The dominant emphasis in Western models of bereavement is on the breaking of bonds with the deceased in order for healing to occur. Failure to let go often leads to a diagnosis of 'pathological grief'. This paper challenges the assumption that death invariably means that the bonds with the deceased have to be severed. Situating Western models of bereavement in a modernist context not only challenges the 'truth' claims of these models, but also facilitates a deconstruction of the elements that contribute to the emphasis on letting go. In contrast to these theories, two Xhosa rituals (umkhapho and umbuyiso) that seek to sustain the bond with the deceased person will be examined. Such rituals demonstrate that it is possible to both maintain the bond and for the bereaved person to move on with their lives. Despite different contexts, it will be argued that these Xhosa bereavement rituals have a contribution to make to Western models of bereavement and some implications for therapy will be explored.

The US Bureau of the Census (1999) projected that by 2004, 14 million people in sub-Saharan Africa will develop full blown AIDS, making this region by far the largest disease burden in the world (World Health Organization, 2002). The United Nations AIDS Programme judged South Africa to have the leading number of people living with HIV/AIDS worldwide (World Health Organisation, 2002). To date there has been extensive research conducted on the socio-economic impacts of HIV/AIDS on families in Africa. However an area of investigation that has remained largely underreported is the inquiry into the psychological impacts of HIV/AIDS on elderly caregivers. In African families older women increasingly have to provide care to their adult children with AIDS and their orphaned grandchildren. However few research studies have assessed the experience of parental caregiving and its psychological impacts on these women. This qualitative research study hypothesised that the role of primary parental caregiver in fact causes a range of psychologically distressing states, which serve to compromise the psychological well-being of these caregivers. To investigate this hypothesis three Xhosa speaking women living in informal settlements in Grahamstown, in the Eastern Cape Province of South Africa were selected for the study. The women were interviewed by means of semi-structured interviews, which consisted of questions related to their caregiving experiences, their experiences of loss, their choice of coping strategies, the role of support networks and their experiences of foster care responsibilities. The interviews were transcribed and analysed using a grounded hermeneutic approach. The research results confirmed the working hypothesis. The research revealed that although it was considered culturally appropriate for older women to care for their children and grandchildren, their caregiver roles caused significant psychological distress. Their distress was related to: emotional and physical exhaustion, complicated grief reactions and ongoing emotional and physical upheaval related to foster care responsibilities. Based on the results, the research recommendations emphasised the need for continual awareness of the psychological implications of caregiving for older African women with the aim to preserve their capacity to function as the primary caring resource to families struck by HIV/AIDS.

The purpose of this qualitative study is to explore how narrative therapy may facilitate not only a lessening of distressing symptoms for bereaved persons, but may also facilitate growth in identity. Five case studies are presented. The participants were chosen to illuminate different grief experiences. The case studies include a description of grieving people from different backgrounds, each with a unique relationship with the person or people who died, all of whom had different causes of death such as suicide, murder and natural causes. These differences provide an opportunity to explore the application of the therapy model with a range of grief experiences. A full and rich description of the experiences of the participants yield insight into the shared themes such as the impact of social expectations of how a grieving person should conduct him or herself, difficult physical and emotional experiences, the many losses flowing from the death, as well as an in-depth discussion of the identity growth that takes place as the bereaved person takes on different roles and tasks. Postmodern epistemology and social constructivism informed the praxis and interpretation of narrative therapy as bereavement model. Narrative therapy is shown as especially effective for grief therapy with therapeutic tenets such as deconstructing and creating richer narratives and alternative stories that enables the bereaved to explore diverse aspects of their character. The emphasis on what remains rather than what is lost, and the concept of remembering the loved one who died in the community of those who stay behind, transmute the loss-story to one of remembering and incorporating, which tends to bring significant emotional relief. This study contributes towards the field of growth through bereavement for which there seems to be a paucity in research. Furthermore, it provides additional evidence for post-traumatic growth in general, especially with the assistance of narrative therapy. / Psychology / Ph. D. (Psychology)