Men's Grief, Meaning and Growth: A Phenomenological Investigation into the Experience of Loss

Headnote

Abstract

There is a scarcity of research on men's experience of bereavement (Reiniche, 2006), particularly in relation to qualitative research that focuses on the meaning of such an experience. This paper seeks to address this scarcity by presenting the findings from a phenomenological study of the lifeworlds of a small number of bereaved men. The study looked specifically at how the loss of a spouse influences men's experience of meaning, grief and loss. Three men aged between 32 and 54 years old who had all lost their partners to cancer between 3 and 7 years ago were interviewed. The hermeneutic phenomenological method of Van Manen (1990) was used to uncover three key themes, labelled grief and self-reflection, meaning of life and loss, and refiguring the life-world. These themes are discussed in the light of broader existential concerns and the extant literature.

Since the publication of Freud's (1917/1957) Mourning and Melancholia, grief and bereavement theories have suggested links between grief and bereavement and mental health and depression. Lindemann's (1944) classic work Symptomatology and Management of Acute Grief describes the characteristics of normal grief, which include bodily distress, preoccupation with the image of the deceased, hostility, guilt, and the incapability of functioning as well as before the loss. However, theories of grief and bereavement have developed considerably since these early psychoanalytic conceptualizations. Parkes (1972) drew attention to the limitations of Lindemann's theory and argued that Lindemann provided limited data on the frequency of the described symptoms, the number of times the clients were interviewed and the amount of time between the interviews and the time of the loss. Parkes' (1972) work expanded the understanding of grief and offered valuable insights into the effects of grief on physical and mental health further. This work provided strong evidence of a link between grief and physical and mental health. Based on these findings it is clear that it is imperative that researchers aim to gain a deeper understanding of grief, health and the meaning of life in order to design appropriate interventions for those offering support (such as counselling and psychotherapy) to people who are experiencing bereavement. This is particularly true for men experiencing bereavement, as this remains an under-researched topic (Reiniche, 2006). The aim of this paper is to provide new insight into the experience of bereavement for men through a phenomenological study of a small number of men who have lost their partners through cancer.

Research conducted in the second half of the twentieth century clearly showed that certain processes occurred while people 'worked through' the loss of a loved one. Worden (1982) described certain 'tasks of mourning' that form part of 'grief work' and that need to be undergone before a comprehensive mourning process is completed. A large number of grief theories have further described and theorised processes of 'grief work' (Spaten, 2008). These theories all conceptualise grief as manifesting in several distinct phases. Phases that have been described in the literature include Kûbler-Ross's (1969) stages consisting of (1) denial and isolation, (2) anger, (3) negotiation, (4) depression, and (5) acceptance, as well as a later Scandinavian version of these phases consisting of (1) shock, (2) reaction phase, (3) repairing phase, (4) new orientation phase; Cullberg, 2004). In the Danish best-selling book The Necessary Pain, Leick and Nielsen (1990) argue that the loss has to be acknowledged in order for an emotional unblocking to occur. Once this has occurred new competences can be developed and then used and fine-tuned before returning (to life itself) with new energy. The most well-known stage-theory of grieving is that of Elizabeth Kûbler-Ross (1969). Although this theory has been criticised for the highly subjective manner in which the observations were obtained and interpreted (Fitchett, 1980a; Garfield, 1978; Schultz & Aderman, 1974) it was an important work in the field as it raised awareness of the need to study death and dying, and challenged many widespread taboos regarding death. Criticisms of stage models of grieving such as Kubler-Ross's model (Fitchett, 1980b; Garfield, 1978; Sánchez, 2005) have been based on the argument that grief needs to be understood in more complex and multifaceted terms. Stroebe and colleagues (cf. Stroebe, Hansson, Schut, & Stroebe, 2008) have suggested that grieving processes ought to be understood simultaneously and not as distinct phases. Advances in research (Stroebe & Stroebe, 1987; Stroebe et al., 2008) have shown that there is no large scale empirical validation for the positive outcome of support groups that insist on 'grief work' operating through separate phases, stages or tasks. Indeed, maintaining continuous symbolic bonds with those who have died appears to be of great importance. Research increasingly suggests that while mourning is necessary, people experience grief in many different ways. The purpose of the present study was consequently to explore alternative perspectives on grief as embedded in individual, social and interpersonal contexts. The study was based on the assumption that different contexts may enable or disable the search for the meaning of loss and ultimately the possibility of growth through such experiences.

Meaning of loss and life

Many existential philosophers have argued that life is inherently meaningless (including figures such as Nietzsche, Sartre, and Camus; see Macquarrie, 1972) and that individuals need to create meaning for themselves in the light of this anxiety (or nausea) provoking fact of existence. This is necessary if human beings are to face the world with fortitude and passion. In contrast, Frankl (1992/1997) argued that man's basic motivation in life is to find (not create) meaning. Human beings are therefore challenged to discover meaning in the light of the challenges with which they are faced. Regardless of which existential philosophical tradition is followed, it is clear that meaning plays a crucial role in existence. Without meaning in life we experience psychological distress, frustration, emptiness and depression (Frankl, 1984, 1986; see also Bugental, 1981; Yalom, 1980; as well as Baumeister, 1991, for empirical support for the argument). When confronted with the loss of a loved one, survivors are faced with fundamental existential questions regarding the loss of their loved one and the meaning of life now that the deceased is no longer present. Whilst a search for meaning may be fundamental to existence, finding meaning in the death of a loved one is not always achievable, as reflected in the poignant gravestone inscription written by Sir Henry Wotton (1884): "He first deceased; she for a little tried to live without him, liked it not, and died." (Smith, 1907, p. 246).

According to Janoff-Bulman (1992), most people experience the world as predictable, safe, fair and meaningful, and people consider themselves relatively invulnerable. Prior to Janoff-Bulman's (1992) description of this experience, the existentialists characterised this as the process of sedimentation, which is the process through which human beings become fixed in their belief systems (Merleau-Ponty, 1962). Many people live contentedly with such sedimented beliefs. However, at times these beliefs are challenged and this results in the sediment being violently disturbed. The occurrence of a tragedy such as the death of a partner challenges an individual's assumptions about him or herself, others and the world. In the aftermath of such a tragedy the survivor seeks meaning or causes for the terrible episode, and this means that he or she must transform their assumptions about the world (Davis & Hoeksema, 2001). People have the capacity to find meaning in a given event, although this may not be easy, by explaining the event as being in accordance with their existing view of the self and the world or by changing the picture so that it is consistent with their meaning of the loss (Davis & Hoeksema, 2001).

A large Danish study by Elklit and Jind (1999) found significant links between gender and the experience of meaning in death. The results of this study suggested that women are more likely than men to find meaning in the loss of their loved one. Based on these findings, this study speculated that men may experience a greater 'sense of meaninglessness' in relation to bereavement.

Davis and Nolen-Hoeksema (1998) distinguish between two aspects of sense-making in relation to the death of a loved one. The first relates to finding benefits in light of the loss (finding benefits) while the second relates to finding explanations for what happened (making sense of loss). Davis and Nolen- Hoeksema (1998) found that both these aspects play a role in the adjustment process following a loss. According to their results, being able to 'make sense of loss' is associated with less grief in the first year after the loss, while 'finding benefits' from the loss is associated with adaptation a year after bereavement.

The ability to find meaning after the loss of someone significant seems to have a major impact on the quality of future life. However, the process of meaning-making is not static and appears to evolve through the grief experience (Lydall, Pretorius, & Stuart, 2005). It is therefore important that counsellors and psychotherapists are aware of and able to identify the signs of meaninglessness and that they have an awareness of how these signs may shiftand change over time. Once people who are bereaved have found meaning in their loss, there may be an opportunity for personal growth and significant personal change.

Personal growth

Many people are able to make sense of bereavement and manage their feelings in an adaptive way (Dutton Chentsova & Zisook, 2005). The experience of difficulty, such as the loss of a loved one, may result in positive changes. Tedeschi (cited in Sheikh & Morotta, 2005) coined the term 'posttraumatic growth' to describe this phenomenon.

Posttraumatic growth represents a shiftin perception, knowledge, and/or skill that may occur in survivors who begin to accommodate the effects of a traumatic event, enabling them to recognize positive changes in their interpersonal relationships, in their perceptions of themselves, and/or in their philosophy of life. (Tedeschi in Sheikh & Marotta, 2005, p. 66).

Follow-up studies of survivors have shown that many report experience of positive developments after bereavement. Davis and Hoeksema (2001) found that the vast majority of participants in their study reported experiencing positive changes after the death of a loved one. The study found that individuals who were able to find explanations and benefits in loss experience tended to state that they had grown in character and that they had developed stronger relationships and an improved perspective on life. Although the positive aspects of grief do not change the painful consequences of loss, recent research does indicate that for some people grief work is a positive, self-reflective and personal growth process. Many individuals report that the positive effects occur gradually and often unexpectedly, as grief work increases their ability to engage with life, over time (Bugge, Eriksen, & Sandvik, 2003). However, there is also some evidence that the loss of a partner may lead to an increased mortality rate for the surviving partner, suggesting that understanding successful ways of coping and recovering from loss are particularly important (Stroebe & Schut, 2001; Stroebe, Stroebe & Schut, 2001).

Self-reflection and self-esteem

In addition to an understanding of existing research on bereavement, our research interest in this topic was also generated by our experience of working therapeutically with men who had experienced loss. It became apparent that our clients would continually ask questions about the loss, themselves and the world - continuously shifting paradoxically between meaning and meaninglessness. When attempting to understand these men's experiences it became clear that existing stage-models of grieving were inadequate for the task. Instead, we felt that we needed to investigate men's experiences of loss in their own terms, as lived experiences rather than through any pre-existing theoretical framework. We therefore turned to phenomenology to guide our inquiry. Our clients reflected upon their experiences and asked profound questions about identity and selfhood as they worked through their bereavement, reflecting a contemporary concern with the 'reflexive project of self' (Giddens, 1991, 1992).

Self-reflection appears to be the hallmark of life in the West in these late- or post-modern times (Giddens, 1991, 1992). Self-reflective competencies are increasingly becoming the cornerstone during endless and restless decision-making in relation to the constantly changing demands of life-choices. The loss of a partner results in numerous unanswered questions and reflections. These include questions such as: "Should we instead have...?" "Could I have done ... before?" "What is life about?" "Who am I now?" Such self-reflective activity often occurs internally and for some persons these self-reflections may result in exaggerated worries. Furthermore, people who experience bereavement may have expected to follow a particular path through their bereavement as a result of societal norms. If the gap between their expectations and their experience is too great this may result in a diminished sense of self-esteem (James, 1890/1963). In this regard, people experiencing grief will undoubtedly be puzzled and tentative, but certainty and a sense of sameness and continuity are important pillars of personal identity (Spaten, 2009). This sense of identity may be threatened during the turmoil of radical changes and unanswered selfreflections that emerge with bereavement.

However, as mentioned above, positive growth does take place and research has demonstrated that some bereaved individuals may experience positive selfperceptions and a sense of direction and hope within a few months of their loss (Dutton Chentsova & Zisook, 2005). Some resilient widows and widowers have demonstrated considerable self-development. In addition, research suggests that a low tendency to self-blame is associated with lower levels of grief (Field & Bonanno, 2001). Indeed, for some of individuals, adjustment to bereavement results in the discovery of personal strengths and a sense of being a separate human being (Dutton Chentsova & Zisook, 2005).

Support services for bereavement in Denmark

Until a few years ago organisations such as The Danish Cancer Society and The Centre for Infant Mortality were the only organisations in Denmark to provide support groups that dealt with grief and mourning for men experiencing bereavement. Although these were important initiatives, there was a sense that much more needed to be done and that more support groups and organisations ought to be involved (Reiniche, 2006). In recent years, Denmark has witnessed an increase in the number of men's crisis centre facilities available, with these facilities now being located in more than ten cities in Denmark and more facilities planned for the future. Conducting groups with men suffering 'pathological grief' has already been evaluated and found to be significantly useful in enabling men to move beyond a personally problematic grief state (Reiniche, 2006; Stroebe & Schut, 2005).

Research Method

This study focused on the life-worlds of men experiencing bereavement and as such made use of the hermeneutic phenomenological method of Van Manen (1990). For this method "lived experience is the starting point and end point of phenomenological research" (Van Manen, 1990, p. 35). Van Manen's (1990) method, like many hermeneutic phenomenological methods inspired by Gadamer's work (1975), provides a guide to analysis rather than a rigid set of rules to follow and is thus heuristic in nature (Langdridge, 2007). The method focuses on how language reveals different aspects of the lifeworld, within particular cultural and historical limits, through a fusion of horizons between participant and researcher (Van Manen, 1990). This entails an investigative process that moves continuously between part and whole in a hermeneutic circle. Van Manen (1990) described six basic steps in relation to this method:

1) Turn to the phenomenon and commit to it;

2) Investigate experience as lived (rather than conceptually);

3) Reflect on the essential themes which characterise the phenomenon;

4) Describe the phenomenon through writing;

5) Maintain a strong and oriented disciplinary relation to the phenomenon;

6) Balance the research context by examining parts and whole.

These steps were used in this study in order to focus the work on revealing the life-worlds of three men who have all lost their partners and who have had to face this rupture in their worlds. The study thus explored the subjective meaning these men attached to the everyday experience (phenomenon) under investigation (Denzin & Lincoln, 1994).

Participants

The participants selected for this study form a relatively homogeneous sample, with all three men having experienced bereavement as a result of the loss of their primary partner due to cancer when the men were in their twenties, thirties or forties. All of the losses occurred between 3 and 7 years ago. The participants were all men with a Danish ethnic background, middle class socio-economic status, and a Danish higher education. The men thus have broadly the same cultural and socio-economic background. This form of purposive sampling enables hermeneutic phenomenological researchers to gather detailed information from a specific group about a particular life experience (Thorne, 2008). The three participants in the study are briefly introduced below:

1) Martin is 32 years old. Four years ago he lost his pregnant girlfriend to leukaemia. The loss was very sudden.

2) Jens, who is 54 years, lost his wife to cancer seven years ago after a long illness. Following her death, he was leftalone with two small children.

3) Claus is 41 years old and lost his wife to cancer five and a half years ago, following a few years of illness. He was leftalone with their son.

One of the selection criteria was that the men had to have been between 20 and 40 years old when they lost their partner. This age bracket was selected based on the fact that this is often an age that is characterized by optimism and attention to creating families and a sense of a permanent home life. People of this age rarely think about the risk of their partner dying, especially if both partners are in good physical and mental condition (Kaslow, 2004). Experiencing the illness and death of a partner at this age has been linked to an experience of a sense of meaninglessness. Surviving partners often find it difficult to come to terms with the premature death of their partners. Furthermore, when one's partner dies after a lengthy illness and when the survivor is still young, perhaps with children, the survivor often experiences 'overwhelming feelings' in relation to the extra duties imposed on a single parent. These feelings may also be mixed with a sense of relief that an exhausting illness is over (Kaslow, 2004). In this study, two of the participants experienced the strain of a prolonged illness, while one of the participants lost his partner suddenly while she was pregnant. This variation in experience was not considered problematic, although it was noted during the analysis of the experiences. In addition, this variable also provided an opportunity to illuminate the possible ameliorating impact of children on the experience of bereavement for men. In summary, our selection criteria required that the participants a) were between 20 and 40 years of age at the time of the loss; b) had recently lost their partner; c) spoke Danish fluently; d) were willing to participate in the study; and e) were able to articulate about their experiences (Creswell, 2003; Giorgi & Giorgi, 2008).

Procedure

In Denmark very few men participate in grief group work or seek help at the Danish Cancer Society or Men's Crisis Centres. During the course of gathering data for a quantitative survey on men's bereavement at the above mentioned centres a participant interview request letter was also sent. Only three of the respondents met the inclusion criteria outlined above (Byrialsen & Spaten, 2008). It is interesting to note that even within the supportive context of the Cancer Society very few men were willing to discuss the death of their partner. In addition, according to the staffat the centre there are huge difficulties in even recruiting men for grief work. Internationally, few men participate in this kind of research and the acceptance rate for participation is generally rather low (Stroebe & Stroebe, 1991). This suggests that our sample represents a particularly limited group who both sought support through these organisations and also volunteered for a research study. Their experience may therefore not be typical of the experiences of most bereaved men.

Data was collected from our participants through the conducting of one hour long qualitative semistructured interviews (Kvale & Brinkman, 2009). The interviews were conducted at the Men's Crisis Centres in small Danish villages and were digitally recorded and subsequently transcribed verbatim. Very few pre-determined interview questions were used, and the focus was on asking the participants to describe their experience of losing their partner. Follow-up questions were similarly descriptive, asking about aspects of experience including physical and emotional responses, social support and the process of coming to terms with their loss. A tight phenomenological focus was maintained throughout the interviews and all the material produced was driven by the concerns of the men participating in the study rather than by any pre-existing theoretical framework.

The transcribed interviews were analysed in accordance with the guidelines provided by Van Manen (1990). It should be noted that Van Manen (1990) does not provide a prescriptive method with clear and concrete steps for analysis. Instead, following Gadamer (1975), his method describes how the analysis needs to recognise the role of the analyst in the co-construction of meaning, based on the researchers' desire to understand the other and the structures of their experience. The focus was on thematically differentiating between the universal and the particular, drawing on the three techniques described by Van Manen (1990, p. 93, emphasis in original):

1) In the holistic reading approach, we attend to the text as a whole and ask: What sententious phrase may capture the fundamental meaning or main significance of the text as a whole? We may then try to express that meaning by formulating such a phrase.

2) In the selective reading approach, we listen to or read a text several times and ask: What statement(s) or phrase(s) seem particularly essential or revealing about the phenomenon or experience being described? These statements we then circle, underline, or highlight.

3) In the detailed reading approach, we look at every single sentence or sentence cluster and ask: What does this sentence or sentence cluster reveal about the phenomenon or experience being described?

We employed all three techniques in our analysis and, as a result, produced a thematic description of the life-worlds of these men as they relate to their experience of bereavement. These themes are described and discussed in the sections below.

Ethical considerations

Ethical issues in relation to the study were considered by the Qualitative Research Centre at Aalborg University, and were discussed in detail by the researchers. Prior to participation, the three men were briefed about the research and completed informed consent forms. They understood that their participation in the study was voluntary and that they could withdraw at any time. The participants were also informed about confidentiality and anonymity, and pseudonyms were used to protect their identities. Potential risk from participation in the interviews was minimised as the participants had all participated in group grief work. In addition, arrangements were made for the participants to see psychologists if the need arose for counselling and psychotherapy. When the interviews were over, the men engaged in a debriefing discussion and a summary of the findings was discussed with each participant at a later stage of the research.

Findings and discussion

The process of data analysis is the core stage in any phenomenological research endeavour and includes the exhaustive work of going back and forth between the whole and the parts in order to identify the essence of the experiences described by the participants (Polkinghorne, 1989; Van Manen, 1990). During this analytic process three essential themes emerged: (1) grief and self-reflection, (2) meaning of life and loss, and (3) re-figuring the life-world. These themes form the focus of the next section of this paper.

The results of this study suggest that the men experienced a series of reactions in relation to their experience of loss. They were forced to review and re-consider the meaning of their lives as the impact of the bereavement leftthem lacking motivation and engagement in everyday life. Furthermore, some of the experiences and reactions they described included feelings of anger, sorrow, emptiness, fatigue, difficulties in concentration, indifference, guilt, apathy, fear of death, drowning, self-destructive behaviour and an 'appetite' for dying themselves. These experiences all relate to feelings of meaninglessness following the loss. In the sections that follow these reactions are described and elucidated within the three overarching themes.

Grief and self-reflection

The men described a lack of comprehension in relation to the loss. Their lives were suddenly changed and they struggled to face this change, to realize their loss and to deal with the consequences of such a loss.

To enter the apartment the day she died, I came home from the hospital; it was like she was not taken away. All her shoes, all of her mittens and hats and everything; she [Mette] could have come straight in through the door and lived her life further on. (Martin)

Martin thus experienced a rupture in his life-world but remained haunted by a sense of continuity in the material world of objects associated with his partner. Although Mette was no longer with him, everything in the apartment was the same as it was when they were together a few days ago. Little details of the everyday life that was common before, things like her mittens and hats, provided a reminder of what might have been. Mourning was encountered and overwhelmed by a feeling of emptiness. Claus described a similar experience of overwhelming feelings of grief and emptiness when he returned to the house after the death of Tanja. He stated that "everything is completely different when she is not here". However, at the same time, he had to take care of their son and this forced him to continue to engage in life, allowing no possibility for withdrawal. Like Claus, Jens also has children and their physical presence meant that there was some sense of continuity for Jens. However, this continuity was experienced in a dramatically changed world, a world where "Suddenly it is I who must be both father and mother for the children".

On a structural level, our analysis revealed that all three participants described experiencing the shock of the loss of their partner in similar ways. After Mette's death, Martin was in shock. He stated that he had walked around like a zombie: "You are present without being present anyway". The participants experienced their bodies as moving around with them and described this as a sense of 'being present without being present'. For Martin, although others witnessed his presence and even perceived him to be carrying on with his life relatively as usual (accepting his grief state), his life-world was actually so profoundly shattered that his very being was called into question. After the initial shock, Martin described experiencing a sense of bodily rupture. He felt torn apart; a visceral embodied emotionality overcame him:

I was ready to do anything, because it just hurt so terribly inside my body, it feels like someone is trying to rip your body apart from the inside, so it can't [-] it's a pain that I can't compare to anything I have ever experienced, you know, I have put my arm around a stove and it was nothing, you know this, this was [- ] it was so unspeakably painful.

Martin spoke evocatively of the deep embodied pain he felt. His pain was incomparable to anything that might be straightforwardly felt as a physical experience. Indeed, this pain was so strong that Martin described it as being unspeakable. One of the characteristics of intense pain (whether physical or psychological) is the difficulty people have in articulating the experience (Scarry, 1985). Martin's use of simile, in his comparison of his mental pain with the pain that is felt when being burnt by a stove, represents an attempt to communicate the level of distress that he has experienced. However, even with the use of such devices, he knows that it will be hard for the 'other' to understand the intensity of his pain unless they have experienced it themselves. This could suggest that men like Martin may well find further group work with other men who have experienced a similar event beneficial. At the very least, he might find comfort in knowing that the 'other' in this particular case is familiar with some of the pain he is experiencing.

When the individual realizes that future experiences with the partner have now disappeared, this often results in a feeling of losing control. All the participants described experiencing a wide range of emotions when they realized that everything they had previously done with their partners they now had to do on their own. They experienced feelings of grief at being leftalone, but also reported feelings of anger. Martin described scolding his wife because of her death: "[...] I stood out in the kitchen and cried to her that she had not been allowed to leave [...]." He was also angry with people when they said they were sad: "It was my right to be upset".

Martin's anger increased a few days after Mette's death as he was made to feel inferior/less-than. Following her death, Martin no longer had access to anything which belonged to his now former partner Mette because Martin and Mette had not been married. Martin was a student and Mette had a permanent job and as a result she had paid most of their living costs. This meant that Martin also had financial difficulties following her death. Martin is not entitled to receive Mette's retirement savings and this resulted in him suddenly feeling like a complete stranger to her life, with no formal links and influence:

[ - ] there was never anyone who told us that it would be a good idea if we had written a piece of paper which said that we were each other's closest. So from the moment she stopped uh breathing, I was just a random bypasser in her life.

He became, in his words, 'a random by-passer in her life'. He was thus wrenched, in a very practical everyday manner, even further from her life. His anger was deeply individualized, and he struggled to understand how others might experience the pain of bereavement he was experiencing:

Her parents lost their child and to lose a child is devastating, no doubt about that, but I am the one who experience it every morning, I would get up and experience the loss every morning, every night when I went to bed, I missed her, every time I wanted to say something, I was alone with no one to listen.... Ehhmm so so so [-] I can remember I was angry at people when they said they were sad, I was allowed to be sad, they were not allowed to.

Jens also reported experiencing anger during the initial grieving process, both during Ingrid Marie's illness and after her death. His anger was directed against a doctor who he described as 'a psychopath' because he felt he lacked appropriate empathy in his treatment. The strength of the anger experienced by these men highlights an important aspect of grieving amongst men that may otherwise be missed and may be qualitatively different from the grieving experience of women. The sense of unfairness, the rupture in their life-worlds, resulted in a rage that potentially disconnected them from others who may have been able to offer comfort and support. In the immediate aftermath of the loss, there was a profound sense of being alone, in both a practical daily sense and in an emotional sense.

Meaning of life and loss

The sense of anger, feeling alone and emptiness in their lives provoked a profound existential crisis for these men. Although the men did not specifically mention questioning the meaning of life, this idea served as the backdrop for most of their interviews. Following the death of their partners they experienced an overwhelming sense of emptiness, meaninglessness, and irrelevance. Claus spoke of the minutes and days immediately surrounding the death of his partner:

On Sunday [-] ehme [-] well, then we were besides her until Tuesday when she died, ehme [-] and the whole process it was just crying [-] and yes, to be there with her [-] And then I had a reaction when we came home again [-] when we leftthe hospital, came home to the farm and suddenly thought [-] Wow [-] now she's simply not here anymore, so ... [-] and thus came the next big reaction, right, but the reaction of emptiness - complete emptiness and such indifference - everything is completely irrelevant.

Claus thus experienced emptiness and a sense of a lack of meaning in life. Martin also wondered whether life was worth living at all, now that he was alone:

It was me who saw it every morning. I stood up and someone was missing. Every evening when I went to bed, someone was missing. Every time I wanted to say something, I missed someone to hear it. (Martin)

Feeling leftalone in the world was the immediate sentiment for all of these men, but as time passed and the participants had some distance from the immediacy of the loss they moved through their own personal process of grief and appeared to find meaning in the loss and changed way of living (Kruse, Vinther, & Byrialsen, 2007). They also reported experiencing a more solid sense of selfesteem. When asked how he perceived his life today, Martin responded:

By and large I guess very few things will uh [-] er [-] really distress me any longer [-] So uh [-] and I usually tell myself every once and a while that you had actually survived this, they will really have to come up with a lot in order to make me, in order to make me unable to survive one more time, right?

These findings are consistent with the findings reported by Byrialsen and Spaten (2008) and Davis, Nolen-Hoeksema and Larson (1998), who found that individuals a) who find meaning and learn from the loss and b) who learn to appreciate life more following the experience of death, deal with grief better than individuals who do not manage to find the positive aspects (Dyregrov, 2004, p. 63).

Claus and Jens's experiences differed from those of Martin, presumably because they have children and were therefore forced to engage with life immediately. Claus describes how the first focus after his wife's death was taking care of their son. Responsibilities towards children appear to have made it necessary for Claus and Jens to engage in life immediately. Martin did not have the same responsibility and commitment, and this may be one possible reason for his strong emotional reactions and difficulties in engaging with life after Mette's death. The two men with children had to face the additional difficulty of dealing with their children's reaction to the loss. Claus describes how he had to face his questioning son, reminding him of his previous promise that everything would be well:

... my boy's strongest reaction was when we received the disappointing results from mum's first chemo cure and she was sent on to the next. Then I said to him, OK the first did not work [-] so now we must try a second and then mum will recover. Then he looked at me and said, that you said that all the other times as well dad [-] and his truism was tough ... And I was just about to get mad at him, and that just isn't fair because we have to fight this together and things like that. ... And then I started thinking [-] no, he is absolutely right, right, it's us who put words in his mouth and said it will be good again. ... And it hit me very much when he said that.

Claus was reminded of the seriousness of the disease, which he had tried to ignore. It became important for them as a family to spend the last time together, to have a good time and to enjoy and appreciate each other's company. He described the time after Tanja's funeral as follows: "[...] we were about to find out [-] what is it we need to do [-] only the two of us [-] two boys [-] how is it the world looks like?" Following his wife's death, Claus immediately contacted the Cancer Society in order to get help for his son because, as he stated, "I did not know what to do with a boy of his age". At the Cancer Society he received help for his son and was offered counselling himself.

It appears that Claus was able to find meaning in life immediately by engaging in being a good enough parent for his son. During the interview, Claus reflected that he had also learnt from his son's own reaction. All three men appear to have searched for meaning after the death of their spouses; this search involved searching for a meaning in the loss and also searching for a meaning for their new life without their partners. Life is said to be a series of paradoxes or dilemmas between, for example, the experience of meaning versus meaninglessness (Van Deurzen, 1998). This study revealed a number of considerations regarding the way in which these men considered whether life is worth living, and how they found meaning in the light of immediate feelings of anger, fear and emptiness.

Yalom (1998), drawing on existentialism, argues that all human beings require a sense of meaning in order to live their lives. He further argues that commitment to life is an important way of finding meaning, particularly by helping to make the world better for others. Altruism, creativity and self-actualization seem to have served as ways in which these men found meaning in their lives following their bereavement. All three men participated in group grief work and found the sharing involved in this group work beneficial: "Although it was not exactly the same things we went through we did a lot of mirroring in each other and the stories that were told". Claus has even become a leader of a grief group after his own experience of being a group member. Additionally, the creative processes in love relationships give life meaning (Yalom, 1998) so when Martin described how a new relationship was "a necessary step in the healing process" this could be his way of finding meaning. During the interview, Jens explained how he had found a new aspect of self-hood, which he had not expressed when his partner was alive. He has now read several books on Tibetan Buddhism and this has proved to be a way for Jens to relate to death and also to live his life differently: "The death of my wife has changed my life. I would not have been right here in my life if she was still here, would I?"

Finding meaning in the loss of a spouse was a necessary process for the participants as it altered their basic assumptions and allowed them to find new ways of living in the light of their bereavement. The challenge to their taken-for-granted assumptions regarding their life-worlds resulted in a realization that life is fragile and should be lived in tension between the finite and infinite, a living in 'inwardness' (Kierkegaard, 1849).

Re-figuring the life-world

Recent research has suggested that men who lose their partners tend to fluctuate between being focused on their loss and being in a future-oriented state (Stoebe & Schut, 2005). The men in our study described this struggle, between the present (inflected by the past) and the future (with new possibilities), from a position where they are able now to look back and reflect on these experiences. The three men believed that their loss had made them stronger, and that they had gained new strength to face the challenges of life. Martin explained: "Generally, more will have to happen before I will be shocked [...] I have survived this loss [-] now I just can't imagine what could happen that will get me down [...]". Martin is now facing the life-world from a different and more self-assured platform. Although each participant had unique and different ways of seeking meaning, with time they all found meaning through confronting and then embracing life's basic conditions (Yalom, 1980).

We understood this process through drawing on Ricoeur's (1984, 1985, 1987, 1988, 1992) work on narrative, particularly his notion of 'narrative refiguration'. Ricoeur writes describes a fundamental human need to re-configure the episodes of our lives together into a coherent narrative. It is through this narrative that we construct our identities. This narrative is, in part, the product of a human attempt to reconcile the irreconcilable, to bridge the gap between the vast, essentially infinite, quality of cosmic time and the limited, finite, nature of phenomenological time (time as lived). The human desire to leave traces on the cosmos results in the production of histories, both socio-cultural (through the array of stories that we are thrown into) and personal, as we attempt to make meaning out of often seemingly disparate and conflicting moments in our lives. A crisis, such as the loss of a partner, ruptures any sense of narrative continuity. This rupture of continuity was clearly experienced by the participants. Following the rupture, the future as planned is no longer possible and there is a danger of becoming stuck in only present and past concerns. However, these men did find ways of moving beyond such 'stuckness', not by forgetting or by 'moving-on' but instead by finding ways to integrate their loss into their life stories. Although this is not an easy task, it was clearly an essential one as it once again opens up future possibilities within the consciousness.

Each of the men faced particular struggles in renarrating their identities. Specifically, each of these men found themselves being identified by others as 'the man who had lost his partner'. This identification may have been due to the fact that the loss was so unexpected. Martin described this identification as follows:

I didn't experience the curiosity, but I know people around me were curious, that is [-] they heard someone: [-] Were you the one? [- ] Or do you know the man with the dead wife? Uh, and [-] it's hard eh, it's hard to be the man in the neighbourhood with [-] I mean to be the man with the dead wife ... but it was never something I was confronted directly with, it was, it was something other people came to me and told me, said that you are the one who eh [-] and I also read something about that in that book that he experienced that as well, and it is not unusual (laughs) apparently if you are young and lose someone, then you are the one with the dead wife because it uh [-] it's uh apparently more common if you're 65 you can say ...

Being possessed of a new identity, at least in the eyes of others, added to the work the participants needed to undertake to re-figure their story of self-hood. Although Martin was never openly confronted with others referring to him as the 'man with the dead wife', he heard about these experiences from those he knew and was therefore confronted with the social world and normative cultural perceptions of loss in a very real way. This is an example of the way in which cultural values shape experience. Martin, like the other men in this study, found a way to move beyond being nothing more than 'the man with the dead wife' and forged a new identity for himself in the light of his new and changed sense of self-hood. Martin stated:

[-] Now I can't imagine what would happen that [...] could get me really down [-] of all these common things as [-] uh layoffs and whatever else is [...] it can't really touch me [-] I'll do fine [...] Life's good [...] and now it seems like we are expecting a child eh [-] now there are only a few months back eh [-] so everything is bright and well.

The participants all spoke of having learned a number of things as a result of their experience of loss. This has resulted in them having greater strength and appreciation for life itself. They express great appreciation for close family and believe that people need to learn to live their lives to the fullest (Byrialsen & Spaten, 2008). They are less focused on the minutiae of life and the loss has strengthened their relationships with significant others. These men are better able to prioritize what is important to them based on their own values and not on societal expectations. Finally, they described how the loss has resulted in increased self-awareness, a more positive attitude, strength and gratitude. In general, the participants stated that they have become more inclusive, tolerant, caring, sensitive, outgoing and generous to others. Finally, two of men stated that their experience of loss led them to finding solace in Buddhism or Christianity and these religious philosophies have helped them become aware of the importance of getting something out of each day (Kruse et al., 2007; Byrialsen & Spaten, 2008). Jens described this experience as follows:

I feel I have learned much and have a little more of that presence, of course one can easily forget it [-] when you are [-] care too much about details, that in the great picture basically don't matter at all ... I have a greater presence concerning some things that many people can benefit from and, and it is without putting yourself up on a high-horse, but you know, I think so ... hmm, at least I feel like that sometimes and it comes from that if it hadn't happened and that, then I wouldn't be there.

These accounts support Tedeschi's (2005, 2006) findings regarding posttraumatic growth. Tedeschi's (2005, 2006) research on bereavement and loss suggests that bereavement creates positive changes in people's perceptions of themselves, strengthens their relationships with significant others, and results in positive changes in their philosophy of life. The way in which the participants have dealt with their loss also testifies to the strength of these men as they have been able to face the adversities of life, regardless of their difficulty, with 'the courage to be' (Tillich, 1952).

Limitations and Recommendations

This study had a number of limitations and the findings should therefore be considered tentative, although they do point to some important factors in successful grieving processes. The focus of this study was men's experiences, and the sample did not include any women, therefore no conclusions were drawn about the differences between men and women's experiences. Interestingly, many issues that might have been thought to be specific to men did not emerge in our data and future research may usefully explore whether this was an atypical result and whether other men speak more closely to concerns related to men and masculinity. The participants in our study did not overtly reflect on issues concerning men and masculinities, even when discussing the need to take on the role of single parent. This may be a product of these men living in a socially progressive country in which gender stereotyping is less common. However, given the small sample size any argument regarding the impact of specific or stereotypical gendered cultural values on men's process of finding meaning after bereavement must be interpreted with caution. One possible exception concerns the sense of anger described by the participants. Although the emotion of anger has been documented amongst women suffering loss, the power of the men in this study's anger was palpable and this may be a particularly masculine experience. This is an area that warrants future research.

Future studies might usefully make use of larger samples and/or samples involving men of different ages, ethnicity, social class or other socio-cultural variables. In addition, future samples could consider varying the length of time between the interviews and the loss. However, it seems likely that future studies will be confronted with the same recruitment difficulties that were experienced in this study. When recruiting participants for this study we found that few men were willing to participate, an experience that echoes research findings that suggest that men engage in more extreme avoidance strategies than women (Stroebe, Stroebe & Schut, 2001). Finding ways of engaging men in research of this kind must remain a priority. The men in our study all appeared to have made sense of their loss but it is not possible to know whether this is true for other men. Although the nature of the sample does create problems in relation to the generalizability of this study, the aim of this study was not to be generalizable but instead to offer insight into the experiences of three men who have sought support and found successful ways to cope with their loss. Future studies with larger and broader samples could facilitate a deeper understanding of this experience as well as the development of a broader perspective regarding the experience of meaning, grief, and growth due to partner loss.

Implications of the Study

This is a small study and so any implications must be considered tentative. These findings have implications for practitioners' understanding of men coping with bereavement. For the participants in this study grieving was a complex experience consisting of meaning, meaninglessness, and posttraumatic growth. However, the men did not experience grief in distinct phases but instead oscillated between processes of loss and reorientation in their everyday life experiences. Our interviews indicate that finding meaning does not occur at the end of the grieving process, several years after a loss or immediately after the initial phase of shock. Instead, meaning is found alongside powerful feelings of anger, grief and despair. As part of the grief work facilitated by the support groups with which these men are involved, group participants are encouraged to share stories about the deceased in order to ensure the continued existence of strong bonds. The interviews in our study revealed that men experienced a variety of rather ambivalent feelings towards themselves, other people and the world including anger, sadness, despair, and joy. At times, these feelings had profound implications for their social relationships and the way in which they were perceived. While our analysis highlighted the essence of the process of grieving for these men, the grieving process is also highly individual and is influenced by many contextual factors. The unique and contextual nature of grief is perhaps the most important message for practitioners working in the field.

Conclusion

This phenomenological study has highlighted the complex multi-faceted nature of the experience of bereavement for a small number of men. The process of grieving was emotionally complex as conflicting feelings emerged and disappeared. The participants also expressed a need for a continuing bond to the lost loved one. These findings pose a distinct challenge to previous research, which has focused on grieving as a series of discrete stages. The results of this study found no evidence for discrete stages of grieving, instead they suggest that grieving is a complex and dynamically shifting process. The participants in this study moved between experiences of anger and emptiness due to the their experience of a rupture in their life-worlds, towards a sense of finding meaning in their loss and being better able to engage with life. The men expressed strong and varying emotions and also focused on the importance of social sharing. Moreover, cross-referencing of the transcripts revealed that phenomena such as grief, anger, and continuing bonds with the deceased were present in all the transcripts. This finding is in line with newer bereavement theories, such as those advanced by Stroebe et al. (2008), but at odds with traditional theories of bereavement.

The men in this sample did not demonstrate stereotypical masculine traits, such as the need to hide their feelings, although they did spend considerable periods of time during the interviews talking about things other than the loss of their partner. They initiated conversations about everyday life, and periods of stillness and reflection were very common. It is perhaps important for researchers and practitioners to be aware of and recognize in this silence a delicate balance between denial and the minimizing of loss and the need to express deeply troubling emotional responses.

The results of this study have implications for support services and practitioners with regard to the need to personalize grief therapy rather than adopting a 'one size fits all' approach. This may be particularly important in group-facilitated treatment for men. Having children was also a significant factor in the grieving process, as this served to keep two of the participants engaged in the world even when faced with the immediate impact of grief. Martin, who did not have children, reported a move in his experiencing process where he was able to make sense of his loss and re-connect with the world around him. The men did not speak of a sense of 'letting go', but instead of an ability to find a way to story their experience such that this crisis provoking episode made sense within their understanding of themselves through the development of new narrative identities.

Sidebar

Referencing Format

Spaten, O. M., Byrialsen, M. N., & Langdridge, D. (2011). Men's grief, meaning and growth: A phenomenological investigation into the experience of loss. Indo-Pacific Journal of Phenomenology,11(2), 15 pp. doi: 10.2989/ IPJP.2011.11.2.4.1163

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