus. For L, she moved from being a student to a f u l l - t i m e t e a c h i n g p o s i t i o n while her f r i e n d moved toward having a new baby. For W, she and her f r i e n d were separated by her f r i e n d ' s move, and the focus a l s o s h i f t e d with the advent of a new baby. For T, her f r i e n d , a l s o pregnant with a new c h i l d , began to r e c i p r o c a t e in the r e l a t i o n s h i p by b e g i n i n g to share in T's j o y s and concerns and in o f f e r i n g exchanges of c h i l d c a r e . T moved from t i p t o e i n g around her f r i e n d in acknowledgement of her f r a g i l i t y to a more honest and mutual communication of needs. The frequency of c o ntact began to resume former p a t t e r n s , there was more mutual i n i t i a t i o n taken and the new commitments brought about a s h i f t in focus in the content of the exchanges. 24. Looking to Future -127- One becomes aware of a s u b t l e s h i f t of focus from the present moment to a concern f o r the f u t u r e of the bereaved f r i e n d . The degree to which one's focus s h i f t s toward f u t u r e concerns v a r i e s with the e l a p s e d time s i n c e the l o s s . For L, "the experience f o r her had resumed a manageable p o r t i o n r a t h e r than an all- c o n s u m i n g p l a c e in her l i f e . T h i s broad al1-encompassing t h i n g had come down to something q u i t e s p e c i f i c ; i t was one p a r t of her f r i e n d ' s l i f e but the experience had found i t s p l a c e " . As L looked to the f u t u r e , she found both she and her f r i e n d moving i n t o new and separate phases of l i f e . Although she knew they would always be able to t a l k of the l o s s and would continue t h e i r f r i e n d s h i p with t h e i r shared experience a pa r t of them, L f e a r e d f o r her f r i e n d ' s tendency to overfocus on her immediate world, c a u s i n g her to lose touch with l a r g e r i s s u e s and concerns. For T, she experienced a be g i n n i n g s h i f t toward f u t u r e concerns, but the focus was s t i l l on present i m p l i c a t i o n s of the l o s s . For example, T's f r i e n d had j u s t had her pregnancy confirmed but T f e a r e d that her f r i e n d and husband had not yet -128- s u f f i c i e n t l y come to terms with t h e i r son being gone. She was concerned too with the impact the l o s s had on t h e i r marriage and as she looked to the f u t u r e , she longed f o r them to have a good s o l i d f a m i l y a f t e r a l l they had s u f f e r e d . For W, she f e l t the pro c e s s of being a companion to her f r i e n d had changed but i n no way had ended. She looked to the f u t u r e with the impending b i r t h of a hea l t h y c h i l d and a l l the changes that would b r i n g f o r her f r i e n d s and her r e l a t i o n s h i p to them. She foresaw a change where the pa i n would continue to lessen with them having a c h i l d they d i d n ' t p r e v i o u s l y have, but she p r o j e c t e d that "the l o s s would be r e l i v e d f o r a long time". She compared her f e e l i n g s about l o o k i n g ahead to what she experienced in her own g r i e f p rocess f o l l o w i n g her mother's death; "the i n t e n s i t y i s n ' t t here, there are the t r i g g e r s , but somehow the i n t e n s i t y i s 1 ess " . N a r r a t i v e D e s c r i p t i o n The themes of the experience were i n t e g r a t e d and interwoven to form a d e s c r i p t i v e account of the meaning of the experience of the companion in g r i e f . -129- Descrip't ion The experience of the companion in g r i e f begins when one makes one s e l f a v a i l a b l e to a f r i e n d f a c e d with the p o t e n t i a l of a s i g n i f i c a n t l o s s . At the f i r s t h i n t of f e a r that i n t r u d e s i n t o the l i f e of one's f r i e n d when an unexpected turn of events occurs, one becomes present and a v a i l a b l e to her. One's ready a v a i l a b i l i t y stems from a p r e e x i s t i n g f r i e n d s h i p c h a r a c t e r i z e d by a mutual l o y a l t y which has stood the t e s t of time. With the i n i t i a l f e a r and dread that overtakes the f r i e n d when fa c e d with the p o s s i b i l i t y of impending death of a loved one, her f e e l i n g s r e v e r b e r a t e to the companion. One shares the f r i e n d ' s bewilderment at t h i s u n c e r t a i n time and a l l her v a c i l l a t i n g hopes and f e a r s about the outcome. With sudden trauma at b i r t h or in the event of an a c c i d e n t , there i s no time to prepare o n e s e l f . One i s g r i p p e d by f e a r and a s i c k nauseating f e e l i n g of dread that t h i s c o u l d go e i t h e r way. One j o i n s one's f r i e n d in the dawning r e a l i z a t i o n that a l l the hope and d e n i a l in the world w i l l not change the p o s s i b i l i t y that f a c e s them. When-one i s given an extended time to -130- a n t i c i p a t e the death, i t i s as i f one has entered the scene of an Emergency Room but in slow motion. One r e s i g n s o n e s e l f to the p o s s i b i l i t y of death 1 while w i l l i n g l y remaining open to a miraculous turn of events, u n t i l i t becomes p a t e n t l y c l e a r that death i s imminent. When there i s p r e p a r a t i o n , one has the o p p o r t u n i t y to p a r t i c i p a t e in the f r i e n d ' s a n t i c i p a t o r y g r i e v i n g as together they r e s i g n themselves to the i n e v i t a b i l i t y of death. In the moment that news i s r e c e i v e d c o n f i r m i n g the death, one responds with an o u t f l o w i n g of the deep f e e l i n g that has been h e l d in check. One who has had the o p p o r t u n i t y to prepare f o r the death and p a r t i c i p a t e with the fa m i l y in s a y i n g t h e i r goodbyes, i s f l o o d e d with a f e e l i n g of r e l i e f and g r a t i t u d e to have shared in the l i f e and even the d i g n i t y of the death of t h i s c h i l d . One who experiences the death as sudden and unexpected, a f t e r an i n i t i a l o u tpouring of f e e l i n g , i s numb and dazed. Then, through the s u r f a c e shock and numbness a r i s e s a p r e s s i n g , angry p r o t e s t ; No! T h i s cannot be happening! T h i s apparent nightmare cannot be r e a l . -131- One has a p r e s s i n g need to see one's f r i e n d face to f a c e , to h o l d her and be h e l d , to c r y together, to share in the f r i e n d ' s s h a t t e r e d r e a l i t y and p a i n , to enter in by one's presence. Because of the empathic s h a r i n g of the sorrow, the h u r t , the p a i n , one assures one's f r i e n d of her a v a i l a b i l i t y . One becomes s e n s i t i v e to the f r i e n d ' s immediate needs, s t r u g g l i n g to d i s c e r n when to be present to respond to her need to t a l k and share her f e e l i n g s , and when to allow the a p p r o p r i a t e d i s t a n c e . New p a t t e r n s of more freguent contact than i s usual in t h e i r r e l a t i o n s h i p emerge, and i t becomes mutually understood how i n i t i a t i v e w i l l be taken. One s e t s a s i d e competing demands as f a r as i s p o s s i b l e to assure the f r i e n d of one's a v a i l a b i l i t y whether the c a l l s come in the middle of dinner or the middle of the n i g h t . One's openness to b e i n g present, without e x p e c t a t i o n of m u t u a l i t y in the r e l a t i o n s h i p i s d i s c o v e r e d to be fundamental to the r o l e of the companion. One f i n d s o n e s e l f from the o u t s e t , a n t i c i p a t i n g the needs of the bereaved person, and responding with s p e c i f i c o f f e r s of a s s i s t a n c e , by -132- t a k i n g on such p r a c t i c a l f u n c t i o n s as c h i l d c a r e , phoning to inform a d e s i g n a t e d c i r c l e of f r i e n d s of the l o s s , a s s i s t i n g with the f u n e r a l or memorial, and the everyday tasks of meals. E s s e n t i a l as these tasks are, one becomes aware that doing f o r the f r i e n d i s l e s s important than b e i n g there f o r her. One i s a v a i l a b l e , a c t i v e l y l i s t e n i n g to her f r i e n d in an attempt to encourage her to t e l l and r e t e l l her s t o r y , as r e p e t i t i v e l y as necessary. One demonstrates a non-judgemental acceptance which assures the f r i e n d she w i l l not be r e j e c t e d . One p r o v i d e s a s a f e p l a c e f o r the f r i e n d to share aspects of the experience that she h e r s e l f f e a r s f a c i n g , f e e l i n g s of g u i l t , of anger, and d e s p a i r . Once deep t r u s t i s e s t a b l i s h e d in the r e l a t i o n s h i p , the p a r t i c u l a r context f o r l i s t e n i n g to one's f r i e n d i s immaterial, whether i t be in person, by phone, d u r i n g mealtimes or a c t i v i t i e s , or even by mail and l o n g - d i s t a n c e c a l l i n g . One f a c i l i t a t e s the f r i e n d ' s g r i e v i n g experience as she names and i d e n t i f i e s f o r the f r i e n d what she hears and observes, o f t e n u n d e r l y i n g her words and a c t i o n s as she seeks to v a l i d a t e her f e e l i n g s . One l e a r n s to r e f r a i n from -133- s u g g e s t i n g how she 'should'' f e e l . By h e l p i n g to i d e n t i f y that the f r i e n d ' s way of g r i e v i n g her l o s s i s unigue, one i m p l i c i t l y or e x p l i c i t l y communicates to the f r i e n d ' s p a r t n e r an acceptance of how one g r i e v e s , thereby encouraging each to g r i e v e in t h e i r own way. One not only encourages the f r i e n d ' s e x p r e s s i o n of sadness, longings, f e a r s , anger, and r e c o g n i z e s her need to work out personal meaning, but she a l s o o f f e r s encouragement by p o i n t i n g out markers in the g r i e v i n g p r o c e s s i n d i c a t i n g to her that movement i s t a k i n g p l a c e in what seems to her to be an all-consuming and en d l e s s p r o c e s s . One uses s e n s i t i v i t y to the f r i e n d ' s r e a d i n e s s to be i n c l u d e d in former p u r s u i t s and s o c i a l o u t l e t s . Through d i a l o g u e with her, one p r o v i d e s avenues to encourage the f r i e n d to begin the process of r e i n t e g r a t i n g s o c i a l l y . The f r i e n d s e t s the pace. The n e c e s s i t y f o r breaks becomes apparent, and one encourages the f r i e n d to take breaks o c c a s i o n a l l y , as well as r e c o g n i z i n g one's own need to take breaks as a way of c a r i n g f o r o n e s e l f . As one pauses to r e f l e c t , one sees o n e s e l f as a v a i l a b l e i n s p i t e of competing demands of -134- c h i l d r e n , s t u d i e s , and work, as u n c o n d i t i o n a l in one's support as a non-judgemental l i s t e n e r , as a s a f e and approachable conduit f o r o t h e r s to approach the bereaved f r i e n d and as a p r o t e c t i v e b u f f e r between the f r i e n d and the l a r g e r world. There i s a sense that t h i s i s not an o b l i g a t i o n or in any way a p r o f e s s i o n a l s e r v i c e one i s r e n d e r i n g , but r a t h e r i s an i n t e g r a l p a r t of what i t means to accompany one's f r i e n d on her journey. As one person expressed i t , "she was the beanbag c h a i r , so i f her f r i e n d f e l l i n t o i t , she would take her shape, but she would be f i r m enough that her f r i e n d would never h i t the f l o o r " . One person imagined h e r s e l f as another set of eyes and ears that r e c e i v e d and recorded the u n f o l d i n g s t o r y and as a v o i c e that l e t her f r i e n d ' s v o i c e be heard through her as a p p r o p r i a t e , as at the f u n e r a l or in her conduit r o l e . The advice one person suggested o f f e r i n g to another in t h i s r o l e would be, "make no demands, s i t back, l i s t e n , t r y not to judge, take breaks, look a f t e r y o u r s e l f , and j u s t don't g i v e up!". As one accompanies the f r i e n d on her journey, there i s an awareness that the p a i n of l o s s i s -135- r e t r i g g e r e d and i n t e n s i f i e d in r i t u a l events and markers. T h i s begins with one's p a r t i c i p a t i o n in the f u n e r a l or memorial and c o n t i n u e s throughout the succeeding months as each s i g n i f i c a n t marker approaches, such s p e c i a l days as b i r t h d a y s , Christmas and the a n n i v e r s a r y of the death. One e n t e r s i n t o the l o s s of f u t u r e hopes and dreams by s h a r i n g one's own images at these times and r e l e a s i n g the f r i e n d to share her own images of what might have been. One searches f o r ways to be s e n s i t i v e to the f r i e n d ' s r e l i v i n g the l o s s and a l l i t s i m p l i c a t i o n s at these times of heightened i n t e n s i t y . One companion learned that f o r her f r i e n d , Christmas, which came s i x months a f t e r the l o s s , was as p a i n f u l as the death of her c h i l d . One becomes open and r e c e p t i v e to the p a r t i c u l a r s i g n i f i c a n c e to the f r i e n d of these s p e c i a l days, which f o r some, in c l u d e u n p r e d i c t a b l e markers. One who becomes a companion to a f r i e n d g r i e v i n g a s i g n i f i c a n t l o s s l i v e s the pain with her and i d e n t i f i e s with her l o s s to the extent that memories of one's own past l o s s e s as well as the f e a r f o r p o t e n t i a l l o s s e s are t r i g g e r e d . T h i s s t i r r i n g up of memories and f e a r s v a r i e s from a -136- r e f l e c t i v e pondering to a consuming preoccupation with the r e a l i z a t i o n that one's own l i f e i s i r r e t r i e v a b l y changed. One's foundations as a person may be profoundly shaken. When the l o s s one's f r i e n d i s s u f f e r i n g can be imagined as one's own, as f o r example i f a c h i l d has d i e d and one has c h i l d r e n of one's own, t h i s powerful sense of i d e n t i f i c a t i o n can evoke such f e a r s that a l l that i s p r e c i o u s in one's l i f e i s imbued with a new f r a g i 1 i t y . Because of the i n t e n s i t y of the experience of being a companion in g r i e f , one acknowledges one's own personal needs. One sees h e r s e l f as a person with l e g i t i m a t e emotional, s p i r i t u a l , and s o c i a l needs that have been v o l u n t a r i l y set a s i d e in the r e l a t i o n s h i p with the bereaved f r i e n d . One needs to r e p l e n i s h o n e s e l f and seeks a support network of one's own, a p l a c e of refuge, whether with one's husband or c l o s e f r i e n d , where i t i s p o s s i b l e to r e l e a s e one's f e e l i n g s and to t a l k without r e s e r v a t i o n . Sometimes, one g r a v i t a t e s towards those whose comfort zone about death and l o s s i s wide due to t h e i r l i f e e xperience. -137- Belng a companion In g r i e f takes one c l o s e to the heart of l i f e , which lends c l a r i t y to one's s p i r i t u a l o u t look. Regardless of one's experience of r e l i g i o u s f a i t h , one d i s c o v e r s inner q u a l i t i e s of compassion, p a t i e n c e , s e 1 f - f o r g l v e n e s s s , se1f-acceptance, and acceptance of o t h e r s , which are s p i r i t u a l in nature. One assumes a transcendent p e r s p e c t i v e and i s open to f i n d i n g meaning, purpose, and goodness in the s u f f e r i n g that has come in the wake of t r a g i c circumstances. There i s a deepened sense of the mystery of l i f e and of God and one i s open and r e c e p t i v e to b e i n g moved by t h i s experience to explore one's own s p i r i t u a l b e l i e f s . One person was moved by the experience of a v u l n e r a b l e , dying c h i l d who in h i s u t t e r defense 1essness, c a l l e d f o r t h a sense of compassion in her so deep that she had the empathy to strengthen the c h i l d ' s mother as he d i e d and to f i n d anew the love f o r her own f a t h e r . One person whose experience of God was i n c a r n a t i o n a l and present in the events of her l i f e , d i s c o v e r e d God compassionately s h a r i n g the darkness where she walked with her f r i e n d . T h i s strengthened her own f a i t h in t r u s t i n g the compassionate presence of -138- God with her in her own p l a c e s of pain and hardness. There i s an overwhelming sense of g r a t i t u d e that l i f e i s a g i f t and a l l that i s s t i l l i n t a c t and untouched in one's own l i f e i s prec i ous. One i e drawn i n t o an experience of emotional and s p i r i t u a l depth that Is so intense that one r e c o g n i z e s some need f o r l e v i t y . One f i n d s that humour and glimpses of what was f a m i l i a r in the r e l a t i o n s h i p tends to l i g h t e n the experience. One d e a l s with the i n t e n s i t y by s h a r i n g humourous moments and by r e t u r n i n g o c c a s i o n a l l y to s i t u a t i o n s of f a m i l i a r i t y and s u p e r f i c i a l i t i e s as r e a s s u r i n g reminders that l i f e w i l l again resume i t s normal course. One l e a r n s about the g r i e v i n g p r o c e s s and one's p l a c e in i t by drawing from one's own personal experience of having g r i e v e d , of having walked with o t h e r s who have g r i e v e d , and from one's own empathy with the f r i e n d who a c t s as a guide to what one needs in the g r i e v i n g p r o c e s s . One i s c o n f r o n t e d by i n e v i t a b l e o b s t a c l e s which must be overcome i f one i s to remain committed to being a companion in g r i e f . The major o b s t a c l e i s -139- the demanding nature of t h i s non-sanctioned r o l e in terms of time, energy, and commitment that i s o f t e n d i s c o u n t e d by o t h e r s who may c a l l upon one's d e p l e t e d r e s o u r c e s . Another o b s t a c l e i s a new f r a g i l i t y in the r e l a t i o n s h i p . One who p e r c e i v e s the bereaved f r i e n d as f r a g i l e may be r e t i c e n t to e xplore a s p e c t s of the r e l a t i o n s h i p or concerns that c o u l d r a i s e c o n f l i c t . One who c o n s i s t e n t l y r e f r a i n s from e x p l o r i n g i s s u e s of concern f i n d s there i s s t r a i n p l a c e d on the r e l a t i o n s h i p . T h i s t i p t o e i n g out of concern f o r the f r i e n d v a r i e s depending on the sense of s e c u r i t y one f e e l s w i t h i n the r e l a t i o n s h i p . One i s s e n s i t i v e to the impact one's presence has on the f r i e n d ' s p a r t n e r in the marriage, but i s r e a s s u r e d to d i s c o v e r the g r a t i t u d e that one's presence a c t u a l l y l i g h t e n s the burden on the spouse. One who i s f r i e n d s e q u a l l y with both p a r t n e r s in a marriage has the unique p o s i t i o n of f a c i l i t a t i n g communication between them. There i s a l s o a s p e c i a l r o l e one p l a y s with the s u r v i v i n g c h i l d r e n and with the p r e p a r a t i o n f o r subsequent c h i l d r e n . One i s the s p e c i a l a d u l t f r i e n d who c a r e s f o r and a n t i c i p a t e s the needs of -140- the c h i l d r e n who are a l s o g r a p p l i n g with a l o s s but one they do not understand. By r e a d i n g books on death and l o s s at the a p p r o p r i a t e l e v e l of understanding, and h e l p i n g her with her own f e e l i n g s , and by b e i n g there to l i s t e n and help with the i n e v i t a b l e q u e s t i o n s and need f o r reassurance, one a s s i s t s the s u r v i v i n g c h i l d . One a l s o walks' with the bereaved person through a subsequent pregnancy, a n t i c i p a t i n g the need f o r the f r i e n d to face the f e a r s of bonding and to r e l i v e memories t r i g g e r e d by t h i s new l i f e t r a n s i t i on. One gains unexpected b e n e f i t s of a deepened bond with one's f r i e n d through the experience, a deeper c a p a c i t y f o r compassion and understanding in other r e l a t i o n s h i p s , and a new openness to r i s k b e i n g v u l n e r a b l e and e x p r e s s i v e of one's own f e e l i n g s . One has a wider comfort zone when fa c e d with p a i n f u l e x periences of one's own and o t h e r s . One f i n d s a new confidence in one's own s t r e n g t h and r e s o u r c e s to stay v u l n e r a b l e and continue growing. One d i s c o v e r s that one has matured. There i s a change in r e l a t i o n s h i p with the bereaved f r i e n d over time. There are s i g n s of -141- resumlng aspects of the former r e l a t i o n s h i p and a r e s t o r i n g of some m u t u a l i t y , a gradual movement to other concerns i n c l u d i n g the l o s s , and a s h i f t in focus through i n e v i t a b l e l i f e changes that come with time both p e r s o n a l l y and p r o f e s s i o n a l l y . T h i s s h i f t i n focus i n d i c a t e s a movement toward the ending of the experience of the companion, g i v i n g new focus f o r time spent together w i t h i n new and l e s s frequent p a t t e r n s of contact where the i n i t i a t i v e which i s taken i s shared. One a l s o e x periences a s u b t l e s h i f t in focus from concern f o r the immediate moment to concern f o r the f u t u r e . The degree to which one's focus s h i f t s toward f u t u r e concerns v a r i e s with the e l a p s e d time s i n c e the l o s s . One person d e s c r i b e d that "the experience f o r her had resumed a manageable p o r t i o n r a t h e r than an all-consuming p l a c e in her l i f e . T h i s broad al1-encompassing t h i n g had come down to something q u i t e s p e c i f i c ; i t was one pa r t of her f r i e n d ' s l i f e but the experience had found i t s p l a c e " . Even in acknowledging that the all-c o n s u m i n g aspect of the experience of wa l k i n g with one's f r i e n d on her journey had changed, one accepts that the l o s s w i l l be remembered f o r a -142- long time, and the mourning goes on but the i n t e n s i t y grows i e s s . One w i l l continue one's f r i e n d s h i p to the bereaved f r i e n d with t h e i r shared experience an i n t e g r a l part of them and t h e i r r e l a t i o n s h i p , but there i s a r e c o g n i t i o n that new and separate phases of l i f e l i e ahead. The E s s e n t i a l S t r u c t u r e The e s s e n t i a l s t r u c t u r e i s a condensed v e r s i o n of the n a r r a t i v e d e s c r i p t i o n . It i s comprised of the b a s i c elements of the n a r r a t i v e and forms a framework that p r e s e n t s the core of the experience. The purpose of the e s s e n t i a l s t r u c t u r e i s to present the meaning of the experience as c o n c i s e l y as p o s s i b l e . The S t r u c t u r e The experience of the companion in g r i e f begins when one becomes present and a v a i l a b l e to a f r i e n d who i s faced with the p o t e n t i a l of a s i g n i f i c a n t l o s s through death. One f e e l s the r e v e r b e r a t i o n s of f e a r and dread mingled with the v a c i l l a t i n g hope of the f r i e n d who awaits the outcome a f t e r an unexpected turn of events. When death i s not immediate, one j o i n s in the f r i e n d ' s -143- a n t i c i p a t o r y g r i e v i n g , as together they r e s i g n themselves to the impending death. When the news of the death i s confirmed, one i s deeply moved. When there has been an extended time of a n t i c i p a t i o n , one f e e l s r e l i e f t i n g e d with the sadness, whereas in sudden death, one responds with an i n i t i a l o u t p o u r i n g of intense sadness and empathy f o r the p a r e n t s . A numbness descends and through the s u r f a c e shock, a r i s e s an angry p r o t e s t in an attempt to deny that t h i s nightmarish r e a l i t y i s t r u e . One f e e l s a need to make d i r e c t c o n t a c t , to be present to one's f r i e n d . Because of the empathic s h a r i n g of the sorrow, the hurt and the p a i n , one assures the f r i e n d of one's a v a i l a b i l i t y and s e n s i t i v i t y to her immediate needs. One a n t i c i p a t e s the f r i e n d ' s need to be heard, to be h e l d , and to be p r a c t i c a l l y supported with concrete o f f e r s of a s s i s t a n c e , c h i l d c a r e , phoning of f r i e n d s and r e l a t i v e s , and a s s i s t a n c e with the f u n e r a l or memorial. E s s e n t i a l as these tasks are, one becomes aware that doing f o r one's f r i e n d i s l e s s important than being there f o r her. -144- There i s an o f t e n unspoken agreement that former e x p e c t a t i o n s of m u t u a l i t y in the r e l a t i o n s h i p are set aside and new p a t t e r n s of contact emerge. Contact i s more frequent than i s usual in t h e i r l o n g s t a n d i n g r e l a t i o n s h i p , and the focus i s on the f r i e n d in her l o s s . Through one's w i l l i n g n e s s to l i s t e n , one demonstrates a non-judgmental acceptance, and c r e a t e s f o r the f r i e n d a safe p l a c e to share her experience without r e s e r v a t i o n . One encourages the f r i e n d ' s e x p r e s s i o n of sadness, her longings, f e a r s , anger, g u i l t , and her need to work out personal meaning. One mediates between the f r i e n d and o t h e r s , o f f e r i n g the f r i e n d a p r o t e c t i v e b u f f e r to the o u t s i d e world, and p r o v i d i n g those more p e r i p h e r a l l y i n v o l v e d a channel through which to approach the bejreaved person i n d i r e c t l y . Although the f r i e n d s e t s the pace in the g r i e v i n g process, one f a c i l i t a t e s t h i s process by naming and i d e n t i f y i n g what one hears and observes, s e e k i n g always to v a l i d a t e her f e e l i n g s and experience. One encourages gradual r e i n t e g r a t i o n i n t o a wider s o c i a l network in accordance with the f r i e n d e x p r e s s i n g her r e a d i n e s s . On -145- s e l f - r e f l e c t i o n , one sees o n e s e l f as a v a i l a b l e in s p i t e of competing demands of c h i l d r e n , work, and s t u d i e s , and as an u n c o n d i t i o n a l l y a c c e p t i n g l i s t e n e r , and mediator to o t h e r s . One accepts one's r o l e of companion as an i n t e g r a l p a r t of being a f r i e n d . As one accompanies one's f r i e n d on her p a i n f u l journey of g r i e v i n g her l o s s , there i s an awareness of the impact of r i t u a l events and markers such as the f u n e r a l , b i r t h d a y of the deceased, Christmas, and the a n n i v e r s a r y date of the death. These s p e c i a l days i n t e n s i f y the p a i n of s e p a r a t i o n , r e l e a s i n g images and l o s t dreams, c a l l i n g f o r t h in the companion a need f o r one's presence and s e n s i t i v i t y . One l i v e s the p a i n with the f r i e n d and i d e n t i f i e s with her l o s s to a v a r y i n g degree, as memories of one's own past l o s s e s as well as f e a r f o r p o t e n t i a l l o s s e s are t r i g g e r e d . With the l o s s of a c h i l d when one has c h i l d r e n of one's own, the i d e n t i f i c a t i o n i s profound so that a l l that once seemed secure i s imbued with a new f r a g i l i t y . Because of the i n t e n s i t y of the experience of being a companion, one comes to accept and -146- l e g i t i m i z e one's personal needs f o r replenishment. One seeks a support network and r e l i e s upon one's spouse or c l o s e f r i e n d s to provide a p l a c e of refuge to r e l e a s e one's own f e e l i n g s and to t a l k without r e s e r v a t i o n . Being a companion in g r i e f takes one c l o s e to the heart of l i f e , which lends c l a r i t y and depth to one's s p i r i t u a l outlook and b e l i e f s . One i s aware of the coming to f r u i t i o n of inner q u a l i t i e s which are s p i r i t u a l in nature; compassion, p a t i e n c e , s e l f - a c c e p t a n c e , u n c o n d i t i o n a l acceptance of o t h e r s as well as a new r e c e p t i v i t y to f i n d i n g meaning, purpose, and goodness even in s u f f e r i n g and in t r a g i c circumstances. There i s an a p p r e c i a t i o n f o r the mystery of l i f e , and f o r some, a deeper f a i t h in God. One experiences a compassionate presence in the midst of events, d e s c r i b e d v a r i o u s l y as a mysterious r e l e a s e of empathy with the c a p a c i t y to touch o n e s e l f and o t h e r s , or as "God s h a r i n g the darkness" both in the moment and in t r u s t f o r one's f u t u r e p l a c e s of pain and hardness. One views l i f e and a l l that remains i n t a c t and untouched as p r e c i o u s . -147- One Is drawn Into an experience of emotional and s p i r i t u a l depth. There i s need f o r humour and glimpses of the f a m i l i a r and the s u p e r f i c i a l to give l e v i t y and p e r s p e c t i v e , and as r e a s s u r i n g reminders that l i f e w i l l again resume i t s normal course, d e s p i t e the i r r e t r i e v a b l e change that has taken p l a c e . One l e a r n s about the g r i e v i n g process and one's r o l e w i t h i n i t by c a l l i n g upon one's own personal experiences of having g r i e v e d , by having walked with o t h e r s who have g r i e v e d , and by l e t t i n g the needs of one's f r i e n d act as a guide to the g r i e f p r o c e s s . One i s c h a l l e n g e d by i n e v i t a b l e o b s t a c l e s to remaining committed. The demands on one's time, energy and commitment that are p a r t of t h i s non-sanctioned r o l e are o f t e n d i s c o u n t e d by o t h e r s c a l l i n g upon one's d e p l e t e d r e s o u r c e s . Another o b s t a c l e i s the p o t e n t i a l s t r a i n on the r e l a t i o n s h i p when one who p e r c e i v e s her f r i e n d as f r a g i l e r e f r a i n s from e x p l o r i n g i s s u e s and concerns, which can c o n t r i b u t e to an accumulation of u n r e s o l v e d t e n s i o n in the f r i e n d s h i p . One's t i p t o e i n g around the f r i e n d out of concern f o r her v a r i e s with the time e l a p s e d -148- s i n c e the l o s s and with the sense of s e c u r i t y one f e e l s w i t h i n the r e l a t i o n s h i p . One i s s e n s i t i v e to the impact one's presence has on the f r i e n d ' s p a r t n e r in the marriage, but i s r e a s s u r e d to d i s c o v e r one i s a welcome r a t h e r than an i n t r u s i v e presence, and may even ease communication between the p a r t n e r s . One may a l s o be the s p e c i a l a d u l t f r i e n d , c a r e g i v e r , and c o n f i d a n t e to s u r v i v i n g c h i l d r e n , a n t i c i p a t i n g t h e i r need to g r i e v e . One may help to prepare the way f o r subsequent c h i l d r e n in encouraging h e a l t h y bonding by acknowledging the f e a r s and memories a p r o s p r e c t i v e c h i l d evokes in the p a r e n t s . One d i s c o v e r s unexpected b e n e f i t s from b e i n g a companion; a deepening r e l a t i o n s h i p with the f r i e n d through the experience, a deeper c a p a c i t y f o r empathy and compassion which extends to o t h e r s , an openness to r i s k b e i n g v u l n e r a b l e w h ile growing in s t r e n g t h as a person with a wider comfort zone with one's own and o t h e r s ' p a i n . One experiences a growing m a t u r i t y and awareness of one's r e s o u r c e s . There i s a changed r e l a t i o n s h i p with the bereaved f r i e n d over time as t h i s broad, -149- al1-encompassing experience they have shared begins to i n v o l v e only a p o r t i o n of one's l i f e . There are s i g n s of resuming former p a t t e r n s of contact with a s h i f t to the i n c l u s i o n of other concerns as well as the l o s s and i t s i m p l i c a t i o n s . There i s a mutual acknowledgement of l i f e t r a n s i t i o n s , both p e r s o n a l l y and p r o f e s s i o n a l l y with new jobs and subsequent pregnancies, p r o v i d i n g a d d i t i o n a l focuses f o r time spent together. There i s some s h i f t toward r e i n t e g r a t i n g i n t o a wider s o c i a l network which v a r i e s with the time e l a p s e d s i n c e the l o s s . One acknowledges that the l o s s w i l l be remembered, that the mourning w i l l continue but the i n t e n s i t y l e s s e n s . One c o n t i n u e s in one's f r i e n d s h i p to the bereaved f r i e n d with t h e i r shared experience an i n t e g r a l p a r t of them, bonding them in t h e i r r e l a t i o n s h i p . But new and separate phases of l i f e 1ie ahead. -150- Chapter V Di s c u s s i on The thorough d e s c r i p t i o n of the r e s u l t s of the study, presented in the p r e v i o u s chapter, provide the context f o r a d i s c u s s i o n of the r e s e a r c h e r ' s personal e x p l i c a t i o n of assumptions and those a r i s i n g from the l i t e r a t u r e . T h i s study y i e l d e d 24 themes common to three i n d i v i d u a l accounts of the experience of companioning a g r i e v i n g person. The themes were interwoven u s i n g a dramatic form to c r e a t e a common s t o r y of the experience. T h i s n a r r a t i v e d e s c r i p t i o n was condensed to the e s s e n t i a l s t r u c t u r e , which presented the meaning of the experience as c o n c i s e l y as p o s s i b l e . The d i s c u s s i o n p resented in t h i s chapter i s based on the r e s e a r c h e r ' s r e f l e c t i v e p r o c e s s of how these r e s u l t s support, do not support, or tend to extend or q u a l i f y p r i o r e x p e c t a n c i e s about the experience, as o u t l i n e d in the opening two ch a p t e r s . Included in the d i s c u s s i o n are the t h e o r e t i c a l and p r a c t i c a l i m p l i c a t i o n s and the qu e s t i o n s posed f o r f u r t h e r r e s e a r c h a r i s i n g out of t h i s study. -151- The e s s e n t i a ] s t r u c t u r e h i g h l i g h t e d c e r t a i n commonalities between the experiences of the three women c o - r e s e a r c h e r s in the study. Each woman had a p r e - e x i s t i n g h i s t o r y of r e l a t i o n s h i p with the g r i e v i n g person which accounted f o r an u n d e r l y i n g l o y a l t y . An i n d i v i d u a l c o u l d presumably become a companion by v i r t u r e of having experienced a common l o s s , and have no p r e e x i s t i n g f r i e n d s h i p . The p a r t i c u l a r l o s s b e i n g g r i e v e d was the death of the f r i e n d ' s c h i l d in each case. The companions in g r i e f o u t l i n e d t h e i r experiences of p a r t i c i p a t o r y g r i e v i n g ; • t h e compassion they experienced as they empathized with a f r i e n d who had s u f f e r e d the d e v a s t a t i n g l o s s of a c h i l d , t h e i r p a r t i c u l a r f e e l i n g s and t h e i r c o n f u s i o n at times b e i n g in a p o s i t i o n where there was no guide map. They each r e f l e c t e d upon as p e c t s of the r o l e and common elements emerged i n c l u d i n g b e i n g present and r e a d i l y a v a i l a b l e , extend p r a c t i c a l and concrete support most p r e v a l e n t in the e a r l y stages, l i s t e n i n g with non-judgemental acceptance r e g a r d l e s s of the context, m e d i a t i n g and r e l a y i n g i n f o r m a t i o n to as well as on behalf of the f r i e n d , f a c i l i t a t i n g the ex p r e s s i o n of g r i e f , and -152- encouraging the bereaved f r i e n d on her journey in r e c o g n i t i o n of the f r i e n d ' s need to set the pace and e v e n t u a l l y begin to i n t e g r a t e the l o s s i n t o her own f u t u r e d i r e c t i o n . Each woman r e f l e c t e d on the impact that her experience of be i n g a companion had on the r e l a t i o n s h i p with her f r i e n d , and on her own l i f e and personal and s p i r i t u a l growth. There were common c h a l l e n g e s to be overcome in each case. The i n e v i t a b l y demanding nature of the r o l e in terms of one's time, energy, and commitment was w i l l i n g l y accepted but r e q u i r e d l e g i t i m i z i n g personal needs f o r replenishment i n c l u d i n g the need f o r one's own support network. There were a l s o commonly r e c o g n i z e d b e n e f i t s that were unexpected; deeper c a p a c i t y f o r r e l a t i o n s h i p , d i s c o v e r y of personal r e s o u r c e s , and a c l a r i t y of s p i r i t u a l experience, which exceeded the c o s t l y nature of the commitment. As these commonalities of experience emerged in the e s s e n t i a l s t u c t u r a l meaning of the experience, i t was found that the r e s e a r c h e r ' s p r i o r assumptions were congruent with and supported the r e s u l t s . However, these i n i t i a l assumptions were unfocused glimpses of what -153- emerged with g r e a t e r c l a r i t y and f u l l n e s s through the r e s u l t s of the study. For example, the commitment r e q u i r e d of the lay companion i s not only l o n g - l a s t i n g and i n t e n s e , but may i n v o l v e l e v e l s of s e l f - s a c r i f i c e in terms of time, p h y s i c a l and emotional energy, and l o s s of m u t u a l i t y in r e l a t i o n s h i p , that pose c h a l l e n g e s f o r p r o s p e c t i v e companions in g r i e f to contemplate the cost of commitment in assuming the r o l e at the o u t s e t . The length of the process i s longer than s o c i e t a l e x p e c t a t i o n s set f o r t h . In the event of the p a r t i c u l a r l y d e v a s t a t i n g l o s s of a c h i l d , there i s some r e c e s s i o n of g r i e f a f t e r the f i r s t a n n i v e r s a r y date of the c h i l d ' s death, but the need f o r the s u p p o r t i v e presence of the companion co n t i n u e s well i n t o the second year, p a r t i c u l a r l y as s p e c i a l markers approach, r e t r i g g e r i n g the pain of l o s s . The issue of what c o n s t i t u t e s a p p r o p r i a t e c l o s u r e of the experience of the companion i s unanswered by the r e s u l t s of the study. There are p a r t i c u l a r q u a l i t i e s common to the companion in g r i e f which are c l e a r l y r e f l e c t e d in the s t r u c t u r e of the experience. One wonders i f these q u a l i t i e s p r e - e x i s t e d in the l i v e s of -154- each c o - r e s e a r c h e r , q u a l i f y i n g them f o r the experience, and to what extent these q u a l i t i e s came to f r u i t i o n as a r e s u l t of the experience. Included among these q u a l i t i e s are l o y a l t y , empathy, p a t i e n c e , humour, s p i r i t u a l r e c e p t i v i t y , and perseverance. Quali f i c a t ions It i s the goal of phenomenological r e s e a r c h to i d e n t i f y the common elements of a phenomenon that expresses i t s e l f in a d i v e r s i f i c a t i o n of experience. The phenomenological method takes account of the a c t i v e i n d i v i d u a l i t y of each person who p a r t i c i p a t e s in the experience and what i s unique in each experience. It i s f o r t h i s reason that i n c l u d e d with the p r e s e n t a t i o n of the r e s u l t s i s a s y n o p s i s of each i n d i v i d u a l c o - r e s e a r c h e r and an o u t l i n e of t h e i r p a r t i c u l a r s t o r y . These b r i e f d e s c r i p t i o n s h i g h l i g h t what i s unique to each experience. It must be understood that the e s s e n t i a l s t r u c t u r e , as i t p r e s e n t l y stands, p r o v i d e s a s t a r t i n g p o i n t f o r i n c o r p o r a t i n g an ever wider d i v e r s i t y of experience i n t o a more i n c l u s i v e s t r u c t u r a l understanding of the phenomenon. The r e s u l t s have meaning f o r the -155- three c o - r e s e a r c h e r s p a r t i c i p a t i n g in t h i s study, and what i s unique to each i n d i v i d u a l i s accounted f o r in the r e s u l t s . For example, Co-Researcher L r e l a t e d her experience of be i n g a companion in g r i e f to her f r i e n d whose one twin d i e d at b i r t h , but i t became c l e a r at the in t e r v i e w that the focus of the companioning experience was on the l o s s of the second twin, who d i e d nine months l a t e r . In c o n t r a s t to the other two co - r e s e a r c h e r s , whose experience of a n t i c i p a t i n g the l o s s was no more than twenty-four hours, the common theme of "Sharing the A n t i c i p a t i o n of the Loss" extended over nine months f o r L. Consequently, her experience of the theme, "Being Moved by the News of Death" was one of peaceful r e s i g n a t i o n and even r e l i e f and g r a t i t u d e in c o n t r a s t to the ot h e r s who experienced intense pain and angry p r o t e s t at what was t r a g i c and unforeseen. The wide range of experience subsumed under a s i n g l e theme i s accounted f o r in the f u l l d e s c r i p t i o n of the theme, and to a l e s s e r extent in the e s s e n t i a l s t r u c t u r e . Another example in which a d i v e r s i t y of experience i s re p r e s e n t e d as -156- a s i n g l e theme i s that of " I d e n t i f y i n g With the Loss". Both Co-Researcher L and Co-Researcher W are t r a i n e d and employed in the h e l p i n g p r o f e s s i o n ; L with her PhD in C l i n i c a l Psychology and t e a c h i n g at a Community C o l l e g e l e v e l , and W as a Master's l e v e l counselor at the High School l e v e l . Both L and W had a l s o experienced s i g n i f i c a n t personal l o s s e s through death in the recent p a s t . N e i t h e r had r a i s e d c h i l d r e n . Co-Researcher T i s employed as a Travel Agent and has never r e c e i v e d t r a i n i n g or education in psychology. Apart from the death of one grand-parent she had not experienced the death of anyone c l o s e to her u n t i l a f t e r her f r i e n d ' s two year o l d son d i e d . At that time she, l i k e her f r i e n d , was p a r e n t i n g two pre-school aged c h i l d r e n . L and W, because of t h e i r l i f e experience had a wider comfort zone around death and l o s s and g r i e f . T's i d e n t i f i c a t i o n with the l o s s of her f r i e n d ' s c h i l d was more profound because of her more l i m i t e d comfort zone with death and g r i e f and because she was a mother of young c h i l d r e n and f e a r e d f o r a l o s s that she was -157- c o n t i n u a l l y reminded c o u l d have been her own. The theme of i d e n t i f y i n g was common to a l l three women but the degree of i d e n t i f i c a t i o n covered a spectrum from moderate to extreme. Although such d i v e r s i t y of experience i s accounted f o r in the r e s u l t s , i t i s noted as a p o s s i b l e q u a l i f i c a t i o n in t h i s type of r e s e a r c h . The re s e a r c h e r acknowledges that the e s s e n t i a l s t r u c t u r e i s in f l u x as i t appears in t h i s study. That i s , by s p e c i f y i n g a d d i t i o n a l c r i t e r i a f o r the s e l e c t i o n of c o - r e s e a r c h e r s , i t i s p o s s i b l e to i n c o r p o r a t e p a r t i c u l a r m a n i f e s t a t i o n s of the phenomenon. For example the re s e a r c h e r c o u l d design a study to determine the e s s e n t i a l s t r u c t u r e of the experience of the companion to parents of leukemic c h i l d r e n with a l i f e - t h r e a t e n i n g i l l n e s s to i n v e s t i g a t e the phenomen of being a companion in a n t i c i p a t o r y g r i e v i n g . The re s e a r c h e r thus c l a r i f i e s her i n t e n t i o n at the o u t s e t , as the e s s e n t i a l s t r u c t u r e i s not intended to g e n e r a l i z e u n i v e r s a l l y , but i s presented as a s t a r t i n g p o i n t , -158- and Is capable of b e i n g made broader to c r e a t e an i n c r e a s i n g l y i n c l u s i v e s t r u c t u r e . T h e o r e t i c a l I m p l i c a t i o n s The aim of t h i s r e s e a r c h study i s p r i m a r i l y p r a c t i c a l but the t h e o r e t i c a l i m p l i c a t i o n s a r i s e from the f a c t that the study p r o v i d e s a d e s c r i p t i v e b a s i s f o r a theory of companioning a g r i e v i n g person. F i r s t l y , the n a r r a t i v e d e s c r i p t i o n and e s s e n t i a l s t r u c t u r e seem to i n d i c a t e that the s o c i a l support p r o v i d e d by a companion in g r i e f i s s i g n i f i c a n t in c o n t r i b u t i n g to a h e a l t h y and unblocked g r i e v i n g p r o c e s s , which would support the consensus in the g r i e f l i t e r a t u r e , and s p e c i f i c a l l y as i s confirmed by i n t e r v e n t i o n s t u d i e s . Due to the f a c t that the r e s u l t s of t h i s study are drawn from s u b j e c t i v e e xperiences based on d i a l o g u e with the c o - r e s e a r c h e r s , and not upon s e l f - r e p o r t s by the bereaved persons they supported, the s i g n i f i c a n c e of the companion's support r o l e , though s t r o n g l y i n d i c a t e d , cannot be c l e a r l y e s t a b l i s h e d . However, Rando's statement u n d e r l i n e s the consensus in the l i t e r a t u r e of the s i g n i f i c a n t -159- r o l e of s o c i a l support; "nothing i s more t h e r a p e u t i c in the process of g r i e f than the presence of an a c c e p t i n g and non-judgemental c a r i n g other" (Rando, 1984, p. 82). The companions in t h i s study c l e a r l y demonstrated the q u a l i t i e s named as e s s e n t i a l to t h i s t h e r a p e u t i c presence. A d d i t i o n a l q u a l i t i e s and common f e a t u r e s of the companion i d e n t i f i e d in the l i t e r a t u r e as s i g n i f i c a n t f a c t o r s in f a c i l i t a t i n g h e a l thy g r i e v i n g which are supported by the r e s u l t s of the study i n c l u d e the f o l l o w i n g ; c o n s i s t e n t a v a i l a b i l i t y , compassionate l i s t e n i n g , t r u s t w o r t h i n e s s , awareness of some of the dynamics of the normal g r i e v i n g process, awareness of one's human l i m i t a t i o n s , and a d e s i r e to help the bereaved resume adequate f u n c t i o n i n g and s o c i a l r e i n t e g r a t i o n . Secondly, the r o l e of the companion in f a c i l i t a t i n g the g r i e f p rocess which emerges in the d e s c r i p t i o n of the experience in the study i s congruent with v a r i o u s needs assessments reviewed in the l i t e r a t u r e . The assumptions in the l i t e r a t u r e r e g a r d i n g g u i d e l i n e s f o r f a c i l i t a t i n g h e a l t h y g r i e v i n g and h e l p i n g with completion of g r i e f work f a l l i n t o two b a s i c -160- c a t e g o r l e s ; those drawn from a medical model which aim at p r e v e n t i o n of pathology and post-bereavement m o r b i d i t y , and those drawn from a more w h o l i s t i c model which aim at p romoting growth. Components of the r o l e of companion or f a c i l i t a t o r of h ealthy g r i e v i n g which emerge in t h i s study support the t h e o r e t i c a l r o l e requirements which correspond to the needs assessments o u t l i n e d in the l i t e r a t u r e . These requirements i n c l u d e g i v i n g concrete a s s i s t a n c e with tasks in the e a r l y stages, encouraging the v e n t i l a t i o n of the pain of l o s s , l i s t e n i n g with acceptance as the bereaved r e p e t i t i v e l y reviews d e t a i l s and i m p l i c a t i o n s of the l o s s , and o f f e r i n g ' intimacy and reassurance to normalize the f l u c t u a t i n g and intense emotional r e a c t i o n s (Lindemann, 1945; Bowlby, 1961; Parkes, 1983; Raphael, 1983; Rando, 1984; Schneider, 1984; Worden, 1982). The w h o l i s t i c model, most c l e a r l y e x e m p l i f i e d by Schneider, a l s o i n c l u d e s an emphasis on an u n d e r l y i n g respect f o r the p r o c e s s of h e a l i n g and growth so that the n a t u r a l i n c l i n a t i o n to do something r e q u i r e s s h i f t i n g to -161- p r o v i d i n g a compassionate presence to a l l o w s o c i a l s a n c t i o n so that g r i e v i n g i s not blocked. In a d d i t i o n , the s a f e p l a c e that i s p r o v i d e d by the companion, p e r m i t t i n g the e x p r e s s i o n of g r i e f and a l l o w i n g the necessary review, i s seen as a p l a c e to review not only what i s l o s t , but a l s o what was not l o s t , p r o v i d i n g f o r new growth and a foundation to b u i l d upon CWorden, 1982; Schneider, 1984; and Rando, 1984). The aims of p r e v e n t i n g pathology and of promoting growth are seen to be mutually achieved by the r o l e of the companion as i t emerges in the r e s u l t s of the study. The stage model of g r i e f i s r e f e r r e d to by one c o - r e s e a r c h e r in the study and i s p e r c e i v e d as c o n s t r a i n i n g f o r the companion by the i n f e r r e d sequence of stages. There i s the need to acknowledge, from the r e s u l t s of the study, that p a r t i c u l a r a spects of the g r i e f p r ocess w i l l be present but the p a r t i c u l a r m a n i f e s t a t i o n of the g r i e v i n g person, which in turn a f f e c t s the r o l e of the companion, w i l l be unique to each i n d i v i d u a l and s i t u a t i o n . P r a c t i c a l I m p l i c a t i o n s The r e s u l t s of t h i s study have i m p l i c a t i o n s f o r c o u n s e l i n g and p r a c t i c e . The meaning of the -162- experience of the companion r e v e a l e d through the study can help p r a c t i t i o n e r s in the h e l p i n g p r o f e s s i o n s to o r i e n t and to equip laypersons who are c a l l e d upon to be companions to g r i e v i n g persons. In a c u l t u r e which has become e x p e r i e n t i a l 1 y ignorant of dying and g r i e f , the p r o f e s s i o n a l c a r e g i v e r i s i n c r e a s i n g l y turned to by bereaved persons who f e e l i s o l a t e d in t h e i r experience of g r i e f , and by those who f i n d themselves i l l - e q u i p p e d to o f f e r a p p r o p r i a t e support. One i m p l i c a t i o n of t h i s study i s to pro v i d e a resource f o r p r o f e s s i o n a l s from which to develop a guide to o f f e r to lay companions s e e k i n g guidance to equip them f o r the experience. The meaning r e v e a l e d through t h i s study can c o n t r i b u t e to g u i d e l i n e s r e g a r d i n g e x p e c t a t i o n s and demands of the r o l e , time and course e x p e c t a t i o n s of the g r i e f p r o c e s s , a t t i t u d e s and s k i l l s which f a c i l i t a t e h e a l t h y g r i e v i n g and ways and means to ensure s e l f - c a r e of the companion. Such a guide would help to normalize the g r i e f p rocess f o r those who surround the bereaved in t h e i r g r i e f and would a s s i s t in s a n c t i o n i n g the r o l e of the lay -163- companlon. The value of p r o v i d i n g s o c i a l s a n c t i o n i n g f o r the r o l e i s expressed c l e a r l y in the words of one c o - r e s e a r c h e r at the completion of her f i r s t i n t e r v i e w with the r e s e a r c h e r ; I t h i n k t h i s p rocess i s very very u s e f u l . I l i k e the idea of the d e b r i e f i n g . Who d e b r i e f s the d e b r i e f e r ? I was the d e b r i e f e r f o r my f r i e n d , and who h e l p s me unload? Now my f r i e n d s l i s t e n e d to me but they're my f r i e n d s and here you are, a concerned t h i r d p a r t y , anonymous in a way. And what you're doing i s a s k i n g q u e s t i o n s in a c a r i n g way, you're a s k i n g the r i g h t q u e s t i o n s and you're h e l p i n g me put some s t r u c t u r e , and you're h e l p i n g me p l a c e in p e r s p e c t i v e what I've gone through. And I never had, that i s , I've always downplayed what I've done, because there i s no r o l e , i t ' s a non-sanctioned r o l e , even though i t got me i n t o the S p e c i a l Care Nursery and i t got me out of h a l f a c l a s s , but i t ' s not r e a l l y a n y thing r e c o g n i z a b l e ; there i s no formal s t r u c t u r e f o r i t . L i k e housewives and l i k e women's work, we downplay -164- i t ; we don't get p a i d f o r t h i s . So I am now l e a r n i n g and have been l e a r n i n g over the l a s t few years that j u s t because i t i s not r e c o g n i z e d by a number of o f t h e r people, or at l e a s t not r e c o g n i z e d by s o c i e t y as a u s e f u l t h i n g ; s o c i e t y can b e n e f i t from i t and I can now give myself c r e d i t f o r having done i t . A guide to the companion would p r o v i d e bereaved persons with an a l t e r n a t i v e to the expense and f o r m a l i t y of s e e k i n g p r o f e s s i o n a l c o u n s e l i n g f o r uncomplicated g r i e f . The p r o f e s s i o n a l c o u l d turn more a t t e n t i o n to the r o l e of / c o a c h / to companions in p r e p a r i n g and s u p p o r t i n g them in u n d e r t a k i n g t h i s journey. The r o l e of 'coach' c o u l d take the form of d i s t r i b u t i n g guides to p r o s p e c t i v e companions see k i n g guidance from a p r o f e s s i o n a l or through c o u n s e l i n g o f f i c e s to bereaved persons who wish to make t h e i r needs known to those in t h e i r support network. The r o l e of 'coach' c o u l d a l s o be employed in s e t t i n g up programs to t r a i n v o l u n t e e r 'companions' in hospice work and g r i e f recovery, - 1 6 5 - and w i t h i n the context of mutual s e l f - h e l p groups l i k e The Compassionate F r i e n d s . These t r a i n i n g programs would provide i n f o r m a t i o n - s h a r i n g to normalize the g r i e f p rocess and to present the a p p r o p r i a t e g u i d e l i n e s f o r the companion, but would a l s o p r o v i d e a context f o r d e v e l o p i n g l a t e n t q u a l i t i e s of p r o s p e c t i v e companions and f o r t e a c h i n g the s k i l l s of a c t i v e l i s t e n i n g , a p p r o p r i a t e s e 1 f - d i s c 1 o s u r e , and the w i t h h o l d i n g of a p r i m a r i l y p r o b l e m - s o l v i n g approach. The programs would l e g i t i m i z e the needs of the companion and help them to gain the t o o l s f o r s e l f - s u s t a i n i n g s e 1 f - n u r t u r a n c e . An issue that t h i s study r a i s e s f o r the r e s e a r c h e r i s the need f o r a s c r e e n i n g process to be used by p r o f e s s i o n a l s in programs f o r t r a i n i n g v o l u n t e e r s to c l a r i f y the s e 1 f - m o t i v a t i o n f o r p r o s p e c t i v e t r a i n e e s . People who seek to become companions may be doing so out of u n r e s o l v e d co-dependency needs, or before s u f f i c i e n t time has e l a p s e d f o l l o w i n g t h e i r own personal g r i e f e xperience. In such i d e n t i f i e d cases, a p r o f e s s i o n a l c o u l d p r o v i d e r e d i r e c t i o n u n t i l a l a t e r time a f t e r these personal i s s u e s have been addressed. The -166- p r o f e s s i o n a l c o u l d thus a s s i s t bereaved persons by s c r e e n i n g t h e i r p o t e n t i a l companions, to r e d i r e c t those who c o u l d , a l b e i t u n i n t e n t i o n a l l y , e x p l o i t the needs of the bereaved. I m p l i c a t i o n s f o r Research Because the e s s e n t i a l s t r u c t u r e or meaning a r t i c u l a t e d in the study i s p e r c e i v e d as a s t a r t i n g p o i n t f o r understanding the experience of the companion, i t can be used as a foundation f o r b u i l d i n g upon. There are s e v e r a l r e l a t e d areas and q u e s t i o n s which are posed by t h i s study that are yet to be ex p l o r e d . For example, what i s the experience of the male companion to a g r i e v i n g person? I m p l i c i t in t h i s q u e s t i o n i s whether there are d i s t i n c t l y male p a t t e r n s of f r i e n d s h i p which i n f l u e n c e the experience of b e i n g a companion in g r i e f to another male. What i s the experience of the " c o l l e c t i v e " companion to a g r i e v i n g person? U n d e r l y i n g t h i s question i s whether v a r i o u s c o l l e c t i v e forms of t a k i n g on the companion r o l e such as mutual s e l f - h e l p groups, (Bereaved Parents Groups), the extended f a m i l y o p e r a t i n g as a u n i t , or an org a n i z e d c o l l e c t i v e of f r i e n d s , s hould be encouraged and developed. What -167- l s the experience of the companion to the bereaved in d i f f e r e n t bereavement s i t u a t i o n s , such as the l o s s of a spouse or the l o s s of a parent in c h i l d h o o d g r i e f ? What i s the impact of the l o s s of a c h i l d on the p a r e n t s ' marriage in the absence of o u t s i d e support? What were the h i s t o r i c a l analogues to the companion in Western l i t e r a t u r e ? What i s the experience of the companion in g r i e f in other non-Western c u l t u r e s ? In what ways do r i t u a l s in g r i e f f a c i l i t a t e the g r i e v i n g process? T h i s i s a small sample of q u e s t i o n s posed by t h i s study that remain to be e x p l o r e d in f u r t h e r r e s e a r c h s t u d i e s . Cone 1usi ons T h i s r e s e a r c h study responds to the q u e s t i o n ; what i s the experience of the companion to a g r i e v i n g person? Understanding the multi d i m e n s i o n a l aspects of the experience of the companion in g r i e f i s a su b j e c t f o r q u a l i t a t i v e r e s e a r c h . T h i s was accomplished through employing a phenomenological method of r e s e a r c h . The re s e a r c h e r was guided by dramatic form in c r e a t i n g a common s t o r y and s t r u c t u r a l meaning of the exper i ence. -168- It i s widely r e c o g n i z e d that the presence and ap p r o p r i a t e support that f r i e n d s and f a m i l y g i v e to the bereaved i s a f a c t o r in f a c i l i t a t i n g h e a l t h y g r i e v i n g . There i s l i t t l e a t t e n t i o n given in the growing body of l i t e r a t u r e to the phenomenon of p a r t i c i p a t o r y g r i e v i n g and the journey undertaken by the companion, who chooses to be a v a i l a b l e to a bereaved person. T h i s study i n c l u d e d three women co - r e s e a r c h e r s , each of whom was able to a r t i c u l a t e her experience of being a companion to a mother who had g r i e v e d the l o s s of her c h i l d through death. The c o - r e s e a r c h e r s were asked to give d e t a i l e d d e s c r i p t i o n s of t h e i r experience as i f they were t e l l i n g a s t o r y ; how i t began, what happened in the midst of the experience, and how i t ended <if i t had). The d e s c r i p t i o n s were tape-recorded and t r a n s c r i b e d and the t r a n s c r i p t s or p r o t o c o l s were analyzed by the re s e a r c h e r who d e l i n e a t e d meaning u n i t s and e x t r a c t e d themes common to a l l three p r o t o c o l s . The themes were woven i n t o an i n t e g r a t e d n a r r a t i v e d e s c r i p t i o n , which in turn was condensed i n t o the e s s e n t i a l s t r u c t u r e or meaning of the experience. The^ -169- c o - r e s e a r c h e r s were interv i e w e d three times, and at each stage of the a n a l y s i s , the r e s e a r c h e r and c o - r e s e a r c h e r s cooperated so that a l l the r e s u l t s were v a l i d a t e d by the f i n a l i n t e r v i e w . From the meaning of the experience r e v e a l e d in the study, a d i s c u s s i o n on p r i o r e x p e c t a t i o n s and assumptions drawn from the r e s e a r c h e r ' s personal experience and r e a d i n g of the l i t e r a t u r e was p o s s i b l e . In the d i s c u s s i o n , i t was p o s i t e d that the study c o n t r i b u t e d to theory development, to suggested i m p l i c a t i o n s f o r p r a c t i c e and to new d i r e c t i o n s f o r f u r t h e r r e s e a r c h . By s t u d y i n g the nature and meaning as l i v e d of the experience of being a companion to a g r i e v i n g person, i t s problems, p i t f a l l s , and rewards, p r o f e s s i o n a l s are p r o v i d e d with a t h e o r e t i c a l b a s i s f o r the education and t r a i n i n g of p r o s p e c t i v e companions to g r i e v i n g persons. -170- BIBLIOGRAPHY A v e r i l l , J.R. "Grief: I t s Nature and S i g n i f i c a n c e . " Psychological B u l l e t i n , 70, No. 6 (1969), pp. 721-748. B a l l , J.F. "Widow's G r i e f : The Impact of Age and Mode of Death." Omega: Journal of Death and Dying, 7, No. 4(197-7) ;.ppS- 1976-1977. Borstein, P.E., P.J. Clayton, J.A. Halikas, W.L. Maurice, and E. Robins. "The Depression of Widowhood." B r i t i s h Journal of Psychiatry, 122 (1973), 561-566. Bowlby, J . "Processes of Mourning." International Journal of Psychoanalysis, XLII (1961), 317-339. "Separation and Loss Within the Family." In The C h i l d i n His Family. Ed. E.J. Anthony and C. Koupernik. New York: Wiley-Interscience, 1970, pp. 197-216. Attachment and Loss. Vols. I, I I , and I I I . Middlesex: Penguin Books, 1978. Cameron, J . and CM. Parkes. "Terminal Care: Evaluation of E f f e c t s of Surviving Family of Care Before and Af t e r Bereavement." Postgraduate Medical Journal, 59 (1983), 73-78. Cary, R. "Weathering Widowhood: Problems and Adjustment During the F i r s t Year." Omega, 10 (1980), 163-173. Cassidy, S h e i l a . Sharing the Darkness: The S p i r i t u a l i t y of Caring. London: Darton, Longman and Todd, 1988. Clayton, P.J. "The E f f e c t s of L i v i n g Alone on Bereavement Symptons." American Journal of Psychiatry, 132 (1975), 133-137. Cochran, Larry and Emily C l a s p e l l . The Meaning of G r i e f : A Dramaturgical Approach to Understanding Emotion, Westport: Greenwood Press, 1987. C o l a i z z i , P.F. R e f l e c t i o n and Research i n Psychology: A Phenomenological Study of Learning. Dubuque: Kendall-Hunt, 1973. C o l a i z z i , P.F. "Psychological Research as the Phenomenologist Views I t . " In Existential-Phenomenological A l t e r n a t i v e s f o r Psychology, Ed. R.S. V a l l e and M. King. New York: Oxford Un i v e r s i t y Press, 1978, pp. 48-71. Forrest, G.C., E. Standish, and J.O. Baum. "Support A f t e r P e r i n a t a l Death." B r i t i s h Medical Journal, 285 (1982), 1475-1479. -171- Fowler, S.G. and H.W. Fowler. Pocket Oxford Dictionary. Oxford: Oxford Un i v e r s i t y Press, 1973. Freud, Sigmund. Mourning and Melancholia. London: Hogarth Press, 1957. Gerber, I., A. Wiener, D. B a t t i n , and A.M. Arkin. " B r i e f Therapy to the Aged Bereaved." In Bereavement: I t s Psychological Aspects. Ed. B.M. Schoenberg and I. Gerber. New York: Columbia U n i v e r s i t y Press, 1975. G l i c k , I. R.S. Weiss, and CM. Parkes. The F i r s t Year of Bereavement. New York: John Wiley & Sons, 1974. G i o r g i , A. Psychology as a Human Science: A Phenomenologically Based Approach. New York: Harper and Row, 1970. "An A p p l i c a t i o n of Phenomenological Method i n Psychology." In Duquesne Studies i n Phenomenological Psychology I I . Ed. A. G i o r g i , G.T. Fischer, E.L. Murray. Pit t s b u r g : Duquesne Un i v e r s i t y Press, 1975. Grollman, E. What Helped Me When My Loved One Died. Lexington: Beacon Press, 1981. Jamieson , K.R., Wellisch, D.K., and R.D. Pasnov. "Psychosocial Aspects of Mastectomy." American Journal of Psychiatry, 135 (1978), 432-436. Kubler-Ross, E l i s a b e t h . On Death and Dying. New York: MacMillan, 1969. Death: The F i n a l Stage of Growth. New Jersey: P r e n t i c e - H a l l , 1975. Kupst, M.J., Tylk, L., L Thomas, M.E. Mudd, C. Richardson, and J.L. Schulman. "Strategies of Intervention with Families of P e d i a t r i c Leukemic Patie n t s : A Longitudinal Perspective." S o c i a l Work i n Health Care, 8 (1982), 31-47. Lewis, C.S. A G r i e f Observed. New York: Bantam Books, 1976. Lindemann, E. "Symptomatology and Management of Acute G r i e f . " American Journal of Psychiatry, 101 (1945), 141-148. Nouwen, H. Compassion. Garden C i t y : Doubleday & Co., 1982. Osterweiss, M., Frederic Solomon, and Morris Green, eds. Bereavement: Reactions, Consequences and Care. Washington: National Academy Press, 1984. Parkes, CM. "The Nature of G r i e f . " International Journal of Psychiatry, 3 (1967), 435-438. -172- Parkes, CM. Bereavement: Studies of Grief i n Adult L i f e . New York: International U n i v e r s i t i e s Press, 1972. "Bereavement Counseling: Does i t Work?" B r i t i s h Medical Journal, 281 (1980), 3-6. . Recovery from Bereavement. New York: Basic Books, 1983. "> Rando, T. G r i e f , Dying and Death: C l i n i c a l Interventions f or Caregivers. Champagne: Research Press, 198^/^ Parental Loss of a C h i l d . Champagne: Research Press, 1986. Grieving: How to Go On L i v i n g When Someone You Love Dies. Toronto: Lexington Books, 1988. Raphael, Beverley. "Preventive Intervention with the Recently Bereaved." Archives of General Psychiatry, 34 (1977), 1450-1454. " A Primary Prevention Action Program: P s y c h i a t r i c Involvement Following a Major R a i l Disaster." Omega: Journal of Death and Dying, 10 (1979-1980), 211-226. The Anatomy of Bereavement. New York: Basic Books, 1983. Sanders, CM. "A Comparison of Adult Bereavement i n the Death of a Spouse, C h i l d , and Parent." Omega: Journal of Death and Dying, 10, No. 4 (1979-1980), pp. 303-320. S c h i f f , H. The Bereaved Parent. Middlesex: Penguin Books, 1978. Schneider, J . "Growth from Bereavement." Proceedings from the 1980 International Congress on Death and Dying. London: Pittman Medical Publishers, 1980. Stress, Loss and G r i e f . New York: U n i v e r s i t y Park Press, 1984. Schoenberg, B. Mark. "When a Friend i s i n Mourning." Loss and G r i e f : Psychological Management i n Medical Practice . New York: Columbia U n i v e r s i t y Press, 1970. Schoenberg, B. Mark, A.C Carr, A.H. Kutscher, 0. Peretz, eds. Bereavement: I t s Psychological Aspects. New York: Columbia U n i v e r s i t y Press, 1974. Schowalter, J.E., P.R. Patterson, M. Tallmer, A.H. Kutscher, S.V. Gullo, and D. Peretz, eds. The C h i l d and Death. New York: Columbia U n i v e r s i t y Press, 1983. -173- Schwab, J . J . , J.M. Chalmers, S.J. Conroy, P.B. F a r r i s , and R.C. Markush. "Studies i n G r i e f : A Preliminary Report." In Psychological Aspects of Bereavement. Ed. B. Schoenberg, I. Gerber, A. Wiener, A.H. Kutscher, D. Peretz, and A. Carr. New York: Columbia University Press, 1975. V a l l e , R.S. and M. King, eds. Existential-Phenomenological A l t e r n a t i v e s f o r Psychology. New York: Oxford University Press, 1978. Weisman„ A > D > "Early Diagnosis of V u l n e r a b i l i t y i n Cancer Patients." American Journal of the Medical Sciences, 271 (1976), 187-196. Worden, W. J . G r i e f Counseling and Gri e f Therapy: A Handbook for the Mental Health P r o f e s s i o n a l . New York: Springer Publishing, 1982. Yeagley, Larry. G r i e f Recovery Keene,Texas: Published by author, 1984.

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