Continuing Bonds in Grief: What the Research Says

Sep 24

7 min read

TL;DR Continuing bonds is the idea that a relationship does not end at a death, it changes form. Dennis Klass and colleagues named it in 1996, replacing decades of advice about letting go. Thirty years on, researchers still cannot say whether holding on helps, but between 47% and 82% of bereaved people report sensing the presence of the person who died, and a 2020 review in Schizophrenia Bulletin concluded the vast majority of these experiences are benign.

Key points

Stroebe and Schut concluded in 2005 that neither continuing nor relinquishing a bond is generally helpful, and a 2023 review of 79 studies reached the same verdict.
The field's best attempt at a fix separates internalized bonds (carrying their values and voice) from externalized ones (objects, places, sensed presence). Across four samples, Black and colleagues found internalized bonds tracked better adaptation. The studies are cross-sectional, so nobody knows which way the arrow points.
A 2026 psychometric study found the main continuing bonds questionnaire fits poorly even after revision, which puts every cross-study comparison on softer ground than it looks.
Writing about grief has a small measured effect across 13 randomised trials. It is larger with more sessions and larger again when someone responds to what was written.

A woman I will call Renata came to see me a year after her mother died. Details changed, as always. She had kept the voicemail greeting, eleven seconds of her mother's voice, and she played it in the car. She was certain this was a sign she had failed to move on.

In the same conversation she mentioned that her daughter had knocked over a glass at dinner, and that she had heard herself say oh, it is only a thing, in her mother's exact cadence. She had not decided to say it. It arrived.

Those two things have the same name in the research literature, and what that literature can and cannot tell us is worth knowing if you are carrying either one.

What are continuing bonds in grief?

Continuing bonds is the term for the ongoing relationship a bereaved person has with someone who died. It covers talking to them, keeping their belongings, marking their birthday, hearing their advice in your head, and sensing their presence. The model was set out by Dennis Klass, Phyllis Silverman and Steven Nickman in 1996 and replaced an older view, descended from a reading of Freud, in which grieving well meant detaching.

The shift mattered because the older model made ordinary behaviour look like pathology. Under a detachment model, a widow who still sets out two cups is failing at grief. Under a continuing bonds model, she is doing something most bereaved people do.

Is it healthy to keep talking to someone who died?

The honest answer is that research cannot yet tell you. Margaret Stroebe and Henk Schut reviewed the evidence in Death Studies in 2005 and concluded that neither continuing nor relinquishing bonds could be described as generally helpful, calling instead for work on how and for whom each one helps. Eighteen years later, Hannah Hewson and colleagues reviewed 79 studies and reported that the literature had still been unable to confirm it.

Two systematic reviews, nearly two decades apart, reaching the same non-answer is unusual. It suggests the question itself may be wrongly posed, and that asking whether holding on is good or bad is like asking whether talking is good or bad.

What is the difference between internalized and externalized bonds?

Internalized bonds are the ones you carry inside: their values, their phrases, the sense of them as a steady presence you can consult. Externalized bonds reach outward for proximity, through belongings, places, and sensed presence. The distinction came from Nigel Field and Charles Filanosky and is the field's main attempt to explain why studies contradict each other.

In 2020 Joanne Black and colleagues tested it across four samples, covering the loss of a romantic partner, the loss of a dog or cat, and prenatal loss. Internalized bonds were associated with better adaptation, including more secure attachment to the person who died. Externalized bonds were more strongly associated with trauma symptoms.

It would be easy to read that as a verdict, and it is not one. Those studies are cross-sectional, meaning everything was measured at once. Distress may drive people toward externalized bonds rather than the other way round, or a sudden or traumatic death may produce both. Nobody has established the direction. Reaching for a sweater that still smells like someone is not evidence of anything being wrong with you.

Is it normal to sense their presence?

Yes, and it is far more common than most people assume. An interdisciplinary review led by Kirsten Kamp, published in Schizophrenia Bulletin in 2020, found that between 47% and 82% of bereaved people report sensory or quasi-sensory experiences of the person who died. A sense of presence was the most common. The authors concluded that the vast majority of these experiences are benign and should be read in the context of the person's life and relationships.

That review makes no claim about what causes those experiences, and I am not going to borrow it to make one. What I believe, from my own practice and my own faith, is that the people we love remain reachable. That is belief, and I keep it in its own paragraph on purpose. The research above stands without it, and it stands without the research.

If you would like to experience that connection for yourself, I offer evidential mediumship sessions online and in person.

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Why do researchers still disagree after thirty years?

Four reasons worth knowing, because they change how much weight any single study deserves.

The core question is unresolved. Two major reviews, in 2005 and 2023, both declined to say whether holding on helps.
The leading explanation is confounded. The internalized and externalized distinction is built almost entirely on cross-sectional data, so causal direction is unknown.
The measurement may not be sound. In 2026 Rebecca Cumben and colleagues put the Continuing Bonds Scale through confirmatory factor analysis and item response theory, removed items that performed poorly, and still reported suboptimal model fit. Their conclusion was that the field may need to reconsider how it defines and measures the construct.
The findings are not universal. A cross-national study by NaYeon Yang and Karen O'Brien, published in Death Studies on 8 September 2026, found different predictors of adjustment among grievers in the United States and South Korea. Most of this research has been done in Western samples and then described as though it applied everywhere.

One popular claim deserves a direct correction. You will often read that rituals have been shown to reduce grief. The study behind that claim has been publicly questioned by one of its own co-authors regarding reproducibility, and I would not rest anything on it. A 2021 scoping review of ritual elements in grief therapy found symptom reduction in 19 of 22 studies, but the authors note that effects were measured for whole treatments and only one study isolated the ritual itself.

What can I actually do with this?

Here is a practice built on the one place the evidence gives a directional steer, which is the internalized side. It takes several short sittings rather than one long one.

Set aside ten minutes on four or five days. Not one long session.
Each time, write about what of them is in you now. Not what you miss. What you carry.
Be specific and small. A phrase you use. A standard you hold. The way you answer the phone. What you do when someone is upset in front of you.
On the last day, read it all back and notice how much of it you did not know you had.
Tell one person what you found, or read a line of it aloud to them.

The evidence for this is real and modest, and you deserve to know its size. A 2025 meta-analysis of 13 randomised trials of expressive writing for grief found a small effect on grief, with a stronger effect when there were more sessions and stronger again when a therapist responded to the writing. A prompt at the bottom of a page is the weakest version of that design, which is why the last two steps matter more than they look.

Nothing here promises relief, a timeline, or growth. Some people find this useful and some do not.

Ready to feel that connection for yourself?

If something in this piece stirred a question about the person you are carrying, I would be honoured to sit with you. A mediumship session is a gentle, grounded space to hear from loved ones in spirit. If you are not sure where to start, a free discovery call lets us talk first, with no pressure.

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Frequently asked questions

Is it unhealthy to keep a loved one's belongings?

There is no good evidence either way. Keeping belongings is something a great many bereaved people do, and no study has shown it to be harmful or helpful on its own. Popular grief writing is more confident about this than the research supports.

Does everyone experience continuing bonds?

Not everyone, and not in the same form. Reviews find wide variation between people and between cultures, and a 2026 cross-national study found the pattern differs between countries. There is no correct version.

Should I be worried if I hear or see the person who died?

A 2020 review across multiple disciplines found these experiences in roughly half to four fifths of bereaved people and described the vast majority as benign. If an experience is frightening you, or if it comes with something else that worries you, that is worth raising with a doctor or a counsellor.

Does talking to them mean I am in denial?

Denial in the clinical sense means not accepting that the death happened. Most people who talk to someone who died know perfectly well that they died. The two are not the same thing.

How long should this last?

Nobody has established a normal timeframe for continuing bonds, and the sources that try tend to be describing custom rather than evidence.