Colin Murray Parkes

St Christopher's Hospice · Department of Psychiatry

In this article Cruse Life President Colin Murray Parkes describes the early days of Cruse and how pioneers brought about the science of the care of the dying and bereaved, tracing the development of grief counselling and the body of Cruse volunteers who provide today’s invaluable work.

All societies have their own customs and beliefs surrounding death. In the West, traditional ways of mourning are disappearing, and although Western science has had a major impact on how people die, it has taught us little about the way to die or to grieve. Many whose work brings them into contact with the dying and the bereaved from Western and ot...

In the course of a long career Colin Murray Parkes, one of the most important and influential psychiatrists working in the field of bereavement and loss, has produced a body of work which can be considered truly ground-breaking. His early studies involved working alongside John Bowlby in the development of attachment theory and led to his pioneerin...

the Diagnostic Statistical Manual of Mental Disorders Volume 5 (DSM-5) is the most recent update (2013) in a series published by the American Psychiatric Association which aims to provide authoritative guidance to psychiatrists on the diagnosis of mental disorders. This article outlines the main changes in the DSM-5 regarding issues relating to ber...

During the course of a short lecture/consultation visit to Japan, victims of atomic bombs and survivors of the great Tohuko tsunami raised ethical, psychological and historical issues.

Specialists in death, dying, and bereavement and their consequences for individuals, families, and communities have experience and research findings that are relevant to an understanding of the reactions of individuals faced by deadly violence. At such times, powerful emotions and ingrained patterns of thought and behavior can given rise to disprop...

Why do responses to terrorist attacks often perpetuate cycles of deadly violence?

Death is, perhaps, the ultimate test which we face as patients, relatives and members of the caring professions. All of us have to cope with it and, no matter how experienced we become, the coping is seldom easy. Death is often a loss but it can also be a time of peaceful transition. It may represent failure or success, ending or beginning, disaste...

Loving and grieving are two sides of the same coin: we cannot have one without risking the other. Only by understanding the nature and pattern of loving can we begin to understand the problems of grieving. Conversely, the loss of a loved person can teach us much about the nature of love.

Love and loss are two sides of the same coin. Patterns of attachment to parents in childhood predict how adults will respond to losses in adult life. Avoidant attachments predict avoidance of closeness, delayed grief and self-reproaches, anxious attachments predict severe and protracted grief, and

Elisabeth Kűbler-Ross’s influential book, On death and dying, is a collection of very moving case studies of people approaching death, which, in 1969, helped to bring public attention to the topic and drew attention to the need for improving care. Sadly, her self-promotion, and her failure to acknowledge or to work with other pioneers in the develo...

While complicated grief has been addressed in part through some recommendations for modifications in the upcoming fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there remain reasons for substantial concern about its scope therein and within clinical practice. The authors issue a call to the field, reiterating th...

Over the last millennium patterns of mortality have changed and have determined who grieves and how. At all times grief has been recognised as a threat to physical and mental health. More recently the scientific study of bereavement has enabled us to quantify such effects and to develop theoretical explanations for them. This paper reviews our evol...

There are many ways of construing the psychology of loss. This paper describes one such model, which enlightens some, but not all, aspects of bereavement and needs to be used alongside other models. Loss is one aspect of psychosocial transition, the psychological change that takes place whenever people are faced with the need to undertake a major r...

Bereavement is a universal experience, and its association with excess morbidity and mortality is well established. Nevertheless, grief becomes a serious health concern for a relative few. For such individuals, intense grief persists, is distressing and disabling, and may meet criteria as a distinct mental disorder. At present, grief is not recogni...

This article reviews four DVDs of recent films about the Rwandan massacres of 1994 and gives a summary of the history leading up to the violence. The author considers the inevitable bias of those who are in a position to write history, film as a tool for meaning-making, and the possible role of bereavement interventions in breaking vengeful cycles...

Some of the words and terms in common usage following bereavement are ambiguous or likely to be misunderstood. Words that need special caution include ‘grief,’, ‘mourning’, ‘meaning-making’, ‘dependent,’ ‘empathy’, and various words used to describe the problems to which grief can give rise. The risk of misunderstanding is no reason to stop using t...

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Recent studies have suggested that the vulnerability to complicated grief (CG) may be rooted in insecure attachment styles developed in childhood. The aim of this study was to examine the etiologic relevance of childhood separation anxiety (CSA) to the onset of CG relative to major depressive disorder, posttraumatic stress disorder, and generalized...

While it is unethical to introduce services for the terminally ill and their families that are not well founded or evaluated there are special problems in research conducted with this population. This has deterred some from carrying out research in this field and has caused others to place obstacles in the way of would-be researchers. This paper de...

Violence begets violence and it is important to understand how cycles of violence are perpetuated if we are to find solutions to the global problems they present. A multi-disciplinary group of The International Work Group on Death, Dying and Bereavement has developed a model of the cyclical events that perpetuate violence at all levels including th...

John [Skelton’s paper (2003, this issue)][1] reminds us that literature can put into words thoughts and feelings which we might otherwise be unable to think or articulate. This is an important attribute and one which we can make use of in our attempts to help patients and families faced with life-

Over the last millennium, patterns of mortality have changed and have determined who grieves and how. At all times grief has been recognized as a threat to physical and mental health. More recently the scientific study of bereavement has enabled us to quantify such effects and to develop theoretical explanations for them. This article reviews our e...

Lamont have begun to help tease out the factors involved in end of life predictions. In oncology, the end of chemotherapy usually signals the terminal phase. In other specialties, prognosis is much less demarcated. Doctors should better define landmarks or turning points in prognosis and begin to acknowledge these to ourselves and to our patients....

Objective: To describe doctors' prognostic accuracy in terminally ill patients and to evaluate the determinants of that accuracy. Design: Prospective cohort study Setting: Five outpatient hospice programmes in Chicago Participants: 343 doctors provided survival estimates for 468 terminally ill patients at the time of hospice referral Main outcome m...

Losses of one sort or another are commonly encountered by patients, their families and the staff who care for them within palliative care. Nurses have important roles to play in preparing people to cope with loss, identifying those who are likely to develop psychological difficulties and ensuring that they receive adequate counselling and care to p...

People bereaved by AIDS are likely to be in special need of support by reason of the social situations that accompany this type of loss and the risk of infection in the survivors. Problems associated with grief, depression, and the misuse of medicinal and other drugs are common. Special problems arise when the bereaved are partners, spouses, or par...

Avoidance of griefAlthough most people oscillate between confronting and avoiding grief, extreme avoidance of grief always takes place for a reason. People may avoid grief because they are members of a family or a society in which grief is frowned on; they may avoid it because they fear the consequences if they should express it; or they may simply...

This is the fourth in a series of 10 articles dealing with the different types of loss that doctors will meet in their practiceThe loss of body parts can have distinct but overlapping psychological consequences. These can be bodily changes—alterations in the way patients, their families, and others perceive their bodies—or changes of function—alter...

This is the first in a series of 10 articles dealing with the different types of loss that doctors will meet in their practiceDoctors are well acquainted with loss and grief. Of 200 consultations with general practitioners, a third were thought to be psychological in origin; of these, 55—a quarter of consultations overall—were identified as resulti...

Because women die at an older age than men, and marry men older than themselves, widows outnumber widowers and the average woman can expect to survive her husband by five to six years. In fact, widows make up a substantial proportion of the elderly population. In this paper the current state of our knowledge of the reaction to bereavement in the el...

During the 100 days which followed the assassination of the Presidents of Rwanda and Burundi on 6 April 1994 up to a million people, mainly members of the Tutsi tribe, were massacred in Rwanda. This paper describes the consequences and provides a personal view regarding the factors that, taken together, explain this awful act of genocide. Factors t...

It is unethical to introduce services for the bereaved that are not well founded and evaluated; yet there are special difficulties in conducting research with bereaved people. This situation has deterred some from carrying out research in this field and has caused others to place obstacles in the way of would-be researchers. The ethical difficultie...

In his important book Loss and Change1, Peter Marris spoke of the way in which ‘structures of meaning’ are undermined by bereavements and other major life-change events. Marris was deliberately vague about exactly what it is that gives meaning to life but it is clearly not one thing but many, and that these things that give meaning to life vary in...

Celia Hindmarch Radcliffe, £ 12.50, pp 133 ISBN 1 870905 19 9The death of a child is traumatic to medical staff as well as to the families who are bereaved. This is recognised with sympathy and understanding by Celia Hindmarch in her short book of practical guidance for those whose work brings them into contact with families who are losing or have...

Bereavement by murder or manslaughter is often associated with a high incidence of factors which increase the risk of lasting psychological problems after bereavement. In this study it appears that self-perpetuating vicious circles often accounted for the persistence of symptoms, which fitted the diagnostic categories of post-traumatic stress disor...

Bereavement by murder or manslaughter is often associated with a high incidence of factors which increase the risk of lasting psychological problems after bereavement. In this study it appears that self-perpetuating vicious circles often accounted for the persistence of symptoms, which fitted the diagnostic categories of post-traumatic stress disor...

There is widespread recognition that many who seek or are referred for help to psychiatric and social services are acutely disturbed and require only short-term help if they are to come through a period of transient disruption in their lives. The frequency with which people in crisis consult their GP or visit a local Social Service Department is un...

There are many kinds of crisis service. Most are open only to people who have been diagnosed as mentally ill. They facilitate rapid admission to short-stay in-patient services with the back-up of multidisciplinary teams working in the community. Others attempt to keep patients out of hospital by providing support to patients and their families in t...

c1 Dr CM Parkes, Senior Lecturer in Psychiatry, The London Hospital Medical College, Turner Street, London E1 2AD, UK.

The Gulf War forced combatant nations to prepare for the possibility of large numbers of traumatic bereavements. As part of the response in the United Kingdom a conference on this topic was organised by Cruse Bereavement Care, which took place on 20th February, 1991 in London. In the event deaths were largely confined to the Iraqi forces. Even so,...