This investigation involved three procedural areas. The first was the development of a "Grief Work Treatment Program" designed for smokers who wanted to quit or reduce smoking. The second was the use of the program in experimental research in order to distinguish a relationship between structured grief work and cigarette-smoking reduction. The third area of investigation concerned evaluation of the program in terms of the subjects' goals for their smoking behavior. Results of the study indicated that the Grief Work Treatment Program was effective. A statistical comparison of treatment and control subjects using Analysis of Covariance, with number of cigarettes smoked daily at the beginning of the program as the covariate, produced a significant F at the 0.05 level on measures taken immediately after the treatment and four weeks later. Thus, in terms of the subjects’ respective goals, the grief work program was effective in assisting subjects to quit or reduce smoking. In addition, correlational tests concerning the treatment group indicated significant relationships existed between the variable, decrease in number of cigarettes smoked daily, and the variables: length of time a subject smoked prior to treatment; importance of cigarettes to the subject; and number of cigarettes smoked daily at the outset of the program. On comparisons of these variables, significant Spearman-Rank and Pearson Product Moment Correlational Coefficients ranged from 0.67 to 0.85.

The study of the loss of a sibling in mainstream bereavement literature has been largely neglected in psychology. This sentiment has often, and still continues, to be expressed by those outside and within the psychological field. The focus in the childhood bereavement literature has been on the loss of a parent and, in adulthood, on the loss of a child or of a spouse. Despite the growing interest in sibling loss in more recent times (since the 1980s), more specifically in childhood and adolescent sibling loss, in reality bereaved siblings remain ‘forgotten’ and even marginalised. The present study concerned the experience of the loss of a brother or sister in young adulthood, an area that has been largely neglected. The phenomenon was explored using a qualitative approach and employing the empirical phenomenological psychological research method as articulated by Amedeo Giorgi. In-depth interviews with three research participants who were asked to describe their experience of the loss of their sibling were used to gather the data. The emphasis was on discovery, on allowing the siblings to speak for themselves by posing an open-ended question rather than focusing on isolated aspects of the loss experience. The general psychological structure revealed that the experience of the loss of a brother or sister evolves over time and cannot meaningfully be understood as an event that can be contained within a specified moment in time. The experience is a fundamentally relational and paradoxical phenomenon and is reflective of the context in which it occurs. With the loss, the sibling's whole world changes in a very radical way. It is a triple loss: the loss of the brother or sister, the loss of the family unit and the 'loss' of the parents as the siblings had known them. Initially bereaved siblings put aside their grief in an attempt to protect parents and significant others. A conspiracy of silence evolves which conceals their pain and as they continue with life as ‘normal’ there is a deceptive belief of ‘coping well’, of personal stability. Yet internally the bereaved sibling struggles with intense emotions and a lonely struggle ensues. The lack of acknowledgement of the sibling’s grief by others compounds the sense of isolation and alienation and he/she begins to feel like an “implicated alien”, a participant-spectator; part-of and also apart-from the grief situation. Finding a safe space to grieve is critical to bereaved siblings and when this is possible they are able to let go of their deep emotions and grieve the loss of their brother or sister. The loss of a sibling is the experience of losing various parts of the self and needing to reclaim and reintegrate self. The main contribution of this study can be described as providing insights concerning the complex, multi-layered and multi-dimensional process of this loss experience to clinicians and others who care for bereaved siblings. Where the extant psychoanalytic and object relations literature is willing to concede that a sibling relationship exists, screened behind parental relationships, the present study reveals that siblings have a unique relationship of their own and that the loss of this relationship demands radical mourning. This study also reveals that death in the family is a fundamentally relational experience. The loss of a sibling and the loss of a child frequently overlap and tumble into each other and it is difficult to know for whom the sibling is grieving at any particular moment. Thus, grief over the loss of a brother or sister cannot be reduced to a purely intra-psychic or psycho-social process. The fact that sibling grief is not visible, does not mean that it does not exist. Clinicians and caregivers need to be aware of the existential chaos, the trauma, and the ambiguous and paradoxical nature of the sorrow experienced by a sibling-who-loses-a-sibling. Future research into the loss of a brother or sister beyond young and middle adulthood, an area that has also largely been neglected, would constitute an important contribution to the psychology of siblings and of sibling loss/bereavement throughout the life cycle. Also significant would be the exploration of what happens in the sibling group following the loss of one of their members. / Thesis (PhD (Psychotherapy))--University of Pretoria, 2007. / Psychology / unrestricted