Death, Grief, and Mourning

by John S. Stephenson

Overview

How do Americans cope with death? Do our feelings about dying influence the way we live? How are our ideas of death different from those of our ancestors?

These questions and others are addressed in this innovative new book — a comprehensive, interdisciplinary approach to the processes, practices, and experiences concerning death and dying in the United States. Drawing on sociology and psychology as well as history and literature, John S. Stephenson surveys the range of individual and social responses to death — from our very conception of its meaning to the complex ethical dilemmas surrounding suicide and euthanasia.

Stephenson synthesizes a theoretical perspective of death from the contributions of such important thinkers as Freud, Jung, Ernest Becker, and Robert Jay Lifton. He reviews the evolution of American attitudes and behaviors toward death — from the Puritan era to the present, and charts the significance of such organizations for the dying as hospitals, hospices, and nursing homes. Bereavement as both personal reaction (grief) and social convention (mourning) is also discussed, as is the denial of death as a coping mechanism for individuals and institutions alike.

In his final chapters, Stephenson analyzes the ceremonies of death (including gravestones as social indicators) and provides a psychosocial overview of suicide as a final, desperate attempt to assert control. He concludes by exploring the implications of euthanasia at a time when technology can extend life dramatically but is not always capable of assuring its quality.

Throughout, authentic case examples — many drawn from Stephenson's own clinical work — illustrate the multi-faceted imagery and experiences that comprise the American way of death.

Stephenson's book will be welcomed by sociologists, psychologists, social workers, religious leaders, nurses, and others concerned with caring for the dying and the bereaved. It is a brilliant and elegantly written work that crosses disciplinary boundaries to provide a valuable synthesis of existing knowledge and offer educators and professionals a firm foundation for teaching, practice, and research.

Product Details

ISBN-13:	9781416573562
Publisher:	Free Press
Publication date:	08/22/2007
Pages:	292
Product dimensions:	6.00(w) x 8.90(h) x 0.90(d)

About the Author

John S. Stephenson is Associate Professor of Sociology at San Diego State University and President of the Forum for Death Education and Counseling.

Read an Excerpt

From Chapter Six: Survivors of Death

Through our examination of the grief process, we have been able to develop an understanding of the psychological ramifications of death. In discussing mourning, we examined contemporary American society's response to loss, including its normative expectations of the bereaved. In this chapter we will examine yet another dimension of bereavement — its social and psychological eff ects upon categories of people: children, the widowed, the family, and people whose loved ones commit suicide.

Children as Survivors

As we have already seen, children conceive of death very differently than do adults. The image of death that a child holds is a product of his or her experiences with death, the information available about death, and his or her level of cognitive development. When a death occurs, the child may have to reconcile his or her understanding of death as an abstraction with the reality of a loss of a loved person. For example, a child may conceive of death as a state that is similar to sleeping. When the child realizes that the dead do not wake up, then death must be redefined by the child as a permanent state. When someone who was a source of need fulfillment for the child dies, not only does the child have to change his or her understanding of what death is, he or she also has to cope with the loss of a love object. "Only in childhood can death deprive an individual of so much opportunity to love and face him with so difficult a task of adaptation." The child is often handicapped by an immature reasoning ability as well as little experience in loss management. Thus, in terms of the ability to cope with the situation, the experience of the death of a significant person is generally expected to be more difficult for children than for adults.

While the child's vulnerability to trauma as a result of the death of a loved person is obvious, this does not mean that every child who experiences the loss of a family member is somehow damaged for life. There are many intervening variables which can influence the outcome of bereavement. Furman lists three factors that affect the child's ability to cope with loss: (1) the child's mental ability to deal with loss, (2) the role that the dead person played in the child's life, and (3) the circumstances surrounding the loss and the grieving process which follows.

Let us examine each of Furman's factors in more detail: The child's mental abilities include both cognitive and emotional development. On a cognitive level, it is difficult for a child who has not yet fully developed the ability to understand abstract concepts such as death to integrate the full meaning of death. Generally, the younger the child, the more difficult the process of grieving. The young child is vulnerable to the loss of loved ones, especially his or her mother. The process of childhood development can be thought of as a differentiating of self from parents. When death interrupts this process, bringing it to an early end, the child must go through the grief process in order to resolve successfully the trauma of loss. The importance of the loss cannot be underestimated, especially in the younger child. The older child is beginning to have his or her emotional needs met from diverse sources, such as peers, teachers, and extended family members. He or she is also developing a sense of mastery, or control, over the environment. But the younger child is still dependent upon parents (or parent figures) for all of his needs, both physical and emotional. Further, the younger child lacks the ability to manipulate his environment in order to find new sources of love and nurturance. For these reasons, the younger the child, the greater the potential for damage by the loss of a parent to death.

Without the ability to comprehend death fully, the child may acknowledge the parent's death, and yet still imply living attributes to the deceased. Freud described this in the grieving of a ten-year-old boy, who said, "I know Father's dead, but what I can't understand is why he doesn't come home for dinner." From a psychological perspective, the child may have been defending against the strong emotions connected with the loss. Lopez and Kliman describe a four-year-old, presented for psychological treatment because of her exceptional grief reactions following her mother's suicide, as saying, "I know about my Mommy. Don't talk about her. I get scared." Therapist Jill Miller points out that in children the grieving process has a different aim than it does in adults. While adults seek to reorganize their lives without the dead person, the child often seeks "to avoid the acceptance of the reality and emotional meaning of the death and maintain in a more internal form the relationship that has been ended in external reality." In Miller's description of the psychodynamics of children's resistance to grief work, we can see that for the child to work through the loss means to give up the internalized image of the dead person, which is, in a sense, all that the child has left.

Magical thinking, whereby the child believes his or her thoughts can influence the external world, may play an important part in the child's adaptation to loss. For example, a woman who as an infant wished that her abusive father would go away suffered from guilt into adulthood because she felt that she had somehow caused his desertion of her and her mother. Finally, and perhaps most obviously, the child who somehow either lacks enough resiliency or who has been subjected to other traumas prior to the death may have a more difficult time resolving the loss of a significant person, because past traumas have left the child with depleted emotional resources for coping with stressful events.

The role that the dead person played in the life of the child, Furman's second factor, recalls our earlier discussion of the grieving process, where it was argued that grief needs to be understood in terms of what the loss means to the survivor. A child living an existence isolated from others, with the exception of his or her nurturing mother, will most likely react more intensely to her death than will a child surrounded by many sources of love and support. Or the child may have ambivalent feelings toward the dead person, as in the case of the child and her abusive father described above. Being glad that her father was out of her life, she also felt sad for having lost him. As we saw in examining exceptional bereavement, ambivalent feelings can make the resolution of grief a more difficult process.

Finally, Furman speaks of the circumstances that surround the death as affecting the child's resolution of the loss. As we shall see when we examine the long — term effects of childhood bereavement, many factors external to the grieving child can effect the resolution of loss. Sula Wolff, in her study, Children under Stress, states that "the harmful effects of bereavement are more often due to its long — term social consequences and to the emotional reactions of the surviving parent than to the impact of the death itself upon the child. Where the grief of the surviving parent "dominates the household," the children tend to have more difficulty in accepting the loss themselves. A surviving parent's smothering and clinging to the children may make it difficult for them to reorient themselves to a world without their dead parent. Also, if the surviving parent refuses to fully accept the loss, the children may find that this hinders their own grief work. What appears to be more common is the withdrawal of the surviving parent into his or her own grief. As a result, the children feel doubly abandoned — first by the death of one parent, and then by the withdrawal of the surviving parent.

The circumstances surrounding the death itself may be an important factor in the child's coping with the loss. Accidents, which might have implicated the surviving child in some way, may be interpreted by the child as his or her fault. Younger children, with their belief in magical thinking, are particularly vulnerable to this kind of guilt. Cain, Fast, and Erickson report that often, in families where the surviving siblings were involved in the accident, there was a prohibition against discussing the accident. Whenever the surviving children attempted to talk about their involvement in the accident, the parents would interrupt with reassurances and stop the child from discussing the death any more. The authors point out that the parents either believed or had been told by professionals that to let the children discuss the event would only make it linger in their minds all the more, and the best thing to do was to discourage the children from talking about it. Also, the parents were already under great emotional stress, and might have feared that the rage at their surviving children that they were suppressing might be released by further discussion of the event. Finally, Cain, Fast, and Erickson point out that the parents sought to avoid a discussion that might implicate the surviving children in the death. The last thing that they needed at this time was to acknowledge that their terrible sorrow was caused by another whom they loved dearly.

Another facet of the circumstances surrounding the loss which may affect the child's grieving process is the economic impact of the death. Many times the death of the breadwinner can plunge the family into hard times, so that the child is forced to deal with the trauma of poverty as well as grief. The family may have to move from their home. The economic situation may force the surviving parent to leave the home in order to support the family. As a result, the child may feel an additional sense of abandonment and loss with the absence of the remaining parent.

The role of the extended family and the larger community can have an impact upon the child. Having been abandoned by one parent, there is always the possibility that the other will die as well. Knowing that there are other people who will take care of the children can be reassuring. With older children who are developing social lives of their own, the support of peers and others within the community can be positive influences as the child seeks to work his or her way through the crises.

The survivor's ability to grieve successfully over the loss of a sibling is influenced by many of the factors described earlier. The nature of the sibling relationship may lead to unique kinds of problems when the child becomes enmeshed in the process of exceptional bereavement. Guilt, often embodied in sibling rivalry and jealousy, may be a factor in the survivor's reaction to death and may block resolution of the grief. In some situations where younger children survive the death of a sibling, the parents may rebuke them for not seeming to be saddened by the loss, which may be interpreted by the children as an indication of their guilt in somehow causing the death.

Lacking the capacity to fully integrate adult images of death, the child may react to the news of the death of a significant person in his or her life with almost total nonchalance. It may take months or even years before the full impact of the loss is felt by the child. A research assistant of mine related her experiences with a neighbor's young child who matter-of-factly announced that her grandmother had recently died. She added that her mother and father had cried, but she hadn't. When asked about this, she simply replied, "My tears aren't ready yet." Unfortunately, this kind of behavior is often interpreted as a lack of caring, rather than being understood as a result of the child's lack of ability to fully understand what death is. To expect an adult response to death from a child is to demand more than the child is often capable of doing. To dismiss his or her later incessant questioning or desire to discuss death with an adult is to deprive the child of an opportunity to work through the loss that has occurred.

Another effect of sibling death may be what Krell and Rabkin call "family protective maneuvers." The vulnerability to death felt by the family is translated into overprotection of the surviving children. This may precipitate defensive gestures on the part of the surviving children, which may range from passive acceptance to rebellion against the overprotective actions of the parents.

An extreme reaction to the loss of a child may be a total suppression of any talk about the death. This silence, similar to what we saw in discussing accidental deaths, leaves the surviving child "haunted by something mysterious and uncertain, knowing and yet not knowing, and afraid to ask for clarification." The young child may surmise that even though the death was not accidental, somehow he or she is responsible for this event which is so terrible and mysterious that no one will discuss it. There is no opportunity to share his or her own fears, doubts, and grief.

Adolescence — that intense time of biological, psychological, and social change — appears to be a time when death is not a part of the person's everyday imagery. Kastenbaum points out that the adolescent lives in the present; the past (childhood), and the future (adulthood, aging, and death) are not powerful images in the mind of the adolescent. What is important is now. Entering a period of maximum biological energy, freed from the bonds of childhood, life is intense and the new freedoms and energies are all — powerful. Death becomes a romantic, distant image.

Wass, surveying 144 high school seniors, found that 39 percent reported that death was never talked about in their families, while 25 percent reported that the subject was brought up only when it was necessary, and then only for a short period. This would indicate that the adolescent is influenced not only by his or her psychobiological constitution, but also by a social environment that denies the importance of death in life.

Where the denial of death becomes great enough to prohibit open mourning, the adolescent may choose to act out his or her grief in acts against society. Shoor and Speed report studies of adolescents involved in delinquent behavior, all of whom had recently undergone the loss of a loved person, Unable to express their grief in socially acceptable ways, the young people "acted out their tears" through delinquent behaviors. Rosenblatt also raises the question as to how much of deviant behavior in our society is the product of repressed grief and mourning. Perhaps, as Rosenblatt suggests, a great deal of antisocial behavior results from the aggressive, angry feelings of repressed grief.

Copyright © 1985 by John S. Stephenson