Antioch University AURA - Antioch University Repository and Archive Student & Alumni Scholarship, including Dissertations & Theses Dissertations & Theses 2015 The Experience of Sibling Death in Childhood: A Qualitative Analysis of Memoirs Katrin Neubacher Follow this and additional works at: http://aura.edu/etds Part of the Clinical Psychology Commons Recommended Citation Neubacher, Katrin, "The Experience of Sibling Death in Childhood: A Qualitative Analysis of Memoirs" (2015).edu/etds/255 This Dissertation is brought to you for free and open access by the Student & Alumni Scholarship, including Dissertations & Theses at AURA - Antioch University Repository and Archive. It has been accepted for inclusion in Dissertations & Theses by an authorized administrator of AURA - Antioch University Repository and Archive. For more information, please contact dpenrose@antioch.edu, wmcgrath@antioch. Running Head: SIBLING DEATH IN CHILDHOOD The Experience of Sibling Death in Childhood: A Qualitative Analysis of Memoirs by Katrin Neubacher B., Antioch University New England, 2012 DISSERTATION Submitted in partial fulfillment for the degree of Doctor of Psychology in the Department of Clinical Psychology at Antioch University New England, 2015 Keene, New Hampshire SIBLING DEATH IN CHILDHOOD i Department of Clinical Psychology DISSERTATION COMMITTEE PAGE The undersigned have examined the dissertation entitled: THE EXPERIENCE OF SIBLING DEATH IN CHILDHOOD: A QUALITATIVE ANALYSIS OF MEMOIRS presented on June 11, 2015 by Katrin Neubacher Candidate for the degree of Doctor of Psychology and hereby certify that it is accepted*.
Dissertation Committee Chairperson: Theodore Ellenhorn, PhD Dissertation Committee members: Martha Straus, PhD Porter Eagan, PsyD Accepted by the Department of Clinical Psychology Chairperson Kathi A. Borden, PhD on 6/11/15 * Signatures are on file with the Registrar’s Office at Antioch University New England. SIBLING DEATH IN CHILDHOOD ii In liebevoller Erinnerung an Stefan. SIBLING DEATH IN CHILDHOOD iii Acknowledgements Words cannot express how grateful I am to my chair, Dr.
Theodore Ellenhorn, and to my committee members, Drs. Porter Eagan and Martha Straus, for their support, dedication to my learning, and inspiration. Porter—you taught me how to think deeply and helped me truly appreciate the beauty and complexity of the minds of the children with whom I work. Marti—your brilliance and passion for working with traumatized children has inspired me, you pushed me forward, and you are someone who I want to be when I grow up.
And Ted—you pulled me through the most agonizing and intense task of my life so far, and in the midst of that, you helped me find my voice. I would like to thank my study partner and friend, Courtney, whose commiseration and support throughout grad school has helped me come out the other end in one sane piece. I could not have done this without you. I want to acknowledge my incredible support system—my friends, who graciously stood by me during years of social hibernation; Lil, who so willingly edited various iterations of my dissertation; and Sarah, for her unwavering friendship.
And finally, I would like to thank my parents and my siblings, whose support and love have sustained me in every possible way. You are what I love most about my life. SIBLING DEATH IN CHILDHOOD iv Table of Contents Abstract. 1 Chapter 1: Review of Relevant Literature.
2 The Child’s Grief. 5 The Grieving Process. 7 Tasks of mourning. 9 Memoir as Inquiry.
13 Research Design: Interpretive Phenomenological Analysis. 15 Step 1: Reading and rereading. 15 Step 2: Initial noting. 16 Step 3: Developing emergent themes.
16 Step 4: Searching for connection across emergent themes. 17 Step 5: Moving to next narrative. 17 Step 6: Looking for patterns across narratives. 19 SIBLING DEATH IN CHILDHOOD v Data Analytic Procedure.
21 Societal response to sibling grief. 26 Affect restriction and fear. 29 Connecting with the deceased sibling. 34 Grieving through suffering.
39 Parental misattunement to child’s grief. 40 The unbearable grief of the other. 44 Familial disconnect through grief. 45 The goal of survival.
48 Response to parental grief. 50 Compensating for parental loss. 52 Knowing details of the circumstances of the death. 57 Therapy as healing.
61 Expression and words as healing. 67 SIBLING DEATH IN CHILDHOOD vi Chapter 4: Discussion. 68 The Experience of Society and Culture. 70 Devaluation of sibling grief.
72 Experience of Grief in the Family System. 74 The absent parent and avoidance of grief. 81 Connecting with the deceased sibling. 83 Experiences of the Self.
84 The disorientation and damage of the self. 84 Integration and reconnection of the self. 88 Experiences of God. Make no assumptions about the etiology of the mental health symptom.
Carefully consider if, how, and when, to include the family system in treatment. Consider the child’s age and developmental level. Support the child’s ongoing relationship with the deceased sibling. Consider an attachment-based approach.
97 Fundamental clinical skills for working with bereaved children based on results of the analysis. 101 Limitations and Future Directions. 101 SIBLING DEATH IN CHILDHOOD vii References. 104 Appendix A: Emergent Themes.
115 Appendix B: Superordinate Themes. 116 Appendix C: Example of Emergent Themes. 117 Appendix D: Example of Superordinate Themes. 129 SIBLING DEATH IN CHILDHOOD 1 Abstract This qualitative study explored the experience of the death of a sibling in childhood.
Seven memoirs written by individuals who lost a sibling in childhood were analyzed using Interpretive Phenomenological Analysis. Themes focused on the child’s lived experience of sibling loss, parental and familial function, and factors identified as supporting the child’s grieving and functioning. Where relevant, an in-depth review of the existing literature of relevant psychological research and theories supported and expanded on the themes identified in the narratives. As the purpose of this research was to inform a model for understanding the life and grief of a bereaved sibling, the study informed ways in which to facilitate the child’s grieving process in the therapeutic setting and concrete implications for mental health treatment were identified.
Keywords: grief, death, childhood, sibling, recovery SIBLING DEATH IN CHILDHOOD 2 The Experience of Sibling Death in Childhood: A Qualitative Analysis of Memoirs Chapter 1: Review of Relevant Literature When I started to write the book, I thought that I would write the story of my parents’ lives, of everything they lost when Roy died. (…) It took me quite some time to realize that the sister’s story was a very important story as well. (Smith, 2004, epilogue) Memoirs written by individuals whose sibling has died highlight the gravity of pain and loss that is caused by the death. However, the death of a sibling in childhood has received little attention when compared to the effects of the death of a parent and the parent’s response following the death of a child (Dickens, 2014; Horsley & Patterson, 2006; Worden, Davies, & McCown, 1999).
Research suggests that approximately one quarter of children who have had a sibling die are at risk for developing significant, long-term psychiatric difficulties due to unresolved grief, and require clinical interventions (Worden et al. The suffering and stressors in a child’s life following the death of a brother or sister bring with it not only grief over the loss of a playmate, friend, and life companion, but also the loss of the caregiver’s usual attention, nurturance, and presence (Barrera, Alam, D’Agostino, Nicholas, & Schneiderman, 2013; Crehan, 2004). As the death of a child is associated with the highest levels of grief in parents compared to other losses, the bereaved parents’ ability to meet the emotional and physical needs of the surviving child is compromised (Worden, 1996). In some cases, the parents’ distress can cause a rupture in the parent-child relationship and, if unattended, may result in significant mental health difficulties for the child in the future (Goldsmith, 2007).
A careful review of the existing literature reveals a marked lack of understanding of the child’s experience of the losses and changes that ensue in the family and caregiving system after a brother or sister has died. This research study’s aim was to remedy the gap in the literature by exploring, highlighting, and analyzing first-person accounts of sibling death in childhood, SIBLING DEATH IN CHILDHOOD 3 attending particularly to sibling loss and the impact of the parent’s grief on parental functioning. In this chapter, the psychological research and literature on childhood grief, sibling loss, and the grieving process will be reviewed to begin to identify salient aspects of sibling bereavement. The Child’s Grief Grief affects many aspects of the child’s daily life and necessitates the assistance of others to progress in a healthy fashion (Schwab, 1997; Worden, 1996).
Grieving children require support from adults in understanding the circumstances of the death, in expressing their thoughts and feelings, and making sense of their loss and the implications of the death of a loved one (Horsley & Patterson, 2006). In order to support a child’s grief, the lived experience of the death of a sibling in childhood must first be understood. Society paints a vivid picture of acute adult grief. The image is of an individual in dark clothing speaking in a somber voice amidst bouts of tearfulness.
A child’s observed grief, however, does not necessarily align with this image. Adult death rituals have developed over time to assist the bereaved in their grieving processes. Yet as childhood grieving behavior differs from that of adults, these rituals may not necessarily support childhood grieving processes (Dickens, 2014; Himebauch, Arnold, & May, 2008; McCown & Davies, 1995). A child’s internal pain and suffering is much like that of adults, yet the expression of their grief differs (Schwab, 1997).
Children often do not communicate their distress verbally and expression of grief can occur in the form of regressive behavior, fear of death and being alone, withdrawal, aggressive behaviors, and delinquency (Schwab, 1997). Their grief may occur sporadically (Himebauch et al., 2008) and manifest in affect (sorrow, fear, guilt, anxiety, anger, helplessness, loneliness), cognitions (confusion, difficulty with concentration and memory, auditory and visual hallucinations), physical reactions (headaches, nausea, insomnia, fatigue, sleep disturbance, loss SIBLING DEATH IN CHILDHOOD 4 of appetite), and behaviors (crying, social isolation, anhedonia) [Davies & Limbo, 2010; Schupp, 2003; Worden, 1991]. These manifestations of grief do not occur in a predictable fashion (i., variations in expression of grief, and time of acute grief responses), and there is a dearth of information in the research and literature giving caregivers and mental health professionals a clear image of what a child’s grief looks like. What is known, is that grieving children’s singular behavioral patterns may more closely resemble that of children who present with symptoms of psychiatric illnesses than those of children who do not carry a diagnosis of a mental disorder, such as Major Depressive Disorder (Birenbaum, 1999).
The available research and literature on behavioral and emotional manifestations of grief in children is insufficient for an informed understanding of the experience of sibling loss in childhood. This dearth of knowledge can indicate that caregivers and mental health professionals may not appreciate the meaning of a particular behavior and may thus not recognize effective ways of responding to the child’s needs (Dickens, 2014). In service of aiding mental health professionals in working with this population, this study aimed to paint a picture of a child’s experience of grief, including the depiction of the child’s emotional world, perceptions of parental grief and available support, as well as factors that contribute to healing. Though research on childhood grief over the past decades has shed light onto expected behavior patterns, such as externalizing and internalizing behavior problems in children, there is still much to be learned.
The understanding that children grieve was first ushered into the world of mental health professionals through John Bowlby’s research on the child’s separation from the mother in 1961 (Silverman, 2000). Since that time, gains have been made in terms of acknowledging and understanding childhood grief.