Experiencing the presence of someone who has died: A Continuing Bonds Theory perspective

TRIGGER WARNING: This article discusses themes related to death, dying, and bereavement, which some individuals may find distressing.

Many of us report having the feeling that a lost loved one is somehow still around, making their presence known through signs and coincidences. Noticing feathers, finding lost items, hearing the person's favourite song, or feeling connected through the night sky or wildlife can provide opportunities to reflect upon our relationship and bring a sense of ongoing connection. 

Such experiences sometimes co-occur with a felt sense that the person is somehow present as if trying to relay a message from the afterlife. Following vivid and sensory experiences such as feeling physically touched, seeing them appear, or hearing them speak, the bereaved gain a sense of the person being somehow close by despite physical death. 

Sensory and quasi-sensory experiences

A recent interdisciplinary review conceptualised such experiences as sensory and quasi-sensory experiences of the deceased (SED). Unlike memories, SED are perceived externally, as though the individual continues to exist and engage with us. 

Studies estimate that between 47 per cent to 82 per cent of us will have at least one of these experiences following bereavement. Though the majority report gaining a sense of comfort, SED co-occur with heightened and traumatic grief reactions, and vivid manifestations of SED have been incorporated into diagnostic frameworks for prolonged grief, as described by the DSM-5.

If you have had this experience, or something similar, you may have been unsure what to make of it, perhaps it led you to question what happens after death, or maybe the experience confirmed your expectation of an afterlife. You may have found it difficult to articulate what happened due to the experience being unexpected, or in contrast with your own belief system. 

In the absence of spiritual or religious belief, you may have felt confused, or explained the experience through a scientific or psychological framework acknowledging the role of your 'unconscious' or 'the brain'. Difficulty conceptualising SED is common, with frameworks for meaning centred around religious, cultural, personal, and scientific explanations bringing tensions that are difficult to resolve.   

Research examining SED has considered the role of psychological, philosophical, and neuroscientific factors in predicting and maintaining them. Soon after bereavement the experience has been framed as the brain struggling to 'catch up' with the absence of the person. 

The maintenance of SED has been associated with emotional loneliness, attachment avoidance, trauma, and historical mental health difficulty. The role of SED in grief processing has been debated with the research pointing to the potential for both benefits and harms. 

Though most individuals derive benefits including comfort, the opportunity for last goodbyes, and the lessening of existential concerns, a smaller minority report experiences of stigma, fear of 'going mad', and overwhelming grief. 

In the context of relational conflict, and traumatic loss, the experience may even be experienced as intrusive by replaying traumatic memories, or with the voice of the deceased acting as a more malignant voice or unhelpful presence in the person's life.

To best support the bereaved, it is important that such experiences are normalised, as a common reaction to loss, with bereavement support providing a forum to talk about them and understand the feelings they may raise.  

Continuing Bonds Theory and bereavement

One paradigm of research that sparked my interest in SED was introduced by Klass et al. (1996). The Theory of Continuing Bonds (CB) has extended theoretical and evidence-based practice in bereavement to highlight the importance of the relationship that transcends physical-death. CB research redefines traditional grief models by demonstrating that maintaining an ongoing, inner relationship can be a natural and beneficial aspect of the grieving process. 

The research in this field highlights that psychological wellbeing can stem from continuing bonds, providing comfort, affirmation of identity, and a sense of connection for the bereaved.  A key distinction has been made between internalised and externalised bonds, with internal bonds integrated as part of autobiographical memory, and external bonds, such as SED, retained as representations of the person that are still present within the world. 

Continuing Bonds Theory has contributed to the development of therapeutic practices and interventions that are directed towards transformation and continuation of the relationship after death. The use of legacy interventions including artwork, keepsakes, scrapbooks, memory boxes can be developed to represent valued traits, belief, stories and values of the person promoting a continual process of meaning making for the bereaved. 

Within psychological therapies the practice of inviting reflection on the person, through what narrative therapist Michael White (1988) described as 'saying hullo again', allows reflection on valued aspects of the relationship, and how restoring these might inform restorative coping and future focused narratives. 

Interestingly, the working through of 'unfinished business' has been associated with a reduction of distressing SED, sometimes allowing for the development of a supportive bond and internalised bond. 

My PhD Thesis: Continuing bonds in adjustment to bereavement - a mixed methods study

Given that cross-sectional studies have limited understanding of both SED and CB, I have aimed to add to the existing literature by exploring how SED and CB unfold longitudinally for the bereaved. 

Given current debates within the literature and contrasting findings between qualitative and quantitative paradigms, I chose to approach this through a mixed methods design that allows for exploration of participant life worlds alongside validated measures of bereavement outcome.

It was particularly important to address a broader range of bereavement outcomes since SED and CB have been associated with both grief symptomology and personal growth. The research design has therefore incorporated a mixed-studies systematic review exploring the range of impacts that CB bring, a qualitative longitudinal interpretative analysis, and a quantitative longitudinal survey. Given that the review findings suggest that CBs can aid in reconstructing meaning, transforming self-identity, and affirming spiritual beliefs. 

The subsequent empirical studies have been designed to build further upon this finding. In order to extend existing knowledge of how SED unfold and affect bereavement, the research takes a further interest in afterlife belief and meaning making to examine how these direct the impact CB has on both bereavement-related distress and post-traumatic growth. 

The research has been designed with feedback and collaboration from a patient and public involvement group comprising bereaved individuals and bereavement care professionals within the region. 

Progress and future plans

Our systematic review findings highlight the impact of CB as a source of comfort and distress, and expand upon the opportunities they present for identity transformation and relational identity following bereavement. One of the themes attended to the process of conceptualising SED and the tensions this raised for the bereaved. 

So far, qualitative longitudinal analysis has been fruitful in describing the experience and meaning of SED and CB for bereaved individuals, highlighting how this supports meaning making and transformation of the relationship. 

The final quantitative study remains open for participants and will examine the relationships, CB types, afterlife belief, meaning making, and grief outcomes. We hope to use this data to develop guidelines and training for bereavement practitioners. 

Read the systematic review findings.   

If you have been affected personally by bereavement or are seeing or sensing someone that has died, talking with a bereavement listener or counsellor at Cruse, or via your GP may help you to better understand your feelings.