What is my main interest?
What is my interest in being here?
How might my interest help others?

Liz Rolls set the context for the conference themes

‘Developing’ models of bereavement as in reflecting on those that have appeared in the literature

‘Developing’ models as in an understanding of how models are built and thinking is shaped.

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Plenary session – Prof Jenny Hockey, University of Sheffield

Prof Hockey began with a quote from Tom Stoppard

‘ No, no, it isn’t like that. Death isn’t romantic…….death is not anything…..death is ….not. It’s the absence of presence, nothing more.’

Death has no intrinsic meaning so how do people respond to it and theorize about it? As a sociologist, Prof Hockey proposed to examine different levels of theory and to use data collected in an individual study about disposal of cremation remains to identify the theories developed by bereaved people and the professionals supporting them.

Sociology produces knowledge about other people’s knowledge – both lay knowledge and expert knowledge. These theories make up all parts of a society’s knowledge and the different theories interact so for example, commonsense or lay theories and beliefs develop in a number of ways:

Popularised versions of expert theories
Individual experiences
Family theories.

We need to think critically about the theories we turn to when faced with loss. Often when faced with the intensity of pain (our own or others’) we want accessible, strong beliefs. Critical reflection brings its own challenges of standing back and learning. We all believe we know what death is, as it is a familiar event. Prof Hockey used a quotation from Robert Hertz (1907) who on pondering death describes as ‘sacrilegious’ the attempt to ‘apply reason to a subject where only the heart is competent’. So part of the theorizing around death looks to how heart and mind go together.

Is the grief experience universal?

Sociology uncovers theories, lay theories and expert theories. These can be used to compare societies. Prof Hockey described the anthropological studies of Unni Wikan who compared the societies of Egypt and Bali, in particular their response to and meaning making around death and loss. Ostensibly the societies are similar. Both are Muslim societies where death is accepted as pre-ordained. However the cultures of the two societies differ.

In Egypt child death is accompanied by intense expression and feeling over many years for mothers, yet this is not seen as problematic, the grief is allowed and facilitated by society. In contrast, in Bali there are initial expressions of emotion but effort is made to remain calm. The underlying interpretation is that excessive grieving is challenging God’s will.

Prof Hockey examined the Bali/Egypt differences under the headings:

Relationships - the mother-child bond is central and close in Egypt, while Bali society adopts a ‘fostering’ model so bonds may not be as close;

Loss - the general pattern of expression in Egypt and subdued reaction in Bali holds for all losses;

Emotion - expression is healthy in Egypt and people will make time and listen to an comfort the bereaved while in Bali the belief is more that the expression of sadness feeds sadness, that sadness is dangerous and contagious.

Amongst other things these examples illustrate that society uses ‘feeling rules’ to govern emotion and it’s display. From a Western contemporary perspective it is important to note that there may be simultaneous feeling rules suggested to the individual – different advice from family, friends, experts as to what is appropriate behaviour.

So, grief occurs in a societal context. Prof Hockey referred to Neil Small’s analysis of how grand theories or models and individual experience interplay. Modernity for example was the dominant model or system of belief from the 1850s to the 1970s. Modernity was characterised by rationality, progress and single truth models. However this way of thinking did not necessarily fit individual experience – powerful individual experiences like bereavement put rationality under strain.

The theories about separation and bereavement hold within them the assumptions of a broader framework. Prof Hockey briefly traced developments including Gorer and death as the new taboo, Freud, Bowlby, Stroebe and Schut, Walter and Klass. Theories are subtle and involved and usually not prescriptive, however from a modernist framework a bias of simple interpretation of a ‘simplistic rendering’ can mean the popularisation of aspects of a theory, for example stages of grief.

The developing models of bereavement have connection to the deceased as a focus. This raises questions as to whether people always maintained connections but did not volunteer this information (contradictory as it was to the dominant view of ‘letting go’ in order to survive grief).

In essence Prof Hockey concluded that the dominant model or grand theory of modernity has become vulnerable to people’s actual experiences, the ‘little narratives’. Modernity’s emphasis on control, technology and linear progression though experience has come into question and now diversity and individual difference is accepted. However, as Walter alluded to in ‘The revival of death’ we still look to theory to govern our grieving, we still seek advice and expect to resolve grief over time.

Prof J Hockey – Part Two

Part Two of Prof Hockey’s presentation centred on a research study ‘Environments of memory: changing rituals of mourning and their implications’.

The study focused on changing behaviours: for example, there are now new disposal options, in the UK the practice of removing ashes from crematoria has increased from 12% to 50% over the past 30 years.

Does this represent consumer choice and do these new opportunities help in bereavement? To some extent there seems to be a shift towards continuing bonds which can be observed in informal memorials at cemeteries and through roadside memorials.

Implications of changing practice and choice

Professional Context

A tension between supporting the bereaved person’s choice and the need to ‘do the right thing’ or worry about the bereaved’s health.

Professionals describe funeral and disposal as ‘event’

Lay context

Choice for individual versus the need to conform to family wishes

The influence of the wishes of the deceased

The costs of disposal options curtail choice

Bereaved people describe funeral and disposal as memorial and ‘process’.

Case studies

Prof Hockey went on to discuss a case study – that of Mr and Mrs Devon. She illustrated with examples Mrs Devon’s decision-making around memorialising her father. She had decided to bury his ashes under a birdbath in her daughter’s garden ‘he’s warm there – he had had a condition where he was always cold’. The alternative of scattering ashes at the garden of remembrance at the crematorium was rejected as unsuitable- ‘ he could get blown away, onto someone’s washing….’

Mrs D’s decision served two time scales – comfort in the here and now; (she wanted her father with her, did not want to leave him) and continuance for the future (the ashes were in a container and could be reinterred, for example if Mrs D’s daughter was to move house). In summary, choices were made with reference to the bereaved person’s well-being (need to memorialise and re-socialise) but also out of respect for the deceased. Mrs D considered her choice as healthy, while her husband was less sure, feeling the proximity of the ashes was ‘bringing it all back’

Prof Hockey went on to contrast the lay case study with the accounts of professionals – acknowledging that professionals hold powerful positions to influence disposal and ritual. Interviews with midwives and funeral directors illustrated a number of themes. Firstly, professionals were more future oriented, concerned with for example, parents’ future needs. Secondly, professionals were seen to be agents of change to the system – for example to involve parents in decision-making.

The review of case studies showed a mix of bereavement theories coming to the surface. Mrs Devon’s actions around memorialising her father pointed to a continuing bonds model, midwives held with a continuing bonds outlook but also felt it was important to step back from memorialising. The funeral directors referred to a stage model.

There were a number of questions and Prof Hockey was warmly thanked for her contribution to the Bereavement Research Forum conference.
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Poster sessions

Six poster presentations were made to the Forum.

1 Liz Rolls – Children’s experiences of bereavement services

2 Gilliam Chowns – The pre-bereavement needs of children

3 Jan Obeydke (presenting for Andrew Hawkins)

4 Jesus – Effectiveness of primary bereavement care for widows

5 Jan Obeydeke (presenting for Andy Dunne)

6 Julie Clarke – Ways of managing ‘missingness’

  Developing models of bereavement research – the research process and theory into therapeutic practice

Dr Linda Machin and Dr Gordon Riches

Dr Gordon Riches reviewed the terms we use in research and our understandings of them. Beginning with the question ‘What is a model’? - a picture, representation, framework or theory? Amongst the value of models is helping the reflexive practitioner to compare practice with an ideal. Ultimately, all of us are theorists and model builders through our own observations and practice and practitioners should inform research.

Other terms used in the research were explored – concept (definitions which are consistent and agreed upon); conceptual framework (hanging ideas or concepts together, representing in order to test reality against the framework); hypothesis ( proposition or hunch- a hypothetical assumption, offered for testing); theory (description and explanation of connections, for example ‘grand’ theories such as Marxism); positivism (beliefs about the world which state that truth is ‘out there’, that theory approximates to truth and reality); social constructionism ( an alternative set of beliefs whereby nothing has intrinsic meaning, rather meaning is viewed as socially constructed, language is seen to structure knowledge, cases embody culture and culture is a system of assumptions).

Dr Riches went on to identify some of the sources for models which guide research and practice (insights of participants, hunches and hypotheses, literature and the importing of published models).

Dr Linda Machin described her model for exploring the range of responses to loss and mapping individual grief. She described her attitude to grief (AAG) scale which demonstrates there dimensions of grief experience – overwhelmed, balanced and controlled.

The Adult Attitude to Grief scale (AAG) was devised initially to verify categorical difference but then became a tool used to profile individual grief and the relative presence of each dimension. She went on to describe a study which set out to assess the usefulness of the scale in a clinical setting – for example, in framing a story or narrative, in depicting tension between the three dimensions, it provides a promising way of mapping the general and particular characteristics of response to loss in individual clients. Consideration is also given to varying therapeutic approaches needed to help clients regain the equilibrium disturbed by their grief.

Exercises

The Adult attitude to grief scale provided the framework for two workshops – firstly examining the interpretation of numerical scores and secondly, the use of the items for guiding individual narrative and stories of loss.

Close

The conference for 2004 was closed by Ann Dent, Chair of the BRF. Ann thanked all who had participated and looked forward to meeting people again at the symposia during the year.

If you would like to contact any of the speakers or require more information please contact the Bereavement Research Forum.