Daily Excerpt: Harnessing the Power of Grief (Potter) - Grief in Modern Times
Excerpt from Harnessing the Power of Grief (Potter):
Grief in Modern Times
“Are
we perhaps simply formalizing and making applicable to urban life a procedure
that would naturally be followed in rural and more closely knit communities?” —Phyllis
Silverman studied widowed and children’s grief and the benefits of mutual
support [Silverman][1]
Where we are today
Western culture gives limited
attention and support to those who are grieving. After a few weeks of grieving,
our action-oriented culture thinks (and hopes) you are okay and wants you to
return to normal. Some may seem uncomfortable in speaking with you. You may
sense that people are avoiding you or avoiding the topic of your loss in
conversation. The level of discomfort may increase with the severity of the
loss, e.g., a homicide, a suicide, the death of a child, or a sudden death.
People may also underestimate the effect on you of other kinds of losses:
divorce, relocation, or retirement, and sooner than not, may lightheartedly
say, “Congratulations!”
Public acknowledgement of death
focuses on the funeral arrangements, including the funeral home viewing and
service and perhaps an additional memorial service. Employers may give 2-5 days
for bereavement leave. At a time, when most vulnerable, the survivor faces
additional time-consuming and stressful responsibilities beyond the funeral
itself: notifying family and friends; administrative responsibilities, such as
providing death certificates to businesses, insurance companies and financial
institutions; dealing with the will and the estate; and facing the reality that
there may be fewer financial resources available to live on.
Death is private.
In many cultures, including
ours in the West, death is a private event. Notwithstanding sudden or traumatic
death when death can occur anywhere, anytime, people generally die at home or
in a health care setting.
If one’s final hour is in a
hospital, one may be moved to a private room for privacy considerations of the
patient and family. Removing the body from the room upon death is carried out surreptitiously
so as not to disturb others. The body will be covered, and by the way the cloth
is draped, it will not be recognizable as a body. Death is invisible in the
hospital.
Death is a medical event.
If one dies in a medical
facility, the medical professionals oversee the care: monitoring vital signs,
giving treatments, recording the time of death, and noting the medical cause of
death. Sometimes, things happen so quickly in an emergency that your permission
for treatment will be solicited with little or no time for discussion or for
your input. If you would like to refuse further treatment for yourself or for
your loved one, your wishes hopefully will be honored but not before the
doctors and you discuss the implications of your decision. If they don’t agree
with you, you may need to sign a form stating that your actions are “Against
Medical Advice.”
Even if your loved one dies at
home, medical professionals become involved. You might dial 911 for assistance.
If the death is expected, your first phone call will be to the doctor or to a
medical agency overseeing the care such as a home health agency or hospice.
After notifying the medical world, you would call family, your religious
organization, and the funeral home. You might first call family or friends, but
that would be to get advice. “This is what has happened. What should I do now?
Who should I call?”
After the death, those in the
medical profession necessarily move on to the next person’s life to save,
enhance, and treat. You have left the medical community and the team of
doctors, nurses and various therapists who had been there by your side. You may
receive condolence cards from them. They may even attend the funeral. After that,
you may not hear from them again, and if you do, they may not have the time or
inclination to talk with you about your loss. Many grieving people experience this
as an additional loss.
Everyone does not know your loss because you belong
to many separate communities.
In the city or town where you
live, there may be many sub-communities and social networks. Those you work
with may not know your family and friends. If you work for a big company, you
may only know your department. Your neighbors may be different from your
friends. You may have several friends or groups of friends who do not know one
another. There may not be one overall umbrella community where you are known by
everyone and where everyone knows and cares about you.
In our-present day Western
culture, we do not have a ritual or a protocol that says to all the communities
of which we are members, “I am grieving.” You may look okay, but inside that
may not be the case. This is one reason why people may feel alone and powerless
in their grief.
Death is invisible for many years for a large
segment of the population.
To survive to old age is common
in modern society. You may not attend funerals regularly before the age of
sixty. As a grieving person, you may be new to grief. Because others may also
have little experience with grief and how to help a bereaved person, they may
be uncomfortable around you, not knowing what to say or how to act. This may be
less true in communities where racism, joblessness, violence, drugs, and
poverty take too many lives, both young and old.
How
we got here
From America’s rural past in the 19th and
early 20th centuries to the present, we have experienced sweeping
changes in how we live, die, and grieve.
Grief
in the 19th and early 20th centuries
Alan C. Swedlund, an anthropologist, studied village
illness and death in Massachusetts in the 18th, 19th, and
20th centuries. Although his studies covered a small area, his
insights appear to apply to the U.S. culture in general.
Prior to the 1850s, death was
experienced as an event with family and close friends nearby. Death was
private. Into the early 20th century, many illnesses were fatal, and
their victims were primarily babies, children, and young adults. Scarlet fever,
tuberculosis, whooping cough, diphtheria, typhoid fever, the flu, childbed
fever, and pneumonia were common diagnoses. “Whereas each year in
Massachusetts thousands of children died of infectious diseases, the numbers
for those over sixty were in the hundreds.” [Swedlund][2]
There was little that could be
done, except to make a diagnosis, help patients to be comfortable, and hope for
the best. Doctors were scarce, and their methods were more folk medicine than science. My
father, who grew up in a small town in New Hampshire during the early part of
the 20th century, told me that when he was growing up, he would see
young boys about his age sitting on their front porches, looking ill and tired.
He knew that they were going to die of tuberculosis, the deadly disease of that
time. We can be sure this was a sobering, frightening, and common occurrence.
Death was a real and present possibility for most people.
Not that long ago, conditions
that we see as serious but not necessarily life-threatening, such as compound
fractures, could easily have resulted in an amputation and possibly death. The
serious illnesses of today, cancer for one, were not experienced as often in
the past probably because many people did not survive long enough to get them.
The medicalization of death
Little by little, with the
advancement of medical knowledge, realistic hope for cures and for a long and
productive life increased. The days of providing folk remedies and comfort care
gave way to life-saving drugs and surgeries. Antibiotics, immunizations, and
improved hygiene wiped out many lethal diseases. Children had a much greater
chance to become adults. Young mothers and their babies could survive
childbirth. Young adults could survive to old age.
Prior to 1850, artistic
renderings of a person’s final hour would include the minister. In later art,
it was the doctor who was at the bedside. [Swedlund][3]
The medicalization of death had begun. Death became the intruder, a necessary
evil to be forestalled and avoided, and at worst, a failure of medicine.
To look at grief today, we need
to look at medicine. Medicine has removed the specter of death from daily life.
No wonder we don’t know how to act when someone dies. Medicine can even make us
feel ashamed to die. One may refer to a loved one’s death in this way: “He gave
up the fight.” There is a subtle undercurrent: “It is his fault that he died.”
“If he hadn’t given up, maybe he would still be here today.” “Maybe he
shouldn’t have given up.” “I wish I had done more to encourage him to keep
fighting.” The recognition that there is a natural progression of life from
birth to death has become a thing of the past.
Movement from the country to the city
At the same time medicine was
working miracles and changing society’s view of death, people were also
migrating to cities in search of new lives and jobs. They left behind farm and
village life where everyone knew each other.
A loss experienced in a village
would be felt by all. If your loss was a death, everyone would know the person
who died and would sympathize with you because they would have lost that person,
too. Your loss affected the whole community. You may not have been on friendly
terms with everyone, but everyone would know your loss. The loss could also be
a house or barn burning down, loss of livestock, or a bad growing season that
affected everyone’s crops.
With migration to the city, a
person left his community—an umbrella of safety and common knowledge—and became
a member of multiple communities. Daily interactions now occurred with
strangers—shopping, car upkeep, banking, dining, to name a few. Your loss would
not be known by everyone.
What
other cultures can teach us
Proximity to other cultures offers opportunities to adopt
much of their wisdom into our own culture. Paul C. Rosenblatt, a psychologist,
tells us that cultures are not static. They are in a state of change (some more
than others) with many individual differences. [Rosenblatt][4] A Buddhist, a
Jewish person, an African American, a Protestant, will grieve in the unique
ways of their cultures. Variations exist among subgroups (based on lifestyle
and income, religious variations within and between denominations),
intermarriage, and cross-cultural influences. Consequently, we all are bumping
into one another, learning from one another, loving one another, reading about
one another, and interacting with one another.
Funerals and memorial services in Western culture tend to
stand alone, like shooting stars in the night. They may be memorable and
beautiful, but then we are left with the rest of the night. In some cultures,
funeral rites are part of the whole day of life: the setting sun, the coming of
night, the dawn, and the new day. Here are some examples of what we can learn
from other cultures.
Death
is not a failure.
Many cultures do not see death as a failure or an
aberration. Rather, death is regarded as a part of life to be experienced by
everyone. Loss does not end at the occurrence of death and the funeral. The
experience of the loss continues and changes in healthful and even joyful ways
throughout one’s life.
The Mexican holiday DÃa de los Muertos, Day of the Dead, is celebrated in the U.S. and other countries in Latin America. Everyone remembers the deceased in a festive way, with meals, social gatherings, church altars with pictures and mementos associated with the deceased, and processions to the cemetery. The activities and foods that are prepared are ones that the deceased enjoyed in their lifetime. “On DÃa de los Muertos, the dead are also a part of the community, awakened from their eternal sleep to share celebrations with their loved ones.” [National Geographic][5] This holiday is not a somber remembrance. Rather, it serves to unite everyone in the important universal life experience of death. The dead are not forgotten. The survivors are not alone in their grief and remembrance. Everyone experiences loss;- this is part of the life experience. The whole community remembers the universality of death in a joyful two-day celebration.
Remembering
is important.
The revered Buddhist Monk Thich Nath Hanh describes a
Vietnamese tradition: “In Vietnam we have a tradition of worshipping our
ancestors. Every family has an altar in their home. Every day people offer a
stick of incense to their ancestors to help connect to their heritage. It only
takes a minute….” [Thich Nath Hanh][6]
This daily ritual connects the present with the past and even points to the
future. If you would like to practice this ritual, you do not have to have an
altar, per se, but maybe a shelf in your home with pictures or memorabilia of
your deceased loved ones. Simply bow to your loved ones and ancestors or ring a
bell in reverence and appreciation. You can ask for a blessing for your day or a
special event or a journey. When day is done, or when you return from your
journey, again you can bow in reverence to your loved ones.
Those who are dear to us do not leave us. Their lives are
a part of us. By honoring their memory and subtle presence in the form of
pictures and memorabilia, dreams, and shared stories, we feel protected and
guided. Cultures that honor the dead help the community to honor this bond. These
remembrance rituals help us not to feel so alone in our grief and remind us
that those who have died have a place in our hearts and in our life’s journey.
Many Vietnamese people take pictures at funerals and
wakes to remember the deceased. Li Nguyen, blog author of “Stories, Thoughts, Reviews
and Whatnots,” said, “To Americans, talking about death is taboo, but to my
family, it’s connecting a duality. Death is just as much a part of life as is
the reverse, a delicate interwoven tapestry. There is a balance as fine as a
silk thread that has long been revered by us. When we take pictures of funerals
or wakes, it’s not to be macabre but more like a quiet reverence. The pictures
show (that) the deceased was just as important in death as when they were
alive. When we are older and our memories begin to fail, we are comforted
knowing that we have our pictures to show us the full panoramic view of our
loved one’s life.” [Nguyen][7]
Community
participation is required.
Hosea L. Perry, in his studies of African American
funeral customs, found that African Americans typically encourage everyone to
attend the funeral. Whether you are an immediate member of the family, a
distant relative or friend, a colleague, a neighbor, or simply an acquaintance,
your presence is required. It is a social obligation. [Perry][8]
In the Mexican American community, attendance by all is encouraged, too. How
many times have we heard someone say, “I didn’t know the person well, so I did
not go to the funeral?”
When my brother died, two of my close friends attended
the funeral. They did not know my family or my brother, but they did know me.
Their attendance meant so much to me. At a time when I felt bereft, there they
were. They connected me to the love beyond my family and beyond the grief we
were feeling. I will always remember their kindness and their presence.
Judaism has the custom of Sitting Shiva. Shiva means
seven. For seven days following a death, people visit, bring food, reminisce,
and comfort the survivors.
The
mourner’s participation is required.
Some cultures have rituals and behaviors that are meant
to help the deceased on his way to the afterlife or next life. Survivors are
not lonely, powerless witnesses. They have a role to play. The secondary
benefits of these behaviors are that they help the survivor and they help the
community. The survivor may feel distraught, in shock, and alone, yet there is
something that she can do to meaningfully participate in the loss. The mourner
has a place in the death, and a place in the communal grieving process. [Goss
and Klass][9]
In New Orleans, the Jazz Funeral includes a walking funeral procession to mourn
and celebrate the deceased person’s life with music—at first solemn, but then
joyful and lively.
In our modern culture, you may not be able to duplicate
elaborate and meaningful grief rituals. However you can create rituals that
involve others in your loss, e.g., a meal celebrating your loved one’s
birthday; having informal remembrance events after the funeral such as enjoying
an activity together that was special to the deceased; displaying photos of
your loved one; going to the cemetery with family and friends; creating a
memorial in honor of your loved one (roadside memorials commemorating a loved one
who died in a car crash are now familiar to us); planning religious memorial
events in addition to the funeral, creating a photo album or memory journal, and
reminiscing with others.
How
our culture is changing
Now that we have explored why grief can be lonely in
Western culture and what we can learn from other cultures, let’s look at the positive
side of Western culture.
Our modern culture is in a state of change, exploration,
and the study of new ideas. In 1969 Elisabeth Kübler-Ross’s book On Death and Dying opened the eyes of
the public to the subjects of death and dying. Then a year before her death in
2004, she and David Kessler explored the grief process in On Grief and Grieving.
In 1961, Granger Westberg, a chaplain and minister at the
University of Chicago Divinity School and Medical School, was asked to give a
sermon on grief at the Rockefeller Chapel, where many notable people had given
sermons and lectures. His sermon was broadcast on the radio, and afterwards, a
thousand positive letters came in. This was a record; usually the response from
the public was about ten letters. Westberg thought that his preaching was
working. So, the next time he was invited to preach, he gave a sermon on a
different topic. This time, only a few letters came in. He then realized the
importance of the topic of grief and how people were hungry for knowledge, for
help, and for hope. He published his well-received sermon in a book titled Good Grief [Westberg][10]
that is still in print today.
Our culture is youth-oriented. There is a good side to
this: the desire to learn, to try new things, to meet new people, to live in
the moment, to grow and change. No matter our age, we all have the capacity to
reach out and connect with different people and to create bonds with people
beyond our comfort zone.
We
have roots, but we want rootedness.
We have cultural roots, but we may lack cultural
rootedness, the rootedness that assures us that we belong, that we will make
it, and that our actions are important and contribute to collective love and
healing. We may feel lonely in a fast-moving culture. The feeling of loneliness
diminishes our power. Hence, we reach out to one another, sometimes to complete
strangers—people our ancestors would not have known or communicated with—to establish
roots of love in the modern world. Like our ancestors, but without the
encouragement of a supportive culture, we ask: Who am I? Why am I here? What is
love? Will I survive? Will I be happy? What is life’s meaning? Reaching out to
others gives us new roots and enhances our sense of belonging.
In the 1960’s, support groups were rare. “I don’t need
therapy.” “People will think I am crazy if I join a group.” These were typical
responses to the suggestion to join a support group. Support groups are therapeutic,
but they are not therapy. As communities became more fragmented, support groups
became more accepted. You can now find support groups for just about everything,
including grief. Members can meet in person and chat online, too. Support
groups bring together total strangers who have an immediate bond based on a
pivotal event in their lives. Frequently friendships evolve, and a new
community is created.
We
are creating a community of caring knowledge.
Elisabeth Kübler-Ross worked to bring death into our public
consciousness. As a result, the medical profession has become less secretive and
now discloses more information to the patient and family. Kübler-Ross was
instrumental in starting the hospice movement in this country, where those who
are dying receive comfort care and the cessation of active treatment for
diseases in which the prognosis is six months or less. Her work began to change
how we view illness, death, and grief.
Since then, medical diagnoses such as cancer, Alzheimer’s
disease, alcoholism, AIDS—diseases that in the not so distant past were
shrouded in silence, misinformation, and frequently, shame—have become visible
to the public and are openly discussed. Groups now champion medical causes.
Notably, the Susan Komen Race for the Cure champions research for a cure for
breast cancer, and champions those who are living with cancer.
In his book, Being
Mortal, surgeon and author Atul Gawande, MD,[11] says,
“Medical professionals concentrate on repair of health, not sustenance of the
soul.” He warns that encouraging and even pressuring the patient to do all that
is medically possible may compromise the patient’s quality of life and the
lives of family members, too. Treating an illness includes enhancing the
patient’s psychological and social well-being and taking into consideration his
wishes and goals. The doctor and the patient can work together in a
collaborative way.
While Kübler-Ross was studying death, Phyllis Silverman[12]
was studying spousal grief. She asked widows if six weeks—the common belief at
that time—was how long it took them to overcome their grief. The emphatic
answer was No! Two years, if you were lucky, was the overwhelming response.
What helped the widowed person the most? Counsellors? Therapists? No. Other
widowed people, because they understood the experience. She helped to start a
widow-to-widow group where trained widowed volunteers helped newly widowed
people, in one-on-one settings, support groups, social gatherings, and
educational events. Her pioneering work brought individual grief into the open.
Grief is not something to be glossed over and forgotten, a short, dreaded
experience. It is part of the human experience, and we, as friends, neighbors,
and colleagues, can help one another when it happens.
These three phenomena—removing the secrecy and shame
about death, honoring grief as an important universal experience, and the
ongoing change from authoritarian to collaborative medicine—continue to evolve
and help bring us together.
Presently, there is a growing body of information on
grief. Let’s call it a community of knowledge. For years, authors wrote about
the many different stages of grief. Although some researchers still see merit
in the stage model of grief, many are moving away from it. Bereavement therapy
was honored as the best way to help people. Today, studies reveal that grief
therapy does not always help the normal griever and may be harmful.
Consequently, many therapists are revising their methods to primarily help only
those whose grief is intractable and never-ending. Grief is a natural part of
life. The number of years for one’s grief to finish? Two years? Not necessarily.
It can be a short period of time or a long one. Since the 1960’s, many people
have added to the field of grief and to our understanding. Many have devoted
their lives to the study of grief. Some tell their own grief stories to help
themselves and others.
This complex discussion may seem overwhelming. Juan
Enriquez, businessperson and author, says, “…when you think of how much data is
coming into our brains, we are trying to take in as much data in a day as
people used to take in in a lifetime.” [Enriquez][13] Rather than
be overwhelmed, listen to your inner heart. Deep inside, you know what will
help you, what resonates with your inner spirit. This will be different for
each person and true for each person.
Chapter
Summary
In the 19th and early 20th
centuries, people lived in communities where everyone was known. Your loss was
known by all. Death was common among all ages, particularly among young people.
The doctor might have been able to diagnose your problem but could seldom
provide a cure.
In the early 20th century, dramatic advances
in medicine helped people to survive to adulthood and old age. Death became
much less common among younger people. At the same time, the migration to urban
areas improved job opportunities and led to the creation of many sub-communities.
No longer would everyone know when you had experienced a loss. With lower early
mortality rates, many people did not necessarily know how to be of help to
someone who was grieving.
We can learn from other cultures. Death is not a failure
or endpoint but a natural part of life. Many cultures include the bereaved in
funeral, burial, and memorial rituals. Their participation helps the soul on its
journey and unites the community around the loss. Survivors are not just
witnesses. Instead, they have a significant role to play in the funeral and
other remembrance services. Remembering the deceased on a regular basis is a
way to link us with those who have died, e.g., annual celebrations of the
deceased, and ancestor worship.
Our culture is changing, too. In the 1960’s we began to
accept that illness, death, and grief are a natural part of life. Doctors began
to share more information and options with patients and families. People began
to see that grief is important and can last longer than six weeks. This slow
and important journey of change continues to this day.
Many professionals and grieving people alike are creating
a different kind of community – a community of caring knowledge.
[1] Silverman, Phyllis Rolfe, “The
Widow to Widow Program: An experiment in preventive intervention”, Mental Hygiene, vol. 53, no. 3, 1969,
337.
[2] Swedlund, Alan C., Shadows in the Valley a cultural history of
illness, death, and loss in New England, 1840 – 1916, (University of
Massachusetts Press, Amherst and Boston, 2010), 126.
[3] Swedlund, Alan C., Shadows in the Valley a cultural history of
illness, death, and loss in New England, 1840 – 1916, (University of
Massachusetts Press, Amherst and Boston, 2010), 174.
[4] Rosenblatt, Paul C. “Grief Across
Cultures: A Review and Research Agenda”, 207-222 in Stroebe, Margaret, Robert O.
Hansson, Henk Schut and Wolfgang Stroebe, eds, Handbook on Bereavement Research and Practice, (American
Psychological Association, Washington, DC, 2008), 208.
[5] Dia de los
Muertos http://education.nationalgeographic.com/media/dia-de-los-muertos/
[6] Thich Nhat Han – Thich Nhat Han
Dharma Talks, Monthly Archives, Ancestors Archives, February 11, 2014, http://tnhaudio.org/
[7] Nguyen, Li, “Life and Death the
Vietnamese Way”, September 18, 2009, http://www.aslantedview.com/life-and-death-the-vietnamese-way/
[8] Perry, Hosea L., “Mourning and
Funeral Customs of African Americans,” 51-64, in Ethnic Variations in dying, death and grief: diversity in universality,
Irish, Donald P., Kathleen F. Lundquist, and Vivian J. Nelson, eds (Taylor
Francis, Philadelphia, PA, 1993), 63.
[9] Goss, Robert E. and Dennis Klass,
“Tibetan Buddhism and the Resolution of Grief: The Bardo-Thodol for the Dying and the Grieving,” (Death Studies, vol.
21, no 4, 1997, 377-395) 393.
[10] Westberg, Granger, Good Grief, 50th anniversary
edition, (Fortress Press, Minn., MN, 2011), 61.
[11] Gawande, Atul, Being Mortal, (Metropolitan Books, Henry
Holt and Co., 2014), 128.
[12] Silverman, Phyllis, Widow to Widow – How the Bereaved Help One
Another (Brunner Routledge, NY, 2004), 11.
[13] Enriquez, Juan, “Are We Evolving
into a Different Species?” from TED Radio Hour, “How It All Began”, October 9,
2015, npr.org. www.npr.org/programs/ted-radio-hour/357837221/how-it-all-began
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