Forming our grief rhythm: The relational window of tolerance for bereaved parents.

The shared loss of a child can present challenges to couple relationships as both partners attempt to cope with their own grief and their partner's grief. In this longitudinal qualitative study, five bereaved parent couples participated in 13 total interviews, revealing coregulatory interactions surrounding their shared loss. Using thematic coding and grounded theory analysis, their reflections were organized into three interrelated process themes: regulating self, regulating other, and forming our grief rhythm. This article explores the complexity of the last theme "forming our grief rhythm" in-depth, and a new theoretical orientation, the relational window of tolerance, is introduced to examine how couples coregulate both fragile and stable states within their shared grief. The reflections of bereaved parents indicated that prolonged "dual fragile states" and prolonged "imbalanced states" may hinder relationship quality. In order to regain relationship stability, couples learned to trade off supporting one another and/or to resonate with one another in their shared pain. Implications for future research and clinical practice are discussed, focusing especially on how to integrate individual and relational needs into grief therapy frameworks.

"The child is our focus": On couple issues in child oncology treatment.

OBJECTIVE: This study explored the perspectives of child oncology professionals and parents about the attention professionals should give to the parent couple relationship during treatment of the child. METHODS: We employed a qualitative research design, framed within the approach of consensual qualitative research (CQR), gathering data from four focus groups with 20 professionals and from nine in-depth interviews with 16 parents. Thematic analysis of the focus group and interview data was done with MaxQda software, using two coders and member checks to strengthen confidence in the analysis. FINDINGS: Both professionals and parents talked about an elevated tension in the partner relationship during oncology treatment of the child. However, explicit attention to the partner relationship in this context felt inappropriate to professionals and parents. All emphasized the importance of the professional helpers' openness to conversation and an attuned response to the parental couple relationship. CONCLUSION: During treatment, the child is the primary focus for parents and professionals. The parents' focus on supporting their child makes talking about their own emotions or about issues in the partner relationship potentially disruptive and unhelpful. Therefore, it is crucial for professionals to support the parents in their parents' role, but with an openness to converse about issues in the partner relationship at the moments when these issues might threaten their focus on the child.

"We Hardly Ever Talk about It": Emotional Responsive Attunement in Couples after a Child's Death.

Within Western cultural traditions, the idea that parents should talk about the death of their child with each other is deeply rooted. However, across bereaved parent couples there are wide variations in communication about their grief with each other. In this study, we explored the experiences of bereaved couples related to the process of talking and not talking. We used a thematic coding approach to analyze 20 interviews with 26 bereaved parents (11 interviewed as couples, four as individuals). Four main meanings emerged out of our analysis: not talking because of the inadequacy and pointlessness of words in grief, not talking as a way to regulate emotions in daily life, not talking as an expression of a personal, intimate process, and not talking because the partner has the same loss but a different grief process. In addition, we found that the process of talking and not talking can partly be understood as an emotional responsive process on an intrapersonal and interpersonal level. In this process partners search for a bearable distance from their own grief and their partner's, and attune with their relational context. A better understanding of this process is sought in a dialectical approach, emphasizing the value of both talking and not talking in a tense relationship with each other. Implications for clinical work are described.

"Cycling around an emotional core of sadness": emotion regulation in a couple after the loss of a child.

In contrast to the traditional view of working through grief by confronting it, recent theories have emphasized an oscillating process of confronting and avoiding the pain of loss. In this qualitative study, we sought a better understanding of this process by conducting a detailed case study of a bereaved couple after the loss of their infant daughter. We employed multiple data collection methods (using interviews and written feedback) and an intensive auditing process in our thematic analysis, with special attention to a recurrent metaphor used by this bereaved couple in describing their personal and relational experience. The findings suggest the presence of a dialectic tension between the need to be close to the deceased child and the need for distance from the pain of the loss, which was evidenced on both individual and relational levels. For this couple, the image of "cycling around an emotional core of sadness" captured their dynamic way of dealing with this dialectic of closeness and distance.

"It's Hard to Talk When Your Child Has a Life Threatening Illness": A Qualitative Study of Couples Whose Child Is Diagnosed With Cancer.

When parents are confronted with something as fundamental as a cancer diagnosis for their child, it is generally assumed that sharing the emotional impact of it, in the form of talking about it with the partner, is helpful and necessary to cope as an individual and a couple. However, couple communication in the context of childhood oncology is often challenging. In this qualitative research, we aimed for a better understanding of how partners experience their couple communication during treatment of their child. Thematic coding was done on in-depth interviews with 16 parents (7 couples interviewed together and 2 mothers). We found that the circumstances of the treatment period affected couple communication. In the interviews, parents provided three main meanings to their limited talking: (a) because of the hospital and treatment context; (b) for self-care/self-protection related to the value of blocking emotions; and (c) because of each other. These findings invite us to rethink emotional closeness being equated with frequent or intense emotional communication in couples with a child who has cancer. This research, framed in a dialectic approach, emphasizes the value of both talking and not talking in the tense and challenging couple situation of dealing with a child's cancer diagnosis and treatment. Rather than advocating for the general promotion of open communication, our study suggests the value of hesitations to talk at certain points in the process, while also taking into account the degree of marital difficulties in offering interventions aimed at improving couple communication.

Toward Understanding the Child's Experience in the Process of Parentification: Young Adults' Reflections on Growing up With a Depressed Parent.

This article reports on a qualitative study with 21 young adults who grew up with a depressed parent. We examined how young adults make sense of their childhood experiences of parental depression and how their retrospective reflections help us to understand the experiences of children and the processes of parentification. Participants recounted that their childhood consisted mainly of actions in the service of family well-being. At that time, they reflected on their own experiences only rarely. In adolescence, there was an evolution toward a greater consideration for oneself and a repositioning within the family. In the discussion, we explore the therapeutic implications of this study--and in particular--the meaningfulness of silence in the family process of parentification.

The complexity of couple communication in bereavement: an illustrative case study.

Sharing grief experiences, or "storying"grief can be a key resource in adapting to loss, one that can contribute to stronger bonds and relational intimacy within the family. In this article, the authors conceptualize communication between grieving family members in terms of 3 "D" processes, emphasizing the extent to which such communication is dialectic, dialogic, and dynamic in nature. They illustrate the complexity of sharing about a mutual loss, focused on these 3 features, by referring to a case study of a couple coping with the death of a child in the context of a newly formed family. Rather than unilaterally advocating the promotion of open communication, the authors suggest that therapists working with bereaved families first discuss the complexities of communication with the family members, specifically those concerning talking and keeping silent, and explore the different meanings associated with sharing grief experiences with each other.