By Shanun-Klein, H (formerly: Kagan (Klein), H)
Adapted from: Kagan (Klein), H. (1998). Gili’s Book, A Journey into Bereavement for Parents and Counselors. New York: Teachers College Press, Columbia University.
1. Parental bereavement is a unique form of grief.
2. Parental bereavement is not an illness, a disorder nor pathology and therefore there is no ‘recovery’ from, nor ‘healing’ or an end to it.
3. Parental bereavement is a normal constellation of reactions to an abnormal event.
4. Deep Sadness underlies parental grief, not Depression, an Anxiety Disorder or a PTSD.
5. Parental bereavement is best described as a non-linear process of readjustment to a reality of living with loss, of re-learning to live without the deceased child. This process is characterized by Inward Steps and Outward Steps taken simultaneously, not by Stages, Phases, or Tasks.
6. In this process, a new self emerges which has incorporated and internalized aspects of the deceased child.
7. Bereaved parents do not detach themselves from their deceased children, i.e., there is no ‘final goodbye.’
8. Bereaved parents do not stop grieving, although the grief may vary in intensity. It is often unpredictable, but it is life long, as the process of readjustment is life long. There are no timetables in parental bereavement.
9. In time, the parent develops a ‘dual-image’ of his or her child: a ‘real-image,’ and a ‘shadow-image.’
10. A turning point in the bereavement process occurs when the parent identifies a mission – reconstructs a new meaning, a new reason, passion, or focus to live for.
11. In order to understand a parent’s grief, we must take into consideration this individual’s social, cultural and spiritual worlds, history, beliefs, and values. It is an individual process beyond gender and other stereotypes.
THE READJUSTMENT MODEL OF PARENTAL BEREAVEMENT – INWARD and OUTWARD STEPS
- Inward and Outward Steps characterize the process of Readjustment to living with loss.
- Both types of Steps are defined from the bereaved parent’s perspective and according to her/his intention.
- Inward Steps – private; the parent may/may not be fully aware of them. e.g., re-running in her/his mind life story.
- Outward Steps – visible; the parent connects to outside world intentionally. e.g., talking to people.
- Both Steps are taken simultaneously.
Deep Sadness is the underlying constellation of emotions, cognitions, and behaviors characteristic to parental bereavement.
Cause: Always known – death of child.
- Life long
- Varied intensity
- Focus on the deceased child (thoughts, dreams, hearing/feeling/seeing sensations of child’s presence)
- Usually a strong need to talk about the deceased child and the traumatizing experience
- A wish to join the child – may/may not indicate suicidality
- A search for meaning (“Why?”)
- A spiritual search
- Temporary/permanent changes in beliefs, habits/behaviors – sleeping, eating, work, interactions with people/environment
- Need to commemorate child
- Turning points – finding a goal/goals to live for (emergence of a new self)
- Best treatment: Emotional support (family, friends, counseling); self-help
- Medication not recommended.