Research Question: What makes for an effective grief support

group?

Ethan Sullivan

Senior Project Advisor: Arava Greva

12th Grade Humanities

Animas High School

27 February 2017

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Part 1: Introduction

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 Grief is a force so powerful for people that it can completely devour people and

then spit them out. Everybody differs on how their grief affects them and for how long it

lasts. Research suggests that men and women have different brain structures, which

makes them differ in perceptions, priorities and behavior with ways of handling emotion

(Wallace 1). There is an expectation in this society that expects women to be more

expressive with their emotion regarding grief and for men to stay strong and not as

expressive. Despite this, there is a niche that exists in the grief world that allows people

to be expressive in whatever way they please: through grief support groups. Support

groups vary in how they are composed, but they all involve people supporting each other

through the grief process. Being surrounded by people who can understand and help a

bereaved person process grief due to the fact that they have been through a similar

experience is a very powerful and reassuring feeling. It is reassuring for the bereaved

person to know that her or she is not the only one who suffers from the terrible tragedy

of losing someone really close to them and that everyone in the group shares a mutual

interest in grief. A friend of mine from a grief support group for children with parents

suffering from cancer said I felt all alone and like nobody could understand what I was

going through until I found this group and then I felt immediately like a had a

community who understood what I was going through (Negron).

Considering how grief support groups can be beneficial when they are properly

composed, this paper seeks to identify the factors that can increase their effectiveness.

The research clearly shows that grief support groups have had a high success rate in

helping people learn to cope with their grief and that these types of groups will only

continue to grow as grief is an inevitable force in the world. What makes for an effective

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grief support group is the establishment of strong personal connections with all

participants led by a compassionate and empathetic facilitator who runs the group with

passion.

Part 2: Historical Context

The first form of modern grief support groups were introduced in 1935 as a way

to help hopeless alcoholics (Oka and Borgman).These groups did not end up lasting

for very long or being that successful due to the fact that group therapy models were not

widely recognized enough at the time. Support groups did not start to gain popularity

until after WWII (Oka and Borgman). In the 1960s civil rights movements started to

occur in many developed countries because people began to realize the effectiveness of

their collective power and this sparked the self-help group movement. In 1976 edited

books and journals were written by social scientists, featuring the impact that self-help

support groups can truly have on people, including a report on support groups for people

with disabilities from social scientists in Japan.

It wasnt until the 1980s that these groups started to become an international

trend and when Japan and countries within North America started to go in separate

directions with their support groups. Finally, in the 1990s online support groups started

to grow and gain in popularity quickly. Online support groups have made it easier for

people to communicate especially from long distances and it has given people the

capability to just search online for support groups and be able to easily find groups to

participate in. In todays society support groups are bigger than ever and only seem to

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continue to grow. There are currently 500,000 to 750,000 support groups that exist in the

United States with an estimate of 10-15 million participants (Oka and Borgman).

Support groups have become a tremendous aspect of healing for not only people who are

suffering through the grief of losing a loved one, but also for a wide variety of other

things such as disabilities and addiction.

Part 3: Research and Analysis

When we lose someone close to us whether it is a close friend, or family member

the effects on a person neurologically are really profound and widespread. Brain

imaging studies done on grievers show that there is increased activity in the neurons of

the brain. Mood is not the only thing affected as a result of grief, but so is memory,

perception, conceptualization, regulation of the heart, the digestive system, and other

organs. In the article This Is How Your Brain Reacts To Losing A Loved One, by

Thomas Crook Ph.D, Danish companies tracked the performance in the two years before

and after many CEOs experienced a death in the family. They found that financial

performance had a 20% decline after the loss of a child, 15% after the loss of a child,

and 10% for the loss of any other family member. When the activity in the neurons of

our brain increases the negative aspects that we hold can be exposed and dramatically

shown as a result to the grief of losing a loved one. The more we dwell on these negative

thoughts the more exposed and detrimental these neural pathways become (Crook 1).

The results of this can be chronic preoccupation, sadness, or even depression. This

emphasizes the importance to having a successful grief support group in place to to

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prevent these things from happening by giving people hope and comfort in their grieving

journey.

Many people think that grief just affects humans neurologically, causing mainly

emotional changes, but it can also have serious physiological effects, which should not

be disregarded. Research has shown that especially for the elderly when they suffer

through grief their immune systems begin to weaken, leaving them more prone to

contracting infectious diseases (Crook). Anna Phillips, a professor of behavioral

medicine at the University of Birminghams School of Sport, Exercise, and

Rehabilitation Science studied two different age groups of mourners, one with an

average age of 32 and another with an average age of 72. In this study they found that

the older group of mourners had reduced function of a white blood cell used to ward off

infections in the body known as neutrophils. The younger groups of mourners definitely

had notable physiological changes as well, but not comparable to those of the older

generation. This is all due to the age relating hormones called DHEA, which begins to

decrease in the body at around the age of 30 increasing the risk of contracting infectious

diseases. Clearly, physiology can be greatly affected by grief and it does not just affect

you neurologically. This all raises the importance to having grief support groups in our

world to help people learn to live with their grief and stay healthy in this difficult

journey.

Men and women have different brain structures, which is what makes them

perceive grief in different ways. In our society women are expected to be much more

expressive with their emotion and also are more neurologically hardwired to process

their grief in this fashion. They are much more likely to be attracted to something such

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as a grief support group to utilize it as a nice open space to share their feelings regarding

their grief. Men on the other hand are expected to be the strong steady rock for the

family through the process of grief, which can force them to put their grief on hold. Dr.

Lou Wallace of the Palliative Care Unit in Greensboro stated that there is a lot of

discomfort in our culture when a man weeps openly or shudders with fear. Because

being a man means avoiding his feelings and moving into thinking and activity, he is

set up to move away from his grief instead of moving toward it. He is unable to do the

work of mourning his loss (Wallace 1). Many boys early on in their life learn to not be

dependent upon others and keeping strong. Since this culture exists, men can often feel

anxious or vulnerable about seeking help for healing; however, in supportive group

settings men can put this hindering cultural expectation aside and allow anybody to be

expressive about their grief however they choose, so that the grief does not become

buried.

Grief support groups can be a highly effective setting for this type of expression.

Grief support groups come in many forms and can be left to multiple interpretations, but

are most commonly defined as a group of bereaved people with common experiences or

concerns who provide each other with encouragement, comfort, and advice in a group

setting.

Groups can be open, meaning that anyone with a common grief experience can

join, or they can be closed, meaning that only a regular group of people meet and that

newcomers are not allowed. Both the open and closed groups have many pros and cons

to them. Open groups tend to have more of a freelance approach to them such as not

meeting at a set time and allowing anybody to join at any time. Closed groups usually

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meet at a set time and may exclude people who need help. When choosing to participate

in a support group it is important to consider who you are and what setting you would be

most comfortable participating in. Additionally, groups can be open-ended and meet

indefinitely, or they can meet for a finite time. It is really important when looking into

grief group participation to consider the dynamic and which type of setting you would

fall into as a result of this.

Also, groups can be led by a trained therapist or not have a leader at all. While

they take many forms, support groups are setup to achieve the purposes of helping each

other through bereavement. The idea is that only people who have through a similar

grief situation can truly understand the experience. While grief support groups take

many forms, there are commonalities that make for an effective support group; all of the

aspects of effectiveness focus on the people who are in the group, the participants and

the leaders. One key aspect to this would be the sense of community with people who

have a shared common tragedy of losing someone or something very valuable and

meaningful. This adds tremendously to the effectiveness of the groups, strengthening the

group's dynamics.

In the article Positive and Negative Experiences from Grief Group

Participation: A Qualitative Study done by Norwegian researchers Johnsen, Kari

Dyregrov, and Atle Dyregrov, under the section of `positive experiences from

participants of Grief Support Groups, the researchers really emphasized the importance

to the aspect of having a strong sense of community to make the grief support groups

effective for everyone. A woman who lost an unborn child from the study spoke for

herself as well as for a majority of other participants within the grief support group

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chapter stating that I think that everybody needs this kind of community in order to feel

normal in a quite unnatural situation. To achieve thisthe grief group is quite

unique.(Dyregrov, Dyregrov, and Johnsen 7).

The feeling of commonality and knowing that you are not alone in your suffering

is one of the core benefits brought to people during the process of grieving. In this study

the researchers also stated that many of the bereaved claimed that this feeling was

extremely reassuring by saying that It was comforting to meet with others who also

jumped when they looked at themselves in the mirror, had lost their concentration, felt

reassured when they heard of others losses, or ruminated over all kinds of strange

thoughts. (Dyregrov, Dyregrov, and Johnsen 7).

Many of the bereaved stated that they feel excited to come to the grief support

group meetings. The feeling of normality and knowing that you are not cursed is a very

reassuring feeling that is necessary to have when grieving because it will give you a new

perspective on your grief and what is normal or what to expect in the process. In this

article it also discussed the open ability for grievers to share their thoughts and feelings.

A majority of friends and family cannot fully grasp the impact that these kind of losses

can have on a person, but participants of these grief support groups do because of their

similar experiences. It was truly a safe space for these bereaved people to share their

thoughts and feelings. A number of the bereaved who participated in grief support

groups said that they did have support from networks consisting of family and friends,

but they could not get into their innermost feelings regarding their grief which presented

hardships for many of these people until they came across grief support groups. Here

they were allowed to dwell into their innermost feelings and were able to accurately

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express how they were feeling to compassionate people who understood how they are

feeling. A woman who lost an unborn child that participated in grief support groups said

As soon as you attend such a group we go straight to the core of the matter . . . to what

you really want to talk about all the time, but which you maybe hide . . . or spare/shield

your friends a little from taking part in. (Dyregrov, Dyregrov and Johnsen 7). The

strong sense of community to have when suffering through grief is a very crucial aspect

to creating positive dynamics to give people a safe space to grieve where they may not

be able to accurately do so elsewhere.

Another key aspect to having a successful support group for all grievers would

be to have a strong and compassionate facilitator to lead the group. It is crucial to have

someone who understands grief very well to lead the group, which usually means

somebody who has experienced a hardship with grief in some way so that they can

relate. It is also essential to have somebody who is well educated to lead the group,

preferably somebody who holds a college degree in some type of grief counseling

training or has had training in grief counseling prior.

According to Judith Bernstein, author of When the Bough Breaks: Forever after

the Death of a Son or Daughter, in some cases, leaders who have had no formal training

in leadership or any mental health disciplines may not be a successful at facilitating a

successful support group (175). If one participant dominates the group or if a shy

newcomer joins the group, a strong confident facilitator needs to be there to address

these issues. Compassionate Friends is an organization that has been able to achieve this

aspect of having a successful support group excellently, even though the facilitators

arent necessarily mental health care providers. They only allow people who have

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training with grief or have an expertise in the subject to lead the group. A person who

was a trained psychologist and a member of Compassionate Friends had another

member express concern to him about some of the policies of the leaders. They

questioned whether the other leaders may have been leading the group in an unhealthy

or unproductive direction.

This can happen in some groups that dont have a strong leader. Bernstein

suggested in When the Bough Breaks that people who lead grief support groups need to

have a really deep background in grief somehow so that they know how to properly lead.

Bernstein stated that at times it feels akin to asking someone who has never taken a

course in anatomy to please remove your appendix. It can be a case of the blind leading

the blind (Bernstein 176).

It is also important for the leader to not allow competitiveness and comparison of

the losses to create tensions among the group. A father who led a support group chapter

for years got fed up with the one up manship in the group and could no longer keep

listening to people try to compare the way they lost their child, so he finally quit the

chapter and never came back (Bernstein 177).

I would challenge that this responsibility should actually be placed on the leader

to notice and eliminate these negative dynamics in the group to make everybody feel

comfortable and equally significant. Judy Austin, a professional grief therapist in

Durango, Colorado, states that one role of a good facilitator can be to take a back seat

during a discussion so that all members have an opportunity to speak and feel

significant.

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 While being well educated in the subject and having professional training is

important, its not as essential as being a steady presence for group members and

knowing how to not bury your own grief, but be able to contain it to not let your

emotions become an influence in the group. One leader of a Compassionate Friends

chapter whenever she introduced herself to the group of people she was leading she

would always introduce herself and sign her writings as Claras mom decades after

losing her child (Bernstein 193). The concern among leaders of other support group

chapters was that she was setting a bad example for the newly bereaved. She gave the

impression that the grief that these people are feeling will span for decades. This could

force participants to not feel as hopeful when they see this because it will give them the

feeling of resolving their grief and that their pain will never go away.

In the study conducted by Norwegian researchers called Positive and Negative

Experiences from Grief Group Participation: A Qualitative Study, a large piece of

criticism that came from participants was the insufficient leadership. Several participants

complained about the fact that many leaders brought up their grief too much or had

insufficient beliefs about the normal variations of grief. A woman gave an example of

how the lack of expertise in the subject contributed to their own insecurities regarding

their grief among many participants in the group by saying I really doubted the two

leaders . . . they were not professional ...I think they dwelt with the fear that we were

going to kill ourselves in a rather unprofessional way. . . . Many times I felt strange

when I went there. I felt unsafe. (Dyregrov, Johnsen 12). This should be a key

responsibility for leaders because it is crucial to ensure safety and to make sure that there

is a strong sense of belonging and comfort to the group.

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 Part 4: Conclusion and Findings

Grief is the single most painful thing that can be suffered by any human being

and it is important to seek support during this process as it will only continue to eat you

alive otherwise and prevent you from finding happiness and hope again. It is important

when suffering through grief to not feel like you are not alone. Men and women have

different brain structures, as well as societal expectations and pressures when it comes to

grieving. Grief support groups have given both men and women the ability to express

their grief however they please by putting expectations and pressures aside.

While individual approaches can have a powerful effect on healing from grief,

they lack a key element to healing and that is the feeling of commonality and knowing

that you are not alone in your suffering. These support groups have provided a safe

haven for grievers who may not be able to do this accurately around family and friends

who cannot properly understand the grieving process as well as others who have

suffered a similar tragedy. In order to have a grief support group be effective it needs to

feel safe and comfortable for everyone.

The feeling of commonality and knowing that you are not all alone in your

suffering is a very powerful and reassuring feeling. As mentioned earlier in part three a

woman from a study done on the Positive and Negative experiences from participants

and their time spent in grief support stated that I think that everybody needs this kind of

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community in order to feel normal in a quite unnatural situation. To achieve thisthe

grief group is quite unique(Dyregrov, Dyregrov, and Johnsen 7).

While it is evident that support groups have tremendous upside to bereaved

people, they have their fair share of downsides as well. The biggest downside presented

for bereaved people here would be the type of loss that occurred. If the kind of loss

suffered was a suicide or murder support groups may not be the best approach in helping

grief. Many of the participants in the study on Positive and Negative Experiences from

Grief Group Participation stated that people who lost their loved one in this fashion

would perhaps not be best suited for using a support group to help them heal. Losses that

occur in an instant and are very traumatic can take an especially large toll on a person. In

order for these people to be supported in the best way possible, approaches such as

therapy with a licensed counselor or therapist would be more supportive versus group

therapy with people who havent suffered the loss of their loved one in this way. In a

study Participants Recommendations for the ideal support group: A Qualitative Study

conducted by the same Norwegian Researchers it discussed what is needed for bereaved

whose loved one suffered a really traumatic death. It suggested that these people seek

individual deep therapy with a counselor or therapist to help them process, but then

maybe consider moving to group therapy later in the grieving process.

Sufficient leadership is another key aspect to having a successful support group.

The leaders main responsibilities when facilitating a grief support group is to ensure

safety and comfort for every participant and to grant people hope for their grief journey.

As stated earlier in part three a woman who was a leader of a Compassionate Friends

chapter always opened each session that she hosted by stating that she is Claras mom

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decades after the passing of her child and for the newly bereaved this gave them more

limited hope. No participants who are seeking group support during the grieving process

should ever feel a lack of hope as a result, which stresses the importance to having

sturdy leadership. These support groups need to be facilitated by a leader who is

confident, comfortable, and capable of keeping their emotions at bay to help the

bereaved.

It is important to consider the effect that grief can truly have on a person and this

research seeks to emphasize the importance to bringing awareness to it and the pieces

that need to be in place in order to make a support group effective for bereaved who are

seeking this approach. The ultimate feeling that participants of grief support should walk

away with as a result should be a feeling of belonging and never having a doubt in their

mind about this. Another thing is to learn about who you are as a griever and how to

handle that particular process going forward, by finding hope that you can make it

through the painful process of grief. This is precisely what all support groups and forms

of them need to begin to strive towards in order to maximize the effectiveness for each

participant.

Grief is also one of the leading causes of causing relationships to spiral

downward. Grief can at times cause people to be selfish with their own feelings and not

consider others feelings who have been impacted by the loss. In the Article The Hard

Truth About Staying Married After The Loss Of A Child by Heather Spohr she herself

experienced the loss of a child and the way she kept her marriage alive afterwards was

by allowing her and her husband to take care of each other by being supportive of each

others needs in whatever way that meant. They even sought out therapy and attended it

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together to help them process. This reinforces the importance to having support systems

in place to help the bereaved heal and to keep healthy relationships intact.

Various accounts of research suggests that the two most critical elements are

having strong positive group dynamics as well as a leader who runs the group with

passion. By doing this it will allow everybody to feel safe and comfortable to openly and

accurately convey their thoughts and feelings regarding grief, as it is not healthy to keep

it bottled up constantly. More support group leaders should start to turn to this approach

to maximize the support for each individual participant and for the overall effectiveness

of the group because many people are seeking to gain a feeling of hope and

commonality as a result of these groups.

When all the correct elements are present and grief support groups are composed

effectively, they can be a powerful force for the bereaved in a horrible time. Many

people report that the people in these groups become some of their best friends

(Bernstein 180). Grief support groups have granted people light during the darkest time

of their lives by gifting the bereaved with hope and by allowing them to experience a

deep feeling of human connection through commonality of suffering a heart wrenching

tragedy.

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