Post on 06-Mar-2023
INTRODUCTION
“But I was in pain. I was I thought I would die. Talagang, yung pain na... Ano yung sabi nila. Yung kumikirot yung puso mo. It was true. Kumikirot talaga. And parang may kirot na mabigat na I dunno. I dunno how to explain ano yung feeling na yun. Now in hindsight, I think ano. He is in a better place. Will I say I'm grateful? Na kinuha siya? Hindi, pero ngayon ko lang naintindihan words ni Lord na, na you have to accept, you have to...”
Ms. Starbucks
Death is a natural yet inevitable part of life that everyone will have to experience sooner
or later. People know that it is bound to happen but are never really prepared for this certain
reality. We go through our lives as if we will live forever. We think that our parents, siblings,
and children will always be with us, but we have to understand that as humans we are finite
beings, and thus we are always limited by time. The death of a loved one is never easy to handle.
People are left to deal with the reality of the permanence of the loss. The dead will remain dead,
but the living must go on. This traumatic experience leaves the person preoccupied. In some
cases, these people refuse to let go, persistently holding on to those memories they had with their
most cherished ones. These lingering attachments are manifestations of continuing bonds when
bereaved persons hold on to the relationship they had with the deceased.
Continuing bonds is a complicated phenomenon that occurs during bereavement.
Bereavement here is not defined as a reaction, but as a state of deprivation a state of losing
someone you love. Attig (2004) defines bereavement as the “state of having lost someone we
care about or love through death” (p. 343). He adds that this deprivation people feel during
bereavement “redefines and limits our life consequences and possibilities” (p. 343). This state of
loss often leads to grief, accompanied by pain and anguish. Ang (2010) describes what makes
this stage of bereavement, and grief, so painful. First, the bereaved loses a sense of stability due
to the sudden change caused by the loss of the loved one. Second, the bereaved experiences a
loss of identity along with the loss of his/her loved one because his/her identity was tied to the
deceased. Third, the bereaved loses meaning in his/her life, due to the fact that his life was
centered around that of the one he/she lost. Lastly, the loneliness of losing a physical relationship
is extremely difficult for the bereaved.
Given the state of bereavement, some people find it difficult to deal with the loss, and are
therefore inclined to maintain a relationship with the deceased. This is where continuing bonds
comes in as an ongoing relationship with the deceased (Boelen, Stroebe, Schut & Zijerveld,
2006). These continuing bonds are formed when bereaved individuals construct mental
representations of the deceased as a way of incorporating them into their lives (Russac,
Steighner, & Canto, 2002). For the sake of consistency and clarity, the conceptual definition of
continuing bonds for this study will be the one provided in Boelen, Stroebe, Schut, and
Zijerveld’s work.
REVIEW OF RELATED LITERATURE
Given that continuing bonds are manifested in the context of bereavement, grief is
often at the center of the picture; yet continuing bonds and grief are different. Grief entails
having the bereaved’s energy invested onto another object, resulting to the decline and the
complete disappearance of the attachment to the deceased. On the other hand, continuing
bonds entail the bereaved continuing to incorporate the deceased into his life through creating
meaningful mental representations of the loved one (Delespaux, RyckeboschDayek, Heeren
& Zech, 2013). Russac et al. (2012) also describes a difference between grief and continuing
bonds, wherein grief manifested by the bereaved entailed having his perceived similarity with
the deceased decline over time. On the other hand, continuing bonds entailed maintaining this
perceived closeness over time. Furthermore, continuing bonds also means that the death of a
loved one does not necessarily end the bond that they had with the deceased; it redefines the
relationship as something that goes beyond physical presence.
In his psychodynamic theory, Freud discusses bereavement, claiming that the
continuation of the deceased as the bereaved’s “lovedobject”, as well as his or her inability
to let go of the death of the loved one leads to pathological grief (Epstein et al., 2006).
Furthermore, he claims that detachment to the deceased is crucial in order to relieve the pain
of the death. However, more recent studies suggest that both grieving and continuing bonds
may be more complicated than first conceived by psychodynamic theory.
One of the more painful types of bereavement and loss is that of a parent’s towards
his/her child when a mother or a father is separated with the person whom he/she has loved and
has grown accustomed to taking care of. Some parents choose to cope with this loss they feel
through the relationship they maintain with their deceased child a continuing bond. Whether it is
through remembering the memories they had with their child, or the ways in which they were
able to cope with the loss, parents narrate their different experiences in order to process the loss,
as well as keep this relationship with the deceased. Parents construct the meaning of their
relationship with their child through the stories that they tell about their deceased child.
In a study done by Klass (1993), parents nurture three forms of continuing bond
expressions with their deceased child. First, parents link objects to their child’s life, which
gives proof that their child, although already dead, had existed. Second, bereaved parents
usually associate their child’s presence with religion or spirituality, like how they say that
their child has already gone up to heaven. Lastly, parents also find solace in living out their
memories of the child.
Continuing bonds are manifested in many other ways. Field, Nichols, Holen, & Horowitz
(1999), identified four different expressions of continuing bonds. First is a recurrent sense of the
deceased presence, in a way that the bereaved felt that they were being watched or guided by the
deceased. Another is maintaining the deceased’s possessions, in a way that the deceased’s room,
belongings, clothes, and/or furnishings was kept exactly how it was left. Continuing bonds are
also manifested through seeking comfort through contact with belongings, in a way that they
used the deceased’s belongings. Lastly, these were manifested in the way comfort was gained
through keeping memories with the deceased, in a way that they draw comfort from dreaming or
thinking about the deceased.
On the other hand, Ang (2010) delineates two types of continuing bonds. One
way is through spiritual manifestation, where one communicates with the deceased,
prays to the deceased in hoping to see them, and dreams of them. An example of this
is when the bereaved is found to say things such as “magkikita rin tayo” (“We will see
each other again”). There are also nonspiritual manifestations such as showing care,
where the bereaved still cares about the opinion of the deceased, and loyalty, where
widows still choose not to marry despite the loss.
A maintained relationship with their child can at times be helpful and beneficial in
coping, yet at times it can keep the parent from moving on from the loss. While there is no
clear line that establishes adaptive from maladaptive manifestations of continuing bonds,
certain researchers provide explanations as to how these continuing bonds affect the way that
parents are able to cope with the loss of their child.
Manifestations of Maladaptive Continuing Bonds
Lingering attachments to the deceased may be seen as maladaptive if it is seen as a
negative adjustment to the loss of a loved one. Boelen et al. (2006) claims that these
expressions or manifestations are linked to distress, and can even be predictors of poor
outcomes. Furthermore, Field and Filanosky (2010) state that these maladaptive continuing
bonds are generally manifested externally, as evidenced in hallucinations and illusions. These
external expressions of continuing bonds have been linked to bereavement through violent
deaths. Epstein et al. (2006) also gives another perspective, saying that that some of these
externalizations (i.e. “dreaming and yearning for the deceased”) may be maladaptive, as they
are linked to high anxiety, insomnia and pathological grief. This can be explained due to the
fact that these externalizations keep the attachment with the deceased and therefore prevent
the bereaved from adapting to the changes caused by the death. Physical proximity, such as
holding on to the possessions of the deceased, has also been linked to more grief (Boelen et
al, 2006).
Despite this, it is important to consider the cultural background of the bereaved, due
to the fact that some externalizations of the expressions of continuing bonds may be
considered as a cultural norm and may even be adaptive (Klass, 2006). Examples of these
cultural norms include cremation or second burials.
Manifestations of Adaptive Continuing Bonds
The study conducted by Epstein, Kalus, and Berger (2006) suggested that not all
aspects of continuing bonds are unhealthy, as some may be integral in the process of letting
go of the deceased. In their study, onethird of the respondents said that expressing closure
(i.e. saying goodbye to the deceased, reliving the relationship with the deceased, sensing the
presence of the deceased) is beneficial in terms of adjustment to bereavement. Furthermore,
Field and Filanosky’s study (2010) suggests that adaptive continuing bonds expressions are
usually linked to internalization, which means having mental representations of the deceased.
One type of mental representation is identification, wherein the deceased’s traits are
consciously incorporated to the bereaved as if these attitudes were his own. Another is
introjection, where the representation of the deceased is also incorporated into the bereaved’s
personality without them consciously knowing that they have instilled these traits themselves.
This internalization process regarding the death may also be beneficial in helping with the
bereaved’s selfidentification (Russac et al., 2002). Some of these internalized expressions
also include a focus on the positive memories with the person, the use of the image of the
deceased as a secure base for making decisions, or the use of the deceased as a role model.
These manifestations of internalization were typically present in people who had a close
relationship with the deceased. Moreover, internalization is suggested to be healthier and
more adaptive is even linked to personal growth.
It is clear from the different manifestations of continuing bonds that people, even
parents, experience bereavement in different manners. While some choose to avoid certain
memories they had with the child, others choose to immerse themselves in these memories.
Certain factors affect these differences on how continuing bonds are manifested.
Factors Affecting Continuing Bonds
Attachment. Attachment theory acts as way to understand certain patterns of how the
bereaved person grieves (Stroebe, Schut, & Stroebe, 2005). Sochos and Bone (2012) claimed
that a person’s attachment to the deceased is similar to his or her attachment style with regards to
his current relationships. Moreover, a study conducted by Wayment and Vierthaler (2002) claim
that an individual’s attachment style is activated when one is placed under a distressing situation.
Attachment theory may then prove to be useful in describing and understanding the continuing
bonds that is experienced by the bereaved as this theoretical framework is one of the most
comprehensive in understanding the way individuals develop certain kinds of grief reactions
(Delespaux, et al., 2013).
A study by Christiansen, Olff, and Elklit (2014) on bereaved parents resulted to the
fact that mothers had more anxiety attachment to their lost child, coped through focusing on
their emotions, and had showed less avoidant symptoms than did the fathers who had lost a
child. Moreover, Wayment and Vierthaler (2002) assert that certain forms of continuing
bonds are typically manifested by people who have a certain attachment style. Firstly,
anxiousambivalent individuals readily seek the attachment figure, in this case the deceased,
especially in times of distress. Anxiousambivalent individuals will then express their
continuing bond in the way of having with them an item that represents the deceased, so that
they may hold on to something that will calm them down in a stressful situation. This kind of
continuing bond was suggested to be linked to depression. On the other hand, avoidant
individuals typically have a somatic type of reaction to the deceased (i.e. physical illnesses)
which are suggested to be caused by the repression of feelings of grief. Lastly, secure
individuals express their grief more freely and openly with the deceased loved one.
Table 1.
Kinds of Attachment Styles
Attachment Style
Characteristics Manifestation in CB
Anxious Ambivalent
Reluctant to be close with others and in forming new relationships, may be clingy and overdependent, distraught when relationships end
Holding on to something material (i.e. an old possession of the deceased) for them to calm down in a stressful situation
Avoidant Avoids investing emotions in relationships, does not often share feelings and thoughts with others, express little distress when relationships end
Transfers their grief of the deceased into a somatic manner such as getting a certain illness
Secure Has long lasting relationships, seek out the support of others, can be open about their feelings and thoughts
Freely expresses their grief to friends and relatives
In addition to this, Field as well as Field and Filanosky (2010) provide a pattern for
bereavement, with the attachment theory as basis. In this pattern, the bereaved initially refuses to
accept the loss of the deceased. Eventually, he or she accepts the loss but still retains feelings of
pain and resentment. Finally he grows from this loss and positively integrates this experience
into his own life. Ainsworth, Blehar, Waters, and Wall (1978) also studied a certain pattern for
bereavement. These researchers claim that continuing bonds manifested early on in bereavement
were considered to be indicative of searching attempts to reclaim the dead person, because the
deceased may simply be perceived as missing. This refusal to let go of the relationship with the
deceased supposedly causes maladaptive expressions of continuing bonds.
Once the bereaved person finally accepts the loss, he goes through a “despair” phase
wherein he experiences a sense of hopelessness and withdrawal, attempting to avoid things
that may serve as reminders of the death (Field, Gao & Paderna, 2005). The bereaved’s sense
of identity may be somewhat disrupted during this phase due to the fact that his own goals,
expectations, and interests that were linked to the deceased is gone (Field & Filanosky, 2010;
Field, 2006). Hence, it is during this period that he might feel extreme grief and pain from the
loss.
Finally, the bereaved eventually learns to cope positively with the death, and may
even eventually grow from the experience of bereavement. This becomes possible through an
internalization of the positive image of the deceased, which may endure after the loss of a
valued relationship. Furthermore, viewing the deceased as a secure base to help the bereaved
search for exploratory bases may help him/her build a new life (Field & Filanosky, 2010;
Field, 2006). Due to this, the internalization process constitutes a central part of grief
resolution by enabling the bereaved to preserve a sense of identity and meaningful
connection with the past (Ainsworth, Blehar, Waters, & Wall, 1978).
A person’s type of attachment plays a role in grief, which in turn affects the
adaptiveness (or maladaptiveness) of a person’s manifestations of continuing bonds. Not only
does attachment style affect the way a person expresses continuing bonds, but the way people
grieve and how much they grieve over a death of a loved one also affects their expression of
continuing bonds.
Nature of Separation. In a study by Stroebe, Abakoumkin, Stroebe, and Schut
(2012), they have found that sudden or expected loss were thought to lead to poorer
bereavement outcome. However, vulnerability of the individual (ex. poor selfesteem among
others) can also be a factor. In addition, individuals who were unwilling to relinquish ties
with the dead can be detrimental to adjustment following an unexpected loss. Certain
unwillingness may stem from the sudden loss of a loved one as there might be some
unfinished business with them. This is because they have no time to prepare for living
without the tangible presence of a close loved one, as compared to losing a person with
whom you have a distant relationship to. Moreover, results also showed that people who
experienced an unexpected loss had a harder time in dealing with the pain as compared to
those whose loss was expected (Stroebe, Abakoumkin, Stroebe and Schut, 2012).
Cultures also uphold some morals and practices that affect the way continuing bonds
are expressed by a bereaved. Following a certain cultures’ roots may better give people a
better understanding as to why certain continuing bonds are manifested.
Religion and Culture. Based on an article by Clark (1998), religion, or more specifically
the Catholic faith, is the center of grief and bereavement. When Filipinos grieve for the loss of
their loved ones, they are comforted by the idea that their loved ones are in heaven. In other
instances, they look to the Lord for guidance during times of grieving. Moreover, Guballa (n.d.)
discusses healthy grieving as creating a new life given the loss of the loved one. She also gives
importance to the role of other members of the family, as well as the community, in helping the
bereaved cope with the loss.
The effect of religion on continuing bonds has also been prevalent across different
cultures. In a study by Suhail, Jamil, Oyebode, and Ajmal (2011), people were able to cope
with the death because of some of their religious beliefs (i.e. “the bereaved is already in the
hands of Allah”). Another study on Pakistani Muslims living in the United Kingdom
(Hussein & Oyebode, 2009) claim that manifestations of continuing bonds were affected by
external family structures, communal gatherings, and mourning rituals. These behaviors were
a result of the participants’ religion, and affected how people in the community cope with
death. Given the influence of religion on continuing bonds, the researchers aim to include
religion in the study.
Culture and ethnicity also affect continuing bonds. In another study conducted among
Chinese participants, it was found that these participants perceive continuing bonds as either
initiated by the deceased (i.e. through dreams) or initiated by the bereaved persons
themselves (i.e. through talking to the deceased) (Chan, et al., 2005). Moreover, in Lalande
and Bonnano’s study (2006), they discovered that more expressions of continuing bonds
among the Chinese resulted to better adjustment 18 months after the death of the loved one.
However, participants from the United States who showed strong continuing bonds were
poorly adjusted 18 months after the loss.
Gender. Gender was also seen to affect continuing bonds. Men, in particular, were
found to have more maladaptive ways of expressing continuing bonds than women. Men also
tend to be more avoidant and detach themselves from the memory of the deceased than do
women and that as opposed to bereaved women, bereaved men tend to be more stiff and less
open about the pain of loss during counseling sessions (Sochos & Bone, 2012).
It is clear that many factors, from an individual to his or her surroundings, affect the
way continuing bonds are expressed. The review of related literature now turns to a particular
qualitative methodology that allows for a better understanding of the factors that affect
continuing bonds. It seems that that an interpretative phenomenological analysis is a viable
approach to understanding how continuing bonds are manifested based in different factors,
and how it offers insights as to how individuals make sense of this phenomenon.
THEORETICAL FRAMEWORK According to Smith and Osborn (2007), an Interpretative Phenomenological Analysis
(IPA) is a qualitative approach with a means to explore a person’s way of creating sense in
their personal and social events that happen in their lives. Its purpose is to extract a detailed
examination of the person’s life and delve into their stories in order to seek the person’s own
perception on an event, instead of the objective truth of a situation. The use of this
phenomenological method will give a richer approach to the person’s experiences, as it does
not only focus on the reality of the physical world and how people are passive individuals in
their experiences, but that they also take an active part in interpretating and understanding the
world through their life experiences in which that will make sense to them.
The use of an IPA approach will be most effective for this study as the aim of this
study of continuing bonds will look into, not a step by step approach of the process of
grieving, but the unique experiences of losing a child and how they manifest their continuing
bonds. The IPA approach gives the researchers also an active part in the interview process as
the participants make sense of their experience, while at the same time, the researchers also
try to grasp their experience and make sense of how the participants make sense of their
unique experience. IPA is generally concerned with trying to understand the involvement of
the participant, thus making this a 2way process as the information being given also depends
on the researcher’s conceptions (Smith & Osborn, 2007). Thus, this joint reflection of the
participant and the researcher forms the analytical approach of the IPA.
A major difference of IPA from other modes of research is that its semistructured and
flexible nature allows for extensive information to be gained, especially the ones that
researchers do not expect to obtain. As the participants answer the basic questions, follow up
questions may be asked in order to gain more insight on their responses. This allows
participants to make use of their own unique perspectives to communicate their stories and
experiences, providing more information than one can typically obtain from any other form
of data collection. The nature of IPA being qualitative and phenomenological recognizes that
research is a dynamic process (Brocki & Wearden, 2005). It follows that the IPA is bounded
on whatever the participant conveys, through their ability to properly express their thoughts
and feelings towards their experience, and how the researcher also reflects and analyzes these
responses. This kind of analysis would be appropriate to bereavement in terms of how they
deal with the loss of a loved one.
IPA utilizes a purposive way of sampling in order to gain a specific group of people,
which of whom the interview will be significantly relevant to, specifically in this case,
bereaved parents. Gaining information from a semistructured interview engages an in depth
dialogue with the researcher and participant, in which, after it is transcribed, gives the
researcher running themes from the interviews conducted. Through an IPA method,
researchers will be able to create connections within themes and experiences by each
participant, with the help of verbatim statements made by the participants (Chapman &
Smith, 2002).
Chapman and Smith (2002) also state that an IPA is the same as an anthropologist
conducting a study within a community as it gives a detailed report on their culture, but it
does not generalize on all cultures, as it leaves room for more research to be conducted. Thus,
IPA may aid in the understanding of continuing bonds in a much more broad social context;
and at the same time an individual’s social context might provide more insight as to the
manifestations of continuing bonds in the Philippine context, if ever these are present.
Continuing bonds is a very dynamic concept mainly because it involves a process of
internalizing the loss into the life of the bereaved. This process is based on the idea that these
continuing bonds are predicted by the bereaved’s attachment to the deceased, which
attenuates across time. The researchers feel that IPA would be the most appropriate method
to encapsulate these changes in the continuing bond expressions. IPA allows us to give an
overview of the thoughts and feelings that occurred based on the stories shared by the
bereaved.
RESEARCH PROBLEM
With the research findings and the theoretical framework already discussed above, the
research problem remains to be stated. For this study, the research problem is as follows: How
have continuing bonds of Filipino mothers changed from death until the present?
Given the literature regarding continuing bonds, it can be argued that there are still gaps
and inconsistencies among the present studies. For one, there are limited studies that have been
done about parental continuing bonds in the context of the Philippines, as this topic is fairly new.
Thus, further research can still be done here in the Philippines, with regards to the changes in
continuing bonds manifested by Filipino mothers.
Moreover, understanding continuing bonds can help society find effective
interventions for disaster management programs and counseling here in the Philippines.
Losing a child is not uncommon here in the country. Findings from this topic can serve as
grounds to understand and provide action to those who are in need of help from the
government or NGOs. Moreover, an advocacy approach on the research problem appears to
hold strong with the beliefs of the researchers. With this in mind, the end goal of the current
study is not just to add to the existing knowledge regarding continuing bonds, but also to
create an opportunity to help those who have experienced bereavement, most especially in the
Philippine setting. If fruitful, results gained from this research will provide purposeful means
for certain interventions about coping with the loss of a loved one.
However, this study has a limited scope in terms of the population it covers. Other
limitations will be fully discussed in the next section.
METHODOLOGY
Despite the number of studies on continuing bonds, these studies remain to be limited,
most especially in the Philippine context. Most articles in the present repertoire seem to be
very western in terms of sampling and theory. Given that there are limited studies on
continuing bonds here in the country, the researchers will be using a qualitative design as a
basis for research. This research design was chosen due to the fact that this method was
suggested to be the best way to break new ground on the topic.
The researchers chose a qualitative design over a quantitative design because the data
obtained would also be qualitative in nature. Moreover, given that culture and religion are
unique and therefore important aspects of the way Filipinos manifest continuing bonds, an
outlook of the general themes present can help build theories that are most apt with the
Philippine society. The limited number of studies about parental continuing bonds in the
Philippines, as well as the low generalizability aspect of other studies make the need for
studies on continuing bonds more pressing. Lastly, the limited number of participants, given
the inclusion criteria, would allow for the researchers to conduct a qualitative analysis. More
evidently, there is an apparent lack of data and no concrete theory to run a quantitative
analysis regarding continuing bonds.
PARTICIPANTS
The group obtained a sample size of n = 4 from the population of parents who have
lost a child and have exhibited certain expression of continuing bonds with the deceased.
First and foremost, individuals to be included in the sample must have lost a child at least 5
years prior to the interview. This is patterned from a study by Floyd, Seltzer, Greenberg, and
Song (2013), wherein the average time span between the death of child and the study was 5.5
years. The researchers claim that within this time period, parents still struggle with the loss
for quite a time after the death of their child.
Participants include Filipino mothers. The researchers opted for a female sample due
to the fact that mothers have a special kind of attachment and relationship with their child as
compared to fathers because mothers solely care for their children nine months prior to their
birth. As mentioned previously, women also tend to be more open about their experiences in
dealing with bereavement (Sochos & Bone, 2012). It is stated in a study by Kochanska and
Kim (2013) that there are very few findings and journals on fatherchild attachments in which
the researcher’s study cannot expound on just yet. Moreover, participants must belong to the
middle adulthood age group, specifically parents in their 40s and 50s. In Erikson’s
Psychosocial Development theory, it states that this is the stage where generativity versus
stagnation is prominent as a basic conflict. This is the period when most parents are very
involved with their children’s lives and have a strong desire to leave a legacy behind (Papalia
& Feldman, 2012).
Moreover, the nationalities of the participants must be considered. The researchers
include individuals who identify themselves as Filipino, so as to make the current study more
applicable. Furthermore, the researchers will also limit the participants to include those from
the urban middle to upper class. The group argues that people in the lower class might have
an easier time in coping faster with the death of a child. This is due to the fact that poverty
affects them in such a way that they cannot afford to dwell on the deceased because they have
to deal with surviving and obtaining resources to be able to live their daily lives. Moreover,
differences between people from urban and rural areas in terms of continuing bonds might
also be prevalent in terms of lifestyle, and even culture. Thus, the sample will be selected
from urban areas (i.e. Manila) for constancy and for practicality.
Factors such as the number of children, birth order, and age of child will be adjustable
depending on the availability of participants. However, the criteria on the manner of death
will not be strictly imposed to give the researchers richer data from the participants. Those
aforementioned will not be strictly established unless the researchers will be able to find
sufficient participants that fit a similar criterion.
MEASURES
Preliminary interviews. A preliminary interview will be held in order to filter out
participants who do not fit into the aforementioned criteria. Demographic information, which
include age, nationality, gender, income, and marital status will be identified. Questions
about the bereavement would also be included in the interview, such as the child’s age,
gender, and cause of death.
Narrative interview schedule
1. How was your relationship with your child prior to his/her death?
2. How did your child pass away?
3. What was it like immediately after your child’s death?
4. How was it like a year after the death of your child?
5. In the succeeding years, how is your relationship with your deceased child?
The interview will be presented in English to avoid problems in translation accuracy.
However, the participants may choose to answer the questions with the language most
comfortable to them.
PROCEDURE
The researchers will be looking for participants that fit the criteria mentioned above.
They will then undergo a preliminary interview to make sure that they fit into the inclusion
criteria. After filtering the prospective participants, these people will be chosen and scheduled
for the continuing bonds interview. The researchers will be conducting the interview, one of
which will be facilitating the interview and the other two taking note of behavioral cues like
facial expressions and body movements, that may or may be aligned to what the participants
may say. Taking note of these behaviors may help the researchers in creating a more
comfortable environment for the participants (i.e., noticing a mother acting uncomfortable
talking about a certain topic, thus researchers will not push the subject matter). Before the
interview, the interviewer will brief the participant regarding nature and confidentiality of the
study.
Interviews will also be recorded (voice and video) for the content. The transcribed
data will then be used for the data analysis which will be discussed in the next section.
DATA ANALYSIS
In a study which also made use of an interpretative phenomenological analysis,
Brocki and Wearden (2005) suggest that meaningmaking in their experience is the center of
any IPA. This idea will then be the center of the analysis of the experiences provided by the
participants. For the given study, voice recordings will be the main source of data for the
given study. Given the collection of data, the interview of the first participant will be
transcribed and studied by each researcher individually.
Chapman and Smith (2002) gives importance to the flexibility of the interview
questions so as to give opportunities for the researcher to get into more detail when an
interesting point has been made. With a semistructured interview, a rapport with the
participant is made as the interview questions do not require short and brief answers,
therefore making it easier for participants to answer more extensively and freely say what is
on their mind.
As mentioned by Smith and Osborn (2007), the analysis of the interviews in an IPA
require multiple times of rereading the transcript as each reading may produce new insights.
It was suggested that the researchers put their comments on the side of each transcript made,
which had been done, that may help create a better understanding towards the preliminary
interpretations. The manner of speaking of the participant (i.e. shift in language, stuttering)
may also be taken into account as to show their comfortability in expressing themselves.
Progressing through the transcript, the researchers will be able to comment on similarities,
differences, and inconsistencies in the interview. After writing comments, reading through
the transcript again will better help the researchers in seeing rising themes in the interview.
It is crucial in this next step to find expressions that are very apparent in the interview
so as to find theoretical connections across the different interviews, yet still be bounded by
the specificities of what the participant has said. After which, a list of themes are made and
the researchers make connections across interviews. Some may group together creating a
bigger umbrella for a theme or some may stand as its own. It is important to note that in
clustering themes, it is backed up by verbatim statements made by the participants in order to
see the connections. It is through this that the researcher creates an interpretation of the
sensemaking of the participant’s experience of losing a child. Finally, an extensive analysis
is made with the themes extracted from the interviews of the bereaved mothers (Smith &
Osborn, 2007).
The goal of this method is to completely and thoroughly analyze the behaviors and
sensemaking of the participants in their experience of losing a child; more specifically their
expressions of continuing bonds following their bereavement.
RESULTS
Four mothers whom of which have experienced the pain of losing a child from a medical
ailment were interviewed to obtain rich accounts of the process of loss, bereavement, and
continuing with their lives. To better understand the themes surrounding this particular process,
four comprehensive stories are narrated below.
Ms. Caritas and Tricia
Ms. Caritas, at the age of 44, currently works as a paralegal, with the occasional
buyandsell business. During her free time, she participates in CFC (Couples for Christ) as a
music ministry volunteer. She is currently separated with her husband, and has five children one
of which passed away around 14 years ago.
Her child, named Patricia Janine (or Tricia for short), was her third child and the eldest
girl. Her mother describes her as a very beautiful girl. She was very gentle and obedient, and she
always looked out for her siblings. Whenever her mother would scold her siblings, she would
talk to her mother and calm her down.
Tricia passed away last 2000. Her mother described it as an unexpected event, which
started when she caught a fever from their vacation to Isabela. Ms. Caritas explains how she felt
depressed at the time she lost her child her weight went down to 90 lbs., and she was drinking
up to 13 cups of coffee everyday. She narrates that she would be out of her mind, especially
when her other children were in school. She says how she couldn’t even act out her hysteria,
because she had four other children to feed. She wanted to cry so badly, but she could not due to
the fact that she had to take care of her other children. She also rebelled against God, wondering
why it was her daughter that was taken.
She was only able to cope with the experience through a positive outlook in life,
understanding that she had to get over her depression quickly; not for herself, but for her children
mostly. She constantly thought of her children, and how it wouldn’t help to act out all her
negativity. Moreover, she was also distracted by them and their distinct personalities. Because of
them, she was able to cope with the death of her daughter.
Ms. Caritas says that she was only able to let go six or seven years prior to the death. She
would feel the occasional pain whenever she remembers certain memories with Tricia. Until
now, she claims to still talk to her, most especially when she has grave problems, yet she says
that she does not feel as depressed anymore, and that she has even moved on. During Tricia’s
birthday, she greets her and includes her in the mass for that day. Her faith in God was restored,
and even strengthened. She claims that the whole experience changed her in a way that she had a
better understanding of how to be a loving and fair mother. She also realized how to love more
fully and more deeply.
Mrs. Bo and Russell
Mrs. Bo is currently a housewife whose husband works in the States. She is living with
her son, who is at his third year of college. She is very familyoriented; she always travels with
her family, eats out with them, or even watches movies in the cinema with them. This is why
when her son, Russell, passed away eight years ago, she was extremely heartbroken.
Russell was closer to his mother than his brother was. He was described as very
intelligent and very independent. He was very responsible when it came to duties in his
schoolwork and his household chores. He was also caring towards his family, especially his
younger brother, as well as his friends in school.
Russell was twelve years old when he died due to a very rare disease pulmonary
hypertension. Until now, Mrs. Bo claims that she still has not recovered from the death, saying
that she doesn’t think that the pain will heal. Her initial reaction was to question God to try to
comprehend why it was her son who was taken, and at that age as well. She still has a hard time
talking about Russell, and she cries whenever she does talk about him.
Mrs. Bo had Russell cremated, and she brings his ashes wherever she goes, and saves a
seat for him when eating out or when travelling. Russell had a certain fondness for Pluto (the
Disney character), so she has a lot of Pluto stuffed toys with her all the time. Although she threw
out some of his belongings, she still keeps some of them, like his school projects and toys. She
also wears Russell’s tshirts from time to time. Whenever Mrs. Bo had a problem, she tells
Russell, and believes that her problem gets fixed after a while.
She was able to cope with Russell’s death through distractions from work, as well as
through her responsibilities in the house. Her second son was also extremely helpful as a
distraction, as well as a source of strength. Her son was always there with Mrs. Bo whenever she
felt sad or depressed. Moreover, Mrs. Bo participated in therapy sessions with her son for about a
month. She was also active as a coparent in her son’s high school going to soup kitchens and
participating in outreach programs.
After a while, Mrs. Bo claims that her faith in God has already been restored. Because of
the event, she also learned to be more understanding, as well as to have more compassion for the
poor. Despite these things, she claims that she still has not been able to move on.
Mrs. Marikina and Pia
Mrs. Marikina is a business woman with 3 children. Her youngest daughter, Sophia died
at the age of 4. She was very close to her. Pia would always chase her around and cling to her,
even refusing to let her mother out of the house.
They went on a family swimming trip to a nearby resort days before Pia’s death. The
following day, she came down with a fever. Mrs. Marikina rushed her to a hospital to get her
checked. The doctors said that it was just a common cold. Nonetheless, Mrs. Marikina was
uncomfortable about the situation, especially when her daughter refused to drink the medicine,
saying that it was already past its expiration date. She was transferred to St. Lukes the following
day. During the ride, she was beginning to have seizures. At 3pm, Pia passed away. Mrs.
Marikina was only informed after 3 hours. The doctors could not tell her more than that her
daughter had died from contracting an airborne viral disease.
She felt that she wanted to die along with her daughter. She did not want to leave the
house and was always in a daze. After her daughter’s funeral , she did not want to go to places
they had gone before. She said that she had premonitions. Her daughter said that she wanted to
be an angel. She wanted to wear the costume made for a municipal event weeks earlier. So
during the wake, Mrs. Marikina dressed her child in her angel outfit. It was grand as a party, just
like what her daughter asked for days before her death.
It was a difficult time for her. She could not say that her daughter had died. She would
only say that Pia had went on a vacation for a while. When she saw poor children on the street,
she wondered why they were still alive, while her Pia had died. She was surely better groomed
and fed. People tried to console her saying that now, she has an angel that will guide her.
She does not celebrate her child’s birthday or anniversary up until now. She says that she
only prays for her and lights a candle for her. One thing that brought her back to her senses was
the thought of her other children who also need her help. But she never stopped grieving, she still
keeps pictures of her daughter around. Not just small photographs but big tarpaulins. She has
now disposed some of Pia’s clothing but kept a few inside her room. She says that she sniffs it
from time to time. She continues to talk to Pia, especially when she has problems. She
remembers Pia when she is alone or when she sees another kid around. However, when work
comes in, she gets distracted from the thought of her deceased daughter.
Mrs. Marikina says that the death of her child was unlike any other death she has
experienced. She keeps longing for her child. She feels that she has given everything to her child
and that she is now in a better place in heaven.
Ms. Starbucks and Jj
Ms. Starbucks currently works as a Vice President for Human Resources at a business
called Bitmicro. She has three children with her first husband, one of which is Jj, who passed
away, and has one stepson with her second husband. She splits her time here in the Philippines to
take care of her two daughters, and in the United States where her second husband and her
stepson are based.
Jj was the second born and the only boy of Ms. Starbucks. He was born with a congenital
disease called hydrocephalus and has lived as a vegetable ever since. At the age of 10, when Ms.
Starbucks was on a business trip in the United States, Jj passed away. This devastated their
whole family. During the first few years, the doctors would already warn Ms. Starbucks that Jj
could only live for a short time. Unconvinced, Ms. Starbucks moved Jj to another hospital nearer
their home and hopeful to hear different results. Unfortunately, the news was just the same.
When Jj passed away, Ms. Starbucks felt like she lost her mind. “Nagwala talaga ako” (I
had gone crazy), she said. She remembers thrashing everything in her hotel room when she
received the news her son had already passed away. Prior to the call from the Philippines, she
recalled that she had a strange nightmare about a boy telling her to “let go”, in which she was
awakened by her officemates from the adjoining room because of her thrashing.
For a while, Ms. Starbucks shut off the world around her and focused a lot of her time on
work. On a normal day, she would not enjoy working overtime, but after Jj’s death, all she did
was work, work, work. She recalled the times she did not like hearing comforting words from
people, she became less sweet to her daughters, and became numb from the world. She never
touched Jj’s room after his death. Ms. Starbucks mentioned that she was so selfcentered after
the death of her son that she forgot that her daughters will also grieving and hurt with the loss.
Ms. Starbucks mentioned she would pass by Jj’s urn at home in their altar and talk to his
urn and would ask him how he is. She also has dreams wherein she would see Jj at his current
age and height playing with his siblings. Eventually, she joined a humanistic group that helped
her cope with the loss of her son.
She also mentioned that because of Jj’s death, she improved relationships with her
exhusband. She says that they are now the best of friends. This also made Ms. Starbucks realize
the value of company and family that she has here in the Philippines because they are always
here to support you. In addition, Ms. Starbucks’s faith in God became stronger.
13 years has passed and Ms. Starbucks does not mourn any more, but still feels the pain
of losing her son. She imagines where he could be now if he was still alive and comes to a
conclusion that God gave her Jj for a reason to be less selfish from who she was before and that
the world did not revolve around her.
Themes
Upon reviewing the data, the group was able to identify main themes that were applicable
to most, if not all, of the participants interviewed. Themes identified were based on the mothers’
reactions to the death of their child, as well as their ongoing relationship with their child.
Themes Description
Grief Denial of the child’s death, depression, unique experience of losing a child
Feelings of injustice towards God
Questioning God about the death of the child, anger towards God, feelings of injustice
The Halo effect Admiration towards the deceased child, looking up to the child emphasizing the good
qualities of the child, praying to the child, viewing them as their personal angel
Ongoing Relationship Perception of an ongoing relationship with the deceased child, longing for the deceased child, keeping of material possessions
Life after loss Focusing on work to take care of their other children, enjoying time with their other children, joining organizations to cope, acceptance of the death, disposal of deceased’s belongings
Grief: “Kumikirot yung puso mo eh”
One of the themes that were prevalent was intense grief experienced by the bereaved
mother “Kumikirot yung puso mo eh (Your heart really aches)”. This grief was evident as the
intense pain felt by the mothers who struggled with the loss of their child. The presence of this
grief was one of the most common prominent among the participants, mostly due to the typical
motherchild relationship they had with the deceased, as well as the close attachment they had
with their child.
Grief was initially present with the denial of the child’s death, as well as the mother’s
struggle to accept the loss. Mrs. Marikina was one of the participants who exhibited this, saying
that her daughter was just away on vacation when she passed away. Seven years after the death
of her child, she still has a difficulty facing the fact that she lost a child. Moreover, some of the
participants also showed signs of hysteria, one of which is Ms. Starbucks who, when finding out
about the loss of his child, destroyed things in her hotel room, like the television set. As expected
with grief, most of the participants also exhibited symptoms of depression, including loss of
appetite and lack of sleep. Some participants had no desire to have any social interaction, and
one participant even had a desire to die with her child. On the case of Ms. Caritas, she went
down to 90 lbs. and was drinking 13 cups of coffee everyday.
Until now, some mothers still grieve for their child, despite the fact that it has been 6 to
13 years since their child passed away. Participants, like Ms. Caritas, choose to avoid these
reminders because reminders they have of their child can somehow still cause pain. “Ngayon,
okay na ko. Wag lang ako may naririnig na mga dinidiscuss tungkol sa kanya ha, ayoko. Ayoko,
dinidismiss ko, yung mga ospital, uhm... burol”. Mrs. Bo, eight years after the death of her son,
is still mourning, even if it is not manifested explicitly. “I'm still crying, I'm still grieving. Pero
alam naman niya na nasasaktan nasasaktan ako, alam niya, pero not this, hindi niya [her son]
ako nakikita pag ganito”. Despite the fact that a number of years have already elapsed, the
grieving process for the mothers still continue.
Feelings of injustice towards God:“Why, God?”
An especially striking theme that was noticed during the interviews was the mothers’
tendency to question God. All of the participants thought of this after the death of their child.
“Why God?”, they would ask. Their questioning of God is brought about by feelings of injustice,
which they think they and their children do not deserve, the unique experience of losing a child
that goes against the laws of nature, and the mere curiosity of asking God “why” it had to
happen.
The participants narrated how they felt a sense of injustice after the loss of their child.
The statement “bakit yung anak ko?” was often brought up during the interview. For them, it
was unfair to have their child taken away from them when they were well dressed, properly fed,
and given the medical care they needed. This was explicitly said during the interview with Mrs.
Bo. She felt that her child didn’t deserve to die when “ang dami naman kasing, diba, sa street
children, those who cannot afford to study, those who don't have that, uhm, they don't have that
ambition to, in life eh. And yet, andiyadiyan pa sila.” From the statement, it can be observed how
she feels that her child was more worthy to live in comparison to other children on the grounds
that they had more and have dreams in life. On the other hand, to Mrs. Marikina, the injustice
was focused on her when she said “Di naman ako masamang tao di naman ako ng argabyado ng
tao.” She felt that she didn’t deserve that kind of treatment when she didn’t do anything to
wrong or harm anyone. For Ms. Caritas, she affirms that she has been a good mother to her child
in her statement “Yung mga pabaya diyan na nanay, bakit nabubuhay ang anak, ang dudumi ng
anak? Ako, masipag ako eh.” Moreover, she questions God why those women who do not take
care of their children properly are not the ones who experience their children taken away from
them. Ms. Starbucks also mirrors the three other participants when she said “ang dami daming...
masasamang loob, rapist, killers, murderers... bakit... bakit hindi anak nila?”
The feelings of injustice experienced by the 4 mothers were directed to God whether they
feel that it was unfair for their child or for them. All of them were angry with God directly after
the loss of their children. Why them? Why not other people? However, despite the anger they
felt, they never stopped to be religious. Ms. Caritas found herself “rebelling” against God for a
while but then returned to Him. She even stated that “Napalapit (siya) sa simabahan” after her
ordeal. Mrs. Bo also reconciled with God after a year. She had a “feeling against God during
then” but “bumalik din naman,” similar to Mrs. Marikina. For Ms. Starbucks, it was a learning
experience. She didn’t go to church and was angry for a time but then gradually came back and
even thanked the Lord for “for teaching (her) those values that (she) didn't have, (she) didn't
possess at that time". For the four mothers, questions of injustice eventually turned into
acceptance of “God’s plan” and the their child is now in a “better place.”
The Halo Effect: “Angel siya, eh”
Another theme that was observed was the positive perceptions of the mothers towards
their children. This halo effect experienced by the mothers in relation to their deceased child was
described in terms of the child’s relationships prior to his/her death with his/her siblings,
friends, and of course, mother. All of the participants described their child with good qualities
obedient, responsible, intelligent. Mrs. Marikina even perceived her daughter literally as an angel
during her funeral, dressing up her daughter in thee angel costume she wore for an event.
More than this angelic image, the mothers also perceived their deceased child to be their
“guardian angels”. Ms. Caritas talks to her child in prayer, asking for her intervention whenever
she encounters difficulties in her life. Ms. Starbucks exhibits the same behaviors, constantly
talking to him, telling him about her day and about his siblings, and asking him to help her with
difficulties she may face. Mrs. Bo similarly finds comfort when talking to her son whenever
problems arise. She claims that solutions are somehow provided one way or another within a
span of three days, and she says that it is because her son has helped her. Lastly, Mrs. Marikina
brings up her daughter in everyday conversations: “... pag nagbibiro ako, ‘Pag andiyan si Pia
patay kayo’, kasi ano yun eh, maldita nga. Sabi ko, di kayo uubra pag andiyan si Pia.”
Ongoing Relationship: “I don't know kung if it is being practiced, pero that's that's the way I did
it and I'm doing it until now.”
There seems to be a presence of an ongoing relationship between the mothers and their
deceased child across the interviews. Most of the time, material representations of the child like
photographs and clothing are kept inside the house. In Mrs. Marikina’s case, it was not just a
small photograph but a big tarpaulin displayed in their living room and her bedroom. Moreover,
she still keeps some of her deceased child’s clothes in a chest, bringing them out occasionally to
sniff them. Mrs. Bo takes it a step further. She narrates how she has brought the ashes home and
has to greet the urn “Good morning” and “Good night.” She shares her problems with him and
tells him about how her day went. She even brings the urn with her abroad when possible. She
also has a Pluto plush toy to bring when travelling with the ashes is questioned. Most of the time,
when dining out, she brings Pluto and sits him in one of the chairs. Mrs. Bo also keeps her
deceased son’s clothes, sniffing them from time to time. During the interview day, she even wore
one of his shirts.
Ms. Starbucks kept some her deceased child’s belongings. However, her ongoing
relationships seems to be represented in her dreams. She stated how Jj “appears in her dreams a
lot.” She tries to find meaning in these dreams and even follows them for advice. Ms. Caritas,
however, disposed all of her daughter’s belongings as a way to “rebel” against God. The others
were kept by her husband who according to her, is more attached to their deceased daughter.
The ongoing relationship also presents itself in the way the mothers continue to long for
their children. Mrs. Marikina says that “hinahanap mo ung anak mo.” She also insists that her
child is just there or “nandiyan lang siya” and refuses to celebrate death anniversaries. Ms.
Caritas says that “everywhere (she) looks, it’s her that (she) sees,” which implies a feeling of
longing. Mrs. Bo seems talks to her son frequently and asks him for advice stating that “he can
analyze more now, because malaki na rin siya,” as if he were still physically present. Ms.
Starbucks says that she “misses him every day, every second,” especially when she sees his urn.
She talks to the urn quite often as well. This ongoing relationship, as implied by its name,
continues on for years. These behaviors are not just present at the beginning stage after the loss
but all throughout the grief stories of the participants.
Life after loss: “Ang dami nating support sa family, extended family, friends”
The resilient Filipino mother is surrounded by family and friends, thus their way of
moving on from the loss has many avenues. One of which is that the mothers get preoccupied
with their work. Ms. Starbucks explicitly stated that after the death of her child, she “worked and
worked and worked. That was my coping mechanism. I worked so hard.” despite not enjoying
being given a lot of work prior to the death of her child. She reasoned out that working overtime
robbed her of her time of being a mother to her children. The same way, Mrs. Bo also felt that
working helped her get over her grief on the loss of Russell, “ It took a while... my work…
Helped me also in this stage. Yung work ko, and my responsibility in the house”. She also stated,
“staying at home will make you feel more sad” wherein being idle and at home will only remind
her of memories of her passed son.
These working mothers prioritize and keep busy with their work. They work also because
they have other children of theirs to take care of. In Ms. Caritas’ situation, she said, “Alam kong
hindi ako pwedeng mag lokaloka, kasi may apat pa akong anak na kailangan asikasuhin.” Their
other children also serve as a distraction and entertainment from the loss the family has
experienced in which Mrs. Bo said about her youngest son Dwayne, “ If not for Dwayne, maybe
because, I will not be here, like this siguro. I can cope up na rin because of Dwayne. So I have
to be strong for Dwayne.” Being strong for their other children was prevalent after the death of
their child. Ms. Caritas also quipped that she mostly had a positive outlook after the death of her
child because of her other children who were delightful. She said, “nalilibang ako kay Marisse,
kasi ang kulit.” These mothers found their other children as an outlet of their grief. Their children
provided them happiness on the other side of things.
The mothers also have gained a lot of support from their friends and families especially
here in the Philippines where the sense of community is very strong. This is most especially true
for Ms. Starbucks, wherein she felt the support of her loved ones here in the Philippines, She
said, “Siguro ang advantage natin sa Philippines is we have so much support system. That's one
way of coping also. Ang dami nating support sa family, extended family, friends. We have so
much time here.”
Some of them even join support groups, which has a positive change from their
perspective in life. Like Mrs. Bo who joined a Soup Kitchen by the school of her sons, she
explained that it had helped her cope with the loss, “It helps, yes, it helps. Kasi, yung mga
coparents ko are also there to encourage me, to talk to me, yung ganun. They help me also.”
Supporting this, Ms. Starbucks also joined a humanist movement a year after she lost her son.
She said, “I think that helped me too kasi may mga activities kami na you have to lead.” She also
explained further how this helped her for her own growth and understand other people’s feelings,
as well.
In addition, the mothers also exhibited what they have taken away from this experience,
making them more gentle, but still firm, as mothers who have loved and lost.
“Ngayon ko lang pwede masabi na ‘I’m okay”
A sign of moving on, with help of work, their other children, and support groups, is the
showcasing of the mothers’ gradual letting go and acceptance of their child’s death. The mothers
would say that they are doing okay, but that the pain of losing a child never leaves. As Ms.
Starbucks said, “you don’t forget the pain”. For her, losing Jj, even though it has been thirteen
years, still hurts her. She has said that she does not grieve any more, but she still feels the pain of
the loss of her son. The pain never goes away.
In addition, at first, they would not move the belongings, clothes, or the room of their
deceased child, but as time slowly passes, as they accept the loss, they build up the courage to set
aside the belongings of their deceased child. “‘Yung gamit niya ngayon ko pa lang medyo na
idispose eh”, said Mrs. Marikina. Their moving on is manifested in the way they start to tinker
with their child’s rooms, and belongings, eventually signaling their gradual letting go of their
child.
DISCUSSION
The experience of bereavement is a challenge for anyone to handle. For these four
Filipino mothers, the death of their child has been the most difficult trial they had to go through
yet. All the participants had a very close attachment with their child, which was exhibited
through the continuing bonds manifested in each of the mothers’ narrations. Themes that were
found in the results were similar to that of found in the KublerRoss’ Stages of Grieving
(KublerRoss & Kessler, 2005), such as grief and life after loss. The difference between the
results and these stages was that grieving for the participants was not a linear process, because
although they experienced the same thing, the mothers coped with the loss in different ways.
Moreover, certain themes were present that were not part of the KublerRoss stages, such as
feelings of injustice towards God, ongoing relationship with the deceased, and Halo effect. This
signifies the process of grieving is culturebound in the case of Filipino mothers, mostly due to
the influence of their collectivistic nature, as well as religion, culture.
Manifestations of Continuing Bonds
As mentioned in the beginning of this paper, a continuing bond is described as having an
ongoing relationship with the deceased person (Boelen, et al., 2006). There were different
behaviors in which continuing bonds were manifested by the bereaved mothers. Aforementioned
studies differentiated adaptive continuing bonds (wherein the lingering attachment proves to be
helpful for the bereaved) from maladaptive continuing bonds (wherein the lingering attachment
proves to be unhealthy for the bereaved). Despite the fact that the mothers showed signs of both
adaptive and maladaptive continuing bonds, all of them seem to be able to somehow accept the
death and cope with what happened. Furthermore, the experience of grieving and continuing
bonds seem to be very unique to the individual while certain manifestations of continuing bonds
seem to be maladaptive, the mother might find this certain behavior helpful in coping with the
death of her child.
One of the most evident signs of continuing bonds was the perceived continuing
connection that the mothers had with their child. This is in line with Field and his colleagues
Continuing Bonds Interview created in 2004 (Ronen, Packman, Field, Davies, Kramer, & Long,
2010) (see appendix A). Most of the questions asked in the interview were very much relevant to
the Philippine context. Most mothers, like those in the CBI study, experienced a continuing
connection with the deceased child. Almost all of the mothers too, have kept their child’s
possessions and have associated places they have gone to before with the deceased child. They
even described dreams they had of their child.
For most of the participants, manifestation of continuing bonds are shown through
speaking with their passed son or daughter directly to their urn, greeting them good morning, just
asking how they are, and asking them for help in their daily struggles. Having conversations with
the deceased child was also present in the CBI questionnaire.
According to Epstein et. al. (2006), these sort of manifestations are considered
maladaptive, due to the fact that these manifestations of continuing bonds keep the mother
attached to her child, therefore making it more difficult to move on from the death of the child.
Despite this, the participants feel that their rituals, no matter how unusual they might seem, give
them some sense of comfort; that regardless of the absence of their loved one, they are still
somewhat comforted by the presence of their child.
Furthermore, identification with the child, where parents describe their child as role
models and garner a sense of admiration towards the deceased child was apparent across all the
stories. This Halo effect coincides with an item in the CBI interview mentioned above. In this
observed theme, the participants viewed their children in a positive light what was remembered
of them were their good qualities. This process, which Russac et al. (2002) calls internalization,
allows for the person to view the deceased as a role model, even to the extent of making these
traits part of the bereaved’s self. An internalization process was evident in the way Ms. Caritas
coped with the death of her daughter. When she was talking about Tricia, she was saying how
her daughter would always made her mother calm down whenever she would be temperamental,
especially when she was dealing with her other siblings. In the same way, Ms. Caritas shared
how she learned to become a more patient and loving mother in terms of her relationship with
her other children.
Other participants also manifested internalization in the way that they focused on positive
memories with the deceased. When asked about their relationship with their children, all of the
participants described a very close relationship with their child, giving short anecdotes of what it
was like before the death of the child. An example of this is Ms. Starbucks, who described how
she had a special bond with their son that was difficult to understand from an outsider’s point of
view. Mrs. Bo also describes having a close relationship with her son, seeing as they did almost
everything together as a family. These sort of internalizations, according to Russel et al. (2002),
are considered as adaptive continuing bonds, because they allow for the participants to have a
securebase about the death of their children. Furthermore, these attachments can even be an
avenue for personal growth. While Epstein et al. (2006) mentions closure as an important factor
towards adaptive continuing bonds, none of the participants seemed to have expressed a sense of
closure with the deceased, mainly because they derive strength from the comforts of somewhat
still being with their children. Furthermore, other factors have helped the participants have also
allowed the participants to better cope with the death of their child, such as their spirituality, as
well as the comfort of their families and friends.
Religiosity, Spirituality, and Culture
Guballa (n.d.) mentions the concept of healthy grieving, wherein the bereaved creates a
new life for herself, given the loss of her loved one. Despite the fact that some participants
seemed to still be in the grieving process or exhibit maladaptive continuing bonds, healthy
grieving was very helpful for the participants mainly because of their religiosity, spirituality and
the comfort of the people surrounding them.
Spirituality is defined as the aspect of life that goes beyond the material or the physical
(Sagberg & Røen, 2011). It is the ability of people to transcend time and space to find and
understand meanings. Religiosity, on the other hand, deals with creeds, rituals, and other outward
forms of belief (Damianakis & Marziali, 2012). For the for Catholic participants, these two seem
to be very large factors as to why they find their manifestations of continuing bonds to work for
them. They’re not just avenues for coping but also for growth.
These two concepts are very apparent in the Philippines. We are known to be very
religious and spiritual. It is plausible that these two traits have also helped buffer the effects of
maladaptive continuing bonds among the four participants, aiding in mental and physical health.
Damianakis and Marziali’s study supported this finding (2012). They discussed that people who
experience loss try to fit everything in their preexisting religious and spiritual schema. Some
even try to create new schemas to process the meaning of the loss. Therefore, Religiosity and
Spirituality takes on an active role during bereavement.
Looking at the themes, God persists to be a common entity present in all, most obviously
seen in how they questioned God when their children passed away. The loss of their child
emitted a lot of anger and doubt towards God. The theme stood out in the interviews because
every single participant had the same feelings and ideas, just differently stated. They felt
injustice had been done to them if not their child. They compared themselves and/or their child
to other people, whom of which have done so much harm to others. They have also compared
themselves to mothers who have abandoned or failed to take care of their children properly. It is
with this injustice that they release their anger towards God.
This doubt in God did not last very long. They eventually accepted the fact that their
child is in a better place. As religious and spiritual beings, Filipinos tend to believe in the
supernatural, thus seeing the own child as their personal guardian angel to whom they pray to to
look after them and help them with their struggles. Eventually, the mothers had relinquished the
anger they felt towards God with their own reflections and support received from other people.
Especially that Filipinos are very familyoriented. They have realized that everything is part of
God’s plan. Through these realizations, they have become better persons, as well as better
mothers.
Limitations
The most basic limitation for this study is the lack of required participants for the
dissertation. The researchers were only able to interview 4 out of the required 6 for a qualitative
study. It is recommended that future researchers follow the prescribed number of participants in
order to obtain more data. Furthermore, the research only includes mothers from urban Manila
that fall under a specific class. Future researchers can opt to include fathers’ accounts, spread
their sampling to rural areas, and try to get participants across the social classes. This can give a
richer understanding of how continuing bonds and bereavement are manifested by different
people. Future researchers can also try to tap into participants from different religions. All of the
participants in this study were Catholics or Christians, which is probably why spirituality had a
great part in their story. Perhaps interviewing participants from other religions can give a fuller
understanding of the role of spirituality in bereavement. In addition, Our research was only able
to obtain participants who have lost their child through a medical condition. Other causes of
death like accidents, murder, or suicide may perhaps lead to different findings. Interested
researchers may delve into these other perspectives as well.
It must also be taken into consideration that all the stories in this research are based on
oral accounts of events that have happened years ago. Possible tweaks or biases may have been
formed during the retelling of their stories. These issues regarding accuracy and truthfulness
must be bypassed, and whatever narration is given will be taken. Moreover, analysis of the four
accounts are only based on voice recordings. Future researchers can consider taking videos of the
interviews in order to study the participants’ behavior, as well.
RESEARCH DIARY
Patricia Py’s Reflection
Thesis has always been a learning experience more than a burden to me. True, it was a
difficult process of searching for literature, transcribing interviews, and trying to organize and
make sense of the multitude of data presented before us, but I have always enjoyed the work
while it lasted.
More than the workload, what really struck me while doing this dissertation was the
stories I have heard from our participants. In all honestly, I found myself affected by their grief.
There were times that I had to hold back tears just to give off a facade of professionalism.
However, beyond the emotions, I have experience a kind of renewal to why I am studying
Psychology now. I realized that pursuing this discipline can aid me to help others. There are so
many things that are yet to be discovered, and the knowledge acquired can do so much for
others.
Michelle de Guzman’s Reflection
Honestly, writing this thesis mostly like finishing my requirements something I had to
do before I graduated, to give me a sense of being a Psychology major. The concept of death was
very distant to me, as the closest person I have known who has passed away was my
grandmother, and we weren’t even that close. Initially, I was doing this thesis for a general idea
of how painful it would be for a mother to lose her child an idea that felt really distant and
abstract.
Unfortunately, this thesis became concrete and real to me when one of my kids in Kythe,
Ashley, passed away. The pain became all too real and inescapable; and then I realized what
more for her mother? What more for this woman who has been taking care of her child for 10
years, and then just losing her in the blink of an eye?
And so, I am dedicating this thesis to her to Mrs. Sy, who is one of the strongest women
I have ever had the pleasure of encountering. I am also dedicating this thesis to Ashley, who has
taught me so much more than what I learn inside classrooms. And finally, I am dedicating this to
Kythe to an organization that keeps on struggling to help these kids, despite the pain that comes
along with this experience of reaching out.
This thesis also dedicated to my friend Sei, who has always inspired me to keep on
working for this advocacy.
Angelina Mendoza’s Reflection
The idea of this thesis had been from a recent personal experience of losing a close friend
of mine and understanding the relationship each person had with this close friend. I had
witnessed first hand how his mother, father, relatives, friends, blockmates, and professors
grieved over his death. It piqued interest in me when I observed how different each person
nourished their relationship with him after his death, thus the emergence of continuing bonds as
the topic of our study.
Aside from the fact that this thesis should give us more information on the behaviors of
how mothers exhibit continuing bonds to their deceased sons and daughters, it most importantly
broadened my perspective in life, and made me more empathetic as I, hope to someday be a
mother, as well. I had gotten to know stories of their greatest pain and heartache, and it humbles
me that these mothers held no information back from us researchers despite this being a very
sensitive topic to share with three strangers. Moreover, it gave me more reason to love my major,
Psychology, as this study may someday help grieving mothers and give a deeper and broader
understanding of continuing bonds here in the Philippines.
In addition, I would like to dedicate this work of love to the Ancheta family, Tita
Cynthia and Tito Mike, to whom my friends and I had gotten close to because of the loss of a
beloved son and friend, Miko Ancheta, to the parents who treated us like their own children, to
the two breathing reminders of Miko to us. To Lyka Gonzales, who had stood strong and
gracefully went through this stormy patch. And lastly to Miko, you will always be remembered.
Thank you for continuing to inspire each and everyone of us. Thank you for your endless Love
and Light.
CONCLUSION
The process of loss, grief, bereavement, coping, and letting go is not as linear as it seems
to be. There is no equation with regards to life after losing a child, particularly here in the
Philippine setting. Culture seems to play a dynamic role in this. Whether mothers exhibit
adaptive or maladaptive continuing bonds, they seem to be living well. Of course, the sadness
will always be there, but they have the capacity to cope with it and live a normal life. Religion
seems to be the defining factor in the process. The type of continuing bonds, coping mechanisms,
anger, and feelings of injustice, and other themes revolve around religiosity, which is a big factor
in the Philippine setting. No matter how jumbled and inconsistent the equation is, God is found
to always be a constant.