Complex Bereavement: An Existential Psychodynamic Study of Temporality and Attachment

Comfort Shields, School of Psychology

This dissertation study examined how patterns of insecure attachment and restrictive temporality (restricting thoughts and emotional affect related to the past and future) relate to adult complex bereavement. While the DSM-V (2013) has for the first time in history included a severe form of grief, called persistent complex bereavement (PCBD) as a subtype of other specified trauma and stressor-related disorders, the scientific literature is lacking a philosophical and theoretical foundation that contextualizes the etiology of PCBD. The literature is increasingly utilizing a framework of attachment theory to understand reactions to loss. However, little is known about how attachment relates to the traumatizing effect related to human finitude. This study draws on Stolorow’s (Stolorow, 2007, 2011, & 2013) existential-psychodynamic theory of traumatic temporality, which holds that individuals who grow up with patterns of caregivers unresponsive to their emotional affect defensively and narrowly reorganize their experience of time when faced with trauma. In this mixed-methods study a sample of adults (N=77) aged 19 to 74 years (M=47) completed a survey measuring: (a) extent of complicated grief through The Inventory of Complicated Grief (ICG); (b) temporality (restrictive or non-restrictive) through The Balanced Time Perspective Scale (BTPS); and (c) extent of insecure attachment through The Experiences in Close Relationships-Short Form (ECR-S). A qualitative analysis of narrative data regarding participants’ experiences of grief was also conducted. Six themes were identified, which supported and further enriched the quantitative analyses. Reflections on the researcher’s values and experiences of grief were included as part of the qualitative methodology. Multiple linear regression analysis demonstrated that restrictive temporality and insecure attachment-anxious style together accounted for 14% of the variance for complicated grief, confirming that participants with a restrictive sense of time and greater extent of insecure attachment experience more complicated grief than those with a non-restrictive sense of time or a greater extent of secure attachment. Findings are discussed in terms of implications for clinical interventions of PCBD, primary prevention efforts, increasing the dialectic of a social and cultural conscience surrounding death and grief, as well as identifying areas for further study.