Perspectives on bereavement from counselling by The Grief Series

Perspectives on bereavement from Counselling.

Contents Introduction………………………………………………………………………………….page 4 D.I.Y approaches to grief, two examples: ‘Good advice’ & ‘Bad advice’…….page 4 Key Theories Section one: Modern approaches to grief Freud………………………………………………………………………………………… page 6 Bowlby and Attachment theory…………………………………………………………page 7 Kubler Ross……………………………………………………………………………………page 8 Dual Process Model………………………………………………………………………..page12 Section two: postmodern approaches to grief Continuing Bonds…………………………………………………………………………page 13 Thomas Attig, Relearning the world: making and finding meanings…………….page14 Section three: Theory in practice Cranwell and approaches to helping young people……………………………..page 17 Tools and Structures……………………………………………………………………….page 21 Oxley and dealing with parental loss in a group context…………………………page 22 Conclusion…………………………………………………………………………………..page 26 How to use this book As the Grief Series progresses we are noticing more and more interest from people who deal with grief in their careers or as part of their studies. This booklet is more of an academic reference point that highlights some articles that Ellie has found useful for this series of work. There are clear headers and each section deals with a different text. As you are reading you can quickly see how the theories and articles have influenced the projects in Grief Series by looking for the pictures. Wherever you see a picture next to a theory or article it means that article has had a clear influence on the art work produced. Key

Part 1 Etiquette of Grief Part 2 The Reservation Part 3 What Is Left

Introduction Ellie: There seems to be a central tension in much of the writing on bereavement and loss: the tension between letting go/moving on (detachment) and recognising that you will always remember the person you have lost (continuing bonds). They might perhaps be divided into two waves comparable to the modern and postmodern. Where Freud’s writing Mourning and Melancholia talks about withdrawing your energy from the lost person and giving it to someone alive (modern), theories such as continuing bonds and Attig’s notions of web weaving bring an awareness of the past, in all its complexity and despite contradictions, into a person’s on going present. This book is an overview of what I have been reading, with large excerpts of the texts so you might get enough of a feel to select which areas you may want to research further. It certainly isn’t an exhaustive list of grief theory but rather a signpost to some key ideas. I openly favour notions of continuing bonds but also reference some of the reading I disagree with. D.I.Y Below are two examples of Do It Yourself bereavement advice

Bad Advice Ellie: I found this leaflet in Rippon cathedral and considered confiscating it in case anyone bereaved found it and used it as a guide. Some of the bad advice is directly quoted in part 1 of the series Etiquette of Grief such as ‘Grow up!’ ‘Keep pruning the tree of worry branch by branch’ and ‘cry IN PRIVATE, then say STOP.’

Good Advice This leaflet was sent to me by grief counsellor Henry De Mena from his bereavement seminar which you can view online at http://www.facebook.com/l.php?u=http%3A%2F%2Fwww.youtube.com%2Fwatch% 3Fv%3DuYrZvVC-aH0&h=vAQEP2lnw Having lost her husband, a client put this sign on her fridge so that when friends visited the house, they would see it.

Key Theories Section one: Modern approaches to grief A summary of Freud Scholars frequently have used the term modernist to characterise the cultural zeitgeist of contemporary Western society, in contrast with that of the preceding century, which has often been described as romanticist…The modernist approach to life is one that emphasises goal directedness, efficiency and rationality. In psychology, modernism has given rise to the machine metaphor of human functionality. When applied to grief, this view suggests that people need to recover from their state of intense emotionality and return to normal functioning and effectiveness as quickly and efficiently as possible. …Grieving, a debilitating emotional response, is seen as a troublesome interference with daily routines, and should be “worked through”. Such grief work typically consists of a number of tasks that have to be confronted and systematically attended to before normality is reinstated. Reducing attention to the loss is critical, and good adjustment is often viewed as a breaking of ties between the bereaved and the dead. The belief in the importance of severing ties from a deceased loved one found early and important expression in Freud’s (1917) work. Freud conceptualised love as the attachment(cathexis) of libidinal energy to the mental representation of the loved person (the object). When the loved person dies, the libidinal energy remains attached to the thoughts and memories of the deceased. Because the pool of energy is limited, the cathexis to the lost object has to be withdrawn in order for the person to regain these energy resources. The ties to the loved object are severed by a process of energy detachment that Freud termed hypercathexis. Freud saw the psychological function of grief as freeing the individual of his or her ties to the deceased, achieving gradual detachment by means of reviewing the past and dwelling on memories of the deceased. This process is complete when most of the energy is withdrawn from the lost object and transferred to a new one. Those who fail to hypercathect remain emotionally stunted. (Klass, D, Silverman, P.R, Nickman, S.L, 1996, p.32-33)

Bowlby and Attachment Theory If, as is found in mourning, the loss of someone or something is irretrievable, Bowlby thought that there was a conflict between the urge to regain the lost object and the reality of the loss. This is known as “Separation Anxiety” (this process is similar to Freud’s views on the griefwork tasks or re-investment). For Bowlby attachment to someone is inevitable. As a price for it we have to also experience the pain of loss. Since all attachments are modelled upon the primary attachment to the mother/mother figure there will be a strong connection between the degree of separation anxiety and the quality of this primary relationship. … Above all Bowlby was developing a theory about attachment and separation based upon observations of children. The external reality of loss was more interesting for Bowlby rather than the internalised psychic trauma of loss described by Freud and Klein. Bowlby’s attachment theory refers to three key areas, namely protest, despair and denial. All of these are experienced by the infant in response to the possible separation from the attachment figure. Bowlby maintained that protest could be linked to separation anxiety, despair to grief and mourning, while detachment was linked to defence. Bowlby categorises four phases of mourning: Numbness; Yearning, searching and anger; Disorganisation and despair; and reorganisation. These stages are seen as occurring successively and, as such, suggest a possible blueprint for those who wish to help the bereaved. We can see that Bowlby is important in linking Freud and Klein’s views on mourning with latter theorists who would offer a staged model for the ‘griefwork’. (Calderdale College, 2010, p.1-2)

Kubler Ross Below is a handout given to me by Roger Higgins, a senior lecturer in psychological therapies and mental health at Leeds Metropolitan University. It is worth noting that there seem to be a number of five and seven stage models in circulation and The Grief Series is based on a seven stage model however it is worth noting this version as a common one.

Dr. Elizabeth Kubler-Ross, through her work with terminally ill patients and their families, identified the following five stages which are commonly experienced by people confronting the inevitability of their own death and by their families and friends in coping with the loss of a loved one. These stages have come to be known as “the grieving cycle”: 1. Denial and isolation – By denying what has occurred (or what one knows will certainly happen) people give themselves the time to gather their inner resources for coping with a painful reality. 2. Anger – When it becomes impossible to continue to deny what has happened, the next stage is frequently anger. People ask, “Why does it have to happen to me? It’s not fair.” This anger can often be directed at anything or anyone around them. 3. Bargaining – In an effort to postpone dealing with a situation and feelings which seem overwhelming, people affected by the type of trauma associated with death often try to make some type of bargain with a higher power. “If I do X, then such and such will not happen.” The bargain that is made often reflects guilt that people feel about something they have not done or people they have hurt. 4. Depression – people are unable to keep up the sense of numbness associated with denial or the rage which is part of stage two. These feelings are replaced by a deep sense of loss. 5. Acceptance – If a person has had the opportunity to work through the previous stages, he or she can come to a point of quiet acceptance of what has occurred. The acceptance stage is not simply giving up; it is moving past those feelings to a deeper understanding of the bigger patterns of life which are part of being human.

Ellie: Below is an extract from Death and Dying by Kubler Ross that both resonated with my personal experiences of bereavement but also in my professional capacity as a teacher. I think in a society that focusses on what technology can offer us and often overlooks what it takes away from us, this story becomes increasingly relevant. As Sherry Turkle suggests in her 2012 Ted talk Connected but Alone, (https://www.youtube.com/watch?v=t7Xr3AsBEK4&feature=youtube_gdata_player) we use technology to distance ourselves and to make complicated things, apparently simple and ‘clean’. I teach a generation of young people often referred to as ‘digital natives’ it is important to reconnect with the personal, find space to be present in the moment, even if that moment is difficult and complex. I remember as a child the death of a farmer. He fell from a tree and was not expected to live. He asked simply to die at home, a wish that was granted without questioning. He called his daughters into the bedroom and spoke with each of them alone for a few minutes. He arranged his affairs quietly, though he was in great pain, and distributed his belongings and his land, none of which was to be split until his wife should follow him in death. He also asked each of his children to share in the work, duties and tasks that he had carried on until the time of the accident. He asked his friends to visit him once more, to bid goodbye to them. Although I was a small child at the time, he did not exclude me or my siblings. We were allowed to share in the preparations of the family just as we were permitted to grieve with them until he died. When he did die, he was left at home, in his own beloved home which he had built, and among his friends and neighbours who went to take a last look at him where he lay in the midst of flowers in the place had lived in and loved so much. In that country today there is still no make-believe slumber room, no embalming, no false make up, no pretend sleep. Only the signs of very disfiguring illnesses are covered up with bandages and only infectious cases are removed from the home prior to the burial. Why do I describe such “old fashioned” customs? I think they are an indication of our acceptance of a fatal outcome, and they help the dying patient as well as his family to accept the loss of a loved one. If a patient is allowed to terminate his life in a familiar and beloved environment, it requires less adjustment for him. His own family knows him well enough to replace a sedative with a glass of his favourite wine; or smell of a home-cooked soup may give him the appetite to sip a few spoons of fluid which, I think, is still more enjoyable than an infusion. I will not minimize the need for sedatives and infusions and realize full well from my own experience as a country doctor that they are sometimes life-saving and often unavoidable. But I also know that patience and familiar people and foods could replace many a bottle of intravenous fluids given for the simple reason that it fulfils the physiological need without involving too many people and/or individual nursing care. 10

The fact that children are allowed to stay at home where a fatality has stricken and are included in the talk, discussions, and fears gives them the feeling that they are not alone in the grief and gives them the comfort of shared responsibility and shared mourning. It prepares them gradually and helps them view death as part of life, an experience which may help them grow and mature. This is in great contrast to a society in which death is viewed as taboo, discussion of it is regarded as morbid, and children are excluded with the presumption and pretext that it would be “too much” for them. They are then sent off to relatives, often accompanied with some unconvincing lies of “mother has gone on a long trip” or other unbelievable stories. The child senses that something is wrong, and his distrust in adults will only multiply if other relatives add new variations of the story, avoid his questions or suspicions, shower him with gifts as a meagre substitute for a loss he is not permitted to deal with. Sooner or later the child will become aware of the changed family situation and, depending on the age and personality of the child, will have an unresolved grief and regard this incident as frightening, mysterious, in any case very traumatic experience with untrustworthy grownups, which he has no way to cope with. It is equally unwise to tell a little child who lost her brother that God loved little boys so much that he took little Johnny to heaven. When this little girl grew up to be a woman she never solved her anger at God, which resulted in a psychotic depression when she lost her own little son three decades later. We would think that our great emancipation, our knowledge of science and man, has given us better ways and means to prepare ourselves and our families for this inevitable happening. Instead the days are gone when a man was allowed to die in peace and dignity in his own home. The more we are making advancements in science, the more we seem to fear and deny the reality of death. How is this possible? We use euphemisms, we make the dead look as if they were asleep, we ship the children off to protect them from the anxiety and turmoil around the house if the patient is fortunate enough to die at home, we don’t allow children to visit their dying parents in the hospitals, we have long and controversial discussions about whether patients should be told the truth – a question that rarely arises when the dying person is tended by the family physician who has known him from delivery to death and who knows the weaknesses and strengths of each member of the family. (Kubler-Ross , E, 1969, p19-21) 11

Dual Process model of coping with bereavement (Margaret S. Stroebe and Henk Schut) Although grief work is a necessary way of coming to terms with loss, Stroebe and Schut (2000) believe other processes need to be considered. As well as coping with the loss of the loved person, the bereaved person also has to make significant adjustments as a secondary consequence of the death. Both of these processes can be sources of anxiety and stress. Stroebe and Schut (2000) refer to these processes as: 

Loss orientated coping (working through aspects of the loss experience itself, e.g. crying, yearning for the person).



Restroration orientated coping (mastering of tasks previously done by the person who has died, developing a new identity)

However, according to Stroebe and Schut (ibid.,p58) “One cannot simultaneously attend to both: Coping at any point in time is either loss or restoration orientated. The bereaved individual can, in fact, to some extent choose to ignore or to concentrate on one or the other aspect of loss or change in their lives. Thus it becomes necessary to introduce a regulatory process which we have called Oscillation.”

(Higgins R, 2007, p.1-3)

Section two: postmodern approaches to grief Continuing bonds Ellie: Continuing bonds is perhaps part of a new wave of theories on grief that challenge the notion that attachment to the lost person ends or should end. Whereas the various models that include phases and stages suggest a linear progression, leading to a final resolution or end, there is the observation that this is frequently taken too literally. A simplified picture of the phase/stage model has seeped into popular culture and has taken on the status of common-sense truth for many who offer bereavement support and for bereaved people themselves. (Riches, G, Dawson, P, (2000), p.35) Continuing bonds acknowledges that it is impossible, and unhealthy, to erase all memory of someone who has died. Klas notes that “death ends a life but it does not end a relationship.” (Riches, G, Dawson, P, (2000), p.36) Using the example of parents who have lost children This model argues that memory is itself a dynamic part of the process of identity building in bereaved people. Rosenblatt (1996) argues that the idea of a single severance from the deceased person makes little sense. Memories emerge over time, and new aspects of the deceased child’s life, and details of the death, may be triggered many years later. Unknown facets of the child’s character and events in which they took part may be communicated by friends only after considerable time has elapsed. The main points can be summarised: 

Grief results not from losing a relationship, but from having to transform it;



This relationship may well continue throughout bereaved people’s lives;



The deceased continues to influence the identity of the bereaved person;



Grief is not a progression from preoccupation with the deceased to reattachment with the living, rather it is an oscillation between the demands of the living and continuing perceptions of the deceased;



‘Resolution’ of grief does not involve letting go of the deceased, but in finding a way of ‘holding on’ to them in the light of their physical absence;

Successful grief work results not in giving up the deceased but in being able to contemplate their lives with warmth and affection rather than with a sense of overwhelming distress. (Ruben 1984) (Riches, G, Dawson, P, (2000), p.36) 13

Thomas Attig Relearning the world: making and finding meanings. Ellie: Traditionally, ‘complicated grief’ arises when the bereavement has failed to be processed or is unresolved in some way. The phrase ‘complicated grief’ is similar to Freud’s term Melancholia in that both come with the underlying implication that there is a right or wrong way to grieve and a prolonged emotional connection to the dead person is unhealthy. Attig challenges this terminology to form theories that are more postmodern in that they are less linear and acknowledge multiple narratives rather than the sequential phase models. All quotations are from Attig’s book, published in 2000, Relearning the World: Making and Finding Meanings. “Grieving is nearly always complicated – “nearly” because sometimes we grieve moderately for someone who was not particularly close or whose life did not extensively interconnect with our own; nearly “always” because, ordinarily, grieving involves nothing less than relearning the world of our experience (Attig, 1996); and “complicated” in the straightforward, dictionary sense of the term...involved, intricate, confused, complex, compound, the opposite of simple (Oxford English Dictionary ) Grieving is ordinarily complicated in the following ways: It is what we do in response to the compound suffering that bereavement introduces into our lives. As we grieve, we relearn a complex world. Our relearning itself is multidimensional. It involves simultaneously finding and making meaning on many levels. We grieve individually and collectively in complex and interdependent interactions with others in our families and communities. As we grieve we engage with several of the great mysteries of life in the human condition. We make a multifaceted transition from loving in presence to loving in absence and we reweave the lasting love into the larger, richly complex fabric of our lives. …I pay particular attention to aspects of what has been called, perhaps too casually “meaning making” in grieving. Making in this expression strongly suggests we are self-consciously active, take deliberate initiative, and bring new meanings into existence as we grieve. I agree that, as we grieve, we give meaning to our experiences and actions, and especially to our suffering. We often read new meanings into or off of our surroundings. We create unprecedented patterns of meaning in our daily lives. We venture forth on new - and, we hope, meaningful – life courses. We restructure and reinterpret aspects of our life narratives and the self-understandings based in them. And we re-evaluate and often modify our understandings of our place in the larger scheme of things. 14

But there is also a strong sense in which much of what we do is a matter of “meaning finding”. Finding in this expression strongly suggests that at other times we are less self-conscious in what we do, are more passive and receptive, and return to or encounter something already established, and often not of our own doing, as we mourn. “ (p. 33-34) Bereavement and Suffering When those we love die, we embark on a difficult journey of the heart. We begin by suffering bereavement. We “suffer” in the sense that we have been deprived of someone we love. Bereavement in its origin means “the state of being deprived.” Bereavement deprives us of the living presence of someone we love or care about, presence that has inestimable and irreplaceable value. …In bereavement, we also “suffer” in the sense that when we lose someone dear, we experience loss of our wholeness. It is as if each of us were a web of connections to the things, places, other people, experiences, activities, and projects we care about (Attig 1996 pp. 134-143). By extension, it is as if our families, communities, and all of human kind are joined as webs of webs. Our life stories, and those of our families and communities, are filled with weaving and reweaving of webs of connection, patterns of caring within which we find and make meaning. Bereavement strikes a blow to these webs, to our personal, family and community integrity. The weaves of our daily life patterns are in tatters. Much of the weaving that comprises our individual and collective life histories is undone. (p. 35-36)

Functions of grieving Grieving is what we do in response to what happens to us in bereavement. As we grieve we respond in two principal and interrelated ways. On the one hand we struggle to put our lives back together in a process I call “relearning the world.” As we relearn the worlds of our experience, we reweave the fabric of our lives and come to a new wholeness (Attig 1996 pp.146-156). We reshape and restore integrity to our daily lives. We redirect and once again experience continuity and meaning in our life narratives. And we reconnect with larger wholes in meaningful ways. Relearning the world of our experience in each of these ways is a blend of meaning finding and meaning making. .. …On the other hand, we struggle to come to terms with the pain and anguish that accompany the devastation in our lives and the hard labour of grieving itself (Attig, 1996, pp. 143-146). We eventually overcome some of our pain. We learn to carry some of our pain. But, more important, we move from being our pain - being wholly absorbed in and preoccupied with it – to having our pain – to carrying residual sadness and heartache in our hearts. We carry it in a place alongside other places where we hold those who died in lasting love and where we love others, love ourselves, and hold the cares that give our lives meaning and bring us joy and fulfilment. We find and give meaning to our suffering. These two functions of grieving are intimately interrelated. Coming to new wholeness in our lives tempers some of our pain and anguish and modifies the meanings of our suffering, especially when we weave lasting love for those who die into the new wholeness. Reciprocally, as we overcome some of our pain and anguish and learn to carry what remains, we become better able to contend with the challenges of relearning our worlds and coming to new wholeness in our lives. (p. 37)

Section three: Theory in practice. Approaches to helping young people with bereavement Brian Cranwell Bill: This section refers to Brian Cranwell’s book, Where’s My Mum Now? I have tried to summarise and highlight key elements from the book, however there are many more recommendations and suggestions within the book that didn’t make it to this summary. Copies of the book can be ordered from http://www.briancranwell.co.uk/homesite/?page_id=100. Ellie: It is vital to use clear and logical language in explaining death to children. Phrases such as ‘gone to sleep’ or ‘passed away’ can confuse children and even create additional fear and anxiety. A child told that a relative was ‘sleeping’ naturally made them afraid to go to sleep. Children being told people have passed/gone away can imply they will return, giving rise to additional sadness when the child realises their loved one is not coming back. Sayings such as ‘God always takes the best, first’ can make children afraid of behaving well. Whilst all of these phrases might arise out of a desire to protect the young person, being more direct is actually less difficult for many children.

Teacher: ‘Sit down everyone, around me. I’m afraid I have some bad news for you this morning that we are all sad about. This is Jimmy our Gerbil who died during the weekend. As you can see he is completely still. He is not breathing and cannot see or hear, and his heart has stopped beating. He will never move again’ Child: Can we touch him miss? Teacher: ‘No it’s best not to, we don’t know what he died of, and he’s all cold and stiff. We will bury him out in the garden shortly in this little box. (p9.)

Bill: In the next section Cranwell discusses religious euphemisms and explains that these can be confusing to children as they often allude to an afterlife or other place where that dead person has gone. Cranwell gives the following example: “Youngsters told that ‘daddy has gone to see Jesus’, can lead to the conclusion that he had left the family by choice.” (ibid)

Chapter 2 is entitled Anticipating a Death. In this chapter Cranwell states that children that know their parent is dying are often liberated by knowing this, allowing the child and the parent to have open and honest conversations about what life without them will be like.

…The reactions of those children warned of impending death does indicate that children can cope with the truth if they have grown up with it. It clearly gave the children who were warned and prepared a sense of being treated in a grown up way and being trusted. Being told the truth enables the children to be given and feel support through the period when grief is anticipated, thus enabling them to begin working through their pain. (p14) The chapter also goes on to state that being told the truth permits the child to feel like an equal member of the family. Chapter 3 deals with ‘giving and receiving bad news’. In this chapter Cranwell discusses ‘magical thinking’ which is where young children believe that the death of the loved one is caused by naughty behaviour or flippant thoughts. It is therefore very helpful for a child to be reassured that everything possible was done for the dead parent, by nearest and dearest, by ambulance staff, the doctors and nurses, and that there was nothing the child could have done to help the deceased. (p19.) Bad news is still bad news however sensitively the information is given. (p20.)

The chapter explores ways in which bad news can be delivered and cushioned. It states that children prefer to be talked to frankly and honestly as this leaves little room for confusion and can allow the child the opportunity to understand the situation and their emotions. Chapter 4 is about if it is appropriate for children to see the body, or not. In the conclusions and recommendations sections it states that is can be useful for the child. Cranwell highlights the fact that parents may feel they are protecting the child by not allowing them to see the body, but this can be damaging. Chapter 5 talks about going to funerals and the rituals associated with them. The general consensus of the chapter is that most children want to go and it can help them to understand their feelings. It stresses the importance of ritual and how children want to be involved in the proceedings.

The following chapter discusses the issue of going back to school and how other children and teachers may react. The recommendations made in this section are as follows:

        

“Ensure that the head and class teacher are aware of what has happened. Teachers need to know how to recognise symptoms of extreme grief and behaviour caused by grief anger. Staff need to be alert for any sign of unpleasant language or bullying. Ensure that a bereaved child in not treated in such a way as to feel they are singled out as ‘different’ from their peers. Ensure there is someone the child can talk to if required. Be aware of the child’s possible need to have short periods away from everybody. Asking a child as to the progress of a parent known to be very ill is appreciated and remembered. Do not assume that children will forget their hurt if it is not mentioned, or treat them as though nothing has happened. Locate helpful local and national services – libraries, bereavement support organisations who usually have helpful literature for schools and many of whom will tailor short training programmes to suit school staff at minimal cost” (p. 47-48)

Chapter 9 discusses personal and spiritual issues. The chapter raises the point that spirituality isn’t just about religion, but is to do with the non-material elements of being human. The chapter also states that it is important to not brush off or put down a child’s right or interpretation of religion. The 10th chapter is entitled “personal development and change” (p66.) The summary to this section is as follows:  



“Children bereaved of a parent feel different to their peers but do not wish to be singled out as different. Actions such as the symbolism of lighting a candle on the birthday of a deceased one or at Christmas with the actual expression of how much the person is still loved and remembered can help a child overcome feelings that their appreciation of the deceased was not appreciated sufficiently while they were still with them. Many are aware of having come through a crisis better than they ever imagined they could have done, and being the stronger and more self-reliant as a result. The adult (whether parent, teacher, social worker, or other) who is explicit in commending a child who comes through in this way helps the child’s sense of self-esteem. Children often see themselves as underestimated by adults” (p.69)

Chapter 11 talks about help from outside the family and signposts the reader to information about groups and networks that specialise in dealing with grieving children and young people, and discuss the positive effects that these organisations can have on young people.

Tools and Structures Ellie: There are many tools used by organisations to help grieving children: grief board games, grief ball games and grief Jenga. There are the bear cards and dice to help children identify the mixture of feelings they might be experiencing. Just as the rules make games more fun, the structure these tools use take the pressure off the child to know where to begin when talking about their loss. Many of the tools used in counselling bereaved children have found their way in to the Grief Series performances and projects, and work just as well on adults as they do on children in that context. The tools pictured throughout the book were photographed by me at the kind permission of Jane Driver at Just B Bereavement Support who gave me access to their counselling spaces for young people. There are also some exercises in the following section by Liz Oxley. Child bereavement charity Winstonâ&#x20AC;&#x2122;s Wish created a three part documentary called The Mummy Diaries and you can see how the tools work in practice in a therapeutic context. You can view all three programmes on the Winstonâ&#x20AC;&#x2122;s Wish website and a link to part one is here http://www.winstonswish.org.uk/page.asp?section=00010001001000150001 It is worth noting that the programmes follow families where the mother has a life limiting illness. I found it extremely moving seeing how these tools can be used in both pre and post bereavement contexts.

There are organisations operating regionally and nationally to support both young people and adults affected by bereavement. A few of these are listed on the final page of this book.

Liz Oxley Summary of first draft of ‘It’s so unfair’ which was later published in the March 2009 edition of the AUCC (Association for University and College Counselling) Journal Six years ago after completing a piece of counselling work with a student in her 20’s whose father had died of cancer, the client expressed a wish to join a group of other people who had been bereaved. I understood her need; one to one counselling for such premature bereavement comes with limitations – the excruciating isolation that bereaved youngsters experience can in some ways seem to be further emphasised whilst at University. It is rare that they come across peers who have ‘lost’ a parent and consequently can often believe that they are alone in this experience – is does not happen to other people. What the students witness is mums and dads of their friends delivering and collecting them to and from university; mums and dads rescuing their kids from the fixes they have got themselves into. What they hear is their housemates talking to their parents on their mobiles or to them, worse still, complain that they will have to buy a card or present for Mother’s or Father’s Day. What they imagine is an idealised notion that their friends will be returning to homes with love and support from two parents. Setting up a Parental Loss group The primary aim of the group is to reduce the sense of isolation by introducing the students to others with some commonality of experience and to explore and share their stories in a safe environment. Timing of the Group We have 8 meetings on consecutive weeks – each meeting lasting for 1½ hours. At the end of the session an additional half hour is offered to the group without me being present. This half hour is time without ‘mother’ and puts the students back into reality without ‘mother’. It is an opportunity to process the session, to network and bond. Preparation of the room This part is as important to me as the content and process of each session; attention to detail and constancy matters. There are parallels between the empty group room and the empty space left after death of the parent; the space is filled with the balance of my presence and giving enough space for the students’ presence – it is ‘filled enough’ with supportive nurturing. I have a ritual of setting up the room before the students arrive, holding in my mind that the group members, although they have elected to be in the group, are likely to feel churned up about attending.

Examples of activities Some kind of activity is planned each week. This is by way of a structure to avoid fears of awkwardness or embarrassing silences within the group. They have probably experienced quite enough of those since the death of their parent(s). Certainly when I talk to the students individually before they join the group, the notion of planned activities is usually met with relief. “I found that what worked best was the interaction between the group members – how they could make you realise a different, more positive point of view. Of course, this was achieved through, and thanks to the different exercises we did. Even though these could be quite painful at times, they served their purpose very well, helping to confront and deal with issues.” Introductory activity In pairs: A and B A tells B the story of their loss (usually for about 10 minutes) then B tells their story to A for the same time allocation. Then the pairs return to the group and A’s and B’s are asked to introduce their partner to the group e.g. This is Alice and her mum died from breast cancer when she was 15…………………….One of the things she found most difficult was …………………….. Students often say they find it easier to talk about someone else’s experience rather than their own and that they immediately feel empathy for their partner. It can be a powerful experience to hear their own story from someone else; sometimes students find this hard and begin to acknowledge that they have been through (and continue to go through) some hugely emotionally challenging times. It can also be difficult to report another’s sad, traumatic experiences. Projective techniques/sculpting Equipment: lots of buttons, pebbles and shells. I usually check to see if anybody has a phobia of buttons – this is usually met with a degree of mirth and I have heard comments like “God I thought I had problems”. The students work in pairs and I suggest they sit on the floor. I always encourage group members to work with someone they have not already worked with. This sideby-side activity is immensely powerful and can quickly access emotions. It invites quite intimate disclosures in a seemingly relaxed mode (sitting casually on the floor) without the need for potentially embarrassing eye contact.

Students are invited to take their turns, and using the buttons, pebbles and stones to represent significant people, activities or issues presently in their lives; I suggest they choose a button/shell/pebble to represent themselves, place it on the floor and then take time to select appropriate shells etc. to represent other significant people/things in their current lives. As they make their personal map, they will talk to their partner about why they have chosen this particular shell/button and why they have placed it where they have. So for instance, they may say something like, ‘ I have chosen this glass button with multi colours to represent my best friend because she has a vibrant, sparkly personality – I have placed her near to me because she offers continued support to me. I have chosen this rough piece of coral for so and so because………..This black button represents my uncle and I’m putting it (and him) as far away from me as possible because………. This large stone close to me symbolises the pressure of academic work that I am currently finding overbearing………’. After working in pairs the group comes together and they are invited to share their map with the rest of the group. I usually ask them to consider if there is anything they would choose to change (someone nearer or more distant) or if they have omitted anyone, either deliberately or unknowingly. My experience of using this activity early on in the group sessions is that it quickly accesses and helps to express feelings. It can give clarity about relationships and who is available (or unavailable) to offer love and support. It is acknowledged that there is always the possibility of fluidity, of the shape everchanging – what is present in the map today may not be tomorrow; what appears close or distant today may not be tomorrow.

Other issues requiring sensitivity As one might imagine, although there are many common threads to the experiences of grief member s, there are vast differences; socio economic status, whether or not the relationship with the deceased parent was close, whether the student even knew the parent, whether the student was adopted, whether the death was sudden, whether there are siblings, the relationship the student has with 24

the remaining parent, where the student was at the time of death and how much time has elapsed since the death. Where a student has been orphaned, it is tremendously hard for them to be in a group where others still have a parent – understandably, envy is likely to be repressed. And the knowledge that one’s worst fear (losing the other parent) actually can happen is a bitter reality to the other group members. This creates an unspoken hierarchy of loss – “their loss is greater than mine.” I believe the hierarchies are self-constructed; I have known students who are ‘stuck’ in their grief, perhaps because they have never been allowed to express their feelings, and who say they feel fraudulent at being in the group 7 years on from the death of their parent. These differences need careful attention and acknowledgment at appropriate times. It is my experience that fellow group members are hugely empathetic, sensitive and accepting of differences. These differences add to the richness of the group experience and students have sometimes commented they would never have imagined (outside of the group) mixing or getting on with particular individuals in the way that they do. Future Losses Inevitably, future losses are frequently raised; knowing that the dead parent will not be attending their graduation ceremony is particularly hard for final year students who often hit a period of “what’s the point in completing my degree?” as they near the end of their university life. The fantasies of having two parents at their wedding or two grandparents for their children are often held in mind as broken dreams.

Conclusion Bill: Over the last few months I have steadily become more literate in issues surrounding grief and in ways to manage and deal with grieving people. What we hope this booklet has provided is a series of signposts to other articles, themes and publications that have informed the grief series. What has been striking to me has been the varying approaches professionals and people that are personally experiencing grief use. From the notions of ‘continuing bonds’, to the dual process model to the more disturbing Ripon leaflet we hope we have showcased the multiple, complex and nuanced voices that are speaking about grief today. Ellie: As an artist favouring postmodern approaches both to art making and to grieving processes, I think it is less about picking one theory and following it to the letter, and more about using the bits of theories that resonate to navigate your way through grief. Bill: Early on in the process I wryly sneered at “Where’s my Mum Now?” and jested to Ellie, wouldn’t it be funny if it just said ‘dead’ inside. Ellie’s response was that this would be a good thing as it would leave little room for confusion. It was at this point that I began to realise the complex task of understanding grieving children, a subject which Ellie is well informed about and that has formed a large section of this booklet. Whilst this joke might seem flippant and inappropriate on paper, it helped me understand the role and purpose of The Grief Series, I felt comfortable enough to be able to make this joke, it was understood as humorous and it led to a frank and honest discussion about what we felt were appropriate ways to talk to children and young people about grief. The Oxley article made a logical progression from ‘Where’s my Mum Now?’ and mentions ways in which university students may choose to deal with their grief in group settings. The practical applications of this article gave a different perspective and offered some tangible and physical ways of working with grieving people offering a new perspective that I hadn’t really considered before commencing work on the Grief Series. What strikes me most about this body of articles is the ways in which they appear within the performance works of The Grief Series, sometimes explicitly, sometimes covertly but always with the sensitivity and interrogation that is required when creating such a series of work.

Bibliography Image References: All images by Ellie Harrison except for the top image on page nine by Matt Tullett of part two of The Grief Series, The Reservation

Attig, T. (1996) How We Grieve: Relearning the World. New York: Oxford University Press. Attig, T. (2000) Relearning the World: Making and Finding Meanings. In R.A. Neimeyer Meaning Reconstruction and the Experience of Loss. Washington DC: American Psychological Association. Calderdale College, (2010), John Bowlby and theories of loss and grief, unpublished handout. Cruse Bereavement Care, 2007, Some more models of grief, Cruse Bereavement Care Cranwell, B, (2010), Where’s my mum now, Author House Dent, A, (2005), Supporting the bereaved: theory and practice, First published in the July 2005 issue of the Healthcare Counselling and Psychotherapy Journal; reprinted and accessed http://www.bacpworkplace.org.uk/journal_pdf/acw_autumn05_ann.pdf De Mena, H, (2011), Bereavement Seminar, parts 1-16, available on youtube http://www.facebook.com/l.php?u=http%3A%2F%2Fwww.youtube.com%2Fwatch% 3Fv%3DuYrZvVC-aH0&h=vAQEP2lnw Higgins, R, (2007), Dual Process model of coping with bereavement, (from Margaret S. Stroebe and Henke Schut), Unpublished handout Klass, D, Silverman, P.R, Nickman, S.L, (1996), Continuing Bonds: New understandings of grief. London: Taylor and Francis Kubler-Ross , E, (1969), On death and dying, Scribner Lendrum S, Syme G, (1992) Gift of Tears: a practical approach to loss and bereavement counselling, Routledge Oxley, L, Summary of first draft of ‘It’s so unfair’ which was later published in the March 2009 edition of the AUCC (Association for University and College Counselling) Journal Parkes, C.M, (1972) Bereavement: studies of grief in adult life, Penguin Riches, G, Dawson, P, (2000), An intimate loneliness, Open University Press 27

Stokes, J, (2009), Resilliance and bereaved children, Bereavement care, Volume 28, Article 9, Routledge Turkle, S., Connected but alone, (https://www.youtube.com/watch?v=t7Xr3AsBEK4&feature=youtube_gdata_player

Signposts to information and support for Bereaved People Childhood Bereavement Network: http://www.childhoodbereavementnetwork.org.uk/haad_teachers.htm Cruse Bereavement Care http://www.crusebereavementcare.org.uk/ Dying Matters http://www.dyingmatters.org/ Gone Forever Bereavement Trust: http://www.goneforever.org.uk/ Grief Encounter http://www.griefencounter.org.uk/ Leeds Bereavement Forum http://www.lbforum.org.uk/index.htm Seasons for Growth http://seasonsforgrowth.co.uk/ The WAY Foundation http://www.wayfoundation.org.uk/ Winstonâ&#x20AC;&#x2122;s Wish: http://www.winstonswish.org.uk/