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The experience of grief for surviving friends Martin, Debra Lucille 1996

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THE EXPERIENCE OF. GRIEF FOR SURVIVING  FRIENDS  by DEBRA LUCILLE MARTIN  B.A., U n i v e r s i t y o f V i c t o r i a ,  A THESIS SUBMITTED  1991  IN PARTIAL FULFILLMENT OF  THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in  THE FACULTY OF GRADUATE STUDIES (Department o f C o u n s e l l i n g Psychology)  We accept t h i s t h e s i s as conforming to the r e q u i r e d s t a n d a r d  THE UNIVERSITY OF BRITISH COLUMBIA April  Copyright  1996  Debra L u c i l l e M a r t i n ,  1996  In presenting  this  thesis in partial  degree at the University of  fulfilment of  the  requirements  for  an advanced  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  department  or  by  his  or  her  representatives.  It  is  by the head of  understood  that  copying  my or  publication of this thesis for financial gain shall not be allowed without my written permission.  Department of The University of British Columbia Vancouver, Canada Date  DE-6 (2/88)  11  Abstract The  expanding  predominantly role  Despite  defining about  been  on t h e g r i e f with  close  grieving  and  t h e meaning t h e bereaved  rights,  has  and k i n o f t h e  of the r e l a t i o n s h i p  friend  o f bereavement has  r e a c t i o n s o f f a m i l y members.  t o t h e spouse  often  t h e deceased,  the experience of g r i e f  shared  minimal  almost  deceased.  between t h e  research  f o r these bereaved.  The  Little  exists  i s known  f r i e n d bestows on h i s or h e r e x p e r i e n c e  grief. The  purpose  surviving  of this  friends.  study i s t o e x p l o r e t h e e x p e r i e n c e  A phenomenological  interviews  was undertaken  to explore  women  have  t h e death  who  explicit  survived  t h e meanings  meaning s t r u c t u r e of  i n the f i e l d  i t s attendant  accorded  the intimacy  surviving  in  focused  o f "bereaved",  exclusively  of  body o f l i t e r a t u r e  grief  themes  illuminated  this of a  i n their  c o n t a i n i n g the e s s e n t i a l  f o r these  common  implicit  study based  bereaved  friends  to the experience  and d e s c r i b e d .  were a l s o d i s c u s s e d .  experience close  elements  was c l a r i f i e d .  of g r i e f  Implications  on u n s t r u c t u r e d with  friend.  experience  of grief  four By  adult making  of grief,  the  o f t h e phenomenon Ten elements  f o r a l l informants f o r research  or were  and p r a c t i c e  iii TABLE OF CONTENTS PAGE ABSTRACT  i i  TABLE OF CONTENTS  i i i  CHAPTER I - INTRODUCTION  •  1  CHAPTER I I - LITERATURE REVIEW  4  T h e o r i e s and models o f g r i e f  5  Phenomenological  examinations  of g r i e f  15  D i s e n f r a n c h i s e d and hidden g r i e f —  •  22  Empirical studies of friendship g r i e f CHAPTER I I I - METHODOLOGY Foundations  27  :  33  o f method —-  33  T r u s t w o r t h i n e s s o f the proposed Participants  research  34  r  37  Data g a t h e r i n g  ;  •  38  Data a n a l y s i s  39  Presuppositions  42  Definitions  -  44  CHAPTER IV - RESULTS  45  Situated Structures  45  Anna's e x p e r i e n c e o f l o s s  45  Natasha's e x p e r i e n c e o f l o s s  •  Carla's experience of l o s s Diane's  experience of l o s s —  52  •  60 :  ;  67  General S t r u c t u r e Emotional d i s t r e s s  75 -  75  Exclusion  77  Inclusion  79  Concession  •  81  iv  TABLE OF CONTENTS PAGE Control  82  Dissonance  84  Integrity  86  Meaning  87  - Ritual  90  Acceptance  92  CHAPTER V - DISCUSSION Results  96  i n r e l a t i o n to current  Limitations Implications  and i m p l i c a t i o n s  literature  f o r future research  for practice  108 109  REFERENCES APPENDIX A - P r e - s c r e e n i n g  96  114 questions  118  APPENDIX B - I n t e r v i e w p r o t o c o l s  119  APPENDIX C - D e f i n i t i o n s o f unique and common themes  120  APPENDIX D - E i d e t i c a n a l y s i s o f Anna's e x p e r i e n c e  123  APPENDIX E - E i d e t i c a n a l y s i s o f C a r l a ' s  experience  128  APPENDIX F - E i d e t i c a n a l y s i s o f Diane's e x p e r i e n c e  133  APPENDIX G - E i d e t i c a n a l y s i s o f Natasha's e x p e r i e n c e  139  APPENDIX H - Common themes  144  1  CHAPTER 1 Introduction G r i e f has been w i d e l y e x p l o r e d i n r e c e n t y e a r s , and a  process  emotional,  of  responding  to  intellectual,  loss  which  spiritual  l e a d i n g t o r e s o l u t i o n o f the l o s s  and  includes physical  an  i s d e f i n e d as integration  reactions eventually  (Kubler-Ross,  1969;  Lindemann,  Worden, 1991).  T h e o r i e s o f g r i e f have v a r i o u s l y d e s c r i b e d the  of  one  grieving  stages  as  involving  (Kubler-Ross,  1969)  phases  and  tasks  (Parkes,  1987-88;  The the  concomitant  physiological  components 1991). of  An  to  perceived  grief  of  indicates  h e a l i n g , and  t o the  loss.  of  that  healing  (Worden,  component o f t h i s h e a l i n g p r o c e s s i s the  presence  the  support.  resolution  A  review  agreement  of g r i e f .  The  on  of  the  the  recent  n e c e s s i t y of  presence  of such  literature this  support  they have a s o c i a l l y  (1991) and Raphael  the  clarified,  many  facets  these  comprehensively  i n the  writers the  Qualitative replete expand  i n the and  literature the  sanctioned role  r e g a r d i n g the  there  Cowles and  of  grief  exists  of g r i e f  as  concept  a  which  need  to  i t i s lived  of need  grief. to  be  d e f i n e more  and  perceived  bereaved.  studies literature.  challenge  and  (1987) i n d i c a t e the e x i s t e n c e  phenomenon  suggest  experience  by v a r i o u s c a t e g o r i e s o f  allows  S k l a r & H a r t l e y , 1990).  and M i d d l e t o n  of  on  component  also  As o u t l i n e d i n t h e i r reviews o f bereavement l i t e r a t u r e ,  Among  to  specific  r i g h t t o g r i e v e (Doka, 1989;  of much ambiguity  of  requires  mourners the p e r c e p t i o n t h a t  Rodgers  1961);  such  general  to the r e s o l u t i o n  Bowlby,  as  facilitate  social  process  p r o c e s s of g r i e f work, or mourning, i s s i m i l a r  process  important  1944;  (Worden, 1991), the c o m p l e t i o n  which i s c o n s i d e r e d n e c e s s a r y i n o r d e r t o adapt  of  are  beginning  In so doing,  specific  aspects  to  address  these of  the  the  ambiguities  s t u d i e s have begun leading  theories  to of  2  grief.  In  Carter  exploring  (1989)  theoretical  illuminates  on  expectations  a  the  features  that  comprehensive  unique responses as  the  in  well  as  which body  categories of  grief  reactions  including  of  close of  members  surviving  endorsed  the  uncommonly,  disenfranchised, in  other  mourning  Sklar  & Hartley, The  be  the  the  are  spouse the  grief for (Sklar  eligible  are  Rando,  the  rituals  societal  This  other provide  bereavement.  Carter  a  do  and not  "broad  range  anticipated  to  grief  the  (p.  of  358).  need  focus of  to  be  the  may  the  friends  are  exclusion  healing  process,  1989;  and  such  Meagher,  the  Minimal survivors,  s i m i l a r to grief  Though that  1990).  as  1989;  nor Not  unrecognized, active  of  reactions  acknowledged  Hartley,  from  on  deceased.  further  g r i e f by  (Doka,  the be  &  expanding  f o r those  socially  Sklar  The  deceased.  loss  neither  regarding  predominantly  grief  friends  1992-93;  literature  grieve.  r e l a t e d to  1990),  generally  their  to  kin  not  surviving  are  of  and  to  e x p e r i e n c e of  surviving  in  and  & Hartley,  1989;  personal  of  responses  by  pervasive  bereaved,  limitations in  f r i e n d s , who  components  other  for  addressed the  grieve.  experience  l i t e r a t u r e appears  of  these  to  not  e x p e r i e n c e of t h a t phenomenon.  survivors  friends  (Doka,  of  experienced,  involves  bereaved" needs t o be  to  exists defining  process  family  of  aspect  way  universal  appear  bereavement  research  the  also  i t is  theoretical perspectives  c o n s i d e r e d i n u n d e r s t a n d i n g the There  as  bereavement  such  caring  from the  grief  of  correct  existing  that  of  experience  d e f i n i t i o n of  concludes  Personal  One  grieving  regarding  suggest  (1989)  phenomenon  perspectives.  influence  studies  the  or  involvement  the  .funeral  Sklar,  and  1991-92;  1990).  preceeding  research  opportunity  exists  for  legitimately  enter into  such and  appears survivors  complete the  r e a l i t y of g r i e f f o r s u r v i v i n g  to  indicate as  bereaved  grieving  f r i e n d s , the  that  process.  little  friends  to  Given  the  question t h i s thesis  seeks  3  to  answer  i s , "What  s u r v i v o r who The  Through  the sought  research  unstructured  each p a r t i c i p a n t w i l l clarify  f o r the  non-familial  i s g r i e v i n g the l o s s through death o f a c l o s e  phenomenological  question.  i s the e x p e r i e n c e o f g r i e f  method  interviews,  be uncovered  question.  will  be  used  to  address  the meanings  and themes  will  be  friend?". this  of g r i e f f o r  illuminated  to  4  CHAPTER I I Literature This  chapter w i l l  literature  on  phenomenon. grief current  review a c r o s s - s e c t i o n o f the expanding body of  grief  to  Selected  will  be  that  empirical to  of  have  conceptualizations Several  highlight  reviewed  understanding  concerns  Review  the  various  findings,  illustrate  grief.  arisen  theories,  their  Selected  from  the  conceptions and  of models  contributions  theoretical  presence  of  this  and  such  to  of the  clinical multiple  of g r i e f w i l l a l s o be h i g h l i g h t e d .  reviews  of  the  field  of bereavement  literature  contend  t h a t a coherent and e m p i r i c a l l y supported model o f bereavement has y e t to e v o l v e . concern.  Numerous r e m e d i a l Among those  systematic  suggestions  suggested  phenomenological  are o f f e r e d t o address  i s a need  studies  f o r an i n c r e a s e d  i n order  to c l a r i f y  exists  phenomenological contributions  review  reactions of  family  rarely  studies  will  methodological  empirical be  data.  reviewed  approach has  to made  on  wherein A  there  sample  illustrate to  the  of the  evolving  of g r i e f .  of the l i t e r a t u r e  and g r i e f members.  represented  investigations, grief.  limited  this  conceptualization A  only  focus  the e s s e n t i a l  a s p e c t s o f g r i e f as i t i s l i v e d and e x p e r i e n c e d , an area currently  this  also  indicates  that  the bereavement  e x p e r i e n c e s i n v e s t i g a t e d have p r i m a r i l y been those Mourning in  friends  academic  and  other  bereaved  conceptualizations  i n c l u d i n g the c u r r e n t  and  non-kin  are  empirical  phenomenological examinations o f  To e l u c i d a t e t h i s gap i n the l i t e r a t u r e ,  Doka  (1989) s t a t e s ,  We are i n v o l v e d i n webs of r e l a t i o n s h i p s t h a t i n c l u d e not o n l y f a m i l y . . . b u t a l s o l o v e r s , f r i e n d s , c o l l e a g u e s and c a r e g i v e r s . Though t h i s p o i n t seems obvious, i t i s o f t e n i g n o r e d i n a s o c i e t y t h a t emphasizes the primacy of the d y a d i c r e l a t i o n s h i p and the n u c l e a r f a m i l y , e x t e n d i n g t o those r e l a t i o n s h i p s almost e x c l u s i v e monopoly to mourn (p. 329).  5  Literature be  focused  reviewed  to  on  these  provide  a  disenfranchised  composite  and  hidden  mourners  r e p r e s e n t a t i o n of  this  will  bereaved  population. Despite  such  the l i t e r a t u r e , provide  conceptual e f f o r t s  o n l y a l i m i t e d number of e m p i r i c a l  s y s t e m a t i c data  population  of  bereavement  i n surviving  review  of  friends,  t o r e c o g n i z e bereaved  related  bereaved.  those  Fewer  point  the  The  empirical  chapter  studies  to the f a c t t h a t  t o address  experience will  c o n c e p t u a l gap  of g r i e f  emphasize  bereaved  the  the  friends  for surviving need  and  friends,  essence  of  their  in  which  in  this  focus  conclude  focus  on  on  with  a  bereaved  i f any,  phenomenological  i n this  population.  literature this  related  aspect  f o r more phenomenological  the  grief yet  will  which  few,  i n the  of  studies  s t u d i e s have examined the e x p e r i e n c e o f g r i e f order  studies exist  experience  empirical  friends.  existing  and w i l l  to  non-kin  grief  o f the  studies as  to  In the  review  focused  i t i s lived  on and  experienced. The G r i e v i n g  Process  T h e o r i e s and Models o f G r i e f Based perished first  on  h i s o b s e r v a t i o n s of  i n a Boston  nightclub  thanatological  he noted  could  such  by his  be  aroused  relatives  by  and  compiled  of  to  study  remarkably  and  grief  similar grief as  symptoms  c o n c e p t u a l i z i n g bereavement as a d i s t i n c t  of  victims  (1944) was  normal  t o the deceased.  signs  survivors  Lindemann  circumstances  allusions  list  fire,  theorists  Amongst the bereaved  bereaved  receiving  response  a  of  the  reactions.  r e a c t i o n s which sympathy,  Although offers  one  who  visits  not e x h a u s t i v e , foundation  to c r i s i s  for  involving  a s e t o f c h a r a c t e r i s t i c b i o p s y c h o s o c i a l responses. According elements  to  common  Lindemann's  to  the  grief  observations, there reaction.  These  appeared symptomatic  t o be  six  elements  6  included  feeling-related  self-reproach; and  throat,  image  of  hostile  somatic  to  the  a  phenomena  distress  sense  of  deceased,  reactions;  deceased  in  the  ranging  disbelief  of  warmth i n r e l a t i o n s h i p s  as  sadness,  from  patterns  in of  behavior  of  the  guilt  in  the  and  chest  preoccupation with  the  reality  conduct,  w i t h o t h e r s ; and  anger,  tightness  depersonalization;  and  loss  such  the  including  appearance  bereaved,  of  of  the  death; loss  of  of  the  traits  notwithstanding  other  b e h a v i o r a l symptoms such as s l e e p and a p p e t i t e d i s t u r b a n c e s . Although symptamology  one  of  the  established  earliest by  studies  Lindemann  (1944)  robust when s u b j e c t e d t o t h e o r e t i c a l Loya,  & Hodde-Vargas, 1989,  work  continues  today  to  d i a g n o s i s and p r a c t i c e Since  the  and  p. 1484). provide  of  grief  appears  empirical  a  general 1986;  Lindemann's  developed  to  address  such  frame w i t h i n which  the g r i e f  grief  Although  in  resolution.  their  these  conceptualizations  of  conceptualizations  of  approach of Lindemann In describe (1969)  her  theory  the  grief  conceptualizing  of  death of  a sequence  first  of  the  five  dying,  loss  The  i n r e s o l u t i o n o f the g r i e f The  and  sequencing  grief.  process i n v o l v i n g  the  literature  as  the  in  the  on  the  time  facilitation  seem t o d i f f e r  t o be s i m i l a r .  expanded  clinical  somewhat  central Such  of  themes  subsequent  symptomalogical  (1944) t o i n c l u d e a component of sequencing.  experience  advocates  have  early  1982).  issues  phenomenon,  r e l a t e d t o the p r o c e s s o f g r i e f appear  proven  S e v e r a l models have  o c c u r s , and  the  the  (Vargas,  for  (1944) work,  approaches  "have  Lindemann's  Worden,  process-related  response  to  guideline  the f i e l d o f bereavement and g r i e f has burgeoned. been  reactions,  scrutiny"  Additionally,  (Schwartz-Borden,  publication  of  and as  grief a  phenomenon of f i v e  which, has in  been  general,  fundamental of  grief  stages which  adapted  Kubler-Ross  component is  to  considered  in a  e v e n t u a l l y culminate  reaction. stages  outlined  by  Kubler-Ross  (1969) i s  7  c o n c e i v e d as d e n i a l , The  stage  with  that  God  f o r having  dissipating indicate  anger  i s succeeded  the bereaved  depression  which  the bereaved by  other  state  suggestive  will  be  attempts  such  anger  with  the  to grieve.  The  cognitions  which  or some  higher  the l o v e d one's  as  faith  o r good  t o r e t u r n the s t a t u s quo,  of depression  mediated,  and  known b e f o r e  fail  from  t o anger  themselves  commodity  o f the l o s s .  range  alone  behaviors  as i t was  f o r some  may  the deceased,  are bargaining with  When a l l p r e c e e d i n g  fourth  of  d i e d and l e f t  i n exchange  works. the  the l i f e  f o r the return of l i f e  death,  i n the r e a l i t y  f o l l o w s i s one o f anger,  f o r taking  deceased  power  a state of d i s b e l i e f  ensues.  facilitating  E v e n t u a l l y the  the  final  stage  of  acceptance. The one  sequence o f stages  stage  longer next  t o the next  denies  stage  variable  the r e a l i t y  until  t o be one i n which movement  i s linear.  o f anger.  rate  appears  Once t h e bereaved  o f the death,  Transition the f i n a l  stage  individual  a transition  through  the stages  o f acceptance  from  occurs  no  t o the  continues  at a  o f the death i s  achieved. As model  a  i s effective  grief. and  r e p r e s e n t a t i v e of  movement  from  steady s t a t e . the  i n demonstrating  In d e l i n e a t i n g  behavioral  emphasis  necessary  responses, initial  the  reaction  approach,  t h e dynamic,  the p r o g r e s s i v e s h i f t s model through  Kubler-Ross'  adaptive  on l i n e a r i t y .  may  impose  Resolutibn  movement on  demonstrates  the  to resolution  o f one  t o the next;  the bereaved  nature o f  i n emotional,  stage an  cognitive  process  of  and r e t u r n t o  A drawback o f t h e stage-based model appears  to f a c i l i t a t e  inadvertently  the stage-based  to exist i n  appears  implication  the expectation  t o be which  that a l l  stages must be e x p e r i e n c e d and s e q u e n t i a l l y so i n o r d e r f o r a d a p t a t i o n to  occur. Grief  has s i m i l a r l y  been c o n c e p t u a l i z e d as a p r o c e s s  involving a  8  sequence  of  theories,  phases.  Bowlby  instinctually mother.  Based  (1961)  similar  on  attachment  views  to  a  the  child's  and  grief  response  response  He proposes a model i n which  grief  object  to  the  relations  to  loss  absence  as  of i t s  i s understood as a p r o c e s s  of p r o g r e s s i o n through f o u r phases. As  o u t l i n e d by Bowlby  numbness, to  grieving  individuals  r e u n i t e w i t h the l o s t  child the  enter a  object,  the  first  searching  or deceased  phase  searching  return  phase  during  this  o f the l o s t be  involved.  As  the  diminish,  a sense to  be  disorganization. accompanying  final  hope  A  As  The  progression,  Where  between phases. clearly  of  to  the deceased the  angry  coax  point,  begins  of  to  the bereaved i s  described  the  the  or o t h e r s  deceased  phase,  evolves  and  e x p r e s s i n g the p a i n  this  third  engaged i n  extent  of  as  one  the  aspect  of  the  this  phase  eventual  is  of  losses  considered  relinquishing  of  the  The p r o c e s s o f r e l i n q u i s h m e n t h e r a l d s the  the bereaved b e g i n s t o r e o r g a n i z e and  eventually  attachments.  in  appears  former  phase-based The  to  staged-based  the  differentiated  fluidity,  At  effort  the  the bereaved b e g i n s t o e x p e r i e n c e symptoms of  distinction  the  the  i t facilitates  emphasised  approaches.  ensues.  depressive  g o a l s and new  movement  with  adult  and  attempt  As does  weeping  i s an  towards  reunion  awareness  t o the deceased.  subtle  directed  in  exhibits  weeping  i n an  individual.  w h i l e the anger  of  engaged  stage, i n which  form new  one,  of d e s p a i r  i n that  attachment  The  variously  the death,  depression. adaptive,  phase.  loved  abandonment may  considered  characteristically  o f shock  phase  i n response t o the absent mother, the g r i e v i n g  behaviors  of  (1961), a f t e r  models  model  model  overlapping  exist  between and  quality  that  appears  appears would  to to  return  in  process  focus  on  emphasize  linear  overlaps  Within t h i s  t o a p r e v i o u s phase  of  phase-based  seem t o i n d i c a t e  b o u n d a r i e s between phases.  the bereaved may  the  as a  less  system result  9  of t r i g g e r s such as unexpected Critical bereaved  must  is  instead  an  process  of the  deceased.  o f the i m p l i e d p a s s i v i t y o f phases as a p r o c e s s t o which  the  therapeutic  reminders  acquiesce,  active  process,  intervention.  of mourning  Worden  (1982,  and  1991)  one  which  Adaptation to l o s s  w i t h i n which  proposes  certain  is  must  grief  responsive  i s here  tasks  that  to  c o n c e i v e d as be  completed  a in  o r d e r t o r e s o l v e the c r i s i s of l o s s . Worden active  (1991) poses  part  i n the  t h a t one's awareness o f the o p t i o n t o take  grieving  process,  the  feelings  The  tasks involved i n grieving  outlined loss, as  follows.  emotional  this  in  environment  i n which  emotional  depends  emotional the  Worden bereaved  by  the  on the  deceased  of  task  without  individual,  as  deceased  the  nature  the  a n t i d o t e to  the that or  promote  until  the  of  the  The  that  pain or the  and  an  and  are  of  the  as  the  be  bereaved  nature with  task  of  involves  the  deluge  of  intense  require  This  the memory emotion.  s e l f - g e n e r a t e d by  professional  completion  allow  i n the world. recall  may  this the  to  be  if  the  an  and  ability  t a s k s may  the  to  endeavour which would  these  is  expressed  adjustment The  fully  well  villainizing  relationship  live an  35).  pain i t s e l f  may  remaining  accompanying  their  intellectual  i s missing.  by  (p.  reality  requires that  involves  deceased,  directions  the  idealizing  task  i s signalled  (1991) suggests  to  such  deceased.  t o s e t new  relocation  intervention  accept  i n v o l v e s both  avoided,  critical  relocation  the bereaved  must  further  is  behaviours  Another  played  bereaved  A  task  deceased.  roles  a powerful  s i m u l t a n e o u s l y mediated  n e g o t i a t e the p a i n o f g r i e f  if  adjustment  can be  t a s k which  acceptance.  acknowledge and  of  The  a time-consuming  indirectly  be  of h e l p l e s s n e s s t h a t most mourners e x p e r i e n c e "  as  resolved;  "can  an  the  counselling bereaved  is  e x p e r i e n c i n g d i f f i c u l t y i n e n t e r i n g i n t o the h e a l i n g p r o c e s s . Raphael  and  Middleton  (1987)  offer  a  definition  of  grief  which  10  appears  to  preceeding  c a p t u r e the models  of  similar  grief.  themes  that  From t h e i r  bereavement r e s e a r c h , Raphael  weave through  examination  of  a l l of  the  the  field  of  and M i d d l e t o n c h a r a c t e r i z e g r i e f as,  an i n i t i a l shock and numbness g i v i n g way t o d i s t r e s s , y e a r n i n g and s e a r c h i n g b e h a v i o r s as w e l l as anger and p r o t e s t as the bereaved e x p e r i e n c e s the p a i n of the s e p a r a t i o n from the l o v e d person; then g r a d u a l l y and i n c r e a s i n g l y t h e r e are sad and even d e s p a i r i n g d i s o r g a n i z e d responses as the f i n a l i t y and i r r e v o c a b i l i t y of the l o s s become a c c e p t e d (p. 7 ) . The  definition  appears  to  s y n t h e s i z e many  phenomena d e s c r i b i n g the g r i e f  of  the  commonly  response i n the f i e l d of  accepted  thanatological  literature. F a c t o r s s u p p o r t i n g or h i n d e r i n g the f a c i l i t a t i o n Regardless considerable either  of  theoretical  agreement  i n the  support or h i n d e r the  i s the r o l e t h a t s o c i a l Worden note  that  literature  i t i s the  support  stress  of  facilitation  p e r c e p t i o n of which  bereavement.  The  and  of g r i e f .  social  alleviates "goodness  the q u a l i t y  of  factors,  of  the  of  Stylianos,  1988) .  v a r i o u s members In her  assessment  t h e i r bereavement, Raphael  nonsupport  are  placed  occurring  as  was  f o r her g r i e f .  have d e l i t e r i o u s on  effects the  rapidly  that  may  factor  on  that  the  including  and  the  the degree  social  one  the  presence of  network  the  actual  i t i s p e r c e i v e d by  impact  (Vachon  o f the most  social  support  a d a p t a t i o n t o bereavement that  others  of  the  &  weeks o f distinct  the widow's p e r c e p t i o n of inadequate  F u r t h e r , the  bereaved as  the  effects  f i t " between  1988)  than  of widows i n the e a r l y  (1977) noted  p r e d i c t o r s o f poor adjustment or  be  such  rather  adverse  factors,  concurrent s t r e s s o r s , p e r s o n a l i t y the  support,  the  of  on  One  to  Vachon & S t y l i a n o s ,  of support as  bereaved w i l l be determined by s e v e r a l  loss  appears  support p l a y s i n a d a p t a t i o n t o bereavement.  itself,  offered  there  regarding factors  (1991) and o t h e r s (Raphael, 1977;  actual  support  standpoint,  of g r i e f .  adjustment  expect  to  (Lehman,  system  may  i f expectations  the  loss  Ellard,  &  is  not  Wortman,  11  1986;  Vachon & S t y l i a n o s ,  conclude  that  adjustment  1988).  although  is  i t is  facilitated  Raphael difficult  by  indicates that several  which  perceived  opportunities  positively  to  social  literature is  and state  support,  f a c t o r s may by  the  f o r support, c a t h a r s i s ,  Middleton  definitively a  review  be a t p l a y .  bereaved  (1987)  not  of  in  his  responsible  shattered  for  giving  M i d d l e t o n , 1987, Another of  only  provides  and making meaning of the event,  factor  of the l i t e r a t u r e  assumed  a  affecting  sense  the  of  adjustment  suggests c o n s i s t e n t is  13),  the adjustment  high  level  positively  are  dominated  in  powerful  facing  most  (Raphael  Planning  &  and  the deceased.  related  to  be  much  "this  all  or  have been  1977;  Worden, 1982).  of  dependency,  and  relationships,  feelings  deeply  the of  (Raphael & Nunn, 1988,  and  important  p.  been a  with  the  Raphael sense anger  of and  though  in  relationships  those  the  bereaved  of the g u i l t  some  may  have  t h a t would  be may  193).  participation  in  component  adjustment  in  p.  Similarly  ambiguity  n e g a t i v i t y because  be  (Worden, 1991,  relationship  greater,  of  intensity,  A l t h o u g h i t may  of p a i n "  intensified.  feelings  of  i n the  case  review  the i n t e n s i t y  the  someone you  Raphael,  i n the  A  c o m p l i c a t e d when t h e r e has  ambiguity  1983;  that  be  quality  so d e n i a l or exaggerated i d e a l i z a t i o n o f the dead person  appear i n s t e a d "  another  to  or  subsequently exists  by  difficulty  state  appears  ambivalence  involved,  dependency  (1988)  abandonment protest  t o l o s s may  (Parkes & Weiss,  Nunn  gone"  agreement t h a t  " i t i s impossible to lose  of  perhaps  t o bereavement i s the  a t t a c h e d t o without e x p e r i e n c i n g some l e v e l  and  is  of the r e l a t i o n s h i p w i t h the deceased.  that  deceased  person  value  between the bereaved  experienced  closeness,  him  where  self-  p.12).  the r e l a t i o n s h i p  grief  world,  the  Interaction  but a l s o appears t o h e l p "the bereaved p e r s o n t o h o l d a sense o f worth  how  rituals  signifying to  the  bereavement.  death  is  Worden  12  (1991)  states  ways.  Not  the  the  funeral  o n l y does  loss,  but  this  i t also  ritual  facilitates  formal r i t u a l  provides  an  adjustment  the f a c t  of  o p p o r t u n i t y f o r the  bereaved  to  and draws the s o c i a l  to  1991) .  bereaved  present find  a t the f u n e r a l ,  no  other  (Worden, also  (Worden,  external  1991;  Yoder,  appears  opportunity  to  for  way  to  1986).  those  validate  bereaved  to  be  the  a part  adjustment,  support network bereaved  t o l o s s may  Having  facilitate the  For  adjustment  may to  Even the i n f o r m a l r i t u a l  facilitate depend  whether  revelations  which  Stanwood  (1992) s t a t e s  the  may  the  personal Reeves, conveyed  a d a p t a t i o n here seems  r e g a r d i n g how  response  the  news o f the death was  o f the bereaved  these  death funeral  (Hocker, 1990;  was  with  the  provide  symbolically  announcement  Correlated  of  may  the  s h o u l d be made (Raphael & Nunn,  not  c o m p l i c a t e d i f they  it  or h i n d e r a d a p t a t i o n t o the l o s s ;  upon  expectations  o f how  close  are  i n p l a n n i n g the  as  express  who  reality  meaning o f t h e i r r e l a t i o n s h i p w i t h the deceased 1989).  several  h e l p t o make r e a l  openly express t h e i r g r i e f , the  in  synchronized with of t h i s  the  nature  1988).  factors  variously  i s the  affect  individual's  adjustment  t h a t d u r i n g the f i r s t  physiological  to  bereavement.  year a f t e r  a major  loss,  immune system i s o f t e n lowered, l e a v i n g the bereaved more prone  infection. bereaved state,  A c a u s a l l i n k between l o s s and subsequent m o r t a l i t y i n the is  however  "While  c a u t i o n e d by  t h e r e i s now  immunity,...direct  links  Gendered There on  Raphael  substantial  of  evidence  Middleton linking  (1987)  who  behavior  and  reaction-immune  changes-  (p. 14-15).  response t o g r i e f .  i s much debate  i n the  the  of  experience  and  literature reactions  debate has c e n t r e d on widowed i n d i v i d u a l s sustains  and  loss-bereavement  d i s e a s e have not been e s t a b l i s h e d "  gender  to  greater  difficulties  while  regarding to  grief.  and which  i n the  process  the  Much  gender, of  effects of  of the  i f either,  grieving.  In  13  their  research  1988)  state  that  differential writers  on the widowed, Weissman and Klerman likely  reporting  suggest  distressed  a  that  than  of  for  the  symptoms between males  widowed  widowed  explanation  females  males  only  because  debate  and  appear  males  ( c i t e d i n Sanders, is  females.  to be  more  generally  the These  severely  report  less  a f f e c t i v e d i s t r e s s and fewer symptoms than females. This  differential  supported norms  Stroebe  influence  affects They  by  the  state  way that  and  coping  i n our  show  their  (Stroebe control  styles  in  each  males  and  females  to  Stroebe,  of emotions  "men  t r y to  women  are  feelings....[and]  &  grief  generally  to  or  to  seek  perhaps  Such  norms  the way  that  sex  reactions.  control  their  distraction in  even  in  further  consequently  grief  others  22) .  influence  which  report  alone  is  assert  expected  allowed,  p.  They  gender,  are  cope  turn  1989-90,  responses  (1989-90).  society,  tend  work...[whereas]  of  Stroebe  i n which  emotions, .... [and] their  reporting  expected,  times  of  about  i n which  to  stress"  the each  selfgender  e x p r e s s e s g r i e f r e a c t i o n s and r e c e i v e s s o c i a l support f o r the same. In Lister of  his  review  (1991) a l s o  grief  of  appears  reactions.  experienced  the  He  by males may  t o agree  asserts not be  i n t e n s e l y experienced. to  discuss  death  differences (1984-85) death,  and  Sex related  i n reported found  including  experience  more  that the  literature  that  difficulty  in  In  towards  their  to  grieving  differential  a l t h o u g h the  norms may  appear  of  this  to  be  own,  Da  more whereas  discussing  the  assessment  death.  death  reporting grief  i t i s nonetheless  also influence their  males,  i n t e n s i t y of  o v e r t l y expressed,  attitudes  event  with  issues.  females  pertaining  Silva  open  to  males and  tendency  of  gender  and  Schork  discussing appeared  to  death-related  issues. Stroebe other  and  Stroebe  (cited  i n Rapheal,  f a c t o r s , the sex r o l e norms as w e l l  1987)  assert  as the l i m i t e d  that  among  availability  14  of  the  buffering  greater mental  risks and  effects  social  i n bereavement  physical  experienced  of  support  f o r males than  illness,  depression,  t o a g r e a t e r degree by  for  men,  females.  contribute They s t a t e  m o r t a l i t y and  widowed males  that  suicide  compared  to  are  married  men,  versus widowed females  compared t o m a r r i e d women.  Given t h i s  the  preceding  regarding  be  dictated  assertions  sex-norms  may  w e l l be  the  way  f o r the  experienced  i n which  subsequent  each gender may  gender  then  be  appear  to  o v e r t e x p r e s s i o n of g r i e f  d i f f e r e n t l y by  each  support,  what  the  grief  perception  qualitatively  and  culturally  I f norms  r e a c t i o n s and experience  different.  and  reactions, grief  each gender.  expresses  to  receives  of  In essence,  dictate  grief  for  g r i e f may  be  a gendered e x p e r i e n c e .  area  The  s t a t e of c u r r e n t r e s e a r c h .  The  effect  of  contention  bereavement, expanding clarify  and  in  Raphael  body  t h e o r i e s and writers  of gender on  of  concepts that  bereavement has  and  experience  literature. Middleton  literature,  provide  contend  the  the  (1987)  data  coherent  yet t o e v o l v e .  reviewing state  research  related  i n the f i e l d . a  In  current  systematic  of bereavement i s but  that has  to  the  field  failed  aspects  empirically  They a l s o suggest  of  despite  of  supported  the  yet  to  accepted  Among s e v e r a l o b s e r v a t i o n s ,  and  one  these  model  of  t h a t the v a l i d i t y  of  bereavement s t a g e s , as w e l l as the essence  of bereavement r e a c t i o n s i n  the  spouse,  various  c a t e g o r i e s of mourners  addressed. (1987)  Of  indicate  phenomenological representative (p.  s e v e r a l remedial the  need  studies of  the  for  (e.g.,  suggestions, an  which,  reality  of  the  Raphael  increased in  parent)  focus  effect,  experience  need  and on  be  Middleton systematic  "would of  to  be  bereaved  more people"  9)• The  Rodgers  call  f o r phenomenological  (1991) i n t h e i r  review  of  r e s e a r c h i s r e i t e r a t e d by Cowles literature  concerning  grief  and  within  15  the d i s c i p l i n e s lack to  of nursing  of a s p e c i f i c  disagreement  conceptualization  regarding  the bereaved.  Cowles  for  research  a  additional primary  and m e d i c i n e .  source  of g r i e f  appropriate  and Rodgers on g r i e f  of  These  i n general  interventions  that  utilizes  data....Such  bereavement issues  phenomenological  literature.  raised  Rodgers  The f i n d i n g s  (1991)  reviews.  f i n d i n g s i n a sample  following  o f phenomenological  is  begun  "a need  essential  to  to populate the  to c l a r i f y  and M i d d l e t o n  The  i n treatment o f  125).  have  appear  leads  i n - d e p t h i n t e r v i e w s as  research  studies  i n t h e Raphael  often  (1991) conclude t h e r e e x i s t s  u n d e r s t a n d i n g g r i e f as i t i s e x p e r i e n c e d " (p. Recently,  authors note t h a t t h e  (1987)  section  some o f those  and Cowles  will  and  discuss the  studies.  Phenomenological Examinations o f G r i e f The and  phenomenological  experienced.  grief,  Carter  adults,  In an attempt  were  themes,  grief  to tap into  as i t i s p e r c e i v e d  the l i v e d  experience of  (1989) conducted open-ended i n t e r v i e w s w i t h 30 bereaved  Nine themes a s s o c i a t e d w i t h bereavement further  delineated  and a c o n t e x t u a l  into  The  five  Stopped,  comprehend life's  of  characterized sadness,  themes  or  an  the r e a l i t y  daily  metaphors  core  guilt,  injury  intensely  anger  common  theme is  painful  to  reported  sadness,  reportedly  experienced  by  three  meta-  the q u a l i t y  feel  include  the pain  and  and r e - e n t e r  the usual  flow o f  frequently  described  through  that  of  emotions  and s o r r o w f u l w i s h i n g .  unanimously  themes,  identified.  e x p e r i e n c e s which  ability  of the l o s s ,  physical  were  was found t o a f f e c t  interrupted  The  core  o f deceased  bereavement.  describe  events.  by  five  theme which  and meaning o f each i n d i v i d u a l ' s  Being  examines  28 o f whom were k i n and two o f whom were f r i e n d s  individuals. These  approach  o t h e r emotions  a l l participants.  Hurting, such  which  is  as  unrelenting  Though each  participant  such A  as anger  were n o t  third  theme i s  16  described the  as M i s s i n g ,  magnitude  of  and  the  i s characterized  loss.  theme  preservation  of  Holding,  i s typified  by  which  particularly  and  relationship pleasant. is  aspects  The  were  The f i n a l  characterized  representing  core  such  by  as  deceased  both  awareness o f  meaning  by  is  focusing  theme i s d e s c r i b e d  by a search  acute  characterized  the  acts  an  on  laden  selective  described facets and  as  of the  generally  as t h a t o f Seeking, which  f o r comfort,  and f o r meaning  i n the  loss. Carter  (198 9)  illuminated  also  describes  i n the i n t e r v i e w s .  These themes  wherein  the e x p e r i e n c e  softens  i n i n t e n s i t y , although  potentially  be  the meta-themes  o f bereavement  triggered  by  acute  include  itself  bereavement  that  changes  attacks  some event  about  of  i n quality  of p a i n f u l  even years  grief  after  participants'  plans, The  lives  and s e l f - e s t e e m second  participants prescribed appeared  involves  perception  to contradict  that  of  there  the way The  and  death  five  core  themes.  perspectives  t o have  final  describes  socially  and  expectations,  meta-theme  career  increased). the  personally  however,  i n which the p a r t i c i p a n t was  often  actually  of I n e x p r e s s i b i l i t y  inadequacy i n f i n d i n g the words t o  theme o f p e r s o n a l  of the deceased  to  Carter the  (1989) on  held  history, by  or the meaning  the bereaved,  o f the  underlies a l l  (1989) emphasizes t h a t u n d e r s t a n d i n g who  survivor  e x p e r i e n c e o f the bereavement Carter  a  aspects of  behaviours,  Expectations,  exists  could  sense of t h e i r bereavement.  contextual  was  reported  The p e r c e i v e d  grief.  life  deceased  often  the p a r t i c i p a n t s p e r c e i v e d  convey the f e l t The  relationships,  that  to g r i e v e .  the  as  (which was  meta-theme,  way  experiencing  such  and  the death.  The e x p e r i e n c e o f bereavement a l s o induced changes i n o t h e r the  Change,  essential  for  understanding  the  itself.  compared  bereavement  is  the  these  embodied  themes  with  i n the works  the of  theoretical  Freud,  Kubler-  17  Ross,  and  various  features  of  the  participants of  grief  are  participants  the  apparent  Carter her  waves of  individual of the  not  in  process  intense  meaning  expectations  included  the  stages  of  often  are  of  grief  field  have  r e l a t e d to how  f e a t u r e s may  compared which  in  appear to be  the  changing  by  the grief,  death;  the  the  existence  factor i n influencing and  be  one  social  and  pursued, which  should  addressed by study,  experience  the  theories  with  several  features  are  touched upon by  intensity  a  In  loss.  image  not be Carter's  f o r i n t e n s e emotional relation  deceased,  holding  of  the  features  in  the  other  of bereavement. For example, Zysook, Devaul and  described  the  after  g r i e v i n g should that  by  the  changes  bereavement;  expectation  potential  of  of  several  elucidated  aspects  a critical  features  Among  qualitative  or p r e s e r v i n g  that  described  uniquely  t r i g g e r e d years  h i s t o r y as  and  as  theories.  are the  pain  states  grief.  they  aspects  are  burdensome  A l t h o u g h these which  i n those  of h o l d i n g ,  personal  the  study  She  experience  states  deceased; p e r s o n a l  individual  writers.  bereavement  which  including  existential  process of  the  to  the  (1944)  defined  deceased.  the  And  of  behavior  finally,  as  personal  a  significant  some  and  of  years  the  and  the after  existence  aspects  Weiss  in  (1982)  noted  of  the  with  the  (cited  in  preoccupation  Parkes  have r e f e r r e d to the  Click  upto 10  aspects  described  Raphael & Nunn, 1988) h i s t o r y , as  grief,  r e a c t i o n s to occur  preservation  Lindemann  and  of  workers  q u a l i t y of r e l a t i o n s h i p , or  i n f l u e n c e determining  the  quality  of bereavement. Nevertheless, by  Raphael and  grief  appears  bereavement. experience  of  Carter's  Middleton to Her grief  (1989) f i n d i n g s support  (1987) t h a t no  comprehensively work that  brings diverge  to  one  from  a s s e r t i o n made  theoretical perspective  capture light  the  the  features  phenomenon of  characteristics  the  on of  lived  outlined  in  18  prevailing as  t h e o r i e s of g r i e f .  For i n s t a n c e , the meta-theme d e l i n e a t e d  E x p e c t a t i o n s d e s c r i b e s the burden s h o u l d e r e d by of  theoretical  "stages of g r i e v i n g " .  Here C a r t e r seems t o a l l u d e t o the  detrimental  effects  adjustment  system  does  on  of supports  guide  her  such  study,  rigidly  C a r t e r concludes  range  of unique  to b e t t e r support the bereaved  persons.  familial  relationship  potential  were  Given to  for  experience. sample,  the  socially-accepted  i f the  theoretical  that  responses  the  collapsed  the  their  can  prescription  were o u t l i n e d  thus  be  of  the  would  limited  f r i e n d s of  include a  in  their  representation  of the methodology t h e i r  and  combined  the  f a m i l y members, the p o t e n t i a l l y  unique  grief  f e a t u r e s o f the  regarding  within  t h a t by v i r t u e  common  non-  bereavement  fact  with  in  anticipated  question arises  differences  their  as  loss.  experience  deceased,  qualitative  Because  and  that  and/or  c o n v e r s e l y by u s i n g  themes as  through t h e i r  bereaved  (1989) i n c l u d e d i n the group o f p a r t i c i p a n t s two  deceased  the  to  adhere t o one  phenomenologically-generated  a broad  Carter  correspond  individual  of a d a p t a t i o n t o l o s s . a  not  whose  experience  the  grief  the bereaved  the  accounts  experiences  of  experience f o r  s u r v i v i n g f r i e n d s were most l i k e l y e l i m i n a t e d . A  final  note  relates  p a r t i c i p a n t s which ranged to be  too wide a time  t o the from  e l a p s e d time  t h r e e weeks t o 23  I t seems l i k e l y  bereaved  weeks  bereavement, no  longer  lengths  of  three  whereas  be  living  time  those the  for grief  1991), a time frame o f two (cited is  will  who  most  This  t h a t p a r t i c i p a n t s who  have  a  experienced  experience resolution  appears  of  limited loss  23  bereavement.  cannot  be  experience  years  earlier  Although  generalized  This  general  time  frame  of may  exact  (Worden, Freese  t o d e s c r i b e the d u r a t i o n i n which  intensely.  of  have been  t o t h r e e years has been suggested by  i n F l o e r c h i n g e r , 1991)  experienced  years.  f o r her  frame w i t h i n which t o capture the e x p e r i e n c e  g r i e f as i t i s l i v e d . for  o f bereavement  is  grief also  19  supported by the r e s e a r c h of Zisook, Devaul that  grief-related  peak  in intensity  feelings,  especially  w i t h i n one  many symptoms o f g r i e f  to  appear  two  and  those  years  Click  (1982) who  related  after  the  f o r some i n d i v i d u a l s  to  dysphoria,  death,  t o be  state  although  present  for  years. The  observations  (Personal  of  Communication,  time  frame.  She  most  intensely  October  suggests  over  the  reality  of  characterized all  the  by  an  that  first  E l g e r t d e s c r i b e s the f i r s t the  bereaved 14,  begins  t h r e e years  possible.  loss,  first  envision  Although  this  t h r e e y e a r s , i t may  by would  time  explored.  t o be  s i n c e the  within In  whereas  the  awareness  how  a  take  second  of the  The  process  which  order  w i t h i n the f i r s t  Pollard-  extent  is  of the  t h i r d year i s one  reconnection is  year  with  often loss  in  i n which the  life  g e n e r a l l y mediated  might within  s e v e r a l more years t o r e a l i z e  be the  the  full  again.  to  the  experience  describe  the  of  grief  experience  of  in  to a  Carter's  recent  adults related  interviews. categories experience  From of of  might grief  be as  best i t is  phenomena may  be  t h r e e to f i v e years o f bereavement.  relation  illuminated bereaved  this  experienced  death.  the o p t i m a l time w i t h i n which t o e x p l o r e t h i s  In  suggest  f i n d i n g s suggested by these s t u d i e s seem t o i n d i c a t e a g e n e r a l  frame  lived,  Pollard-Elgert  also  appears  e x t e n t o f the l o s s and t o f u l l y immerse i n l i f e The  L.  year as b e i n g consumed by the s t r u g g l e w i t h  expanding  to  1994)  bereavement  a s p e c t s o f the s u r v i v o r s l i f e .  survivor  clients  were  by  experience  interviews,  predominant loss  study,  dissertation  their  these  (1989)  integrated  Douglas  and  themes  The  themes  (1994).  o f bereavement  five  feelings.  similar  Twelve  i n open-ended  evolved  commonalities  bereavement  were  based of  i s defined  l o s s which: permeates through  the body and  s o u l of a bereaved  individual  on the  as  a  20  c a u s i n g profound emotional and p h y s i c a l p a i n . A l o s s o f d i r e c t i o n , purpose, and i d e n t i t y i s e x p e r i e n c e d , o f t e n accompanied by thoughts o f s u i c i d e . The bereaved are f a c e d w i t h i r r e v e r s i b l e changes i n themselves t h a t are i n some cases seen as positive. Loss o f a l o v e d one b r i n g s t o most a deeper sense o f s p i r i t u a l i t y and u n d e r s t a n d i n g of l i f e and death, and many bereaved i n d i v i d u a l s seek t o h e l p o t h e r s who are e x p e r i e n c i n g p a i n f o l l o w i n g the death o f a l o v e d one. The  bereavement  themes  coincide  with  (1989).  In a d d i t i o n ,  which  various  elucidated aspects  participants  the  themes  in  this  illustrated  the o c c u r r e n c e of s u i c i d a l sense  by  Douglas  thoughts  (1994).  These  each  Carter  experience  themes i n c l u d e  accompanying a sense  of s p i r i t u a l i t y ,  study  by  t h e r e are a s p e c t s o f the bereavement  are*! u n i q u e l y o u t l i n e d  w e l l as a deeper  of  by  o f anomie,  as  e x p e r i e n c e d a t some p o i n t  by most of the p a r t i c i p a n t s . A  third  study  demonstrate  the  illuminates experience conducts of  Brice  of  ability unique  grief.  mothers While  briefly  with  as  well  In  his  d e s c r i b e d here,  which as  the  15  mourning  universal  themes  phenomenological  the  death  of  an  describes  a  nothingness.  sense  of  by  paradox.  emptiness  Paradoxically, this  fullness,  or  a  bursting  "experiences her c h i l d  For  that  study,  with  mourning  her  if  with  the  child  will  end  mourning, yet i n o r d e r t o evade the torment she that  wishes  to  erase  e v e n t u a l l y the  the  child  grieving  from mother  her  to  tries  1991,  relationship  each  of l i f e  memory.  comes  to  adult  participant child's  as  a  each  sense mother  to r e t a i n  p. 26); she  maternal  her  Further,  must e x p e l i n o r d e r t o mourn p r o p e r l y " ( B r i c e ,  each  are d e l i n e a t e d ,  i s experienced  as a p a r t of her which she  the  (1991)  or  s t r u c t u r e of  example,  grief.  in  Brice  young  to  method  month, with  corresponds  emptiness  serves  present  infant,  g e n e r a l themes o f maternal  i s characterized  also  phenomenological  (1991) concludes t h a t the g e n e r a l t h e m a t i c  mourning  of  grief,  12 i n t e r v i e w s , s e p a r a t e d by i n t e r v a l s of one  three  child.  the  of  she  Brice accept  fears  completes  without her (1991) that  she  but  her  child, states will  21  never  fully  accept the death,  to m a i n t a i n by  "an  some c o n n e c t i o n t o her  ambiguity  with  c o n f l i c t i n g or non In (1991) and  states that  there  complexity  since  paradoxicaland of  which  child.  s e l f - d e c e p t i v e way  d e s c r i b i n g the  profiles  a c o m f o r t i n g r e s o l u t i o n which a l l o w s  the  the  investigator  could  hope  (1991)  here  relates  doing,  he  suggests  to  the the  to d e f i n e the essence  the  of  study  show  of  ability  are  the  grief  the  35). Brice  ambiguous  limited  by  those  no  single  35).  Brice  response.  In  phenomenological  of a phenomenon g i v e n the  non-  grief,  themselves...  of  p.  i s essentially  c h a r a c t e r i z e i t " (p.  complexity  potent  1991,  phenomenon  of any  fully  straightforward, (Brice,  mourning  which  mourning i s s t r u c t u r e d  no  to l i v e "  findings  phenomenon  is  of  "maternal  Her  her  so  method  e x i s t e n c e of m u l t i p l e  realities. In c o n s i d e r i n g the common and the  forefront  by  these  qualitative  method  interviews,  a  emphasizes experienced  is  wealth  both  the  (Brice,  meanings  generated  1991).  As  is  studies,  of  p.23),  the  presence  demonstrated  r e s e a r c h i t i s not i d e n t i c a l the  clarification  the  rich  variation  i n v e s t i g a t i o n seeks The expands the  research and  of  the the  course  obtained  invariant  well of  these  hallmarks  as  the  multiple  of  which  unique  in  components  w i t h i n that experience,  of  a  lived  which the  the  in-depth  of  lived  dilemnas  realities  studies,  of  to  inevitably  themes"  and  (Krefting,  phenomenological  r e p e t i t i o n which i s sought.  essential  I t i s rather  experience,  and  phenomenological  to d e f i n e . by  enriches  Brice the  s u b j e c t i v e experience  expansion,  by  is  and as  of In  information  "universal  f e a t u r e s of g r i e f brought  one  illustrated.  1991, by  unique  (1991),  body of  however, a review  bereavement r e a c t i o n s and  Carter  (1989)  of bereavement grief  as  and  Douglas  literature  i t is  lived.  by  (1994)  exploring  Despite  of the l i t e r a t u r e would i n d i c a t e t h a t  experiences  this the  i n v e s t i g a t e d have g e n e r a l l y been  22  those of f a m i l y members and the  literature  reactions  regarding  i n the  the deceased.  A  Disenfranchised  roles"  i n the  and  Doka on  which  parent  sibling  contrast,  of  of g r i e f  unrelated  f o r these  to  survivors  following section.  (1989)  observes  reactions  kin  (p.1). of  that  in socially Despite  loss  "most  of  concerning  the  recognized  some debate  precipitates  the  generally grief  of  activates  individuals surviving  the  has  and  sanctioned  i n the  literature  most  a protracted  grief  literature  intense  i s widespread agreement t h a t death of a c h i l d ,  the  in  bereavement  are  expanding body of l i t e r a t u r e  type  there  In  severity  to the  grief  reaction, or  and  a gap  Hidden G r i e f  o f bereaved  regarding  essence  composite r e p r e s e n t a t i o n  In r e f e r e n c e  concentrated  the  There appears t o be  c a t e g o r y of g r i e v i n g i n d i v i d u a l s who  w i l l be d e s c r i b e d  reactions,  related kin.  grieving death  grief spouse,  response.  of  a  close  f r i e n d i s acknowledged yet minimized, a tendency which i s r e f l e c t e d i n the statement by R.  S. Weiss  (1988):  The death of a spouse or a c h i l d tends to be f o l l o w e d by years of g r i e f ; the death of a f r i e n d or c o l l e a g u e . . . tends to be f o l l o w e d by d i s t r e s s and sadness but not by severe and persisting g r i e f . . . . T h e r e w i l l not, o r d i n a r i l y , be p a i n , p i n i n g , search, p r o t r a c t e d d i s t r e s s and o t h e r elements of g r i e f , (p. 37). Weiss p r o v i d e s  no e m p i r i c a l data however to support h i s a s s e r t i o n .  Although  Raphael  surviving close to  be  f r i e n d s , the  indirectly  minimized  experience.  In her  literature,  Raphael  grief  of  conjugal  (1983)  devotes  friends.  grief  and  working  patterns  of g r i e f  more  grief by  the  three  amount  and  and  of  in  text  published  lines  Raphael compares  suggests t h a t , mates,  tentative  her  treatment  response of t h i s p o p u l a t i o n  survey of over 400  close  friends,  is  of  mourning, but  works on  text  to  they are  to  likely  may  their  bereavement  to  partnerships  associates,  appears  discussing  friendship grief  "Less i n t i m a t e  business  devoted  have  t o be  of  the  that of  of  close  similar  attenuated"  23  (p.  227).  This  similarly  echoed  primarily  as  is a  (1991)  the  who  of  1989;  how  of  to  close  friends  is  grief,  but  friendship  loss i n general  the  s c h o l a r l y papers  occurrence  kinship.  Doka  Kauffman, 1989)  of  (1989)  experience  grief  grief and  which  is  which  precipitates  have  experienced  others  argue t h a t the  s u r v i v o r s i s l a r g e l y u n r e c o g n i z e d and often  grief  alludes  illustrating  growing body of  document  boundaries Pine,  of  angst.  There to  Worden  a means of  existential  begun  minimalization  (Deck  grief  recently  outside  &  the  Folta,  1989;  of these n o n - f a m i l i a l  unacknowledged.  disenfranchised,  These  or  survivors  without  social  legitimacy. Doka  (1989) d e f i n e s  experience  when  they  disenfranchised  incur  a  loss  grief  that  is  as  that  not  or  cannot  acknowledged, p u b l i c l y mourned, or s o c i a l l y  supported"  described  a  norms  as  that  (Doka,  phenomenon  prescribe  1989) ;  spouses  and  source  of  who,  norms  how  which  immediate  kin  the  grief  h i s or her  Kauffman  judgement  their of  own  (Deck  as  for the  &  lies  in  that  who  a  might  It i s  While  the  of  societal  should  1989) .  failure  be  done  bereaved the  of  for  primary  others  d i s e n f r a n c h i s e m e n t may  bereaved  individual  (Kauffman, 1989;  s u r v i v i n g non-kin may as  (p. 4).  of  i n non-kin, the  openly  definition  Folta,  "persons  be  consequence  whom g r i e v i n g  r i g h t to g r i e v e  grief  others  i l l e g i t i m a t e or The  and  wherein  own  (1989) e x p l a i n s  acknowledge  exists  reserve  response  intrapsychically,  recognize  which  disenfranchisement  legitimize occur  a  which  means  of  consider  also  does  Pine,  not  1989).  themselves f a i l  avoiding the  to  the  expressed  perceived grief  media.  friends  as  friends  are  as  inappropriate.  bond of f r i e n d s h i p i s f r e q u e n t l y e x t o l l e d i n l i t e r a t u r e and  popular  to  Yet,  compared  in to  frequently  spite  of  the  high  many  other  social  among  those  who  level  of  intimacy  relationships,  lack  a  socially  in  among  surviving sanctioned  24  right  and  r o l e to p a r t i c i p a t e i n the  (Deck & F o l t a , 1989). a  "hidden"  They are,  population.  acknowledged,  Sklar  where concern appears to Deck and angry  outbursts,  perceived  as  societal any  Folta  socially  display  of  Folta,  hours  a  p.  week  colleague's  and  and  and  a  close  to  Hartley  friend  this  grieving  granted state  while  is  kin  (1990)  generally  acknowledgement  to of  yet  side  by  In  for  generally (1989)  are  for  is  a  a  expected  to  work  the  i s grief,  but  such  public (Deck  "one  &  may  spend  for  forty  colleague  i t i s often  this  lacking  discouraged  same  as  generally  "society  states  with  such  family,  friends",  side  be  absence... t h e r e  process  grief is  reactions  sadness  friends.  S i m i l a r l y Doka  working  grief  prolonged  dysphoria  85).  years  to S k l a r and  that  that  normal  recognizable  1989,  twenty-five  the  i s not  emotion  of  granted  end.  (1989) a s s e r t  of  tolerance  loss  contends  impulsivity  part  according  Though  (1991-92)  g r i e v i n g process  way  in  that  disenfranchised"  (p. 32) . F a c t o r s which appear to 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 i n are  often  unavailable  recognized from  role  grieving  of  to  the  grieving  "bereaved",  openly  (Doka,  surviving 1989).  experience e f f e c t i v e l y precludes of  social  Hartley,  support  (Doka, 1989;  1990).  effectively  The  dictates  and  friend. friends  As  a  In are  t h e i r access to the Meagher,  1989;  predicament  of  is  by  dictated  the  inhibited  their  crucial  Rando,  private component  1992-93; S k l a r  diminished the  lacking  often  result,  general  social  unacknowledged  &  support grief  of  the s u r v i v i n g f r i e n d . A serious  consequence of t h i s p e r c e i v e d  the p o t e n t i a l f o r c o m p l i c a t e d  mourning  93)  as  describes  effectively access  to  in  this the  state mourning  support may  tend  a  process.  l a c k of  social  (Rando, 1992-93).  compromised Bereaved  towards d e n i a l  of  support i s  Rando  (1992-  to  engage  individuals  without  ability  aspects  or  implications  25  of  the  loss,  were s t i l l states  or may  continue  alive.  these  As  funeral r i t u a l  grief.  The  bereaved may  prolonged  in life  long  i f the  deceased  mourning,  mourning,  a f t e r the  Rando  and  have  death of  the  sharing  the  of  marginal  funeral  where  often  not  1989;  Sklar,  provides  f u n e r a l may loss.  r o l e i n the  cases  i s another important f a c t o r i n the  The  may  be  public  no  The  friend i s in a  symbolic  few  their  that  of  to  meaning  of  the  friend in f o r mutual a  a s u p p o r t i v e guest; except  in  eulogize  the  ritual  to the  anomie"  relationship  often  deceased,  no  they  (Deck &  role  In e f f e c t ,  (Deck & F o l t a ,  1989,  to p u b l i c l y  previously  are  Folta,  i d e n t i t y , no  deceased.  opportunity i s denied  the  which  surviving  however,  f r i e n d "has  of  within  opportunities  t h i s therapeutic  state  facilitation  plays  function with respect  a consequence, the  the  friend,  grieving  the  forum  For  of the  asked  and  As  as  i n planning  1991-92) .  grieving  one  grieving  funeral  friends  included  be  recognition,  83).  a  openly express t h e i r g r i e f .  particular,  the  as  t h e i r complicated  experience  reinvesting  indefinately  one. The  of  live  r e s u l t of  bereaved  continued d i f f i c u l t y loved  a  to  shared  p.  express  with  the  deceased. A major r e p e r c u s s i o n planning  or  attending  to a c c e p t i n g In  the  considering  inability  to  the  accept  ritual,  g r i e f reactions Deck limit places  the of  and  the  funeral  r e a l i t y of the  r e s o l u t i o n of g r i e f . funeral  of e x c l u s i o n  the  grieving the  r o l e of  risk  is  (1989)  grieving  employment  tasks of  is  outlined the  will  increased  loss  friends. grant  a  the  the  by  Worden  of  impediment  Deck & F o l t a ,  1989).  (1989),  the  p o t e n t i a l l y hinders  the  prolonged  a s p e c t s of or  the  complicated  Rando, 1992-93).  institutional  They i n d i c a t e few  benefits  potential  therapeutic  for  Meagher, 1989; explore  therapeutic  (Doka, 1989;  Without access to the  (Doka, 1989; Folta  ritual  loss  reality  from the  hours  for  that  policies  which  a l t h o u g h most  funeral  attendance,  26  personnel p o l i c i e s in  the event  critical kin  r a r e l y recognize  o f the death  and i n t e n s i v e  only,  and  "even  of a close  care  units  or s i b l i n g "  (Deck  friend.  often  the a i r l i n e s  g r i e v e r s - exchange o r r e f u n d parent  extended absenteeism as l e g i t i m a t e  limit  have  a  granted only  & Folta,  almost  close  no i n s t i t u t i o n a l i z e d  friends.  visitation  definition  1989, p. 82) .  apparent  (1993)  posits and  suggesting  expectations  several  about  factors  institutional  of l e g i t i m a t e  grievers.  He  i s that  the  and  traditional on  Additionally, legitimate  relationship which  that  and that  benefits  should  encountered  be  kinship 1  and  list  from bereavement property  "society  marriage  of factors  is  institutional  the (p.  support  value  284) .  afforded  to  was t o be spread of benefits  And i n c o n s i d e r i n g  may  be  considerable  the i n t e n s i t y o f the r e l a t i o n s h i p  i n contrast  t o the l e g a l  Sklar  suggesting  that  He observes t h a t  negation  implied i n  of  the extension  r i g h t s as a means o f p r e v e n t i n g  o f the deceased.  the  " e x c l u s i v i t y of  based"  resource  there  provides. by  e x p l a i n the  enlarging  some  cost-effective.  i n gauging  might  the t h r e a t  least  Further,  f a m i l y t o be unimpeded i n i t s c l a i m s The  at  extended,  consequent i n t e n s i t y o f g r i e f ,  Kamerman s  Hartley  106).  i t undermines  g r i e v e r s may be d i l u t e d i f t h i s  difficulties  child,  and  that,  to  the amount and i n t e n s i t y o f s o c i a l  to f r i e n d s would not be c o n s i d e r e d whom  which  states  relationship  amongst a wider body o f mourners.  to  acceptable  the bereavement o f  resistance  widening the domain o f g r i e v e r s  assumptions  of  S u r v i v o r - f r i e n d s might be a l l o w e d t o be unhappy f o r a  societal  definition  t o immediate  Sklar  s h o r t p e r i o d f o l l o w i n g a death, but t h a t i s a l l " (p. Kamerman  policies i n  f o r death o f spouse,  (1990) echo these words i n t h e i r o b s e r v a t i o n has  Hospital  to t h i s  o f the g r i e f  f r i e n d s does not appear t o be u n i v e r s a l .  this  (1991-92) friends their  simplicity augments  a r e excluded access  exclusion  t o the  allows the  property. experienced  Halberg  by s u r v i v i n g  (1986) d i s c u s s e s the  27  attempts  that  colleges  and  address  deaths  on  evident  in  literature  settings  the  (Balk,  contrast  u n i v e r s i t i e s are  campus.  1991;  then, t h e r e  These on  &  1993;  a greater  friends  Podell,  deficit  grief  deficit  of  surviving  empirical that who  i n the  studies  address  g r i e v i n g the  Several this  friends  of  gap  1990) .  the  reflected  this the  in  problem.  population  of  Deck  writers  & Folta,  in  1989;  studies  "of  situation,  there  extent  manifestation  and  facilitate  grief,  332).  research  and  Although  considerations, exploratory  is  the  studies  of  the  grief,  field  grief should  the  strategies  limited  in  the  school In  population.  exists  of  of  the  number  of  few  studies  surviving  friends  who  are  few.  be  done  seek  their  Sklar  (198 9)  variables  that  thanatology  1992-93;  to  Hartley,  each  documenting  to  the  complicate  two  or  grief"  address  as  the  that  almost  ameliorate  ability  some i n d i c a t i o n of  &  decry  contends In  that  f o l l o w i n g r e l a t e d study as w e l l provide  also  1989).  limited  adult  Rando,  that  in  to  a close, platonic friend.  the  disenfranchised  are  recognition  There  They would appear to agree w i t h Doka  extensive  (p.  institutional  l o s s through death of  prominent  (e.g..  and  is  exploring  specifically are  social  effort  in organizational  e f f o r t s to respond to the g r i e f of f r i e n d s i n the a d u l t This  an  efforts  adolescent  Perper,  appears to be  in  institutional  bereaved  Brent  making  these  small-scale  grieving  patterns  of bereaved f r i e n d s . Empirical  s t u d i e s of f r i e n d s h i p g r i e f .  Park and  Cohen  (1993) i n t e r v i e w e d  their  r e l i g i o u s and  close  friend.  A  were  used  measure  religious appraisals  to  non-religious  structured  orientation; and  outcomes such as  coping level  96  coping  interview  as  characteristics use  of  with  the  well  as  dysphoria.  in  recent  and  response As  a  about  death  of  a  five  questionnaires  the  participants'  including  religious  strategies of  undergraduate s t u d e n t s  non-religious to  r e s u l t of  the  causal  death;  several  and  complex  28  findings, belief  the r e s e a r c h e r s suggest t h a t  i n a divine  coping process. aspects  plan,  plays  Religiosity  o f the impact  important  as e x p r e s s e d by the  positive  d i d not, however, appear  o f the f r i e n d ' s  a  springing  from the l o s s o f another and the continuance o f l i f e  friend  prolonged friends  to  the  may  and Cohen  applying  purpose  individuals  Park  death,  period  make  of  time"  (p. 574).  o f the death,  the study  take  some  t o be d e a l t  Regardless appears  r e a c t i o n s i n f r i e n d s a r e i n t e n s e and appear  (1993)  refuge i n  "the n e g a t i v e  a r e n e v e r t h e l e s s p r e s e n t and need  i n the  to mitigate a l l  that  larger  religious  death.  role  conclude  the  while  an  religiosity  emotions without  w i t h over a  o f the meaning  to indicate  that  grief  t o remain i n t e n s e f o r some  p e r i o d o f time. While Park and Cohen  (1993) i n d e e d add another p i e c e t o the p u z z l e  of  the e x p e r i e n c e o f s u r v i v i n g  of  the methodology t o the r o l e  gleaned and or  from  this  expressed  research  their  grief,  friends,  of r e l i g i o n  r e g a r d i n g how both  these  Little  mourners  can be  experienced  and e x t r a p e r s o n a l l y ,  how g r i e f was e x p e r i e n c e d and expressed f o r those s u r v i v i n g r e p o r t e d t o be n o n r e l i g i o u s .  do  not  explain  participants  state  their  certain  o f sampling  responses  rationale  that  group.  this  for  Park  the  sole  pertaining  responses  these  and Cohen  (1993)  observation  friends.  researchers f a i l  to t h e i r  It i s difficult  o f these bereaved  friends  of  Although  c a t e g o r y o f mourner was not chosen  convenience,  any assumptions  participant  Furthermore,  who were i n the c a t e g o r y o f bereaved  i s almost  the b a s i s  are  i n coping.  intrapsychically  who  it  the focus i s l i m i t e d by v i r t u e  friends  specific  to assess  are unique  common t o a l l s u r v i v o r s ,  to c l e a r l y  choice  whether  of  spouse  this  the coping  o r r a t h e r whether  including  on  and k i n .  they The  f o l l o w i n g e x p l o r a t o r y s t u d i e s p a r t i a l l y address these q u e s t i o n s . Sklar studies  and H a r t l e y  they  conducted  (1990) in  an  describe effort  two to  small-scale explore  unpublished  aspects  o f the  29  bereavement  of  of  cannot be  the  data  reports,  close  their  exploratory conducted  a project who  previous  five  eighteen  and  ranging  from  behavioral experiences  latter  the  their  The  events  cognitive  following  death  In  Sklar  Hartley  and  interviews a  close  responses.  of  protocol  encompassing to  and  The  the the  the  the  and  thirteen  bereavement  adult  as  loss  of of  by the  ages  of  questions affective,  their  friend;  others  to  the  findings  from  i n v o l v i n g a mutual  surviving  friends.  participants  i t related  (1990)  essays  the  funeral;  reactions  for  first  friend within  authors combined the  authors  these  their  involved  r e s u l t s of a second p r o j e c t , by  validity  interest.  of  interview  death;  included  experience  of  in-depth  responses  the  organized  project  the  and  u n p u b l i s h e d n a t u r e of  1985-86,  involved  forty-five.  group  are  reliability  P a r t i c i p a n t s were s t u d e n t s between  t h i s p r o j e c t w i t h the support  in  survived  the  to the  findings  which  years.  participant's grief  due  undertaken  had  and  Although  verified  preliminary  study,  participants  friends.  to  who  their  This  discussed position  of  surviving friend. The  authors  group meetings, closely  parallel  & Hartley,  1990,  state  that  from these  interviews,  and  well-known p.  have e x p e r i e n c e d  108).  several  loss  that in  themselves;  dysphoric  deceased over  f r i e n d which  things  especially emotional  daily  left the  constituents  for  emerged i n  range  of  broad  familial  anger and  associated  months with  bereavement"  with  of  a the  that (Sklar  familial  affected  their  deceased  tendency death,  their for to  grief, sense  and  the  to  a profound  hallucinations  resulted i n questioning and  themes  the  the p a r t i c i p a n t s were found  several  sensations,  unsaid;  "there  to cope, accompanied by  matters;  anniversary  reactions.  a  for  Specifically,  lingered  performance  essays  findings  i n c l u d i n g a decreased a b i l i t y of  studies,  own  and  with  involving sanity;  the guilt  anniversary  dates,  precipitate  intense  30  Sklar reported  and  many  grieving rarely that  Hartley of  the  family  same  members,  a t t r i b u t e d to surviving  legitimacy  of  surviving  could  own  it  experiences  friends.  The  did  not  and  effect,  findings  had  a  also  In t h e i r c o n c l u d i n g  are  indicated  recognize  of  grief  that  the  amongst  "friends  mourned  hidden  with  experiences  prevalence  each  are  and  realized  participants  associated  themselves  the  none  although  seems,  (p. 110).  and  although  emotions  grief,  mourn,  that  same  often  In  Survivor-friends, themselves"  these  friends  their  assert  emotions  surviving  friends.  'category'  (1990)  as  a  independently.  population  even  to  remarks, the authors s t a t e ,  we c o u l d o n l y f i n d one p a r t i c i p a n t i n our r e s e a r c h who f e l t he had been acknowledged by o t h e r s as t r u l y g r i e v i n g to the same degree t h a t a f a m i l y member might. By c o n t r a s t , o t h e r p a r t i c i p a n t s who c o n s c i o u s l y attempted to g r i e v e as might be expected by a f a m i l y member... d i s c o v e r e d they were not " p e r m i t t e d " to do so (p. 110). Sklar  and  assertions experience members.  Hartley's of  (1990)  exploratory  (e.g.,  Doka,  others  features  of  Further,  grief  this  studies  1989)  that  illustrate surviving  commonly  attributed  i s often  disenfranchised  grief  to  Based need  on  their  exploratory  f o r more s y s t e m a t i c  findings,  research  to  the  authors  examine  friends  bereaved  r a r e l y acknowledged to have the p o t e n t i a l i n t e n s i t y of  i n that familial  suggest  i n depth  the  the  the  family i t is grief. urgent  experience  of g r i e f f o r s u r v i v i n g f r i e n d s . The (1992-93)  urgent and  in  their  this  situation i s  repeated  (1993) .  They  suggest  the  i s increasing  society.  maintains,  mourning,  Although  grief  address  d e r i t u a l i z a t i o n and  contemporary  creates,  to  Kamerman  disenfranchised urbanization,  need  the  societal  or  more  (1993)  r e s u l t of  of  individuals grief  in  to  of the  are the  be  Rando  incidence  such p r o c e s s e s  concludes,  individuals  those  recognition  a  reorganization  Rando  permits  as  that  by  "the  nuclear more  risk"  surviving  (p.  as  family society  disenfranchised at  of  in  54).  friend  may  31  prove to be He  states  a slow p r o c e s s , that  in  those people who  a  Kamerman  society  work w i t h  so  disenfranchised  try  to b r i n g about those changes" review  regarding  of  the  populations  of  of  bereaved, these  as  they  experience  of  empirically "black  themselves  verified.  box".  If  283).  the  indicate  however,  lived  experience  grief  of  if  review  burgeoning  has  field  findings,  illustrated  friends  have  f r i e n d remains  of  theoretical  bereavement assertions  reviewed to h i g h l i g h t t h e i r of  this  phenomenon.  empirically  model  s u g g e s t i o n s f o r remediation, in  the  literature  limited  be  representation  appears of  this  the  evolution  of  non-kin,  requires  further  bereaved  literature.  examination  is  the  A  individual  bestows  perceived  and  hence t h e r e  focus  systematic  lived;  on  the  gap and  second  phenomenological  experience  studies  indeed  a  of  the  empirical have  been  coherent  that  more  and  Among many several  appears  and  subjective  appears to be  is  defined.  a  to  gaps  be  the  specifically  r e l a t e d area  experience  There e x i s t s l i m i t e d e m p i r i c a l data r e g a r d i n g  bereaved  prototypical  evolve.  requires  such  been  conceptualizations  that to  the  yet  grief  current  yet  One  f r i e n d s , i n the  on  has  as  grief  of  however  grief  regarding  Selected  models  addressed.  bereaved  itself.  and  empirical  cross-section  literature.  c o n t r i b u t i o n to  It  supported  selective  the  i n surviving  not  unacknowledged  a  any  Assertions  to  various  Despite  grief  r e a l i t y f o r c e r t a i n mourners, t h e i r r e a l i t y needs to be This  for  agreement  among  friends.  little  it.  surviving  advocates  widening  e x p e r i e n c e of  perceive  expertise,  ones i n a good p o s i t i o n  surviving  surviving  The  i n e f f e c t are  (p.  would  professional  disenfranchised  the  among  who only  assertions  grief  on  the  including  evidence e x i s t s d e s c r i b i n g friends  "are  literature  reality  of  prevalence  griever,  the  reliant  grievers,  the  A  (1993) i s n o n e t h e l e s s o p t i m i s t i c .  of  that grief  the meaning grief  as  a need f o r an i n order  of  of  to  it  the is  increased  clarify  the  32  essential  elements  of  this  phenomenon  as  i t i s experienced  by the  bereaved. Through address  the  surviving  a  phenomenological  essence  of  friends.  grief  It will  approach, as  this  i t i s lived  attempt  t o make  bestowed on the e x p e r i e n c e o f g r i e f by s u r v i v i n g essential  elements  population this terms  of  can be  o f the l i v e d the  as  i t w i l l begin  experience  circle  of  A  t o address  of g r i e f  legitimately  and  seeks  to  experienced  by  explicit  the meanings  friends  such t h a t t h e  i t i s experienced  c l a r i f i e d and d e s c r i b e d .  research i s that  essence,  the phenomenon  research  major  by  implication  this of  the c o n c e p t u a l gap i n  f o r surviving bereaved  friends.  as  In  implied  by  r e p r e s e n t a t i o n i n t h e l i t e r a t u r e may be e n l a r g e d t o i n c l u d e these nonfamilial  bereaved.  experience research right  Furthermore,  their  grief  as  of t h i s  nature  may  and r o l e t o g r i e v e .  i f  partially begin  surviving or  wholly  to re-establish  friends  indeed  disenfranchised, their  legitimate  33  CHAPTER I I I Methodology Foundations o f Method C o l a i z z i s t a t e s the phenomenological approach attempts t o d e s c r i b e and  clarify  critical  integral  "first  components  step" i n research.  the  phenomenological  approach  and  "how"  i s , rather  something  essence  of  question  o f why  what  Given t h a t lived the  something such and  as  Similarly, one  than  is, is  phenomenon  is,  phenomenon,  giving  description"  (p. 3) .  To Karlsson  approach  Reeves  further  Karlsson  aims  "why"  it is.  such  will  asserts  this  approach  be  at d e s c r i b i n g He  p.  "respects  meditative  clarify  the  aim  attempt the  exploration  of  differentiates  as i t i s  problem.  to  study what  a  the  of  a  thoughtful  the phenomenological  between  14) .  complexity and  the  clarified,  t o address t h i s  i n an  "the  to  1993,  has not yet been  that  "what"  asserts, prior  (Karlsson,  used  i s the  (1993) d e f i n e s  epistemologically  friends  (1989)  it  (1993)  as  a s p e c t s o f the e x p e r i e n c e of g r i e f  and e x p e r i e n c e d by bereaved  Accordingly,  and  which  such i s the case"  the e s s e n t i a l  phenomenological  the  o f a phenomenon,  approach,  phenomenal  and  phenomenological l e v e l s o f o b s e r v a t i o n , both of which a r e e s s e n t i a l t o the  process of d e f i n i n g  phenomenal subject's level  traces in  (Karlsson,  out the  1993,  for their  of  i n the  meaning  with  p.  facts.  straightforward  structure,  14).  The  detail The  these  approach  aspects of  phenomena,  experience,  which  phenomenological  the  the  the  explicit  implied  essential  encompasses  experience  entailed  not  level  the  "whereas  or  the  a phenomenon. recounting a  i . e . , the  logos  researcher  i s interested  but  rather  essence  of  of  the  phenomenological  essential of  The  the  constituents, phenomenon" i n the  facts  f o r the meanings which the  phenomenon  facts  are  imbued.  seeks  to  illuminate  lies  in  Fundamentally, the  meaning  are the the the  34  experiencing and  individual  (1993)  to e x p l a i n the  the  term  essence  the  or  that  way.  In f a c t  experience  find  study"  the  expression  as  i t is  from  out  the  of  greek  perceived  the  essence or the  1993,  the  never  grasped  making e x p l i c i t  on  In  the  of  deeper understanding Trustworthiness Since strategies  level"  structure  the  means eidetic  contrary.  It  natural 1993,  p.  experience,  which  As  not any  i n the  be  the  clarified  the  and  individual  a consequence of in  of  in  (Karlsson,  imbedded  is  which  modified  i n the  by  become d i s t i n c t .  meaning  be  (implicitly)  themes  explains  r e d u c t i o n does  phenomenon can  of t h a t e x p e r i e n c e  this  experience,  a  achieved.  of the Proposed Research  criteria for  of  reliability  establishing rigor  (1991) suggests  that  every  its  trustworthiness  for  e s t a b l i s h i n g and  research w i l l  The  r e d u c t i o n i s q u i t e the  the  (p.  meaning-structure  phenomenon w i l l  a thematic  process,  the  45) .  given  He  implementing  the meanings s u f f u s e d  s t r u c t u r e s h i s or her world thematization  "by  p.  or meaning s t r u c t u r e , of the  described.  reduction"  "eidos"  hence  "the meaning of the  but  word  and  (Karlsson,  experience  "eidetic  i n the methodology.  e x p l i c a t i n g t h a t which was  attitude,  essence,  stems  wish to  imply  By  the  meaning-structure,  t h a t which we  aims at  employs  e s s e n t i a l process  "eidetic"  r e d u c t i o n we  50) .  on  lived. Karlsson  45)  bestows  be  and d e p e n d a b i l i t y  based  in  validity  other  evaluating  research  criteria.  the  are  qualitative  qualitative on  discussed  and  not  appropriate  research,  Krefting  r e p o r t must e s t a b l i s h Three  trustworthiness  here i n c l u d i n g c r e d i b i l i t y ,  such  strategies  of  qualitative  transferability  ( K r e f t i n g , 1991).  Credibility strategies. According  to  qualitative phenomenon as  Krefting research  (1991)  credibility  through  i t i s perceived  the and  can  accurate  lived  by  the  be  established  description participants.  of In  in the the  35  present  study  criteria is  will  be enhanced through t h e use o f s e v e r a l  as o u t l i n e d by K r e f t i n g (1991).  described  opportunity to  credibility  as member t o check  checking,  wherein  t h e transformed  experience.  misrepresentation  This and  from  criteria  interview  description accurately  represents  that  their  an  first  process  insures  o f those  p a r t i c i p a n t s are given  data  i n s u r e t h a t t h e w r i t e r ' s thematic  their  The f i r s t  minimizes  the  the m u l t i p l e  risk  realities  of  of the  p a r t i c i p a n t s are accurately described. Reflexivity Krefing  (1991)  researcher's process. prior that  t o data  health  care  insure  that  and  and  be  grief,  chapter.  credibility will  include  regarding  my  own  role  as a  clinician  influence will my  will  the  be  role  and  data  required as  be  to  researcher  itself. will  process  a l s o be enhanced through  and i t s f i n d i n g s w i t h  my  the experience  of g r i e f .  scheme  I  Such checks w i l l  have  used  frequent  research  ensure t h a t I have a c c u r a t e l y d e s c r i b e d  t h e coding  research  presuppositions  with  of the  o f g r i e v i n g , and t h e  reflection  not i n t e r f e r e  the  measures  others  potentially  constant  does  my  on  t o enhance  These  These  credibility.  assessment  biases  taken  Further, may  the  the experience  o f t h e bereaved.  role  Credibility  of  will  as  and d i s c u s s i o n w i t h  analysis:  this  to establish  and a n a l y s i s .  professional  the research  research  interests  concerning  i n this  employed criterion  measures  collection  and r o l e s  collection  of  this  of s e l f - r e f l e c t i o n  documented  be  perceptions,  Reflexive  identity  will  also  defines  presuppositions  and  will  checks o f t h e  supervisor.  the m u l t i p l e  This  perceptions  a l s o ensure t h e v a l i d i t y  to i d e n t i f y  common  experiential  themes. A (cited  potential  threat  i n Krefting,  based on s o c i a l  to c r e d i b i l i t y  1991) occurs  desirability.  when  according  to Kirk  participants'  To i n s u r e a g a i n s t  this,  and M i l l e r  responses a r e I will  refrain  36  from  asking  specific  experience. interview  The  by  questions  participant  non-verbal  spontaneously and  trustworthiness  verbal  is  of  of  the  the  of  throughout her  the  experience  finding  are" and  from  will  also  towards  as  the as  be  220).  context (see  participants in  that  providing to  assess  Descriptions  research  provided  as  f o r "others  i n chapter V  the  poses  criteria  allow  (p.  increasing  (1991)  such  data i n o r d e r to  quotes  grief  strategy Krefting  be p r o v i d e d i n t h i s c h a p t e r as w e l l  experience  describe  participant's  possible.  through  t h e i r backgrounds  direct  the  encouraged  cues to  study.  established  transferable  Numerous  be  another  the  is  dense d e s c r i p t i o n  participants,  will  of  strategies.  Transferability  how  and  aspects  i n as much d e t a i l as  Transferability  transferability  about  itself  will  Limitations).  regarding  chapter  of  IV  to  their further  enhance t r a n s f e r a b i l i t y . Dependability  strategies.  Dependability  i s also  trustworthiness. consistency  of  a  strategy  Strategies findings.  r e s e a r c h e r must d e s c r i b e  to  how  repeatable  criterion Data  1991, will  analysis)  d e t a i l the  be as  study  p.  be  or  the  how  present  analysis,  the  i n Appendices  D,  E,  After I will  months to recode t h a t data and  a l s o be  a segment of return  to  data  the  analysis.  information the  as  to  situation" dependability  Data g a t h e r i n g and  G  which  and will  experience.  enhanced by  t h i s data  compare the  F,  to  qualitative  and  study  (see  evaluating  relate  unique  i n t h i s chapter  of t h i s study w i l l  code-recode procedure. the  methods " p r o v i d e s  In  established as  of  e i d e t i c a n a l y s i s of each p a r t i c i p a n t s  Dependability  during  dependability  (1991) argues t h a t  might  221).  well  and  exact methods of data g a t h e r i n g  comprehensive d e s c r i p t i o n  (Krefting,  enhance  Krefting  This  the  for establishing  conducting  i s thematically after  results.  a period  a  coded of  2  37  Participants Participants the  fact  that  essentially  will  they  be r e f e r r e d  are i n f l u e n c i n g  generate  the data  have s u r v i v e d the death In  the i n t e r e s t  experience,  of  gendered  needs t o be taken interest likely 90)  attempting  to  study;  1989).  to  capture  will  into  be  (approximately  bereavement, account  o f homogeneity  co-researchers  will  Co-researchers  will  potential  of  adult  as  age,  suggested  when s e l e c t i n g  of experience,  given  chosen t o i n t e r v i e w female  that  friends  o f age) .  The  literature, In the  women may  (Stroebe  of from  co-researchers.  ( D a S i l v a & Schork,  surviving  years.  ranging  i n the  be more  & Stroebe,  and may be more open t o d i s c u s s i n g t h e i r e x p e r i e n c e related attitudes  five  homogeneity  19 t o 60 years  to volunteer f o r in-depth interviews  as w e l l as death  t o emphasize  o f a c l o s e f r i e n d w i t h i n the l a s t  adulthood  response  the  (Reeves,  the co-researchers  young t o middle  t o as c o - r e s e a r c h e r s  1989-  o f bereavement  1984-85), I have  about t h e i r e x p e r i e n c e o f  grief. Four c o - r e s e a r c h e r s w i l l be i n t e r v i e w e d . and  given  potentially assume the  the  substantial  will  be generated  that  this  structure,  number  quantity by each  and  of g r i e f  quality  protocol,  of p a r t i c i p a n t s  or essence,  In c o n s i d e r a t i o n o f time  will  of  data  which  i t i s reasonable  be  sufficient  to  to trace  as i t i s e x p e r i e n c e d by these co-  researchers . A p r e - s c r e e n i n g telephone researchers Appendix  f i t the  A) .  This  interview w i l l  description relationship  companionship,  wherein  participant's  most  affirmatively  t o the p r e - s c r e e n i n g  would  consider  eight friends,  the deceased  intimate  the deceased  of  i n s u r e t h a t p o t e n t i a l co-  "bereaved  will  be  was  friends.  defined  considered If  question  t o have been  close  the  as  a  (see  non-sexual  t o be one o f t h e respondent  determining  among  friend"  answers  whether  her c l o s e s t  she  seven  she w i l l be c o n s i d e r e d a c o - p a r t i c i p a n t i n the study.  or  38  Co-researchers year  after  most  will  the death,  intense.  not n o r m a l l y  when  This  research-based, Further, interview  may  help  to  supportive,  nature  t o a v o i d t h e misunderstanding  will  r e s e a r c h nature will  be a d v i s e d  during  o f t h e study. be  given  that  their  grief i s  avoid  the  potential  of  the  the  the p r e - s c r e e n i n g  References  to individuals  are c u r r e n t l y r e c e i v i n g  purpose  contingent Finally  of on  in  unresolved counselling address Data  research,  discussing  the or  the  event  for local upon  their  complicated  resources  they  the  grief,  may with  be  contact  o f the  grief counselling request  their  i f their  grieving.  will  included  their  interview I  available  potential  If  c o u n s e l l i n g , and a r e c o g n i z a n t o f  the same  that  interaction.  be p r o v i d e d ,  i n t e n t i o n was t o r e c e i v e c o u n s e l l i n g t o f a c i l i t a t e individuals  from the p r i m a r i l y  o f the purpose o f the  as one w i t h i n which c o u n s e l l i n g w i l l  participants  agencies  be expected  f e e l i n g s which may r e s u l t  versus  i n order  i t might  guideline  exacerbation of dysphoric  be i n t e r v i e w e d w i t h i n the f i r s t  present  study  counsellor.  catalyses  inform  i n the c i t y  i n the  or  uncovers  the p a r t i c i p a n t  which  might  of  hopefully  her bereavement needs.  Gathering  Data w i l l be gathered wherein the p a r t i c i p a n t s question 1993,  spontaneously  p. 94).  arranged  time.  approximately  upon  The f i r s t  t o " d e s c r i b e the phenomenon i n  and  interview w i l l one-half  as p o s s i b l e " ( K a r l s s o n ,  hours,  be audio-taped contingent  at a pre-  and w i l l upon  the  last co-  t h a t she i s s a t i s f i e d w i t h her d e s c r i p t i o n o f  Interviews w i l l  t o be  her own home.  be asked  and i n as much d e t a i l  researcher's i n d i c a t i o n s  agreed  will  the use o f u n s t r u c t u r e d i n t e r v i e w s ,  Each c o - r e s e a r c h e r w i l l be i n t e r v i e w e d twice,  one  the e x p e r i e n c e .  through  comfortable  take p l a c e i n an environment which i s f o r the c o - r e s e a r c h e r ,  perhaps  within  39  After signed.  the purpose o f the study  As c o - r e s e a r c h e r s may not be f a m i l i a r  unstructured this  i s e x p l a i n e d , the consent  type  interview,  of  indicates  an e x p l a n a t i o n  interview  readiness  to  will  be  I  the design  o f the purpose  offered.  commence,  with  will  When begin  form i s o f an  and format  of  the  co-researcher  the  interview  by  stating,  We have t a l k e d e a r l i e r about the purpose o f t h i s study b e i n g an attempt t o map or d e f i n e the p r o c e s s o f g r i e f e x p e r i e n c e d by f r i e n d s s u r v i v i n g the l o s s through death o f a c l o s e f r i e n d . You have mentioned the death o f your c l o s e f r i e n d and your e x p e r i e n c e of g r i e v i n g t h a t l o s s . I wonder i f you would share your s t o r y about your l o s s , b e g i n n i n g i f you l i k e w i t h the moment t h a t stands out the most f o r you. The  story  including  according  cognitions  t o the way  experiencing  it.  i n which  and  The be  experienced  the c o - r e s e a r c h e r  The c o - r e s e a r c h e r w i l l  i n t e r v i e w by v e r b a l and n o n - v e r b a l spontaneously  events  will  unfold  experienced,  and i s  be encouraged throughout  the  cues t o d e s c r i b e her e x p e r i e n c e as  and i n as much d e t a i l as p o s s i b l e (see Appendix B ) .  second  i n t e r v i e w w i l l take p l a c e i n the same s e t t i n g .  an o p p o r t u n i t y t o check w i t h  the c o - r e s e a r c h e r  It will  t o i n s u r e t h a t the  thematic d e s c r i p t i o n o f her s t o r y a c c u r a t e l y r e p r e s e n t s her e x p e r i e n c e (see Appendix  B) .  This  second  interview w i l l  require  approximately  one hour, o r l e s s , t o complete. Data a n a l y s i s Unless this  study  otherwise will  which proceeds analysis  of  be  indicated, adapted  from  that  of analysis  outlined  i n a series of f i v e steps. data  will  themes can be compared, co-researchers story Each completed drafted  the method  progress revised  (Reeves,  simultaneously, and r e f i n e d w i t h  I have  Karlsson  The  (1993),  collection  such  that  the a d d i t i o n  and  emerging o f each  1989).  interview w i l l  protocol until  by  employed i n  be t r a n s c r i b e d , and I w i l l  a clear  understanding  read the  of the content.  40  In  this  first  step  t e x t and r e f r a i n s it"  (Karlsson,  reflected  from imposing  1993, p.  upon  experience.  o f the a n a l y s i s ,  the " r e s e a r c h e r  any t h e o r e t i c a l  98).  Each  and understood  aspect  i s open  t o the  e x p l a n a t o r y model upon  o f the p r o t o c o l w i l l  i n the context  When I have a c l e a r u n d e r s t a n d i n g  o f the whole  be  o f the  o f the p r o t o c o l , I w i l l  move onto step two. In the second s t e p o f a n a l y s i s the p r o t o c o l w i l l smaller units, of  meaning  contextual  can be p e r c e i v e d whole,  discrimination researcher shift (p.  a shift  as a d i s t i n c t  o f the e x p e r i e n c e .  o f meaning  t o adopt  o f meaning  "a  units  Each  unit  segment i n the g e s t a l t , or  Karlsson  (1993) d e s c r i b e s  as a p r a c t i c a l  concentrated  [necessary  i n meaning.  a i d which  and d w e l l i n g  this  h e l p s the  attitude  on  each  f o r ] the p e n e t r a t i n g a n a l y s i s i n step  3"  97) . In  focused  step  three,  the a n a l y s i s proper  on the meaning  analysis of  each o f which s i g n i f i e s  be d i v i d e d i n t o  imbued  explicitly,  experience  will  each  i n her p r o t o c o l .  the p r o c e s s  contained  i n each  experience general  will  be  meaning.  particular  facts  In will  short,  or  implicitly  and  transformed  Keeping i n mind the c o n t e x t u a l whole,  the d i s t i n c t  be  analysis,  Each u n i t o f meaning i s here  abstracted  and i s  t o t r a c k the meaning  describes-, both  of dwelling or r e f l e c t i n g unit,  place,  Eidetic  be employed  subject  i n t o the r e s e a r c h e r ' s language. through  t o take  i n the f a c t s .  o f meaning-structure,  the l i v e d  begins  on the p o s s i b l e meanings  aspects  o f the  and  eventually  the  co-researcher's  transformed  into  "a  participant's  transformed  into  description  language  a of  o f meaning"  ( K a r l s s o n , 1993, p. 99). In t h i s  step o f the a n a l y s i s ,  t u r n out t h a t two d i f f e r e n t In  occasions  and/or  (1993) emphasizes  " i t may  f a c t s have the same p s y c h o l o g i c a l meaning.  a d d i t i o n , one and the same  different  Karlsson  fact  may  for different  have  different  people"  (p.  meanings 97).  on  Upon  41  completing  the  transformation  of  units  of  meaning  into  general  meanings, I w i l l proceed t o step four i n the a n a l y s i s . As of  described  the  transformed  structure', units  o f meaning define  Reeves  (1989),  in  meaning  may  units  be  omitted  or  I will  ask  This  that  final  constituents experience  into  general  definition  situated  a general  runs  (p. which  describes  the  transformed  structure,  illuminated  As  of  stated  (Karlsson,  from  "one  essential  protocol  to  i s the i n v a r i a n t  is  aspects  a l l protocols  1993, p. I l l ) . The d e f i n i t i o n w i l l  a  structure  final  note,  i s the model  Karlsson used  (1993)  of  a  essentially  a  of  the  in  the  (Reeves, 1989, p. 41).  indicates  when a l l the s i t u a t e d  that  the  general  structures  can be  He suggests  study  one  the  structure Such  than  s h o u l d be p r e s e r v e d  typological  structures  meanings a r e found i n v a r i o u s  structure  of  as a " t y p o l o g i c a l  are i n d i c a t e d protocols;  study"  e f f e c t i v e l y embody " a l l  one c o n f i g u r a t i o n .  more  lived  Meaning i s h e r e i n  m e a n i n g f u l l y condensed i n t o contains  (1993),  manifestations  structure  a s p e c t s o f the phenomenon's e s s e n t i a l meaning" As  o f my  participant's  by K a r l s s o n  o f a phenomenon  general the  each  e x p e r i e n c e o f g r i e f f o r a l l o f the c o - r e s e a r c h e r s . generalized  as suggested by  i s t o condense the common e i d e t i c  a l l diverse  The  t o more  experience.  structure.  through  93) .  rearranged  v e r i f y the v a l i d i t y  structure  o r "meaning-structure  which  phenomenon"  the  Here, the  the t r a n s f o r m e d meanings and thematic  step i n the a n a l y s i s from  'situated  (p. 106).  t o review  will  synthesizing  so-called  and  o r thematic  r e p r e s e n t the p a r t i c i p a n t ' s  'thread'  a  At t h i s point  second i n t e r v i e w  i n t e r p r e t a t i o n s by i n s u r i n g  The  "entails a  shifted  co-researchers  o f meaning and the s y n o p s i s ,  structure  into  the meaning s t r u c t u r e .  t h e i r story.  this  (1993), s t e p f o u r  p r e s e n t e d i n the form o f a s y n o p s i s . "  clearly  units  by K a r l s s o n  when  that  i fa  phenomenon,  each  structure" aspects  (p. 93) .  of  and " t o omit such  divergent  typological  42  constituents  i n o r d e r t o condense the data  into  one  general  would mean t h a t much p s y c h o l o g i c a l r e l e v a n c e would be 1993,  lost"  (Karlson,  p. 88) . A  pilot  insure  that  study w i l l the  via  the  synopsis  will  be  researcher. this  study  conducted  proposed  of  study proper,  grief  to  methodology  appears the  to  t o be  pilot  clarify  for  method.  illuminated  I f the  pilot  be  experience  accessed  the  structure  proves able  will  surviving  Meaning  capture  the  add  friends  units  and  experience  effective,  to  be  the methodology,  to  and  the  i n c l u d e d i n the  can  be  a  thematic  of  the  the  data  and  co-  data  from  collected  results  of  in the  study. Presuppositions As  stated  the d a t a  i s not  understanding one  by  cannot  between  Karlsson  free  arises  move"  the  heritage)  studied.  merely  a linguistic, He  and  descriptions  attitude  open as p o s s i b l e  of  the  to  being  aware  imposing  my  Additional  linguistic  attempting  to  researcher's  own  that  these  reality  understanding  her or h i s own  are  of  a  presuppositions  and d i s c u s s i o n w i t h o t h e r s , I am  pre-conceived on  presuppositions  data.  as  which  the  notions,  experiences  will  phenomenon o f  become  I  of  clearer  hope  the as  to  Throughout  the  process  of  the  aware o f  grief. avoid  In then  co-researchers. I  encounter  data, and as o t h e r s f a m i l i a r w i t h the methodology observe my of  be  t o the phenomenon  obtaining results  p r e s u p p o s i t i o n s r e g a r d i n g the of  and  balance  Reeves, 1989).  Through s e l f - r e f l e c t i o n o f my  the r e s e a r c h e r ' s  (cultural of  of  h o r i z o n beyond which  in relation  avoid  phenomenon, the r e s e a r c h e r must c l a r i f y  several  cultural  pre-understanding  Consequently,  ( K a r l s s o n , 1993;  "researcher's understanding  d e f i n e s r e s e a r c h as a d e l i c a t e  complimentary  presuppositionless being  from  (p. 89) .  a  the  from p r e s u p p o s i t i o n s . . . I n s t e a d ,  researcher's  and  (1993),  the  treatment  interviews,  data  43  analysis  and  reporting  presuppositions by  the  to  of  results, I will  insure  co-researchers.  they My  are  not  continually  reflect  influencing  presuppositions  are  the  on  these  meanings  listed  and  held  described  below. Degrees of d i s e n f r a n c h i s e m e n t amongst g r i e v i n g Disenfranchised varying of  degrees, the  g r i e f as  factors  the  surviving  relationship  and  bereavement, factors if  their  members,  of  grief  functions imbued  and  by  the  the  in  own  expectations  life  right  to  the  roles  is  a healthy be  a  influenced grief  private,  degree  i n the  death  about  in  the  of  the and  If  these  friends,  assumptions  response but  only  disenfranchised  to  life  grief  grieve.  by  Several  bereaved  and  to  I conceive  intensity.  and  perceived  grief  may  prevalence appears  of  to  individuals  a  Vancouver. surviving  grieve  their  friend.  to some i n t e n s i t y of g r i e f i n s u r v i v i n g  phenomenon.  support  survivors'  accompany,  and  which  in  family  experience  for  friends.  literature  Elgert,  may  grief, including  meanings  deceased,  including  then  The  the  the  that  exclusive  the  open g r i e f w i t h  surviving  several  the  expression  associate  which  a continuum of  i n t e n s i t y of  friend;  contribute  phenomenon  along  fulfilled  with  a  g r i e v i n g p r o c e s s of a s u r v i v i n g  the  deceased  deceased;  is  being experienced  influence  which the of  grief  friends  She  their  counselling  supported have  have  referred  from  to  the  perceived  would  have  loss.  As  by  grief  had the  allowed a  their an  stated  Living  lacked them  result,  t o a s s i s t them i n r e s o l v i n g  I  have  personal  interview  situations  they  as  conversations  discussed  recently  counsellor  friends which  be  who  I  grief  disenfranchised  of the  with  encounter  with  openly  they  sought  t h e i r turmoil  Pollard-  Society  in  c l i e n t s who  as  sanction  and  social  to  L.  Loss  several  the  had  with  Through  in  and the and  legitimately support  of  their grief.  44  One o f t h e i m p l i c a t i o n s the  interview  surviving painful  research  may  well  be  that  format i t s e l f might be one o f the few o p p o r t u n i t i e s f o r  friends  to discuss  l o s s may p r o v i d e  Scurfield,  o f the p r e s e n t  experience.  emotional  1985) as w e l l  meaning t o t h e i r  their  as a s s i s t  relief  Telling  to survivors  the s t o r y o f (Hocker,  them i n b r i n g i n g a g r e a t e r  1990;  depth o f  experience.  Definitions Bereavement. As d e f i n e d  by Rando  (1984),  i s the s t a t e  of having  endured a l o s s . Complicated mourning. T a k i n g i n t o c o n s i d e r a t i o n the amount o f time since  the death,  occurs  when  ability These  there  of  the  of that  relinquishing deceased.  process,  loss,  When  reinvestment  the  outlined  compromise,  include  accompanying  The bereaved  by  or  i n various  processes  loss.  Rando  mourning  avoidance pain,  may  in life  and  also  d i s t o r t i o n s occur  i s interrupted,  complicated  G r i e f . As d e f i n e d by Rando  (1992-93),  d i s t o r t i o n i n the  i n d i v i d u a l , or r e a d j u s t i n g  any o f these  thought t o be e x p e r i e n c i n g  as  t o engage  of  the deceased  grief  failure,  or d i s t o r t e d  implications  the  is a  o f the bereaved  denied  aspects  complicated  processes. or d e n i a l of  the  attempt to l i f e  to  of full  avoid  without  i n the g r i e v i n g  and the i n d i v i d u a l i s  grief.  (1984), i s the p r o c e s s o f i n t r a p s y c h i c ,  s o c i a l and somatic r e a c t i o n s t o l o s s . Mourning.  As  defined  by  Rando  (1984),  mourning  is a  state  c h a r a c t e r i z e d by responses t o l o s s which a r e guided o r d i r e c t e d by the i n d i v i d u a l ' s i n t e r n a l i z e d c u l t u r a l response t o g r i e f .  45  CHAPTER IV Results T h i s chapter i s d i v i d e d i n t o two s e c t i o n s . encompass the  loss  individual  elements  o f her c l o s e  structure,  friend.  or synopsis,  definitions  of  will  be  each  The f i r s t  co-researcher's  section  will  experience  For each  co-researcher  presented  first  the  situated  (see Appendix  o f elements o r themes; and Appendixes D through  of  C for  G f o r the  e i d e t i c a n a l y s i s of each p r o t o c o l ) . The second the  s e c t i o n o f the chapter c o n t a i n s an o v e r a l l s y n t h e s i s o f  co-researchers'  This  experience  generalized description  the e x p e r i e n c e  of g r i e f  i n the form  will  of a g e n e r a l  d e s c r i b e the e s s e n t i a l  structure. elements o f  common t o a l l c o - r e s e a r c h e r s i n the study (see  a l s o Appendix H). Situated Structures Anna's E x p e r i e n c e of Loss N e a r l y 3 years ago Anna s u f f e r e d the l o s s of her good f r i e n d Anna c h a r a c t e r i z e d her r e l a t i o n s h i p w i t h "N" as b e i n g of  k i n , and she noted  and  that  which  relationship shielded  she had  with  them  similarities  each  from  between her r e l a t i o n s h i p  experienced o f them was  aspects  of  similar  with  her f a t h e r .  to that with  which  might  o f f e n c e , and they i n t u r n d i d the same f o r h e r .  "N"  For Anna, the  c h a r a c t e r i z e d by p r o t e c t i o n .  reality  "N".  have  caused  She them  As such,  she wondered  i f N's d e l i b e r a t e e f f o r t  t o h i d e the t r u t h o f h i s i l l n e s s  from her was  an  her  attempt  impending  to  protect  from  the  pain  of  the  suspected  at  punishment f o r who resolve. on  the  of h i s  death.  For "N" the d i a g n o s i s o f AIDS seemed t o reduce Anna  reality  In s p i t e fact  that  times  that  he  believed  he was, a thought  he  his self-regard.  deserved  own  integrity  a  which she found v e r y d i f f i c u l t t o  o f the p a i n o f her l o s s e s however, her  t o d i e as  remained  intact  Anna  remarked  throughout  his  46  illness  and  after  i n t e n s i t y of her Though  she  Anna  required  that  imminent  death.  sense  loss  respond he  she  had  she  not  made  concessions  restrain She  her  impeded  i n order  not  want  implications.  c o n f r o n t him  his  death  been  to  to  f o r her  open and herself  d i m i n i s h e d by  when he  however  these  allowances  the  she had  other  friend  sharing with  the  i n how  he  death.  terminal  condition  was  led  close  "N"  him  and impending  reality  concessions  her  which  e x p r e s s i o n about  autonomy  his  denied  of  dying  genuine  from  respect h i s  discuss  typical  Thus even when h i s i l l n e s s  not  The  not  d e s c r i b e i t as  t o the r e a l i t y o f h i s i l l n e s s  did  her.  and  grief. would  relationships,  of  h i s death,  obvious  her  wished She  unresolved  made c o n f l i c t e d  i n f r i e n d s h i p t h i n g s s h o u l d not be hidden or  w i t h her  to  its  she  of h i s c o n d i t i o n .  to  own  sensed  and  t o her  his  did  After  feelings  conviction  for that  pretended.  Such c o n c e s s i o n s a l s o l e d i n p a r t t o a sense o f e x c l u s i o n f o r Anna in  N's  ordeal  intensified terminal  leaving  wishes  no  Her  sadness  that  despite  her  impeded i n d i s c u s s i n g  in  his  loss  was  of  his  knowledge  i t with him  until  his  away  a  physical  separation  constant  companions.  to  die  specific  later  at  expectations  from  "N".  Yet  when  h i s parents of  his  Before  home  friends  he  his  illness  in  another  regarding h i s  or needs d u r i n g h i s i l l n e s s and a f t e r h i s death.  Anna about  were  moved  death.  imminent.  experienced  he  and  awareness  she was  i l l they  advanced city,  her  death was  also  became  by  illness  illness,  impending Anna  of  his  s t r u g g l e d with loss  if  she  discuss  with  her  the  however  that  she  forcing  such d i s c u s s i o n  could  whether had  she  have  that  "N"  insisted  implications not  would  have  of  insisted  she b e l i e v e d  he needed i n a s u p p o r t i v e f r i e n d .  his  felt  disclose  illness. on  more  this  resolved  and She  openly  resolved  disclosure.  In  she would not have f i t w i t h what  47  Anna b e l i e v e d h e r response expected  t o N's l o s s was t y p i c a l o f what she had  to experience with g r i e f .  sadness  and meaninglessness  despite  many  indications  She d e s c r i b e d a sense  which  that  were  prolonged  her f r i e n d  o f anguish,  and i n t e n s e .  "N" was  about  And  t o d i e , she  d e s c r i b e d a c o n t i n u a l sense o f d i s b e l i e f i n o r d e n i a l o f t h i s end. She found t h a t her  anguish.  certain  objects or circumstances  Immediately  after  N's death  i n t e n s e she c o u l d not look a t p i c t u r e s offered  condolences  from  been.  Even  sadness  and l o n g i n g when  such  two years  people  as t u l i p s  those  and  events  longing,  Anna  t o h e l p her focus  hoped  distractions  pain  of her l o s s  she c o n t i n u e d  and h e l p  symbolic  that  to  herself  In o r d e r  to avoid  with  t r i g g e r her  distractions  on the t a s k  her t o f u n c t i o n  experience o f him,  seeking  "magically" a s s i s t  o r be  reminders  she f e a r e d would  her thoughts  would  was most  she and " N " had  close  he had l o v e d .  found  techniques such  knew how  she encountered  o r people  when h e r anguish  o f him i n h a p p i e r times,  h i s death  i n the S p r i n g which  thoughts,  anguish  after  who  seemed t o t r i g g e r  a t hand.  or She  h e r i n a v o i d i n g the h e r normal  l e v e l of  competence i n h e r work. One  year  ago Anna  f r i e n d who l i k e with  the l o s s  J's  experience  openly  to  impending friend  experienced  the l o s s  "N" a l s o d i e d o f AIDS. o f "N", Anna of i l l n e s s  each  other  death.  o f " J " , another  In c o n t r a s t t o h e r e x p e r i e n c e  described a process  through  about  She spent  the  " J " , and was witness  of being  t o h i s death. significance  a great  amount  to h i s gradual  Anna of  decline.  " J " e a r n e s t l y requested her f o r t h r i g h t n e s s  feelings  about  needed and d e s i r e d second of  guessing  confusion  and death.  by h e r d y i n g  i n that  not o n l y  friend  friendship". during  Anna  was  with  process  and  her dying  Throughout  this  i n expressing her  " J " , and s t a t e d  h i s dying  and " J " spoke  aware  This c l a r i t y  included i n  his illness  o f time  process,  h i s decline  close  o f what  was  " t h e r e was no  reduced  h e r sense  but a l s o  after his  48  death. Well before begun t o accept over  J's death Anna was r e s o l v e d t o h i s l o s s .  h i s impending  h i s decline,  death  as an a l t e r n a t i v e  and h i s discouragement  with  She had  t o h i s anguish  no l o n g e r b e i n g  who he  once was.  She b e l i e v e d t h a t " J " had a n t i c i p a t e d and was a t peace w i t h  his  death,  which made i t e a s i e r f o r o t h e r s i n c l u d i n g h e r s e l f t o accept  its  inevitability.  Though she was saddened by h i s absence, she was a t  peace w i t h h i s death. During including asked  his illness  those  regarding  made  h i s expectations  others'  conduct  during  explicit,  h i s funeral.  When  by J's p a r t n e r t o read h e r c h o i c e o f poems a t the f u n e r a l ,  was  unsure o f h e r a b i l i t y  way  t h a t would  despite the  " J " had  emulate h e r f r i e n d ' s  her f e a r  reading  t o read the poem c a l m l y and c o m p l e t e l y  of losing  courage.  She was a b l e  composure by reminding  t h a t " J " d i d not want h i s f u n e r a l  herself  Anna ina  t o do so throughout  t o be an o c c a s i o n f o r  d r e d g i n g out the t r a g e d y o f h i s death. During effects  the time  of i l l n e s s  i n which  " J " was d y i n g ,  on h i s i n t e g r i t y .  awareness o f o t h e r s ' d i s c o m f o r t w i t h impending death, feeling of  his self-regard  and e x p r e s s i n g  others' opinions.  became d i s c o u r a g e d diminished. burden.  wished t o l i v e Rather  than  She r e c a l l e d  aware  o f the  t h a t d e s p i t e J's  and d i s d a i n  f o r h i s d i s e a s e and  remained i n t a c t .  He remained t r u e t o  he was g e n u i n e l y  with  experiencing regardless  the way i n which the q u a l i t y t o look  J's l i f e  forward  dwindle  t o death  o f h i s l i f e had  and the end o f h i s  t o the p o i n t where he no l o n g e r  seemed t o d i m i n i s h Anna's d i s c o m f o r t w i t h  experiencing  the sadness  w i t h h i s death, Anna d e s c r i b e d f e e l i n g the  was  With the advancement o f h i s d i s e a s e however, he  He began  Witnessing  what  Anna  way " J " had attempted  that  an i n c r e d i b l e  f o r so l o n g  d e s p i t e the a d v e r s i t y o f h i s i l l n e s s .  she b e l i e v e d  t o adhere  sense  h i s death. others  felt  of p r i d e i n  t o a way  of being  49  In r e c a l l i n g  her l a s t  c h e r i s h e d o f " J " wherein The  During sense  death,  this that  before. wake  and  last  he was  sitting  up  i n bed  recognizing she  to r e c e i v i n g  was  important  loss  was  spread,  she  captain  of  she was  The i n her  comforted  to  of  see  the  died  during  loss.  intuitive I t was  her  to  night,  an  the  status  of l o s i n g  as  bereaved  both  "N"  and  response  close  was  an  "J"  In  of her  t o her  support  of her  attempt  t o a d j u s t t o the l o s s  group  of  by  of  During  ceremony wherein  others  e m o t i o n a l l y moved by chartered  who  intensity the  the  cried  as  loss  friends of  i n knowing t h a t s e v e r a l o t h e r s  the  him  l e d her  i n others' recognition  and  a  true.  recognition  had  an  content  the  they  his  him.  understood  being  boat  to  ever e x p e r i e n c e d w i t h  e x p r e s s i n g her  his loss, the  recalled  i n the f a c e of  adjust  would  she had  and  t o openly  important.  the  she  " J " had  and  as bereaved  Similarly  her  a dream of which  that  support.  response  reaction.  than  loss  especially  In her anguish  time  i n Anna's e x p e r i e n c e  entitled  and  similar  had  her  herself  felt  helped  l a t e r confirmed t o be  of  aspect  last  sense  impression  Recognition  such,  the  away she  the  which  she  eating a popsicle.  w i t h " J " b e f o r e he d i e d , Anna had  or d i s t i n c t  i m p r e s s i o n which was  important  one  would be  While  with  was  visit  this  more c e r t a i n  her  w i t h " J " , Anna d e s c r i b e d an image  image seemed t o r e s t o r e h i s c h a r a c t e r i s t i c v i t a l i t y  impending  a  visit  "N".  shared of  her  l e g i t i m a c y of J's  ashes  response while  were  of  the  witnessing  t h e i r p o i g n a n t ceremony d e s p i t e knowing n e i t h e r them nor " J " .  she  At  times  Anna  had  had  i n each  times  whether she  should their  have had illness,  s t r u g g l e d with friends'  had  the and  control  was  a  degree  illness  and  ability  to  occasionally  way  of  of  f i x , change  quelling  so. the  She  She  them.  She  or p r e d i c t  struggled with  t o do  control  death.  done enough t o support  s e l f - r e p r o a c h i n b e i n g unable with  the  her  or  influence  questioned  at  believed  she  the  course  culpability  of and  wondered i f t h i s s t r u g g l e  sense  of  vulnerability  that  50  arose  when  itself.  she  was  confronted with  She acknowledged  that  the  the l o s s  taught her t h a t death i s a r e a l i t y  inevitability of someone  t o which  of  close  mortality  t o her had  no one i s immune, and one  which can be n e i t h e r p r e d i c t e d nor c o n t r o l l e d . Anna  was  the l o s s e s the  generally  able to t o l e r a t e  of "N" and " J " .  bereaved  i n their  She was  response  c o u l d accept those d i f f e r e n c e s , also experienced t h i s towards  herself,  loss.  When  died,  d e s p i t e the f a c t would  that  a t t e n d , Anna  o t h e r female  aware of the d i f f e r e n c e s  t o the deaths, "it  responses t o  and s t a t e d  chose  i t was  remarked  o f the way not  to  neither  Anna  individuals  she responded  attend  assumed everyone that  she  wasn't a shared e x p e r i e n c e " .  i n terms  Anna  amongst  though  sense o f t o l e r a n c e i n o t h e r bereaved  especially  "N"  o t h e r s ' unique  t o N's  his funeral.  i n N's group  her absence  Yet  of f r i e n d s  nor t h a t  of h i s  f r i e n d s a t the ceremony was ever q u e s t i o n e d by any o f the  group members. In c o n t r a s t  t o such t o l e r a n c e , Anna a t times e x p e r i e n c e d a  of d i s s o n a n c e i n her l o s s e s . response others' N's  to  loss  response  death, Anna  months  d i d not  found  and s t a t e d  composed  competent in  and  reflecting  f i t with  her  t o the l o s s was d i f f i c u l t  and  herself  that  found these responses as  This discord  inconsistent  influential her  o c c u r r e d both when her own self-perception,  o n l y t o c r y i n those  w i t h a sense  Considering  person,  sense  of  and  f o r her t o condone.  as y e t she had not a c c e p t e d  realistic.  on  wanting  sense  she e x p e r i e n c e d powerlessness  first  few  a  She  she d e s c r i b e d normally  further  in  After  h i s death.  of s e l f  herself  when  being  very  dissonance unable  to  i n f l u e n c e the f a t e of e i t h e r of her f r i e n d s . At the  times  loss  affronting displayed  she e x p e r i e n c e d d i s c o r d  of her f r i e n d s when one  were  o t h e r s whose  dissonant with  of her f r i e n d s  them t o the group  with  such  took  that  her own.  pictures  those who  a t N's  responses She  found i t  funeral  were absent  to  and  from the  51  ceremony she  c o u l d witness  h i s experience.  experienced dissonance  w i t h o t h e r s who  when they were c o n f r o n t e d w i t h the J's death.  fact  In her attempt meaningful  that  were  important  i f they  in  the  symbolically  commemorative ceremony s h o u l d be.  to be  she  she was  had  felt  death  of " J " ,  i n denial  already  a sense  accepted  o f peace  process.  represented  The  She the  found  such  deceased,  her  or her e x p e c t a t i o n s of what a ritual  involving  the  scattering  took p l a c e i n the company o f s u p p o r t i v e o t h e r s and  a fitting  and  courage.  p e r s o n a l r e l a t i o n s h i p w i t h the deceased,  of J's ashes  the  t o cope w i t h her l o s s e s , Anna found t h a t p e r s o n a l l y  rituals  meaningful  after  insisted  In c o n t r a s t t o t h e i r anguish she  p r i d e i n her f r i e n d ' s  rites  And  ceremony t o r e p r e s e n t h i s l i f e  and  loss.  seemed  Conversely,  at a wake f o r "N"  which took p l a c e i n an atmosphere of t e n s i o n between  participants,  found  of  him  and  ritual  she  discuss  she was  something  i t discomfiting  him  in  happy  d i s t u r b e d by  her  t o be  times.  expected  In  conviction  t o view  attending  that  this  photos  this  latter  ceremony was  "N" would have wanted.  Though she had no unanswered q u e s t i o n s r e g a r d i n g J's death, found  herself  loss. had  She  illness.  light  s e a r c h i n g f o r a means o f making sense  found h i s l o s s  considered  would  not  him  the  so d i f f i c u l t least  to e x p l a i n  likely  to  be  especially  Anna  of  N's  i n p a r t because  she  struck  by  the  terminal  She hoped f o r someone t o p r o v i d e an e x p l a n a t i o n f o r her  quell  her  pain,  o f her b e l i e f  yet  that  realized  the  futility  she c o u l d not make sense  of  this  o f N's  that  desire  death  in  because  death i t s e l f d i d not make sense. Anna e x p e r i e n c e d her response "J"  as  uniquely  connected  in  his  individual. process  r e s o l v e d about  h i s death,  compared  response  this  of  In  t o the l o s s o f "N" terms  of  and  death,  dying  and d i d not  to  her  " J " , to she  and t o t h a t whom  believed  she she  f e e l anguish w i t h h i s l o s s .  reaction  after  the  death  of  "N",  of  felt was She in  52  whose death  she has y e t t o f i n d  t h a t "N" never with  acceptance  accepted h i s i l l n e s s  a continuing feeling  o r impending death,  of regret.  d i e d w e l l b e f o r e " J " , Anna suggested s o l e l y a f u n c t i o n o f time  she would  considering believed  never  that  which l e f t h e r  of the fact  t h a t f o r her,  o f h i s death,  again  t h e death  In l i g h t  She b e l i e v e d  of  she would  have "N"  never  and  certain  accept  by t h e f a c t  o f h i s company.  other  their  was not  She c o n t i n u e d  and was angered  the pleasure  t h a t "N"  acceptance  o r o f f a m i l i a r i t y w i t h death.  to be s t r u c k by t h e f i n a l i t y that  and peace.  loved  loss,  In  ones,  she  and r e s o l v e d  that  death was n o t something t h a t she would ever become accustomed t o . Natasha's E x p e r i e n c e o f Loss Natasha's  friend  was  exclusion.  After  the  friend  J . i n childhood,  Natasha  was  d e n i e d access t o a t t e n d i n g h e r f u n e r a l .  The s i g n i f i c a n c e  characterized illness  loss  first  predominantly  and death  was  not r e c o g n i z e d  Natasha  by  of her best  e f f e c t i v e l y excluded  close.  experience  or  of the loss  of a  a  aware  extenuating  she  Natasha  with  a  that  may have  pattern  her f e e l i n g s  surrounding  response  circumstances  suspected  J's death  developed  process  others,  c o n s i d e r e d " J " someone w i t h whom she f e l t  i n terms o f h e r p r e s e n t  following,  by  o f Natasha's and  she was  equal  and v e r y  from bereavement s t a t u s .  She b e l i e v e d t h e c i r c u m s t a n c e s  of  of  acknowledged  significant  status  sense  close  related  to loss.  which  may  her l i f e  unable  to loss.  from  f o r the bereavement  t o the extent  to f u l l y  In e f f e c t ,  were v e r y  Though she was  account  her e x c l u s i o n  impacted  of being  J's death  that  acknowledge and t h e e x c l u s i o n had  attenuated her a b i l i t y to f u l l y g r i e v e . Natasha intense  sense  palliative  described  an event  o f anguish  care  which  f o r her.  she b r i e f l y  some  While  years working  later  anguish,  an  as a c h a p l a i n i n  met a woman whose death  p r o f o u n d l y t h a t she e x p e r i e n c e d  triggered  affected  her so  c o n f u s i o n and d e p r e s s i o n w i t h  53  an  intensity  she had never  meaning o f h e r response I  was r e a l l y  trigger Since the  grieving  before  she s t a t e d f o r myself.  she had not shared  bewildering.  of  But I a l s o  symbolic  feelings  which  significant relieving  means  deeply  she had been  losses.  their  when  grief  no  and  that  and c l e a n s i n g e f f e c t F o r Natasha,  to  such  other  that  her  loss  death  this  was  woman,  initially  had a l l o w e d her experience  t o do w i t h  thereafter  triggers  she was t h e  with  completely  other  as though  I had e x p e r i e n c e d " .  p r e v i o u s l y unable  She s t a t e d  c o u l d have.  that  i f t h e woman's  to  think that  relationship  reaction  She wondered  through  deaths  a significant  Natasha's  In c o n s i d e r i n g t h e  " i n a l o t o f ways I f e l t  f o r a l o t o f accumulated  intensity  encountered.  the  h e r more  she understood t h e such  as movies  a l l o w t h e bereaved  t o channel  appropriate  triggers  format  exists  f o r them t o  otherwise l e g i t i m a t e l y do so. Her  sense  of e x c l u s i o n with  and  unexpected  him  f o r some time, but was unable  death,  death  J's death  o f J's b r o t h e r .  she was d e n i e d  access  r e s u r f a c e d with  Natasha  the recent  had planned  to contact  t o do so b e f o r e h i s death.  to information that  With h i s  she b e l i e v e d  would  have a s s i s t e d h e r i n r e s o l v i n g i s s u e s and r e c o v e r i n g memories from t h e part of her l i f e  she had shared w i t h " J " .  Natasha a g a i n d e s c r i b e d a sense o f e x c l u s i o n w i t h t h e death o f h e r friend  "L", who d i e d 1 year  ago.  She had been v e r y c l o s e  most o f h e r s c h o o l y e a r s , and they There  had been  times  i n their  remained  relationship  communication due t o d i s t a n c e and d i f f e r e n t thus  n o t aware  advanced.  of the recurrence  She e x p e r i e n c e d  friends u n t i l  a sense  when life  there  o f shock  upon  L's death.  were  phases.  o f L's cancer  to "L" f o r  until  gaps i n  Natasha was i t was  hearing  very  that her  f r i e n d was i l l w i t h r e c u r r e n t cancer, and had been so f o r 2-3 years by the  time  tragic  t h e news was d i s c l o s e d  circumstances  surrounding  to her.  In l e a r n i n g  L's i l l n e s s ,  she a l s o  further  of the  e x p e r i e n c e d an  54  overwhelming and simultaneous  sense sadness  and  anger.  "L" had been l i v i n g and h o s p i t a l i z e d i n another p r o v i n c e . Natasha's  final  incredibly  frustrating  she  was  so  close  accessible. another  visit  For  with that  to  by  death  Natasha,  world...and  "L"  had  before  her  the  time  she  that  she  was  i t was  as  death, actually no  i f her  succumbed t o death".  difficult  V  openly she  f o r Natasha t o t o l e r a t e .  acknowledge  experienced  continued Through  to  her  Natasha  the  approaching  great  frustration  deny  the  efforts  was  recognizing  reality  "L"  able  had  her  friend's  needs  and  massaging  was her  friendship, regardless would only  be  painful  and of her  death  with  physical  others,  before  dying.  contact  She with  symbolized for  sense her  Natasha  loss  of her need t o  i t s implications,  including  such  f o r so  "L",  who  this  denial,  responses.  long  i n order  and  "L"  In  to  stay  a  of  to  to  influence  L's  physical  through  Natasha  the who  the  bond  act  their  believed  that  consciousness  the  act  final  and  This  was  Natasha's  one  her  sense  of  of  friend  of  of  appreciate.  death  gained  tended  f o r her  In b e i n g p r e s e n t w i t h  needs,  experienced a  d e s p i t e i t s imminency.  diminished l e v e l  could  in  a b l e t o endure the d e n i a l .  empowering  "L"  t r e a s u r e d memories. her  act  friend's  "L"  of  make  This  was  something  visit  to  feet.  and  or  already  Natasha s t r u g g l e d w i t h her a b i l i t y process  able  "L"  death  friend  t o the impending  In l i g h t  tolerate  a l i v e f o r her young son, Natasha was During t h i s v i s i t  "was  also  it  present  the m o t i v a t i o n behind  to  fought  of  with L's  t o understand  eventually that  of  loss  her  longer  She  found  saw  friend  f e e l i n g o f d i s s o n a n c e w i t h o t h e r s whose response of L " was  she  During  and  inclusion,  most  caring a  sense  for of  b e i n g a b l e t o p a r t i c i p a t e i n and ease L's d y i n g p r o c e s s . During her l a s t v i s i t of  superficiality  moments  of  that  lucidity.  w i t h "L", Natasha had been aware of a dominated  She  conceded  their that  conversations the  during  superficiality  of  level L's this  55  last  contact  "L".  had  Despite  relationships her  actually  dying  her  circumscribed  by  realized  bond  this  support  requisite  formed  childhood  in  intact  extenuating had  her  her  She  loyalty depth  with  strength  physical  intimacy  remained  of  their  with  in  her  constant  to been  youth,  she  of  belonging  and  that t h e i r  friendship  had  in  their  sense  of t h i s  distance  relationship  bond had  a  recognized  the  her  and  circumstances  provided  years.  their  depth  Though the  throughout by  despite  for  adulthood,  friend.  d u r i n g those  been s u s t a i n e d  c h a r a c t e r i z e d much of  and  bond which  often  remained  very  different  perspectives i n l i f e . In  the  months b e f o r e  the i n e v i t a b i l i t y death  than  of her  after.  In  L's loss  her  impending death, Natasha her music and by one  i n her  the music of an who  played  was the  dying. one  death, and  attempt  During  artist She  learned  that  sense of numbness.  She  mixture  of  life  a positive  friend of  had  the  Amidst  the  friend's recurrent  the  life.  with  the  f o r her  to  play  illness  sadness of her  courage t o b a t t l e  had loss,  these  with  had  her  had  feelings  the  months  had  on  and  L's  loss  in  and  experience  repeatedly of  of  i n that  of  her  a  her aware  friend.  a sense of p r i d e long  an  death  suffering  integrity  f o r so  losing  i n part  the  life  loved  experienced  relief  years  a  s t r u g g l e , Natasha was  felt  L's  of  L's  Natasha  f o r her  addressing  numbness as  and  of  to  p a r t i c u l a r l y moved  Natasha  this  ended,  reality  songs,  own  died,  described  In r e f l e c t i n g on  i n spite  in  her  of  her  illness.  Natasha q u e s t i o n e d L's  L's  alternative  endured.  effect  to  herself  g r i e v e d more b e f o r e  t h i s time she was  "L"  initial  was  cope  resigned  whose songs seemed t o be  word  sadness t h a t  to  found e x p r e s s i o n  art.  had  b e l i e v e d she  which most resonated  Upon- r e c e i v i n g  Natasha  Before  L's  whether more c o u l d have been done to have saved death,  she  experienced  great  frustration  in  56  learning  that  treatment  " L " had been  at  a  possibilities illness She  centre  existed  too l a t e ,  was angered  the  where  didn't an  that  her d o c t o r s  was  i n seeking  that  promising  o f her  friend's  t o i n f l u e n c e the s i t u a t i o n .  "something  transpire".  important  aware  In l e a r n i n g  was powerless  by the f a c t  o f death;  by  Natasha  f o r treatment.  Natasha  circumstances  finality  discouraged  c o u l d have  She  was  happened and  confronted  t i e to her past,  that  by the  which  had  s u s t a i n e d her i n h e r youth, was gone. The was  sense  again  with  whom  disclosed been  o f e x c l u s i o n Natasha had e x p e r i e n c e d d u r i n g L's i l l n e s s  heightened Natasha  by a l e t t e r had  i n a previous  struggling  with  which  loss.  I t was a response  been  letter  since  letter  close  i n further  working  through  L's death.  Natasha  was a b l e  sister,  years.  Natasha  the i s s u e s t h a t she had she r e c e i v e d a  of i n v a l i d a t i n g  h e r p a i n and  t o Natasha t h a t she would be  her l o s s  of her l o s s  to t o l e r a t e  w i t h L's s i s t e r . the l o s s  discussing  L's twin  In response,  which i n d i c a t e d  the p a i n  f o r many  t o L's s i s t e r  f o r Natasha had the e f f e c t  impeded  grieve  also  she r e c e i v e d from  with  within  this  friend.  h e r own  the d i s e n f r a n c h i s e m e n t  After  support  group,  she had endured  She r e c o g n i z e d t h a t h e r f r i e n d had not y e t begun t o o f h e r own  sister,  and had c o n t i n u e d  t o deny t o  h e r s e l f the s i g n i f i c a n c e o f her l o s s . When h e r p a i n was d i s c o u n t e d by L's s i s t e r , avenues through  which she c o u l d openly  of  She g a i n e d  L's l o s s .  enabled support  t o openly group.  discuss  a  sense  also  heightened  daughter. and  After  e x p l o r e and c l a r i f y  of i n c l u s i o n  her experience  her l o s s .  by the development L's death,  acknowledge h e r l o s s .  of being h e r own  t o s t r u g g l e with h e r  Her sense  o f i n c l u s i o n was  of her f r i e n d s h i p  their  other  t h e meaning  through  with  Natasha c o n t a c t e d K. t o o f f e r Through  sought  i n terms  of l o s s  There she was g i v e n t h e l a t i t u d e  p a i n and the i s s u e s s u r r o u n d i n g  Natasha  "K", L's  h e r support  open d i s c u s s i o n o f L's l o s s  57  and  i t s implications,  deeper depth  level  with  Natasha  "K".  It  had  the  is a  experience  connection  that  connecting  continues  at  to  a  gain  as they r e s o l v e t h e i r e x p e r i e n c e of l o s s . Natasha  found  the  freedom  i n her  support  what the l o s s of "L" had meant f o r her. stating,  " o n l y when I was  to f e e l ,  and  able  to  feel  t o be  through  that  which  began  to  family real  her for  friendship her  realize  potentiated  the  with  symbolized  that  a parallel  i n her  d e s c r i b e d her  life.  her  She  "L",  she  experience  had  acknowledging  the  of  of  the  and loss  absence  c o n s i d e r e d " L " and  never  her  had.  recognized  i n her  youth  belonging.  She  of  "L"  o f her  L's  may  own  have  natural  f a m i l y t o be also  Through t h i s with  to  I able to  she  f o r "L" she was  relationship  the e x t e n t of her l o s s and  experience  t h e r e and  obtained  family  g r i e v e the  f a m i l y she  meaning  had  express  of what I needed  In so doing,  support,  need t o  of the b i r t h  confirmed  fully  l o n e l y p l a c e was  form".  f a m i l y , and wondered i f i n g r i e v i n g loss  to  fullness  i n that r e a l l y  then l e t i t go and emerge i n a new that  She  group  t o go t o the depths of the d e s p a i r t h a t was  acknowledge t h a t , and  the  of  "L",  grieving  process she  the l e g i t i m a c y of her  her  of  further  bereavement  status. Natasha losses, would  searched  but  also  honor  conscious unable feelings  the  of  to  a  not  f o r a way meaning long  to  response has She  she to  and  the  should. the  loss  a  means  grieve  their  the  lives  a  Two  ideal  a  of  sense  her  found  and  moved her i n her own  that was  herself  experience  L's  death,  in so  a  film  deeply  experience  t o l o s s she would wish  her  Natasha  f r i e n d as c o m p l e t e l y character  her  Natasha  she  after  of  friends  embodied. wherein  years  close friend  s t a t e d t h a t i n her response  making  acknowledge  recalled  s i n c e wished t o emulate t h i s  of  death  had  g r i e v e d f o r her  She of  fully  loss.  q u e s t i o n e d whether she had believed  to  for  established pattern  immediately  related  only  as  whose  that of  she  she  loss.  t o " g r i e v e the  58  loss  at  the  time  deceased  •••  [ i n order  what was  s p e c i a l about them i n your own  In  her  Natasha  attempt  reflected  losses.  She  ability  to  attending yard  She  to  ways  those  in  death,  perspective.  Natasha  which  After  and  she  funeral  commemorate later  went to p l a c e s  that  h a v i n g taken a p i c t u r e of  an  J's  was  her  the  an  as  she  of dead  been s i g n i f i c a n t .  tombstone was  an  the  bird  in  school ceremony She  some  i n her  to  her  loss.  her  returned  other  child  the  J's  put  a  from  attempt  and  to  factors i n  impeded  a  friends,  adapted  ceremony  for  life  adult  had  of  channelling  of  important  being  ritual  J's  as  had  as  the  loss  experience  wondered i f t h i s  Years  the  at l e a s t having w i t n e s s e d  l e g i t i m i z i n g her a  meaning  life".  watched  that  the  c a r r y i n g t h a t and  resolve  in  losses.  created  symbolically  home and  the  believed  having  J's  on  funeral,  significant  after  honor them by  to m e a n i n g f u l l y  resolve J's  recalled  to]  acknowledge  i d e n t i f i e d meaningful r i t u a l s  fence.  was  i t happened... and  childhood  death her  She  into  childhood  believed  important  time  step  that  towards  resolution. She of  the  [she  s t a t e d t h a t c r e a t i n g a r i t u a l enabled her deceased.  In  seemed] to be  recognized she  that  needed to  so  aspects  create  was  yet ready to do  feelings in  her  an  that loss.  commemorated this  latter  L's  embodied.  conjunction  artwork as  of  a ritual  "L"  In  had  i t allowed  hanging onto about t h a t  meaning not  doing  loss  She  The the  process  remained u n r e s o l v e d her  r e a l i z e d however  ritual,  difficulty  process  life  " l e t go  of  whatever  to  Natasha  f o r her,  and  commemorate  the  at  she  that  present  this.  with  had  to  person's death".  t h a t would a l l o w  she  avenue which i n her she  her  to honor the meaning  and  that  of  acknowledging  writing  was  described  the  a d u l t h o o d enabled her  meaning she  also  of able  was the to  and  deceased. to  to access  fully  another  begin  creation  way  work  the  experiencing in  It  of  which  was  she  through  through  the  59  loss  of  "L".  When  "L"  journey t o a t t e n d the the  service  and  L's  died  Natasha  funeral. family  in  t o the way  she  believed  attenuated,  she  acknowledgements which was  card  which  resolved as  o t h e r bereaved  ability  to  past  ritual,  grieve  losses  writing  and  long  acknowledged a l l  over the many years o f t h e i r  i n which her  another  took p a i n s t o compile f o r  friendship.  i t s e l f was  individuals was  in  unique  respond.  characteristically  part  displaying  through  pieces of  c a p t u r e the meaning of t h a t p a r t i c u l a r deceased  such artwork  individual.  She  u n c e r t a i n whether such acknowledgements would be made by o t h e r s i n  their own  justify  q u e s t i o n e d whether her response t o l o s s  relation  Though  not  I n s t e a d she  a multi-page  t h a t " L " had meant t o Natasha Natasha  could  experience of  loss,  but  believed  such  p r o c e s s of a t t e m p t i n g t o r e s o l v e her Similarly,  be unique  she  future.  She  t o her  compared  the  response  lesser  been  response  to losses  degree  t o L's  she may  of i n t e n s i t y  f r i e n d s h i p w i t h "L" t o her more r e c e n t r e l a t i o n s h i p s has  "connected  growing  ability  speculated present which  at  that  deeper  to her  attain  depth  and  with  people".  g r e a t e r depth  response  experience with  the  levels  the  to  loss  fullness  of  losses  grief  loss  would  suffer  i n the  attained  i n her she  considering  her  relationships,  she  in  "L" would be  her  i n her  through which  In  i n these  these of  helpful  losses.  q u e s t i o n e d whether her  in relation  had  relation  unique,  would  to  and  correspond  her  one to  in the  depth o f c o n n e c t i o n she had thus e s t a b l i s h e d . In stated she  considering that  believed  the way  i n which  i n some r e s p e c t s she she  should  f o r her  memorial  c a r d she composed and  believed  she  friend's  life.  completed  had  she  has  has  been  friend.  sent t o L's  begun t o acknowledge and In  considering  i n her g r i e v i n g  and  such,  she  grieved  f o r "L",  a b l e to g r i e v e Through  such  Natasha  i n the as  the  f a m i l y a f t e r her death,  she  channel  her  the meaning  wondered  i n a c c e p t i n g L's  loss  means  way  i f she  of  was  than what she  more had  60  thus  far realized.  closure  to  Though she b e l i e v e d she needed t o b r i n g some  the  process,  the  depth  experienced  she  of  questioned  grief  i f she  f o r "L"  had  that  she  not  final  already  believed  she  e s s e n t i a l l y would e x p e r i e n c e . In the  reviewing  emotional  her e x p e r i e n c e  impact  o f death  some degree by o t h e r s . the  death  culture denial  i s soon  o f L's l o s s ,  on the bereaved  may  concluded  be  that  recognized to  She b e l i e v e d however t h a t the s i g n i f i c a n c e o f  lost  i n the i n t e n s i v e ,  t h a t honors performance and d e n i e s exists  Natasha  f o r a l l loss  including  frenetic grief.  lifestyle  of a  She suggested  t h a t o f a f a m i l y member,  this  but i s  i n t e n s i f i e d when the l o s s i s t h a t o f a f r i e n d . C a r l a ' s E x p e r i e n c e o f Loss Carla described a long h i s t o r y with her own l i f e  n e a r l y 2 years ago.  were b a b i e s ,  and had l i v e d  lives  next  women  their  friendship  c h i l d h o o d and youth continued,  although  experiences. their  the  years  recover,  illness  Carla  by  belief  her  maintained in  When "S" became i l l , C a r l a  increasingly  become  S's  encouraged  potential.  recovery.  of  unstable  periods  her  spent  offering  psychiatric  hope  that  friend's  time  support  Initially  during  "S" talent  would and  during her friend's and  hope  f o r her  However as S's d i s e a s e advanced and she watched her f r i e n d  diminished  and d e s t a b i l i z e d  Carla  w i t n e s s i n g the d e c l i n e o f t e r m i n a l i l l n e s s . as  closeness  C a r l a b e l i e v e d "S" had the p o t e n t i a l  s u c c e s s f u l l y do whatever she a s p i r e d t o i n l i f e . 6  As  adulthood.  Before the onset o f i l l n e s s , to  took  f o r much o f t h e i r  f l u c t u a t e d w i t h the waxing and waning o f S's s t r u g g l e w i t h i l l n e s s i n early  who  They had known each o t h e r s i n c e they door t o each o t h e r  s h a r i n g most a l l o f t h e i r  young  "S", a c l o s e f r i e n d  she r e s i g n e d h e r s e l f  h e r s e l f beginning  began  her impending  she was  Her hope began t o d i m i n i s h  t o the i n e v i t a b i l i t y  to accept  to believe  o f S's f a t e .  loss well before  She  found  S's a c t u a l  61  death.  She b e l i e v e d  c h a r a c t e r but a l s o She  o f t e n found  getting  little  friendship. their  herself  exhausted  i n return  "S"  had not o n l y  they had shared after  their  f o r the energy  I t had become obvious was  of t h e i r  friendship's  and  i n their  visits  primarily  and f e l t  to  S's  friendship. she was  she was p u t t i n g i n t o  determined  diminished  integrity  "S", she m a i n t a i n e d  intimacy,  by  psychiatric unit, seeing  Carla  avoiding  their  years o f  end  her  own  attempted  together.  During  what she d e s c r i b e d as t h e r o l e i n order  of a  t o remind  visits friend,  "S" o f the  Though C a r l a o f t e n worked e x t r a s h i f t s  i n o r d e r t o a v o i d f u r t h e r discouragement  her f r i e n d  to maintain  the use o f h e r p s y c h i a t r i c time  focused on happy o r n e u t r a l t o p i c s  j o y f u l aspects of l i f e .  in  t o erode  t o h e r t h a t i n the f i n a l  knowledge t o i n f l u e n c e "S" d u r i n g t h e i r with  begun  life.  Aware the  the i n t e g r i t y  relationship  anguished  the i l l n e s s  there,  she r e f u s e d t o work  shifts  on the  and sadness on t h a t  unit  when "S" was admitted. Carla that  maintained  others  found  h e r support  disturbing,  to  be an equal p a r t n e r i n t h e i r  to  make such  She  and i n s p i t e friendship.  as a r e s u l t  b e l i e v e d that her p r o f e s s i o n a l  understand others  S's p l i g h t  whose  recovery. attempts took  concessions  f o r "S" i n the f a c e  and found  approach  She was of others  advantage  of  t o S's  t o augment S's  illness  o f S's d i m i n i s h e d  ability  She b e l i e v e d she was a b l e  o f t h e bond she shared with "S".  knowledge a l s o h e l p e d her t o b e t t e r  herself  illness  frustrated  o f an  with  e x p e r i e n c i n g dissonance seemed  the seemingly  S's therapy,  vulnerability  to i n t e r f e r e  by  with  with her  counterproductive  and angered  recruiting  by those  who  her during  her  i l l n e s s i n t o an u n f a m i l i a r f a i t h . While  C a r l a was away on h o l i d a y s , "S" took h e r own l i f e .  knowing the reason that  f o r h e r sense  o f urgency,  Without  C a r l a had a s t r o n g  she and her f a m i l y s h o u l d r e t u r n home e a r l y  from  sense  their holidays.  62  Upon t h e i r funeral  arrival  was  considered  was  informed  scheduled  for  later  important  heeded her she  she  to  intuitive  believed  that  the  S's  She  companionship. t h a t of her This  f r i e n d had  It  would  was  have  died  a  and  the  memorial  she  had  not  missed  found the  intuition  shared w i t h  "S"  had  she  unnerving,  inexplicably  funeral. funeral, Carla  image which  continued  f r i e n d t r a n s f o r m e d as an comforting  finally  f r i e n d had  refused  to view her  i n s t e a d chose to remember "S"  An  image was  her  day.  Though she  open casket  lying i n state.  yet  c l o s e bond she  drawn her home f o r the During  that  attend  sense.  that  stand  out  vitality for  I t symbolized  peace which she  had  f o r her  been l o n g  and  Carla  angel at the moment of her  for Carla.  found the  to  i n her  friend  was  death.  that  her  struggling  for. The  formal  ritual  her.  It failed  lives  of C a r l a and  to her, meet  to  of S's  f u n e r a l was  acknowledge the others.  needs  bereaved fitting  for  friends ritual.  of p e r s o n a l funeral  immediately  supportive  others.  its  others,  opportunities She  In  f o r her believed  of  the  S's  her.  This  Carla to  had  that  had  latter  took  she  grief  evening  was  through  ritual  such and  for the  place  recognized  share her  the  funeral  life  shortcomings)  and  had  in  would  spent  more  sharing  that  the  with  a  mutual  rituals  the  unfamiliar  Carla  and  for  on  f o r a ceremony t h a t  contrast,  after  I t commemorated  (despite  p o s i t i v e e f f e c t "S"  expectations  closure.  remembrances  u n s e t t l i n g experience  I t s p r o c e e d i n g s were extremely  f u r t h e r f r u s t r a t i n g her  her  an  of  company as  of  important  have i t acknowledged  missed these g a t h e r i n g s ,  the  she  by  would  have f e l t more i s o l a t e d i n her l o s s . Rather sense of own  than  shock and  intuition  attend  experiencing  her  shock  with  the  news  of  d i s b e l i e f were r e l a t e d more t o the  that  friend's  urged  her  funeral.  early Carla  return  from  recognized  S's  strength  holidays that  death,  in  despite  her  of  her  time  to  having  63  been  prepared  f o r her  e x p e r i e n c e d a sense to  friend's  inevitable  o f numbness as a r e s u l t  absorb t h e news b e f o r e the a c t u a l  death,  her l i f e .  funeral.  some  time  after  replaced  by  triggered tasks  She d e s c r i b e d a sense the f u n e r a l .  a  sense  especially  which  bereavement  of  She f e l t  during  times  d i d not r e q u i r e she found  that  time  unprepared f o r  as one o f the worst  o f b e i n g on "automatic p i l o t " f o r  When  anguish  nonetheless  o f having had l i t t l e  the memorial and recounted the day o f the f u n e r a l in  she  the numbness' d i s s i p a t e d  i t was  and  longing  which  seemed  when  she was  alone  o r engaged i n  her t o t a l  concentration.  a n n i v e r s a r y dates  such  Later  to  be  i n her  as S's b i r t h d a y and  the date o f her death a l s o t r i g g e r e d her anguish. In  the f i r s t  several  months  following  the death  C a r l a e x p e r i e n c e d a sense o f e x c l u s i o n or i s o l a t i o n  o f her f r i e n d ,  i n her bereavement  experience.  T h i s e x c l u s i o n was generated p r i m a r i l y by her b e l i e f  the meaning  and e x t e n t  who  d i d n o t know  comprehend resolved  o f her l o s s  "S" when  the l e v e l  initially  she was  of intimacy  that  grief". lived  really  didn't  Her c l o s e f a r away  healthy. their  were  I  who not  and s t a t e d  had p e r m i s s i o n  were  also  always  by  She b e l i e v e d  friendship  as a burden  think  friends  and  not be understood  those  few would  had reached,  she c o u l d speak w i t h no one about  She e x p e r i e n c e d her r e s t r a i n t myself....I  would  that  and  her l o s s .  "I kept i t a l l t o to talk  about  my  grieving  the l o s s  o f "S"  accessible,  which  further  e x a c e r b a t e d her sense o f i s o l a t i o n . Carla herself She  also  a  sense  of  dissonance  in  from openly d i s c u s s i n g her e x p e r i e n c e o f l o s s a f t e r  perceived  resolving  herself  her i s s u e s ,  in  her a b i l i t y  by  her sense  friend  experienced  to  very  yet i n this  to resolve of being  and a d m i t t i n g  be  it.  torn  that  forthright  situation  This f e e l i n g  between  i t was  of loss  S's death.  discussing she f e l t  and  impeded  o f d i s c o r d was heightened  longing  only  in  restraining  f o r the r e t u r n  i n death  that  o f her  "S" found the  64  peace she had wanted. When C a r l a r e a l i z e d t h a t h e r f r i e n d would never again share  birthdays  finality someone  and  o f death with  other  special  itself.  whom  she  She e x p e r i e n c e d  she c o u l d  f r i e n d s who met other  needs,  characteristics  typified  that  times,  share  was  struck  loneliness  her sadness.  she r e a l i z e d t h a t h e r bond  with  S's death  Carla  be t h e r e t o by the  and longed f o r Though  she had  the unique h i s t o r y and "S" were  irreplaceably  gone. Amidst with  h e r anguish  her f r i e n d .  possessed  after  Given  i n her health,  the i n t e g r i t y she found  also  she b e l i e v e d  i t difficult  difficult  intelligence,  that  given  S's  "S" must have c l e a r l y  home.  C a r l a was e v e n t u a l l y  able  the  funeral  believed later  i t would be h e r p a r e n t s  r a t h e r than s e l f i s h n e s s .  found h e l p f u l the c r e a t i o n  t o wear c o l o u r f u l c l o t h i n g i n s t e a d  represented  her vibrant  S's  death and s t r u g g l e  the  j o y her f r i e n d ' s l i f e a ritual  set  aside  each time  with l i f e ,  January, to  she c r e a t e d  had a l s o  embodied.  another  focus  on  "S".  ritual  wherein  the p o s i t i v e  And  d w e l l i n g on  She r e s o l v e d  the month o f S's b i r t h ,  purposefully  because she  f r i e n d s h i p with  i n h e r bereavement when she found h e r s e l f c o n s t a n t l y  in  of her  Though she assumed i t customary t o wear b l a c k t o  she chose  i t better  such  t o make sense o f S's a c t and accept  to her l o s s , Carla  own p r i v a t e r i t u a l s .  I t was  o f h e r l i f e l e s s body i n t h e i r own  i t by a t t r i b u t i n g h e r motive t o d e s p e r a t i o n In a d a p t i n g  choice.  i n t e l l i g e n c e , and d e s p i t e  known t h a t  who would make the p a i n f u l d i s c o v e r y  to t o l e r a t e  but a l s o the way i n  i n the community had s e n s a t i o n a l i z e d t h a t  t o accept  anger  h e r f r i e n d had  not o n l y  the means by which S. had chosen t o end h e r l i f e , which o t h e r s  experienced  t o honor t o engage she would  and  happy  memories o f S's l i f e . Recognition bereaved  was  of  also  the extent  an important  of her l o s s factor  and o f her s t a t u s  i n Carla's  adaptation  as  to her  65  loss.  The support  o f those  close friends  was h e a l t h y was paramount f o r C a r l a .  who had known S " when she W  She d i d n o t expect  those who d i d not know S. w e l l but c h e r i s h e d such received. whose  She was impressed  hospitality  support  by the g e n e r o s i t y o f the w i f e o f a f r i e n d other  f r i e n d s t o gather and o f f e r each other support i n t h e i r  loss.  the  initial  recognizing herself her  pain  herself she  by  months  i n times  S's  death  the importance  o f anguish  Carla  her experience  of  Only  loss  d i d she  and o t h e r s  than deny i t s l e g i t i m a c y .  She e x p e r i e n c e d  She  relief  friends  found  herself  t o be i n t e r v i e w e d  herself  extent  with  to quell  t o convince  agreeing  give  the f u l l  do so, and s t a t e d "now I know t h a t  struggled  o f her l o s s .  after  bereaved  She attempted  repeatedly attempting  a friend".  acknowledge t o h e r s e l f  to  after  f o r Carla  as l e g i t i m a t e l y bereaved.  had " o n l y l o s t  about  i t possible  diminishing  from  when i t was  and  In  made  support  permission  of her l o s s  to  rather  i n allowing herself  are allowed  to grieve  and w i l l g r i e v e " . Upon acknowledging the l e g i t i m a c y o f h e r own l o s s , t h a t her c l o s e f r i e n d s , were  likely  hers.  feeling  separated  them,  and i n v i t e d  means  of  legitimizing  entitlement  both  t o support.  i n their  her f e e l i n g s  them t o share  realized  from h e r and each o t h e r by d i s t a n c e ,  as i s o l a t e d  She r e s o l v e d t o share  Carla  the same.  their  grief  about h e r l o s s She made  experience  In so doing,  as she had been i n  of  C a r l a . found  o f "S" w i t h  the o f f e r loss  and  as a their  that her previous  sense o f i s o l a t i o n began t o d i s s i p a t e . Though she found a f f r o n t i n g some responses Carla  was g e n e r a l l y a b l e  to tolerate  o t h e r s bereavement responses. friend death. response  who  rescinded  Though  autonomy  i n terms o f  She d e s c r i b e d t h e response  o f a mutual  h e r support  individual  o f "S" w e l l  she d i d n o t condone i t , C a r l a  by r e s o l v i n g  that  o f o t h e r s t o S's death,  by v i r t u e  before  the  latter's  accepted  this  friend's  of her upbringing  this  friend  66  c o u l d not have been expected t o respond d i f f e r e n t l y t o S's b e h a v i o u r . Carla events such  described  which  event  anguish mutual  as uncanny  h e l p e d h e r adapt  as o c c u r r i n g  the o c c u r r e n c e  to her l o s s .  She d e s c r i b e d  d u r i n g S's f u n e r a l  of h e r s e l f  another  event  which  Several  after  the attempted  S's death,  Carla  a  dream  which  s u i c i d e w i t h the death o f S.  months  connected  adapt  person  S's outcome,  with  in i t .  struggling.  Later  patient's  attempt  that  a t some l e v e l  She was unnerved  she had p r e v i o u s l y a v o i d e d a d d r e s s i n g . that  intervene,  aspects  had remained  she was  struggling  by the a b i l i t y  o f S's death,  The such  dream  helped  of her  u n r e s o l v e d and she needed  comforting i n that  resolved i n believing save S.  thus  making  that  her  to talk  to  sense  to  about  She found the  o f i t , she became more  she and o t h e r s had done e v e r y t h i n g they c o u l d t o  Her f r i e n d ' s death was u l t i m a t e l y h e r own c h o i c e .  acknowledged future,  after  which  as h e r r e s p o n s i b i l i t y  her e x p e r i e n c e o f l o s s i n o r d e r t o r e s o l v e such i s s u e s . dream  at  responsibility  unconscious t o f o r c e her t o make meaning o f a s p e c t s o f the l o s s  recognize  that  In a t t e m p t i n g t o make sense o f the dream  she b e l i e v e d  her c u l p a b i l i t y  to her l o s s  on the ward.  this  Carla  to intervene i n  she concluded t h a t d e s p i t e never h a v i n g taken c o n s c i o u s for  later  she had been  was the s o l e  s u i c i d e o f one o f the p a t i e n t s  she had  of her  support o f a c l o s e  helped her f u r t h e r  and t o r e s o l v e a s p e c t s o f the l o s s w i t h which Some time  the f i r s t  and "S" who u n c a n n i l y happened t o be i n town  a t t h e time o f S's death and f u n e r a l . experienced  unlikely  where i n the midst  she was a b l e t o e x p e r i e n c e the unexpected friend  night  of c e r t a i n  thoughts  she was comforted  about  her r e s p o n s i b i l i t y  i n knowing t h a t  may  Though she  recur  everything that  i n the  could  have  been done was done t o save h e r f r i e n d . In r e f l e c t i n g on h e r e x p e r i e n c e of l o s s , her  the l o s s  experience.  of a  close  She b e l i e v e d  friend that  was  Carla  primarily  i n contrast  a  suggested t h a t f o r uniquely personal  t o the l o s s  of a  family  67  member with  wherein  the  there  loss,  bereaved  to  are  some  the death  relate  to  commonly  of a c l o s e f r i e n d  specifically  She  concluded  which  someone who  the  t h a t the meaning of the clarified  loss  privately  c o u l d a l l o w the bereaved  associated  f o r the  particular  non-  level  of  s t a t e d t h a t o t h e r s are g e n e r a l l y  of i n t i m a c y a p a r t i c u l a r  c o u l d o n l y be  meanings  is difficult  because  i n t i m a c y a t t a i n e d i s not a g i v e n . She unaware of the l e v e l  accepted  f r i e n d s h i p has a t t a i n e d .  of a  or  close friend  through  the  was  one  a s s i s t a n c e of  t o e x p l o r e the e x p e r i e n c e  without  interference. Though  painful  predominated increasing times. to  Carla's  ability  Carla  deny  memories  the  of  thoughts,  to  focus  she  on  s t a t e d t h a t two painful  focus on them.  f r i e n d ' s presence. stages of l o s s , was  grateful  Her  f r i e n d had  no  finally  but  of  after  could  felt  finally  s t r u g g l e had  "S"  S's choose  anguish  i n death  to  manage  she  but  d i d not  simply  have  not  missed  what she  life  the peace t h a t had  to her  considered  f r i e n d ' s death.  i n her  an  healthier  more w i l f u l l y  completed  the p a i n  initially  i n happier  death  a t peace with her  struggle with found  of  e v e n t u a l l y able  b e l i e v e d she had  and was  t h a t S's  was  memories  longer  She  years  years  memories  She  S's  had  She  ended.  evaded her i n  life. Diane's  E x p e r i e n c e of Loss  Diane d i s c u s s e d the l o s s of f o u r c l o s e f r i e n d s who span of s e v e r a l years i n her a d u l t l i f e . g r e a t e r depth  of meaning i n the l o s s .  intensely  i n v o l v e d w i t h her  and  dying  her  experiences enhanced friends. members  with  her  have  grandmother them  ability  Since  ailing  in their to  cope  aspects  informed  whom  her  of  had d i e d over a  With each death  she g a i n e d a  During these years she was  also  mother who  d i e d when Diane was  26,  she  14  Her  lost  processes  of  and  find  her  experience  perception  dying  meaning  of  years  loss,  later.  and  death  i n the  deaths  with such  her  dying  aspects  largely of  her  family will  be  68  included close  i n describing  her experience  of grieving  the deaths  of her  friends. Diane's  first  experience  with  her f r i e n d "A", 21 years ago. culminated  i n h i s death,  deterioration. death,  and l o n g a f t e r  self-imposed  the r e a l i t y o f the f a c t  herself  in i t .  w i t h death She  emotionally  unable  after  t h a t he would never  At this  t h e sudden  point  return.  unable  to  make  of  his  by h i s  for this  Diane  denied  She e x p e r i e n c e d a  i n her l i f e  sense  that  him b e f o r e h i s  his loss,  and c o u l d f i n d no she was  and had not y e t acknowledged the r e a l i t y  remained  illness  i n herself  c o n f r o n t a t i o n with death  early  loss of  overwhelmed  t o be w i t h  disappointment  For some time  sense o f d i s s o n a n c e i n t h i s meaning  was  experienced  exclusion.  was w i t h  During the b r i e f d i s a b l i n g  she  She found  death  unfamiliar  of i t s existence.  death  until  after  w i t h h e r mother's p r o c e s s o f d y i n g  helped  e x p e r i e n c i n g the l o s s o f h e r own mother. Her her  i n t e n s e involvement  t o accept  the r e a l i t y  o f death  and f i n d  meaning  in i t .  Whereas  her e x c l u s i o n from A's p r o c e s s o f d y i n g had d e n i e d her access t o such meaning,  she w i t n e s s e d  illumination  o r transcendence  Through h e r i n c l u s i o n there  existed  their  suffering.  mystery.  i n her a i l i n g  peace  mother  i n the midst  a  sense  of her  of  spiritual  deterioration.  i n her mother's e x p e r i e n c e o f d y i n g she r e s o l v e d i n death,  and t h e d y i n g welcome i t as an end t o  She began t o p e r c e i v e o f death  as an awe  inspiring  And s i n c e t h i s e x p e r i e n c e she has l o o k e d f o r and sensed  this  s p i r i t u a l aspect of death i n a l l the l o s s e s she has endured. Through  her experience  with  p e r v a s i v e d e s i r e t o understand need  t o understand  inclusion While  being  contracted  treated  later for a  Diane  developed  t h e e x p e r i e n c e o f death and d y i n g .  and support  some y e a r s  h e r d y i n g mother,  this  process  i n her f r i e n d life-long  her a  J's e x p e r i e n c e  chronic  a d i s e a s e which was t e r m i n a l .  allowed  illness  Her a b i l i t y  sense  a  Her of  of dying.  her f r i e n d  had  t o support him  69  in  h i s s t r u g g l e a l l o w e d Diane and J . t o openly and c o n t i n u a l l y  his  illness  and impending  death, and the i m p l i c a t i o n s i t h e l d  of  them.  As  of t h i s  a  result  inclusion,  the closeness  f r i e n d s h i p deepened d u r i n g h i s l e n g t h y i l l n e s s 9 years ago. Diane  was i n s p i r e d  a  terminal chronic  grown  face his  illnesses.  illness  impending  again  the r e a l i t y  was  associated  with  the way  of agonizing pain,  of h i s terminal i n the  h e r own acceptance o f  and had c u t h i s w r i s t s  As w i t h h e r f r i e n d  of dissonance with the r e a l i t y  his life  have  her l o s s .  o f h i s death  may  taken  have  h i s own  f o r some time a f t e r by l e a r n i n g  he had endured that  had  a s s e t s a f t e r h i s death.  "A",  Her d i s c o r d  itself  ended.  after  h i s death.  but r a t h e r  In l i g h t  between  She f e l t  o f the  resolving  and s t r u g g l e d  t o make  Her sense o f d i s s o n a n c e  h i s death  i n h i s family ensued  life  Diane  both  o f the unnecessary  throughout  h i s c h i l d h o o d , and  h i s family  members  over h i s  c o n f r o n t e d by what she d e s c r i b e d as  unfairness of l i f e . Diane  sudden she  perspective  he had possessed, she had g r e a t d i f f i c u l t y  he may  was i n t e n s i f i e d  the  with  he had  and l o n g s t a n d i n g courage  o f h i s agony.  i n which  that  fighting  reality  this  that  chronic  i n having l i v e d  believed  helped to f a c i l i t a t e  a night  not w i t h  s t o i c i s m she f e l t  the  He  with  hospitalizations,  the p r e s e n t  t o death  e x p e r i e n c e d a sense  suffering  nearly  death.  i n the midst  sense o f t h i s  their  of being  h i s struggle  frequent  of dying.  and accept  died after  fact  throughout  involved  His resignation  seemingly  the  life  of i t s i n e v i t a b i l i t y  "J"  in  h i s death,  t o a purpose  He c o n f i d e d t o h e r t h a t  which  him t o bear  illness.  by the adherence  her f r i e n d ' s  up w i t h  helped  f o r each  ,  characterized and  until  discuss  struggled  loss.  found  Though  herself  with  issues  she had been  unprepared  of  control  resolved  f o r how  especially  around  t o J's i n e v i t a b l e  suddenly  h i s death  J's  death,  actually  70  occurred.  Her sense  of v u l n e r a b i l i t y  was h e i g h t e n e d by her s t r u g g l e  to cope a t the time o f J's death w i t h the f a i l i n g and grandmother, the  and the impending  vulnerability  of t h e i r  h e a l t h o f her f a t h e r  death o f the l a t t e r .  mortality,  she found  herself  and s t a t e d "I d i d n ' t go and s c a t t e r J's ashes because could face i t . . . i t Several vulnerability suddenly  C h a l l e n g e d by overwhelmed  I didn't think I  was j u s t too much". years  later  with the l o s s  and w i t h o u t  sense  of great  shock  after  h i s funeral.  Diane  again  o f her f r i e n d  warning.  She  and d i s b e l i e f She  was  struggled  "D",  confronted who  described  having  i n h i s death f o r some  died  this  4 years ago  experienced a  which  time  by  lasted  with  the  meaninglessness o f h i s death, and r e c o g n i z e d t h a t her t r i a l  long  seeming  was due i n  p a r t t o b e i n g c o m p l e t e l y unprepared f o r h i s l o s s . Her e x p e r i e n c e o f D's l o s s was f u r t h e r shaped by events which l e d her t o f e e l loss,  she was  impinged fully  intense dissonance. enraged  advance  discord  was  whose e x p l o i t a t i v e  She f e l t  further  y e t by  an  actions  t o openly and  offended that  a t the expense  and acknowledge t h e i r  heightened  and c o n f u s i o n o f her  and o t h e r bereaved  grief.  her own needs  t o honour  the p a i n  mourner  o f Diane  e x p e r i e n c e and share t h e i r  who wanted o n l y of  by another  on t h e a b i l i t i e s  mourner would  Amidst  this  o f o t h e r bereaved  loss.  Diane's  sense  image  of  young  D's  daughter whose l a s t memory o f her f a t h e r was t h a t o f him f i g h t i n g w i t h her mother.  She was saddened  i n knowing t h a t  this  conflict  would  be  h i s daughter's f i n a l memory o f him. She him  believed  o f t h e chance  resolution  h i s sudden  death  had robbed  "D" and those  t o say and do what was needed  to h i s l i f e .  She was l e f t  w i t h a sense  from h i s d y i n g and death.  With  the s p i r i t u a l  she had r e c e i v e d  feedback  that  to bring  h i s death  close to  a sense o f  of being excluded  she r e c o g n i z e d she l a c k e d through her i n c l u s i o n i n  her mother and J's p r o c e s s e s o f d y i n g ; feedback which  she b e l i e v e d was  71 an important f a c t o r i n f i n d i n g meaning i n and a c c e p t i n g the l o s s . Her  sadness  prolonged  to  appeared  and i n a b i l i t y  h e r , and  she  to find  found  that  an  i n h i s death  intense  sense  o f h i s death  she sought  friend.  of  In her struggle  the advice  o f "J.H",  f r i e n d who h i m s e l f was d y i n g o f a t e r m i n a l i l l n e s s . letter  seemed these  t o be t r i g g e r e d by v a r i o u s c i r c u m s t a n c e s such as e n c o u n t e r i n g  s t r a n g e r s who resembled h e r deceased sense  meaning  "J.H" d i s c u s s e d  physical  the d e g r a d a t i o n  deterioration,  dependence,  and  fear  h i s impossible  approaching death. own impending  his  he  of  challenge  to  He suggested t h a t because  death he was enabled t o l i v e  another  close  In h i s responding  experienced  total  t o make  through h i s  incapacitation make  sense  and  of h i s  "D" had n o t expected h i s  his life  fully  and w i t h o u t  such s t r u g g l e u n t i l  t h e moment o f h i s death.  Diane b e l i e v e d  i t more than a n y t h i n g h e l p e d h e r t o cope w i t h D's  that  In r e v i e w i n g t h e l e t t e r ,  death. Recognition important  factor  o f her l o s s i n Diane's  and o f h e r s t a t u s  adjustment  With each death, she c l a r i f i e d  t o her l o s s e s ,  had  meaint  to  her.  l e g i t i m a t e l y bereaved. full  depths  o f each  situation,  With  each  suffered  she  her attempt  many o f t h e bereaved  t o adapt  herself  and o t h e r s c o u l d  would  ritual. support  Diane She  not be  were simply unaware o f t h e In o r d e r t o address the t o seek out  loss.  to h i s loss  she witnessed,  meaningful  fund which  and what  considered  Diane made e f f o r t s d u r i n g and a f t e r h i s f u n e r a l  personally  memorial  loss  o t h e r ' s c o n n e c t i o n s t o "D".  disenfranchisement a  had been i n l i f e  by h e r s e l f  such bereaved and acknowledge the mutual In  i n c l u d i n g D's.  However w i t h D's death she was aware t h a t the  e x t e n t o f the l o s s  acknowledged because  was an  t h e e x t e n t and s i g n i f i c a n c e o f t h e l o s s  through the a c t o f r e v i e w i n g who her f r i e n d he  as bereaved  and f u r t h e r  found h e l p f u l supported  a workshop  r e c t i f y the  the c r e a t i o n o f  the c r e a t i o n  offered  of a  annually i n h i s  72  area  of  speciality.  bereaved the  individuals  memorial  avenue  not  and  something  which  invest  year  ago  enduring  experience  of  exclusion.  the  of  honouring  disenfranchised  energy  Diane  a his  She  from  less She  "D",  the  pain  recognized conceived of  but  bereaved  fourth  illness  close  of  also  could their  for  loss  was  friend,  several  as  an  receive  loss  into  who  died  and  during this  discuss  She  with  characterized  interim  him  found h e r s e l f  "J.H",  years.  had been aware o f h i s t e r m i n a l  openly  implications.  a  impending  need  to  lost  terminal  i t t o her  his  by  illness  she  a  initial sense  of  w e l l b e f o r e he  felt  impeded  impending  painfully  Her  death  restraining  her  i n her  and  its  anguish i n  presence. After  inclusion  his  disclosure  of  his  illness,  i n h i s experience of dying.  c a r e t o the v e r y end  involvement  in  She  of h i s l i f e .  they o p e n l y d i s c u s s e d h i s i l l n e s s Her  those  i n i t s co-creation.  a means  the  disclosed  his  as  encouraged  positive.  One  his  then  to a s s i s t  only  through  support  after  She  his  was  gained  this  the s i g n i f i c a n c e deepened  a  intensely  Throughout  and  experience  she  sense  of  involved i n  time t o g e t h e r of h i s l o s s .  their  friendship,  and  a s s i s t e d her sense o f acceptance i n h i s l o s s . A l t h o u g h Diane was process, illness who  she  i n t e n s e l y dedicated to a s s i s t i n g  allowed  others  autonomy  and approaching death.  for  various  tolerated  their  reasons  inability  She  could to  be  in  their  encountered  not  offer  involved  "J.H" i n h i s d y i n g  own  response  s e v e r a l mutual  him  despite  their her  to  friends  support  own  his  and  compelling  commitment t o him. She intact  witnessed despite  confided ability  to  the  her  in  her  friend  adversity that  his  to continue to f i g h t  of  "J.H." his  mounting for l i f e ,  an  integrity  debilitating  illness.  incapacitation y e t he  that  adhered  remained He  had  challenged  his  t o the  purpose  73  of  living  death  the  with  of  his  t h a t same d i g n i t y .  extremely dying  remainder  painful,  process.  her  She  own  felt  life  And  with  though  integrity  proud  dignity loss  remained  of her  and o f f e r support i n s p i t e of her own  the  and  accepting  of her  intact  ability  to  friend  was  commit  his  to h i s  care  sorrow.  and  t h a t h i s death was  confirmed by h i s p a r t n e r . "J.H."  assure  were  each  given  other  of  the  imminent.  In having t h i s opportunity  their  love  was  throughout  Before d e p a r t i n g on a h o l i d a y , Diane e x p e r i e n c e d i n her l a s t w i t h "J.H." a s t r o n g sense  his  to  f o r one  reality say  a  Her  intuition  confirmed,  final  another.  visit  She  Diane  goodbye  and  believed  they  were a b l e t o l e t go w i t h peace and r e s o l v e . While  she  standing  was  anxiety  replaced  by  a  about  feeling  finally  l e t go  learned  t h a t her  felt  away she  of  "J.H." of  suddenly  peacefulness.  life.  Her  friend  was  a s e n s a t i o n wherein  had  diminished,  She  instinct  was  d i e d a t the  her  sensed later  that  long-  and  was  "J.H"  affirmed  had  when  she  she  had  same moment i n which  a sense of peace. In  the  weeks  surrounding  something p o s i t i v e w i t h the  experienced  mechanism  death.  After  h i s death  the energy  of  ritual  his  funeral  Diane  felt  she  from her anguish.  important  in  helping  i n the  company  of  her  other  needed she  found  adjust  to  J.H's  who  were  bereaved  c l o s e t o "J.H.", she p a r t i c i p a t e d i n a ceremony wherein  were  s c a t t e r e d over  a l s o donated After involvement her own  his  death,  she  resolving  and  recognized  i n h i s dying process  life.  him  She  other  a bench i n h i s honour t o a l o c a l  She  had  felt  h e r s e l f c o n t i n u e to l i v e burden  ocean.  with not  to  her cry  own  she had  that  through  impeded h e r s e l f suffering  During h i s i l l n e s s  sorrow,  while  mutual  and  i n his  made  presence.  h i s ashes  close  friends  her  intense  from  enjoying  park.  t h a t w h i l e he was  fully.  do  Again  also  the  to  a  she  c o u l d not  she d i d not want t o  further After  concession each  visit  of she  74  would a l l o w h e r sorrow her way home. she  paid  death,  Though she d i d not r e g r e t h e r c o n c e s s i o n s  a toll  experience  t o s u r f a c e and c r i e d w h i l e alone i n h e r c a r on  f o r her intense  of joy before  she f e l t  support  h i s death.  the r e l i e f  i n having  She was  of being  able  she b e l i e v e d  blocked  aware  that  to continue  her own  after his  to l i v e  fully  again. Diane several long  d e s c r i b e d her e x p e r i e n c e  years  term  earlier  and  acceptance".  and t h a t  the  with  the l o s s  o f h e r grandmother  o f "J.H." as s i m i l a r  preparedness  and  the  i n terms o f "the  deep  talks,  and  the  She b e l i e v e d h e r e x p e r i e n c e w i t h t h e d y i n g and death o f  her grandmother had most i n f l u e n c e d h e r a b i l i t y t o f i n d meaning i n the death  o f "J.H.".  She d e s c r i b e d an e x p e r i e n c e  grandmother which  immensely  her  death  grandmother's  prizes,  Diane  had  somehow  sent  p a i n by d e s c r i b i n g  the l o s s  certain his  of her  h e r p e r c e p t i o n o f death.  After  won i n a l o t t e r y  this  two c o n s e c u t i v e  o f her f r i e n d  that  painful  i n death  message  "J.H.".  life  first  She b e l i e v e d h e r attempt  to  i n death.  ease  Several  she was a b l e t o b r i n g t h i s meaning Despite  "J.H." had found  struggle with  i n an  the j o y she had found  years a f t e r her grandmother's death to  the l o s s  each o f which was a b o t t l e o f "Joy" perfume.  grandmother Diane's  affected  after  joy.  and had gone  h e r anguish He had been  on i n peace  she  felt  freed  from  to a better  place. J.H's  illness  she  had accepted  and  continual  had  done  year his by  loss,  she found  that  and i n watching  i t was t e r m i n a l .  of g r i e f "  she b e l i e v e d that  dedicated although  certain  him d e t e r i o r a t e  She had e x p e r i e n c e d  i n the months b e f o r e h i s death,  o f the work  h i s death  the bench  conceded  that  anguish  "most  after  had been long-term,  before  intense  and s t a t e d she  h i s death.  Although  a  she had come t o terms with much o f symbolic  t o h i s memory, she was s t i l l  reminders,  triggered  mourning,  such  as p a s s i n g  h e r sadness.  the t r i g g e r e d  She sadness  75  was not i n d i c a t i v e of  o f a l a c k o f acceptance  o f J.H's l o s s ,  but r a t h e r  the depth o f h e r f e e l i n g s f o r him. In  "grief loss  c o n s i d e r i n g a l l o f her e x p e r i e n c e s i s about  mourning  of l o s s ,  she r e s o l v e d t h a t  our own m o r t a l i t y as much  o f the o t h e r person".  as mourning the  She b e l i e v e d t h a t h e r l o s s e s ,  especially  those t h a t were sudden, had taught h e r t o make the most o f each moment with  others.  acknowledged  And  i n witnessing  she was h e r s e l f  and purpose i n h e r own l i f e  such  inspired  courage  i n her f r i e n d s ,  towards g r e a t e r courage,  she  wisdom  and work. General S t r u c t u r e  The Meaning o f G r i e f f o r a l l C o - r e s e a r c h e r s D e s p i t e the d i v e r s i t y to of  of t h e i r experience  be an i n v a r i a n t t h r e a d which r a n through grieving  the  death  of  her  close  of loss,  there  each c o - r e s e a r c h e r ' s  friend.  This  constructed  o f 10 themes common t o a l l the e x p e r i e n c e s .  survivor's  story  experiences  of  contained  loss,  some  themes  the meaning  of  not  grief  found  Inclusion,  Meaning, R i t u a l , These pattern the  elements  experience however,  i t  simultaneously of l o s s .  the elements  would and  will  t o be  appear at  Though  each  the  Emotional  experienced  appeared  that  several of  be p r e s e n t e d  i n the c o - r e s e a r c h e r s '  other  Distress, Integrity,  distress.  in a  of loss some  points  linear  were t o l d by  elements  were  throughout  the  the f o l l o w i n g p r e s e n t a t i o n , i n a linear  t o supercede experience  of  manner w i t h the  another grief.  element, o r theme, t o be p r e s e n t e d i s t h a t o f Emotional Emotional  was  in  Dissonance,  As the s t o r i e s  For the sake  t h a t no one element  influence  Control,  d i d n o t appear  w i t h i n the e x p e r i e n c e s .  experienced  thread  and Acceptance.  co-researchers,  caveat  Concession,  story  f o r a l l co-researchers  seemed t o embody the f o l l o w i n g themes o r elements: Exclusion,  appeared  i n terms o f The  distress.  first  76  With t h e death o f her f r i e n d , of emotional confusion, These  distress  disbelief,  feelings  regardless reaction  which may have i n c l u d e d such longing,  appeared  to  to  multiple stressors  be  of the deceased, her  loss.  a  sense  f o r the death when  facets  of being  experienced  intensified  to  as anguish,  overwhelmed.  varying  degrees  o f her f r i e n d .  the  death  was  This  sudden  or  existed.  Throughout her bereavement by v a r i o u s f a c t o r s  and be  o f her p r e p a r a t i o n seemed  t h e c o - r e s e a r c h e r d e s c r i b e d a sense  these  feelings  tended  f o r the c o - r e s e a r c h e r , i n c l u d i n g  t o be  triggered  symbolic  reminders  or the acknowledgement by o t h e r s o f the l e g i t i m a c y o f  Other  triggers  were  also  reported  such  as  dreams  and  moments o f q u i e t o r s o l i t u d e . In  response  anguish,  t o the l o s s  sadness  and sense  o f her f r i e n d  "N", Anna  o f meaninglessness  t y p i c a l a s p e c t s o f bereavement.  which  e x p e r i e n c e d the  she b e l i e v e d  were  She s t a t e d t h a t when "N" d i e d ,  the e x p e r i e n c e was so i n t e n s e l y p a i n f u l and so t y p i c a l o f what people t h i n k o f t h a t enormous sense o f sadness and wanting t o c r y and not wanting i t t o happen.... a l l I wanted t o do was t o know how to g e t through the days....A couple o f people a t work knew "N", and t h a t we had a v e r y c l o s e r e l a t i o n s h i p and I j u s t d i d n ' t want them t o say a n y t h i n g . . . I [ d i d n ' t ] want t o c r y . . . a n d I was a f r a i d something would t r i g g e r . . . Similarly, intense She  sense  with  the l o s s  o f her f r i e n d  "S", C a r l a  e x p e r i e n c e d an  o f anguish which was o f t e n and u n e x p e c t e d l y  triggered.  stated,  She'd been d o i n g r e a l l y good so i t was a r e a l shock....my sadness and p a i n came up a t funny times, d u r i n g dreams and w h i l e d r i v i n g or d o i n g o t h e r t a s k s . . . . I t h i n k o f her a t d i f f e r e n t times and i t ' s now j u s t sad. I t ' s not an ache or a shock anymore, I j u s t miss h e r . With sense  the deaths  o f anguish  o f her c l o s e  and l o n g i n g ,  friends,  and a t times  Diane felt  also  experienced  overwhelmed  a  by her  77  loss.  She d e s c r i b e d an i n t e n s i f i e d  sense  o f these  especially  during  the i l l n e s s and a f t e r the death o f h e r f r i e n d "J.H", and s t a t e d  With "J.H." i n p a r t i c u l a r the l o s s was so apparent and so l o n g term, you know [I was] c o n t i n u a l l y grieving...I was always c o n s c i o u s about not c r y i n g i n f r o n t o f him and so I'd see him and then d r i v e home i n my c a r bawling my eyes o u t . That was an ongoing p a r t o f i t . So when he a c t u a l l y d i e d t h e r e was a l o t o f t h a t work t h a t had a l r e a d y been done...A couple months ago I walked by the apartment t h a t he used t o l i v e i n and I s t a r t e d c r y i n g . . . i t ' s not a l a c k o f acceptance. I t ' s more j u s t how d e e p l y you f e e l about i t and how c l o s e the r e l a t i o n s h i p got through the process of l o s s . After sense  the l o s s  of her l i f e - l o n g  friend  "L", Natasha  o f shock f o l l o w e d by an overwhelming sense  described a  o f sadness and anger,  stating  The cancer was i n h e r bones by the time I had found out about i t , and so a l o t o b v i o u s l y o f t h a t meeting I was i n shock.... I f e l t sad, and shocked and angry....And i t was February b e f o r e she a c t u a l l y d i e d but i t was l i k e when I f i r s t found out - i t was k i n d of l i k e I was numb. I heard the news but I guess p a r t o f i t was r e l i e f mixed w i t h sadness. Exclusion. The  co-researchers  experience  of loss.  also  d e s c r i b e d a sense  Such e x c l u s i o n was e x p e r i e n c e d  including  physical  in  physically  present  funeral.  Similarly  being  friend's bereaved  friend  aspects  of  e x c l u s i o n wherein  was impeded,  the  of exclusion i n t h e i r  impending  with  the bereaved the d y i n g  exclusion  actual  friend  friend  was  o r impeded h e r s e l f , or  i n several  loss.  was  or  experienced  o t h e r s or they  themselves  denied  impeded  during  the  when  the  i n openly d i s c u s s i n g Some  co-researchers  e x p e r i e n c e d e x c l u s i o n i n terms o f t h e i r own bereavement s t a t u s wherein  forms,  itself,  the l e g i t i m a c y of t h e i r  loss  thereby l i m i t i n g t h e i r access t o support. For Anna, a f t e r both  emotional  her c l o s e f r i e n d  and p h y s i c a l  "N" became i l l , she e x p e r i e n c e d  s e p a r a t i o n from him.  B e l i e v i n g he d i d not  78  want t o t a l k about h i s i l l n e s s ,  she f e l t  impeded  i n openly  exploring  and  r e s o l v i n g w i t h N. t h e meaning and i m p l i c a t i o n s o f h i s l o s s .  his  illness  progressed,  he moved t o h i s home town t o d i e .  e f f e c t i v e l y excluded from h i s d y i n g her  continued  process,  d i f f i c u l t y i n accepting  She  which may have  his loss.  When felt  influenced  She s t a t e d ,  "N", who was so c l o s e t o me, kept t h e knowledge o f h i s i l l n e s s and the f a c t t h a t he was going t o d i e from me u n t i l i t was c o m p l e t e l y obvious....my g r i e f i n h i s death was t h a t we r e a l l y d i d n ' t t a l k about i t . . . a n d so t h a t I t h i n k h e i g h t e n e d t h e more typical sadness.... I f he had an i d e a o f how he wanted t h i n g s t o happen, he c e r t a i n l y never s a i d t o anyone. He went home [to another c i t y ] to d i e . Carla  also  experience. uncertainty not  only  and  extent  experienced  Her sense regarding  believed  to  have  the legitimacy  that  of exclusion  of exclusion  others  of her l o s s ,  h e r s e l f had r e a l l y  a sense  were  was generated  primarily  o f h e r bereavement generally  but a t times  also  unaware  exclusion  by h e r  status.  whether she  Such u n c e r t a i n t y  from  She  o f t h e meaning  questioned  suffered a legitimate loss.  l e d t o her s e l f - i m p o s e d  i n h e r bereavement  bereavement  seems  status,  i n h i b i t i n g h e r a b i l i t y t o openly g r i e v e and seek support. She s t a t e d ,  I d i d n ' t r e a l l y f e e l t h e r e was anyone who understood where I was at, so I j u s t s o r t o f kept i t a l l t o m y s e l f . I r e a l l y didn't t h i n k I had p e r m i s s i o n t o t a l k about my g r i e f . . . . N o b o d y knows what you're m i s s i n g because they don't know what l e v e l o f f r i e n d s h i p you had.... i t was l o n e l y , but then I kept t h i n k i n g "Oh w e l l , g e t on w i t h i t , j u s t get on w i t h i t . She was j u s t a f r i e n d . " With varying here  t h e deaths  experience  D's  exclusion  death,  h i s dying  prevented  h e r from e x p l o r i n g  his  had h e l d  life  i n the l o s s  of exclusion  unexpected from  of her friends,  of exclusion  her experience  After  of 3  f o r her.  with  Diane process.  Diane  o f each.  the l o s s  experienced His  believed  described She  a  describes  o f h e r f r i e n d "D". an  sudden  and r e s o l v i n g w i t h Diane  also  intense death  sense o f effectively  him t h e meaning  such  exclusion  that  created  79  great  difficulty  f o r h e r i n r e s o l v i n g h i s l o s s and s t a t e d ,  His death was so sudden....I d i d n ' t get the s p i r i t u a l feedback t h a t was important with the o t h e r p e o p l e t h a t d i e d , t h a t would have h e l p e d me t o accept i t . . . . I d i d n ' t get a sense back t h a t t h e r e was meaning i n i t . Natasha a l s o d e s c r i b e d 2  friends.  Her f i r s t  childhood  was  exclusion  from  believed  a sense o f e x c l u s i o n w i t h the deaths o f h e r  experience  characterized bereavement  greatly  affected  o f the l o s s  predominantly  status. the way  I t was  o f her best by  the  friend i n  experience  an e x p e r i e n c e  i n she g r i e v e d  later  of  which she  losses.  She  stated,  Nobody seemed t o understand the s i g n i f i c a n c e o f J's death t o me, and I was not a l l o w e d t o go t o the f u n e r a l . I felt really left out. . . .The f a c t t h a t I was d e n i e d access - d e n i e d v a l u e - i n wanting t o g r i e v e her death formally I think has a l s o been another p a t t e r n i n my l i f e . . . . I do have t h i s p a t t e r n o f not b e i n g a b l e t o r e a l l y p r o c e s s my f e e l i n g s and t o g r i e v e . . . . I don't even remember c r y i n g a t my f a t h e r ' s f u n e r a l . Inclusion. At  other  described  times  i n their  of the l o s s  the c o - r e s e a r c h e r s  and i t s i m p l i c a t i o n s  t h e d y i n g f r i e n d , o r by o t h e r s who r e c o g n i z e d  loss. for  of loss,  f e e l i n g a sense o f i n c l u s i o n . Such i n c l u s i o n was e x p e r i e n c e d  when open d i s c u s s i o n by  experience  was  encouraged  the l e g i t i m a c y  I n c l u s i o n was a l s o e x p e r i e n c e d through such a c t s  as  o f the  care-taking  t h e d y i n g f r i e n d , o r c a r r y i n g out h i s o r h e r s p e c i f i c wishes.  co-researcher's legitimacy  sense  of  inclusion  was  o f h e r l o s s and o f h e r s t a t u s  further  enhanced  when  as bereaved was r e c o g n i z e d  The the by  the bereaved h e r s e l f o r by o t h e r s who were aware o f her l o s s . Anna d e s c r i b e d and  a sense o f i n c l u s i o n i n J's e x p e r i e n c e o f i l l n e s s  dying' through t o h i s death,  explaining,  " J " and I t a l k e d about him b e i n g i l l , we t a l k e d v e r y openly about how he f e l t . . . . a n d what [dying o f AIDS] meant t o him...we t a l k e d  80  about the r e g r e t t h a t we would not get o l d t o g e t h e r . . . . " J " would f o r c e me, would almost say "you t e l l me what i t i s you r e a l l y t h i n k " . . . . T o the v e r y end I was a p a r t o f h i s e x p e r i e n c e . While  her f r i e n d  "S" was i l l C a r l a  also  experienced  a sense  i n c l u s i o n i n S's c a r e , o f f e r i n g  support  and hope f o r h e r r e c o v e r y .  the  death,  Carla  initial  months  after  S's  p o s i t i o n as l e g i t i m a t e l y bereaved. the as  validity  of her l o s s ,  she began  t o openly  loss,  while  same.  But e v e n t u a l l y a f t e r  she a g a i n  experienced  acknowledge  encouraging  other  struggled  h e r own  of i n c l u s i o n  the meaning  bereaved  Jn  acknowledging  a sense  and e x p l o r e  mutually  with  of  friends  of her  t o do the  She s t a t e d ,  A f t e r a g r e e i n g t o do t h i s i n t e r v i e w , I l e t myself e x p l o r e my f e e l i n g s . . . . I r e a l i z e d t h a t i f t h e r e was a study b e i n g done on t h i s , t h a t maybe I wasn't the o n l y f r i e n d who was g r i e v i n g the loss of a friend. I t was l i k e d i s c o v e r i n g I was a l l o w e d t o f e e l t h i s way...I've r e a l i z e d i t i s a c c e p t a b l e t o g r i e v e l i k e t h i s f o r a f r i e n d . . . . I wrote [a mutual f r i e n d a l s o g r i e v i n g the l o s s o f "S"] t o l e t h e r know t h a t she c o u l d c a l l me t o t a l k and t h a t i t ' s okay t o g r i e v e "S", t o reach out.... Diane  also  bereavement "J.H.", was  with  open  intensely  process.  had  a  both  sense " J " and  of  inclusion  "J.H."  i n h i s care  her  Especially  d i s c u s s i o n o f h i s impending involved  in  death  was  t o the v e r y  She d e s c r i b e d h e r sense o f i n c l u s i o n ,  experience  with  her  ongoing,  of  friend and she  end o f h i s d y i n g  stating  We were c l o s e [and] we got c l o s e r a f t e r he got AIDS.... t h e r e were a group o f us who were a support group who s a t w i t h him and d i d a round the c l o c k watch....the e x p e r i e n c e o f t h a t was the c o n n e c t i o n we [J.H. and I] h a d . . . . i t meant t h a t I c o u l d t a l k t o him about how I f e l t about him going, and t h a t I c o u l d t e l l him t h a t I l o v e d him and t h a t he c o u l d t e l l me he l o v e d me.  Natasha a l s o the  death  openly  d e s c r i b e d a sense  of her f r i e n d  "L".  discuss the l o s s with  of i n c l u s i o n  Though  i n her experience of  she b e l i e v e d  her a b i l i t y  L's f a m i l y was d i s c o u r a g e d ,  to  she g a i n e d a  81  sense  of inclusion  with  her own  freedom t o f u l l y express  support  group  where  she found the  what t h e l o s s o f " L " had meant f o r her.  She  s t a t e d t h a t i t was " o n l y t h e r e t h a t I was a b l e t o f e e l  and go t o t h e  depths  leti t  Her  o f d e s p a i r . . . and  final  a sense  t o acknowledge  and o n l y v i s i t  that...and  then  go".  w i t h " L " b e f o r e she d i e d a l s o a l l o w e d Natasha  of i n c l u s i o n .  She f e l t  she had been g i v e n an o p p o r t u n i t y t o  p a r t i c i p a t e i n and ease L's d y i n g p r o c e s s , and s t a t e d  One o f my b e s t memories was I got t h a t peppermint f o o t cream and I massaged h e r f e e t - i t p r o b a b l y symbolized an awful l o t but i t f e l t good t o be a b l e t o do something t h a t I thought no matter what stage she was a t i n h e r c o n s c i o u s n e s s , she c o u l d p r o b a b l y f e e l and appreciate that. Concession. Each dying  co-researcher  friend.  also  found  In o r d e r t o support  or her d y i n g p r o c e s s ,  the bereaved  h e r s e l f making  concessions  the needs o f the i l l friend  allowed  friend  i n his  i n her r e l a t i o n s h i p  w i t h the d y i n g f r i e n d what she n o r m a l l y would not otherwise her  f o r her  condone i n  friendships. Anna made c o n c e s s i o n s f o r her d y i n g f r i e n d "N" which r e q u i r e d t h a t  she  c o n s t r a i n open and genuine e x p r e s s i o n about h i s impending  o r d e r t o a l l o w him autonomy i n how he wished t o cope w i t h Such  concessions  may have  r e s o l v i n g h i s death.  c o n t r i b u t e d to her continued  loss i n  h i s fate.  difficulty in  I n d e s c r i b i n g her c o n c e s s i o n s , she s t a t e d  R i g h t l y o r wrongly I sensed i t was something he p a r t i c u l a r l y d i d not want t o share. . . . [yet] f r i e n d s h i p means f o r me a c e r t a i n i n t e n s i t y , a b e l i e f t h a t you don't have t o h i d e t h i n g s . . . . I f e e l l i k e I missed something....Why d i d n ' t I do what I g e n u i n e l y wanted? - so i t ' s r e g r e t . . . . s h o u l d I have s a i d "Now don't l i e t o me. You t e l l me how you f e e l " . But I c o u l d n ' t because I wanted to be h i s v e r s i o n o f t h e p e r f e c t f r i e n d . . .my guess was t h a t he d i d n ' t want t o say a n y t h i n g . C a r l a t o o made c o n c e s s i o n s f o r h e r f r i e n d "S". support  f o r "S" i n s p i t e  o f the l a t t e r ' s  ability  She m a i n t a i n e d h e r  t o be a c o n t r i b u t i n g  82  partner i n t h e i r friendship.  Carla explained,  I spent a l o t o f time w i t h " S " d u r i n g h e r rough times.... Because "S" had decompensated f o r so many years we'd lost that c l o s e n e s s . . . i t was so d r a i n i n g , l i k e I was t r y i n g t o put so much energy i n t o h e r t o t r y and get h e r out o f t h i s d e p r e s s i o n and she wasn't g i v i n g a n y t h i n g back t o me...I psyched myself up q u i t e a b i t t o go out and see h e r but I'm g l a d I d i d . Diane  also  especially from  concessions  f o r her f r i e n d  fully  illness  made  enjoying  "J.H.".  h e r own  and death.  Though  b e l i e v e d she p a i d a t o l l  during  her  experience  She c o n s c i o u s l y  life  during  J.H.'s  she d i d not r e g r e t  of  impeded  long  loss  herself  struggle  with  her concessions  she  f o r h e r i n t e n s e support and e x p l a i n e d ,  I wasn't r e a l l y l e t t i n g myself enjoy myself t o the max, because I f e l t I c o u l d n ' t r e a l l y have so much f u n i f my f r i e n d i s d y i n g and suffering. I c o u l d n ' t r e a l l y go on and l i v e .  Natasha a l s o made a c o n c e s s i o n f o r h e r f r i e n d "L". that much  the s u p e r f i c i a l i t y of  her  relationship  conversations, realization she  was  however,  of t h e i r  but  dying".  her l o y a l t y  contact  "L",  always  "I  very  the l a c k  remained  months b e f o r e L's death.  we  d i d have  s u p e r f i c i a l . . . and  o f depth  constant  actually characterized  mean  t h a t c o n t a c t I had w i t h  Despite  the s u p e r f i c i a l i t y ,  with  i t was  went i n t o  last  She r e c o g n i z e d  h e r i n those i n their  to her dying  She s t a t e d she f u l l y  so  some that  days when  relationship  friend  over the  recognized, i n s p i t e of  "what L had meant t o me over the y e a r s , and how we  had managed t o s u s t a i n the f r i e n d s h i p i n s p i t e o f t h e d i s t a n c e and our d i f f e r e n t avenues i n l i f e " . Control. During address  her experience  h e r own  sense  of loss,  the c o - r e s e a r c h e r  o f powerlessness  somehow i n f l u e n c e the course  o f events  i n being  able  o f t e n needed t o to control  or  l e a d i n g up t o and s u r r o u n d i n g  83  the  loss.  whether with  At  times  enough had  her  satisfaction researchers the  been  in the  death but  of "N"  found she  and  ability  the  with  death  dying  she  had  friend.  i n f l u e n c e the  " J " , and  have  them not  their  of  her  own  done  done  enough  When  confronted  outcome,  had  struggling  i n the  course  to  For  often  several  the  of both  degree  the  that  of co-  the  loss  in  terms  of  the  co-  challenged  inevitable  or  most  cope with  vulnerability  friend  with  so.  only  the r e a l i t y of her own  herself  had  to  challenged  also  r e s e a r c h e r to address  influence  f o r her  to p r e d i c t or  their  itself;  Anna  whether  o s c i l l a t e d between a sense of powerlessness and  friend  mortality  questioned done  actual a b i l i t y  co-researchers  of  she  death. of  control  illnesses  and  or  deaths  stated  What g r i e f as w e l l means f o r me i s a sense of r e s p o n s i b i l i t y ; a c h i l d i s h sense t h a t I had enough c o n t r o l to f i x i t . . . t h a t I c o u l d have changed t h i n g s . . . I even have t h i s i r r a t i o n a l thought t h a t I s h o u l d have been more s u p p o r t i v e and s a i d " w e l l you don't have to d i e , you can be the one person [who beats t h i s d i s e a s e ] "... I suppose I d i d n ' t say t h a t because I d i d n ' t t h i n k t h a t . . . . b u t everyone once i n a w h i l e I ' l l t h i n k "what e l s e could I have done?"  C a r l a a l s o s t r u g g l e d w i t h the degree of r e s p o n s i b i l i t y influencing stop  "S"  people, that  she  suicide.  S's  from  fate,  and  hanging  found  h e r s e l f a s k i n g why  herself".  including herself, and  others  had  She  explained,  who  done  had  After tried  everything  she  considering to  had  in  "wasn't a b l e  to  the  intervene  they  could  she  to  number  she  of  resolved  prevent  S' s  There, was n o t h i n g I c o u l d do, or anybody e l s e . I f a l l these s t r o n g and c a r i n g people c o u l d n ' t h e l p her through i t , then maybe i t j u s t wasn't meant to b e . . . . i t was her c h o i c e . Diane's e x p e r i e n c e also  c h a r a c t e r i z e d by  of the l o s s of her f r i e n d s " J " and then "D" a  s t r u g g l e with  her  sense  of  control.  was  Though  84  she was by  the  She  resolved fact  was  that  he  may  unprepared  herself both  t o J's impending  for  overwhelmed by  her  father  have  and  the the  to  confronted  by  to  make sense  to  recognize  had  a sense o f the that  vulnerability.  early  that  some  of  at  was  i n my  do  sudden l o s s  his  the  confronted  through  suicide.  and  same time  also  the  found  health  failing.  She  of  stated  f a c e a t the time,  in a big  way.  sorting  She  was  again  herself  unable  out".  when she  of another  his  herself  loss,  seriously  o f powerlessness  resolving  She  ended h i s l i f e  grandmother  I  really  found  fact  really  I  she  suddenness  "people's m o r t a l i t y was think  death,  loss  found  friend,  meant  "D".  She  acknowledging  began  her  own  stated.  The o t h e r p a r t [about g r i e f ] i s coming t o terms w i t h my own m o r t a l i t y . What I've g o t t e n from a l l o f these e x p e r i e n c e s i s the l i v i n g t o the moment... people can l e a v e r e a l l y suddenly, so no matter what age they are we need t o c h e r i s h the time we have. Natasha out  too  a l s o s t r u g g l e d w i t h her sense  late  treatment  that  at  possibilities  a  her  friend  had  centre  where  Natasha  existed  for  been  treatment.  that  situation  happened  and  the  difficult  for  me."  where  you  circumstances  discouraged was  She  c o u l d have been done t o have saved her kindof  o f powerlessness  aware  think didn't  that  life  from  that  questioned  friend's  in finding seeking promising  whether  and  something  t r a n s p i r e . . . that  more  stated " i t ' s could was  have really  Dissonance. The beliefs with  her  co-researcher about own  experienced  the deceased  a  or about  sense  grief  of  dissonance  reactions  were  in  when  conflict  o v e r t b e h a v i o r s or the o v e r t b e h a v i o r s o f o t h e r s .  sense of d i s c o r d was response  to  other  bereaved  friend  to  e x p e r i e n c e d as anger, persons  whose  accept.  Such  This  f r u s t r a t i o n or r e v u l s i o n i n  reactions discord  her  may  were  difficult  have  also  for  the  occurred i n  85  terms of her  own  as  with  dissonant  should  have  response or  coped  t o the  contrary  with  Anna e x p e r i e n c e d her  friend  death  "N".  which  felt  a  completely  isolated  herself  an  also  Constraining herself experienced otherwise issues.  as  and  explained,  part  speaking  dissonant  instrumental She  a  from  for in  was  the death  disdainful  t o her.  To  of  friend,  Carla's  his  avoid  others,  Anna  " i t ' s not  part  experience  of  loss.  to o t h e r s about the l o s s of "S"  really life  an a s s e r t i v e person".  She  o t h e r s , i n c l u d i n g "S",  i n t h e i r response  of  idiot".  who  forthrightly  i n my  herself.  after  i n front  or  often  anguish  concerned  of  after  would  of  crying  Carla,  " I t was  myself... everything e l s e  dissonance  intensity  and  explained to a  was  experienced  b e l i e v e d she  this  c h a r a c t e r t o be a b l u b b e r i n g k i n d of Dissonance  to  she  loss;  foreign  e m o t i o n a l l y overwhelmed  my  way  a t times  of d i s c o r d e s p e c i a l l y  becoming  of  the  experienced  and  which was  as f r u s t r a t i o n or r e p r o a c h w i t h  a sense  She  to  such  e x p e r i e n c e d by the bereaved  loss  perceived  herself  discussing  and  a burden keeping  a sense  - I'm  loss] quite  of d i s s o n a n c e  t o S's death,  be  resolving  i t [S's  I always d e a l w i t h  also experienced  to  was  with  stating  I was angry a t the g o s s i p i n the town a f t e r she d i e d . And I was angry about how she chose t o do i t [ s u i c i d e by hanging] - I was v e r y angry about t h a t . How c o u l d people be so unkind? Diane e x p e r i e n c e d of  her  with  friends.  the  courage  death and  illnesses, t h a t he may  She of  a sense  with  d e s c r i b e d an i n t e n s e sense her  friend  determination and  of dissonance  in light  in  "J". the  of t h i s  have taken h i s own  She  face  stoicism  life,  had  of she  the  loss  of s e v e r a l  of d i s c o r d  especially  been  his had  inspired  chronic  and  difficulty  by  J's  terminal resolving  and s t a t e d  I t h i n k I've always q u e s t i o n e d t h a t too i f he d i d take h i s l i f e . . . that part is still hard f o r me to come to terms with...maybe because i t was i n c o n g r u e n t w i t h the s t o i c n a t u r e of  86  h i s c h a r a c t e r . . . . t h e r e was a l s o some b a t t l i n g going on i n h i s f a m i l y about h i s a s s e t s , so t h e r e ' s t h a t kind of negative s i d e . . . I remember coming back from t h e f u n e r a l s e r v i c e , I f e l t a l o t o f anger. Natasha a l s o e x p e r i e n c e d she  experienced  her  need  this  t o openly  with  her  t h e death  acknowledge  what t h a t meant t o her, stating,  a sense  had  frustrating,  really  of her f r i e n d  t h e impending  and d i s c u s s e d how "L".  loss  In l i g h t o f  o f h e r f r i e n d and  she e x p e r i e n c e d g r e a t f r u s t r a t i o n w i t h o t h e r s ,  " I went back home t o v i s i t  she  of dissonance,  succumbed  h e r [but] a t t h e p o i n t where I saw  to  and on top o f t h a t  death.  everybody  I  found  seemed  i t incredibly  t o be denying  that  she was a c t u a l l y d y i n g " . Integrity. In aware  her experience of  integrity, with  pride  the  effect  of l o s s , that  each  co-researcher  impending  death  o r adherence t o a code o f v a l u e s . t h e way  i n which  her f r i e n d ' s  despite  the a d v e r s i t y of i l l n e s s .  sadness  how such  integrity  S e v e r a l c o - r e s e a r c h e r s were a l s o  impending  or a c t u a l  on t h e i r  on  t o become  her  friend's  The c o - r e s e a r c h e r integrity  threatened  illness.  death  had  Or c o n v e r s e l y ,  had been  seemed  noted  remained  intact  she r e c a l l e d  with  or diminished  by t h e  aware o f t h e e f f e c t  of the  own sense  of i n t e g r i t y  and t h e i r  a b i l i t y t o l i v e w i t h c o n v i c t i o n and meaning. Some c o - r e s e a r c h e r s f r i e n d which symbolized of  death.  integrity,  This and  described a s p e c i f i c  image o f t h e i r  that friend's serenity or v i t a l i t y  image  seemed  appeared  to  to restore assist  o r uphold  t h e bereaved  deceased  i n the face  their  friend's  i n managing  her  anguish. Anna r e l a t e d t h a t a l t h o u g h both h e r f r i e n d s had d i e d o f AIDS, t h e illness  had v e r y  different  effects  on t h e i r  t h a t " J " had "acknowledged how he f e l t who he was...he d i d n ' t f e e l l i k e  integrity.  She s t a t e d  about t h a t , but he never  i t was a punishment...! f e l t  denied  so proud  87  of  him, so i n c r e d i b l y proud  of him".  he  "really  i n some way  d i d believe  that  Whereas w i t h  "N"  he deserved  she  explained  to d i e , that i t  was a punishment". C a r l a was a l s o aware of the e f f e c t of i l l n e s s She  was  saddened  in  watching  d e s t a b i l i z e d by her d i s e a s e ,  her  friend  on S's  become  integrity.  diminished  and  s t a t i n g "S" had  the looks, the b r a i n s , the t a l e n t . So when you knew the p o t e n t i a l , to slowly watch i t crumble away was so p a i n f u l . . . and knowing how smart she was I was saddened t h a t t h a t was the way.that she f i n a l l y succeeded i n k i l l i n g h e r s e l f . Amidst  their  integrity  illnesses,  possessed  Discussing  her sense  impact of h i s l i f e so r e s i l i e n t , mean how And  Diane  especially of t h i s  also by  recognized  her  friends  as i t r e l a t e d  the  courage  " J " , and  and  "J.H."  t o " J " , she s t a t e d  "the  on me was the courage... when you see someone who i s  s u f f e r i n g w i t h more than almost anybody can d e a l with,  c o u l d we not make a courageous e f f o r t  though  her  losses  were  extremely  about our own  painful,  remained i n t a c t throughout t h e i r d y i n g p r o c e s s e s .  her  own  I  lives". integrity  She recounted,  I'm r e a l l y proud o f myself f o r b e i n g a b l e t o be t h e r e . . . i t ' s r e a l l y about b e i n g aware of what you can g i v e and what you can't, and what y o u r ' l i m i t s a r e , and t r y t o be t r u e t o y o u r s e l f and the other p e r s o n i n t h a t way.  Natasha her  dying  suffered just  was  aware o f the e f f e c t o f i l l n e s s  friend. with  really  time...[the and  also  She  reflected  her r e c u r r i n g fought  cancer]  a  illness,  brave  battle  had r e o c c u r r e d  t h a t was her f i n a l b a t t l e . " Meaning.  on  the and  on the i n t e g r i t y  number  years  " L " had  stated  "I thought  she had  a  long  over  and then  of  of  very  reoccurred  period  a third  of  time,  88  It  i s important here  meaning  observed  meaning  i s that  researchers' extracted on  her  in  which  experience  of  i s addressed  or e x p l i c i t  of  loss.  grief.  grief.  The  , the meanings i m p l i c i t  the  The  elements  the  levels  of  first  level  of  the  co-  are  of in  fact  implicitly  the  bestowed  phenomenological  i n the l i v e d  the e s s e n t i a l  two  elements  the bereaved  Through  allowing  between  i n a l l the  meanings which  e x p e r i e n c e of  are made e x p l i c i t , to be  the  experience  observation  to d i f f e r e n t i a t e  level  e x p e r i e n c e of  elements  of  grief  of the phenomenon  illuminated. The  second l e v e l  of g r i e f process loss.  itself. of  of meaning observed i s i n the form o f an  Meaning  consciously  The  element  as an element  striving  o f Meaning  an a c t i v e p r o c e s s of f i n d i n g which  most honored  second  level  to  was  i s the c o - r e s e a r c h e r s '  attribute  also  element  cause  or  active  reason  to  the  e x p e r i e n c e d by the bereaved as  c o n c r e t e ways t o g r i e v e the l o s s i n a  way  what the deceased had meant t o the bereaved.  of meaning  e x p e r i e n c e d as  an  element  in itself  The  will  be  d i s c u s s e d as f o l l o w s . Though Anna occurred  for  me  even  someone  pain  no  unanswered  some time a f t e r N's,  means o f making wasn't  had  sense  of  a logical  the  yet resolved,  she found h e r s e l f earlier  explanation  t o p r o v i d e an  q u e s t i o n s about  as  still  loss  of N.  t o why  he  explanation  f o r her  J's  death,  which  searching  for a  She  got  stated  ill."  that  t h a t w i l l make sense.  She  would  "there's nothing that's going to sort  "there hoped  quell  this  out f o r  Because death doesn't make sense."  C a r l a a l s o s t r u g g l e d t o make sense o f the death o f her f r i e n d and  the means by  which  "S"  had  attained  that  end.  make sense of her f r i e n d ' s a c t a f t e r  resolving that  the o n l y o p t i o n which  and  explained looked  "I  guess  o f f e r e d peace  that's  very peaceful  her  how  when he  desperate found  her,  an end she so  She  was  f o r "S",  t o her  I guess  able death  struggle.  was...her  "S", to was She  dad  said  she  that's  what  she  89  wanted".  This  search  d r i v e n a t times  f o r meaning  a t an unconscious  dream s e v e r a l months a f t e r  was  compelling,  level.  and seemed  C a r l a d e s c r i b e d having had a  the l o s s which h e l p e d h e r t o make sense o f  a s p e c t s o f S's death which had remained u n r e s o l v e d , of  responsibility  "it's  weird  how  Carla strong  herself your  d e a l w i t h t h i n g s , you can't  close friend,  especially  such as the degree  had i n p r e v e n t i n g  subconscious just  keep b r u s h i n g  i n her f i r s t  it.  She s t a t e d  i s , and i t ' s important  to  them away . . . o b v i o u s l y  somewhere i n s i d e o f me t h e r e was some p r e t t y s t r o n g For Diane,  t o be  experience  t h e r e ensued a s t r u g g l e t o make sense  feelings." with  the l o s s  of a  o f A's death.  She  stated,  I r e a l l y wasn't i n touch w i t h the f a c t t h a t people would a c t u a l l y d i e . . . i t was a v e r y sad p a r t o f my l i f e but not something I was mature enough o r e m o t i o n a l l y a b l e t o d e a l w i t h o t h e r than i n j u s t b e i n g overwhelmed. She of  was unable  t o make sense  h e r own mother,  1 year  of her experience  later,  the meaning o f the impending l o s s . around  f o r me...since  part  and l o o k e d  loss  of her f r i e n d  struggled deal  of  less time  then  after  the death  time  exploring  She s t a t e d " I t h i n k t h i s  turned i t  with  whom she spent  I've always  f o r the s p i r i t u a l  part  sensed  agonizing  loss,  to find during  meaning  i n the death.  his illness  for  struggle with  h e r attempt  the death  Her most  She had spent  administering  illness,  to  recent  sense  o f her f r i e n d s  found  [was] j o y w i t h  losses,  t h a t would  t h e i r l i v e s had embodied. She e x p l a i n e d ,  and  A f t e r witnessing h i s long  Diane  o f those  a great  h i s needs  meaning  i n J.H.'s  death."  t o cope w i t h her l o s s e s , Natasha searched  a means o f making  grieve  spiritual  "J.H." was one w i t h which d e s p i t e h e r anguish she  s t a t i n g t h a t f o r him "there In  the r e a l l y  o f death."  e x p l o r i n g with him the meaning o f h i s l o s s . and  until  but also  not o n l y  f o r a way t o  honour t h e unique  meaning  90  I'm t r y i n g to f i n d a way f o r me to g r i e v e . . . I've c r e a t e d w r i t i n g s or p o e t r y or s a y i n g s or whatever seems to be a p p r o p r i a t e and meaningful...the meaning of the person t h a t has been important to you l i v e s w i t h i n you and i n a l o t of ways you honour them by carrying t h a t and c h a n n e l l i n g what was s p e c i a l about them i n your own l i f e . Ritual. Ritual and/or  i s here  metaphorically  essential  aspects  described  by  life-cycle enclosing context  present  for  the  study.  the  dramatic shared  rituals  with  and  of  intense  f i t the  funeral,  engaged  in  the  life  ritual  it  a  p r i v a t e or of her  (p.  the  effective  symbolized  the  expectations  of  the  and  Anna,  who  was  reading  asked  value  deceased  the  friend,  and  read  her  was  I  one  c o u l d get  get through Further,  she  through this, found  it...I  I'm  not  ritual  Road Not  thought going  to  Taken, but  r e s p e c t my  to c r y , I'm  h e l p f u l when i t met  a commemorative ceremony s h o u l d be.  just  loss.  or  place  2  a  to her  if it in  the  nature.  poems  of a p e r s o n a l l y s e l e c t e d poem was  I wanted to read i s The  each which  helpful  took  of  the  adjustment  of a shared  choice  in  her  her  bereaved  This  act  in facilitating  F u r t h e r , the r i t u a l  to  or  by safe  friend,  legitimized  of  a  60).  bereaved  p u b l i c ceremony  friend,  As  disruptive  ...they p r o v i d e  of  more  threatening  emotion"  experience  or  deceased.  h e l p e d her s y m b o l i c a l l y honour the meaning of J's l i f e . "The  one  In an attempt to adapt to the l o s s of her  if  the  the  less  company of s u p p o r t i v e o t h e r s when the r i t u a l was For  moment  "make p o t e n t i a l l y  manageable  r e l a t i o n s h i p with the deceased. fit  a  of p r e s c r i b e d a c t i v i t i e s  to  commemorated the  loss  into  (1988)  expression  appears  commemorative a c t which s y m b o l i c a l l y  relationship  more  them i n a web  described  the  the  Imber-Black  co-researcher  She  of  a  condenses  transitions  definition  both  d e f i n e d as  at  ritual  She  J's that  recounted  I d i d n ' t know i f  friend going  I'm  going  to read  to  this."  her e x p e c t a t i o n s of what  D e s c r i b i n g the d i s p o s i t i o n  of  J's  91  ashes,  a  stated  " i t was  found  own  the  way a  neither  I  can't  Carla reflect formal  things  to  of  at  S's  the  She  the  funeral  for  his  these  be."  her  friends,  she  Conversely,  she  friend  N.  which  she  i n terms  of  I going to  do  fitting  "what am  pictures... this  is  unreal... I  of i t . " e x p e r i e n c e of  v a l u e of  disturbing  that  to  close  wishes nor  she  the as  p o s i t i v e e f f e c t s "S"  explained  few  to h e r s e l f  found u n s e t t l i n g the  of  thus r e p r e s e n t others.  planned  look  a  supposed  recalled thinking  e x p e c t a t i o n s or  ritual  are  with  would have wanted any  also  her  place  ceremony  bear  don't t h i n k N.  took  representative  needs, and  now.  and  which  disturbing  believed her  ceremony  ritual  deceased. i t failed  had  had  believed  on  at a  that She  to  the  did  not  found  the  eulogize  lives  of  and Carla  funeral,  they s h o u l d t a l k about the person and t h e i r l i f e , and how they touched people, and [the church] j u s t d i d n ' t do t h a t . . . s o whereas at some f u n e r a l s you e x p e r i e n c e c l o s u r e because you can s i t and t h i n k about t h e i r l i f e , hers was j u s t l o n g and so b i z a r r e .  In  contrast  was  a  the  more  evening  fitting  spent w i t h bereaved  ritual  for  Carla  t h e r e been honoured through p e r s o n a l about  S.  She  recounts  important... that about her  S."  Carla  friend  lives  me  I ' l l be  was  also  stating,  together  thought  to  day  chose  colors,  mourning on  the  private not  to  so  I  the  felt  a f t e r the  her  friend's  remembrances the  with  more of  created  "I  were  "that  who  friends  those  old  funeral rituals  wear b l a c k wore  outside  but  a  friends  honour  to  very inside  life  group had was  because we to  funeral  the  shared really  reminisced the  life  of  funeral...our  colorful colors  had  dress... I  i s what  she  is." In her the  creation  ailing pain  attempt to adapt to her of  personally  f r i e n d "J.H." to do and  create  a  losses,  meaningful  Diane a l s o  rituals.  living,  contributing  important  Encouraged  something p o s i t i v e w i t h the  "fitting,  found  by  energy from  memorial"  for  her her her  92  deceased would D's  friend  assist  area  such  she  the  important  f r i e n d "J.H."  She  energy.  commemoration  other  helped  She  to  administration  speciality.  some of my  public  several  in  of  directed  "D",  establish of  stated I t was  helpful people,  an  a  memorial  fund  annual  workshop  offered  "the  memorial  a way also  was  really  to honour him."  in  adjusting  including  the  to  later  which in  how  She  I  found  the  death  of  death  of  her  stated  what's h e l p e d me i n the g r i e v i n g has been to do t h a t k i n d of memorial t h i n g t h a t "J.H." t a l k e d about...and w i t h "J.H." we went out and s c a t t e r e d h i s ashes near l i g h t h o u s e park and t h a t was really b e a u t i f u l . . . those things are really important in the acknowledgement [of the l o s s ] . Natasha a l s o b e l i e v e d her  the  c r e a t i o n of a meaningful r i t u a l  to honour the meaning of her  access  to  the  r i t u a l s she  funeral  created,  of  her  deceased f r i e n d s .  childhood  A f t e r being  f r i e n d " J " , she  enabled denied  described  the  stating  I remember s t a n d i n g out on the fence of the s c h o o l y a r d watching [J's] f u n e r a l . . . somehow i t seemed v e r y s i g n i f i c a n t t h a t I had at l e a s t seen i t . . . I remember a b i r d d y i n g and I b u r i e d i t and put a c r o s s on the grave. Whether t h a t was a way of c h a n n e l l i n g J's death I'm not s u r e . . . [And l a t e r as an a d u l t ] I took a p i c t u r e of J's tombstone and t h a t seemed to have been something really important to do.  In  describing  bereavement, and is  the  Natasha  I need to sacred  let  it  and  importance  create has  explained rituals  of  rituals  further, that  meaning to me.  "I'm  honour the And  in a  her very  value  experience spiritual  and  through d o i n g  the  that  person  life  I'm  of  that  able  to  go."  Acceptance. The  final  element  to  be  discussed  e x p e r i e n c e of l o s s i s t h a t of Acceptance. that  in  adapting  to  her  loss,  she  in The  the  co-researcher's  co-researcher  eventually  began  to  indicated experience  93  acceptance place  of that  over  an  researcher, over time  loss  extended  as a r e s u l t period  o f time.  seemed t o be f a c i l i t a t e d  o f h e r f r i e n d ' s death  of r e s o l u t i o n t h a t the bereaved described  a  sense  f o r and b e g i n  through  h i s lengthy  pain  t o accept  experience death  he e x p e r i e n c e d  and found peace i n impending  which gained  i n J's l o s s .  o f h i s death,  his loss.  of i l l n e s s  as a p o s i t i v e  with  f o r each  co-  clarity  o f peace o r j o y i n death.  o f acceptance  prepare  h i s impending  took  sense  h e r s e l f was a t peace w i t h the l o s s .  r e s i g n e d t o the i n e v i t a b i l i t y  and  by a b e l i e f  that  seemed t o be accompanied by a  herself  accept  process  Acceptance,  t h a t h e r f r i e n d had found a sense  Acceptance  Anna  o f an a c t i v e  which  found  helped her  She had supported and d y i n g ,  him  and began t o  alternative  t o the anguish  Believing  " J " anticipated  h i s decline.  death,  She  she e x p l a i n e d ,  I had watched him become a person t h a t he d i d n ' t want t o be... I d i d n ' t want him t o l i v e t h a t way anymore, and I knew t h a t he d i d n ' t want t o l i v e . . . T h e r e were no o t h e r o p t i o n s . And he was r e l a t i v e l y ok w i t h [ d y i n g ] , as ok as anybody c o u l d be...The b e s t t h i n g about J's death i s he made i t a w f u l l y easy for his f r i e n d s . . . I have a q u i t e p e a c e f u l f e e l i n g about t h a t d e a t h . . . I t i s something t h a t i s sad but n o t something you have t o keep t r y i n g t o s o r t out... oddly enough i t f e e l s l i k e he d i e d a l o n g time ago, although i t ' s j u s t a year. In c o n t r a s t , though N's death  had o c c u r r e d almost  Anna found she had not y e t accepted N's l o s s ,  2 years b e f o r e J ' s ,  stating  Not t h a t I had a c l o s e r f r i e n d s h i p w i t h "N" than I had w i t h " J " . . . [ b u t ] the o t h e r t h i n g i t goes back t o i s i f you b e l i e v e people get what they want when they d i e , t h a t h e l p s . In a sense " J " got what he wanted, and then t h e r e ' s t h e o t h e r sense t h a t "N" d i d n ' t get what he wanted. And so t h e r e ' s t h a t element m i s s i n g . So t h e r e ' s t h a t r e g r e t . . . I don't know t h a t I ' l l ever f e e l i t ' s okay t h a t "N" d i e d . . . i t f r i g h t e n s me t o say t h a t t h e r e wouldn't be acceptance.  Carla's brought  anguish  over  her  h e r t o a p o i n t where  friend's she began  struggle to resign  with  illness  also  t o S's f a t e  well  94  b e f o r e the a c t u a l death. R e c a l l i n g a c o n v e r s a t i o n w i t h a mutual of day  S's  b e f o r e the  suicide  she  stated,  were  to  the  call  we  were j u s t couple  the  years."  herself  concomitant  death,  get  that  both she  Two  years  after  S's  acknowledged  had  s o r t o f p r e p a r i n g o u r s e l v e s . . . she was  of  allowing  going  "we  taken  so tormented  death,  through  t o acknowledge the e x t e n t of her l o s s anguish,  Carla  believed  she  her  had  that  one  l i f e . . .we those  a  last  process  and  finally  friend  of  experience  accepted  S's  explaining  That's what she wanted and i n the end i t was her c h o i c e . . . She i s at peace f i n a l l y a f t e r s t r u g g l i n g so long...I'm j u s t happy t h a t she's not s t r u g g l i n g l i k e she was, and now I'm a b l e t o j u s t enjoy the good memories... I' ve had so much time t o t h i n k about i t and I've l e t myself t h i n k about i t . Now I can t a l k about i t without r e a l l y g e t t i n g emotional because I'm a t peace w i t h i t now.  For of her  Diane, illness  participating  and death h e l p e d f a c i l i t a t e  friends,  especially  f a m i l y members, sense  she  of  her  involved,  resolved.  She  "J.H.", and  with  grandmother's  "J.H.".  she  death  She  and  In the  described  as  whose  whose  an  f o r the deceased  sensed t h i s mystery  in  experiences  her acceptance o f the deaths  " J " , and  wherein  or j o y .  friend  intensely  "A",  w i t n e s s e d what  of s p i r i t u a l i t y ,  by a sense o f peace death  i n her mother  dying  death  was  awe  was  of  her  inspiring accompanied  e s p e c i a l l y i n the  process  she  deaths  of  she  most  was  most  immediately  stated  His l o s s was so l o n g term, we were g r i e v i n g c o n t i n u a l l y . . . so when he a c t u a l l y d i e d , t h e r e was a l o t o f t h a t work t h a t had a l r e a d y been done...what I got from death is...someone whose body i s d e t e r i o r a t i n g and who i s r e a l l y i l l , r e a l l y welcomes death... t h e r e i s peace i n i t . . . t h e r e i s j o y w i t h death...and he was g o i n g t o a really nice place...All that stuff has h e l p e d me with the acceptance. With "the  the  suddenness  unexpected of i t . . . I  death  of  her  friend  "D"  d i d n ' t have the a b i l i t y  however  she  stated  to process i t l i k e  I  95  did  w i t h the o t h e r s . "  another life,  dying  and  until  f r i e n d who  that  the  Her  suggested  h i s sudden  end.  That  i n c a p a c i t a t e d . . . or  acceptance  and is  have  to  o f h i s l o s s was  to  her  unexpected a  death  positive,  cope  with  that  that  the  "D"  facilitated had  had  " a l l o w e d him he  did  knowledge  a  full  to  live  not of  by  become  impending  death. " And she had the  years  i n the months b e f o r e the death o f her f r i e n d L.,  also resigned  news o f  relief  L's  f o r Natasha,  in  L's  that  h e r s e l f t o the i n e v i t a b i l i t y  death death  arrived was  of s u f f e r i n g that  l o s s , she b e l i e v e d  L. she  a  Natasha  positive  had  e x p e r i e n c e d sadness, alternative  endured.  To  needed t o b r i n g  p r o c e s s of g r i e v i n g t h a t l o s s , but  o f her l o s s .  to  the  When  but  months  also and  e x p e r i e n c e acceptance i n some f i n a l  closure  to  the  stated  I've g r i e v e d f o r her i n a l o t of the ways t h a t I've needed t o [but] I may need t o b r i n g some f i n a l c l o s u r e t o i t and acknowledge t h a t . . . w i t h f r i e n d s , I don't know what r e a l l y l e t t i n g them go i s like. I o n l y know the way t h a t I've done i t .  96  CHAPTER V Discussion The  purpose  the l i v e d  of  interviewed  loss  as  in this  meaning  or  study,  each  the  was  For the bereaved  Acceptance,  of  of  involving  a  loss,  the  (1944)  set  elements.  The  experienced  several  a l l of  following  six  study,  of  these  following  elements  d e s c r i b e d as  guilt  and  researchers  Anger  also  this  study,  seemed t o be and  was  wherein  either  others  researchers  also  in  the  The  the  forms a c r o s s remained  sadness  appeared  grief  that  Emotional  of  Distress,  Ritual.  as  aspect  of  her to  own  crisis  Lindemann's  in  this  loss, as  such  reaction  element  experience  guilt  the or  to  be  All  co-  which  was  Distress."  f o r the  to  were  sadness,  appeared  element  have  although  as  "Emotional  the  or  symptomatic  study.  an  experience as  to  Lindemann  phenomena  study  here  appear  by  phenomena  their  of  to  bereavement,  outlined  These  present  reaction  study  in their  first  in  a  or  the c o - r e s e a r c h e r e x p e r i e n c e d a sense with  the  b i o p s y c h o s o c i a l symptoms  bereaved  defined  or  of  elements.  including  as  feeling-related  an  thread  the e x p e r i e n c e o f  present  elements  responses  d e f i n e d i n the  "Dissonance", with  by  experienced  thematically  grief  self-reproach.  experienced  common  meaning  Dissonance,  the  co-researchers  essential  elements,  characteristic  experienced.  was  a  of  Literature  co-researchers  the  10  elements  In examining  four  be  i t s essential  Control,  consistently  variably  embodied  characterized  of  the  to  I n c l u s i o n , I n t e g r i t y , Meaning, and  Lindemann  anger,  of  appeared  that  Results i n R e l a t i o n to Current  not  each  friends i n this  Concession,  Exclusion,  there  friends.  have been m a n i f e s t e d i n d i f f e r e n t  experiences  constructed  for surviving  experience  an element may  same.  t o d e f i n e the e s s e n t i a l  d e s c r i b e d by  Although of  study was  experience of g r i e f  experience  shared  of t h i s  bereaved  in  theme  of  of d i s c o r d loss.  Co-  self-reproach.  97  although  they  described  their  experience  i s s u e s of c o n t r o l and powerlessness  more  as  a  struggle  with  r a t h e r than t h a t of g u i l t .  D i s b e l i e f i n the r e a l i t y o f the death, another d i s t i n c t element o f the  grief  reaction  illustrated loss.  i n the  Her  "A",  and  fact  that  first  described  present  study  Lindemann's  especially  e x p e r i e n c e w i t h death was  f o r some time he  in  after  would never  u n f a m i l i a r w i t h death  his loss  return.  and  had  not  also  a  At  study,  i n Diane's  was  also  experience  w i t h the l o s s of her  she  denied  this  the  friend  reality  p o i n t i n her  yet acknowledged the  life  of  of  the  she  was  reality  of i t s  existence. Hostile  reactions,  characteristic  of  the  grief  symptom  described  response,  was  t h r e e of the c o - r e s e a r c h e r s i n the study. described  what  experiences  of  may  be  defined  bereavement.  as  These  variably  hostile hostile  another  experienced  dissonance  h e r s e l f enraged on  the  by  abilities  experience  their  confronted  by  appeared  characteristic disruption  the  of  Diane  grief.  the  and  Carla  gossip  of  other  also  of  her  symptom o f g r i e f .  d e s c r i b e d an  initial  disruption  i n her  Natasha  also  With  work as w e l l  of  experienced  6  some  to  also  and  found  "D"  openly  impinged  and  fully  dissonance whose  when  actions  suicide. of  conduct  as  a  e x p e r i e n c e d more as a  death  of  her  p a t t e r n of  i n her form  as  Diane  actions  patterns  the  their  defined  "N".  individuals  i n her as  during  each  invalidated  loss  Such l o s s was  study.  this  of  Carla  openly  experienced  non-bereaved  loss  and  experienced  friend  bereaved  similarly  d e s c r i b e d the  by  Anna  another mourner whose e x p l o i t a t i v e  present  and  who  o f her  pain  i n the  experienced Diane  bereaved  t o her t o be s e n s a t i o n a l i z i n g her f r i e n d ' s  Lindemann  Anna  amidst  experienced  r e a c t i o n s are  dissonance  w i t h the l o s s  as  reactions  i n the p r e s e n t study.  Anna's f e e l i n g s of anger  Lindemann  Anna, Diane  the e x p e r i e n c e o f "Dissonance" when c o n f r o n t e d by  by  of  social  friend  "N",  conduct,  and  life.  disruption  Carla, in  their  98  p a t t e r n s of conduct The  final  characteristic  symptomology appetite  of  in  including  the  (1969).  of  friend,  model.  and  present  and also  a v a r i e t y of such d i s t u r b a n c e s , i n c l u d i n g  vivid  In  by  energy.  had  loss.  form.  and  study.  by  their  experience Only  Bowlby  findings  of  one  i f i t occurred  (1961)  and  regarding  the  1969)  of g r i e f ,  grief  generally did  co-researcher  i n stages.  Before  comparing her own  t o assess  apriori  the  extent  knowledge.  the  Most  elements  by  example the  waned  throughout  the  element  co-researcher  in  clarity  seemed  to  other  the of  Acceptance  definition  mediated o t h e r elements of her e x p e r i e n c e ,  the as  such  as  of  stages to  this  bereaved  in  experienced  and  may  death, the  her  experience  co-researchers'  well before  and  overlap  not  death  experience  the  linear  the  t o which her  For  a  spoke of  been f a m i l i a r w i t h a model o u t l i n i n g  a t v a r i o u s times For  experienced  to  (Kubler-Ross,  found h e r s e l f  such  proposed  the elements of t h e i r g r i e f d i d not seem t o be  linear  experienced  grief  contrast  i n the  as  later  of  or stages  It i s d i f f i c u l t  t h i s study,  waxed  loss  Carla  affected  a  sleep study  t o emerge i n t h i s  of g r i e f ,  of  r e g a r d i n g Lindemann's  symptoms,  Co-researchers  models  (Bowlby, 1961)  experience  in  the  s e q u e n t i a l aspect  appear  was  behavioral  here  r e s u l t s of the p r e s e n t study can a l s o be d i s c u s s e d i n r e l a t i o n  aspects  phases  her  of  illustrated  s l e e p - d i s r u p t i n g dreams, and changes i n a p p e t i t e and  Kubler-Ross  or  that  to experience  The to  is  t o be  disturbances.  appeared and  a f t e r the l o s s of t h e i r r e s p e c t i v e f r i e n d s .  were  re-  experience have  yet  been  variably  surviving  friend  t h a t of C o n t r o l or  Meaning. The grief  as  limited phases  methodology  emergence  in  or  may  chosen.  stages Each  d e s c r i b e her e x p e r i e n c e her  experience  which  the  present  well  be  co-researcher  of l o s s by  seemed most  study  explained in  this  commencing her important  or  of  such  by study  the was  aspects  of  particular asked  to  s t o r y at a p o i n t i n  fitting  as  a place  to  99  begin.  The  intent  of t h i s  approach was  t o a l l o w the  co-researcher to  focus on a s p e c t s of her e x p e r i e n c e which she h e r s e l f deemed t o be most meaningful  and/or  experience  problematic,  itself  co-researcher beginning  allowing  the  essence  t o d i c t a t e the emergent s t r u c t u r e of g r i e f .  been  at  thereby  a  instructed point  in  i n s t e a d to her  describe  experience  as  her  of  her  Had  the  experience  determined  by  by  the  r e s e a r c h e r , i t i s p o s s i b l e t h a t a c h r o n o l o g i c a l or s e q u e n t i a l form have emerged i n terms of her e x p e r i e n c e of the elements of her  grief.  D e s p i t e the f a c t t h a t c o - r e s e a r c h e r s d i d not d e s c r i b e the of  stages  or phases  of g r i e f proposed illuminated study.  in  the  (1961)  such  that  triggers  bereavement." having  triggered  intense  did  not  rather  also  events  Carla's  suicide  Several  of  emotional to  which  the  intervening several  disturbing began her  to  her  dream  which  recognize  friend's  had  that  suicide  to  at  with  such  them  further  discussed. Carla  make  adapt  ensued.  In  some l e v e l own  to,  she  had  potential  often  r e g r e s s i v e but and  often  months  event of  and  find  aspect  after  found  these  been  also  which  of her p a t i e n t s .  light  phase  study  t h i s dynamic, an  this  of  suggested  earlier  unexpectedly  of  study.  Co-researchers  as  Several  of one sense  an  present  experiences  were  phenomenon He  be  present  in this  responses.  To i l l u s t r a t e  attempt  her  the  models  acceptance  phenomena  behavioral  friend,  suicide  attempting  be  in  the  the  of the deceased.  unexpected  or  helped  close  i n the  days  in  disruptive  bereaved  perceive  will  the  presence  (1961) appear t o  a r e g r e s s i o n towards  encountered  experience  of  described  grief  reminders  g r e a t e r meaning i n , t h e i r l o s s . of  of  of  by most of the bereaved  precipitated  seem however as  Bowlby  described  as unexpected  described  aspects  anger, d e p r e s s i v e - l i k e symptoms and  triggers,  of  other  (1969) and  experiences  t o v a r y i n g degrees  Bowlby  such  experience,  by Kubler-Ross  Disbelief,  experienced  in their  may  the  herself She  the  spent vivid,  events  Carla  struggling  since  culpability  in  it, a  100  disturbing  issue  which  unacknowledged and had  been  a  until  the  unresolved.  trigger  which  second  Witnessing  helped  her  suicide  this  had  remained  second s u i c i d e  f u r t h e r adapt  to  her  attempt  loss  and  b r i n g g r e a t e r c l a r i t y of meaning to i t . The  experience  bereaved  friends  w i t h Worden's  of g r i e f  in this  grief  as  a  resolution  task of  negotiation the  elements when  her  was  i n her to  that" that  loss.  the  In  and  was  process  the  pain  e v o l v i n g over  to have a dynamic a s p e c t example  loss, of  and  each  to  the  able  to  begin  i n the  friendship,  to  as  well  each  of  as  appears  to be  considerable  alleviating bereavement. others  or  exacerbating In  (Raphael,  their 1977;  the  research Vachon  &  on  impact  of  rituals  i n the  social  kin  S t a l i a n o s , 1988)  the goodness of f i t between the a c t u a l support  an  grief.  to  as  in  her  a means  have  either  loss.  effects  bereaved  such  was  seemed to  appeared  agreement  adverse  loss  f o r meaning  personal  terms of the importance of the r o l e p l a y e d by  the  experience  h i n d e r e d or enhanced her a b i l i t y to adapt to her There  anguish  o t h e r elements appeared  searched  which  only  co-researchers,  which  Similarly,  the  d e s p a i r . . . and  r e s o l v e her  other  for  of  s t a t e s i t was of  and  grief  experience  depths  time  of  of  eventual  acknowledgement  i m p l i c a t i o n s of  actively  process.  the  experience  co-researchers'  co-researcher  her  this  i n the  a p e r i o d of  created concessions  honouring  towards  d e s c r i b i n g her  the  keeping  n e g o t i a t i n g the p a i n  go  and  f o r the  in  i s a dynamic  bereavement, Natasha  feel she  of  For Natasha as w e l l as the of  seems to be  bereaved  aspect  t h e i r e v e n t u a l a d a p t a t i o n to l o s s .  For  finding  also evident  inclusion "able  for  dynamic  study.  acknowledgement active  leads  The  a c t i v e process  assertion that g r i e f  this  was  acknowledge over  in  of  she  which  pain  This  an  a c t of acknowledging and  loss.  of  bereaved  study.  (1982, 1991)  Worden d e s c r i b e s the  appeared to be  literature  support of  the  Worden observe  o f f e r e d and  in  i n either stress (1991)  that the  of and  i t is quality  101  of support  as i t i s p e r c e i v e d t h a t  predictors bereaved  of  adaptation  non-kin,  effect  of  According  to  Kauffman  appears  bereavement.  (1989)  and  perceived  social  to  observations,  their  support  on  a v o i d i n g the  overt expression of g r i e f social  support  appears  (Pine, 198 9) which may Doka kin,  (1989) and  of  may  others  (Deck  & Folta,  1989)  writers  assert  and  immediate  kin,  bereaved  that  the  as  a  non-kin  stress  of  their  limited  bereaved. for  non-  r o l e i n the  consequence  are  loss.  to  isolation  that  of bereaved  acknowledgement f o r t h e i r exacerbates  fail  of  support which p l a y s a primary  These  grief.  consider  argue  the  so as a means  p r o l o n g a d a p t i o n t o the l o s s f o r the  spouses  subsequently  do  i n t e n s e sense  norms which r e s e r v e the d e f i n i t i o n  support  of  often  and may  on  observe  T h i s p e r c e p t i o n of  t o c o n t r i b u t e t o an  grief.  support and  also  non-kin  o f o t h e r s who  societal  receiving  research  experience  grief,  as i l l e g i t i m a t e .  i t i s the a c t u a l s o c i a l  experience  the  o f the s t r o n g e s t  their  (1989)  bereaved  p e r c e i v e d judgement  one  In  Pine  acknowledge and/or r e c o g n i z e t h e i r own of  t o be  for  of  surviving  excluded  from  Such a t t e n u a t e d  bereavement  for  non-  kin . The  findings  assertions and  i n this  r e s e a r c h appear t o i l l u s t r a t e  r e g a r d i n g p e r c e i v e d and  Diane  indicated'  bereavement  was  Natasha was  a t times  support.  Both  bereavement  was  support appears  the  adequate,  level the  and  perceived inadequate.  social  support  experience that  that  of  the  Carla's  of  support.  received loss  experience  subsequently stating  my  when  "Why  right  t o openly  r e c e i v e support. s h o u l d I get  [the deceased]  has  She  and  Carla  and  in  their  exclusion  from  perception that  g r i e v e the death questioned  two  their  social  her  t o have someone t o t a l k  parents  Anna  such  received of  these  during  e x c l u s i o n from  support  of  While  f o r both  t o have been i n f l u e n c e d by her i n i t i a l  bereaved, grief,  of  d e s c r i b e d as  she d i d not have a l e g i t i m a t e friend  actual  each  beautiful  of role  to  her as  about  children  102  who  are g r i e v i n g  initially  excluded  available. loss  When  her from  accessing  she e v e n t u a l l y  believed  Conversely  recalled the  loss  exclusion have  later  appeared  her  largely  including  whether  suffered  a  there  loss.  her  from  was  others  actually of her that  she  little  friend  process... i f i t i s l i k e  in  childhood. during  suffered  culture that  as w e l l  just  loss,  experience  this i n i t i a l  of available i n adulthood.  does  f o r a family  loss  member,  during  She s t a t e s  honour  of  appears  support  f o r anybody not  Natasha  and support f o r  Her  out t h e r e  social  as her r o l e as  of  or no r e c o g n i t i o n  i s support  Our  of actual  experience  her perception those  i n her experience  t o the l a c k  her l o s s  first  s o c i a l support  affected  question  f o r both  with  close  from a c t u a l  losses,  that  perceptions  the legitimacy  the support  t o be r e l a t e d  she r e c e i v e d  of  the support  such  she d i d not have a r i g h t t o a c c e s s .  Especially that  that  acknowledged  she found  and acknowledgement  bereaved.  indicated  f o r Natasha, h e r sense o f e x c l u s i o n  bereavement  support  to  Carla  and o f her p a i n ,  initially  of  her l o s s ? "  who  the  "I has  grief  i t i s multitudes  t h a t t h a t d e n i e s the g r i e f o f a f r i e n d . " Given the focus o f t h i s paper on s u b j e c t i v e making,  i t i s beyond  the scope o f t h i s  fact i t i s the perception greater  study  o f o r the a c t u a l  e x p e r i e n c e and meaning  t o determine whether i n  s o c i a l support t h a t  e f f e c t on the e x p e r i e n c e o f g r i e f .  Nonetheless, i t would seem  t h a t depending on t h e unique a s p e c t s o f the s u r v i v i n g and  historical  level  of  experiences,  available  both  support  the actual  are  has the  as w e l l  significant  friend's as t h e  factors  current perceived  in  either  e x a c e r b a t i n g or a l l e v i a t i n g the s t r e s s o f bereavement. Parkes and Weiss 1982)  suggest t h a t  quality  (1983) and o t h e r s  (Raphael & Nunn, 1988; Worden,  another f a c t o r a f f e c t i n g adjustment  o f the r e l a t i o n s h i p  between  Among o t h e r f a c t o r s a h i g h l e v e l  the bereaved  t o l o s s i s the  and the deceased.  o f ambiguity i n t h e r e l a t i o n s h i p w i t h  103  the  deceased  may  be  Anna  may  complicate  illustrated  and Natasha  adjustment  i n the present  whose  to l o s s .  study  concessions  i n the g r i e f  for their  a d v e r s e l y a f f e c t e d t h e i r adjustment  Such  dying  t o the l o s s .  genuine e x p r e s s i o n about h i s impending  friends  death.  contributed  have  The c o n c e s s i o n s  that  loss,  which l e f t  to  her  continued  her w i t h many  Such  difficulty  concessions  i n resolving  For Natasha, d e s p i t e her awareness o f the l a c k o f depth  relationship  w i t h her d y i n g  friend  "L", her l o y a l t y  remained  over the months l e a d i n g up t o L's i n e v i t a b l e death. address  her concerns  continued  of  may  unanswered and u n r e s o l v e d q u e s t i o n s a f t e r h i s death. have  experiences  "N" r e q u i r e d t h a t she c o n s t r a i n her open and  Anna made f o r her f r i e n d  may  complications  w i t h her f r i e n d ,  t o q u e s t i o n whether  i n her  constant  She was unable t o  and l o n g a f t e r L's death  she and f u l l y  his  Natasha  g r i e v e d and r e s o l v e d her  loss. There  appears  to  be  r e g a r d i n g the importance (1991) m a i n t a i n s with  an  support Worden  the  doing  ritual  to  experience  she  (Reeves, be  an  support.  denied She  created private  an  express  of  rituals  death.  that  to  Worden  the bereaved and  receive  in  their  as a v i a b l e  a t v a r i o u s times  to  study  her  denied grief  adjust  i n her l i f e  to  of  also  found In  and  access receive  loss,  t o both  her  o f her  such  her  a  means o f  t o the f u n e r a l  that i n being  i n order  creation  bereavement.  access  be  the meaning o f the  i n this  express  t o l o s s may  The  suggested  denied  and m a i n t a i n e d  anguish  to v a l i d a t e  the  factor  opportunity  of g r i e f .  t h a t adjustment  Co-researchers  Natasha was  believes  their  literature  i s not p r e s e n t a t the f u n e r a l ,  i s found  has been  important  i n childhood,  was  ritual  1989).  of g r i e f ,  i n the e x p e r i e n c e  (1986) observe  reality  i n the  of the f u n e r a l provides  openly  i f no o t h e r means and  reference  I f the bereaved  (1991) and Yoder  p e r s o n a l l y meaningful  friend  to  i n their loss.  relationship  so  of r i t u a l  t h a t the r i t u a l  opportunity  complicated  considerable  she  validate  104  and  commemorate her  private  rituals  adjustment  to  friend's l i f e  seemed  especially  l o s s when the  a  of the  commemorative  ritual  of  meaning  the  of  funeral  her  be.  failed  to  life,  of  (1989) and  who  assert  others  that  the  unrecognized  and  researcher's  experience  exclusion. inclusion social  and  in their  of  which  of  was  when  the  for  and  for  her  of  allowed  her  a  though  found  sense  support  of  was  an  d i s e n f ranchisement  was  not  protocols of  as  I was  to  l e t this  reading  them.  such d i s e n f ranchisement  extensive  evidence of  this  of  by  within  of  element  of  a component  of  group of  important as  loss.  her  in  own  her  Even support therapy  bereavement  co-researchers  element  dominant  co-  sense  a c t u a l l a c k of  inclusion the  each  a  their  an  in  the  element  in  meaning as  was  I had  been q u i t e i n f l u e n c e d by  the  r e l a t e d to the phenomenon of d i s e n f r a n c h i s e d  a c o n s c i o u s attempt not  is largely  literature.  review of the l i t e r a t u r e ,  literature  aspects  an  Kauffman,  survivors  of  which  observations  1989;  l o s s , which i n c l u d e d  the  embodied.  a l s o e x p e r i e n c e d an  acknowledgement  loss,  Pine,  formal  rituals  f r i e n d ' s l i f e had  1989;  the  represent  private  characterized  co-researchers  neither  f r i e n d of what  thus  non-related  exclusion  In my  find  and  Certainly  grief  i n d i c a t e d i n the aforementioned  evidence  of  I t would seem t h a t w i t h i n  study,  grief,  the  example,  e x p e r i e n c e d what appeared t o be  experience. this  grief  experiences  recognition  recognition  group  bereaved  created  & Folta,  disenfranchised.  However, the  Natasha, who  (Deck  often  co-researchers'  representative  the  eulogize  Carla  the  r e s u l t s of t h i s study i l l u s t r a t e o n l y i n p a r t the  Doka  1989)  in  and  r e l a t i o n s h i p shared w i t h  For  would e f f e c t i v e l y honour the meaning her The  Such p e r s o n a l  was  h e l d by  should  friend's  ritual  (or of the  expectations  ceremony  death.  important  public  of the meaning of the deceased deceased) nor  and  information  b i a s my  grief.  I made  perception  However I a l s o expected t o and  was  s u r p r i s e d when I d i d  phenomenon i n the  protocols  at  of find not  hand.  105  S e v e r a l f a c t o r may e x p l a i n t h e minimal the e x p e r i e n c e Firstly  s i n c e few i f any e m p i r i c a l s t u d i e s , i n c l u d i n g  grief,  an element o f e x p e r i e n c e as Conversely,  the experience  i l l u s t r a t e d as an element  may have than  had been  emerged  that  present  of  study  the present were  frequently  experienced  intensity  support  Lister  of grief  1985)  report  about death.  that Given  support,  to  a  greater  has  also  by  gender.  may be r e t i c e n t  t h a t such  gender  co-researchers  i n the  t o Stroebe  females degree  grief  Similarly  of co-  of disenfranchisement  observed  males,  group  and Stroebe  report than  having  their  that  male  despite the  reactions  a r e not  D a S i l v a and Schork  to discuss  their  (1984-  attitudes  r e p o r t e d t e n d e n c i e s may minimize  to  social  it  i s p o s s i b l e t h a t an element  have  r e a c t i o n s more openly and  subsequently  experienced  males  grief  well  of the opposite  The  and a c c o r d i n g  (1991)  o v e r t l y expressed by t h i s  were  informants.  males;  and p o t e n t  may  i f a different  The element  r e p o r t and e x h i b i t  social  counterparts.  of grief  a l l female,  than  i s not as common  of disenfranchisement  interviewed.  of friendship  suggested.  i f the co-researchers  (1989-1990) females more  has been  study.  phenomenological  appear t o have focused on t h e e x p e r i e n c e  i t may be t h a t d i s e n f ranchisement  researchers  phenomenon on  of the co-researchers interviewed i n the present  investigations,  been  influence of this  access  i f males had been i n t e r v i e w e d i n t h e p r e s e n t o f d i s e n f ranchisement  might  study  have  been  illuminated. Further,  co-researchers  mental h e a l t h f i e l d . assumption  t h a t these  some  aspect  their  work  deepened grief  were a l l employed  As a mental h e a l t h p r o f e s s i o n a l co-researchers  o f t h e phenomenon experiences  ability  i n some aspect  may w e l l  like  of g r i e f have  to discuss, explore  as i t i s l i v e d and p e r c e i v e d .  myself  and d e f i n e  I have made t h e  have had t o address  i n their  developed  of the  work,  and  through  t o v a r y i n g degrees their  a  experience of  I t may a l s o be assumed t h a t  these  106  bereaved social some  could  have  had  support than those bereaved  aspect  other  potentially  o f mental  health.  access  to  sources  of  related  to  employed  in  whose v o c a t i o n s are not  Had  v o c a t i o n s , or unemployed,  greater  the  an  informants  element  of  been  disenfranchisement  may  w e l l have been i l l u m i n a t e d . The r e s u l t s o f t h i s study appear t o i l l u s t r a t e K r e f t i n g ' s argument (1991)  regarding  clarify  both  the  the  experience.  In  ability  invariant  the  invariant  or  the  themes  present  weave through the l i v e d Such  of  study,  and 10  universal  aspects  Douglas'  study  phenomenological  development  i n each  spirituality and of  deeper grief  in  and  the  understanding  understanding also f o r the  their  friends  time  her  that  greater  of l i f e appear  friend  had  understanding  a  found  of  often  c o - r e s e a r c h e r ' s own  study study.  relation of g r i e f  life  a and  characterized  by  elements  such  observed a  This  be  the  sense  of  experience  For  the  co-  t o be an a s p e c t  gained or to  an  spirituality  study.  appeared  seemed  be  each  o f the  clarity  over  j o y i n death. be  an  aspect  A of  i n a g r e a t e r depth o f meaning i n the  and i n e v i t a b l e death.  the  (1989),  death  to  a s p e c t s o f the  o f peace  to  study,  o f a deeper  o f acceptance, wherein  sense  friend.  o f meaning, where the s t r u g g l e t o make  resulted  life  to  Carter  found  which  to  study t o t h a t i n  was  present  conviction  t h e i r e x p e r i e n c e o f the element  In  t o be  lived  appear  latter  death.  to  appeared  the  grief  sense o f s p i r i t u a l i t y  developed  sense o f the l o s s  In  and  c o - r e s e a r c h e r s i n the  e x p e r i e n c e o f the element  surviving  also  found i n t h i s  of  of  f o r each bereaved  o f the bereaved p a r t i c i p a n t s  r e s e a r c h e r s t h i s deeper of  experience  themes  grief  (1994).  approach  meanings  invariant  of  the elements  element  unique  experience of g r i e f  i l l u m i n a t e d when comparing  essential  phenomenological  search  found  in  Carter's  themes were a l s o the  theme  f o r meaning  of  i n the  observed  phenomenological i n the p r e s e n t  "Seeking",  which  loss.  search f o r  The  was  107  meaning i n l o s s was  a l s o an element of the e x p e r i e n c e  c o - r e s e a r c h e r s i n the p r e s e n t study. as  "Hurting",  "Missing", loss.  characterized  C a r t e r a l s o observed intensely  painful  f o r the  such  themes  emotions,  and  c h a r a c t e r i z e d by an acute awareness of the magnitude of  In  the  experienced  by  present each  rich  study,  illuminated  This  variation  elements  and  of  in lived  through  the  were d e f i n e d  experience  use  i s illuminated  as  of  both  the  amongst  were  the  within  the  present  study t o the o t h e r phenomenological  this  The  also  theme  or  approach.  study,  and  in  s t u d i e s reviewed  in  findings  within  the  present  study.  A  theme which permeated Anna's e x p e r i e n c e  of the  loss  of her  friend  "N"  i t relates  to  the  was  t h a t of b e i n g u n r e s o l v e d .  and  then r e s o l v e d another  she  still  remain  could  unresolved  experienced the  not  a  loss  interview  losses  had  aspect  of  reference  t o the  loss  had  the  occurred. experience  sense  had  been  a  experience  this  sense  N's  fact  for of  of  of  remained  yet  similarity  in  several  t h a t she  discussed  had  suffered  time  element  but  not  her  intuition,  other  nor  co-researchers at  elapsed of  the  time  since  intuition  Diane,  was  d i d Diane  Natasha and  Anna  did in  an In  Carla  e x t e r n a l evidence  status;  of  their  a l l co-researchers.  close friend,  friend's  death,  b e l i e v e d i t would  unresolved  of knowing without in  and  the  the  a particular  change  death  None  Similarly,  Anna each d e s c r i b e d a sense there  of  unaccepted.  which  despite  D e s p i t e the  be  l o s s of a v e r y c l o s e f r i e n d s i n c e N's  make  and  in  is  will  as  variation  bereaved  experience  firstly  rich  the  phenomenological  comparing t h i s paper.  grief  the  Distress".  variation  also  such  co-researcher,  element of "Emotional The  by  of g r i e f  and that not  their  e x p e r i e n c e of l o s s of o t h e r c l o s e f r i e n d s . In comparing the unique those as  elements of g r i e f found i n t h i s study w i t h  found i n o t h e r phenomenological  t h a t of  "Integrity"  and  studies of g r i e f ,  "Concession"  such  elements  which were important  themes  108  in  the e x p e r i e n c e of bereaved  friends  in this  be i l l u m i n a t e d i n the o t h e r phenomenological  study, do not appear  to  studies discussed i n this  paper. Given method  the  appears  illuminating the  unique  writer of  e x i s t e n c e of m u l t i p l e a  highly  the essence  aspects of  are  effective  means  by  if  phenomenological  towards  experience  f o r each  (1991) i n h i s a s s e r t i o n s  limited  Subsequently  the  defining  of the phenomenon o f g r i e f ,  i t s lived  with Brice  study  (p. 35) .  be  both  agrees  any  to  realities,  those  no  profiles  single  as w e l l  bereaved.  that  that  and  "the  show  investigator  as  This  findings  themselves"  is  able  to  realistically  c a p t u r e the e n t i r e essence o f the phenomenon o f g r i e f i t  appears  further  fully  that  phenomenological  c o n c e p t u a l i z e the  essence  and  research  potential  is  required  typologies  F u r t h e r areas o f i n q u i r y are suggested i n the f o l l o w i n g L i m i t a t i o n s o f the P r e s e n t Study and I m p l i c a t i o n s The  focus o f t h i s study was  surviving  friends.  I t was  beyond  the  scope  the p o t e n t i a l d i f f e r e n c e s  which  between  exist  distinctions studies  may  which  include  to h i g h l i g h t any All possible  that  individuals  grief.  section.  f o r Future Research  prove  participants  of  this  study  to  i n the e x p e r i e n c e o f  friends  and  bereaved  draw grief  kin.  useful.  Further  from both  camps would be  Such  phenomenological required  distinctions.  a  had  in  different been  of both  the  present  structure  male,  of  genders.  if  study  of  grief  the  Similarly,  were would  study  female.  It  emerge  included  if  i n o c c u p a t i o n s which  Future r e s e a r c h f o c u s i n g  bereaved  a l l c o - r e s e a r c h e r s had  o t h e r work  and  f o c u s e d on the area o f mental  on the e x p e r i e n c e of g r i e f  education  related  o c c u p a t i o n s may  f o r the prove  is co-  some  o f p o s t - s e c o n d a r y e d u c a t i o n and were employed e i t h e r d i r e c t l y  indirectly  in  bereaved not  co-researchers  researchers  level  or may  of  more  t o observe the e x p e r i e n c e o f g r i e f f o r  c o n c l u s i o n s about may  to  or  health. bereaved  useful  to  109  b e t t e r understand the essence of All  co-researchers  in this  p r i o r to the deaths of t h e i r suffered  several  her  losses  may  have  grief  as  study were aware of the  friends.  expected l o s s e s  sudden and  emerged  for  grief.  of  Only one  close  unexpected.  i f sudden  loss  was  in  this  a l l co-researchers  such  different structure  a  factor  study.  i l l n e s s vs. non-kin) ,  as  the  context  sudden d e a t h ) ,  or  impossible  the to  essential and to  determine Further,  phenomenological to  It  between  exist.  describe  of  condense  meaning.  an  death  context  of the  the  of  research  may  of  grief.  dependent term  gender) .  situated  of  grief  It  structures  on  terminal  r e l a t i o n s h i p (ie kin (ie  vs.  may  be  into  one  t y p o l o g i c a l s t r u c t u r e of g r i e f without l o s i n g seems t h a t  more phenomenological  such p o t e n t i a l l y unique whether given  element  one  of  w e l l be long  had  experience  Additional  (ie  bereaved  such  the  of such a t y p o l o g y  the  all  various that  method may  cross-reference  of  the  profile  c o n f i g u r a t i o n or g e n e r a l  order  in  loss  who  f r i e n d s , experienced  s t r u c t u r e of the phenomenon of g r i e f may  factors  within  co-researcher,  A  prove u s e f u l i n d e t e r m i n i n g the e x i s t e n c e The  impending  of  a l l such  typological  no  choose lived  contexts  two  exactly  to  are  the  structures  of  the  heading  necessary  i n v a r i a n t but  in  grief  using  same thematic  i t would be  identify  both  necessary  investigators  experience,  studies  studies  to  variously  l a b e l l e d themes. Implications  for Practice  Hocker  (1990)  and  Scurfield  s t o r y of p a i n f u l l o s s , the well  as  gain  results  of  several  of  itself story  the the  was in  a  one a  way  greater present  s u r v i v o r may  depth study  co-researchers of  the that  few  (1985)  of  suggest  in  the  most  in  support present  opportunities  seemed  in  telling  the  e x p e r i e n c e emotional r e l i e f  meaning  seem to  that  they  relevant  his  or  their  her  loss.  The  assertions.  For  study, had and  as  had  the to  interview tell  meaningful.  their They  110  described experiencing r e l i e f do  so  without  fear  of  i n the knowledge t h a t they were a b l e t o  interruption.  encouraged t o d i s c u s s the a s p e c t s personally  meaningful,  researcher  experienced  meaning i n h e r l o s s . reported  such  implications therapeutic listening of  and  seemed  o f her e x p e r i e n c e  i n simply  emotional  being  relief  at  our  and g a i n e d  follow-up  for practitioners, influence  at  attempts  such  least  in  feedback  t o , the co-  i n the p r e s e n t In  seems  terms  study  o f the  t o i n d i c a t e the  stages  of  simply  t o the c l i e n t ' s  experience  themes by which the c o - r e s e a r c h e r s s t r u c t u r e d t h e i r  experience  loss. The  are a l s o  important  clinical  considerations.  phenomenologically-generated study, broad  the p r a c t i t i o n e r range o f responses  loss.  In terms  dying  o r deceased  continue study,  themes  outlined  client  the allowances  and t h e impact  t o have on the c l i e n t ' s Carla  the c l i e n t  of concession,  made  had done  c o n c e s s i o n s appeared  to f a c i l i t a t e  i n h i s or her be u s e f u l t o  concessions  to loss.  f o r her dying  a l l she c o u l d  a  which were made f o r t h e  t o save  had and  In t h e p r e s e n t  friend  r e a s s u r e h e r o f the f a c t t h a t she had remained l o y a l subsequently  the c l i e n t  i t may  such  adjustment  such  i n the p r e s e n t  and e x p l o r e w i t h  i n o r d e r t o support  friend,  the c o n c e s s i o n s  By u s i n g as a guide  as those  can a n t i c i p a t e  o f t h e element  e x p l o r e w i t h a bereaved  and  being  a g r e a t e r depth o f  initial  at intervention  in  which seemed most  meeting.  the  that  listened  Three o f the f o u r bereaved  effects  without  It  appeared  to  to the f r i e n d s h i p her f r i e n d .  her adaptation to her l o s s .  Such On t h e  other hand, t h e c o n c e s s i o n s t h a t Anna made f o r h e r f r i e n d "N" may have hindered her  h e r adjustment  ability  t o openly  to h i s loss, discuss with  s i n c e these  concessions  him h i s impending  death.  negated Several  years a f t e r h i s death  she c o n t i n u e s t o f e e l u n r e s o l v e d about h i s l o s s ,  and  lack  wonders  i f this  o f acceptance  i s the c o s t  which were made out o f l o y a l t y f o r h e r f r i e n d .  of  concessions  Ill  The  element  bereaved  client.  often  manifested  being  unable  may  prove  described  a  bereaved  sense  of  f o r the  several  i n f l u e n c e of l o s s an  study,  and  the  to a s s i s t  for  many  also  client  be  may  useful  be  be  coped  explore  experiencing.  i s experienced  should  to  the  may  survivor's  well  the  in It  friend. study  their  be and  as  sense  of  client's  own  a  shared  may  prove  with,  such  discord  sense  both  appear  to  of  present  manifested study  and  be  may  r e s o l v e the  exclusion very  i n various  appeared  to  forms  inclusion  in  i t s various  the  i n the way the  factors  a  client's  in  The  in  the  either  element of  co-researchers  in  s u r v i v o r ' s sense  of  to l o s s .  forms  response  inclusion  f o r the  increase  a  loss.  and  important  d i s t r e s s and h i n d e r her adjustment of  actual  attenuate  or e x a c e r b a t i n g the s t r e s s of bereavement.  was  dissonance  c o n t r a r y t o h i s or her b e l i e f  alleviating exclusion  loss  the  of  element  guilt,  address  experience  emotional  was  present  clients,  I f the  a b i l i t y t o f u l l y g r i e v e and subsequently  the  control  demise.  support  them to  bereaved  the  or her i n e x p l o r i n g  in  dilemma  with  perhaps  friend's  him  co-researchers i n forcing  address  f o r the c l i e n t t o e x p l o r e .  may  The  present  powerlessness,  existential  grief  to  able to r e a l i s t i c a l l y  the  of  i n the  client  or she was  Such  important  i n f l u e n c e or p r e d i c t  this,  beneficial  bereaved  the  appears  to  experience  loss  as  he  mortality.  loss  For  empowering  Further  It  control  to e i t h e r  areas wherein  to  of  Conversely,  appeared  to  the  facilitate  adjustment. It  may  experience assessed,  of  support  useful  to  the  element  of  examine  also  grieve assess  the with  loss the  with  exclusion.  i n c l u d i n g the c l i e n t ' s  legitimately should  prove  own  and client  the  client  Several  his  her  should  be  p e r c e p t i o n of h i s or her r i g h t  to  r e c e i v e support. the  availability  factors  or  The and  practitioner viability  of  systems, w i t h the c l i e n t b e i n g encouraged t o access those t h a t  112  exist. For  the c o - r e s e a r c h e r s  i n the p r e s e n t  study,  the e x p e r i e n c e  b e i n g i n c l u d e d i n the f r i e n d ' s p r o c e s s o f d y i n g appeared adjustment  t o the l o s s .  Such  addressed w i t h the bereaved  experiences  client.  of  to f a c i l i t a t e  inclusion  I f none e x i s t ,  should  t o encourage t h e c l i e n t  In r e - c r e a t i n g the time have  the o p p o r t u n i t y  loss  with  the  t o r e - c r e a t e the s t o r y  frame b e f o r e the a c t u a l death,  to explore  deceased  the meaning  friend  himself,  by the  o f death.  the c l i e n t  and i m p l i c a t i o n s  or  be  or i f the death o f  the f r i e n d was sudden, psychodrama e x e r c i s e s c o u l d be suggested practitioner  of  with  other  will  o f the  important  r  individuals loss.  i n the s t o r y ,  Such  experiencing  exercises some  potentially  may  degree  be  of  facilitating  adaptation  c o n t r a - i n d i c a t e d i f the  psychosis  wherein  reality  to the  client  is  testing  is  compromised. I t may prove or  h e r awareness  friend's,  beneficial o f how  t o the c l i e n t ' s  the d y i n g  process  and/or  as w e l l as h i s o r h e r own, l e v e l  effect  that  illness  o r death  to explore h i s  death  a f f e c t e d the  of i n t e g r i t y .  s h o u l d be a s s i s t e d i n d e v e l o p i n g a r e a l i s t i c the  adjustment  The c l i e n t  and meaningful  had on the i n t e g r i t y  version of  o f those i n  question. For the bereaved the  loss  Although facilitate of  was  an  the  ability  important  adjustment  to  element find  study,  the s e a r c h  i n their  meaning  f o r such  the  loss  of  grief.  appeared  to  t h e r e was o f t e n an aspect  meaning.  require assistance i n their  f o r meaning i n  experience  in  t o the f r i e n d ' s death,  s t r u g g l e i n the s e a r c h  c l i e n t s may a l s o the  i n the p r e s e n t  Accordingly,  attempt  bereaved  t o make sense o f  death. The  co-researchers  appeared  effective,  under s p e c i f i c  to  I t i s important  loss.  to  find  the  element  conditions, i n f a c i l i t a t i n g to explore  with  their  the c l i e n t  of  ritual  adjustment  the degree t o  113  which the  formal or p r i v a t e  deceased  or  the  r i t u a l s e f f e c t i v e l y symbolized the meaning o f  relationship  shared  with  the  deceased,  and i f  those r i t u a l s f i t the c l i e n t ' s e x p e c t a t i o n s . If r i t u a l not  f a i l e d to f i t the needs of the bereaved,  participate  i n such commemorative ceremonies,  or i f he or she d i d the p r a c t i t i o n e r  at an a p p r o p r i a t e time a s s i s t the c l i e n t i n c r e a t i n g to f i t those unmet needs.  may  a personal r i t u a l  114  References Balk, D. E. (1991). Death and a d o l e s c e n t bereavement: C u r r e n t r e s e a r c h and f u t u r e d i r e c t i o n s . 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The AIDS bereaved: C o u n s e l i n g s t r a t e g i e s . In J . W. D i l l e y , C. P i e s , & M. H e l q u i s t (Eds.). F a c t t o f a c e : A guide t o AIDS c o u n s e l i n g (pp. 267-274). San F r a n c i s c o : AIDS H e a l t h Project, U n i v e r s i t y of C a l i f o r n i a . Worden, J . W. (1982). G r i e f c o u n s e l i n g York: S p r i n g e r P u b l i s h i n g Company, I n c .  and  grief  therapy.  New  Worden, J . W. (1991). G r i e f c o u n s e l i n g and g r i e f t h e r a p y : A handbook f o r the mental h e a l t h p r a c t i t i o n e r (2nd ed. ) . New York: S p r i n g e r P u b l i s h i n g Company, I n c . Yoder, L. (1986). The f u n e r a l meal: A s i g n i f i c a n t J o u r n a l o f R e l i g i o n and H e a l t h , 25(2), 149-159.  funerary  ritual.  118  Appendix A P r e - s c r e e n i n g Questions Name Age  Sex  Was t h e person who d i e d a f r i e n d w i t h whom you were i n v o l v e d i n a nonsexual f r i e n d s h i p ? Would you d e s c r i b e friends?  this  friend  among  your  closest  seven  or  eight  How l o n g ago d i d your f r i e n d d i e ? Are you p r e s e n t l y i n c o u n s e l l i n g t o h e l p you a d j u s t t o t h e l o s s o f your friend? ( I f t h e p e r s o n responds a f f i r m a t i v e l y t o t h i s , i t w i l l be suggested t h a t she d i s c u s s t h e p o s s i b i l i t y o f involvement i n t h e study w i t h h e r c o u n s e l l o r , such t h a t h e r p a r t i c i p a t i o n i n t h e study w i l l not i n t e r f e r e w i t h t h e work she i s d o i n g i n t h e r a p y ) . Do you f e e l you r e q u i r e c o u n s e l l i n g t o h e l p you f a c i l i t a t e g r i e v i n g process? ( i f t h e person responds a f f i r m a t i v e l y , r e s e a r c h purpose o f t h e study w i l l a g a i n be e x p l a i n e d , and respondent w i l l be asked i f she would l i k e t o be p r o v i d e d r e f e r e n c e s f o r l o c a l g r i e f c o u n s e l l o r s and a g e n c i e s ) .  your the the with  119  Appendix B I n t e r v i e w P r o t o c o l For F i r s t  Interview  Primary I n t e r v i e w Q u e s t i o n We have t a l k e d e a r l i e r about the purpose o f t h i s study b e i n g an attempt t o map or d e f i n e the p r o c e s s o f g r i e f e x p e r i e n c e d by f r i e n d s s u r v i v i n g t h e l o s s through death o f a c l o s e f r i e n d . You have mentioned t h e death o f your c l o s e f r i e n d and your e x p e r i e n c e of g r i e v i n g t h a t l o s s . I wonder i f you would share your s t o r y about your l o s s , b e g i n n i n g i f you l i k e w i t h the moment t h a t stands out the most f o r you. I n t e r v i e w P r o t o c o l f o r Second I n t e r v i e w As we d i s c u s s e d e a r l i e r , your account o f your e x p e r i e n c e o f g r i e v i n g f o r your f r i e n d has been t r a n s f o r m e d i n t o a thematic structure. It i s hoped that the themes capture the s t r a i g h t f o r w a r d as w e l l as the u n d e r l y i n g ( e x p l i c i t and i m p l i c i t ) meanings t h a t compose e x p e r i e n c e o f g r i e f . Would you p l e a s e r e a d over t h i s s t r u c t u r e t o i n s u r e t h a t i t r e p r e s e n t s your e x p e r i e n c e of g r i e v i n g f o r your f r i e n d . P l e a s e take as much time as you need; your c a n d i d feedback w i l l be v e r y important i n h e l p i n g us t o a c c u r a t e l y d e s c r i b e what the e x p e r i e n c e o f f r i e n d s h i p g r i e f i s like.  120  Appendix C D e f i n i t i o n s of Unique and Common Themes The f o l l o w i n g themes were found i n the e x p e r i e n c e s of l o s s . While 14 themes are i d e n t i f i e d below) o n l y 10 themes were i l l u m i n a t e d i n the g e n e r a l s t r u c t u r e because they were found i n a l l f o u r p r o t o c o l s . 1. Acceptance. The c o - r e s e a r c h e r i n d i c a t e d t h a t a c c e p t i n g the l o s s of her f r i e n d was an a c t i v e p r o c e s s . In the situations where i l l n e s s preceeded death, acceptance seemed t o be f a c i l i t a t e d by a b e l i e f which g a i n e d c l a r i t y over time t h a t her f r i e n d had found a sense of peace or j o y i n death. There was o n l y o n e . s i t u a t i o n where a c o - r e s e a r c h e r e x p e r i e n c e d the l o s s of a f r i e n d through sudden death. Her acceptance of t h i s l o s s was f a c i l i t a t e d by her r e s o l u t i o n t h a t i n b e i n g unaware of h i s own impending death her f r i e n d was enabled t o l i v e h i s l i f e f u l l y and without s u f f e r i n g . For a l l c o - r e s e a r c h e r s , acceptance of her f r i e n d ' s death seemed t o be accompanied by a sense of r e s o l u t i o n t h a t she h e r s e l f was a t peace w i t h the l o s s . 2. Concession. As a r e s u l t of her bond, the c o - r e s e a r c h e r found h e r s e l f making c o n c e s s i o n s f o r her d y i n g f r i e n d . In o r d e r t o support the needs of the i l l f r i e n d i n h i s or her d y i n g p r o c e s s , the bereaved f r i e n d allowed' i n her r e l a t i o n s h i p w i t h the d y i n g f r i e n d what she n o r m a l l y would not otherwise condone i n her f r i e n d s h i p s . 3. Control. During her e x p e r i e n c e of l o s s the c o - r e s e a r c h e r o f t e n needed t o address her own sense of powerlessness i n b e i n g unable t o c o n t r o l or somehow i n f l u e n c e the course of events l e a d i n g up t o and s u r r o u n d i n g the l o s s . A t times she q u e s t i o n e d whether she had done enough or whether enough had been done f o r her friend. When c o n f r o n t e d w i t h her a c t u a l a b i l i t y t o p r e d i c t and/or i n f l u e n c e the outcome, several co-researchers oscillated between a sense of powerlessness and t h a t of s a t i s f a c t i o n i n t h e i r a b i l i t y t o have done so. For most c o - r e s e a r c h e r s , the death c h a l l e n g e d them not o n l y t o cope w i t h the l o s s of the f r i e n d but a l s o w i t h t h e i r own v u l n e r a b i l i t y i n terms of m o r t a l i t y i t s e l f ; the death of her f r i e n d o f t e n c h a l l e n g e d her t o address the r e a l i t y o f her own i n e v i t a b l e death. 4. Emotional D i s t r e s s . With the death of her friend the coresearcher experienced such feeling-related phenomena as denial, anguish, l o n g i n g , c r y i n g , c o n f u s i o n , and a sense of b e i n g overwhelmed. These f e e l i n g s appeared to be experienced to varying degrees r e g a r d l e s s of p r e p a r a t i o n f o r or r e s i g n a t i o n t o the death of the friend. T h i s r e a c t i o n seemed t o be i n t e n s i f i e d when the death was sudden or m u l t i p l e s t r e s s o r s e x i s t e d . Throughout her bereavement these f e e l i n g s tended t o be t r i g g e r e d by v a r i o u s f a c t o r s f o r the c o - r e s e a r c h e r , i n c l u d i n g symbolic reminders of the deceased, or the acknowledgement by o t h e r s of the l e g i t i m a c y of her l o s s . Other t r i g g e r s were a l s o r e p o r t e d , such as dreams and moments of q u i e t or s o l i t u d e . Several co-researchers reported that through v a r i o u s means an attempt was made t o a v o i d those thoughts, events or people t h a t would t r i g g e r such r e a c t i o n s . 5. Dissonance. The c o - r e s e a r c h e r e x p e r i e n c e d a sense of d i s s o n a n c e when her b e l i e f s about the deceased or about g r i e f r e a c t i o n s were i n c o n f l i c t w i t h her own o v e r t b e h a v i o r s or the o v e r t b e h a v i o r s of others. T h i s sense of d i s c o r d was a t times experienced as anger, f r u s t r a t i o n or r e v u l s i o n i n response t o o t h e r persons whose r e a c t i o n s  121  were d i f f i c u l t f o r t h e bereaved f r i e n d t o accept or t o l e r a t e . For some c o - r e s e a r c h e r s such d i s c o r d a l s o o c c u r r e d i n terms o f t h e i r p e r s o n a l response t o the l o s s which was e x p e r i e n c e d as d i s s o n a n t w i t h or c o n t r a r y t o t h e way they b e l i e v e d they would o r s h o u l d have coped with such a loss; such d i s s o n a n c e was o f t e n e x p e r i e n c e d by the bereaved as f r u s t r a t i o n o r r e p r o a c h w i t h h e r s e l f . 6. Exclusion. The c o - r e s e a r c h e r d e s c r i b e d a sense o f e x c l u s i o n i n the e x p e r i e n c e o f her f r i e n d ' s l o s s . Such e x c l u s i o n was e x p e r i e n c e d i n s e v e r a l ways, i n c l u d i n g p h y s i c a l e x c l u s i o n wherein t h e bereaved f r i e n d was impeded i n b e i n g p h y s i c a l l y p r e s e n t w i t h the d y i n g f r i e n d , or d u r i n g the f r i e n d ' s f u n e r a l . S i m i l a r l y e x c l u s i o n was e x p e r i e n c e d when t h e bereaved f r i e n d was impeded, or impeded h e r s e l f , i n openly discussing aspects o f the impending or actual loss. Some cor e s e a r c h e r s e x p e r i e n c e d e x c l u s i o n i n terms o f t h e i r bereavement s t a t u s i t s e l f , wherein o t h e r s o r they themselves denied the l e g i t i m a c y of t h e i r l o s s , thereby l i m i t i n g t h e i r access t o s o c i a l support. 7. Finality. The c o - r e s e a r c h e r was s t r u c k by the f i n a l i t y o f death, and the f a c t t h a t c e r t a i n a s p e c t s o f her r e l a t i o n s h i p w i t h the deceased c o u l d never be r e p l a c e d . 8. Inclusion. The c o - r e s e a r c h e r d e s c r i b e d a sense o f i n c l u s i o n i n her e x p e r i e n c e o f coping w i t h the l o s s o f her f r i e n d . Such i n c l u s i o n was e x p e r i e n c e d when open d i s c u s s i o n o f the impending o r a c t u a l death and i t s i m p l i c a t i o n s was encouraged by the d y i n g f r i e n d , o r by o t h e r s who r e c o g n i z e d the l e g i t i m a c y o f t h e l o s s . For some bereaved, a sense of i n c l u s i o n was a l s o e x p e r i e n c e d by p a r t i c i p a t i n g i n the f r i e n d ' s d y i n g p r o c e s s i t s e l f , through such a c t s as c a r e - t a k i n g o r c a r r y i n g out the d y i n g f r i e n d ' s s p e c i f i c wishes. In c o p i n g w i t h t h e death o f her f r i e n d , t h e c o - r e s e a r c h e r ' s sense of i n c l u s i o n was f u r t h e r enhanced when the l e g i t i m a c y o f her l o s s and of her s t a t u s as bereaved was r e c o g n i z e d by the bereaved herself and/or by o t h e r s . The c o - r e s e a r c h e r a l s o attempted t o i n c r e a s e the sense o f inclusion for other bereaved by recognizing and acknowledging the l e g i t i m a c y o f t h e i r mutual l o s s . 9. Integrity. In r e v i e w i n g t h e d y i n g f r i e n d ' s response t o h i s o r her illness, the c o - r e s e a r c h e r gained awareness o f the e f f e c t o f such i l l n e s s on her f r i e n d ' s i n t e g r i t y o r adherence t o a code o f v a l u e s . The c o - r e s e a r c h e r noted w i t h p r i d e the way i n which her f r i e n d ' s integrity remained i n t a c t despite the a d v e r s i t y of i l l n e s s . Or c o n v e r s e l y , she r e c a l l e d w i t h sadness how such i n t e g r i t y had been t h r e a t e n e d o r d i m i n i s h e d by the i l l n e s s . S e v e r a l c o - r e s e a r c h e r s were a l s o aware o f the e f f e c t o f the impending o r a c t u a l death on t h e i r own i n t e g r i t y and t h e i r a b i l i t y t o l i v e w i t h c o n v i c t i o n and meaning. Some c o - r e s e a r c h e r s d e s c r i b e d a s p e c i f i c image o f t h e i r deceased f r i e n d which symbolized t h a t f r i e n d ' s s e r e n i t y or v i t a l i t y i n the f a c e of death. T h i s image seemed t o r e s t o r e o r uphold t h e i r friend's i n t e g r i t y , and appeared t o h e l p t h e bereaved manage t h e i r anguish. 10. Intuition. The c o - r e s e a r c h e r d e s c r i b e d a sense o f knowing without e x t e r n a l evidence t h a t t h e r e had been a change i n her f r i e n d ' s s t a t u s o r t h a t her f r i e n d had d i e d . 11. K i n - l i k e Bond. The c o - r e s e a r c h e r used m e t a p h o r i c a l o r a c t u a l comparisons t o f a m i l y or k i n as a means o f d e s c r i b i n g t h e type o f bond shared w i t h t h e deceased f r i e n d .  122  12. Meaning (search for) . The c o - r e s e a r c h e r s were engaged i n an a c t i v e p r o c e s s of c o n s c i o u s l y s t r i v i n g to a t t r i b u t e cause or reason to the l o s s . S e v e r a l informants were a l s o engaged i n an a c t i v e p r o c e s s of f i n d i n g c o n c r e t e ways to g r i e v e the l o s s i n a way t h a t would most honor what the deceased had meant to them. Some c o - r e s e a r c h e r s b e l i e v e d they c o u l d not f u l l y accept or make sense of t h e i r l o s s . D e s p i t e t h e i r e f f o r t s to f i n d meaning i n the death, a s p e c t s o f the l o s s remained i n s e n s i b l e . 13. Ritual. R i t u a l i s here d e f i n e d /as a commemorative a c t which s y m b o l i c a l l y and/or m e t a p h o r i c a l l y condenses i n t o a dramatic moment one or more e s s e n t i a l a s p e c t s of the r e l a t i o n s h i p shared w i t h the deceased. As described by Imber-Black (1988) rituals "make p o t e n t i a l l y d i s r u p t i v e l i f e - c y c l e t r a n s i t i o n s more manageable and l e s s t h r e a t e n i n g by e n c l o s i n g them i n a web of p r e s c r i b e d a c t i v i t i e s . . . t h e y p r o v i d e a s a f e c o n t e x t f o r the e x p r e s s i o n of i n t e n s e emotion" (p. 60). T h i s d e f i n i t i o n appears t o f i t the e x p e r i e n c e of the bereaved i n the p r e s e n t study. In an attempt to adapt to the l o s s of her f r i e n d , the c o - r e s e a r c h e r engaged i n a p r i v a t e or p u b l i c ceremony which both commemorated the l i f e of her deceased f r i e n d and l e g i t i m i z e d the l o s s . The c o - r e s e a r c h e r d e s c r i b e d the r i t u a l e f f e c t i v e i n f a c i l i t a t i n g her adjustment to the l o s s i f i t symbolized the v a l u e of the deceased or her r e l a t i o n s h i p w i t h the deceased. F u r t h e r , the r i t u a l was h e l p f u l i f i t f i t the e x p e c t a t i o n s of the bereaved f r i e n d , and took p l a c e i n the company of s u p p o r t i v e o t h e r s when the r i t u a l was of a shared n a t u r e . 14. Uniquely I n d i v i d u a l Response. The c o - r e s e a r c h e r was aware t h a t a s p e c t s of her response to the l o s s were unique i n r e l a t i o n to t h a t of other bereaved or t h a t d e s c r i b e d i n models of bereavement w i t h which she was familiar. Some c o - r e s e a r c h e r s acknowledged that their response to the l o s s i n q u e s t i o n was i n i t s e l f unique compared t o other l o s s e s they had suffered because of the nature of the r e l a t i o n s h i p they had shared w i t h t h a t f r i e n d , and the circumstances of the death. The c o - r e s e a r c h e r a l s o seemed to a l l o w o t h e r s , i n c l u d i n g the d y i n g friend, autonomy i n terms of t h e i r own unique response to the impending or a c t u a l l o s s . A l t h o u g h she may not have understood t h e i r unique response, the bereaved f r i e n d was g e n e r a l l y a b l e to t o l e r a t e it.  123  Appendix D E i d e t i c A n a l y s i s o f Anna's E x p e r i e n c e Thematic C l u s t e r of Meaning U n i t s  Thematic  Description  1.  Acceptance (MU #11, 14, 17, 18, 37, 47, 49, 60, 62, 65, 67)  In r e f e r e n c e to J. , with whom she had been a p a r t o f h i s experience of dying, Anna d e s c r i b e d a sense o f acceptance i n h i s l o s s . She began to accept his impending death as an alternative t o h i s anguish over h i s decline. She b e l i e v e d J . a n t i c i p a t e d and was a t peace w i t h h i s death, which made i t easier f o r others i n c l u d i n g h e r s e l f to accept t h e i n e v i t a b i l i t y o f the same.  2.  Concession (MU #6, 13, 22, 26, 27, 28)  Anna made concessions especially f o r her dying friend N. which required t h a t she c o n s t r a i n open and genuine e x p r e s s i o n about h i s i l l n e s s and death i n o r d e r to a l l o w him autonomy i n how he wished t o respond t o the same. She would not describe this constraint t y p i c a l however o f h e r o t h e r close relationships.  3.  Control (MU #48, 50, 51, 52, 59, 63, 69)  Anna struggled with the degree of control or influence she had i n the course of each of her f r i e n d ' s i l l n e s s and death. She questioned at times whether she d i d enough t o support them. She wondered if h e r s t r u g g l e w i t h , and belief in, personal r e s p o n s i b i l i t y was a way o f quelling her sense of vulnerability that arose when confronted with the inevitability of mortality itself.  124  4.  Emotional D i s t r e s s (MU #4, 40, 44, 46, 55, 56, 68, 69)  Anna considered various aspects o f h e r response t o the l o s s o f h e r f r i e n d s t o be what she p e r c e i v e d as common grief responses. S p e c i f i c a l l y i n response t o the loss of N., she experienced the anguish, sadness and sense of meaninglessness which she believed were typical aspects of bereavement. Several months after her l o s s , she found t h a t c e r t a i n objects or circumstances continued to trigger her anguish, especially related to the l o s s o f N. She attempted to avoid such triggers by seeking d i s t r a c t i o n s which she hoped would " m a g i c a l l y " a s s i s t h e r i n a v o i d i n g the p a i n o f h e r loss.  5.  Dissonance (MU #35, 38, 41, 43, 56, 61, 63)  Anna e x p e r i e n c e d a sense o f dissonance i n her l o s s e s . T h i s o c c u r r e d both when h e r own response t o t h e l o s s d i d not f i t with her self p e r c e p t i o n , and when o t h e r s ' response t o each l o s s was difficult for her to tolerate.  6.  Exclusion (MU #5, 7, 16, 24, 26, 29, 39)  Anna d e s c r i b e d a sense o f exclusion from N's experience of i l l n e s s and death. Her sadness was i n t e n s i f i e d by h e r awareness that despite h e r knowledge of h i s terminal illness, they d i d not d i s c u s s i t o r its implications u n t i l h i s impending death was obvious. She also experienced a physical separation from him. As his illness advanced, N. chose t o move away t o l a t e r d i e at h i s parents home in another city, leaving no specific expectations of h i s friends regarding h i s wishes or needs d u r i n g h i s i l l n e s s and  125  a f t e r h i s death.  7.  Finality (MU #41, 59)  Anna was c o n f r o n t e d by the finality or irreversibility of death.  8.  Inclusion (MU #8, 9, 10, 17, 19, 20, 29, 30, 31, 33, 37, 44, 54, 57)  Anna d e s c r i b e d a sense of i n c l u s i o n i n J's e x p e r i e n c e of i l l n e s s and d y i n g through t o h i s death. Through t h e i r open discussions, she was aware of what was expected and desired by her dying friend J., a factor which appeared to minimize her confusion i n terms of her response t o h i s l o s s . R e c o g n i t i o n of her l o s s and of her status as bereaved was an important f a c t o r i n Anna's e x p e r i e n c e . In recognizing herself as bereaved and in other's r e c o g n i t i o n o f her as such, her sense o f i n c l u s i o n was g r e a t l y enhanced. She f e l t e n t i t l e d t o r e c i e v e support for as well as openly express h e r response t o the l o s s of both N. and J .  9.  Integrity (MU# 17, 29, 31, 36, 37,53, 66)  10.  Intuition (MU #65, 67)  Anna was aware of the e f f e c t of i l l n e s s on the i n t e g r i t y of her dying f r i e n d s . Their sense of s e l f and adherence to a way of being either remained i n t a c t d e s p i t e the adversity of illness, or c o n v e r s e l y was d i m i n i s h e d by it. She was a l s o aware o f the e f f e c t o f her l o s s e s on her own integrity. She believed that despite her pain the i n t e n s i t y of her grief would n e i t h e r damage nor d i m i n i s h h e r . Anna had an i n t u i t i v e sense t h a t her f r i e n d J . would d i e b e f o r e her next v i s i t with him. I t was a more c e r t a i n  126  or d i s t i n c t sense than she had ever b e f o r e experienced w i t h him.  11.  K i n - l i k e Bond (MU #2, 25, 27 41)  Anna described a kin-like r e l a t i o n s h i p with her f r i e n d N., w i t h whom she was so close t h a t she and o t h e r s d e s c r i b e d t h e two o f them as twins.  12.  Meaning (MU #12, 42, 44, 46, 57, 58, 60, 64)  Though she had no unanswered questions about J's death, she found h e r s e l f s e a r c h i n g f o r a means o f making sense of the l o s s o f N. She hoped f o r someone t o p r o v i d e an e x p l a n a t i o n f o r h e r t h a t would q u e l l her pain, y e t realized the futility of t h i s d e s i r e i n l i g h t of her belief t h a t she c o u l d not make sense o f N's death because death i t s e l f d i d n o t make sense.  13.  Ritual (MU# 23, 31, 32, 34, 39, 40, 41)  In h e r attempt t o cope w i t h the loss of her f r i e n d s , Anna found that personally meaningful rituals were important i n the p r o c e s s . She found the rite meaningful i f i t s y m b o l i c a l l y r e p r e s e n t e d the deceased, her personal relationship with the deceased, or her of what a expectations commemorative ceremony s h o u l d be.  14.  Uniquely I n d i v i d u a l Response (MU #3, 11, 15, 21, 23, 36, 41, 43, 45, 57, 63, 70)  Anna experienced her response t o the l o s s o f N. and t h a t o f J . a u n i q u e l y individual. She also experienced this i n d i v i d u a l i t y o f response i n r e l a t i o n t o o t h e r s who were also grieving the l o s s o f her f r i e n d s . Anna was g e n e r a l l y a b l e to tolerate others' unique responses t o the l o s s e s o f her friends. She also  127  experienced this tolerance from other bereaved individuals, especially in terms of the way she responded t o the l o s s o f N.  128  Appendix E E i d e t i c A n a l y s i s of C a r l a ' s E x p e r i e n c e Thematic C l u s t e r of Meaning U n i t s 1.  3.  Thematic D e s c r i p t i o n  Acceptance (MU #20, 23, 26, 38, 48, 58, 60, 64, 66)  47,  Concession (MU #14, 25, 68, 71)  67,  Control (MU #39,  42,  51,  44,  64,  46)  C a r l a d e s c r i b e d her l o s s of S. as a g r a d u a l p r o c e s s of deterioration wherein S. finally achieved her own death. Though C a r l a d i d not indiscriminantly disclose her resignation to the i n e v i t a b i l i t y of S's death, her anguish over t h i s loss brought her t o a p l a c e where she began t o accept S's f a t e well before her actual death. Two years a f t e r her friend's death, Carla b e l i e v e d she was f i n a l l y at peace with S's loss, and c o u l d speak about her loss without anguish.  C a r l a m a i n t a i n e d her support for S. i n the f a c e of an illness that others found d i s t u r b i n g , and i n s p i t e of S's d i m i n i s h e d a b i l i t y t o be an equal partner in their friendship. She believed she was a b l e t o do so both as a r e s u l t of her knowledge of p s y c h i a t r y and the bond t h a t she had shared with S. Further, despite her inability to condone S' s final choice of means by which t o end her l i f e , C a r l a was eventually able to accept S's act by attributing her motive to desperation rather that to selfishness.  Carla struggled at times w i t h her a c t u a l a b i l i t y , and culpability, in terms of influencing her friend's fate. Though she acknowledged that thoughts  129  about her r e s p o n s i b i l i t y may r e c u r , she was comforted i n knowing t h a t e v e r y t h i n g t h a t could have been done was done t o save S. Emotional D i s t r e s s (MU #3, 10, 11, 21, 22 29, 30, 34, 50, 57, 58, 59, 64, 79)  Carla recognized s i m i l a r i t i e s between a s p e c t s of her own response t o l o s s and that outlined in a c o n v e n t i o n a l model o f g r i e f w i t h which she was f a m i l i a r . In reflecting on her response t o S's l o s s , she d e s c r i b e d having experienced i n h e r bereavement a sense of shock and d i s b e l i e f , and an i n t e n s e sense o f anguish and l o n g i n g . Initially uncertain of the legitimacy of her anguish, C a r l a attempted t o diminish her pain by diminishing the importance of h e r l o s s . In the f i r s t several months after her friend's death she found t h a t thoughts o f S's p a i n f u l s t r u g g l e w i t h l i f e dominated her memory o f her f r i e n d . She also found that her sense of anguish had a tendency to be triggered unexpectedly during times when she was alone or engaged i n t a s k s which d i d not require her total concentration.  Dissonance (MU #17, 24, 26, 35, 36, 55, 68, 71)  Constraining herself from speaking t o o t h e r s about her loss was experienced as dissonant f o r Carla, who perceived herself to be otherwise instrumental in forthrightly d i s c u s s i n g and resolving issues. She a l s o experienced discord with others, including S. herself, i n their response to S's i l l n e s s and death.  Exclusion (MU #8, 9, 27, 33, 34, 36, 37, 40, 45, 62, 69, 80)  In the f i r s t s e v e r a l months f o l l o w i n g the death o f her friend, Carla described a sense of exclusion of  130  i s o l a t i o n i n her bereavement experience. This exclusion was generated primarily by her b e l i e f t h a t the meaning and e x t e n t of her l o s s would not be understood by o t h e r s . As a r e s u l t , she initially spoke w i t h no one about her response t o the death of her good f r i e n d . 7.  Finality (MU #36, 49,  82)  Inclusion (MU #6, 7, 9, 28, 32, 40, 41, 47, 56, 59, 61, 69, 75, 77, 81)  When C a r l a recognized that her f r i e n d would never a g a i n be t h e r e t o share b i r t h d a y s and o t h e r s p e c i a l times, she experienced loneliness and longed f o r someone w i t h whom she c o u l d share her sadness about the finality of her loss. Though she had f r i e n d s who met o t h e r needs, she r e a l i z e d t h a t the unique history and characteristics t h a t t y p i f i e d her bond w i t h S. were i r r e p l a c e a b l y gone.  C a r l a f e l t i n c l u d e d i n S's e x p e r i e n c e of i l l n e s s . She spent much time with S. d u r i n g her u n s t a b l e p e r i o d s , offering support and hope f o r her recovery. Though i n f r e q u e n t , she a l s o had the opportunity to d i s c u s s with her own p a r e n t s and another m u t u a l l y c l o s e f r i e n d t o S. her experience of S's i l l n e s s and death. In the initial months after S's death, Carla struggled with recognizing herself as legitimately bereaved. Upon acknowledging the l e g i t i m a c y of her loss, she made a marked e f f o r t to l e g i t i m i z e the e x p e r i e n c e of l o s s of 2 other f r i e n d s a l s o g r i e v i n g of S., the loss their acknowledging e n t i t l e m e n t t o support. This recognition of the e x t e n t of her l o s s and of her s t a t u s as bereaved was an important factor in C a r l a ' s e x p e r i e n c e of l o s s . She b e l i e v e d t h a t those who d i d not know S. w h i l e she  131  was healthy would not understand the meaning of her loss. Consequently, r e c e i v i n g support from such individuals was unexpected but c h e r i s h e d .  Integrity (MU #5, 15, 16, 18, 19, 23, 24, 26, 48, 64, 65)  Carla was saddened in watching her f r i e n d become diminished and destabilized by her disease. • She was angered by S's final choice of means by which to end her l i f e and found i t d i f f i c u l t to condone given the integrity she believed S. had at one time p o s s e s s e d . During S's open casket funeral Carla refused to view her friend lying in state, choosing instead to remember S. f o r her v i t a l i t y and companionship. She b e l i e v e d the i l l n e s s had also diminished the integrity of their friendship. As such she attempted to maintain the friendship's integrity by avoiding the use of her professional psychiatric knowledge to influence S. d u r i n g t h e i r time t o g e t h e r .  10.  Intuition (MU #1, 2,  Before r e c e i v i n g news of S's death, Carla had a strong sense that she and her family should return home e a r l y from t h e i r h o l i d a y s . Though she found it unnerving, she b e l i e v e d the close bond that they had shared i n e x p l i c a b l y drew her home f o r the f u n e r a l .  11.  Meaning (MU #6, 25, 44, 45)  12,  26,  53)  42,  43,  Carla struggled to make sense of S's death and the means by which S. had attained that end. This search for meaning was c o m p e l l i n g , and seemed to be driven at times at an unconscious l e v e l . She a l s o described the o c c u r r e n c e pf  132  certain unlikely events which she believed helped her to make sense of a s p e c t s of the l o s s w i t h which she had been s t r u g g l i n g .  12.  Ritual (MU #4, 29, 31, 54, 72, 74, 76, 78)  13.  Uniquely I n d i v i d u a l Response (MU #52, 53, 61, 62, 67, 73)  70,  63,  Carla found the formal ritual of S's funeral u n s e t t l i n g as i t f a i l e d to eulogize and thus r e p r e s e n t the p o s i t i v e e f f e c t s S. had had on the l i v e s of Carla and others. In contrast, the evening spent with bereaved friends after the f u n e r a l was f o r C a r l a a more fitting ritual because it involved personal remembrances of S., and took place in the company of supportive others. This latter ritual was an important opportunity for Carla to openly share her pain and have it acknowledged. She also created private rituals in o r d e r to f u r t h e r a s s i s t her adjustment to her loss and to honor the life of her friend.  Carla was aware t h a t some a s p e c t s of her response to S's loss were unique in relation to a conventional model of l o s s w i t h which she was familiar. Because she had r e s i g n e d h e r s e l f to the l o s s w e l l b e f o r e S's death, she b e l i e v e d her experience of such responses as shock and d i s b e l i e f were a t y p i c a l when compared to their conventional description. She also recognized and tolerated the i n d i v i d u a l i t y of o t h e r bereaved i n terms of their response to the l o s s of S.  133  Appendix F E i d e t i c A n a l y s i s o f Diane's Thematic C l u s t e r of Meaning U n i t s 1.  Experience  Thematic  Description  Acceptance (MU #8, 9, 15, 25, 61, 62, 65, 68, 69, 71, 74) •  J's life was ended by a terminal illness which was contracted while being treated for a life-long chronic illness. His resignation to death and l o n g - s t a n d i n g courage i n the face of its inevitability facilitated Diane's acceptance o f h i s impending death. With the deaths of her mother and especially her grandmother, she witnessed what she d e s c r i b e d as an awe inspiring sense of s p i r i t u a l i t y incorporating a sense of peace or j o y i n death. She sensed this mystery especially in the death o f her f r i e n d J.H., i n whose d y i n g p r o c e s s she was most i n t e n s e l y i n v o l v e d and with whose death she was most immediately r e s o l v e d .  Concession (MU #57, 65)  In her intense involvement w i t h the d y i n g p r o c e s s of J.H., her most r e c e n t l o s s , Diane impeded h e r s e l f from e n j o y i n g her own l i f e . She felt that amidst his suffering she could not c o n t i n u e t o enjoy l i f e and live fully. Because she d i d not want t o burden him w i t h her own sorrow she made a further concession and r e s o l v e d not t o c r y i n h i s presence. Though she d i d not r e g r e t her concessions she b e l i e v e d she p a i d a t o l l for her i n t e n s e support i n having impeded her own experience of joy before h i s death.  134  3.  Control (MU #18, 22, 37, 46, 51, 54, 75, 77)  Diane s t r u g g l e d w i t h i s s u e s of c o n t r o l e s p e c i a l l y around the sudden losses o f her f r i e n d s J . and D. Though she was resolved t o J's i n e v i t a b l e death, she found herself unprepared f o r how suddenly h i s death a c t u a l l y occurred. Her sense of vulnerability was i n t e n s i f i e d by her s t r u g g l e to cope with the failing health o f her f a t h e r and grandmother, and the impending death of the latter. Some y e a r s l a t e r she i s again confronted with such vulnerability i n terms of mortality by the sudden death o f her f r i e n d D.  4.  Emotional D i s t r e s s (MU #3, 5, 6, 22, 37, 52, 65, 66)  Diane d e s c r i b e d her response t o the l o s s o f A. as one i n which she f e l t overwhelmed by the unfamiliar confrontation with death. She remained i n a s t a t e o f denial for an extended period o f time after his death. With the death o f h e r friend J. she again e x p e r i e n c e d a sense o f b e i n g overwhelmed as h i s death had coincided with the f a i l i n g health of both her grandmother and f a t h e r . Several years later, after the sudden death o f her friend D., Diane d e s c r i b e d having experienced p r i m a r i l y a sense o f shock and d i s b e l i e f w i t h h i s l o s s . She s t r u g g l e d f o r some time with the seeming meaninglessness of his death, and r e c o g n i z e d t h a t her s t r u g g l e was due i n p a r t to being completely unprepared f o r h i s death. And w i t h the most r e c e n t l o s s o f her f r i e n d J . H. she described an intense and c o n t i n u a l sense o f anguish, much of which she experienced while caring f o r  135  him i n the months b e f o r e h i s death.  5.  Dissonance (MU #1, 17, 21, 38, 40, 42, 44, 49)  Diane's experience o f the l o s s o f her f r i e n d A. was characterized in part by dissonance. At that early part i n her l i f e she was unfamiliar with death and had not y e t acknowledged the r e a l i t y of m o r t a l i t y . L a t e r , w i t h the death o f her friend J. she again e x p e r i e n c e d dissonance, not with the r e a l i t y o f death i t s e l f but r a t h e r w i t h the way i n which h i s l i f e may have ended. She had been i n s p i r e d by J's courage and d e t e r m i n a t i o n i n the f a c e o f his chronic and terminal illnesses, and i n l i g h t o f t h i s s t o i c i s m she had g r e a t difficulty resolving the f a c t t h a t he may have taken h i s own l i f e . With the death o f her f r i e n d D., her e x p e r i e n c e o f sudden l o s s i s shaped by her intense rage with another mourner whose exploitative actions impinged on the a b i l i t i e s o f Diane and o t h e r bereaved t o openly and f u l l y experience and share their grief.  6.  Exclusion (MU #2, 36, 48, 50, 56)  Diane d e s c r i b e d a sense o f e x c l u s i o n i n her e x p e r i e n c e of t h e l o s s o f A. She f e l t unable t o be with him d u r i n g the acute i l l n e s s t h a t l e d to his death, and experienced disappointment in herself for this selfimposed e x c l u s i o n f o r a l o n g period o f time after his death. She a g a i n e x p e r i e n c e d a sense o f e x c l u s i o n w i t h the sudden death o f her f r i e n d D. In h a v i n g had no time t o prepare f o r his loss she believed she was prevented from a c c e s s i n g t h e s p i r i t u a l feedback t h a t was n e c e s s a r y  136  for  her t o r e s o l v e h i s l o s s . Her initial experience w i t h the impending l o s s of J.H. was characterized by exclusion. She had been aware of his terminal illness well before he disclosed i t to her and d u r i n g t h i s i n t e r i m she f e l t impeded in her need to openly d i s c u s s w i t h him h i s impending death and its implications.  Inclusion (MU #14, 16, 20, 39, 43, 51, 55, 57, 58, 60, 66)  Diane e x p e r i e n c e d a sense o f i n c l u s i o n i n J's p r o c e s s o f dying. They openly discussed his impending death and what i t meant f o r each of them. Her experience o f the l o s s of J.H. was also one of inclusion. Open d i s c u s s i o n of h i s i l l n e s s and impending death was ongoing between them, and she was intensely i n v o l v e d i n h i s c a r e t o the very end of his dying process. R e c o g n i t i o n o f her l o s s and of her status as bereaved was an important f a c t o r i n Diane's adjustment to each of her l o s s e s . With each death she acknowledged the e x t e n t and s i g n i f i c a n c e of the l o s s through the a c t of r e v i e w i n g who her f r i e n d had been i n l i f e and what he had meant t o her. With each of her l o s s e s she c o n s i d e r e d legitimately herself bereaved.  Integrity (MU #15, 19, 23, 51, 55, 58, 64, 67, 70, 74, 76)  Despite the life-long chronic and terminal illnesses that ended J's life, she was inspired by h i s courage and adherence t o a purpose of being. She again witnessed in the illness and death of her friend J.H. this same integrity which remained  137  i n t a c t d e s p i t e the a d v e r s i t y of a d e b i l i t a t i n g i l l n e s s . And though h i s loss was extremely p a i n f u l , h e r own integrity remained intact throughout his dying process. She e x p e r i e n c e d p r i d e i n h e r a b i l i t y t o be there f o r him and offer support i n s p i t e o f h e r own pain.  9.  Intuition (MU # 59, 62)  Before departing on a holiday, Diane experienced w i t h J.H. a s t r o n g sense o f his imminent death, and b e l i e v e d he would d i e w h i l e she was away. Her i n t u i t i o n was l a t e r confirmed.  10.  Meaning (MU #7, 8, 17, 20, 46, 50, 51, 68, 69, 72)  Especially in her first e x p e r i e n c e s w i t h the l o s s o f a close friend, Diane s t r u g g l e d t o make sense o f their deaths. With the death o f h e r f r i e n d A. she was e m o t i o n a l l y overwhelmed by h i s l o s s and was unable to make sense of her experience u n t i l a f t e r the death o f h e r own mother. L a t e r w i t h the deaths o f h e r f r i e n d s J . and then D. she struggled to find meaning more i n t h e way i n which these friends died rather than in the deaths themselves. Her most r e c e n t loss of her close friend J.H. has been one w i t h which d e s p i t e h e r anguish she has struggled less to find meaning i n the death. After a long and agonizing s t r u g g l e w i t h i l l n e s s , Diane r e a l i z e d t h a t i n death J.H. had found j o y .  11.  Ritual (MU #41, 43, 51, 73)  In h e r attempt t o adapt t o her losses, Diane found important the c r e a t i o n of personally meaningful rituals. As a means o f doing something positive  138  w i t h her anguish r e l a t e d t o the l o s s of D., she h e l p e d to create a memorial fund which would a s s i s t i n the a d m i n i s t r a t i o n o f an annual workshop o f f e r e d i n h i s area of speciality. She found such public commemoration h e l p f u l also i n a d j u s t i n g to the deaths of her friend J.H. and her grandmother, and donated gifts to the community i n honor of t h e i r memory.  139  Appendix G E i d e t i c A n a l y s i s of Natasha's E x p e r i e n c e Thematic C l u s t e r of Meaning U n i t s 1.  3.  Acceptance (MU # 7, 10,  11,  Thematic  41,  46)  Description  In the months before L's death, Natasha had resigned h e r s e l f to the i n e v i t a b i l i t y of her l o s s . When the news of L's death a r r i v e d Natasha experienced sadness, but also relief i n that death was a positive alternative to the months and years of suffering that L. had endured. Though she asserted a need to bring some f i n a l closure to the process of grieving L's loss, Natasha wondered if she had not already experienced the depth of grief for L. that she believed she essentially would e x p e r i e n c e .  Concession (MU #9, 13)  Natasha conceded that the s u p e r f i c i a l i t y of t h e i r l a s t contact actually characterized much of her relationship with L. Yet her loyalty remained constant to her dying friend. Natasha realized t h a t her f r i e n d s h i p with L. had been sustained throughout t h e i r l i v e s by a bond which remained i n t a c t despite their physical distance and often very different perspectives in life.  Control (MU #4,  Natasha questioned whether more c o u l d have been done to have saved L's life. She a l s o s t r u g g l e d with her own ability to have influenced the course of her friend's illness and her painful p r o c e s s of d y i n g .  8)  140  4.  Emotional D i s t r e s s (MU #3, 5, 10, 38, 39)  Natasha e x p e r i e n c e d a sense of shock upon h e a r i n g t h a t her f r i e n d L. was i l l w i t h recurrent cancer, and had been so f o r 2-3 years by the time the news was d i s c l o s e d to her. With this disclosure she also experienced an overwhelming and simultaneous sense of sadness and anger. Upon r e c e i v i n g word t h a t L. had died, Natasha described a sense of numbness, p a r t o f which was a mixture o f sadness t h a t L's life had ended, and relief that her struggle with illness was finally over.  Dissonance (MU #7,16)  Natasha e x p e r i e n c e d a sense of dissonance with others whose response to the l o s s of L. was d i f f i c u l t f o r h e r to tolerate, In l i g h t of her need to openly acknowledge the impending loss o f L. and what t h a t meant to her, she experienced great frustration with others, i n c l u d i n g L., who c o n t i n u e d to deny the r e a l i t y o f L's death d e s p i t e i t s imminency.  Exclusion (MU #3, 6, 16, 23, 26, 28, 29, 36)  Natasha's first experience of the l o s s of a close friend is characterized predominantly by a sense o f exclusion. After the illness and death of her best friend i n childhood, Natasha was d e n i e d access t o a t t e n d i n g the f u n e r a l . The s i g n i f i c a n c e o f h e r l o s s was not recognized by others, and she was effectively excluded from bereavement status. She again describes a sense of exclusion in a d u l t h o o d w i t h the death o f her f r i e n d L. Natasha was unaware o f t h e r e c u r r e n c e o f  141  her f r i e n d ' s cancer u n t i l i t was v e r y advanced. By the time Natasha saw L., her f r i e n d was so c l o s e t o death that she was no longer present or accessible to Natasha. Her sense of exclusion is heightened after L's death when she attempts to disclose her struggle over L's l o s s t o L's sister, with whom Natasha had a l s o been c l o s e . The sister's response to Natasha' s pain had the effect of i n v a l i d a t i n g i t , indicating t o Natasha that she would be impeded i n f u r t h e r d i s c u s s i n g her l o s s w i t h L's s i s t e r .  7.  Finality (MU #14)  In acknowledging a s p e c t s o f t h e meaning o f L's loss, Natasha was confronted by the f i n a l i t y o f death.  Inclusion (MU #8, 14, 15, 17, 18, 44, 47)  Natasha's most treasured memory o f her f i n a l visit with L. was that of massaging L's f e e t . This f i n a l and o n l y v i s i t w i t h L. before her death allowed Natasha a sense of inclusion. She gained a sense of being able to p a r t i c i p a t e i n and ease L's dying process. Her sense o f i n c l u s i o n i n terms o f b e i n g enabled t o openly discuss her e x p e r i e n c e o f l o s s was later influenced by her p a r t i c i p a t i o n i n her support group, as well as the development of her relationship with L's daughter K. Natasha found the freedom i n her support group to fully express what the loss o f L. had meant f o r her. In so doing, she came to r e c o g n i z e the e x t e n t o f her l o s s and the l e g i t i m a c y of h e r bereavement s t a t u s .  142  9.  Integrity (MU #13)  Natasha was aware of the effect of illness on the integrity of her dying f r i e n d L. She r e f l e c t e d on the number of years her f r i e n d had s u f f e r e d w i t h her recurring illness, and was struck by L's courage to b a t t l e f o r her l i f e f o r so long.  10.  K i n - l i k e Bond (MU #44)  Natasha realized that her e x p e r i e n c e of the l o s s o f L. may have been intertwined with grieving the l o s s of the ideal natural family which she felt she never had.  11.  Meaning (MU #12, 21, 22, 30, 40, 42, 45, 46)  35,  12.  Ritual (MU #13, 22, 24, 25, 31, 33)  27,  13.  Uniquely Individual Response (MU #7, 20, 30, 46)  In her attempt t o cope w i t h her l o s s e s , Natasha s e a r c h e d not only f o r a means of making sense of those l o s s e s , but a l s o f o r a way to g r i e v e the death o f her f r i e n d s t h a t would honor the meaning their lives had embodied. Aspects of L's death, i n c l u d i n g the meaning of her l o s s , still remain u n r e s o l v e d f o r Natasha.  Natasha believed the creation of a meaningful r i t u a l e n a b l e d her t o honor the meaning o f the deceased. The development of such r i t u a l s was a l s o accompanied by the c r e a t i o n of artworks and w r i t i n g s r e l a t e d t o the deceased, which a l l o w e d her to further resolve her feelings related to her losses.  Natasha questioned whether her response t o l o s s i t s e l f was unique i n r e l a t i o n to the way in which other bereaved i n d i v i d u a l s respond to such loss. Further, based on the depth o f her  143  relationship with L., she questioned whether her response t o the l o s s of L. would be unique i n r e l a t i o n to her response to losses which she may s u f f e r i n the future.  144  Appendix H Themes Common t o t h e E x p e r i e n c e o f a l l Co-Researchers Theme  Anna  Carla  Diane  Natasha  1.  Acceptance  MU#11,14, 17,18,37, 47,49,60 62,65, 67  MU#20,23, 26,38,47, 48,58,60, 64, 66  MU#8,9, 15,25,61, 62, 65,68, 69,71,74  MU#7,10, 11,41,46  2.  Concession  MU#6,13, 22,26,27 28  MU#14,25, 51,64,67, 68,71  MU#57, 65  MU#9,13  3.  Control  MU#48,50, 51,52,59, 63, 69  MU#39,42, 44,46  MU#18,22 37,46,51 54,75,77  MU#4,8  4.  Emotional Distress  MU#4,40 44,46,55 56,68,69  MU#3,10 11,21,22 29,30,34 50,57,58 59,64,79  MU#3,5,6 22,37,52 65, 66  MU#3,5 10,38,39  5.  Dissonance  MU#35,38 41,43,56 61, 63  MU#17,24 26,35,36 55,68,71  MU#1,17 21,38,40 42,44,49  MU#7,16  6.  Exclusion  MU#5,7 16,24,26 29, 39  MU#8,9 27,33,34 36,37,40 45,62,69 80  MU#2,36 48,50,56  MU#3,6 16,23,26 28,29,36  7.  Inclusion  MU#8,9 10,17,19 20,29,30 31,33,37 44,54,57  MU#6,7 9,28,32 40,41,47 56,59,61 69,75,77 81  MU#14,16 20,39,43 51,55,57 58,60,66  MU#8,14 15,17,18 44, 47  8.  Integrity  MU#17,29 31,36,37 53, 66  MU#5,15 16,18,19 23,24,26 48, 64, 65  MU#15,19 23,51,55 58,64,67 70,74,76  MU#13  9.  Meaning  MU#12,42 44,46,57 58,60,64  MU#6,25 26,42,43 44,45  MU#7,8 17,20,46 50,51,68 69,72  MU#12,21 22,30,35 40,42,45 46  Ritual  MU#23,31 32,34,39 40,41  MU#4,29 31,54,70 72,74,76  MU#41,43 51,73  MU#13,22 24,25,27 31, 33  10.  

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