PRACTICAL THEOLOGY (ARTICLES ASSOCIATED WITH THE SPTSA)

 

Unattended grieving in the context of COVID 19 in Botswana: Psycho-pastoral accompaniment

 

 

Tshenolo Jennifer Madigele^I; Ronald Tshelametse^II

^IUniversity of Botswana, Botswana. madigeletj@ub.ac.bw
^IIUniversity of Botswana, Botswana. tshelame@ub.ac.bw

 

 

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ABSTRACT

This article explores the phenomenon of unattended grieving in the context of the COVID-19 pandemic in Botswana. It focuses on the integration of psychological and pastoral care approaches to provide psycho-pastoral accompaniment for individuals experiencing grief during this crisis. The article examines the unique challenges faced by individuals in processing their grief and proposes a comprehensive approach that combines psychological interventions with pastoral support. It is believed that by adopting the psycho-pastoral accompaniment approach, individuals in Botswana can effectively navigate the grieving process and find solace and healing beyond the pandemic.

Keywords: Unattended grieving; COVID 19; psycho-pastoral accompaniment; holistic pastoral care; grieving practices

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1. Introduction

The COVID-19 pandemic has presented unprecedented challenges worldwide, with Botswana being no exception. The pandemic has brought forth not only the loss of loved ones but also unique circumstances surrounding grieving in the face of restrictions on funeral rituals and increased social isolation (Hopfgarten 2021:xii). This article aims to delve into the concept of unattended grieving. Unattended grieving, often referred to as "unresolved grief," can be defined as a complex emotional state characterized by persistent and prolonged grief reactions without the necessary emotional processing, resolution, or integration (Worden, 2009). In unattended grieving, individuals may struggle to effectively cope with the loss or adapt to life without the deceased or the source of their grief. This state of unresolved grief can lead to a range of emotional, psychological, and even physical difficulties, as individuals remain entangled in the intense and distressing emotions associated with the loss (Shear et al. 2011). Addressing and working through unattended grieving is essential to promote emotional healing and well-being (Neimeyer 2001).

The central argument of this article revolves around the critical need to integrate psychological and pastoral care approaches to provide psycho-pastoral accompaniment for individuals experiencing grief in the specific context of Botswana. The COVID-19 pandemic has resulted in an overwhelming number of deaths on a global scale, triggering profound grief among countless individuals. However, in Botswana, there has been a noticeable lack of attention given to the emotional and spiritual needs of those grappling with grief (Molebatsi & Kgositau 2020). This oversight has led to unattended grieving experiences, a term that encapsulates the mourning and bereavement process occurring without the necessary support or attention from family, friends, or the community (Hopfgarten 2021:xii). Unattended grieving can have profound negative repercussions, affecting the mental and emotional well-being of individuals, as well as their ability to cope with loss (Stroebe et al., 2008).

To comprehensively offer pastoral care to those who are grieving, it's essential to have a precise understanding of the concept of grieving, particularly from a theological standpoint. Grieving entails the experience of intense and enduring emotions, such as disbelief, shock, despair, sadness, and guilt, which can be challenging to manage (Freud 1917; 1915). However, it's crucial to recognize that these emotions represent a natural part of the healing process. Embracing these feelings allows individuals to progress in their lives. Until the grieving process is effectively undertaken, regaining a sense of composure can prove to be challenging, as a part of the individual remains anchored to the past. It's important to emphasize that grieving is not synonymous with forgetting but rather entails discovering a different perspective, one that provides individuals who are grieving with an alternative context. Viewing grieving as a normative metaphorical expression can be a helpful lens through which to comprehend the various life experiences that provoke grief. Among these, death stands as one of the most profound losses. Importantly, grief is a universal human reaction, but its expression can vary significantly based on cultural, social, and individual factors (Worden 2008; Kübler-Ross 1969; Stroebe et al. 2015).

COVID-19 grief is distinctive in several ways, primarily due to the tension and uncertainty it brings (Mackenzie 2020:x). Many traditional social rituals that facilitate proper goodbyes were not performed during the pandemic, amplifying the emotional burden. Additionally, individuals were already contending with other life changes, including job losses, which compounded their emotional and psychological strain. The multidimensional pain experienced during the COVID-19 pandemic contributes significantly to unattended grieving, creating what Kastenbaum termed "bereavement overload" (Kastenbaum 1969). These multiple losses can become overwhelming and lead to various health complications.

Stroebe et al. identify a type of grief known as "unresolved grief," which occurs when the relationship between the bereaved and the deceased was extremely close and dependent, there is a history of depression, often due to financial losses, and social support is lacking (Stroebe et al., 1993). When grief remains unaddressed, individuals may resort to unhealthy coping mechanisms such as substance abuse or self-destructive behaviours, which temporarily numb emotional pain but result in long-term negative consequences for both the individual and their loved ones (Kübler-Ross 1969).

Moreover, unattended grieving can have inter-generational effects, particularly within families (Worden 2009). When parents or caregivers do not address their grief adequately, it can impair their ability to provide emotional support and guidance to their children. This, in turn, can perpetuate a cycle of unresolved grief being passed down through generations, leading to negative impacts on individuals and communities. Moreover, chronic grief, characterized by its prolonged nature, often involves self-pity and self-reproach that perpetuate the grieving process (Shaver et al. 2001). In particular, maternal grief, due to the unique mother-child relationship, can be lengthy and intense. It is imperative to identify individuals who have suspended their grieving, experienced sudden or traumatic deaths of loved ones, and exhibit evidence of chronic grief. These individuals should be attended to through pastoral care, and some may seek help after realizing they are experiencing bereavement-related distress.

It is also crucial for individuals experiencing grief, especially when it becomes overwhelming or interferes with daily life, to seek support and assistance (Stroebe et al., 2008). Mental health professionals, including psychologists and psychiatrists, are trained to provide guidance and support during the grieving process. Furthermore, the Church, support groups, counselling services, and bereavement programs can offer valuable resources and a sense of community to aid individuals in navigating their grief effectively.

This article will proceed by examining each of these aspects in greater detail, providing a comprehensive exploration of unattended grieving during the COVID-19 pandemic in Botswana and the importance of integrating psychological and pastoral care approaches in addressing this issue.

 

2. Unattended grieving in Botswana

2.1 Impact of COVID-19 on grief and bereavement

The COVID-19 pandemic has disrupted traditional mourning practices, such as funerals and gatherings, leading to unattended grieving experiences. The lack of physical presence and support has intensified feelings of isolation, complicating the grieving process (Worden, 2008). In the context of COVID-19 in Botswana, unattended grieving has become a significant concern as the pandemic has disrupted traditional mourning practices and support systems. The COVID-19 pandemic has brought about numerous changes in how societies handle death and mourning rituals. In Botswana, like many other countries, restrictions on gatherings, travel limitations, and social distancing measures have been implemented to curb the spread of the virus. These measures have had a profound impact on funeral ceremonies and mourning practices, leading to unattended grieving experiences for many individuals (Keitumetse et al. 2019).

One of the primary challenges faced by individuals in Botswana during the COVID-19 pandemic is the inability to participate in traditional funeral rituals. Funerals in Botswana are typically communal events where family members, friends, and community members come together to mourn and pay their respects to the deceased (Bolaane 2011). However, with restrictions on gatherings, funeral attendance has been limited, often only allowing a small number of immediate family members to be present. This restriction prevents extended family members and friends from participating fully in the mourning process, leading to feelings of isolation and unattended grief (Molefe et al. 2020).

Furthermore, travel limitations imposed during the pandemic have also hindered individuals from attending funerals outside their immediate vicinity. In Botswana, it is common for people to travel long distances to attend funerals of relatives or close friends. However, with travel restrictions in place, many individuals have been unable to physically be present at funerals, further exacerbating feelings of unattended grieving. The lack of physical presence and support from loved ones during the mourning process can have significant psychological and emotional consequences (Brown 2020).

This crisis also encompasses a range of mental health issues, including increased rates of anxiety, depression, and post-traumatic stress disorder (PTSD), as well as exacerbation of pre-existing mental health conditions (Mackenzie 2020:x). Factors such as social isolation, fear of infection, and economic uncertainties have contributed to a rise in mental health crises that have often gone unaddressed. Given the lack of resources and attention given to mental health services during COVID-19, there is an urgent need for intervention. These untreated mental health issues can have long-term consequences if not addressed promptly (Hopfgarten 2021:xii).

Furthermore, the COVID-19 pandemic has had a significant economic impact on Botswana, affecting sectors such as tourism, mining, agriculture, small businesses, employment, income, and government finances (UNDP 2020; Mooketsi 2020). The economic impact of the pandemic has also affected grief experiences in Botswana. Many people have lost their jobs or experienced financial hardships, which can compound feelings of grief and loss. The stress of financial instability can make it even more challenging for individuals to navigate their grief effectively (Mooketsi 2020). Grief is a complex and individual experience in the context of Botswana and elsewhere. As demonstrated, it is accompanied by physical, psychological, social, and economic challenges. The absence of traditional support systems can make it even more challenging to navigate.

The Sunday Standard Newspaper titled, "How gender-based violence became Botswana's parallel pandemic" (Kuhlman 2022), reports that Gender-based violence cases escalated more during the COVID-19 pandemic. About 70% of women in Botswana had either experienced sexual or physical abuse. This percentage is double the global average (Kuhlman, 2022). During lockdowns, many experienced multiple losses and were not able to change their life situations. Others lost jobs on top of losing their loved ones, hence life became so meaningless amidst other stressors such as social isolation and loss of income. Increased gender-based violence cases had been relegated to increased personal, relational, and economic stressors (Madigele and Baloyi 2022). Botswana has also recorded skyrocketing suicides during COVID-19 than in any other years. Suicide has, as a result, largely become a public concern. It has also been relegated to depression, anxiety, and a lack of problem-solving skills (Olashore et al. 2022).

2.2 Sociocultural influences on grief in Botswana

The extended family system in Botswana is a fundamental element of the sociocultural fabric. This familial structure holds immense importance in providing essential support to those grieving. In times of loss, family members unite to offer solace, reminisce about the deceased, and assist with practical matters. This collective support network plays a vital role in helping individuals traverse the complex terrain of grief and manage their emotional responses. The presence of multiple generations within the extended family structure facilitates the transmission of cultural values and traditions associated with grief and mourning (Bolaane 2011; Republic of Botswana 2001). These customs provide a framework for grieving individuals to understand and express their emotions within the cultural context.

Botswana's culture is deeply rooted in the concept of community and interconnectedness. This communal ethos significantly influences how grief is experienced and managed within the society. The close-knit community acts as a robust support system for bereaved individuals. In times of bereavement, the community comes together to offer emotional support, practical assistance, and a profound sense of belonging. This communal solidarity serves as a powerful antidote to the isolation and loneliness that often accompany grief. By sharing their grief with others who have faced similar losses, individuals find comfort and solace in the collective experience (Msimanga 2015).

It is noteworthy that prevailing theories of grief and mourning, primarily developed in Euro-Western contexts, tend to emphasize the individual's emotional journey (Kubler-Ross 1969; Kubler-Ross & Kessler 2005). However, African-centred epistemologies have challenged this individualistic perspective (Baloyi & Makobe-Rabothata 2014; Nwoye 2000, 2005; Nwoye & Nwoye 2012). These African perspectives underscore the communal and culturally embedded nature of grief experiences. In Africa, grief is often a shared and communal process, with entire communities actively participating in mourning and providing support to the bereaved (Gichinga 2007).

 

3. Psycho-pastoral accompaniment during grieving work

Psycho-pastoral accompaniment during grieving work signifies a holistic approach to counselling and support, harmoniously blending pastoral and psychological elements to provide comprehensive care to individuals navigating the challenges of grief. This approach encompasses the provision of guidance, care, and counselling that considers the multifaceted nature of an individual's well-being, including mental health, emotional needs, and spiritual beliefs (AAPC 2016; Graham 2006).

Within psycho-pastoral accompaniment during grieving work, faith and spirituality hold a central role, acknowledging their significance in an individual's experience of grief and healing (AAPC 2016). This approach skilfully amalgamates insights and therapeutic techniques drawn from both pastoral counselling and psychological counselling, recognizing the potential synergy between these domains in the context of grieving work (Menz 2003; Oates, 1982). The primary objective is to nurture an individual's spiritual development, aid in emotional recovery, and enhance mental well-being, all while honouring their religious or spiritual convictions (AAPC 2016).

Psycho-pastoral accompaniment during the process of grieving exhibits an inherent client-centered approach, meticulously tailoring the counselling process to cater to the distinct needs and deeply held beliefs of the individual. This approach manifests a profound respect for the individual's religious traditions and personal convictions, as espoused by the American Association of Pastoral Counsellors (AAPC 2016). In the context of grief work within African settings, psycho-pastoral accompaniment can be conceptually characterized as a comprehensive and culturally attuned framework aimed at providing support to individuals and communities as they navigate the intricate and collective experience of grief. Within this framework, particular attention is paid to the multifaceted nature of grief, synthesizing psychological and pastoral perspectives (Buffel 2022).

This approach underscores the paramount importance of recognizing grief as a communal and spiritual process deeply interwoven with indigenous cultural rituals and traditions (Nwoye 2000; Gichinga 2007). Psycho-pastoral accompaniment, in this context, is characterized by the provision of emotional and psychological support to individuals while also exhibiting profound respect for the cultural and spiritual dimensions of their grieving experiences (Canham 2020). Furthermore, it acknowledges that grief transcends the boundaries of individualized or clinical matters and is fundamentally a shared experience that encompasses biological, emotional, and social dimensions (Nwoye 2005). This approach places significant emphasis on fostering community solidarity, preserving and respecting cultural rituals, and nurturing the spiritual connection between the living and the departed (Asante 2013; Baloyi & Makobe-Rabothata 2014).

In essence, the goal of psycho-pastoral accompaniment within the African context is to empower both individuals and communities to collectively navigate the complexities of grief. This approach places a particular emphasis on upholding the dignity of the departed and preserving their memory (Canham 2020). Within the context of psycho-pastoral accompaniment during grieving work, grief is viewed as a complex emotional journey with profound spiritual and psychological implications. Pastoral counsellors emphasize that grief is a natural part of the human experience and offer spiritual guidance to help individuals navigate their grief with compassion and resilience (AAPC 2016). From a psychological standpoint, grief is examined in terms of the emotional and cognitive processes individuals undergo when confronting loss. Psychological counsellors may employ evidence-based modalities, such as cognitive-behavioural therapy or specialized grief counselling, to support individuals in managing their grief and facilitating psychological healing (Gladding and Newsome 2010).

Psycho-pastoral accompaniment during grieving work underscores the intricate nature of grief and advocates for a balanced approach. It harmoniously blends the pastoral dimension, emphasizing spiritual healing, with psychological insights addressing the emotional and cognitive aspects of grief. In this collaborative approach, individuals are encouraged to explore their grief within the prism of their faith, finding solace and purpose in their religious beliefs, while simultaneously benefiting from therapeutic interventions aimed at addressing the emotional and psychological challenges inherent to the grieving process (AAPC 2016; Gladding and Newsome 2010).

 

Accompaniment

Accompaniment, in a broader sense, is a transformative and empathetic practice of being present with individuals or communities who are facing challenging life circumstances, collective traumas, or social injustices. It involves offering unwavering support, solidarity, and a non-judgmental presence to those in distress, without imposing external solutions or interventions (Edge, Kagan & Stewart 2003; Farmer 2011). Accompaniment signifies a profound commitment to sharing the journey with others, respecting their autonomy, and acknowledging the inherent dignity and worth of each person (Farmer 2013). This practice can be found in various fields, including social medicine, human rights advocacy, pastoral support, and liberation psychology, where it is employed to accompany individuals and communities who are marginalized, oppressed, or facing adversity (Lykes 2001).

Accompaniment underscores the significance of active listening, empathetic dialogue, and cultural sensitivity in addressing the multifaceted aspects of suffering, aiming to empower individuals and communities to take control of their own healing and transformation (Freire 2000). In this practice, the accompanier plays a pivotal role in providing a bridge to a broader world for those accompanied, offering hope, compassion, and a commitment to bearing witness to their struggles (Watkins 2012). Accompaniment often entails the accompanier's willingness to be present even in situations of danger or difficulty, exemplifying a spirit of genuine solidarity (Langer 1991). Furthermore, it involves a process of decolonizing the accompanier's own mindset, challenging hierarchical power dynamics, and adopting a more equitable and respectful stance towards those they accompany (Gutierrez 1983). Ultimately, the concept of accompaniment underscores the value of human connection, empathy, and shared humanity in the pursuit of justice, healing, and social transformation (Goizueta 2009).

Grief work, within the context of psycho-pastoral accompaniment, refers to the process of acknowledging, experiencing, and navigating the intense emotions and psychological responses that arise following the loss of a loved one or significant life change. It encompasses the multifaceted and often complex journey individuals undergo as they come to terms with their grief, find ways to cope, and eventually integrate their loss into their lives (Kubler-Ross 2014). Grief work extends beyond the mere experience of grief and mourning; it involves active efforts to understand, express, and process the emotions associated with loss (Worden 2009).

In African contexts, grief work has unique cultural dimensions and communal rituals that play a crucial role in supporting mourners (Nwoye 2000, 2005; Nwoye & Nwoye 2012). It emphasizes the collective nature of grief and mourning, often involving "patterned ways" of healing psychological wounds within traditional communities (Nwoye, 2005). These rituals and practices are deeply interconnected with spirituality and cultural beliefs, offering a framework for individuals to cope with loss collectively (Walter 2007; Gichinga 2007). African grief work acknowledges the vital role of community solidarity, spirituality, and rituals in supporting those who are grieving (Baloyi & Makobe-Rabothata 2014). It underscores the importance of dignified recognition of life and death within African communities and views grief as a transition to a spiritual realm rather than an end (Baloyi & Makobe-Rabothata 2014).

African Grief Therapy (AGT), as conceptualized by Nwoye (2000), offers a comprehensive framework for understanding and addressing grief within African contexts. AGT recognizes grief as a holistic experience encompassing biological, emotional, and social dimensions while emphasizing the significance of community support and solidarity. Contrary to pathologizing grief, AGT regards it as a political act that honours the dignity and memory of the departed, underscoring the importance of preserving cultural rituals and practices to facilitate the grieving process (Canham 2020).

Within the domain of practical theology, pastoral accompaniment assumes a pivotal role in providing guidance and support to individuals and communities navigating grief (Buffel, 2022). Acknowledging the interdisciplinary nature of grief support, practical theology acknowledges that individuals may seek assistance from diverse professionals, including pastors, psychologists, and traditional healers (Pruyser 1976). Pastors and ministers are uniquely positioned to offer pastoral-theological perspectives that complement psychological and social support (Pruyser 1976).

 

Psycho-pastoral accompaniment and pastoral care

Psycho-pastoral accompaniment is a specialized field within pastoral care, which combines elements of psychology and theology to provide emotional and spiritual support to individuals. This approach is often used by pastoral caregivers such as chaplains, ministers, and other spiritual leaders to provide holistic care that addresses both the psychological and spiritual needs of the individual. A key figure in the development of psycho-pastoral accompaniment is Emmanuel Y. Lartey, a Ghanaian theologian who has made significant contributions to the field of pastoral theology. In his book "In Living Colour: An Intercultural Approach to Pastoral Care and Counselling", Lartey advocates for an intercultural approach to pastoral care that respects and values the cultural diversity of individuals receiving care. This approach requires pastoral caregivers to be sensitive to the cultural backgrounds of individuals and to incorporate these cultural contexts into their care practices. Lartey's approach to psycho-pastoral accompaniment is based on his concept of "intercultural pastoral theology". According to Lartey, this approach involves understanding the cultural contexts in which individuals live and how these contexts influence their experiences of suffering and healing. This includes understanding the psychological processes that are influenced by cultural factors, such as how individuals perceive and experience emotions, how they cope with stress and trauma, and how they make sense of their experiences (Lartey 2006).

Another key figure in psycho-pastoral accompaniment is Daniel J. Louw, a South African theologian known for his work on pastoral care and counselling. Louw's approach focuses on the role of hope in healing, arguing that pastoral caregivers should aim to instil hope in individuals as part of their caring process. In his book "Cura Vitae: Illness and the Healing of Life", Louw outlines his theory of "cura vitae", or "care for life", which emphasizes the importance of holistic care that addresses not only physical illness but also emotional and spiritual suffering. Louw's approach to psycho-pastoral accompaniment is based on his understanding of the human condition as characterized by vulnerability and dependency. According to Louw, pastoral caregivers should recognize the inherent vulnerability of individuals and provide care that supports their physical, emotional, and spiritual well-being (Louw 2004).

John Patton, an American pastoral theologian, is another influential figure in psycho-pastoral accompaniment. Patton's approach emphasizes the importance of narrative in pastoral care, arguing that individuals construct meaning through the stories they tell about their lives. In his book "Pastoral Care: An Essential Guide", Patton outlines his theory of pastoral care as a process of helping individuals to tell their stories in ways that promote healing and growth. Patton's approach to psycho-pastoral accompaniment is based on his understanding of the therapeutic power of narrative. According to Patton, pastoral caregivers can facilitate healing by helping individuals to tell their stories and by listening attentively to these stories (Patton 1996).

In acknowledgment of the multifaceted emotions associated with grief, pastoral caregivers may integrate psychological techniques such as cognitive-behavioural therapy (CBT) to aid individuals in processing their emotions and challenging negative thought patterns linked to their loss (Neimeyer 2016). By amalgamating psychological and pastoral approaches, psycho-pastoral accompaniment during grief work aims to address the diverse and profound needs of individuals and communities grappling with loss and bereavement within the African context.

3.1 Cognitive-behavioural therapy (CBT) and its effectiveness

CBT is a widely recognized and evidence-based therapeutic approach that focuses on the connection between thoughts, emotions, and behaviours. It aims to help individuals develop healthier thinking patterns by challenging and modifying negative thoughts that contribute to emotional distress (Eisma et al. 2015). CBT operates on the premise that our thoughts influence our emotions and behaviours. Negative thought patterns can often arise following a significant loss, such as the death of a loved one, divorce, or job loss. These thoughts may include self-blame, guilt, hopelessness, or feelings of worthlessness. By identifying these negative thoughts and examining their accuracy and validity, individuals can gain insight into how their thinking may be contributing to their emotional distress (Boelen et al. 2007). There is a connection between unattended grieving and negative thoughts, emotions, and behaviours. Negative thoughts may include self-blame, guilt, or feelings of worthlessness, as individuals may question their actions or choices surrounding the loss. They may also experience a sense of hopelessness or pessimism about the future, struggling to find meaning or purpose in their lives.

Negative emotions associated with unattended grieving can be intense and persistent. These may include sadness, anger, resentment, or even numbness. Individuals may feel overwhelmed by these emotions, leading to difficulties in daily functioning and strained relationships (Stroebe et al. 2017). Unattended grieving can also manifest in negative behaviours. Individuals may engage in avoidance or isolation, withdrawing from social interactions or activities they once enjoyed. They may turn to unhealthy coping mechanisms, such as substance abuse, self-destructive behaviours, or excessive work, in an attempt to numb or distract themselves from the pain of grief (Worden et al. 2009). Addressing unattended grieving is crucial for individuals to heal and move forward. It is essential to create a safe and supportive environment where individuals feel free to express their emotions and share their grief. Seeking professional help, such as therapy or counselling, can provide individuals with the necessary guidance and support to navigate the grieving process (Neimeyer 2016). Therapeutic interventions, such as cognitive-behavioural therapy (CBT) or grief counselling, can help individuals identify and challenge negative thoughts associated with their grief. They can also learn healthy coping mechanisms to regulate their emotions and develop positive behaviours that promote healing and growth.

One of the key techniques used in CBT is cognitive restructuring. This involves identifying negative automatic thoughts (NATs) - spontaneous thoughts that occur in response to specific situations and challenging their validity through evidence-based reasoning. By examining the evidence for and against these thoughts, individuals can develop more balanced and realistic thinking patterns (Shear et al. 2014). CBT also incorporates behavioural interventions to complement cognitive restructuring. These may include behavioural activation, which involves engaging in activities that bring a sense of pleasure or accomplishment, and exposure therapy, which gradually exposes individuals to situations or memories associated with their loss to reduce avoidance and fear (Eisma et al. 2015). CBT further emphasizes on the importance of individualized treatment plans tailored to each person's unique needs and circumstances (Neimeyer 2016).

Pastoral accompaniment can incorporate elements of cognitive behavioural therapy and grief work to provide comprehensive support for individuals experiencing grief and loss. By addressing both the spiritual and emotional aspects of the individual's experience, pastoral accompaniment can facilitate healing and promote overall well-being.

3.2 Psycho-education about the grieving process

Psycho-education about the grieving process holds a significant place within the framework of psycho-pastoral accompaniment, where psychological understanding and pastoral care intersect to provide comprehensive support for individuals navigating grief (Worden 2009). Within the context of psycho-pastoral accompaniment, psycho-education serves as a crucial tool for pastoral caregivers to empower individuals undergoing grief. It involves providing them with knowledge and insights that enable a deeper comprehension of the grieving process while incorporating spiritual and emotional dimensions into the conversation (Worden 2009).

One foundational aspect of psycho-education is helping individuals recognize the normalcy of their grief reactions, encompassing both psychological and spiritual aspects (Patton, 1996; Lartey, 2006; Louw, 2004). By acknowledging that grief is a highly individualized journey, pastoral caregivers can emphasize the importance of respecting each person's unique experiences, blending psychological stages with spiritual insights to create a more personalized approach. The stages of grief, such as those outlined in the Kübler-Ross model (1969), including denial, anger, bargaining, depression, and acceptance, are integral components of psycho-education. Pastoral caregivers, drawing inspiration from psycho-pastoral accompaniment principles, can help individuals explore how these stages intertwine with their faith, beliefs, and spiritual well-being (Lartey 2006; Louw 2004).

Moreover, psycho-education within the context of psycho-pastoral accompaniment delves into the development of healthy coping strategies. Pastoral caregivers, drawing from the insights of pastoral theologians, can guide individuals to incorporate spiritual practices, self-care activities, and a support system that aligns with their faith and values (Patton, 1996; Lartey, 2006; Louw, 2004). This approach ensures that individuals receive guidance that resonates with their spiritual and emotional needs.

Additionally, psycho-education addresses misconceptions and myths surrounding grief. Pastoral caregivers, enriched by pastoral theologians' wisdom, can dispel common misunderstandings by offering spiritual guidance that promotes patience and self-compassion within the unique timeline of each person's grief journey (Patton 1996; Lartey 2006; Louw, 2004).

Furthermore, pastoral caregivers, as part of psycho-pastoral accompaniment, play a pivotal role in connecting individuals with appropriate support systems. This includes facilitating connections with mental health professionals specializing in grief counselling and linking individuals with bereavement support groups that provide both psychological and spiritual solace (Patton 1996; Lartey 2006). In essence, psycho-education about the grieving process is intricately interwoven with the principles of psycho-pastoral accompaniment, where psychological insights are seamlessly integrated with spiritual and emotional support. By embracing the perspectives of pastoral theologians like Patton, Lartey, and Louw, pastoral caregivers can offer a comprehensive approach that respects individuality and addresses the diverse needs of those experiencing grief (Patton 1996; Lartey 2006; Louw 2004).

3.3 Pastoral accompaniment and stages of grieving

Pastoral accompaniment, particularly within the context of psycho-pastoral accompaniment, holds a vital role in helping individuals navigate the intricate stages of grief, especially in the context of unexpected and traumatic losses, such as those caused by the COVID-19 pandemic. Drawing upon insights from pastoral theology, as well as pastoral theologians and grief theorists, pastoral caregivers play a pivotal role in providing comfort, understanding, and spiritual guidance during the grieving process (Bowlby 1977a; Engel 1961).

The initial stage of grief, often characterized by denial, becomes particularly challenging when individuals are faced with sudden and unexpected deaths, as seen during the COVID-19 pandemic. Pastoral accompaniment during this stage involves creating a safe and empathetic space for individuals to express their feelings, acknowledge their disbelief, and gradually come to terms with the harsh reality of the loss (KüblerRoss 1969). Pastoral theologians, such as Emmanuel Lartey, emphasize the importance of understanding the cultural and spiritual dimensions of grief within the specific context of individuals, allowing for a more personalized and holistic approach to pastoral care (Lartey 2006).

Attachment theory, as expounded by Bowlby (1977a), highlights the profound bonds individuals form with their loved ones over time. Threats to these bonds can result in both physical and mental health complications, underscoring the need for a multidisciplinary approach to grieving, which includes addressing the physical and psychological dimensions of trauma (Engel 1961). Pastoral theology reminds us that pastoral care encompasses the whole person, addressing both their spiritual and emotional needs in times of grief.

As individuals progress through the stages of grief, pastoral accompaniment remains instrumental. The stage of anger, characterized by frustration and resentment, requires validation of these emotions while offering guidance on healthy coping mechanisms. Pastoral caregivers may explore religious teachings on forgiveness and the search for meaning amidst suffering (Kübler-Ross 1969). Insights from pastoral theology, such as the emphasis on empathy and compassion, can inform pastoral caregivers' approach to supporting individuals in this stage.

Subsequently, the bargaining stage may manifest as individuals attempting to negotiate with a higher power or themselves to reverse or alter the loss. During this stage, pastoral accompaniment may involve delving into spiritual beliefs and practices that provide solace, such as prayer, meditation, or rituals (Kübler-Ross 1969). Pastoral theology, influenced by theologians like Daniel Louw, emphasizes the importance of compassionate caring and understanding, aligning with the pastoral caregiver's role in providing comfort during this phase (Louw 2004).

Depression, a common stage of grief marked by sadness and hopelessness, necessitates emotional support, encouragement to seek professional help if needed, and reminders of a compassionate and caring God through pastoral accompaniment (Kübler-Ross 1969). Pastoral theologians, including John Patton, have highlighted the need for pastors to be equipped with psychological knowledge to effectively address emotional distress in individuals, further emphasizing the interdisciplinary nature of pastoral care (Patton, 1996).

The ultimate stage of grief, acceptance, signifies a shift towards coming to terms with the loss and seeking ways to rebuild life. Pastoral accompaniment during this stage focuses on helping individuals find purpose and meaning once more, assisting in reconstructing their sense of self, and exploring avenues to honour the memory of what has been lost (Kubler-Ross, 1969). Pastoral theology, with its emphasis on finding spiritual meaning and support, aligns with this stage of the grief journey.

Nevertheless, it is essential to recognize that grief is a highly individualized process, and individuals may not necessarily experience all stages uniformly. Pastoral caregivers, in alignment with the principles of psycho-pastoral accompaniment and pastoral theology, should adapt their approach to the unique needs and responses of those in mourning, acknowledging that grieving occurs in phases and varies from person to person (Kübler-Ross 1969; Bowlby 1977a; Engel 1961).

Psycho-pastoral accompaniment, enriched by insights from pastoral theology and theologians, emphasizes the importance of recognizing the diverse needs and responses of individuals within their grief journey. By drawing from these theological and psychological perspectives, pastoral caregivers can offer empathetic, culturally sensitive, and spiritually grounded support, acknowledging that the stages of grief are not rigid but fluid, and that each person's experience is unique (Kübler-Ross 1969; Bowlby 1977a; Engel 1961).

3.4 Psycho-pastoral accompaniment and the spiritual dimension of grief

The spiritual dimension of grief encompasses the profound impact that loss has on an individual's sense of meaning, purpose, and their connection to something greater than themselves. It raises questions about the nature of life, death, and the potential existence of an afterlife. Grief often prompts a search for deeper understanding and meaning in life (Garrett 2008; Buffel 2022). This quest for meaning can take various forms, including the exploration of existential questions, a deep dive into spiritual or religious beliefs, a re-evaluation of personal values, and the quest to find purpose amid the experience of loss.

Psycho-pastoral accompaniment recognizes the spiritual dimension of grief and aims to address both the psychological and spiritual aspects of this complex process. It does so by seamlessly integrating therapeutic techniques with spiritual guidance, acknowledging that individuals may find solace and hope in their spirituality (Makgahlela et al. 2019; Buffel 2022). In the context of psycho-pastoral accompaniment, trained professionals provide a secure and supportive environment for individuals to explore their feelings of grief. They employ a range of therapeutic approaches, such as active listening, empathetic communication, and cognitive-behavioural interventions, to assist individuals in processing their emotions and developing healthy coping mechanisms. Additionally, they may incorporate spiritual practices such as prayer, meditation, or rituals to address the spiritual needs of individuals (Buffel 2022).

Loss often leads to a profound sense of meaninglessness, challenging individuals' conceptions of the world and their own identity. Pastoral care, especially within the framework of psycho-pastoral accompaniment, can facilitate the deconstruction and reconstruction of meaning. In this context, grieving is a deeply subjective experience, underscoring the importance of personalized support and accompaniment. Individuals need assistance in relearning how to navigate life without the presence or intervention of the deceased, and pastoral accompaniment can provide a path towards finding new meaning and purpose (Makgahlela et al. 2019; Buffel 2022).

Furthermore, psycho-pastoral accompaniment offers a holistic framework for supporting individuals in grief. It acknowledges that grief extends beyond emotional experiences and delves into existential questions, spiritual struggles, and the essential need for social support. This approach aligns with the Setswana worldview, where care is seen as holistic and encompasses all dimensions of an individual's life (van Rensburg, 2010). It involves understanding human behaviour from various perspectives, addressing articulated needs, appreciating cultural contexts, and emphasizing communal pastoral care.

In this holistic approach, pastoral caregivers compassionately care for individuals as whole beings, addressing their mental, physical, emotional, and spiritual needs. The interconnectedness of these aspects is recognized, and the fulfilment of one dimension contributes to the well-being of the others. Thus, holistic pastoral care, as articulated by Masereka (2012), concerns all facets of an individual's life (Masereka 2012).

The spiritual dimension of grief is a profound aspect of the grieving process that raises questions about life's meaning and purpose. Psycho-pastoral accompaniment, enriched by insights from pastoral theologians like Lartey, Patton, and Louw, acknowledges and addresses this spiritual dimension. It provides a safe and supportive space for individuals to explore their grief, deconstruct and reconstruct meaning, and find solace and hope through spiritual practices. This approach aligns with the theme of psycho-pastoral accompaniment during grief work, emphasizing the holistic support needed to navigate the complexities of grief (Makgahlela et al. 2019; Buffel 2022; Lartey 2006; Patton 1996; Louw 2004).

In the context of providing psycho-pastoral accompaniment during grieving work in Botswana, it's crucial to recognize and respect the cultural traditions and customs that surround death and mourning. These cultural practices play a significant role in the grieving process and are deeply rooted in Setswana culture. Insights from pastoral theologians and scholars, including Masekela, Buffel, Makgahlela et al. 2019; Buffel 2022; Patton, Lartey, and Louw, can help pastoral caregivers navigate the delicate balance between providing psycho-pastoral support and respecting cultural traditions.

Botswana's rich cultural heritage underscores the importance of community and communal support during the grieving process. Setswana culture views death as a natural part of life, and while it is accepted, grieving is taken seriously and involves numerous cultural customs and traditions (Bhusumane 2017; Bolaane 2011). The funeral ceremony, in particular, is a central aspect of Setswana grieving customs, where the community comes together to pay respects, offer support, and celebrate the life of the deceased. This communal gathering aligns with the pastoral theology emphasis on community support and the role of extended family members (Masekela 2020).

During the funeral ceremony, various customs and traditions are observed, reflecting the spiritual and cultural significance of the event. For example, the wearing of specific colors by mourners, the display of the deceased's body, and the rituals performed all have cultural and spiritual meanings (Msimanga 2015; Bolaane 2017). Here, pastoral caregivers can draw from the insights of pastoral theologians like Louw, who emphasize the importance of understanding cultural and spiritual dimensions in pastoral care. This understanding allows caregivers to provide more culturally sensitive and relevant support (Louw 2012).

Extended family members often play a significant role in providing practical and emotional support to the grieving family. This aligns with the pastoral theologian's perspective of communal pastoral care, where the community comes together to provide assistance and comfort during times of grief (Buffel 2022). The involvement of extended family members underscores the interconnectedness and interdependence within Setswana culture.

Additionally, traditional beliefs in Botswana, such as the continued existence of the spirits of the deceased, influence grieving practices (Itumeleng 2017; Molefe 2013). These beliefs are important to consider in psycho-pastoral accompaniment, as they can impact an individual's understanding of death and the afterlife. Pastoral caregivers can draw on insights from scholars like Makgahlela et al. (2019) to navigate discussions surrounding spirituality and the afterlife during the grieving process.

Furthermore, the disruption of cultural practices and grieving rituals due to the COVID-19 pandemic is a significant challenge. This calls for a contextual and need-based approach to care and counselling, considering the restrictions on gatherings and travel (Bhusumane 2017; Msimanga 2015). Insights from pastoral theologians and scholars like Buffel (2022) can guide pastoral caregivers in adapting their support to the unique challenges posed by the pandemic while respecting the cultural and spiritual dimensions of grieving in Botswana.

Psycho-pastoral accompaniment in Botswana's cultural context involves a delicate balance between providing psychological support and respecting cultural traditions and beliefs. Pastoral caregivers can benefit from drawing on the insights of pastoral theologians, such as Masekela, Buffel, Makgahlela et al. (2019); Buffel (2022); Patton, Lartey, and Louw, to offer culturally sensitive and spiritually grounded care to those experiencing grief in Botswana.

3.6 Psycho-pastoral accompaniment and interdisciplinary approach to grieving

The interdisciplinary approach to grieving, encompassing psychology, sociology, anthropology, and theology, is instrumental in providing comprehensive psycho-pastoral accompaniment during the grieving process. This approach recognizes the multifaceted nature of grief and the diverse needs of individuals in their unique grief journeys. In the realm of psychology, grief is understood as a complex process involving emotional, cognitive, and behavioural dimensions (Eisma et al. 2015). Therapeutic techniques like Cognitive-Behavioural Therapy (CBT) and narrative therapy are highlighted as valuable tools in helping individuals navigate their thoughts and emotions related to loss (Buffel 2022). The integration of psychological insights underscores the importance of addressing the emotional and psychological needs of grieving individuals.

Sociology plays a crucial role in understanding the impact of social relationships and cultural norms on grief (Masekela 2020). Insights from sociology inform interventions aimed at strengthening social support systems for bereaved individuals. The sociological perspective recognizes that grief is not an isolated experience but is influenced by one's social context and relationships.

Anthropological studies on grief provide valuable insights into how different cultures and societies conceptualize and ritualize mourning practices (Buffel 2022). These insights emphasize the importance of respecting and honouring diverse cultural expressions of grief while providing appropriate support. Pastoral caregivers, drawing from pastoral theologians like Louw, recognize the significance of cultural and spiritual dimensions in grief work, aligning with the interdisciplinary approach (Louw 2012).

Additionally, pastoral theological perspectives on grief delve into existential questions related to loss and meaning making (Patton, Lartey). These perspectives offer individuals a spiritual framework for understanding their suffering and seeking meaning within a broader spiritual context. The interdisciplinary approach recognizes the significance of addressing the spiritual needs of grieving individuals.

Collaboration between mental health professionals, pastoral caregivers, social workers, healthcare providers, and community organizations is essential, as it allows for the pooling of expertise and resources to develop integrated care plans (Makgahlela et al. 2019). This collaborative effort ensures that grieving individuals receive comprehensive support that addresses their emotional, psychological, social, cultural, and spiritual needs, aligning with the insights of pastoral theologians and scholars who emphasize the importance of holistic and contextually relevant care during the grieving process.

The interdisciplinary approach to grieving, enriched by insights from pastoral theologians like Masekela, Buffel, Makgahlela et al., Buffel, Patton, Lartey, and Louw, underscores the importance of providing holistic and spiritually grounded psycho-pastoral accompaniment during the grieving process. It acknowledges the unique needs of individuals and recognizes that grief is a multifaceted experience that requires comprehensive support from various disciplines and perspectives.

 

Conclusion

Unattended grieving during the COVID-19 pandemic in Botswana poses significant challenges for individuals in their grief journey. This academic paper has highlighted the importance of a psycho-pastoral accompaniment approach in addressing these challenges. By integrating psychological interventions and pastoral care practices, individuals can receive comprehensive support that addresses their psychological, emotional, and spiritual needs. Pastoral caregivers attending to the grieving in the context of COVID 19 should assess care seekers' attitudes towards death from different perspectives such as psychological, religious, and sociological perspectives. They should investigate the process of adaptation to new life without the lost individual and ensure that mourner's identity is not damaged. They should also evaluate individuals' process of mourning such as their behaviour, emotions, and physical reactions. Relationships and interactions are important in the context of grieving as they could enhance coping skills. Adaptation also entail awareness of one's state of life and range of emotions and thoughts thereof. It also entail the restructuring of negative thoughts, emotions, and behaviours.

Psycho-Pastoral Accompaniment recognizes the unique context of Botswana and aims to facilitate healing, resilience, and hope amidst the pandemic. Further research and collaboration are needed to implement and evaluate the effectiveness of this psycho-pastoral accompaniment approach in supporting individuals experiencing unattended grieving in Botswana. Pastoral caregivers play a crucial role in supporting individuals and communities through the grieving process, particularly during challenging times like the COVID-19 pandemic. To effectively provide psycho-pastoral accompaniment, they should prioritize cultural competency and sensitivity, respecting local customs and collaborating with cultural experts. Continuous training in grief counselling and related fields is essential for skill development. Flexibility and adaptability are key, recognizing that grief experiences vary widely. Collaborating with mental health professionals, social workers, and healthcare providers ensures comprehensive support. Integrating spiritual practices, active listening, and empathy into pastoral care can provide comfort. Providing psycho-education about grief, addressing existential questions, and involving extended families and communities in support are vital. Self-care, using technology for virtual support, and regular evaluation of pastoral care practices are also recommended. Ultimately, pastoral caregivers should strive to enhance their skills, resilience, and advocacy efforts to provide holistic support during grief.

 

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