Grief and Loss Across the Lifespan : A Biopsychosocial Perspective

"[Grief and Loss Across the Lifespan] represents a significant advance because it looks at the issues from a bio-psychosocial perspective. To a social worker who has worked mainly in a medical and nursing environment, this is a great step forward." --Bereavement Care "[Offers] valued sensitivities, knowledge, and insights, and most importantly, age-appropriate interventions for a range of significant losses....Counselors will want to keep this indispensable work close at hand." -Kenneth J. Doka, PhD Author, Counseling Individuals With Life-Threatening Illness "By taking a lifespan view, this book fills a gap in the literature on loss and grief and takes theory and practice in new and invigorating directions. It will be welcomed by those professionals of all disciplines who daily listen to and help re-write narratives of loss." -Jeffrey S. Applegate, PhD Professor Emeritus Graduate School of Social Work & Social Research Bryn Mawr College "[A] thorough, thoughtful, sensitive, and up-to-date contribution that may be the best book available today for teaching bereavement, grief, and mourning .[H]ighly recommended for experienced grief professionals as well as for students." -Jeffrey Kauffman, MA, MS, LCSW, BD, CT, CAS, BCETS Psychotherapist in private practice, Philadelphia, PA "Walter and McCoyd have written a well-organized and comprehensive examination of grief and bereavement that will be useful to the seasoned professional as well as the student new to grief and loss. The historical analysis of grief theory from classic to postmodern is interesting reading and essential for a full understanding of grief and loss in modern society. " --Paige E. Payne, MS, MSW, LSW Support Services Manager PinnacleHealth Home Care and Hospice Harrisburg, PA Grief and Loss Across the Lifespan is unique in its treatment of grieving patterns and intervention strategies for different age groups. With this book, students and practitioners will learn how grief is influenced by biological responses to stress, psychological responses to loss, as well as social norms and support networks. The authors utilize a developmental framework, as each level of development from infancy through old age is addressed in four ways: Reviews normal developmental issues, abilities, and challenges for the age in question Analyzes how individuals of each age cope with serious loss of a significant other, and how they may experience life-threatening illness themselves Examines how significant others react to and mourn the death of someone in that age range Identifies the normative losses a person is likely to experience, and addresses protective and risky ways of coping with those losses The authors review important grief theories, such as postmodern and Dual Process Theory, and discuss current topics in grief, including continuing bonds, meaning making, ambiguous loss, and disenfranchised loss. With the help of this book, practitioners and students of grief counseling can learn to help patients of all ages understand that loss is at the heart of life and growth. MuPDF error: syntax error: invalid key in dict MuPDF error: syntax error: invalid key in dict MuPDF error: syntax error: invalid key in dict MuPDF error: syntax error: invalid key in dict MuPDF error: syntax error: invalid key in dict MuPDF error: syntax error: invalid key in dict MuPDF error: syntax error: invalid key in dict MuPDF error: syntax error: invalid key in dict MuPDF error: syntax error: invalid key in dict Contents 8 Preface 16 Acknowledgments 18 1 Introduction 20 Text Structure 21 Introduction to Grief Theory 22 Classical Grief Theory: Task-Based Theories 23 Classical Grief Theory: Stage-Based Theories 26 The Transition to Postmodern Grief Theory 32 Meaning-Making and Grief 33 Dual Process Theory 35 Continuing Bonds and Grief 36 Disenfranchised Grief 37 Ambiguous Loss 38 Biological Effects of Grief 39 Issues of Intervention 42 A Final Word About Grief Work 44 2 Perinatal Attachment and Loss 46 Developmental Aspects of Pregnancy 47 Biological Developmental Context of Pregnancy 48 Psychological Aspects of Pregnancy 49 Social Aspects of Pregnancy 52 Summary of Development in the Prenatal Period 54 Loss as Experienced by a Fetus 55 Loss of a Fetus as Experienced by Significant Others 56 Infertility 56 Reproductive Health Conditions 57 Biological Changes Associated With Intrauterine Fetal Death 58 Psychological Aspects of IUFD 60 Social Aspects of IUFD 65 Readings 68 Hyperemesis Gravidarum: A Medical Complication of Pregnancy 68 Heartbreaking Choices and Losses of Potential 77 Summary 85 3 Infancy and Toddlerhood 88 Developmental Stage: Trust Versus Mistrust and Autonomy Versus Shame 89 Biological Development 90 Psychological Development 91 Social Development 93 Losses Experienced in Infancy and Early Childhood 94 Loss of Caregiving 94 Death of a Caregiver 97 Loss of a Child’s Own Health 99 Parental Loss of an Individual at This Age 99 Death of an Infant or Toddler 99 Loss of the Idealized Child 100 Maturational and Other Losses Experienced at This Age 101 Birth and Gradual Loss of Complete Care 101 Readings 103 Starting With Abandonment and Loss 103 Baby James 108 Nina’s Travels Through the Foster Care System 113 Summary 119 4 Elementary-School-Age Children 122 Developmental Stage: Initiative Versus Guilt and Industry Versus Inferiority 123 Biological Development 124 Psychological Development 126 Social Development 128 Loss Experienced by an Individual During the Elementary School Years 129 Age Differences in Perceptions of Loss 129 Loss of a Pet 130 Losses Resulting From Sexual Abuse 131 Loss Caused by Parental Divorce 131 Loss and the Military 132 Intervention Issues With Elementary School Children 133 Loss of an Individual of That Age as Experienced by Others 135 Parents’ Loss of a Child 135 Readings 138 The Challenged Child 138 Loss of a Pet in Childhood: The Loss of a Companion 140 Summary 145 5 Tweens and Teens 148 Development: Identity Development Versus Identity Diffusion 149 Biological Development 149 Psychosocial Development 152 Losses of Adolescents 156 Teens’ Experience of Death (Others’ or Their Own) 157 Death of a Sibling 159 Response to the Death of a Teen 161 Parents’ Loss of a Tween or Teen 161 Other Losses Experienced by Teens 162 Maturational Losses 162 Readings 166 Childhood Chronic Health Conditions and Sibling Loss: Celebrating Strengths and Acknowledging Difficulty 166 Teenagers and Traumatic Grief: Tina’s Story 171 Loss of Love for an Adolescent: Carolyn’s Public and Private Loss 181 Summary 187 6 Young Adulthood 190 Developmental Crisis: Intimacy Versus Isolation 191 Social Development 191 Psychological Development 192 Losses Experienced by Young Adults 193 Chronic Illness 193 Death of a Parent 196 Maturational Losses in Early Adulthood 197 Delaying Decisions About Childbearing 197 Infertility 197 Losses Connected With the Transition to Parenthood 198 Loss of Romantic Relationships 199 Addictions 200 Loss of a Young Adult as Experienced by Others 200 Mental Health Problems and Loss Related to the War in Iraq 200 Death of a Spouse 201 Death of a Nonmarried Opposite-Sex Partner 204 Death of a Gay Partner 204 Death of a Lesbian Partner 205 Readings 206 The Case of a Young Adult Who Has Lost a Parent 206 The Losses of Infertility 213 Case of a Young Adult Struggling With Addictions 223 Summary 227 7 Middle Adulthood 230 Developmental Crisis: Generativity Versus Stagnation 231 Psychological Aspects of Development 231 Biological Aspects of Development 233 Social Aspects of Development 233 Loss Experienced by Midlife Adults 234 Transformation of Identity and “Letting Go of Past Dreams” 234 Immigration as an Example of Transformation of Identity 235 Facing a Chronic or Life-Threatening Illness 236 Death of Parents 238 Death of a Sibling in Adulthood 240 The Loss of the Midlife Adult as Experienced by Others 241 Death of a Spouse 241 Death of a Nonmarried Opposite-Sex Partner 242 Death of a Lesbian Partner 243 Death of a Gay Partner 244 Maturational Losses of Midlife Adults 245 Loss/Transition of Employment 245 Loss Experienced by Parents When Adult Children Are Leaving Home 247 The Loss of the Family Home 248 Off-Time Issues of Parenthood—Fertility Issues Arise Again 249 Readings 250 Illness Doesn’t Discriminate: One Story From the Gay and Lesbian Community 250 Losses of Professional Identity and Career Aspirations 260 Kudu’s Story: Changing Lives 265 Summary 269 8 Retirement and Reinvention 272 The Transition to the Third Quarter of Life: Retirement or Reinvention? 273 Losses Experienced by Adults During Retirement and Reinvention 276 Loss and Transformation of Identity 276 Loss of Routine: Search for Balance 279 Loss of or Change in Relationships 280 Changes Within the Marital/Partner Relationship 281 Changes in Relationships With Friends 283 Loss of Financial Resources 284 Loss of or Change in One’s Belief System: The Importance of Spiritual Growth 285 Changes in Relationship to One’s Community 285 The Process of Change: Coping With the Transition Process 286 Loss of Adult as Experienced by Others 287 Adult Children 287 Parents 288 Readings 289 Case Study on Midlife Career/Life Transition 289 Early Retirement Among Baby Boom Women: Some Losses and Some Gains 292 Summary 299 9 Older Adults 300 Developmental Crisis: Integrity Versus Despair 301 Social Changes 302 Psychological Changes 303 Biological Changes 303 Losses Experienced by Older Adults 304 Resilience 304 Developing a Point of View About Death 306 Coping With Chronic/Life-Threatening Illness 308 Death of a Spouse 310 Death of a Nonmarried Opposite-Sex Partner 314 Death of an Adult Child 316 Death of Friends 317 Maturational Losses 318 Loss of Home/Relocation 318 Grandparent Caregivers 319 Hospice as a Resource for Patients and Their Families 321 Readings 321 The Story of Rachael and Hal 321 Marital Bereavement in Later Adulthood 328 Olivia’s Journey 334 Summary 339 10 Conclusions 342 Maturational Losses as Examples of Disenfranchised Losses 343 Importance of the Dual Process Model of Coping With Bereavement 346 Importance of Continuing Bonds 348 Meaning-Making as a Process of Growth 350 Interventions 353 References 356 Index 386 A 386 B 387 C 387 D 388 E 388 F 388 G 388 H 389 I 389 J 390 K 390 L 390 M 390 N 390 O 391 P 391 R 391 S 392 T 392 V 392 W 392 Contents......Page 8 Preface......Page 16 Acknowledgments......Page 18 1 Introduction......Page 20 Text Structure......Page 21 Introduction to Grief Theory......Page 22 Classical Grief Theory: Task-Based Theories......Page 23 Classical Grief Theory: Stage-Based Theories......Page 26 The Transition to Postmodern Grief Theory......Page 32 Meaning-Making and Grief......Page 33 Dual Process Theory......Page 35 Continuing Bonds and Grief......Page 36 Disenfranchised Grief......Page 37 Ambiguous Loss......Page 38 Biological Effects of Grief......Page 39 Issues of Intervention......Page 42 A Final Word About Grief Work......Page 44 2 Perinatal Attachment and Loss......Page 46 Developmental Aspects of Pregnancy......Page 47 Biological Developmental Context of Pregnancy......Page 48 Psychological Aspects of Pregnancy......Page 49 Social Aspects of Pregnancy......Page 52 Summary of Development in the Prenatal Period......Page 54 Loss as Experienced by a Fetus......Page 55 Infertility......Page 56 Reproductive Health Conditions......Page 57 Biological Changes Associated With Intrauterine Fetal Death......Page 58 Psychological Aspects of IUFD......Page 60 Social Aspects of IUFD......Page 65 Hyperemesis Gravidarum: A Medical Complication of Pregnancy......Page 68 Heartbreaking Choices and Losses of Potential......Page 77 Summary......Page 85 3 Infancy and Toddlerhood......Page 88 Developmental Stage: Trust Versus Mistrust and Autonomy Versus Shame......Page 89 Biological Development......Page 90 Psychological Development......Page 91 Social Development......Page 93 Loss of Caregiving......Page 94 Death of a Caregiver......Page 97 Death of an Infant or Toddler......Page 99 Loss of the Idealized Child......Page 100 Birth and Gradual Loss of Complete Care......Page 101 Starting With Abandonment and Loss......Page 103 Baby James......Page 108 Nina’s Travels Through the Foster Care System......Page 113 Summary......Page 119 4 Elementary-School-Age Children......Page 122 Developmental Stage: Initiative Versus Guilt and Industry Versus Inferiority......Page 123 Biological Development......Page 124 Psychological Development......Page 126 Social Development......Page 128 Age Differences in Perceptions of Loss......Page 129 Loss of a Pet......Page 130 Loss Caused by Parental Divorce......Page 131 Loss and the Military......Page 132 Intervention Issues With Elementary School Children......Page 133 Parents’ Loss of a Child......Page 135 The Challenged Child......Page 138 Loss of a Pet in Childhood: The Loss of a Companion......Page 140 Summary......Page 145 5 Tweens and Teens......Page 148 Biological Development......Page 149 Psychosocial Development......Page 152 Losses of Adolescents......Page 156 Teens’ Experience of Death (Others’ or Their Own)......Page 157 Death of a Sibling......Page 159 Parents’ Loss of a Tween or Teen......Page 161 Maturational Losses......Page 162 Childhood Chronic Health Conditions and Sibling Loss: Celebrating Strengths and Acknowledging Difficulty......Page 166 Teenagers and Traumatic Grief: Tina’s Story......Page 171 Loss of Love for an Adolescent: Carolyn’s Public and Private Loss......Page 181 Summary......Page 187 6 Young Adulthood......Page 190 Social Development......Page 191 Psychological Development......Page 192 Chronic Illness......Page 193 Death of a Parent......Page 196 Infertility......Page 197 Losses Connected With the Transition to Parenthood......Page 198 Loss of Romantic Relationships......Page 199 Mental Health Problems and Loss Related to the War in Iraq......Page 200 Death of a Spouse......Page 201 Death of a Gay Partner......Page 204 Death of a Lesbian Partner......Page 205 The Case of a Young Adult Who Has Lost a Parent......Page 206 The Losses of Infertility......Page 213 Case of a Young Adult Struggling With Addictions......Page 223 Summary......Page 227 7 Middle Adulthood......Page 230 Psychological Aspects of Development......Page 231 Social Aspects of Development......Page 233 Transformation of Identity and “Letting Go of Past Dreams”......Page 234 Immigration as an Example of Transformation of Identity......Page 235 Facing a Chronic or Life-Threatening Illness......Page 236 Death of Parents......Page 238 Death of a Sibling in Adulthood......Page 240 Death of a Spouse......Page 241 Death of a Nonmarried Opposite-Sex Partner......Page 242 Death of a Lesbian Partner......Page 243 Death of a Gay Partner......Page 244 Loss/Transition of Employment......Page 245 Loss Experienced by Parents When Adult Children Are Leaving Home......Page 247 The Loss of the Family Home......Page 248 Off-Time Issues of Parenthood—Fertility Issues Arise Again......Page 249 Illness Doesn’t Discriminate: One Story From the Gay and Lesbian Community......Page 250 Losses of Professional Identity and Career Aspirations......Page 260 Kudu’s Story: Changing Lives......Page 265 Summary......Page 269 8 Retirement and Reinvention......Page 272 The Transition to the Third Quarter of Life: Retirement or Reinvention?......Page 273 Loss and Transformation of Identity......Page 276 Loss of Routine: Search for Balance......Page 279 Loss of or Change in Relationships......Page 280 Changes Within the Marital/Partner Relationship......Page 281 Changes in Relationships With Friends......Page 283 Loss of Financial Resources......Page 284 Changes in Relationship to One’s Community......Page 285 The Process of Change: Coping With the Transition Process......Page 286 Adult Children......Page 287 Parents......Page 288 Case Study on Midlife Career/Life Transition......Page 289 Early Retirement Among Baby Boom Women: Some Losses and Some Gains......Page 292 Summary......Page 299 9 Older Adults......Page 300 Developmental Crisis: Integrity Versus Despair......Page 301 Social Changes......Page 302 Biological Changes......Page 303 Resilience......Page 304 Developing a Point of View About Death......Page 306 Coping With Chronic/Life-Threatening Illness......Page 308 Death of a Spouse......Page 310 Death of a Nonmarried Opposite-Sex Partner......Page 314 Death of an Adult Child......Page 316 Death of Friends......Page 317 Loss of Home/Relocation......Page 318 Grandparent Caregivers......Page 319 The Story of Rachael and Hal......Page 321 Marital Bereavement in Later Adulthood......Page 328 Olivia’s Journey......Page 334 Summary......Page 339 10 Conclusions......Page 342 Maturational Losses as Examples of Disenfranchised Losses......Page 343 Importance of the Dual Process Model of Coping With Bereavement......Page 346 Importance of Continuing Bonds......Page 348 Meaning-Making as a Process of Growth......Page 350 Interventions......Page 353 References......Page 356 A......Page 386 C......Page 387 G......Page 388 I......Page 389 N......Page 390 R......Page 391 W......Page 392

"[Grief and Loss Across the Lifespan] represents a significant advance because it looks at the issues from a bio-psychosocial perspective. To a social worker who has worked mainly in a medical and nursing environment, this is a great step forward."

--Bereavement Care

"[Offers] valued sensitivities, knowledge, and insights, and most importantly, age-appropriate interventions for a range of significant losses....Counselors will want to keep this indispensable work close at hand."

-Kenneth J. Doka, PhD
Author, Counseling Individuals With Life-Threatening Illness

"By taking a lifespan view, this book fills a gap in the literature on loss and grief and takes theory and practice in new and invigorating directions. It will be welcomed by those professionals of all disciplines who daily listen to and help re-write narratives of loss."

-Jeffrey S. Applegate, PhD
Professor Emeritus
Graduate School of Social Work & Social Research
Bryn Mawr College

"[A] thorough, thoughtful, sensitive, and up-to-date contribution that may be the best book available today for teaching bereavement, grief, and mourningÖ.[H]ighly recommended for experienced grief professionals as well as for students."

-Jeffrey Kauffman, MA, MS, LCSW, BD, CT, CAS, BCETS
Psychotherapist in private practice, Philadelphia, PA

"Walter and McCoyd have written a well-organized and comprehensive examination of grief and bereavement that will be useful to the seasoned professional as well as the student new to grief and loss. The historical analysis of grief theory from classic to postmodern is interesting reading and essential for a full understanding of grief and loss in modern society. "

--Paige E. Payne, MS, MSW, LSW
Support Services Manager
PinnacleHealth Home Care and Hospice
Harrisburg, PA

Grief and Loss Across the Lifespan is unique in its treatment of grieving patterns and intervention strategies for different age groups. With this book, students and practitioners will learn how grief is influenced by biological responses to stress, psychological responses to loss, as well as social norms and support networks.

The authors utilize a developmental framework, as each level of development from infancy through old age is addressed in four ways:

• Reviews normal developmental issues, abilities, and challenges for the age in question
• Analyzes how individuals of each age cope with serious loss of a significant other, and how they may experience life-threatening illness themselves
• Examines how significant others react to and mourn the death of someone in that age range
• Identifies the normative losses a person is likely to experience, and addresses protective and risky ways of coping with those losses

The authors review important grief theories, such as postmodern and Dual Process Theory, and discuss current topics in grief, including continuing bonds, meaning making, ambiguous loss, and disenfranchised loss. With the help of this book, practitioners and students of grief counseling can learn to help patients of all ages understand that loss is at the heart of life and growth. "[Grief and Loss Across the Lifespan] represents a significant advance because it looks at the issues from a bio-psychosocial perspective. To a social worker who has worked mainly in a medical and nursing environment, this is a great step forward." —Bereavement Care "[Offers] valued sensitivities, knowledge, and insights, and most importantly, age-appropriate interventions for a range of significant losses....Counselors will want to keep this indispensable work close at hand." - Kenneth J. Doka, PhD Author, Counseling Individuals With Life-Threatening Illness "By taking a lifespan view, this book fills a gap in the literature on loss and grief and takes theory and practice in new and invigorating directions. It will be welcomed by those professionals of all disciplines who daily listen to and help re-write narratives of loss." - Jeffrey S. Applegate, PhD Professor Emeritus Graduate School of Social Work & Social Research Bryn Mawr College "[A] thorough, thoughtful, sensitive, and up-to-date contribution that may be the best book available today for teaching bereavement, grief, and mourningÖ.[H]ighly recommended for experienced grief professionals as well as for students." - Jeffrey Kauffman, MA, MS, LCSW, BD, CT, CAS, BCETS Psychotherapist in private practice, Philadelphia, PA "Walter and McCoyd have written a well-organized and comprehensive examination of grief and bereavement that will be useful to the seasoned professional as well as the student new to grief and loss. The historical analysis of grief theory from classic to postmodern is interesting reading and essential for a full understanding of grief and loss in modern society. " — Paige E. Payne, MS, MSW, LSW Support Services Manager PinnacleHealth Home Care and Hospice Harrisburg, PA Grief and Loss Across the Lifespan is unique in its treatment of grieving patterns and intervention strategies for different age groups. With this book, students and practitioners will learn how grief is influenced by biological responses to stress, psychological responses to loss, as well as social norms and support networks. The authors utilize a developmental framework, as each level of development from infancy through old age is addressed in four ways: Reviews normal developmental issues, abilities, and challenges for the age in question Analyzes how individuals of each age cope with serious loss of a significant other, and how they may experience life-threatening illness themselves Examines how significant others react to and mourn the death of someone in that age range Identifies the normative losses a person is likely to experience, and addresses protective and risky ways of coping with those losses The authors review important grief theories, such as postmodern and Dual Process Theory, and discuss current topics in grief, including continuing bonds, meaning making, ambiguous loss, and disenfranchised loss. With the help of this book, practitioners and students of grief counseling can learn to help patients of all ages understand that loss is at the heart of life and growth. "[A] thorough, thoughtful, sensitive, and up-to-date contribution that may be the best book available today for teaching bereavement, grief, and mourning .[H]ighly recommended for experienced grief professionals as well as for students."--Jeffrey Kauffman, MA, MS, LCSW, BD, CT, CAS, BCETS. Psychotherapist in private practice, Philadelphia, PA. "[Offers] valued sensitivities, knowledge, and insights, and most importantly, age-appropriate interventions for a range of significant losses."-Kenneth J. Doka, PhD. Author, Counseling Individuals With Life-Threatening Illness. Gr Addresses death experiences across the lifespan along with identification and intervention strategies for normative losses. This text reviews normal developmental issues for the age in question, particularly the abilities and challenges that are specific to that age. It identifies the normative losses a person is likely to experience.