When those we love die, we embark on a journey of the heart. We begin in bereavement. The experience of loss deprives us of a living presence, a loved one. Our daily lives are thrown in disarray. Our life stories careen off their expected courses. Our connections with the larger contexts within which we find meaning are strained. We feel devastated and helpless in the face of forces and events we could not control.
(Thomas Attig, 2000, p. 281).
‘Discourse’, a somewhat scholarly term for what is otherwise an art of conversation, can serve as both a social and cultural boundary and an indicator at one and the same time. And while some discourse, or conversation, may be contentious and perhaps prone to heated debate (especially for those holding contrary or opposing views and opinions), they can also complement one another too, providing valuable perspectives and possibly opening up further fields of enquiry for all concerned. And while that may be the case, extrapolating key elements from varying discourses such as care for the dying and the bereaved, reveal a complex socially constructed reality in which we all live, especially in the West. What is ‘right’, what is ‘not right’? What is ‘appropriate’ what is ‘not appropriate’?
I used to work in a professional context in which I supported bereaved adults and children. In this role, I also worked alongside (to varying degrees) psychologists, psychiatrists, psychotherapists, physicians and clinical social and welfare workers, all who had their own bereavement and grief narratives and associated discourse. Within this mix of health and allied health professionals, the discourse relating to models of grieving and their applicability often ranged from the Five Stages of Grief theory (Elisabeth Kubler-Ross, 1973), to the Complicated Grief model (Horowitz et. al., 1993, pp. 904-910; Lichtenthal et. al., 2004, pp. 637-662: Prigerson et. al., 1996, pp. 1484-1486) to the Continuing Bonds model (Klass & Steffen, 2018).
Adding to this complexity was always the issue of power, authority and credibility. Who is more credible, the psychiatrist, the bereavement worker or the bereaved? Who has the authority to influence policy and determine guidelines for appropriate service provision for the bereaved? And in the midst of all of this where do the bereaved sit? How do they feel about all this theorising and power-play which impacts them?
In categorising grief as a disease, Glass (2005) comes to the conclusion that sometimes it is. In poignantly articulating that the painful process of normal grief following bereavement certainly warrants sympathy and concern he then blandly states that complicated grief warrants more research about effective ways to prevent and treat it. I often wonder how the bereaved would feel, if they knew that there were so many people so ready to classify their grief, and what’s more, make determinations for their welfare based on those social constructions?
How do you comfort an 81 year old widow, whose husband has died after 56 years of marriage, who comes to see you 18 months after his death? Do you ship her off to a mental health professional who will prescribe anti-depressant medication, or do you just listen, and be present in the shared moment of overwhelming grief and passionate sadness (McKissock, pers. com. September 2006). For me, it’s the latter. Perhaps for those whose discourse is framed within a psychological/psychiatric discourse, it would no doubt be the former. But then, that is the essence of competing discourses, is it not?
Photo by Markus Winkler on Unsplash
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