Sense of presence experiences and meaning-making in bereavement: a qualitative analysis

Perinatal meaning-making and meaning-focused coping in the COVID-19 pandemic

INTRODUCTION

The COVID-19 pandemic caused unprecedented levels of stress amongst pregnant women and new mothers. The current qualitative study explored the ways in which perinatal women made meaning of their experiences during the COVID-19 pandemic.

METHODS

Data came from a parent study in which 54 perinatal (pregnant and postpartum) women in the United States completed semi-structured interviews from October 2021 to January 2022 describing their experiences during the COVID-19 pandemic. The data was interpreted using a hermeneutic, phenomenological approach to delve deeply into the concept of meaning-making.

RESULTS

Despite high levels of stress and challenging circumstances, participants reported engaging in meaning-making through finding connection, focusing on gratitude, and identifying openings for change. Unique forms of meaning-making amongst this population include a sense of connection to women throughout history, connection to their baby, and recognition of the need for systemic change for perinatal women.

CONCLUSIONS

Perinatal women coped with the stress of the COVID-19 pandemic by making meaning from their experiences. Future research should further explore the importance of these aspects of meaning-making to perinatal women and implement these findings to adapt prevention and treatment approaches to address perinatal stress, especially during times of crisis.

Bereaved Individuals Attempts to Explain Their Unexplainable Experiences Related to the Death of Their Loved one Through Attribution Thinking

Continuing bond manifesting as unexplainable experiences reflects bereaved´s attempts to restore connection with the deceased. As an experience unaligned with a person's overall schemas of meaning unexplainable experiences are a source of anxiety that individuals aim to alleviate by attribution thinking. This study describes how bereaved aim to explain unexplainable experiences related to the death of their loved ones. The study analysed 408 narratives of 181 bereaved individuals. Bereaved individuals (1) described the meaning of their experience to be receaving information, emotions or support by the experience and communicating about crossing the boundary between life and death. As (2) reflections on the cause of their experiences bereaved individuals described certain and uncertain explanations of the phenomenon, ruling out explanations and the compatibility or incompatibility of the experience with their prior worldviews. The process of attribution thinking must be perceived as meaningful regardless of the outcome of the bereaved person's reflection.

Are Sensory Experiences of One's Deceased Spouse Associated with Bereavement-Related Distress?

Following late-life spousal bereavement, sensory and quasi-sensory experiences of the deceased (SED) are commonly reported. This longitudinal study examined SED among 310 older widowed adults 6-10 (T1) and 18-20 (T2) months post loss. Reports of SED in the first 6-10 months after loss were associated with higher symptom levels of prolonged grief, post-traumatic stress, and loneliness at T1. Experiencers of SED were more likely to experience symptoms of prolonged grief and post-traumatic stress above cut-off scores at T1. Importantly, only a minority of the experiencers of SED displayed these elevated levels of bereavement-related distress. In addition, employing multi-level-modeling, a similar trajectory of decreasing bereavement-related distress over time was found for both experiencers and non-experiencers of SED. We argue that SED may be one of several potential reactions to bereavement, which should not be seen as an indicator of grief complications per se.

Insights on spirituality and bereavement: A systematic review of qualitative studies

AIM

To describe a synthesis of the experience related to the spirituality of those living a bereavement journey in primary qualitative studies.

DESIGN

A systematic review of qualitative studies.

DATA SOURCE

A systematic review was carried out in March 2019 and was updated in January 2023. Searching was accomplished by an online database, such as CINAHL, MEDLINE, PsycINFO, MedicLatina, LILACS, SciELO and Academic Search Complete. The search strategy did not consider a timeline as an eligibility criterion. The quality of the studies was assessed, and a thematic synthesis was performed in this review.

METHODS

A systematic review of qualitative studies was conducted according to Saini and Shlonsky's methodology.

REPORTING METHOD

PRISMA checklist.

RESULTS

The review included 33 articles. Most of the studies were phenomenological and focused on parents' and family experiences of bereavement. Seven significant categories emerged, which match unmet spiritual needs during the grieving process. Two major categories were identified regarding the role of spirituality in bereavement: Spirituality as a process and spirituality as an outcome.

CONCLUSION

In clinical practice, attention to spirituality and providing spiritual care is critical to guarantee a holistic approach for those experiencing bereavement.

IMPLICATIONS

The findings of our study could foster awareness that healthcare professionals should include the spiritual dimension in their clinical practice to provide holistic care to individuals, enhancing the healing process in bereavement.

NO PATIENT OR PUBLIC CONTRIBUTION

This is a systematic review.

Knowledge and attitudes of medical students toward death: a cross-sectional comparative study between an Arab and a Western University

BACKGROUND

Cultural factors influence attitudes toward death, and gender disparities are evident. Prior studies show that medical students have limited knowledge about death and are uncomfortable with it. Moreover, there is limited research that has examined factors that influence medical students' knowledge and attitudes toward death.

OBJECTIVES

The objectives of the study were to compare cultural and gender differences in relation to knowledge and attitudes toward loss and grief and to screen for complicated grief among medical students at the Arabian Gulf University and the University of Toronto.

METHODS

A cross-sectional study was disseminated to medical students at both universities in 2022. The variables in the survey included four parts: demographic characteristics of the participants, religious observance, history of encountering loss of a loved one, grief following loss, attitude toward death, and learning about how to deal with grief and death during medical school. The brief grief questionnaire and the death attitude profile-revised scales were used.

RESULTS

The study sample consisted of 168 medical students, with 74.1% being female. Complicated grief scores were higher among Arabian Gulf University students (3.87 ± 2.39) than among University of Toronto students (2.00 ± 1.93) and were higher for participants with a higher degree of religious observance in both schools (p < 0.05). Death avoidance (p = 0.003), approach acceptance (p < 0.001), and escape acceptance (p = 0.038) domains were significantly higher among Arabian Gulf University students than among University of Toronto students. Almost three-quarters of University of Toronto students reported not being taught about grief, compared to 54% of Arabian Gulf University students.

CONCLUSIONS

Arabian Gulf University medical students scored higher on complicated grief, most likely due to cultural and religious factors. Females at both institutions as well as those who indicated a higher level of religious observance reported higher scores of complicated grief. The study highlights how cultural and religious beliefs influence medical students' attitudes toward death and bereavement. It provides valuable insight into the knowledge and attitudes of medical students toward loss.

Consequences of Unexplained Experiences in the Context of Bereavement - Qualitative Analysis

Unexplained experiences are common among bereaved people and are a natural part of grieving, but their consequences may affect their coping with grief. However, professionals lack awareness of these unexplained experiences, which may lead to an unnecessary pathologising of the experiences and a lack of opportunity for the bereaved to process their experiences in a safe environment. The study involved an inductive content analysis of 408 narratives of the consequences of unexplained experiences shared by 181 bereaved individuals. The consequences of the unexplained experiences were: (1) Experiencing after-effects which may alleviate or aggravate wellbeing, as well as be life-affecting; (2) consequences related to sharing or concealing the experiences, and the reactions of others to recounting the experience; (3) documenting the experience through videography, photography and keeping mementos. In conclusion, these experiences have consequences to bereaved which needs to be taken account in support interventions aimed at bereaved individuals.

Exploring an Extended Conception of Grief: Sense of Presence and Grief Reactions in German Widows

This study explores sense of presence (SOP) as an important feature of continuing bonds (CB) in the context of normal grief. A community sample of widows (N = 51) filled in a multidimensional grief questionnaire and a depression scale. A moderate positive association between sensing the deceased husband´s presence and cognitive and emotional impairments emerged. A positive relationship between SOP and guilt was found only if the influence of religiosity was controlled for statistically. There were no significant associations of SOP with long-lasting positive reactions to loss, such as personal growth and increase in sensitivity for others. Widows with clinically relevant depression indicated a stronger SOP than those with lower depression scores. These differentiated findings may stimulate the elaboration of an extended conception of grief beyond the focus on clinically relevant impairments.

The functions of the dreams of the deceased: A qualitative study of women bereaved by partner's suicide

Suicide bereavement is a challenging experience that affects relationships, feelings, and physical and mental health. The research on dreams during suicide bereavement might deepen the understanding of how the loved one's suicide affects the person and what functions the dreams can have during the bereavement process. Therefore, the goal of the current study was to explore the functions of the dreams of the deceased during suicide bereavement in a sample of 9 women bereaved by their partner's suicide. The data was gathered by conducting semi-structured interviews and analyzed using reflexive thematic analysis. Three themes were generated: dreams function as helping during the process of suicide bereavement; dreams reflect the traumatic aspects of suicide bereavement; dreams function as a space to maintain or sever an ongoing relationship with the deceased. The findings reveal that dreams can function in different ways and can be a valid part of suicide bereavement.

Description and Impact of Encounters With Deceased Partners or Spouses

This study investigates perceived interactions with the deceased, a phenomenon reported across societies, with 30-34% of individuals likely experiencing at least one ADC in their lifetime. Despite this prevalence, studies examining the impact of ADCs' on those who have lost partners are limited. We present data from 70 individuals reporting partner ADCs via an online survey. Forty percent reported accelerated recovery and 42.9% confirm the ADCs' significant influence in their grieving, with 61% expressing a desire for continued contact. ADCs, interestingly, didn't worsen their pain. The influence on grief-related sadness varied: 41% noted no change, while 40% reported reduced sadness. Forty-seven percent acknowledged ADCs eased their loss acceptance. The data highlight ADCs' substantial, potentially therapeutic role in grief and healing, despite varying effects on sadness and recovery. This study underscores the ADCs' possible positive influence on bereaved partners, advocating for a deeper understanding of this phenomenon in the grieving process.

Mitigating Loss and Trauma: The Continuing Bonds Experience of Daughters Bereaved to Intimate Partner Femicide

The current study sheds light on the continuing bonds experience of adult Israeli daughters whose mothers were murdered by their fathers. Through 11 semi structured interviews, common externalized and internalized continuing bonds with the deceased mothers were closely examined. The interpreted results supported the existence of bonds, yet revealed a unique manifestation; the bonds were purposefully and defensively restricted, which seemed to be an adjustive compromise in light of the strong traumatic component of the loss. Our results contribute to the theoretical and clinical understanding of the restrictive effect that trauma components have on loss components in cases of traumatic bereavement.

Very Present and Very Real: A Case Study of Regularly Hearing the Voice of the Deceased Without Distress in Bereavement

Although sensory and quasi-sensory experiences of the deceased (SED) have been the subject of much debate, research on the phenomenology of auditory verbal experiences in the bereaved has been neglected. This case study describes the phenomenology of a regularly occurring voice hearing experience and its meaning for a single bereaved individual. The voice of the deceased can be heard as though in external space, and the experience can feel real, even when the death is fully acknowledged. A bereaved individual can welcome and benefit from the experience even when it is not recognized as a normal part of grieving in the individual's cultural context, when no afterlife belief is present, and when the experience remains unexplained. The case study demonstrates that hearing the voice of the deceased can be a regular occurrence without causing distress or dysfunction and lends support to the idea that SED are a common concomitant of normal bereavement.

Factors Moderating the Impact of After Death Communications on Beliefs and Spirituality

After death communications(ADCs) are defined as perceived spontaneous contacts with living individuals by the deceased. This research presents on a subset of data from a recent large international survey of individuals who experienced ADCs and provided systematic information regarding these experiences. In our research we explore the impact of having an ADC on reported spirituality, religiosity, beliefs and attitudes about death and dying and also explore the moderating factors of this impact. We found that having an ADC was perceived as a positive life experience and that it was associated with a reduction in fear of death, belief in life after death and that the deceased could communicate with the living, and increased reported spirituality. Moderating factors include aspects of having or desiring physical contact with the deceased as well as perceiving some emotional reaction to the ADCs. Future directions for research exploration are also provided based on our findings.

The impact of continuing bonds following bereavement: A systematic review

Following bereavement, continuing bonds (CBs) include engaging with memories, illusions, sensory and quasi-sensory perceptions, hallucinations, communication, actions, and belief that evoke an inner relationship with the deceased. To date, the literature has been unable to confirm whether retaining, rather than relinquishing, bonds is helpful. A mixed studies systematic literature search explored how CBs affect grief. Studies on the effect or experience of CBs on adjustment following bereavement were eligible for inclusion. Six computerized databases were searched. A total of 79 of 319 screened studies were included. Three themes were derived from the thematic analysis: (1) comfort and distress, (2) ongoing bonds and relational identity, and (3) uncertainty, conceptualizing, and spirituality. Themes describe the role of CBs for the accommodation of the death story, transformation of the relationship, meaning reconstruction, identity processes, and affirmation of spiritual belief. Results shed light on the adaptive potentials for CBs.

The felt-presence experience: from cognition to the clinic

The felt presence experience is the basic feeling that someone else is present in the immediate environment, without clear sensory evidence. Ranging from benevolent to distressing, personified to ambiguous, felt presence has been observed in neurological case studies and within psychosis and paranoia, associated with sleep paralysis and anxiety, and recorded within endurance sports and spiritualist communities. In this Review, we summarise the philosophical, phenomenological, clinical, and non-clinical correlates of felt presence, as well as current approaches that use psychometric, cognitive, and neurophysiological methods. We present current mechanistic explanations for felt presence, suggest a unifying cognitive framework for the phenomenon, and discuss outstanding questions for the field. Felt presence offers a sublime opportunity to understand the cognitive neuroscience of own-body awareness and social agency detection, as an intuitive, but poorly understood, experience in health and disorder.

Sensory experiences of one's deceased spouse in older adults: An analysis of predisposing factors

Objectives This study focuses on pre-disposing factors associated with sensory experiences of the deceased (SED), also called bereavement hallucinations. Even though SED are common among older widowed adults, our knowledge of these experiences is still limited.Method Survey responses were obtained from 310 older widowed participants (M = 70.05 ± 8.39), complemented with data from Danish national registers.Results Hierarchical logistic regression analysis revealed four significant pre-disposing factors: prior experiences of SED in the context of previous significant bereavements (OR = 4.72), a history of interpersonal trauma (OR = 5.8), high pre-death relationship closeness (OR = 2.76) and stronger religious/spiritual worldview (OR = 1.12). No association to registered mental health diagnosis was identified.Conclusion: SED may be considered an interpersonal experience, which may be more likely to occur if the pre-death relationship is described as very close and if the bereaved has previously experienced interpersonal trauma. We argue that SED should not necessarily be considered an indication of neurodegenerative or psychiatric diseases.

Spirituality and Religiosity during Suicide Bereavement: A Qualitative Systematic Review

A loved one’s loss to suicide can be a traumatic experience and trigger a difficult grief process, identity changes, a loss of the sense of meaning and a spiritual crisis. Spirituality and/or religiosity (S/R) can be both an important resource and a source of stigmatisation during suicide bereavement. This study aims to synthesise the extant findings about S/R during suicide bereavement in qualitative studies. After an exhaustive selection of articles, the current review utilised a total of 484 citations and seven studies. A thematic synthesis yielded five major themes related to S/R during suicide bereavement: the need to be helped by the religious community without being judged; S/R-related experience of the deceased as a figure who continues to exist; S/R experienced without a conscious choice; conscious reach towards S/R themes; not relating to S/R during suicide bereavement. These findings indicate that the role of S/R during suicide bereavement is complex and varies from providing help to serving as a source of suffering. Hence, practitioners and religious communities should be mindful of the S/R themes during suicide bereavement.

The phenomenology and impact of hallucinations concerning the deceased

Background

People who have suffered the loss of a loved one may subsequently report sensory experiences of the deceased (termed ‘after-death communications’, or ADCs). Such encounters are common and can be a source of comfort to the bereaved. Nevertheless, there has been limited empirical investigation of this phenomenon, and consequently mental health professionals feel ill-equipped to support those who disclose them.

Aims

To map the phenomenology of ADCs, and identify covariates and effects upon the recipient.

Method

We conducted an online mixed-methods survey comprising 194 items about all aspects of ADCs. A purposive sample of 1004 respondents across three language groups (English, French and Spanish) completed the survey.

Results

The most common form of ADC was during sleep, but large numbers of cases involved sensory modalities of touch, sight, hearing, smell and sense of presence that externalised the phenomenon for the recipient. Variations in incidence with participant gender and language group suggest a psychosocial component. ADCs were typically regarded by the participant as deeply meaningful and comforting. Respondents reported significant increases in their sense of spirituality, but not religiosity.

Conclusions

ADCs are a common feature of bereavement that occur unexpectedly, and are independent of any underlying pathology or psychological need. For the person experiencing the hallucination, they are important and meaningful events that they interpret in terms of continuing bonds with the deceased. This adaptive outcome may be stymied where mental health professionals trivialise or pathologise disclosures about ADCs.

Prevalence and Phenomenology of Sensory Experiences of a Deceased Spouse: A Survey of Bereaved Older Adults

Sensory and quasi-sensory experiences of the deceased (SED), also called bereavement hallucinations, are common in bereavement, but research detailing these experiences is limited. Methods: An in-depth survey of SED was developed based on existing research, and 310 older adults from the general Danish population participated in the study 6-10 months after their spouse died. Results: SED were reported by 42% of the participants with wide-ranging phenomenological features across sensory-modalities. In particular, seeing and hearing the deceased spouse was experienced as very similar to the couple's everyday contacts before death. SED were endorsed as positive by a majority of experiencers, and the experiences were often shared with family and friends. Discussion: SED are conceptualized as social and relational phenomena, which may comfort the surviving spouse in late-life bereavement, but also provide tangible help to some experiencers. In clinical practice, SED may be considered a potential resource for the therapeutic grief process.

Perceptual phenomena associated with spontaneous experiences of after-death communication: Analysis of visual, tactile, auditory and olfactory sensations

The purpose of this study was to create a detailed characterization of the nature of the sensory perceptions associated with after-death communication. A primary aim was to determine if perceptions of after-death communication (ADC) support one or more of three hypotheses: (1) they are the result of hallucinations or day-to-day thoughts about the deceased; (2) they are subjective phenomena reflecting the extrasensory perception of remote events; or (3) they constitute objective phenomena, perceived more solidly, as if within the physical world. Methods: The study included a quantitative analysis and qualitative first-person narrative description of part of the data set from a detailed questionnaire study (991 viable cases) investigating the phenomenology of spontaneous ADCs. Results and Conclusions: A majority of respondents reported that ADCs were distinctly different from simple thoughts about the deceased. Specifically, relative distribution of ADCs across the senses was 46% visual, 44% auditory, 48% touch, and 28% olfactory, with 34% sensing the presence of the deceased without input from the five senses. ADCs often were perceived as external and having properties of the material world (e.g., solidity, tactile qualities). Even the more nebulous 'sense of presence' cases were perceived as having a distinct location in space and as being identifiable as a specific deceased presence despite the lack of sensory cues. These elements are more compatible with hypotheses 2 and 3 than hypothesis 1.

Sensory and Quasi-Sensory Experiences of the Deceased in Bereavement: An Interdisciplinary and Integrative Review

Bereaved people often report having sensory and quasi-sensory experiences of the deceased (SED), and there is an ongoing debate over whether SED are associated with pathology, such as grief complications. Research into these experiences has been conducted in various disciplines, including psychiatry, psychology, and anthropology, without much crossover. This review brings these areas of research together, drawing on the expertise of an interdisciplinary working group formed as part of the International Consortium for Hallucination Research (ICHR). It examines existing evidence on the phenomenology, associated factors, and impact of SED, including the role of culture, and discusses the main theories on SED and how these phenomena compare with unusual experiences in other contexts. The review concludes that the vast majority of these experiences are benign and that they should be considered in light of their biographical, relational, and sociocultural contexts.

Presence phenomena in parkinsonian disorders: Phenomenology and neuropsychological correlates

INTRODUCTION

The feeling of a presence that occurs in the absence of objectively identifiable stimuli is common in parkinsonian disorders. Although previously considered benign and insignificant, recent evidence suggests that presence phenomena may act as the gateway to more severe hallucinations and dementia. Despite this, we still know relatively little about these phenomena.

OBJECTIVE

To examine parkinsonian disorder patients' subjective experience of presence phenomena, and retrospectively analyse their cognitive correlates, in order to elucidate the emergence of information processing deficits in parkinsonian disorders.

METHODS/DESIGN

25 patients who endorsed presence phenomena were asked to complete a semi-structured interview about their experiences. The cognitive profiles of these patients were then compared to those of age- and education-matched patients who denied presence phenomena.

RESULTS

Patients described the presence as mostly that of an unknown human with neutral valence. Patients who described it as unpleasant were noted to also demonstrate elevated anxiety. Patients who identified the presence as a known person, described it as touching them, or interacted with the presence emotionally or physically demonstrated reduced insight. Patients with presence phenomena demonstrated more frequent impairments in visual processing, executive function and speed of processing.

CONCLUSIONS

Presence phenomena occur in the company of advancing cognitive impairment and involvement of the posterior cortical functions. Initially encountered as a neutral spatial skeleton, the experience is then shaped by the patient's affective state and level of insight.

Recovering the body in grief: Physical absence and embodied presence

This paper addresses the complex issue of the embodiment of grief. It explores how a theoretical shift to the body has influenced scholarly literature about grief and bereavement. Despite this shift, we argue that bodily interpretations and experiences are undertheorised in western psychological literature on bereavement. Specifically, we argue that linear stage models of grief have encouraged the view that grief needs ‘working through’ in the mind, and not necessarily the body. We draw on empirical data from interviews with bereaved people undertaken in England to illustrate aspects of the embodied experience of grief that differ from how psychological grief theories conceive of the bereaved person’s body. Findings highlight the role of the bereaved person’s body in managing grief and how the absence and continuing presence of the deceased person is managed through embodied practices. We conclude that understanding grief as an embodied experience can enable the development of grief theories that better capture the complex negotiation between the psychological processes of grief and the materiality of bodies.

Use of Spirituality to Make Sense of Loss by Homicide

This article presents a magnification of Stage 2 of the Theory of Post-Homicide Spiritual Change, a three-stage grounded theory of spiritual change after homicide (Theory of PHSC). Having endured the disintegration of their belief systems in the immediate aftermath of murder (Stage 1), survivors turn in Stage 2 to a more extended process of grappling with a crisis of meaning. This Stage 2 process is presented within the framework of the meaning making model, with attention to spiritual meaning making and transcendental experiences. Findings can help service providers support homicide survivors throughout an intermediary stage of bereavement that is marked by a sense of stagnation and diminished well-being. By accompanying survivors through the difficult meaning making efforts that characterize this stage, providers can help position them to break free of intensive cognitive meaning making and gain forward momentum in Stage 3 of the Theory of PHSC and can focus on aspects of life that can help them successfully make meaning of their loss while positioning them to gain forward momentum.

Understanding the spirituality of parents following stillbirth: A qualitative meta-synthesis

This meta-synthesis aims to synthesize qualitative evidence from primary studies to better understand the experience of the spirituality of parents and its relationship to adapting following stillbirth. Five electronic databases were systematically searched and the quality of 21 eligible studies was critically appraised. A thematic synthesis revealed two analytical themes: (1) Spiritual suffering following stillbirth; (2) Moving through spirituality to adapt to the loss, each encompassing four descriptive themes. The findings can inform a more culturally and spiritually sensitive approach to care, taking into account the parents' beliefs, folk customs, religion, values, and spiritual needs.

How many bereaved people hallucinate about their loved one? A systematic review and meta-analysis of bereavement hallucinations

BACKGROUND

Bereavement hallucinations (BHs) entail a perception of a deceased in any sense modality or as a quasi-sensory sense of presence. BHs are an associated feature of the proposed Persistent Complex Bereavement Disorder (PCBD) in DSM-5. The goals of this review are to estimate the prevalence of BHs, identify possible moderators, and review the methodological status of this research field.

METHODS

A systematic literature search was conducted through the databases PubMed, PsycINFO, and CINAHL. Studies systematically assessing the prevalence of BHs of a relative or friend were included.

RESULTS

Twenty-one eligible studies were identified and 8 meta-analyses of BHs in different sense modalities were conducted. The prevalence of having one or more BHs was estimated to be 56.6% (95% CI 49.9-63.2), and the estimated prevalence of BHs in specific sense modalities ranged within 7.0-39.7%. Meta-regression analyses revealed associations to age and conjugal bereavement, but results are tentative and dependent on the type of BH in question.

LIMITATIONS

The included studies were methodologically heterogeneous. Limitations included the lack of a valid measure of BHs and low sample generalizability.

CONCLUSION

This first systematic review and meta-analysis of BHs suggests that more than half of the bereaved people experience some kind of BH. However, there are considerable methodological limitations in the research of BHs, which is of pertinent interest as BHs have been linked to the development of a future diagnosis of clinically impairing grief. A valid measure of BHs needs to be developed and used in high-quality epidemiological research using population-based designs.

How religious and spiritual beliefs explain prolonged grief disorder symptoms

This study investigated the importance of religious and spiritual beliefs in daily life in explaining prolonged grief disorder (PGD) symptomatology. Participants were 588 bereaved adults who completed a questionnaire. The importance of spiritual beliefs in daily life explained a small to medium, significant 3% of variance in PGD symptoms, but religious beliefs in daily life did not. Individuals who placed moderate importance on spiritual beliefs in their daily life may experience more intense grief.

A Qualitative Examination of Continuing Bonds through Spiritual Experiences in Individuals Bereaved by Suicide

Introduction: Suicide is a public health problem worldwide, and spiritual experiences may be important positive experiences or coping mechanisms for difficulties associated with surviving a suicide loss. Studies have found that continuing bonds through spiritual experiences are common among individuals bereaved by suicide. However, the literature lacks depth in understanding these experiences, such as sense of presence. Aims: The aim of this study was to qualitatively examine descriptions of continuing bonds through spiritual experiences after death by suicide. Method: A total of 1301 individuals bereaved by suicide provided 2443 free responses about their spiritual experiences based on four different prompts, which were analyzed using an inductive approach. Results: Nine common themes were identified, selected for interest, and reported: (1) a helpful sense of comfort; (2) a helpful sense of connection with the deceased; (3) intense sadness evoked by the spiritual experiences; (4) confusion regarding the spiritual experiences; (5) negative reminders of the deceased or negative meanings of spiritual experiences; (6) evidence of an afterlife; (7) general importance of the spiritual experiences’ meaning; (8) impact of and on religious beliefs; and (9) others’ responses to disclosure of suicide or spiritual experiences. Conclusion: For the overwhelming majority of participants, spiritual experiences such as a sense of presence have deep meaning and are often regarded as a positive source of healing and transformation after a suicide death.

Meaning Making in Wartime Bereavement: Lessons Learned From Bereaved Parents and Siblings

Wartime deaths are traumatic and leave many grieving families in their wake. Yet, the unique, nuanced bereavement needs and experiences of those who remain are largely unknown. This Canadian, qualitative study examined the bereavement experiences of family of origin, bereaved during the mission to Afghanistan. The findings provide rich data on the predominant ways in which family members found and made meaning following the death and the ways in which military culture influenced the meanings made.

Predictors of Continuing Bonds Among Bereaved Adolescents

This study examined the relationship between continuing bonds (CBs) among 50 bereaved youth (ages 11–17) and their bereaved adult caregivers, and predictors of CBs among youth. Results indicated there was not a significant relationship between caregiver CB and youth CB. However, significant relationships were found between youth bereavement symptomatology, their relationship to the deceased, and youth CB. Specifically, youth with higher levels of symptomatology and those who lost an immediate family member were more likely to maintain CBs. Results suggest the need for practitioners to incorporate grief symptomatology and CBs in assessment and intervention with bereaved youth.

Examining Posttraumatic Growth Among Bereaved Family Members of Patients With Cancer Who Received Palliative Care at Home

OBJECTIVE

The present study examines the factor structure of the Japanese version of the Posttraumatic Growth Inventory (PTGI-J) among bereaved family members who lost loved ones to cancer after home-based palliative care in Japan. It evaluates the relationships between total score, each PTGI-J domain, and participants' having a religious belief, gender, age, relationship to the patient, and time since patient death.

PROCEDURE

Bereaved family members (n = 849) completed the PTGI-J and a demographic questionnaire. The factor structure was tested using confirmatory factor analysis (CFA), and univariate analysis was used to test hypotheses.

RESULTS

Confirmatory factor analysis showed that the current sample moderately fitted to both 4-factor and 5-factor models. Univariate analysis revealed that having a religious belief and gender were associated with all domains and total PTGI-J score. Age, time since patient death, and relationship to the patient showed significant differences with the domains of PTGI-J.

CONCLUSION

Clinicians may be able to adjust the support they provide based on patients' personal characteristics. Future research should look at the mechanisms of PTG by examining the role of rumination, social support, and emotional distress among bereaved family members of patients with cancer.

The Sensed Presence Questionnaire (SenPQ): initial psychometric validation of a measure of the "Sensed Presence" experience

Background

The experience of ‘sensed presence’—a feeling or sense that another entity, individual or being is present despite no clear sensory or perceptual evidence—is known to occur in the general population, appears more frequently in religious or spiritual contexts, and seems to be prominent in certain psychiatric or neurological conditions and may reflect specific functions of social cognition or body-image representation systems in the brain. Previous research has relied on ad-hoc measures of the experience and no specific psychometric scale to measure the experience exists to date.

Methods

Based on phenomenological description in the literature, we created the 16-item Sensed Presence Questionnaire (SenPQ). We recruited participants from (i) a general population sample, and; (ii) a sample including specific selection for religious affiliation, to complete the SenPQ and additional measures of well-being, schizotypy, social anxiety, social imagery, and spiritual experience. We completed an analysis to test internal reliability, the ability of the SenPQ to distinguish between religious and non-religious participants, and whether the SenPQ was specifically related to positive schizotypical experiences and social imagery. A factor analysis was also conducted to examine underlying latent variables.

Results

The SenPQ was found to be reliable and valid, with religious participants significantly endorsing more items than non-religious participants, and the scale showing a selective relationship with construct relevant measures. Principal components analysis indicates two potential underlying factors interpreted as reflecting ‘benign’ and ‘malign’ sensed presence experiences.

Discussion

The SenPQ appears to be a reliable and valid measure of sensed presence experience although further validation in neurological and psychiatric conditions is warranted.

"I thought they should know… that daddy is not completely gone"

This study aimed to explore the experiences, responses, and conceptualizations of sense of presence experiences in bereavement in terms of family meaning-making. A case study framework was chosen, using group and individual interviews and ethnographically derived observations in a father-bereaved family in the south of England. Interview data were analyzed by applying both phenomenological and social constructionist perspectives to the same data set. It was observed that there was a division between the mother, who had derived much personal benefit from sense of presence experiences, and the children, who dismissed the experiences as incompatible with their own worldviews and how they made sense of their father's death.

Grief, Consolation, and Religions: A Conceptual Framework

Consolation is grief's traditional amelioration, but contemporary bereavement theory lacks a conceptual framework to include it. The article begins to develop that framework. The article argues that grief is inter-subjective, even at the biological level. Consolation and grief happen in the same inter-subjective space. Material from the histories of several religions sets the article in a cross-cultural and historical environment. The article examines consolation in interpersonal relationships, and then moves to consolation in cultural/religious resources that range from the literal image of God as an idealized parent to the abstract architecture of Brahm's Requiem. The most common consolation in the histories of religions comes within continuing bonds that are accessed in a wide variety of beliefs, rituals, and devotional objects. The article closes by briefly drawing the connection between consolation and faith.

Let me hear of your mercy in the mourning: forgiveness, grief, and continuing bonds

Clarity about the utility of continuing bonds (CB) continues to be evasive in the research. In 2 different correlational studies, the authors explored the relationship between CB and 2 other variables: 1 representing mental health (forgiveness of the deceased) and the other representing psychological distress (prolonged grief). Although researchers have addressed the latter relationship in the literature, assessing the relationship between CB and forgiveness has not been undertaken. Results suggest that forgiveness in general, and affective aspects of forgiveness in particular, predict psychological forms of CB. Results related to grief depended on how CB was assessed. These findings provide evidence of the relative health of certain types of relationship with deceased persons and also suggest that forgiveness interventions may be a way of promoting such healthy bonds.