DEATH OF A FAMILY MEMBER: THE MALAY GRIEF EXPERIENCES SHARED IN

BEREAVEMENT SUPPORT GROUP

BY

HANIZA RAIS

INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA

2007

Time is witness!

Verily, Man is indeed in a state of loss,

Except - those who attain faith and do good deeds.

and enjoin upon another the keeping of truth (right) and

Be patient in adversity.

(al ÑAsr 103:1-3)

DEATH OF A FAMILY MEMBER: THE MALAY GRIEF EXPERIENCES SHARED IN

BEREAVEMENT SUPPORT GROUP

BY

HANIZA RAIS

A dissertation submitted in partial fulfilment of the requirement for the degree of

Doctor of Philosophy

Institute of Education International Islamic University

Malaysia

JUNE 2007

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ABSTRACT

In life, death is one of the greatest certainties, and it is always associated with grief and loss. A qualitative study was conducted to describe the Malay participants' grief experiences in losing a close family member and their reactions to the group experience. A series of bereavement support groups called "Living With Loss" were conducted. Group memberships were solicited through campus advertisements and word-of-mouth. The groups were closed and semi-structured. Memberships were voluntary. Interested individuals were screened and interviewed to ensure memberships met the inclusion criteria. Two homogenous groups were established at two different locations (IPTA1 and IPTA2). They were university students in bachelor's to doctoral degree programs at public higher institutions (IPTA), who had experienced death of a close family member. Both groups, IPTA1 and IPTA2, met seven and six times respectively in three semesters. Each session lasted for ninety minutes. The study adopted the participant-observation design with in-depth group interviews. Semi-structured open-ended interview protocols were used. Data were also collected through various group activities such as sharing photos, mementos or sentimental items, letter and journal writing. Follow-up interviews and phone calls complemented the data collection. All the sessions were video and audio taped, and transcribed for analysis purposes. The major findings mapped out the Malays’ unique coping reactions that can be recognized as Universal Responses, Spiritual-inclined Responses and Ethnic-specific Responses. The results of the study were clustered under three levels of categories which has its own sub-themes. The levels rank the data from "Universal responses" to the “Spiritual-inclined” responses and finally to the “Ethnic-specific” - which seemed to be the unique descriptions of the participants’ responses. As expected, universal responses like crying were found to be practiced by the Malays. The study presented evidence of the acceptance of crying as a typical grief reaction of the bereaved. However, the study revealed that religious understanding has made the Malay participants aware of the fact that crying, though sometimes inevitable, must be in moderate manner. Some coping expressions that were unique and specific to the Muslims reflected their awareness of Islamic teaching: increased actions of making doa (supplication) for the dead; getting closer to God as they remember the deceased; being patient and accepting (redha). The ethnic specific responses unique to the bereaved Malays were: frequent visits to the graves; the recitation of tahlil or Surah Yasseen and kenduri arwah. The group outcomes showed the participants' positive reactions to the group discussions and activities and how they were affected by the group experience. They found the new experience to be beneficial and would recommend such group to be continued and practiced more widely in the society. The groups played significant roles in providing an avenue for members to share their stories – something they could not even do with their families though they came from close-knit families. Other findings revolved around family issues, roles and relationships affecting family members. For instance, remarriages after deaths of mothers or fathers heighten the sadness of the bereaved as role shifts inevitably took place when a new member entered the family and replaced the loved ones.

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ملخص البحث

ودراسات الحزن ليست جديدة على موضوعات البحث في . الموت مثل الولادة، ظاهرة طبيعية في كل مجتمع

دف هذه الدراسة إلى تجميع وتوثيق المعلومات حول خبرات الحزن بسبب الموت ولذلك. الإرشاد النفسي

توثيق الموت والفقدان لدى ) 1: ( ة لتحقيق ثلاثة أهدافوتسعى الدراس. والفقدان في اتمع الملاوي في ماليزيا

وصف خبرة الملايوين المشتركين في فقدان فرد من الأقارب ، و) 2.( المسلمين كما يطبق ذلك اتمع الملاوي

في ذوي الخبرة( تم اقتراح مجموعات من فرق الحرمان المساعدة . توثيق رد فعل المشتركين حيال خبرة اموعة) 3(

كما تم اختيار الأفراد الراغبين في المشاركة ، وأجريت مقابلات معهم من أجل تصنيف اموعات ، ) الفقدان

شاه علم : هما (وتم تشكيل مجموعتين متجانستين في مكانين مختلفين . وذلك لضمان معيار ومقياس الحكم

ن مستويات الإجازة الأولي إلى طلاب برامج جميع الأعضاء المشاركين كانوا من طلاب الجامعة، م) . وجونباك

وكانت اموعات مغلقة وشبه . الدكتوراه، من الذين كانت لهم خبرة في الحزن بموت عضو قريب من العائلة

وتمت قراءة نماذج الموافقة المكتوبة ووقعت قبل بدء . كما كان اشتراك الأعضاء اختياريا. مركبة

و )IPTA1(أما الفريقان . رق لمدة ساعة ونصف خلال ثلاثة فصول دراسيةتكررت اجتماعات الف.اموعات

)IPTA2 (تبنت الدراسة استعمال النموذج النوعي بتصميم . فقد اجتمعا لمدة ست وسبع مرات علي التوالي

) 1998(تون وطبقا لبا. مراقبة المشتركين، بالإضافة إلى المقابلات المكثفة للمجموعات ، والتي تمت خلال لقاءاا

فان أحسن طرق البحث لزيادة فهم الفرد لتعقيدات ظاهرة معينة ، الحزن علي سبيل المثال،هي الملاحظا ت المباشرة

ولذلك تم إعداد ا ستبيان عميق شبه مركب من نوع مفتوح النهايات ، كدليل، وذلك ليساعد . للمشاركين

كل ذلك . عدد من الموضوعات التجريبية لتكون دليلا للمناقشةكما تم تحديد . المشاركين علي استخلاص تجارم

جرى توحيده ودمجه من خلال نشاطات اموعات التي استعملت للحصول علي بيانات مفصلة متصلة بخبرات

وشملت النشاطات عرض صور الأحبة ، والعينات العاطفية المذكرة بالموت، وكتابة الرسائل ، والأدوات . الحزن

و جمعت البيانات من خلال مقابلات المتابعة " . اعرض وأخبر" و " بكتاباتي: " الرقيقة التي تعرف العاطفية

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. وكذلك تم تحليل النصوص الحرفية تحليلا نوعيا. وتم تسجيل وتصوير ووصف جميع الفصول . والاتصالات الهاتفية

مواجهة الحزن يمكن أن تعتبر استجابات عالمية وأوضحت النتائج الرئيسية للدراسة أن ردود أفعال الملايويين في

ونظمت . و صنفت نتائج الدراسة تحت ثلاثة مستويات ، لكل مستوى عدة جوانب فرعية. ، وروحية وخاصة

استجابات عرقية " وأخيرا إلي " مائلة إلي الروحانيات" إلي استجابات " استجابات عالمية: " مستويات البيانات من

يتعلق بالأوصاف النموذجية لاستجابات الملايويين، وكما هو متوقع، فقدد اتضح أن استجابات وفيما ". خاصة

وأكدت الدراسة مفهوم قبول البكاء باعتباره رد فعل نموذجي للحزن . مثل البكاء ، مستعملة من قبل الملايويين

جعل الملايويين المشاركين في الدراسة ومن ناحية ثانية، فإن الدراسة بينت أن فهم الدين أدى إلي . بسبب الفقدان

وبينت الدراسة أن بعض تعبيرات . يدركون أن البكاء ، برغم أنه أحيانا لايمكن تفاديه،إلا أنه لا بد أن يتم باعتدال

إن موت أحد الأحبة . التغلب علي الحزن تعتبر فريدة وخاصة بالمسلمين، وهذه تعكس الوعي بالتعاليم الاسلامية

. زيادة الدعاء للميت ، كما يؤدي إلي التقرب إلي االله بقدر تذكرالفقيد، والتزام الصبروالرضى بقضاء االلهيؤدي إلي

. كما وضحت الدراسة أن من مميزات الملايويين في التعامل مع الحزن تلاوة سورة يس ، والتهليل والكندوري

وعلي سبيل المثال، فإن تكرار . لتي تؤثر في أفرادهاودارت نتائج الدراسة الأخري حول قضايا الأسرة والعلاقات ا

الزواج بعد موت الأمهات أوالآباء يؤدي إلى مضاعفة الحزن بحسب التغير الذي يحدث من خلال دخول عضو

وخصص الفصل الأخير لتقويم نتائج اموعة بعد أن ساعد قائد . جديد علي العائلة، ليحل محل الفقيد المحبوب

وأظهرت النتائج أن المشاركين كانوا . شاركين علي استعمال خبرام باعتبارهم أعضاء في اموعة الفريق الم

كما دلت النتائج على ردود أفعال المشاركين لنشاطات المشاركين وكيف . إيجابيين فيما يتصل بالنقاش والنشاطات

ة ، وأم سوف يقترحون استمرار مثل هذه بعد أن وجدوا أن الخبرات الجديدة مفيد. تأثروا بخبرات اموعة

لقد لعبت اموعات أدوارا مهمة من خلال فتح الطريق . اموعة وتطبيق نشاطها في اتمع علي نحو واسع

وهو أمر لا يستطيعون القيام به مع أسرهم ، وذلك علي الرغم من أم –لأعضائها للمشاركة بعرض خبرام

. ترابطةينحدرون من عائلات م

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APPROVAL PAGE

The thesis of Haniza Rais has been approved by the following:

…………………………………….. Nik Ahmad Hisham Ismail

Supervisor

…………………………………….. Nik Suryani Nik Abd Rahman

Supervisor

…………………………………….. Kathleen Gilbert

Supervisor

…………………………………….. Hasan Langulung

Supervisor

…………………………………….. Ssekamanya Siraje Abdallah

Internal Examiner

…………………………………….. Amir Awang

External Examiner

…………………………………….. Rex Stockton

External Examiner

…………………………………….. Ibrahim M. Zein

Chairman

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DECLARATION I hereby declare that this dissertation is the result of my own investigations, except

otherwise stated. I also declare that it has not been previously or concurrently

submitted as a whole for any other degrees at IIUM or other institutions.

Haniza Rais

Signature ………………………….. Date: ……………………

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INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA

DECLARATION OF COPYRIGHT AND AFFIRMATION OF FAIR USE OF UNPUBLISHED

RESEARCH

Copyright © 2007 by Haniza Rais. All rights reserved.

DEATH OF FAMILY MEMBER: THE MALAYS' GRIEF EXPERIENCE SHARED IN BEREAVEMENT

SUPPORT GROUP

No part of this unpublished research may be reproduced, stored in retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without prior written permission of the copyright holder except as provided below.

1. Any material contained in or derived from this unpublished research

may only be used by others in their writing with due acknowledgement.

2. IIUM or its library will have the right to make and transmit copies

(print or electronic) for institutional and academic purposes. 3. IIUM or its library will have the right to make, store in a retrieval

system and supply copies of unpublished research if requested by other universities and research libraries.

Affirmed by Haniza Rais

……………………………… …………………… Signature Date

viii

My Mom Hajah Hamidah Abdullah (1945-1999),

whose love and care are always felt and remembered. And

My most recent and sudden loss (3rd April 2006) My dad

Haji Rais Haji Abu (1941- 2006), Who never stopped giving and loving

Thank you for giving me 'life' and love

This work is for both of you. May Allah bless your souls and place you together among the righteous

Al-Fatihah

“My Solat (prayers) and my devotions, my living and my dying, are for Allah alone,

The Lord of all the Worlds” (Al-An’Ém:162)

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ACKNOWLEDGEMENTS I would like to extend my gratitude to the following for the birth of this thesis.

First, I thank Allah that this journey has finally come to an end. I thank Allah, for giving me the strengths to accept my own loss and the courage to pursue this topic. I thank Allah for all challenges that I had to go through for the past few years in order to reach to this point. The last few weeks before submission I was tested again. All this, despite the difficulties, I thank Allah for making it possible for me to go through this journey with the help and support from people around me.

Special thanks and appreciation to all the members of my bereavement groups, who volunteered to be part of the study. In doing so, they sacrificed their time and energy, taking the risks to share a very personal matters so that other may benefit from their unique experience. Their commitment in assisting me in this research was unbelievable. I treasure the moment with them and found myself learning new things every time we met. "Only those who had the experience can actually understand how it feels to lose someone"

My special gratitude to my supervisor, and the committee members for their continuous support, critiques, views and suggestions, for being there in times of frustration and in search for 'lights' when I got lost in the dark. Assoc Prof Dr Nik Ahmad Hisham, the supervisor who looked at this research beyond academic boundary by acknowledging life surrounding my academic territory. Thank you for understanding my other priorities in life; Dr Nik Suryani, a friend whose professionalism no one could deny, who always brought me back to the ground to face reality. Thank you for accompanying me to venture into discovering the world of qualitative research. Assoc Prof Dr Kathleen Gilbert, Indiana University- Bloomington, who introduced 'grief' back in Summer 1997, even before I knew what grief was all about. I am honored that Prof Dr Hasan Langulung was willing be part of the project as his views helped strengthen the Islamic content of this thesis. My former counseling professors at Indiana University-Bloomington for their continuos guidance and support since my earlier days in counseling until recently.

I also would like to acknowledge friends and professionals who helped me during my visit to the UK, hunting for information from organizations that either involved in conducting research in grief or providing services to the bereaved. I feel honored to be able to sit and discuss my research interest with one of the world's well known pioneer in Bereavement, Dr Colin Murray Parkes. His willingness to accept a stranger to his living room, listening to my research ideas and sharing his experiences and views (not to mention the great view of his English garden). For pushing me to present my papers at the International Conference on Bereavement in July 2005 despite the scary bombing incident. He is just a great inspiration.Dr Sheila Payne and all her team at University of Sheffield, Susan from St Andrew Hospice, Hazel from Winston Wish, Compassionate Friends, St Christopher's Hospice, Child Bereavement Trust, Cruse Bereavement Care and our hosts in UK, Noris (Nailsea), Suhailah, Latif, Azam and their families.

My appreciation to my resource persons: the late Dr Muhammad Al-Mahdi, Dr. Ismail Hassanen, Dr A. M. Raba and my auntie Hajah Fatimah Hj Abu.

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All INSTED's Family: Assoc Prof Dr Marzuki (INSTED's Director), Prof Dr Sahari (our former Dean), my Motivation lecturer (Dr Zaleha), lecturers and colleagues who have supported my works especially Suhailah, K. Nik, K. Siti Rafiah and Tunku Badariah. The supporting staff friends Riza, Yati, K. Nor, K. Ina, Meor and Lokman. My PhD support group especially Nor Aziah Alias, Kaseh, Halimaton, Norisah, Zahiri, Burhan and Sulaiman. My dearest wonderful friends: Ojie and Noris who have been there for me through thick and thin.

Most importantly my wonderful parents and family. My most respected dad, Haji Rais Haji Abu for teaching us to love education

and to have perseverance and determination in discovering our hidden potentials in life. Who went all out in helping the family deal with the loss while managing his own. My late mom, the caring and loving Hajah Hamidah Abdullah who always made us all feel special. Who always put family as her priority. She will always be our 'Home Queen'. We never thought you both would leave us so soon. None of us were prepared for this great loss. They had made the most wonderful parents that any children in the world could hope for. I thank Allah for letting us have both of them for a short while. May all their exemplary parental roles be rewarded by Allah. My grandmother, my sisters and brother: Lina, Ejan, Fiza, Dura, Nana and Along. All the tears and sadness we shared have brought us all together. Many things we had faced together but nothing has affected us as much as the day we lost mom. April 3, 2006 we were hit again, ayah left us so suddenly. It has never been easy. To my sisters, I wish I could take away the pain from you. My support systems include my mother in-law, aunties and cousins.

I thank Allah for rewarding me with three wonderful children: Aliya, Aina and Alif, the colors of my life . "Stress releaser" in its own category. Who have taught me to become a mom while I was struggling living without my own. Who have changed me and my priorities in life. Thank you dear for giving me strengths to move forward. Last but not least, my wonderful understanding husband, Nor Azman Nordin, for his continuous love and support and for being there for me when the greatest loss happened to me. Who knows the exact things to do and say to help me struggle with challenges in life. Thank you for taking the kids out 'whereever' just to let me have the house alone and complete my write-up. I can't thank you enough. "You are the wind beneath my wings"

Thanks to all, for sharing my passion and interest in this topic. We never know how much time we have together. It is either one of us, no one knows. May this work bring us closer to Allah, InsyaAllah.

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TABLE OF CONTENTS

Abstract ......................................................................................................................ii Abstract in Arabic ......................................................................................................iii Approval Page............................................................................................................v Declaration .................................................................................................................vi Copyright Page...........................................................................................................vii Dedication ..................................................................................................................viii Acknowledgements....................................................................................................ix List of Tables .............................................................................................................x CHAPTER ONE : INTRODUCTION ......................................................1

Introduction To The Study .............................................................................1 Background Of The Study..............................................................................1 Statement Of The Research Problem..............................................................4 Statement Of Purpose And Research Questions.............................................7 The Significance Of The Study ......................................................................7

Contribution To The Evolution Of Knowledge And Theory..................7 Contribution To Practice .........................................................................8

Delimitation ....................................................................................................8 Limitation .......................................................................................................8 Focus of the Study ..........................................................................................9 Phenomenological Inquiry ......................................................................9 Definitions of Terms and Concepts ................................................................10 Loss .........................................................................................................10 Grief ........................................................................................................10 Bereavement............................................................................................10 Mourning.................................................................................................11 The Bereaved, The Bereft, The Griever and The Mourner.....................11 Grieving ..................................................................................................11 Group Work ............................................................................................12 Assumptions ...................................................................................................13 Social Construction .................................................................................13 Close Relationship and Attachment Theory ...........................................13 Group Counseling ...................................................................................13 Overview of Literature Review ......................................................................14 Overview of Methodology..............................................................................14 Overview of the Complete Document ............................................................15 Chapter One: Introduction ......................................................................15 Chapter Two: Literature Review.............................................................15 Chapter Three: Methodology ..................................................................15 Chapter Four: Grief and Loss: Death and Bereavement in Islam ...........16 Chapter Five: The Coping Responses of the Malay Participants............16 Chapter Six: The Malay Participants' Group Experience .......................16 Chapter Seven: Summary, Discussion and Conclusion ..........................17 Conclusion ......................................................................................................17

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CHAPTER TWO : REVIEW OF LITERATURE.....................................18 A Glimpse Of The History And Development Of Bereavement In Counseling ......................................................................................................18 Grief And Loss ...............................................................................................21 Types Of Losses......................................................................................21 What Is Grief? .........................................................................................21 Other Types Of Grief ..............................................................................23 Grief and Mental Health .........................................................................24 Normal vs Abnormal Reactions ..............................................................25 Grief And Depression .............................................................................27 Stages Of Grief........................................................................................27 Determinants Of Grief Responses...........................................................30 Meanings In Relationships With The Deceased..............................30 Time And Duration..........................................................................31 Effects Of Grief.......................................................................................31 Experience And Expression Of Grief .....................................................33 The Coping Responses: Models And Theories ..............................................34 Coping Definition And Context ..............................................................35 The Development Of Coping Theories And Models ..............................35 Grief As Emotion And Grieving As Process (Attig, 1991).............37 Dual Process Model Of Bereavement (Stroebe And Stroebe, 1999) ...........................................................38 Psychosocial Transition (PST) Model (Parkes, 1996) ....................39 Continuing Bond (Klass & Walter, 2002).......................................39 Religion And Culture ..............................................................................40 Helping The Bereaved ....................................................................................40 Development Of Bereavement Services .................................................42 Grief Counseling. Does It Work? ...........................................................44 Groups And Social Sharing.....................................................................44 Group Work....................................................................................................45

Group Intervention..................................................................................45 Group Counseling As The Choice Of Treatment....................................47 Group As Therapeutic Forces (Yalom, 1985).........................................48 Group In Islam ........................................................................................48 Grief And Bereavement Support Group.........................................................49

The Purpose Of Bereavement Support Group (BSG).............................50 Group Leader/Counselor In Bereavement Group ...................................50 Nature of Group Counseling: Planning And Conducting Groups ..........50 Group Formation.....................................................................................52 Important Practical Considerations (Corey & Corey, 2002) ...........52 Group Stages ...........................................................................................53 Starting Group .................................................................................53 Journey To Working Stages ............................................................54 Ending Group ..................................................................................55 Evaluation of Group Experience.............................................................55 Theoretical Rationale......................................................................................56 Social Constructionist .............................................................................56 Group Counseling ...................................................................................57 Other Related Theories ...........................................................................58

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Meaning Making .............................................................................58 Social Psychological Approach.......................................................59 Theories Of Attachment And Close Relationships .........................60 Culture And Religion In Bereavement ............................................61 Islam In View Of Grief Related To Death...............................61 Conclusion ......................................................................................................61 CHAPTER THREE : RESEARCH METHODOLOGY ...............................64 Recapitulation Of The Research Questions And Research Design ................64 Investigator's Perspective ...............................................................................66 Research Paradigm..................................................................................66 Stories In The Interviews ........................................................................67 Observation Tool: Content Vs Process In Group ...........................................68 Theoretical Constructs In The Method...........................................................69 Social Constructionist .............................................................................69 Group Work ............................................................................................71 Positionality ....................................................................................................71 Participants .....................................................................................................72 Bereavement Support Group For The Malays................................................72 The Group Proposal........................................................................................73 The Proposal: Introduction......................................................................73 Rationale .................................................................................................73 Type of Group.........................................................................................74 Group Objectives ....................................................................................75 Program Assumptions .............................................................................75 Group Counseling Participants Recruiting Procedure ............................76 Group Memberships' Recruitment ..........................................................76 Group Announcements ...........................................................................76 Screening And Memberships Selection Process .....................................77 Inclusion vs Exclusion Criteria For Group Membership ................77 Intake Session .........................................................................................78 Pre-Interview, Screening And Pre-Group Briefing.................................79 Intake Session and Pre-interview ....................................................79 Consent, Confidentiality And Precaution ...............................................80 Discussion Guidelines And Suggested Topics........................................82 Group Counseling Activities ...........................................................83 Expert Review And Pilot Study......................................................................84 Group Leader Cum Researcher ......................................................................84 Limitations ..............................................................................................85 Evaluations..............................................................................................85 Data Collection ...............................................................................................85 Data Collection Procedure ......................................................................86 Phase One: Professional And Personal Preparation ........................88 Phase Two: The Group....................................................................89 The Group Formation ..............................................................90 Conducting Group....................................................................90 Phase Three: Post-Group Interview And Follow-Up Interviews ....90 Method of Analysis ........................................................................................93 Rigor And Trustworthiness ............................................................................93

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Conclusion ......................................................................................................95 CHAPTER FOUR : GRIEF AND LOSS: DEATH AND BEREAVEMENT IN ISLAM....................................96 Spirituality In Bereavement............................................................................96 Spirituality And Islam ....................................................................................100 Sources Of References ............................................................................100 The Qur'Én .......................................................................................102 The Sunnah......................................................................................102 Spirituality In Human Beings .........................................................................103 Creation Of Man And The Dual Nature of Man.....................................103 Physical Being (Al-Rum 30:20) ......................................................104 Spiritual/Divine Being (RUHANIYAH).........................................104 The Purpose Of The Creation Of Man....................................................104 Value of Life: An Islamic View of Suicide ............................................106 Life On Earth In Relation To Life Here-After ........................................106 Awareness of Death In Daily Lives ........................................................108 Description Of Death In The Qur'Én .......................................................109 Death In Islam: Important Assumptions .................................................109 Return To The Creator.....................................................................109 There Is No Escape From Death .....................................................110 Death Is For Everyone.....................................................................110 Time Of Death Is Unknown To Us .................................................111 Death Is Not Our Final Destination.................................................112 What Happens When A Person Dies? .............................................112 Alam Barzakh .........................................................................................113 The Dooms Day And Resurrection .........................................................113 The Day of Judgement ............................................................................113 Helping The Dying .........................................................................................113 Immediate Reaction To Death ................................................................113 Role Of Community: Relatives, Friends And Neighbours .....................114 Grief And Loss In The Context Of Islam .......................................................115 Loss Of A Loved One Is A Test .............................................................115 Sign Of Allah's Love...............................................................................115 Tests In Islam And Its Relevance To Death ...........................................116 Preparing For Death........................................................................................117 Remembering Death ...............................................................................118 Benefits Of Remembering Death ............................................................119 Coping With Hardships ..................................................................................121 Sabr (Patience, Forbearance) And Redha (Acceptance) .........................121 Being Thankful .......................................................................................123 Crying Is Normal ....................................................................................123 Helping The Bereaved ....................................................................................124 Communicating With The Bereaved ..............................................................126 CHAPTER FIVE : THE MALAYS COPING RESPONSES TO LOSS ..127 Data Analysis..................................................................................................127 Universal Responses ...............................................................................127 Unbelievable Truth ..........................................................................127

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How I Wish......................................................................................128 Guilt .................................................................................................128 Universal Tears And Sadness ..........................................................128 Life Without ....................................................................................130 Continuing Bond Unaffected...........................................................131 Moving Away..................................................................................131 The Religious Spirituality-Inclined Responses.......................................132 Facing Dying And Death.................................................................132 Closer To Allah And Gifts For Them..............................................132 Redha (Total Acceptance) And Sabr (Patience)..............................134 The Malay Ethnic-Specific Responses ...................................................135 Reciting Yaseen And Kenduri Arwah.............................................135 Visiting The Grave ..........................................................................136 Reminiscing Signs ...........................................................................136 Preparing For The Loss ...................................................................137 Longing For The Closeness.............................................................138 Dealing With Changes.....................................................................139 Conclusion ......................................................................................................141 CHAPTER SIX : GROUP EXPERIENCE ............................................142 Introduction ....................................................................................................142 Group Results/Data Analysis..........................................................................142 Demographic Data ..................................................................................142 IPTA Group 1: The Participants......................................................142 IPTA Group 2: The Participants......................................................143 Recruiting Memberships .........................................................................144 Intake And Screening Session: IPTA 1 ...........................................144 Intake And Screening Session: IPTA 2 ...........................................144 The Bereavement Groups........................................................................145 Pre-Group Meeting: 29th Jan 2005 (IPTA 1) And 26th Feb 2005 (IPTA 2) ...................................................................145 IPTA 1: Summary Of The Group Sessions .....................................146 Meeting 1: 29th Of January, 2005 ............................................147 Meeting 2: 3rd Of February 2005 .............................................147 Meeting 3: 18th Of February, 2005 ..........................................147 Meeting 4: 1st Of March 2005..................................................148 Meeting 5 & 6: 15th Of March 2005 & 22nd August 2005 .......148 Final Meeting: 28th Of November, 2005..................................149 IPTA 2: Summary Of The Group Sessions .....................................149 Meeting 1: 26th Of April, 2005 & Meeting 2: 2nd Of March 2005..........................................................................................150 Meeting 3: 16th Of March, 2006 ..............................................150 Meeting 4: 17th Of June, 2006.................................................150 Meeting 5: 2nd Of September 2005 ..........................................150 Final Meeting: 15th Of March 2006 .........................................151 Group Activities ......................................................................................151 The Assignment: Letter (IPTA1).....................................................151 Sharing The Memories: Photos And Items With Sentimental Value................................................................................................153

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Other Activities ...............................................................................154 Follow-Up Interviews .............................................................................154 Group Experience ...................................................................................154 Prior Group Experience...................................................................155 Responses To The Reasons For Joining The Group .......................155 Benefits Of Group From Members' Point Of View ................................156 Processing Group Experience .................................................................157 The 'Magic' Tears ............................................................................157 Founded Support Venue For Sharing And Listening ......................158 A Good Reminder............................................................................160 Not Alone ........................................................................................160 Self-Reflection.................................................................................161 Lesson Learned................................................................................162 Conclusion ......................................................................................................162 CHAPTER SEVEN : SUMMARY, DISCUSSION AND RECOMMENDATION..............................................163 Summary.........................................................................................................163 Discussion.......................................................................................................164 New Issues Surface In The Study ...........................................................167 My Observations: The Group .................................................................168 The Activities ..........................................................................................169 Change of Plan ........................................................................................169 Limitation of Study.........................................................................................170 Mental Health And Counseling Implication...................................................170 Processing My Own Personal Observation And Thoughts ............................171 Professional .............................................................................................171 Personal ...................................................................................................172 Other Challenges.....................................................................................173 Recommendation ............................................................................................173 Conclusion ......................................................................................................174 BIBLIOGRAPHY......................................................................................................176 APPENDIX A: ANNOUNCEMENT .....................................................................187 APPENDIX A1: GROUP ADVERTISEMENT .......................................................188 APPENDIX A2: SAMPLE BROCHURE/HANDBILL SAMPLE ..........................189 APPENDIX B: SCREENING AND INTAKE PROCEDURES ............................190 APPENDIX B1: INTAKE FORM / DEMOGRAPHIC INFORMATION...............190 APPENDIX C: CONSENT AND CONTRACT FORMS......................................192 APPENDIX C1: HUMAN SUBJECT INFORMED CONSENT FOR RESEARCH PARTICIPATION AND AUDIO/VIDEO RECORDING............192 APPENDIX C2: GROUP COUNSELING MEMBERSHIP CONTRACT..............194 APPENDIX D: INTERVIEW PROTOCOLS/GUIDE ...........................................195 APPENDIX D1: GUIDELINES FOR DISCUSSIONS WITH MUSLIM SCHOLARS ..................................................................................196 APPENDIX D2: PROTOCOL FOR COPING RESPONSES ..................................198 APPENDIX D3: PROTOCOL FOR GROUP COUNSELING EXPERIENCE.......204 APPENDIX D4: PROTOCOL INTERVIEW ON CONFIDENTIALITY &

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INFORMED CONSENT...............................................................205 APPENDIX E: GROUP MEMBERS DEMOGRAPHIC INFORMATION..........206 APPENDIX E1: IPTA1 PERSONAL PROFILE .....................................................207 APPENDIX E2: IPTA2 PERSONAL PROFILE .....................................................209 APPENDIX F: PARTICIPANTS’ PROFILE OF LOSS........................................211 APPENDIX F1: IPTA1 PROFILE OF LOSS ..........................................................212 APPENDIX F2: IPTA2 PROFILE OF LOSS ..........................................................213 APPENDIX G: RESEARCH SCHEDULE ............................................................214 APPENDIX H: LETTERS AND CORRESPONDENCE.......................................216 APPENDIX H1: COVER LETTER SENT TO UNIVERSITY FOR RECRUITMENT OF PARTICIPANTS .......................................217 APPENDIX H2: SAMPLE LETTER TO BEREAVEMENT SITES FOR VISITATION PERMISSION AND APPOINTMENT IN MALAYSIA ..................................................................................218 APPENDIX H3: SAMPLE LETTER TO BEREAVEMENT SITES FOR VISITATION PERMISSION AND APPOINTMENT IN UNITED KINGDOM....................................................................219 APPENDIX H4: SAMPLE VISIT ACCEPTANCE LETTER FROM BEREAVEMENT SITES IN UNITED KINGDOM ....................220 APPENDIX H5: SAMPLE LETTER TO ISLAMIC SCHOLARS TO SECURE

PERMISSION FOR DISCUSSIONS............................................221 APPENDIX I: LIST OF BEREAVEMENT CENTRES VISITED.......................223 APPENDIX J: LIST OF BEREAVEMENT PERSONNEL AND PROFESSIONALS INTERVIEWED ...........................................224 APPENDIX K: FUNERAL PROCESSION AND OBSERVATIONS ..................225 APPENDIX L: QUESTIONNAIRE.......................................................................226 APPENDIX L1: PRE-GROUP QUESTIONS..........................................................226 APPENDIX L2: GROUP EVALUATION...............................................................227 APPENDIX M: SAMPLE VERBATIM TRANSCRIPT (TRANSLATED) ..........228

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LIST OF TABLES Table No. Page No. 3.1 The Methods of Gathering Data Based on The Research

Questions 92

LIST OF FIGURES Figure No. Page No. 3.1 Research process of the study 87

7.1 The Funnel Journey to the Malay’s Coping Responses 165

7.2 The Overlappings: The Coping Responses from Different Angles 166

1

CHAPTER ONE

INTRODUCTION

INTRODUCTION TO THE STUDY

This chapter presents an introduction to the study that attempted to describe the grief

responses of adult Malay students attending bereavement support groups at two

different universities in Malaysia. The research was conducted to capture their coping

reactions to the death of their close family members as they share those experiences in

the support groups.

The chapter provides an overview of the study. It begins with presenting the

background of the study as the basis of pursuing the topic. The statements of the

problem defined the problem into the research context from which research questions

were constructed. The significance of the study, the limitation and delimitation are

also briefly described in this chapter. The focus of the study puts in place the context

of the study, followed with the identification of related terminology in the definitions

of terms and concepts. The overview of literature and the overview of methodology

provide the readers with brief introduction to the coming chapters. The chapter ends

with an overview of the organization of the complete document.

BACKGROUND OF THE STUDY

Losing someone to death can be one of the most painful experiences in life. Unlike

births that can be predicted, the time of death is unknown. Sometimes death can be

expected due to one's poor health conditions such as chronic illnesses. However,

whether it is anticipated or unexpected, death is still not something that anyone can

2

really be prepared for. Death of a loved one and the mysterious 'life' after death leaves

family and friends with no choice but to deal with the painful loss.

Despite the certainties of death for every life, people do not usually discuss the

matter as much as they talk about life itself. It seems that most people are indifferent

to death until it comes to their door steps, only when it happens to someone important

to them.

Each of us has our own conceptions of death and deals with it differently. The

way people think about death is everywhere culturally embedded (Rosenblatt, 2003).

Thus, this conception, usually shaped by culture, may be important factors that

influence a person's coping reactions to the loss. On the other hand, in helping the

bereaved, one should not also assume the similar background of religion, race or

nation would lead to similar experience and understanding of grief (Rosenblatt, 2003).

Grief reactions to loss are always unique from one person to another.

Studies on grief and loss conducted abroad covered a myriad range of losses.

They do not necessarily refer to losses due to death. There have been studies on grief

and bereavement since the early 1600s. It has covered the subject from multiple

angles from the basic stages of grief (Kubler-Ross,1969 & Worden,1991) to

understanding different types of losses (Worden,1991) and on to the discussion of

other issues in bereavement such as determinants of grief (Parkes,1998); pathologic

grief (Jacob, 1993), disenfranchised grief (Doka, 1998), complicated grief (Prigerson,

2004) and many more. Research investigations presented a more complex

phenomenon of bereavement on various bio-, and psycho- and social levels using

more sophisticated methods based on finer-grained theories (Stroebe et al., 2002).

Bereavement studies are no longer targeted at the elderly people but also have

started to look at bereaved people of all ages, young and old. The works in

3

bereavement studies have obviously led to significant reactions among the public and

also policy makers in most developed countries. As a result, today, we can witness an

increased awareness of bereavement counseling and services especially in countries

like United Kingdom, United States and Australia. Bereavement support and

assistance are widely available through established agencies such as Cruse

Bereavement Care, St. Hospice, etc. It has become another important branch of

counseling. Death Education (Thanatalogy) is now being offered as a course in many

universities. For example, Indiana University has been offering a course on Grief in

Family Context through the internet for the past few years (Gilbert, 2002). The

awareness about the importance of death and bereavement in a western context has

grown and developed over many years and it keeps on expanding in depth and

breadth.

In Malaysia however, bereavement support and services are seen in a different

form. There has been no direct assistance to help individuals deal with grief and loss.

Most of the supports focus on the physical aspect of loss such as the funeral rituals

and arrangements which are normally managed according to the deceased religious

belief.

In terms of preparing people for loss, HOSPIS Malaysia has been identified as

one of the NGOs that offers assistance to people with life threatening illnesses

(Personal communication, Dr Ednin, 2006). The awareness of loss due to terminal

illnesses has grown from providing care for medical to emotional needs. There are at

least three other organizations offering services that are supposedly inclined to have

some aspects of loss and bereavement assistance in nature: Breast Cancer Welfare

Association, Cancer Link Foundation and Malaysian AIDS Council. These services

focus on specific target groups. Some non-governmental organizations like Talian

4

Sahabat, All Women Action (AWAM) and Befrienders have been providing

counseling services to the public for all kinds of concerns. (Collections of counseling

referrals at Institute of Education, IIUM Counseling Resources).

Counseling services are also available in schools. The recent policy instituted

by the Ministry of Education stated that the provision of having at least one counselor

per five hundred students by 2010. Local universities like Universiti Putra Malaysia,

Universiti Malaya and International Islamic University Malaysia are currently

involved in offering counseling programmes to pre-service and in-service teachers.

School counseling, career counseling and family counseling have started to be

available and offered in different organizational settings. Jabatan Kebajikan

Masyarakat has appointed counselors in local districts that provide services to the

community (Personal communication, JKM Personnel, 2006). However, it is not

specified whether or not counselors are equipped with the skills and knowledge to

provide bereavement counseling to their clients. However, an awareness of the

importance of this subject has started to get the attention of some counseling

professionals and educators. Amir Awang and Hapsah (2005) presented the roles of

teacher and counselor in helping dealing with grief at the National Convention for

PERKAMA (Malaysian Counseling Association).

STATEMENT OF THE RESEARCH PROBLEM

Although studies on grief and bereavement are not new to researchers in the area of

counseling, documentation on grief responses, death and bereavement in an ethnic

Malay community in Malaysia context is still lacking. Literature on grief experiences

of the Malays is not available. From my observations, the topic has not captured the

public attention. Could it be due to the culture itself that prevents an open discussion