Theory+of+chronic+sorrow

Primary Author: Abby Church

Theory of Chronic Sorrow

The current Theory of Chronic Sorrow defines it as, “the periodic recurrence of permanent pervasive sadness or other grief-related feelings associated with ongoing disparity resulting from a loss experience (Eakes et all, 180). This theory was developed by Olshansky in 1962 as a theory to explain the sorrow that a parent may feel as the result of the birth of a handicapped or disabled child. This sorrow or grief develops as a response to the loss of the “perfect” or “ideal” child that the parent had been envisioning. Originally, this theory was developed specifically as a response to the birth of a mentally handicapped child. The theory has been expanded since that time to include not just mentally handicapped children, but also physically handicapped and terminally ill children as well. This theory has been found in recent years to apply to adults with chronic illness in addition to their loved ones and caregivers. In addition, studies have been conducted that include HIV positive adults (Lichtenstein, Laska, & Clair, 2002), patients with diabetes (Hayes, 2001), and spouses of persons with Alzheimer disease (Mayer, 2001).

The Theory of Chronic Sorrow has four critical attributes according to Lindgren et al., (1992). The first is that there is a perception of sorrow or sadness that over time in a situation that has no predictable end. This means that the child (and oftentimes, loved one) may be suffering from a chronic handicap or chronic illness. There is no end in sight for this illness or disability and the caregiver or parent must continually deal with this loss. The second attribute is that this loss will occur on a very cyclical basis. This means that the grief may get better and then worse and that this will continue to happen over and over throughout the life-cycle of the affected individual. The third is that the sorrow is triggered either internally or externally and brings to mind the person’s losses, disappointments or fears. These triggers can be an internal trigger or an external trigger, such as a milestone in the affected person’s life such as walking, talking, or riding a bicycle. The fourth attribute is that the sadness or sorrow is progressive and can intensify even years after the initial sense of disappointment, loss or fear.

As mentioned earlier, the theory was expanded from Olshansky’s original dealing specifically with children with disabilities to include similar responses seen in parents of children with chronic illnesses (Clubb, 1991; Phillips, 1991), physical disabilities, and to individuals who care strongly, provide care, and who may be immediately affected by the feelings of loss (Burke, et al., 1992). Further research has gone on to show that emotions can also vary from feelings of sadness and sorrow, and can include fear, hopelessness, anger, frustration and many other emotions associated with the grief reaction (Eakes, et al. 1998). As Teel (1991) stated, “When a relationship of attachment is changed from the hoped-for child or from known person, recurrent sadness, or chronic sorrow, is a frequently encountered response.” Teel (1991) further states that, “Besides being recurrent, the sadness of chronic sorrow is also permanent, variable in intensity between situations and persons, and interwoven with periods of neutrality, satisfaction, and happiness.” This means that the individual who suffers from chronic sorrow can lead an “almost” normal life when not confronting their feelings of sorrow. They can feel great joy and feelings of satisfaction with their own lives and even the lives of the affected, but they will always cycle back and forth with the chronic sorrow. It is very important when discussing chronic sorrow to remember that these individuals are oftentimes not considered to be clinically depressed. According to Lindgren et al., (1992), depression itself can occur along with chronic sorrow and chronic sorrow is a risk factor for depression. Thus, depression and chronic sorrow are two completely separate concepts (Lindgren et al.; Mayer, 2001).

According to Eakes (1998), the individual who has chronic sorrow has the ability to cope with the problem on an internal and external basis. On the internal level, the individual most often copes with chronic sorrow in a positive way by using strategies that will help them feel more in control of the situation and by extension, their own lives (Eakes, 1998). These types of strategies can include such activities as maintaining interests outside of caring for the affected individual, pursing activities that will provide them restful opportunities, and an opportunity to “get away” from the situation. Also, seeking information related to one’s loss experience, and by extension others’ loss experiences can also be a helpful coping strategy. Other types of coping strategies can be cognitive, interpersonal, emotional, and spiritual. External coping strategies can come from sources such as the medical staff working with the individual’s family if they feel that the individual is at risk of developing Chronic Sorrow (Eakes, 1998).

Burke, M., Hainsworth, M., Eakes, G. and Lindgren, C. (1992) Current knowledge and research on chronic sorrow: A foundation for inquiry.  Death Studies 16(3):231–45.

Clubb, R. (1991) Chronic sorrow: Adaptation patterns of parents with chronically ill Children.  Pediatric Nursing 17(5): 461–6.

Eakes, G, Burke, M., Hainsworth, M. (1998) Middle-range theory of chronic sorrow.  Image—The Journal of Nursing Scholarship 30(2): 179-184.

Hayes, M. (2001). A phenomenological study of chronic sorrow in people with type 1 diabetes. Practical Diabetes International, 18(2): 65–69.

Langridge, P. (2002) Reduction of chronic sorrow: A health promotion role for children’s community nurses.  Journal of Child Health Care 6(3): 157-170.

Isaksson, A, K., Ahlström, G. (2008). Managing Chronic Sorrow: Experiences of Patients with Multiple Sclerosis. Journal of Neuroscience Nursing 2008. 40(3): 180-192.

<span style="font-family: 'Times New Roman',Times,serif;">Lichtenstein, B., Laska, M., & Clair, J. (2002). Chronic sorrow in the HIV-positive patient: Issues of race, gender, and social support. Aids Patient Care and STDS, 16(1): 27–38.

<span style="font-family: 'Times New Roman',Times,serif;">Lindgren, C, Burke, M., Hainsworth, M. and Eakes, G. (1992) Chronic sorrow: A lifespan concept. <span style="font-family: 'Times New Roman',Times,serif;"> Scholarly Inquiry for Nursing Practice: An International Journal 6(1): 27-40.

<span style="font-family: 'Times New Roman',Times,serif;">Mayer, M. (2001). Chronic sorrow in caregiving spouses of patients with Alzheimer’s disease. Journal of Aging and Identity, 6(1): 49–60.

<span style="font-family: 'Times New Roman',Times,serif;">Olshansky S (1962) Chronic sorrow a response to having a mentally defective child. <span style="font-family: 'Times New Roman',Times,serif;"> Social Casework 43: 190-193.

<span style="font-family: 'Times New Roman',Times,serif;">Phillips, M. (1991) Chronic Sorrow in Mothers of Chronically Ill and Disabled Children. <span style="font-family: 'Times New Roman',Times,serif;"> Issues in Comprehensive Pediatric Nursing 14(2): 111–20.

<span style="font-family: 'Times New Roman',Times,serif;">Teel, C. (1991) Chronic sorrow: Analysis of the concept. <span style="font-family: 'Times New Roman',Times,serif;"> Journal of Advanced Nursing 16(11): 1311–19.