Unit 5 -- Developmental Issues #2
Late Adolescence through the Later Years
Grief in a Family Context --HPER F460/F560
Goals for this Unit
The intent of this unit is to extend the previous unit through stages of
development in adulthood. In this unit, we explore the grief of later
adolescence and adulthood, when the sense of one's self becomes stable and
the individual explores and expands on that stabilized sense of self.
When we look at implications of adult development for our understanding
of the grief process, we need to retain a certain degree of caution. Our
understanding of grief is largely based on observations of and research on
women (primarily widows and bereaved mothers). At the same time, much
of our understanding of adult development is based on the development of
men. Increasingly, arguments have been made that what is considered
appropriate and normal development for males is not the same for females
and, in fact, we may see some clashes between our expectations for
"healthy" development and "healthy" grieving.
Kagan(Klein), H. (1998). The emergence of a new model: Parental grief as a
normal response (pp. 113-123). In H. Kagan(Klein), Gili's book: A readjustment
model of parental bereavement. Teachers College Press, Columbia University.
Kagan(Klein), H. (1998). The readjustment model of parental bereavement: Inward
and outward steps (pp. 124-121). In H. Kagan(Klein),Gili's book: A readjustment
model of parental bereavement. Teachers College Press, Columbia University.
Kagawa-Singer, J. (1994). Diverse cultural beliefs and practices about death
and dying in the elderly. Gerontology and Geriatric Education, 15, 101-116.
Developmental Tasks for College Students
Grief in Later Adolescence
In the previous unit, we looked at issues of earlier adolescence, when the
adolescent is legally a minor and usually still living at home. Many of the
same issues continue through later adolescence, while they continue to
work to establish a secure sense of identity, separate from their parents. I
include later adolescence in this unit because it often is assumed that,
because someone legally reaches adulthood, he/she becomes an adult in
every way, including the way in which he/she grieves, assumptions that can
lead to problems.
Adolescence is a transitional stage between childhood and adulthood and
adolescents very much feel the uncertainty of this transition. In a sense,
adolescents want to be apart from and a part of their family. In later
adolescence, this time continues to be a challenging one, for the adolescent
as well as for others in his/her life. They must deal with physical, emotional,
psychological, and relational changes in the lives of the adolescent. In the
previous unit, we tended to focus on issues of earlier adolescence, up to the
point at which the adolescent reaches legal adulthood. Later adolescence,
extending through middle 20's will be given greater emphasis in this unit.
Tasks of early adulthood overlap those of late adolescence and this may
lead to increased stress. The assigned reading from the Web,
Developmental Tasks for College Students, describes developmental
tasks that college students face. You may recognize that these tasks involve
both those of adolescence (focusing on identity vs. confusion) and early
adulthood (focusing on intimacy vs. isolation). Consider how they could
influence and complicate the grief process during this time.
As was noted in the last unit, grief during later adolescence may evidence it
in ways that are not recognized by others as grief. Antisocial or socially
inappropriate behavior (especially if there is no recent history of such
behavior) may actually be the expression of grief. Physical and social forces
are also at work to encourage these types of behaviors. There may be an
increase in sexual behavior or in the seriousness of the behavior. It may be
that the adolescent is attempting to replace someone who has been lost or
to fill a sense of emptiness after a loss. Another possibility is that this sexual
activity actually fills a need to be nurtured and/or close to another. Because
this is a socially acceptable (in some cases, the only socially acceptable) way
for males to be held and be touched, they may feel a strong need for sexual
contact. They may also seek the security of a continuing relationship with
another person to avoid the feeling of loneliness that is tied to the loss.
Later adolescents may also engage in dangerous, possibly illegal activities,
as a way of expressing their intense emotions. They may also use alcohol or
drugs as a means of blocking out their emotions and thoughts about the
Grief at this time may feel out of proportion to the loss; in fact, the person
experiencing this maybe astonished by the intensity. One possible
explanation is that the grief is not just for the immediate loss, but for prior
losses that were not successfully resolved. Unresolved issues of childhood
losses may be triggered at this time and grief that was delayed will emerge
now. Issues that were believed to have been resolved at an earlier time will
be considered from a new perspective and in the context of new life
Grief in Adulthood
Adulthood is a time for exploring and expanding the identity one has
established in earlier stages of development and the timing of a loss, in
terms of the adult life course, will affect the way in which the individual
views the loss and interprets its meaning for him or her.
As I indicated above, our understanding of grief is based on adult grieving,
so you should review the models presented in Unit 1 for an understanding
of that. At the same time, remember that these models are normative, that
is, they describe grief as a general phenomenon, but do not match exactly
with the grief of individuals.
Osterweis and Townsend (1988) summarized adult bereavement as
including the following:
Another important point to keep in mind about adult grief is this: Although
it seems that adult would have a full conceptual understanding of death
(e.g., it is final, irreversible, universal), this is not necessarily so. Writing
from a psychotherapeutic perspective, Beverly Raphael (1983) observed
that adults engage in the following:
- The bereavement process is long, much longer than most people
consider. In fact, some people find that the second year of grief is more
difficult than the first. For many people, the grief process may take
- The bereavement process does not necessarily progress in an orderly
fashion. As we talked about in Unit 1, people do not systematically
move through a series of stages as they address and resolve their grief.
- Individual variation in grief is substantial. People vary in how fast
they are able to recover from loss and the issues that are a part of their
grief work. They also have different resources to draw on and this affects
speed of resolution.
- Many emotions and behaviors that might be judged abnormal
under other circumstances are common following loss. It is
inappropriate to judge the bereaved by "normal" standards, as their life is
not normal after a loss.
- Anniversary reactions are common. Grief makes it difficult, if not
impossible, to enjoy joyful times. This makes it difficult to experience
times that were once joyous. Holidays, anniversaries, important family
events, the time the loss occurred all may be experienced as painful
rather than joyous now.
Probably because of the intensity of the loss and its impact on their
assumptive world, these activities are far more likely with traumatic losses.
Losses that occur out of sequence most often experienced as trauma. You
may think of other examples of these; a partial list includes young
widowhood, the death of one's child at any age, the death of one's wife at
any age). We will discuss this in greater detail later in the semester, in the
units on Complicated Grief in Families and Traumatic Loss and Grief.
- magical thinking, the feeling that they may have somehow been
responsible for the loss because they wished for it or in some other way
- fantasies about the deceased, the belief that one might be reunited with
or maintain an active connection with the deceased. She would include
here the belief that the deceased is an active (albeit ephemeral) part of
one's life after death; the belief that one can be reunited with the
deceased through dreams; and that one can reunite with the deceased
through the use of spiritual mediums.
- magical rituals, by performing certain acts, the bereaved maintains a
connection with the deceased. This would include a variety of rituals and
ceremonies that are both formal and informal.
- dread of word "death" or anything related to it. This is the
superstitious view that you shouldn't tempt fate by using the "forbidden"
word. "If you don't talk/think about it, it won't happen."
Another factor that has is very much in evidence among adult grievers is
guilt. This is particularly true among adult grievers. Miles and Demi (1986)
identified six different manifestations of guilt among parents who have lost a
child. Their grief seems to come from being helpless unable to protect their
child from harm. The guilt they describe for parents often can be seen
among other grievers and among those who are grieving losses other than
those caused by death:
Finally, I would like, again, to point out that grief in adulthood is not
restricted to loss to death. Divorce, for example, results in grief that is quite
similar to that of a widow(er). Women relinquishing a child for adoption
and the child are likely to experience grief. Adoptive parents for whom it
was important to produce their own child must grieve the "death" of their
wished-for biological child or the result can be that their adoptive child will
become a replacement child for that imaginary biological child. If their
spouse has been unfaithful, the partner must grieve the "death" of trust and
of their image of their marriage. This list may have triggered some thoughts
on your part about other sources of grief not related to death.
- death causation guilt -- the belief that they either contributed to or
failed to protect their child from death.
- illness-related guilt -- these relate to perceived deficiencies in the
parent's behavior during child's illness or at time of death.
- parental role guilt -- in this, the parents feel they failed to live up to
their own or societal expectations in their overall performance of the
- moral guilt -- the belief that child's death was some type of punishment
or retribution for violating a moral or religious standard.
- survival guilt -- in this, parents struggle with the violation of the
standard that a child should outlive his/her parents and, in their case, this
was not true.
- grief guilt -- relates to the view that they did not grieve "right" at the
time of their child's death.
Some Factors Related to Adult Bereavement
Review of life of the deceased.
After a loss has taken place, adults often will engage in a review of the life
of the deceased (or may feel deeply frustrated by the fact that they are
unable to do this. Parents who have lost a child early in life or during
pregnancy often express tremendous pain that their child has little or no
history. As has been seen with other processes, reviews take place over and
over, as new information is learned and new issues arise. An example of this
can be seen in a man whose father died when he was very young. The son
may find himself reviewing his father's life when he, the son, goes through
important transitions, such as, when he too becomes a father. The review is
not always a positive experience; the deceased may be vilified or sanctified,
Financial implications of loss
Losses that occur in adulthood may involve family division of property.
Arguments over things financial can cause a great deal of hostility among
survivors. Spouses/parents may die intestate (i.e., without a will). They may
distribute their estate unevenly, for reasons that may seem unfair to the
survivors. Interestingly, arguments over property often are not about the
objective value of the property, but are over symbolic meaning. Objects that
are seen as providing a link to the deceased (i.e., "linking objects") hold a
great deal of power for the bereaved and these objects may symbolize both
positive and negative links.
The call to support
Bereaved adults may find themselves acting in the role of supporters for
others they never anticipated needing this (e.g., being called to
simultaneously provide support for their parent(s) and their child(ren) while
also coping with their own loss). Earlier relationships between children and
their parents are carried into adulthood. For example, a mother and her
daughter may have established a pattern in which the daughter has felt
judged by her mother. Conflict that occurs between the adult daughter and
their mother over appropriate support behavior might compromise the
ability of the daughter to provide that support
Gender as a issue
Gender is very much an issue for adult grievers. We will discuss gender in
great detail in two weeks and will save our discussion for that time.
One loss, many griefs
With each loss, adults grieve for a variety of things. The simple fact that
they maintain several roles in their families puts them in the position of
actually grieving many losses. They might be grieving the loss of their
spouse while also grieving the loss of their children's other parent. At the
same time, they see that their children have lost a secure future, a loving
parent, a mentor and they feel a sense of loss at that. We will discuss this in
greater detail when we discuss Roles and Relationships.
In addition to experiencing multiple griefs, adults may be experiencing
simultaneous crises in their lives at the time of their loss, which will affect
their grief. For example, they might be concurrently coping with a
grandparent who is increasingly incapacitated by Alzheimer's disease,
downsizing at their place of employment, children who are growing
increasingly independent and secretive.
Another way in which one loss can lead to many griefs is that previously
unresolved losses likely will be unearthed by a later loss. The simple fact is
that the longer one lives, the greater the opportunities to experience loss
and if these losses are not resolved at the time they take place, they will be
reexperienced when later losses occur. I would like to note an observations
I've made from my own research: I don't believe that it is possible to
completely resolve a loss at the time it occurs. We can only resolve it in
relation to our present needs and understanding. When the loss involves a
particularly important or valued person, we will reexperience past losses as
they are meaningful to us in relation to our present needs (e.g., the loss of a
parent will be reexperienced with each event in our lives where our parents
"should" be there).
Adult Developmental Stages and Grief
Young Adulthood -- from 20 or 21 to 45
- According to Erik Erickson (1959), the choice in this developmental
stage is between intimacy vs. isolation. During this stage of development,
the individual focuses on the establishment of relationships and on
professional development. Affection and love are central themes in
- Throughout this developmental stage, adults come to understand the role
their parents played in their lives. They may also develop a greater
appreciation for their parents and move toward more of an adult-adult
relationship and become more secure in themselves.
- Losses to death at this stage (possibly excepting the death of a
grandparent) are experienced as out-of-sequence. It's important to note
that the loss of a child at any age is experienced as out-of-sequence and
likely to be traumatic.
- Some specific losses:
- Pregnancy or infant loss
- The parents may experience pregnancy or infant loss,
losses that frequently are disenfranchised. Parents in my
research reported being told such things as "It's not as if
you lost a real baby," or "You're lucky you didn't have a
chance to get attached to it."
- Because these are not seen as legitimate losses, these
bereaved parents may receive little or no support.
- Just because a child dies in pregnancy or infancy, it does
not mean that the child is not loved and grieved. The loss
of a baby results in the loss of dreams.
- There is a lack of focus in grief because of the lack of
social recognition of the reality of the child. There is a need
- With recent advances in prenatal care, especially with
ultrasound imaging, loss in pregnancy has become
meaningful for fathers as well as for mothers.
- Abortion, which may include termination of wanted pregnancy (in
this case, a lethal or serious medical condition has been identified
and the parent or parents make the decision to terminate).
- There is a great deal of controversy about the intensity (or
even existence) of grief after a termination of a pregnancy
that is not wanted. The research indicates that, in the vast
majority of cases, the most common response in this case is
one of relief, not grief.
- In cases where the pregnancy was wanted, the grief
experience is similar to that of parents who experienced a
miscarriage (technically called a spontaneous abortion).
Added complications include: having made the choice to
terminate; often they are also coping with fertility
problems; and feelings of being flawed if there are genetic
- Guilt is very common among those who are ambivalent
about the pregnancy or feel they are somehow responsible
(with termination of a wanted pregnancy), for the condition
that led to their decision to terminate.
- Sudden Infant Death Syndrome (SIDS)
- The cause of SIDS is unknown and may actually have
several causes, since it is based on cluster of symptoms.
- This type of loss comes without warning and allows for no
preparation. As a result, it is particularly traumatic to the
- anger and guilt are common.
- This is experienced as a death out of sequence.
- Because the assumption is that the wife will survive the
husband, men experience death of their wife at any age as
out of sequence.
- If there are children, the surviving spouse will have their
own grief and that of their children to cope with.
- At this age, a will may not have been written, making the
time after loss more difficult.
- The surviving spouse may feel disloyal when/if he/she
- Widows may be particularly surprised if they feel strong
sexual urges after their husband's death, leading to guilt
- Loneliness is common. The sense of being a "fifth-wheel"
and being seen as different contributes to a sense of
- Non-marital partner
- These may be either heterosexual or same-sex
relationships, yet their sense of loss will be the same as that
of a marital spouse.
- They likely will be disenfranchised grievers. They may be
unable to express their grief because the relationship has
- In the case of HIV/AIDS, the stigma associated with the
disease may be an added layer of burden.
- They may experience rejection, stigmatization and isolation
from people they anticipated would be supportive or may
be surprised by the positive support they receive.
- The relationship between the young adult and parents is
changing at this time and moving toward an adult-adult
- In particular, the loss of the parent of the same sex may be
experienced as the worst case situation. Issues will remain
- If the relationship with the parent was conflictual, the grief
will be more difficult.
- Rituals that provide for resolution of and closure on the
relationship can be very helpful.
Middle Adulthood -- 40's through 60's
- This developmental stage is focused on generativity vs. stagnation. Here,
the individual focuses on productivity and concern for others by
facilitating the development of others through such things as mentoring
and caring for the welfare of others. This has been described as the
"sandwich generation" because individuals in this stage often are torn
between caring for their elderly parents and their children. Because
women provide most of the day-to-day care and the nurturance, I have
referred to this as the "sandwich gender-ation."
- The loss of one's parents commonly occurs during this developmental
- Some specific losses:
- The death of a parent
- The death of a parent is the most common mid-life loss
and, with the death of the second parent, the adult children
become members of the oldest generation with its attendant
sense of personal vulnerability. The sense that one's parents
"protect" one from death by standing between death and
the adult child can no longer be held.
- It may involve disability and diminished capacity.
- Adult children grieve the death of the parent they knew at
the time of death, but they also grieve the parent of their
childhood years. Unresolved issues from earlier points in
life now may be seen as unresolvable.
- The history of their relationship affects the intensity of their
- The death may be a relief, especially if the parent suffered
before the death or if the parent had been abusive.
- This loss may not be to death. The parent may be lost to a
degenerative neurological condition and may no longer be
seen as the same person anymore. The adult child may
experience this as an ambiguous loss, something we will
discuss in greater detail when we talk about Ambiguous
- With the loss of one's parents, the ability to achieve a
wished for relationship with her/him is now forever lost for
the adult child.
- Research on widow(er)hood is more common at this stage
than at young adulthood, probably because it is more
- This type of loss moves toward becoming less
out-of-sequence in this developmental stage, but it is still
seen as such by men and, as a result, is more intense for
- Loss at this stage is experienced as abandonment.
- Anger and guilt are common.
- The relationship that existed before the death may have
been ambivalent or conflicted (In fact, almost all are, to a
degree.), so the widow(er) may experience relief after the
death, which may also contribute to a sense of guilt.
- The widow(er) experiences role loss and social adjustment
- The widow(er)ed need opportunities to talk about life with
their deceased spouse.
- Financial adjustment often is necessary (for others in the
family as well as for the widow(er).
- The death of one's spouse becomes multiple losses (e.g.,
the loss of one's partner, the loss of oneself as a partner,
one's friendship network changes as a result of the loss)
- "Paired" relationships
- These are relationships with others of approximately the
same age and at a similar level in the power hierarchy.
- Examples include non-marital partners, siblings, friends and
- The intensity of the loss depends on the intimacy and
significance of the roles the deceased played in the
- As for young adults, the loss of a non-marital partner (same
or other sex) often is disenfranchised.
- The loss of a sibling in adulthood has received little
research attention. Research that has been done suggests
that this can be a devastating loss.
- Losses experienced as a parent
- Adolescence is a conflictive time and if the adolescent dies
during this time, the conflict will remain unresolved and
will intensify the grief of parents.
- The adolescent may die as a result of suicide, homicide or
accidental death involving socially unacceptable behavior.
Parents will experience this as disenfranchised, with
attendant guilt, anger and sense of stigma.
- Parents of adolescents may cope with other sources of grief
they experience as a result of their child's actions. As the
child works to establish his/her independence, he/she may
engage in highly inappropriate or dangerous behavior and
risk-taking. The parent must then grieve for the loss of the
hoped for relationship with the child as well as the loss of
the child they knew. They must also give up their view of
themselves as parents who can shape their child's
Late Adulthood -- age 55 and above
- According to Erickson, the pulls of this stage are ego integrity vs.
despair and disgust. The goal is an inner sense of wholeness, the bringing
of an order to their lives and a coming to terms with their past life.
- The ability to reminisce and engage in a life review is an important one
for older adults and facilitates the development of in inner sense of
wholeness while also leaving a legacy for those who follow.
- This stage has been further broken down further: Individuals who are 55
to 75 are young- olds and those above 75 are seen as old-olds. Some
gerontologists further differentiate those 85 and above as the oldest-olds.
- Individuals in this stage often must cope with and grieve their own
disability and diminished capacity. There will be a loss of functioning,
which includes sight, hearing, sexual function, fertility, health and well
being, body functions, brain functions as with Alzheimer's or other
degenerative mental condition.
- Older adults may find it difficult, if not impossible, to accomplish the
central tasks of grieving described in Unit 1 and to resolve their loss.
Their personal and social resources may be limited, especially if they are
grieving a spouse or other close companion.
- Some specific losses:
- With the loss of a spouse, most men remarry. Those who
do not have higher mortality rate than those who do.
- Widows in this developmental stage have a better
adjustment than do younger widows.
- The loss of a life-long partner requires much adjustment,
because the spouses develop an integrated mutuality and
intertwine their lives with each other. Their adjustment
after loss requires that they take on tasks they might never
have anticipated they would be required to do.
- Especially for older individuals, memories of one's
deceased spouse are welcome ones. Older widow(er)s are
far more likely to be allowed by their support network to
discuss these memories than are younger widow(er)s.
- Loss of a non-marital partner
- Very little has been written about this type of loss, but
what little there is suggests that the loss is equivalent to the
loss experience of spouses.
- Loss of a sibling
- Again, little has been written about sibling loss.
- The death of a sibling, regardless of closeness of the
relationship, is an acute reminder of one's own mortality. A
particularly frightening situation may occur if the cause of
death is hereditary in nature.
- Death of a sibling may result in a realignment of roles in the
family and may have broader implications, depending on
what those roles are.
- The death of an adult child
- The loss of a child, regardless of age, is traumatic. It will
always be out-of- sequence.
- Parents will experience survivor guilt, questioning why
they survived while their child did not.
- The death of the child may result in the loss of one's
caregiver or potential caregiver. In fact, the demands and
stress of caring for the elderly parent may contribute to the
death of the adult child.
- With the death of their child, the older adult may feel grief
for the loss of their child's spouse and the children of their
- Death of grandchildren
- This loss can be especially devastating.
- As grandparents, they will grieve for their child, the
now-bereaved parent, and for their own loss of a
- The general pattern of grandparental grief is to experience
intense denial at first, which moves to anger and then
depression at their inability to "fix" or control the situation.
They may feel a sense of responsibility for situation.
- Grandparents may experience conflict with adult children
over appropriate grief, and over the way in which each of
them handles the situation (both before and after the
- The death of a pet
- The death of one's pets may be the last experience of loss
the elderly person experiences.
- This type of loss is disenfranchised. The elderly person may
be told to "just get another."
- The loss may not be to death. It may be because the elderly
person must move into restricted housing or because of
her/his inability to care for the pet.
- The intensity of their grief may surprise the elderly person.
Just as the grief of children and younger adolescents varies because of
development, so too does grief vary among later adolescents and adults.
The particular issues of loss that are relevant to each stage will influence the
grief process of the individual.
The responsibilities of adulthood complicate the grief process, as they
increase the likelihood that additional stressors will be added to their grief
and that they will grieve multiple losses, their own and their grief for the
losses of others important to them.
Earlier losses, to death and other causes, will be reexperienced as later
losses occur in adulthood. Although they may learn coping skills that can be
used to cope with later losses, adults who have experienced losses earlier in
life may find unresolved aspects of the loss difficult to cope with, especially
if they believed they had "gotten over that."
Questions for Discussion
Post your response to the following questions on the Class Discussion.
- Look at the list of tasks for college age individuals. What impact might
a loss have on the ability of the individual to complete these tasks. What
might another person do to facilitate successful completion of these tasks
by someone who is bereaved?
- In the Lifestory Archive , read one
of the lifestories (they all address adult grief). Keeping your class readings
in mind, look at the grief described by the author of the lifestory. What
are your thoughts on the author's grief? What types of coping strategies did
- It has been suggested that, for many older adults, dying is not traumatic
and is approached as a natural part of life and that it is not death that
the elderly fear, but the potential of disability. What is your response to
this? What can we learn from Kagawa-Singer's article about death and dying
in diverse cultures? Is this information consistent or in conflict with your
own observations? How?
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