Between loss and restoration: The role of liminality in advancing theories of grief and bereavement

Katherine Bristowe; Liadh Timmins; Alexandra Pitman; Debbie Braybrook; Steve Marshall; Katherine Johnson; Michael King; Anna Roach; Deokhee Yi; Kathryn Almack; Elizabeth Day; Paul Clift; Ruth Rose; Richard Harding

doi:10.1016/j.socscimed.2024.116616

Between loss and restoration: The role of liminality in advancing theories of grief and bereavement

Katherine Bristowe, Liadh Timmins, Alexandra Pitman, Debbie Braybrook, Steve Marshall, Katherine Johnson, Michael King, Anna Roach, Deokhee Yi, Kathryn Almack, Elizabeth Day, Paul Clift, Ruth Rose, Richard Harding

Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation

1Department of Hepatology, Imperial College London, London, UK. 2Institute of Liver Studies at King's College School of Medicine at King's College Hospital, London, UK. 3Institute of Human Health and Performance, University College London, London, UK. 4Department of Asthma Allergy and Lung Biology, King's College London, London, UK. 5Division of Critical Care Medicine, University of Alberta, Edmonton, Canada.
Swansea University Medical School The Grove, Swansea University, Singleton Park Swansea United Kingdom
Univ London, Birkbeck University London, University College London, University of London Royal Veterinary College, University of London, St Georges University London, Imperial College London, Kings College London, Royal Holloway University London, Queen Mary University London, Div Populat Hlth Sci & Educ
RMIT University
Great Ormond Street Institute of Child Health
University of Hertfordshire and Hertfordshire Partnership University NHS Foundation Trust
Patient and Public Involvement Representative

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

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Abstract

A recent national survey of bereaved partners found high levels of complicated grief and psychological distress, with evidence that loneliness and isolation may contribute to these outcomes. However, the mechanisms of action for this have not been explored. To advance grief theory this paper reports analysis of the survey free-text data to examine the relationship between social support and emotional responses to bereavement. Individuals bereaved of a civil partner or spouse 6-10 months previously were identified through death registration data. 569/1945 (29 %) completed surveys were received. Of those, 311 participants (55 %) provided responses to two free-text questions which asked about their 'feelings since the death of their partner or spouse', and 'about the support around' them. Data were analysed using corpus-assisted discourse analysis and the discourse dynamics approach for figurative language. Participants described diverse emotional responses to the bereavement (e.g. sadness, anger, denial, acceptance), and the value of formal and informal bereavement support. Although many of the experiences described are accounted for in existing grief theory, some participants described a liminal experience not recognised within these theories. They felt trapped, unable to engage with loss or restoration, and unable to move forward as their planned future no longer existed. They sought out 'communitas' (solidarity in experiences), but often found support from their social networks had diminished. Metaphors were used to describe this liminality, with partner grief expressed as a dark agentic force, a monster, an abyss, and as water. The findings of this study offer original insights into experiences and trajectories of bereavement, and our understandings of prolonged or complicated grief. A novel model 'Between Loss and Restoration' is presented to include these experiences. Recognition of the place for liminality within the spectrum of grief experiences could enhance grief literacy and improve formal and informal bereavement support provision.

Original language	English
Article number	116616
Journal	Social Science & Medicine
Volume	344
Early online date	23 Jan 2024
DOIs	https://doi.org/10.1016/j.socscimed.2024.116616
Publication status	Published - Mar 2024

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10.1016/j.socscimed.2024.116616Licence: CC BY

Between loss and restoration_BRISTOWE_Accepted18January2024_GREEN AAM (CC BY)Accepted author manuscript, 626 KBLicence: CC BY

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Bristowe, K., Timmins, L., Pitman, A., Braybrook, D., Marshall, S., Johnson, K., King, M., Roach, A., Yi, D., Almack, K., Day, E., Clift, P., Rose, R., & Harding, R. (2024). Between loss and restoration: The role of liminality in advancing theories of grief and bereavement. Social Science & Medicine, 344, Article 116616. https://doi.org/10.1016/j.socscimed.2024.116616

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title = "Between loss and restoration: The role of liminality in advancing theories of grief and bereavement",

abstract = "A recent national survey of bereaved partners found high levels of complicated grief and psychological distress, with evidence that loneliness and isolation may contribute to these outcomes. However, the mechanisms of action for this have not been explored. To advance grief theory this paper reports analysis of the survey free-text data to examine the relationship between social support and emotional responses to bereavement. Individuals bereaved of a civil partner or spouse 6-10 months previously were identified through death registration data. 569/1945 (29 %) completed surveys were received. Of those, 311 participants (55 %) provided responses to two free-text questions which asked about their 'feelings since the death of their partner or spouse', and 'about the support around' them. Data were analysed using corpus-assisted discourse analysis and the discourse dynamics approach for figurative language. Participants described diverse emotional responses to the bereavement (e.g. sadness, anger, denial, acceptance), and the value of formal and informal bereavement support. Although many of the experiences described are accounted for in existing grief theory, some participants described a liminal experience not recognised within these theories. They felt trapped, unable to engage with loss or restoration, and unable to move forward as their planned future no longer existed. They sought out 'communitas' (solidarity in experiences), but often found support from their social networks had diminished. Metaphors were used to describe this liminality, with partner grief expressed as a dark agentic force, a monster, an abyss, and as water. The findings of this study offer original insights into experiences and trajectories of bereavement, and our understandings of prolonged or complicated grief. A novel model 'Between Loss and Restoration' is presented to include these experiences. Recognition of the place for liminality within the spectrum of grief experiences could enhance grief literacy and improve formal and informal bereavement support provision.",

author = "Katherine Bristowe and Liadh Timmins and Alexandra Pitman and Debbie Braybrook and Steve Marshall and Katherine Johnson and Michael King and Anna Roach and Deokhee Yi and Kathryn Almack and Elizabeth Day and Paul Clift and Ruth Rose and Richard Harding",

note = "Funding Information: This work was supported by the Marie Curie Research Grants Scheme: grant reference - MCRGS–07–16–45 . Publisher Copyright: {\textcopyright} 2024 The Authors",

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doi = "10.1016/j.socscimed.2024.116616",

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T2 - The role of liminality in advancing theories of grief and bereavement

AU - Bristowe, Katherine

AU - Timmins, Liadh

AU - Pitman, Alexandra

AU - Braybrook, Debbie

AU - Marshall, Steve

AU - Johnson, Katherine

AU - King, Michael

AU - Roach, Anna

AU - Yi, Deokhee

AU - Almack, Kathryn

AU - Day, Elizabeth

AU - Clift, Paul

AU - Rose, Ruth

AU - Harding, Richard

PY - 2024/3

Y1 - 2024/3

N2 - A recent national survey of bereaved partners found high levels of complicated grief and psychological distress, with evidence that loneliness and isolation may contribute to these outcomes. However, the mechanisms of action for this have not been explored. To advance grief theory this paper reports analysis of the survey free-text data to examine the relationship between social support and emotional responses to bereavement. Individuals bereaved of a civil partner or spouse 6-10 months previously were identified through death registration data. 569/1945 (29 %) completed surveys were received. Of those, 311 participants (55 %) provided responses to two free-text questions which asked about their 'feelings since the death of their partner or spouse', and 'about the support around' them. Data were analysed using corpus-assisted discourse analysis and the discourse dynamics approach for figurative language. Participants described diverse emotional responses to the bereavement (e.g. sadness, anger, denial, acceptance), and the value of formal and informal bereavement support. Although many of the experiences described are accounted for in existing grief theory, some participants described a liminal experience not recognised within these theories. They felt trapped, unable to engage with loss or restoration, and unable to move forward as their planned future no longer existed. They sought out 'communitas' (solidarity in experiences), but often found support from their social networks had diminished. Metaphors were used to describe this liminality, with partner grief expressed as a dark agentic force, a monster, an abyss, and as water. The findings of this study offer original insights into experiences and trajectories of bereavement, and our understandings of prolonged or complicated grief. A novel model 'Between Loss and Restoration' is presented to include these experiences. Recognition of the place for liminality within the spectrum of grief experiences could enhance grief literacy and improve formal and informal bereavement support provision.

AB - A recent national survey of bereaved partners found high levels of complicated grief and psychological distress, with evidence that loneliness and isolation may contribute to these outcomes. However, the mechanisms of action for this have not been explored. To advance grief theory this paper reports analysis of the survey free-text data to examine the relationship between social support and emotional responses to bereavement. Individuals bereaved of a civil partner or spouse 6-10 months previously were identified through death registration data. 569/1945 (29 %) completed surveys were received. Of those, 311 participants (55 %) provided responses to two free-text questions which asked about their 'feelings since the death of their partner or spouse', and 'about the support around' them. Data were analysed using corpus-assisted discourse analysis and the discourse dynamics approach for figurative language. Participants described diverse emotional responses to the bereavement (e.g. sadness, anger, denial, acceptance), and the value of formal and informal bereavement support. Although many of the experiences described are accounted for in existing grief theory, some participants described a liminal experience not recognised within these theories. They felt trapped, unable to engage with loss or restoration, and unable to move forward as their planned future no longer existed. They sought out 'communitas' (solidarity in experiences), but often found support from their social networks had diminished. Metaphors were used to describe this liminality, with partner grief expressed as a dark agentic force, a monster, an abyss, and as water. The findings of this study offer original insights into experiences and trajectories of bereavement, and our understandings of prolonged or complicated grief. A novel model 'Between Loss and Restoration' is presented to include these experiences. Recognition of the place for liminality within the spectrum of grief experiences could enhance grief literacy and improve formal and informal bereavement support provision.

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VL - 344

JO - Social Science & Medicine

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M1 - 116616

ER -

Between loss and restoration: The role of liminality in advancing theories of grief and bereavement

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