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Grieving

When a loved one suddenly and unexpectedly dies, there is no time to raise defenses. A common reaction is shocked denial: "It can't be!"

Shortly after the shooting of John Lennon, his wife, Yoko Ono, responded in the classic manner of a person confronted with sudden and unexpected death of a loved one. "Tell me it isn't true."

"Every year thousands of new widows and widowers utter such words," said Edwin Schneid­man, professor of thanatology at the University of California at Los Angeles. "Unexpected death of the beloved whether due to heart attack, assassin­ation, suicide, automobile or airplane accident catches people with their psyches down." (Dullea, 1980)

What is the common reaction to sudden and unexpected death of a loved one?

One student observed the power of denial when her father died unexpectedly:

About a year ago my father died of a heart attack. It was very unexpected as he had a positive check-up only a few days earlier...

I was in such a state of shock I couldn't cry, but my Mom really went to pieces. It was then that I realized I had to be strong to keep her going.

For a while she was 'fine' but the day of the funeral came and she just kept talking about my father being sick. Of course she was upset at the funeral–that was normal.

But for two or three months, even, she only spoke of my father as being sick. We couldn't even mention my daddy's name or the words 'heart attack' without her going to pieces.

Finally I got to the point where I was about crazy. I just sat her down and talked to her. I know I was being kind of harsh, but I had to get through to her.

I told her that all I really had left of my daddy was all the good memories that my family had shared. I needed to talk about him to keep those good memories alive.

I told her that denying the fact that he was really gone was not going to bring him back. After our talk she began to think about it. Now we can all talk about my father with fond memories. [Author's files]

What is the "conventional wisdom" about mourning?

After the initial shock, a healing process is set in motion. But it takes time. The conventional wisdom is that bereavement (grief over death) lasts about two years after death of a spouse or loved one.

One year is needed to absorb the reality of the person's death, another year to get back into normal social activities. But that is "conventional wisdom" and often does not apply to individual cases.

Not everybody reacts to the death of a loved one with spectacular emotional reactions such as depression or denial. Over half the widows and widowers studied by researcher Camille Wortman of The University of Michigan adjusted to the death of a spouse without exagger­ated grief or despair.

They grieved, but they were not obses­sive in their grief. They went on with normal life activities. They did not show denial (pretending the spouse was still alive), and they did not show signs of depression.

What did Wortman find out when she interviewed widows and widowers?

Belief systems may play a role in adjustment. A 1986 study of Mormons, who view marriage as eternal and continuing after death, found only one in five experienced severe depression in the months after a spouse died.

The classic work on stages of grief came from Erich Lindemann, a psychiatrist at Massachusetts General Hospital who studied 101 bereaved people. He wrote an article, published in 1944, titled "Symptomology and Management of Acute Grief." In this article he described a set pattern:

What was Lindemann's classic proposal?

–After an unexpected death, there is initial shock that lasts 10-14 days.

–After the initial shock comes a period of intense sadness, and the grieving person may withdraw from social contact.

–Next comes anger, as the grieving person seems to "protest" the unexpected death.

–Finally, within a year or so, the grief is resolved and the person returns to normal.

Criticisms of this scheme are much the same as criticisms of other stage theories. First, not everybody reacts the same way; actual data show wide varia­tions in responses.

Second, if doctors and counselors expect a predictable series of stages, they may become impatient or presump­tuous in their relations with grieving people. Each person is a unique case.

What are criticisms of Lindemann's scheme?

One expert on mourning, Dr. Mardi Horowitz of the University of California Medical School at San Francisco, said mourning is often incomplete, as if the surviving person is "frozen" at some point in the normal mourning process and cannot get it to pass. Horowitz believed the following stages represent a normal mourning process:

What is Mardi Horowitz's theory of grieving stages?

–Immediately after the death, survivors may experience a wish to "do something" for the sake of the dead person, which Horowitz interprets as a sign the mourner has not begun to grasp the loss. An elaborate funeral, or even a simple service held "the way he would have wanted it" often satisfies this need.

–Next, mourners may turn away from all reminders of death. "Yet the dead person may seem alive in dreams."

–The mourner may feel numb in all emotions.

–After regaining their emotional equilibrium, mourners typically engage in a review of their life with the deceased. To those without close ties to the deceased, this phase may occur immediately, and they may be full of memories of the deceased while at the funeral.

"For those most upset by the death, though, it is usually weeks or months later that the vivid memories begin to flow." At that point, sadness or intrusive memories may make it hard to concentrate on anything else.

Horowitz found that such emotional floods tend to alternate with periods of putting such feelings out of the mind. "So the mourning proceeds in manageable doses."

–Feelings of intense grief fade with time. Yet, paradoxically, the survivor may experience a persistent longing for the deceased person at the same time life seems to get back to normal. Horowitz interprets this as a last attempt at denial. "This yearning gradually yields to an emotional acceptance of death." (Goleman, 1989)

About a third of all people seeking psycho­therapy are there because they are having difficulty getting over the death of a loved one. Signs of incomplete mourning may include anxiety, depres­sion, difficulty concentrating or doing creative projects, or inability to feel pleasure.

Unexpected deaths are especially likely to leave scars. Many people lingering in one of the phases listed above for two to four years after the death.

What are typical experiences of parents to a miscarriage or the death of a newborn?

Parents of babies who die at birth, or shortly after birth, often experience profound grief reactions. Even parents who lose a child through a miscarriage (a natural abortion occurring before pregnancy is complete) may experience a full spectrum of grief reactions.

They also may encounter lack of understanding about this grief from relatives and acquaintances. Insensitive comments such as "You can always have another" do not help.

Such parents may be helped by peer counseling, which is simply meeting with a of people who have had similar experiences. Nobody can empathize with a grief-stricken parent as well as a person who has been through the same experience.

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References:

Dullea, G. (1980, December 15). When Death is Sudden. New York Times, p.B16.

Goleman, D. (1989, August 8). New studies find many myths about mourning. New York Times, p.Y17.

Wortman, C. B., & Silver, R. C. (1989). The myths of coping with loss. Journal of Consulting and Clinical Psychology, 57, 349-357.


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