Bereavement: Studies of Grief in Adult Life PDF
Preview Bereavement: Studies of Grief in Adult Life
BEREAVEMENT Fourth edition The loss of a loved one is one of the most painful experiences that most of us will ever have to face in our lives. This book recognizes that there is no single solution to the problems of bereavement but that an understanding of grief can help the bereaved to realize that they are not alone in their experience. Long recognized as the most authoritative work of its kind, this new edition has been revised and extended to take into account recent research findings on both sides of the Atlantic. Parkes and Prigerson include additional information about the different cir- cumstances of bereavement including traumatic losses, disasters, and complicated grief, as well as providing details on how social, religious, and cultural influences determine how we grieve. Bereavement provides guidance on preparing for the loss of a loved one, and coping after they have gone. It also discusses how to identify the minority in whom bereavement may lead to impairment of physical and/or mental health and how to ensure that they get the help they need. This classic text will continue to be of value to the bereaved themselves, as well as the professionals and friends who seek to help and understand them. This page intentionally left blank BEREAVEMENT Studies of grief in adult life Fourth edition Colin Murray Parkes and Holly G. Prigerson First published 2010 by Routledge 27 Church Road, Hove, East Sussex, BN3 2FA Simultaneously published in the USA and Canada by Routledge 270 Madison Ave, New York, NY 10016 Routledge is an imprint of the Taylor & Francis Group, an Informa business Copyright © 2010 Colin Murray Parkes and Holly G. Prigerson Typeset in Times by RefineCatch Limited, Bungay, Suffolk Printed and bound in Great Britain by TJ International Ltd, Padstow, Cornwall Cover design by Anú Design All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. This publication has been produced with paper manufactured to strict environmental standards and with pulp derived from sustainable forests. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data Parkes, Colin Murray. Bereavement : studies of grief in adult life.—4th ed. / Colin Murray Parkes and Holly G. Prigerson. p. cm. Includes bibliographical references and index. 1. Bereavement—Psychological aspects. 2. Grief. I. Prigerson, Holly G. II. Title. BF575.G7P37 2009 155.9′37—dc22 2009006589 ISBN: 978–0–415–45118–5 (hbk) CONTENTS List of Figures vii List of Tables viii Foreword to the First Edition by John Bowlby ix Foreword to the Fourth Edition by Robert Jay Lifton xi Acknowledgements xiii Introduction xiv 1 The cost of commitment 1 2 The broken heart 15 3 Trauma 33 4 Attachment and loss 48 5 Continuing bonds 68 6 Anger and guilt 90 7 Changing the assumptive world 100 8 Complications of grief 122 9 Determinants of grief I: Kinship, gender and age 137 10 Determinants of grief II: Mode of death 152 v CONTENTS 11 Determinants of grief III: Personal vulnerability 164 12 Determinants of grief IV: Social and cultural influences 181 13 Helping the bereaved I: Bereavement support: History and evaluation 193 14 Helping the bereaved II: Types of help for types of problem 220 15 Helping the bereaved III: Sources of help 238 16 Reactions to other types of loss 252 17 Disasters 267 Appendices 279 Organizations Offering Help to the Bereaved 305 Recommended Further Reading 307 References 309 Index 337 vi FIGURES 1 Changes in indicators of grief over two years post-bereavement 280 2 Mortality rate of widowers after bereavement as a percentage of rate for married men over ten years post-bereavement 281 3 Sedative consumption, before and after bereavement, in forty-four widows in two age groups 291 4 Scores of insecure attachment × overall distress in 181 persons referred for psychiatric help after bereavement 293 5 Anxious/ambivalent attachment scores correlated with other variables 294 6 Score of separations from parents during childhood correlated with other variables 295 7 Avoidant attachment scores correlated with other variables 296 8 Disorganized attachment scores correlated with other variables 297 9 Mean grief/loneliness scores × age group × living alone or with others 298 10 Severity of emotional disturbance in twenty-five widows during the first three months of bereavement 298 11 Mean General Health Questionnaire scores before and after intervention in bereaved persons in two therapy groups and a control group 300 12 Mean outcome scores in three groups of hospice bereaved 304 vii TABLES 1 Psychiatrist’s predictions of cervical cancer and biopsy diagnosis in fifty-one women admitted for investigation of suspicious smear test 281 2 London Study: Intercorrelation of health indices and anger in twenty-two widows 282 3 The Yale Bereavement Study: Prolonged grief disorder (PGD) at six months predicts impairment at thirteen months 285 4 London Study: Correlation (r) between mean year scores on psychological measures among twenty-two London widows 287 5 Tests of moderation for targeted population 299 viii FOREWORD TO THE FIRST EDITION Some ten years ago a young psychiatrist wrote from the Maudsley Hospital calling my attention to Darwin’s work on grief. This proved of great value to me. Soon we had met and discovered that our thoughts were running along similar lines. When opportunity offered, therefore, we joined forces and a happy, mutually productive part- nership has followed. During these years, despite uncertain financial support, Colin Murray Parkes has devoted himself without reserve to unravelling the problems of grief and mourning. In this admirable book we have the fruits of his labours. Considering the attention given to the subject by Freud half a century ago and the classical work of Lindemann in the early 1940s, it is remarkable that psychiatrists have been so long in recognizing bereavement as a major hazard to mental health. Not until this past decade has any sustained research been mounted, and hitherto few books on grief have been published by psychiatrists. In the understanding of an illness a turning-point comes when the pathological processes of the illness can be seen as intensifications, deviations, of prolongations of processes that occur in health. In keeping with this rule, the increased understanding of grieving and its pathological variants available today is a direct result of our greatly increased knowledge of the processes of grieving that occur in ordinary people. To this advancing knowledge Dr Parkes has made major contributions. As this book goes to press the detailed findings of studies he has conducted in the United Kingdom from the Tavistock Institute of Human Relations and in the United States from Harvard Medical School are being published in the scientific journals. Not only has Dr Parkes furthered our scientific understanding of grieving, but he has played an active part in trying to develop means whereby bereaved people can be helped. Through his clinical work ix
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