Accommodating Loss

Article excerpt

In "Good Grief," an article in The New-Yorker on Feb. 1, author Meghan O'Rourke detailed the history of changes in mourning over the last century or so and offered explanations for the shift from public recognition of death to a more private form of mourning. Death is less a part of our lives, she implied. For example, seldom do multiple generations live together anymore. And death has been removed from the home to the sterile confines of the hospital, while funeral parlors now take care of the body. Death has become an unknown, thus, something to fear; acknowledging it or demonstrating distress over it adds to our discomfort. O'Rourke also noted conspicuous exceptions of current privatized mourning by citing deaths of celebrities (e.g., Princess Diana of Wales and Michael Jackson) whose passing occasioned widespread public involvement.

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I concur with her about the movement toward the privatization of grief. I'd add that this is an unfortunate development. As a licensed professional counselor, I believe that in our desire to keep grief private, we have (especially in Western culture) unwittingly created a population ignorant of the variety of ways people grieve loss.

That ignorance leads to experiences in which the individual dealing with a loss suffers secondary distress because the intensity of grief is seen not as "normal," but as prima facie evidence that there must be something "wrong" with the sufferer. And that's usually not true. In my clinical work, I have observed that loss is a necessary and intimate part of living and must be accommodated. (My field tries to avoid the word "recovery" because it implies a return to an original state, and in loss, that rarely happens.) However, for most people, understanding loss and how to accommodate it is not a process which with they are familiar. The subtitle of O'Rourke's piece is, "Is There a Better Way to Grieve?" The answer is yes.

Interpreting loss

Loss can be conceptualized in a variety of ways. Tangible losses are those we can see: death of a loved one; downsizing of a job; ashes of a burned building; physical deterioration of aging; the move of adult offspring away from their childhood home. Intangible losses are psychosocial and involve no visible manifestation: loss of expectations of a happy marriage in divorce; parental disappointment in a child's poor choices; the realization that one has advanced in one's career as far as possible.

The paradox of loss is that it has neither positive nor negative valence, even though we tend to inflect it one way or the other. Rather, loss is a necessary and, if you think about it, neutral concomitant to change in one's life. For example, for a couple to marry, both parties must relinquish their current status and perception of themselves as independent individuals (lose something) in order to wed (gain something). Or when a student graduates, the use of the term "bittersweet" in commencement speeches reflects the acknowledgement that something has to end for something new to begin. So, even as one embraces what is expected to be a fulfillment, a lack is always occurring.

Confronting loss

There have been numerous attempts to build a model of accommodating losses. In 1944 Erich Lindemann, chief of psychiatry at Massachusetts General Hospital and an early researcher in the field, suggested tasks that must be completed to come to terms with loss. They included accepting the fact of the loss, adjusting to life without the deceased and forming new relationships. Various phase-based theories have been posited, most suggesting an initial state of shock followed by various emotional responses like anger and guilt, and then a reestablishment to former functioning. (See, for example, Robert E. Kavanaugh, Facing Death, 1972, and J. William Worden, Grief Counseling and Grief Therapy, 1991.) Most famously, in 1969 psychiatrist Elisabeth Kubler-Ross published her groundbreaking treatise, On Death and Dying, which argued that people went through five stages to deal with loss: denial, anger, bargaining, depression, and acceptance. …