Bereavement Reactions, Consequences, and Care (1984) / Chapter Skim
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4 Reactions to Particular Types of Bereavement
4 Reactions to Particular Types of Bereavement
Pages 71-98
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From page 71... ...
There is also discussion of the response to suicide, often regarded as one of the most difficult types of loss to sustain. Other types of particularly difficult losses, such as multiple simultaneous deaths resulting from accidents or natural disasters and deaths caused by war and terrorism, are not discussed.
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From page 72... ...
The loss of the husband may mean the loss of the family's chief income producer, imposing on the widow not only sole responsibility for managing the family's finances, but also the problem of compensating for the husband's absent contribution. The sudden need to manage finances and, perhaps, enter the labor force maY be Particularly stressful for older widows who never received training In money matters and who frequently lack practical job skills.
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From page 73... ...
Problems of social isolation may be particularly pronounced among elderly widows who frequently cannot afford social outings and who may live some distance from grown children. Failing health among the elderly may also make it difficult to engage in social activities following bereavement.
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From page 74... ...
74 / Bereavement: Reactions, Consequences, and Care
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From page 75... ...
Nevertheless, 400,000 children under the age of 25 die each year from accidents, diseases, suicide, or murder, leaving approximately 800,000 bereaved parents.~° And, as life expectancy increases, the number of elderly adults who experience the deaths of their middIe-aged children con also be expected to multiply.
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From page 76... ...
Although this forewarning could provide parents with an opportunity for anticipatory grieving, the tendency to rely heavily on denial when told of an intrauterine death commonly precludes this. Kirkley-Best and Keliner,35 in their clinical observations, have found that the emotional reaction to both types of stillbirth is similar-both are experienced as "the simultaneous birth and death of the child." By the time of a stillbirth, the subtle but powerful bonding of parents, especially of mothers, to a baby has usually progressed to a stage of "primary maternal preoccupations and a narcissistic investment has been made in the child.
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From page 77... ...
Until recent years, the intensity of the parental attachment was underestimated, resulting in stillborn babies being whisked away before being seen by the parents. Research conducted since 1970, however, indicates that visual and physical contact with the dead infant may facilitate the bereavement process.70 An increasing number of hospitals are now encouraging parents to name and spend time with the infant, and to collect memorabilia such as pictures, locks of hair, and the nursery bracelet.
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From page 78... ...
Nevertheless, many people still ignore the loss and avoid discussion of it, instigating feelings of anger in the bereaved parents.4 Other troublesome reactions include anxiety about the ability to produce a healthy child, a sense of the unjustness of a child never having had a chance, and feelings of guilt. According to the research of Benfield et al.,4 mothers blame themselves for such deaths far more than fathers do, assuming that they had done something during pregnancy to cause the death, such as smoking, drinking, having intercourse late in pregnancy, or not taking enough care of themselves.
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From page 79... ...
In an attempt to help avoid upsetting encounters between police and bereaved parents, a program in Washington, D.C. {at the Children's Hospital National Medical Center in conjunction with the District of Columbia Medical Examiner's Office)
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From page 80... ...
Describing participants in a support group for bereaved parents, Macon44 said that "bizarre" responses, regressive behavior, and suicidal thoughts were common. In a comparison of depressed psychiatric outpatients and matched community controls, CIayton~5 discovered that the death of a child in the previous six months had occurred in a surprisingly high proportion of the depressed patients, supporting her view that the "death of a child is the most significant and traumatic death of a family member." The course of the bereavement process for parents may be considerably longer and more complicated than was previously believed.
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From page 81... ...
Based on her own research and the work of others, Raphael57 concludes that, although the child will probably have left home, "the older parent who experiences the death of an adult child is likely to be deeply disturbed by it." From his clinical observations, Gorer27 has come to believe that "the most distressing and Tong-lasting of all griefs, it would seem, is that for the loss of a grown child." Gorer,27 Raphael,s7 and Levav38 all infer that untimeliness is what makes this form of bereavement so difficult. Older parents typically fee} that it is "unnatural" for a young or middle-aged adult to die while an older parent lives on, which may be a particular form of "survivor guilt.
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From page 82... ...
In relationships lacking a pattern of stable communication, help from friends, relatives, or mental health professionals may be needed to facilitate mutual understanding. Another potential complication involves the discrepancy between a parent's real feelings for his or her child and the feelings he or she believes should exist.
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From page 83... ...
In their study of life events in 2,300 persons matched for demo * This section is based on material prepared by Victoria Solsberry, M.S.W., research associate.
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From page 84... ...
In a study of 35 persons seeking treatment following the death of a parent, compared with 37 field subjects who had also lost a parent but who had not sought treatment, Horowitz et al.30 found that "the death of a parent is a serious life event that can lead to a measurable degree of symptomatic distress." Furthermore, the data suggested that the death of a mother was harder to sustain than the death of a father, possibly because of her earlier status as the nurturing caretaker.3i Another theory suggests that because in three out of four marriages the husband dies first,39 most adults lose their fathers by death before their mothers. When the second parent dies, some adults may mourn the loss of having "parents." The death of the second parent may "leave the child bereaved for the loss of the specific relationship, stripped of all living parents, and also with a reactivated mourning process for the earlier parental death."3i In contrast to these findings, several studies reported that the loss of a parent in adulthood was the least disruptive and caused the least intense grief reactions.
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From page 85... ...
Nevertheless, it is rare to find adult siblings who have completely severed ties with one another.60 Observation suggests that many sisters and brothers continue to visit each other, share memories, reunions, and responsibility for aging parents, and psychologically influence each other explicitly and implicitly, such as in the selection of marital partners.49 Despite an earlier view that sibling relationships were simply a function of and subordinate to a child's relationship to parents, researchers are now commenting on the special characteristics unique to the sibling bond.49 The empathy siblings form for one another when they are young may continue into adult life, making this tie a potentially profound one. tant.
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From page 86... ...
In an exploratory study of adult sibling relationships, Ross and Milgram60 found that shared childhood experiences and critical life events {including parental deaths) influence the level of sibling closeness in adult life.
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From page 87... ...
There also is good evidence that children whose parent committed suicide are at risk for enduring adverse consequences and for suicide itself {Chapter 5~.63 Clinical observations of suicide survivorsi2 65 reveal that they experience some reactions that are unique to this type of bereavement, as well as displaying typical bereavement reactions in exaggerated form. While the death of a close relative by any cause may leave the survivor with feelings of abandonment and rejection that may be irrational, the feeling of rejection following suicide is almost universal.
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From page 88... ...
Children, especially, who have been warned that they are "upsetting Mommy" or accused by the parent of "driving me crazy" are especially vulnerable to feelings of guilt following a suicide. In Bow~by's7 clinical experience, repeated threats often leave the survivor frightened and frustrated, finally wishing that the other person would just "go ahead and do it." Suicide also may leave survivors with feelings of rage over being abandoned, which in tandem with the sense of relief that the person's problems will no longer demand attention, can intensify survivor guilt.
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From page 89... ...
Following suicide, denial is frequently used to mask feelings of guilt, rage, relief, and shame. Resnik,s9 in a study of nine families in which an adolescent child committed suicide, found that this denial may take the form of hostility towards the medical examiner, police, or anyone who calls the death a "suicide." Denial and anger may also contribute to a tendency to idealize the deceased.
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From page 90... ...
Roman Catholics, regarding suicide as a mortal sin, used to forbid memorial mass and last sacraments for a Catholic who died in this way and insurance companies continue to deny benefits to families of people who commit suicide within two years of buying life insurance. These social stigmata compound the problems of suicide survivors.
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From page 91... ...
This allows him to provide appropriate subsequent help as the grief work progresses. In her clinical experience, silverm~n65 has found that suicide survivors are often initially wary of those who offer help.
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From page 92... ...
For example, suicide is a sudden death that should be compared with bereavement following other sudden deaths such as motor vehicle fatalities. As a "volitional" death, suicide is more similar to drinking oneself to death {c~rrhosisJ or smoking oneself to death after heart disease has been discovered than it is to deaths caused by conditions over which individuals have no control.
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From page 93... ...
DJucb attention teas been paid to responses to conuga1 beIeavenacotin adults' but tbereisIelatively UttleinfoI~astion on other types oflosses' such as the death of siblings and parents. As the average age at deatb continues to rise and as ~acdicaltechnolo ~ allows be prolongation oflivestbat previously should brave ended naturally' an increasing nu~abeI of people ~'iH brave to deal mild issues raised by eD derly and aging parents' including the tboray issues surrounding assisted suicide.
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From page 94... ...
Initial psychological response to parental death. Archives of General Psychiatry 38:316-323, 1981.
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From page 95... ...
Help for bereaved parents. Social Casework: The journal of Contemporary Social Work November: 558-565, 1979.
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From page 96... ...
and Freeman, S Correlates of enduring stress patterns following bereavement: social network, life situation, and personality.
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From page 97... ...
Bereavement During Childhood an c] Adolescence
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From page 98... ...
art a::: ::::::::::: :: ~ :::: ::::::::::::::::::::: :::::::::: . As vividly depicted" In the Kathe Ko11witz print entitled Killed in Action, children are especially vz~erabJe to psychological problems after the death of a parent or sibling.
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