Meaning Reconstruction in the Wake of Loss: Evolution of a Research Program Robert A. Neimeyer University of Memphis, Memphis, Tennessee, USA As theories of bereavement have evolved, so too have evidence-based interventions to mitigate complications in post-loss adaptation. This article reviews one line of programmatic research grounded in a conceptualisation of grieving as an attempt to reafﬁrm or reconstruct a world of meaning challenged by loss. Anchored in therapeutic encounters with the bereaved, a meaning reconstruction approach to loss has grown over the past 15 years to generate an increasingly substantial research base, as well as to develop and reﬁne a wide array of contributions to psychological assessment and therapy. By summarising the major models, measures and methods resulting from this collaborative work, it offers an introduction to meaning reconstruction for those unfamiliar with it, noting its contributions to date, its areas of future development, and its relevance for clinical practice. ■ Keywords: grief therapy, bereavement, meaning reconstruction, spiritual struggle At the point that Linda sought therapy, some six months after the death of her ﬁanc´ e, Mark, in a tragic boating accident, she described herself as ‘depressed and hopeless’, in a seemingly meaningless cycle of ‘wake up and repeat’ days that did not ‘really feel like living’. Although she acknowledged the well-intentioned support of friends, Mark’s death renewed her cynicism cultivated by disappointing past relationships, and left her ‘drowning’ in the ‘black hole’ that accompanied his absence. Compounding her pervasive grief, intrusive images of the accident itself (e.g., Mark’s ﬂoating face down, neck broken after his reckless dive in the shallow cove of the lake in which they had anchored) and the four days of critical care that followed (e.g., his inability to move his limbs, his fearful agitation, his mechanical ventilation) crowded into her thoughts and dreams, adding a dimension of traumatic hyperarousal to a ‘surreal’ experience that appeared unbearable. Though not actively suicidal, she found herself wondering ‘whether living was worth it’, as all joy seemed to have died with the man she loved. Most of all, Linda found herself ruminatively ‘replaying’ the circumstances of Mark’s accident, the period of his hospitalisation, and her anguished decision to remove him from the ventilator following his brain death and the corrosive guilt it engendered. Swirling around each of these was a welter of haunting questions about whether she could have foreseen or prevented the accident, whether Mark realised he was dying, and whether she should have made different decisions about his treatment. More basic than any of these were the unanswerable questions, ‘Why me? Why us?’ As a religious person, Linda described her inability to discern God’s will as precipitating a spiritual crisis for her, her anger at God leading to her to withdraw from contact with a being and a faith community that no longer felt trustworthy, loving and reliable. Address for correspondence: Robert A. Neimeyer, University of Memphis, Memphis, Tennessee, USA. Email: neimeyer@memphis.edu. Readers interested in reading more about meaning-oriented research and practice are encouraged to browse the author’s web site at robertneimeyerphd.com 65 Behaviour Change Volume 33 Number 2 2016 pp. 65–79 c  The Author(s) 2016 doi 10.1017/bec.2016.4 https://doi.org/10.1017/bec.2016.4 Published online by Cambridge University Press