Ambivalent-to-distressing presences in bereavement
: psychotherapy and the hallucinating of the deceased

  • Pablo Sabucedo Serrano

Student thesis: Doctoral Thesis


Between 30% and 60% of bereaved people sense or feel the presence of the person they have lost, primarily in the form of a vision, a voice or a felt presence. This phenomenon is known, in psychology and in psychiatry, as an experience or sense of presence, or as a post-bereavement hallucination. Research has established that approximately 75% of these experiences are comforting for the bereaved and, as a normal feature of human grieving, require no mental health care. A minority of approximately 25%, however, are experienced in an ambivalent or distressing way. This thesis focuses on the latter subset, aiming to understand (1) what the sources of distress are when experiences of presence go awry, (2) how ambivalent-to-distressing experiences of presence are, and should be, treated in clinical practice, and (3) whether the experiencer’s socio-cultural environment influences these processes. This mixed-method investigation is subdivided into two studies: a cross-cultural survey on psychotherapy practice with ambivalent-to-distressing experiences of presence, supplemented with semi-structured interviewing, and a narrative analysis on sources of distress and ambivalence reported in participant narratives on experiences of presence. Research outcomes from this investigation indicate that, when experiences of presence go awry, distress can originate from unfinished issues in the departed-bereaved relationship or pre-existing mental health issues. Stigma or taboo toward these experiences, in the social circle of the bereaved, can also influence the way they are felt, but distress should not be seen as specific to a given culture. Considerable differences are present amongst the mental health disciplines on how to work with, and make sense of, ambivalent-to-distressing experiences of presence in the therapy room, but there is a partial agreement regarding the importance of acceptance, normalisation, exploration and support. The thesis concludes with a discussion reflecting on future empirical research and clinical practice in the area.
Date of Award10 Feb 2021
Original languageEnglish
Awarding Institution
  • University of Roehampton
SupervisorJac Hayes (Director of Studies) & Chris Evans (Co-Supervisor)


  • Sense
  • Experience
  • Illusion
  • Bond
  • Grief
  • Mourning
  • Widowhood
  • Voice-hearing
  • Clinical
  • Counselling

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