The bereaved and the dead Everyone faces some sort of bereavement, whether of an animal, friend or relative. Bereavement is the state of surviving a significant loss, usually caused by death.
Although we do not usually plan to be bereaved, from time to time we are more acutely aware of its likelihood because of our relationships and friendships with other people who face death.
Expressions of grief vary between religions and cultures. Buddhists believe that death is an inevitable part of the many changes that occur in life, and Hindus believe death is the start of another life depending on their karma in previous ones. Jews, Muslims and Christians, however, believe that we have only one life. Accordingly, Jews and Muslims bury the body as soon as possible to show respect, while Shintos and Buddhists maintain contact with deceased ancestors by regularly offering food at family altars. Jews sit with the bereaved for a week and Muslims build up soil over graves to mark them as special.
Muslims visit graves during Id festivals and Jews burn a candle in memory of the deceased every year. Hindus and Buddhists often burn flowers with the corpse while Christians leave flowers on display as a symbol of the sweetness and brevity of life.
Within western Christian culture, religious leaders and institutions have had an important role when death occurred in order to link the dying with the living. From the Middle Ages onwards, Catholicism emphasised the significance of how people behaved on their deathbed - affirming belief, exhorting family and friends, praying and repenting - so that the bereaved had a sense that their loved ones were in a better place, and that their eternal destiny was assured because they ‘had died believing.’ This interest in how well people died endured through the Reformation and even into the nineteenth century. By this time medical expertise in assuaging the dying person’s pain had developed, and this had begun to replace the religious belief that enduring such pain reflected a spiritual state. Nowadays people move more frequently for employment, live further from their family of origin, and tend not to attend or join religious organisations, and when they are bereaved they cannot as easily talk to religious leaders, family and neighbours as in the past.
Phase models and ‘grief work’ Today the steady decline of formal religious influence and more mobile and changeable lifestyles have opened the way for newer professions, such as social work, psychiatry, psychology and counselling, to provide support. In line with this change, models and theories of loss and grief have developed.
At the beginning of the twentieth century, Freud emphasised the importance of personal attachment to objects and people, and the need for the ego to disengage slowly and painfully from those attachments. In 1944 Eric Lindemann studied the reactions of bereaved people whose family and friends were killed in a fire. He was the first to suggest that grief follows a recognisable pattern with five characteristics: somatic distress, preoccupation with thoughts and images of the deceased, guilt related to the deceased or to the death event, hostility, and disorganised behaviour. The idea that grieving was a kind of ‘work’ also developed from his suggestion that bereaved people need to accomplish certain tasks: to undo psychological and emotional attachments to the deceased, to readjust to an environment without the deceased, and to rebuild new relationships.
From the 1950s onwards John Bowlby explored attachments in both animals and humans, believing them to be instinctive and adaptive in order to provide individuals with a basis for survival and security. After watching children that had been separated from their mothers, he discerned four general phases (numbing, yearning and searching, disorganisation and despair, and reorganisation) that he believed indicated their adaptation to loss and prefigured how they would respond to other losses later in life. In the 1960s Elisabeth Kiibler-Ross talked with terminally ill people and developed a theory of five stages sof 59 May 2003 of grief (denial and isolation, anger, bargaining, depression, acceptance), which was later applied to grieving people generally. In the 1980s and early 1990s William Worden refined these phases of grief and applied his theory to practical aspects of bereavement counselling. He identified four tasks for bereaved people to work through: accepting the reality of the loss, working through the pain of grief, adjusting to an environment in which the deceased is missing and emotionally This overview reminds us that there is some sort of linear progression in bereavement since numbness and disbelief are common in the early days when the world is suddenly changed by a person’s absence, but highly unlikely a year later. Furthermore, when the world around seems to have become stable again and the pain of grief has abated, new and changed relationships may be reconsidered. eiocatine tha a A anal : SITUATION TASKS OR PHILOSOPHICAL, SPIRITUAL OR ania ———— ee PHASES RELIGIOUS RESPONSES | Recently, however, such phase models absence of numbness, unjust, meaningless & disordered world; — have come under criticism for being deceased dis-belief, denial isolated, lonely, anxious individual in that applied in much more concrete, linear and & isolation world . normative ways than was originally physical, yearning & search for deceased; search for meaning/ proposed. The significance of Kubler- psychological, searching purpose in or of life, self & the world; — Ross’s work, for example, was that it cognitive, anger & anger at God, the world, other people, explored a taboo topic, but it now seems emotional, bargaining the deceased; attempt to control self & inappropriate to apply her theory of the spiritual pain other people st” oe five stages of terminally ill people to all changed despair, depression, | punishment from God/naturellife; bereaved people, whatever their age and circumstances. Similarly, the ‘grief work’ hypothesis has come under attack for its environment disorganisation search for meaning/purpose in or of life, - self & world insistences that distress or depression is future plans inevitable, that such emotions must be reorganise life hope & uncertainty; changed plans and ideas, new choices © worked through, and that a ‘recovery’ to previous or normal functioning is beliefs relocate deceased afterlife or reunion, internalised dialogues, cosmic overview ted. baa ake other people Dimension, oscillation and hope & uncertainty, new possibilities; search for meaning/purpose in or of life, self & world a new and changed relationships biography models Many new models recognise grieving to be circular, cyclical and often reversible rather than a straight, linear process. In the 1980s St Christopher’s Hospice developed a model of simultaneous change along a number of dimensions such as emotional, social, physical, lifestyle, practical, spiritual, and identity. A decade later, Margaret Stroebe and her colleagues recognised that bereaved people oscillate between two types of coping behaviour, either undertaking loss orientation that is ‘grief work’ (yearning and ruminating for the deceased and visiting places associated with them) or avoiding ‘grief work’ and doing restoration work instead (mastering the roles and tasks of the deceased and making lifestyle adjustments). A third model emphasises the importance of continuing, rather than severing, the relationship with the deceased. Tony Walter’s biographical model (1996) emphasises the importance of talking to other bereaved people about the deceased so that a durable story, comprising multiple viewpoinis, may be built up and a new relationship with the deceased integrated into people’s daily lives. Dennis Klass et al (1996) suggest that bereaved people frequently make a place for the deceased in their daily lives, and even in their communities, whereby they are enabled to function more fully.
Philosophical, religious and spiritual responses Bereavement counsellors, perhaps unlike religious personnel, need to keep up to date with contemporary thinking while using theories and models with which they feel comfortable. Below is a synthesis of common situations, tasks or phases and possible philosophical, spiritual or religious responses that any bereaved person may think, feel or talk about. sof 59 May 2003 We search for some kind of philosophical, religious or spiritual purpose (or meaning) in life, and perhaps do more of this when grieving. This kind of search is a constant thread in our understanding of the world. There is a distinction to be made, though, between purpose (or meaning) in life and purpose of life, and this difference mainly rests upon whether or not people believe in an afterlife or immortality.
For those who have, or develop, a sense of a divine or cosmic plan and believe that all human activity has significance as part of that plan (although imperfectly understood), death and human striving have a meaning that will be best understood only after death. In this sense, death is a necessary pathway to gaining knowledge of things that cannot be fully understood here. For such people, the meaning of life is a cosmic one including this life, death, and the next (or continuing) life that follows this one. Their perception of order and purpose in nature may also reflect a need to see all of life and death as part of a divine plan.
For those who do not hold a belief in a divine plan, meaning (or purpose) in life is possible in a terrestrial, hereand-now sense. Contemporary naturalistic and secular views tend to see death as part of the process of nature, altering but not stopping the direction of its living elements in an apparently endless series of re-combinations. If nature is not regarded as personal, conscious, active or even capricious (e.g., Mother Earth), no moral meaning can be attributed to death, suffering and pain. Without a divine or overall (though hidden) purpose, individuals have the opportunity to make meaning for themselves. From this perspective, death and human striving can have a purpose which it is possible to understand while alive, and such meaning-making is often to be found in terms of happiness, relationships, love, friendship, service for others and enjoyment of the present moment. This meaning in life, which is individual, fluid and changeable over the lifespan, encourages a sense of personal identity, direction in life, and confidence in an ability to cope. Such attitudes and skills may quite reasonably be challenged or immobilised by the death of a loved one because involvement in, and commitment to, relationships is considered to be one of the highest forms of human achievement, entailing sorrow when a relationship ceases.
Having faith in the future — and believing that there will be a future — enables even those in the most appalling circumstances such as war, ghettos or concentration camps to survive. It also enables humans in more ordinary circumstances to live without anxiety about death while acknowledging that it is a certain but unknowable event for them until it happens. This faith may derive from what have been called symbolic forms of immortality which, though death is final, give a sense of connection with the future beyond our present individual lives. These forms include: having a sense of continuity through children and family; creating and influencing (teaching, writing, inventing, constructing), uniting with nature (enjoying and caring for it while alive and returning to it, reconstituted, when dead); and transcending the present moment or living it to the full (through such things as music, art, sex, physical activity).
Changing views of bereavement experiences and responses As has been suggested, philosophical, spiritual and religious issues may involve a sense of loneliness, despair, meaninglessness, responsibility and existential anxiety. As we age, each loss we encounter reminds us that we too will die, and avoidance of grief can sometimes be part of the difficulty humans have in facing their mortality. Spiritual beliefs — which of course are different from religious ones — are sometimes the only things bereaved people have left to support them and to provide meaning for a death.
Believing in an afterlife of some kind, in reunion somewhere, or in an overall cosmic justice and ultimate rightness can help in coming to terms with death.
Religion traditionally provides a value system that helps us believe we will transcend mortality by becoming part of the infinite — however it is named. When a religious tradition, group or leader cannot offer support in the way that people expect they may become angry and disillusioned. This realisation has implications for SoF members, particularly those in religious roles, since we may be unable to give bereaved people the assurance that there is a heaven, that their loved one has gone there, or that there is a divine plan governing the world.
At one time, Christian ministers and leaders might have dismissed the bereaved person’s declaration that they had seen or heard the deceased even though this is the experience was that Saint Paul seems to have had.
Nowadays, bereavement counsellors accept that such experiences are common, particularly soon after a death, and may explore how far they comfort or clarify issues for the bereaved person. Hearing or seeing the deceased, or smelling or sensing their presence may occur in the home, at certain places or times associated with them, or when the bereaved decide to ‘talk things over’ with them. Originally termed ‘hallucinations’ (a perception without objective reality), such experiences are now more frequently accepted and are described in phenomenological rather than scientific terms as sensing the presence of, or having a continued relationship with, the deceased.
In all cultures, cemeteries are common places for the living to talk to the dead, especially while cleaning the grave area or laying flowers, and in western culture in recent years the private, detached and sometimes dangerous space of car journeys has also become a favourite. In Japanese homes, by contrast, the living can talk to the dead by lighting incense or ringing a bell at the family altar where photographs are displayed and food is frequently offered.
Items that had belonged to the deceased or which are associated with her or him can also provide a link and may be deliberately sought for that reason. The handing down of possessions through legal wills not only retains such items within the family, but also reminds the bereaved of the character, values and ideals of the deceased. Nowadays, the taking of photographs at almost all social occasions ensures that images of the deceased, alone or with family and friends, can be used to remember and ‘talk to’ him or her. Another way to maintain a relationship with the deceased is by visiting a spiritualist medium. However, whilst western grief professionals focus on the bereaved, mediums are usually asked about the deceased and whether they are ‘at peace’ or ‘rest’. In this way the medium’s role is similar to the priest’s at the deathbed since both comfort the bereaved with assurances of the deceased’s spiritual state, thereby encouraging possible forgiveness and reconciliation.
Death and the world around us When we are bereaved the world may suddenly become an unsafe place because habits of living that we have come to rely on - that the deceased will be in our life - must be reviewed. Ideas about ourselves and the justness ard orderliness of the world may also need to be reaffirmed or revised. Such ideas can include beliefs about how the universe works, what our place and power is in it, how links with the deceased may be maintained, whether or not there is a God or divine power, what the meaning or purpose of or in life is, and what meaning, if any, can be found in that person’s death. Some bereaved people may find it helpful to talk to others who knew the deceased in order to share different perspectives. Some may prefer to talk to a stranger such as a bereavement counsellor in order to work through feelings and ideas or to undertake socalled grief tasks. Others may be helped by talking to a religious minister about their beliefs or to a spiritualist medium about the deceased. Whatever approach we choose, it is likely that our need for different kinds of support will continue to change as our beliefs about life and death and the ‘place’ where the dead are change also.
References Klass, D., Silverman, P. R. & Nickman, S. L. (eds) (1996) Continuing bonds: new understandings of grief Taylor & Francis Walter, T. (1996) ‘A new model of grief: bereavement and biography’ Mortality 1, 1, 7-25 Valerie Clark runs Thanatos Books, lectures for City College, Manchester and is undertaking research into counselling supervision at the University of Manchester. She successfully completed a PhD at the University of Plymouth in 1996 and part of this article is based on her thesis.