Acknowledgements:We would like to extend our sincere thanks to two anonymous reviewers and to Robert A. Neimeyer and Nigel Field for their invaluable and insightful advice and support in helping us to develop this article for publication.1 Address correspondence to Edith Steffen, Department of Psychology, University of Surrey, Guildford, Surrey, GU2 7XH, United Kingdom. E-mail: e.steffen@surrey.ac.uk, Tel.: +44 (0)1483 689553 Keywords: bereavement; continuing bonds; meaning-making; post-traumatic growth; sense of presence; spirituality Bereavement has been described as a major life crisis with potentially severe effects on the survivor's physical and psychological well-being (Lindemann, 1944;Parkes, 1970Parkes, , 1996. 2 SENSE OF PRESENCE EXPERIENCES AND MEANING-MAKING IN BEREAVEMENT: A QUALITATIVE ANALYSISFor much of the twentieth century, Western approaches to bereavement have emphasized emotional disengagement from the deceased and the 'working-through' of grief (Freud, 3 1917). Following increasing challenges to this 'grief work' paradigm (e.g. Wortman & Silver, 1989), a new strand of bereavement research has started to identify positive effects of bereavement under the categories of coping (e.g. Folkman, 2001) and post-traumatic growth .Linking bereavement research with research into post-traumatic cognitive processes has drawn attention to the significance of post-bereavement 'meaning-making'. According to Janoff-Bulman (1992), major trauma can shatter people's 'assumptive world' with regard to core beliefs about the benevolence and meaningfulness of the world and one's self-worth.Such 'existential trauma' (Benore & Park, 2004) can lead to a 'search for meaning ' (Frankl, 1959;) ,with the goal of integrating the loss into the assumptive worldview or 'self-narrative' (Neimeyer, 2001) through meaning reconstruction processes such as sense-making, benefitfinding, and identity change (Neimeyer, 2006).Religious and spiritual beliefs can aid these processes (Davis, Nolen-Hoeksema & Larson, 1998), and the potentially positive role of religion in bereavement has been observed (e.g. Becker et al., 2007;Golsworthy & Coyle, 1999;Wortman & Park, 2008). However, a major loss can also challenge existing religious beliefs or lead to a (re-)discovery of faith and spiritual change (Balk, 1999). Spiritual experiences in bereavement may play a significant role here. Benore and Park (2004) 1996) and is generally perceived as 'comforting' (e.g. Parkes, 1970;Sormanti & August, 1997), 'pleasant' (Grimby, 1998;), and helpful or positive (e.g. Chan et al., 2005;LaGrand, 1997). Sometimes, though, sense-of-presence experiences are perceived as negative; for example, Tyson-Rawson (1996) noted that an 'unwelcome' or 'intrusive presence' is often linked with 'unfinished business' in the relationship with the deceased. Although the reported percentages of negative experiences are small compared to positive ones, e.g. 6% and 69% respectively by Rees (1971Rees ( , 2001) and 14% and 86% respectively by Datson and Marwit (1997), di...

Can "sense of presence" experiences in bereavement be conceptualised as spiritual phenomena?This paper explores the possibility of conceptualising the frequently occurring experience of "sensing the presence of the deceased" in bereavement as a spiritual phenomenon and examines how such a conceptualisation can be related to two recent perspectives in the field of bereavement research, "continuing bonds" and "meaning-making". It is argued that "sense of presence" experiences are expressions of the continuing relationship with the deceased that can be spiritually understood but that pose various challenges for their meaningful integration into the bereaved person's worldview or meaning structuressomething that may need to be more explicitly incorporated into current theoretical frameworks. It is suggested that these experiences can be the catalyst for "post-traumatic growth" through a socially mediated and interactive narrative exploration and that this has important implications for bereavement counselling and therapy.

Bereaved people often report having sensory and quasi-sensory experiences of the deceased (SED), and there is an ongoing debate over whether SED are associated with pathology, such as grief complications. Research into these experiences has been conducted in various disciplines, including psychiatry, psychology, and anthropology, without much crossover. This review brings these areas of research together, drawing on the expertise of an interdisciplinary working group formed as part of the International Consortium for Hallucination Research (ICHR). It examines existing evidence on the phenomenology, associated factors, and impact of SED, including the role of culture, and discusses the main theories on SED and how these phenomena compare with unusual experiences in other contexts. The review concludes that the vast majority of these experiences are benign and that they should be considered in light of their biographical, relational, and sociocultural contexts.

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Background Young sudden cardiac death (YSCD), often occurring in previously healthy individuals, is a tragic event with devastating impact on affected families, who are at heightened risk of posttraumatic stress and prolonged grief and may themselves be at risk of YSCD. Previous research suggests that surviving family members’ psychosocial support needs are often unmet. Purpose This study sought to identify how YSCD-affected families experience dedicated community and peer support in light of their psychosocial support needs. Methods The study used a qualitative design, employing a thematic analysis of focus group and interview data. Three focus groups and five individual interviews were conducted with affected family members ( N = 19). The sample was drawn from a UK-based charity, Cardiac Risk in the Young. Audio-recordings of the focus groups and interviews were transcribed and subjected to thematic analysis. Results Three super-ordinate themes were identified: 1. YSCD community support as offering a place of safety, 2. YSCD community support as fostering sense-making, 3. YSCD community support as facilitating finding new meaning. Conclusions YSCD-affected families can benefit from access to dedicated community and peer support that offers a safe environment, provides affiliation, understanding and normalisation and enables sense-making and the rebuilding of a sense of self. Dedicated community support can facilitate meaningful re-engagement with life through helping prevent YSCD and through memorialisation and legacy-building to maintain a continuing bond with the deceased. Clinicians need to be aware of the need to incorporate available community and peer support into patient pathways.

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