A qualitative exploration of sensing the presence of the deceased following bereavement

Are Sensory Experiences of One's Deceased Spouse Associated with Bereavement-Related Distress?

Following late-life spousal bereavement, sensory and quasi-sensory experiences of the deceased (SED) are commonly reported. This longitudinal study examined SED among 310 older widowed adults 6-10 (T1) and 18-20 (T2) months post loss. Reports of SED in the first 6-10 months after loss were associated with higher symptom levels of prolonged grief, post-traumatic stress, and loneliness at T1. Experiencers of SED were more likely to experience symptoms of prolonged grief and post-traumatic stress above cut-off scores at T1. Importantly, only a minority of the experiencers of SED displayed these elevated levels of bereavement-related distress. In addition, employing multi-level-modeling, a similar trajectory of decreasing bereavement-related distress over time was found for both experiencers and non-experiencers of SED. We argue that SED may be one of several potential reactions to bereavement, which should not be seen as an indicator of grief complications per se.

Very Present and Very Real: A Case Study of Regularly Hearing the Voice of the Deceased Without Distress in Bereavement

Although sensory and quasi-sensory experiences of the deceased (SED) have been the subject of much debate, research on the phenomenology of auditory verbal experiences in the bereaved has been neglected. This case study describes the phenomenology of a regularly occurring voice hearing experience and its meaning for a single bereaved individual. The voice of the deceased can be heard as though in external space, and the experience can feel real, even when the death is fully acknowledged. A bereaved individual can welcome and benefit from the experience even when it is not recognized as a normal part of grieving in the individual's cultural context, when no afterlife belief is present, and when the experience remains unexplained. The case study demonstrates that hearing the voice of the deceased can be a regular occurrence without causing distress or dysfunction and lends support to the idea that SED are a common concomitant of normal bereavement.

Factors Moderating the Impact of After Death Communications on Beliefs and Spirituality

After death communications(ADCs) are defined as perceived spontaneous contacts with living individuals by the deceased. This research presents on a subset of data from a recent large international survey of individuals who experienced ADCs and provided systematic information regarding these experiences. In our research we explore the impact of having an ADC on reported spirituality, religiosity, beliefs and attitudes about death and dying and also explore the moderating factors of this impact. We found that having an ADC was perceived as a positive life experience and that it was associated with a reduction in fear of death, belief in life after death and that the deceased could communicate with the living, and increased reported spirituality. Moderating factors include aspects of having or desiring physical contact with the deceased as well as perceiving some emotional reaction to the ADCs. Future directions for research exploration are also provided based on our findings.

The impact of continuing bonds following bereavement: A systematic review

Following bereavement, continuing bonds (CBs) include engaging with memories, illusions, sensory and quasi-sensory perceptions, hallucinations, communication, actions, and belief that evoke an inner relationship with the deceased. To date, the literature has been unable to confirm whether retaining, rather than relinquishing, bonds is helpful. A mixed studies systematic literature search explored how CBs affect grief. Studies on the effect or experience of CBs on adjustment following bereavement were eligible for inclusion. Six computerized databases were searched. A total of 79 of 319 screened studies were included. Three themes were derived from the thematic analysis: (1) comfort and distress, (2) ongoing bonds and relational identity, and (3) uncertainty, conceptualizing, and spirituality. Themes describe the role of CBs for the accommodation of the death story, transformation of the relationship, meaning reconstruction, identity processes, and affirmation of spiritual belief. Results shed light on the adaptive potentials for CBs.

Sensory experiences of one's deceased spouse in older adults: An analysis of predisposing factors

Objectives This study focuses on pre-disposing factors associated with sensory experiences of the deceased (SED), also called bereavement hallucinations. Even though SED are common among older widowed adults, our knowledge of these experiences is still limited.Method Survey responses were obtained from 310 older widowed participants (M = 70.05 ± 8.39), complemented with data from Danish national registers.Results Hierarchical logistic regression analysis revealed four significant pre-disposing factors: prior experiences of SED in the context of previous significant bereavements (OR = 4.72), a history of interpersonal trauma (OR = 5.8), high pre-death relationship closeness (OR = 2.76) and stronger religious/spiritual worldview (OR = 1.12). No association to registered mental health diagnosis was identified.Conclusion: SED may be considered an interpersonal experience, which may be more likely to occur if the pre-death relationship is described as very close and if the bereaved has previously experienced interpersonal trauma. We argue that SED should not necessarily be considered an indication of neurodegenerative or psychiatric diseases.

Prevalence and Phenomenology of Sensory Experiences of a Deceased Spouse: A Survey of Bereaved Older Adults

Sensory and quasi-sensory experiences of the deceased (SED), also called bereavement hallucinations, are common in bereavement, but research detailing these experiences is limited. Methods: An in-depth survey of SED was developed based on existing research, and 310 older adults from the general Danish population participated in the study 6-10 months after their spouse died. Results: SED were reported by 42% of the participants with wide-ranging phenomenological features across sensory-modalities. In particular, seeing and hearing the deceased spouse was experienced as very similar to the couple's everyday contacts before death. SED were endorsed as positive by a majority of experiencers, and the experiences were often shared with family and friends. Discussion: SED are conceptualized as social and relational phenomena, which may comfort the surviving spouse in late-life bereavement, but also provide tangible help to some experiencers. In clinical practice, SED may be considered a potential resource for the therapeutic grief process.

Perceptual phenomena associated with spontaneous experiences of after-death communication: Analysis of visual, tactile, auditory and olfactory sensations

The purpose of this study was to create a detailed characterization of the nature of the sensory perceptions associated with after-death communication. A primary aim was to determine if perceptions of after-death communication (ADC) support one or more of three hypotheses: (1) they are the result of hallucinations or day-to-day thoughts about the deceased; (2) they are subjective phenomena reflecting the extrasensory perception of remote events; or (3) they constitute objective phenomena, perceived more solidly, as if within the physical world. Methods: The study included a quantitative analysis and qualitative first-person narrative description of part of the data set from a detailed questionnaire study (991 viable cases) investigating the phenomenology of spontaneous ADCs. Results and Conclusions: A majority of respondents reported that ADCs were distinctly different from simple thoughts about the deceased. Specifically, relative distribution of ADCs across the senses was 46% visual, 44% auditory, 48% touch, and 28% olfactory, with 34% sensing the presence of the deceased without input from the five senses. ADCs often were perceived as external and having properties of the material world (e.g., solidity, tactile qualities). Even the more nebulous 'sense of presence' cases were perceived as having a distinct location in space and as being identifiable as a specific deceased presence despite the lack of sensory cues. These elements are more compatible with hypotheses 2 and 3 than hypothesis 1.

Sensory and Quasi-Sensory Experiences of the Deceased in Bereavement: An Interdisciplinary and Integrative Review

Bereaved people often report having sensory and quasi-sensory experiences of the deceased (SED), and there is an ongoing debate over whether SED are associated with pathology, such as grief complications. Research into these experiences has been conducted in various disciplines, including psychiatry, psychology, and anthropology, without much crossover. This review brings these areas of research together, drawing on the expertise of an interdisciplinary working group formed as part of the International Consortium for Hallucination Research (ICHR). It examines existing evidence on the phenomenology, associated factors, and impact of SED, including the role of culture, and discusses the main theories on SED and how these phenomena compare with unusual experiences in other contexts. The review concludes that the vast majority of these experiences are benign and that they should be considered in light of their biographical, relational, and sociocultural contexts.

A Qualitative Examination of Continuing Bonds through Spiritual Experiences in Individuals Bereaved by Suicide

Introduction: Suicide is a public health problem worldwide, and spiritual experiences may be important positive experiences or coping mechanisms for difficulties associated with surviving a suicide loss. Studies have found that continuing bonds through spiritual experiences are common among individuals bereaved by suicide. However, the literature lacks depth in understanding these experiences, such as sense of presence. Aims: The aim of this study was to qualitatively examine descriptions of continuing bonds through spiritual experiences after death by suicide. Method: A total of 1301 individuals bereaved by suicide provided 2443 free responses about their spiritual experiences based on four different prompts, which were analyzed using an inductive approach. Results: Nine common themes were identified, selected for interest, and reported: (1) a helpful sense of comfort; (2) a helpful sense of connection with the deceased; (3) intense sadness evoked by the spiritual experiences; (4) confusion regarding the spiritual experiences; (5) negative reminders of the deceased or negative meanings of spiritual experiences; (6) evidence of an afterlife; (7) general importance of the spiritual experiences’ meaning; (8) impact of and on religious beliefs; and (9) others’ responses to disclosure of suicide or spiritual experiences. Conclusion: For the overwhelming majority of participants, spiritual experiences such as a sense of presence have deep meaning and are often regarded as a positive source of healing and transformation after a suicide death.

The Structure and Measurement of Unusual Sensory Experiences in Different Modalities: The Multi-Modality Unusual Sensory Experiences Questionnaire (MUSEQ)

Hallucinations and other unusual sensory experiences (USE) can occur in all modalities in the general population. Yet, the existing literature is dominated by investigations into auditory hallucinations (“voices”), while other modalities remain under-researched. Furthermore, there is a paucity of measures which can systematically assess different modalities, which limits our ability to detect individual and group differences across modalities. The current study explored such differences using a new scale, the Multi-Modality Unusual Sensory Experiences Questionnaire (MUSEQ). The MUSEQ is a 43-item self-report measure which assesses USE in six modalities: auditory, visual, olfactory, gustatory, bodily sensations, and sensed presence. Scale development and validation involved a total of 1,300 participants, which included: 513 students and community members for initial development, 32 individuals with schizophrenia spectrum disorder or bipolar disorder for validation, 659 students for factor replication, and 96 students for test-retest reliability. Confirmatory factor analyses showed that a correlated-factors model and bifactor model yielded acceptable model fit, while a unidimensional model fitted poorly. These findings were confirmed in the replication sample. Results showed contributions from a general common factor, as well as modality-specific factors. The latter accounted for less variance than the general factor, but could still detect theoretically meaningful group differences. The MUSEQ showed good reliability, construct validity, and could discriminate non-clinical and clinical groups. The MUSEQ offers a reliable means of measuring hallucinations and other USE in six different modalities.

Hallucinations in Healthy Older Adults: An Overview of the Literature and Perspectives for Future Research

KEY POINTS

➢ Studies suggest a substantial minority of healthy older adults have hallucinatory experiences, in line with existing evidence on hallucinations in other age groups, though it is still unclear if hallucination prevalence increases or declines with age in older cohorts.

➢ Stigma attached to both hallucinations and ageing leads to considerable under-reporting of these experiences in healthy older adults and may negatively bias how professionals, family members, and the public respond.

➢ Why and when hallucinations in healthy older adults remit, persist, or progress to other clinical disorders remains poorly understood.

➢ Current evidence points to a range of factors associated with hallucinations in older adults including decline in sensory or cognitive functioning, poor sleep, and psychosocial stressors (e.g., social isolation, loneliness, and bereavement), highlighting the need for accurate assessment and tailored interventions.

Hallucinations, though common in youth and younger adults, are not the preserve of these age groups. Accumulating evidence shows that hallucinatory experiences are also present at surprisingly high rates in healthy older adults in the general community. Furthermore, stigma and misunderstanding of hallucinations, together with ageism, may lead to under-reporting of these experiences by older adults, and misdiagnosis or mismanagement by health and mental health practitioners. Consequently, improved public and professional knowledge is needed about the nature and significance of hallucinations with advancing age. The purpose of this review is to provide a comprehensive overview, and critical analysis, of research on the prevalence, psychosocial, and neurobiological factors associated with hallucinations in people aged 60 years and over. To the best of our knowledge, this is the first review of its kind in the literature. The evidence supports a dynamic conceptualization of hallucinations, in which the emergence of hallucinations is viewed as a balance between the sensory, cognitive, or social impairments accompanying advancing age and the degree to which compensatory processes elicited by these impairments are successful. We briefly summarize the implications of the literature for aged care services and interventions, and stress that far more studies are needed in this important field of research.