Making room for grief: walking backwards and living forwardIn this paper, the authors describe an aspect of a program of research around grief and clinical practice. The first phase of the study involves examination of experiences of grief with attention to troublesome or problematic beliefs that fuel the extent of suffering in the bereaved. The data, obtained from a review of videotaped clinical interviews with families seen in the Family Nursing Unit at the University of Calgary were analyzed according to philosophical hermeneutic tradition. Findings suggest that grief is an experience that is ongoing, that changes in nature over time, but that involves a continuing relationship with the deceased; it is a graceful, periodic, deliberate walk backwards while keeping a sure foot in living forward. Key words: beliefs, bereavement, grief, loss.Making room for grief is not a popular concept. In the past 100 years, attention has been placed on models of practice around grief that involve assisting people to let go of grief and symbolically and emotionally to let go of the lost person. This paradigm and widely accepted model of grief therapy is inherently based on a modernist tradition, and grief research has, until recently, been grounded in quantitative assessment that supports this worldview . A changing perspective of grief as an ongoing experience that is not resolvable, but is imminently livable is emerging in the literature (Attig 1996; Klass, Silverman and Nickman 1996; Moules 1998; Moules and Amundson 1997;Neimeyer 2001Neimeyer , 2003. The bereaved themselves, however, suggest that the general public continue to be influenced by prevailing modernist beliefs. Discourses that suggest that successful recovery from grief involves an absence of feelings of grief and the achievement of relinquished emotional connections with the deceased, continue to create problems that increase suffering in the bereaved. This suffering shows itself in the internalization of beliefs that constrain, confine, and pathologize the experience of grief.In clinical practice with the bereaved, it is apparent that there are commonly held beliefs which contribute to the amount and nature of their suffering in grief. These beliefs are perpetuated through popular literature, culture, and the nature of some therapeutic practices. Yet, experiences of grief contradict these culturally sanctioned theories, and this very contradiction can inadvertently create a sense of failure, incompetence, and even pathology, thereby leading to even more suffering in the lives and relationships of those who find themselves in the universal situation of loss.

The courage and willingness to walk alongside families in grief calls forth particular beliefs and practices in nurses and other health care professionals. In this second phase of a study on grief and grief interventions, the researchers examine experiences of bereaved family members who received care in a grief support program and explore program clinicians'explanations of the work that they do with the bereaved. Findings of this interpretive study suggest that it is not so much models of grief intervention but maps that most guide the clinicians--maps that are drawn out of experience and with awareness of their limitations. The family members and the clinicians bring us to an understanding that, often, it is the willingness to step off of the map that makes for the best traveling companion in the spiritual walk of grief.

The five C-STOP categories require resources and alignment of urban specialist, rural provider and family expertise. Specialty clinic efforts promoting self-care are incomplete without matched resources for rural providers.

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This article is excerpted from a research interview completed as part of the second phase in a hermeneutic research study around grief and clinical practice. This phase involved the examination of clinicians“ and families” understandings of support and interventions with the bereaved as they occurred in the Calgary Health Region Grief Support Program. In this interview, Reverend Bob Glasgow, the founder and coordinator of the Grief Support Program, offers his perspective on the powerful call of grief to health and human services professionals and the obligation we have to answer the call with skill and love.