How to Handle Bereavement at The Wrong One Died by Irvin Yalom - Article Example

The Wrong one died” Analysis by Irvin Yalom (1989) Student name/ id: Supervisor name: Institution: Date submitted: The loss of a loved one is a process that no one is prepared for. This is regardless of the circumstance surrounding the death event, either through sickness, accidents, suicide or even murder. No one can indeed say the words ‘I have let go’ but as research indicates the intensity and duration of the responses to the death vary depending on the cause of the death, the role of the deceased in the family, the attachment and bond, the character and personality and character of the deceased, the age at time of death, the cultural way of coping with bereavement, the gender and social factors (Boss 1999; Raphael 1973; Stroebe & Schut 1999). These factors contribute a lot to how the grief is expressed and how the family copes with the bereavement. I shall expand broadly on some of the factors in the sections below. In this article, we shall focus on an example on how to handle bereavement using the article written by Irvin Yalom ‘the wrong one died’ (Yalom 1989). The example illustrates the state of grief of a lady called penny and how she has handled the grief since the loss of her daughter. The one thing that comes out clearly from the beginning of the article as Yalom later admits is the commitment of Penny to get better from her current situation seen in her desperation to see the researcher (Yalom 1989, p. 118). Penny a woman separated from her husband and having two surviving children had undergone a lot of emotional turmoil that had affected her decisions in life. She blamed everyone else for her behaviour as well as the decisions she had made in life (Yalom 1989, p. 135). The Grief process starts with denial of the status leading to the event of death. In his article, Yalom showed how Penny experienced denial of her daughter’s sickness and the progression of the disease leading to death (Yalom 1989, p. 121). As with the sick role in Parson’s theoretical perspective where the sick role is seen as temporary, the grieving is also seen as a temporary state and it is required that the affected individual or family will get back to the normal state of functioning. Complicated grief is a state of disorder and disorganization and in the modern world, this state is not recognized and hence the need to look for ways to re-organize an individual’s life. A common narrative used to illustrate this is ‘I was well yesterday, today am sick, tomorrow I will be well again’ (Frank 1995 cited in Stroebe & Schut 1999, p. 202), this according to the Buddhist beliefs (cf.buddhist beliefs) is far from what is in the real world. In her sessions with Yalom, Penny acknowledged that denial of the daughter’s condition had consequences on the relationships between her and her daughter Chrissie and with the other family members. The denial had been achieved through penny not helping her daughter to talk about her feelings as well as not finding out how the rest of the family was responding to the situation (Yalom 1989, p. 122); her hope was that her daughter would recover. The same denial was depicted in her death when the mother refers to her birthday in the present tense (Yalom 1989, p. 121). The coping mechanism of grief can affect the socially interrelationships we have with other people (Stroebe & Schut 1999, p. 202). This is because people cope differently with bereavement; hence can either lead to strengthening or weakening of the relationships. In Penny’s example, her attachment to her late daughter during sickness and even after her death resulted in disastrous effect resulting in complete break up with her husband (Yalom 1989, p. 123) and poor relationship and lack of attention to her two boys. The boys became distant and ended up making detrimental choices with Jim resulting to illicit drug trade while Brent ended up in Juvenile hall detention because of burglary (Yalom 1989, p. 126). Part of the grief work quoted in (Stroebe & Schut 1999, p. 198) indicates that coping in grief can be managed well by the help of other people like other family members. Penny did not have this support as she closed off the rest of the family and it became about her and how she could keep her daughter with her. Guilt is a process that is borne from an individual blaming themselves for what they did not do or what they should have done which leads to individuals punishing themselves continuously and as a result tries to make up for the missed opportunities by holding onto the deceased in the hope of making amends (Yalom 1989, p. 139), as Penny indicated that “I deserted her when she was dying, no way am going to desert her again” (Yalom 1989, p. 124). Her guilt was based mainly on her lack of control over the situation; she felt she could have done more. According to Boss (1999 p. 4), human beings value their control over nature and hence find it hard to cope or comprehend why the event occurred, there is a tendency for an individual to feel like he/she did not do something to prevent the event from occurring or did not do something to make the situation better. Penny blamed herself for not releasing her daughter earlier and in turn making her endure the suffering so as to continue keeping her alive. She goes on to say that maybe she would have made the situation better if she had helped her daughter to talk about her feelings and in turn prepare her for the unavoidable event of death (Yalom 1989, p. 122) The event of death has two major phases to the bereaved, the Loss phase and the Transcendence phase (Weenolsen 1991, p. 61). The nature of grief is applied during the loss phase; the loss can be either object loss or project loss (Yalom 1989, p. 132). The loss of parents or lifelong friends can result in one feeling the loss of what the past meant to them. They associate the loss with the memories of the good and bad of their past .The project loss on the other hand refers more to the loss of children who depict the future (Yalom 1989, p. 132). Many parents feel a loss when their children die as the reality that there will be no one to look after them in their old age and also f that when the children grow up they will be able to take care of the parents as well as protect them hence when the loss occurs the parents feel helpless that they could not have protected their child and thus also feel that there is no one to protect them (Yalom 1989, p. 140). For those who like Penny did not have a stable home or supporting family, the parents lived their dreams through their children, hence in the event of the death of the child, the loss becomes too much to bear (Yalom 1989, p. 132). Penny in one of her sessions with Yalom described a dream where she saw her two boys as girls, dressed like girls but dressed wrongly, she gave a deductive reasoning of the dream by implying that the dream depicted her boys who according to her had grown up all wrong ‘everything is wrong about them and has always been” (Yalom 1989, p. 128). This was unlike the daughter Chrissie who she termed as an angel. It is due to this comparison that she uttered the words “the wrong one died” that in a nutshell described her state of mind as regards her loss (Yalom 1989, p. 128). This thought brought about many explosive feelings of anger, rage and disappointment that come with unresolved grief (Klein-sela & Or-Chen 2011, p. 466; Yalom 1989, p. 129; Somer). Instinctively she felt that she had gotten what most people call ‘a raw deal’ the best or the one who would have rescued the family from poverty had been taken away and she had been left with two individuals who would contribute only to more misery and poverty (Yalom 1989, p. 128). This brings about the factor of the role of the deceased in the home and their character and her/his impact on the duration and intensity of grief (Raphael 1973, p. 2). Indeed I believe from Penny’s situation, if the deceased would have been one of the boys, I do not think, she would have grieved for long as she did with Chrissie as she put it “ she prayed that Jim’s body be given to Chrissie (what did he need it for? He was going to kill it soon anyway with drugs, Aids)” (Yalom 1989, p. 130) In many cases of bereavement, transcendence is achieved if the individual is able to create a successive and long lasting memory of the deceased and selecting the meaning of the deceased to the bereaved families and integrating this meaning into their lives (Walter 1997, p. 263). This meant basically looking at the deceased in a different perspective, a role model, a unifying factor or a gift to the family rather than as a loss. It also involves transferring the roles held by the deceased to other family members (Stroebe & Schut 1999, p. 203) for example if the deceased was the breadwinner in the home, someone else taking up the role would hasten the process from loss to transcendence. This would enable the grieving individual to once more embrace the recreation of life and its meaning (Weenolsen 1991, p. 61). In the case of Penny, her grief had turned frozen; hence, the process of transcendence had been halted. Frozen grief was basically a metaphor applied to chronic grief or complicated grief which comprised of excessive thoughts about the deceased, a yearning and longing, feeling of numbness, feeling loss of meaning in life and impaired function in social and other responsibilities (Prigerson & Jacobs 2001, p. 617).Much of these criteria were exhibited in Penny’s example. She had a longing and yearning for her daughter and this was evident in the way she slept in her daughter’s bed every night, the times she spent by her graveside. She also started questioning the meaning of life as she considered her past and her future (Yalom 1989, p. 131) and also the grieving had impaired her functions as a mother and as a wife leading to the separation with the husband and neglect of her two boys (Yalom 1989, p. 130). The one evidence of this neglect was how even after Chrissie died, the mother did not give the available room to one of the boys who shared a small room in the house; instead, she turned Chrissie’s room into a memorial (Yalom 1989, p. 131). According to Freud, the preoccupation and obsession over a loss and the complete refusal to detach from the lost object is referred to as complicated grieving or Melancholia (Freud n.d cited in Boss 1999, p. 5). This unresolved grief can become pathological and hence affects one’s health (Boss 1999, p. 5). The bereavement due to the loss of a child is one of the major stressors that can result to serious psychopathological consequences (Rubin & Malkinson 2001, p. 222). The cause of death and the age at which death occurs can greatly vary the duration and intensity of the Grief (Somer, Klein-sela & Or-chen 2011, p. 465). This in essence means that the more violent the death or neglect at death, the more the intensity of grief. The grief is also magnified more if the suffering and the death event occur when the child is young for example a child dying when he is 10 years as opposed to the child that dies at age 35 years. The parents feel more responsible for the younger one than for the older child (Davies 2001, p. 1332). The intense preoccupation with the deceased child can lead to a varied response of bereavement. (Rubin 1993, cited in Stroebe & Schut 1999, p. 208), this was evident in Penny’s attachment to her daughter Chrissie in the much time she spent with her in hospital and the times she spent at the graveside, keeping in touch with Chrissie’s friends so as to ‘update Chrissie’, celebrating her birthdays, attending Chrissie’s class graduation, the last statement and will of Chrissie placed on the fridge door. Penny had basically gotten stuck in her grief, as she felt overcoming the grief would cause her to forget her daughter. (Yalom 1989, p. 123). Yalom’s questions to Penny elicit many thoughts of how the grieving individual constructs and positions the deceased in their lives yet cannot practically locate or point out this position to anyone else, it becomes their reality. Yalom asked Penny “where is Chrissie?” (Yalom 1989 p124), she explained about feeling her presence at home and even at the graveside and also indicated that it seemed the presence was fading suggesting reincarnation of the daughter. The reincarnation beliefs have been used by many people including Penny to creatively cope with their grief (Somer, Klein- sela and Or- Chen 2011, p. 460). Research shows that survivors with a strong belief in reincarnation have tended to adapt easily to the coping of bereavement and gain a good understanding of their loss (Conant 1996, p. 182); hence, the progressive fading of Chrissie aided Penny in confronting her loss and in turn attaining a recovery position. The attainment of transcendence is possible as long as an individual is able to confront all losses in his or her life (Weenolsen 1988, p. 61). For people who go through complicated or frozen grief, which might be referred to as primary loss (Cook & Oltjenbruns 1998, p. 93), there is usually a resultant secondary loss and the grief is magnified with every additional loss. Penny had her initial loss, which was her daughter Chrissie, but her unresolved grief led to the loss of her marriage and the loss of motherhood for her two surviving children. The coping strategies in a family can lead to varied responses for example Penny grieved for her child by making Chrissie’s room a memorial, sleeping in Chrissie’s bed, celebrating her birthdays while Jeff coped by trying to forget what had happened, this two coping strategies were the opposite of each other and that is what lead to their separation (Yalom 1989, p. 131). The loss of motherhood for her children was made evident when they told her how they yearned for time with her and this had the led the boys to be distant and to resort to bad behaviours like burglary and drug addiction (Yalom 1989, p. 130). Though this should have been a turnaround for Penny with her having her sons yearn for her love, instead it magnified her grief. It seemed that the boys reminded her of what she had lost and instead of taking care of the boys as a way of making them better like Chrissie; she instead had so much rage against them for living instead of her Chrissie (Yalom 1989, p. 131). Another factor that affects the response to grief is the socio-economic background of the survivors (Raphael 1973, p. 2); this means those who are economically stable tend to grieve for a short period of time unlike the ones who are economically disadvantaged. An example of the death of a person who contributed or was to contribute to the betterment of the economic and financial status of the family may lead to a prolonged and chronic type of grief with the survivors lamenting on the lost opportunities that could have been provided by the deceased (Parsons 1951, p. 122). This was depicted in Penny’s case where she felt that the loss of Chrissie had robbed them of the person who would have rescued them from the life of misery and poverty (Yalom 1989, p. 128). In the Social context, grief is excercebated by broken relationships and the desire to escape ones failures and yet not being able to (Wambach 1985, p. 202). Penny had had a terrible childhood that consisted of unstable family unit with an alcoholic and absent father and an alcoholic and promiscuous mother. The family had gone through distress economic times and penny had vowed to ensure her children had a decent home. This experience had left her relationship between her mother and her sisters severed (Yalom 1989, p. 137). In her struggle to make it in life she had ended up having relationships that did not work out but this did not deter her determination to better her life and that of her children. She ended up overworking to make this possible. In trying to keep the family together and stable, she achieved this by paying mortgage for a house and through contributions of the family managed to buy a cemetery plot where they could all be buried (Yalom 1989, p. 128). Even with all this struggles, she had seen Chrissie as her hope and dream of a better life. She even talked of how she had not gone to school and that Chrissie was going to do it for both of them (Yalom 1989, p. 133). Part of the reasons for why an individual may have difficulty overcoming the loss or grief is due to an underlying event in the past that relates much to the present loss (Doka 1989, cited in Attig 2004, p. 130). The example of penny’s case illustrates how the event of her having had twins in the past has cropped up into the process of her grieving. This secret according to Doka (1989,cited in Attig 2004,p 130), can be qualified as disenfranchised grief and can lead to an individual not acknowledging its existence to anyone and suffering the consequences alone. Many do this out of feeling shame or inadequate like Penny. At first when she had the dream of the boys who look like girls, she did not relate to the past but as is seen in the last session with Yalom, it seems that all along she had been thinking of this event (Yalom 1989, p. 135) and its presence had contributed to the excercebation of her grief. The feeling of shame and fear of being judged can lead to an individual being reluctant to confront his/her losses hence prolonging the grief (Parkes 1998, p. 1522). Though Penny might have tried to imply that she did not regret giving up her children, yet in the loss she had encountered the memories of this event become relevant. In my own thinking, I believe that Penny could have thought how the loss of her daughter Chrissie could have been made more bearable if she had had her twins, that maybe they could have provided the hope that she had lost after losing Chrissie. There are various models that illustrate how an individual or individuals can achieve ‘the working through’ ways of coping and overcoming the grief. On model that has been widely used is the cognitive stress theory (Folkman & Lazarus 1980, p. 220), where the situation at hand is either categorized as challenging or stressful. The coping strategies for stressful situations like Penny’s is to determine the problem and look for solutions to solve it and to enable the individual manage the emotion that comes with the change (Billings & Moos 1981, cited in Stroebe & Schut 1999, p. 205). Another model is the Grief work formulation method (Stroebe & Schut 1999, p. 199) Grief work enables the individual to confront the experience of loss of the loved one, going over the events prior and after the death, focusing on the memories and thus coming to terms with the loss and detachment from the deceased; this prevents psychopathological consequences like depression and mental ill health (Stroebe 1992, cited in Stroebe & Schut 1999, p. 199). At the final session and in the visits afterwards, Yalom showed that Penny had attained transcendence. She had started recreating her life and had started rebuilding her relationship with the two sons Brent and Jim. The transcendence was initiated when she realized after the many sessions how she had made many mistakes in life, how she had contributed to the breakup of her marriage, she acknowledged and cried for all the losses she had encountered in her life (Yalom 1989, p. 137), the unrecovered years lost with her sons, the twin daughters that were lost, the father she had lost who she never really knew, for the lost love that she had shared with her husband. She also cried for her poor mother and her sisters and the lost relationships. She was able to detach herself from Chrissie and turned her attention to the two boys, this was the most evident change that Yalom was able to register during the follow up visits. In conclusion it would be right to say that indeed coping with the loss of a loved one is not an easy step but it is a major step in the right direction to one moving forward with their lives. 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