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The interface between grief research and practice by Moira O'Connor

Moira O'Connor's presentation from the British Sociological Association Death, Dying and Bereavement Symposium - November 2009

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The interface between grief research and practice by Moira O'Connor

  1. 1. The interface between grief research and practice Dr Moira O’Connor WA Centre for Cancer and Palliative Care, WA [email_address]
  2. 2. Map <ul><li>Brief background to psychological theories </li></ul><ul><li>Key assumptions leading to a dominant discourse </li></ul><ul><li>Implications </li></ul><ul><li>Medicalisation of grief </li></ul><ul><li>Implications </li></ul><ul><li>Egs </li></ul>
  3. 3. Background <ul><li>Freud – process to be worked through & relinquishing relationship to the deceased </li></ul><ul><li>Fulconer (1942) – stages </li></ul><ul><li>Lindeman - acute, needs withdrawal & needing ‘grief work’ </li></ul><ul><li>Breaking attachment bonds (Bowlby), relocating the deceased & ‘moving on….’(Worden) </li></ul><ul><li>Now seen differently but these classic theories remain salient </li></ul>
  4. 4. Key assumptions <ul><li>Distinct & uniform pattern </li></ul><ul><li>Short term and finite </li></ul><ul><li>Tasks and work needed </li></ul><ul><li>Quasi-linear stages </li></ul><ul><li>Finding meaning & positives </li></ul><ul><li>Emotional expression necessary for to properly mourn the deceased </li></ul>
  5. 5. Research participants <ul><li>Classic grief research with participants who were mainly: </li></ul><ul><ul><li>North American </li></ul></ul><ul><ul><li>White </li></ul></ul><ul><ul><li>Middle-class </li></ul></ul><ul><ul><li>Female </li></ul></ul><ul><ul><li>Middle-aged-elderly widows of men who had a long-term illness </li></ul></ul>
  6. 6. Implications <ul><li>Dominant discourse & cultural narrative </li></ul><ul><li>These hegemonic assumptions are culture-biased & gender-biased and not relevant for many outside this narrow band </li></ul><ul><li>Where does this leave people who fall outside this experience? </li></ul><ul><li>This dominant discourse pervades professional and lay understandings of grief (media) </li></ul><ul><li>There is a lack of questioning </li></ul><ul><li>The notion of grief police (Walter) </li></ul><ul><li>Recent eg from media ‘The stages of grief and how to get over it’ </li></ul>
  7. 7. Negative impact on the bereaved <ul><li>Service providers may not meet needs of the bereaved – oppressive supports </li></ul><ul><li>A focus on forgetting and moving on </li></ul><ul><li>Distress and feeling not ‘normal’ – falling outside the ‘norm’ </li></ul><ul><li>Self policing </li></ul><ul><li>Judgements and labelling </li></ul>
  8. 8. Further medicalisation of grief <ul><li>DSM5 diagnostic category of Prolonged Grief Disorder </li></ul><ul><li>Clearly focussed on: intensity, continued attachment, intrusive thoughts, long lasting </li></ul>
  9. 9. Implications <ul><li>It may be very easy for people to be diagnosed with this ‘disorder’ </li></ul><ul><li>Potential for all grief to be pathologised </li></ul><ul><li>Labelling & stigma </li></ul><ul><li>Censure by others </li></ul><ul><li>Less likely to seek support if labelled </li></ul><ul><li>Supports may become ‘heavier’ </li></ul><ul><li>Less powerful > likely to be labelled or silenced </li></ul>
  10. 10. Egs <ul><ul><li>Grief following road traffic crashes in WA </li></ul></ul><ul><ul><li>Long-lasting, no detachment, oscillation of emotions, maintain relationships, rarely any positives </li></ul></ul><ul><ul><li>People silenced and imposition of the dominant narrative </li></ul></ul><ul><ul><li>Relationships change and not always for the better </li></ul></ul><ul><ul><li>Superficial understandings of grief by others </li></ul></ul><ul><ul><li>Unique </li></ul></ul><ul><ul><li>Learning to live with not get over </li></ul></ul><ul><ul><li>Majority would meet criteria for prolonged grief disorder </li></ul></ul><ul><ul><li>Challenges </li></ul></ul>
  11. 11. Egs <ul><li>Suicide in Aboriginal communities </li></ul><ul><li>40% higher than national average </li></ul><ul><li>Community grief – extensive grief </li></ul><ul><li>Funerals – importance & implications </li></ul><ul><li>Public expression of grief </li></ul><ul><li>Rituals such as not naming the deceased </li></ul><ul><li>Silenced & minimised </li></ul>
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