Adaptation To Bereavement

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Adaptation to Bereavement
a b
Yulia Chentsova Dutton & Sidney Zisook
a
Stanford University , Stanford, California, USA
b
University of California at San Diego and Veteran
Affairs Medical Center, San Diego , San Diego,
California, USA
Published online: 23 Feb 2007.
To cite this article: Yulia Chentsova Dutton & Sidney Zisook (2005) Adaptation to
Bereavement, Death Studies, 29:10, 877-903, DOI: 10.1080/07481180500298826
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ADAPTATION TO BEREAVEMENT
YULIA CHENTSOVA DUTTON

Stanford University, Stanford, California, USA
SIDNEY ZISOOK
University of California at San Diego and Veteran Affairs Medical Center,
San Diego, San Diego, California, USA
Much of the literature on the effects of conjugal bereavement has focused on the
detrimental effects of losing a spouse. Although it is very important to be aware
of the emotional, physical, and social problems often associated with bereavement,
these difficulties are not universal accompaniments of grief. Accumulating evi-
dence suggests that resilience in the face of bereavement is the norm rather than
an exception. This article uses a multidimensional model of bereavement adap-
tation and reviews literature on multiple paths to resilience among bereaved indi-
viduals. Each dimension of adaptation is illustrated with quotes from
participants of the San Diego Widowhood Study.
‘‘I count each day as a true gift—that life is a blessing to be enjoyed for the
moment.’’
Try to imagine what sort of an individual wrote this passage. He or

she is able to focus on the positive aspects of life and enjoy them to
the fullest. Perhaps you would be surprised to discover that these
are the words of a recently bereaved woman. The terms grief
and bereavement evoke images of sadness, despair, and loneliness.
Although it is true that bereavement can be a very difficult time
in one’s life, many widows and widowers are able to make sense
of their loss, manage their feelings in an adaptive way, maintain
emotional stability, master new tasks, develop new friendships, fos-
ter romantic relationships, and, perhaps most strikingly, positively
Received 4 January 2005; accepted 11 July 2005.

Address correspondence to Yulia Chentsova Dutton, Department of Psychology,
Stanford University, Building 420, Jordan Hall, Stanford, CA 94305. E-mail: yulia@psych.
stanford.edu
877
878 Y. Chentsova Dutton and S. Zisook
redefine their sense of who they are in the months following the
death of their spouse. This difficult time in their lives also becomes
a time of remarkable growth and resilience for many.
Losing a loved one is a potentially traumatic life event that
affects all of us at some point in our lives. Any death, be it the
death of a friend, a parent, or a sibling, can be painful and difficult.
Of all these losses, spousal bereavement may be among the most
devastating. Spouses play a multitude of roles in each other’s lives,
such as those of friend, confidante, lover, partner, and source of
emotional and financial support. Thus, the death of a spouse can

be tremendously disruptive to one’s functioning and well-being.
Sigmund Freud was the first to describe the tug of war between
the fact of death and continuing attachment to the deceased in
his 1917 article ‘‘Mourning and Melancholia’’ (Freud, 1957). He
stated that the reality of a loved one’s absence from one’s environ-
ment can sharply contrast with vital and meaningful ties that con-
tinue to connect the survivor with the deceased, and proposed that
loss of a loved one can powerfully interfere with healthy psycho-
logical functioning. It is not surprising that the psychiatric literature
has focused on the detrimental effects of spousal bereavement
(Miles, 1985; Stroebe & Stroebe, 1987; Zisook, Paulus, Shuchter,
& Judd, 1997; Zisook, Schneider, & Shuchter, 1990). Research sug-
gests that negative outcomes of bereavement, such as severe and
persistent grief responses and difficulty in coping with grief, are
particularly likely following certain types of losses, such as violent
deaths (Kaltman & Bonanno, 2002; Rynearson & McCreery, 1993)
and suicides (Farberow, Gallagher-Thompson, Gilewski, &
Thompson, 1992), and among certain kinds of individuals, such
as those with excessive dependency on their spouses (Parkes &
Weiss, 1995; Stroebe, 2002; Van Doorn, Kasl, Beery, Jacobs, &
Prigerson, 1998).
Although bereavement has been linked with unfavorable
psychological and physical health outcomes such as depression,
anxiety, poor physical health, and impaired occupational and
social functioning, most widows and widowers are strikingly resili-
ent and are able to adapt to bereavement successfully (Bonanno,
2004; Lund, Caserta, & Dimond, 1993; McCrae & Costa, 1993).
Even in the face of acute grief, many of these individuals are able
to draw strength and vitality from struggling with the trauma
of their spouses’ deaths. In fact, some bereaved individuals
Adaptation to Bereavement 879
(particularly those who tended to have ill spouses or conflicted

marriages) may even show improved rather than worsened
psychological functioning following their loss (Bonanno et al.,
2002; Bonanno, Wortman, & Nesse, 2004). These findings do
not suggest that successful adaptation to bereavement is unambigu-
ously positive. Widows or widowers may take bittersweet pride in
their mastery of new tasks and more meaningful relationships
while continuing to grieve their loss. This article will review
elements of successful adaptation to spousal bereavement. This
promising area of research is understudied relative to research focus-

ing on detrimental effects of bereavement (Lund & Caserta, 1998).
Models of Bereavement Adaptation
Several contemporary theoretical models describe healthy adjust-

ment to bereavement. For example, Shuchter and Zisook proposed
a multidimensional model of bereavement adaptation (Shuchter &
Zisook, 1993). The six dimensions of grief outlined in this model
include (a) emotional and cognitive experiences; (b) coping with
loss; (c) the continuing relationship with the deceased spouse;
(d) functioning; (e) social and intimate relationships; and (f) identity.
In this model, bereavement adaptation is described as a complex
process, requiring adjustment not only to the loss itself, but also
to the multitudes of secondary stressors. This model also poses that
levels of adaptation to the loss may vary across the dimensions of
grief and, thus, successful adaptation strategies may show consider-
able heterogeneity across bereaved individuals. The Dual Process
Model of coping with bereavement (Stroebe & Schut, 1999;
Stroebe, Schut, & Stroebe, 2005) poses that bereaved individuals
oscillate between attending to and coping with loss-oriented (such
as thinking about the deceased or yearning for his or her presence)
and restoration-oriented (such as mastering new tasks or negotiat-
ing a new identity) tasks and stressors. This model proposes that
the dynamic regulatory mechanism of oscillation allows the
bereaved to confront or avoid stressors based on their level of
emotional functioning or the circumstances. The Dual Process
Model also stresses that bereavement does not occur in a social
vacuum and that coping strategies span both intrapersonal and
interpersonal domains. Bonanno and Kaltman (1999) proposed
another model that focuses on four components of adaptation to
bereavement including (a) the contextual variables that influence

adjustment to the loss, such as age, gender and perceived social
support; (b) the subjective meaning that is assigned to the loss;
(c) the changing representation of the lost relationship with the
deceased spouse; and (d) coping and emotion regulation strategies.
In another model that focuses on restoration of the coherence of
life’s narrative after a potentially devastating and disrupting loss,
Neimeyer (1998, 2005) stressed that there are multiple ways to
reconstruct the life story after the loss.
These models have several features in common. First, all of

these models share a focus on resilience and adaptation and
attempt to identify the characteristics of effective coping. Second,
all of these models recognize that adaptation to the loss of a spouse
is complex, requiring different adaptive strategies across different
life domains and situations. Third, all of these models pose that
adaptation to bereavement can take many different shapes. These
models attempt to identify potential sources of individual differ-
ences in adaptation. Fourth, all of these models identify key aspects
of adaptation to the loss, such as coping strategies, emotional regu-
lation, changes in the survivor’s identity, and negotiating the lost
relationship to the deceased spouse. Finally, all of these models
acknowledge that bereavement is shaped by the sociocultural con-
text. Although contemporary evidence is consistent with several of
these theoretical perspectives, in this article, we will use Shuchter
and Zisook’s (1993) multidimensional model to organize our dis-
cussion of the literature on successful adaptation to bereavement.
To illustrate the different aspects of adaptation to bereave-
ment, we will directly quote widows and widowers who partici-
pated in the longitudinal San Diego Widowhood Project. The
sample was gathered from all new widows and widowers in San
Diego County who had lost their spouse, as recorded by death
certificates filed at the San Diego County Department to Health
Services. The bereaved individuals who lived within 50 miles of
downtown San Diego were mailed a description of the project
and were invited to volunteer to participate by returning a postcard
indicating their willingness for a home interview. Of the 435
persons who returned postcards expressing some interest in partici-
pating in the study, 350 (80%) ultimately agreed to be interviewed
in their own homes 7 to 8 weeks following their spouse’s death.
Follow-up questionnaires were sent at 6, 13, 18, and 25 months
after the death. Of the 350 widows and widowers who entered the
study, 259 (74%) completed the entire 25-month study. The mean
age of the sample was 62 years, 73% of participants were woman,
and 96% were Caucasian. A full description of this population is
available elsewhere (Zisook, Mulvihill, & Shuchter, 1990).
Emotional and Cognitive Experiences
People often erroneously equate grief and depression. Notably,

bereavement is the only psychosocial stressor that can negate diag-

nosis of major depression during the first 2 months after losing a
loved one (American Psychiatric Association, 1994). Although
research shows that a substantial number (19–58%) of bereaved
individuals are depressed at 1 month post-loss (Bornstein, Clayton,
Halicas, Maurice, & Robins, 1973; Harlow, Goldberg, &
Comstock, 1991; Lund, Caserta, & Dimond, 1986), it is important
to keep in mind that the majority of bereaved spouses does not
become clinically depressed following the loss. Moreover, in most
cases absence of depressive symptoms appears adaptive and is not
associated with emotional aloofness or lack of attachment to the
deceased (Bonanno et al., 2002).
Acutely, bereavement is characterized by pervasive and
intense negative emotions including sadness, loneliness, anguish,
disbelief, hopelessness, helplessness, guilt, anxiety, fear, and anger.
Feelings of distress are common for at least several months after
the loved one’s death. With time, they often become more epi-
sodic, recurring on anniversaries, special events or when encoun-
tering poignant reminders of the deceased. One 64-year-old
widow wrote a year after her husband’s death:
I’m doing better and feeling better, but I continue to be amazed at how the
grieving process continues to ‘‘grab me’’ at most unexpected times and
places. It feels like a very long, slow process getting through all of this. I
am happier now than I was six months ago, but I still miss my husband
terribly, and wonder if those feelings will ever go away.
Empirical evidence suggests that the answer to this widow’s

question is that, typically, the feelings associated with grief do not
fully disappear with time (Shuchter & Zisook, 1993). On the other
hand, they do become less disruptive and overwhelming. Thus,
successful adaptation is marked not by the absence of negative feel-

ings, but by an individual’s ability to manage the ‘‘ebb-and-flow’’ of
distress and to focus on positive emotions. For instance, the widow
quoted above points out that she is doing ‘‘better and better’’ and is
‘‘happier now,’’ while she acknowledges the pangs of grief. Unfor-
tunately, most existing studies on spousal bereavement do not
assess the participants’ experiences of positive emotions. We know
that at 2 months after losing a spouse almost a third of widows and
widowers report experiencing a sense of relief in knowing that their
loved ones are no longer in pain (Shuchter & Zisook, 1993). This is
particularly true for those who cared for the dying spouse or
watched their spouse suffer over long periods of time.
Self-help grief resources commonly advise that expression of
negative feelings, such as sadness, guilt, and anger, aids in grieving
(e.g., see a guide for families, Kemp, 2005). Contrary to popular
wisdom, Bonanno and colleagues have found that verbal-
autonomic dissociation (a discrepancy between expressed emo-
tions and physiological responsiveness) (Bonanno, Znoj, Siddique,
& Horowitz, 1999) and fewer facial expressions of negative
emotions were associated with positive psychological consequences,
as indexed by the low levels of grief and better perceived health
over time (Bonanno & Keltner, 1997). An exploration of
behavioral correlates of positive emotions demonstrated that genu-
ine laughter among bereaved individuals is associated with
reduced experience of negative emotions and increased experi-
ence of positive emotions (Keltner & Bonanno, 1997). Individuals
who could laugh were also judged by observers to be better
adjusted than individuals who could not. The groups did not differ
in other important aspects, such as personality traits and character-
istics of death. It appears that the ability to express joy rather than
sadness in the midst of a tragedy is indicative of healthy emotional
adaptation. Remarkably, the majority of participants in this study
were able to show facial expressions of positive emotions (smiling
and laughing) when describing their relationship with the deceased
spouse.
It has been suggested that culture may play a role in one’s
emotional reaction to bereavement. Even within the United States,
Latinos and African Americans are said to be more expressive and
grieve more openly than Asian Americans, but empirically derived
data is lacking in this important area. In one study that compared
hypothetical emotional reactions of American and Spanish stu-

dents, Americans were more likely than Spaniards to indicate that,
after experiencing a hypothetical death of a loved one, an average
person would experience negative emotions, such as a sense of
loss, anger, loneliness, confusion, guilt, and denial (Caitlin, 1993).
At present most of the longitudinal studies of grief are based on
samples of European American widows and widowers. Actual,
rather than hypothetical, feelings in response to spousal bereave-
ment remain to be studied cross-culturally.
There are a number of cognitive patterns that appear to be

associated with successful adaptation to the loss of a spouse. Stu-
dies suggest that adaptive thoughts and narratives of loss are char-
acterized by a propensity for change and development over time
(Pennebaker, Mayne, & Francis, 1997). Adaptation to bereavement
requires recognition and acceptance of the changes that come with
the loss. Such recognition and the accompanying emotional and
cognitive mastery of the trauma are gained gradually. For example,
one of the participants (a 59-year-old widow) of the San Diego
Widowhood Project wrote:
It is now seven months since my husband’s death—I think until a month ago,
while I had accepted his death, it did not seem real (almost like he was on
another cruise and would return). A month ago . . . there were a few days I
felt very sorry for myself and I cried a lot, I was angry and resentful. I have
since felt that I’m doing OK—both physically and emotionally.
The ability to begin to accept her loss was a very important

step in this woman’s adaptation to widowhood. With time, she
may accept the new reality of her life as a widow more fully. For
example, a year and a half after losing her spouse, another
66-year-old woman wrote of her bittersweet acceptance of her
husband’s absence:
I would never have believed that I could ever mention his name without
tearfully breaking down. But as my mother used to solve my girlhood pro-
blems with ‘‘This too shall pass,’’ I have come to accept that I will never
again be held in his arms or hear him call me ‘‘darling.’’
A change in this widow’s cognitive and emotional reaction to

her loss is one of the signs of adaptation. Empirical studies have
reported that flexibility in the way bereaved individuals think
and talk about the death of their loved ones over the course of time
predicts adaptive bereavement outcomes (Pennebaker et al.,
1997). In contrast, inflexible and ruminative thinking patterns
(such as repetitively focusing on one’s negative emotions and
intrusive thoughts) have been shown to be associated with lower
levels of psychological well-being among bereaved partners of
men with AIDS (Nolen-Hoeksema, McBride, & Larson, 1997).
More rumination was also shown to be associated with other nega-
tive outcomes, such as less optimism about the future and dam-
pened ability to experience positive emotions.

The ability to focus on the positive aspects of one’s life also
marks successful adaptation to bereavement. Strikingly, a majority
(87–89%) of widows and widowers in the San Diego Widowhood
Project agreed with the statement ‘‘My life has great richness’’ at 2,
13, and 25 months after losing a spouse. Similarly, more than half
(60–71%) of widows and widowers endorsed the statement ‘‘My
life is pretty full.’’ Several studies have found that, despite going
through a distressing period in their lives, grieving individuals tend
to focus on the positive rather than negative aspects of their lives.
For instance, positive narrative themes, such as discussion of trust,
admiration, or identity are more common than negative themes at
6 months after the death of a spouse or partner (Maercker,
Bonnano, Znoj, & Horowitz, 1998). Schwartzberg and Janoff-Bulman
(1991) found that bereaved young adults tend to endorse a view of
the world as a place where good things outnumber the bad as
often as their non-bereaved peers. Another study examined
bereaved individuals’ reports of recent life changes and found that
they tended to describe more positive (such as increased self-
esteem) than negative life changes (Lehman, Davis, DeLongis, &
Wortman, 1993). A majority of bereaved individuals in this study
reported at least one positive life change since losing their loved
one. When given an opportunity to describe her life in her own
words, one 54-year-old widow from the San Diego Widowhood
study was able to talk about her painful loss as an opportunity
to appreciate life’s beauty:
My experience in losing my precious husband has made me more aware of

the beauty in everyday life, the need to share the hurts and joys of
others . . . It sustains me and I look forward to the challenge of each day
with an appreciation much keener than before.
According to one theory of stress and coping, cognitive

appraisal of the loss can determine whether or not a traumatic
event is experienced as stressful by the individual (Lazarus &
Folkman, 1984). Thus, a widow’s or widower’s positive cognitive
interpretations of the loss may protect against experiencing it as
a severe stressor. Overall, literature on emotional and cognitive
adaptation to bereavement suggests that positive emotions and
positive information processing schemas are crucial to healthy
adjustment. Expanding our understanding of emotional and cogni-
tive patterns associated with successful adaptation to bereavement

can be of tremendous benefit is designing intervention strategies
for individuals at risk for complicated bereavement.
Coping with Loss
This is the first Christmas I will be a widow. It is certainly not easy, but not
nearly as difficult as I thought it would be. I’ve gotten involved in the com-
munity and helping others who are homeless or otherwise worse off than
myself.
This 68-year-old widow has learned that assisting others in

need helps her cope with her grief. Helping others has been ident-
ified as an important coping strategy in bereavement research
(Lund, 1999). Each widow or widower discovers the most effective
coping strategies for him- or herself. The many ways in which
grieving individuals cope with the disruptions in their lives and
the emotional aftermath of losing a loved one can ease or compli-
cate their adaptation to bereavement. Acceptance of the loss,
emotional control or numbing, redefining the loss in a positive
light, avoidance of all reminders of trauma, intellectualization
and rationalization of the loved one’s death, and humor and dis-
traction are just a few of the coping strategies often used by widows
and widowers to manage their loneliness and distress. Some may
cope by isolating and turning to alcohol, whereas others may
develop new interests or become involved in community service.
Many widows and widowers turn to their religion for comfort.
Some individuals may avoid all reminders of the lost spouse and
may be hesitant to talk to others about their pain. In contrast,
others may readily express their distress to friends, relatives, and
support groups, keep a diary, and be more willing to expose them-
selves to painful reminders of their spouse.
Not all coping strategies aid adjustment. Some strategies, such

as avoidance, social isolation, and use of alcohol can exacerbate
feelings of sadness, emptiness, and despair. This is illustrated by
this account written by a 48-year-old widow only two months after
the death of her spouse:
My life had no meaning. I could not, nor could anyone, help to alleviate my
depression, fear, anger, emptiness, hopelessness. Certainly not God . . . I
could not eat or sleep, but I could drink and work and drink some more.
Increasing one’s intake of alcohol is a problematic coping

strategy that is atypical of the majority of widows and widowers
(Cleiren, 1991). In contrast to the previous individual quoted,
another participant of the San Diego Widowhood Project reported
seven months after the death of his wife that his coping efforts are
helpful in his adjustment to bereavement. This 61-year-old wid-
ower is refocusing his attention and energy away from his grief
and onto his faith and involvement with others.
I have found and am convinced that the following have strengthened me:
faith in God and in his direction in my life each day, and love of other
people and being sensitive to their needs. A great help is to simply itemize
in two columns your blessings and your hurts. The list of blessings is so
much longer and richer.
The word blessing appeared again and again in the accounts of

the San Diego Widowhood Project participants. As mentioned in a
previous section, the tendency to focus on the positive aspects of
one’s life and being able to find a ‘‘silver lining’’ in the experience
of a loved one’s death is a coping strategy that is associated with
lower levels of distress and grief (Davis, Nolen-Hoeksema, &
Larson, 1998; Maercker et al., 1998). For example, ascribing a
meaning to bereavement experience appears to be a common
and beneficial adaptive coping strategy. Evidence shows that the
vast majority of bereaved individuals are able to assign a meaning
or multiple meanings to their loss (Davis et al., 1998; Gamino,
Hogan, & Sewell, 2002). One group of researchers (Davis et al.,
1998; Davis & Nolen-Hoeksema, 2001) found that discovering or
relinquishing a positive meaning of loss soon after the loss con-
tinues to affect grieving individuals’ adjustment during the course
of their bereavement. They reported that the individuals who are
able to articulate beneficial aspects of their loss experience show

declines in their levels of distress. On the other hand, their counter-
parts who lose the ability to find positive meaning in their loss
report increasing psychological distress.
In fact, some studies suggest that the ability to find not only
positive, but any meaning in the death of a relative is adaptive.
Schwartzberg and Janoff-Bulman (1991) asked participants who lost
their parents whether or not they were able to find any meaning in
their loss. Those participants who were able to provide an answer to
this question were grieving less intensely than their counterparts

who could not articulate a meaning and saw the deaths of their par-
ents as meaningless. Likewise, Davis et al. (1998) reported that mak-
ing sense of death was related to lower levels of psychological
distress. In both studies, the psychological benefits of making sense
of loss did not depend on the particular meanings ascribed to death.
That is, any answer to the question of ‘‘why’’ appears to be better
than no answer for most bereaved individuals. In contrast, a subset
of bereaved individuals does not search for meaning and yet
appears to adjust well to their loss (Davis, Wortman, Lehman, &
Silver, 2000). It is possible that bereavement does not seriously
disrupt the coherence of these individuals’ lives, thus obviating
the need to search for meaning (Neimeyer, 2005). In summary,
research demonstrates considerable variability in paths linking
meaning-making strategies to psychological adjustment. Identifying
individual difference factors that account for different outcomes
of search for meaning remains an important goal of future
research.
The ability to make sense of the loss was also related to
bereaved individuals’ spiritual and religious beliefs in these stu-
dies (Davis et al., 1998). These core beliefs may have provided
a framework that assisted bereaved individuals in making sense
of their tragedy. Approximately half of the participants of the
San Diego Widowhood Project were able to say that their spouse’s
death was for the better at 2 months after the loss (Shuchter
& Zisook, 1993). A majority of these participants relied on
prayers to relieve their distress and felt comforted in believing
that their spouse was in heaven. Being able to rationalize
that the death of her husband was for the better allowed
one 67-year-old widow a measure of comfort 7 months after
the loss:
Life has changed so greatly after my husband died. I know, because of the
extreme pain he was in, his death was a blessing.
A majority of the bereaved individuals report that their ability

to cope with the challenges of life improved as a result of their loss.
In one study, most widows regarded themselves as better copers 1
year after losing their spouses (Lindstrom, 1995). Similarly,
another study found that bereavement among caregivers of rela-
tives with progressive dementia was associated with an increased
sense of personal mastery and competency (Mullan, 1992). Offering
bereavement intervention programs that focus on self-care practices,

daily living skills, and taking on responsibilities that were once
assumed by the deceased spouse can be beneficial in further
promoting personal mastery among widows and widowers (Caserta,
Lund, & Obray, 2004).
Coping strategies can be extremely helpful, but they do not
fully eliminate the tasks of grieving. As illustrated by this quote
of a 75-year-old widow, every widow and widower grieves, and
some are better able to adapt to their grief:
Because I have been able to handle it quite well, doesn’t mean that I
haven’t grieved and suffered over the loss of my very best friend of over
fifty years. My very best efforts have helped me adapt, partly because I
keep very busy and have very good health for my 75 years. This would
be my advice to other widows—keep busy and make new friends.
The Continuing Relationship with the Deceased Spouse
The death of a spouse forces a widower or widow to renegotiate his

or her ties to the loved one. The relationship with the deceased
spouse does not cease to exist with bereavement, but continues
to have an impact on the grieving individual’s life. The reality of
the loved one’s absence from one’s environment often sharply con-
trasts with a psychological reality in which one’s ties to a spouse
continue to be very vital and meaningful. Older theories of
bereavement were influenced by Freud’s (1957) view of mourning
as the process of relinquishing one’s attachment to the lost object.
It is now understood that successful adaptation to bereavement can
allow for the relationship to the spouse to be continued in some
form, be it through objects; spiritual experiences; rituals of com-
memoration; seeing the dead spouse in oneself, the children, and
grandchildren; or carrying on the legacy of the deceased. A

bereaved individual needs to construct a new life narrative that
accounts for the past relationship with the deceased spouse and
assimilates the profound loss into the post-loss identity (Neimeyer,
2005). One way to do so is to integrate continuing bonds with the
spouse into one’s self-narrative. Continuing bonds appear to pro-
vide solace to the bereaved, as well as offer moral guidance to sur-
vivors (Klass, 2001). Empirical evidence suggests that many
widows and widowers maintain their bonds to the deceased (Field,
Gal-Oz, & Bonanno, 2003; Shuchter & Zisook, 1993). For

example, a majority of participants in the San Diego Widowhood
Project reported that they felt their deceased spouse’s presence at
times and believed that the spouse was watching out for them
throughout their first year as widows and widowers (Shuchter &
Zisook, 1993). A living legacy is another form of maintaining the
connection to the deceased. Most of the participants stated that
they were interested in carrying out the deceased spouse’s wishes.
Thus, maintaining bonds with deceased spouses appears to be the
rule rather than an exception.
Field, Gao, and Paderna (2005) suggested that the adaptive (or
maladaptive) function of continued bonds to the deceased spouse
may depend on a number of factors such as the time since the loss,
type of loss, attachment security, culture, and religion. For
example, the time since the death appears to influence the adaptive
function of maintaining the relationship with the deceased spouse.
Field et al. (2005) found that among recently bereaved individuals,
greater use of continued bonds is associated with increases in nega-
tive, but not in positive mood, indicating distress. In contrast,
among individuals who lost their spouses several years earlier,
greater use of continuing bonds is associated with a poignant blend
of both negative and positive mood (Field & Friedrichs, 2004).
Thus, the adaptive function of continuing bonds appears to change
over time and vary across domains of functioning (e.g., psychologi-
cal well-being, levels of grief, positive, and negative mood; Field
et al., 2003).
Even early on in the course of bereavement, not all forms of
maintaining bonds may be maladaptive. One study found that
some aspects of continuing attachment, such as a tendency to hang
on to the possessions of the deceased spouse to gain comfort, are
associated with more intense grief throughout the first 2 years of
bereavement (Field, Nichols, Holen, & Horowitz, 1999). On the

other hand, the same study found that comforting oneself through
memories of the deceased spouse appears to be associated with
better adjustment. Thus, emotionally ‘‘relocating’’ the relationship
with the deceased from the physical to the mental and spiritual
realms appears to be a marker of healthy adaptation as long argued
by grief counselors (Worden, 2002). However, keeping material
possessions of the deceased spouse early on in the course of
bereavement can be of tremendous comfort, as attested to by this
49-year-old widow, writing about her first year after the loss of her
husband:
I kept his old bathrobe for a long time. I used to put it on to smell him
because he smoked a pipe and it was ensconced in that bathrobe. It was
ready for the rag bag long before.
For another 41-year-old widow it is the no less tangible resem-

blance between her husband and their children that gave her a
sense that her husband is present in their lives:
I don’t feel that he is dead, and the main reason is that every time I look at
my kids I see him.
Preservation of bonds to the dead may play an even more sig-

nificant role in cultures that place emphasis on interpersonal ties
and mutual interdependence (e.g., Asian and Latin American cul-
tures). In Japan, continuing bonds to dead ancestors (deceased
relatives and respected others) are maintained through keeping
memorial tablets at the family altar (Klass, 1996; 2001). Spirits of
the dead are included in the lives of the living through daily com-
munications about their concerns and accomplishments (Klass &
Goss, 1999). Thus, these spirits continue to be available to the liv-
ing for communication and comfort. Once a year, the spirits are
welcomed back to their homes for the return of the dead festival.
Similarly, in Mexico deceased relatives’ and friends’ lives are cel-
ebrated during the ‘‘Day of the Dead’’ celebration (Salvador,
2003). In cultures that place emphasis on maintaining ties to the
deceased, a successful adaptation may be marked by finding com-
fort in communicating to the spirit of the deceased spouse for years
after their death. A spiritual relationship with the deceased may
take the form of communicating with the dead relative, sensing
his or her presence, or recruiting his or her assistance to solve pro-

blems. Even in European American cultural context, communica-
tions like this are common. One 63-year-old widow wrote:
It’s just a nice warm feeling, and I just feel good when I think about him and
the time we had together. I don’t have that feeling of utter loss anymore.
When I want to talk to him, he’s just a prayer away.
Some widows and widowers may believe that the deceased

spouse is protecting them and their family, as illustrated by this
story shared with us by another 36-year-old widow:
The baby couldn’t walk and fell down a flight of stairs and suddenly on the
third step from the bottom before he was ready to crack his head open on
the cement floor, he sat up. To me there was just no logical explanation for
it. I’m sure there probably is, but at the moment I said, ‘‘Thank you, God,
and thank you, Dick.’’ In that order.
Although some aspects of preserving the relationship to the

dead spouse may be associated with poor adjustment (Field et al.,
1999), it appears that finding unique means to preserve the attach-
ment provides a measure of comfort and security and allows
widows and widowers to adapt to their loss.
A related aspect of adaptation to bereavement for many
widows and widowers is activation of spiritual beliefs (Shuchter
& Zisook, 1993). In one study (Richards & Folkman, 1997),
almost half of all bereaved individuals whose partners died of
AIDS made references to spiritual phenomena. Similarly, Brown,
Nesse, House, and Utz (2004) reported that widowed individuals
were more likely than married controls to increase their spiritual
and religious beliefs. Renewed faith and spirituality were associa-
ted with active engagement in problems and lower levels of grief
in these studies. Religion and spirituality may provide comfort to
the bereaved and often shape the communication with the
deceased spouse through religious rituals or prayer. On the other
hand, the role of religion in the bereavement process may be
more complicated and equivocal, leading to some negative
outcomes as well (see Stroebe, 2004, for a review). More
studies that carefully examine both positive as well as negative
effects of religious and spiritual beliefs and practices are sorely
needed.
Functioning
Losing a spouse can impair the bereaved individual’s functioning

in several important areas. Physical and emotional health can
suffer following the loss (Clayton, 1974; Zisook, Mulvihill, &
Shuchter, 1990; Zisook et al., 1997). Many widows and widowers
develop symptoms of depression and anxiety, complain of more
physical ailments, and increase their intake of alcohol and tobacco
in the months following the loss. Social and occupational function-
ing can be negatively impacted by the loss as well. Isolating from

friends and coworkers and losing interest and pleasure in social
interactions and one’s work can also accompany bereavement.
The confusion and distractibility that often characterize acute grief
can further impair work performance. Finally, the death of a
spouse is often associated with financial hardship. Sometimes
women take time off work to raise families. Thus, the loss of a
husband’s paycheck or retirement payments puts many widows in
financial crisis. Despite these risks, many surviving spouses are able
to adapt to bereavement successfully by mastering new occupational
skills and expanding their social networks. The majority of widows
and widowers in the San Diego Widowhood Project illustrate this
pattern in their reports that their health was good or even excellent,
their use of alcohol and cigarettes under control, and their work
satisfactory during their first year of widowhood (Shuchter & Zisook,
1993). Only 7 months post-loss one 47-year-old widow wrote:
I have enrolled in a typing class. I find when I leave the class composed
entirely of persons younger than me, that I am experiencing a new ‘‘high.’’
Another 58-year old widower reported that he is living a

healthy life, immersing himself in his work, maintaining his friend-
ships, and keeping the option of a new romantic relationship open:
I kept busy and have gone on several trips. I will continue with teaching
back-packing part-time in the adult education program, as well as the hik-
ing class.
I lead for seniors, and I plan to travel with friends from time to time. I
plan to re-marry, but have no firm idea at this time as to whom or when.
The adjustments to widowhood are many and range from mas-

tering everyday tasks previously delegated to the spouse, such as
balancing a checkbook or cooking a meal, to assuming major new

responsibilities, such as financially supporting children or manag-
ing family finances on one’s own. Mastering these novel tasks is
an important part of adaptation to widowhood (Caserta, Lund, &
Obray, 2004). Each day can bring new challenges to a newly
bereaved individual, as described by this 50-year-old widow:
I had to change a tire on my girlfriend’s car and I said, ‘I don’t know how.’
I’d watched people change tires before and I just never thought I could, but
I did. You know, I didn’t have to call on someone to come and rescue us,
and that was an enlightening experience. I find that I can handle things
pretty well.
As illustrated by this widow, acquiring each new skill, no mat-

ter how small, provides a sense of personal mastery and indepen-
dence. In one study, bereaved individuals were interviewed
6 months after their loss (Bauer & Bonanno, 2001b). Their inter-
views were analyzed for themes of self-efficacy (or beliefs in their
personal abilities). Individuals who felt self-efficacious were less
likely over time to experience intense grief. Specific self-efficacy
beliefs may differ for widows and widowers. Whereas widows
may be forced to learn stereotypically masculine skills, some
widowers have to assume a more nurturing role in their children’s
lives. This 49-year-old widower wrote about raising two children
by himself:
When you are a man . . . you do the work and you come home, and any
problems the mother usually handles. And now, if the kids have any pro-
blems, they come to me. I think you really have to be more sensitive to
the children, and maybe that has made me a better person.
Both of these individuals became more independent and

more capable as a result of their new responsibilities. Our assess-
ment of widows’ and widowers’ functioning needs to be more com-
prehensive to take new skills and improved physical, social, or
occupational functioning into account.
Social and Intimate Relationships
The death of a husband or wife deprives the surviving spouse of

friendship and companionship. Spouses are often at the very
center of each other’s social worlds. Thus, the ability to strengthen

existing social ties with friends and family, reengage socially, and
explore the possibility of new friendships and intimate relation-
ships is crucial to adapting to bereavement. Many widows
and widowers report that their relationships with family and
friends are better after their loss than they were before their
spouse’s deaths (Shuchter & Zisook, 1993). During the first year
of widowhood, many describe their relatives and friends as very
supportive. It is also common for bereaved individuals to pursue
new friendships with one another (Caserta & Lund, 1996).

Emotional loneliness gradually decreases after bereavement
(Van Baarsen et al., 2002), and successful adaptation is marked by
strengthened ties with family and renewed interest in friendships
and dating (Schneider, Sledge, Shuchter, & Zisook, 1996). On the
other hand, problems in social relationships have been associated
with higher levels of depression among recently bereaved partners
of AIDS patients (Nolen-Hoeksema et al., 1997). Caring for others
can also become a source of strength. Being able to care for and
comfort those in need can serve as a reminder of one’s strengths,
as illustrated by this 62-year-old widow:
I find that caring about others is one of the greatest helps. So many need
our love and friendship (genuine), and when you are busy with others
and see their needs, there is no time to pity yourself.
Another 57-year old widow is actively attempting to enrich

her social world:
This has been a year of many adjustments, but life goes on and I enjoy
being with people, so I make an extra effort to get out and meet new
people—especially widows and widowers. I have joined a support group
of widows=widowers and receive a lot of help in this group. I also get
out a lot as I look forward to meeting someone to share the rest of my life
with. Since I had two happy marriages, I look forward to another and feel
my husbands would want me to as I would want them to.
This individual’s reliance on existing social ties is clearly a

source of comfort and support. One year after losing her spouse,
she is also open to the possibility of a new intimate relationship.
New romance and remarriage were found to be associated with
greater psychological well-being among widows and widowers
who participated in the San Diego Widowhood Project (Schneider

et al., 1996). Over half of all widowers and about one-fifth of
widows were involved in a new romantic relationship two years
after losing their spouse. Seven months after losing her husband,
this 49-year-old widow is beginning to consider the possibility of
finding a new romance. It is very important for her to ensure that
the new relationship does not replace the love she continues to feel
for her deceased husband:
Life has changed so greatly after my husband died. I by no means miss him
less or love him less even if new people come into my life. A new love is
something that everyone needs after such an empty feeling and loneliness,
but no one will ever take place of my late husband. . . . If you and your hus-
band truly loved each other neither one would want the other to be alone
and lonely. Life must go on, but that does not mean your lost love will ever
be forgotten.
Another quote illustrates the renewed sense of satisfaction

with life that can accompany a new intimate relationship.
This 48-year-old woman has remarried one year after being
widowed:
I continue to be happy. When I look back on my spouse’s death I felt a total

blackness, total hopelessness and total loneliness. Since I have remarried I
am extremely happy, hopeful and fulfilled. I hope others may know that
life can be wonderful again—that life can go on and that it is possible to feel
well and complete again . . . I count each day as a true gift—that life is a
blessing to be enjoyed for the moment.
The social aftermath of bereavement may vary from culture to

culture. In one study, American and Spanish students who had
experienced equally distressing deaths of loved ones were asked
to describe the effects of a hypothetical bereavement on an individ-
ual. American students reported that bereavement diminishes
one’s sense of trust in others. In a highly individualistic culture,
such as the United States, the stress of bereavement may be asso-
ciated with increased isolation and lack of trust in others. On the
other hand, the Spaniards’ responses indicated that bereavement
is associated with increased sense of trust of others (Caitlin,
1993). A culture that places more emphasis on interpersonal rela-
tionships may view bereavement as a time to renew other social
ties and draw support from them.
Identity
As illustrated by the data from the San Diego Widowhood Project

presented in Table 1, positive self-perceptions and a sense of
direction and hope are very common among the recently
bereaved. Only two months after losing their spouses most widows
and widowers report feeling good about themselves. This 50-year-
old widow is one of the participants who indicated that increased
sense of self-esteem accompanied their adjustment to loss:
I think I feel really good about myself for the first time in a long time. I feel
younger. I feel like if I wanted to do something, I’m just going to do it. I’m
not going to worry about how it’s going to look, because nobody is really
paying attention anyway.
As time went on, more and more bereaved individuals

reported surprising themselves by mastering new tasks and enjoy-
ing the freedom of being on their own. These data illustrate that for
most individuals even a severe stressor, such as bereavement, does
not diminish their positive views of themselves. Research suggests
that self-enhancement and lack of tendency to blame oneself for
failures to live up to expectations are associated with lower levels
of grief (Bauer & Bonnano, 2001a; Bonanno, Field, Kovacevic, &
Kaltman, 2002; Field & Bonanno, 2001).
TABLE 1 Self-esteem and Sense of Purpose Following the Death of a Spouse
% endorsing each item
Positive self-perceptions 2 months 13 months 25 months
Self-perception
Feel more self-sufficient 81 75 82
Feel more sensitive 78 81 84
I continue to surprise myself by new 58 64 71
tasks I have mastered
Self-esteem
I feel good about myself 82 79 86
I am a better person for this experience 42 50 50
Direction=purpose
Feel hopeful about the future 66 60 67
I look forward to tomorrow 81 83 86
I enjoy the freedom of being on my own 36 53 60
For some widows and widowers, adaptation to bereavement

means discovering personal strengths and recognizing the freedom
to be a separate individual. One 52-year-old widow wrote 7 months
after losing her spouse:
He didn’t like to travel. This summer I bought a 27 foot motor home and
drove across country alone. I’m proud of that.
The same individual continued to expand her horizons and to

explore her new identity as a single woman two years after her loss.
Her sense of vitality is remarkable and contagious:
I am traveling a great deal, having driven across country several times

alone. Hopefully, I’ll be able to go to Europe in the fall. Also I’m planning
on building a new home this summer. I truly enjoy being alone, and being
my own boss. At times I miss my husband dreadfully, but I am doing things
he wouldn’t do. I am enjoying life: I look forward to each day.
Other widows and widowers redefine themselves through dis-

covering new interests and starting new projects. By coping in such
a way, they are also altering their view of themselves, their interests
and their strengths. A sense of surprising themselves is frequent in
their accounts, as illustrated by this 55-year-old widow:
I am doing things I never imagined I would do as a single person. I bought

a new van, am getting a loan, and am planning to build a new house and
rent it . . . Planning it is very exciting. I also changed religions.
Perhaps the most remarkable reports of changes in identity

accompanying bereavement tell us about the sense of personal
growth and new-found strength and confidence in tackling other
problems. The sense that bereavement has prepared them well
to face any other life’s challenges is expressed by many. One
63-year-old widower wrote:
I feel more growth in the past six months than in the prior ten years.
Another 57-year-old participant commented that she sur-

prised herself with her ability to cope. Her sense of self as emotion-
ally fragile had undergone a transformation:
I always felt that I would be the kind of person to fall apart. But I found an
inner strength that other people knew I had, but I didn’t know. I really feel
that it made a stronger person of me.
The reality of bereavement adaptation often exceeds common

expectations. For example, Caserta and Lund (1992) reported that
coping levels reported by older adults who recently lost their
spouses was underestimated by their non-bereaved counterparts.
It is most striking to see the identity of survivor and fighter emerge
in the accounts of the widows and widowers. Early comments from
these individuals often tell us of despair, pain, loneliness, and hard-
ship. This 44-year-old widow had to adjust to life as a single work-
ing mother. Her first year after losing her husband was a struggle.
Two years after losing her husband, she wrote:
The loneliness, the anxiety, and everything else—it’s made me stronger,

more experienced. I see myself as more valuable, more capable than I
thought of myself before. I know I can raise two children by myself. I know
I can work and I can support everyone if I had to. I will never be afraid. I
don’t want to be alone, but I will never be afraid again.
Other widows and widowers note the changes in their person-

alities during the first 2 years of bereavement. One 51-year-old
widow discovered that she had become less reticent and more out-
going:
He was the more outgoing. It was easier a lot of the time to just sit there and
be amused than to do a whole lot myself. Now I find that I do very nicely
by myself, and I enjoy it, and I like myself more.
On the other hand, another 35-year-old widower describes

how his interpersonal style evolved as a result of becoming a
full-time caretaker to his dying wife and their young child:
I am a much more sensitive individual than I would have been. I sense

subtle nuances in people’s behavior and conversation. It’s been helpful in
my work. It’s made me a little more responsive to people’s needs in a direct
sort of way.
In many cases, the individuals’ goals and priorities changed as

well. This 49-year-old widower remarked at two years after losing
his wife:
I define achievement differently. Money does not mean as much to me now.
In all these cases, adaptation to bereavement allowed these

widows and widowers to rediscover their identities and develop
new interests and aspirations. While grieving for their loved ones,
they were able to emerge from their loss as vital and hopeful
individuals.
Conclusion
While it is very important to be aware of the emotional, physical,

social, and occupational problems often associated with bereave-
ment, these difficulties are not universal accompaniments of grief.
Only 2 months after their loss, over half of the widows and
widowers in the San Diego Widowhood Project reported that their
overall adjustment was good or even excellent (Shuchter & Zisook,
1993). As painful and devastating as it can be, bereavement can
also be associated with improved coping, personal growth, and a
new appreciation for life. Those widows and widowers who are
able to successfully cope with the stressors of their spouse’s deaths
have much to teach us. Much remains to be learned about sources
of their resiliency. Identifying the elements of successful adaptation
to bereavement can allow practitioners to design and implement
new grief counseling interventions.
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Adaptation To Bereavement

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This article was downloaded by: [McGill University Library]

On: 14 October 2014, At: 15:40

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YULIA CHENTSOVA DUTTON

San Diego, San Diego, California, USA

Try to imagine what sort of an individual wrote this passage. He or

Received 4 January 2005; accepted 11 July 2005.

emotional and financial support. Thus, the death of a spouse can

(particularly those who tended to have ill spouses or conflicted

promising area of research is understudied relative to research focus-

Models of Bereavement Adaptation

Several contemporary theoretical models describe healthy adjust-

bereavement including (a) the contextual variables that influence

These models have several features in common. First, all of

Emotional and Cognitive Experiences

People often erroneously equate grief and depression. Notably,

bereavement is the only psychosocial stressor that can negate diag-

Empirical evidence suggests that the answer to this widow’s

successful adaptation is marked not by the absence of negative feel-

hypothetical emotional reactions of American and Spanish stu-

There are a number of cognitive patterns that appear to be

The ability to begin to accept her loss was a very important

A change in this widow’s cognitive and emotional reaction to

pened ability to experience positive emotions.

My experience in losing my precious husband has made me more aware of

According to one theory of stress and coping, cognitive

tive patterns associated with successful adaptation to bereavement

Coping with Loss

This 68-year-old widow has learned that assisting others in

Not all coping strategies aid adjustment. Some strategies, such

Increasing one’s intake of alcohol is a problematic coping

The word blessing appeared again and again in the accounts of

able to articulate beneficial aspects of their loss experience show

this question were grieving less intensely than their counterparts

A majority of the bereaved individuals report that their ability

bereavement intervention programs that focus on self-care practices,

The Continuing Relationship with the Deceased Spouse

The death of a spouse forces a widower or widow to renegotiate his

grandchildren; or carrying on the legacy of the deceased. A

Gal-Oz, & Bonanno, 2003; Shuchter & Zisook, 1993). For

bereavement (Field, Nichols, Holen, & Horowitz, 1999). On the

For another 41-year-old widow it is the no less tangible resem-

Preservation of bonds to the dead may play an even more sig-

his or her presence, or recruiting his or her assistance to solve pro-

Some widows and widowers may believe that the deceased

story shared with us by another 36-year-old widow:

Although some aspects of preserving the relationship to the

Losing a spouse can impair the bereaved individual’s functioning

ing can be negatively impacted by the loss as well. Isolating from

Another 58-year old widower reported that he is living a

The adjustments to widowhood are many and range from mas-

balancing a checkbook or cooking a meal, to assuming major new

As illustrated by this widow, acquiring each new skill, no mat-

Both of these individuals became more independent and

Social and Intimate Relationships

The death of a husband or wife deprives the surviving spouse of

center of each other’s social worlds. Thus, the ability to strengthen

new friendships with one another (Caserta & Lund, 1996).

Another 57-year old widow is actively attempting to enrich

This individual’s reliance on existing social ties is clearly a

who participated in the San Diego Widowhood Project (Schneider

Another quote illustrates the renewed sense of satisfaction