Attachment bonds describe the emotional connection or relationship one has with another person, deceased or alive. At this early stage, it is important to state that different terms (continuing bonds, affectionate bonds, attachment bonds/theory) are used in the literature interchangeably, but this commentary will use attachment bonds. It appears that the existing empirical literature presents complex and diverse perspectives about the role of attachment bonds in grief resolution. There are varying permutations about the role of attachment bonds in grief resolution (Root and Exline, 2014), with claims that continuing with these bonds after death helps the bereaved to achieve a less painful, or more bearable, bereavement (Klass, 2006). On the other hand, there are claims that experiencing grief helps to sever attachment bonds with the deceased and, therefore, allows the bereaved to move on with their life and eventually form new attachments bonds. Although the outcome ends up being the same, that is, bearable bereavement (healthy adjustment), the processes are quite different, leading to questions about whether both processes can be credible.
The crux of the argument is the claim (regardless of the process taken) that attachment bonds are linked to better adjustment in bereavement. Klass called this link ‘the causality thesis’, which he then rejected as not having a valid basis to substantiate the claim (2006). The causality thesis asserts that maintaining or continuing with attachment bonds with the deceased causes a healthy bereavement adjustment to life without the dead person. However, what is not clear in this assertion is how a healthy adjustment is measured, since each death is unique, and the degree of attachment bonds may also differ from one relationship to another. To claim causality here is to put forward the argument that attachment bonds alone are solely responsible for healthy adjustment in grieving. According to Klass (2006), healthy adjustment is dynamic and includes a number of factors, for example, the nature and degree of emotional attachment with the deceased while still alive, the meaning and timing of the death and the meaning of the survivor's life without the deceased. The presence and support of the family, community and cultural membership (i.e. adhering to and respecting one's cultural norms) also go a long way in determining healthy adjustment for the bereaved (Klass, 2006; Root and Exline, 2014). Attachment bonds are, therefore, not entities that are either present or absent; instead, these are emotional intricacies with cultural and religious undertones that can also change over time.
The person who has died is central to how attachment bonds may continue, or may change, and, therefore, they determine the nature of the relationship going forward. Where the emotional relationship was positive, favourably held and meaningful, the attachment bonds may remain deeply held throughout the bereavement phase. However, Klass reported that, where attachment bonds were ‘loaded with pathological elements’, it may benefit the bereaved to disengage and break the bonds in order to rebuild their lives (Klass, 2006:845).
It can be argued that discontinuing these bonds should happen before death, but it is also plausible to argue that most people would prefer to carry on in the bond out of respect or commitments such as religious faith and cultural membership, which may make it hard to break bonds while the person is still alive. For community nurses supporting families in bereavement, it is worth remembering that it is too simplistic to try and answer or determine whether maintaining attachment bonds with the deceased leads to a healthy adjustment. Attachment bonds play multiple roles, some positive and others negative, and some may change over time. It all rests on how they are internalised by the bereaved.
The role of religion and faith in the bereavement process cannot be ignored; therefore, any assessment should continue to take all the different perspectives into account and ensure there is no blanket approach to supporting the bereaved. Attachment bonds are individual and personal, and any care should first accept the uniqueness of bereaved persons and families and then tailor any support uniquely.