The Psychology of Dying

Kubler-Ross 5 stages: –1) Denial: (and Isolation) “the defense mechanism by which a person is unable or refuses to see things as they are because such facts are threatening to the self” –2) Anger: “blame directed toward another person” –3) Bargaining –4) Depression –5) Acceptance

William Worden 4 Tasks of Mourning: –Task One: To Accept the Reality of the Loss –Task Two: To Experience the Pain of Grief and to Express the Emotions Associated With It –Task Three: To Adjust to an Environment in Which the Deceased is Missing –Task Four: To Emotionally Relocate the Deceased or Other Changed Condition and Move On With Life

Lofland “dying scripts” Elements: –Space –Population –Knowledge –Stance

Em. M. Pattison 3 phases of the dying process: –1) acute crisis phase –2) chronic living-dying phase –3) terminal phase

A. Weisman 3 degrees of denial: –1) the person denies the facts –2) the person accepts the diagnosis but refuses to believe that it is terminal –3) person vacillates beween open acknowledgement of death and its repudiation

Glaser and Strauss 4 contexts of awareness: –1) closed awareness –2) suspicion –3) mutual pretense –4) open awareness

Duties of the Dying 1) arrange a variety of affairs 2) adapt to the loss of loved ones and self 3) manage medical needs and balance emotions 4) plan for future loss 5) identify and cope with the death encounter

Role of the FD With the Dying Prerequisites for the FD: –1) acknowledge one’s mortality –2) understand the grief process –3) effective listening and appropriate response –4) commitment to the dying –5) knowledge of personal limits

Social Responses to Death variety of socialization processes demographic norms Preindustrial: high mortality rates –small, tightly integrated communities Postindustrial: drop in mortality rates –death is distanced, sanitized

Death of a Parent natural event unfinished emotional business little/no allowance for untimely, violent, or unexpected death allow the adult child to express the feelings of loss support groups

Death of a Spouse secondary losses social issues support groups

Death of a Child parents and siblings aren’t the only ones who mourn the loss of a child, but the parental grief response is the most complex friends may avoid the parents “service guilt”, “survivor’s guilt”

Guilt Composed of: –Regrets –Misgivings –Unresolved past conflicts with the child –Every aspect of the relationship and childcare

Secondary Losses child may have filled a “gap” child as well as friend sense of status/self-esteem/purpose continued guilt can give rise to complications changed identity camily structure is altered

Parental Anger feel that core identities have been ripped out world no longer makes sense rage at those perceived to have a role in the death feelings of betrayal anger directed toward survivors

Coping With Other People Need to be aware that there are people in their lives from whom they will never get the support they would have expected or desire.

Parental Fear Fear of losing other children or any close person causes bereaved parents to overprotect.

“New Me in a New World” The image of the child exists within but is no longer physically available as an external reality. Create a new internal picture of who they are in the outside world. Their loss and grief accompany them everywhere they go.

Painful Reminders seasonal reminders unexpected “moments” continual acknowledgment of the child at family events can still feel connected

Linking Objects and Continuing Bonds helps maintain continuity of a relationship provide support for grieving parents

FD Responsibilities reinforce that their feelings are acceptable and normal point out to them society’s inability to comprehend their loss well-meaning people’s comments create an atmosphere of security, comfort and accessibility

High Divorce Rate Myth 1999: 72% still married 28%: 16% ended due to death of spouse 28%: 16% ended due to death of spouse 12% ended in divorce Grieving parents do experience some marital strain and have to make readjustments in their marriages.

Death of a Sibling greater chance of healing if parents remain in their lives parents grieve openly parental grief is shared siblings may experience shame or embarrassment preteens and teens are particularly sensitive

Replacement Expectations parents may inappropriately place expectations on children parents may consciously or unwittingly communicate that surviving children take on the dead sibling’s role parents may deify the dead child parents may focus on the dead child to the exclusion of the surviving siblings

Surviving Adult Siblings least acknowledged by society facing the death of someone in their own generation…..personal confrontation with their own mortality FD should be available to them

Implications for Funeral Directors 1) society’s perception of the death may not “track” with the individual’s response 2) be sensitive to conflict between what is expected and what they feel 3) provide information about resources 4) small library of books, tapes etc. 5) provide clear, complete and accurate communication