Monday, May 23, 2011

The Five Ways We Grieve

A friend of mine stopped by late on a Saturday afternoon.  We learn together (that's code for learning Jewish stuff). It so happens she's a psychiatrist. The soft tap on the door rouses me from an out-stretched position on the floor.

"Did I wake you?" she asks, concerned. Nobody likes waking anybody.

"No, I was reading."

"I woke you, for sure."

"Seriously. I was reading." She looks at me in disbelief.

"Look. Here's the proof. I'm reading two books at once." I point to the books on the floor.

"How can you read two books at once?" she challenges me.

"I read a half-hour of one, get bored, pick up the other, read awhile, get bored, pick up the other." I thought everyone did this. One book is a novel, the other is The Five Ways We Grieve, by Susan A. Berger. For sure a summary of her Harvard dissertation research.

"I almost didn't even start this one," I tell my friend, pointing to Berger's book. "Because I hate anything that minimizes the topic to numbers like five. But her publicist sent me the book to review, so I felt obligated to at least start it. And the work is solid qualitative work, well done, and she really did find five themes, five ways that people grieve. She summarizes the literature well enough, makes sense, and teaches with examples. Who doesn't like examples?"

She agrees, lets me steer away from the topic. "Tea?" she asks.  You have to love psychiatrists.

If she had asked me for more, I would have told her that the way of grieving that we focus upon in therapy, the emotional kind, doesn't even get top billing in the book. Grieving isn't the issue so much as the way a person manages life under the influence.

There's an assumption that there will be sadness, anger, denial, guilt, maybe acceptance at some point. The five ways of grieving are ways of marching through it all.

For example, one way is to Memorialize. When I refused to give my father's things to consignment, chose to  inventory it all with Excel, put items up on Ebay, wrap and mail them myself, participate in the neighborhood yard sale ($1600 bucks!) this was a way of Memorializing my father. With every sold chackha (sounds like got'ch'kuh, or Kafka, hard ch) I could say, He invested in this.  Now she (mom) gets something out of it.

There are other ways to grieve. FD would probably Normalize, put it all in perspective. The deceased (pick any deceased) was really old and really sick and now he's out of his pain, and he would have liked those eulogies. Or:
Everyone has to dies sometime, we should really appreciate life. 
My brother and sister-in-law, who put my father's affairs in order, a monumental, ridiculously complicated task, returned life to normal. Turned chaos into sums.

Then there are those of us who can't do that, can't Normalize, who think: Death is really not normal, nothing about it is normal except that we all will die.

If anyone in my family had spare cash, or chose to raise huge sums to cure heart disease or arthritis, or any of the other illnesses that afflicted my father in his lifetime, this would be Activism, another way of grieving. Mothers Against Drunk Drivers grieve as Activists. Many moms in this club have lost a child and crusade to protect other mothers from the same affliction-- loss.

People who turn to answering the Big Questions in Life, who find that now they need meaning, understanding, spirituality, perhaps a way to explain a sudden, untimely death, are called Seekers. They turn to the holy books, consult rabbis, even people like me, for an explanation and meaning. Their previous carnations feel transparent.

And finally, when grief isn't resolved, when it shatters the psyche, sets us pathologically adrift, shatters our world view, rips our very selves from our bodies, we become vulnerable to grieving as Nomads. Losing a parent as a young child can do this to us. It's like losing such a huge piece that we can't be in the same room with everyone else because they all have their pieces and we don't. So we literally rove without seeking, rather we coast, float through the years. The ones who turn to alcohol, sex, and drugs after a loss fall into this box, this way of grieving.

Therapists see a lot of Nomads. Some call what we see unresolved grieving, others call it complicated.

Cheryl represents the classic Nomad. She lost her brother Allan in the North Tower 9-11 terrorist attack. Twenty years his senior, having parented him since his birth (I can't recall the details in the book, maybe they were orphans), the news of Allan's death hit her as if she had lost a child.

But because Allan had married Judy just the year before, authorities contacted her, not Cheryl, with tidbits of news.  Judy would be the one to hear that a bone matched Cheryl's DNA, for example. As his sister, not his wife, certainly not the mother of Allan's fatherless newborn child, Cheryl fell into the last to know about anything Allan-related category. Similarly, condolences, letters, settlements, media interviews-- all attention escaped her. Disenfranchised, this is called.

Disenfranchisement is quite common according to grief researchers. The disenfranchised are lovers, very close friends, colleagues, nieces and nephews, siblings. They are unacknowledged, sometimes even avoided after the death of a loved one. In Cheryl's case, perceived as independent, not needy, nobody visited her. No one took care of her in her grief.

This used to happen fairly regularly when sexual minority persons lost a partner. The deceased's parents called dibs on grieving and burial rights, relegating a partner to persona non gratis for lack of a marriage license.  Perhaps this is changing.

What moves me most about the topic of loss is the idea of attention. A part of grieving is wanting to isolate, to be left alone; and a part finds the loneliness, the isolation, unbearable. And there is a need to be nurtured, cared for, even fed.  A need for hands-on attention.  The Nomad, Cheryl, needed that,

Another way of grieving, not mentioned specifically in the big five, is ritual.  Ritual grieving that lasts longer than a few days, or one week.

A few weeks ago my rabbi lost his mother.  The following week, after the shiva,* he delivered a public eulogy, talked about his mother and what it was like for him to be a mourner.  He told us that during usually during shiva people visit and some bring food,  not just a Jewish thing I understand. Then the official week of sitting shiva passes and you have to follow a litany of rules (certainly a Jewish thing), mainly things you cannot do for a full year, and things you must do for a full year, like praising the One who took your loved one, three times a day.  Some of us ask someone else to go to the synagogue, to pray by proxy, to be sure it is done, the Kaddish, the prayer of praise.

And while everyone else is dancing at weddings, buying new clothes, listening to music, living, you stay home and putter around the house. It feels right, separating yourself, but you do feel alone. And that, the Rav says, is the point.

therapydoc

P.S.  This post has absolutely nothing to do with my break from blogging!  It just occurred to me that some people might think so.  

*Shiva marks the seven days following the burial of a Jewish person. During this time the children of the person who has passed away, the siblings and spouse, aren't supposed to go to work, or cook for themselves.  Rather they stay home and are comforted by visitors.

9 comments:

corti said...

Thanks, this was such an enlightening post. It's good to know that these are all healthy ways of grieving. Like you, I know people from all 5 categories, but I always thought some of them were being destructive to themselves. As a (hypothetical) "Memorialist," I view the person who "Normalizes" as being in denial, and so on across the categories who don't understand each other- but it makes more sense to me now.

Have a nice summer, I'll miss your insight.

porcini66 said...

We were supposed to have buried my father this weekend. He died in January and it's too cold to dig then, so the committal was put of until the spring. When they tried to dig, the ground was too wet from all of the rains. We don't have any idea when we will finally lay his body to rest and I'm a mess. I have been struggling mightily with trying to "label" my grief. The Kubler Ross business just didn't fit. This does. Thank you.

I'm a seeker, btw, trying desperately not to become nomadic...

therapydoc said...

See, that's one of the things I like best about ritual. In our tribe, it's get them in the ground ASAP. It does make sense, for whatever the reason. At least to me, and now you've given us some insight as to why.

Smitty said...

I've lost a close uncle a week ago, and I see the whole family helping in the grieving process. I hope to do my part for his wife, my aunt M.

I really like the idea of praising the One who took her loved one home. My uncle had always been the strong one, but his illness took that from him. He was not the man we knew and it is a blessing that he passed just days after he was taken off life support....

Tzipporah said...

And of course, if you're a mother, unless you've lost your child you're not ALLOWED to grieve, because who's going to take care of the children and their incessant needs while you break down?

Ella said...

I'm doing Bernstein's Kaddish Symphony No 3 in June, with Samuel Pisar as narrator doing his "layman's Kaddish". Complicated grief.

lynette said...

thanks, therapydoc, i am actually reading this book and the one reassuring message i am getting from it is that it is okay for my journey in grieving to be a long and thoughtful one -- it is my journey after all.

Syd said...

I was a seeker. I wanted to understand the why of my father's death and read a lot about COPD. I have become more accepting of death, although I think that I am still a seeker of answers, of something in books, rather than looking to a Higher Power for comfort.

Lorinne said...

After my Sioux grandmother died, we had a give away. In the old days the closest relatives actually gave almost all of their possessions away. My parents had the right to say no to all invitations for a year. At the end of the year we had another ceremony that invited them back into living and socializing. Then they gave gifts to everyone who came. It symbolized how happy my parents were to be back.
The ceremonies put structure around the grief and gave us all jobs to do.
We all need more rituals. They're like a trellis that allows plants to grow higher and get more sunlight.