Young widowhood, conceptualized as the loss of one’s spouse before the age of 50, is a profoundly painful and distressing loss (Den Elzen, 2017, 2018). The literature on young widowhood shows the death of a partner generally causes a fragmentation of the self, as it violates expectations of the normal life cycle, namely growing old together (Haase and Johnston, 2012; Levinson, 1997). Premature loss of one’s spouse tends to be experienced by the surviving partner as distressing or traumatizing, such as having witnessed their suffering in illness or through accident (Den Elzen, 2018) or in struggling with unfinished business (Holland et al, 2020). Whilst post-traumatic stress is well-known and has been widely researched across various disciplines, the concept of post-traumatic growth is much newer and by contrast has received less attention. PTG was introduced as a scholarly concept by Tedeschi and Calhoun in the mid-1990s and is defined as a positive psychological change as a result of the struggle with highly challenging life events (2004). Calhoun and Tedeschi’s notion of PTG has been backed by a recent systematic review. In the first meta-analysis of moderate-to-high PTG, Wu et al. found that of the 10,181 subjects, about 50% experienced PTG (2019). They also reported that women, young people and victims of trauma experienced higher levels of PTG than men, the elderly and those who experienced indirect trauma. PTG has attracted some controversy, with some researchers questioning its scientific validity (Jayawickreme and Blackie, 2014). Others caution against the minimization of people’s suffering. Hayward is a trauma counsellor who advises approaching PTG carefully, highlighting that if it is introduced with clients too early it can "often be construed as minimizing someone's pain and suffering and minimizing the impact of the loss" (cited in Collier, 2016, n.p.). In addressing the critique of PTG, Calhoun and Tedeschi (2006) emphasize that the focus on investigating positive psychological change following trauma does not deny the common and well-documented negative psychological responses and distress following severe life stresses: “Negative events tend to produce, for most persons, consequences that are negative” (p.4). They argue however, and their research supports this finding, that for many people distressful events can foster positive psychological changes. We view PTG as a possibility following (profound) loss, and emphasize that PTG may continue to co-exist with painful and/or unresolved emotions regarding the loss itself. We conceptualize PTG as a continuum and not as an either/or binary with grief. Further, we wish to highlight that PTG is a highly individual process that depends on many factors, and we are not suggesting that the absence of PTG is to be seen as a failure. This chapter intends to contribute to the study of PTG through a person-centered approach. The most used method to assess PTG is the 21-item posttraumatic growth inventory developed by Calhoun and Tedeschi in 1996 (Jayawickreme & Blackie, 2014). Self-reported posttraumatic growth has been the foundation of PTG research, which has aimed to identify to what extent PTG evokes improved psychological and physical health. In discussing our own creative narrative processes of PTG, our practice-led-research lens aims to contribute to research on how PTG might be fostered. We propose a Writing-for-wellbeing approach in this context and explore what it offered us both as writers and widows and what it might offer the field of Writing-for-wellbeing and by extension clinical and scholarly practice.
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Each of us has a story that comes alive as we wake up in the morning, develops throughout the day, and holds layers of meaning as we lay our heads down at night – it might be called a narrative of our identity. When loss occurs, our story fragments into unfamiliar pieces, and who we identify as becomes scattered – sometimes even shattered. We must work to reconstruct meaning in our lives and to rebuild our identity. As leading author on this editorial, with an article of my own in this issue, I confronted this when my father died. I felt his story slipping away, becoming blurred, forgotten, and for some, erased – and the same held true for me. The chaos of my shattered identity exacerbated the deep pain of losing him and I experienced complicated grief. I had to reshape my narrative to remember the authentic parts of me and rebuild a new self in a fatherless world. This journey is in part what motivated me to become a symposium co-editor for the journal. All four of us editors of this special issue have experienced “living with loss” following the premature loss of either our father or spouse, and I wanted to see what lived experience and knowledge we could bring to the readers about loss in the fields of both guidance and counselling.
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Background Eating behaviour of older adults is influenced by a complex interaction of determinants. Understanding the determinants of a specific target group is important when developing targeted health-promoting strategies. The aim of this study was to explore interpersonal determinants of eating behaviours in older adults living independently in a specific neighbourhood in the Netherlands. Methods In the neighbourhood of interest, populated by relatively many older adults, fifteen semi-structured interviews were conducted with independently living older adults (aged 76.9 ± 6.4y). Interviews were complemented with observations among the target group: three occasions of grocery shopping and three collective eating occasions in the neighbourhood. A thematic approach was used to analyse the qualitative data. Results When we asked the older adults unprompted why they eat what they eat, the influence of interpersonal determinants did not appear directly; respondents rather mentioned individual (e.g. habits) and environmental factors (e.g. food accessibility). Key findings regarding interpersonal factors were: 1) Behaviours are shaped by someone’s context; 2) Living alone influences (determinants of) eating behaviour via multiple ways; 3) There is a salient norm that people do not interfere with others’ eating behaviour; 4) Older adults make limited use of social support (both formal and informal) for grocery shopping and cooking, except for organised eating activities in the neighbourhood. In this particular neighbourhood, many facilities (e.g. shops at walking distance) are present, and events (e.g. dinners) are organised with and for the target group, which likely impact (determinants of) their behaviours. Conclusions The study showed that older adults do not directly think of interpersonal factors influencing their eating behaviour, but rather of individual or environmental factors. However, multiple interpersonal factors did appear in the interviews and observations. Moreover, neighbourhood-specific factors seem to play a role, which underlines the need to understand the specific (social) setting when developing and implementing intervention programmes. Insights from this study can assist in developing health-promoting strategies for older adults, taking into account the context of the specific neighbourhood.
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