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MEN IN GRIEF:DEATH OF A PARTNER

BY
John MattheW'O'Brien

A.DISSERTATION

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

DOCTOR.OF PHILOSOPHY
Department of Counseling and.Educational Psychology and Special
Education

1996

ABSTRACT
MEN IN GRIEF: DEATH OF A PARTNER

BY
John Matthew 0 ’ Brien

The literature is replete with articles about the
grieving process that occurs when one loses a partner
(Bowling, 1988; Feinson, 1986; Folken, 1991; Gass 5. Chang,
1989; Schuchter & Zisook, 1986; zisook & Schuchter, 1991).
However, men are seldom the sole focus of partner loss
research (Lister, 1991) and the literature on gay grief is
even more sparse (Doka, 1987; Siegel & Hoefer, 1981). The
purpose of this qualitative study was to examine the
experiences of both heterosexual and gay men grieving the
death of a partner due to chronic illness. Although there
were unique aspects of heterosexual and gay men's grief,
results demonstrated that many issues relevant to grieving
the death of a partner transcend the issue of sexual
orientation. Key findings focused on recognizing the
diversity of men and exploring the relationship between
gender socialization outcomes and men's grief.
Recommendations for practitioners working with grieving men

and researchers focusing on men's grief are offered.

For My Wife Wanda: Love Will Never Go Away
Orville Kelly

Spring and the land lies fresh and green
Beneath a yellow sun.

We walked the land together, you and I.
And never knew'what future days would bring:
Will you often think of me,

When flowers burst forth each year?
When the earth begins to grow again?
Some say death is final
But my love for you will never die.
Just as the sun once warmed our hearts,
Let this love touch you some night,
When I am gone,

And the loneliness comes-

Before the dawn begins to scatter
Your dreams away.

Summer, and I never knew a bird
Could sing so sweet and clear,
Until they told me I must leave you
For a while.

I never knew the sky could be so deep a blue,
Until I knew I could not grow old with you
But better to be loved by you,

Than to have lived a million summers,
And never known your love.
Together, let us, you and I
Remember the days and nights
For eternity.

Fall, and the earth begins to die,

And leaves turn golden—brown upon the trees.
Remember me too, in autumn, for I will walk with you,
As of old, along a city sidewalk at evening time,
Though I cannot hold you by the hand.

‘Winter, and.perhaps someday there may be
Another fireplace, another room,
With crackling fire and fragrant smoke
And turning, suddenly, we will be together
And I will hear your laughter and touch your face,
And hold you close to me again.

But, until then, if loneliness should seek you out,
Some winter night, when the snow is falling down,
Remember, though death has come to me,

Love will never go away!

DEDICATION

This dissertation is dedicated to my father

Paul Joseph O’Brien
August 20, 1931 - November 26, 1994

An Irish Blessing

May the road rise to meet you.

May the wind be ever at your back.
May the sun shine warm upon your face.
May the rain fall soft upon your fields.
And until we meet again
May God hold you in the palm of His hand.

iv

ACKNOWLEDGEDMENTS

I would like to express my sincere appreciation to
specific people who have greatly contributed both to this
project and to my development. I am grateful to the members
of my committee: Dr. Gershen Kaufman, Dr. Robbie Steward, and
Dr. Ann.Austin for their support of this project. I am
especially grateful to my committee chair, Dr. Linda Forrest,
for her guidance and support. I am indeed fortunate to have
been mentored by such talented and dedicated faculty.

I also appreciate the input of Dr. Betsy Becker, Dr.
John Schneider, Dr. Cindy Morgan, Susan Zimmerman, Lynn
Breer, and members of the Grief Research Group. Special
thanks to Dr. Royce Scrivner at the Dallas VA Medical Center
for reviewing drafts of this manuscript. I also wish to
especially acknowledge Lisa Stephen and Gregg Mousley for
their love and support during my graduate years.

I am grateful to my family for providing me with an
environment that recognizes the importance of education.
Special thanks to my mom, Carol O'Brien, for supporting me in
my pursuit of academic achievements: from teaching me to read
“Hop on Pop" to obtaining my doctoral degree.

Finally, I would like to acknowledge the courage and
strength demonstrated by participants in.my research project.

Without them, this dissertation would not have been possible.

V

TABLE OF CONTENTS

CHAPTER.ONE
IntrMUCtion......... ...... .................................1

CHAPTER TWO
Literature Rev1ew9

CHAPTER THREE
Hethws................ ..... .......... ....... ..............48

CHAPTER FOUR
ResultSI................................ ........ ...........68

CHAPTER FIVE
Resultsz................... ................. ..............120

CHAPTER SIX
DiSCUSSion................................................174

Appendices................................................200

Appendix A: Participant Data.........................200
Appendix B: Recruitment Procedures...................212
Appendix C: Initial Letter to Participants...........213
Appendix D: Initial Consent Form.....................214
Appendix E: Preliminary Information Form.............215
Appendix F: Letter to Interviewees...................216
Appendix G: Interview Consent Form...................217
Appendix H: Background Information Form..............218
Appendix I: InterviewflProtocol.......................220
Appendix J: Letters to Nonselected Volunteers........223
Appendix.K: Follow-Up»Letter to Interviewees.........224
Appendix L: Lansing Area Bereavement Resources.......225
Appendix M: Grand Rapids Area Bereavement Resources..227
Appendix N: Ann Arbor Area Bereavement Resources.....229

List of References........................................231

vi

INTRODUCTION

This study focused on the experiences of men grieving
the loss of a partner. Men have rarely been the sole focus of
grief research (Lister, 1991). When they have been studied,
it is usually in comparison to widows or to married men in
their age cohort (Wister & Strain, 1986). By focusing
specifically on men, I examined the impact of gender
socialization outcomes on men's grieving. Both heterosexual
and gay men were included to gain greater understanding of
similarities and differences in the grieving of heterosexual
and gay men.

Men in the United States are part of a society that
encounters difficulty with the meaning of death (Shapiro,
1994). Death is no longer considered a normal part of the
life-cycle for many Americans and has become increasingly
distanced from our everyday lives. "The more we are making
advancements in science, the more we seem to fear and deny
the reality of death. we use euphemisms, we make the dead
look as if they were asleep, (and) we ship the children off
to protect them from the anxiety and turmoil around the
house" (Kubler-Ross, 1969, p. 3). Death is viewed as
something that occurs in old age, something associated with
hospitals and nursing homes (Kubler-Ross, 1969). It is rare
for someone to die at home, surrounded by family and friends
(Kubler-Ross, 1969). Mainstream American society
compartmentalizes death as if individuals can control when

and where it occurs. "In our early adult years, we learn to

1

2
cope more effectively with loss by believing we are the

exception to the rules, especially the ones about limits and
death" (Schneider, 1989, p. 27). Yet, no matter how much we
believe that we have conquered death, we haven't. "Death is
still a fearful, frightening happening and the fear of death
is a universal fear, even if we think we have mastered it on
many levels" (Kubler-Ross, 1969, p.5).

Because of this seemingly universal denial, thinking
and talking about death may be very difficult for many
clients with presenting problems related to the death of a
partner. In addition, researchers and practitioners who
study and support the bereaved.may attempt to avoid facing
loss on a personal level, evading a confrontation with their
own mortality and fears of losing their loved ones."
Clinicians and grief counselors...are first and foremost
human beings who struggle with (their) own cultural
assumptions to live meaningful lives while facing the
possibility of loss and the certainty of death" (Shapiro,
1994, p.5). If left unaddressed, their struggle with issues
of grief and loss will only serve to inhibit their clinical
effectiveness and/or their sensitivity when conducting
bereavement research.

Researchers and clinicians must work to overcome their
personal biases and become more cognizant of the complexity
of the grieving process. The death of a loved one may often
bring clients to therapy or to participate in a research

project to understand more about their experience. Given the

3
aforementioned societal attitude about death, therapy or

research projects may be the only place that clients feel
validated for talking about their pain. I experienced this
in conducting research for my Master's thesis (O'Brien, 1991)
as many of the participants had not talked previously with
anyone about their grief. Helping professionals in either
role need to be prepared to deal with their own reactions as
‘well as the varied reactions of those grieving individuals
with whom they work.

Holmes and Holmes (1970) constructed a table of life
events that correlated with stress in individuals. The death
of a spouse was at the top of their list. The stress
associated with this experience may result in severe
depression (Zisook & Shuchter, 1991). "Spousal bereavement
is often the:most profoundly disturbing and disruptive event
in an individual's life" (Shuchter & zisook, 1986, p. 295).
Widows and‘widowers may seek counseling or other services in
adjusting to their new life.

The proportion of men and women who are widowed rises
sharply after the age of 65, although male levels are
markedly lower than those for females. "In 1981, 68.5% of
all women 65 and older were widowed compared to 21.7% of men
65 and older" (Roberto & Scott, 1986, p. 498). Perhaps due to
this gender discrepancy in frequency of losing a spouse, much
of the research literature is devoted to examining the
experiences of widows. When widowers are studied, they are

usually studied in contrast to widows (Lister, 1991).

4
Authors rarely focus specifically on the experiences and

needs of men grieving the death of a partner.

Another factor influencing the emphasis on women's
experiences has been the gender discrepancy in those who
enter counseling. In general, women are much more likely to
seek support in a therapeutic relationship (Good, Dell &
Mintz, 1989). This discrepancy may result from gender
differences in socialization. "Men are socialized to be
emotionally inhibited, assertive, powerful, independent, and
to equate sexuality with intimacy, manliness, and self-
esteem. Given this socialization, men often do not seek
therapy, and when they do,...they are often fearful of
disclosing or quite unaware of their feelings" (Mintz &
O'Neil, 1990, p.382). Men's needs and expectations entering a
therapeutic relationship may be quite different from women's,
including their needs in grieving the loss of a partner.
Equally so, the preconceived expectations that clinicians
have of men and how they "should" grieve may inhibit their
ability to work effectively with them in therapy. .Many
authors (Gass 8 Chang, 1989; Lister, 1991; Staudacher,l991)
have acknowledged some of the ways that men.may grieve
differently.

Since grief is often a reason that people seek
psychological services, clinicians must learn about the
grieving process and effective ways to treat clients. Even
though.men are currently less likely to experience the loss

of a partner or to seek counseling services to assist them in

5
the adjustment process, clinicians should be prepared tO‘work

with those who do, either through traditional counseling
services or through other interventions that might better
meet men's needs. If clinicians are aware of the critical
issues of men who have experienced the death of a partner and
understand how they can be most effective in service
delivery, men. will be more likely to have positive
experiences.

With the recent rise of the men's movement, many men are
becoming more in touch with their emotional sides and their
needs for intimacy (Bly, 1990). This major shift in men's
view of themselves and their needs may result in their
greater participation in the therapeutic process. Men may
also become more comfortable with utilizing emotional coping
strategies in responding to difficulty when they discover
that other strategies have not worked for them.

we are living in an important and fruitful moment now,
for it is clear to men that the images of adult manhood given
by popular culture are worn out; a man can no longer depend
on them. By the time a man is thirty-five he knows that the
images of the right man, the tough man, the true man he

received in high school do not work in life. Such a man is
open to new visions of what a.man is or could be (Bly, 1990,

p.x).

However, not all men's experiences are alike. Doka
(1987) studied the grieving process of individuals who lose a
partner in a "non-traditional" relationship. These
relationships included extramarital affairs, cohabitation,
and gay relationships. "When one experiences the loss of a

significant other in a nontraditional relationship, it is

6
more difficult to complete... tasks (of mourning). It is

harder to accept the reality of loss if one is excluded from
the dying process, restricted from funeral rights, inhibited
from acknowledging the loss, or even receives delayed
knowledge of the death" (p. 465). Lack of social support is
just one of the factors that can exacerbate grieving in this
type of relationship.

Although there are likely’many commonalities in all
men's experiences of grieving the death of a partner, there
will also be points of divergence. Factors such as age of
surviving partner, culture, race, ethnicity, socio-economic
status, and sexual orientation are all important elements in
the identity of men. Clinicians and researchers need to
attend to these within group differences as these can all
exert unique influences on a man's ability to grieve.

The grieving process can be differentially impacted by
the mode of death of the partner, whether natural or violent,
expected or unexpected. Natural or expected losses allow the
bereaved to begin the process of grieving before death,
anticipating their impending loss (Stroebe & Stroebe, 1987).
Violent or sudden death does not allow for a period of
preparation and may result in a longer period of mourning
after the death (Stroebe & Stroebe, 1987). In an effort to
reduce the variation in participants' experiences, this study
will focus on men‘whose partner died from chronic illness,
allowing for some period of preparation before their

partner's death.

7
This study examined the following questions:

(1). What is the experience of men who are grieving the
untimely death of their spouse/partner?

Many studies in the past have focused either solely on
women in this situation or have compared men with women. The
sole purpose of this study was to hear men's experiences of
loss. Thirty to fifty year old.men.were the population of
interest, making the death of their spouse/partner unexpected
developmentally.

‘WOlfelt (1990; 1992) suggested that men's grief is
"naturally complicated" by the outcomes of their
socialization. Difficulties with affective expression,
seeking support, focusing inward, and acknowledging their
pain, as well as striving for independence, all impact the
mourning process for men (Wolfelt, 1990). Men's experiences
will be examined in light of these assertions to ascertain
their accuracy.

(2). What is the impact of sexual orientation on men‘s
grieving?

I recruited both heterosexual and gay men to be involved
in this study. Rothblum (1994) suggested that, in studying
issues in adult development, researchers should attend to
gender and sexual orientation to understand how each of these
‘variables contributes to a phenomenon. Although the primary
purpose of this studwaas to examine the grief experience for
men, some preliminary hypotheses were generated about the

impact of sexual orientation on bereavement.

8
Gelso and Fretz (1992) outlined unifying themes that

distinguish counseling psychology from.cther fields in the
helping professions. Among these distinguishing
characteristics are (1) concentrating on individual's assets
and strengths, regardless of their degree of disturbance and
(2) focusing on the interaction between individuals and their
environment. In this study, I explored the strategies that
men used to cope effectively with the death of their partner.
I also examined aspects of men's environments that positively
and/or negatively impacted their mourning. Clearly, the foci
of this study were appropriate to the traditions of
counseling'psychology.

By interviewing men about their experiences of losing a
partner, data were generated that benefited helping
professionals working with grieving men. First, the field
gained a greater understanding of the impact of the death of
a partner on a man's life. The influence of gender
socialization outcomes on.a.man's grieving process were
highlighted to offer implications for practitioners working
with this population. Second, grieving a death due to
chronic illness was examined to learn more about the
complexity of this process. Finally, the impact of sexual
orientation‘was examined with the hopes of assisting
practitioners in dealing with issues unique to gay grief. I
hope that the results of this study enabled psychologists to
respond in a sensitive and thoughtful manner to men grieving

the loss of a partner.

LITERATURE REVIEW

Overview

This work will draw on many knowledge bases. After
highlighting general grieving models and symptomatology of
mourning, I explore extant literature on men's
socialization, their experiences in therapy, and their
grieving process. Next, issues unique to the experiences of
gays and lesbians in our culture are covered, including the
comparability of their relationships to heterosexual
marriage. Finally, the literature on loss in heterosexual

and gay partnerships is summarized and critiqued.

Grief Models

In her book On Death and Dying, Kubler—Ross (1969)
articulated a five stage model of grieving developed through
research with terminally ill patients. She and her students
interviewed individuals whO‘were dying to learn about their
reactions and needs, as well as the responses and needs of
those close to them. They discovered a commonality in the
patients' attitudes towards dying. .As the clients became
more aware of their impending death, they moved through
stages or phases of their grief process, including denial,
anger, bargaining, withdrawal, and acceptance. .Although
developed on dying individuals, Kubler-Ross noted a similar
grieving process for the patient's family, as they struggled

to make sense of the loss of their loved one. In my

10
experience, this model is perhaps the most widely known

conceptualization of mourning.

Schneider (1984) outlined a grieving model consisting of
six phases including limiting awareness, awareness of loss,
gaining perspective, resolving the loss, reformulating the
loss, and finally transforming the loss. Schneider viewed
loss in a holistic framework, claiming that it occurs
simultaneously on many levels (physical, cognitive,
behavioral, spiritual, and emotional). This model highlights
the complexity of the grieving process by noting that it is
not simply an emotional or cognitive process to master.

Schneider (1989) focused on the transformative power of
grief and loss, that both natural and disruptive losses are
an integral part of everyday life . "Natural losses continue
throughout life, and eventually we encounter the losses of
family, friends, work, and sometimes health simply as a part
of the process of living...Disruptive losses include
traumatic...occurrences which exceed our capacity to«continue
life as usual...These include such wrenching events as life—
threatening illness, deaths of children, divorce, or rape.
They all demand our energies for a long time afterwards just
to cope and adjust" (p. 27). Schneider claimed that in
situations of loss, whether natural or disruptive,
individuals are confronted‘with a potential for growth.
Transformation occurs when the person finds "strength in
acknowledging...weaknesses instead of denying them,

discovering new realms of consciousness and rediscovering

11
innocence through renewal and forgiveness" (p. 28). Since

grief and.mourning are an integral part of the life cycle, I
‘would posit that the way we respond to the natural losses in
everyday life influences our response to the more disruptive
events, such as death, that we must confront.

WOrden (1991) described his view of the four tasks of
mourning. He believed it was necessary to (1) accept the
reality of the loss (2) experience the pain of the grief (3)
adjust to the environment in which the deceased is missing
and (4) withdraw emotional energy and reinvest it in another
relationship. These tasks occur over a period of months, at
'which point the mourner rejoins life and reinvests his/her
energy in relationships.

WOlfelt (1992) believed that one is never capable of
truly resolving losses, but merely becomes reconciled to
their reality. To reach this point of acceptance, the
mourner initially evades the impact of the loss and, when
ready, encounters its existence. Some men, according to
Wolfelt, avoid the encounter phase of their grieving in an
attempt to shun its true impact. Ultimately, this only
further complicates their grieving process.

Many’models of grieving exist in the literature. One
commonality to all these depictions is a clear expectation
among clinicians and researchers that one who is grieving
must go through a process that is phasic to ultimately
resolve/reconcile their loss. A danger of relying too

heavily on any conceptualization of mourning is the

12
assumption of homogeneity. Although these models may depict

points of convergence for many people, grieving remains a
highly individualistic process (Shuchter & Zisook, 1993).
Grief researchers must continue to develop these models in an
effort to identify both the necessary and sufficient

conditions for grieving to occur.

Cultural/Situational Factors

Bolton and Camp (1987) studied the impact of funeral
rituals as facilitative of the grieving process. They
utilized.a Chi-square design to determine the degree of
association between number of rituals practiced and the
adjustment of the survivor. Contrary to expectations, there
was no significant relationship between these two variables.
These authors concluded that the sample (who had previously
been clients in a counseling program for the widowed) were,
in general, active in their use of rituals, perhaps more
active than others. This may have been the reason for
nonsignificant findings. They concluded that more work is
needed examining the impact of mourning rituals before,
during and after the funeral/memorial service.

Stroebe and Stroebe (1991) examined the question of
necessary grief in an effort t0>challengezmainstream
assumptions about.mourning. They interviewed 30 widows and
30 widowers at three intervals (4-7 months, 14 months, and
just over 2 years) after the death of their spouse. Stroebe

and Stroebe operationalized "grief work" as an individual's

l3
confrontation with their loss (i.e. , whether they avoided

situations/people that reminded them of their spouse and/or
chose to keep themselves busy). The Beck Depression
Inventory (BDI) was used as a measure of psychological
adjustment. A two-factor analysis of variance indicated that
widows had slightly higher BDI scores than widowers and that
both groups reported a decrease in depressive symptomatology
in the two years following the death.

Hierarchical regresssions did not clearly demonstrate
that those confronting their loss were better adjusted
(having lower BDI scores). Men who were avoiding the loss
were less well adjusted than those confronting the death of
their spouse. However, there was no significant difference
in overall adjustment between women who avoided their loss
and those who confronted people and situations that reminded
them of the deceased. When all subjects were examined
together, there was no significant difference in adjustment
(as measured by the BDI) between those avoiding and those
confronting their loss. The authors noted that the
significant difference may reflect a gender difference in the
extent to which loss is avoided; namely, that men would go to
greater extremes to avoid dealing with grieving than women.
Participants in this study were from five towns in southern
Germany. This cultural context may account for differences
in the grieving process that might not be similar in the
United States. Its applicability to American culture is

unclear. However, this work raised two important ideas worth

14
considering: (1) Is there a healthy grieving process? (2)

What are the characteristics of healthy grief?

In a comprehensive review of the literature, Stroebe,
Gergen, Gergen and Stroebe (1992) examined the idea that
expectations about grieving are culturally and.historically
defined. They noted that the prevailing "zeitgeist” dictates
how individuals view the grieving process and‘what
differentiates ”normal” vs ”abnormal” grief.

In American culture, there is an assumption that to
resolve grieving, one must break bonds with the deceased and
move quickly back to active participation in life, including
work and leisure activities (Staudacher, 1991; Stroebe,
Gergen, Gergen and Stroebe, 1992). These assumptions are not
necessarily true in all cultures. Yamamato, Okoniji, Iwasaki
and Yoshimura (1969, cited in Stroebe a Stroebe, 1992) found
that Japanese widows, who practiced Buddhism.and Shintoism,
were better adjusted than British widows who*were of
Christian background. Buddhism and Shintoism.encourage the
mourner toumaintain contact with the deceased. There is not
a "necessary separation” so that one is always in contact
‘with any and all ancestors. For these cultures, this is a
normal, healthy approach to grieving.

Mandelbaum (1959) reported that the Hopi, a Native
American tribe in Arizona, fall on the other end of the
continuum. Once a person has died, they are no longer spoken
about and are forgotten as quickly as possible. The mourners

carry on'with life as usual so that they do not become

15
contaminated with the spiritual world. Some Muslim cultures

encourage the mourner to work through their grief by denying
their pain. .Mourners instead are expected to laugh and be
joyful (Wikan, 1988; 1991).

.Along with culture, history can play an important role
in defining "appropriate" mourning practices. During the
Romantic era, people believed that individuals could
literally die of a broken heart because their center or soul,
the source of love and creative inspiration, was permanently
affected. Grieving for a loved one might continue for as
long as a person lived (Rosenblatt, 1993). Even today, this
may occur. Farber (1990) reported finding that "some
continued emotional attachment to the lost partner seems
inevitable" (p.45).

Cultural and historical milieu, as well as other
individual characteristics of the bereaved, are all essential
factors to consider in understanding their grieving process.
Models of grieving may not adequately consider aspects of
individual development. Practitioners cannot judge someone's
grief process in light of their own or societal

(mis)conceptions about what "normal” grief entails.

Grief symptoms
Lindemann (1944) wrote that grief occurred.on both

physiological and psychological levels. He based his
observations on clinical work as a psychiatrist with people

'whO‘were experiencing a variety of different reactions to

16
loss. The main focus of his study was mourners who had lost

family in a traumatic event (a nightclub fire) whereas the
remaining subjects had experienced death of a loved one
through natural causes. Although he observed a wide variety
of situations (in the mode of death of the loved one and in
the mourner's grieving process) and people, he identified
commonalities in the griever's experiences. Reactions that
he associated with acute grief were somatic distress,
preoccupation with images of the deceased, guilt feelings,
hostile reactions to others, and loss of patterns of
activity. Lindemann's work was anecdotally based on his work
with a small sample of clients. The generalizability of the
findings to all populations remains unclear.

More recently, Stroebe and Stroebe (1987) presented a
comprehensive five factor model of the components of
grieving. These factors included: affective reactions
(depression, anxiety, guilt, anger and hostility, anhedonia,
loneliness), behavioral.manifestations (agitation, fatigue,
crying), attitudes toward self, deceased, and the environment
(low self-esteem, helplessness/hopelessness, sense of
unreality, suspiciousness, interpersonal problems, attitudes
toward deceased), cognitive impairments (retardation of
thought/concentration), and.physiological changes (loss of
appetite, sleep disturbance, energy loss, bodily complaints,
physical complaints similar to deceased, changes in drug

taking, susceptibility to illness and disease).

17
Although differential diagnosis between normal and

pathological grief is difficult, Wahl (1970) offered a
taxonomy to assist clinicians in making such a distinction.
His foci were factors related to the nature and extent of the
griever's reactions. Similarly, Stroebe and Stroebe (1987)
recommendedmmaking this determination by examining the
severity of the symptomatology as well as the time since the
death.

Middleton, Raphael, Martinek, andMMisso (1993) explored
the extensive literature on pathological grief, also labeled
as, "absent, abnormal, complicated, distorted, morbid,
maladaptive, truncated, atypical, intensified and prolonged,
unresolved, neurotic, and dysfunctional.”(p. 44). Although
each of these characterizations may have some commonalities,
they may also emphasize different views and aspects of grief.
Middleton et a1. stated that "where grief for a particular
individual, in a particular culture, appears to deviate from
the expected course in such a way that is is associated with
excessive or prolonged psychological or physical morbidity,
it may be labeled as pathological" (p. 44).

Grief research has only begun to recognize the
complexity of grieving and of defining pathological grief.
Distinguishing between normal and pathological grief may be

clearer to do in theory than in practice.

18
Men's issues

Before further exploring the impact of male
socialization, I wish to acknowledge my own bias. One can
view the results of gender role socialization in two
competing*ways: highlighting differences or highlighting
similarities (Hare-Mustin & Maracek, 1988). In focusing on
men, I operate from the assumption that "males and females,
even within ethnic and social class variations, are
socialized differently in this society" (Lister, 1991, p.
225). I highlight differences in an effort to explore how
socialization outcomes may affect men who are grieving.

"The late 1970's and early 1980's will probably be known
as times when men recognized that they (were) also victims of
restrictive gender role socialization and sexism in their
lives " (O'Neil, 1981, p. 203). Perhaps in response to the
changing roles of women in our society, men have begun to
look at the ways that gender stereotypes have affected their
development. O'Neil (1981) noted.both positive and negative
aspects to being socialized as a male. In thinking about the
struggles of men who have lost a partner, I look at the
negative aspects of their socialization, as these are the
areas that may inhibit a man's ability to handle loss.

In an extensive review of the literature, O'Neil (1981)
cited four outcomes of male sex-role socialization, that
included (1) need for power (2) need for control (3)
competitive focus and (4) restrictive emotionality. O'Neil

noted that these outcomes can affect men's interpersonal

19
lives, their career development/work life and their

physical/emotional health (p. 68). Of specific interest in
this study‘was the examination of the impacts of
socialization on a man's interpersonal life and his
physical/emotional health.

Maccoby (1990) reviewed the literature on gender
differences in relationships from a developmental
perspective. She concluded that differential patterns of
interaction which were seen in boys and girls could be linked
to interactional patterns in adolescence and adulthood.
Maccoby deduced that the results of socialization put men at
an advantage in groups, as they have learned to assert their
needs and have their voices heard. However, they may
encounter more difficulty in dyadic relationships, especially
with other men, possibly because of what Maccoby calls their
”restrictive interactional style." This style attempts to
inhibit communication between participants by bringing the
interaction to an abrupt end.

O'Neil (1981) noted that men experience difficulty‘with
sexual and affectionate behavior. Because of their developed
needs for power, control, and dominance, they can view sexual
relationships more as a conquest than as intimate
communication (O'Neil, 1981, p. 208). Men may separate sex
from loving, affectionate behavior. If Maccoby (1990) and
O'Neil (1981) are correct about these developed styles of

interacting, I would posit that men socialized in these ways

20
encounter more difficultes than women in developing and

‘maintaining intimate relationships.

Meinecke (1981) reviewed literature on men's health,
linking socialization processes to their higher mortality
rate. "It is my suggestion that hypermasculinity...coupled
with acquired insensitivity to idiosyncractic needs and
limitations can generate behavior patterns that eventually
lead to early death in males" (p. 241). O'Neil (1981)
agreed, stating that "unresolved tensions, role conflict and
overload, and physical and emotional stress can contribute to
the higher mortality of men than.women" (p. 74). There is
also a tendency for men to "be strong" and to deny when they
are ill or in need of medical attention (Goldberg, 1976).

The socialization process results in men being less likely to
seek medical attention yet more likely to need it.

Emotionality is another area of men's lives that can be
affected by strictly adhering to prescribed gender roles. .An
awareness and expression of one's affect is usually equated
with emotional health. This is not something that most men
learn how to do. Pleck and Sawyer (1974) stated:

Staying cool, no matter what, was part of what we

learned growing up male. we knew that big boys didn't

cry, and that real men didn't get too excited except in
places like football games. Spontaneous emotion -
positive or negative - was suppressed or restricted to
certain settings. We learned to mute our joy, repress

our tenderness, control our anger, hide our fear. (p.4)
Rather than express what they are feeling, men may respond to

distress by searching for a way to resolve the current

problem (O'Neil, 1981). Because their emotions may not be

21
acceptable socially, they learn to value intellect over
affect. Men may struggle in situations where there is
nothing to do but feel. If a.man does express affect, it may
not be received positively by others. "From.a male, tears
create discomfort...and even mild disgust at his inability to
control himself” (Goldberg, 1976, p. 60). This would
decrease the likelihood of a similar response in the future.
Although there are many benefits of white male
socialization processes, such as societal status and power,
there are also liabilities. Some of these difficulties cited
in the literature included problems with intimate
relationships and communication, mortality rates at a younger
age, and restricted emotional expression. Goldberg (1976)
summarized the negative aspects of male socialization
processes in stating:
Unlike some of the problems of women, the problems of
men are not readily changed through legislation. The
male has no apparent and clearly defined targets against
‘which he can vent his rage. Yet, he is oppressed by the
cultural pressures that have denied him his feelings, by
the mythology of the woman and the distorted and self
destructive way he sees and relates to her, by the
urgency for him to "act like a.man" which blocks his
ability to respond to his inner promptings both
emotionally and physiologically and by a generalized
self hate that causes him to feel comfortable only when

he is functioning well in harness, not when he lives for
joy and personal growth. (Goldberg, 1976, p. 16).

Men in therapy
Statistics about the utilization of mental health
services indicate that two thirds of all clients who enter

therapy are female (Good, Dell & Mintz, 1989). One in seven

22
men, in contrast to one in three women, receive professional

counseling at some point in their lifetime (Good, Dell and
Mintz, 1989). Gender socialization is often posited as one
of the reasons for this imbalance (Good, Dell & Mintz, 1989).

Chesler (1972) suggested that both marriage and
psychotherapy were agents of societal oppression of women.

In both relationships, women were/ are rewarded for adhering
to gender role expectations. Chesler highlighted the ways
that psychotherapists might inhibit women's development
beyond traditional gender-role expectations . New evidence
suggests that therapists may be recapitualating this process
with men.

Robertson and Fitzgerald (1990) explored how the process
of therapy may be oppressive to men by reaffirming societal
expectations concerning appropriate male behavior.

Counselors viewed videotapes of a depressed male client and
responded at different intervals as they might if they were
conducting a therapy session. At the conclusion of the tape,
they rated the client using the Bem Sex Role Inventory and
recorded their hypotheses concerning diagnosis and etiology
of the problem. When the client was seen as nontraditional
(that he stayed home with children), counselors viewed him as
having more pathology and attributed his depression to his
life situation. Robertson and Fitzgerald concluded that
these findings may reflect the inability of psychotherapists
to deal with the new roles of men, similar to Chesler's

contentions twenty years earlier in regard to new roles for

23
women. .Although the authors noted several limitations of

this study, including the use of an analogue design, I
believe its conclusions raise valid arguments that are worthy
of further exploration.

Good, Dell and.Mintz (1989) studied the relationship
between help seeking behavior and adherence to the
traditional male role. Undergraduate men completed paper and
pencil measures of stereotypic male qualities and help
seeking behavior. Results of canonical correlation and
regression analyses revealed that a traditional view of the
male role, as well as concern about expressing emotion and
affection, were significantly related to negative attitudes
about seeking professional psychological help. Good, Dell and
Mintz hypothesized that.more traditional men who enter
therapy are more at risk for feeling uncomfortable with the
process, perhaps terminating prematurely. This assertion can
be further extended. A.man's level of comfort/discomfort
with therapy may depend not only on his level of adherence to
the traditional male role but also on the theoretical
orientation of the therapist. Further research is needed to
answer these questions.

Barrows and.Halgin (1988) summarized current issues
relevant to psychotherapy with gay men. They reviewed the
literature‘with specific emphasis on the impact of the AIDS
crisis. These authors recommended that clinicians become
educated about AIDS to better understand its impact and to

serve as a source of valuable information to clients. They

24
also stated, "we urge clinicans to sensitize themselves to

the complex issues that gay individuals confront in their
intrapsychic and interpersonal experiences, such as issues of
discrimination, feelings of being different, pressures to
conceal information, and fears of being rejected" (p. 401).
Although these are not new issues in psychotherapwaith gay
men, they are of increased importance in light of the reality
of.AIDS.

Wilcox and Forrest (1992) summarized the literature on
men in therapy, noting that men's difficulties in counseling
have often been viewed as intrinsic to them due to their
gender. This results in the notion that the field either
must "liberate" men or change the counseling process to
create a better fit for male clients. These authors
recommended utilizing a social constructionist paradigm to
resolve this dilemma. "If constructing gender is viewed as a
process, the fluidity of gender constructions can be
acknowledged through the therapy process" (p. 302). This
would free both counselors and clients from preconceived
notions of appropriate male behavior.

In writing about Gender.Aware Therapy, Good, Gilbert and
Scher (1990) asserted that "the current goal of most
therapies is to restore troubled men to their traditional
gender role model of mental health (to be strong, assertive,
and independent)" (p. 376). Both.men and women experience
deleterious effects of the process of socialization. They

recommended that, through the use of Gender Aware Therapy,

25
counselors work to free themselves and their clients of

restrictive views of gender appropriate behavior. Counselors
must examine their own personal stereotypes of gender
appropriate behavior so that they can encourage personal
growth for individuals.

In summary, the literature indicates that gender role
socialization exerts some influence on the process of
therapy. Some men's restrictive emotionality and
difficulties with interpersonal skills may inhibit their
ability to seek therapy or, once there, to have positive
experiences. However, one cannot make generalizations about
all men, especially with the changing views of the male role
in our society. Utilizing a social constructionist
perspective allows the counselor to assist an individual in
examining his experience of gender-role socialization and its
influence on his current life. The impact of male norms of
behavior, the ways that they are changing, and the impact on
therapeutic relationships demand continued attention to gain

more insight into men's avoidance of therapy.

Men in Grief

Grief literature seldom focuses solely on the
experiences of men. ”we have witnessed a proclivity for
social gerontological research to focus on the older'widow
rather the widower. This impetus is not surprising given the
preponderance of widows compared to*widowers" (Wister &

Strain, 1986, p. 205) . When research does focus on men, it

26
usually compares them tO‘WidOWB or to married men of the same

age (Wister & Strain, 1986). These authors noted some of the
many reasons for this phenomenon, including gender
differences in life expectancy and the remarriage rates of
males as opposed to females.

Lister (1991) reviewed the social work literature
dealing with.men in grief. He highlighted the impact of the
socialization process on men's initial experiences of
mourning and working through their loss. He cited evidence to
suggest that widowed men, especially those‘who do not
remarry, have a greater risk of death, especially in the
first year after losing a spouse. Evidence also pointed to
an increased risk in this population of suicide and use of
alcohol/drugs. Lister noted that substance abuse may serve
as a way for these men to cope with depression whereas their
female counterparts might be2more‘willing to receive
counseling. He urged clinicians to seek out and support men
‘who are grieving since many of them may not be aware of or
willing to acknowledge the depth of their loss. This can
result in repressed grieving which.manifests itself in other
ways. "When not dealt with, a.man's grief may find outlet in
dysfunctional behaviors and self-destructive activities"
(Lister, 1991, p. 233).

Scully (1985) wrote about her experiences as a therapist
for men mourning the loss of a child. .Among the difficulties
that these men faced were: (1) the assumption that women are

more emotionally sensitive than.men, (2) men's difficulty

27
experiencing and expressing deep emotional pain, and (3) the

expectation that a husband be strong for his wife and other
children. Scully noted the important function that
counseling can serve for a.man grieving the loss of a child.
"Psychotherapy can be a vital part of the grieving and
healing process. The therapist provides a place for the
father to unleash his feelings of pain and disbelief, to
share his dreams that will not come true, to open his
questioning” (p. 99). This author emphasized the importance
of also listening to what the man is not saying to help him
clarify thoughts and feelings about which he may be only
partially aware.

WOlfelt (1990) reflected on his personal experiences
working with men in grief, emphasizing why he viewed the
process as "naturally complicated" for men. He described
five factors as the primary influences that complicate
mourning in males. These include: inability to‘overcome
social conditioning, the need to remain self-sufficient, the
intolerance of slowing down and turning inward, the inability
to seek support, and the inability to acknowledge pain and
loss. The images that men project often.make them appear to
others as copingwwell with their loss. However, Wolfelt
maintained that this facade may not match their inner world
of pain and confusion. Men may avoid feeling and view the
symptoms of grief as threatening, as opposed to a natural

part of experiencing a loss.

28
At a conference on.Men in Grief, Wolfelt (1992) further

explored the conflicting demands placed on.men who are
grieving. Common masculine traits (including control,
stoicism, aloofness, competence, strength, and mastery) are
in direct Opposition to the feelings of grief necessary to
embrace the mourning process (helplessness, pain, fear,
powerlessness, sadness, vulnerability, depression). wolfelt
stated that many men have not experienced giving up these
stereotypically masculine ways of being and.must face these
issues as they simulteneously respond to their loss.

The literature on.men's experiences of grieving is still
in its infancy. .Although.many authors have hypothesized what
men's grief is like and how it can be naturally complicated,
the paucity of research on men's grief and.mourning process
makes definitive conclusions about their experiences
impossible. Further research is necessary to explore the
impact of gender socialization outcomes on grieving. Men
have seldom been the sole focus of grief research, studied
often in contrast to women. By restricting the focus of
grief research to men, clinicians may gain.more insight to
their mourning process and ways that this experience is
unique for men or perhaps unique to different men as

individuals.

Gay/Lesbian Issues

”Stigmatization of gay persons because of their

unpopular sexual orientation occurs throughout the life span"

29
(Kimmel, 1978, p.128). In 1973, the American Psychological

Association changed its view of homosexuality as
pathological, eventually removing it from the Diagnostic and
Statistical Manual (3rd Edition) as a diagnostic category.
Although the official stand of this organization changed,
some practitioners and many members of American society in
general continue to view the gay lifestyle as aberrant. "The
tension between the needs of this group of patients and the
continued insistence within many schools of psychotherapy and
by a large number of psychotherapists that homosexuality is
abnormal or pathological places the gay person at risk for
iatrogenic damage from the very persons and approaches that
are supposed to be available to alleviate their distress"
(Stein, 1988, p. 88). The paucity of research on
homosexuality outside the pathological paradigm makes the job
of therapists working with this population all the more
difficult.

Kimmel (1978) applied Levinson's model of adult
development to existing data on older gays. He outlined
three major concerns that are of special relevance to elderly
gay persons: lack of support/understanding of bereavement,
physical disability (and its impact on gay relationships) and
stigmatization of older gays, both in society at large and
within the youth-oriented gay subculture. Kimmel advocated
for the inclusion of gay and lesbian perspectives in research

examining issues of adult development.

30
Woodman (1989) noted that loss is a central theme in the

lives of many gays and lesbians. Losses (or potential
losses) can emanate from the coming out process, to both self
and others. The individual may potentially lose self-esteem,
family, friends, children, support of organized religion, and
even a job. When there is a break up or loss in a romantic
relationship, these previous losses can exacerbate an
individual's reaction. "Whether the loss occurs through
separation or death, often the surviving (remaining) partner
is denied the traditional rights to grieve and.mourn. Lack
of access to such rituals and supports only intensifies
stress or crisis" (WOodman, 1989, p.58).

Ritter and O'Neill (1989) also focused on the numerous
losses that are a part of the lives of lesbian women and gay
men.

The losses of gay and lesbian people are many and they

are profound - their feelings of not belonging to the

church, family, society, or the'workplace; the loss of
friends and loved ones to AIDS; the psychic destruction
caused by heterosexual society's often projecting upon
them its greatest fears and secrets; and the general
loss of respectability, knowing that their very beings

are unhesitatingly and unquestioningly despised by many
(p.12).

These authors recommended that, as clients, gays and lesbians
must continuously articulate and work through the multiple
losses in their lives (by releasing anger and pain) to gain a
sense of autonomy and value their individuality.

The literature suggests that social support for gays and
lesbians is limited at best. They must exist in a

heterosexist society that is hostile and oppressive to them,

31
merely due to their sexual orientation. The field of

counseling psychology has much to learn about the unique
perspective that gays and lesbians have in issues related to
adult development, one being the experience of bereavement.
Multiple losses in their lives may make gays and lesbians
particularly vulnerable to complicated grief and mourning.
Equally so, these experiences of loss on a daily basis may
innoculate them against more severe reactions when grieving

the death of a loved one.

Relationships

Societal stereotypes view homosexual relationships as
based solely on sexual gratification (Isay, 1989). Lipman
(1986) noted that many gays and lesbians reject the label
”homosexual" as it connotes a relationship based solely on
sex and ignores factors such as commitment, love, and
companionship. "Homosexuals of both genders insist that
homosexuality is a way of life encompassing the entire
personality structure rather than merely the one dimensional
facet of sexual orientation" (Lipman, 1986, p. 51). Research
has begun to illuminate differences between gay male and
lesbian life-styles and relationships (Kurdek, 1988; 1989)
demonstrating that diversity exists between gays and lesbians
as well as within each of these populations (Bell & weinberg,
1978). Sex is clearly not the sole component of a
homosexual relationship'or the only factor that distinguishes

heterosexual and homosexual individuals.

32
Kurdek (1989) examined the relationship quality of gay

and lesbian cohabitating couples. Each partner in the couple
completed an extensive questionnaire that assessed factors
such as reasons for being involved in the relationship,
shared decision-making, social support, and trust in one's
partner. These measures were taken at two intervals, a year
apart, in an effort to also investigate the effects of the
development of the relationship.

The results of a multiple analysis of variance and
univariate analyses of variance showed that lesbian couples
reported higher overall relationship quality over both time
periods than gay couples. Of specific interest to:my study
was the finding relevant solely to gay couples. The Time 2
measure of relationship quality for gay couples was predicted
by the Time 1 variables of satisfaction*with social support,
high expressiveness, and comfort with disagreements in the
relationship. .Kurdek warned against overinterpreting this
finding since (1) there were more gay couples than lesbian
couples in the study and (2) the consistency of responses of
the lesbian couples over the two time periods resulted in
little variance that was unexplained. Overall, these results
affirm earlier conclusions that there are many factors other
than sex that influence the satisfaction of gay and lesbian
relationships.

Bell and.weinberg (1978) studied gay and lesbian
couples, delineating five different categories of life—

styles. These included: closed-coupled, open-coupled,

33
functionals, dysfunctionals, and asexuals. Of these

categories, those in the closed-couple or open-couple
relationships were comparably well adjusted to a comparision
group of married heterosexuals.

In sum, societal stereotypes continue to promulgate the
belief that gay and lesbian relationships are based solely on
sex. Extent research has begun to demonstrate that there are
numerous other factors, such as social support or beliefs
about conflict, that impact relationship quality and
satisfaction in these relationships. In fact, these
variables are common to both heterosexual and homosexual
partnerships. "The characteristics and functionality of
long-term.relationships show'many similarities between
homosexuals and heterosexuals and tend to transcend the issue
of sexual preference" (Lipman, 1986, p.54). This indicates
that studies of men's and women's relationships should
incorporate both heterosexual and homosexual partnerships to
gain clarity about the many commonalities as well as the
potential differences that exist between them. Rothblum
(1994) advocated for research that includes both gender and
sexual orientation as it "allows for the examination of the

relative salience of (these variables)" (p.217).

Grief in heterosexual couples

An extensive body of literature exists describing the

process of mourning the death of a spouse. The literature

34
emphasizes the experiences and needs of widows, as this is

the grieving population most often encountered by clinicians
and other helping professionals. When men in mourning are
studied, they are often contrasted with women in an attempt
to highlight gender differences.

Many factors have been associateduwith the process of
grieving a spouse. Stroebe and Stroebe (1987) categorized
these factors as sociocultural, individual,
antecedent/situational, mode of death, and circumstances
after the loss. This classification of factors provides a
framework for an examination of the conclusions of extant

literature.

Sociocultural factors.

Much research has evaluated the impact of sociocultural
factors, including social class (Bowling, 1988), gender
(Bowling, 1986; Feinson, 1986; Jacobs, Kasl, Ostfeld,
Berkman, 8 Charpentier, 1986; Sabatini, 1988), and age
(Jacobs, Kasl, Ostfeld, Berkman, & Charpentier, 1986; Roberto
& Scott, 1986). Stroebe and Stroebe included the variable of
racial/ethnic background in this section but noted that the
homogeneity of research participants makes conclusions about
the importance of these variables impossible. This may be
true for other sociocultural variables. A few examples will
illustrate this point.

Bowling (1988) reported that ”those in higher social

classes were more at risk of mortality after bereavement than

35
those in lower classes" (p. 149) although Stroebe and Stroebe

(1987) concluded that "there is a great deal of evidence to
indicate that widowed of low socioeconomic status are less
healthy than bereaved of high socioeconomic status.“ (p.
173). Similarly, Carey (1979) concluded that widows were at
greater risk than widowers in grieving whereas Feinson (1986)
found no differences in these two groups. Similar
conflicting results can be seen about the effects of age.
Few definitive conclusions can be drawn about the impact of

any of these variables.

Individual factors.

Individual factors relevant to grief research include
religiosity, personality, and health prior to bereavement.
Stroebe and Stroebe's (1987) review of the literature did not
produce any conclusive results about the relevance of these
variables. Importance and frequency of religious practices
and personality variables (such as level of anxiety or self-
esteem) may contribute to bereavement outcome but have not
been consistently significant. When mental and physical
health are examined, only previous mental health problems

emerge as contributing to greater difficulty in mourning.

Anpecedent stresses.

Antecedent stresses include prior nonspecific life
stress (as well as stress from previous losses) and quality

of the relationship with the deceased (including dependency

36
or ambivalence). These variables have not received much

systematic consideration in the literature. They could
contribute greatly to bereavement outcomes in either a
positive or negative direction. Stroebe and Stroebe (1987)

recommended further analysis of their contributions.

Mode of death.

Mode of death, whether from natural or violent causes
and expected or unexpected, is important to consider in
bereavement studies. Rynearson (1986) described the
psychological effects of unnatural death on the grieving
process. Grievers experience not only reactions associated
with all losses but also concomitant complications such as
grotesque death imagery, despair, victimization, and post-
trauma responses. This includes the grief associated with
suicide (which has its own body of literature). If the type
of death is not taken into consideration, the prolonged
grieving process might be considered abnormal or pathological
grief, as it may take much longer to resolve. For this
reason, Rynearson recommended that, "Subjects whose
bereavement is associated with unnatural dying should be
treated as a separate research population" (p.275).

Gass and Chang (1989) found that "sudden death of a
spouse was directly related to fewer resources which
increased threat appraisal and psychosocial health
dysfunction" (p.35). Similarly, Stroebe and Stroebe (1987)

concluded that sudden, unexpected death is associated with

37
more intense grief and greater health risks. Variables

associated with mode of death are important to attend to in
any bereavement study. In this study, mode of death was

controlled by restricting it to chronic illness.

Social suppprt.

In recent years, there has been an increased interest in
the importance of social support in assisting individuals
during life transitions (Hays & Oxley, 1986). Clearly, the
death of a spouse or partner prompts a period of tremendous
upheaval for the bereaved. Stroebe and Stroebe's review of
the literature (1987) included social support as an important
factor in predicting psychological adjustment after the death
of a spouse.

Doka (1987) cited lack of social support as one of the
potential complications for those mourning the loss of a
significant other. In a qualitative study of nontraditional
relationships (cohabitation, extramarital affairs, and gay
relationships), he found thermourner's grief was exacerbated
since "there is no formal recognition that they are bereaved,
little support or sympathy for emotional reaction, no
personnel policies that cover time off from work" (Doka,
1987, p. 462).

Support systems can also have negative impacts. Morgan
(1989) challenged the conception that social support of
family and friends is always positive. He studied women

grieving the loss of a spouse through discussion groups that

38
focused on positive and negative impacts on their adjustment

as widows. Widows identified relationships that were
facilitative of or problematic to their grieving process.
Contrary to popular notions, Morgan discovered that some
social support networks can produce deleterious effects on
the mourner. Lack of understanding of family members, as
opposed to friends, was more difficult to endure, as friends
who lacked understanding could be avoided and selected out of
the widow's social network.

Recent interest in social support facilitated its
inclusion in models of grieving significant others. In
general, these support systems were perceived as assisting
the mourner in coping. However, other research has pointed
to the potential harmful effects that these networks can have
on the mourner. Both sources and experienced level of both
positive and negative social support are important to
consider in bereavement research.

Numerous factors have been associated with bereavement
outcomes in heterosexual partnerships. Evidence is often
inconclusive when considering the contributions of many of
these variables. More work is needed to clarify and expand

these findings.

Grief in gay couples

A paucity of literature explores the unique experience
of gay grief. By integrating case studies and theory, Siegal

and Hoefer (1981) illustrated the duality of the gay

39
bereavement process in that "gay persons...(must) encounter

the cruelty of society's antihomosexual stigma while
simultaneously mourning the loss of a lover or spouse" (p.
518). Emotions connected with their grieving can be
exacerbated as they conceal the depth of their relationship
‘with the deceased (describing him/her as only a good friend).
Unresolved guilt about their sexual orientation can reemerge
as the mourner feels guilty about what he/she might have done
to save the deceased. Feelings of isolation can result from
the exclusion of the partner from the intensive care unit,
lack of mention in the obituary, and lack of acknowledgement
at the memorial service. These are just some of the barriers
that complicate the grieving process for gays.

Siegel and Hoefer (1981) maintained that the counseling
field is ill-prepared in general to deal with the needs of
gay individuals. Whenever a gay man or lesbian woman seeks
support in a counseling relationship, their motives may be
misunderstood by the therapist. Their presenting issue:may
be viewed as a symptom of the true latent problem, their
sexual orientation. In fact, Haldeman (1994) noted that,
"Many practitioners still adhere to the officially debunked
illness model of homosexuality and may base their treatments
on religious proscriptions against homosexual behavior" (p.
221).

The American Psychological Association Task Force on
Psychotherapy with Gays and.Lesbians (1991) examined the

extent to*which.members' practices conformed to the

40
organization's stance on the clinical treatment of gays and

lesbians. Their results indicated that much needs to be done
to combat the prejudices against gays and lesbians that
remains in the field of counseling. Some therapists still
maintain that regardless of the presenting problem, the
distress a gay individual is experiencing results solely from
their "sexual preference" (APA Task Force, 1991). Siegal and
Hoefer (1981) argued against this approach to treatment.

"The general focus of grief counseling is to suppdrt the
survivor through their process of mourning rather than
attempt to change their sexual orientation" (p. 523).

Klein and Fletcher (1987) compared the grieving
experiences of widows and gay men in traditional and
nontraditional support groups after loss of a partner. Their
data were drawn from a grief recovery group for men who had
lost a male partner, mostly through AIDS. Lengths of these
relationships varied from eight months to twenty two years.
.Although cause of death and length of relationship‘were
reported, their unique contribution to the grieving process
was not examined. The authors reported that the added
burdens of the clients' mourning processes became obvious in
their work. "Social stigma, homophobia, fear of contracting
the disease or of being a carrier and special reentry and
dating problems are only a few of the concerns that
complicate their grief" (p. 15).

More recently, researchers have focused on the unique

needs of gay individuals struggling with AIDS related

41
bereavement. Cadwell (1991) and Weiss (1988) focused on the

emotional devastation of those suffering from.AIDS, as well
as their need for support and intervention. Lennon, Martin,
and Dean (1990), Geis, Fuller, and Rush (1986), and Martin
(1988) examined the mourning process of friends and lovers of
people with AIDS .

Cadwell (1991) described his experiences working with
AIDS patients as a clinician in private practice.
Misperceptions about AIDS transmission, blaming the person,
labeling AIDS as a gay plague, and viewing AIDS as the result
of promiscuous, immoral behavior are social realities that
stigmatize people with AIDS and nmpact their adjusoment.
Cadwell recommended that clinicians examine their
internalized homophobia and other countertransference issues
with AIDS clients before undertaking clinical work with this
population.

Weiss (1988) explored the experiences of three people
with AIDS through interviews ranging in length from four to
eight hours. The intensive interviews covered many topics
including how these individuals view their disease, the
challenges of the disease, their need for supportive
relationships (physician, friends, family, and support
groups), the disease's effect on intimate relationships
(including sex life), and other psychological issues that
were deemed relevant (e.g., hope, meaning of life). This
article was descriptive but not prescriptive. It was an

excellent summary of the concerns and needs of clients with

42
AIDS but did not offer any implications for clinicians

working with them.

Both of these articles offered a summary of the grief
issues for men coping with the effects of AIDS. The content
presented was an excellent summary of factors to be
considered when working with a client who has AIDS. However,
the lack of rich descriptions in this qualitative research
made it difficult to determine the transferability of these
impressions and recommendations to the larger gay population.

Martin (1988) used a structured interview to study 745
gay men, examining the relationship between AIDS-related
bereavement(s) and their reported level of psychological
distress. Participants were recruited through advertisements
and referrals (from individuals previously interviewed). The
interview schedule contained measures of psychological
distress, substance use (beer/wine, sedatives, marijuana,
other recreational drugs), professional service use (visits
to a:medical doctor and.psychologistsIpsychiatrist), and
bereavement episodes (number of persons subject knew“who had
died of AIDS). Demographic factors, past sexual behavior,
symptoms of AIDS-related complex (ARC), HIV antibody status
(including knowledge that one is positive), and appraised
vulnerability to.AIDS were adjusted for statistically to
minimize their influence on the results.

Number of bereavements was positively related to
psychological distress (traumatic stress response,

demoralization, and sleep problems). Individuals affected by

43
a greater number of losses reported experiencing higher

levels of distress. Similarly, the use of sedatives and
recreational drugs, as well as the use of psychological
services, were also positively associated with number of
losses. Other variables were not significantly associated.
.Although this sample underrepresented specific subpopulations
of the gay community (such as African American and Hispanic
men, as well as non-college educated men), Martin maintained
the validity of the results for these diverse populations. I
do not concur with generalizing these findings to all members
of the gay community. Further research should be conducted
to confirm or disconfirm this claim.

Lennon, Martin, and Dean (1990) interviewed 180 gay men
who had lost a lover or close friend to AIDS. They examined
the relationship between the experience of grief and
instrumental/emotional social support mechanisms available in
the participants' lives. A newly developed grief reaction
scale was utilized to assess the extent of their grief
reaction. Other questions in the interview focused on the
availability and adequacy of instrumental social support
(assistance in caretaking) and emotional social support
(assistance in dealing with the psychological pain of seeing
a loved one die of AIDS). Demographic variables (including
race, education, age at time of bereavement, frequency of
contact with deceased) were adjusted for statistically before

analyses were completed.

44
Regression analyses indicated that emotional and

instrumental social support influenced the extent of the
grief reaction of the participants. Availability of support
systems was necessary but not sufficient. Effectiveness of
supports, how responsive they were to the needs of these
individuals, was critical to their perceived usefulness.
These authors noted the implications of this finding for both
formal and informal support networks. Individuals who are
friends of people with AIDS or agency workers who assist in
their treatment are both equally vulnerable to intense grief
reactions. This study highlighted the importance of
supporting the friends and lovers of people with AIDS, as
well as supporting the professional caregivers, all of whom
must potentially deal with multiple losses.

In summarizing issues in psychotherapy with gay men,
Barrows and Halgin (1988) focused on the needs of the gay
‘widower and how'psychotherapy could facilitate his mourning
process. "Gay widowers are often unable to count on the
support of their biological families, their friends, or
social institutions. Thus therapists are a vital-and
sometimes the only-source of support for lovers of persons
with AIDS" (p. 401). This highlighted the potential
importance of a therapeutic relationship in the mourning
experience of a gay man who has lost a partner to AIDS.

The gay community has struggled to cope with losses due
to AIDS and clinicians must consider how they can most

effectively respond to the needs brought about by this

45
disease. However, AIDS is not the only source of loss in gay

partnerships. Counseling psychologists could benefit from an
understanding of issues of gay grief, regardless of the
partner's cause of death. Further, clinicians could also
profit from an awareness of the unique issues that impact gay
grief (e.g., societal stigma associated with being gay,
influence of social support mechanisms), especially*whether

these facilitate or exacerbate their grieving process.

§BEEE£1

A variety of factors must be considered when dealing
with death in partnerships. Many of the articles in the
literature focus on multiple variables at once in an effort
to gain as much information as possible. This methodology
has only been marginally successful in clarifying the
importance of many variables, as the literature is full of
contradictory claims. Therefore, it is the intent of this
author to examine only a few of these variables in rich
descriptions available through a qualitative method.

The following is a summary of the:main points brought
out in the review of the literature:

1. Numerous models have been developed to describe the
grieving process. The utility of these models depends
heavily upon the cultural and historical context in which the
mourner exists. Distinguishing normal from pathological

grief may be easier in theory than in practice.

46
2. Men's traditional gender socialization outcomes can

potentially interfere with many aspects of their
intrapersonal and interpersonal life, including their ability
to grieve. .Adhering to stereotypically masculine behaviors
may not allow them to mourn. Therapists may be as unprepared
to deal with new roles of men as they were twenty years ago
when responding to new roles of women.

3. Despite societal stereotypes, there are many
commonalities that exist between heterosexual and gay
relationships that transcend the issue of sexual orientation.
Any study of men's and women's relationships could benefit
from the inclusion of both heterosexuals and gays in an
effort to understand the unique contributions of gender and
sexual orientation.

4. As oppressed members of our society, gays and
lesbians experience multiple losses. These numerous
experiences with loss might facilitate or exacerbate coping
with the death of their partner.

To explore these issues, heterosexual and gay men were
interviewed about the loss of their partner due to chronic
illness. Specifically, I investigated the influences of
gender—related thoughts/behaviors for all participants and
the concomitant experience of oppression for gay men to gain
insight into its impact on their grieving. This highlighted
the within-group variation that exists for bereaved men.
Other factors that have been addressed previously in the

literature (including social support, religion, rituals, and

47
view of the afterlife) were explored to further understand

their influence. I hope that through this study, counseling
psychologists became better able to understand men and the
multiple ways in which their grieving process may be

complicated.

DESIGN AND METHODOLOGY

Introduction

Men who have experienced the death of a partner were
interviewed about their grieving process. Sexual orientation
*was also examined to generate preliminary hypotheses about
its impact on grieving. In this chapter, I outline the
specific methodology utilized in this study, including the
format for the interviews. First, I clarify why a

qualitative methodologwaas selected.

Methodolpgical rationale

Paradigp.

In the Handpook of nglitative Regearch, Guba and Lincoln
(1994) acknowledged that the title of this text may be
misleading. .Although the term "qualitative” denotes specific
methods of collecting and treating data, it does not define
the set of assumptions utilized to guide the researcher's
inquiry. Qualitative methods are most often associated with
alternative paradigms, yet they can also be employed within a
positivistic framework. Equally so, quantitative methods are
tools that may be selected by researchers within the post-
positivistic, critical theory, and constructivist paradigms.
As Guba and Lincoln (1994) noted, "questions of method are
secondary to questions of paradigm" (p. 105). The first step
in developing a methodological rationale is to locate this

inquirwaithin one of these paradigms.

48

49
A paradigm, as defined by Guba and Lincoln (1994) is "the

basic belief system or worldview that guides the
investigator, not only in choices of method but in
ontologically and epistemologically fundamental ways" (p.
105). It is therefore critical that I outline my belief
system in conducting this study. I will define my assumptions
concerning ontology, epistemology, and methodology that will
dictate the selection of a paradigm. This examination draws
heavily from.Guba and Lincoln (1994).

Beliefs about ontology describe an individual's
perceptions of reality (Guba & Lincoln, 1994). Is there an
objective world outside of us that can be apprehended and
defined? Or is reality more of an individualistic
phenomenon, something defined for and by people and their
communities? My assumptions here are the latter. I believe
that individuals construct their own views of the world in
‘ways that are meaningful to them. .My ontological position is
one of relativism.

Epistemology defines one's position on knowledge. Are the
knower and the information to be known completely separate?
If so, then a knower's position.must be objective.
Conversely, one may believe that a knower and the known are
connected, making the knower's position more subjective. I
hold to a more subjectivist position as I believe that all
acquired knowledge is filtered through individuals. All
knowledge development is transactional, a creation for and by

the knower (Guba & Lincoln, 1994).

50
Assumptions about.methodology follow directly from one's

position on epistemology. 'What is the relationship between
researcher and subject? Does the researcher have no impact
on the subject or do they impact each other throughout the
inquiry? I accept the tenet that, in studying people,
researchers and their subjects mutually impact each other.
My position on.methodology is therefore
hermeneuticalldialectical (Guba & Lincoln, 1994).

At this point in my analysis, I can locate the paradigm
that is consistent with these assumptions regarding ontology
(relativism), epistemology (transactional), andumethodology
(hermeneutical/ dialectical). A constructivist paradigm
captures all of these assumptions, making it my paradigm of
choice in conducting this inquiry.

Schwandt (1994) described numerous frameworks within the
constructivist paradigm, including the work of Guba and
Lincoln (1989). Inquiry, according to these authors,
involves a search for truth, defined as "the best informed
and most sophisticated construction on*which there is
consensus at a given time. (This method)....unfolds through
a dialectic of iteration, analysis, critique, reiteration,
reanalysis...that eventually leads to a joint contruction of
a case" (Schwandt, 1994, p. 128). One of the greatest
challenges of utilizing this paradigm is to ascertain a
trustworthy picture of constructions so that the "consensus"

construction can be realized.

51
Method.

In writing on the utility of qualitative methods for
developmental psychology, Kindermann and Valsiner (1989)
called for a redefinition of the term scientific. They noted
that quantitative research has often been equated with
rigorous science whereas qualitative inquiry has been viewed
as ”soft" science. In recent years, however, alternative
paradigm researchers have developed strategies to ensure the
rigor of their methods, arguing that their data and
conclusions are equally valid. Kindermann and Valsiner
(1989) attempted to resolve this debate by asserting that
true science denotes "examin(ing) the fit between the
perceivable organization of the object of investigation and
the investigator's theoretical system" (p. 16). A scientific
inquiry in this respect entails a careful matching between
method and object of study. Toward this end, differences
between quantitative and qualitative methods will be examined
in light of the focus and goals of this inquiry to determine
the:most scientific approach to the data.

Qualitative research places greater importance on the
individual's point of view (Becker, 1994). Quantitative
methods often look at issues from the nomothetic perspective,
relying more heavily on inference to determine the
significance of a phenomenon for an individual. "Qualitative
investigator's think that they can get closer to the actor's
perspective through detailed interviewing and.observation"

(Becker, 1993, p. 5). Drawing on an extensive review of the

52
literature, Shuchter and Zisook (1993) noted that "grief

is... an individualized.process-one that varies from.person
to person and moment to:moment " (p. 23). Since grief is
such an individualized process, I believe that qualitative
methods would better capture this variation, as opposed.to
relying on inference.

Guba and Lincoln (1994) and Becker (1993) both noted that
quantitative research has been criticized for "contextual
stripping" (Guba & Lincoln 1994, p. 106). This process is
often undertaken deliberately to control for extraneous
variables that may impact results. Rosenblatt (1993) warned
against this type of approach when conducting bereavement
research. "A.sensitivity to cultural differences
should....prevent ethnocentric assumptions that ones own
culture or experience necessarily provides a valid baseline
for understanding the grief of somebody from a different
cultural background" (p. 104). Some quantitative researchers
(Eagly, 1983; Lott, 1985) have recognized the critical role
that context plays in understanding phenomena and have
advocated that quantitative research.must work to capture
this complexity. However, a qualitative method.allows for
”rich descriptions" of phenomena (Geertz, 1973) that promote
a.more in-depth view of how context variables interact. With
this in mind, qualitative methods are better suited to this
inquiry as they more completely capture the contribution that

culture makes to the grieving process. They also allow the

53
reader a vicarious experience of participants' lives in a

manner unattainable through quantitative methods.

Qualitative researchers focus more on rich descriptions,
on emic and idiographic elements of a phenomenon (Denzin 8
Lincoln, 1994). Grief "encompasses simultaneously so many
facets of the bereaved's being...that attempts to limit its
scope or demarcate its boundary by arbitrarily defining
normal grief are bound to fail” (Shuchter & Zisook, 1993, p.
23). Qualitative methods allow'me to explore men's grief
‘without delimiting it and potentially excluding important
variables.

Kindermann and‘Valsiner (1989) asserted that qualitative
and quantitative methods each focus on a different level of
analysis. Whereas quantitative methods emphasize the
structure of a phenomenon, qualitative methods accent the
process level of phenomena. Qualitative methods can also
better capture the changes experienced through the process of
development, that an analysis of past to present experiences
does not necessarily indicate the present to future evolution
of phenomena. In discussing measurement issues in the field
of bereavement, Hansson, Carpenter, and Fairchild (1993)
argued that grief research could benefit from a greater focus
on the adaptational processes of the bereaved, not simply the
severity of their symptomatology. A qualitative approach
will allow for this type of analysis, for a focus on both the

factors that facilitate an individual's bereavement and the

54
changes they have experienced and are anticipating in their

grieving process.

Qualitative methods have been previously utilized in grief
research. Balk (1983) explored how teenagers coped with a
sibling's death. Interviews focused on their emotional
responses to the death and difficulties talking about it, as
well as the effects this loss had on relationships with
parents, peers, grades and religious beliefs. O'Brien,
Goodenow, and Espin (1991) examined the effects of the death
of a peer on adolescents. Through in-depth interviews, they
sought to determine how practitioners can be most helpful to
students grieving the loss of a contemporary. Clearly,
qualitative methods are germane to a study of individual's

grief.

am

The following is a summary of key points developed in the
methodological rationale:

(1) In conducting inquiries, researchers must first locate
themselves within a paradigm, based on their beliefs about
ontology, epistemology, and methodology. My assumptions
regarding these constructs match the constructivist paradigm.

(2) Scientific studies carefully match the object of study
with the method of inquiry.

(3) Qualitative methods seem more appropriate for this
inquiry because

a. grief is an individualistic process;

55
b. context is critical in understanding grief;

c. rich descriptions are needed to capture the
complexity of grief and interaction of factors and;

d. process is equally as important as content.

Interviews

Interviews were conducted with twelve men who had
experienced the loss of a partner due to chronic illness.
The death of their partner may have been anticipated in many
respects, allowing for anticipatory grief and preparation
time prior to their actual death. Originally, I intended to
restrict participants to men between the ages of thirty and
fifty. This age group was selected as their partner's death
would likely be viewed as untimely, if considered in the
context of their stage of development. When participants were
recruited, some volunteers were outside this age range.
Given the limitations of the participant pool, I elected to
interview'men age 65 or below. Even up until this age, the
death of a partner is still unanticipated, especially in
heterosexual relationships, as a woman's average life
expectancy is currently around 80 years old. Even though the
age range had to be expanded, the emphasis on men who had
experienced the untimely death of a partner was maintained.

The interviews were semi-structured and explored factors
that appeared most salient in the review of current grief
literature. These factors included: nature of relationship

with the deceased, social support for the relationship,

56
emotional expression in grieving, impact on

religious/spiritual life, relationship‘with work performance,
importance of mourning rituals/practices, previous experience
with loss, and.views of the afterlife (see.Appendix I).

A pilot study was conducted with one man who had
experienced the death of his wife to examine the wording and
relevance of different questions in the interview format.
This pilot interview was not included in the data. However,
through this interview, I analyzed and improved the
interview structure. Some questions were reworded, some were
added, and a few questions were eliminated. Ultimately, this
resulted in a smoother interview structure and better framing

of questions.

Participppts

Due to the sensitive nature of this topic, participants
self-selected to be involved in this study. Participants
were contacted in a variety of ways. First, contact was made
‘with Elizabeth DeRath at Gorsline-Runciman Funeral Home. Dr.
DeRath is a clinical psychologist whO‘works full-time,
offering individual, group and family counseling to those who
are bereaved. I attended a support group for bereaved
partners (both.men and women) and described.my research. I
contacted Jerre Cory, director of Ele's Place (a children's
grief counseling agency) to access fathers of bereaved
children. I also contacted Liz Schweitzer, Administrator of

St. John's Student Parish. .Ms. Schweitzer brought my

57
announcement to an Interfaith AIDS Council that was forming

in Lansing. I spoke with Peggy Barnes, a social worker at the
Lansing Area AIDS Network and Lynn Breer, Bereavement
Coordinator at Visiting Nurse Hospice of Lansing. These
contacts were successful in producing a few potential
participants.

‘WOrd of mouth was the second means to contact
participants. I utilized personal contacts in the local
community, including personal friends and therapists that I
knew professionally. This was by far the most successful
vehicle for contacting participants.

A third strategy implemented to contact participants
involved advertising in publications in the Lansing area.
Advertisements were placed in local papers in East Lansing
and Mason. I wrote to John Schneider at the Lansing State
Journal and he devoted part of his column on March 1, 1995 to
my study. The advertisement/ announcement utilized for these
contacts is in Appendix B.

Even with the time and energy I expended in the above
efforts, I still experienced some difficulty recruiting
enough potential participants that met my study criteria.
Therefore, after receiving UCRIHS approval, I expanded my
recruitment efforts to Grand Rapids and Ann Arbor and
prepared resource lists for these cities (see Appendices M
and N). I contacted AIDS organizations and hospices in these

locations. Once I added these cities and began the process of

58
advertising, I recruited enough participants from which to

draw an appropriate sample.

The phone number in the advertisement was my voice-mail
number in the College of Education. Men interested in
participating discretely left their name and number so that I
could return their call. Participants were then contacted and
screened through a follow-up phone conversation to determine
their appropriateness for the study. In the conversation, I
gave my name and affiliation, a description of the project,
and the extent of the interviewing procedure (see Appendix A
for topics covered). Through these conversations, five
contacts were eliminated from consideration as they did not
meet study criteria. Four of these were men who had lost
parents and had not read the advertisement clearly. One was
the mother of a thirteen year old boy who had dealt with
numerous loss issues in his life (adoption, abuse). These
people were thanked for their contact and sent referral
information about resources in the Lansing area (see Appendix
L).

The remaining individuals indicated continued interest
in participating. I sent each of them a cover letter
outlining the project, a consent form to participate, and a
preliminary demographic sheet (see Appendix C). The cover
letter outlined the process of being included in the study.
Participants at this level were made aware that they may or
may not be selected for an interview but that they would

receive a listing of grief support services in the Lansing

59
area. They were instructed to review the study materials and

then return the initial consent form and preliminary
information form to me if they would be willing to continue
participating.

Over a period of four months, sixteen men returned the
preliminary questionnaire. I selected twelve participants
from this group in an attempt to represent a diverse group of
men. Six heterosexual and six gay, representing different
socio-economic backgrounds, were picked for the study.
Although I had hoped to represent different racial and
cultural backgrounds, all the participants were Caucasian
and did not appear to identify strongly with their cultural
heritage. These men fit the predetermined criteria of age
(under 65, as noted above) to represent the untimely death of
a partner. Initially, I intended to restrict time since loss
to at least one year. However, participant pool limitations
necessitated that I reduce time since loss to six months. In
two cases, volunteers were not at the six month marker.
Therefore, with their permission, I waited until they reached
the six month after the death of their partner before I
interviewed them. Men who were eliminated from consideration
were sent a thank you letter and a listing of grief support
services (see Appendix J).

The men who were selected for interviews were
recontacted by phone and an appointment was made for the
interview (see Appendix A for topics covered). After the

phone conversation, a letter confirming our appointment and

60
once again describing the project (see Appendix F) was sent

to each participant. Included with this letteeras another
consent form and.a.more detailed demographic sheet (see
Appendices G and.H). Participants were instructed to bring
the signed form and the demographic sheet with them to the
appointment. Each participant was contacted the day before

the interview by phone to reconfirm the appointment.

Procedures

Originally, I intended to conduct interviews in my
office in the College of Education or another room.on campus.
However, through the pilot interview, I became aware that an
office or classroom on campus would not necessarily be
comfortable for participants. Therefore, when I set up the
interviewWwith each participant, I gave them options for a
location for the interview. They could select their home, my
apartment, or an office on campus. Of the twelve
participants, nine requested to'be interviewed in their own
homes and three preferred to come to my apartment.

I began the interview by talking a little about myself
and my interest in the topic of grief, including what I hoped
to learn from conducting this research. I brought tissues
with.me to each interview and they were needed for most
interviews, as the interview format accessed painful emotions
for all the men.

Interviews will be audiotaped so that I could fully

attend to each man's experience. Participants were made

61
aware of this before they agreed to participate. Complete

confidentiality was guaranteed to the participants by
changing their names and slightly altering some of their
individual data. These strategies were used so that there was
not enough information included that would readily identify
any specific individual. Tapes were kept in a filing cabinet
in.my apartment and, once transcriptions were checked for
accuracy, they were erased.

At the conclusion of the interview, I talkedwwith each
participant about the experience. Local grief resources were
highlighted so that each participant was aware of
opportunities to receive further support if they had
reactions after the interview. The participants were also
reminded of the College of Education phone number where I
could be reached if further difficulties arose after the
interview. Once all this information was disseminated and.we
talked about the interview experience, the interview ended.
After the interview, I sent each participant a thank you

letter to recognize their participation (see Appendix K).

Data.Analysis

Interviews were transcribed by a professional secretary.
I then listened to each interview, checking the
transcriptions for accuracy and allowing me to become
familiaerith the data for analysis. Once the transcriptions
were reviewed and edited, the tapes were destroyed. The data

were then ready to be entered into the analysis program.

62
The computer program utilized to assist in data

management was HyperQua12 , developed by Raymond Padilla
(1993) and distributed by Qualitative Research Management.
This program organizes meaningful chunks of data on cards
then allows the researcher to code and sort data as well as
write memos. A helpful summary of this program can be found
in Weitzman and Miles (1995).

The data were entered into the HyperQua12 program onto
data cards organized by interview. Cards were structured to
correspond with each major topic area addressed in the
interview with probe questions structured as subquestions
under each topic. For example, interview topic #4 dealt with
emotions. The major question, “What emotions did you
experience" was entered on a card as question 4 whereas probe
questions addressing emotions experienced when alone and
emotions shared with family were entered on cards 4a and 4b,
respectively. Data processing continued until all interviews
were entered utilizing the same data card structure. The
data were then downloaded to a word processing program,
organized by responses to questions. This allowed for the
responses of all participants to each question to be easily
organized and reviewed.

Data analysis then proceeded utilizing the constant
comparative method articulated by Lincoln and Guba (1985) .
This process involves four stages: comparing incidents
applicable to each category, integrating categories and their

properties, delimiting the constructions, and writing the

63
constructions. Data matrices were utilized to summarize and

analyze responses, as recommended.by Miles and Huberman
(1994)

In the first stage, the data were initially assigned to
categories through a constant comparative method. The data
‘were organized by units that expressed a complete thought
(response to each question). Data chunks from each
participant were then summarized and initially compared to
each other through a stepdwise process that summarized
response themes into categories. This was completed on a
"looks right, feels right" basis (Lincoln and Guba, 1985,
p.340).

The next stage involved integrating each of the theme
categories developed previously. Analysis focused on
comparing incidents that were grouped in a single category
with each other, forcing me to be more explicit about the
decision rules utilized to place each unit in that category.
This allowed for a double check on the assignment of units to
theme categories and for an initial understanding of the
relationship of this category to men's grief. .Although no
new categories were developed during this phase, themes and
subthemes began to emerge from the data.

Delimiting the constructions was the third phase of
analysis. .A final check was made on the assignment of units
to each category and in-depth analysis of each category
continued. "Fewer and fewer modifications will be required as

more and.more data are processed" (Lincoln and Guba, 1985,

64
p.343). Guba and Lincoln's structure for analysis during this

phase was augmented by recommendations of Miles and Huberman
(1994).

After the categories of content had been developed, a
series of matrices were developed to assist in the analysis
process. A.matrix was created for each category, collapsing
the experiences of all participants for that content area.
Within each.matrix, responses for heterosexual and gay men
were examined separately so that preliminary hypotheses about
the commonalities and.differences in their experiences could
emerge. These matrices allowed me to more clearly examine
themes that were emerging from.the data concerning the impact
of both male gender socialization outcomes and sexual
orientation on the grieving process.

The final phase of the data analysis process involves
writing the constructions. Lincoln and Guba (1985) observed
that "there is no agreement among persons working in
nonstandard paradigms about reporting techniques" (p. 357).
Data from this inquiry are presented in two chapters. In
Chapter 4, the results of the above question by question
analysis are presented. Once this chapter was written, a
second stage of analysis proceeded. .After reading the
summarized.data (which included.quotations from individuals
to reify themes), I developed an outline of themes and
subthemes corresponding to the two questions motivating this
inquiry. The data were then reanalyzed to code for instances

of each theme and subtheme throughout the interviews. Recoded

65
data were reexamined utilizing the constant comparative

method noted above. Results of this analysis are reported in
Chapter 5, separately addressing themes relevant to the
inquiry questions. Findings are interweaved with extant
literature to compare conclusions of other authors with data

from the voices of participants.

Establishing;Trustworthiness

Until recently, inquiry utilizing alternative paradigms
was often judged as invalid because it did not meet the
criteria set forth by positivism (Smith, 1990). Qualitative
researchers have begun to establish criteria to judge the
rigor of their research, although debate continues about what
those criteria should be (Smith, 1990). Criteria as
established by Guba and Lincoln (1989) were utilized in this
study to ensure rigor and establish trustworthiness of
results. These criteria parallel research standards of
positivism and include credibility (internal validity),
transferability (external validity), dependability
(reliability), and.confirmability (objectivity).

Credibility refers to the accuracy of ”the match
between the constructed realities of respondents and those
realities as represented by the evaluator” (Guba and Lincoln,
1989). This criterion establishes the accuracy of the
researchers perceptions and conclusions. I accomplished this

through member checks and peer debriefing.

66
Member checks occurred.both in the interviews and after

a preliminary draft of the results section had been written.
During interviews, I worked to be sure that I clearly
understand participants' experiences. .After the data had
been analyzed, two participants reviewed Chapter 5 and gave
me feedback about my conclusions.

I recruited a disinterested peer to assist in my
research. This peer was disinterested in that he was not an
active part of the inquiry. He served as a "sounding board"
or consultant with whom.I discussed interviews, ongoing data
analysis and the conclusions drawn from the study.

Transferability is the equivalent of generalizability in
positivistic terminology. In positivism, the researcher is
responsible for arguingwwhy and how his/her findings are
generalizable. In qualitative research, ”the burden of proof
is on the receiver" (Guba and Lincoln, 1989, p. 241). He/she
must decided if the participants in the study are equivalent
to the population he/she serves. I addressed transferability
by providing rich description of my participants so that the
reader can make this determination.

The positivistic criterion of reliability is paralled by
dependability. In alternative paradigm research, changes in
the design or method can occur in the middle of the
implementation phase. Although a threat to reliability in
positivist research, alternative paradigm.research sees ”such
changes and shifts (as)the hallmarks of a maturing-and

successful-inquiry” (Guba and.Lincoln, 1989, p.242). I

67
addressed dependability by keeping a journal throughout the

process of this study, including important decisions that are
made about design or analysis and recording important
thoughts/ideas/quotes. This journal is available for peer
review.

Confirmability reflects an effort to be objective while
conducting alternative paradigm research. Guba and Lincoln
(1989) noted that this can be accomplished by triangulation
of sources of information and a “confirmability audit" (p.
243). I triangulated.my results by examing the consistency
of respondents answers to‘questions throughout the interview,
as well as their overall demeanor and interaction with me. A
confirmability audit allows persons who are interested to
review raw data, examining how results and.conclusions were
drawn. All of the material from my inquiry is available for

this purpose.

RESULTSl
In this chapter, the results of the data analyses are
examined. First, demographic data about the sample are
summarized. Second, significant themes that emerged from the
results of question by question analyses are reported by

topic area. The chapter closes with a summary.

Sample characteristics
Aggregate descriptive data about both the participants
and their partners are recorded below. More specific
information about each participant is available in Appendix
A. .Although summary data are accurate, some individual data
have been altered to protect the anonymity of participants.
Pseudonyms are used for both participants and their partners

as an additional safeguard.

Participants

Six heterosexual and six gay men participated in this
research. Average age of the participants was 43 years;
within groups, the average age of heterosexual men was 49.5
years whereas for gay men it was 36.8 years. All
participants classified themselves culturally as Caucasian
and did not further explicate their ethnic heritage. At the
time of the interview, participants categorized their
relationship status as follows: single (no relationship) (9),
dating (1), livingtogether with a partner (1), and in a
committed relationship (1). Participants' level of education

68

69
was reported as: H.S. Diploma (1), some college (4),

Bachelor's degree (3), Master's degree (2), Ph.D. (2). Income

was distributed as follows:

Ipcome bpacket (in dollars):
0 -$20,000

21-$40,000

4l-$60,000

61-$80,000

81-$100,000

over $100,000

HHHmelz

Religious affiliation of participants was reported as:
Presbyterian (2), Lutheran (2), Methodist (1), Catholic (1),
Church of God (1), Spiritualism (1), Atheist (1), and own

spirituality (3).

Deceased.partner

Average age of the deceased partner was 46 years. The
deceased women's age was 49.5 years old whereas the deceased
men's age was 42.5 years old. Partner's religious
affiliation was reported as: Presbyterian (l), Lutheran (2),
Methodist (1), Catholic (3), Church of God (1), Spiritualism
(1), Atheist (1), and own spirituality (2). Six of the
partners died of cancer, five died of AIDS, and one died of
congestive heart failure. Average time from diagnosis to
death was 28.8 months with a range of 5 to 60 months. One
partner was eliminated from this calculation as she had
received her diagnosis 30 years previously. Level of

education of the deceased was reported as: some high school

70
(1), H.S. Diploma (4), some college (2), Bachelor's degree

(0), Master's degree (3), Ph.D. (2).

Responses by Question
Motivation to Participate

In the first section of the interview, participants were
asked about their reasons for participating in this research
project. This was done for two reasons. First, I thought it
would provide a smooth transition into the interview,
allowing participants to become comfortable with the process
before more personal questions were asked. Second, I believed
that the reasons they responded to my recruitment efforts
were an important framework for understanding the results.
This information might explicate why these men were different
from.men who had chosen not to respond to advertisements.

Two central themes emerged from the responses of
participants: (1) to be of help to others (2) to have the
opportunity to reflect on their own experience. These will be
further explored below.

Eight of the 12 participants expressed an interest in
helping others. They hoped that by sharing with the
interviewer, their experiences would be useful in assisting
other men in their grief process. Some also noted that they
wished to be of help to me in completing my dissertation
research. Here are some of their reflections:

I think there (are) a lot of day to day issues that

someone in my position, having lost my wife, having three
kids here to raise, day to day issues that are taken for

71
granted by people that are trying to help you. So I just
think its an excellent opportunity to put some of the
thoughts together in a form that maybe can help somebody
else, to help them.out. Brendan

Hoping that I could do a little good; that somebody can
learn from.my experiences in dealing with my grief. A friend
told me about this and (it) sounded like something I*would
like to participate in...to be able to help other people.

Andy

Half of the participants stated that they hoped to
profit from reflecting on their own experience. Some felt
stuck in their grief for various reasons. Steve (quoted
below) acknowledged trying to sort out the differences
between grief and depression. Others just wanted an
opportunity to talk, as they had not recently (or ever) had a
chance to talk about their loss in this great depth.

I volunteered because I'm still grieving. And I've been
grieving two years...I liked the topic, I thought (the
project) was insightful and I need to talk about (my grief).
I need to understand my own grief. Steve

I thought, I want to go talk about it. Your friends and
family after a certain period of time, it's like they don't
‘want to hear about it any longer. And so*who do you tell?

Patrick

Nine of the 12 participants were personally connected
with me in some way. Five had friends in common with me who
had spoken to them about my research. Two were clients of
colleagues. Finally, two of the participants were referred
by another participant who had been through the interview
process and found it helpful. I believe that knowing I was
“okay" through friends/professionals was a critical element

in their willingness to participate and share some of their

deepest personal pain.

72
Relationship

This section of the interview asked participants to
comment on their relationship with the deceased partner.
Questions examined how they met, what their relationship was
like, their common interests, and how they managed conflict.
Gay men were asked if their relationship with the deceased
partner was recognized by others as a committed relationship.

Ten participants did not mention physical
characteristics as the source of their attraction to their
partner but commented on aspects of their partner's
personality. They stated, “She was extremely generous,
extremely caring...she got the best out of everyone she was
around, including me" (Brendan) ”We had a similar outlook on
life, sort of a spiritual connection with people" (Rick) “One
of the things that made me love Frank was his sense of humor.
He was a very funny person. He could always get me to laugh"
(Andy). Two of the twelve interviewees mentioned that they
were initially attracted by their partner's physical
characteristics. Steve stated, “I thought she was very
beautiful" and Carl acknowledged, “I like guys that are in
shape and Richard was very much in shape." However, even
these interviewees emphasized that what was most important
was who their partner was as a person. Physical attraction
appeared to have less or little to do with their reason for
being together than personal characteristics. Carl commented

directly on this in his interview:

I can tell you that all thgse (physical) things worked
for me. What really works, all that could go out the window
tmnorrow if the person has a brain. I mean I'm absolutely
mowed over by intelligence. . .that's what has to work and I
have to know. . .much more than the physical thing.

Length of these relationships varied from 4 to 38 years
with a mean of 16.2 years. When participants are divided by
sexual orientation, lengths of relationships appear quite
distinct: heterosexual 24.6 years (range 12 to 38) and gay
7.8 years (range 4 to 12). Age of participants likely
impacted this variable. Average age of participants when they
lost their partner was 43 years old. When this is subdivided
by sexual orientation, gay men (36.8) were on average 13
years younger than heterosexual men (49.5) which may account
for some of the discrepancy in relationship length.

To investigate the quality of the relationship, I asked
about their shared activities and their ability to resolve
conflict. Although no clear themes emerged from their answers
about shared activities, the couples did have varied
activities that they enjoyed doing together. These
activities included athletics, reading, cooking, and
entertaining. With regard to conflict resolution, five of the
six heterosexual men said that they had been able to resolve
issues with their partner by talking through the
disagreement, although their wives seem to have taken the
lead in these discussions and they weren't necessarily

comfortable with resolving conflict. Mark, who had been

married for 38 years stated,

74

Of course you have disagreements. we never had a real
serious one where either of us threatened to leave the other
one...and I remember she'd say, don't go to sleep at night
with a chip on your shoulder. Try to resolve it if you can
And.we never had to seek outside help to try to help us
through anything.
Danny acknowledged a similar situation:

We talked a lot. She was very good in that she would
not permit disagreement to lie. If it hadn't been resolved,
she wouldn't let it go. She'd say, we're not done. We

haven't talked about this. And she would get very mad at me
because I seemed at those times abstract.

All of the gay men acknowledged some difficulties with
resolving conflict with their partner. The level of these
difficulties differed. Some of the couples found it
challenging to talk through disagreements, although they were
eventually successful. For example, Matthew said, "I think,
being an only child, that I tended to internalize a lot of my
feelings and not talk about things as openly as I should."
His partner helped him to become more adept at talking his
way through conflict instead of shutting down emotionally.
Some of the couples encountered.much greater difficulty‘with
conflict, leaving issues unaddressed. Two of the gay men
said many disagreements in their relationship‘were often left
unresolved. As Andy noted:

On the occasions that conflicts or disagreements would
come up, Frank would always fly away from it. He didn't want
to deal with anything...a lot of times we'd just, if there
was something bothering one of us, we would mention it but
basicallwaouldn't discuss it much. Communication for, in

conflicts I'd probably say wasn't really great. Was kinda
swept under the carpet.

75
Rick talked about a similar struggle with his partner:

Sometimes we were able to talk about (the conflict). And
I was, for my own insecurities a lot of times, I needed to
address things and just move on through them. He resolved
things over time, more internally...and a lot of times didn't
‘want to address things. And more than anything else, we
wound up using therapy for helping us with our issues...we
sort of learned how to deal with issues through that.

One possible influence on conflict is the age
differences between partners in these relationships. Overall,
there was a 9.58 year age difference between men and their
deceased partner, with these men being both older and younger
than their partners. ‘When participants are grouped by sexual
orientation, an important influence on conflict becomes more
distinct. Heterosexual couples differed in age by
approximately 5 years whereas gay couples differed by nearly
14 years (for four couples the age difference was 15 years or
more). Many of the gay couples' conflicts may have been
partially rooted in their differing developmental levels.

All of the men felt that their relationships were
accepted by families and friends. The heterosexual couples
had all been married to affirm their relationships and
publicly commit to each other. None of the gay couples had a
public ceremony but felt that their families and friends
acknowledged their relationships. Some had never talked about
their commitment in the relationship or the fact that they
were gay but simply assumed that their families/friends

understood. Although they all appeared to have tacit

recognition from significant others in their lives, this

76
recognition would be tested later after their partner's

death. Some of these couples worked very hard to gain
recognition. Here are Gary's thoughts:

It took our families awhile, especially mine. It seems
like Kurt's was a little more accepting and I think that's
because Kurt taught them. He spent a lot of time with them
and he always made an effort to be himself. He didn't hide
anything. Shortly after we moved into this house, his
parents offered to pay to have our chimneys relined. They
said, 'You know, when your sister and brother got married, we
gave them money too. It...makes sense, the fact (is) that
you're a couple.’

Carl and Richard worked hard to receive recognition from
their’community:

One of the members of the board of trustees threw a
reception and invited Richard. He didn't respond because the
invitation was addressed only to him...The woman called his
secretary and asked if he had gotten the invitation. .And she
said, 'Richard doesn't respond to invitations that don't
include Carl.’ She called and apologized to him and sent a
new invitation. So, we always made, there were other

confrontational things we did to drive home the fact that we
were a couple.

Partnep's Death

The expgrience.

In this section, I asked participants about reactions to
their partner's death. Questions focused on what the
experience of losing their partner was like, what they did
immediately to cope, and their vegetative reactions
(eating/sleeping). Relevant demographic data about their
partner's death is included in this section.

Five of the heterosexual partners died of cancer and one
died from heart failure. Five of the six gay partners died

from AIDS while one died from cancer. However, since Gary's

77
partner was a young gay man, people assumed that he was dying

from AIDS, not believing him when he denied an AIDS
diagnosis. Gary said that some people still believed that
Kurt has AIDS and treated them with the stigma associated
with this disease.

All of the participants considered themselves as their
partner's primary caregiver throughout his/her illness. Two-
thirds of the participants brought their partners home to die
and cared for them with hospice support. Four of the
participants had the support of a hospital/skilled nursing
facility.

When I asked interviewees what happened for them when
their partner died, all twelve either spontaneously or with
minimal prompting began to talk about the course of their
partner's illness. Their grieving over their partner's death
seemed to begin somewhere during his/her illness. Brendan
commented on this directly:

Well, no I can't talk about it in terms of when she died
because the dying process started right at the beginning. I
knew, I'm a salesman. My job is to be able to look at people
and read people and sort of get inside them without them
really knowing. . .she was acting weird and I could see that
she was uptight and scared a little bit. I said 'What's the
matter?’ , you know, 'talk to me.’ She said, I think I found a
lump in my breast. And, its like, took the wind right out of
me and I caught my breath.

Rick talked about his partner's decline and how it appeared
that ultimately he decided when he wanted to die.

He'd been sick off and on quite awhile. He was slowly
deteriorating . People around him knew he was headed toward

death. He had said that he didn't want to live at the point
he couldn't be creative any more, do what he wanted to do,

78
liked to do. He really wanted at that point to go. And he
and I shared the belief that we all determine when it's time
to make the decision ourselves at some point. He came home
after playing for a wedding and he was in tears because he
'was getting neuropathy. He couldn't feel his feet and his
hands were bothering him...was really discouraged. Ten days
later he was dead.

In response to the question, “Who had been there when
the partner actually died?", five of the six heterosexual men
reported that they had the support of their families. This
included their children and/or their siblings. Brendan, the
young father of three, was the only man in this categorwaho
had only a family friend with him when his wife died. Mark's
experience is much.more reflective of the other heterosexual
men:

.And so I got all my kids together and went into the
bedroom with her, sat with her and was with her right up to
the last moment, last breath. And then we just kinda all
gathered as a family and we knew what we had to do...try to
cope the best you can.

Conversely, five of the six gay men were alone or‘with
one other person‘when their partner died. This other person
was a friend (2), a family member (1), or'a hospice nurse
(1). One gay man had the support of his partner's family.
Matthew's experience was unique as he was all alone and only
checking in with a hospice nurse as needed:

Jack*was uttering in a language that was indiscernible
to»me. He'd periodically look up at the ceiling and raise
his arms and then he'd lower his arms again. He'd look
around the room as if he were seeing things or people. I
held his hand through all of this or as much as possible. I
was right there by his side. Eventually he calmed down and I

just put my arms around him...then there was just...I guess
it was kind of a feeling that I could feel, an aura or

79
something...and I could tell when he passed, there was a void
there. It was draining, I was very distraught.

Vegetative Reactions.

All of the participants noted a disturbance in their
sleeping patterns before their partner's death. This was
especially noticeable when they had their partner at home
during the final stage of their illness. Mark's comments
reflect this:

Sleeping was disturbed because in taking care of Patty,
I had a monitor in her room all the time. And I would take
the monitor with.me, you know, wherever I went... knew that I
couldn't let her be alone...so my sleeping had to be on the
light side.

All but one of the participants found that their sleep
was disturbed after their partner's death. Carl was the only
man who did not see a disruption of his sleep. .After his
partner's death, he found that he,

slept wonderfully. I hadn't for over two years. And I
would say probably terribly for six months...but it was all
done. He's not laying next to me getting up three times a
night and he's not breathing heavy.

The other men encountered real difficulty trying to get
to sleep or trying to stay asleep. Here are some of their
comments:

I shifted from being a day person to a night person.
Married to Victoria, I got up early in the morning. We were
very active in the morning. Worked hard all day and I'd go
to bed at 10:00 or 10:30 at night. Now I find it very hard
to sleep. I get up as late as I can in the morning and still
get to the office...and easily stay up, often pointlessly.
But I have no interest in sleep. Steve

So, my whole sleeping pattern, everything in my life was
disrupted long before Kurt died but it just, it got quite a

80

bit worse after his death. It was strange to sleep alone for
a long time. I didn't want to go to bed. So I would sit up
until 1,2:00 in the morning. I'd finally get so exhausted
I'd have to sleep, I had no choice. Every time I would go up
to the bedroom, he was always in bed. And he'd say 'Come to
bed, honey.’ And when I'd go up to the bedroom, I would
expect to hear him say come to bed. .And I couldn't stand not
hearing, I guess. I just didn't go to bed until I had to.

Gary

Nine of the 12 participants acknowledged difficulties
with eating either before (1) or after (8) the death of their
partner (one participant reported both). These problems
included not eating, eating less than they should, not eating
a balanced diet (i.e., lots of candy) and overeating. Two of
the participants had children to feed, forcing them to
maintain a balanced diet for themselves. One participant
acknowledged a connection between eating and grieving:

I don't know if it was because the nurses brought me
food...I kept it together the whole time except when I was

eating. Whenever I would eat, I would cry. That is when I
would cry. I ate (but) I wasn't really hungry. Patrick

Emotions

Before exploring the responses that these men had to
questions about emotions, I want to acknowledge the
prominence of affect in each of the interviews that I
conducted. All of the participants were stirred effectively
by the interview, expressing both sorrow and anger. Most of
the participants became choked up or cried openly in
remembering the loss of their partner. Four expressed
anger/irritation at the way they had been treated by their

partner's family.

81
Emotional reactions.

Participants experienced a variety of emotions after the
death of their partner. Interview questions were structured
to elucidate the emotions they had experienced and how these
feelings had impacted them The most prominent emotions that
emerged in their comments were sorrow (11), loneliness (11),
relief (8), anger (7) and guilt (7). These will be further
explored below. Other emotions that were reported less
prominently included shock (3), confusion (2), fear (1), loss
of control (1), and idealization of the relationship with the
deceased (1).

Eleven of the:men acknowledged feeling sorrow when their
partner died. In my opinion, the one man who did not mention
sorrow likely assumed that his sadness was understood. To
some degree, all participants were sorrowful about the death
of their partner. They missed their partner and were still
dealing with their lack of companionship. Here are some of
their comments.

And when you have thirty seven years of holidays and
everything like that, with a person, you're going to feel
(sad) on those days, even though Christmas was seven months
later, holidays like that bothered me...and they do yet
today. Mark

Sad. Sad that she's gone. You lay down in bed and
there's no one there (cries). But, yeah, its
sad...sad...nothing you can do to make somebody appear, you
know, I 'd go home from work and I always had the habit of
rushing home from work. Even after she died I'd rush home
from work to see how she was doing and nobody's there. Ted

Just loss, a sort of sense of losing direction from.my

life and.my goals for the future... still look forward to
getting old and doing things...(but) there's a part of my

82
being that's not there and I don't feel as complete as I used
to. Matthew

Eleven participants acknowledged feelings of loneliness
and emptiness at their partner's death. These two emotions
seemed interrelated. The men felt very much alone in the
world, externally and this manifested itself as a feeling of
emptiness inside, a loss of meaning. As Carl noted, his
language had to change.

When Richard.was in the hospital, sick for the first
time, I remember saying, 'We'll fight this . We'll make it.
We'll do this’ well, there's no we anymore. And I feel
vulnerable.

Patrick noted that his initial experience of emptiness
took on a physiological manifestation.

That empty feeling. Guttural, it was a guttural pain. I
had a physical stomach pain for the first twO‘weeks after it
happened. My stomach literally hurt...it was like I had the
flu...the stomach is where I felt it.most.

Ted and Gary acknowledged not only their feelings of
loneliness/emptiness but also efforts that they made to avoid
these feelings.

I'd come home and listen and there's nothing there. And
you turn the TV loud, just to have it cover up the emptiness.
Lots of TV, a lot of TV. Ted

Just loneliness, extremely, extremely lonely. Didn't
have that person to talk to about...just coming home from
work and having someone to greet you...I avoided coming home
for awhile...when I could. Gary

Eight participants acknowledged feelings of relief once
their partner had died. Although they still loved their
partner and wanted them alive, they did not want them to

suffer. Many of the partners had to deal with loss of bodily

83
functions, inability to care for themselves, and intense

physical and emotional pain. When death came, participants
viewed it as a blessing.

Just the fact that she didn't have to go through the
pain. She didn't have to go through the complete agony, or
physical pain, emotional pain. I was relieved and thankful
that she died as quickly as she did , as the deterioration
started to take over. She didn't lose her mind, she was
sharp to the end. So I knew that we were fortunate. Brendan

I remember feeling inside like I wanted to say
'Hallelujah' but I looked and I remember restraining myself
because the people I was with (Keith's family) were
so...opposite to me, the way they were feeling. And I just
felt sort of embarrassed. Rick

There was also a sense of relief for the men themselves.
All of them had been the primary caregivers for their
partner. Whether the partner was at home or elsewhere, they
all kept crazy schedules to meet the demands of work, running
a home and taking care of their partner. But this sense of
relief didn't always feel comfortable. Danny's comments
noted this feeling.

Relief from responsibility of taking care of her, making
sure that she took her medicine. Making sure that somebody
was at the house when I wasn't there. Just the pressures, the
overall pressures. And one time I felt guilty about that,
down the road. I don't know why but I did.

Seven participants acknowledged anger in some form.after
the death of their partner. The target of the anger was
different in.many cases. For some it was anger at their
situation, others were angry at God, and still others became

angry with their partner. Their reflections on anger speak

for'themselves:

84

So, yes, you do experience anger. You look at other
people and you get so angry. People your own age, you see
them.together. They're having fun, they're laughing. And its
pretty hard to realize or understand why you're left alone
here today...You're driving down the road and you see people
together in a car...they’re about your age...You know they've
been together for awhile and...you're riding there all alone
Pretty hard to understand why you're thrown into that
position. Mark

The other emotion that has surfaced is anger. And the
anger is reflected toward religion. Or toward whatever God
is or was. I have changed.my conception of God. And I'mino
longer interested in the God that I knew before Victoria's
death. That God is gone. Steve

But I didn't have any anger at God. Then in the summer
I read through her papers ...there was a sort of backlash. I
‘was angry at her for awhile...not for dying but for not being
the ideal that I had spent half a year building. Kirk

I'd say right after he died, I was angry at him
because...he gave up on life. I really felt that if he would
have tried a little harder that he would have been alive for
a lot longer. Andy

Seven participants noted that they felt guilty in some
way after the death of their partner. Guilt was caused by not
having been a good enough partner, not doing enough for their
partner, or other emotions they were experiencing. Kirk felt
guilty as he reflected back on his relationship with Margaret
as he realized that in some ways, he had held her back from
achieving things professionally. Others experienced guilt
because of the ways they had treated their partner in the
past. Gary and.Mark reflected these sentiments.

And there was some guilt. What could I have done to make
those last few years better. What could I have done to make
his life better. What are the things that I could have done
but didn't do? Gary

You have a guilt feeling...right from the start. You

think 'Geez, I wish I hadn't done this..;when I treated her
that way.’ She always wanted to do this. I wish I would have

85
done that with her. You're criticizing yourself for not doing
these things with her when she was here with you. Mark

W

In the next series of questions, I explored who these
men had used as sources of emotional support. I wondered if
there were feelings that these men had kept to themselves (as
men are often socialized to do), with whom they had been able
to share their feelings, and if they had been inhibited in
any way from sharing their feelings.

All of the participants were able to talk about their
feelings of loss with someone. The intensity and frequency of
these discussions varied greatly but they had all found some
source of emotional support. Yet, seven of the participants
admitted that there were emotions that they shared with no
one.

Oh yeah. Several things. I mean, there's no way
to...express what I was really going through. The sheer
terror, the horror of it all. The intensity...I tell people
and I told people, I lost 80% of me that day she died. That
leaves a pretty empty shell. Brendan

A lot of times, it surprised me that it was so
animalistic...the grief, the pain...the cry was so guttural.
You know, it's from so deep within. and I did that all
private...when I would cry like that it would be all private.

Patrick

With whom were they able to share their emotions? Of the
seven participants who had children, five of them shared
their feelings with their kids. Brendan, the father of three

young children, and Carl, whose children live at a distance,

were the only twO‘who»did not mention voicing their feelings

86
to their children to receive support (although they talked

with them about feelings). Aside from their children, seven
of the participants were able to share their feelings with
other members of their own family, whether parents or
siblings. Half of the participants were able to openly
express affect to their partner's family and receive support.
Nine of the participants were able to depend on their friends
for emotional support. However, three of them found
difficulties in sharing with friends. Their friends either
became busy with their own lives:

Even people who were very close friends have gradually
disappeared. And I've never been one to talk that much to
people anyway....They all had their own needs. Kirk
or couldn't handle it when the man tried to be open with them
about what they were really feeling:

Good friends. Some of them can't handle certain things.
Richard used to say 'Nobody intimidates you'. And I think,
yah, I'm.not intimidated. But, all of a sudden, now, there's
some chinks in the armor. I don't like that...And what I'm
finding is that friends see this strong Carl who is not
intimidated. So, when Carl sits there at dinner and tells
them he's scared to death or he doesn't feel as strong as he
used to, they don't get it. They can't handle it. Carl

To further examine this issue, I asked participants if
anything had kept them from sharing their feelings with other
people. Nine of the participants recounted ways that their
seeking of emotional support had been inhibited. Some men did
not acknowledge any difficulties with this when asked

directly and yet, in their responses, they described

situations when they monitored how'much they disclosed based

87
on their surroundings. Their reasons for being inhibited

could be summarized as efforts to protect others or protect
themselves.

All nine men acknowledged either directly or indirectly
that they did not share certain emotions in an effort to
protect others. These “others" included both family and
friends. Here are some of their reasons for protecting
others:

I gotta be strong. . .for my children. And I always tried
to maintain that with my boys especially. Now, my daughter
and I have gotten into some serious discussions since then
and I can talk (with her) emotionally. I can talk with her
freer than I do with my boys because I want my boys to feel
strong. Mark

I could talk to my kids but every time you talked to
them, they would be crying just as bad as I was. . .and it was
no help. . . (we could) cry on each other's shoulders but I
couldn't help them and they weren't helping me. Ted

There was all kinds of opportunities to talk about
emotions...and I think, we did for quite a while. But then I
got to the point where I thought, ‘I don't want people to
hate to see me coming...so (then) there were only very few
people I could really share the entire experience with. Gary

Three participants seemed to be making an effort to
protect themselves. Patrick was one of these men. He
admitted that he did not want others to see the depth of his
pain. He felt more comfortable restricting that to times
when he was completely alone.

I think it was basically because I felt it was very
private. And I'm not sure the rest of the world would have
understood. It was more of a private thing for me. I wasn't

willing to share that with the rest of the world. I didn't
want people to see that.

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Emotional changes.

In closing a discussion of emotions, I asked
participants how their feelings had changed, if at all, since
their partner died. There was considerable variation in the
length of time since their partner's death and in their
ability to deal with their grief. However, all of the
participants stated that they had noticed some changes in
their emotions . The prominent changes noted were either in
the emotions that they experienced as most salient or in the
intensity of their emotions .

Seven participants acknowledged that different emotions
were emerging at different times in their grief process. As
time passed, other emotions would become more prominent. Here
are some of their thoughts:

I think maybe the anger was prominent early. And I
think that has changed. I was really angry about the way he
left. I didn't have a chance to say good-bye. I didn't
expect his death...I guess its just not like it is in the
movies. Gary

Well, anger has left. I guess it took a long time for
that to get to me. I lost or got rid of some of my anger of
why, why (God) took her and not somebody else. The
loneliness, when I'm alone here, (remains). Mark

Seven men stated that either their emotions had become
less intense or they had become better equipped to handle
them. For example, Kirk remembered :

They definitely became less. . .for the first few months,
I had no physical control with them at all. I would have to
put things down. . .and then the emotions would rise up. . .like
just now. ..if I talk intensely about it. But then I started

to be able to talk to people about her, not distantly but
with calm.

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For all of these men, their emotions were still changing in

some*ways, even after five years. Some of the differences
noted in this section are likely impacted by the time since
the partner's death. For example, two participants lost
their partner only six months previously whereas one
participant had been dealing with his grief for nearly five
years. This considerable variation likely accounts for some
of the differences in emotional changes over time as some

participants had only recently experienced their loss.

Social Suppgrt

Questions in this section focused on the quantity and
quality of social support that participants and their
partners had received throughout their partner's illness and
after his/her death. Friends were mentioned by all of the
participants as a source of social support. Family also
emerged as a very important source of social support for all
but one of the participants. However, differences emerged
when participants were sorted.by sexual orientation and

whether the source of support was their own family or their

partner’s.

Sources of social suppprt.

Five of the six heterosexual men received support from
their own family and the same number received support from
their partner's family. Kirk and Brendan were the men who

reported not feeling supported by their own family or their

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partner's family, respectively. These dynamics appeared to

stem.from issues earlier in the relationships. Here are

their comments:

My family is supportive of me. And they expressed
sincere sadness at her death. But...they live alone like I
live, very alone. And so their way of support has been to be
just supportive of me in.my present circumstance but not to
talk to. Kirk

I was the (one) who took their little girl away...so I
*was never the favorite for that. (And) they were very bitter
about not being informed about (her illness). I just flat
out told them, 'She's your daughter and when she wants her
parents to know~what her situation is, she'll tell you.’
But, it cost.me big time...major, major problems‘with these
people. Brendan

Five of the six gay men.mentioned their own family as a
source of social support during their partner's illness. Carl
was the only one who did not feel the support of his own
family. He said that his parents seemed simply incapable of
helping, although they tried. .But, his partner's family
seemed.even less invested in reaching out to him:

His parents, per Richard, knew that I was a spouse and
that I'd get everything, and that I cared for Richard. They'd
send us every year, some sort of Christmas gift to the two of
us. Last couple of years it was a check to go to dinner.

And this year I didn't even get a card from them. He died a
month before Christmas...And their local paper did an
obituary on him. They listed everybody but there was no
mention of me. I was good enough to care for their son for

two years...they did literally nothing for his care...but I’m
not good enough to be in the obituary because that means he's

QaY-

Matthew and.Andy also encountered not only a lack of social

support but conflict with their partner's family after their
partner died. Their relationships suddenly took a turn for

the worse as the partner's family contested the will and/or

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their rights to their partner's things. .Andy's comments

reflected the bitterness he felt in how his partner's family
treated him.post-mortem:

I don't understand how anyone can be that way. His
father and son just said some awful things that I don't think
I can ever forget. For ten years, the two families mingled
‘well. My family and his together for Christmas dinner. Once
these legal matters get settled, I'll write the letters to
let his family know all the crap that they've put me through
(that) I didn't deserve. In the three years from diagnosis
to death, I was there for him every single step of the way
and none of his family can say that.

For most of the participants, there had been a variety
of sources of social support. I was curious to see who had
been the most important source of support for them. Who had
they relied upon most? Some of the participants gave more
than one category, but their most important sources of social
support had been friends (10), siblings (4), and kids (4).
Most noteworthy were the responses of two participants. When
asked this question, they each thought.a.minute and replied,
“Me". Here are their reflections.

Hmm. Me. Just having faith and trying to logic my way
through everything. I just relied that I had faith, that
somebody upstairs is gonna be guiding me through these
situations and guiding me to do the right things. So, pretty
much self reliance. Matthew

Myself. That sounds strange but I never called anybody
up saying I have to talk. I read, you didn't mention that
but I got a lot from reading. I took a couple of courses,
one in theology and two bible study courses that were very
helpful to me. Kirk

I asked.participants if they had chosen to become
inVOlved in a support group after their partner's death.

Questions examined.their reasbns for/against participation

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and if/how groups were helpful. Seven of the participants

acknowledged having tried attending a support group. However,
not all of them found the experience rewarding.

Brendan, Mark, and Ted found their support group to be
helpful and were still actively involved in these groups at
the time of the interview (attendance ranged from 7 months to
1.5 years). Matthew attended a time-limited six week
structured didactic group and learned much about the grieving
process. Danny tried attending a group before his wife died
but attended the wrong group (he attended a group for people
who had already experienced a loss). Given this experience,
he didn't return after his wife died. Patrick and Andy tried
attending a support group and did get something from the
experience. Yet, both left after a few sessions as some
aspects of these groups were not helpful. Andy found the
information presented was helpful but wanted to receive more
support and to verbalize his experience. Patrick attended
one group but decided that it was not appropriate for him.
When he first arrived at the support group, he heard an
emotionally distraught man who had been attending for seven
years voicing his experience. His reactions were as follows:

It was helpful to me...because I got there and decided I
don't want to be here seven years. I am not going to dwell
on this for seven years. It is a major part of my life (now)
but I don't want that to be the focus for seven years.

Steve, Kirk, Rick, Carl, and Gary didn't even try to
attend any meetings offered to them because they weren't

comfortable with the idea of a support group. They were

93
convinced they “didn’t need it" or were afraid of feeling out

of place:

There's sometimes I feel really inadequate, just because
(of) the group dynamics that I've seen on a couple of
occasions (in other groups). There are people who seem.to be
sort of skilled at these things, groupies or something...they
like to talk, they like to have an audience. To me, its sort
of a personal thing that I find difficult to sit down and
share with other people. Rick
Ultimately, the reasons some men chose to not pursue a
support group or left prematurely seem to fall into two
categories: (1) when they attended, some men were
uncomfortable with the group structure and (2) some
participants did not believe that a support group could be
helpful to them. Additionally, some gay men acknowledged the
added struggle of trying to have their relationships

validated in a primarily heterosexual group.

Social world.

I asked participants how their social worlds had changed
since the death of their partner. Their responses
incorporated positive and negative changes. Negative changes
included social discomfort when with other couples, feeling
lonely, and friends not calling. Positive changes identified
were dating, developing a broader social network than before,
and self growth.

“Friends not calling" was the most prominent negative
<=hange in the participants' social world. Half of them saw a
difference in the number of times that friends called them.

.After the funeral was over, many friends seemed to become

94
refocused on their own lives, having less and less contact

with the surviving partner. For example, Carl noted that
many people became uncomfortable when they saw him and didn't
know what to say. He also found that some of these former
close relationships became even hostile:

There were people who were friends, very close friends,
who if anything now, it might be a little strong to say
enemies. . .people just act weird. Friends we had for years
and years don't call or talk or say hello.

Carl recounted that one particular friend was traveling when
Richard died but wanted to be involved in the memorial
service.. .even though she would be out of town when the
service was held. When Carl went ahead and planned the
service without her, she, “called me up and bitched me out
and I haven't heard from her since."

Four participants commented on feeling “like a fifth
wheel" when out with other couples. This feeling prevented
and/or inhibited them from going out socially or made them
uncomfortable when they did. Mark noted that when he got
beyond the discomfort and went out socially with other
couples, he was often reminded of his loneliness by being
with other couples:

You go back to thinking, 'Why did this happen to me?
Why am I alone here today and they're still here with each
other? So, it brings back memories and its hard to deal
with.

Along with Mark, four other participants acknowledged

that they experienced intense loneliness from their lack of

social companionship. Yet, these men did not need to be with

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others to experience this feeling. Loneliness permeated all

aspects of their lives.

Among the positive changes noted, six participants
reported that they had dated and that this brought excitement
to their lives. Rick'was experiencing dating for the first
time in his life:

I never dated in the gay community. I met Keith after
being ”out" only a couple of years. I only dated my wife
during college and I only dated one woman in high school.
Most of the dating I'd ever done in my life was in junior
high school. So, in that sense my social life changed
because I started dating.

Rick, Matthew, and Andy found that their social network
of friends expanded. They realized that perhaps they had
been inhibited by their partner and now they were free to be
social and connect with a wider circle of friends. These same
men, along with Kirk, also noted that they were experiencing
a period of intense self growth, that they were learning
about new parts of themselves. For example, Andy had been
religious when he was younger but had fallen away from the
church in college when he came out. When he was interested
in rejoining a faith community, Frank was against it as he
was very anti-organized religion. Once Frank died, Andy
became more in touch with the spiritual part of himself and
eventually joined a church. Here are his thoughts about these
and other changes he’d seen in himself:

If there's any good that has come out of Frank's death,
it's good that I've learned to love myself all over again,

learned to depend upon myself and nobody else, and really
become that much better of a person. I've really grown a lot

96
in past two years and I’m really pleased with what I’m all
about now.

werk

In the next section, I asked participants how their job
performance was impacted by their partner’s death.
Initially, I was anticipating that their job would be
profoundly affected after the death of their loved one, but
data emerged that substantiated an impact on their employment
both before and after their partner’s death.

All of the participants found that their work was
affected in some way. Mark was the only participant who was
not employed full time. He had been retired from his job as
a policeman for a few years prior to his wife’s death. But,
in some respects, he wished that he had been working:

I oftentimes would sit here and say ’I wish I was
working.’ Cause I know that would occupy my mind. I’d be
occupied at least eight/nine hours a day. That would give me
something to do.

Yet, even Mark saw an impact on his work life. Prior to his
wife’s death, he had been taking part-time construction jobs
to supplement their income. His wife had accompanied him on
these jobs as his assistant. But, once she died, he could
not pick up with this work:

After I lost her...to this day, I have not gotten back
into doing these jobs...because I can’t make myself do it.
I’d miss her. She was supportive of me and she loved it
(too). Lots of times, she’d go to jobs with me and called

herself a gopher...so, I have not gotten back into this and I
don’t know if I’ll ever get back into it.

97
Ten of the remaining eleven participants acknowledged

taking some amount of time off both before and after their
partner’s death. .As the primary caregiver of their partner,
they had to take days off and/or reduce hours to attend to
their partner’s medical needs. The amount of time taken off
after their partner’s death varied from three days to a
month. This seemed to vary depending upon whether the man
found work to be a helpful distraction or a negative energy
drain. It also depended upon his employer’s policies and
level of support.

One of the participants did not take any time off either
before or after his partner’s death. Carl and Richard owned
a business and Carl felt it was necessary to have one of them
checking in on the store at all times.

Every day I went to the store. In fact, I think that
some people were disgusted or were upset with me (for doing
this).

For many of the participants, work was a helpful
distraction yet, for Carl, it was a constant reminder of his
deceased partner. Their desks were back to back in the
office and memories of Richard were all over the place. So,
work was not an escape for him:

I go to work and his desk is still right there. There’s
other stuff on it but it’s still right there and all day
long, I’m.pulling out files that have his handwriting on
‘them. You know, I can’t get away from that.

All of the participant who had been working found that

their concentration at work was affected in some way, either

98
before and/or after the death of their partner. Danny was

having such a difficult time that he asked his doctor to
prescribe some medication :

I had a helluva time. Then my doctor put me on Zoloft.
I noticed that I could concentrate. Instead of my mind going
a mile a minute with pressures at home and pressures at work,
the medication helped with.my concentration...A.lot of people
at work didn’t know how I juggled everything and, to be
honest, I don’t know how I did either.

Yet, for some, work was an escape, a place where they
could “forget" their loss...or at least try to. .Andy
acknowledged that he had tried this:

When I returned, I dove into it as much as I possibly
could. That’s when I started working ungodly hours. I was
going in at 6 am.and working until 9 every night. My focus
or thought pattern was, the more I can think about work, the
less I have to think about all my grieving and dealing with
Frank and going home to an empty house.

Participants commented on the support of their
colleagues and supervisors. All eleven men stated that they
had received support from their work environment as they were
allowed to take days off, reduce hours, and have people cover
for them. Fellow employees brought in food for these men to
take home to their families, took up collections for their
needs, and attended services for their partner. All
participants found a great deal of support from their work
environment.

Two of the gay men encountered difficulty when trying to

take bereavement leave. Since their partner was not

considered a legal spouse, they had to take other types of

99
leave (i.e., vacation, sick days) and this brought different

challenges with it. Here are their stories:

I buried Frank on Saturday. I’m supposed to be back to
work Monday. I called my boss on Sunday and this is the only
derogatory thing he ever said to me. I called and said, ’I
can’t come back. It’s just too soon.’ And he said to me,
’You’ve got this new job, you’ve gotta come back.
Everything’s kinda falling apart.’ I said ’I’m not coming
back, you gotta understand, I gotta have at least one more
week off.’ He said, ’If you feel its necessary, then I guess
its okay. But when you come back, you’re gonna have to come
back at 110%. So I took another week off. I really needed
another week on top of that but I couldn’t do it. Andy

I was spending a lot of time during work hours arranging
for his care. I was encouraged when the family medical leave
act came into being, but again I still didn’t fall under
those criteria...because I was not married to him, in a
legally recognized relationship. (After he died), I did get
short changed out of a few days without pay...they granted my
leave and then.were investigating what their previous
practices had been regarding a situation like mine. And they
never got back to me. So, I felt cheated that I wasn’t
treated as equally as a heterosexual couple would have been
but things are the way they are. So, that’s just one of the
things I had to accept and move on. Matthew

Rituals

In this section, participants commented on the rituals
they utilized to commemorate their partner. After they
described the rituals, I explored with them who had been
involved in planning these rituals and if they found these
services helpful in some way.

All of the participants reported having a funeral or
memorial service at the time of their partner’s death. Most
of these services were held at churches or funeral homes and
involved some religious component. Instead of a traditional
funeral, Steve and his children planned a celebration of his

*wife’s life at a local private club. Since they were not a

100
religious family, there was not great emphasis placed on

religion as part of this service, although a religious
component was incorporated:

We invited friends to speak. It was a place to remember
Victoria, her sweetness, her brilliance, and her contribution
to everybody...how she had affected people’s lives. And
people came from all over the country...and a friend who is
an ordained minister, for those who felt religion would be an
important way to say good-bye to Victoria, he did a nice
prayer.

Carl and his friends also put together a celebration of
Richard’s life at a local club. They recruited friends from
different parts of Richard’s life to speak about him and his
contribution to the arts community and the gay community.
But, there was a conscious effort to distance this service
from religious/spiritual practices as was stipulated by
Richard before his death:

I’ve been to too many gay men’s funerals where it was to
make their parents feel good. And this wasn’t going to be a
compromise in anwaay. Richard had some language in his
will...it said that the memorial service could not be held
within 500 feet of a church, synagogue, or temple or anything
spiritual. No rabbi, clergy, or other ordained people could
speak and there could be no prayers...he and I shared those
opinions so that wasn’t a problem.

Seven of the 12 participants acknowledged that, together
with their partner, thewaere actively involved in planning
the funeral/memorial service. Three of the couples planned
all of the service themselves. Patrick acknowledged that he
and.Edward preplanned services for a reason:

we went together to the funeral home. It seems kind of
odd but I’d recommend it to anybody. His mother is a very

strong willed woman and she usually gets her way. So, if we
didn’t have this planned beforehand, she would have gone and

101
done something that I didn’t agree with. And we didn’t want
that.

Four couples planned the service with the assistance of
the deceased’s family. However, as Brendan discovered, this
became a source of conflict that added to the tension at an
already difficult time:

Before Eileen died, I asked her, ’What arrangements do
you want your folks to handle?’ She just looked at me and
said, ’None’. You’re my husband, you know what I want, you
handle it.’ But, after she died, I knew that if I didn’t
include her folks, it was really going to make a bad
situation worse. So I called them and had them come down to
the funeral home with me...Her dad does wood.working and he
walked right over to one of those ornately carved caskets and
says,’ I like this one. This is the one we should get’. So,
I turned over the card, $35, 000! I said, ’We aren’t getting
that.’

Four participants planned the memorial service with
their children and/or their partner’s parents/siblings. They
had not talked about a memorial service at all with their
partners prior to their death and thus negotiated all of the
arrangements after their partner died. Although this was
difficult to do, it gave them something to focus on after
their partner’s death.

Andy and Frank had not talked about a funeral and/or
services. As death approached, Frank’s family began to plan
services back in their hometown about two hours away. This
became a source of intense conflict and ultimately resulted
in Andy’s exclusion from much of the mourning process:

They were (angry) that I wouldn’t come over to pick out
the casket, the flowers, the gravesite. My logic was, there

was a lot of time to do that after he died. .And the last
thing I was going to do was leave his bedside while he was

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still living to go pick out things for his death. I wouldn’t
do it. He had a very manipulative ex-wife and she and his
mother took over from that point and planned the whole thing.
The last thing he would have wanted was to have his ex-
father-in-law give his eulogy. But I was so weak and so tired
of fighting that I just gave in to all that and let his
family do everything...Through the whole ordeal I felt like
an acquaintance and that really (angered) me.

Patrick acknowledged that he might have been in a
similar situation but that he expected recognition from.other
people...and that he felt full recognition as a ”spouse."

I am very strong willed and I don’t know if everyone was
afraid to step on my toes or if they just didn’t do it to be
polite but the family was very supportive (of me). They let
me have it the way I wanted it...I tried to include others
but I knew that I was the focus. And that was nice because I
knew of people who were completely shut out and I couldn’t
have dealt with that.

All of the participants acknowledged that they found the
memorial services helpful in acknowledging their loss. Nine
of the participants stated that contact with their support
system was the most meaningful part of this process. They
found it valuable to be reminded of all the people that cared
for them and whose lives their partner had touched. Steve
summarized the importance of the support:

The old rituals work...doing the ritual, having another
chance to remember the person, talking about the person,
hearing the person’s name mentioned. Hearing people say that
she was a good person...that validation of their life is very
important. And its also designed to support the family and

support me. And to say ’we know you’ve really lost
somebody’...cause she was something else. And that helped.

Religion/Spirituality
In this section, participants commented on their

involvement in organized religion and/or spirituality prior

103
to their partner’s death. Questions assessed whether or not

this served as a source of support during their partner’s
illness/death and if their religious/spiritual belief system
was impacted in anwaay.

Five of the six heterosexual men stated that they were
active to some degree in organized religion prior to their
partner’s illness/death whereas this was true for only one of
the six gay men. Of the remaining participants, Steve
(heterosexual man) talked about an active spirituality
outside organized religion as did Patrick, Rick, and Matthew.
Carl and Andy stated that they did not have any active
religious/spiritual life or belief system at the time of
their partner’s death.

Seven of the participants, both heterosexual and gay
men, stated that religion/spirituality did not change in
importance in their lives as a result of this experience.
However, for five of them, there was some impact. For two
heterosexual men (Steve, Kirk), religion/spirituality became
of less importance. As Steve noted:

And the anger is reflected toward religion or toward
whatever God is or was. I have changed my conception of God.
And I’m no longer interested in the God I knew before
Victoria’s death. That God is gone. No longer interested in
that entity.

For Rick, a gay man, his spirituality became less
important too.

I think that because of his death, that experience that

I had when he died of knowing that its okay to make the
'transition...just that awareness that death is nothing to be

 

104
afraid of. It put to rest for me a lot of the wonder and
searching that I had been through.

For two gay men (Matthew and Andy), organized religion/
spirituality became more important through this experience,
but for different reasons. Through Jack’s death, Matthew
found a new connection to a Higher Being as well as
experiencing a continuing connection with his deceased
partner. For Andy, however, it was not his partner’s death
that initiated a reconnecting with religion/spirituality. He
had an active belief system in the years prior to coming out
but had distanced himself from this when he acknowledged that
he was gay. His partner had been very anti-religion and kept
Andy from actively investing energy in religion/spirituality.
Once his partner was deceased, however, Andy began to
consider this lost part of himself:

About a year after Frank’s death, I was really
struggling to find people here that I could get along with
and associate with. And there’s a gay Christian group in
town...I met two people in it. I was so lonely and desperate
to make friends, I thought, ’Alright, I’ll give this group a
shot.’ and its a wonderful experience. Sundays used to be my
most depressing days...now I look forward to them. I’m
volunteering at the church and becoming more and.more
spiritual...knowing that there’s someone up there calling the
shots... I really believe that now.

Two thirds of the partners did not experience a
significant change in their spirituality as a result of their
impending death. Their belief systems remained the same as
they moved toward the end of their lives. However, for one

woman and three gay men, their religion/spirituality became

of greater importance as their death drew near. Kirk found

105
that his wife prayed.more and became more involved in

traditional aspects of her faith than she had before. Gary
noted that his partner became:much.more active in their
faith. Patrick’s partner began to talk more about God, about
making peace with God, and praying to God. Matthew’s partner
seemed to have the most drastic change in his
spiritual/religious life:

He did go for a baptism later on in his illness...in the
Pentecostal church. And that evening, we had gone home, he
said ’Well, did I freak you out?’ I said, ’No, its just a
part of your being I haven’t experienced.’ He said, ’I think
I did this more for my family but I also know that this is
the right thing I should be doing.’ So, yes, his
spirituality did grow toward the end of his illness. I think
he believed that he was doing the right things for himself.

For eight of the participants, religion/spirituality‘was
an important source of support during this experience.

People for'whom.re1igion had been important were able to
utilize the tenets and practices of their faith to support
them. As Brendan noted:

we found it to be an extraordinarily strong guiding
source in our lives. Frankly, our ability to work through the
illness, go through the dying, and through the death, I
firmly believe that the strength was handed down from.God. I
don’t see any‘way we could have gone through it without it.

Yet, for four of the participants, religion/spirituality
‘was not important and remained that way for these couples
'throughout the partner’s illness and death. Carl’s partner
had reconsidered his position on religion/spirituality as

death approached but did not make any shifts in his belief

system nor use religion/spirituality as a source of support:

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He did say toward the end one day that he had reexplored
(religion) in his mind and decided that he was still right.
So, we weren’t spiritual at all and I’m not. I don’t think
that I’ll ever see him again. I don’t think that there’s a
higher place that we’re going to go to. I don’t think that
I’ll ever have contact with him again.

Previous Losses

In this section, participants talked about previous
experiences they had with losing someone significant through
death. After they identified who they had lost, I asked them
what they had learned from these prior experiences. Finally,
I asked if, in their view, these experiences impacted their
ability to deal with the loss of their partner

Nine of the twelve participants had lost some
significant figures in their lives. Five of the participants
had lost a father or both parents. Four had lost
grandparents and other relatives. Three had not lost anyone
significant (i.e., a close relative/friend) prior to losing
their partner. However, regardless of their previous loss
history, none of these men felt prepared to deal with their
grieving process when losing their partner.

Even my father’s death, which was five years ago. Yes,
I had had the experience with death and in working on
remembering. That I thought remembering was important...
saying the person’s name was important. All of that was
helpful to the family and helpful to me. But the intensity
of losing Victoria was like, I don’t know, 50 times more than
losing my father. Steve

I think it was totally different. When we lost our
mother, I and my brothers and sisters dealt with it
collectively and it just seemed like it was an easier
situation. And I had my wife at that time and I had my

family to fall back on. But to lose your spouse is a much
closer relationship,:much, much closer. Mark

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For some this experience was the first time that they

truly dealt with bereavement. Gary remarked that in losing
his partner, he recognized emotions of grief/loss and finally
started to deal with the death of his father years before:

I don’t feel that I really learned.much from those other
experiences. I just don’t feel like I ever really dealt with
them. (In Kurt’s death), I was forced to, I had no choice.
Just really had to face the feelings that I was experiencing
and I just could not deal with it like I had in the past. I
don’t think that I ever really dealt with grief when my
father died...And maybe that is why I was so»much.more
intense...it all gushed out. And it takes being hit over the
head to actually get to the point that I can begin to feel.
Cause I’ve done a good job of not feeling for a long time.

Regardless of their contact with death, I asked
participants what they had learned either through their loss
experiences or through their life experience about how to
deal with death. What had they learned from significant
others in their lives about how to manage losses? Three of
the participants learned something positive about coping with
death whereas the other nine participants had absorbed only
negative ways of dealing with loss.

Three participants acknowledged learning that support
was important from.others in their lives when a death occurs
and that there was a reciprocity to this support. People
close to the deceased needed to come together to be there for
each other. Steve mentioned this in his comments:

And I simply knew it was important to be there and to be

part of the family at these times...to look at old
photographs and remember good times and remember the person.

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The other participants recounted learning negative

strategies or nothing at all about how to deal with grief.
Ted and Rick said they learned to keep busy and remain
focused on their lives. Ted even found this to be true when
he lost his mother and father:

My parents died, I didn’t grieve for them...never
really. I mean I was upset that my parents had died. But, I
never grieved for it because I didn’t know there was such a
thing as grieving. It happened, it’s gone and your life goes
on.

Matthew, Patrick, and Gary stated that they learned to
not talk about their emotions. They learned, either directly
or indirectly, to keep their affect bottled up inside. For
example, Matthew had been to memorial services and had
absorbed.how to deal with arrangements and social customs.
Yet, he had no idea how to cope with the emotions:

Dealing with the funeral yes. In dealing emotionally,
no. .As I said, it was more the procedural things that I
absorbed. I guess there were some social things I observed
too. Just saying particular kinds of things to relate to
certain people. But I really don’t think my prior funeral
experiences helped me to deal with my loss of Jack...nothing.

Carl, Andy, and Kirk could not identify anything that
they had learned from.others about how to deal with death.
They felt completely confused about what to do and how to
handle their grief. Carl had lost many extended family
members but had not learned.much about grief. However, Andy

and Kirk had not lost anyone significant. And thus, this was

their introduction to the process of grieving Here are

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Andy’s reflections about how ill-prepared he felt when

dealing with bereavement:

Absolutely nothing. I’d have friends’ fathers die or
something like that, but none of that really meant anything
to me. I’d never had anybody significant die in my life

until Frank. Prior to his death, I had absolutely no
connection, no experience with death.

Afterlife

In this section, I asked participants questions about
their views of the afterlife and if losing their partner had
impacted this view in any way. Four of the men held a
traditional view of the afterlife that incorporated a heaven
and hell. Four other men thought of the afterlife as “ a
better place." Two participants believed in reincarnation or
a continuation of their loved one’s spirit in another form on
earth. Two other participants had no beliefs about the
afterlife. Kirk said that he did not have a view as he was
“simply incapable of understanding what it could be like."
And Carl said that he believed that there was nothing:

And that’s the hardest part of the mechanics of death to
understand...if you respect this guy so much, that he can
just go to sleep and it all stops. I think that Christians
don’t want to buy that, that’s just too hard to handle. It’s

like your computer, when you pull the plug, it goes off. When
you shut the blood off, it went off. (He) just doesn’t exist

anymore.

Two thirds of the participants did not believe that
coping with the death of their partner had impacted their
'view of the afterlife. Their views held constant through this
experience and, for most, served as a source of support in

their grief. But, four men acknowledged having thought more

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deeply about the afterlife and'where their loved one was

through this experience. Patrick and Matthew had these
thoughts:

I had a lot of different beliefs...and tried to figure
it out. What is he doing now...’Are you going to a light? Are
you floating somewhere in a corner, watching me?’ And I think
that’s why I made religion more personal after the fact.

Patrick

I might not even have this particular opinion at this

point in my life had it not been for going through this

experience with Jack. So, I think this has brought a
spiritual awakening in a sense to me, which is good. Matthew

9221.93

In this section, questions focused on strategies that
participants utilized to cope with their partner’s death. I
also asked participants how they might cope differently now,
as they retrospectively look back on their loss. The final
question of this section asked them to identify the most
difficult aspect of their loss.

When asked these questions about self care, four
participants’ first responses focused on “not deserving it"
or “not being interested in it." They were so grief stricken
by the illness and death of their partner, they did not want
to focus on themselves. Two men ended up in the hospital
themselves after their partner’s death.

Steve said that cognitively he could accept the absence
of his wife but not emotionally. “I couldn’t adjust to it,"
he said. And one of the ways he coped was by considering

suicide:

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That summer after she died, I took one run at suicide...
it was kind of feeble. I was riding my bike...I heard the
train blow...and I thought, ’You know, I bet if I keep riding
at this pace, I’ll get to the tracks about the time the train
does and then I wouldn’t have to worry about a thing.’ .And
so I kept on riding. And I kept saying, ’This is
irrational...the children will be very upset’, but I also
kept hearing, ’I feel so goddam bad. My life is worthless
now. You could get out of this pain’ ...I came right up the
hill and there was the train like 100 yards away and I
thought, ’This is really neat, he hasn’t got a prayer of
stopping...I pedaled in front of the train but then across
the road. That half mile I rode thinking about the train felt
good. I could get out of this pain, the intensity of the
pain that I was feeling.

Mark acknowledged that he didn’t do a very good job of
focusing on his needs, on remembering to take care of
himself. And this was the result:

Even before I lost Patty, when I was taking care of her,
there’d be times when I’d have chest pains and couldn’t catch
my breath. I wouldn’t tell anybody...not my kids, not her...I
didn’t want anybody to know because I wanted to take care of
her...then after I lost her, I didn’t eat right, didn’t sleep
right...the grief of losing her, the stress...and that’s when
I ended up in the hospital.

Strategies of coping that participants implemented fell
into two categories: attending to physical health and
supporting mental health. Seven men acknowledged focusing on
their physical health as a.means of self-care. They
attempted to do this by getting a physical, eating better,
taking vitamins, and exercising regularly. Six of the
participants attended to their mental health by seeing a
therapist individually, joining a support group, journaling,
and reading books.

‘When asked to retrospectively examine how they might

cope differently, five participants stated that they'would

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attempt to facilitate their own grief more effectively. They

‘would try to allow themselves more time to grieve and/or seek
out better support systems for their grief. Rick
acknowledged this in his comments:

I think I*wou1d have been gentler on.myself...instead of
trying to rush the grieving or setting a timetable for
grieving, just acknowledge that its gonna take some
undetermined amount of time. And I think...toibe more
consciously aware of the fact that I was grieving...probably
gotten some help sooner about what are the signals of grief.

What was the hardest part of their loss? Eleven of 12
participants acknowledged that loneliness was the most
difficult aspect of losing their partner. They missed having
the other person as ”an energy source," ”someone to talk to,"
or ”physical contact." Matthew had been composed through the
entire interview but when asked this question, he became
tearful, saying:

WOw...just actually realizing and accepting the fact
that there isn’t a chance that I could open the door and Jack
would be there. I’ve just not gotten that far yet. The
aloneness is the hardest adjustment...and the realization
that there is no hope...I’m.a very hope filled.person and
there is no hope that Jack will return...in the physical
being. But I’m.trying to shift my thought process to the
idea that there is hope of a reunion in the future...in the
continuum of life.

Andwaas the only one who identified another experience.
Although he clearly missed Frank and was lonely, Frank’s
family had treated him so badly that angeeras most prominent
for him. This overshadowed his loneliness and seemed to

further complicate his grieving process:

His family, without a doubt...as painful as it was to
lose Frank, I lost his whole family. He was an only

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child...his mother and father are living and he has two adult
children. Throughout the years of our relationship, I was
supposedly seen as a loving family member, seen as their son,
seen as their father...when he got sick, within the last six
months of his life, his whole family turned on me and I was
the bad guy. They caused me so:much pain, stress,
aggravation, anger, hatred, and to this day it’s still going
on. When I met Frank, he didn’t want a thing to do with his
mother and father and his kids. I was the one to foster the
relationship, I was the one that went out and bought birthday
presents, the Christmas presents, wrapped them...forced him
into family situations and everything else. And for his
family to turn on.me the way they did, hurt me almost as much
as Frank’s death.

Advice/Reflectippp

In the last two sections of the interview, I allowed
interviewees to offer additional information about their
experiences. First, I asked participants to provide advice
to professionals who work with grieving men. What was
important for them to know? Second, I asked a general
question that addressed unasked for information that
participants felt was important for me to know in
understanding their experience. There was considerable
overlap in the themes that emerged from responses to these
questions so the data have been aggregated into one section.
Participants responses fell into two categories: individual
grieving factors and the influence/response of others on a
person’s grief.

Four themes emerged from their reflections on an
individual's experience of grief. These themes were (1)
grief is individual; (2) grief is ongoing; (3) grief feels
out of control and (4) a relationship with the deceased

continues. These themes will be further expanded below.

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Five of the participants emphasized that grieving is

very individualized. Although people may compare their own
grief to that of other people to discern the “correct" way to
process a loss, this is a futile effort. These men had
discovered that although there may be commonalities of
experience, there are also unique aspects to a person’s
grieving that cannot be captured by models or stages. As
Gary noted:

It’s important to allow a person the opportunity to deal
with things at their own pace rather than try to fit someone
into these little steps...’You’re gonna go through this
period and then you’re gonna go through that period.’ It
doesn’t seem like anything I’ve ever felt has fit into any
little set model...I think it’s such a personal experience.

Gary, Brendan, and Steve noted that their grief is
ongoing. They had anticipated a faster end to their
bereavement, that they would get beyond their loss more
quickly. Their grief did not resolve as they had expected it
would. Brendan had these thoughts:

It’s critically important that (the bereaved) understand
that its gonna be a long, slow, hard process. You’ll digest
everything that happened. It’s probably the most commonly
occurring thing I hear (from others)...’I really thought I’d
be a lot farther down the road. I didn’t know it would be
this long, slow, and hard.’

Five participants noted that their grief felt beyond
their control at many times. As much as they tried to stifle
or manage their grief, their feelings seemed to have a life

of their own. Their grief was unpredictable...and this was

very difficult for them to manage. Patrick summarized the

115
ups and downs he had seen in himself and others who are

bereaved:

Today they may be nice, tomorrow they may be whiny, next
day they’re going to cry, next they’ll complain all day, then
they’ll be really mean and finally they’ll be a sweetheart
again...that can happen within one day, I found.myse1f doing
that within a few short hours.

Four participants noted that, contrary to their
expectations, a relationship with their deceased partner had
continued beyond their death. They talked about struggling
to categorize the relationship*with their partner, that they
didn’t want to put an end to it or pretend that it hadn’t
happened. Matthew acknowledged in the interview that he was
still processing his relationship with Jack:

Reaffirm in the grieving person that their being is now
different than it was during the relationship but to not have
the fear that because the relationship is no longer that
they’re giving up on the person who’s deceased. Memories may
dwindle over time and physical remembrances may disappear,
but your life has been changed by the relationship that you
were in with that person and that’s a good thing. That is a
part of your being that no one can take away, that you’ll
never lose...that’s something to take comfort in.

Other responses in this section reflected themes
centering on the influence of others on an individual’s grief
experience. Seven of the participants noted that men often
receive the message that they need to be strong and
independent. If they follow that message, this could
complicate their grieving as it would not allow them to be

open to support from others. Matthew noted this in his

comments 8

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No matter how much equal rights activity is going on,

and how much particular roles are played down, the way of the
world today is the man is still expected to be strong all the
time, through all circumstances to be the leading force, the
guiding light, to know what’s going on. And (now I believe)
its okay to experience things, to accept the fact that I have
no idea what’s going to happen next.

Four men recounted how important it is to hear from
others that they will get through it. At times, they lost
hope or wondered if they were going crazy, wondered if they
could possibly survive. They needed reassurance from others
that they can go on with their lives, that things will get
better. Patrick stated:

Let them know its going to be okay...1ike ’I don’t know
what it is you’re going through but if there’s anything I can
do, I’m there for you, and you will get better’. Somebody to
reinforce that survival instinct.

Three of the men noted the importance of allowing
happiness back into their lives when they were ready. They
had received the message, either from internal thoughts or
from.other people, that it was not permissible to have fun,
to enjoy themselves. When they did have fun, it was as if
they had broken a rule or were behaving inappropriately.
Brendan’s comments reflected this struggle and how he dealt
‘with his children around this very issue:

My daughteeras feeling really guilty about going out
and riding her bike. She asked, ’Can I go out and do fun
stuff?’ Its like (yes), do the fun stuff. We go canoeing, we
always did as a family and still do...four of us instead of
five. Do some of the fun things if you have the strength and
energy, do it. Because there will be times you’ll damn wish
jyou could and.you don’t have the energy or the focus, the

pain of the burden is so great you can’t get out from
'underneath it. Its okay to try to carry on and enjoy life.

117
Three participants noted the influence of family members

on their grief. This included both their children and

extended family. Children seemed to have a positive influence
on both participants that mentioned them. Their kids had kept
them going during the most difficult times. Kirk noted this:

It makes a huge difference in the person’s life if they
have someone else depending upon them. I would think that
the grieving process would be different if your spouse was
your only (responsibility), if you had no children. I think
that feeling that you (could) just get up and walk away,
change environments totally (could) lead to something
absolutely stupid. I think without something, in my case
children that I was very concerned about, it would be even
harder to hold it together, to find a duty, an organizing
principle in your life to keep you together until you’ve
gotten over the worst of your grief.

However, those participants whoimentioned the influence
of people outside the immediate family had a negative
experience. These relationships further complicated their
grieving process. This does not reflect the negative
influence of all extended family but highlights the
possibility that these relationships can.make the surviving
partner’s life miserable. Brendan mentioned this in his
comments:

I have zero support frompmy in-laws. Zero from.that
side of the family. They’re all probably madder than hell
because the way that we dealt with the'whole issue. I dealt
with (her) death and dying the*way she wanted it dealt with,
which wasn’t the way I wanted. She excluded a lot of
people...and of course they’re bitter and I’m the guy left so
I kinda take the brunt.

Two of the six gay men felt that their relationships
were not valued, that they were not seen as equal to

heterosexual relationships. This frustrated these men as

118
their partners were dying and after their death. Carl and

Andy emphasized that gay partnerships need to be seen as
committed relationships of value. Carl stated:

While we might say its so endearing to see those guys
care for each other, I think as a society we haven’t come to
the realization of the value of (gay) relationships. And I
think even among some gay people that doesn’t happen. I think
that we don’t understand (these) relationships well.

Earlier in the interview, he had noted the reaction of others
to Richard’s death, that they failed to recognize the depth
of loss he had experienced:

I think in some respects some of them treated it no
different than if I had put my dog to sleep.

While five of the participants had lost a partner to
AIDS, only one stated that he was HIV+ himself. Andy had a
unique perspective to offer on the grieving process as he had
processed not only his partner’s death but the reality of his
own mortality. He talked about feeling angry with his
partner as Frank had only focused on himself during his
illness and failed to recognize the difficult position that
Andy would be in after Frank died:

One of the interesting things about Frank throughout the
three year span from diagnosis to death was that he acted
like he was the only one in this...it didn’t involve me,
emotionally or physically...and I’ve got the virus too. He
only saw it from his perspective. One night we were talking
about it and he was in his little pity pool., And I said,
’You know, there's one thing you haven’t even said here.
Chances are you are gonna die before me and I’m.here for you
every step of the way until you die. Who’s going to be here
for me? Think about me being left by myself to pick up the
pieces.’ I’m.not gonna sweat over it now and feel today's the
day but there are some issues that are very pertinent like
'who’s gonna take care of me?

119
Summapy

In this chapter, themes that emerged from the data in
each section were identified and reified by relevant
examples. Patterns of responses that differed significantly
for heterosexual and gay men were highlighted. Overall,
there appeared to be considerable overlap in the experiences
of these men, regardless of sexual orientation. In the next
chapter, these results are further integrated and compared
with extant literature in light of the questions motivating

this inquiry.

RESULTSZ

The purpose of this chapter is to analyze the data at a
conceptual level. Participants’ responses have been
summarized in Chapter Four and this chapter seeks to find the
meanings imbedded in their responses in light of the
questions motivating this inquiry. Where appropriate, current
literature is compared and contrasted with results. The
chapter is divided into two sections. Section One addresses
the research question: What is the experience of men grieving
the untimely death of a partner? After reviewing the
demographics of the sample, the data relevant to this
question are examined under the topics of (1) Relationships
(2) Seeking help and coping (3) Self (4) Previous losses and
(5) Grief. Section Two summarizes data relevant to the
research question: What is the impact of sexual orientation
on grieving? Data are examined in this section as follows:
(1) Impact of AIDS (2) Relationships (3) Work (4) Religion

and (5) Previous losses. The chapter closes with a summary.

Section One: What is the experience of men grieving the

untimely death of a partner?

Demographics
Before proceeding to examine data relevant to this
question, I believe it is important to first consider the
participants’ demographics. There may be ways that this

sample is unique and therefore not representative of the

120

121
entire population of men. The reader must be aware of these

differences and view my conclusions in light of these
factors.

Due to the sensitive nature of this inquiry,
participants were recruited on a voluntary basis. Responses
from men who did not volunteer to be interviewed would likely
be substantially different from those who participated.
Stroebe and Stroebe (1989) compared characteristics of men
who initially volunteered to participate in their research
with those who did not. They discovered that men.who
participated in their research were less depressed than those
who did not. This may or may not be an accurate
characterization of participants in this research.

Equally so, men in this study possessed good social
skills (were able to articulate their ideas quite
effectively) and affective skills (were adept at identifying
and discussing emotions). Participants’ well developed
emotional and social skills appear to be in direct contrast
to current literature on men’s issues (Brooks & Gilbert,
1995; Eisler, 1995; O’Neil, 1981). These differences may
reflect unique qualities of this sample, that the type of man
who is attracted to a study such as this has better
social/emotional skills than men who choose not to
participate. Additionally, Mattison and.MoWhirter (1990)
found that the stages of relationships of male couples with
AIDS were accelerated as compared to HIV—negative couples.

Perhaps through coping with their partner’s chronic illness

122
and death, these men became more affectively and

interpersonally aware. Finally, the work of Robertson and
Fitzgerald (1990) and Wilcox and Forrest (1992) may be of
relevance in understanding this finding. Perhaps the lenses
we use to view'men may effect their interactions with us
and/or our interpretation of their behavior. If men are in an
environment (such as the interview with me) that invites
their exploration of affect and encourages their self
expression, they may demonstrate skills that are discouraged
by other people/environments.

All participants were Caucasian and, aside from one
participant, did not emphasize their cultural background in
the interview. .Although culture is an important variable to
consider in the grieving process (Stroebe, Gergen, Gergen &
Stroebe, 1992), these men were either not strongly influenced
by differences in culture or they were unaware of their
differences. Race and culture remained an invisible variable
in this inquiry.

Men in this study were recruited from two cities in a
large midwestern state. Therefore, data are skewed toward
participants from urban/suburban areas. Additionally, nine of
the twelve participants were born and raised in the state
where the inquiry took place (two were originally from.the
Western United States and one was from a Southern state).
Geography may be another factor that is skewing these

results.

123
Relationships: Their impact on grief

In this section, I examine the nature and function of
the relationships of the participants with their partners,
.family (parents, siblings, partner’s family), children, and
friends. The goal of this section is to richly describe how

these relationships were impacted by the partner’s death.

Partner

When asked about the sources of attraction to their
partner, ten of 12 participants commented on aspects of their
partner’s personality or “who" he/she was as a person. Even
the two participants who mentioned physical characteristics
placed greater emphasis on their partner’s personality. As
Carl noted:

All that could go out the window tomorrow if the person has a
brain. I mean I’m absolutely mowed over by intelligence...
that’s what has to work...much.more than the physical thing.

Peplau (1991) reported that men place greater emphasis
on sex in intimate relationships as compared to women. One
might posit that this could lead to an emphasis on sexual
gratification in intimate relationships and.equating sex with
intimacy, as has been noted by other authors (Levant, 1995).
Shapiro (1994) reported that a psychoanalytic model of
grieving emphasizes the gradual withdrawal of love from the
lost “object" so that libido (sexual energy) can be
reinvested in a new object. If men’s experiences were

consistent with this view, wouldn’t they emphasize sexuality

as the main source of attraction to their partner? Although

124
men.may emphasize sexuality in their relationships, data do

not substantiate the view that, when losing a partner, men
can easily seek another partner to satisfy their sexual needs
and in doing so, replace their lost partner. Staudacher
(1991) noted that while some men may engage in excessive
sexuality after losing a partner, they are actually avoiding
their feelings of loss instead of expressing intimacy for a
new'partner.

Levant (1995) reported that men have greater difficulty
with managing and resolving conflict than do women. The data
are consistent with this literature. .Although all the men
reported varying degrees of success in dealing with conflict,
more of the heterosexual men (5/6 successful) indicated that
conflict was effectively resolved in their relationships as
compared to gay men (4/6 somewhat successful). The
heterosexual men seemed to depend on their wives to take the
lead in resolving conflict. Kirk noted this in his comments:

We talked a lot. She was very good in that she would
not permit disagreement to lie. If it hadn’t been resolved,
she wouldn’t let it go. She’d say, ’We’re not done. We
haven’t talked about this.’ And she would get very mad at me
because, at those times, I (became) abstract.

What implications might this have for the grieving
process? In writing about heterosexual relationships Shapiro
(1994) observed that ”if the (pre-existing) relationship was
characterized by conflict...developmental reintegration may
be harder" (p. 37). Unresolved conflict has some implications

for the grieving process and this has greater implications

for gay men that will be addressed in the second section.

125
Additionally, if heterosexual men’s partners do not take the

lead in processing their impending death, these men may find
themselves unable to start their grieving prior to their
partner’s death and ultimately may feel incapable to deal

alone with the conflict of their partner’s death.

Family

When participants were asked about social and emotional
support that they received, they were asked about the
importance/influence of "family". Their definitions of
family varied greatly to include only their current nuclear
family, their biological family of origin (including parents
and siblings), and/or their partner’s family of origin. In
interviews, I attempted to gain insight into the quality and
importance of all of these relationships. Children seemed to
play an important role for those who had kids and their
influence will be addressed in the next section.

Ten of the 12 participants did not experience a
significant change in their relationship with their family
(which included their parents,siblings, and children).
Families/family members that had been supportive of their
relationship were supportive of the participant when their
partner died. Families/family members that had been less
supportive/unsupportive were not available to the participant
in his grief. Matthew noted this in his comments:

My (nuclear) family wasn’t real supportive of the

relationship so I didn’t feel I could talk with my family
very much. My grandfather had died that year so my

126
grandmother and I spoke quite frequently...we helped each

other get through numerous difficult times.

However, two of the participants did experience a change
in their relationships with their families. Brendan and Andy
found that some relationships became closer as a result of
their partner’s illness and death. Brendan saw a change in
his relationship with his brother and found that his brother
became much more involved in his life:

My brother in particular, a tremendous amount of change
for him. He (was) the type of guy that was a big partier and
let’s avoid responsibility at all costs. But he saw what was
going on with Eileen and I and decided to help us in any way
he could.

Andy acknowledged that during his relationship with
Frank, he emphasized developing connections between Frank and
his family to the neglect of his own family. Once Frank
died, Andy reconnected with his own family and found that
they were a tremendous source of support and affirmation:

I poured all my time and energy into Frank’s family and
put mine on hold for ten years. I have a lot of guilt for
that but I’m making up for it in these last two years.

The data illustrated a different conclusion about
relationships between the participant and his partner’s
family (parents, siblings,and children). Over half (7/12) of
the participants experienced some change in their
relationships with the partner’s families and all these

changes were perceived as negative. These changes varied

from feeling uncomfortable around their partner’s family, as

127

noted by Rick and Ted, to intense conflict with their
partner’s family, as recounted by Brendan:

The people that I wanted to share the most with were
Keith’s family, because they knew him...they knew him.better
than anyone and were there through thick and thin. But to
this day they won’t talk about (him). Rick

My wife has one brother and sister (living). Now that
she’s passed away, the brother is quite close. But the sister
can’t face me very well. When I come over, she’s distant

because it reminds her of her sister dying. So, I don’t go
back. Ted

Her side of the family have not lifted a finger except

to throw darts (at me). But their lives go on just like they
always did. Ours are totally changed forever. Brendan

Children

There are a lot of day to day issues that someone in my
position, having lost my wife, having three kids here to
raise, day to day issues that are taken for granted by people
trying to help you. Brendan, 39 year old father of three

Nine of the participants had children involved in their
relationship with their partner. Seven of the participants
had children of their own and two had relationships with
their partner’s children from a previous relationship. The
powerful influence of children on the grieving process was
manifest in the data. Having children in the home versus
having grown children appeared to impact the participant
differentially.

Shapiro (1994) noted the influence of children in the
home when a spouse dies. ”Although children in the home can

assuage feelings of loneliness for the bereaved parent, the

demands of child rearing are likely to interfere with the

128
process of creating a new adult life structure" (p. 40). Two

participants were left to raise young children by themselves.

Kirk’s and Brendan’s experiences resonated with
different pieces of Shapiro’s observations. Although their
children were a source of support, these men were more
focused on giving support to their kids as opposed to
receiving it. Kirk found that having children to take care
of gave him a reason to keep going. Although Brendan found
that this was true, he acknowledged the effect that children
had on his social life. Their comments speak for themselves:

I think it makes a huge difference in a person’s life if
they have someone depending upon them. If you had no
children, I think (you’d have) that feeling that you could
just get up and totally change environments. It would be
really strong. Without something, in my case children that I
was very concerned about, it would be even harder to hold it
together, to find a duty, an organizing principle in your
life to keep you together until you got over your worst
grief. Kirk

It’s difficult for me to have a social life, it’s so
much work. It takes a lot of time preparing the kids,
whether they’re coming or not. All these things have to be
done when you’re married, (but) it happens a lot quicker.

Brendan
Although having children seemed to give Brendan a purpose to
keep going, it kept him from developing socially.

Of the remaining five participants that had grown
children, four acknowledged using them for social and/or
emotional support. Carl’s children were living at a distance
from him and, although he may have found these relationships
important, he did not seek to gain support from his kids.
Mark, Ted, Steve, and Rick acknowledged the important role

that their kids played in their recovery process:

129
I don’t know how people make it without kids. I really don’t

know how because my kids have been real supportive, you know,
and give me good support. I always say I wouldn’t make it
without them...they’ve been good to me. Mark
The children came home from school. Victoria regulated their
behavior. They came as much as she wanted but she wanted
them to continue their lives. But, they did come often and
still do. My son was here last night just to talk. The
children are very close (to me). Steve

However, there were limits to the amount of support that
some of these men were willing to take from their children.
Mark noted that he made a conscious effort not to depend too
much on his kids, apparently so he wouldn’t be seen as an
interference in their lives:

I don’t think you should lean that heavily on your kids.
They are there to support you and they will help you in their
way if you let them. (But), I didn’t ever go to my kids in a
down mood and I didn’t go say ‘Can I stay over tonight?’, I
didn’t do that, as lonely as I’d feel.

Ted found that although he could receive help from his
children at many times, there were limits to their ability to
help. He found that when he tried to talk with them, he
would only get them upset. He learned to get more of his
emotional support elsewhere for this very reason:

The kids, I could talk to my kids but every time I
talked to them, they would be crying just as bad as I was. I
couldn’t help them and they couldn’t help me, (aside from)
crying on each other’s shoulders.

Staudacher (1991) reported on observations of a men’s
group facilitator on the effect of children. This
facilitator noted that the men felt some support from their

children, but they didn’t feel free to depend on them.

Staudacher also highlighted the problems faced by some men in

130
communicating on an emotional level with their children, that

instead of assisting each other in grieving, fathers and
children can simply exacerbate each other's grief process.

These data demonstrate the importance of understanding
the family system of the grieving person. The nuclear family
of the griever, as well as his family of origin and his
partner's family of origin can facilitate or complicate the
grieving process. Brendan, who had experienced intense
conflict with his partner's family, noted the importance of
the family system in his recommendations to counselors:

It would be nice if, as a counselor, you could get into
the family structure outside the immediate family that has
the loss to get to some of these other folks. I offer these
things because I have zero support from Eileen's family. She

excluded a lot of people and of course they're bitter and
because I'm the guy left, I kinda take the brunt.

Friends

Participants found friends to be an important source of
emotional and social support during their partner's illness
and after his/her death. As noted in Chapter Four, friends
were listed by nine participants as a source of emotional
support from friends and by ten as an important source of
social support. Two participants did not emphasize friends as
sources of support but this seemed to be connected to their
personality style as opposed to the unavailability of
friendships. Both Matthew and Kirk seemed.more comfortable
being self sufficient and preferred to serve as their own

primary source of support.

131
Andy's case serves as an excellent example of the

important function of friendships. He had been forbidden by
Frank to talk to anyone about their HIV status or about
Frank's health status. However, as Frank's health began to
worsen, Andy was unable to carry their secret any longer:

There were two friends that I told the truth about a
year prior to his death because I just couldn't keep it in
anymore. And though he was really mad at me at first,
(eventually) he was really relieved because he used those
friends too during the last year of his life to get things
off his chest. And they were there for us, almost every
weekend. we did a lot of things together during his last
year. We were always close but in the last year of Frank's
life we had gotten a lot closer.

Gary found that he and Kurt were buoyed up by an
excellent network of friendships. Contrary to Andy's
experience, Gary felt that his partner had worked to develop
this network so that Gary would have people to support him in
his grief:

I think the only thing that really helped us through it
was having an amazing group of friends, very supportive.

Kurt really pulled us all together. He helped prepare the way
for his death by getting all these people involved in our
lives.

However, friendships were not without their problems.
Five of the participants reported negative changes in
relationships with friends. Participants found that some
friends “drifted away" or avoided them after their partner’s
death. At a time in their lives when they needed support the
most, participants found that these friends seemed unwilling

and/or unable to'be there for them.

And what I'm finding is that friends see this strong
Carl who isn't intimidated. So when I sit there at dinner

132

with them and tell them I'm scared to death or I don't feel
as strong as I used to, they can't handle it, they can't
relate. They don’t want to hear it. Carl

After a period of time, your very closest friends
sometimes seem to depart from you. At first, you have a lot
of friends. But then because you're one lone person, you're
like two thumbs one hand. (Contact with them) seems to
diminish and pretty soon they've just about dropped you,
except for the really close friends. Mark

That's what shakes you up because...I'm alive now and a
lot of people did see my wife in the hospital so it wasn't
that people didn't see her when she was alive. But the
illness is what brings them to you rather than friendship.
Because where are they now? Ted

Staudacher (1991) stated that, “one of the:most valuable
sources of support a man can have following his loved one's
death is the genuine friendship and companionship of another
man or men” (p. 201). While some of the participants noted
the importance of both male and female friendships in their
grief process, three of the participants specifically
mentioned the lack of support they received from some/most of
their male friends. Gary and Rick noted that some of their
male friends were unable to give them the emotional support
they needed. Gary had this comment:

We really discovered who our friends were and.most of
them were women. The people that were the most supportive
were the women friends. Most of our male friends just
couldn't deal with it.

Rick found that many of his male friends were lacking in
their ability to provide social support:

One of the things I couldn't let go unsaid (at the
funeral) was that the women in (the gay) community are truly
the caregivers and the nurturers. Gay men or men in general
say, let me know if you need help. The women don't do that,

they just do it. They know you're not gonna call. They just
show up.

133
Although men may value the companionship and support that

they can potentially receive in relationships with.male
friends, some of them.may find their friends to be incapable
of providing the support they need. Male socialization may
inhibit men's abilities to deal with their own emotions or

those of their friends.

1%

”Whether bereaved individuals can rely on their families
and friends to stand by them and help them in their distress
is likely to be an important moderator of bereavement
outcome" (Stroebe & Stroebe, 1987, p.215). Participants in
this study seemed to experience adequate emotional and social
support from family and friends. However, at times, they also
experienced lack of support in these relationships,
especially in regard to their partner's family.

Lopata (1993) found that both friends and children were
the most frequently cited sources of social support for
American widows but children (60%) were much more frequently
identified as sources of emotional support as opposed to
friends (10%), siblings (10%), or other relatives (9%). In
contrast, men in this study relied more consistently on
friends for both emotional and social support with some
support noted from children and siblings. This difference
may simply be an artifact of the participants in this study
or it may be indicative of a gender difference in parental

relationships with children. Future research will be needed

134
to examine these variables in greater depth. These

relationships significantly impacted the participants
grieving process/level of social support and are an important
consideration in understanding participants' grieving. In
advocating for a systemic approach to bereavement issues,
Shapiro (1994) noted the importance of relationships in the
lives of bereaved family members:

The systemic developmental model of family bereavement
is meant to extend a clinician’s awareness of a grieving
individual's developmental stage at the time of death and the
impact of death on the individual's web of life-sustaining
relationships (p.18).

Seeking help and coping

In this section, I examine issues related to how
participants sought emotional/social support and their coping
strategies. Relationships with family and friends are not
the primary focus in this section but they are examined to
consider factors that may have complicated their use as
sources of support. Support groups and their helpfulness to
participants are explored. Strategies that participants

utilized to cope are compared with predictions from extant

literature.

Emotional support

Participants acknowledged that children, other family
members (i.e., sibling, parents), and friends served as
important sources of emotional support. However, some

obstacles remained in the ability of these men to seek and

135
receive social support: (1) they experienced some emotions

that they were not able to share with anyone and (2) some
people/situations kept them from sharing.

Seven of the participants acknowledged that there were
some emotions that they were not able to share with anyone.
Matthew, Kirk, Gary and Patrick noted that it was the intense
emotions of grief that there were not able to share with
others. Patrick was often surprised by how overwhelming his
feelings of loss were and he wanted to experience those when
he was alone:

A lot of times it surprised me that it was so
animalistic...the grief, the pain, the cry was so guttural.
You know, it's from so deep within...and I did all that
private...when I would cry like that it would be in private.
Rick, Brendan, and Carl identified specific feelings that
they chose not to share with others. Rick did not talk about
intense guilt he felt around the circumstances of his
partner's death. Brendan could not talk about the intense
loneliness he experienced since Eileen's death. Carl could
not share the intensity of his feelings of vulnerability. No
one was able to support them in dealing with the above
feelings.

Nine of the participants talked about intrapersonal/
interpersonal dynamics that appeared to inhibit their ability
to seek/receive emotional support from others. All nine men
indicated that they were in some way protecting other people

from their grief or from other aspects of their lives. Ted's

136
comments are an example of this. He talked about protecting

his daughters from the intensity of his grief:

I could talk to my kids but every time you talked to
them, they would be crying just as bad as I was...and it was
no help...(we could) cry on each other's shoulders but I
couldn't help them.and they weren't helping me.

However, three of these men also seemed invested in
protecting themselves and the ways they were perceived by
others. Patrick's comments are representative of this:

I might not be as frank as I would like to be or I don't
feel quite at ease to speak what I'm truly feeling. Perhaps
for fear of pushing...as far as my family goes, they are
somewhat accomodating of my lifestyle, somewhat not. And I'm
afraid that if I say too much, I might push them farther away
and right now I need to be careful because my family is all
I've got.

Pollack (1995) and Eisler (1995) noted that the results
of gender socialization likely inhibit men from.expressing
emotions and seeking emotional support, especially when
experiencing ”emotions of warmth, caring, sadness, and.pain"
(Pollack, 1995, p.44). Staudacher (1991) and Wolfelt (1990)
asserted that many men will encounter difficulty in both
experiencing and expressing emotions of pain and
vulnerability after the death of a loved one.

Although the men in this study were adept at expressing
their emotions, many of them still encountered some
difficulties when attempting to seek emotional support from
others. Pollack (1995) and WOlfelt described how social

influences shape young boy's experiences to discourage the

expression of affect. According to these data, social

137
influences still assert a powerful effect on these men and

their ability to gain emotional support.

Social suppprt

Men in this study were able to access numerous sources
of social support. Family and friends as well as community
support groups aided participants in their adjustment.
However, these sources of social support were not all

perceived as positive influences. These dynamics are

described below

Family and friends.

Participants reported that they had received social
support from children, other family members
(siblings/parents), and friends. When asked to identify the
most important source(s) of social support, nine named
friends, five identified family, and two replied “self." Yet
some problems did exist in their support system and could.be
identified as (1) negative changes in relationships (2)
inadequate support system.

Brendan and Andy experienced intense conflict‘with their
partner's families after their partner's death. (At a time
when these people could have been tremendous sources of
social support, these family members became antagonistic and
even disruptive of these men's lives. ‘When asked what had

been the most difficult part of his loss, Andy stated:

138
His family, without a doubt. As painful as it was to

lose Frank, I lost his whole family. And throughout the ten
years of our relationship, I was supposedly seen as a loving
family member, seen as their son, seen as their father. When
Frank got sick, his whole family turned on me and caused me
so:much pain, stress, aggravation, anger, and hatred.

Shapiro (1994) described the importance of attending to
the changes that occur in family relationships after the
death of a loved one. These men's negative experiences with
their partner's family highlight the importance of a systemic
perspective in understanding their grief. Instead of being a
source of support, the relationship with their partner's
family was a factor that complicated their grieving.

Matthew, Danny, and Kirk did not have a very large
support system but for different reasons. Matthew and his
partner, Frank, seemed to have focused,mostly on each other
during their relationship to the exclusion of other people.
This left Matthew without much support when Frank died. Danny
and Kirk appeared to depend upon their wives for making
social connections and developing friendships. Once their
wives were gone, their connections with the social support
network were tenuous at best. Kirk saw friends moving away
from him.but didn't seem interested in pursuing these
relationships or gaining their social support:

Even people‘who were very close friends have gradually
just disappeared. And I've never been one to talk to people
anyway. There are (just) a couple of people that I can talk
to at work every now and then.

Wolfelt (1990) reported that socialization encourages

men to be self-sufficent and discourages them to seek or

139
simply accept support from.others. Staudacher (1991)

acknowledged that widowers who depended upon their wives for
social contacts often become reclusive and engage in a
variety of solitary, passive activities to structure their
day. WOlfelt’s and Staudacher's observations seem accurate

for these three participants.

§EEEQ£E_Q£QEE§;

Three patterns emerged from these men's experiences
around seeking and becoming involved with a support group.
There were men who attended a support group, felt buoyed up
by this experience, and continued to attend. Brendan, Mark,
and Ted found this to be true. Brendan commented on what he
found helpful about the group:

(I valued) the support you get from sitting in a room
with a dozen people who are in the same hole you're in.

We're all at different depths in that hole, based on time and
our various tools that we have to help pull us out...When you
watch people who are really suffering every bit as much as
you are, right to the very core of their being, get stronger,
get better and actually say, 'I don't need this anymore, I
can go on by myself....you go, 'dammit, I'm next or its gonna
be me pretty soon.

Some participants had tried attending a support group
but did not stay for a variety of reasons. Matthew attended
a time limited didactic grief group, finding it full of
valuable information. But when he tried to locate an ongoing
support group, he couldn't identify one that would fit his
needs (at age 27). Danny, Patrick, and.Andy all tried

attending a group but left after a fewHweeks. Danny found

140
the group ”too cliquey" and that it was not appropriate for

him. Once his partner died, Andy responded this way:

I just felt like, 'Now that I've lost my partner, I need
to go to this bereavement group. I just thought it was
something I was supposed to do. I only went a couple of
times because it was more of a lecture and I don't like
sitting in a room getting lectured to about bereavement and
grief. So, I only went twice.

Patrick said that when he arrived at his first group
meeting, he heard a man speak who had been attending for
seven years and who still appeared to be emotionally
distraught. He never returned to the support group, but
noted:

It was helpful to me...because I got there and decided
that I don't want to be here in seven years. I am not going
to dwell on this for seven years. It is a major part of my
life (now) but I don't want that to be the focus for seven
years.

There was also a group of men who did not feel motivated
to join a support group. Their reasons for not attending a
group seemed to be that either they believed that the group
couldn't offer them anything (“didn't need it"/ “wouldn't
benefit from it") or they would not find people similar to
themselves in attendance (“wouldn't fit in").

I felt like I didn't need it. I thought I was getting a
little bit of support (from friends). Looking back on it, I
probably should have or could have gained something from
being in a support group. Gary
Kirk noted that he felt as if he could get just as much from

reading, journaling, and studying by himself. He didn't feel

the need to go and share with other people. It was

141
beneficial to know that assistance was available if he really

needed it.

I think I’m able to take comfort in the offer itself.
And that alone is enough not to feel totally isolated.

Several factors seemed to influence the reactions of
these men to participating in a support group. Premorbid
personality, structure of the support group, meeting
activities, and composition of group membership were among
the factors that seemed to be influential in determining if a
man pursued a support group and if he stayed with it. This
highlights the within-group differences that were present in
the participants and likely reflects differences in the
larger group of men. Wilcox and Forrest's (1992)
recommendation to view gender issues flexibly seems
particulary pertinent when considering the idea of
appropriate interventions for men in grief.

Alexander and.Parsons (1982) identified three
interpersonal styles that vary on their need for both contact
with and independence from others. They labelled the three
styles as engaging, midpointing, and distancing. Participants
in this study appeared to reflect each of these styles,
influencing whether they chose to attend a support group and
the type of support they sought. Lieberman (1993) noted that
although grief support groups do share some common elements,
there are unique elements to each group that influence the
group process. This highlights the importance of attending to

different interpersonal styles and different group structures

142
when practitioners are referring to or designing support

groups or other grief interventions.

gem—ma

Participants were asked about their coping strategies
for dealing with the death of their partner. Five
participants reported that they were not interested in self-
care when their partner died. For some, these feelings
remained for nearly a year whereas for others these were
acute, transient feelings that waned within a few weeks. Two
of these men ended up hospitalized themselves shortly after
their partner's death. Mark's story typifies the attitude
that these men brought to self-care. When asked what he had
done to care for himself, Mark responded:

Well, I guess I didn't do a very good job. Even before
I lost Patty, I felt these heart problems starting to
develop. In fact, there'd be times when I’d have to lay down
because I was having some chest pains and couldn't catch my
breath. I wouldn’t tell anybody..not my kids, not her. I
didn't want anybody to know cause I wanted to take care of
her. So, I did. And then after I lost her...as the weeks
went by...it finally got to me. That's when I ended up in the
hospital.

Coping strategies utilized by these men (eventually) and
other participants targeted physical and/or mental health.
Nine of the participants engaged in ways to take care of
physical health including getting a physical, eating a

balanced diet, taking vitamins, and exercising. Seven of the

participants pursued support for their mental health through

143
participating in individual therapy, joining a support group,

journaling, reading books, and listening to/playing music.

One third of the participants acknowledged additional
coping strategies: that they had been/were currently on
medication to help them cope with the death of their partner.
They reported needing the medication to help them deal with
the stress, anxiety, and/or depression that they were
experiencing. Danny noted why he was put on.medication:

As for depression, the doctor has put me on medication
for that...it seems to help. He put me on it about a year
and a half before she died because I was dragging rock bottom
and I needed something so I could cope with day to day
pressures at home and at work, get my rest at night, and
maintain.my sanity.

Danny was interviewed simeonths after his wife’s death and
he was still taking medication at that time. Two of the
other participants stated that they had a drink just after
their partner died to “try to calm.down a little bit and
relax." .Although they seemed to be using alcohol to self-
medicate during a stressful moment, this did not appear to be
a consistent pattern. None of the participants acknowledged
using alcohol/illegal drugs excessively.

Many authors highlight men's difficulty with nurturing
both themselves and others (Brooks & Silverstein, 1995;
Fanning & McKay, 1993; WOlfelt, 1992). WOlfelt asserted that
men often are incapable of self-care or self-nurturing.
Brooks and Silverstein recounted.men's ”physical self abuse"

that results in an increase in use of alcohol/tobacco, an

increase in accidental injury, and a lack of attention to

144
preventive health care. .Although these statements reflected

the experience of some of the participants initially, all of
them eventually came to recognize the importance of some
aspects of self care, both physical and/or mental health.
This may indicate that the type of man attracted to a study
such as mine is good at self-care. These data may also
reflect how'men's views of self-care are changing for the

better.

W

Differences existed in participants' abilities to seek
help and cope. Some men were more adept than others at
utilizing family and friends and community groups to receive
support. Although the men utilized different coping
strategies, none of the participants acknowledged using “dark
sided" male coping strategies (Brooks & Silverstein, 1995),
such as drugs/alcohol or excessive sexuality, as ways to

manage their grief.

Self
Both positive and negative changes in the sense of self
were noted by participants. Schneider (1994) reported that
changes in “self" are a consequence of losses in our lives.
"we may find ourselves saying, “This is the new me. I've
never thought about myself (in this way). Such statements
reflect our struggles with defining and sometimes losing who

we are" (p.47). Yet, in his model of grief, he also asserts

145
that losses can produce transformations in our lives and in

our identity. “By admitting what no longer is, we can find
out what remains and what can grow from it" (p. 267).

All participants reported dramatic changes in their
sense of self as a result of the loss of their partner.
These changes seem to parallel aspects of Schneider's model
of grief. Some of the men focused on a part of themselves
that was no longer (what is lost) while others emphasized
ways that they had grown positively since their partner's
death (what is possible). Some men identified changes in
their identity that incorporated both of the above.

Two thirds of the participants reported negative changes
in their sense of self after their partner's death. These
changes included feeling as if they had lost an important
part of themselves, losing their self-confidence and/or
reporting that they lost their sense of direction in life.
These changes were intensely painful for these men and all of
them appeared to still be struggling to deal with the “void"
or feeling of being an “empty shell" left by their partner's
death. Here are some of their comments:

(Friends) have this persona (of me) in mind and what
they don't realize is that a lot of it was Richard. It
wasn’t just me. Because when I opened my mouth, Richard was
there too. And they're attracted to this person...Richard
used to say 'Nobody intimidates you.’ And I don't get
intimidated in situations where people would. But all of a
sudden there's some chinks in the armor a little but and I
don't like being intimidated. Carl

Just a sense of losing direction for my life and my
goals for the future. I still look forward to getting old
and doing things but there's an emptiness there. There's a

part of my being that's not there and I don't feel as
complete as I used to. Matthew

146

R:I remember feeling depressed when he died that I had
lost my sexual partner...and not just any sexual (partner)...
but in terms of a deep and intimate feeling...somebody who I
just know and who knew me SO‘WE could just let it all hang
out. I have in some ways filled the void.

I: How have you filled the void?

R: I've been very busy...part of that's my nature..I'm
just an active person...but part of it is avoidance...filling
the void is avoidance. Rick

Seven participants noted positive changes in themselves
since their partner's death. They have discovered new parts
of ”self" now that they were alone or when they were dating
new people. They also reported becoming more self reliant and
learning to be comfortable being alone. Although they all
noted that they would prefer to have their partner back, they
were able to identify positive changes that had resulted from
their loss. Patrick, Kirk, Andy were among the men noting
these changes:

And I want to go on and make that a part of my history.
I think that the whole process I went through made me a.
stronger person now. (And there had to be a purpose. I think
there's a purpose to everything. I needed that strength and
so that's why I went through it. Patrick

But I worked really hard at the relationship, especially
as her career evolved. And there I lost some parts of me
that I don't mind reclaiming now. And so at this point, I'm
discovering a little bit (about) who I am alone, apart from
supporting another individual or a couple that I was a part
of. Kirk

Since he’s died, its been two years, for the first year
after his death I didn't know anybody in town. Then a year
ago I started meeting people and having a vast amount of
friends. If he had been alive and.we were living here, I
wouldn't know any of these people I know today. And those
friends have said we are so lucky to have you in our lives.
and.we know that if Frank was here, chances are we wouldn't
know you. Andy

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Changes in identity seem inevitable in adjusting to the

death of a partner. These changes can be either identifying
aspects of the self that no longer exist or becoming aware of
personal strengths that had previously gone unrecognized. The
data demonstrate the importance of attending to both the
positive and negative impact of partner loss on a person's

identity.

Previous losses

Stroebe and Stroebe (1987) reviewed extant literature on
the impact of previous bereavement(s) on a current loss. They
concluded that a past loss can either predispose the
individual to a ”poor grief outcome" (more depressed than
others without such a past loss) or ”facilitate a good
outcome" (less depression) (p.201). These authors noted that
the age at which the loss is experienced and the time between
losses seem to be pivotal in understanding their impact on
the current death of a spouse.

Nine of the 12 participants in this study had previously
lost significant people in their lives including parents
(five) and grandparents or other signifiant relatives (four).
However, none of these men felt that these prior experiences
prepared them to deal with the intensity of their current
loss. Steve's and Ted's comments addressed this issue
directly:

Even.my father's death, which was five years ago. Yes, I
had had the experience with death and in working on

remembering. That I thought was important...saying the
person's name was important. All of that was helpful to the

148

family and me. But the intensity of losing Victoria was
like...50 times more than losing my father. Steve

I was upset that my parents died and I've had lots of
deaths in the family like everybody else has had. But I've
never grieved for (them) because I didn't know there was such
a thing as grieving. When it's your own companion, they you
say 'What is grief? What am I doing? Where am I at?’ Ted

The data do not demonstrate that these previous
experiences with loss facilitated or exacerbated the current
grief of these men. Patrick experienced numerous losses
concurrent with the death of his partner. Since he is a gay
man, his reactions will be addressed in Section Two of this
chapter. Three participants did report learning positive ways
to deal with grief from these previous experiences. These
included learning to ”just be there" and learning to ”be part
of the family to be supportive." The other six participants
(with.prior significant losses) acknowledged learning nothing
from previous experiences or learning to cope by avoiding
their grief. They acknowledged avoidance strategies of
”keeping busy" or just not talking about their emotions.

The results of my study are inconclusive about the
impact of previous loss. I agree with Stroebe and Stroebe's
(1987) assertions about the importance of time between losses
and age of the individual when the loss occurred.
Additionally, I would emphasize that how effectively an
individual copes with the previous loss is an important
consideration in understanding its impact on current

bereavement. Who the individual lost through death

(parent/child/grand)parent/uncle/aunt) will have different

149
levels of impact on a person. Individual personality

characteristics appear to play an important role as well.
More research needs to be done to determine the intricacies

of the impact of prior bereavement on a current loss.

Grieving
Participants' comments on grief clustered around two
main ideas: their initial reactions to their loss and
observations about the grieving process. Data relevant to

these main ideas are examined under these two headings.

Reactions

Participants experienced.both physiological and
emotional reactions to their partners' illnesses and deaths.
Their reactions produced consequences for these men and these
effects will be explored in greater depth.

Sleep patterns were disturbed for all participants
before their partner's death and continued to be problematic
for almost all of them (one exception) after their partner
died. Appetite and eating patterns were disturbed for nine
participants as some reported initially not eating, eating
less than they should, not eating a balanced diet, and
overeating. These ”symptoms" of grief are also recognized in
DSM-IV as vegetative signs of depression. Given the
depression/sadness experienced by many of the participants
and their physiological reactions, many could be misdiagnosed

as clinically depressed. DSM-IV criteria utilizes two months

150
as the time marker for differentiating bereavement from the

development of a Major Depressive Disorder, although the
authors warn that culture must be taken into consideration in
making a differential diagnosis. Stroebe and Stroebe (1987)
offer a different perspective:

In our view, grief becomes clinically relevant when the
depressive reactions are excessively intense and when the
process of grieving is unduly prolonged. A diagnosis of
clinical depression may be based on the criteria of both
intensification and of prolongation...If symptoms are still
present after a couple of years, then clinical depression is
likely to be diagnosed. (p. 24)

In future studies, researchers must work to clarify how long
these disturbances continued to identify effective strategies
to distinguish grief from depression.

A variety of emotional reactions were acknowledged by
participants. Affects that emerged.most consistently in the
data.were sorrow, loneliness, anger, guilt and relief. What
effect did/might these emotions have on these men and.members
of their support system? .Although all these emotions have
been regarded in other sources (Schneider, 1994) as part of
the grieving process, I have grouped them into categories as
(1) facilitative of grief or (2) inhibitory of grief.

Sorrow, loneliness, and, at times, relief seemed to be
emotions that facilitated grief. When participants
experienced sorrow and loneliness, they were confronting the
reality of their partner's death and their lack of
companionship.

Sad that she was gone. Lay down on the bed, there's no
one there (cries). Nothing you can do to make that person

151

appear. I’d (still) rush home from work to see how she was
doing and nobody was there. Ted

Every time that I’d go up to the bedroom, Kurt was
always in bed before me. And he’d be half asleep and he’d
say,’Come to bed, honey’ And when I’d go into the bedroom, I
would expect to hear him.say ’Come to bed.’ And I just
couldn’t stand not hearing (that). So, I just didn’t go to
bed until I had to. Gary

For many participants, these emotions seemed
interconnected with relief. When they were the most
depressed, they would remind themselves of their partner’s
gradual deterioration and suffering as they approached death.
They would then realize that, although they wanted their
partner back healthy, they would not want their suffering to
continue. Part of the grief process was to move back and
forth between sorrow/loneliness and relief as evidenced in
Danny’s remarks:

Just tears. (Then) the feeling that in a sense I was
glad that her suffering was over. I know that she’s at peace
now but on the other hand I wish that she was still
here...but not suffering. And a lot of times, I wish that
she was still here, even if she was still suffering but I
can’t keep her earthbound because that’s not good either.

Other emotions reported, although still part of the
grieving process, seemed to be inhibitory of the person’s
adjustment. Anger, guilt, and, at times, relief were
blockades to dealing with the sadness of losing their
partner. Some authors have articulated connections between
anger/guilt and the griever’s adjustment. Schneider (1994)
‘wrote that, ”Guilt usually serves two purposes: It deflects

our awareness of what we lost by focusing on ourself and it

allows us to believe that events are controllable."

152
Staudacher (1991) believed that, ”Anger sets up a barrier, a
defense between yourself and the deeper, more painful
feelings of loss" (p.33). Perhaps anger and guilt were a way
for these men to take control of situations that gave them no
control or ways to defend against the unpleasant reality.
Here are some of their comments:

Immediately after losing her, you do experience anger.
You wanta know why her? Why did I lose her when there’s a lot
of other people you can think about that maybe would be
better off. You can’t understand why (God) took her when he
did. Mark

I have one item of guilt. And the quilt is that maybe
Victoria would be alive today if instead of staying locally
we went to the Mayo Clinic or where leukemia specialists are
found. We decided not to...but I wonder if maybe some other
doctor in Seattle could have cured it. Steve

Rick also talked about anger and guilt in a decision he
made as his partner was dying. .Although Keith had previously
decided that he did not want to be resuscitated, at the last
moment he changed his mind and said that he did.want this.
Rick acknowledged:

I was so angry because everything we had talked about
was flipped around. Here’s this guy dying, I mean his body
‘was shot. So, I made the decision and even now, there’s still
some guilt. And I remember talking to him, he was in a coma
but I felt like he could understand, before I signed the
papers. And that was the hardest thing I’ve ever done in my
life. It was probably the single biggest issue that I had to
process...cause I was grieving, what I felt emotionally when
he died, and then there’s this huge thing being crammed on me
tm.

As noted above, relief served as an emotion to
facilitate the adjustment of the mourner as a counterpart to

their sorrow. However, relief also brought some

complications to the grieving process. Some participants

153
acknowledged being uncomfortable with the feeling of relief

from responsibility (as noted by Danny) or that feeling
relief was out of line with what other grievers were
experiencing (Rick and.Hatthew):

Relief from the responsibility of taking care of her,
making sure she took her medicine...just the overall
pressures. At one time down the road, I felt guilty about
that. Danny

I remember feeling inside like I wanted to say
“hallelujah” but I remember restraining myself because the
people I was with were so opposite to me, the way they were
feeling. I felt sort of embarrassed. Rick

Although Matthew had experienced intense sorrow
immediately when Jack died, he also began to feel a sense of
joy for Jack, relieved that his suffering was over. Because
he was outwardly demonstrating this relief, he ran into
problems with Jack’s family:

Like I said, I was still in a state of being happy and
jubilant in a way. Some of (his) family members accused me
of inappropriate behavior. I shouldn’t be light hearted, I
shouldn’t laugh. This should be a very sorrowful time. But
I think there is a lot to celebrate and I still feel that
way.

Participants did acknowledge that their emotions changed
in two major ways over time: (1) different emotions emerged
over time and (2) the intensity of these emotions gradually
declined to a more manageable level. .Although these
observations are not unique to men’s grief, the changes in
emotions of grief over time does substantiate models of grief
that demarcate processing through different emotions and that

these emotions can vary in their intensity (Kubler-Ross,

1969; Schneider, 1994).

154
All of the emotions noted above are part of the grieving

process. However, the data suggest that some served to
assist the bereaved with defending against the reality of the
loss (inhibit grief) whereas others seemed to promote an
awareness of loss (facilitate grief). These observations are
consistent with Schneider’s model (1994;1989) of grief.

Anger and guilt are emotions that assist the grieveerith
limiting their awareness of loss and sorrow/loneliness are

emotional aspects of the awareness of loss.

P1300688

Participants were asked to make observations about their
own grieving process and identify what they had learned about
grief. Data from their analyses of grieving (and.my
observations of them) resulted in assertions about: (1) the
time course of grief due to chronic illness (2) the
universality of grief reactions and (3) the relationship*with
the deceased. These conclusions will be compared to current

literature.

Time course.

Stroebe and Stroebe (1993; 1987) suggested that mode of
death (whether a sudden or anticipated loss) differentially
affects the grieving process. They noted that anticipated
losses are associated with less of a risk for “mental and
physical debilities" (1993, p.220) as the mourner has more

time to adjust to the reality of the death. However, as

155
Schneider (1994) noted, some grievers may not utilize this

time to begin processing their grief, remaining defended
until their loved one dies when they can no longer avoid the
reality.

As noted in Chapter Four, when participants were asked
about their reactions to their partner’s death, all of them
either spontaneously or with.minimal prompting talked about
the course of their partner’s illness until his/her death.
They began to address the reality of their partner’s
impending death and began grieving at this point. For
example, Carl noted that his most severe reaction to
Richard’s illness occurred at the beginning:

When he first became diagnosed, I used to sit in here on
the sofa at night when he was in the hospital and talk to Max
and cry. And I lost lots of weight...So, the maximum amount
of impact happened when he was first diagnosed, I mean, it
was ugly.

Three of the participants observed that, for them, grief
was an ongoing process. Brendan had lost his partner
approximately one year prior to the interview whereas Gary
and Steve had lost their partners nearly two years prior to
the interview. .All of them acknowledged that the grieving
process was actively ongoing. Even Rick whose partner had
died nearly five years prior to the interview verbalized a
conflict about whether his grief was resolved and.whether it
"should" be:

And now, I don't know. Am.I grieving now? Am I not

grieving now? Should I be grieving? All of these are
questions I have.

156
In his model of grief, Wolfelt (1992) asserts that grief is

never truly resolved, that we merely become reconciled to the
reality of our loss to cope as best we can. Shapiro (1994)
noted that it may take two to three years for the bereaved to
return to a “reasonable level of successful external
functioning" (p. 23). Participants’ experiences seem to
resonate with these observations and highlight the ongoing
adjustment of the bereaved, Gary’s comments summarize this
point:

I guess that I'm not expecting (an end) anymore. For
awhile, I was thinking it should come to an end. But I don’t
think that is gonna happen. I think it is really just an
ongoing part of life. I don’t have to say, ’Okay, you’re

dead, you’re not around anymore.’ He's always going to be
there, there’s no doubt about it.

Universality.

Five participants observed that grieving is an
individualized process. This is consistent with the
perspective of some authors that grief remains “an
individualized process- one that varies from person to person
and moment to:moment"(Shuchter & Zisook, 1993, p. 23).
Shapiro’s (1994) perspectives on family bereavment also give
credence to this viewpoint. Although.models of bereavment
give us an understanding of the commonalities of the
experience, grief remains a phenomenon that is unique for
everyone. Brendan eloquently expressed this idea:

Everybody goes through (grief) differently. I know
there are some real commonalities (but there are) various
levels of grief, various ways of expressing yourself through

grief. I use this analogy. I can line up ten people here
that all have black hair, but when you line them up,you can

157

see that all those black hair colors are a little different.
And that is the way (grief) is, its different for everybody.

Relationship‘with deceased.

Although the expectation still exists within our culture
that ”healthy" grief results in the letting go of the lost
love (Shapiro, 1994), some authors are beginning to assert
the belief that a severing of this relationship is not a
necessary part of grieving (Farber, 1990; Schuchter & zisook,
1986). As Farber (1990) stated, “Some continued emotional
attachment to the lost partner seems inevitable" (p. 45).

In their observations about grief, Steve, Matthew, Kirk,
and Gary asserted directly their belief that they would
always have an ongoing relationship with their deceased
partner,that this was an expected part of grief. Data also
demonstrate that, while not acknowledging this directly, five
other participants believed that their partner was still
actively ”alive" in their lives in some way, that their
impact and influence still existed even though they were no
longer physically present. One participant spoke quite
poignantly about how he reconciled his partner’s death and
their relationship. As he sat in his living room surrounded
by pictures and memories of his partner, Matthew shared these
observations:

I feel that Jack is always with me and that rather than
being in my presence or being my forward focus, he's now
moved to a position where he is at my side and.we’re
progressing forward in different worlds- he’s in the
spiritual world and I’m in this world here. But, I still

feel his presence, there are certain days that I feel his
presence very heavily.

158
Later in the interview, Matthew extended his belief further:

The deceased person is still present in some degree.
Your life has been permanently changed by the relationship
that you were in with that person and that’s a good thing, a
part of your being that no one can take away from you and
you’ll never lose.

For the majority of participants, an ongoing
relationship with their partner was present. Their
experience is not reflective of cultural stereotypes but more
consistent with those of Shapiro (1994). “Grief does not
require the relinquishment of the lost love but the

reestablishment of a new relationship, still vital and

enduring but now internalized" (p. 42).

Summary:Secti9n.One

Men’s experiences of grief are much.more diverse than
current models would suggest. Data from this inquiry have
demonstrated that some men are adept at seeking support and
processing their emotions. Yet, there were some ways that
their experiences were complicated by both internal and
external factors. In the next section, I will examine issues

that seemed relevant to the experiences of gay men’s grief.

Section Two:What is the impact of sexual orientation on
grieving?
Lipman (1986) stated that ”the characteristics and
functionality of long-term.relationships show'many

similarities between homosexuals and heterosexuals and tend

159
to transcend the issue of sexual preference" (p. 54). In

conducting interviews and analyzing the data, I became
increasingly more aware that there was a significant amount
of overlap in the experiences of the heterosexual and gay
men, that the obstacles/difficulties these men faced were
men’s issues, regardless of sexual orientation.

Some examples will reify this observation. There were no
differences noted between the heterosexual and gay men in
these ways: (1) the sources of attraction (personality)
between partners, the perceived quality of the relationships
or the depth of their loss (2) serving as their partner’s
primary caregiver and taking great pride in nursing their
partner until his/her death. (3) possessing a similar level
of awareness of their emotions and communicating effectively
about them. (4) being somewhat capable of seeking and
obtaining social support. (5) receiving support from their
work environment (6) utilizing similar coping strategies to
deal with their grief. Lipman’s observations depict
accurately the manifold parallels between gay and
heterosexual men’s experiences that emerged from the data.

In writing about explorations of gender issues, Hare-
Mustin and Maracek (1988) acknowledged that authors may take
a position of highlighting differences or emphasizing
similarities. In this section, I will be focusing on the
unique aspects of grieving for the gay men in this study.

Yet, as noted above, considerable overlap existed between

160
heterosexual and gay men. I will now turn to an examination

of those differences.

Impact of AIDS

All participants in this inquiry had lost a partner due
to chronic illness (cancer, AIDS, or congestive heart
failure). .Although many commonalities existed in the
experiences and grieving process of all participants, AIDS
presented a unique set of issues in the chronic stages of the
illness and, ultimately, in death- Martin and Dean (1995)
noted that death due to AIDS is unique in that (1) it
primarily strikes young to middle aged adults in the prime of
life (2) it can be deeply stigmatizing for the person who is
sick and those close to him and (3) those most involved in
trying to control the epidemic and care for the sick are
often at high risk of contracting the disease themselves.
Some of these issues were highlighted in the experience of
the gay men who had lost their partner to AIDS. Patrick
talked about his personal struggle with Edward’s illness:

If anyone asked me questions or approached me directly,
I’d give them an honest answer...about my sexuality or about
us being together. But, when it came down to the disease of
AIDS, that stigma was a terrible black cloud that hung over.
You aren’t allowed to tell anybody about it for fear of
losing your job or fear of being closed out of a group of
friends or just people not wanting to see you anymore. And
when you need the support the most, people are running from
you. For the first few years, I was very self-conscious about
(this)...(People) aren’t gonna come over. Oh my word, they’re
afraid to drink out of my dishes or they’re afraid to eat off
that plate. They don’t want to eat any food that we’ve

prepared. I (didn’t) want to invite anybody to dinner in
case I (might) offend them. So, that was hard. Patrick

161
Other participants struggled with the ramifications of

this disease. Andy was the one participant who acknowledged
that he was HIV-positive himself. His grieving process was
unique in that he mourned his partner’s death as well as his
own current health status and the uncertainty of his own
future. Gary, a gay man whose partner died of cancer, found
that others still assumed that Kurt was dying of AIDS and did
not believe them.when they denied this diagnosis.

Although much can be learned from this inquiry about the
experience of gay grief, five of the six gay men had lost
their partner to AIDS. The stigma of this disease likely
impacted the ways these men grieved and.mourned. Gary’s
experience is an important counterpoint to that of the other
gay men, especially noting that he and his partner were still
impacted by the negative valence associated with AIDS. In
future inquiries, I would recommend that authors work to
explore gay grief in situations of loss other than due to
AIDS to more effectively separate the process of gay grief

from the stigma of AIDS.

Relationships
In this section, I examine dynamics that were unique to
the relationships of the gay men. The recognition that their
relationships with their partners received and the conflict
present in these relationships are explored. I also
described the importance of relationships with friends and?

how these some of these relationships changed over time.

162
Partner

Recognition.

Doka (1987) identified the impact that lack of social
support of a “nontraditional" relationship can have on the
bereaved. Doka asserted that it can be ”more difficult to
complete the tasks of mourning" (p. 465) if the bereaved does
not receive recognition of his relationship with the deceased
in the dying and/or mourning process. Lack of recognition of
gay relationships could put gay men at risk for difficulties
with grieving.

All six of the gay men who participated in this study
asserted that, prior to their partner’s death, their
relationship was recognized and validated by friends and
family, although family recognition varied greatly from
complete acceptance to tolerance. Those men whose families
seemed to be closer to acceptance of their relationship with
their deceased partner remained supportive after their
partner died. For Matthew, Carl, and Andy, relationships
with family, especially their partner’s family, became
conflictual after their partner’s death. .Although they
thought their relationship had been recognized, this
recognition changed after their partner’s death. Here are
some of their comments:

(Richard’s family) understood intellectually that I was
his spouse and that I took care of him. But when the local
paper did an article on him and asked his parents who his
family was, it listed everybody but me. I was good enough to
take care of him but I’m not good enough to be in the

obituary because what that means is that his long time
companion was a man and that means he’s gay. Carl

163

Throughout the whole ordeal, I felt like I was an
acquaintance and it really pissed me off. (His family)
wanted me out of the picture. Going to the cemetery with the
casket, there was one limo. I was assuming that I would get
to ride in that limo with the casket. No, his parents, ex-
wife, and ex-wife’s current husband rode in that limo. I
ended up getting a second limo for myself, his cousin, and
other family members. But that’s the way they treated me and
it was just like I was this little friend that he has had.
Nobody ever acknowledged (our) relationship. Andy

His mother is a strong Pentecostal and the morning when
he died, she came in and.was just wailing all over the place
and she was, of course at various periods, suggesting that
Jack should ask forgiveness for his sin, for his sexuality
for his being, for me being his partner, and things like
this. Matthew

Carl and Matthew also noted that although their families
were not as hostile or dismissing of them.as were their
partner's families, their own family failed to recognize the
profound impact that their partner’s death had on their
lives. Families were not the only source of lack of
recognition, however. Carl noted that some heterosexual
acquaintances treated Richard’s death ”like I had put my dog
to sleep". They too didn’t understand or recognize the
impact of his loss.

What is the impact of being overlooked and/or
unrecognized on grief? Did lack of recognition exacerbate the
grieving process for these men? This is difficult to
determine. At a minimum, it brought more conflict into their
lives at a time when they were trying to deal with their
grief. These men didn’t have as much social support from
their partner’s family at a time when it was most needed.

They also seemed to have anger and resentment about the way

164
they were treated by their partner’s family. These feelings

may have inhibited their ability to deal with their sorrow or
perhaps extended the grieving process, as described
previously in this chapter. Additionally, their attempts to
move beyond their anger may have extended the duration of

their grieving process.

Conflict.

Another important aspect of the gay relationships in
this inquiry was the significant difference in partner’s ages
(that potentially produced greater conflict) and the impact
of these differences on participant’s grief. When
participants were grouped by sexual orientation, gay couples
had differed in age by nearly fourteen years (for four
couples, the age difference was 15 years or more) as compared
to heterosexual couples who had differed in age by
approximately five years. In Levinson’s (1978) model of adult
male development, gay partners would be in vastly different
developmental stages (early vs. middle adulthood), likely
resulting in different needs and greater conflict.
Conversely, McWhirter and.Mattison (1984) asserted that
large discrepancies in age (as well as other variables) are
common in gay couples and determine who in the relationship
has the power. McWhirter and.Mattisons’s observations might
be construed as indicating that there is less conflict in the

relationship because one partner is clearly in control.

165
Data in my inquiry are more reflective of Levinson’s

model. As compared to the heterosexual men, the gay men
seemed to have experienced.more difficulty resolving conflict
in their relationships. While age differences may establish
who has more control in the relationship, these same
differences may bring about greater conflict as partner’s are
likely to be at such different developmental levels. Equally
so, the seemingly greater difficulty of gay men in resolving
conflict in their relationships may simply be an artifact of
having two men in a relationship. Their gender socialization
outcomes may complicate their ability to connect in
relationships as they may be competitive and independent
‘while also needing to avoid affect and be in control. The
impact of the greater conflict in these relationships on
participants’ grief is not clear. More research is needed to
explore the impact of age differences on relationship

dynamics and the resultant grieving process.

Friends

In designing the interview protocol for this inquiry, I
assumed that ”family" and "friends" fell into separate and
distinct categories. However, in working with these gay men,
I learned the importance of including both the biological
family and networks of friends that "replace or supplement
the biological family" (Kimmel & Sang, 1995, p. 205). I

became more clear about this distinction and the important

166
role that these social networks played in the lives of these

men.

All of the gay men noted the pivotal importance of
friends throughout their partner’s illness and death.
Although friendships were important sources of support for
all of the men in this inquiry, friends seemed particularly
important to gay men as their biological families and their
partner’s family were not always sources of support and
affirmation of their relationship.

‘Why were friendships so important? For the gay men,
their friends could respect the value of their relationship
with their partner and therefore more fully understand the
impact of their loss. Gary noted this when asked who had
been the most important source of social support:

Friends, definitely friends. we didn’t actually hide
anything from our families but in terms of common
experiences, our friends were certainly closer and it was
easier to talk with them, the lesbian and gay friends,
because they understood our relationship at a more basic
level.

Carl also noted the importance of friends in understanding
and validating his relationship with Richard. Yet, he noted
that although gay friends were better able to comprehend what
Richard meant to him, some gay friends still did not
completely’understand.

While we may say its so endearing to see those guys care
for each other, I think as a society we haven’t come to the
realization of the value of (gay) relationships. And I think

even among some gay people that doesn’t happen. I think that
we don’t understand these relationships well.

167
Work

All participants in this inquiry who were employed
received support from their work environments. Their
employers allowed them to take time off, reduced their hours,
and found other employees to cover for them. Fellow employees
were also sources of support in providing meals, take up
collections, and attending the funeral/memorial services. No
differences were apparent in these types of support that
heterosexual and gay men received from their work
environment.

However, what distinguished the experiences of some of
the gay men (Andy and Matthew) from their heterosexual
counterparts were the ways that they were allowed to take
time off and the effort necessary to be allowed to take leave
time. Since their relationships were not legally recognized,
these gay men were not entitled to family medical leave or
bereavement leave like their heterosexual counterparts and
instead utilized personal days and.vacation to attend to
their dying partners’ needs and.mourn their deaths. Matthew
acknowledged his frustration with this situation:

I was encouraged when the family medical leave act came
into being but again, I still didn't fall under those
criteria...because I was not married to him, in a legally
recognized relationship. (After he died), I did get short
changed out of a few days without pay...so I felt cheated
that I wasn’t treated as equally as a heterosexual couple
would have been but things are the way they are. So, that's
just one of the things I had to accept and.move on.

In becoming aware of this inequity, some large

corporations (Apple Computer, Disney) and universities (U-Cal

168
Berkeley) are offering partner benefits to same-sex couples

and unmarried domestic parters. Many Fortune 500 Companies
have begun to include sexual orientation in their
nondiscrimination policies (Marino, 1996). Initiatives such
as this will allow gay men and their heterosexual
counterparts to receive similar treatment in being able to
take leave. However, currently this inequality permeates many
work environments and is a source of frustration for many

members of the gay/lesbian community.

Religion/Spirituality

Shapiro (1994) highlights the important role that
organized religion can play as individuals and families cope
with the death of a loved one. ”For many families, a
religious community offers an important source of support
following the death of a family member, both in instrumental
support and offering a sense of meaning for the place of
death and grief in the continuity of life" (p. 285). For gay
men, active membership in a faith community is less available
as a source of support. Comstock (1993) noted the struggle
that gays and lesbians encounter when considering active
involvement in a church. “To have power, to be a leader, or
to be employed by the church requires heterosexual
identification or at the least no overt homosexual
identification" (p. 25). Since organized religion in general
has been condemning of homosexuality, many gays distance

themselves from organized religious communities.

169
Data in this inquiry support these assertions. Only one

of the six gay male participants was active in a church,
finding this community to be a source of spiritual and
instrumental support. Three other gay men spoke about an
active spirituality in their lives as an important guiding
force. The two remaining gay men did not consider themselves
to be spiritual or connected with a higher power. In
contrast, five of the six heterosexual men.were active in
organized religion and the remaining man had an active
individualized spirituality. Organized religion appeared to
be more available to the heterosexual men as a source of
support than to gay participants. Patrick, a gay man,
commented on his views about organized religion:

We weren’t members of a church. we didn’t attend on a
regular basis. I would say we were religious in our own
respect, knowing the difference between good and evil...(but)
I don’t think the religious family and structure would accept
us if we walked in. It wasn’t a major part of our life
(that) we wanted to be involved in.

When asked if their religion/spirituality was an
important source of support during their partner’s illness
and death, five heterosexual men found this to be true
whereas religion/spiritualitwaas important for only three of
the gay men. Participants seemed to be considering the ways
that tenets of their faith and the process of prayer brought
meaning and support during their partner’s illness and death.

However, all of the men active in religious communities also

alluded to the instrumental support their received from other

170
members of their church (including cards, visits, attendance

at the funeral/memorial service and prayers).

As Shapiro noted above, places of worship can be avenues
of social support and make meaning of life and loss. Although
attitudes of many churches are changing in regard to
homosexuality, organized religion remained conspicuously

absent in this inquiry as a source of support to gay men.

Previous Losses

Although demographics of HIV-positive persons and
persons with AIDS are changing to include a.much higher
percentage of heterosexual people (Keeling, 1993), AIDS has
been a disease that has decimated the gay community,
resulting in the untimely death of many homosexual men
(Martin & Dean, 1993). In including gay men in this inquiry,
I believed that they would have more experience with/exposure
to death and grief. While this might result in a more severe
grief reaction, I asserted that these men might be
"innoculated" by multiple losses against a more severe
reaction to the death of a partner.

The gay men in this study (with one exception) had not
experienced multiple losses or more losses than the
heterosexual men. For most of the gay men, previous
experience with loss did not (in their estimation) impact
their current experience of losing their partner. Patrick
was the one exception. He had experienced the deaths of

grandparents and other relatives but reported that these

171
losses seemed to have little impact on his coping with his

partner’s death. However, he experienced the death of seven
other close friends/relatives during the time that his
partner was dying from AIDS. In the interview, he described
that time and the impact these multiple losses had on his
ability to cope with Edward’s death:

P:So in all I went to 8 funerals within a four month
period, one of them being my lover’s. So I was just like
frazzled on funerals and the whole grieving process, the
death processs. I was surrounded by death...so it was awful.

I: How do you think this impacted dealing with Edward’s
death? Did it make it worse or better?

P: Probably better. I knew it was coming. I was worn
out at the time when he died, physically and mentally
exhausted. So, it was kinda like a relief. I had been reading
about AIDS and about death and dying, I was educating myself
about the whole process. And death became a household word.

Although past losses had not impacted him that
significantly, these concomitant losses seemed to propel
Patrick to deal with the reality of AIDS/death and forced him
to become more aware of the grieving process. As noted in
his comments, Patrick believed that being surrounded by death
prepared him for Edward’s death and helped him deal more
effectively with his grief. Was he "innoculated" against a
more intense grief reaction? This was not clear. But at a
minimum, Patrick was more motivated to seek out information
about loss and grief than some other participants.

In writing about bereavement due to AIDS, Martin and
Dean (1993) distinguished between multiple and chronic
losses, examining the impact of both on responses to grief.

Multiple losses included.more than one death within the past

year whereas chronic loss pertained to experiencing a death

172
within the last year and another death 12-48 months

previously. Gay men with multiple or chronic losses differed
significantly from gay men with only a recent loss in
measures of (1) traumatic stress (e.g., symptoms of stress
such as numbing, nightmares, and physical symptoms) and (2)
subjective threat (how'much an individual believed that he
might contract HIV/AIDS).

Martin and Dean’s results focus on the negative outcomes
of previous losses without acknowledging their potential
beneficial impact. Data from.my study indicate the
importance of attending to the deleterious and advantageous
effects of multiple losses as Patrick was both "frazzled on
funerals" but actively seeking knowledge to prepare for his
loss. More research is needed to expand and clarify the

differential impact of multiple versus chronic losses.

Spmmarv: Section Two

Considerable overlap existed between the experiences of
loss for heterosexual and gay men. Differences that did exist
often involved external forces (such as family, friends, and
church) and their impact on these men. ‘Within-group
differences highlighted the importance of attending to
variables other than sexual orientation in providing

assistance to gay men.

173
Chapter Summary

In this chapter, the data have been examined at a
conceptual level and compared to the conclusions of current
literature. Many of the experiences reflected in this
inquiry were consistent with predictions from extant
research. Yet, I believe that much.more is to be learned

about men’s grief and the experiences of grief for gay men.

DISCUSSION
In this chapter, the purpose of the study and
characteristics of the participants are examined. The
practical meaning of results are discussed in light of the
study’s limitations. Recommendations for future research and
implications for practitioners are then reviewed. The

chapter closes with a summary.

Purpose of the Study
The purpose of this study was to explore the experience
of men grieving the untimely death of a partner due to
chronic illness. Twelve men were interviewed to obtain rich
descriptions of their grieving process. Data were transcribed
and then analyzed utilizing methods recommended by Lincoln

and Guba (1985) and.Miles and.Huberman (1994).

Characteristics of the Participants

Of the twelve men interviewed, six identified themselves
as heterosexual and six reported that they'were gay. Average
age of participants was 43 years. When subdivided by sexual
orientation, average age of heterosexual men was 49.5 years
whereas for gay men it was 36.8 years. Participants were
evenly distributed on socio-economic and religious
demographics. However, the sample lacked adequate
representation on certain variables that are important

consider.

174

175
.All participants were Caucasian and did not seem

particularly connected to their cultural background. Yet,
Rosenblatt (1993) asserted that, "grief is shaped by the
social context in which it occurs" (p.102). .Although culture
likely impacted the experiences of participants, their level
of cultural identity did not allow for an exploration of
these variables. Because all participants were Caucasian, I
'was not able to explore the impact of racial factors on
grief.

Regional and.residential (urban/suburban/rural)
variables likely influenced the results. Participants were
recruited in two midsize cities in a large midwestern state.
Nine participants were born and raised in this state. values
or other variables of the midwestern‘United States may have
influenced the results. Additionally, as participants came
from midsize cities, gay men that were interviewed were less
likely to have experienced multiple/chronic losses due to
AIDS that are well documented in larger, urban gay

communities (Keeling, 1993; Martin.& Dean, 1995).

Limitations of the Study
Aside from demographic variables highlighted above,
there are other limitations to this study that are important
to highlight for the reader. Results must be viewed within
the context of these limitations. The following are
important factors to consider: sample size, participant

recruitment, interview protocol, and.participant disclosure.

176
Sample size

Qualitative research is often designed to provide ”rich
descriptions" (Geertz, 1973) of participants' experiences.
Qualitative methods allow the researcher and reader to gain
an in-depth understanding of the phenomenon being studied but
these methods do not allow for a broader based analysis of
variables in a larger population. Although the sample size in
this inquiry has allowed for an examination of relevant
themes and aspects of individual’s experience, the number of
participants limits my ability to make assertions about the
larger population of men. As noted previously, the onus for
determining transferability of these results lies with the

reader.

Participantgrecruitment

Volunteer participants were used for this inquiry due to
the sensitive nature of the topic. Although demographics
indicate that participants were diverse on numerous
variables, the sample underrepresented the influences of
racial, cultural, and regional variables. Other important
variables that I am not considering may also have exerted
influence on these results.

Additionally, this strategy of recruiting participants
does not allow for an exploration of differences between
those men who chose to be interviewed and those who did not.
As Stroebe and Stroebe (1989) discovered, these populations

can be quite distinct in important ways. As noted in Chapter

177
Five, participants may have possessed better social and

emotional skills than men who did not volunteer.

Interview'protocoi

In developing the interview protocol for this inquiry, I
selected content areas from those articulated in the
literature as well as ones I had utilized in previous
research (O’Brien, Goodenow, & Espin, 1991). There might be
factors that were not included in the protocol that are
important in understanding the experiences of grieving men.
Although all participants reported that the interview seemed
to assess the major aspects of their loss, other
factors/areas that are germane to the topic may have been

overlooked.

Participant disclosure

At the beginning of the interview, I assured
participants that their identity and comments would remain
confidential. Even though participants had this assurance, I
observed.two men hesitating to disclose some aspects of their
experiences due to the sensitive nature of the topic.
Although nine participants had a personal connection with me
in some way, they still may not have trusted my ability to
completely obscure their identities and therefore, censored

their comments accordingly.

178
The Researcher as Participant/Observer

Janisek (1994) stated that, ”Qualitative research
requires the researcher to become the research
instrument...(and) incorporates room for the description of
the role of the researcher as well as a description of the
researcher’s own biases and ideological preference" (p.212).
In writing about the importance of identifying subjectivity,
Peshkin (1988) wrote, "If researchers are informed about the
qualities that have emerged during their research, they can
at least disclose to their readers where self and subject
became joined." I believe that it is important to identify
aspects of my subjectivity that exerted an influence both on
my interactions with participants and my interpretations of
the data.

To locate where and when my subjectivity may have
exerted its impact, I reviewed my research journal and
reflected on the process of conducting this inquiry. Through
this analysis, I identified five ”subjective I's" (Peshkin,
1988, p. 18) that emerged for me in studying men’s grief.
These ”I's" include (1) the clinician-I (2) the researcher-I
(3) the male-I (4) the spiritual-I (5) the grieving-I. Each
of these I’s will be further explored below.

The clinician-I appeared in interviewing participants
and in assessing their current level of functioning. My
clinical training helped me to effectively structure the
interviews and keep participants topic focused without making

them feel rushed or ignored. At times, I found it necessary

179
to stifle my clinician-I as I wanted to intervene in

participant’s thoughts or give them feedback during the
interview. In a few cases, I did offer participants some
feedback but waited until the end of the research interview.
Additionally, my clinical training‘was invaluable in
determining if a participant needed a referral for
therapeutic services after the interview. Although I referred
all participants to local grief support services, I more
actively suggested referrals for counseling for two
participants who appeared in need of services. The clinician-
I was very helpful in conducting smooth interviews and
monitoring participants’ mental health.

I discovered the researcher—I in aspects of my research
journal. During interviews, I had become frustratedwwith some
participants who wanted to explore aspects of their loss
experience in great depth, resulting in long and.detailed
interviews. The researcher-I wanted all interviews to be
completed in two hours! Luckily, I had the clinician-I to
temper the goal-directed stance of the researcher-I.
Conversely, the researcher-I mediated the wishes of the
clinician-I to engage the participants therapeutically. I had
to keep reminding myself that although I would likely have an
impact on participants, I was not their therapist.
Additionally, many participants had some personal connection
‘with.me and my perspective as a researcher enabled me to keep

professional distance. The researcher-I and the clinician-I

180
acted together in assisting me with determining appropriate

boundaries with participants.

The male-I was an obvious part of my identity that
emerged in interviews and in data analysis. As a.member of
the group that I was examining, I believe that participants
knew that I would not pathologize them or focus only on their
weaknesses. They likely felt that I would make fair
judgements of their experience and be invested in determining
how men can be most effectively assisted with grief. Because
I do not adhere to traditional male gender roles (in that I
am interpersonally focused and affectively aware), I may have
allowed participants to more openly acknowledge and
experience aspects of themselves that they might not freely
share with others. The male-I gave me credibility in my work
with participants that might not have been available to a
female interviewer or a male with a more traditional approach
to gender roles.

I identified the spiritual-I in the development of this
project and in data collection/analysis. In formulating this
idea, I was not sure if this was the right focus for my
dissertation. Yet through prayer and reflection, I concluded
that men’s grief was the right topic. The spiritual-I finds
great meaning in death as it forces us to make the most of
the time that we have in this world. I also encountered the
spiritual-I during interviews and data analysis about
mourning rituals, the impact of religion/spirituality, and

views of the afterlife. I struggled when my beliefs did not

181
match those of participants, especially men who did not

believe in an afterlife or‘who were scornful of organized
religion. Although I worked to accept participants from other
viewpoints, I could not possibly imagine how someone could
effectively cope with such a great loss without a spiritual
belief system to provide a context for the experience.
Finally, there was/is the grieving-I. Less than a month
after the proposal for my dissertation was accepted, my
father did unexpectedly. Although I had researched and read
much about the topic of loss, the grieving-I taught me more
about grief than any books or theories that I had read. I
shared the grieving-I with participants and found that this
likely gave me further credibility. Losing a parent is not
the same as losing a partner, but my disclosure seemed to
allow participants to begin disclosing at a very deep level
I probably possess other personal characteristics that
exerted an influence on this project. However, the 1’s noted
above appeared most clearly in my analysis of how
subjectivity impacted this research. The reader can now view
the results of this inquiry with a better understanding of
how I served as the tool that produced these data and the

emergent.conclusions.

182
Discussion of Results

In Chapter Five, themes that emerged from the data were
integrated with extant research on grief, men's issues, men’s
grief, gay issues, and gay grief. .Although space limitations
do not permit me to comprehensively review this analysis, I
will summarize the major findings that emerged for me from
this exploration of men’s grief and gay grief. First, I will
comment on how'my findings compare to perspectives offered by

extant models of grief.

Grief models

Many aspects of the participants’ experiences are
consistent with models of grief that exist in the literature.
The following observations are reflective of current models:
(1) physiological reactions to a loss. Sleep and appetite
disturbances were seen in many participants and are an
expected part of grief (Schneider, 1994; Shapiro, 1994) (2) a
variety of emotions. Participants experienced.diverse
emotional reactions to their loss as would be predicted by
Kubler-Ross (1969) and Schneider (1994). (3) changes in
emotions over time. As time passed, many participants found
their emotions becoming less intense and that different
emotions emerged at different stages (Kubler-Ross, 1969;
Schneider, 1994) (4) anticipatory grief. All participants
noted that their grief began during their partners’ illnesses
(Kubler-Ross, 1969; Schneider, 1994) and (5) grief is

individual. Although there were many commonalities in their

183
experiences, many participants acknowledged the uniqueness of

their grieving (Shapiro, 1994).

Some new perspectives emerged from this inquiry that
expand/extend current models of grief. These ideas include
(1) the emotion of relief and its impact, (2) systemic
perspectives on grief, and (3) relationship*with deceased
continuing. Each of these will be further explored below.

Two thirds of the participants mentioned relief as an
emotion that was central to their grieving process. But
depending upon the context, relief resulted in different
consequences. When processed internally, this emotion gave
the mourner a way to move away from the intensity of their
sorrow. However, when it was shared with others, relief could
result in anger/rejection from others, leaving the mourner
with other emotional reactions such as guilt and shame.
Current models do not depict the positive and negative
aspects of experiencing relief.

Until recently, grief was viewed only as an individual
experience. However, Shapiro’s (1994) model of grief from a
family-systems perspective highlights the importance of
attending to ways that individual grief is impacted by others
in one’s family. Additionally, I would assert that the
bereaved are part of other systems that exert influences on
their grief. Networks of friends, work environments, and
places of religious worship also impact the adjustment of the
mourner. Grief models need to take these influences into

account .

184
Shapiro (1994) acknowledged that a continuing

relationship with the deceased is to be expected. Nine of the
participants in this study indicated that they anticipated an
ongoing connection with their deceased partner. These data
lend credence to Shapiro’s observations and demonstrate the
importance of incorporating this perspective as a possible

outcome of the grieving process.

Men’s grief

Although there were many unifying themes for the
experiences of the men in this study, data analysis also
revealed considerable variations of men’s experiences. Men
are clearly not a.monolithic population but a heterogeneous
group that differentially adheres to traditional gender-role
expectations. Lister (1991) emphasized the importance of
culture as a framework for understanding differences in.men’s
grief. Although cultural variations were missing from the
sample, my study supports Lister’s recognition of within-
group differences.

Some grief researchers have focused on men’s inability
to express emotions, especially pain and loss (Lister, 1991;
Wolfelt, 1990). Although they did experience some
difficulties with affect, participants in my study seemed
adept at expressing and labelling their emotions. They did
not experience "alexythymia" in the interview (Levant, 1995,
p.238) but perhaps more accurately dyslexythymia in trying to

understand their grief.

185
Authors have recognized how'men’s emotional

expressiveness is related to societal expectations (Lister,
1991; Scully, 1985; Wolfelt, 1990). Men in my study were
clearly impacted by others in expressing their feelings in
the hopes of receiving support. Nine participants admitted
to:monitoring their disclosure of emotions in an effort to
protect others from discomfort. Although only three of these
men admitted to protecting themselves, all nine‘were likely
unwittingly insulating themselves from the negative reactions
their emotional expression might receive.

Extant research on men’s grief highlights men’s "need to
be independent" (Lister, 1991) and "inability to seek
support" (Wolfelt, 1990). Some men in my study did
experience difficulties in seeking social support or
maintaining preestablished support systems once their partner
died. Yet, others were able to remain involved with
friends/family and seek out new networks of friends. These
assertions about.men’s poorly developed social skills were
not reflective of the majority of participants in my study
and, at a.minimum, do not reflect the experience of some men
in grief.

Grief researchers have noted that the consequences of
men’s difficulties with grief are often (1) a greater risk of
physical illness/morbidity (Lister, 1991) (2) increased.rates
of alcoholism (Lister, 1991) or drug use (Martin, 1988) (3)

increased rates of depression/anxiety (WOlfelt, 1990). Some

participants’ experiences were consistent with these

 

186
observations. Two participants admitted that their lack of

self care resulted in hospitalization within a few'months
after their partner's death. Four participants acknowledged
that they had received prescriptions for anxiety/depression
from their doctor either during their partners’ illnesses or
immediately after their deaths. Two participants reported
the use of alcohol immediately after their partner’s death to
help them relax. However, in general, my results diverge from
extant literature on men’s coping styles. Although these men
experienced some difficulties adjusting to their loss, all
eventually developed.more adaptive coping strategies that
alleviated some of their symptoms without relying heavily on
alcohol or nonprescription drugs. Overall, the participants
in the study were better at coping than current literature
might indicate (Brooks & Silverstein, 1995). My results may
differ from current literature for several reasons. Other
studies have asked directly about use/abuse of drugs and
alcohol (Martin a Dean, 1993) whereas in.my study
participants were not asked directly about substance abuse.
Some researchers have utilized a questionnaire to assess
substance use (Martin & Dean, 1993) that may create greater
anonymity than an in-depth interview, allowing the person
more freedom to acknowledge alcohol/drug use. Additionally,
some participants did use prescription drugs to manage their
affect, eliminating the need for self-medication with other
substances. These factors may have influenced the findings

of my study as compared to previous research.

187
Gay grief

Research on gay grief indicates that the societal stigma
associated with being gay complicates bereavement (Klein &
Fletcher, 1987; Siegel & Hofer, 1981). Some authors have
further proposed that losing a partner can force someone to
openly acknowledge their sexuality for the first time (Siegel
& Hofer, 1981). The gay men in this study did not appear to
be unduly inhibited by the effects of homophobia or by having
to openly acknowledge their sexuality.

However, homophobia can result in a lack of recognition
of the commitment in/value of gay relationships, especially
in understanding a gay man’s loss or recognizing it publicly
(Doka, 1987; Siegel & Hofer, 1981). After their partner’s
death, half of the gay participants in.my study found that
the depths of their relationships were not truly recognized
by family and friends. Carl noted that others seemed to
equate his loss with “putting my dog to sleep". Participants
reacted to these perceptions with anger and irritation,
likely inhibiting their expression of sorrow and loneliness.

Siegel and Hofer (1981) asserted that gay men grieving
the death of a partner can be affected by the reemergence of
guilt associated with their sexual orientation. .Although
some of the gay participants acknowledged experiencing guilt
surrounding their partner’s death, this guilt did not appear
to be related to their sexual orientation and was not
differentiated from the guilt experienced by their

heterosexual counterparts.

188
Barrows and Halgin (1988) asserted that.many gays

experience a lack of support from.both family and friends
during grief and often turn to therapy as their sole source
of support. Gay men in my study did not experience rejection
that was this extreme. However, some did experience a lack
of support from their partner’s family, from.their own
family, and from some friends. They were able to make
adjustments in their support systems (widening their network
of friends, attending a support group) that allowed them to
receive greater support without necessarily relying solely on
therapeutic relationships.

Consistent with the literature on men’s grief, extant
research on gay grief often points to the increased use of
drugs and alcohol as a way to manage grief (Martin, 1988;
Martin and Dean, 1993). Gay male participants in.my study did
not admit to an increase in substance abuse and did not have
a greater incidence of prescription drug use as compared to
their heterosexual counterparts. This finding may be an
artifact of the type of man drawn to my study or may indicate
that findings from.other studies do not accurately reflect

the majority of gay men’s coping abilities.

Recommendations for Future Research
This study was designed as an exploration of men’s
experiences of grieving the death of a partner due to chronic
illness. Results generated observations about grief in

general and the experiences of bereaved.men. Suggestions for

189
research strategies to expand upon these findings will be

made.

Grief

There has been a growing recognition in bereavement
literature of the importance of attending to system/
contextual factors in understanding an individual’s grief
(Shapiro, 1994). Data in this inquiry demonstrated both the
positive and negative impacts of interpersonal relationships
on men’s grief. I would recommend that future research
attend.more closely to systemic variables

One limitation of this study emanated from the lack of
diversity among participants on variables such as race,
ethnicity, and culture. Authors have highlighted the
importance of these variables in providing a context for
understanding grief (Rosenblatt, 1993; Stroebe, Gergen,
Gergen, & Stroebe, 1992). Whenever possible, grief
researchers should incorporate an analysis of these variables
into their research design.

Shapiro (1994) highlighted the importance of considering
characteristics of the premorbid relationship between the
bereaved and his/her deceased partner in understanding an
individual’s grief. Extant research has demonstrated that
ambivalent (Parkes & Weiss, 1983; relationships marked by
love and hate) and dependent relationships (Lopata, 1993) are
associatedwwith.more problematic bereavement outcomes.

Relationships between partners in this study appeared to be

190
intimate and.caring although conflict resolution seemed

difficult, especially for the gay men. Future research would
likely benefit from.a more systematic exploration of
relationship‘variables.

.Many authors have highlighted the importance of mode of
death on the grieving process (Schneider, 1994; Shapiro,
1994; Stroebe, Stroebe & Hansson, 1993; Stroebe & Stroebe,
1987). Although all participants in this study experienced
the death of a partner due to chronic illnesses, some had
lost their partners to AIDS, a disease that often stigmatizes
both the person with the disease and those close to him/her
(Martin a Dean, 1993). Researchers should continue to
acknowledge the differential impact of this type of loss on
grieving. .Additionally, research on gay grief could benefit
from an examination of the untimely death of a gay partner
due to circumstances other than.AIDS. Limited data in this
inquiry suggest that if a gay partner dies from any chronic
illness, he and those close to him may still be stigmatized

‘with issues associated with AIDS.

£2.11

Men’s grief is a topic that has received relatively
little attention in bereavement research (Lister, 1991). When
men have been studied, researchers often compare them to
widows of the same age (Wister & Strain, 1986). My study
allowed for an in depth examination of issues relevant to the

experience of men without the need to compare and contrast

191
their experiences with widows. Much.more could be learned

about aspects of men’s emotional and social support systems
by focusing inquiries solely on men’s grief. Within-group
differences can also be identified to prevent researchers and
clinicians from.viewing men as a homogeneous population.

Stroebe and Stroebe (1989) demonstrated that differences
existed for individuals who chose to participate in
bereavement research when compared to those who did not.
Future research could benefit from attempting to gather data
from.men who choose not to engage in interviews. Measures of
adherence to traditional male gender roles, social/emotional
skills, and stage of grief would provide useful typologies
for understanding how grief research participants may or may
not be a unique population.

Rothblum (1994) asserted that relatively little extant
research examines mental health issues of lesbians and gay
men. She recommended that researchers include both
heterosexual and gay participants in inquiries to explore,
”the relative salience of gender versus sexual orientation"
(p.217). This study endeavored to follow this recommendation
by examining both the similarities and.differences that
existed in the experiences of these groups of men. I would
encourage future researchers to continue this line of
inquiry.

Some work environments have begun to recognize the
importance of offering partner benefits to same-sex and

unmarried couples to address the diversity of their work

192
force (Marino, 1996). Data in this inquiry highlighted the

difficulties faced by gay men attempting to take time off to
care for dying partners or mourn their partners’ deaths. I
would encourage future researchers to examine the impact of
these efforts on an individual’s grief adjustment by
comparing individuals’ experiences in environments that do/do

not offer such benefits.

Implications for Practice
As the interviews in this study were drawing to a close,
participants made recommendations to clinicians working with
grieving men. Some of their comments were relevant to
clinical work‘with (1) the bereaved in general (2) grieving
men (3) grieving gay men. I will address each of these areas
by reviewing important themes that emerged from the data,

along with my own observations.

Elie—f

All of the participants in this inquiry reported feeling
unprepared to deal with the loss of their partner. Some had
never lost a significant figure in their lives and had no
idea.what grief was or how to deal with the affects
associated‘with bereavement. Equally so, some participants
who had lost significant figures in their lives reported.that
they had never grieved before or had not learned anything
from.previous experiences. Clinicians who work with the

bereaved must be prepared to take an active role in educating

193
clients about grief and.models that describe the process.

Yet, clients must also be educated about the individuality of
grief and that their experiences will incorporate unique
issues.

Many authors have hypothesized that previous losses can
negatively impact an individual’s ability to deal with a
current loss, especially if a previous loss has remained
unresolved (Martin a Dean, 1993; Raphael, Middleton,
Martinek, & Misso, 1993). Conversely, in undertaking this
inquiry, I believed that previous losses would prepare men in
some way for the loss of their partner. However, data did
not support this assertion. Practitioners should be aware
that in the view of the bereaved, prior bereavements may or
may not impact a current loss.

"The ability to anticipate a loss and prepare for both
the emotional and practical consequences of the loss is
generally considered protective with respect to the
development of pathological grief reactions" (Martin & Dean,
1993, p.320). Death of a partner due to chronic illness
allows the surviving individual to do some anticipatory
grieving in preparation for their loss. The grieving process
of participants in this study reflected this assertion as
they all began to prepare for their partner’s death prior to
the actual event. Yet, Schneider (1994) noted that some
grievers do not utilize time prior to their loved one’s death
to begin grieving. Practitioners must be prepared for either

possibility.

194
Schneider (1994) outlined the differences between grief

and depression, noting that these terms are often used
interchangeably. .Although grief and depression have many
commonalities (vegetative signs, affects), they are distinct
in many respects and require different therapeutic
approaches. "Grief requires validation, support, safety and
encouragement to trust onself. Depression, on the hand,
requires intervention and treatment" (Schneider, 1994, p.
305). Practitioners must become aware of these distinctions
and develop effective strategies to differentially diagnose
them.

Societal expectations continue to promote the belief
that the severing of the relationship with the deceased is a
necessary part of grieving (Shapiro, 1994). More recently,
authors have begun to recognize that healthy grief may
incorporate an ongoing relationship*with the deceased
(Farber, 1990; Schuchter & Zisook, 1986). Three quarters of
the participants in this inquiry acknowledged directly or
indirectly that they expected to maintain a relationship*with
their deceased partner. Practitioners should be cognizant of
this shift in thinking so that they do not view their
clients’ emotional attachments to deceased loved ones as

necessarily'pathological.

Men

Seven participants acknowledged that men often receive

the message from others to be strong and independent,

195
impacting their ability to seek support from others. Although

men’s difficulties with affect have been identified as an
internal experience of alexythymia (inability to identify and
describe one’s feelings in.words: Levant, 1995), external
forces appeared to be equally powerful in exerting pressure
on.men not to discuss affect. Clinicians should be aware of
the impact of culture on men in both developing and
maintaining their difficulty with affect.

.Additionally, men in my study outlined the positive and
negative influences of family members (both their family and
partner’s family) and friends on their grief. For some
participants, these relationships were an ongoing source of
conflict that impacted their ability to focus on their loss.
Morgan (1989) outlined ways that family relationships can
have negative influences on a widow’s grief, noting the
utility of friendships to fill the void created by
unsupportive family. [Morgan highlighted an important
distinction in this regard: the bereaved can selectively
invest energy in friendships that are more supportive (than
others) whereas they cannot choose family relationships.
Practitioners should be aware that all social support
networks are not necessarily positive and that grieving
clients may need to make adjustments in their networks of
friendships to ensure that they receive the support they
need.

Lieberman (1993) reviewed the literature on bereavement

support groups and identified common elements in these

196
groups. He also acknowledged that unique processes may be

present in these groups that ultimately affect their utility
for individual members and the adjustment of the bereaved.
Thus, different groups will be effective for different types
of people. These differences were evident in reactions of
participants in.my study to support groups they attended and
their interest in remaining involved in these groups.
Practitioners need to be aware that different support groups
may be effective for different personality types of men.
Equally so, different support strategies may need to be
developed for different groups of men (i.e., personality
styles, gay men) to adequately address the diversity that
exists within the population of male grievers. Some men may
respond.more readily to didactic groups whereas others may
feel more comfortable in affectively-based therapy groups.
Brooks and Silverstein (1995) identified “dark-sided
behaviors" of men that are often utilized as coping
mechanisms (p. 280). Although some men in this inquiry
reacted initially to the death of their partner by rejecting
notions of self care, all eventually engaged in some adaptive
coping strategies to deal with their grief. Yet, many seemed
to have underrecognized the importance of self-care or the
numerous strategies that could be used toward this end. This
highlights the important role that clinicians can play in
educating men about the importance of self-care during
stressful times and ways to address their physical and

emotional needs.

197
Gay Men

Current literature suggests that gay relationships are
similar in.many respects to heterosexual relationships
(Kurdek, 1995; Lipman, 1986). However, the American
Psychological Association Task Force on Psychotherapy with
Gays and Lesbians (1991) demonstrated that prejudice still
exists within the therapeutic community against gays/lesbians
and their relationships. Results of this inquiry support the
assertions of the literature and demonstrate the need for
therapists to view heterosexual and gay relationships as of
equal value.

Although all of the gay men in this study believed that
their relationships with their partners were accepted and
affirmed by their families, some found that this was not true
once their partner died. Counselors can be influential in
helping gay men.make a realistic assessment of their support
systems. They can encourage these gay clients to broaden
their social networks as needed to supplement the support
they may/may not receive from their family of origin.

As predicted by Shapiro (1994), organized religion was
an important source of instrumental support for most of the
heterosexual men in my study and provided a sense of meaning
in death/loss. However, only one gay man found support in a
church community. Given the rejection that gays and lesbians
experience in organized religion (Ritter & O'Neil, 1992),
they often are not active in a church and are unable to

utilize a community such as this as a source of both

198
spiritual and instrumental support. Practitioners must be

aware of the spiritual void that these experiences may create
in some gay clients and.work with them to establish a vehicle
for meeting spiritual needs that may emerge from the loss of
a.partner.

One of the gay men in this study lost his partner to
cancer whereas the others lost their partners to AIDS. Yet,
Gary reported that he and his partner still experienced the
stigma associated with AIDS. Although the demographics of
AIDS are changing to include more heterosexual people, AIDS
is still viewed as a gay disease and associated with gay men
who are seen as "carriers of the plague" (Geis, Fuller &
Rush, 1986, p.43). Clinicians who work with gay men should be
cognizant of these pervasive stereotypes and aware that the
stigma related to AIDS may be associated with the death of
any gay man due to a progressive illness, regardless of

actual cause.

SM!

Results of this study demonstrated that much is yet to
be learned about the grieving process for men. .Although some
data in my study were consistent with welfelt’s (1992; 1990)
and Staudacher’s (1991) observations of men’s grief, other
data demonstrated a very different grief experience for some
men. My results illustrated the within-group variation that

is present within the larger population of men.

199
Participants indicated some difficulties with grieving

that appeared linked with outcomes of their gender
socialization. Yet, other data elucidated the effect of
others’ reactions on these men in.maintaining their
difficulties with emotional expression and seeking of
emotional/social support. These findings lend credence to the
observations of Robertson and Fitzgerald (1990); that mental
health professionals and society in general may have a subtle
influence on keeping men in their traditional gender roles.
More research is needed to explore the interactions between
men and their environment.

The data demonstrated the manifold parallels in the
experiences of heterosexual and gay men. Although I had
anticipated that some commonalities would exist in their
experiences, I was surprised by the level of convergence in
the positive and negative influences on their grief. Data
supported Lipman’s (1986) observation that the dynamics of
long term relationships "tend to transcend the issue of
sexual preference" (p.54).

I hope that through this research counselors become more
sensitive to the strengths and needs of men grieving the
death of their partners. My research has demonstrated that
men are willing to talk about their experiences. We must be
ready to hear them in both our personal and professional

lives.

APPENDICES

APPENDIX A

PARTICIPANT DATA

Participant

Pseudonym: Brendan
Age at time of interview: 39
Current relationship status: single/no current relationship
Educational level: Bachelor’s degree
Present annual income: $41-60,000
Occupation: Professional
Geographic region of childhood: Midwest
urban

Religious/spiritual affiliation of childhood: Catholic
Current religious/spiritual affiliation: Catholic
How often attend place of worship: 1 x week
Length of relationship with deceased partner: 14 years
Children from this relationship:
3 2 boys, ages 10 and 4

1 girl, age 7

Partner:
Pseudonym: Eileen
Age at death: 31
Religious/spiritual affiliation of childhood: Catholic
Religious/spiritual affiliation in adulthood: Catholic
Educational level: High school diploma
Most recent occupation: Homemaker/mother
Geographic region of childhood: Midwest
urban
Cause of death: Breast Cancer
Length of illness: 14 months
Time since death at interview: 11 months

200

APPENDIX B

RECRUITMENT PROCEDURES

Advertisement used in recruitment:

Doctoral student in Counseling Psychology at MSU is
interested in contacting men who have experienced

the death of their partner due to chronic illness one or
more years ago for a confidential interview. Through
this research, the counseling community will develop a
greater understanding of how to be helpful to men in
their grieving process. If you would be willing to
consider participating in this project, please call 353-
9685 and leave a voice-mail message for John, including
a number where you can be reached and convenient times
to call. Thank you.

Phone conversations with participants:
First phone contact
Cover: My name and affiliation
Description/importance of the project
Questions they have about project
Get their name and address
Outline steps of the process

Second phone contact
Cover: Their selection for further participation
Extent of interview and audiotaping
Date/place to meet for interview
Remaining questions they have about the
project

212

APPENDIX C

INITIAL LETTER TO POTENTIAL PARTICIPANTS

March, 1995

Dear (Name of Participant),

Thank you for your willingness to consider participating
in my research on men's grief. As I mentioned on the phone,
I am interested in interviewing men who have experienced the
death of their partner. Psychologists could benefit greatly
from hearing directly from men about their needs at a
difficult time such as this.

I will be interviewing a small number of men from the
larger group who have responded to my advertisements. I am
seeking a diverse group of individuals. Please know that if
you are not selected to participate in the next step of this
research, this has nothing to do with you but reflects the
financial constraints of a graduate student. I value your
willingness to share your experience and hope that you can
understand this limitation. Whether or not you are
interviewed, I will send you a list of grief support services
that are available in the Lansing area. I hope that you will
find this list helpful.

Enclosed you will find a consent form for participating
in this research project. You will also find a sheet which
asks for some preliminary information about you and your
deceased partner. If you are willing to participate in this
research, please complete these forms and return them in the
enclosed stamped envelope before March 31, 1995. I will call
you within one month if you are to be involved in the next
step of this study. Otherwise you will receive a notice from
me by the end of April.

Thank you very much for your willingness to assist with
my dissertation research. I look forward to hearing from
you.

Sincerely,
John M. O'Brien
Doctoral Candidate, MSU

Counseling Psychology
353-9685

213

APPENDIX D

INITIAL CONSENT FORM FOR PARTICIPANTS

Consent to Participate

The Counseling Psychology Program at Michigan State
supports the practice of protection for human subjects
participating in research. The following information is
provided so that you can decide whether you wish to
participate in this study. You should be aware that even if
you agree to participate now, you are free to withdraw at any
time.

The goal of this study is to explore the grieving
process of men who have experienced the death of a partner.
A two hour interview will be conducted with a limited number
of participants to gain some understanding of the factors
influencing their mourning process. Even if you are not
selected for an interview, you will receive a list of grief
support services available in the Lansing area.

This work is my dissertation. In writing up my
dissertation results, identities of the participants will be
concealed to ensure confidentiality. If quotes from or
details about individuals are used, names will be changed to
protect their identity.

Your participation is strictly voluntary and is greatly
appreciated. Psychologists and.other professionals who
provide therapy will benefit from the knowledge of how to
best meet the needs of men who are grieving the loss of a
partner.

Thank you for your willingness to consider participating
in this study. If you have any questions about the study,
please contact me at the number below. I look forward to
receiving your information.

Sincerely,

John M. O'Brien, M.A.
Doctoral Candidate
Principal Investigator
353-9685

 

 

Sign here if you agree to participate Date

 

Sign here if you do not agree to participate but would like
the listing of bereavement resources.

214

APPENDIX E

Preliminary Information Form: Men in Grief Study
About you:

Name:

Age:

Cultural/ethnic background:

Current relationship status : _single/no'current

relationship _dating
_living together
_committed.relationship
.ymarried/commitment ceremony
_other (please explain)

 

 

 

Education:___some high school “__Bachelor's degree
__high school diploma (__Master's degree
___some college __ Doctoral degree
__Associates degree
Present annual income: __ less than $20, 000 __$61-80,000
__$21-40,000 __$81-100,000
__$41—60,000 __ +$100,000

Your religious/spiritual affiliation:

 

About your deceased partner:
Sex:.Male/Female

Age at death: Date of Death
(Month/Day/Year)

 

religious/spiritual affiliation:

 

What was the cause of your partner's death?

 

Thank you for taking the time to complete this form.
Please return it in the enclosed envelope.

215

APPENDIX F

LETTER.TO INTERVIEWEES

April, 1995

Dear (Name of Participant),

I am writing to confirm our phone conversation on
.......... I appreciate your willingness to participate in
my research. As you know, I am interested in studying men
who have experienced the loss of a partner. Clinicians may
overlook some of the specific needs of men in this situation
as there is not a great deal of research to guide their
thinking. This study will inform counselors about how they
can be most helpful to men who are grieving.

The interview in which I am inviting you to participate
on ........ at ......... will take approximately two hours.

I realize that it may be difficult to reexperience your
thoughts and feelings about your partner's death and I am
grateful for your willingness to take part in this study. We
will take time after the interview to talk about this
experience. I am prepared to discuss referral options for
further counseling if that is something you are interested in
pursuing.

Your identity will be protected in this process. You
may wish to use a different name in the interview (which will
be audio taped with your permission). When the results are
summarized in my dissertation or in a research article, your
experiences and perceptions may be reported, but your real
name will not be used to ensure complete confidentiality.

Enclosed is a consent form that I would like you to
read. Please sign the form and bring it to our appointment.
I have also enclosed a background information form for you to
complete and bring with you to our meeting.

I hope that you will feel free to contact me if you have
any questions at this time or if you need to reschedule our
appointment. I will call you one day in advance to confirm
the interview time. I will look forward to meeting you on
........ at ..........pm at................

Thank you very much for your willingness to assist with
my dissertation research.

Sincerely,

John M. O'Brien
Doctoral Student
Counseling Psychology
353-9685

216

APPENDIX G

INTERVIEW CONSENT FORM

Consent to Participate

The Counseling Psychology Program at Michigan State
supports the practice of protection for human subjects
participating in research. The following information is
provided so that you can decide whether you wish to
participate in this study. You should be aware that even if
you agree to participate now, you are free to withdraw at any
time.

The goal of this study is to explore the grieving
process of men who have lost a partner. An interview will be
conducted with each participant to gain some understanding of
the factors influencing his mourning process. Results will
be analyzed to examine similarities and differences in
individual's experiences.

Interviews will be taped so that the interviewer can
fully attend to you and your comments. These tapes will be
kept in a file drawer at the home of the investigator. John
O'Brien and the transcription assistant will be the only
individuals with access to the tapes. Once the interviews
have been transcribed, the tapes will be destroyed.

This work is my dissertation. In writing my results,
identities of the participants will be concealed to ensure
confidentiality. If quotes from or details about individuals
are used, names will be changed.

Your participation is strictly voluntary and is greatly
appreciated. Counseling psychologists will benefit from the
knowledge of how to best meet the needs of men who are
grieving the loss of a partner.

Thank you for participating in this study. If you have
any questions which have arisen since our phone conversation,
please contact me at the number below.

Sincerely,

Johan. O'Brien, M.A.
Doctoral Candidate
Principal Investigator
355-8502

 

 

Sign here if you agree to participate Date

 

Sign here if you do not agree to participate

217

APPENDIX H

Background Information Form: Men in Grief Study
About you:

Name:

 

Date of birth: Age:

 

Place of birth:

 

Geographic region of childhood: (please check two)

_ Northeast _urban
_Midwest _suburban
_Michigan _small town
_South _rural

west

:other country (specify):

 

Current relationship status : _single/no current relationship
_dating
_living together
_committed.relationship
_married/domestic partner

Date of current marriage/commitment ceremony (if
applicable) .

 

Do you have any children? Any from this
relationship? .

If yes to either question, please give first name and ages:

 

 

 

Work history: Current occupation:
# years in current job:
# previous jobs:
In what areas?

 

 

 

 

 

 

Religion:
Religious/spiritual affiliation of childhood:
Current religious/spiritual affiliation:
How often do you attend your place of worship?

 

 

 

218

219

How long were you in the relationship with your deceased
partner?

 

Did you live together? If so, for how long?

 

How did you meet?:

 

 

 

 

 

About your partner :

First name:

 

Date of birth:
Occupation:

 

 

Religion:
Partner's religious/spiritual affiliation of childhood:
Partner's adult religious/spiritual affiliation:

 

Geographic region of childhood:

_ Northeast _urban
_Midwest _suburban
_Michigan _small town
_South _rural
_West

_other country (specify):

 

Partner's educational level:

__ some high school __Bachelor's degree
__high school diploma .__Master's degree
__some college __Doctoral degree

__Associates degree

What was your partner's most recent occupation?

 

What was the cause of your partner's death?

 

When did your partner receive this diagnosis?

 

Who was the primary caregiver for your partner during this
illness?

 

Thank you for taking the time to complete this form.

APPENDIX I

INTERVIEW’PROTOCOL

IntervieM{Questions:

This interview is being conducted to understand.more about
the grieving process for men who lose a spouse or partner. I
hope that you will be comfortable expressing your feelings
and views, knowing that all personal information gathered
about you will be kept confidential. When I report these
results for my dissertation or share them with other
professionals, I will do everything possible to ensure
anonymity of participants. This whole interview will take
about two hours. If you have any questions about issues we
are talking about or you want to go on to another topic,
please tell me. This interview is being taped so that I will
not have to take notes and I can concentrate on what you're
saying. If you would like to choose a different name for us
to use on the tape, please do so... Since we will only see
each other today, I'd like to talk with you at the close of
today to make you aware of available grief support services .
Is there a name that you would like to use on the tape? Okay
......, ready to begin? Okay.

Name:

What prompted you to volunteer for this research project?
Probe: reasons for participating?

Relationship
Describe for me your relationship‘with ....... How did you
meet? What attracted you? What was your relationship like?
Probe: How long were you together?
What were some of your shared activities?
How did you manage conflict/disagreements?
gay men: Were you and ...... an acknowledged couple?
.A public ceremony?

Epitnei's Death
Tell me about what happened for you when .....died.
Probe: What did you do immediately after ......'s death?
What were your sleeping patterns like?
What were your eating patterns like?

220

221

Emotionaiiexpression

People may experience a range of emotions during the grieving
process, including anger, depression, anxiety, guilt, shame,
fear, detachment, heightened needs for control, and other
emotions as well. Tell me about the feelings you experienced
immediately after ....... died, in those weeks and months
that followed, and now?
Probe: What emotions did you experience when alone?

What about with family?

What emotions did you share with your best

friend/other?

What is it like to talk with me?

What has kept you from sharing much?

How have your emotions changed over time?

Social support

Describe the support you felt from others before ..... became
sick, during his/her illness, and after his/her death through
to the present.
Probe: Any support from your family or your partner's
family?
Who did you rely on most...Friends, children,
parents, siblings?
Did you seek out support groups? If so, why?
If not, why not?
What type of support was helpful/not helpful?
If no support, what kept you from seeking this
or getting this?
How has your social world changed since ....'s

death?

Work

Did ......'s illness and death effect your work? If so, how?

Probe: How much time did you take off?

How soon did you return to work? Take more
time off?
How well were you able to concentrate when
there?

How did you colleagues respond?
How did your supevisor/boss respond?

Rituals/practices

To facilitate the process of grieving, some people choose
rituals such as a funeral, a memorial service, or a ceremony
to commemorate their loved one. Where there any
rituals/ceremonies that you or others used to remember
......? If so, please describe.

Probe: WhO‘was involved in planning these events?
What were the rituals like...were they helpful
or not?

Religion

 

222

Was religion/spirituality an important part of life for you

and/or you partner? Has it changed in importance in your

life? Did it change in importance in your partner's life?
Probe: Did religion or spirituality help you
and/or your partner in this experience? If
so, how?

Pgevious losses

Prior to this experience, whhat did you learn in your life
about how to deal with death and/or loss?

Probe: From family? Others?
Do you think your current loss was impacted by
this?
Afterlife
Do you have a belief about what happens after death?
Probe: How did this experience affect it?
Healthy/unhealthy

 

During a stressful time like this, people often make an
effort to take care of themselves. What were somethings that
you did immediately after ....died to take care of yourself?
Probe: Did you use time alone to reflect?

Did you read books?

Did you write in a journal?

Creative arts?

Exercise?

Of course, the other side of the question can be true

too..sometimes people do things that may hinder their

adjustment or that may not be good for them. Looking back

now, are there things you might have done differently?
Probe: What has been the most difficult part of your
readjustment?

Advice

What advice would you give to professionals who are working

with grieving men?

Unasked
Sometimes when I do interviews, I find that I have not asked
people about something that they felt was extremely
important. You may have been sitting there saying, ”I wonder
if he will ask me about this?" If so, I invite you to ask
this unasked question.

Probe: How'might you respond?

SHUT OFF TAPE

How have you felt about this interview?
Was there anything difficult to discuss?
Other reactions?

Present with list of Lansing Area Grief Resources.

APPENDIX J

LETTER TO VOLUNTEERS NOT SELECTED FOR INTERVIEWS

April, 1995

Dear (Name of Volunteer),

Thank you for responding to the request to participate
in my study of men who have experienced the death of their
partner. There were many responses to my advertisement and I
‘was grateful to hear from so many willing volunteers.

Unfortunately, I will be unable to speak with you about
your experience. As I mentioned in my previous letter, I was
seeking a group of diverse individuals and have attempted to
represent men with many different life experiences. In doing
so, I hope to make the results of my research useful and
relevant to as many people as possible.

I wish that I had the opportunity to speak with
everyone who responded. Each person brings his own unique
perspective to an experience such as this. I am grateful for
your willingness to share that with me.

Enclosed you will find a listing of grief support
services available in the Lansing area. I hope that you find
this list to be a helpful resource.

I wish you peace of mind and heart.

Sincerely,

John M. O'Brien

223

APPENDIX K

FOLLOW-UP LETTER TO INTERVIEWEES

May, 1995
Dear (Name of Participant),

I want to express my gratitude to you for participating
in the interview about your experiences of grieving. I
appreciated your willingness to trust me with such an
important part of your life. Your input to the study was
greatly appreciated. It is my hope that the results of my
study will inform clinicians about how to respond sensitively
to the needs of men who are grieving.

It has indeed been a privilege for me to hear about your
experiences. I wish you peace of mind and heart.

Sincerely,

John M. O'Brien

224

APPENDIX L

Lansing Area Bereavement Resources
While every effort has been made to include up-to-date information about
grief support in the Lansing area, this is only a partial listing of
services. However, by contacting the organizations below, you will learn
about other opportunities that are available.

 

Information
Widowed Persons Segyice, AARP, 601 E. Street, NW,
Washington, DC, 20049 (202) 434-2260

Theos Foundatipp, for the widowed and their families,
Room 306, The Penn Hills .Mall Office Bldg, Pittsburgh,
PA 15235

Michigan Hospice Organization, Suite 101-C, 900 Third
St. Muskegon, MI 49440 (800) 536--6300: information
about hospice care in MI and referral to hospice
programs for hospice care and bereavement support.
Michigan Seii-HeipyCleaiinghouse: (800) 777-5556 .
Information resource for local support groups on a
variety of topics.

for more specific details about other national, state,
or local information resources or grief support services
in Lansing, contact:

Cendra (Ken'dra) Lynn, Ph.D.,Rivendell Resources P.O.
Box 3272, Ann Arbor, MI 48106-3272 (313) 761-1960
E-Mail: rivndellemsen.com

Bereavement Support Groups
The Widowed Persons Group,Susan Zimmerman:(517) 339-4675

Ele's Piece, 809 Center Street, Lansing, MI 48906: Jerre

Cory, Director- children's groups are the primary focus,

adult group for parents who have children involved.
(517) 482-1315

Lansing Aiea AiDS Network (LAAN)- 855 Grove East

Lansing, MI 48823 information, testing, support groups
for people who have lost someone to AIDS.(517) 351-0303

Grief Recoveiy and Education Center: services available
to individuals and families who have suffered a loss
through death.Referral information is available and a
resource library. (517) 333-3636

Hospice of Lansing: 6035 Executive Drive, Suite 102,
Lansing, MI 48911-information,support groups(517)882-4500

Greater Lansing Visiting Nuise Service Hospice, 4801
Willoughby Suite 7, Holt, MI 48842 hospice services,
information, support groups.Contact: Lynn Breer

(517) 694-8300

225

226

Licensed PsychologistsIPsychiatrists/Social Workers in
Private Practice

Selecting a therapist is an important task. You need to
consider numerous things: (1) Do you have insurance that
covers outpatient mental health services? (2) Does a certain
therapist take your health plan? (3) Do you feel comfortable
with this person? Some clinicians will slide their fee for
those who do not have insurance...or you can pursue an
outpatient mental health facility where rates may be lower
based upon a person's ability to pay. After you have found a
match on your insurance status, you have the power to find a
therapist that fits with your personality. Find out if they
‘will do a consultation session and how'much that costs. You
should also ask about their experience and training in
‘working with clients around grief and loss issues. Check the
Yellow Pages under Psychologists, Psychiatrists (under
Physicians), and Social Workers.

 

Clinics

Community'Mentgi Health

Referral Officeawill determine where most appropriate

services are for you that are currently available

through CMH (517) 374-8000
CRISIS- Emergency Services- (517) 372-8460

MSU Familygand Child Clinic: sees individuals, children,
and families. Therapists are doctoral students who are

 

 

 

 

 

supervised by licensed clinicians. (517) 336-2271
MSU Psychological Clinic: (517) 355-9564
MSU Psychiatry Clinic: (517) 353-3070
§gpggitan.Counseiing'Centep: (517) 337-2338
CathoiigySocigi Serviges: (517) 372-4020
Lptheran Social Services: (517) 321-7663

 

Child and Family Services of Michigan: (517) 699-1600

If you need.more specific information, contact John at (517)
353-9685.

,APPTflflDIXLDI

Grand Rapids Area Bereavement Resources
While every effort has been made to include up-to-date information about
grief support in the Grand Rapids area, this is only a partial listing
of services. However, by contacting the organizations below, you will
learn about other opportunities that are available.

 

Information
Widowed.Persons Service, AARP, 601 E. Street, NW,
Washington, DC, 20049 (202) 434-2260

Theos Foundatipp, for the widowed and their families,
Room 306, The Penn Hills..Mall Office Bldg, Pittsburgh,
PA 15235

Michigan Hospice:Organization, Suite 101-C, 900 Third
St. Muskegon, MI 49440 (800) 536--6300: information
about hospice care in MI and referral to hospice
programs for hospice care and bereavement support.
Michigan Seig-Help‘Clearinghouse: (800) 777-5556 .
Information resource for local support groups on a
variety of topics.

for more specific details about other national, state,
or local information resources or grief support services
in Lansing, contact:

Cendra (Ken'dra) Lynn, Ph.D.,Rivendell Resources P.O.
Box 3272, Ann Arbor, MI 48106-3272 (313) 761-1960
E-Mail: rivndellemsen.com

Bereavement Support Groups:
Widowed Persons Service: (616) 451-2446

AIDS Resource Centep, 1414 Robinson Rd. SE, Grand
Rapids, MI information, testing, and support groups for
people who have lost someone to AIDS. (616) 459-9177

Hospice of Greater Grand Rapids, 750 Fuller NE, 5th
floor, P.O. Box 2427, Grand Rapids, MI 49503
(616) 454-1426

Grand Rapids, Visitinngurse Services Hospice Program,
1401 Cedar NE, Grand Rapids, MI 49503 (616) 774-2702

227

228

Licensed PsychologistslPsychiatrists/Social Workers in
Private Practice

Selecting a therapist is an important task. You need to
consider numerous things: (1) Do you have insurance that
covers outpatient mental health services? (2) Does a certain
therapist take your health plan? (3) Do you feel comfortable
with this person? Some clinicians will slide their fee for
those who do not have insurance...or you can pursue an
outpatient mental health facility where rates may be lower
based upon a person's ability to pay. After you have found a
match on your insurance status, you have the power to find a
therapist that fits with your personality. Find out if they
will do a consultation session and how'much that costs. You
should also ask about their experience and training in
‘working with clients around grief and loss issues. Check the
Yellow Pages under Psychologists, Psychiatrists (under
Physicians), and Social Workers.

Clinics

Community Mental Health
Assessment and Referral Services-will determine where

most appropriate services are for you that are currently

 

available through.CMH (616) 336-3909

CRISIS- Emergency Services- (616) 336-3535
Catholic Sggial Services: (616) 456-1443
Lutheran Sociainepyices: (616) 532-8286

 

Pine Rest Christian Mentai Heaith Services: 300 68th, SE
Grand Rapids, MI. Offers outpatient services to both
families and individuals. (616) 455-9200

West Michigan Guidance Centeg, 3351 Claystone SE, Grand

If you need more specific information, contact John at (517)
353-9685.

APPENDIX N

Ann Arbor Area Bereavement Resources
While every effort has been made to include up-to-date information about
grief support in the Ann Arbor area, this is only a partial listing of
services. However, by contacting the organizations below, you will learn
about other opportunities that are available.

 

Information
MidowegiPepgons Service, AARP, 601 E. Street, NW,
Washington, DC, 20049 (202) 434—2260

Theos Foundation, for the widowed and their families,
Room 306, The Penn Hills Mall Office Bldg, Pittsburgh,
PA 15235
[Michigan Hospice Organization, Suite 101-C, 900 Third
St. .Muskegon, MI 49440 (800) 536--6300: information
about hospice care in MI and referral to hospice
programs for hospice care and bereavement support.
Michigan Seif-Help Clearinghouse: (800) 777-5556 .
Information resource for local support groups on a
variety of topics.
for more specific details about other national, state,
or local information resources or grief support services
in Lansing, contact:
Cendra (Ken'dra) Lynn, Ph.D.,Rivendell Resources P.O.
Box 3272, Ann Arbor, MI 48106-3272 (313) 761-1960
E-Mail: rivndellemsen.com

Bereavement Support Grow
Grief Recovery Ggoupg- regularly scheduled. Call Hospice
of Southeastern.Michigan. (810) 559-9209

Children’s Loss Support Group: for elementary age
children who have lost a parent due to death. Parenting

group available at the same time. (313) 764—9466

Child and Family Services: volunteer widows and widowers
reaching out to support the newly widowed.
(313) 971-6520

Reconnect: a community of support for children and their
families. (313) 994-0561

Wellness Networks- Huron Valley- AIDS and HIV groups,
grief and loss group, referrals: (313) 572-WELL.

Ann Arbor Hospice, Suite 200, 3810 Packard Rd. Ann

Arbor, MI 48108. support groups, resources.
(313) 677-0500

229

230

Hospice of Washtenaw, 806 Airport Blvd. Ann Arbor, MI
48108. support groups, resources (313) 741-5777

Individuaiized.Hospice, 3003 Washtenaw, Suite3 Ann
Arbor, MI 48104. (313) 971-0444

Licensed PsychologistsIPsychiatrists/Social Workers in
Private Practice

Selecting a therapist is an important task. You need to
consider numerous things: (1) Do you have insurance that
covers outpatient mental health services? (2) Does a certain
therapist take your health plan? (3) Do you feel comfortable
with this person? Some clinicians will slide their fee for
those who do not have insurance...or you can pursue an
outpatient mental health facility where rates may be lower
based upon a person's ability to pay. After you have found a
match on your insurance status, you have the power to find a
therapist that fits with your personality. Find out if they
‘will do a consultation session and how much that costs. You
should also ask about their experience and training in
‘working with clients around grief and loss issues. Check the
Yellow Pages under Psychologists, Psychiatrists (under
Physicians), and Social Workers.

 

Clinics

Community Mental Health
Referral Office-will determine where most appropriate
services are for you that are currently available

 

 

through CMH (313) 971-2282
CRISIS- Emergency Services- (313) 936—5900

Qgthoiic Social Services: (313) 662-4534
Mutheian Social Serviges: (313) 823-7700

 

 

If you need more specific information, contact John at (517)
353-9685.

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