Disenfranchised grief and nonfinite loss as experienced by the families of death row inmates

The families of death row inmates experience grief and loss issues that have been neglected by scholars and clinicians alike. The issues found in this population are unique and require our understanding. The present study uses the concepts of disenfranchised grief and nonfinite loss to uncover the pain experienced by the children and other family members who have a loved one on death row. Kenneth Doka's (1989) concept of disenfranchised grief is utilized to bring attention to the ways in which the circumstances surrounding an execution leave the family members of those condemned to death outside of the "grieving rules" that exist in the United States. Family members are disenfranchised from their grief, as society does not socially validate their pain. The loss that they feel is also nonfinite (Bruce & Schultz, 2001) in that it is continuous and denies the families all of the hopes, dreams, and expectations that they had for their loved one who now sits on death row. The qualitative interview method was utilized by the authors of this study to gather data from 26 family members of death row inmates who are incarcerated along the East Coast of the United States. The reactions of this group of family members are varied and complex, yet they include the following common responses: social isolation due to stigma and their own feelings of criminalization, intensified family conflict between family members who grieve differently from one another, diminished self-esteem, shame, diffused and specific feelings of guilt, and a chronic state of despair. This study explores virtually untapped terrain. An examination of the microlevel effects of the death penalty on families provides insight in to the area of death and dying, especially as it is related to disenfranchised loss and nonfinite grief. In addition, this study provides insight into the death penalty and its effects.     

Complicated grief symptoms in caregivers of persons with lung cancer: the role of family conflict, intrapsychic strains, and hospice utilization

Guided by a stress process conceptual model, this study examines social and psychological determinants of complicated grief symptoms focusing on family conflict, intrapsychic strains, and the potential moderating effect of care quality and hospice utilization. Relying on data from 152 spouse and adult child lung cancer caregiver survey respondents, drawn from an ancillary study of the Assessment of Cancer CarE and SatiSfaction (ACCESS) in Wisconsin, hierarchical multiple regression analysis was used to examine determinants of complicated grief. After controlling for contextual factors and time since death, complicated grief symptoms were higher among caregivers with less education, among families with lower prior conflict but higher conflict at the end-of-life, who had family members who had difficulty accepting the illness, and who were caring for patients with greater fear of death. Additionally, hospice utilization moderated the effect of fear of death on complicated grief. Findings suggest that family conflict, intrapsychic strains, and hospice utilization may help to explain the variability found in complicated grief symptoms among bereaved caregivers. Implications for enhancing complicated grief assessment tools and preventative interventions across the continuum of cancer care are highlighted.     

Therapeutic implications of continuing bonds expressions following the death of a pet

Through the exploration of 12 continuing bonds expressions (CBE), this current study investigated the grief reaction and continuing impact of the death of a pet. Thirty-three individuals were interviewed to determine the degree of connection maintained with the deceased pet and how that affects their coping. Findings emphasize that the majority of respondents frequently maintain ongoing meaningful ties with their deceased pet through the use of CBE such as fond memories, rituals, dreams. The findings suggest that it is not the number of CBE but the degree of adaptability that is significant. The importance of recognizing the unique, total experience of those grieving the death of a pet is addressed. Implications for those working with and supporting those in grief are included. Future directions for research are described.     

African Americans in bereavement: grief as a function of ethnicity

Few empirical studies have explored the grieving process among different ethnic groups within the United States, and very little is known about how African Americans and Caucasians may differ in their experience of loss. The purpose of this study was to examine the African-American experience of grief, with particular emphasis on issues of identity change, interpersonal dimensions of the loss, and continuing attachments with the deceased. Participants were 1,581 bereaved college students (940 Caucasians and 641 African Americans) attending classes at a large southern university. Each participant completed the Inventory of Complicated Grief-Revised, the Continuing Bonds Scale, and questions regarding the circumstances surrounding his or her loss. Results revealed that African Americans experienced more frequent bereavement by homicide, maintenance of a stronger continuing bond with the deceased, greater grief for the loss of extended kin beyond the immediate family, and a sense of support in their grief, despite their tendency to talk less with others about the loss or seek professional support for it. Overall, African Americans reported higher levels of complicated grief symptoms than Caucasians, especially when they spent less time speaking to others about their loss experience. Implications of these findings for bereavement support services for African Americans were briefly noted.     

Does the internet change how we die and mourn? Overview and analysis

The article outlines the issues that the internet presents to death studies. Part 1 describes a range of online practices that may affect dying, the funeral, grief and memorialization, inheritance and archaeology; it also summarizes the kinds of research that have been done in these fields. Part 2 argues that these new online practices have implications for, and may be illuminated by, key concepts in death studies: the sequestration (or separation from everyday life) of death and dying, disenfranchisement of grief, private grief, social death, illness and grief narratives, continuing bonds with the dead, and the presence of the dead in society. In particular, social network sites can bring dying and grieving out of both the private and public realms and into the everyday life of social networks beyond the immediate family, and provide an audience for once private communications with the dead.     

Children of the condemned: grieving the loss of a father to death row

This article explores the effects of a death sentence and execution on the children of the accused. Insight into the unique bereavement of this population is provided, while contributing to the literature on death and dying. The experience of losing a father to death row and eventual execution is compared to the wider population of children with incarcerated parents and it is determined that children of death row inmates contend with a much more complicated grief process, one that has gone largely unstudied. This article contains a brief discussion of disenfranchised grief and nonfinite loss, two theories that, we argue, shape the children's grief process. The results section of the article uses qualitative data gathered from 19 children to explore the role that nonfinite loss and disenfranchised grief share in the nature of their bereavement. Our discussion focuses on the impact of stigma and violence on the grieving process. Following a discussion of the unique challenges confronting the children of death row inmates is a discussion of the implications that their experience has for practice.     

Perinatal loss and parental grief: the challenge of ambiguity and disenfranchised grief

Following perinatal loss, a type of ambiguous loss, bereaved couples struggle with and experience distress due to various forms of ambiguity. Moreover, the juxtaposition of their grief with society's minimization often disenfranchises them from traditional grieving processes. The purpose of this study was to explore sources of ambiguity and disenfranchised grief related to perinatal loss. Audio-taped interviews with 13 bereaved couples at 2, 6, and 13 months following the death of their fetus or infant were analyzed. Several categories of ambiguity and disenfranchised grief emerged, pertaining to: (a) the viability of the pregnancy; (b) the physical process of pregnancy loss; (c) making arrangements for the remains; and (d) sharing the news. This study uncovers the many sources of ambiguity and disenfranchised grief that bereaved couples face in interactions with family, friends, society, and healthcare professionals. These insights may inform healthcare professionals in their attempts to ease distress related to perinatal loss.     

Surviving grief: An analysis of the exchange of hope in online grief communities

Online grief communities represent relatively new forms of peer support. However, the degree to which they are helpful for individual grieving processes is unknown. To date, no research has evaluated the type or quality of support exchanged in online grief communities. To begin to address these questions, this study analyzed 564 messages from internet grief websites to: (1) classify the type of helping skills used, and (2) extract themes contained in the content of the messages. Messages selected for analysis were the first response to an original post, assuming they would be the first effort to provide support to a grieving individual. Results revealed a majority of responses contained self-disclosure. Themes in the messages suggested provision of more than "one-way" support; messages themes also included exchanging hope for the future by sharing one's own story, validating the grief experience, providing resources, and exchanging psychosocial support. Clinical implications and research recommendations are discussed.     

Putting "teeth" in your résumé

How can physician executives get the kind of management experience they need to move to the next level? Is the MBA the end all or can significant management experience and top assignments impress recruiters and CEOs? Here are some important questions to ask yourself about each job you have held as you prepare to move forward in your career: How did I improve the organization? How did I contribute to greater efficiency? How did I affect productivity? How did my work increase the bottom line? Thinking about these questions can help you put teeth in your résumé and get you where you want to go. When you can answer those questions from your own experience, you will have created a powerful career track record that is likely to impress the next CEO whose staff you want to join.     

Considerations for grief interventions: eras of witnessing with families

This article describes research that was conducted to articulate interventions with families experiencing grief. Using an interpretive methodology framed by philosophical hermeneutics allowed for a depth of understanding of these therapeutic conversations. The research findings offer explanations of the role of time in relation to grief, particularly the timing of interventions, and describe the significance of working with multiple family members during therapeutic interventions. This research was unique in that it approached grief counseling with a family focus, the participants were interviewed for this study several years after the therapeutic encounter, and the underlying theoretical framework for the interventions focused on grief as a lifelong, life-changing experience, rather than a finite, pathology-laden event.     

Parental grief in three societies: networks and religion as social supports in mourning

How do people respond to the grief of parents over the death of their infant child? This article documents the experience of one of the authors, an American married to a Russian whose child died in England. Responses to this death by friends, colleagues and family in the USA, England, and two cities in Russia varied considerably in terms of depth and degree of engagement (emotional engagement, respect, or distance and avoidance). What factors underlie these varied responses? Two are identified, one structural, the other cultural: the strength of the social ties within social networks, and religiosity as historically sedimented within a culture. The degree of engagement is correlated with network form; but the content of engagement depends on religiosity.     

Older poor parents who lost an adult child to AIDS in Togo, West Africa: a qualitative study

This study analyzes the difficulties that poor parents faced when they lost an adult child to AIDS in Togo. The death of a child is believed to be more distressful to parents compared to the death of a spouse. Evidence also suggests that parental grief is more lasting and may be the most complicated form of grief. Furthermore, the roles played by the deceased child in the lives of the parents also affect the parental grieving process. For instance, in low income regions where parents tend to be socio-economically challenged and where filial obligations are culturally expected, losing an adult child who provided material and financial assistance to parents will be more disastrous. Four kinds of difficulties were identified: financial and social difficulty, psychological difficulty, caregiving difficulty, and disclosure difficulty. The socioeconomic status of the parents made these issues all the more taxing, as respondents were grieving not only the loss of their children to AIDS but also the loss of financial providers. Policy implications of the findings are discussed.     

家族企业海归继承人创业学习过程研究——基于文化框架转换的多案例分析

继承人成长模式是目前中国家族企业理论和实践的热门议题,也是保障和提高家族企业跨代持续发展的首要问题。在家族企业传承和转型的关键时期,作为创业的主力军,家族企业海归继承人的多元文化经历和文化框架转换为其创业学习过程提供了独特资源和路径,本文基于文化心理学的动态建构主义视角,以6个家族企业的海归继承人为研究对象,采用探索性多案例研究方法,通过扎根理论的数据处理程序提炼基于文化框架转换的海归继承人创业学习关键过程要素,包括海外获取性创业学习、创业动机促发、实验性创业学习(直觉和编译创业学习)3个创业学习阶段中,文化构念网络可用性、通达性和情境适用性的构建策略及其与创业学习过程的互动协同机制,试图在家族企业传承背景下构建基于文化框架转换的家族企业海归继承人创业学习过程理论模型,从文化心理学视角解读文化框架转换对家族企业海归继承人创业学习方式、路径选择和创业能力形成的微观作用机制,为家族企业海归继承人这一独特创业群体的成长提供富有前景的答案,为家族企业传承和跨代创业提供启迪和借鉴。     

What to do next

Why do we work? While there may be some obvious, practical answers to this question, like needing to make money to survive, there are other reasons that people work. These include working: to have stimulation and excitement--to meet new challenges and have variety in your life; for love and affection--to be with colleagues, clients, customers and to provide security and protection for family and friends; and to leave a thumbprint on the world and change individuals, systems, and institutions. For quality life, it is necessary not only to work but to enjoy your work. For physicians considering careers in medical management, the key to success is being truly excited about management activities. If you are heading towards management, you need to view some of the tasks as fun or you probably won't stay with it very long.     

Qualitative exploration of the nature of grief-related beliefs and expectations

Societal expectations of grief impact the experience of bereavement. The congruence of societal expectations with current scientific understanding of grief is unknown. Therefore two qualitative studies explored community perceptions of grief. In study one, three small focus groups (N = 9) examined grief-related expectations associated with hypothetical scenarios of bereavement. In study two, the impact of grief-related perceptions on the lived experience of bereavement for 11 individuals was explored through semi-structured interviews. Across both studies, elements of a traditional stage model view of grief were evident, with participants viewing emotional expression of grief as important. An avoidant coping style in the bereaved was considered problematic. Findings of study two suggested that grief-related beliefs may impact the bereavement experience via appraisal of the grief response and willingness to support bereaved individuals. The studies suggested that stage model assumptions in the beliefs of the general population persist, although there was a recognition of diversity in the grief response.     

Wanted--seasoned veterans. Diamonds in the rough need not apply

Health care organizations looking for physician executives prefer seasoned veterans--doctors who have already done the job. They want job-specific experience. Most organizations do not provide training grounds and orderly career ladders for aspiring physician executives. The Permanente Medical Groups, Family Health Plans, and some very large group practices are exceptions, but, for the most part, rising medical directors in these organizations stay with them. Most hospitals are not large enough to have associate or assistant medical directors or an environment that could provide a training ground for rising physician executives. On the other hand, hospitals, larger group practices, health insurance companies, and managed care organizations provide ample opportunities for nonphysician managers to train, gain experience, and climb the ladders. How can the novice physician executive break into the world of management and begin establishing management credentials? The author provides some key steps that can lead to success.     

Understanding crisis and crisis management: an Indian perspective

This study explored individual perceptions of the concept of crisis and the strategies used to manage crisis events. Situated in the national Indian cultural context, this exploratory qualitative study addressed three questions: How do individuals from the Indian national culture define a crisis? How do individuals from the Indian national culture manage a crisis? What impact does the Indian national culture have on individual approaches to crisis management? Interview data were collected from 66 Indian participants with a focus on critical incidents related to crises. The findings from a thematic analysis revealed that, despite sharing the same national cultural heritage, the participants perceived crises very differently, and their approaches to crisis management could be classified into three categories: fighting, compromising, and avoiding. Further, culture influenced the strategies participants adopted to manage their perceived crises, and national cultural norms that bound the society were given the utmost importance by the participants.     

Krisen in Familienunternehmen und Unternehmensfamilien Über parallele, interdependente Dynamiken in Familie und Unternehmen

How can the situation of a crisis in the two systems of family and business of a family business be understood and conceptualized? What does a business crisis mean for the members of the business family, especially for those who work there? What kind of mutual influences and irritations do these different, but closely linked social systems of a family business exert on each other? The article explores the field of crises in family business and business families and tries to answer these questions.After a first overview of some accepted concepts a general understanding of the term crisis for family and business in family businesses is developed. Based on the first results of a current research project conducted by the authors, the mutual influences of a business crisis and a family crisis on either family or business are looked at; especially the performance and role(s) of the business family in the crisis of their enterprise are analysed. Finally a model is developed, which serves to describe the parallel and interdependent dynamics of the crises in family and business of a family business.     

Boldly going where no one has gone before

With all the changes occurring in the U.S. health care system come new opportunities for physician executives willing to boldly go where no one has gone before. These positions are being newly created and thus are somewhat undefined and uncharted. Health care organizations want individuals for high-risk positions with unique skill sets and bright, new ideas. Organizations want to find people who can do what has never been done before-for them, at least, if not anywhere in the universe. How does that translate into experiences that you might want to acquire? Most organizations today are looking for individuals with some networking experience, but analogous experience (such as in a multi-site medical group or active involvement in formation of IPAs) is often a good alternative. In addition, true line experience in one or more organizations is a solid credential. Knowledge of where managed health care dollars begin and end is a necessity. As always, executive style and presence are expected.