Articles

# The Dynamics of Spousal Relationships After the Loss of a Child Among Bereaved Malay Parents

Nur Atikah Mohamed Hussin*a, Taufik Mohammada, Azlinda Azmana, Joan Guàrdia-Olmosb, Anna Liisa Ahoc

Interpersona, 2018, Vol. 12(1), 51–67, https://doi.org/10.5964/ijpr.v12i1.288

Received: 2017-10-18. Accepted: 2018-03-28. Published (VoR): 2018-07-06.

*Corresponding author at: Department of Social Work, School of Social Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia. E-mail: atikah.mhussin@usm.my;

This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

## Abstract

The purpose of this study is to explore the dynamics of the relationship between bereaved parents after the loss of their child. Literature has attempted to understand how coping mechanisms related to gender characteristics, communication, and intimacy influence the spousal relationship after the loss of a child. However, this area is scarcely explored in a Malaysian context. This qualitative study involved 11 bereaved parents. These parents had lost their children due to accidents (n = 9) and homicide (n = 2). Open-ended questions that focused on the patterns of the spousal relationship were administered to the parents. The data were analysed using thematic analysis. Some of the main themes found were that constructive communication and intimacy are interrelated in helping bereaved parents to cope better. Nonverbal intimacy is helpful. Avoidance or limited communication and intimacy are influenced by religion and cultural beliefs. The bereavement responses influenced the spousal relationship, causing it to become stronger, weaker, or causing the parents to act like nothing had happened. This study helps us to understand the effects of the loss of a child on the spousal relationship of the bereaved parents. This study makes recommendations related to the adjustment and maintenance of a healthy spousal relationship after the loss of a child.

Keywords: spousal relationship, communication, coping styles, marriage and bereavement

One of the most discussed issues faced by parents who are grieving is the issue of the various patterns of the spousal relationship dynamics post-death. Past literature had identified a number of issues that arise after the death of a child that may affect the quality of the parents’ relationship. The issues—such as effective communication (e.g., Toller & Braithwaite, 2009), gender differences in coping mechanisms (e.g., Samuelsson, Rådestad, & Segesten, 2001), and the quality of intimacy (e.g., Wing, Burge-Callaway, Rose, & Armistead, 2001; Zerach, Anat, Solomon, & Heruti, 2010)—may affect whether there will be difficulties later in the relationship (e.g., Bohannon, 1991; Hooghe, Neimeyer, & Rober, 2011; Toller & Braithwaite, 2009).

Various studies related to spousal communication have found that spousal communication it is a key to the bereaved parents connecting with each other post-loss. Spousal communication may be achieved through sharing each other’s experiences regarding the loss, which may reduce the intensity of their grieving responses and help to maintain a good relationship post-loss (Toller & Braithwaite, 2009). Different individuals may have different styles in communicating with a spouse during grieving. In a study by Li and Loke (2014) they identified several patterns of spousal communication during grieving, namely mutually constructive communication, mutually avoidant communication, and demand/withdraw communication.

Constructive communication is described as the ability for the couples to discuss issues and cope with conflicts together, and it leads to a better relationship. On the other hand, mutual avoidance is when a couple hinders any effort to have a healthy discussion about the loss. Demand/withdraw communication is when there is a gap in discussion effort where one partner seeks discussion and the other partner avoids it. Both mutual avoidance and demand/withdraw communication patterns are described as negative ways of communicating that can lead to the destruction of the spousal relationship.

In addition, mutually constructive communication has been identified as leading to intimacy among couples (Manne, Badr, Zaider, Nelson, & Kissane, 2010). Intimacy was found to be correlated with open communication regarding support, negotiating about a problem, and respecting each other (Mills & Turnbull, 2004). According to the interpersonal process model (Reis & Shaver, 1988), intimacy encompasses two aspects: self-disclosure and empathetic responding. The former of these two aspects describes the potential for an individual to share her or his personal needs, wants, or emotions, while the latter describes the components of understanding, validation, and caring. This model emphasizes the importance of couples genuinely understanding each other and respecting self-disclosure to ensure harmony in the relationship throughout the grieving journey.

However, it was shown that after the death of a child, a common issue is that the communication between the bereaved parents becomes difficult, regardless of the communication pattern (Rowen & Emery, 2014). Both bereaved parents experience the lack of strength and energy to support each other. In addition, gender differences in expressing loss lead to more difficulties in comforting and caring for each other (Becvar, 2001). Most of the studies of the spousal relationship after the death of a child have attempted to describe the dynamic of the relationship in terms of the effects and the consequences of the death of the child according to Western values. In most Western societies, effective communication (Toller & Braithwaite, 2009) and mutual understanding (Schwab, 1998) were identified as being at the core of strengthening a spousal relationship post-loss. However, Irwin (1991) argued that the need to communicate and express grief focuses much on the needs of oneself and may be culturally insensitive to non-Western societies. This is especially true in a non-Western society that believes that expressing grief is a cultural taboo.

The Asian societies are perhaps societies with the most contrasting way of life to Westerners. A study by Kim, Sherman, and Taylor (2008) among Asian people revealed that they are absent of explicit disclosure. This means that Asian people are not inclined towards explicit disclosure to avoid straining relationships, losing face, or making others overly concerned about their problems. In addition, people in Asian cultures also restrain themselves from expressing negative feelings or complaints. This practice is thought to be valuable both in maintaining self-esteem and group harmony (Sue & Sue, 2003).

In addition, gender coping mechanisms are also identified as a factor that may later influence the bereaved parents’ relationship post-loss. In coping, bereaved mothers are more likely to cry and seek support (Carroll & Shaefer, 1994). They tend to utilize the social support available around them and take advantage of opportunities to talk about the loss with their significant others. On the other hand, bereaved fathers prefer to hide their feelings and avoid seeing other people (Samuelsson, Rådestad, & Segesten, 2001). Many bereaved fathers distract themselves with some activities to avoid remembering about the loss. These differences in coping contribute to a gap that can become the source of misunderstanding between the couple.

The incongruity between fathers’ and mothers’ ways of grieving is predicted to be a factor for bereaved parents experiencing conflict and communication breakdown in their marriage. This phenomenon may lead to divorce (Lyngstad, 2013). However, various scholars point out that it does not necessarily have to end up with divorce (Hooghe, Neimeyer, & Rober, 2011; Toller & Braithwaite, 2009). It depends on the ways in which the parents adapt to the incongruity.

Nevertheless, there were also studies that found that the death of a child strengthens the spousal relationship (e.g., Rosenblatt, 2000; Schwab, 1998). One of these studies reported that in some ways, the ability for the bereaved parents to grieve together as a couple can strengthen their marital bond (Schwab, 1998). This suggests that after the death of a child, there are factors that are vital in determining the strength of a spousal relationship that depend on the ability of bereaved parents to cope with their loss.

The effect of a death is intensified when the death is caused by a traumatic event such as an accident or murder. The traumatic death of a child can impact upon the parents physically and mentally (Walsh, 2007). A comparison study on the traumatic death and non-traumatic death of a child revealed that parents bereaved by a traumatic death experienced more traumatic and extreme responses compared to parents bereaved by non-traumatic causes, such as diseases (Rubin, 1996). The traumatic death of a child can be detrimental to the relationship between the parents (Rosenblatt, 2001). The relationship can become worse as both bereaved parents need to deal with their own grief while also providing support to each other (Umphrey & Cacciatore, 2014).

In general, Malaysians are religious people (Oka, Hussin, & Hagström, 2017). According to The 2010 Population and Housing Census of Malaysia (Department of Statistic Malaysia, 2018), 60% of Malaysians were Muslims, 19% were Buddhists, 9.1% were Christians, 6.3% were Hindus, and 2.6% were Confucians, Taoists, and other traditional Chinese religions. In general, the Malay people are influenced by Islamic teaching in their daily life (Oka, Hussin, & Hagström, 2017). A study on help-seeking behavior among Malay people revealed that Malay people will turn to religious healers to seek for treatment rather than to a medical doctor as they believe that illnesses are usually influenced by spiritual possessions (Haque, 2005).

Religion provides rules that are to be followed in order to ensure a successful life in the hereafter (Oka, Hussin, & Hagström, 2017). This includes their faith that God has determined everything in their life, starting from their birth and leading to their death. Therefore, Malay people must surrender themselves to God rather than question their lives. In terms of bereavement, Islamic teaching provides a guide for how bereaved parents should grieve. In Islamic thought, bereaved parents can cry but not to express their emotion in extreme ways, such as wailing (Maqsood, 2002). Muslims are advised to turn to God during stressful episodes and at times of grief. In terms of parental grief, there was a narration in which the Prophet insisted that children who die before their parents go on to the Hereafter as forerunners for their parents and serve as “protection” for the parents against hellfire (Maqsood, 2002). This provides the insight that Islam teaches its followers to make sense of the death of a child as an uncontrollable event and promotes seeing the benefit of the death in life in the Hereafter rather than just focusing on one’s current life.

Bruner (1990) argues that the ability to make sense of a death and find a benefit in it post-loss is associated with the ability for an individual to narrate or talk about their stories. This implies that effective communication is a key for bereaved parents to share their grief and adapt to their loss as a couple (Toller & Braithwaite, 2009). A study on how Malay couples dealt with their conflicts revealed that Malay couples are able to express personal thoughts and feelings equally (Hasim, Mustafa, & Hashim, 2015); yet, there were also couples who avoided discussing their conflicts. Apart from the religious obligation to avoid from discussion which can lead to conflicts and also helpful to prevent disharmony in a family. However, studies also found that avoidance may lead to dissatisfaction and stress as the couples are not able to express themselves nor seek clarification (e.g., Bodenmann, Kaiser, Hahlweg, & Fehm-Wolfsdorf, 1998; Hasim, Mustafa, & Hashim, 2015). Nevertheless, due to social taboo that describes divorce as the inability to take care of one’s spouse, some Malaysian couples may remain in the marriage even when they are having conflicts in their relationships (Kassim, 2007). This reflects cultural differences—the way Malay parents grieve may require a different understanding to that required for understanding the way Western parents grieve.

In addition to the cultural differences, even though the previous studies managed to identify several communication patterns among married couples dealing with conflicts, this might be different in the context of parental grief as parental grief has its own characteristics. When grieving, bereaved parents do not just need to deal with conflicts but to also have to adapt to their loss (Karney & Bradbury, 1995). This study has no intention of comparing Asian and Western grieving patterns, rather it hopes to describe the notion of the bereavement journey among Malay people, which (as part of an Asian culture) may vary from the existing literature that is derived from the Western perspective. This study focuses on Malay people as there is still limited knowledge on how parental grief can influence the spousal relationship, especially among Malay people. Most of the literature related to bereavement among Malay people has focused on the technical aspects, which include the funeral customs and practices (such as having a feast and praying for the deceased) (e.g., Ishak & Abdullah, 2012; Yakin & Mahali, 2008).

Since the number of respondents for this study is limited, it is impossible for this study to generalize the bereavement journey among Malay people as a whole. The bereavement journey may vary according to people’s backgrounds and beliefs. Yet, this study is important in providing a platform for understanding parental grief among Malay people, which may later also to contribute to understanding various Asian populations in the world.

This study is a vital addition to the literature on how parents from different cultures deal with the conflicts that may ensue from different ways of coping with death of a child. This study hopefully provides professional implications for help providers, helping them to acknowledge the issues that may arise in parental grief and helping them assist bereaved parents maintain harmony in their marriage while going through their grieving process.

## Method

### Respondents

To identify the respondents for this study, social media platforms such as Facebook and Twitter were used. Three types of sampling methods were used:

1. The researchers first created a public post related to the topic of parental grief among Malaysians. The post included an explanation of the aim of identifying bereaved parents in Malaysia, the rationale of the study, the criteria for the bereaved parents, and the voluntary nature of the participation.

2. The researchers also performed internet searches for any posts in social media related to the issue of the loss of a child.

3. The researchers used snowballing.

After obtaining information from the publics or potential respondents, the researcher had identified some potential respondents according to some certain criteria which that has been were set by the researchers for this study. The criteria for participation were:

1. The participants must be Malaysian.

2. The participants must be a parent who has lost their child due to traumatic death (an accident or homicide).

3. The deceased children had to be younger than 18 years old at time of death.

The bereaved parents who responded were contacted individually through a social media messaging service to ask if they were interested in participating in this study. Twenty-five potential respondents were called, yet only 11 agreed to participate. The participants who agreed to participate were free to decide the place, date, and time for the interviews.

There were six bereaved fathers whose ages ranged between 36 and 57 years old. There were five bereaved mothers whose ages ranged between 35 and 54 years old. The causes of the death of the children were accident (n = 9) and homicide (n = 2). The range of time since the children’s death was between one and eight years. The range of ages of the children at the time of death was one to 16 years old. The interviews were conducted at various locations, as follows: at the respondent’s house (n = 5), at a mosque (n = 5), and at a canteen (n = 1).

### The Interview Items

This study aims at understanding the relationship dynamics of bereaved parents after the traumatic death of their child in Malaysia. There were three main keys of considerations, reflecting the previous studies on understanding the relationship dynamics of bereaved parents post-loss:

1. Their communication styles and intimacy post-loss (Becvar, 2001; Carroll & Shaefer, 1994; Reis & Shaver, 1988; Samuelsson, Rådestad, & Segesten, 2001; Toller & Braithwaite, 2009).

2. How they cope and adapt to each other’s coping style (similarities or differences) (Büchi et al., 2009; Moriarty et al., 1996).

3. The impact of the loss on their relationship (Rosenblatt, 2000; Schwab, 1998; Zerach, Anat, Solomon, & Heruti, 2010).

The interview items used for this study comprised of semi-structured open-ended items that asked the parents questions on the three key points mentioned above. Additional questions were asked if the responses given required further understanding by the researcher. This study obtained approval from the Review Board of the School of Social Sciences of the Universiti Sains Malaysia.

### Procedure

The first step of this study involved obtaining the informed consents. The objective of this study was explained to the participants. The participants were reminded that they were free to ask any questions related to this study. They were also told that they had the right to not answer any question for any reason and that they had the right to withdraw from this study at any time.

To increase the trustworthiness in this study, the framework devised by Lincoln and Guba (1985) was used. This framework encompasses credibility, dependability, confirmability, and transferability criteria in order to develop the trustworthiness of a qualitative study. For this study, in order to establish credibility, the whole study process and results were scrutinized and discussed by the researchers. Then, dependability was assured by having a systematic data collection and analysis process using an audio recorder, notebook, and software. Confirmability was gained by presenting the data to the participants so that they could check it and ensure that the information and interpretation were correct. Transferability was gained by intending that this study does not represent all bereaved Malay parents but that it hopes to provide a general understanding of parental grief among the bereaved Malay parents that participated.

### Data Analysis

Thematic analysis was used to analyze the responses of the bereaved parents. Thematic analysis is a method for identifying and analyzing patterns in qualitative data. This study employs the phases of thematic analysis proposed by Braun and Clarke (2006). The first phase involved familiarization with the data. The second stage involved a coding process. During this stage, the researchers repeatedly re-read the transcripts in order to gain a better understanding of the responses. ATLAS.ti (Version 7) was used to provide a systematic coding system. The coding process involved identifying phenomena found in the texts. The coded data were then clustered into themes, and the themes were grouped into categories. The third stage was a process of searching for themes. At this stage, the first researcher listed the codes that emerged from the data and tried to find themes that were relevant to the codes. The other stages—which involved reviewing themes, and defining and naming themes—were conducted with the assistance of the second and third researchers. These processes involved more than one researcher to ensure the accuracy of the codes and themes created by the first researcher. Following completion of the analysis, the summary of the findings was submitted to the respondents to ensure their credibility and transparency.

## Results

Through thematic analysis the themes for the dynamics of the relationships among the bereaved parents were analyzed according to the communication style, intimacy, coping mechanisms, and relationship changes. The first objective was to describe spousal communication and intimacy as a parts of the coping mechanism post-loss. The second was to describe the bereaved parents’ experience of each other’s different coping mechanisms. The third objective was to describe the style of spousal relationship post-loss.

### Communication and Intimacy

The first item of the interview asked the respondents about their styles of communication when they interacted with their spouses. Three themes were identified: constructive communication, avoidant communication, and destructive communication.

#### The Constructive Communication Style and Dyadic Intimacy

A number of bereaved parents in this study reported that communication of their grief to their spouses helped them to grasp a better understanding of themselves. One way in which communication is deemed important can be reflected through the response of a bereaved father who said “Communication is important. In this way I can understand her feelings as she understands mine.”

Some bereaved parents found that constructive communication occurred when both of the spouses were able to maintain intimacy in their relationship. This included the ability to share their feelings and listen to words of encouragement from their spouses. A bereaved mother said: “Every time I feel sad, I need my husband. I talk to him. He never keeps quiet. He motivates me. Sometimes I really need to not keep myself bottling up, then I feel so much better.”

Intimacy is also contributed to by the mutual effort of the bereaved spouses to listen to each other’s stories empathically. A bereaved father remarked: “Yes, as a mother, she must be feeling bad. So, I understand her situation. I never feel burdened to listen to her. I understand her needs.”

In the responses religious motivational words were observed to be a way for the parents to communicate constructively. They were used as a base for both parents to give support to each other and gain support from each other. The narrations of the Prophets (Muhammad) were reported to be the best examples for both to emulate. One of the bereaved fathers said “Every time my wife talks about the loss, I just listen to her. After she finishes, I motivate her. I always advise her to emulate the Prophet’s narration. Even he—as a Prophet—he experienced the death of his son too. From there, we should gain our strength and believe that God will give us something better.”

There were also bereaved parents who found that no matter how challenging the situation is post-loss, they understood that they should mutually try to preserve constructive communication and intimacy. A bereaved father who felt hopeless after the death of his child said “No matter what, we need to understand that she [his wife] is a mother. She might be feeling more devastated. Therefore, I am open to listening to her. We discuss it. I do not feel it as a burden.”

#### Avoidant Communication and Intimacy

Another theme found from some responses was an avoidant communication style that was employed by some bereaved parents. These bereaved parents reported that their communication with their spouses, post-loss was limited due to certain factors. Some of the bereaved parents said that one of the reasons for them to limit the communication was to avoid blaming their spouses for their child’s death. A bereaved father remarked that he still blamed his wife for not being able to protect their son in a car accident:

It took a year for us to get back into our relationship, for it to be like before. For that first year I preferred to remain silent. In my heart, I blamed my wife and I knew that she blamed me too. I just do not understand why she did not hold on to our son tightly? And maybe she was questioning why I hit the thing on the road that made our car lose control. It was difficult.

Some bereaved parents reported that disclosing their grief to their spouses symbolized the human need to talk. A bereaved mother shared the following:

Every time I pass by the accident area, only God knows my feelings. I tried to share my grief feelings with him, but he stopped me. Disclosing my feelings did not mean that I did not accept God’s will. It is just me, being a human being.

Some of the bereaved parents were ridden with uncomfortable feelings when it came to communicate about the loss. The bereaved parents that belonged in this theme used religion as their reason for avoiding discussing the loss. They believed that the loss was related to destiny, as determined by God, which they found no reason to question. A bereaved father felt annoyed when he had to keep discussing the loss and said “Every time my wife started to discuss the loss, I would shut her up. I would change the topic. Why should we ask “Why, why and why?” This is a fate. Just accept it. Do not make things complicated.”

#### Destructive Communication and Intimacy

Some bereaved parents reported that it is important to disclose their grief feelings to their spouses. However, the inability for their spouses to accept the disclosure leads to negative consequences. One of the negative consequences was how the avoidance communication impacted on their spousal relationship. One of the bereaved mothers—who still blamed her husband for giving their deceased son a motorcycle as his death was due to a vehicular accident—remarked:

Every time I tried to bring up the conversation or discuss the loss, we would get into a fight. There was one time when my husband got out from the car and just walked away. We had a huge fight on our way to our home town. Even now, I cannot say anything about the loss in front of him.

Some bereaved mothers described that the masculine characteristics displayed by their husbands influenced the latter’s inability to understand the mothers’ feelings. As a result, it became quite difficult to preserve their intimacy. A bereaved mother, who still blamed her husband for the accident noted:

He is always like that. Men always take things lightly. Every time I talk to him I share my feelings, but he never entertains me. He urges me to not to discuss it. He condemns me by saying I should not become a rebellious religious follower. I understand the concept of fate and destiny, but only God knows what I feel.

#### Non-Verbal Intimacy

On the other hand, there were bereaved parents who reported limiting their conversation post-loss as a way of preventing discomfort. One of the reasons reported was that it gave them time and room for their spouses to grieve on their own and prevent any harm that might come to their relationship by talking about it. They described that any conversation post-loss might somehow lead to discussion about the loss, which in turn might eventually cause discomfort for both. However, the bereaved parents still spent more time together to connect. One bereaved father said:

I understand that the loss must be very hard for her. We limit our conversation because I do not want her to feel upset. However, we do spend more time together. I hug her whenever I miss our daughter. We try our best to spend more time together. We do not want to feel lonely. We do things that interest both of us, such as traveling together. We became closer as a result.

This is similar to another bereaved father who shared the following: “We just lost our loved one and I do not want to lose another. We need to be together. Every time I feel sad, I go to her and hug her.”

### How They Cope and Adapt to Each Other’s Coping Style: Similarities or Differences

The second objective asked the bereaved parents about the ways they coped with the loss in comparison with their spouses. The themes identified in this objective are the parents’ mutual understanding and the struggles experienced when trying to understand each other’s coping mechanism.

#### Mutual Understanding

The bereaved parents acknowledged the importance of providing space and time for their spouses to grieve. The bereaved parents tried to understand their spouses’ conditions and avoid any discussion, which they assumed to be a way to respect their spouses’ feelings (and avoid any sense of blaming each other). A bereaved father commented:” I do respect how she feels. I gave her some time. We agreed to never discuss the loss. She is the mother. She definitely felt it more painfully.”

Positively, the bereaved parents found the opportunity to stay together throughout their grieving process by doing activities together. Instead of grieving individually, some bereaved parents found that spending time together was more beneficial, especially for maintaining their relationship. One of the bereaved fathers claimed that “after the death of our son, we tried to find activities which we could do together. We spend most of our time together. We travel to Thailand more often. We attended religious classes—we go together.”

There were also bereaved parents who reported supporting each other’s way of coping and contributing to the activities where they spent time together. A bereaved mother who lost her child due to homicide reported the effort that her husband made in supporting her coping mechanism. Their togetherness in doing the activities where they spent time together helped her to appreciate her husband better. She remarked:

Whenever I miss my deceased daughter, I pray and donate bananas at the mosques. My husband helps me to buy the bananas and send them to the mosque. I know that coping with the grief in this way may help my deceased child in life in the Hereafter. I really feel that my husband is helping me to cope with the loss. I think that I appreciate him better.

Struggles in understanding each other’s ways of coping: There were bereaved mothers who specifically blamed the masculine coping style of their husbands for influencing their way of supporting their spouses. These bereaved mothers described their attempts to seek support from their spouses as futile. A bereaved mother remarked:

I definitely accepted the loss. However, every time we pass by the incident area, only God knows what I feel. I just need someone to talk to. However, talking to my husband is not helpful at all. Men prefer to take things lightly.

There were also bereaved fathers who specifically described the feminine coping styles in which mothers preferred to reflect upon their loss. The bereaved fathers believed that talking would not change anything and rather that it would make things worse, especially if it made them a rebellious follower of their religion. A bereaved father shared:

Women are different. They love to talk. Maybe because they want to express their grief but that is not rational. It will give you nothing. Talking about the loss shows that you are not being acceptant. You do not believe that everything that happened is because of God’s will. Just remember that.

Some bereaved fathers saw talking about their loss as a burden. Some bereaved fathers reported not understanding why the bereaved mothers were so keen to inquire about their loss. A bereaved father claimed “I just do not understand. The loss is fate. I always tell her not to question it. Do not ask “Why, why and why?” This is fate. Just accept it. Stop discussing complicated issues.”

With the differences in coping styles and the inability to understand each other’s coping styles, some bereaved mothers reported that the way their husbands coped with the death led them to feel neglected. The bereaved mothers also asserted that this was one of the reasons that their relationship became weaker. A bereaved mother claimed that “since the loss, my husband prefers to go out with his friends. I feel so lonely. There was a day when I gave him a knife and asked him to kill me. I cannot take this anymore.”

### The Impact of the Loss on the Relationship

This item asked about the bereaved parents’ perception of the changes in their relationship with their spouses after the loss. There were several themes identified. The first theme was when the parents perceived that their relationship before and after the loss was similar. The second theme related to when the parents perceived that their relationship became stronger. The third theme related to when the bereaved parents found that their relationship became weaker.

#### Acting Like Nothing Has Happened

After the death of a child, there were a number of bereaved parents who were able to maintain their marital dyads. The bereaved parents reported that there was no discussion involved and they acted as if they were fine. One of the bereaved fathers remarked that “our relationship was as usual. Nothing has changed. We act like nothing happened. We do not discuss it. We do not blame each other. We are just acting like we are fine.”

There were also bereaved parents who chose to preserve their marriage rather than to solve their grief feelings. The bereaved parents also reported “pretending” that nothing had happened to maintain their spousal relationship post-loss. A bereaved mother recalled that “after the loss, our relationship has remained the same. Nothing happened. We never talk about the loss. We pretend that nothing happened. We just want harmony in our marriage.”

Furthermore, the effort of maintaining the state of the relationship was done to preserve the harmony in their relationship as well as reduce the potential of harming their spouse’s health. A bereaved mother shared her view that,

there is no use in us fighting or talking about the loss repeatedly. I do not want to see him suffer. I limited the discussion. I do not want to see him sad or sick. Before this, he looked young and happy but after the loss, he got sick easily.

The relationship is perceived to be stronger after the loss: The bereaved parents also reported having a stronger relationship with their spouses, post-loss. The ability to respect and understand each other throughout the grieving process led to a higher appreciation of each other in their relationship. The bereaved parents described that their relationship was not harmed post-loss. One of the bereaved mothers claimed that “we became closer. Even now, we go everywhere together. He is everything to me. He is the only one who is with me all the time and understands me. We definitely became closer.”

There were also bereaved parents who perceived their losses as a chance to put their efforts into being together. As a result, they appreciated the presence of their spouses more. A bereaved father said:

Even though it was hard for us to be together, we made the effort to spend more time together. It is like wherever we go, we go together. Maybe before this, I never appreciated her. Now, after the loss, I realize that she is important in my life. I appreciate her better.

#### The Relationship Is Perceived to Be Weaker After the Loss

On the other hand, there were also bereaved parents who experienced a weakened relationship with their spouses after the death of their child. The inability to discuss and to accept the loss negatively affected their relationship post-loss. This was shown through the inability to understand each other’s way of coping with the death.

One of the bereaved fathers said: “It was difficult for us to get back to normal. It took a long time for us to talk and have a normal relationship after the death of our daughter.”

Similarly, some bereaved parents described that even talking about their deceased child could lead to conflict in their spousal relationship. The bereaved parents talked about their difficulty in rebuilding their relationship after the death of their child. A bereaved mother shared her viewpoint:

Every time we try to talk about our deceased son, we quarrel. There was a time when I told him that the voice of our youngest son is the same as that of our deceased son. He suddenly got angry and we had a big fight. Even now, it is difficult for us to be normal again.

As some perceived that their relationship became weaker, they hoped that their spouses would make efforts to try to understand each other better in relation to their grieving process. A bereaved mother claimed:

I do accept the loss. There is nothing we can do to change it. It is just that I need someone, especially my spouse, to listen to me. I need a place to channel my sadness. Sometimes I feel like it would be better for him [my husband] to kill me. I do not want to live this way. Only God knows what I feel.

Eventually, although the bereaved parents reported experiencing challenges in their relationship throughout their grieving journey, they still considered religion and culture as the main factors keeping them together. A bereaved father who was concerned about the stigma of being a divorcee shared the following:

No matter what happened, remember that we have religion to guide us. We need to remember our role as a husband, a wife, and as parents to the other, living kids. They are our gifts from God. Divorce is not a way to solve any problem. In fact, I do not want to be a widower because of cultural stigma. People will ask what is wrong with me.

## Discussion

This study aims at furthering understanding of the relationship dynamics between bereaved parents after the death of their child. In order to understand the dynamics of relationships between spouses post-loss, three aspects of spousal relationships were examined. The first aspect was the patterns of communication and intimacy that the parents had with each other after the death. The second aspect was the parents’ perception of the quality of their relationship due to certain factors related to the death of their child. The last one was the impact of the loss on the spousal relationships between the parents.

In previous studies, communication has been one of the key points that is widely discussed as determining the dynamics of marital relationships post-loss (Toller & Braithwaite, 2009). To expand on the literature, this study found several patterns of communication in spousal relationship post-loss. Constructive communication was observed when bereaved parents tried to share their feelings, listen to each other, and support each other. This finding suggested that constructive communication also depends on the ability of self-disclosure for both bereaved parents. The bereaved parents reflected on the importance of sharing their grief feelings as a human need. Constructive communication and balanced self-disclosure allow quality intimacy in spousal relationship after the death of a child. The interrelation of self-disclosure, emphatic listening, and constructive communication helps bereaved parents to gain support, validation, and sense-making. Discussion of the death of a child is important in order to exchange support and comfort (Carroll & Shaefer, 1994; Kamm & Vandenberg, 2001).

This current study found that support through constructive communication—based on religious motivational words and the presence of each other—could be helpful in the context of Malay people. Religious teachings and narrations from the Prophet (Muhammad) were found to be the most meaningful support that bereaved parents needed and quoted to each other. The religious motivational words help bereaved parents to make sense of the death of a child and the words could lead to more positive feelings and better ways of coping with the death. The ability to make sense of the death using religion, however, is not unique to the Malay context. Supported by a study in other contexts, the use of religion is shown to help bereaved parents to make sense of their loss (Lichtenthal, Currier, Neimeyer, & Keesee, 2010).

In addition, it is also important to acknowledge the influence of Asian culture, which emphasizes the importance of harmony in a relationship after the death of a child. This study reported that, after communication, additional tools that bring both bereaved parents together are each other’s presence and the togetherness of spending time together. The togetherness of bereaved parents supporting each other helped both to feel closer and appreciate each other. This is displayed by the non-verbal intimacy shown by the respondents. Even though some of the bereaved parents never discussed the loss at home, mutual understanding and emphatic responses were helpful in coping with their grief feelings.

This study has observed the importance of religion in understanding the ways bereaved parents manage their grief. Consistent with the finding from a study related to how Malay spouses deal with marriage conflicts (Hasim, Mustafa, & Hashim, 2015), this study also found the common influence of religion and culture on shaping the ways bereaved parents support and deal with their relationship post-loss. Religion and spirituality are widely discussed in relation to the issue of grief in the related literature. However, its usefulness in helping people to grieve is still inconclusive (Park & Halifax, 2011). This study contributes to the literature by showing that, for a lot of these parents, faith is an important concept to hold on to, at least in the context of the Malay parents. One of the beliefs that was reported to influence the ways the bereaved parents grieve was the concept of fate. They believed that the death of their child was destiny. This belief in the concept of fate was observed to influence the parents in two ways. First, it led to the belief of some bereaved parents that communicating about the loss would not help anything. Instead, the bereaved parents believed that talking excessively about the loss and questioning their loss may reflect a betrayal of their faith. Second, their faith was used as a way to gain a feeling of comfort that helped them in their grief. The bereaved parents who turned to religious words of motivation reported feeling better.

The discrepancy in what the literature observed about the roles of religiosity and spirituality in grieving may be explained by the differences in the cultures of those respondents in the previous studies compared to the respondents in this study. Members of Asian cultures, especially Malaysians, prefer to maintain harmony in their relationships. Even though there were some bereaved parents who were found not to support each other, the bereaved parents remain in their relationship by “acting like nothing happened” or using religion as their reason to avoid further discussion of their loss. Asian individuals whose cultures are heavily influenced by their religions may gain more positive effects from holding on to their belief during grieving (Markus & Kitayama, 1991). However, further investigation into how religiosity and spirituality play different roles in grieving in different cultures should be conducted to further understanding. Apart from that, Asians are more prone to preserving harmony in their daily life. Consistent with the bereaved parents’ self-reports in this study, harmony is repeatedly mentioned as an important core in all their actions, which they referring to as maintaining the marriage bond.

This study supported the idea that gender differences in coping styles may exist. This study reported that bereaved parents may have different needs to express their grief feelings and support each other. However, in certain circumstances, there are feelings of guilt (Weiss, 2008) and parents blame each other. This was prominent in the case of the death of a child after a vehicle accident. Some bereaved parents reported feeling that they failed their child and they experienced increased guilt (Nahla & Lantz, 2006); their spouse’s insistence on discussing the loss increased the negative feeling and contributed to conflicts in the relationship.

In addition, this study suggested that the difficulty of understanding one another is due to unique experiences and beliefs. As also discussed in previous literature, this study reports that bereaved parents display avoidance communication due to several factors (such as religious belief or culture) and to cushion the impact of guilt and blaming one another. The guilt and blaming each other were displayed by bereaved parents who had lost their child due to an accident. Some bereaved parents believed that even though it is God’s will, the accident could have been prevented if they had been more conscious about the situation before it happened.

Some bereaved parents believe that discussing or sharing their grief feelings reflected their human needs; this study reports that discussing the loss and grief feelings reflects disobedience in regard to the teachings of their religion. This is consistent with the belief of acceptance in some religions. Even so, Asian culture also influenced the bereaved parents, encouraging them to preserve the harmony in their relationship post-loss. Rather than having a violent argument, some bereaved parents reported that silence was a way to cushion the impacts of both guilt and parents blaming one another after the death of a child.

As a result, the bereaved parents reported that they “act[ed] like nothing happened” or avoided talking about their loss. Even though avoidance communication is seen to be negative, it is also helpful in preventing disharmony in the spousal relationship. This echoes the influence of Asian culture that emphasizes the importance of preserving harmony rather than being expressive, as described in previous literature. Even though the influence of culture is prominent in the finding, it raises the question of how harmony in a marriage is defined as the bereaved parents were not able to confront their grief feelings. Can acting like nothing happened after the death of child be considered marital harmony?

## Conclusion

This recent study supported previous findings and suggestions from the literature on bereaved parents working together throughout their grieving process and having a healthy communication style. However, one significant finding from this study is the importance of making an effort to understand each other and work together throughout the grieving process. Other than understanding and respecting one another’s differences, it is vital for bereaved parents to make an effort (in the form of their presence and engaging in activities that both of them can do together). Spending time together, even without having a serious discussion about their loss, helps them to share and exchange their experiences. This finding can be used by professional help providers in their assistance for bereaved parents.

In addition, professional help providers must also acknowledge the influences of religious belief among bereaved parents. An issue that is observed in this study is that bereaved parents may potentially not want to discuss their loss because of their trust in God. In this situation, it is vital for professional help providers to underscore that the discussion of their loss is a human need and the bereaved parents’ understanding of the concept of disobedience from their religion’s perspective. Discussion of the loss may help in identifying issues or challenges that may arise and help in formulating ways to cope with the situation.

In conclusion, this study provides a warrant for professional help providers to consider the influence of culture and religion when assisting bereaved parents through their grieving journey. However, it can be a challenge for a professional help provider to educate bereaved religious parents as there may be a thin line between the human need for bereaved parents to express their grief feelings and still preserve their responsibility as a follower of a religion.

## Funding

The authors have no funding to report.

## Competing Interests

The authors have declared that no competing interests exist.

## Acknowledgments

The authors have no support to report.

## References

• Becvar, D. S. (2001). In the presence of grief: Helping family members resolve death, dying, and bereavement issues. New York, NY, USA: Guilford Press.

• Bodenmann, G., Kaiser, A., Hahlweg, K., & Fehm-Wolfsdorf, G. (1998). Communication patterns during marital conflict: A cross-cultural replication. Personal Relationships, 5, 343-356. https://doi.org/10.1111/j.1475-6811.1998.tb00176.x

• Bohannon, J. R. (1991). Grief responses of spouses following the death of a child: A longitudinal study. Omega, 22, 109-121. https://doi.org/10.2190/QCX3-36WQ-KJTQ-3N1V

• Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101. https://doi.org/10.1191/1478088706qp063oa

• Bruner, J. S. (1990). Acts of meaning. Cambridge, MA, USA: Harvard University Press.

• Büchi, S., Mörgeli, H., Schnyder, U., Jenewein, J., Glaser, A., & Fauchere, J.-C. (2009). Shared or discordant grief in couples 2-6 years after the death of their premature baby: Effects of suffering and posttraumatic growth. Psychosomatics, 50, 123-130. https://doi.org/10.1176/appi.psy.50.2.123

• Carroll, R., & Shaefer, S. (1994). Similarities and differences in spouses coping with SIDS. Omega, 28, 273-284. https://doi.org/10.2190/6D89-BQJU-MFXG-JYWU

• Department of Statistic Malaysia [official portal]. (2018). Population Distribution and Basic Demographic Characteristic Report 2010. Retrieved from https://www.dosm.gov.my/v1/index.php?r=column/ctheme&menu_id=L0pheU43NWJwRWVSZklWdzQ4TlhUUT09&bul_id=MDMxdHZjWTk1SjFzTzNkRXYzcVZjdz09

• Haque, A. (2005). Mental health in Malaysia: An overview. In Z. A. Ansari, N. M. Noor, & A. Haque (Eds.), Contemporary issues in Malaysian psychology. Singapore, Singapore: Thomson Learning.

• Hasim, M. J. M., Mustafa, H., & Hashim, N. H. (2015). Exploring new patterns of interaction during conflict among married individuals in Malaysia. Paper presented at the second International Conference on Media, Communication and Culture (ICMCC 2015), Penang, Malaysia.

• Hooghe, A., Neimeyer, R. A., & Rober, P. (2011). The complexity of couple communication in bereavement: An illustrative case study. Death Studies, 35, 905-924. https://doi.org/10.1080/07481187.2011.553335

• Irwin, H. J. (1991). Depiction of loss: Uses of clients’ drawings in bereavement counseling. Death Studies, 15, 481-497. https://doi.org/10.1080/07481189108252774

• Ishak, M. S. B. H., & Abdullah, O. C. (2012). Islam and the Malay world: An insight into the assimilation of Islamic values. World Journal of Islamic History and Civilization, 2(2), 58-65.

• Kamm, S., & Vandenberg, B. (2001). Grief communication, grief reactions and marital satisfaction in bereaved parents. Death Studies, 25, 569-582. https://doi.org/10.1080/074811801753184291

• Karney, B. R., & Bradbury, T. (1995). The longitudinal course of marital quality and stability: A review of theory, method, and research. Psychological Bulletin, 118, 3-34. https://doi.org/10.1037/0033-2909.118.1.3

• Kassim, N. (2007). A walk through life: Issues and challenges through the eyes of a Muslim woman. Kuala Lumpur, Malaysia: NK & Associates.

• Kim, H. S., Sherman, D. K., & Taylor, S. E. (2008). Culture and social support. The American Psychologist, 63, 518-526. https://doi.org/10.1037/0003-066X

• Li, Q., & Loke, A. Y. (2014). A literature review on the mutual impact of the spousal caregiver–cancer patients dyads: ‘Communication’, ‘reciprocal influence’, and ‘caregiver-patient congruence’. European Journal of Oncology Nursing, 18, 58-65. https://doi.org/10.1016/j.ejon.2013.09.003

• Lichtenthal, W. G., Currier, J. M., Neimeyer, R. A., & Keesee, N. J. (2010). Sense and significance: A mixed methods examination of meaning-making following the loss of one’s child. Journal of Clinical Psychology, 66, 791-812.

• Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Beverly Hills, CA, USA: Sage.

• Lyngstad, T. H. (2013). Bereavement and divorce: Does the death of a child affect parents’ marital stability? Family Science, 4, 79-86. https://doi.org/10.1080/19424620.2013.821762

• Manne, S., Badr, H., Zaider, T., Nelson, C., & Kissane, D. (2010). Cancer-related communication, relationship intimacy, and psychological distress among couples coping with localized prostate cancer. Journal of Cancer Survivorship: Research and Practice, 4, 74-85. https://doi.org/10.1007/s11764-009-0109-y

• Maqsood, R. W. (2002). After death life! Thoughts to alleviate the grief of all Muslims facing death and bereavement. New Delhi, India: Good Word Books.

• Markus, H. R., & Kitayama, S. (1991). Culture and the self: Implications for cognition, emotion and motivation. Psychological Review, 98, 224-253. https://doi.org/10.1037/0033-295X.98.2.224

• Mills, B., & Turnbull, G. (2004). Broken hearts and mending bodies: The impact of trauma on intimacy. Sexual and Relationship Therapy, 19, 265-289. https://doi.org/10.1080/14681990410001715418

• Moriarty, H. J., Carroll, R., & Cotroneo, M. (1996). Differences in bereavement reactions within couples following death of a child. Research in Nursing & Health, 19, 461-469. https://doi.org/10.1002/(SICI)1098-240X(199612)19:6<461::AID-NUR2>3.0.CO;2-M

• Nahla, M., & Lantz, M. (2006). When older adults suffer the loss of a child. Psychiatric Annals, 36, 877-880. Retrieved from http://www.healio.com/psychiatry/journals/psycann

• Oka, T., Hussin, N. A. M., & Hagström, A. S. (2017). The diversity of indigenous wisdom on grief: Exploring social work approaches to bereavement. Paper presented at the IAFOR International Conference on the Social Sciences, Honolulu, HI, USA. Retrieved from https://papers.iafor.org/submission33556

• Park, C. L., & Halifax, R. J. (2011). Religion and spirituality in adjusting to bereavement: Grief as burden, grief as gift. In R. Neimeyer, D. L. Harris, H. R. Winokuer, & G. F. Thornton (Eds.), Grief and bereavement in contemporary society: Bridging research and practice (pp. 355-363). New York, NY, USA: Routledge.

• Reis, H. T., & Shaver, P. (1988). Intimacy as an interpersonal process. In S. Duck, D. F. Hay, S. E. Hobfoll, W. Ickes, & B. M. Montgomery (Eds.), Handbook of personal relationships: Theory, research, and interventions (pp. 367-389). Oxford, United Kingdom: Wiley.

• Rosenblatt, P. C. (2000). Parent grief: Narratives of loss and relationship. Philadelphia, PA, USA: Taylor & Francis Group.

• Rosenblatt, P. C. (2001). A social constructionist perspective on cultural differences in grief. In M. S. Stroebe, R. O. Hansson, W. Stroebe, & H. Schut (Eds.), Handbook of bereavement research: Consequences, coping, and care (pp. 285-300). Washington, DC, USA: American Psychological Association.

• Rowen, J., & Emery, R. (2014). Examining parental denigration behaviors of co-parents as reported by young adults and their association with parent-child closeness. Couple & Family Psychology, 3, 165-177. https://doi.org/10.1037/cfp0000026

• Rubin, S. S. (1996). The wounded family: Bereaved parents and the impact of adult child loss. In D. Klass, P. Silverman, & S. Nickman (Eds.), Continuing bonds: Understanding the resolution of grief (pp. 217-232). New York, NY, USA: Routledge.

• Samuelsson, M., Rådestad, I., & Segesten, K. (2001). A waste of life: Fathers’ experience of losing a child before birth. Birth, 28, 124-130. https://doi.org/10.1046/j.1523-536X.2001.00124.x

• Schwab, R. (1998). A child’s death and divorce: Dispelling the myth. Death Studies, 22(5), 445-468. https://doi.org/10.1080/074811898201452

• Sue, D. W., & Sue, D. (2003). Counseling the culturally different: Theory and practice (4th ed.). New York, NY, USA: Wiley.

• Toller, P., & Braithwaite, D. (2009). Grieving together and apart: Bereaved parents’ contradictions of marital interaction. Journal of Applied Communication Research, 37(3), 257-277. https://doi.org/10.1080/00909880903025887

• Umphrey, L. R., & Cacciatore, J. (2014). Love and death: Relational metaphors following the death of a child. Journal of Relationships Research, 5, Article e4. https://doi.org/10.1017/jrr.2014.4

• Walsh, F. (2007). Traumatic loss and major disasters: Strengthening family and community resilience. Family Process, 46(2), 207-227. https://doi.org/10.1111/j.1545-5300.2007.00205.x

• Weiss, R. (2008). The nature and causes of grief. In M. Stroebe, R. O. Hansson, H. Schut, & W. Stroebe (Eds.), Handbook of bereavement research and practice: Advances in theory and intervention (pp. 29-44). Washington, DC, USA: American Psychological Association.

• Wing, D. G., Burge-Callaway, K., Rose, C. P., & Armistead, L. (2001). Understanding gender differences in bereavement following the death of an infant. Psychotherapy, 38, 60-73. https://doi.org/10.1037/0033-3204.38.1.60

• Yakin, H. S. M., & Mahali, S. N. H. (2008). Duang: The semiotic interpretation and perception of the Bajau-sama community in Sabah. Jurnal Komunikasi. Malaysian Journal of Communication, 24, 63-71.

• Zerach, G., Anat, B.-D., Solomon, Z., & Heruti, R. (2010). Posttraumatic symptoms, marital intimacy, dyadic adjustment, and sexual satisfaction among ex-prisoners of war. Journal of Sexual Medicine, 7, 2739-2749. https://doi.org/10.1111/j.1743-6109.2010.01784.x