Meaning-making in bereavement

I have been reading and thinking a great deal lately about suffering and the finding of meaning that seems necessary for people facing loss. Most often expressed in spiritual or even religious terms, these meanings provide the compass for people in the midst of grief or end-of-life decision-making.

Victor Frankl is widely-known for his watershed book, Man’s Search for Meaning. Surviving incarceration in a Nazi concentration camp and seeing virtually his entire family and community killed, Frankl was faced with the gigantic task of trying to make meaning of the experience. In my estimation, his experience gives  him more credibility in addressing the topics of suffering, evil and meaning-making than I could ever hope to have myself.

In the Forward to one edition of Frankl’s book, the famous psychotherapist Gordon Allport* wrote, ”To live is to suffer; to survive is to find meaning in the suffering – if there is a purpose in life at all, there must be a purpose in suffering and dying – but no-one can tell another what that purpose is” (Frankl, 1984, p. 9).  Helping clients discover meaning in their experiences with grief is one of the cutting edge issues for research and theorizing in the bereavement field these days. Anyone who has worked much with grieving people appreciates the importance of this work since meaning-making is the most compelling issue for many bereaved people and virtually every bereaved parent with whom I have worked.

In their chapter on meaning reconstruction in bereavement, Robert Neimeyer and Diana Sands (2011) write, “In the aftermath of life-altering loss, the bereaved are commonly precipitated into a search for meaning at levels that range from the practical (How did my loved one die?) through the relational (Who am I, now that I am no longer a spouse?) to the spiritual or existential (Why did God allow this to happen?). How–and whether–we engage these questions and resolve or simply stop asking them shapes how we accommodate the loss itself and who we become in light of it” (p. 11).

Neimeyer and Sands (2011) quote research indicating that the role of sense-making (which is a form of meaning-making) accounts for nearly all the difference in bereavement outcomes for people whose loved ones died traumatically as opposed to those who died by “natural causes.” They continue their analysis of the research by suggesting that for widowed people and for bereaved parents, the ability to make meaning of the loss contributes to healthy adaptation to the loss.

For those of us who work with the bereaved, the application seems clear. We must accompany our clients, congregants, patients and friends as they discover meaning in their loss. Far from “attributing meaning” or superimposing my meaning on the experiences of another, we must accompany sufferers as they find meaning.

Does this mean that I believe there is no absolute truth and that all meaning is personally-determined. No, not at all. What it does mean is that, while I can always humbly share the meaning I have discovered in this loss or others, I cannot tell another individual that my meaning should become his or hers. As a disciple of Jesus Christ, my faith makes a huge difference (I hope!) in the sense I make of suffering. When invited, I will glady and respectfully share that part of my pilgrimage in accordance with the same boundaries I share other parts of my own experiences with loss.

But as a counselor, I am wise to approach my clients as a facilitator of their growth rather than as a hawker of my understanding of truth. Asking questions about the sense currently being made of a loss, staying present in the sometimes angry protests of “this makes no sense” and quietly helping constituents find ways to make meaning in the loss are essential strategies I’ve found helpful in the counsel and support of bereaved people.

* The quote, “To live is to suffer, to survive is to find meaning in the suffering…” above has been attributed to numerous individuals including Frederich Nietzsche, Victor Frankl, and even American songwriter Roberta Flack. Though my research is far from definitive, I believe Gordon Allport originated the quote.

References.

Frankl, Viktor E. (1984). Man’s search for meaning: An introduction to logotherapy. New York: Touchstone

Neimeyer, R.A. & Sands, D.C. (2011). Meaning reconstruction in bereavement: From principles to practice. In Neimeyer, R.A., Harris, D.L., Winokuer, H.R. & Thornton, G.F. (Eds.) Grief and bereavement in contemporary society: Bridging research and practice (pp. 9-22). New York: Routledge.

“Blessings”–faith when the solution can’t be seen

This spring, I heard a song on Christian radio entitled Blessings and then learned the artist’s name is Laura Story. I’ve enjoyed the song for several months and you can see a great slide show with the music here.

But today for the first time, I heard the story behind the song. When Laura and her husband Martin had been married only about 18 months, he began to have symptoms that eventually led to a diagnosis of a brain tumor just before their second anniversary. Five years later, Martin’s healing has been remarkable–but by no means complete. He continues to struggle with memory and vision deficits.

Out of that experience, Laura wrote “Blessings.” I hope you enjoy the song–and are as moved by it–as I have been.  You can hear Laura tell their story live to the congregation of Gateway Fellowship in suburban Washington DC.

Mediated Death

“Death in the media” has become a real interest to me in recent months, so it’s with great interest that I’ve followed the debate about releasing photos of the dead Osama bin Laden. Interesting that in the midst of all my research interest in “death and media” that we have just this morning sent our daughter, Carolyn off to the state high school journalism competition at University of Texas. She’s planning to study journalism in college starting in the fall.

As I’ve been pondering all of this, I came across these two very compelling stories on–of all places–obit-mag.com (that’s Obit Magazine, an online journal of all-things death). The first is Suzanne Strepek Shea’s Wake Photographer, chronicling her start in the “business” of shooting funeral photographs in the days before your IPhone could instantly zap a photo of grandpa in his casket to (her term) “cousins in Krakow.” I’ve been pondering for some time the whole notion of “webcasted” funerals–which can be a godsend to people prohibited by geography from attending the funeral but can be a cop-out for those of us who just don’t want the inconvenience of  getting dressed and going across town to attend.  Shea’s article is here. 

The other compelling article I’ve discovered is Matt Flegenheimer’s A Mission Accomplished. Flegenheimer was a 13-year old in a Manhattan middle school on that fateful day in September 2001 when “the world changed.” Reflecting back on that experience and the re-lived trauma over the last decade, he writes an insightful and poignant essay that should remind us all that “closure” is an extraordinarily misleading term. You’ll find his article here.

The media plays an incredible role in our everyday lives. Most people derive most of what we know about death and bereavement from the images we see and the words we hear–in the media. I’m glad these two writers have contributed such insightful prose to the mix.

Reading Stiff and pondering its significance

I’m reading Mary Roach’s Stiff: The Curious Lives of Human Cadavers. Okay–it’s a quirk when you “do death for a living!” Seriously, it is a fascinating and well-research read that the good folks over at W.W. Norton sent me to review for textbook adoption in a course I’m teaching this summer at Marian University. While I won’t be requiring my students to read it, it does cause one to ponder the ethical boundaries between advancing science and medicine while still treating the dead with appropriate dignity.

Many of my colleagues suggest that, “When you’re dead, your body is just a shell.” I find this to be neither theologically nor psychologically correct. Switching off from this person being “my loved one” to “just a shell” cannot happen with such a stroke of the pen. Our cultural system of death-related rituals (like funerals, visitations, and funeral home “calling hours”)actually help us gradually bear the dead the “last mile of the way” so we can begin the arduous journey of adjusting our lives after such a significant loss.

How we do those things while allowing for the remarkable teaching that only cadavers can provide is a psychological and ethical conundrum without quick, easy answers. I’ve met few grieving people and NO grieving parents, who in the hours and days after the death could bring themselves to believe their loved one was “just a shell.”

Journalist tells “the truth” about grief–four decades too late

Ruth Davis Konisberg, an “acclaimed” journalist has written a book “exposing” professionals who work in grief and the “dubious” theories to which we apparently all subscribe. The book is entitled The Truth about Grief: The Myth of the Five Stages and the New Science of Loss (Simon & Schuster, 2011).

Konigsberg’s book would have been well-timed if it had only been published 40 years ago in the early years after the publication of what she calls Kubler-Ross’ “seminal work.” While she is right that the journalism field, of which she is well-known member, has kept the “5-stages” alive these four decades, most professionals in the bereavement caregiving field have long-since departed from the theory as anything more than a relic of history.

Even if encountering the theory in training, professional counselors like myself, learn pretty early in our careers working with bereaved people that Kubler-Ross’ model is woefully inadequate. Kubler-Ross described only emotional states (denial, anger, bargaining, depression and acceptance) and did not nearly capture the breadth of the experience of bereavement. Her theory came at a convenient time. Americans, at least, were living in a time of unprecedented technological growth. Having “neat compartments”  (ie stages) for complex concepts made for good publications, even if there was little scientific evidence then or now to support the veracity of her theory.

The news flash is that it has taken so long for the mainstream media to catch on to what we’ve all been saying! Bereavement is a multi-dimmensional and multi-determined phenomenon subject to many, many personal, cultural and spiritual factors, a fact made amply clear by most of the theories published in the first decade after Kubler-Ross’ 1969 book. Following along with most of our colleagues in counseling, the overwhelming majority of practitioners I know appreciate the incredible resiliency in the human spirit, demonstrating one possible explanation for the vast majority of bereaved people adjusting to the loss without the specialized intervention of any professional.

Since the media hasn’t listened to the practitioners of the field, at least now that a journalist has said it, perhaps the media will catch up to the current thinking in our field instead of quoting a theory that is more than four decades old!

Read Bill Hoy’s entire response to Konigsberg’s book here: http://www.griefconnect.com.

Great “Open to Hope” interviews

Two colleagues have been recently interviewed by Dr. Gloria Horsley and her daughter, Dr. Heidi Horsley. View and hear Dr. Ken Doka talk about the differences between instrumental and intuitive grief, popularized in the book Ken co-authored with Dr. Terry Martin.

Plus, my very good friend, Dr. Louis Gamino (Scott & White Healthcare System in Texas) was recently interviewed on the Open to Hope radio show. Hear this great interview now!

Have a wonderful 2011 and a safe New Year celebration!

Check out new resources at Selected Funeral Homes website

Find some of Bill Hoy’s work on the website of Selected Independent Funeral Homes . On the Families & Individuals tab, you’ll find Bill’s work in the sections The Importance of a Funeral, Coping with Loss and Cultural and Religious Funeral Customs.

I’m especially proud of the cultural section where I profile a dozen “families” from various ethnic and religious traditions, explaining a bit about how they marked the death of their loved one. You might especially be interested in some of the families who represent less well-known customs: a Lakota (Native American) family, a Hmong family and a Romanian Orthodox family. Each page includes helpful web-based resources as well as links to useful books on amazon.com.

Selected Independent Funeral Homes has taken an important step in making this information available. Their site is, by far, the most extensive collection of funeral-related information available on the web (a whole lot of which I had NOTHING to do with writing!)

I’ve known these folks for a long time; they are dedicated men and women serving in family-operated funeral service firms. Many of our colleagues in these funeral homes represent the third, fourt, and even fifth generation of their family to serve their communities. You owe it to yourself to get to know the Selected-member firm nearest you!

In with the New

As 2010 draws to a close, we’ve launched our blog to more effectively communicate with the community of caregivers we are priveleged to serve. Whether its through reading our GriefConnections newsletter (become a subscriber at www.griefconnect.com/newsletters/aspx), participating in one of more than 70 continuing education programs offered each year, or picking up a copy of one of our books, we are grateful for the opportunity to walk alongside you as you walk alongside the dying and bereaved.

I hope you’ll use the simple sign up over in the right column to keep abreast of what we’re posting (don’t worry–you’re email address won’t get sold to FingerHut!)

But more than that, I hope you’ll join in our community. Through the comments section, you can interact with other caregivers in our field–and I hope you’ll forge some new connections that way, too.

I look forward to interacting with you in 2011 and beyond!