The (re)construction of self after the death of a partner to HIV/AIDS

Stigma in the bereavement experiences of gay men who have lost a partner to suicide

Despite the high prevalence of suicide in gay communities, the impact of suicide on surviving male partners is poorly understood. This article presents a qualitative case study of two gay men who lost a partner to suicide and explores how stigma may shape gay men's bereavement experiences. Data were collected using photovoice methods and analysed using a thematic approach. Five themes were inductively derived: (1) trying to prevent the inevitable; (2) guilty of keeping secrets; (3) dreams shattered by suicide; (4) abandoned and alone in grief; and (5) a lonesome road to recovery. Within each theme, the article indentifies how stigma-related challenges associated with suicide, mental illness and minority sexual identity shaped gay men's bereavement experiences. Practice and policy implications are discussed, including how the provision of tailored clinical and peer supports can assist gay men in the bereavement of a same-sex partner to suicide. The findings detailed in this study highlight the need for interventions to de-stigmatise mental illness and suicide within and outside the gay community.

Therapeutic writing as a tool to facilitate therapeutic process in the context of living with HIV: A case study examining partner loss

For people with HIV/AIDS (PWHA), partner loss has unique factors that complicate the grieving process and can lead to prolonged bereavement. Empirical evidence has demonstrated the benefits of emotional disclosure through therapeutic writing on physical symptoms, immune responses, and psychological distress. Therapeutic writing is based on the assumption that writing about one's deepest thoughts and feelings allows cognitive, behavioral, and kinesthetic processing of stressful life events and/or traumas. The present case study explores the benefits and challenges of using expressive writing, in addition to cognitive-behavioral therapy, to address partner loss and disenfranchised grief in the context of living with HIV. This article (a) reviews the literature on coping with loss and factors that can make PWHA more vulnerable to disenfranchised grief; (b) describes a former patient whose partner loss was complicated by lack of closure around the termination of his 6-year-long relationship, the death of that partner without the family informing him, and his anger surrounding his partner infecting him with HIV; and (c) discusses how the therapist created a comprehensive treatment plan using therapeutic writing to improve emotional processing. Results suggest that therapeutic writing assisted with symptom alleviation, improvement in psychological well-being, and increased overall quality of life. Although the loss of a partner is a common human experience, therapists need to be aware that PWHA may have additional or different care needs that can put them at risk of heightened or prolonged bereavement. Recommendations for using therapeutic writing are included. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The bereavement experiences of lesbian, gay, bisexual and/or trans* people who have lost a partner: A systematic review, thematic synthesis and modelling of the literature

BACKGROUND

Socially excluded populations have poorer access to care; however, little attention has been paid to lesbian, gay, bisexual and/or trans* people. Lesbian, gay, bisexual and/or trans* people are at increased risk of certain life-limiting illnesses and may not receive the care and support they need at the end of life and into bereavement.

AIM

To identify and appraise the evidence of the bereavement experiences of lesbian, gay, bisexual and/or trans* people who have lost a partner and develop an explanatory model of lesbian, gay, bisexual and/or trans* partner bereavement.

DESIGN

Systematic review (in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines) and thematic synthesis with assessment of reporting and rigour. Quantitative or qualitative articles reporting bereavement experiences of lesbian, gay, bisexual and/or trans* partners were included, excluding articles reporting multiple losses in the context of HIV or AIDS.

DATA SOURCES

PsycINFO, MEDLINE, Web of Science, Scopus, Cochrane Library. Inclusion dates: database inception - 30 April 2015.

RESULTS

A total of 23 articles reporting on 13 studies were identified. Studies described universal experiences of the pain of losing a partner; however, additional barriers and stressors were reported for lesbian, gay, bisexual and/or trans* people, including homophobia, failure to acknowledge the relationship, additional legal and financial issues and the 'shadow' of HIV or AIDS. A novel model was developed to explain how the experience for lesbian, gay, bisexual and/or trans* people is shaped by whether the relationship was disclosed and acknowledged in life and into bereavement and how this impacts upon needs and access to care.

CONCLUSION

There is a need for healthcare providers to avoid hetero-normative assumptions; be mindful of additional stressors in bereavement for lesbian, gay, bisexual and/or trans* people; and consider additional sources of support to deliver individualised holistic care.

Do grief self-help books convey contemporary perspectives on grieving?

Grief therapy and psychology literatures of the modern Western world conceptualized bereavement and grief as processes to be "worked through" so that other relationships could be pursued. In the last decade or so, however, grief theorists have endorsed the value of attaining new meaning(s) and continuing bonds with our lost loved ones instead of "moving on from," "letting go of" or "achieving closure from" them. This article tracks the evolution of thought pertaining to this shift and examines its relevance to grief self-help books that may offer Americans guidance in the ways of grieving.