E.3 Affirmation of Life

Grief and mourning are part of living. Human relationships are life sustaining, but every adult loses someone they love. That can lead to depression or to a life lived more deeply.

Grief

Grief is the powerful sorrow that an individual feels at a profound loss, especially when a loved one dies. Grief is deep and personal, an anguish that can overtake daily life.

The first thing to understand about grief is that it is a normal human emotion, even when it leads to unusual actions and thoughts. Grief is manifested in uncontrollable crying, sleeplessness, and irrational and delusional thoughts—the “magical thinking” Joan Didion described:

When a loved one dies, loneliness, denial, anger, and sorrow come in rapid waves, overtaking normal human needs—to sleep, to eat, to think. Grief usually hits hardest in the first week after death and then lingers—with much of its impact dependent on the details of mourning, soon to be discussed. But first, let us recognize that grief is not always normal (Qualls & Kasl-Godley, 2010; van der Houwen et al., 2010).

In recent times, death has become more private, and for many people less religious. Emblematic of this change are funeral trends in the United States: Whereas older generations may prefer burial after a traditional funeral, younger generations are likely to prefer a memorial service after cremation.

Cremation may seem a simpler, more rational way to deal with death, but grief is neither simple nor rational: Decisions about what to do with the ashes after cremation may be fraught with denial and controversy and thus add complexity (Cranwell, 2010). About 10 percent of all mourners experience complicated grief, a type of grief that impedes the person’s future life (Neimeyer & Jordan, 2013).

Perhaps surprisingly, one type of complication is called absent grief, when a bereaved person does not seem to grieve. This is a common first reaction, but if it continues, absent grief can trigger physical or psychological symptoms—for instance, trouble breathing or walking, sudden panic attacks, or depression. If such symptoms appear for no reason, the underlying cause might be grief that was never expressed.

Absent grief may be more common in modern society than it was earlier. The laws of some nations—China, Chile, and Spain, for example—mandate paid bereavement leave, but this is not true in the United States (Meagher, 2013). People who live and work where no one knows their personal lives have no community or recognized customs to help them grieve.

Indeed, for workers at large corporations or students in universities, grief becomes “an unwelcome intrusion (or violent intercession) into the normal efficient running of everyday life” (M. Anderson, 2001, p. 141). This leads to isolation—exactly the opposite of what bereaved people need.

Modern life also increases the incidence of disenfranchised grief, which is “not merely unnoticed, forgotten, or hidden; it is socially disallowed and unsupported” (Corr & Corr, 2013b, p. 135). For instance, many laws rule that only a current spouse or close blood relative may decide on funeral arrangements, disposal of the body, and other matters. This made sense when all adults were close to their relatives, but it may result in “gagged grief and beleaguered bereavement” when, for instance, a long-time but unmarried partner is excluded (L. Green & Grant, 2008, p. 275).

Many people are disenfranchised; they feel powerful grief but cannot express it. The deceased’s unmarried lover (of the same or other sex), a divorced spouse, young children, and close friends at work may be prevented by the family, either deliberately or through thoughtlessness or ignorance, from saying goodbye, viewing the corpse, or participating in the aftermath of death. Parents who lose a fetus or newborn may be disenfranchised by those who say, “You never knew that baby; you can have another.”

Another complication is incomplete grief. Normally grief is a process, intense at first, diminishing over time, eventually reaching closure. Customs such as viewing the dead, or throwing dirt on the grave, or scattering ashes, all move the process of grief. However, many circumstances can interfere with completion of the process.

Survivor? Two days after the typhoon Haiyan struck the Philippines, this woman mourns her husband, one of over 6,000 dead. She herself is at risk, as disease and stress will mount as she and her neighbors try and rebuild their community. That makes her much more likely to sicken and die in the coming year than in the past one.

NOEL CELIS/AFP/GETTY IMAGES

Traumatic death is always unexpected, and that makes denial, anger, and depression undercut the emotions of grief (Kauffman, 2013). Murders and suicides often trigger police investigations and reporters when mourners need to grieve instead of answering questions. An autopsy may prevent closure if the griever believes that the body will rise, or that the soul does not immediately leave the body. Inability to recover a body, as with soldiers who are missing in action or victims of a major flood or fire, may prevent grief from being expressed and thereby hinder completion.

After natural or human-caused disasters, including hurricanes and wars, incomplete grief is common because procuring the basics of life—food, shelter, and so on—takes precedence over emotional needs. One result of incomplete grief is that people die of causes not directly attributable to the trauma, becoming victims of the indifference of others and of their own diminished self-care.

Mourning

Grief splinters people into jumbled pieces, making them vulnerable. Mourning reassembles them, making them whole again and able to rejoin the larger community. To be more specific, mourning is the public and ritualistic expression of bereavement, the ceremonies and behaviors that a religion or culture prescribes to honor the dead.

Empty Boots The body of a young army corporal killed near Baghdad has been shipped home to his family in Mississippi for a funeral and burial, but his fellow soldiers in Iraq also need to express their grief. The custom is to hold an informal memorial service, placing the dead soldier’s boots, helmet, and rifle in the middle of a circle of mourners, who weep, pray, and reminisce.

AP PHOTO/JOHN MOORE

Mourning is needed because, as you just read, the grief-stricken are vulnerable not only to irrational thoughts but also to self-destructive acts. Some eat too little or drink too much, some forget caution as they drive or even as they walk across the street. Physical and mental health dips in the recently bereaved, and the rate of suicide increases. The death of a child is particularly hard on the parents, who may either distance themselves from one another or become closer. Shared mourning rituals are one way families help each other.

A large study in Sweden of those who had experienced the death of a brother or sister found that, even years later, their risk of death was higher than for other Swedes. That was true even if the siblings had not committed suicide, but if they had, their siblings were three times more likely to kill themselves than other Swedish adults of the same background (Rostila et al., 2013).

All the research shows that the mourning process is particularly needed by survivors after suicide. Survivors tend to blame themselves or feel angry at the deceased, which makes traditional mourning more difficult.

Customs are designed to help people move from grief toward reaffirmation (Harlow, 2005; Corr & Corr, 2013). For this reason, eulogies emphasize the dead person’s good qualities; people who did not personally know the deceased person attend wakes, funerals, or memorial services to comfort the survivors. If the dead person was a public figure, mourners may include thousands, even millions. They express their sorrow to one another, stare at photos, and listen to music that reminds them of the dead person, weeping as they watch funerals on television. Mourners often pledge to affirm the best of the deceased, forgetting any criticisms they might have had in the past.

Same Situation, Far Apart: Gateway to Heaven or Final Rest Many differences are obvious between a Roman Catholic burial in Mbongolwane, South Africa (left), and a Hindu cremation procession in Bali, Indonesia (right). The Africans believe the soul goes to heaven, the Indonesians believe the body returns to the elements. In both places, however, friends and neighbors gather to honor the dead and comfort their relatives.

© W DAVID LARSEN/AFRICANPICTURES.NET/THE IMAGE WORKS
SONNY TUMBELAKA/AFP/GETTY IMAGES

One function of mourning is to allow public expression of grief to channel and contain private grief. Examples include the Jewish custom of sitting Shiva at home for a week, or the three days of active sorrow among some Muslim groups, or the 10 days of ceremonies beginning at the next full moon following a Hindu death.

Memories often return to the immediate relatives and friends on the anniversary of a death, so cultures include annual rituals such as visiting a grave or lighting a candle in memory. Many people who have distanced themselves from the religious rituals of their community find solace in returning to them when a person dies (Rosenblatt, 2013).

As you have read, beliefs about death vary a great deal, and beliefs affect mourning rituals. Some religions believe in reincarnation—that a dead person is reborn and that the new life depends on the person’s character in the past life. Other religions believe that souls are judged and then sent to heaven or hell.

Mourners do whatever they think will help the deceased. Certain prayers may be repeated to ensure a good afterlife. Some religions contend that the spirits of the dead remain on earth and affect those still living; mourners who believe this typically provide food and other comforts to the dead so that their spirits will be benevolent. Some religions hold that the dead live on only in memory: The custom may be to name a baby after a dead person or to honor the dead on a particular memorial day.

The Western practice of building a memorial, dedicating a plaque, or naming a location for a dead person is antithetical to some Eastern cultures. Indeed, some Asians believe that the spirit should be allowed to leave in peace, and thus all possessions, signs, and other evidence of the dead are removed after proper prayers.

This created a cultural clash when terrorist bombs in Bali killed 38 Indonesians and 164 foreigners (mostly Australian and British). The Indonesians prayed intensely and then destroyed all reminders; the Australians raised money to build a memorial (Jonge, 2011). The Indonesian officials posed many obstacles that infuriated the Australians, and the memorial was not built. Neither group understood the deep emotions of the other.

In recent decades, many people everywhere have become less religiously devout, and mourning practices are less ritualized. Has death then become a source of despair, not hope? Maybe not. People worldwide become more spiritual when confronted with death (Lattanzi-Licht, 2013). This is true even for people who do not consider themselves religious (Heflick & Goldenberg, 2012).

Psychologists contend that human cognition naturally leads to belief in life after death (Pereira et al., 2012). Societal undermining of the expression of grief and the customs of mourning may interfere with individual and community health.

A common impulse after death is for the survivors to assess blame—for medical measures not taken, for laws not enforced, for unhealthy habits not changed. The bereaved sometimes blame the dead person, sometimes themselves, and sometimes others. In November 2011, Michael Jackson’s personal doctor, Conrad Murray, was found guilty and jailed for prescribing the drugs that led to his death. Many fans and family members cheered at the verdict; Murray was one of the few who blamed Jackson, not himself.

Life in the Balance The death of a young child is especially devastating to families. This girl is in a hospital in Bangladesh; she suffered from diarrhoeal disease, which kills more than 2,000 children a year worldwide, most of them in areas with unsafe water supplies.

© MONIRUL ALAM/DRIK/MAJORITY WORLD/THE IMAGE WORKS

For public tragedies, nations accuse one another. Blame is not rational or proportional to guilt. For instance, outrage at the assassination of Archduke Francis Ferdinand of Austria by a Serbian terrorist in 1914 provoked a conflict between Austria and Serbia—soon joined by a dozen other nations—that led to the four years and 16 million deaths of World War I.

As you remember, denial and anger appear first on Kübler-Ross’s list of reactions to dying and death; ideally, people move on to acceptance. Finding meaning may be crucial to the reaffirmation that follows grief. In some cases, this search starts with preserving memories: Displaying photographs and personal effects and telling anecdotes about the dead person are central to many memorial services.

When death occurs from a major disaster survivors often seek to honor the memory of the dead. Many people believe that Israel would not have been created without the Holocaust, or that same-sex marriage would not have been be legalized if the AIDS epidemic had not occurred.

Mourners may be helped by strangers who have experienced a similar loss. This explains groups of parents of murdered children, of mothers whose teenagers were killed by drunk drivers, of widows of firefighters who died at the World Trade Center on 9/11, of relatives of passengers who died in the same plane crash, and many more.

Mourners sometimes want strangers to know about a death. Pages of paid obituaries are found in every major newspaper, and spontaneous memorials (graffiti, murals, stuffed animals, flowers) appear in public spaces, such as at a spot on a roadside where a fatal crash occurred. This practice was once discouraged, but no longer. Authorities realize that public commemoration aids grief and mourning, building community: Public markers of bouquets and so on are dismantled only when flowers fade and time has passed (Dickinson & Hoffmann, 2010).

Organizations that are devoted to combating a particular problem (such as breast cancer or handguns) find their most dedicated donors, marchers, and advocates among people who have lost a loved one to that specific danger. When someone dies, survivors often designate a charity that is connected to the deceased. Then mourners contribute, and the death has led to some good.

Mommy’s Memorial Praying beside the ghost bike at the spot where an 18-wheeler killed cyclist Kathryn Rickson may help these two grieve and then recover. Grief is less likely to destroy survivors when markers or rituals are observed.

© ALEX MILAN TRACY/DEMOTRIX/CORBIS

Another way people find meaning in death is to gather in vigils, rallies, or protests, typically seeking some particular redress:

• When a truck killed a 9-year-old in Germany, neighbors and strangers blocked the street for days until new safeguards were installed.
• When a cyclist was killed by a car, other cyclists erected “ghost bikes” and ritualistically raised their bicycles, leading to a plethora of new bike lanes in New York City (Rulfs, 2011; Dobler, 2011).

The impulse to assign blame and seek meaning is powerful but not always constructive. Revenge may arise, leading to long-standing and often fatal feuds between one family, one gang, or one cultural, ethnic, or religious group and another. Nations go to war because some people in one nation killed some from another. Ideally, counselors, politicians, and clergy can steer grief-stricken survivors toward beneficial ends.

Diversity of Reactions

As you see, how someone deals with bereavement depends on the customs and attitudes of their community. Particulars vary. For example, mourners who keep the dead person s possessions, talk to the deceased, and frequently review memories are notably less well adjusted than other mourners 18 months after the death if they live in the United States, but they are better adjusted if they live in China (Lalande & Bonanno, 2006).

Past experiences affect bereavement. Children who lost their parents might be more distraught decades later when someone else dies. Attachment history matters (Stroebe et al., 2010). Older adults who were securely attached as children may be more likely to experience normal grief; those whose attachment was insecure-avoidant may have absent grief; and those who were insecure-resistant may become stuck, unable to find meaning in death and thus unable to reaffirm their own lives.

Reaffirmation does not mean forgetting; continuing bonds are evident years after death (Stroebe et al., 2012). Such bonds may help or hinder reaffirmation, depending on the past relationship between the individuals and on the circumstances of the death.

In Western nations hallucinations (seeing ghosts, hearing voices) are a sign of complicated grief, but ongoing memories and thoughts of the dead person as a role model are “linked to greater personal growth” (Field & Filanosky, 2009, p. 20). Often survivors write letters or talk to the deceased person, or consider events—a sunrise, a butterfly, a rainstorm—as messages of comfort.

Bereavement theory once held that mourners should grieve and then move on, realizing that the dead person is gone forever. It was thought that if this progression did not take place, pathological grief could result, with the person either not grieving enough (absent grief) or grieving too long (incomplete grief). Current research finds a much wider variety of reactions (Rubin, 2012), with continuing bonds a normal occurrence.

On the other hand, psychologists now recognize that bereavement may be a stressor that results in major depression. For example, although DSM-4 had a “bereavement exclusion,” stating that major depression could not be diagnosed within two months of the death of a loved one, DSM-5 changed that. Some people experience major depression when someone dies, and then treatment is warranted.

Practical Applications

The research suggests that many people experience powerful, complicated, and unexpected emotions when death occurs. To help the griever, a friend should listen and sympathize, never implying that the person is either too grief-stricken or not grief-stricken enough.

A bereaved person might or might not want to visit the grave, light a candle, cherish a memento, pray, or sob. Whatever the action, he or she may want to be alone or may want company. Those who have been taught to bear grief stoically may be doubly distressed if a friend advises them to cry but they cannot. Conversely, those whose cultures expect loud wailing may resent it if they are urged to hush.

Even absent grief—in which the bereaved person does none of these things—might be appropriate. So might the opposite reaction, when people want to talk again and again about their loss, gathering sympathy, ascribing blame, and finding meaning.

As you see, assumptions might be inaccurate; people’s reactions are much more varied than simple explanations of grief might suggest. One researcher cited an example of a 13-year-old girl who refused to leave home after her 17-year-old brother was shot dead going to school. The therapist was supposed to get her to go to school again.

Universal Emotions Grief is universal, as evidenced by the reaction of Petrus Vaalbooi, a leader of the Khoisan in Namibia, when his friend, Oom Kawid Kruiper died. Many Khoisan believe the spirit of the dead protect the living. Like many beliefs of people around the world, this one may give meaning to death and thus may soon comfort Petrus.

MOME DE KLERK/GETTY IMAGES

It would have been easy to assume that she was afraid of dying on the street, and to arrange for a friend to accompany her on her way to school. But careful listening revealed the real reason she stayed home: She worried that her depressed mother might kill herself if she were left alone (Crenshaw, 2013). To help the daughter, the mother had to be helped.

No matter what fears arise, what rituals are followed, or what grief entails, the result of mourning may be to give the living a deeper appreciation of themselves and others. In fact, a theme frequently sounded by those who work with the dying and the bereaved is that death leads to a greater appreciation of life, especially of the value of intimate, caring relationships.

George Vaillant is a psychiatrist who studied a group of men from the time they were Harvard students through old age. He writes this about funerals: “With tears of remembrance running down our cheeks…. Remembered love lives triumphantly today” (Vaillant, 2008, p. 133).

It is fitting to end this Epilogue, and this book, with a reminder of the creative work of living. As first described in Chapter 1, the study of human development is a science, with topics to be researched, understood, and explained. But the process of living is an art as well as a science, with strands of love and sorrow woven into each person’s unique tapestry. Death, when it leads to hope; dying, when it is accepted; and grief, when it fosters affirmation—all add meaning to birth, growth, development, and love.