"One step forward, one step backward". Subjective experience of grief reactions as time goes by: an interpretative phenomenological analysis. (#76)
Aim: Complicated grief (CG) is currently being considered for inclusion as a disorder in the DSM-5. Questions are raised as to what valid criterion of time is appropriate to diagnose CG. To date, no study explores the perception of bereaved people regarding the evolution of their reactions along time. This study aims at giving new arguments to define grief reactions and CG in people having recently lost their partner.
Methods: 30 bereaved individuals (20 men, mean age=64.2, mean time since death=7months) having lost their spouse to cancer filled the open-ended questions of the ITG (Prigerson et al, 2001) concerning the evolution of their grief reactions during the last 6-9 months. Their responses were coded and subjected to Interpretative Phenomenological Analysis, a standardized method of semantic data analysis (Smith, 2007), by two investigators specialized in end-of-life and bereavement problematics. Data saturation was gained after 30 responses.
Results: We present two inter-related master themes: (1) coping with spousal loss; and (2) facing a new temporality. Within these, the analysis describes 3 profiles of evolution in grief reactions: (1) a perceived processual nature and oscillation, both in well-being and in distress, (2) an increasing suffering after initial relief, (3) a frozen time, associated with greater distress. A period of 6 months is reported as critical in emotional adaptation. Adjustment was reportedly improved by good memories of the deceased, relations with comforting relatives, and by time, while hampered by guilt and intrusive memories of end-of-life and illness.
Conclusions: Our data indicate that most bereaved spouses are able to identify by their own a temporality of grief reactions and the very nature of this display across the months since their loss. The most frequently reported time bracket to experience relief in grief is 6 months, which is consistent with recent propositions concerning the time criterion of complicated grief. Clinical and research implications of the results are discussed.