What's Happening to Mourning?

Ian Craib

ABSTRACT. The paper attempts to show the way in which psychotherapy can become caught up inwider social processes that change the meaning of psychotherapeutic work in a way of which we arenot always aware. The process of mourning is taken as an example; the classic theories of mourningare examined and the way they have changed over the last thirty years is discussed. It is argued thatthe changes have been a product of social change rather than a deeper understanding of grief, andthat unless we are aware of this, psychotherapy can turn into an instrument of social control.

Introduction

What I want to do in this paper is to look at what happens to psychoanalytic ideas andpsychotherapy when we see them in a different context to the one that we are used to.Something that appears in the consulting room to be a benign and helpful activity canappear in the context of the wider culture in a rather different way. We can think we aredoing one thing - and we can actually be doing that thing - but we can also be doingsomething else, which we do not know about. This should be no problem for thosefamiliar with the unconscious, but what I am suggesting is that there is also a dimensionof the unknown contained in the wider network of social relationships, the sort ofsociety, in which we work, and out of which we develop. My suggestion is that weshould at least be aware of how this wider society might transform the meaning of whatwe do.

I want to try to make my point through looking at what has happened to the way inwhich we think about and deal with death and mourning over the last century or so. Mysuggestion is that there has been a change in what I would call the social organisation ofmourning, an attempt to organise the process of mourning, and perhaps even of dyingitself, in such a way that the real pain and loss are denied, that they can even be seen as `good things'. At its extreme this becomes a mapping in advance of the mourning processas something through which people should be taken - notions of originality, of each griefand mourning as being unique, individual and unpleasant seem to disappear.

A number of social processes are at work in this change. At an everyday level, I cansee its effects amongst my undergraduate students and in experiential groups that I lead.Much of the literature on death talks about it as a twentieth-century taboo, even the `lastgreat taboo', the subject about which nobody speaks; socially approved mourning ritualshave all but disappeared; the bereaved are ignored, or expected to be back in a normallife as soon as possible. I am sure that this is true for some people, but I have noticedthat it is certainly not true for others. When I lecture on death and

This paper is based on Chapter 2 of The Importance of Disappointment, published by Routledge in1994. Ian Craib is a Senior Lecturer in Sociology and Group-Analytic Psychotherapist. Address forcorrespondence: Department of Sociology, University of Essex, Wivenhoe Park, Colchester, EssexC04 3SQ.

British Journal of Psychotherapy, Vol 11(3), 1995© The author

Ian Craib 359

mourning to social science undergraduates, there is a rush to write essays on the subject -it is one of the most popular topics, more popular than sexuality. In the experientialgroups, members often enthusiastically embrace death as a metaphor for the ending ofthe group, sometimes, I think, too enthusiastically, as if they have never felt the fear ofdeath. When I check the library catalogue, the number of books about death, or grief ormourning seems to increase monthly. We can add to this the growth of bereavementcounselling, of CRUSE and of the hospice movement, none of which point to areluctance to talk about death. So perhaps something else is going on.

One way of thinking about it is in the way that Foucault (1984) discusses sexuality.We tend to see the Victorian period as one in which nobody talked about sex, butFoucault points out that it was a period in which talk about sex exploded; more waswritten than ever before, by doctors, psychiatrists, psychologists, biologists and so on. Itwas a period when sexuality was catalogued and classified and brought under the controlof professionals, and Freud was part of this. It was also the time when sexuality becamewhat the sociologist Anthony Giddens calls `sequestered' - split off from the rest ofsocial life and given its own specialised space governed by experts. Perhaps the samething is happening to death and mourning; I will be looking shortly at the way in whichthe psychiatric profession, and then the therapy and counselling profession haveattempted to establish control over mourning. My argument is that this has been at thecost of an understanding of the real complexity of grief and mourning - at a theoreticallevel, if not in everybody's practice; further, unless we are careful, our insights becomecaught up in a process of social control in which our work is geared - without ourknowing it - less to healing or to the integration of the whole individual, or to freeing theindividual to take his or her own decisions than to producing the sort of personality thatis most suitable to contemporary society.

Classic Theories of Mourning

It is tempting to think of changes in theory as developments in theory - that somehow weare getting closer to the truth as time goes on. Sometimes such a view is right, but notnecessarily so. And the deeper we go into the social sciences, the more likely that thechanges in our theory might be the result of the changing social conditions in which wework rather than a growth in knowledge. Indeed in psychoanalytic theories of mourning,I think it is possible to identify a reduction in knowledge content in favour of the `positive' view of mourning that we can find so often today - a view whichunderemphasises the straightforward strength of the pain that is involved and glossesover the depth of guilt and our inherent ambivalence. This is summed up in a quotationfrom Social Work Today's review of Colin Murray Parkes's Bereavement (1987), cited onthe back cover of the book:'. .. he has helped us all to accept our share in the creative useof suffering'. It seems we should always look on the bright side! Others have noted thesame process in relation to dying itself: Anna Witham (1985) talks about the idealisationof dying in health professional training and the difficulties that students have when theycome up against the real thing, and Robert Kastenbaum (1982) has made much the samepoint.

The earlier psychoanalytic theories of mourning, of Freud, Abraham and Klein, allcontain a distinction between normal and pathological mourning, and in this sense canhe seen in Foucault's terms as illustrating a process of a profession carving out an area ofpower for itself. But part of my case is that the distinction in the work of these

360 British Journal of Psychotherapy

writers is qualitatively different from that in the work of more recent writers. Mourningfor Freud (1917) involves a withdrawal from the outside world, and a concentration ofenergy on the one who has been lost; this is accompanied by painful feelings ofdejection and an inability to find a new love object. We work through mourning, withgreat expense of energy, by repeated reality-testing and finding that the loved one reallyhas gone. We withdraw - de-cathect - our feelings from the lost one until we are ready tofind a new love object. The basic model is an energy-flow system: energy is invested inthe loved one, who dies or vanishes; the energy is then withdrawn into the mournerwhere it stays for a shorter or longer time until the loss is accepted, when it is re-invested in a new love object.

Freud argues that we are familiar with this experience, we know that it will pass andtherefore we take it as normal. He went on to identify an abnormal or pathologicalmourning - melancholia - in which the mourner identifies with the lost love one, anddirects the criticism and anger which belongs to the lost one to the mourner him- orherself. Melancholia, then, is a state in which we have taken the lost loved one insideand kept him or her there, attacking ourselves rather than the person who is lost.

In later developments of the theory, we see the tenuousness of this distinction insuch a way as to suggest that the attempt to maintain it is a result less of understandingwhat is happening than of establishing the mourning process as an area of professionalexpertise and control. Abraham (1927), for example, makes the point that the process ofinternalisation of the loved one is a normal part of mourning and, in fact, the `successful'mourner is able to internalise the lost one as a good object; the melancholic is unable toachieve this because hostility to the loved one was so great. This moves us closer to theinternal world and its complexities and the normal/pathological now hangs on the degreeof hostility in the relationship - or perhaps more accurately in the mourner.

These ideas are developed and rendered more sophisticated in Klein's work (1986),and the idea of pathological mourning changes again; to begin with I will take herexample of bereavement (a Mrs A after the sudden death of her son) and examine inparticular her first reactions.

Mrs A begins by sorting out letters, keeping her son's and throwing the others away- disposing of the indifferent and hostile, the bad feelings. This is seen as an attempt atrestoring her son, to keep him safe inside her, an obsessional mechanism used as adefence against the depressive position; the obsessive action wards off the bad feelings.For the first week there was an (incomplete) withdrawal, a numbness and an absence ofdreaming - Mrs A usually dreamt every night. Her first dream brought associations withan occasion when she had recognised that her brother was not as wonderful as she hadthought, an event that was experienced as an `irreparable misfortune'. The event was alsoassociated with guilt, as if it were the result of her own harmful wishes against herbrother. Behind these harmful wishes and `very deeply repressed' was a desire to punishher mother through causing her to lose her son; she was jealous of her mother forpossessing such a son. This led her to a death wish against her brother: one of the deeperdream wishes was `My mother's son has died and not my own'. This was followed bysympathy for her mother and sorrow for herself. Her brother had, in fact, died, andbeside her earlier sorrow at this event she had, unconsciously, experienced a sense oftriumph. Klein argues that some degree of Mrs A's ambivalence to her brother, `thoughmodified by her strong motherly feelings', had been transferred on to her son and enteredinto the present grief.

Ian Craib 361

The first defences, then, were the manic defences against grief: denial and triumph.In Mrs A's internal world, the grief was transferred to her mother, with the denial thatthey were one and the same person. Klein goes on to describe the process of movementinto sorrow and reconnection with the world, and then the retreat into manictriumphalism and denial. The whole to-and-fro movement is seen as involving the re-establishment of the good internal objects with which the mourner can identify.

I have set out this example at some length because of its focus on the complexity ofthe psychological processes of mourning, involving feelings with which it is notnormally associated: jealousy, triumphalism and a desire to punish. It also again blursthe line between normal and pathological mourning, rooting the latter in a deeperpathology which, in turn, is rooted in the earliest stages of life and which cannot be `known in advance'. It seems to me that Klein moves away from thinking aboutpathological mourning to the pathological personality. In fact, Klein is the theorist wholeast fits into my argument, and the interesting thing is that the most recentdevelopments have steadily stripped away the emphasis on the complexity of the internalworld - the less acceptable feelings - at the same time as they have established mourningas a subject for professional intervention and control.

The Development of Contemporary Theory

The most recent and dramatic changes in the theory have taken place over the past threedecades, beginning with two papers by Bowlby in the early 1960s (1960, 1961) andfollowed by Parkes (1972). This decade saw the appearance of a number of other bookson death and mourning (Gorer 1965, Hinton 1967, for example) and the beginning of thecontemporary discourse on the subject. Both Bowlby's work and that of Parkesemphasise the aetiology of mourning and focus on `environmental failure', rather than thedynamics of the internal world. Parkes's book marks the claim of psychiatry over thisrealm, arguing now that all mourning is pathological and should be regarded as a mentalillness. Rather than put forward arguments in favour of such a position, he deals witharguments against it.

The first is the `labelling' argument: if we call mourning a mental illness, westigmatise those to whom the label is attached; Parkes's argument is that if we do not callthe bereaved mentally ill for this reason, we are reinforcing the stigmatising connotationsof the term. This is fair enough if we accept that mourning is a mental illness. Muchmore depends on his second argument. He says people object on the grounds of thenormality of mourning, but measles are normal and nobody would suggest that measlesis not an illness. Grief, he argues, like physical illness, brings discomfort and disturbanceof function:

On the whole, grief resembles a physical injury more closely than any other type of illness. Theloss may be spoken of as a `blow'. As in the case of physical injury, the 'wound' gradually heals;at least it usually does. But occasionally complications set in, healing is delayed or a furtherinjury reopens a healing wound. In such cases, abnormal forms arise, which may even becomplicated by the onset of other types of illness. Sometimes it seems that the outcome may befatal ... I know of only one functional psychiatric disorder whose cause is known, whosefeatures are distinctive, and whose course is usually predictable, and that is grief, the reaction toloss. Yet this condition has been so neglected by psychiatrists that until recently it was not evenmentioned in the indexes of most of the best known general textbooks of psychiatry. (Parkes1987; pp. 25-6)

In trying to define grief in terms of presenting symptoms, Parkes settles for the pining oryearning that he immediately relates to separation anxiety and Bowlby's theory of

362 British Journal of Psychotherapy

attachment needs. Parkes identifies three stages of grief (the presenting symptomschanging with each one): first a numbness, then pining, then disorganisation anddespair, recovery only beginning after this last experience.

In the world of the health professional, progress can easily become a matter ofhaving more illnesses added to the list. On the face of it, Parkes's argument is plausibleand humane - in fact, it is plausible and humane; it also attempts to extend the power ofthe psychiatric profession in a way instantly recognisable to readers of Foucault; and itseems to me that it changes the way we think about mourning in a fairly radical way.One question that emerges is where do we draw the line - should we regard the divorcedor the redundant, or anybody suffering from an upheaval in their lives, as mentally ill? Iwould suggest that this problem has been solved by the growth of psychotherapy, whichbrings almost any human state within the range of treatment without having tomedicalise it.

Now what happens in Parkes's account of mourning is that it is seen as less of aninternal psychological process, of conflicts and reorganisation in the internal world, andthe emphasis is more on the emotions, the external presenting symptoms. By placing itin Bowlby's framework we are moved closer to a quasi-behaviourism. I do not think thatwhat Parkes says is wrong - it is less complete than either the Freudian or Kleinianaccounts of mourning, seeing it in terms of cause and effect rather than as an internalprocessing of experience.

In more recent psychoanalytic accounts of mourning two tendencies sit side by side;on the one hand there is an implicit or even an explicit recognition of the implacabilityof death, the normality of grief and the never-endingness of mourning, and on the otherthere is the desire to iron all this out, turn it into a positive experience and avoid anydepth investigation of the internal world.

A set of three papers in a recent issue of Group Analysis are a good illustration. Theycontain accounts of the work of a group of therapists from a hospital in Edmonton,Canada, who have developed a programme of short-term psychotherapy for loss (Lakoff& Azim 1991a, Piper & McCallum 1991b, McCallum et al. 1991c). The first paper byLakoff and Azim talks about the contemporary denial of death and the absence of arecognised place for mourning; it also points to the difficulties in understanding whatsuccessful or unsuccessful, normal or pathological mourning might be. Quoting a studyby Osterweis et al. (1987) they point out that length of time is no indicator ofpathological mourning, but rather the quality and quantity of reactions over time; theyalso point out that a change that seems to indicate a 'healthy' recovery in one personcould mean the opposite for another. For one person, throwing him- or herself into workmay be avoidance; for another it may indicate a new flow of creativity.

In the second paper, Piper and McCallum survey the studies of group interventionsin mourning; they begin by lamenting the lack of involvement of health professionals inproviding group services for the bereaved. They suggest a classificatory schemainvolving two dimensions, initial and transitional, and two types, normal andpathological; help is usually sought in the transitional stage, and if the mourning isnormal, it is mainly a matter of support and practical intervention. Pathologicalmourning may occur at either stage, and may take the form of too much or too little grief- in terms of intensity or duration. However, although they recognise that brief durationcan mean anything from two months to never and that individual differences influenceprogress through mourning, they then argue that such complication:

Ian Craib 363

... may be partially resolved by considering the debilitating impact of the loss in terms ofsymptomatology and impaired functioning when determining the type of mourning processoccurring. (Piper & McCallum 1991b, p. 365)

The third paper by McCallum et al. is an account of a study of the effectiveness of12-week groups for those caught in pathological mourning according to a standarddiagnosis which, presumably, is not derived from the previous discussion:

Most patients received a DSM-III Axis 1 diagnosis (usually affective adjustment or anxietydisorder) and about one quarter received an Axis 11 diagnosis (usually dependent personality).(McCallum et al. 1991c, p. 377)

The groups were tightly controlled:Two experienced therapists each led four of the eight groups. They followed a technical manualand attended a weekly seminar where conceptual and technical issues were discussed andaudiotapes of sessions were played. The theoretical orientation of the twelve-week, time limitedgroups was psycho-analytic, and this was checked by conducting a process analysis of sevensessions from each group using the Psychodynamic Work and Object Rating System (Piper &McCallum 1988) which confirmed that the therapists were active, interpretive and group-focused, as intended. (McCallum et al. 1991c, p. 177)

In these papers, we seem to have reached the point where it is simply assumed thatprofessionals should be concerned with the mourning process and their absence is to beremarked upon. Despite all the reservations a standard diagnostic tool is used todistinguish pathological grief and there are manuals by which to guide a closelyregulated therapeutic process; it is clear from the account that whilst the therapist islistening closely to the group, he or she knows in advance what sort of interpretation heor she will make: it is mapped out according to a view of the appropriate emotions andtheir expression, rather than on an intimate understanding of the different inner worldsof the group members.

We find here a continued degradation of our understanding of mourning: pathologyis defined by a standard measure and `correct' feelings are laid out in the discussion ofthe groups. Anger seems OK but not hatred; guilt might be appropriate but triumph isnot mentioned. There is, if you like, a taming of grief and we know what the patientshould be doing. There is, further, a move beyond the identification of emotion as a signof pathology to `functional impairment' which hands over the definition of `pathology' toa society which, as many have pointed out, allows no recognised space for mourning. Itis a not very large step to the attempt at control and limitation of mourning set out in arecent handbook for health care professionals as the aims of a therapeutic assessment ofbereavement:

1. To facilitate and consolidate a satisfactorily resolving of bereavement.2. To provide a framework for specific preventive intervention with bereaved who are at high risk ofmalresolution.3. To provide a framework for specific intervention with pathological bereavements so that thesemay possibly be diverted to a more adaptive course. (Raphael 1984, p. 347)

The job becomes getting the machine back on the road.

Psychotherapy as Social Control

My argument concerns the way in which our conception of mourning has changed,especially over the last 30 years. We have lost the depth that can be found in the work ofFreud and Klein, whose papers on mourning have been seminal sources for

364 British Journal of Psychotherapy

psychoanalytic thought. The development has been away from the dynamics of the innerworld towards classifications based on surface criteria, and towards the development ofschemata, programmes for mourning, stages that people have to be moved through. Thesechanges have gone along with the growth of bereavement counselling and the separatingout of death and mourning as a separate area of life - its `sequestration'. I want now tothink about the reasons why this has happened. Put as simply as possible, my argument isthat psychoanalytic ideas, as they enter the wider culture, get taken up and transformed;some aspects get lost and others emphasised; thus the creative dimensions of mourningare emphasised, we are led to think in terms of resolution and so on. It seems to me thatthis is not a normal human resistance to the horror of death - other societies, and oursociety at other historical periods, have thought differently; it has more to do with thesort of changes we are living through. As these ideas get re-interpreted in this way, sothey come to fill a social function which is different from the apparently straightforwardactivity of helping people with which, at first sight, they are associated. My argumenthere is that the ideas and the practices they generate become a form of social control, thetherapy becoming a play of false selves of which the practitioners are unconscious.

We can see the forms of thinking in the wider culture at work, for example, in theattempt to develop programmed treatments for pathological mourning. One way oflooking at it is the development of a therapeutic programme of people to deal with newand different situations. The sociologist Anthony Giddens (1991) argues that the modernforms of self-therapy and the self-help books that seem so popular are precisely providingformulae for dealing with life in what he calls `late modernity'. It is possible to push this abit further. Over the last decade or so, the computer has provided new metaphors fortalking about human beings; whereas in the 1960s psychology departments might havebeen full of rats and pigeons and mazes, they are now full of computers and their objectof study is thought of as a computer. The move from behaviourism to cognitivepsychology has not been a movement towards intellectual depth. In this context, if someof the insights from psychotherapy can be simplified and standardised, they can be seenas programmes for the human computer. The growth in the USA of 12-step programmesfor practically everything is an extreme example of this. This is, of course, reinforced bycontemporary concerns with the economics of health care, the need to be seen to have aproduct to sell and a product that is successful; there might not be much demand for atherapy which promises only a return to `normal human misery'.

The place of the market in health care systems is a symptom of a much wider anddeeper change that sociologists refer to as `late modernity' or sometimes `postmodernity'(Harvey 1989, Giddens 1990). Harvey argues that the economic basis is the developmentof factory production in the third world, and the rapid transferability of money capital,which has meant a radical re-organisation of the labour market in the West andintensified competition: large-scale systematic production has declined and there hasbeen a rapid growth in part-time, or short-term, contract labour. `Careers', whilst notdisappearing, are rarer and more difficult to hold on to, and the emphasis in productionand supplying services is on high turnover and short-term processing. In this contextgoods and services which are used up as soon as they are supplied are ideal (and, ofcourse, psychotherapy can be seen as such a service). If we think of this in terms of theindividual and individual experience, we can see that it can generate a great deal ofanxiety.

Ian Craib 365

These changes have speeded up a process that began with the growth of large, urbancomplexes (Simmel 1950) - a process of external isolation and internal fragmentation. Inhis work on narcissism, Kohut (1971) comments on the change in family structures sinceFreud was working: from a situation where there was too much contact between parentsand children to one where there is too little. This has been accompanied through thiscentury by the steady loosening of community ties, increased geographical and socialmobility (the latter both up and down) and by the decline of what we might call `holdingorganisations'. I have already mentioned the family and the local community but we canadd to those, in this latest rush of fragmentation, business and service organisations (such as British Rail and the NHS), trade unions and professional associations as self-governing bodies - all the collective entities which could stand between the individualand some much wider, anonymous entity we call society. Giddens talks about thedevelopment of abstract systems, the anonymous juggernaut of modernity, at least as itappears from the point of view of the individual.

What happens in such a situation, it seems to me, is firstly the process of mourningbecomes not just a model for major life changes, as it was with the classical theorists butalso a model for everyday life. The modern therapies that Giddens discusses discouragepeople from trying to make lasting attachments, and urge a living for the moment only.Psychoanalysis does not go as far as this, and I doubt that it ever could, but itscontribution to the contemporary denial of pain and complexity lies in its approach togrief and mourning - we can turn loss into `growth' or `creativity', and perhaps we do notneed to think about the loss. And in a society which is increasingly frightening, we canthink of change as always positive, when in fact it is arguable that it is increasinglydestructive - of relationships and lives.

It seems to me that it is arguable that psychotherapy in contemporary society runs thedanger of itself becoming an abstract system, an institution providing formulae for livingas psychotherapists try to proselytise in newspaper columns and popular books. Thisdifficulty, of course, is that as psychotherapists we share the same anxiety as everybodyelse: we have the same threats to our livelihood, our relationships fail, friends andcolleagues move away, or we move away from them; our jobs are threatened or ourprivate practice comes under strain. We seek our own formulae for living - in fact Isuspect that many of us undertake training to try to find such formulae. Perhaps it is asign of a good training that the students completing it are more anxious about their livesthen they were at the beginning, but - going by public pronouncements - there seem to bean awful lot of therapists and counsellors in possession of some sort of truth. Returning togrief and mourning, it seems to me that we need comparatively little experience torealise its individuality, and the sometimes astonishing way that a person finds his or herway through it, to a different life or to their own death - or the equally surprising way inwhich they might decide not to move on from mourning. I suspect an `authentic' therapyshould respect decisions that, according to an abstract framework, are pathological, andperhaps drop the distinction altogether.

This means taking risks, recognising that we do not possess formulae for living, orfor dying. The alternative is that psychotherapy becomes an encounter not between atherapist and a patient in a joint search for meaning but between two false selves, thetherapist hiding behind his or her formulae or programmes which emphasise only oneside of our lives, the patient adopting that false self in an attempt to please and reassurethe therapist. If mourning is the discovery of the meaning of what has been lost, in all

366 British Journal of Psychotherapy

its ambiguity, ambivalence and complexity, then this discovery is pre judged and fencedin, if we set out already knowing what should be happening. The more anxious we are,the more we will need to cling on to such formulae; the more our patients will becomelike the anxious infant trying to protect a more anxious parent by being what the parentwants. In such a situation, our work can seem very successful. On the other hand, we canhelp the patient to suffer. If we see success as therapists only in enabling creativity andhappiness or in being effective in some tangible and possibly measurable way - if, inshort, we see ourselves as selling goods on a market to attract customers or to pleasemanagement - we are developing a false world which will collapse only too easily in theface of our critics.

References

Abraham, K. (1927) Selected Papers on Psychoanalysis. London: Hogarth Press.Bowlby, J. (1960) Grief and mourning in infancy and childhood. In The Psychoanalytic Study of the

Child, 15, pp. 9-52.Bowlby, J. (1961) Processes of mourning. In International Journal of Psycho-Analysis, 42, pp. 317-

40.Foucault, M. (1984) A History of Sexuality, Vol. 1. Harmondsworth: Penguin Books.Freud, S. (1917) Mourning and melancholia. In Collected Works Vol. 11, pp. 245-68.

Harmondsworth: Penguin Books, 1984.Giddens, A. (1990) The Consequences of Modernity. Oxford: Polity Press.Giddens, A. (1991) Modernity and Self-Identity: Self and Society in the Late Modern Age. Oxford:

Polity Press.Gorer, G. (1965) Death, Grief and Mourning in Contemporary Britain. London: Cresset.Harvey, D. (1989) The Condition of Post-Modernity. Oxford: Basil Blackwell.Hinton, J. (1967) Dying. Harmondsworth: Penguin Books.Kastenbaum, R. (1982) Dying is healthy and death a bureaucrat: our fantasy machine is alive and

well. In Interpersonal Issues in Health Care (Eds. M. Dimatteo and H. Friedman). London:Academic Press.

Klein, M. (1986) Mourning and its relation to manic-depressive states. In The Selected MelanieKlein (Ed. J. Mitchell), pp. 146-74. Harmondsworth: Penguin Books.

Kohut, H. (1971) The Analysis of the Self New York: International Universities Press.Lakoff, R.S. & Azim. H.F.A. (1991a) Society's changing views on mourning. In Group Analysis,

24(4), pp. 355-62.McCallum, M. et al. (1991c) The Edmonton Model of Short-Term Group Therapy for Loss: an

integration of theory, practice and research. In Group Analysis, 24(4), pp. 375-88.Osterweis, M., Solomon, F. & Green, M. (1987) Bereavement reactions, consequences and care. In

Biophysical Aspects of Bereavement (Ed. S. Zisook). Washington DC: American PsychiatricPress.

Parkes, C.M. (1987) Bereavement: Studies of Grief in Adult Life. Harmondsworth: Penguin Books.Piper, W. E. & McCallum, M. (1991 b) Group intervention for persons who have experienced loss:

description and evaluative research. In Group Analysis, 24(4), pp. 363-74.Raphael, B. (1984) The Anatomy of Bereavement: A Handbook For The Caring Professions.

London: Unwin Hyman.Simmel, G. (1950) The metropolis and mental life. In The Sociology of Georg Simmel (Ed. K.

Wolff). New York: The Free Press.Witham, A. (1985) The idealisation of dying. In Free Associations, 3, pp. 80-91.