Utay and Miller (2006) described a study in which researchers observed over 100 individuals with unresolved grief reactions. There were three phases of treatment employed with these individuals. The first stage of treatment involved cognitive structuring for the decision to grieve again and for procedure clarification. The second stage involved guided imagery for reliving, revising, and revisiting the scenes at which the loss occurred. The third and final stage involved future-oriented identity reconstruction. The researchers reported that the reliving of the event through guided imagery effectively changed the client's view of reality, and furthermore helped along their grief resolution (Melges & DeMaso (1980), as cited by Utay & Miller, 2006). Moreover, Guided imagery has been established as a versatile and effective intervention.
The importance in assisting the children's mother with the grief process lies in the fact that bereavement is associated with increased risk of morbidity and mortality, and it is important to establish interventions that protect the bereaved from suffering that lasts in severe health impairment (Stroebe, Schut & Stroebe, 2005). Intervention programs that assist the bereaved in confronting and expressing intense emotions have been considered very effective. However, this disclosure of emotions may not be enough. For instance, a study by Stroebe et al. (2005) demonstrated that expressing and sharing emotions did not significantly facilitate adjustment to loss among the bereaved. Furthermore, a deeper, more intense intervention that focuses on processes within the subconscious, like guided imagery, may be more effective.
Intervention strategies must recognize the importance of experiencing a normal grief process. All people who experience loss need to experience a period of grief, including stages of psychological adjustment that can last sometime. Before intervention, it may be beneficial for clinicians to allow for time for the individual to have a grieving period, in which emotions are experienced and run their course. Intervention too early may interrupt this normal healing process and cause further emotional problems in the long-run (Schut & Stroebe, 2005).
After the bereaved person has had a period of time with the grief process, it may be recommended that they join a grief resolution group (Joffrion & Douglas, 1994). This type of group may aid in healing through the development of self-transcendence. Effectively, self-transcendence involves the ability to extend one's self beyond personal concerns at hand and reach out to others without sacrificing one's sense of self. This process results in a broadening of perspectives, purposes and activities in the bereaved person's life. Guided imagery could play an integral role in the development of self-transcendence, and furthermore enhance grief resolution.
Moreover, it is of the utmost importance that an intervention be planned and implemented to aid the mother in the case study with grief resolution in the case of sudden death for her children due to long QT syndrome. The following outlines a multi-stage therapeutic intervention involving guided imagery:
Assist the mother with recognizing the importance of the grief process. Allow her to experience all of the emotions associated with loss, and give her time to process here experiences. It must be ensured that she feels socially supported, and that she has someone to talk to when she requires it.
After sometime with the normal bereavement process, assess her level of grief resolution. At this time it may be appropriate to offer her an intervention such as perceptual reconstruction (Gravitz, 2001). This intervention strategy involves a conscious shift in focus from memories of the death and dying process to more positive memories involving the life of the individual that was lost. Perceptual reconstruction involves a hypnosis-based, imagery-focused strategy that replaces disturbing images that are detrimental to the grief resolution process with hypnotically reconstructed positive memories. Research has demonstrated that this hypnotic strategy is effective in the treatment of inordinate grief, and that the restructure images were maintained and only became stronger over time after the therapeutic session (Gravitz, 2001).
After therapeutic intervention with guided imagery, it may be recommended that the individual join a bereavement support group that is focused on positive outcomes from the grief resolution process, and not focused on the negative experiences associated with bereavement
Elliott, K. (2000). Long QT syndrome. Alberta RN, January/February.
Firth, Hurst (2005). Clinical Genetics, New York: Oxford University Press, 378-9.
Gravitz, MA. (2001). Perceptual reconstruction in the treatment of inordinate grief. American Journal of Clinical Hypnosis, 44(1), 51-5.
Joffrion, L.P., Douglas, D. (1994). Grief resolution: faciliatating self-transcendence in the bereaved. Journal of Psychosocial Nursing and Mental Health Services, 32(3), 13-9.
Meyer, J.S., Mehdirad, a., Salem, B.I., Kulikowska, a., Kulikowski, P., Jamry, W.A. (2003). Sudden arrhythmia death syndrome: importance of the long QT syndrome. American Family Physician, August.
Risser, N., Murphy, M. (2003). Long QT syndrome. Nurse Practitioner, September.
Schut, H., Stroebe, M.S. (2005). Interventions to enhance adaptation to bereavement. Journal of Palliative Medicine, 8(Suppl.1), S140-7.
Stroebe, W., Schut, H., Stroebe, M.S. (2005). Grief work, disclosure and counseling: do they help the bereaved? Clinical Psychology Review, 25(4), 395-414.
Towbin, J.A., Wang, Z., Li, H. (2001). Genotype and the severity of long QT syndrome. Archives of Pathology & Laboratory Medicine, January.