The uniqueness of twin loss and grief

Loss of a twin unexpectedly in adulthood can leave the remaining twin feeling lost, devastated, and empty. The surviving twin can question the normalcy of these feelings and their response to the grief experience as compared to other losses. A literature review on adult twin loss followed by a review on sibling loss produced a sparse amount of information relevant to my questions. Both reviews centered around losses in childhood with little evidence of support for losses during adulthood. Guidance to assist with coping after this type of loss did not reveal specific coping strategies for the twinless twin. The coping strategies identified may be valuable for any person in their grieving process. The unique loss may benefit from future research on the most effective coping strategies. Grief therapists need further resources specific to singleton grief. Further research and clinical work would improve grief experiences during adult twin loss.

Time in Grief: How do Bereaved Parents Mentalize It?

In this multimethod study, we examine bereaved parents’ capacity for mentalizing the temporal dimension of their grief. The theoretical assumptions of our study draw on the clinical and anthropological perspectives on the passage of time in grief. Parents’ mentalization of their experience of grief was measured both in the attachment context, using the Adult Attachment Interview (AAI) and using the narrative Child Loss Interview (CLI). We used thematic analysis to code parents’ mentalizing utterances in order to categorize time-related changes during the grieving process. Parents generally mentalize their grief-related experiences at a lower level of reflective functioning than their general attachment experiences. However, a higher general ability to mentalize contributes to a higher level of RF and greater coherence in mentalizing their grief. Parents experience time in grief through oscillation between the past with the deceased child and a restricted form of existence in the present reality.

What About Us? Experiences of Relatives Regarding Physician-Assisted Death for Patients Suffering from Mental Illness: A Qualitative Study

Physician-assisted death (PAD) for patients suffering from mental illness is legally permitted in the Netherlands. Although patients’ relatives are not entrusted with a legal role, former research revealed that physicians take into account the patient’s social context and their well-being, in deciding whether or not to grant the request. However, these studies focussed on relatives’ experiences in the context of PAD concerning patients with somatic illness. To date, nothing is known on their experiences in the context of PAD concerning the mentally ill. We studied the experiences of relatives with regard to a PAD request by patients suffering from mental illness. The data for this study were collected through 12 interviews with relatives of patients who have or had a PAD request because of a mental illness. We show that relatives are ambivalent regarding the patient’s request for PAD and the following trajectory. Their ambivalence is characterised by their understanding of the wish to die and at the same time hoping that the patient would make another choice. Respondents’ experiences regarding the process of the PAD request varied, from positive (‘intimate’) to negative (‘extremely hard’). Some indicated that they wished to be more involved as they believe the road towards PAD should be a joint trajectory. To leave them out during such an important event is not only painful, but also harmful to the relative as it could potentially complicate their grieving process. Professional support during or after the PAD process was wanted by some, but not by all.

The Virulence of Grief in the Pandemic: Bereavement Overload During COVID

The COVID-19 pandemic brought about bereavement overload as a risk factor for complicated grief. Bereavement overload (BO) describes individuals’ reactions to losses transpiring in a quick succession, without the time and opportunity for coping [9]. It can occur during catastrophic events and impact everyone experiencing the loss. With the high death toll from COVID-19, many people have lost multiple loved ones followed by an abbreviated grieving process due to the nature of the pandemic. This can have psychosocial impact on survivors for years. One of the evolving roles of Palliative Care within and after the pandemic should be to recognize those suffering from BO. Obtaining loss histories may identify those at risk of pathologic grief to provide preventive bereavement care. We present three cases encountered in our health system during the COVID-19 pandemic amongst a family member, a patient, and a healthcare provider. In each case the Palliative Care Team worked closely with these individuals to identify COVID-associated BO and helped them reconcile their unresolved grief to be able to move forward. These cases reflect only a fraction of those who experienced loss during the pandemic, but they illustrate how grief can be complicated by the pandemic for everyone involved. Palliative Care will have a crucial role moving forward, in treating the pandemic of complicated grief within the pandemic to adapt to the needs of all survivors, as we realize the effects of COVID will last long after its virulence has waned.

Embalming, Viewing and the Social Construction of the Corpse: Time for Another Look

Embalming of the dead is more common in the United States than anywhere else in the world. Battles far from home during the Civil War with concern for contagion from dead bodies being shipped home, compelled President Lincoln to direct the troops to use embalming to allow the return of the Union dead to their homes. Viewings were common with war heroes and culminated with the viewing of Lincoln himself. In the 20th century embalming became a tradition despite substantial evidence indicating environmental and occupational hazards related to embalming fluids and carbon dioxide generated from manufacturing steel coffins before placing in concrete burial vaults. Embalming is promoted and considered helpful to the grieving process when families are comforted by a the appearance of a peaceful death. Embalmers are expected to produce an illusion of rest, an image that in some ways disguises death for the benefit of mourners. The dead are carefully displayed in a condition of liminal repose where the 'true' condition is hidden, and death is removed from the actual event. In this paper we highlight the spiritual and cultural complexities of embalming related- issues. We also provide data on the lack of grieving families’ preparedness for the financial burden associated with the death of a loved one and the lack of knowledge of alternative options. We propose an innovative process to empower people facing serious illness, and their families to make shared and informed decisions, especially when death is the expected outcome.

Social Interactions While Grieving Suicide Loss: A Qualitative Review of 58 Studies

The effects of suicide are both widespread and long-lasting in the lives of those closest to the deceased. According to the World Health Organization (WHO), suicide is the third leading cause of death in adolescents. Some research has shown that families who lose someone to suicide are at a higher risk of complicated grief compared to those bereaving from other types of losses. These risks may be emphasized given the socio-cultural context surrounding suicide that may problematize the grieving process. In this review, we analyzed 58 qualitative studies describing the experiences of family who lost someone to suicide. We discuss how negative social interactions due to cultural views towards suicide impacted their grieving process. We provide an integrative interpretation of the experiences of family who lost someone to suicide across the following themes: social withdrawal, family communication approaches, role change, cultural attitudes, the role of professional support, interactions with health care providers, and interactions with religious institutions. We examine these findings using the Assumptive World Theory which proposes that humans seek preservation of their reality by using their perceptions of the past to establish expectations for the future. We find that suicide loss is an experience that challenges people's assumptive worlds; suicide loss can be an unexpected trauma that can have a “shock effect” on the assumptive worlds of the bereaved. The assumptive worlds of relatives grieving suicide loss face unique challenges compared to other forms of bereavement because of ambiguity in social norms surrounding suicide that influence interactions.

Death, A Notion

<p>Contemporary Western society has all but abolished the need for a formal grieving process with death becoming an avoided, feared, and shameful topic. In a brutal revolution from the omnipresent death of the past, death is now unfamiliar and displaced. An all-consuming society rushing to beat mortality by finding new ways to extend one’s lifespan, becoming increasingly secularised and refusing to permit the ugliness of death within the collective happiness of today’s society. This results in places for remembrance and acceptance becoming scarce, with silence and stillness becoming confused and conflicted with the noise of cars and footsteps. Therefore the void between life and death grows larger, increasing in depth and stature as awareness fades. This thesis raises the question of interior design and architecture as a key participant in the discussion of death in contemporary western society. The fractured relationship between death, bereavement and society is analysed in order to establish how societal attitudes and the perception of death has shifted. More precisely the research explores the specificity of an interior spatial design needed to assist the grieving process associated with the loss of a loved one, both at an individual level, and as a collective experience thereby seeking to create a plane of resonance between the land of the living and the obverse, the land of the dead.</p>

Death, A Notion

<p>Contemporary Western society has all but abolished the need for a formal grieving process with death becoming an avoided, feared, and shameful topic. In a brutal revolution from the omnipresent death of the past, death is now unfamiliar and displaced. An all-consuming society rushing to beat mortality by finding new ways to extend one’s lifespan, becoming increasingly secularised and refusing to permit the ugliness of death within the collective happiness of today’s society. This results in places for remembrance and acceptance becoming scarce, with silence and stillness becoming confused and conflicted with the noise of cars and footsteps. Therefore the void between life and death grows larger, increasing in depth and stature as awareness fades. This thesis raises the question of interior design and architecture as a key participant in the discussion of death in contemporary western society. The fractured relationship between death, bereavement and society is analysed in order to establish how societal attitudes and the perception of death has shifted. More precisely the research explores the specificity of an interior spatial design needed to assist the grieving process associated with the loss of a loved one, both at an individual level, and as a collective experience thereby seeking to create a plane of resonance between the land of the living and the obverse, the land of the dead.</p>

Mourning the Mamalith

Mourning the Mamalith: A Graphic Response to GriefOn February 17, 2021, my mother, Ingrid Margarethe Phyllis Gertrud von Reitzenstein Claussner, falls and breaks her neck while doing what she loves most: going to church. "Jesus is the most important person in my life," she once told me. Always subordinate to her divine love affair, my mortal relationship with her was complicated. At key moments throughout my life, starting in infancy when I needed her care and protection most, she was absent. Due to my mother's early childhood trauma, she was unable to get too close to anyone, even to me, her only child. Jesus was her answer to every question, no matter what the question. This level of devotion to an invisible entity was incomprehensible to me, but I loved my mother with every ounce of my being.&nbsp;On February 18, 2021, Gracie is born on a ranch in Nebraska. Her mother dies shortly after giving birth—not from complications of having puppies, but from eating part of a towel.&nbsp;On February 19, 2021, my mother dies in the hospital in Tucson, Arizona.On May 1, 2021, my wife and I drive to Nebraska to pick up Gracie the boxer puppy. She is ten weeks old but still just a teeny five-pound runt. She grows very quickly and continues to thrive. Nevertheless, I have recurring panic attacks at night in response to dreams and spontaneous mental images of Gracie's tiny, vulnerable body. I can't shake the feeling that something might happen to her, and that I may not be able to protect her.In early June, the morning after another night of anxiety and insomnia, I tearfully call my wise therapist friend, Leslie. She tells me that when one's mother dies, part of the grieving process requires that one re-experience every fraught moment and emotion: "You are healing not just your own relationship with your mother, but you are healing your entire maternal lineage. You must relive everything on a deeper level now, even if you've already worked through these feelings before." I realize that my nightly anxiety attacks aren't really about Gracie, but about my own vulnerability when I was an infant. I am re-experiencing those early moments through my visceral connection with this tiny mammal who depends on me.&nbsp;This short comic looks at the mysterious connection between processing childhood vulnerability and trauma, more-than-human and human interdependence, and psychosomatic healing. As I've done in some of my previous work, by materializing thoughts as drawn and written sequential vignettes, I hope to gain and share insight about the mysterious dynamics of embodied cognition.

Clinical Case of a Child with Algoneurodystrophy

A clinical case of a 12-year-old female child with anxiety symptoms and a diagnosis of Algoneurodystrophy in the left hand is presented. The psychological assessment was carried out using the following instruments: observation, psychological interview, Wechsler Intelligence Scale for Children (WISC-III), State/Trait Anxiety Questionnaire for children, and Conners Scales for parents and teachers. The intervention aimed to reduce anxiety levels, promote self-esteem, and alleviate the child's grief. For this purpose, a cognitive-behavioral intervention was carried out with the child and their parents. Through education, the child's parents were alerted to the need to express the feeling of loss, providing an environment for the resolution of the grieving process of all family members. Furthermore, they were also warned about the maintenance factors of the child's anxiety symptoms, such as the issue of high parental demand. As a result, it can be concluded that good therapeutic gains were seen, translating into the resolution of the child's problems and, consequently, increasing their psychological well-being.