Roundtable: Grief and Bereavement
Tuesday, November 25th All Things Considered

How long after a loss should one "still be grieving?" That's the sort of question many people ask -- is a year about the right amount of time? two years? ten? What can complicate the process? What helps bring about emotional healing? The conversation will also touch on significant cultural and religious distinctions that make the processes different for different people.

Read the transcript:

MARCIA BRANDWYNNE, HOST: It's ALL THINGS CONSIDERED. I'm Marcia Brandwynne.

LINDA WERTHEIMER, HOST: And I'm Linda Wertheimer.

Three weeks ago, we began an occasional series called "The End of Life: Exploring Death in America." We began with an examination of some of the aspects of terminal illness. Today, we continue with a conversation about grief and bereavement.

It's certainly true that many families who will be gathering on Thursday will take note that someone is missing -- someone who was there last year; someone who was there a decade ago. That heartfelt "missing" of someone who has died is at the root of many people's grief. We go on living our lives after theirs has ended.

I'm joined this half hour by three people who spend their professional lives helping people who are bereaved. Ken Doka is professor of Gerontology at the College of New Rochelle in New York State. He's also an ordained Lutheran minister and editor of Journeys, the newsletter for the bereaved published by the Hospice Foundation of America. Ken Doka joins us from our bureau in Manhattan. Welcome.

KEN DOKA, PROFESSOR OF GERONTOLOGY, COLLEGE OF NEW ROCHELLE, ORDAINED LUTHERAN MINISTER, EDITOR, JOURNEYS: Thank you. Good to be here.

LINDA WERTHEIMER: And joining us from member station WBUR in Boston is Phyllis Silverman, a social scientist and Professor Emerita at the Institute of Health Professions at Massachusetts General Hospital. Her research has focused on the phenomenon of widowhood and on the grief of children who lose parents. Phyllis Silverman, welcome.

PHYLLIS SILVERMAN, PROFESSOR EMERITA, INSTITUTE OF HEALTH PROFESSIONS, MASSACHUSETTS GENERAL HOSPITAL, ASSOCIATE IN SOCIAL WELFARE, DEPARTMENT OF PSYCHIATRY, HARVARD UNIVERSITY: Thank you. It's good to be here.

LINDA WERTHEIMER: And also with us from Boston is Rabbi Earl Grollman, chairman of the National Center of Death Education -- an author who's written extensively about grief and bereavement. Rabbi Grollman, thanks for coming in.

EARL GROLLMAN, RABBI, CHAIRMAN, NATIONAL CENTER OF DEATH EDUCATION: It's my pleasure.

LINDA WERTHEIMER: Now, let me ask the three of you, just to start with sort of an assessment of how we regard grief in this country -- how we treat it -- grief in the '90s. Do we see it as a -- as something healthy? Or, do you think that in the ordinary way, people tend to see grief as perhaps pathology -- as illness?

Phyllis Silverman
PHYLLIS SILVERMAN: It seems to me one of our dilemmas is that we tend to be afraid of extreme feeling, and we have a tendency to try to label things and assign them into neat little packages where they can be dealt with in an orderly fashion and perhaps disappear. So that grief does tend to get diagnosed as an illness. People are instructed to get over it and get on with their lives, with the appropriate pill or some kind of medication that you often feel that that will ease the pain.

And I think in some ways we stigmatize the bereaved and Ken would say, disenfranchise them by giving them these labels and not allowing them to recognize -- not allowing all of us to recognize that we're dealing with a normal life cycle event that all of have to be expert in learning how to deal with, and that will change us and affect us for the rest of our lives.

LINDA WERTHEIMER: Ken Doka, you were referred to -- you want to speak for yourself here?

Ken Doka
KEN DOKA: Yes, I would agree with Phyllis, and one of the things that I would also point out is I think that many times what happens in our culture is that the media underestimates the ways that people experience death -- experience grief -- and the length of time, as Phyllis says, that we may struggle with it on different levels and in different pieces.

LINDA WERTHEIMER: The media?

KEN DOKA: Well, our culture in general, but a number of years ago, a colleague of mine, Hanelore Wass (ph), did a wonderful study about what television tells us about grief and bereavement. And she made three points. One is that important people often do not die. When they die, they're mourned very, very briefly. And very rarely, except in the most farcical ways, are the rituals by which people deal with grief ever portrayed.

LINDA WERTHEIMER: Rabbi Grollman?

RABBI EARL GROLLMAN: Grief is not a bad word. It's the appropriate response to loss. It's the symbol of our caring and a tribute to the quality of that life which is no longer with us.

LINDA WERTHEIMER: Do you think that there is some way that you can describe the time in which, since this does seem to be something that concerns a lot of people -- we got a lot of letters about it -- that bosses want you back at work; that there seems to be a sense among people themselves that they ought to get over it. Is there a timetable? Is there some kind of natural expectable course for this?

PHYLLIS SILVERMAN: You don't get over anything. You're changed by it. You're a different person as a result. I'm just now doing a chapter in a book on children and death -- on the death of friends. And what impressed me most as I talked to some of the young people I interviewed was how they were changed by the experience and how they see it, and they're all of 15, 16, 18 years old.

They have a sense of appreciation of life that they didn't understand before. They begin to see the life cycle in a fuller sense and to know that this is going to happen. It can happen. They know that they can prevail and deal with what's coming -- what's happened to them in their sadness and their pain. And as a result, they're maybe a bit older than they were before and they live life more carefully and more respectfully.

KEN DOKA: I would prefer -- this is Ken -- I would prefer to really look at it not so much in terms of timetables, but in broad, basic patterns.

PHYLLIS SILVERMAN: Mm-hmm. Mm-hmm.

KEN DOKA: And I think one of the great contributions that Phyllis has made to our literature and our understanding of grief, and that she's re-emphasized earlier today, is that grief is a transition and that once we go through a major loss, our life is never going to be the same.

Now, over time -- and I like -- and I know Phyllis likes to use the word "accommodation" -- I like to use the term "amelioration" -- over time, what happens to most people is that the intense pain that they're experiencing does tend to lessen, although it might come at certain times.

And you gave the analogy of the Thanksgiving -- or related to the Thanksgiving table. And it may be that holidays always have that little quality of somebody missing and events that occur in our life may bring a resurgence of some of these painful feelings. I'm sure that when my son marries, I will miss my father and his presence at that wedding.

I think a second thing that happens is that people return to their basic levels of functioning, and sometimes as Phyllis has indicated, may even function in more effective ways than they've been able to do before.

LINDA WERTHEIMER: The ritual of mourning, which used to be something that was present in -- and every major religion had a response to grief and to mourning, and sort of sometimes a schedule, appropriate ways of behaving, services, events that -- at which there was some sort of ritual recalling of the person who has died. It survives to the greatest extent in Judaism. Rabbi Grollman, could you just talk to us a little bit about -- does that work? Does it help?

RABBI EARL GROLLMAN: I think it helps a great deal for people who are going through a loss in their own family -- would be some kind of structure, to say: what do I do now?
Rabbi Earl Grollman
And in my faith, there are certain structural ways in which people can come together, called the "shiva" for the first seven days in which people share together; where people come and they reminisce and they -- they're there not only because of the person died, but because the person lived.

And then it comes to the soloshin (ph) -- the 30 days; and then it's the jahrzeit -- every year of the anniversary, and it's the unveiling of the tombstone.

Because death ends a life -- the death never ends a relationship, and customs and ceremonials and rituals help us to get in touch with the past because as children of today and tomorrow, we're also children of yesterday, the past still travels with us from afar, and what it has been makes us what we are.

LINDA WERTHEIMER: In Victorian times, there was the custom of dressing in black or wearing mourning jewelry, or of having a sort of social contact which was limited and then less limited and still less limited. Why did it go away, if it works?

KEN DOKA: I think -- from what I understand...

LINDA WERTHEIMER: Ken Doka?

KEN DOKA: ... and I'm not -- and I may be wrong on this history, but one of my understandings is that one of the factors that really led to the demise of those Victorian customs was really the onset of World War I, when there were so many losses that some of the mourning was compressed simply to maintain morale, especially in England, where all those losses were intensive.

But I think the structure that Rabbi Grollman has spoken about -- the need to mark various points in the loss, whether in the rituals that he described or in anniversary masses, or in certain kinds of marks, or even individual rituals that people use in their own homes and in their own families -- can be very helpful and very therapeutic. And we shouldn't lose those pieces.

LINDA WERTHEIMER: Like what?

KEN DOKA: Oh, for instance in some homes maybe a candle is lighted at a holiday to mark the sense of the person's presence; to mark the ongoing relationship. In other families, there may be a ritual where a gift is given in the name of someone who's died as a way of remembering their impact and their legacy.

And all of those are good examples of private little rituals that I think preserve both the memory and the thoughts and allow the family to mark that person's presence and absence in their lives at this moment.

PHYLLIS SILVERMAN: As long as we have the idea and the notion that we should somehow let go of the past, then it's very hard to justify and to create rituals when you feel that you're being criticized by some of the ways in which -- by the larger society in terms of how they see grief and how they expect it to be time-limited and "don't you think it's time you were over it, already?" -- "don't talk about him, it will only upset you" -- "she's been dead for a long time, why don't you put the picture away?" -- typical kind of comments you hear from people from -- that they -- this is what they hear from their friends.

And so, I think we have to keep this in mind as we begin to understand the need for rituals and the value of rituals, that in part people develop these if they don't come from the tradition that Rabbi Grollman and I come from, where it's in some way prescribed for us. We don't have to work as hard.

But I think that if they have the sense that they're doing something wrong, they're not going to do it. It's a long way of coming around to the point. I would just like to make one other point about the -- what we lose and how we see grief.

If we talk about grief as an emotional experience, then I think we're not helping people enough, because in fact it's not only the feelings that are causing the stress, but it's also the fact that people have lost many different things with the death. And often they lose not only the person, but they lose their self that was in relationship to that person. And in a sense, the self that they knew is lost.

And so, there are many kinds of losses. And in that context, you lose a way of life. And so, you're really not only talking about dealing with feelings, but in this transition, you're talking about how do I find a new way of living in the world, given what I've just lost.

LINDA WERTHEIMER: That I'm no longer married. That I'm...

PHYLLIS SILVERMAN: That I'm no longer married.

LINDA WERTHEIMER: I'm living by myself.

PHYLLIS SILVERMAN: Right. Or that I'm no longer parent to this child; or that this friend is no longer here to fill my life; or my sibling is not here. How do I live in such a quiet house? There's no one to fight with.

LINDA WERTHEIMER: We're talking about grief and bereavement in this part of the program. Our guests are Rabbi Earl Grollman, chairman of the National Center for Death Education; Phyllis Silverman, an associate in Social Welfare at the Department of Psychiatry at the Harvard Medical School in Massachusetts General Hospital; and Ken Doka, past president of the Association for Death Education and Counseling.

We're going to take a short break and then we'll be back to continue the conversation.

You're listening to NPR's ALL THINGS CONSIDERED.

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