Loss and profound intellectual disabilities: the significance of early separation responses
| DOI | https://doi.org/10.1108/AMHID-09-2016-0023 |
| Pages | 315-323 |
| Published date | 07 November 2016 |
| Date | 07 November 2016 |
| Author | Hannah Young |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Loss and profound intellectual
disabilities: the significance of early
separation responses
Hannah Young
Hannah Young is a Researcher
at PAMIS, University of
Dundee, Dundee, UK.
Abstract
Purpose –Intellectual disabilities (ID) may complicate the experience of bereavement and loss,
in those with communicative impairments compounded by complex healthcare needs and sensori-motor
limitations. Whilst theorists have argued that the cognitive difficulties of people with profound ID impede
mourning reactions, none have attempted to make sense of the responses they do exhibit. The current paper
discusses this.
Design/methodology/approach –A select review considers the neurobiology underlying attachment
bonds, complications in attachment formation and affect regulation in people with ID, and separation
responses of people with profound ID.
Findings –The current paper demonstrates that by recognising the affective nature of separation distress,
an understanding beyond a cognitive conceptualisation is possible.
Research limitations/implications –It is worth questioning whether people with profound ID are incapable
of any meaningful form of person permanence. A critical review could deal with this comparatively by drawing
on research of person and object permanence in typically developing children.
Practical implications –Of specific interest, the bio-behavioural regulators of relationships may help us to
appreciate the importance of routine physical health and social care for emotional wellbeing in this group.
Originality/value –It is argued that by appreciating the basic emotional and regulatory functions of
relationships, we can achieve a greater insight into the loss experiences of people with profound ID that will
offer therapeutic direction.
Keywords Care, Separation, Attachment, Loss, Neuropsychology, Profound learning disabilities
Paper type General review
Loss may be felt as one of the most painful experiences. Fortunately, most adults adjust to
separation from a loved one without the enduring effects of trauma (Bonanno, 2004). Intellectual
disabilities (ID) may complicate this, those in particular with communicative impairments
compounded by complex healthcare needs and sensori-motor limitations (Pawlyn and Carnaby,
2009). As many as 80 per cent of people with profound ID experience at least one severe
sensory impairment, alongside health-related conditions including epilepsy, respiratory problems
and mobility limitations (Nakken and Vlaskamp, 2007). Communication skills are significantly
compromised and often restricted to vocalisation, facial expression and limited movement.
Whilst theorists have argued that the cognitive difficulties of people with profound ID impede
mourning reactions (Meeusen-van de Kerkhof et al., 2006), none have attempted to make sense
of the responses they do exhibit. This is an important point because bereavement support will be
greatly shaped by the extent to which caregivers perceive the individual as experiencing loss
(McEvoy et al., 2010). That separation responses originate from neurobiological systems is
hugely significant for understanding loss emotions. Though it may be difficult to engage with the
Received 17 September 2016
Revised 17 September 2016
Accepted 18 October 2016
The author thanks Professor
Carlos Schuengel, Vrije Universiteit
Amsterdam, for his helpful
comments and suggestions in
relation to an earlier version of this
manuscript.
DOI 10.1108/AMHID-09-2016-0023 VOL. 10 NO. 6 2016, pp.315-323, © Emerald Group Publishing Limited, ISSN 2044-1282
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
PAGE315
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