We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
During the 20th century, dealing with grief through an ongoing involvement with the deceased (such as speaking to their grave) was seen as pathological by Western authors such as Sigmund Freud. Nowadays, we are presented with the opportunity to continue interacting with digital representations of the deceased. As a result, the paper adopts an Ubuntu perspective, i.e., a sub-Saharan African philosophy focussed on community and relationship to provide a toolkit for using this emerging technology. I will argue that the Ubuntu framework I propose contributes to the use of griefbots in two ways. The first is that it shows that it is morally permissible to use griefbots to assuage our grief. The second is that it delineates how we can ethically use the technology. To do so, I split my analysis into four sections. In the first section, I show that meaningful relationships can occur between the bereaved and griefbots. This will be done by exploring the Western theory of continuing bonds proposed by Dennis Klass, Phyllis Silverman and Steven Nickman. In my second, I flesh out my Ubuntu framework according to Thaddeus Metz’s accounts on Ubuntu as a modal-relational theory. In my third section, I apply my Ubuntu framework to the case of Roman Mazurenko. Furthermore, I consider some counterarguments to the Ubuntu framework regarding privacy, commercialisation and people replacement. Finally, I conclude that, despite these limitations, the Ubuntu framework positively contributes to determining whether we should communicate with the dead through griefbots to assuage our grief.
While caring for seriously ill children is a rewarding experience, pediatric healthcare providers may experience sadness and emotional distress when their patient dies. These feelings, particularly when not addressed, can lead to negative health and occupational outcomes. Remembrance practices can provide a safe space for staff to process their grief. This study explored pediatric healthcare providers’ perceptions of an annual Pediatric Remembrance Ceremony (PRC) and a quarterly program, Good Grief and Chocolate at Noon (GGCN), to learn what components of the programs were considered meaningful and the personal impact on those who attended. The programs pivoted to a virtual platform during the COVID-19 pandemic, and the study also assessed providers’ perspectives of attending the programs virtually.
Methods
A 19 multiple choice survey instrument was designed, reviewed, piloted, revised, and re-piloted by an interdisciplinary bereavement committee prior to administration. The survey included 2 open-ended questions, inviting additional insights into personal impact and future directions for remembrance programs. The survey was administered on an encrypted online platform.
Results
Components of the PRC respondents most valued included the opportunity for staff to choose a name of a patient they cared for and to light a candle for that patient as their name is read. Those who participated in GGCN found story sharing helpful, along with having a speaker address a topic around loss and grief during the second half of the session. Both programs provided reflection, solidarity, and memorialization. Most respondents prefer having both in-person and virtual options.
Significance of results
Healthcare providers are affected by the death of the children they care for and value opportunities provided to join colleagues in remembering their patients. The findings underscore the value of remembrance programs in supporting bereaved staff.
Prolonged grief is a chronic and debilitating condition that affects millions of persons worldwide. The aim of this study was to use a qualitative approach to better understand how relatives with prolonged grief disorder perceive what does or not help them and whether they were able to make recommendations.
Methods
Participants were all relatives of deceased patients admitted to 26 palliative care units involved in the FamiLife study; relatives were included if diagnosed with prolonged grief symptoms (i.e., Inventory Complicated Grief (ICG) questionnaire with a cut-off >25), and volunteered to participate. Semi-directed telephone interviews were conducted by psychologists between 6 and 12 months after the patient’s death. The interviews were open-ended, without a pre-established grid, then transcribed and analyzed using a thematic approach.
Results
Overall, 199/608 (32.7%) relatives were diagnosed with prolonged grief symptoms, i.e., with an ICG score >25, and 39/199 (20%) agreed to be interviewed. The analysis yielded 4 themes: (1) the experience of mourning: intense sadness and guilt (reported by 35/39 participants, 90%); (2) aggravating factors (38/39, 97%): feeling unprepared for death and loneliness, presence of interpersonal barriers to adjustment, external elements hindering the mourning progress; (3) facilitating factors (39/39, 100%): having inner strength or forcing oneself to get better, availability of social and emotional support; and (4) the suggestions grieving relatives had to alleviate the grief burden (36/39, 92%). The analysis enabled to identify 5 suggestions for relieving the grief burden: improving communication, developing education about death and grief, maintaining contact, offering psychological support, and choosing the right time for the palliative care team to contact the relatives.
Conclusions
This study revealed how bereaved relatives experienced the help provided by the healthcare teams, their representations, and what could be improved. These findings could be used to design intervention studies.
This chapter analyzes the concept of distress and its application into climate matters. Distress emerges as a broad concept with many connotations. There are so many similarities between climate distress and climate anxiety as broad concepts that they may be used almost interchangeably, but when these phenomena are more carefully scrutinized, a wide vocabulary of various mental states and emotions is required. The history of the usage of climate distress is provided. The role of power dynamics in the usages is explored. Contextual factors are discussed, especially in relation to various cultures and languages. Related dynamics are explored via the example of discourses about climate distress in Finland and Sweden. It is argued that care is needed in analyzing the usage of concepts by various authors. The dual character of climate distress as both a potential mental health issue and fundamentally an adaptive reaction is highlighted.
A life of the mind can be lived only by creatures who know that they have minds. We call these creatures “persons,” and currently, all such persons THAT we know OF are “alive” in the biological sense. But are there, or could there be, either in the future or elsewhere in the universe, creatures with “a life of the mind” that are not “alive” in the sense that we humans usually understand this term today?
This Element explores how theatre responded to the death and loss produced by the COVID-19 pandemic, by innovating forms and spaces designed to support us in grief. It considers how theatre grieved for itself, for the dead, for lost ways of living, while also imagining and enacting new modes of being together. Even as it reckoned with its own demise, theatre endeavoured to collectivise grief by performing a range of functions more commonly associated with funerary, health and social care services, which buckled under restrictions and neglect. These pandemic theatres show how grief cannot only be let mourn over individual losses in private, but how it must also seep into the public sphere to fight to save critical services, institutions, communities and art forms, including theatre itself.
Der 2. Korintherbrief sucht in seinem ersten Hauptteil (1.15–7.16) die Anstöße aufzuarbeiten, die die Gemeinde im Vorfeld des Briefs an der Ausübung des apostolischen Dienstes durch Paulus genommen hat. Wie die Eröffnung dieses Hauptteils in 1.15–2.2 zu verstehen ist, ist aber in der Forschung umstritten.
Der Aufsatz untersucht die literarische Verortung, den formalen Aufbau und die sprachliche Ausgestaltung des Gedankengangs, um dessen Sinngehalt und Funktion zu klären. Es wird aufgezeigt, wie der Abschnitt einerseits die Modifikation der paulinischen Besuchsabsichten, andererseits das Unterlassen eines angekündigten weiteren Aufenthalts verteidigt. Vor dem Horizont einer grundsätzlichen Reflexion der Basis, Eigenart und Aufgabe des paulinischen Apostolats korrigiert er die negative Wahrnehmung des Paulus auf Seiten der Adressaten und zeigt in drei Schritten auf, dass dieser gerade mit seinen die Gemeinde enttäuschenden Entscheidungen den ihm und seiner Mitarbeiterschaft gegebenen apostolischen Auftrag sachgerecht wahrgenommen hat.
Griefbots are chatbots designed to assist individuals in coping with the loss of a loved one by offering a digital replica of the departed. Navigating grief is a deeply transformative and vulnerable journey intricately tied to one's well-being. Do griefbots aid in the grieving process, or do they complicate it? To address these questions, this article blends insights from philosophy and neuroscience to explore the nature of grief as a means to clarify the ethical dimensions surrounding the use of griefbots.
Prolonged grief disorder (PGD) is associated with impairments in cognitive functioning, but the neuropsychological correlates of early grief in older adults are poorly understood. This preliminary study cross-sectionally examined neuropsychological functioning in bereaved adults with high and low grief symptoms and a non-bereaved comparison sample and further explored the relationship between multidomain cognitive measures and grief severity. A total of ninety-three nondemented older adults (high grief: n = 44; low grief: n = 49) within 12 months post-bereavement and non-bereaved comparison participants (n = 43) completed neuropsychological battery including global and multiple domain-specific cognitive functioning. Linear regression models were used to analyze differences in multidomain cognitive measures between the groups and specifically examine the associations between cognitive performance and grief severity in the bereaved, after covariate adjustment, including depressive symptoms. Bereaved older adults with higher grief symptoms performed worse than those with lower symptoms and non-bereaved participants on executive functioning and attention and processing speed measures. In the bereaved, poorer executive functioning, attention and processing speed correlated with higher grief severity. Attention/processing speed–grief severity correlation was seen in those with time since loss ≤ 6 months, but not > 6 months. Intense early grief is characterised by poorer executive functioning, attention, and processing speed, resembling findings in PGD. The putative role of poorer cognitive functioning during early grief on the transition to integrated grief or the development of PGD remains to be elucidated.
The COVID-19 pandemic disrupted many areas of life, including culturally accepted practices at end-of-life care, funeral rites, and access to social, community, and professional support. This survey investigated the mental health outcomes of Australians bereaved during this time to determine how these factors might have impacted bereavement outcomes.
Methods
An online survey indexing pandemic and bereavement experiences, levels of grief, depression, anxiety, and health, work, and social impairment. Latent class analysis (LCA) was used to identify groups of individuals who shared similar symptom patterns. Multinomial regressions identified pandemic-related, loss-related, and sociodemographic correlates of class membership.
Results
1911 Australian adults completed the survey. The LCA identified four classes: low symptoms (46.8%), grief (17.3%), depression/anxiety (17.7%), and grief/depression/anxiety (18.2%). The latter group reported the highest levels of health, work, and social impairment. The death of a child or partner and an inability to care for the deceased due to COVID-19 public health measures were correlated with grief symptoms (with or without depression and anxiety). Preparedness for the person's death and levels of pandemic-related loneliness and social isolation differentiated all four classes. Unemployment was associated with depression/anxiety (with or without grief).
Conclusions
COVID-19 had profound impacts for the way we lived and died, with effects that are likely to ricochet through society into the foreseeable future. These lessons learned must inform policymakers and healthcare professionals to improve bereavement care and ensure preparedness during and following future predicted pandemics to prevent negative impacts.
The age-friendly movement aims to ensure that people can live healthy and meaningful lives as they age. It is committed to activity and inclusion, with policies, services, and structures that enable older adults to remain engaged in activities that they value. We suggest that there is further opportunity for communities to increase inclusion and reduce ageism by improving their “death-friendliness”. A death-friendly approach could lay the groundwork for a community in which people do not fear getting old or alienate those who have. To this end, we consider the merits of the compassionate communities framework which has emerged out of palliative care and critical public health. Compassionate communities focus on end-of-life planning, bereavement support, and improved understandings about aging, dying, death, loss, and care. The age-friendly and compassionate communities initiatives are complementary in their objectives but have not yet converged in practice. We suggest that they should.
This chapter finds that Augustine self-consciously departed from Stoicism and Platonism (while remaining within eudaimonism) in finding that there were other natural objects of human beings’ eros-love besides the highest good. This finding leads to a new explanation of Augustine’s distinction between use and enjoyment and to a new explanation of his view that grief would be found not only in the lives of the vicious but in the lives of the virtuous as well.
Women who experience pregnancy loss are at increased risk of psychological distress, including post-traumatic stress disorder (PTSD) and depression. Despite the substantial evidence base for trauma-focused cognitive behavioural therapy (CBT) for PTSD, there is limited research on this specific type of trauma, as well as a dearth of research exploring treatment for co-morbid PTSD and depression. This study used a single case experimental design to assess the efficacy of sequential CBT for treating PTSD and depression in a primary care setting in the United Kingdom. Results demonstrate a reduction in scores on the PCL-5 following trauma-focused CBT, but not a clinically significant reduction in depression scores. This write-up reflects on the effectiveness of sequential treatment and suggests alternative approaches. Future directions for research are also given.
Dedication: The authors dedicate this paper to all parents who have experienced pregnancy or baby loss.
Key learning aims
(1) To gain an understanding of some of the challenges in delivering CBT for trauma related to pregnancy loss.
(2) To reflect on treatment of co-morbid PTSD and depression through flexible use of evidence-based treatment, and consider alternative approaches to sequential treatment.
(3) To consider the impact of grief in formulation and treatment.
Diagnosing mental health challenges in bereavement is controversial; however, regardless of one’s position on this matter, assessments of bereaved individuals continue to occur in clinical and research contexts. It is critical for evaluations to account for contextual factors that are unique to bereavement. This paper summarizes considerations for diagnosing depression in bereaved individuals, focusing on use of the six-item Hamilton Depression Rating Scale (HAM-D6).
Methods
Following a literature review of the Hamilton Depression Rating Scale (HAM-D) and various versions, we summarized decision rules we used in scoring the HAM-D6 in a study of parents bereaved by cancer. We expanded on existing scoring guidelines for each of the HAM-D6 items, including depressed mood, work and activities, general somatic symptoms, guilt, psychic anxiety, and psychomotor retardation, and illustrated clinical distinctions and probes for assessors to consider through case examples from our research with bereaved parents.
Results
Considerations for assessing depressive symptoms and behavior changes in the context of bereavement were summarized. Symptoms that may be diagnostic of depression in some populations may reflect other factors in the bereaved, such as a change in priorities, social expectations surrounding grief, or avoidance of grief activators. Nuanced factors are important for assessors to consider when administering the HAM-D6 to bereaved individuals.
Significance of results
Our sharing of these considerations is not intended to promote diagnosis of depression in bereavement but to highlight the unique contextual factors that distinguish symptoms of depression from common experiences of grievers when applying an assessment tool such as the HAM-D6. While validated measures can be constraining, they can have clinical utility; they may increase standardization in research, help clinicians communicate with each other, advance the field more generally to understand the varying struggles bereaved individuals experience, and systemically facilitate access to services via managed care.
A large number of artists with Jewish American backgrounds have been deeply influential to the development of comics (notably of the superhero variety), social and political cartoons, and graphic novels. This chapter examines the recurrence of trauma and grief in the works of several Jewish authors, both as core motifs and as narrative/visual devices. It follows the career of graphic pioneer Will Eisner, who moved from realistically drawn crime and adventure fiction (with The Spirit, an early example of long-form comic appealing to adult readers) to more personal themes such as family history and loss in A Contract with God, the first US publication self-labeled as a “graphic novel.” Art Spiegelman’s work (Maus, 1986 and 1991; In the Shadow of No Towers, 2004) confronts similar themes grounded in trauma, suffering, and transgenerational testimony, where the artist’s memorialization of the past and experience with the present construct a graphic negotiation with grief. The chapter finds echoes of this approach in more recent works from Jewish graphic novelists such as Roz Chast and Ken Krimstein.
This chapter analyses how Pliny absorbs the consolatory philosophy of Seneca. It focuses on his intertextual use of two of Seneca’s epistles (98 and 99) that treat death, arguing that Ep. 98 looms behind Corellius Rufus’ decision to die (1.12), and that Regulus’ display of grief following the death of his son (4.2) echoes Seneca’s condemnation of improper mourning practice in Ep. 99. The allusions reveal Pliny’s opportunistic engagement with Seneca’s philosophical consideration of grief, agreeing and disagreeing with his epistolary predecessor depending upon the specific circumstances of the bereavement. Both his absorption and rejection of Seneca’s arguments show that he could engage and apply philosophical concepts to express his own grief or criticise other’s.
When, in the wake of the September 11 terrorist attacks on the World Trade Center in New York more than two decades ago, the late Queen Elizabeth II expressed her sentiments with the words: ‘Grief is the price we pay for love’, she was making a reference to British psychiatrist Dr Colin Murray Parkes's book Bereavement: Studies of Grief in Adult Life. In the book, Dr Parkes states an obvious, albeit often ignored, fact that the pain of grief is just as much part of life as the joy of love. Following the death of the Queen in September 2022, Joe Biden, the current president of the US, used the same quote as an opportunity to express his own personal sadness about her passing. It was also an opportunity to participate in public grief about the loss of a popular leader, and of innocent lives. It is not uncommon for leaders, religious ones including, to speak of love, especially during such poignant moments. But it is somewhat less common for public figures to bring to our attention the close connection between grief and love. Even when they do, grief is commonly seen in a negative light. Philosophers provide another example of what is, I shall argue, a mischaracterization of grief.
This essay focusses on Sebald’s grandfather Josef Egelhofer. Sebald spent the first years of his life largely in the loving care of Josef, who became far more of a father figure to him than Sebald’s actual father Georg, who was mostly absent during the formative early years of his son’s life. Egelhofer made a profound impression on young Winfried and formed a close bond with his grandson that ended with his traumatic death in April 1956. First, the essay details the importance of this relationship and discusses Egelhofers role as a key figure in Sebald’s life as a teacher of the natural world. It then explores the literary manifestation of Egelhofer in Sebald’s work by way of literary figures that are sometimes directly, sometimes indirectly connected with him: the writer Robert Walser, the naturalist Alphonso Fitzpatrick, the mountain guide Johannes Naegeli, the communist leader Rudolf Egelhofer. Finally, the essay examines the ‘cult of remembrance’ Sebald commemorates in order to creatively confront his burden of grief. It is shown that his grandfather’s death is the original trauma and primal pain to which the mourning work conducted in his literary works must be traced back.
This case study recounts an application of Ehlers and Clark’s (2000) cognitive model of post-traumatic stress disorder (PTSD) to post-intensive care unit (post-ICU) PTSD. An AB single case design was implemented. The referred patient, Rosalind (pseudonym), completed several psychometric measures prior to the commencement of therapy (establishing a baseline), as well as during and at the end of therapy. Idiosyncratic measures were also implemented to capture changes during specific phases of treatment. The importance of the therapeutic alliance, particularly in engendering a sense of safety, was highlighted. Findings support the use of cognitive therapy for PTSD (CT-PTSD) with an older adult, in the context of a coronavirus infectious disease (COVID-19)-related ICU admission. This case is also illustrative of the effectiveness of implementing CT-PTSD in the context of co–morbid difficulties and diagnoses of delirium, depression, and complicated grief.
Key learning aims
(1) To recognise the therapeutic value of CT-PTSD in addressing PTSD following a COVID-19 admission, in the context of complicated grief and delirium.
(2) To consider the importance of a strong therapeutic alliance when undertaking CT–PTSD.
(3) To understand the intersection of complicated grief and delirium in the context of ICU trauma.
(4) To consider the challenges in working with PTSD, whereby the target trauma (COVID–19 ICU admission) is linked with ongoing uncertainty and continuing indeterminate threat.
On 19 December 2016, a terrorist drove a lorry into the Christmas Market on Breitscheidplatz in Berlin. Twelve people were killed, and many were seriously injured. The shock soon gave way to grief. A service was held to commemorate the victims, and one year later, a monument in their memory was unveiled. This chapter examines the two purposes of public grief: to say goodbye to the victims and to remember them and why they died. After the First World War, family members built memorials for fallen soldiers to document their personal loss and to admonish society to act as the dead would have wished. With the Day of National Mourning, introduced in 1925, this commemoration became official. The National Socialists reinvented it as a heroes’ memorial day. Centrally governed countries have the power to prescribe a period of national mourning, as the GDR did after Stalin’s death in 1953, when public life came to a standstill for several days. The Federal Republic has nothing of the kind. Yet numerous people expressed their sorrow and sympathy in the wake of the terrorist attack in Berlin.