Post-traumatic growth following the death of a parent: Does one auto-ethnographic account make a summer?

 

Komal Qasim, MSc

MSc, PhD Candidate, University of Bolton

Komal.qasim@live.com

Professor Jerome Carson

Professor of Psychology, University of Bolton

Abstract

Parental death in adulthood is for many a life-changing event (Pearce & Komaromy, 2021). In recent years, the work of Tedeschi and Calhoun (2004), has focused on post-traumatic growth following trauma. Qasim and Carson, (2020), challenged the inevitability of post-traumatic growth following the trauma of bereavement. This paper considers the loss of her father by the first author, from the perspective of the Tedeschi and Calhoun Model. This looks for growth in five areas; relating to others, new possibilities, personal strength, spiritual change and appreciation of life. This auto-ethnographic account follows a rich tradition of other recent autobiographical accounts in the bereavement field (Mayer & Mayer, 2020; Coles, 2021; Moore, 2021).Bottom of Form

Practice points

1.     Auto-ethnographic approaches to bereavement capture the intensity of the grief experience and can shed light on theory.

2.     The paper examined one personÕs experience in the light of the theory of post-traumatic growth, but found evidence only of intellectual growth.

3.     The case study highlights the importance of cultural factors in grief for practitioners.

Keywords

parental death, post-traumatic growth, auto-ethnography, grief

 

Introduction

The emergence of the field called positive psychology was announced by a special issue of the journal American Psychologist in 2000 (Seligman & Csikszentmihalyi, 2000). Seligman and his colleagues brought together several existing fields in psychology, such as flow, mindfulness, forgiveness, gratitude, hope, happiness and optimism. Rather than focusing on what was wrong with people, as he claimed clinical psychology had done (Seligman, 2018), he suggested a new approach of which the main goal was to increase flourishing (Seligman, 2011). The theory of post-traumatic growth pre-dated the more recent development of positive psychology, but the theory has been enthusiastically embraced by most positive psychologists and is now a cornerstone of therapeutic approaches (Rashid & Seligman, 2018; Carr, 2020). In brief, post-traumatic growth refers to Ōpsychological change experienced as a result of the struggle with highly challenging life circumstancesÕ, (Tedeschi & Calhoun, 2004). While many clinicians have been concerned about the development of post-traumatic stress disorder after natural disasters, terrorist attacks and other types of trauma, some researchers have suggested that psychological growth can take place after trauma (Joseph, 2012). The key elements of post-traumatic growth according to Tedeschi and Calhoun are recognising personal strengths, improving relationships with other people, having a greater appreciation of life, a deepening of spirituality and increased openness to the new possibilities in life (Calhoun & Tedeschi, 1999). Some 30% to 70% of survivors of trauma report positive changes following the traumatic event (Linley & Joseph, 2004). But does post-traumatic growth follow the death of a parent in adulthood? In an earlier paper, the authors Qasim and Carson (2020) presented data from an empirical study of 100 bereaved adults who lost their parents in adulthood. There was little evidence for post-traumatic growth in this group. In this paper, we present an auto-ethnographic account, which also challenges the theory of post-traumatic growth after bereavement.

Methods

Auto-ethnography is becoming a more recognised methodology in the social sciences. According to Bochner (1997) there are five central elements in auto-ethnography. The first of these is that authors write in the first person, breaking the normal separation between researcher and participant. Second, the focus of the account tends to be on a single case. Third, the approach is more akin to storytelling than traditional objective social science discourse. Fourth, the author will generally share some personal details, normally taboo in conventional writing. Lastly, the narrative takes place over time. The second author has used this methodology in a number of recent papers. One compared his psychiatric career with the psychiatric journey of a service user (Voyce & Carson, 2020). A second contrasted the recovery of Andrew Voyce with the life of the musician Syd Barrett, the creative genius behind the band Pink Floyd (Hopkinson, Voyce & Carson, 2021). A third looked at the reasons for studying psychology (Hurst & Carson, 2021).

The authors felt the auto-ethnographic method would be suitable for telling KomalÕs personal story of bereavement and then trying to link her experiences to the post-traumatic growth model developed by Tedeschi and Calhoun. Hence the results section is in two parts. First, Komal will tell her personal story of her bereavement following the sudden loss of her father. Komal wrote this over a period of weeks and Jerome edited it. Second, this paper will then look at the items from the post-traumatic growth inventory, for the five areas that Tedeschi and Calhoun (Calhoun and Tedeschi, 1999) say are central to the concept of post-traumatic growth. Komal will describe her personal situation in the light of the loss of her father and reflect on to what extent she feels that post-traumatic growth occurred in each of these areas. The areas are relating to others (7 items), new possibilities (5 items), personal strength (4 items), spiritual change (2 items) and appreciation of life (3 items). We hope the reader will forgive the inevitable Ōbumpiness in styleÕ between the personal narrative and the research literature.

Results

Part 1: KomalÕs story

My name is Komal. I am the eldest of four siblings and my parentsÕ only daughter. I did my MSc and then MPhil in human development and family studies at the University of the Punjab, Lahore, Pakistan. I got married in October 2013 and moved to the United Kingdom with my husband. The passion for research persuaded me to continue with my studies, hence I did an MSc in positive psychology at the University of Bolton in 2017–2019. I lost my beloved father during my studies in 2018. It has been more than three years now since I lost my father, but the emptiness and the void are still there. No amount of work, studies, research, people and friends can even begin to fill that gap. Being the eldest and the only daughter, the bond I shared with my father cannot adequately be described in words.

About three years following my fatherÕs death, I cried my eyes out reading the auto-ethnographies of Kimmel (2020), LeBlanc (2017) and Phipps, (2018) which made me think that the experience of losing the most beloved person in your life can be the same and yet very unique for each individual. The classic five stages of the Kubler Ross (1970) grief theory are well known, but since no two people are the same, the intensity, strength and order in which each stage might be experienced by the griever are different. Knopke (2018) commented that by narrating the personal story of our own bereavement, we reflect on the social and cultural implications of living with the dead. Therefore I wanted to reflect on my three-year journey following the loss of my father, in the light of Tedeschi and CalhounÕs theory of post-traumatic growth. But before that, I want to narrate and celebrate the mystic, beyond the world, ethereal bond which I had with my father. Just typing these words is literally making me tremble with the sheer ruthlessness of the fact that he is gone. There is a theory that you know you have healed when thinking about that trauma does not produce the same physiological responses in your body that happened when the trauma actually occurred. Yet I am shaking as if it just happened yesterday. The words I have obsessively repeated the most after he was gone were, ŌItÕs impossibleÕ. LeBlanc (2017), characterised mourning as an ongoing process of highs and lows, and I share a similar perspective. Having said that, it seems like, three years down the line, I am still stuck where it all began. His death was not an ending, it was the beginning of a million questions, to which I have no answer to date. The first questions being, ŌWhy did he have to go so soon, just 56 years of age, is so unfair!Õ ŌWhy is life so unfair at times?Õ These questions are rhetorical. Secklin (2001), commented that traumas are multifaceted layers of personal, social, and cultural values and the traumatic event itself is just the beginning of the story.

A week before my 30th birthday, I met my father and he said, ŌI will surprise you on your 30th birthday. There is a big gift I am going to give you this time.Õ It is noteworthy to mention here that I live in the UK and my father lived in Pakistan and I was visiting him when this conversation took place. I spent about three weeks in Pakistan and returned to the UK only to find out six days later, that my father had passed away. I remember the exact time (9.30 pm), the day (Saturday), and the date (24 February 2018) when my brother called my husband to give him this catastrophic news. He was perfectly fine just six days before, so the news blew me away. He was only 56 years old with no underlying health conditions, but I was told he had a sudden cardiac arrest and in a matter of seconds he was gone. If I have to define my feelings in one word, then the word has to be UNEARTHLY. I believe that it is the normal reaction to any grief situation. Research proclaims that the death of a loved one, especially sudden and unexpected deaths, provoke a stronger emotional and physiological response in the grieving individual, as there is naturally less time to process the news and adapt to it (Applebaum & Burns, 1991; Lundin, 1984). I donÕt remember crying much that night. Tears were sliding down my face, but I basically felt emotionless and cold. The only thing that I felt at that time was, ŌWhat is going to happen to my mother now?Õ My husband and I packed our essentials and took the first available flight and went back to Pakistan. I donÕt remember much of the 16 hours travel back home, as I took relaxants and a few sleeping pills. Trauma has a way of etching every minute detail on oneÕs brain (Borawski, 2007) but I guess I was brain-dead at that time. I was eerily calm. Before leaving, there were a few doctorÕs appointments to attend to and a few university meetings and classes to be cancelled. I have no idea how I managed to remember and cancel frivolous appointments like the hairdressers, as if nothing had happened.

We reached Pakistan at 2.30 in the morning of 26 February (my birthday). I was calm when I reached my fatherÕs home. My close relatives were already there. My mother and my brothers looked at me and they were expecting a big, massive reaction, as they knew the intensity of the relationship I had with my father. I was emotionless. It was five in the morning and his body was in cold storage as they were just waiting for me to come and say goodbye – otherwise, in Islamic tradition the deceased is buried the same day if possible. He was to be buried at 10am the same morning. Around 8am, they brought his body all wrapped in white cloth (that is how Muslim burials are meant to be). I remember screaming hysterically when I saw his lifeless body and the first emotions I felt were anger and rage. Anger towards him. Did he have an epiphany that he was going to leave me? What was the surprise that he mentioned a few days earlier that he was going to give me on my birthday? It all seemed like a horrible prank, surreal and nightmarish. That man had so much love, generosity, affection, kindness and warmth to give to practically any and every person, whoever met him even once, and seeing him lying calmly with an unblemished smile on his faceÉ. I hit the zenith of pain and fell hard into the bottomless pit of nothingness and screamed involuntarily. I wanted to burn down the whole world, push away every person who came near me to console me. I wanted the universe to explode and collapse, I wanted everyone to wail and scream, I resisted any human touch, I felt obliterated. Was the surprise on my 30th birthday his funeral? And if it was his funeral, then it had to be the most ruthless gift of all. Or was it the fact that his Ōabsolute absenceÕ on my birthday will mark a Ōforever and eternal presenceÕ on each birthday every year? To date, I have no answer to this question. I saw him. I felt him. I didnÕt touch him though. His lifeless body with an obvious smile on his face was bizarre. Why was he smiling? All the grief theories I had read all my life were just coming true now. Betrayal was the first thing I felt. I know it wasnÕt his choice to abandon me, but I felt rage, indignation and betrayal. I lost my trust in him and for the first time, I didnÕt feel loved. I felt as if God had cheated me and it was just so unfair.

I remember myself staring at him, not really crying. My mind shut down and my heart was as if physically seized and squashed. In the 30 years of my life, he was the one man who had loved me the most and accepted me exactly for what I was. The one man who had believed in me the most. The only human being who would actually give away his own life just to see me happy, and I could not imagine another person I could have loved more in my life than my own father. I had given so much of myself to him that I felt there was nothing much left for anyone else. All I had left to give to others was perhaps the sense of duty and the roles I was bound to perform in everyday life.

At 10am that morning they took the body away to be buried. In Islamic tradition women are not allowed to go to see the burial. They took him away and thatÕs when it hit me hard that this is all real. This is it. He is not coming back and I am not going to see him again. This is it. It was the end of time for me. I screamed without tears. That pain cannot be described in words. Only the person who has experienced it can fathom what I am trying to say. Numb, befuddled, disorientated, passive. The dictionary doesnÕt have enough adjectives to describe the agony of this loss. It leaves you simply speechless.

Part 2: Relating KomalÕs story to the post-traumatic growth model

Relating to others

Items

1.     I more clearly see that I can count on people in times of trouble.

2.     I have a greater sense of closeness with others.

3.     I am more willing to express my emotions.

4.     I have more compassion for others.

5.     I put more effort into my relationships.

6.     I learned a great deal about how wonderful people are.

7.     I better accept needing others.

It dawned upon me that IÕm the eldest one of my siblings and the only daughter and now it is up to me to emotionally support my siblings and my mother. According to Parkes (1971) all family members are affected by major transitions and may require new adjustments and reorganisation of the structure of the family unit. What will happen now and how will we spend the rest of our lives without him? My husband was perhaps the only pillar for all of us to rely on. But going forward, I donÕt think I learnt to rely much on anyone. It was my pain and I had to deal with it myself. Feeling lonely and thinking that there is a lack of social support are common, especially during the early years of bereavement (Kimmel, 2020). His absence was so daunting that perhaps there was no room for anyone else to fit in. For the next month, I stayed with my mother and siblings, acting strong, consoling everyone, hardly shedding a tear, being super active and super aware of the circumstances. The only emotion perhaps I was left with was compassion for my mother. I swiftly paused the part of my brain that wanted to cry, scream, grieve, mourn and accept the reality. I thought IÕd have plenty of time to cry when I headed back to the UK. I used to be sick every morning, stopped eating, but refused to cry because I felt that if I started crying I would collapse. Also, I just didnÕt want people to feel sorry for me. I stayed in Pakistan for about a month and a half. I remember the day of my departure. It was like half of my body and all of my soul had been buried six feet down the ground and only a few little pieces in the form of my mother and siblings were the ones I was leaving behind.

I couldnÕt cry at all when I came back. My husband tried to give as much support as he could, but I didnÕt really know what I wanted. Every morning, the exact same time when I used to call my dad, my body used to ache physically, like a drug addict having withdrawal symptoms. I had a few of his belongings that smelled so much of him and I would hold them for hours and stare at them lifelessly. Friends and family across the UK would come to pay condolences and I just behaved like a robot, not knowing what to say, not knowing what to do. I straightaway joined the university again to finish my studies. For a very weird reason I felt that perhaps I had more emotional support available in the university than at home, because I would sit in front of my teachers, cry a river and thatÕs all. No expectations and no strings attached. They all suggested that I give myself a break and apply for Ōmitigating circumstancesÕ (an academic delay in submitting assignments) and not to worry about finishing my projects. But I thought that forcing myself to work might be a good escape from the harsh reality of bereavement which I did not want to face. It did not help though. All I could think about was my mother. I used to call her at least three times a day to check on her. There was little I could offer her in a practical sense, with me being thousands of miles away from her, but I was surviving being worlds apart from my dad. The urge to speak about the trauma is very common among survivors. They are said to become more sensitive and empathetic towards others (Tedeschi & Calhoun, 2004). But I was so full of rage. Even if I desperately wanted to reach out to others, I just could not. For others I had lost a father, but only I knew what I had lost! I had literally lost my reason. Reason for everything! When anything exciting and new happens in my life, the first person I want to share the news is with him and every time the realisation comes that I cannot share it with him is as tormenting as ever.

New possibilities

Items

1.     I developed new interests.

2.     I established a new path for my life.

3.     I am able to do better things with my life.

4.     New opportunities are available which wouldnÕt have been otherwise.

5.     I am more likely to try to change things which need changing.

I donÕt know whether I learned anything new or anything or anyone changed around me. As Abrams (2000) illustrated, death doesnÕt really make anyone behave like an angel overnight, neither does it tidy things up. It just makes people behave more like themselves than usual. Hence nothing new emerged in my life out of the blue. Everything remained the same, except the fact that I started feeling alienated from everything and everyone. I felt disoriented, directionless and clueless. My ultimate mentor had gone away, closing all doors for any new possibilities for me. I know I am thinking too much inside the box, but I just donÕt have the energy to redeem myself. Like I said, ŌThe show must go on!Õ ChowÕs (2010) claim that for some individuals death of a loved one implies loss of goals and future is certainly true for me.

Personal strength

Items

1.     I have a greater feeling of self-reliance.

2.     I know better that I can handle difficulties.

3.     I am better able to accept the way things work out.

4.     I discovered that I am stronger than I thought I was.

I went into therapy for a year. I read every bit of bereavement literature I could possibly read. I did my MasterÕs thesis on post-traumatic growth following parental death in adults. I went to the Imam. I went to the priest. I went to spiritualists. I travelled for a year. I self-pitied. I found that there is no formula to get over the pain, except to develop a sense of peace to learn to live with the only thing I had left of him, which was the immense mind-numbing pain. I just had to fall in love with the pain of losing him. I had to accept that although he was not eternal the pain of losing him would stay with me as long as I lived. He was larger than life for me to deserve to be got over. And no, IÕm not a sadist. I am just utterly loyal. Loyal to him, loyal to his memories, loyal to the love and the pain he bestowed upon me.

I developed two personalities perhaps. One that would go on in day-to-day life, socialising, working, smiling, and just making sure that the show must go on and the other me, that cocooned herself more and more and delved into making peace with the pain and actually living with it, by befriending it. According to Taku et al (2008) and Tedeschi and Calhoun, (1996), personal strengths in post-traumatic growth are manifested in the individualÕs ability to be more self-reliant, self-confident and assertive in handling difficult situations.

ŌHis one call every morning, used to determine how the rest of my day would be. Just by the way he would say ŌHelloÕ to me, the tone of his voice, the energy, the vigour, would just pour into me, like water into an empty vessel, and IÕd spend the rest of my day based on the energy I had taken out of that one phone call each day. The thought of spending the rest of my life without that ultimate source of energy was and still is so tormenting, but at the same time it made me realise the amount of strength I had that I never knew existed in me.

Spiritual change

Items

1.     I have a better understanding of spiritual matters.

2.     I have a stronger religious faith.

Do I have a stronger religious faith now? Do I have a better understanding of death, afterlife and spiritual matters? My first introduction to Allah was through my father. Half of my life I prayed to God, not because it would make God happy or myself peaceful. I only used to pray because it would make my dad happy. One of my friends who happens to be a priest described the whole thing very simply to me by saying that the only human being you loved, perhaps more than you even loved God, has been taken away by God himself, so there is nothing left between you and God. Now itÕs up to you, which road you follow. The road to redeem and resurrect yourself is to find your own God, not to keep sinking into the darkness of self-pity. People with stronger spiritual beliefs have the tenacity to resolve their grief more rapidly after the death of a close person than people with no spiritual beliefs (Walsh et al, 2002). I believed I was a spiritually strong person, but after this loss, I discovered I was not. I learnt that time doesnÕt heal, you just adapt! I remember crying myself to sleep for days and months following his death. Trying to make sense of what had happened and why. Every religion believes that GodÕs wisdom lies behind everything He does. That may not be comprehensible to us. I have thus far failed to comprehend His wisdom in taking away the most precious person in my life.

Appreciation of life

Items

1.     I changed my priorities about what is important in life.

2.     I have a greater appreciation for the value of my own life.

3.     I can better appreciate each day.

With him gone so suddenly it just made me realise how unpredictable, unreliable and short this life is. His absence did not help me appreciate what was left of my life at all. Rather it changed my entire being, my soul, my chemistry and my philosophy of life. There was never any increased sense of appreciation towards life as Taku et al, (2008), Tedeschi and Calhoun (1996), predicted to be the outcome of post-traumatic growth.

You give to others what you have. What I had was what he gave to me. Like a moon has no light of its own and is given light by the sun, so I had nothing of my own. With my sun gone, there was a permanent eclipse in my life. This all may sound very pessimistic and dark to some and I am open to the fact that I might not feel the same way 10 or 20 years down the line, but every word is a true manifestation of a daughter who lost her idol. And I know in my heart of hearts that this paper is for every son/daughter, who loved their parent(s) to the extent of worshipping them and then lost them and now feels daft and lost in the hideous brutal throng of life. I think ŌItÕs ok, not to be ok!Õ DonÕt let anyone come and tell you that itÕs been days, months and years now, so get over it. This pain sticks to you, like chewing gum stuck beneath your shoe. Every step you take forward is an effort, as you are constantly being pulled downwards. As one client said to the second author, ŌGrief takes as long as it takes.Õ Also as Caine narrates in her book Widow, Ōovercoming grief is not an overnight process. You stumble and waver back and forth over and over again, but once acceptance comes, it brings a lot of peace. She certainly thought of herself as a more confident and strong woman after the death of her husband (Caine, 1974).

Discussion

Reading KomalÕs auto-ethnographic account, there is a clear divergence between what the theory of post-traumatic growth suggests should happen after the trauma of bereavement, and what her personal experience has been. The Tedeschi and Calhoun model suggests five main areas of positive change. In terms of relating to others, it was true that Komal paid more attention to her mother and siblings. Yet she argued that she found it very hard to reach out to others, as she was so full of rage over the death of her father. New possibilities also seemed limited. Indeed, she claimed that she felt alienated from everything and everyone. She discovered that she had more personal strengths than she realised but had none of the other attributes the theory suggests, such as being able to handle difficulties better. While she had always been a very spiritual and religious person, after this loss she realised she was not. In terms of spiritual change, this may in fact have changed for the worse. Finally, in terms of her appreciation of life she comments, ŌWith my sun gone there was a permanent eclipse in my life

One single account does not challenge an entire theory, just as ŌOne swallow does not a summer make.Õ The authors presented data recently that challenged post-traumatic growth following adult bereavement at an empirical level (Qasim & Carson, 2020). These findings caused them to reflect on their own experiences of parental bereavement. The second author lost his mother 48 years ago, aged 16. This left a gap in his life that has never been filled, nor ever can be. As he sometimes comments to others about their mothers, ŌYou only get one mother in life.Õ The existence of post-traumatic growth almost pressures individuals to believe that growth is inevitable after trauma. This may arise more from societal pressures to recover than from the theory itself. Vanessa MooreÕs moving account of the loss of her husband Paul explores in great detail her difficulty adjusting to her sudden loss, which led to her seeking long-term help from four different therapists and being on the verge of suicide. It took years before she could comment, ŌIt occurs to me out of death itÕs possible to find new growth,Õ (Moore, 2021, p215). The second author and a colleague have failed to find similar evidence for post-traumatic growth (PTG) following psychosis in interviews with sufferers, though other researchers have found evidence of PTG where people with psychosis have better meaning-making and greater coping self-efficacy (Mazor et al, 2016). Yet maybe for some people and for some trauma, it may not be possible to experience post-traumatic growth. Alternatively, growth may occur in some areas but not others. For instance, faith may be shaken following the death of a child, but it may lead to a greater appreciation of life. Additionally, there are clearly cultural factors in KomalÕs story. Those of us who have worked with individuals whose close relatives have died overseas know how hard the process of bereavement is when they are separated from family and friends and their unique cultural contexts, with their accompanying reassuring rituals around bereavement.

Steffens and Andrykowski (2015) reported that trauma can induce improved interpersonal, personal and spiritual functioning in survivors. According to McAdams (1993) an individualÕs sense of cognition and reflection may be improved after surviving a traumatic event that may eventually help them to better comprehend their lives and themselves. They may develop a new appreciation for life and find better and more refined ways of tackling life situations. In this respect, a very interesting finding was postulated by Agha and Anis-ul-Haque (2020), who revealed that cognitive processes significantly mediate between bereavement and the post-traumatic growth relationship. They suggested that bereavement or loss does not lead to post-traumatic growth by default. Rather, in order to find meaning in the loss or to grow one needs to cognitively comprehend and accommodate the experience of loss and process it consciously. Avoiding the pain, not thinking about it, blocking the trauma can only complicate the grieving process. The findings somehow confirmed the findings of the current study, showing that an inverse relationship was found between bereavement and post-traumatic growth among 260 bereaved parents and spouses. The concept of continuing relations with the deceased was discussed by McCarthy and Prokhovnik (2006). They postulated that the relationship between the deceased and the griever does not necessarily die and end with death. Continuing bonds may still exist, helping the griever to comprehend the loss and change rather than just thinking of the death as an end.

We do, however, need psychometric tools such as the post-traumatic growth inventory to be able to research growth in different groups and over time. But we also need individual accounts of lived experience that challenge some of the assumptions we make about people and their lives. Psychiatry has been enriched by the publication of first-person accounts (Liebrich, 1999; Davies et al, 2011; Carson, 2015), which allow us to enter the phenomenological world of the sufferer. Through auto-ethnography academics can also introduce us to the connection between their personal worlds and their academic lives (Bochner, 1997; Borawski, 2007; Comerchero, 2014; Seligman, 2018; Parker, 2020). The recent collection of narratives of academics coping with the loss of their parents (Pearce & Komaromy, 2021) presents the somewhat unusual perspective of people who have researched death and dying, reflecting on their personal experiences of bereavement. While each of these accounts is unique, it seems strange to hear from, for many Ōthe father of bereavement research in the UKÕ, Professor Colin Murray Parkes narrating, ŌMy father lay on his side, on the floor by the bedÉ My tears came as I knelt, then lay on the floor and held him. I felt my motherÕs arm on mine É the three of us together for the last time everÕ,Õ (Parkes, 2021, p121). The GP soon arrived and he too was in tears. As professionals we need theories, models and stories that we can apply to ourselves, alongside those we use with our clients.

In this respect, Worden (1991) developed four tasks of grieving which he suggested that the griever must accomplish for the process of grieving to be completed. He also suggested that there is no particular order in which one might fulfil these tasks. From accepting the reality of the loss, to consciously working through the process of grief and then adjusting to the new environment without the deceased, Worden added a fourth task in bereavement, which involved redefining the emotional connection with the deceased and finding new ways to remember that person. The dual process theory (Stroebe & Schut, 2010), shows us how Komal moved between loss orientation, grieving, to restoration orientation, in wanting to re-start her studies as soon as possible, and oscillating between the two types of coping. There is also some suggestion that women experience more grief than men (Hicks Patrick & Henrie, 2016). Similarly, in Grief and Grieving, Elisabeth Kubler-Ross talked about how having studied death and terminal illness for her entire career it was ironic that she should end up suffering herself for many years with a terminal illness (Kubler-Ross & Kessler, 2014). These accounts, and KomalÕs, have a richness which helps us get close to peopleÕs lived experience like that offered to us by CS Lewis in his Grief Observed (Lewis, 2015). These accounts, and those of others (Mayer and Mayer Bird, 2020; Coles, 2021) bring us closer to the people we sit alongside as they wrestle with the pain of bereavement. In this tradition, we humbly suggest that Kathryn Mannix has written what is destined to be the next classic in this field, With the End in Mind (Mannix, 2017).

Conclusion

To return to Komal, her fatherÕs death was the single most catastrophic event that changed her ŌchemistryÕ and the course of her life. She wants to think and believe she is a stronger person now, but has she grown to be a better person after this trauma? She answers definitively, ŌNo!Õ She is certainly not bitter, but she has lost some direction and motivation in life. So many things that mattered to her before no longer matter. Many things that did not matter before now make more sense. But the truth is, this sole event was the actual big bang in her life, where time and space lost their meaning and she is still waiting for the aftershock of that explosion to settle, so she can rebuild her broken universe again. Her fatherÕs death has led her to conduct research into bereavement, and perhaps in that sense this might be seen as some evidence of intellectual growth. Komal has recently become a parent and this may well change her perspective again on her fatherÕs death. It will not fill the hole in her heart that remains. Nothing will.

Acknowledgements

The authors would like to thank three peer reviewers for their guidance and their empathy for KomalÕs story. Komal would like to dedicate this paper to her late father and to her husband who supported her through her loss.

Postscript: on 19 July 2021 Komal gave birth to a son. Muhammad Ibrahim Qasim. Life goes on (JC).

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