Roundtable: Grief and Bereavement
Read the rest of the transcript:
LINDA WERTHEIMER, HOST: This is ALL THINGS CONSIDERED. I'm Linda Wertheimer.
Back with my guests Ken Doka, Phyllis Silverman, and Earl Grollman.
There are losses that seem -- that may seem unreasonable to, you know, to your coworkers, but seem very, very serious to you.
KEN DOKA, PROFESSOR OF GERONTOLOGY, COLLEGE OF NEW ROCHELLE, ORDAINED LUTHERAN MINISTER, EDITOR, JOURNEYS: Yeah. That's actually where I've done most of my work, and it's an area that I call "disenfranchised grief."
LINDA WERTHEIMER: Ken Doka.
KEN DOKA: And those refer to people who have losses that are not socially supported by others. So when your brother dies, everyone may understand that you're grieving. But when your brother-in-law dies or your ex-brother-in-law who still was a person you were attached to in your life, and maybe looked toward -- looked for for support or for friendship -- people may not understand that connection.
They certainly understand when your spouse dies, but not when your ex-spouse. And yet that, still, is a relationship and that still may be part of who we are and part of our identity.
So yeah, I think that is a factor that complicates grief when for one reason or another -- maybe because the relationship is not recognized; maybe because the circumstances of the death are so horrendous that people may be reluctant to share it; maybe because the loss, like the loss of a pet, is not acknowledged; or maybe sometimes because the griever, such as a young child or someone who is developmentally disabled is not recognized as being, you know, "able" to grieve -- all of these factors may complicate loss.
RABBI EARL GROLLMAN, CHAIRMAN, NATIONAL CENTER FOR DEATH EDUCATION: For me personally something happened yesterday. I was shoveling snow and I hurt my back and I couldn't jog this morning, and I called my physician and he says: "look, you deal with dying and death all the time. So you don't jog today -- what are you going to do about it?" I said: "I'll go to another physician."
So I think the important part is that when we deal with loss it is our loss, and don't compare losses. If you feel pain, it is your pain; accept your pain; express your pain if you can commemorate your pain; and then to go on living the best way you know possible.
LINDA WERTHEIMER: But I still would like -- I still would like to ask a question about a kind of loss that I guess I've always thought of as a particularly difficult loss, and that is the loss of a child -- maybe even the loss of a child through miscarriage; the loss of a child through abortion; the loss of a child who died in childbirth, so that the baby was never, you know, in the eyes of the rest of the family, never really there.
RABBI EARL GROLLMAN: And add infertility to that also.
PHYLLIS SILVERMAN, PROFESSOR EMERITA, INSTITUTE OF HEALTH PROFESSIONS, MASSACHUSETTS GENERAL HOSPITAL, ASSOCIATE IN SOCIAL WELFARE, DEPARTMENT OF PSYCHIATRY, HARVARD UNIVERSITY: Yes.
KEN DOKA: Mm-hmm.
PHYLLIS SILVERMAN: Yes, that's another loss that we don't count. Well, I think that this is a loss that many -- women have carried with them for many years and carried with them silently. If you scratch, as I would say it, if you open the subject up, it's very interesting how many women have had these experiences, and you find that they were 20, 30, 40 years ago -- old -- that the loss occurred 20 or 30 or 40 years ago -- and they are still hurting if you let them tell you what went on.
And -- I lost a grandchild who was only a week old. I never met her, 'cause she was born in Israel. But we mourn her as we mourn other people in the family who have died. She lived, she struggled, and she didn't make it. The loss was extreme for her family -- for her parents, for the grandparents as well. And it's not accepted. It's not understood.
But we're getting better at it. For example, at the hospital now, we have a protocol so that when such a death occurs, a mother -- if the baby had been viable, fetus had been viable -- the mother comes home with a picture if she wants; a footprint; a bit of hair -- a sense that this was a person that she carried, that she delivered, that didn't make it, but there's something to mourn.
As opposed to a time when this was quickly disposed of and not discussed. So we're getting better at it, but we still have a lot better to go, and I think part of it is going to depend on us as women, as we become aware with each other of what these losses mean, and are able to share it and recognize it.
LINDA WERTHEIMER: You all have said in various ways that you don't get over a loss; that your grief and your sense of loss is always with you. And that instead what you learn to do is accommodate, ameliorate -- you need -- you integrate the experience of loss into your life.
I wonder if you could offer us some tricks of the trade on that -- about ways in which that happens?
PHYLLIS SILVERMAN: I think first of all, the first job is to articulate the issue in those terms so that people know what to expect.
KEN DOKA: I think a second thing, and I think one of the things we're looking for is an answer that says, you know: "what should everyone do?" And the answer that I often give, and I think one of the key issues that comes up in counseling, is to -- is to look back on our own lives and to look at the ways we've coped with losses before.
And we've all coped with losses before. They may not have been the death of a person. They may have been the breakup of a relationship that was significant. They may be a variety of losses.
And to really look at the strategies we've used. I always like Phyllis' term "adaptive strategies" and to use -- and to use the way of saying: "well, of those strategies that I've used, which ones have worked well for me? And which ones have not?"
PHYLLIS SILVERMAN: I would like to add one other thing that we haven't talked about and that is we've put a lot of emphasis on talking and processing 'cause most of us are that kind of -- those kind of people. But in fact, there are people who are really very quiet about what's going on inside of themselves, and don't always talk and don't always need an audience or need someone to hear them, and seem to prevail on their own.
And I think we have to make room for those people, too.
KEN DOKA: Oh, I would strongly agree with that. That's my present area of interest -- people who may use different kinds of cognitive or active...
LINDA WERTHEIMER: Right.
KEN DOKA: ... strategies of dealing with loss, and do well without that public sharing; do it in a very solitary way, but no less an effective way.
LINDA WERTHEIMER: You talk in your writing about masculine and feminine responses to grief and suggest that -- I mean, sometimes men have a feminine response and women have a masculine response, but one is -- one is not to wish to be emotionally spread out in public.
KEN DOKA: Mm-hmm.
PHYLLIS SILVERMAN: Well, it's not that we're spread out in public.
I think it's that, more often than not, women are likely to want to process. When we just say only women do that, then we're really in big trouble.
LINDA WERTHEIMER: Sure.
KEN DOKA: Yeah.
LINDA WERTHEIMER: Of course. Well...
KEN DOKA: And when we say that men do not want to do that we are equally in trouble. Some men...
PHYLLIS SILVERMAN: That's right.
KEN DOKA: ... really find that very useful. That's why we try to...
PHYLLIS SILVERMAN: That's right.
KEN DOKA: ... use this to say there are styles of grief that may be related to gender, but are certainly not determined by them.
PHYLLIS SILVERMAN: Mm-hmm. Right.
LINDA WERTHEIMER: Thanks very much to all of you.
KEN DOKA: Well, thank you for the opportunity.
PHYLLIS SILVERMAN: It's been a pleasure.
LINDA WERTHEIMER: Ken Doka edits Journeys, the newsletter for the bereaved published by the Hospice Foundation of America. You'll find a link to the online edition in our website. He's also a professor of gerontology at the College of New Rochelle.
Earl Grollman is chairman of the National Center for Death Education and author of many books, including "Caring and Coping When Your Loved One Is Seriously Ill" and "Bereaved Children and Teens."
And Phyllis Silverman is associate in Social Welfare at the Department of Psychiatry at the Harvard Medical School and professor emerita at the Massachusetts General Hospital. Her books include: "Helping Women Cope With Grief" and "Widower: When Men Are Left Alone."
If you want to do more reading about the issues we've been talking about, visit our website at www.npr.org. You'll find readings there as well as links to organizations providing services and information to the bereaved.
Our series on the end of life continues for the next several months. A schedule of upcoming reports can also be found on the website. The address again is www.npr.org.
This is NPR, National Public Radio.
Copyright © 1997 National Public Radio, Inc. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to National Public Radio, Inc. This transcript may not be reproduced in whole or in part, including any electronic download or any other form of copying or distribution without prior written permission. For further information please contact NPR's Office of the General Counsel at (202) 414-2040.