Psychological reactions to loss entail a systematic progression through unique stages of bereavement that have been recognized by the health fraternity and the general public. The passing away of a child at any age is a challenging and awful experience. Whereas bereavement is depressing when it happens, studies have confirmed that the greatest distress and pain are experienced among parents who have lost their sons or daughters. People have different potentials and ways to react to interpersonal loss and overcome such experiences successfully without entering into addictions or some forms of depressions (Palatova & Vasilevich, 2020). Some severe grief follows the loss of a child as compared to any other loss. Such an assumption should be sifted through, though, and the investigation of Juanita and Joslynn will be significant in ascertaining this fact.
Literature Review
Bowlby and Parkes are recognized as the first individuals to suggest a stage theory of grief for adjusting to grief that comprises four levels: "shock-numbness, yearning searching, disorganization-despair and reorganization (Kubler-Ross & Kessler, 2009)." Kubler-Ross and Kessler (2009) tailored Bowlby and Parkes' model to exemplify their 5-stage reaction to terminally ill individuals to the cognizance of their imminent death, including "denial- dissociation-isolation, anger, bargaining, depression, and acceptance." The stage theory of grief was widely recognized and has been assigned to a wide range of losses, such as children's responses to a divorce scenario of their parents, adults' response to divorce, and physicians' responses to the death of an individual under their care.
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Kessler and Ross's Stage theory of Grief suggests five stages, including denial, anger, bargaining, depression, and acceptance. The scholars indicate that denial is the first reaction to grief. During the stage, people and the environment is insignificant and useless. This stage is followed by bargaining, anger, depression, and acceptance. Not many studies have clearly examined if the usual trajectory of response to the issue of death goes through the stages of doubt, yearning, anger, depression, and accepting the occurrence. The recognition of the arrangements of typical grief symptom courses is of clinical interest since it improves how we can appreciate how people psychologically and emotionally process the death of their loved one (Corr, 2019; Kubler-Ross & Kessler, 2009). Knowing this helps in recognizing if a particular progression of bereavement adaptation is typical or unique. If the typical patterns of grief are determined, it becomes easier to identify the abnormal patterns. Consequently, such abnormal bereavement responses or adaptations are easily identified and submitted for treatment.
Following a significant loss, like that of a child or loved one, 30 percent of the directly affected individuals will experience some impact on their health, either physically and mentally, or both. Such ways of bereavements will heighten the susceptibility to dying from chronic diseases and cases of suicide or even lead to many psychosomatic and psychiatric conditions that others undergo. Approximately 25 percent of widows and widowers will experience clinical depression and anxiety immediately after the death of their partners, especially in the first year (Corr, 2019). The risk falls to 17 percent after a year and continues to drop afterward (Corr, 2020). McLean et al. (2021) determined that about 39 percent of 71 elderly patients admitted to a psychiatric unit they were working in had recently lost someone.
Besides such detrimental effects discussed above, losses can also inspire maturity and individual growth. Such a scenario affirms that losses are not all the time harmful but can also motivate the bereaved to have higher inspirations. The impacts of loss are so diverse, and healthcare practitioners and families that have lost their loved ones have not been exposed to training on how to cope with such cases (Kubler-Ross & Kessler, 2009). The basis for this presumption is that loss is irreversible and cannot be treated in that people cannot do anything about it. The most appropriate way of responding to the losses of individuals, especially for healthcare providers, is basically to accept and ignore.
Interview Data Analysis
The two individuals, Juanita and Joslynn, willingly agreed to participate in the interviews for this Theory Application Paper. Thus, there was verbal consent to authorize their participation and information for the researcher's study. The responses from the interview helped me understand how individuals respond to various cases of the loss of loved ones. The questions that the interviewer asked ranged from psychological, personal, physical, financial, and more.
Juanita is a 62-year-old African-American female who experienced the loss of her adult son when he was just 25 years old due to asphyxiation. Notably, the actual cause of death is rumored to be a drug overdose, although she will not confirm. At the time of her son's death, Ashley was 45 years old. She currently resides on the south side of Chicago in a two-bedroom apartment. She does not currently receive any mental health services but does identify as a Christian and states she is very close to her religious family.
Also, there is a case of Joslynn, who is a 27-year-old African-American female. She experienced the loss of her 6-month-old son from SIDS when she was 19-years old. Joslynn was studying nursing at a community college when they had their son together with the boyfriend, who was also attending a football scholarship. She currently resides on the west side of Chicago with her 32-year-old fiancé and 2-year-old daughter. She does not identify as religious but does say she is “very spiritual” and has a Christian background.
The literature review on the stages of grief has revealed several hypothesized responses. First, it is expected that denial of the death of the loved to occur equitably to both Juanita and Joslynn. Denial and shock will be the way of coping and making the event possible since the two participants lost their sons. As much as Juanita spent more time with her son than Joslynn, they all were in a state of shock and denial and probably questioned God. It is a natural way of accepting what one can handle only. Secondly, it is expected that the two will express anger, even though this may appear endless. The irritation could be expressed to God, doctors, family, oneself, or one who died (Kubler-Ross &Kessler, 2009). Joslynn could wonder why the son left so soon, and Juanita would also be angry that the son had gone too soon. Lastly, there could be depression so that both participants' attention moves entirely into the present. The depression stage would feel to both people as though it will not end and may not necessarily indicate a mental case.
Juanita
Juanita had lost her son when he was just 25 years old due to asphyxiation. Patents of older children are determined to experience an extensive range of complicated mental and physical symptoms. Like any other loss, depression is followed by intense situations of sadness, desolation, solitude, abandonment, and wishes of death. Tee-Tee is also a son of her youth, and she remembers, "I was still in high school when I got pregnant with him. I had to go to a school for pregnant girls, and when I was 19, he was born.” Parenting is a teenager for Juanita must have attracted more challenges, such as dealing with judgmental attitudes from individuals, being in class, and finishing one's education. When probed, Juanita recalls how her sister was embarrassed as hell that she and her mother were pregnant at the same time.
Parents also demonstrate a physical sense of attachment to their loved ones, and they feel their loved one would rather be alive and did not deserve to die. Juanita notes in defense of her child,
Everyone talked about how respectful and kind he was. I guess that's why I had a hard time accepting that he was in a gang and doing illegal stuff. He was stealing cars at 18, you know, stupid shit but kid shit. But when he died, he was trying to raise those kids to the best of his ability. Cause those kids were his life.
In explaining the circumstances surrounding her son's death, she states that her son, who was respectful to everyone in his early years, choked on his vomit after drinking. When the child's reality is recognized, the parent often gets disappointed but still in defense. The reality of who the child is as opposed to what the parent thought is excruciating.
Juanita's husband was critical during this time of grieving, as she became more closer to him. In the first years following his death, he was sweet and caring until he started cheating. Her adjustment was to get closer to family more and Shon (her son's peer). She feels that her son would be more caring and helpful and alter the current situation by causing happiness in the family. She is resentful about addiction, yet she feels that it is part of her youthful life. She is also convinced that someone can stop addiction when they want. "I know it's a disease, and it’s not easy, but if you truly want to, you can stop," she states. Her last expression in the interview indicated her acceptance of the event. She said:
I believe we are all born with a number, and when that number is where your time is up. God gave me 25 wonderful years with my son, and I'm grateful. And he left me 8 beautiful grandchildren who gave me 6 beautiful great-grandchildren. I lost my baby, but I gained a lot too. And I know I'll see him again when this life is over.
Joslynn
Just like Juanita, Joslynn became a mother at 19. At least for her, she was at college as opposed to the other who was in high school when having a child. She paints the picture of how they had planned out their lives with the boyfriend, “… were going to get married, move to LA have three more kids (another boy and two girls) and live rich and happily ever after.” For her, she was ready to be a mother since all plans were figured out. The response of Joslynn to the death of her son was anger and shock. She remembers:
I swear I knew my baby was gone from looking at him. I picked him up and screamed. He was cold and hard and soaking wet. I was crying for my mama. And I remember everything slowed down.
The event hurt her, and she felt pain and anger whenever she saw a pregnant woman or a baby stroller. She showed how she was dissatisfied with God, which is a normal reaction for most people who experience the loss of a loved one. She said:
How could the God I was raised to believe in take my baby? And then, all the religious people in my family talking about 'everything happens for a reason,' 'he in a better place' Bitch, my son supposed to be here on Earth with me! Yea, I gave up on God for a minute.
As a way of responding to the loss of the child, Joslynn indulged in heavy drinking. She also indicates that the son's father also felt the pain of losing a son that looked like him. He became sick and blamed Joslynn. She indicated that AJ (the son) was the person who held them together. She wonders:
I actually started to hate him because, for a while, I did believe it was my fault. But I felt like if he were there to help me, then maybe this wouldn't have happened. I don't know. Looking back, that makes no sense, but it did to me then.
Joslynn admits that she became an alcoholic, and most judged her actions, except the mother who stood by her. Those who have lost their loved ones may always resort to drinking to help them not think about the worst. Joslynn did not care that she no longer had relationships, and she experienced solitude. Her aspirations were diverted a little bit because of the passing away of the son. She understood that people are driven to addictions because of circumstances, “I mean, I never thought that things could happen that could drive people to be addicts. I always thought to myself that only weak-minded people use drugs to cope.” She recognizes that addiction can sometimes be severe to the point that one has to join a rehab. For a recovery to occur, one must accept the loss and choose to move in with life. She confirms, "I been in recovery for three years, and one thing I have learned is acceptance. I accept what was and handle what is. I miss my baby. I got his name tattooed on me. I'll never forget him. But I realized in treatment that I still had life to live and a chance to have a family as I want."
Discussion
The two ladies in the cases depict feelings of vulnerability, anxiety, anger, the solitude that accompany their sadness and despair after the loss of their sons. Grieving parents demonstrate anger as their typical response to the loss of a son or daughter. As shown in Juanita's case, the anger is expressed differently, such as drinking in Joslynn and wishing things about their gone children. The irritation can be channeled towards the spouse or other relatives, to God, or even fate. Both the ladies were mad at God at the beginning. In fact, Juanita admits that she only acknowledged God later during the recovery period. Both of them also attributed what happened to fate and that the sons' deaths happened in their time as fate demands. Anger could also be pointed at the self, demonstrating habits of self-hatred, despair, and low self-esteem.
Kessler and Ross Stage Theory of Grief
Kessler and Ross's Stage theory of Grief suggests five stages, including denial, anger, bargaining, depression, and acceptance. The scholars indicate that denial is the first reaction to grief. During the stage, people and their surroundings become meaningless and useless. It is evident in the cases of both Juanita and Joslynn, who were shocked and could believe the departure of their loved one. For instance, Joslynn was shocked to the point that she could hear what her mother was saying on the phone. According to McLean et al. (2021), denial is fundamental in making the bereaved pace their feelings of grief, especially when they can accept the situation.
The second manifestation in this theory is anger, which is part of the healing process. Anger is expressed to things, oneself, physicians, partners, God, and many other things. In our cases, the ladies did not understand why the loss of a loved one had to be at that time. Underneath anger is the feeling of pain and no connection to anyone. Corr (2020) reiterates that the bereaved would opt to blame others and do not make sense of any excuses in their favor, for instance, being angry about an individual who did not attend the burial.
The third stage discussed in the Five Stages theory is bargaining so that one endeavors to do anything to save their loved one. Juanita regrets that probably things could have done things differently: I used to think that maybe if I would've paid that extra money for the more expensive prenatal vitamins or if I would have just let him sleep with me that night, none of this would have happened. Corr (2019) explains that the "if only" makes us find fault in ourselves and what we could think could be done in a different way to spare our loved ones. Parents could even bargain with what they are feeling, with something feeling that they could have been the ones to die in place of their children.
Another aspect is depression, which the two ladies have greatly expressed. Joslynn was depressed to the extent that she became an alcoholic and was taken to a rehab center. Grief entered their lives on a deeper level differently, which pushed them to do something unacceptable by society. Not being depressed after a close person has died is abnormal because when a parent realizes that the child is gone, she will be depressed (Palatova & Vasilevich, 2020). Parents maintain that their grief is sustained in their entire lives, often stating, “It gets different, it doesn't get better.” The many studies that have investigated parents who have lost their children defend that they are often preoccupied with the death of their children throughout the lifecycle.
The final stage is acceptance and is the most critical one for a full recovery to be realized. there is always confusion between acceptance and the dismissals people make of being ok and "all right." Parents do not feel all right about the loss of their loved ones. Joslynn confirms this assertion when she could not take the words of the family who came to console her. Such is confirmed in her remarks, “…all the religious people in my family talking about ‘everything happens for a reason 'he in a better place.” The acceptance stage is about acknowledging the reality that one has passed and physically, they are not present, and it is a permanent situation that one has to live with. Even though the reality is not favorable, but it has to be accepted. The bereaved are introduced to a world that was not familiar to them, and they have to cope with the new situation. Juanita, for instance, feels that things would have been different if the son could have been alive since he respected everybody. On the other hand, Joslynn also feels that their boy was the one who had held them together with her boyfriend. Accepting what happened is a way of reorganizing oneself to have better days than gloomy ones.
Tonkin’s Model of Grief
Less significant ways of expressing grief appear to concentrate on avoidance. This could take the form of indulging in substance abuse and deviant activities or isolation, and among other things. Tonkin's theory of grief indicates that after some time, one's grief will stay the same, but the bereaved's life will adapt around it. In explaining the circumstances surrounding the death of a loved one, Joslyn says, “I remember it like it was yesterday.” This means that the experiences are adaptive but sometimes can be sustained by engaging in new relationships and doing things with a positive attitude. There will be a tendency to adjust to new experiences, seek new relationships and seize opportunities for enjoyment. Involvement in such experiences will eventually suppress the grief so that it is no longer dominant.
Again, Palatova and Vasilevich (2020) support that it is significant to sustain some routine and structure even by growing around grief. The routine adopted should promote self-care and consider steps that would connect the bereaved with others. For instance, Juanita established new relationships with family members and her son's friends. Whereas it is evident that things must always change after losing a loved one, it can be instrumental in implementing the motions of doing these things, watching television, and more to be linked to a routine.
People should be able to find acceptance to grief and move on in the physical absence of their loved ones. We must understand how to reorganize our expectations, needs, and roles and be able to reassign them. People should recognize that we cannot replace what has been lost, but find new relationships, such as getting other children and friends. Successful mourning process amounts to an adjustment in the individual following the death of their family member.
Conclusion/ Implications of Social Work Practice
Many strengths and limitations in this research apply to society and our environment today. Through this study, grieving mothers, whether one has lost an older child or a younger one, can be understood and helped overcome their loss amicably. Often, society has neglected and judged such mothers, but through the study, people can become empathetic and advise them on how to respond to loss. For instance, they can be encouraged that it is okay to be angry and depressed, but one has to accept to adjust to the new life without the loved one.
The limitation to the study is the opposing view that some significant number of bereaved parents and people generally may not always mourn as expected. They may not show obvious indications of depression or grief or any of those signs linked to grieving. The dilemma the findings in this research have is the degree to why such a resilient response may also be expressed by a parent grieving the death of their child, like in the case of Joslynn and Juanita.
In building this research, I suggest more scholars could consider the opposing view that I suggested earlier. They may want to explore whether such women do not normally respond to grief but cope differently than expected. It will be fundamental to determine what can be done to prevent women from resorting to deviant salvaging their depression.
Some implications of this research are that health care teams such as myself can learn how to prepare individuals for the losses of their loved ones before they are experienced. Individuals need time to attain a sense of balance between avoiding and confronting real painful experiences. Healthcare teams need to be careful on how they relay and discuss information regarding a loved one, harrowing facts to the affected. In the future, I may want to explore how healthcare practitioners can involve everyone in society besides just the family in helping people cope with the loss of a loved one .
References
Corr, C. A. (2020). Elisabeth Kübler-Ross and the “five stages” model in a sampling of recent American textbooks. OMEGA-Journal of Death and Dying , 82 (2), 294-322.
Corr, C. A. (2019). The 'five stages' in coping with dying and bereavement: strengths, weaknesses, and some alternatives. Mortality , 24 (4), 405-417.
Kübler-Ross, E., & Kessler, D. (2009). The five stages of grief. In Library of Congress Cataloging in Publication Data (Ed.), On grief and grieving (pp. 7-30).
McLean, E., Singer, J., Laurita, E., Kahler, J., Levin, C., & Papa, A. (2021). Perception of grief responses: Are maladaptive grief responses and the stages of grief considered normal?. Death Studies , 1-10.
Palatova, D., & Vasilevich, A. (2020). Mysticism and reality: the stages of grief and loss in JR Kipling's story “They”. In Педагогические мастерские (pp. 84-85).
