Handbook of Bereavement: Theory, Research, and Intervention
“Bereavement is the objective situation of having lost someone significant; grief is the emotional response to one’s loss; and mourning denotes the actions and manner of expressing grief, which often reflect the mourning practices of one’s culture.” So start my notes from Handbook of Bereavement: Theory, Research, and Intervention. Like many of the topics that I read about, bereavement isn’t “mainstream.” However, it’s important for all of us, because we know for certain that death will call on those we love and on us one day. (See The Denial of Death and The Worm at the Core for more about our thoughts of death.) What if there were secrets to how we grieve that would make it easier, shorter, and less painful?
A Rainbow of Reactions
Reactions to the death of someone you love varies. Some people find themselves sobbing endlessly on the floor, unable to get up or even make their way to a comfortable bed or chair. Others, in somber tone, push forward through the hours, days, weeks, months, and sometimes years of grief. There’s no one way to grieve or bereave. There are ways that last shorter – and longer. There are ways that are more – and less – disruptive to life, beyond the disruption of the loss of the person.
In short, while there are many ways to be bereaved, some of them are less painful. That isn’t to say someone should try to hide or unnaturally manipulate themselves into the belief that they’re doing better than they are. Instead, there’s a desire to discover what makes it easier for people to cope with their loss. The goal is to alleviate unnecessary suffering, not stifle the natural healing process.
Stages of Grief
In addition to the well-known stage model of grief from Kubler-Ross, many others have proposed staged models of grief. (See On Death and Dying and Finding Meaning for more.) I cautioned that many people don’t read carefully enough to understand that the stages aren’t always exactly linear and aren’t experienced in the same way while reviewing The Grief Recovery Handbook. Handbook of Bereavement echoes this point, insisting that people not take any staged model too literally while exposing other scholars who have proposed staged models.
An important point raised is that, just like any trauma, most bereaved never totally resolve their grief. It changes, but it never fully goes away. (See Posttraumatic Growth for more.)
Bereavement as a Special Kind of Trauma
One can get lost in the study of bereavement and grief and get so focused on the details that they fail to appreciate that the broader study of trauma has a lot to offer. Psychological trauma is a temporarily overwhelming event – which anyone who has lost someone close to them can identify with. (See Trauma and Recovery for more on this definition.)
The broader study of trauma helps us to understand the psychological defenses of compartmentalization and dissociation. (See Traumatic Stress and Trauma Therapy and Clinical Practice for more on both.)
Relationship Changes
When someone we love dies, there are obvious relationship changes. They’re no longer physically present. However, there are also psychological relational changes. First, we tend to idealize the person. We forget about the fights and remember the good things about them. This is one of the reasons for the struggles in second marriages of widows and widowers. Their new love feels as if they can measure up. In some ways, they’re right. They’re competing with an ideal image that has been stripped of its frustrations and problems.
Second, we tend to internalize the other person – we create an internal representation of the person with whom we “consult” as though they were still physically with us. This representation of the person is not the same – but it is also a way we keep them with us even long after their death.
Saying the Wrong Thing
Many people in the community, even family members and close friends, tend to isolate the grieving person for fear of saying the wrong thing. Somehow, they don’t see that the act of isolation is the worst part of losing someone, and their movement away exacerbates the problem. (See Loneliness for more.) It’s possible that someone will say something that causes the grieving person to experience more of their grief – but that doesn’t necessarily mean it’s a bad thing. It can be that those emotions needed to be expressed.
In general, there’s not something that can be said that will make the grief worse – at least unintentionally. The fear is largely unfounded. However, that doesn’t change the behavior. It can be someone’s discomfort with grief and emotion that causes the avoidance more than their concern for the grieving.
There is one well-intentioned phrase that won’t likely cause harm – but isn’t helpful. That is, “I know exactly how you feel.” We can’t ever know “exactly” how someone else feels. What we can know is some of what someone else is feeling. The framework we recommend in our Empathetic Conversations course is the definition of empathy, which is “I understand this about you.” In other words, “I know what it was like for me to lose a spouse” is a better response, because it recognizes your limitations in understanding.
Schema of the World
In Efficiency in Learning, we were introduced to an explanation for how we can operate in a complex world with such limited brains. The schemas that we build about the world and its parts allow us to simplify things, so we don’t have to consider all the details all at once. Learning these schemas allows us to be effective in a world that’s too complex for us to really understand everything. (See Focused, Fast, and Flexible.) Gary Klein in Sources of Power explains that these mental models allow us to make better decisions – his recognition primed decisions. When we lose someone, our schemas of the world must change to accommodate the new conditions – and this can be a difficult and overwhelming process.
In my review of The Body Keeps the Score, I discussed trauma in the context of a temporarily overwhelming event and how this shuts down our ability to process the event. (See also Opening Up, In an Unspoken Voice, and Trauma Treatment.) I also connected it to the fact that our sense of consciousness is fundamentally a prediction engine designed to keep us safe. (See Mindreading.) By predicting what will happen, we can avoid bad circumstances and live longer. (See The Selfish Gene, The Evolution of Cooperation, and SuperCooperators for how evolution might have developed consciousness as a protective factor.)
Magical Properties
Sometimes bereavement has an added challenge of shame or guilt. A child who was angry at a parent shortly before their death may believe that their anger resulted in their parent’s death. Similarly, a child who had misbehaved may view the parent’s death as a punishment for their misdeeds. One of Erik Erikson’s stages of development is intuitive vs. guilt and involves magical thinking. (See Childhood and Society.) However, adults can have various forms of magical thinking related to death.
Certainly, there are desires for the person who has died to come back, even if adults know that isn’t possible.
Constructive Thinking Inventory
Constructive thinking is defined as the ability to solve problems in living at a minimal cost in stress. In other words, it is the ability to live with minimal stress. The Constructive Thinking Inventory focuses on areas of emotional coping, behavioral coping, categorical thinking, superstitious thinking, naïve optimism, and negative thinking. Taken as a whole package, this inventory touches on many of the key factors that lead to the kind of destructive thought spirals that were discussed in Capture.
Many of the things measured are also directly addressed by works today. Negative thinking is squarely tackled by Hardwiring Happiness. Naïve optimism is addressed by Bright-sided. Emotional coping is addressed by many works, including Happiness.
Grief Work
The stark statement is, “Our results did not unequivocally support the grief work hypothesis. Widows who avoided confronting their loss did not differ in their depressive or somatic symptomatology from widows who worked through their grief.” However, it can be that the construct for grief work isn’t right. The authors aren’t clear what “grief work” means in this context. It could mean forced processing before the person is ready – which would obviously not be helpful. It could be expected (but not forced) work – which is also not helpful. Grief work, done properly, goes at the pace of the grieving person. They’re exposed to the right amount of re-exposure, awareness, and work to match their capacity.
The follow up is that those who overly distract from or overly control emotions don’t have as good of an adjustment as those who were less controlled.
The Walking Dead
Some bereaved describe themselves as the walking dead. The idea is that they’re hollow or have died inside due to the psychological trauma of losing someone. They feel as if their spark and life is gone. (See Acedia & Me and The Noonday Demon for more on depression.)
There’s no one “cure” for this condition. There will be some improvement as time passes, but it’s definitely a concern and one of the reasons why suicide is so high following the death of a loved one. Loss and pain are expected, but permanent damage should not be.
Death of a Way of Life
Sometimes, it’s not just the loss of the person or person’s that you’re reeling from. Sometimes, the issues are deeper. Not only is there the loss to contend with, but often it changes the entire way of life. A father dies, and the mother needs to take a job outside the house – or the new finances drive changes in what the family can do. Sometimes, the loss of parents means a move.
In the case of spouses, it changes status from married to widow or widower. For children losing their parents, they’re permanently connected to the label of orphan. We can’t untangle the trauma of dealing with the loss and the trauma of having your life upended – nor should we try.
Autonomous Identity
What we must disentangle is our identity as it relates to the other person. Losing a spouse means moving from couple to individual again. Ultimately, we need to decide who we are now that the death has occurred. We can’t go back to our old ways or identity. Parents and grandparents, spouses and siblings, even children and grandchildren may die before us, starting the bereavement process. Unlike life, luckily there’s a Handbook of Bereavement.