Perceiving those who are gone: Cultural research on post-bereavement perception or hallucination of the deceased

Experiencing the continued presence of the deceased is common among the bereaved, whether as a sensory perception or as a felt presence. This phenomenon has been researched from psychological and psychiatric perspectives during the last five decades. Such experiences have been also documented in the ethnographic literature but, despite the extensive cross-cultural research in the area, anthropological data has generally not been considered in the psychological literature about this phenomenon. This paper provides an overview aimed at bridging these two areas of knowledge, and approaches the post-bereavement perception or hallucination of the deceased in cultural context. Ongoing debates are addressed from the vantage point of ethnographic and clinical case study research focusing on the cultural repertoires (in constant flux as cultures change) from which these experiences are labelled as desirable and normal, on the one hand, or as dangerous and pathological, on the other.

When experiences of presence go awry: A survey on psychotherapy practice with the ambivalent-to-distressing 'hallucination' of the deceased

OBJECTIVES

Experiences of presence, involving the sensory perception or felt presence of the deceased, are common amongst the bereaved (30-60%). Despite them being predominantly comforting and reassuring, a minority (approximately 25%) report ambivalent or distressing experiences. The study's aim was to explore how psychotherapy is practised with this subset.

METHOD

A mixed-method approach, involving both quantitative analysis and thematic analysis, was used to analyse data from an online survey, conducted in English and Spanish, amongst mental health therapists (i.e., psychologists, psychotherapists, and counsellors). Seventy responded to the survey and four of them were further interviewed.

RESULTS

The participants primarily framed interventions for ambivalent-to-distressing experiences of presence as grief therapy, with the severity of the presentation as the main factor influencing their clinical decision-making, but several perspectives co-existed regarding how to intervene. These discourses were categorized into two themes: 'A normalising and exploratory psychotherapy' and 'A grief stages psychotherapy'. The main sources of patient's distress, as understood by the sample, were located in the bereaved-departed relationship, in pre-existing mental health issues, and in a societal taboo or stigma.

CONCLUSION

After comparing and contrasting the participants' working hypotheses with existing knowledge on experiences of presence, and contemporary theories in the research area, guidelines are presented on how to intervene with people disturbed by their experiences of presence.

PRACTITIONER POINTS

Perceiving the deceased person, or feeling their presence, is common and normal amongst bereaved people. When these experiences are distressing or ambivalent, therapists' share that psychological suffering may originate from the departed-bereaved relationship, pre-existing mental health issues, or the effect of societal taboo or stigma. Psychotherapy is frequently aimed at normalizing, accepting, supporting, and exploring patient's experience.

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.