Undoing death: Counterfactual thinking and emotional adaptation to bereavement

Counterfactual thinking, mental simulations about how a situation could have turned out differently (if only … then … thoughts), increase grief and depression levels following bereavement. Thoughts about how (in)actions of oneself could have prevented the death (i.e., self-referent upward counterfactuals), are detrimental to post-loss mental health. Conversely, thoughts about how one's current situation could be (even) worse (i.e. downward counterfactuals), are theorized to improve post-loss mental health. There is limited information about what counterfactuals bereaved people spontaneously generate, who generates them, and how they relate to grief and depression severity. Using a Counterfactual Generation Task, we aimed to clarify the associations of characteristics of a generated counterfactual with loss-related characteristics and grief and depression levels in a bereaved sample (N = 343). Counterfactuals were predominantly upward (98%), self-referent (67%), and undid death (74%). Participants who had experienced unexpected, unnatural, or partner or child death generated more upward counterfactuals about undoing death. Higher grief levels were reported by participants who generated upward (vs. downward) counterfactuals and (self-referent) upward counterfactuals about undoing death (vs. other upward counterfactuals). Following bereavement, downward counterfactuals are rare but potentially adaptive, whereas upward counterfactuals about undoing death are common and can interfere with psychological adaptation to bereavement.