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CHAPTER 31 Georgene Gaskill Eakes; Mary Lermann Burke; Margaret A. Hainsworth 613

MAJOR CONCEPTS & DEFINITIONS with spina bifida, which were conducted in Burke’s
(1989) dissertation work. Through this research,
Chronic Sorrow Burke defined chronic sorrow as a pervasive sadness
Chronic sorrow is the ongoing disparity resulting and found that the experience was permanent,
from a loss characterized by pervasiveness and periodic, and potentially progressive (Eakes, Burke,
permanence. Symptoms of grief recur periodically, Hainsworth, et al., 1993). This was the foundation
and these symptoms are potentially progressive. for the subsequent series of studies, including the
interview guides used in these studies.
Loss The NCRCS studies addressed the following:
Loss occurs as a result of disparity between the • Individuals with the following:
“ideal” and real situations or experiences. For • Cancer (Eakes, 1993)
example, there is a “perfect child” and a child with • Infertility (Hainsworth, Eakes, & Burke, 1994)
a chronic condition who differs from that ideal. • Multiple sclerosis (Hainsworth, Burke, Lindgren,
et al., 1993; Hainsworth, 1994)
Trigger Events • Parkinson’s disease (Lindgren, 1996)
Trigger events are situations, circumstances, and • Spousal caregivers of persons with the following:
conditions that highlight the disparity or the recur- • Chronic mental illness (Hainsworth, Busch,
rent loss and initiate or exacerbate feelings of grief. Eakes, et al., 1995)
• Multiple sclerosis (Hainsworth, 1995)
Management Methods • Parkinson’s disease (Lindgren, 1996)
Management methods are means by which • Parental caregivers of the following:
individuals deal with chronic sorrow. These may • Adult children with chronic mental illness
be internal (personal coping strategies) or external (Eakes, 1995)
(health care practitioner or other persons’ inter- Based on these studies, the theorists postulated that
ventions). chronic sorrow occurs in any situation in which the
loss is unresolved. These studies did not demonstrate
Ineffective Management consistently that the associated emotions worsened
Ineffective management results from strategies over time. However, the theorists concluded that
that increase the individual’s discomfort or the studies did support the “potential for progressivity
heighten the feelings of chronic sorrow. and intensification of chronic sorrow over time”
(Eakes, Burke, & Hainsworth, 1998, p. 180).
Effective Management The NCRCS theorists extended their studies to
Effective management results from strategies individuals experiencing a single loss (bereaved).
that lead to increased comfort of the affected They found that this population experienced these
individual. same feelings of chronic sorrow (Eakes, Burke, &
Hainsworth, 1999).
Based on this extensive empirical evidence, the
Sorrow extended the theoretical base of chronic NCRCS theorists refined the definition of chronic
sorrow to not only the experience of chronic sorrow sorrow as the “periodic recurrence of permanent,
in certain situations but also the coping responses to pervasive sadness or other grief-related feelings
the phenomenon. associated with ongoing disparity resulting from
a loss experience” (Eakes, Burke, & Hainsworth,
Use of Empirical Evidence 1998, p. 180)
Chronic Sorrow Triggers
The empirical evidence supporting the NCRCS’s Using the empirical data from the series of studies,
initial conceptual definition of chronic sorrow was the NCRCS theorists identified primary events or
derived from interviews with mothers of children situations that precipitated the re-experience of initial