Category: Experience of Loss and the Psychology of Grieving

Gender Differences in the Grieving Process

Grief is not gender-biased. The feeling of grief is often caused by some sort of stressor. The most impactful and life-altering stressor is bereavement. [1] A stressor such as bereavement could be impactful to the point that it becomes a trauma for an individual. When stress becomes trauma, specifically psychological trauma, an individual has a greater risk of becoming depressed.[2]  Depression is a common emotion people experience when they are dealing with grief. However, males and females do have different chances of experiencing depression after a traumatic and stressful loss. Females are “twice as likely as men to experience depression” in their lifetime.[3] While there is not one specific variable that accounts for the gender difference in depression, it can likely be contributed to the fact it is less acceptable for men to outwardly express their emotions[4] and women are more likely to ruminate on their thoughts.[5]  There are theories about the different ways in which men and women grieve, but there is no scientific evidence that men and women grieve differently.

There may not be evidence to support that “women are more prone to depression than men because of negative effects of estrogen…on mood,” but the cause could be due to the hypothalamic-pituitary-adrenal axis which regulates stress responses. Cortisol is a hormone that is released in response to these stressful situations. People with depression have increased levels of cortisol hormones, meaning there is probable dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. It could be likely that women are predisposed to have dysregulated HPA axes because of the increased prevalence of depression among females. However, the relationship between female depression and the HPA axis has not been studied enough, therefore one cannot conclude that hormones are the reason for gender differences in depression.[6]

Bereavement is likely to cause stress regardless of gender. Neither the bodies of men nor women are well-equipped to handle stress. In fact, the body may present “sickness behavior” such as isolation, loss of appetite, etc. as a result of localized inflammation caused by stress.[7]  Uncoincidentally, the “sickness behaviors” that follow the loss of a loved one are nearly identical to the symptoms of depression. The brain plays a role in the development of depression and how one deals with grief. O’Connor et al. conducted a study in which activation of certain parts of the brain, specifically the subgenual anterior cingulate cortex, were associated with increased local inflammation. They studied inflammation in the mouth in particular because “gingival inflammation is correlated with depression.”[8]  The purpose of this study was to pinpoint an area of the brain that deals with depression, which was successful. However, the participants of this study were solely females, and as aforementioned, females are already at a greater risk of depression; therefore, the results of this study are not necessarily generalizable to the entire population. This study did provide insight into how depression and inflammation are correlated and which part of the brain they affect, but does not provide evidence for gender differences in grieving.

Women are often the focus of grieving studies, but men grieve, too.[9]  Men and women actually experience the same emotions when they grieve, men have just been socialized and reinforced to express their emotions differently. Men are expected to grieve internally; whereas it is more acceptable for women to grieve outwardly, especially in American culture.[10]  Men are subjected to a “constricted range of expression” when it comes to grieving.[11]  There is no difference in the brain makeup of men and women, so why is it men are less likely to express emotion and why is it not socially acceptable in American culture?  Most of it comes down to reinforcement of the idea that men are supposed to be independent and stoic, whereas women are more codependent and rely on relationships more. When it comes to dealing with grief, men are more likely to turn to substance use, while women are more likely to seek assistance via therapy. Alcohol, in particular, is commonly used to mask male depression because men are so reluctant to seek help after the loss of a loved one.[12]  Lister proposes that social workers could be the solution to helping males find productive and positive treatment. Once that intervention is successful, male emotional expression will not be shunned as it is now. Males and females experience the same emotions when it comes to grief and the biological makeup of their brains is the same, it just comes down to social reinforcement of acceptable behaviors.

Complicated grief is grief that is prolonged and more debilitating than normal.[13]  Complicated grief poses serious psychological impact for males and females alike. There are two main pathways that are activated in the brain by those experiencing complicated grief. One pathway is the reward pathway, in which the nucleus accumbens is activated; and the other is the pain pathway, in which the dorsal anterior cingulate cortex, insula, and periaqueductal gray are activated. People who are experiencing complicated grief are more likely to have activation of these areas than those experiencing non complicated grief.[14]  Based on the results of O’Connor’s study, one can conclude that men and women both have these pathways, and neither gender is more likely to experience complicated grief versus non complicated grief.[15]

Males and females also experience the same psychological and biological responses when it comes to grief. While there are potential causes for the gender differences in depression and grieving, there is not enough research to support that there is in fact a substantial difference. Therefore, males and females grieve in similar ways; however, the ways in which they outwardly express their grief is different due to social reinforcement.

Let’s say a man who had just recently lost his wife of twenty years to cancer expresses his grief in the form of anger by punching a hole in his bedroom wall. This expression does not appear out of the ordinary because it aligns with the “socially acceptable” behavior males are to exhibit while going through the grieving process. Men are raised to exhibit characteristics that are deemed “acceptable” by society such as; strength, successfulness, and inexpressive of emotion. Expressing grief, or any other overwhelming display of emotion, is often discouraged in men because vulnerability is viewed as feminine. The concept of being vulnerable and expressing emotions among close friends are the expected outlets of grief women are expected to ensue. Traditionally, women have been raised to be dependent on others for support where the expression of emotions, such as crying, is strongly encouraged.[16] These stereotypes suggest that women more strongly register, and express, grief compared to their male counterparts, however, research has yielded inconclusive results as to which of the genders is more strongly impacted by grief.

The development of these stereotypes raises ethical concerns regarding the treatment of different genders during their time of grieving. With research displaying inconsistent results on which gender is more strongly impacted by grief, the societal pressures being placed on men to conceal their emotions is harmful to their mental and social health.

Men are more likely than women to grieve in isolation and employ strategies of avoidance when grieving. They also have a greater tendency to turn their emotional and psychological pain into physical pain by engaging in risk-taking behavior or committing suicide.[17] Although utilizing coping mechanisms such as avoidance tend to belittle the perception of how strongly the grief is being felt, there has been some research indicating that males may feel grief more strongly than females.

One study conducted on spousally bereaved individuals investigated the gender differences in symptoms of traumatic grief. After collecting data from 270 spousally bereaved individuals who had filled out the Inventory of Traumatic Grief, researchers could only conclude that their “findings suggest that widows and widowers do not differ in terms of absolute levels of TG symptomatology throughout their grieving process.” However, their study did find that the widowers had a more difficult time in recovering from the loss of their spouse, but they could not generalize the results due to their small population size.[18]

Another study, conducted by researchers at UCLA, found that men and women had different responses to an emotional stimulus in the right front of their insular cortex. This region of the brain plays an important role in how individuals experience emotion. The male brains showed higher levels of activity in this area, compared to the female brains.[19] This observation suggests that males may feel grief more strongly than females, but they could simply lack the communicational skills to convey these emotions due to social underdevelopment.

Instead of being taught emotion-focused coping strategies, men have been taught to suppress these feelings of grief. Emotion-focused coping strategies have shown promising results in the management of grief. Women who are better able to cope with their grief have fewer health consequences because they confront and express their grief more than men.[20] The inability to express emotions can creates tension within men, which can have detrimental side effects on their overall psychosocial health.

 

Brain scans comparing the insular lobe activity between males and females when exposed to an emotional stimulus. There are higher levels of activity exhibited in the male brains than the female brains. https://www.dailymail.co.uk/sciencetech/article-3689820/Are-male-female-brains-wired-differently-Scans-opposite-responses-area-responsible-experience-emotions.html

This inability to express emotions has also been suggested to contribute to the fact that men suffer relatively greater health consequences than their female counterparts due to the “higher levels of social support” received by widows than widowers. A study conducted by Strobe found that “social causes” were “responsible for the observed sex difference in health findings.”[21] Another study’s findings were consistent with Strobe in that men’s experiences with grief were “less supported” than women’s experiences.[22] This is of  particular ethical concern and importance because the attitudes towards those who are grieving can be adjusted, so that gender is not a factor in the sympathy received.

Grief is a universal experience, yet how men and women both cope and respond to grief can vary widely throughout the world depending on background and cultural perspective. When examining grief, it is important to have an operational definition of it to ensure that everyone is on the same page as it relates to its core definition. Grief has been aptly described as “First, not a state but rather a process. Second, the grief process typically proceeds in fits and starts, with attention oscillating to and from the painful reality of death. Third, the spectrum of cognitive, social, and behavioral disruptions of grief is broad, ranging from barely noticeable alterations to profound anguish and disruption”.[23] It is important to think about grief as a process rather than a simple one-time action, as it oftentimes has a profound emotional impact on both men and women. While the way men and women grieve are often different and unique, there is also a profound difference in the way men and women experience grief based on cultural norms and expectations. This wide culture variation in grief and its impact helps shape both society and culture writ large.

The first step in becoming more culturally aware and inclusive as a society is to recognize that those who come from differing culture backgrounds often have very different ways of grieving than the average Caucasian American. For instance, in a case study involving a sixteen-year-old African-American female who gave birth to two premature twins who later died, cultural understanding and sensitivity would have provided a greater sense of comfort and understanding to the mother of the newborns. In examining Nileen, the African American mother’s responses, it could clearly be seen that she was despondent. However, the nurse continued to try and interact with her and comfort her, as seen in this excerpt: “Nileen initiated no body movements, nor eye-contact that acknowledge the presence of Jill and the preceptor. Nileen merely stared at the television and turned the channel. Instead of understanding Nileen’s body language and cues that she wanted to be left alone, Jill, the nursing student, chose to ignore Nileen and arguably made the situation worse.[24] While understanding the importance of culture and background is vital in respectfully and gracefully interacting with those from differing cultural backgrounds experiencing grief, it also helps to provide greater understanding as to why people from certain cultures and backgrounds differ in the way they respond to and experience grief.

Understanding that men and women experience and react to grief in fundamentally different ways is the first step in trying to further understand the cultural perspectives as it relates to grief. Alan Wolfeit, author, educator, and grief counselor, shrewdly observes that “Even in the face of tragic loss, men in our society still feel the need to be self-contained, stoic, and to express little or no emotion.”  Deb Kosmer, a bereavement support coordinator for Affinity Visiting Nurses, also succinctly observes,” More men are going to the gym and pound a basketball to work it out, where women have.. built-in support systems”.[25] Understanding these key emotional differences between men and women in our society is crucial. However, there remains a great lack of understanding as it relates to grief and the differing ways it is experienced throughout cultures.

While differing cultures may very well have differing ways of expressing and showing grief, one African-American male in a cultural study on grief candidly stated, “I believe we all grieve the same. Any cultural group would probably use different words, but they all mean the same thing.” A native American male also echoed a similar sentiment, observing that “It’s a part of being human.” A woman of African ancestry tersely stated after acknowledging the many differing ways those in her own cultural grieve, “We all feel the same.” It is also notable that in this cultural study, participants “almost universally contended that as an intrapersonal experience, there are no differences based on culture or ethnicity alone. They rather staunchly maintained that the differences are individual both within cultural groups as well as across cultural groups”.[26] This is a key conclusion to make, as it seems to confirm the fact that when it comes to grief, the emotions and feelings one has after loss are shared across cultures and the human experience.

One of the key issues is the extent to which those in different cultures choose to express or hide their grief. For example, in Japan, “Japanese people have rituals to follow after the death of a loved one. Family and extended family gather together and remember and talk about the family member who has died.” However, as the social makeup of Japan has changed and as the extended family has transitioned away from the nuclear family, nurses and other caretakers are often now tasked with memorial plans.[27]

While cultural and gender differences do indeed shape how a person might grieve the loss of a loved one, the overall emotions and feelings one experiences after the passing of a significant other is remarkably similar across gender and culture. While men may lack the social structure and sense of community that women do, it is important to recognize that there is a remarkable amount of overlap when it comes to the emotion they both experience. Scientific studies regarding gender differences in the grieving process do not have sufficient evidence to definitively state that differences exist. “Social norms” are the main influence on gender differences because they lay out what emotions are acceptable to express while grieving. With inconsistent results in the scientific studies conducted, it is unethical to hold males and females to different standards of grief when there is little evidence to support differences exist. Grief is a universal concept that transcends both gender and culture.

Rebecca Bagley

Emma Bumgardner

Brooks Fitts

 

[1]O’Connor, Mary-Frances, Michael R. Irwin, and David K. Wellisch. “When Grief Heats up: Proinflammatory Cytokines Predict Regional Brain Activation.” Neuroimage 47, no. 3 (2009): 891–96. https://doi.org/10.1016/j.neuroimage.2009.05.049.

[2] Nolen-Hoeksema, Susan. “Gender Differences in Depression.” Current Directions in Psychological Science 10, no. 5 (2001): 367–74. https://doi.org/10.1111/1467-8721.00142.

[3] Ibid

[4] Lister, Larry. “Men and Grief: A Review of Research.” Smith College Studies in Social Work 61, no. 3 (1991): 220–35. https://doi.org/10.1080/00377319109517365.

[5] Ibid

[6] Ibid

[7] Ibid

[8] Ibid

[9] Dubose, J. Todd. “The Phenomenology of Bereavement, Grief, and Mourning.” Journal of Religion and Health 36, no. 4 (1997): 367–74. https://doi.org/10.1023/A:1027489327202.

[10] Ibid

[11] Ibid

[12] Ibid

[13] O’Connor, Mary-Frances, David K. Wellisch, Annette L. Stanton, Naomi I. Eisenberger, Michael R. Irwin, and Matthew D. Lieberman. “Craving Love? Enduring Grief Activates Brain’s Reward Center.” Neuroimage 42 (2008): 969–72. https://doi.org/10.1016/j.neuroimage.2008.04.256.

[14] Ibid

[15] Ibid

[16] Versalle, Alexis, and Eugene E. Mcdowell. “The Attitudes of Men and Women concerning Gender Differences in Grief.” OMEGA – Journal of Death and Dying 50, no. 1 (2005): 53-67. Accessed April 1, 2019. https://doi.org/10.2190/r2tj-6m4f-rhgd-c2md.

[17]  Canetto, Silvia Sara, and Anne Cleary. “Men, Masculinities and Suicidal Behaviour.” Social Science & Medicine 74, no. 4 (2012): 461-65. Accessed March 27, 2019. https://doi.org/10.1016/j.socscimed.2011.11.001.

[18] Boelen, Paul A., and Jan Van Den Bout. “Gender Differences in Traumatic Grief Symptom Severity after the Loss of a Spouse.” OMEGA – Journal of Death and Dying 46, no. 3 (2003): 183-98. Accessed March 28, 2019. https://doi.org/10.2190/6c8g-c0xr-f0q4-vr3x.

[19] Mailonline, Shivali Best For. “UCLA Scientists Uses Scans to Prove Male and Female Brains Do React Differently.” Daily Mail Online. July 14, 2016. Accessed April 05, 2019. https://www.dailymail.co.uk/sciencetech/article-3689820/Are-male-female-brains-wired-differently-Scans-opposite-responses-area-responsible-experience-emotions.html.

[20] Stroebe, Margaret, Wolfgang Stroebe, and Henk Schut. “Gender Differences in Adjustment to Bereavement: An Empirical and Theoretical Review.” Review of General Psychology 5, no. 1 (2001): 62-83. Accessed March 27, 2019. https://doi.org/10.1037//1089-2680.5.1.62.

[21] Stroebe, Margaret S., and Wolfgang Stroebe. “Who Suffers More? Sex Differences in Health Risks of the Widowed.” Psychological Bulletin 93, no. 2 (1983): 279-301. Accessed March 28, 2019. https://doi.org/10.1037/0033-2909.93.2.279.

[22] Stillion, Judith M., and Susan B. Noviello. “Living and Dying in Different Worlds: Gender Differences in Violent Death and Grief.” Illness, Crisis & Loss 9, no. 3 (2001): 247-59. Accessed April 1, 2019. https://doi.org/10.1177/105413730100900302.

[23] Zisook, Sidney, and Katherine Shear. “Grief and Bereavement: What Psychiatrists Need to Know.” (2013).

https://doi.org/10.1002/j.2051-5545.2009.tb00217.x

[24] Ellis Fletcher, Sally,N. “Cultural Implications in the Management of Grief and Loss.” Journal of Cultural Diversity 9, no. 3 (Fall, 2002): 86-90. http://libproxy.lib.unc.edu/login?url=https://search-proquest-com.libproxy.lib.unc.edu/docview/219311841?accountid=14244.

[25]Anderson, Cheryl. “How Men Grieve: Understanding Differences between how Men and Women Handle Grief Leads to Fox Valley Support Network.” The Post – Crescent, Jun 05, 2011. http://libproxy.lib.unc.edu/login?url=https://search-proquest-com.libproxy.lib.unc.edu/docview/870567586?accountid=14244.

[26] Cowles, Kathleen V. “Cultural Perspectives of Grief: an Expanded Concept Analysis.” Journal of Advanced Nursing 23, no.2 (1996): 287–94. https://doi.org/10.1111/j.1365-2648.1996.tb02669.x.

[27] Shimoinaba, Kaori, Margaret O’Connor, Susan Lee, and Judi Greaves. “Staff Grief and Support Systems for Japanese Health Care Professionals Working in Palliative Care.” Palliative and Supportive Care 7, no.2 (2009): 245. https://doi.org/10.1017/s1478951509000315.

How the Age of the Deceased Affects the Grieving Process.

Anyone who has felt the pangs of losing a loved one knows that the process of grieving cannot be reduced to a period of time, a set of practices and anticipated expressions, or a psychological phenomenon. Out of the myriad factors that contribute to someone’s experience of loss, one of them—the age of the deceased—is especially notable since it impacts the relationship between the bereaved and the deceased in a unique way.  However, the bonds between the deceased and the living, the aspects of their culture, and their ethical perspectives will impact the influence of age on the grieving process.

Many people who examine grief through a scientific and psychological lens agree that interpersonal attachment plays an important role in predicting someone’s response to loss. Some have even compared the process of grieving a loved one, both behaviorally and neurobiologically, to the process of recovering from drug addiction.[1] Seeing this powerful nature of interpersonal attachment shows us the significant impact of the age of the dying individual on the grieving process of the living. Since age influences the relationship between two people, we can begin to understand the nuances between an adult grieving a child versus grieving another adult.

Scientists often reference the continuing bonds theory when investigating how a parent responds after losing a child. [2] Along with the loss of a child often comes a partial loss of the parent’s sense of identity, ability, and family; thus, this particular grieving process is often labeled as the most disorganized. Since parents take on the role of the child’s caregiver, they may feel guilty following the death of their child. Furthermore, many parents have high hopes and make investments in their child’s future, and if the child dies unexpectedly, these hopes die as well.[3] However, the age of the child affects the parent’s attachment to the child, and the parent’s attachment to the child affects the intensity of the parent’s grief.

A parent’s attachment to their child progresses along with their familiarity with the child; in most cases, this corresponds to the child’s age. This idea of investment can first be seen before the child’s birth. Pregnant women likely attribute more personhood to their babies as they advance in their pregnancies, and this involves a high level of investment.[4]  Not only does this investment and sense of hope grow stronger as the child develops, but parents also form memories with their children over the years, making it more difficult to adjust to a life that does not involve parenting.[5] As a result of the dreams that parents have for their children, parents often suffer from psychological problems related to attachment. Parents who have lost children report a wide array of reactions to loss, including feelings of anger, hollowness, and jealousy towards other parents, and even physical symptoms such as insomnia, loss of appetite, and hallucinations that their child is still living.[6]  Regardless of the child’s age, however, comparative studies support the idea that grieving a child tends to be more intense than grieving a spouse or parent. Yet, this is not to say that the loss of an older loved one is not just as difficult—it means that it is different.

Mourning the loss of a child is a devastating process due to the parent’s investments in the child’s future. The premature death of an adult is devastating for the same reason, but viewed from a different angle: when an individual loses a friend, spouse, parent, or mentor, they lose someone who has invested in them. For example, losing a spouse (assuming the marriage is healthy) requires a substantial adjustment because the individual is likely not only losing someone who helps make decisions, pay bills, and potentially raise children, but their best friend also.[7] Some people, after losing their spouse, report feeling abandoned since they must learn how to live without the support of their partner. Others may feel abandoned after the death of their parents, reminiscing on how their guardians provided for them and loved them unconditionally as children.[8] Although the premature death of a loved one often leads the living to feel abandoned, an anticipated death often lengthens the process of grieving by expediting its beginning.

Once an adult reaches age 79, their death is no longer considered premature—meaning that their cause of death is less likely to be quick and more likely to be drawn-out.[9]  While the sudden death of a loved one leads to unexpected pain, some argue that premature death is “kinder” to the living because it abolishes the suffering that results from watching a loved one slowly die. The death of an older individual may lead to a longer grieving process than premature death, since family members and friends of the dying person must cope not only with the suffering of their loved one, but also with the expensive care they must provide. This age difference, while seemingly insignificant, dramatically transforms the way people grieve. However, no matter the age, the attachment principle still applies and influences the intensity of grief.

Attachment in relationships has been a topic of interest among psychologists—specifically, Mary Ainsworth. When applied to the ways people grieve, Ainsworth’s patterns of attachment speak volumes about the importance of relationships in bereavement. Those who had secure attachments to the person who died may be at peace when recalling the loss, while those with anxious-ambivalent or disorganized trauma may have trouble remembering and sorting through past conflicts with the deceased.[10] Others, who had an anxious-avoidant attachment to the deceased, may avoid experiencing emotions related to the loss altogether. These different patterns of attachment explain drastically different reactions to death—why some people may struggle with painful rumination around the deceased, while others may avoid everything associated with their lost loved one.

The process of grieving looks less like a clean, straight line and more like a scribble from a child’s coloring book—regardless of the age of the deceased.  Although we can see nuances between the way people grieve children, adolescents, and adults, the relationship between the bereaved and the deceased is a more important factor in determining what the scribbled line looks like. While grief may vary from person to person, it serves the same purpose: it is “part of the natural healing process that enables individuals, families, and communities to live with the reality of loss while going on with living.”[11] Nevertheless, cultural differences further blur this line and cause age to be an even more significant factor in predicting how people will grieve.

Culture has a large effect on the way that people deal with the grieving process. For example, some Americans would be surprised to find out that not all cultures wear black to funerals as a way to observe the dead. Across cultures, there are even different names for funerals, such as wakes and memorial services. Beliefs about what happens to the body after death such as afterlife and reincarnation depend on culture and more specifically religion. The psychology behind the grieving process is also affected by culture – more so, how the age of the deceased affects this.

A debate in death and dying culture in the United States is about which deaths are seen as “worse” or more “heartbreaking.” A common conception across the nation is that the death of a young child is worse than the death of an elderly person. Each death is distinctive in itself and comes with its own aspects to grieve. With these deaths, different relationships and experiences are lost. The loss of a child is the loss of a future, however, the loss of an elder is the loss of our past. A child’s death is a loss of a teaching opportunity and betterment of the future; whereas an elder’s death is the loss of where one first learned and was pushed to grow.[12] Elders have made the world the success it is now, but children have the chance to better the world. Because of these complexities, the debate continues about which death is considered worse. Due to the utter tragedy of an unfulfilled life, United States citizens generally accept that the loss of a child is worse than the loss of an elder. This is not to take away from the value of either life but to accept that an elder has lived a long life, and an adolescent has not been able to experience or achieve their capabilities. To most Americans, death as the conclusion for a long life is the desired outcome and what is preferred. Children outliving their parents and grandparents is highly favored over the adverse. It is almost as though the United States society creates a gradient of least to most tragic deaths, with elders and youths being at the two extremes, respectively. All death seems horrible, but some are milder than others.

One of the greatest ways that age culturally differs the grieving process in the United States is funerals. Traditionally, a “funeral” was held for anyone, regardless of age, who passed away to memorialize their legacy. In recent generations in the United States, the traditional “funeral” has evolved into more modern options for grieving. As opposed to a “funeral” or “memorial service,” the “celebration of life” has become a more current replacement. “Funerals” are now used for the death of a younger person, who has not fulfilled their full life potential, unlike the “celebrations of life, which are for the elderly, whose “time has come” and who has lived a full life. “Celebrations of life” are replacing funerals by having a positive connotation to ease any of the agony associated with a traditional funeral.[13] This event is a reminder of the sweet times spent with the deceased, often reminiscing on fondest memories and achievements, emphasizing the shift of life to death. Whereas many funerals have religious symbolism, the celebration of life ceremony is solely focused on memories of the deceased, in whatever way they desire. This makes for a more inclusivity that can be molded to each individual person’s last wishes. In order to grant the deceased’s last wishes, pre-planning is essential. Some view this as a going-out party and desire to be celebrated in vast ways, while others want a more relaxed remembrance. However, celebrations of life are not seen as appropriate for people who have not lived a long life. For example, it would be culturally inappropriate for a celebration of life to be held for a 6-month old who tragically died. In this case, a funeral would be seen as more appropriate according to cultural standards in the United States.

“10 Amazing Celebrations of Life (Pictures).” FuneralOne Blog. April 19, 2013. Accessed April 09, 2019. https://blog.funeralone.com/funeralone-products/life-tributes/10-amazing-celebrations-of-life-pictures/.

 

 


The images above show the difference between a funeral and a celebration of life, respectively. The colors and posture of the people are indicative of the difference in moods between the two.

 

There are problems with the celebration of life and funeral that point to deeper-rooted problems in United States society. Although the celebration of life ceremony is lively and joyful, it has the potential to diminish the precious value of life by putting a positive spin on death. By “celebrating” death it glorifies that a corpse is the center of attention and the loss of a loved one is a reason for “celebration.” Chad Bird from thefederalist.com says, “Call it a celebration all you want; life is not so much celebrated as death is ignored.”[14] With the pre-planning that a celebration of life ceremony requires, an egocentric and narcissistic attitude can be revealed. It is important that priorities are kept straight and that the individual is not idolized but justly remembered without downplaying the reality of death. The steep price of funerals in the United States, each costing nearly $9,000 according to The Economist, shows the greed of Americans today. Death and dying is a big business opportunity, a production that was worth $16 billion in 2017 in the United States alone.[15] In a time of grief and pain, businesses involved in the funeral process such as burial companies and funeral homes are taking advantage of the distressed families and friends of the deceased.[16] With not much competition across these businesses, there is a large gap for complacency, mistreatment, and inflated prices. These problems with celebrations of life and funerals take away from the grieving process of death and make it a selfish act.[17]

There are various aspects that go into what makes up how United States culture views the death of different ages, such as overall societal norms and how memorial services are held depending on death.[18] The United States is a melting pot of people, ideas, and opinions—especially when it comes to death and dying; however, all of these views together make up the view of most Americans at large.

Loss of a loved one can have several different aspects to it, such as the ones we have discussed, scientific and cultural, but with these aspects, we have to make sure we draw attention to the ethics of grieving. Ethics concerns the moral philosophy of suggesting and debating over the right and wrong of different conflicts. This philosophy controls people’s behaviors and choices. Based on how we perceive what is morally correct and incorrect, a universal definition of morality applied to different situations is non-existent. With different interpretations, people can practice emotions, such as grief, in a variety of different ways, all of which are valid.[19]  Morally, we all have our right to grieve in whichever way or form that we wish, under whatever time constraint we deem as necessary. Overall, the ethics of grievance affects all ages of the deceased equally, with minimal but different present interpretations of the whole process.

The ethical focus of bereavement focuses on ensuring that an individual can be allowed to grieve in a comforting way that allows them to process the event that took place. As mentioned in the cultural and scientific focuses, grief is not a clean-cut topic to explore, but rather a blurred subject (since death remains taboo in our society).[20] Autonomy supports the ethical sphere of grief, giving an individual the choice over their life, along with demanding respect and self-determination over their actions. Another ethical principle that applies to the grieving process is justice: when an individual gives someone what they deserve and what is due in an ethical fashion. The main example of this is giving compassion and allowing people to uphold their autonomy in grieving in the way they wish. The principle of deontology draws upon justice, ensuring that one is consistently respecting and upholding an individual’s moral obligations and duties for an action, based on if it is right or wrong under a series of rules. Practicing this ethical standard may mean disagreeing with someone’s grieving practices but supporting their customs anyway. A common grief model, which provides an outline that is not right nor wrong, is represented by the Kubler-Ross theory that supports individuals’ distinct methods of grievance.

“Recognising Reactions to Change, and Responding to Them.” Elisabeth Goodman’s Blog. November 10, 2013. Accessed April 09, 2019. https://elisabethgoodman.wordpress.com/2011/11/08/recognising-reactions-to-change-and-responding-to-them/.
This graph shows The Kubler-Ross stages of grief; the non-linear curve indicates that there is no linear way to grieve and experience death.

 

The Kubler-Ross psychological stages of grief uphold ethical standards of bereavement as they support that every grievance process is different for all individuals. Outlined by stages of denial, anger, bargaining, depression and acceptance, “the grief process is circular and spirals throughout the various stages.”[21] While this model gives us a good representation of the process, we have to acknowledge that the stages are also “not linear and some people may not experience any of them.”[22]  Becoming aware of these stages and the fluidity of them holds up ethical standards of grief and affirms the griever of the validity of their processes. Between the grievance of children and adults, these stages can take different forms while presenting themselves in common trends between the two. It can be common that people draw more attention to child death than adult death. While both deaths can be unexpected, children are viewed with more innocence and with a decreased possibility of experiencing death. An adult death may be viewed differently since they have had the ability to live and have a greater sense of control in their life.

We can explore that the real ethical issue of grief that leads to its complexity, is not conducting more research towards it. The lack of research on this subject is also due to the ethical concerns around researching bereavement practices.[23] Until we have experienced an equivalent grievance of death, whether it be a child or adult, we cannot come close to fully empathizing with the person going through their unique bereavement process. The difference between emotional bonds and ties between the deceased and the loved ones left behind drives the nature of grief. Our different perspectives of grief should be minimized while comforting the people around us to prevent persuasion towards their vulnerable state and to effectively acknowledge their difference of understanding.

Although grief is a complex concept, we can begin to understand it by examining small aspects such as the effect that the deceased’s age has on the mourning process. Research in psychology and neuroscience has revealed differences in the way people think about death with regards to different ages; culture further changes perspectives on the death of children versus adults; ethics affects the grieving process for all age groups and assures a lack of discrimination between grieving processes. Regardless of these nuances, grief is a necessary and healthy part of processing the death of a loved one.

Miranda Black, Emily Teems, Mikayla Cunningham

 

[1] Chambers, R. Andrew, and Sue C. Wallingford. “On Mourning and Recovery: Integrating Stages of Grief and Change Toward a Neuroscience-Based Model of Attachment Adaptation in Addiction Treatment.” Psychodynamic Psychiatry 45, no. 4 (2017): 451-73. Accessed April 5, 2019. https://guilfordjournals.com/doi/pdfplus/10.1521/pdps.2017.45.4.451.

[2] Janusz, Bernadetta, Joanna Jurek, and Karolina Dejko-Wańczyk. “The Grieving Process After Child Loss from the Perspective of the Continuing Bonds Theory: A Systematic Case Study.” Psychotherapia4, no. 187 (2018): 31-42. Accessed April 5, 2019. http://www.psychoterapiaptp.pl/uploads/PT_4_2018/ENGver31Janusz_Psychoterapia_4_2018.pdf.

[3] Erikson, Erik, Childhood and society. 2nd ed. 1963. New York: W. W. Norton.

[4] Al-Maharma, Dua’ Yousef, Hiba Abujaradeh, Khadejah Fahmi Mahmoud, and Reem Ahmad Jarrad. “Maternal Grieving And The Perception Of And Attachment To Children Born Subsequent To A Perinatal Loss.” Infant Mental Health Journal37, no. 4 (2016): 411-23. doi:10.1002/imhj.21570.

[5] Osterweis, Marian, Fredric Solomon, and Morris Green. Bereavement: Reactions, Consequences, and Care. Washington, D.C.: National Academy Press, 1989. Accessed April 5, 2019. https://www.ncbi.nlm.nih.gov/books/NBK217848/.

[6] Christ, Grace H., D.S.W., George Bonanno, Ph.D., Ruth Malkinson, Ph.D., and Simon Rubin, Ph.D. When Children Die: Improving Palliative and End-of-life Care for Children and Their Families. Washington: National Academies Press, 2003. Accessed April 5, 2019. https://www.ncbi.nlm.nih.gov/books/NBK220798/#ddd00406.

[7]  Osterweis, Marian, Fredric Solomon, and Morris Green. Bereavement: Reactions, Consequences, and Care. Washington, D.C.: National Academy Press, 1989. Accessed April 5, 2019. https://www.ncbi.nlm.nih.gov/books/NBK217848/.

[8] Osterweis, Marian, Fredric Solomon, and Morris Green. Bereavement: Reactions, Consequences, and Care. Washington, D.C.: National Academy Press, 1989. Accessed April 5, 2019. https://www.ncbi.nlm.nih.gov/books/NBK217848/.

[9] Taylor, Shelley E. Health Psychology. New York, NY: McGraw-Hill Education, 2018.

[10] Janusz, Bernadetta, Joanna Jurek, and Karolina Dejko-Wańczyk. “The Grieving Process After Child Loss from the Perspective of the Continuing Bonds Theory: A Systematic Case Study.” Psychotherapia4, no. 187 (2018): 31-42. Accessed April 5, 2019. http://www.psychoterapiaptp.pl/uploads/PT_4_2018/ENGver31Janusz_Psychoterapia_4_2018.pdf.

[11] Taylor, Shelley E. Health Psychology. New York, NY: McGraw-Hill Education, 2018.

[12] Religion. “The Tragic Death Of The Funeral.” The Federalist. December 13, 2013. Accessed April 08, 2019. https://thefederalist.com/2013/12/06/funeral-funeral-celebration-life-one-last-hurrah/.

[13] “Great News for the Dead: The Funeral Industry Is Being Disrupted.” The Economist. April 14, 2018. Accessed April 09, 2019. https://www.economist.com/leaders/2018/04/14/great-news-for-the-dead-the-funeral-industry-is-being-disrupted.

[14] Religion. “The Tragic Death Of The Funeral.” The Federalist. December 13, 2013. Accessed April 08, 2019. https://thefederalist.com/2013/12/06/funeral-funeral-celebration-life-one-last-hurrah/.

[15] “Great News for the Dead: The Funeral Industry Is Being Disrupted.” The Economist. April 14, 2018. Accessed April 09, 2019. https://www.economist.com/leaders/2018/04/14/great-news-for-the-dead-the-funeral-industry-is-being-disrupted.

[16] Olberding, Amy. “Is the Death of an Elder Worse than the Death of a Young Person? – Amy Olberding | Aeon Ideas.” Aeon. April 08, 2019. Accessed April 09, 2019

[17] “Comprehensive Cancer Information.” National Cancer Institute. Accessed April 09, 2019. https://www.cancer.gov/.

[18] Institute of Medicine (US) Committee on Palliative and End-of-Life Care for Children and Their Families. “BEREAVEMENT EXPERIENCES AFTER THE DEATH OF A CHILD.” When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families. January 01, 1970. Accessed April 09, 2019. https://www.ncbi.nlm.nih.gov/books/NBK220798/.

[19] “The Ethics of Grief.” Ethics Beyond Compliance. April 06, 2015. Accessed April 05, 2019. https://ethicsbeyondcompliance.wordpress.com/2013/11/22/the-ethics-of-grief/.

[20] Lee, Raymond L.m. “Modernity, Mortality and Re-Enchantment: The Death Taboo Revisited.” Sociology 42, no. 4 (2008): 745-59. doi:10.1177/0038038508091626.

[21] Roseman, Janet Lynn, Elizabeth Hames, and Paula Anderson Worts. “Grief and Healing.” Alternative and Complementary Therapies 23, no. 3 (2017): 93-97. Accessed April 5, 2019. doi:10.1089/act.2017.29112.jlr.

[22] Gregory, Christina. “Five Stages Of Grief – Understanding the Kubler-Ross Model.” PsyCom.net – Mental Health Treatment Resource Since 1986. Accessed April 05, 2019. https://www.psycom.net/depression.central.grief.html.

[23] Beck, Andrea M., and Candace A. Konnert. “Ethical Issues in the Study of Bereavement: The Opinions of Bereaved Adults.” Death Studies 31, no. 9 (2007): 783-99. Accessed April 05, 2019. doi:10.1080/07481180701537220.

Grief by Age

Everyone will experience death at some point during their life. While adulthood is the most common time for bereavement[1], many children and adolescents will experience death at some time as well. Each person is different in their psychological and emotional response to grief, and much of this is influenced by age. Because death is an unavoidable part of life, it is important for society to increase understanding of the different ways in which people may view and respond to death.

Bereavement During Adulthood

As mentioned earlier, bereavement most commonly happens during adulthood, and the frequency of loss increases with age. However, grief is different in adulthood because adults have a fully developed understanding of death and memories with the deceased. While sadness is an expected grief response, there are many other responses to grief that may be unexpected. For example, researchers have observed physical symptoms in bereaved adults in addition to changes in emotion, thought, and behaviors.  Unexpected responses to grief may also include “‘searching’ behaviors – including hallucinations, dreams in which the deceased is still alive, ‘seeing’ the deceased person in the street, and other illusions and misperceptions.”[2]

Often times, adults may experience dreams or hallucinations in which the deceased are still alive.

When the reality sets in that the deceased is not coming back, symptoms such as depression, anger, and anxiety more commonly begin to surface. Bereaved adults may have intense mood swings as well. Most often, however, adults immediately respond to grief with feelings of shock, numbness, or disbelief. These responses may cause the bereaved to appear to be accepting of their loss because they have not yet processed the reality of the death, much like children during early childhood. With time, however, these feelings of shock or numbness usually shift to feelings of sadness and separation.[4]

Adults may experience feelings of separation, extreme sadness, depression, and anxiety following bereavement.

Bereavement During Adolescence

One of the earliest and continued interests is the developmental progression in children’s concept of death.[6] Adolescents are in Piaget’s formal operational stage of development[7], meaning they have a full, adult understanding of death. However, they may not deal with their grief in the same way. It is known that most adolescents often feel as though “no one understands them”, but these feelings may be especially apparent during grieving. This may lead to intense emotional reactions and difficulty expressing their feelings. For this reason, adolescents may also exhibit high-risk behavior in dealing with grief as a way of challenging their own mortality or as an attempt to regain control[8]. On the other hand, adolescents may not express their emotions at all due to fear of being “weird” or “different” from their peers, much like in late childhood and preadolescence. Socially, adolescents may have greater reliance on their peers or they may isolate themselves. Regardless, emotional support is extremely important in helping adolescents deal with death, as with any age group. However, it is especially important for adults to allow adolescents to remain independent during times of grief, at least to some degree.

Bereavement During Late Childhood and Preadolescence

Amsler uses Piaget’s four stages of cognitive development in understanding how a child’s view of death changes as they develop, most especially in late childhood and preadolescence. Children in late childhood are in Piaget’s concrete operational stage of development, meaning they will begin to gain a deeper understanding of death and think more logically about this process.[9] That being said, children’s understanding of death at this stage is more like an adult’s understanding of death – they understand that death is permanent, but they also attempt to understand both the physical and emotional processes of death. Similar to children in middle childhood, children in late childhood and preadolescents may appear withdrawn and attempt to conceal their feelings, but on a much larger scale. It is suggested that children in this stage may attempt to hide their feelings so as not to appear “weird” or “different” compared to other children their age. It has also been suggested that children in this stage act in this way because sadness is seen as a sign of weakness (especially in boys.)[10] Children in this stage are more likely to express their grief through anger, irritability, and moodiness which can lead to isolation.

Bereavement During Middle Childhood

Unlike during early childhood, children in middle childhood have the understanding that death is permanent. During middle childhood, children have a greater understanding that everything that happens in their environment does not revolve around them. Because of this, a child in this stage may have heightened fears about death and may become increasingly concerned about the health and safety of themselves and their loved ones. Bereaved children at this age may also experience anxiety and depressive symptoms following the loss of a loved one. As mentioned earlier, they may also express anger and sadness that may lead to aggressive behavior and difficulty in school. They may also appear to be withdrawn in an attempt to conceal their feelings (these specific behaviors may be especially apparent in young boys at this age.) Middle-aged children can even regress to an earlier developmental stage as a result of their grief. However, children in middle and late childhood tend to have more coping strategies than children in early childhood. For example, children in this stage may imagine what they would have done to prevent death from happening as a way of coping and attempting to gain control over the situation.[11]

Bereavement during childhood may cause children to have difficulty in school with their peers and schoolwork.

Bereavement During Early Childhood

In early childhood, children view death as temporary and reversible. Children at this age may believe that certain thoughts or feelings can lead to death, which may cause them to feel responsible for the death of a loved one and blame themselves. This is because children at this age believe that everything that happens in their environment revolves around their own thoughts and actions. Sometimes it may seem as though there is an absence of grief in a bereaved child at this age. However, this doesn’t mean that they are unaffected by the death; it may indicate their inability to process the reality of the death at the time. In addition, children who have experienced death at this age may fear that other loved ones will leave them or they may become attached to individuals who remind them of the deceased in some way.

Everyone is different in their own response to death, and much of this is influenced by age – children respond to grief in different ways than adults, and vice versa. However, age is not the only factor that influences the ways in which people respond to death; culture also plays a huge part in the response to grief – in children especially.

While differences in grieving are present among children and adults, the processes differ further when culture is taken into account. A culture with a stark difference to the process of grieving – in comparison to American culture – is the Hispanic culture. The Hispanic element of machismo is used to describe the masculine pride in maintaining self-control, stoicism, and strength that men are expected to adhere to in every situation, including loss of a loved one[13].

These cultural attitudes and beliefs can result in children not receiving the appropriate information or support they need because the adults in their lives are preoccupied in dealing with their own emotions. Without parental or adult support, Hispanic children are more likely to have permanent negative effects, a longer grieving process, and emotional instability[14]. As a result, childhood traumatic grief may be present in more children than previously thought. Hispanic children also have difficulty expressing their anger, sadness, confusion, and other emotions tied to bereavement due to cultural norms[15].They may believe they are helping the family by not showing their emotions, also known as displaying machismo when they are in pain, and not wanting to be a burden to the family.

Painted on the front of a wall, this mural translates to: “Machismo (male chauvinism) puts women and men at risk. You can change it!”

Unaddressed grieving can manifest in many ways, such as acting out behaviors (e.g., bullying, aggression, violence toward self and others), anxiety, eating disorders, isolation, learning problems, perfectionism, and suicidal ideation and attempts[16]. In addition to expressing grief physically and emotionally, it is more culturally acceptable for Hispanics to seek help for somatic symptoms like headaches, intestinal disorders, nervousness, and other physical manifestations of grief than it is to seek mental health care[17]. Even though children are not involved in the bereavement process with adults, they are usually included in all the funeral rites because honoring the person is important for the next generation, who will then have some responsibility in caring for the dead by visiting their grave each year[18].

     An important aspect of most Hispanic families is a cultural hierarchy in which men are the head of the household, women come second to men, and children – as the youngest – are at the bottom of the hierarchy[19]. Although Hispanic families make decisions together, following the family hierarchy is extremely important in most households. As a result of this family hierarchy, parents do not often discuss taboo subjects, such as death, with their children until it becomes necessary[20]. This aspect of taboo subjects is similar to the Japanese culture, where open discussion of death, particularly among children, remains one of the greatest Japanese societal taboos; therefore, little is known about Japanese children’s perceptions of death[21]. In many Hispanic cultures, death becomes a community event in which the family turns to others in the extended for help. However, research supports the concept that many Hispanics, both children and adults, are not open with their emotions, preferring not to express them outside the family[22]. Families in the Hispanic community have a closer personal space within their families than Westernized culture tends to have[23]. For example, a Hispanic child may seek out and welcome a warm, loving embrace when feeling distraught or unhappy. Therefore, Hispanics, including children, express their grief physically as much or more than emotionally[24].

Built into several Hispanic cultures is maintaining some sort of level of connectivity to loved ones who have passed away. Rituals and practices, both religious and iconic, include those that create a bond with the dead in order to not lose connection after death[25]. For example, a prominent festivity in Mexican culture, Dia de los Muertos, or the Day of the Dead, is an annual celebration to honor lost loved ones, also exposing children to the idea of death and the continuation of the spirit in a non-morbid way[26].

A celebration of the Day of the Dead in the streets of Mexico City.

Altares (alters) of loved ones for the Day of the Dead.

This occurs starting on November first, when souls of deceased children are return to the living world, followed by the return of the souls of adults on November second[27]. It is a time when Mexicans celebrate the lives of lost loved ones and seeing death in a more positive light: as a transition to a higher place where they may join their loved ones sometime in the future. The underlying theme of these festivals is not to fear death, but accept it as part of life, making it a viable cultural coping strategy for children and adults[28]. This way of celebrating is meant to be joyful and a way to welcome the dead back into the world of the living for a day, honor them, and to show people that death is not to be feared. This differs greatly from the Westernized or American cultural views of death, where American children grow up in a culture that avoids grief and denies the inevitability of death[29]. With the many cultural setbacks children and adults go through that hinder their grieving process, Dia de los Muertos aids in that process even just for a couple of days.

     Dia de los Muertos helps parents in the Hispanic culture talk to their children about taboo subjects regarding death and furthermore gather together in accepting the concept of death rather than fearing it.  The ways in which children are either welcomed or excluded from the grieving process determines the healthiness and effectiveness of a child’s grief. More importantly, the ways in which parents decide to explain the concept of death to children can be explained and attributed to a series of ethical principles that guides society.

In the relationship that parents have with their children’s grief, most parents subconsciously utilize the principle of deontology to explain grief and death. Most western-cultured parents believe in the common practice of hiding grief and death from children[30]. As mentioned previously, the Hispanic concept of machismo creates a stoic and private grieving atmosphere that hides the excruciating pain associated with losing a loved one. The belief is that this practice will protect children from the pain of grief, and will allow the most optimal outcome with regards to the psychology of the child – when in reality it causes negative effect for the child. This behavior can be named deontological because it follows the general outstanding social law that children should be safeguarded from death[31]. The social law stems from adults’ general feeling that it is one’s moral duty to shield children from the concept of death[32]. On the contrary, studies actually show that excluding children from the grief process is detrimental to their understanding of death and their future mental health.[33]

Studies have shown that being specific, honest and concrete in descriptions of death towards children is the most optimal way to address death to children.[34] Specifically, using euphemisms such as ‘gone to sleep,’ ‘passed away,’ and ‘left us’ confuse children.[35] These euphemisms leave hope for the children to believe that the person will return[36], which confuses children’s concept of finality with death (an already difficult concept to grasp). Instead, using concrete language such as ‘death and dying’ not only directly addresses the confusing concepts of death but also allows children to feel comfortable talking about it[37]. The subject becomes less taboo and integrates a healthy perception of death – rather than a scary formidable one[38].

A mother consoling her child.

The honest inclusion of children into the grieving process can be regarded as a consequentialism because the outcome of action creates a positive outcome for the children in the long run even though it may create temporary pain. In regards to grief, those acting with consequentialism seem to have the most success in overcoming and conquering it.[39]

One of the most detrimental things that a parent can do for a child’s grief is to disclude them in the process of grieving, the extreme being that the child is sent away from the site of communal grieving. Sending a child away to live with relatives while the adults deal with the grief and the funeral rites of the loved one will only create a rift between the child and his/her parents[40]. The child, depending on the age and maturing level, will most likely pick up on the fact that something is wrong while simultaneously being told that everything is okay by his trusted adults[41]. This conflicting views cause a distrust of adults during a time where an adult guidance through grief is vital.

The common myth that children do not grieve, or that their grief is insignificant in comparison, may be easier to believe than for parents to explain and teach their children healthy forms of grieving. Furthermore, as parents grieve routines, attitudes, and attention are suddenly altered which can result in derangement for children. A study showed that when the usual ‘limits and the routines of household, school and play were maintained’ the child coped better with the loss of an important person[42]. This is in drastic comparison to when the limits of the household were relaxed, the children’s anxiety and behavioral response to grief was significant in proportion to the difference in their routine[43]. From this study, in regards to parents, the belief that children do not mourn and that brushing aside parental responsibilities in response to coping with grief actually creates more behavioral problems for the children of the household[44]. For parents, the ethical principle of altruism should be implicated in order to account for the responsibility of not only their own grief, but also their child’s grief.

While parents must account for the well-being of others and therefore should utilize altruism when grieving, adults who can afford the luxury can ethically defend their actions through egoism – more specifically, rational egoism. In adults, a developed maturity allows for a full understanding of death which can lead to a morbid attitude and intense grief when a loved one dies. In an interview discussing his group grief counseling, Reverend Glasgow conceptualizes how people can get into a state of ‘paranoia’ meaning that they catastrophize over grief in that they feel an intense and increasing pain in the first 6-8 months of grieving[45]. For a person who experiences this type of grief, seeking help can be difficult mainly because of the outlook that their grief is no more than the bereavement of the person next to them. This detrimental outlook can be contrasted with the ethical approach of rational egoism – meaning that an action is rational if it maximizes one’s self-interest is morally right. In this sense, rational egoism can be used to support decisions such as time off from work, and more importantly cognitive behavioral therapy to aid the process of grieving and allow for the return to a healthy mental state[46].

The psychology of grieving varies among age groups. A child’s lack of understanding of the finality of death can be very confusing and they might need the support of the adults around them to learn how to grieve in a healthy way. Once the child matures into adulthood, their grieving process is determined on how they were taught to grieve as a child. Grief looks different along latitudes by age and along longitude across cultures. Furthermore, grieving behaviors can be justified by different ethical approaches depending on the stage of life one is in. A consideration of the scientific, cultural, and ethical perspective creates a greater understanding of the psychology of grief across different age groups.

 

 

 

Lisette Bahena, Ellen Hayes, Anika Allen

 

 

 

 

 

[1] Osterweis, Marian, Fredric Solomon, and Morris Green. “Bereavement During Childhood and Adolescence.” Bereavement: Reactions, Consequences, and Care. January 01, 1984. Accessed March 28, 2019. https://www.ncbi.nlm.nih.gov/books/NBK217849/.

[2] Ibid.

[3]“Visitation Dreams.” J.M. DeBord Dream Interpretation. March 27, 2018. Accessed April 08, 2019. https://dreams123.net/dream-interpretation-contact-with-a-deceased-parent-is-it-real/.

[4] Osterweis, Solomon, and Green, “Bereavement During Childhood and Adolescence.”

[5] McKinley. “There Is Nothing You Can Say to Heal Someone Else’s Grief.” The Mighty. April 08, 2019. Accessed April 08, 2019. https://themighty.com/2016/12/what-to-say-to-someone-whos-grieving/.

[6] Robert S Pynoos MD, MPH (1992) Grief and Trauma in Children and Adolescents,Bereavement Care, 11:1, 2-10, DOI: 10.1080/02682629208657280

[7]Amsler, Kyle. “Conceptualizations of Death in Middle Childhood and Adolescence.” Child Life Resources. April 29, 2015. Accessed March 28, 2019. http://www.childliferesources.com/conceptualizations-death-middle-childhood-adolescence/.

[8] Himebauch, Adam, M.D., Robert M. Arnold, M.D., and Carol May, R.N. “Grief in Children and Developmental Concepts of Death #138.” Journal of Palliative Medicine 11, no. 2 (2008): 242-44. doi:10.1089/jpm.2008.9973.

[9] Amsler, Kyle. “Conceptualizations of Death in Middle Childhood and Adolescence.”

[10] “Children’s Developmental Stages Concepts of Death and Responses.” Children’s Responses to Grief. Accessed March 28, 2019. https://www.vitas.com/family-and-caregiver-support/grief-and-bereavement/children-and-grief/childrens-developmental-stages-concepts-of-death-and-responses.

[11] “Children’s Developmental Stages Concepts of Death and Responses.” Children’s Responses to Grief.

[12] “Is Your Child Acting Out?” Psychology Everywhere. September 06, 2017. Accessed April 08, 2019. https://psychologyeverywhere.com/article/is-your-child-acting-out.html.

[13] Arman, “A Grief Counseling Group Design for Hispanic Children,” 3.

[14] Arman, “A Grief Counseling Group Design for Hispanic Children,” 5.

[15] Ibid.

[16] Arman, “A Grief Counseling Group Design for Hispanic Children,” 6.

[17] Clarissa Gonzalez and Bell Hope. “Child-centered play therapy for Hispanic children with traumatic grief: Cultural implications for treatment outcomes.” International Journal of Play Therapy 25, no. 3 (2016): 149.

[18] Henry Fersko-Weiss. “The Hispanic Way of Death and Dying.” International End of Life Doula Association, accessed March 24, 2019, https://www.inelda.org/the-hispanic-way-of-death-and-dying/.

[19] John Arman, “A Grief Counseling Group Design for Hispanic Children,” American Counseling Association, 69, no. 1 (2014): 2.

[20] Arman, “A Grief Counseling Group Design for Hispanic Children,” 3.

[21] Miharu Sagara-Rosemeyer and Betty Davies, “The Integration of Religious Traditions in Japanese Children’s View of Death and Afterlife.” Death Studies 31, no. 3(2007): 223.

[22]Arman, “A Grief Counseling Group Design for Hispanic Children,” 6.

[23] Ibid.

[24] Ibid.

[25] Fersko-Weiss. “The Hispanic Way.”

[26] Ibid.

[27] Fersko-Weiss. “The Hispanic Way.”.

[28] Ibid.

[29] Clarissa Willis. “The Grieving Process in Children: Strategies for Understanding, Educating, and Reconciling Children’s Perceptions of Death.” Early Childhood Education Journal 29, no. 4 (2002): 222.

[30] Ibid, 224.

[31] Elisabeth Kübler-Ross and Ira Byock, On Death & Dying: What the Dying Have to Teach Doctors, Nurses, Clergy & Their Own Families(New York: Scribner, a Division of Simon & Schuster, 2014), 6.

[32] Ibid, 4.

[33] Ibid, 4.

[34] Seccareccia, Dori, and Andrea Warnick. “When a Parent Is Dying -Helping Parents Explain

Death to Their Children.” Palliative Care Files 54 (2008).

[35] Ibid.

[36] Ibid.

[37] Ibid.

[38] Elisabeth Kübler-Ross and Ira Byock, On Death & Dying: What the Dying Have to Teach Doctors, Nurses, Clergy & Their Own Families(New York: Scribner, a Division of Simon & Schuster, 2014), 6.

[39] T, Buddy. “How to Talk to Children About Family Substance Abuse.” Verywell Mind. Accessed

April 08, 2019. https://www.verywellmind.com/what-to-tell-children-about-a-parents-addiction-66633.

[40] Elisabeth Kübler-Ross and Ira Byock, On Death & Dying: What the Dying Have to Teach Doctors, Nurses, Clergy & Their Own Families(New York: Scribner, a Division of Simon & Schuster, 2014), 4,6.

[41] Ibid, 6.

[42] Catherine R. Andrews and Sylvia A. Marotta, “Spirituality and Coping Among Grieving Children: A Preliminary Study,” Counseling and Values 50, no. 1 (2005)

[43] Ibid.

[44] Ibid.

[45] Moules, Nancy. (2009). Following in Behind Grief: An Interview with the Reverend Bob

Glasgow on his Practice of Grief Work. Illness, Crisis, & Loss. 17. 51-69.

[46] Ibid.

 

Full Bibliography:

Amsler, Kyle. “Conceptualizations of Death in Middle Childhood and Adolescence.” Child Life Resources. April 29, 2015. Accessed March 28, 2019. http://www.childliferesources.com/conceptualizations-death-middle-childhood-adolescence/.

“Childrens Developmental Stages Concepts of Death and Responses.” Children’s Responses to Grief. Accessed March 28, 2019. https://www.vitas.com/family-and-caregiver-support/grief-and-bereavement/children-and-grief/childrens-developmental-stages-concepts-of-death-and-responses.

Himebauch, Adam, M.D., Robert M. Arnold, M.D., and Carol May, R.N. “Grief in Children and Developmental Concepts of Death #138.” Journal of Palliative Medicine 11, no. 2 (2008): 242-44. doi:10.1089/jpm.2008.9973.

“Is Your Child Acting Out?” Psychology Everywhere. September 06, 2017. Accessed April 08, 2019. https://psychologyeverywhere.com/article/is-your-child-acting-out.html.

McKinley. “There Is Nothing You Can Say to Heal Someone Else’s Grief.” The Mighty. April 08, 2019. Accessed April 08, 2019. https://themighty.com/2016/12/what-to-say-to-someone-whos-grieving/.

Osterweis, Marian, Fredric Solomon, and Morris Green. “Bereavement During Childhood and Adolescence.” Bereavement: Reactions, Consequences, and Care. January 01, 1984. Accessed March 28, 2019. https://www.ncbi.nlm.nih.gov/books/NBK217849/.

Pynoos, Robert S. “Grief and Trauma in Children and Adolescents.” Bereavement Care 11, no. 1 (1992): 2-10. doi:10.1080/02682629208657280.

“Visitation Dreams.” J.M. DeBord Dream Interpretation. March 27, 2018. Accessed April 08, 2019. https://dreams123.net/dream-interpretation-contact-with-a-deceased-parent-is-it-real/.

Arman, John. “A Grief Counseling Group Design for Hispanic Children.” American Counseling Association 69, no. 1 (2014): 1-14.

Gonzalez, Clarissa, and Bell Hope. “Child-centered play therapy for Hispanic children with traumatic grief: Cultural implications for treatment outcomes.” International Journal of Play Therapy 25, no. 3 (2016): 146-153.

Fersko-Weiss, Henry. “The Hispanic Way of Death and Dying.” International End of Life Doula Association. https://www.inelda.org/the-hispanic-way-of-death-and-dying/ (accessed March 24, 2019).

Sagara-Rosemeyer, Miharu, and Betty Davies. “The Integration of Religious Traditions in Japanese Children’s View of Death and Afterlife.” Death Studies 31, no. 3 (2007): 223-247.

Willis, Clarissa. “The Grieving Process in Children: Strategies for Understanding, Educating, and Reconciling Children’s Perceptions of Death.” Early Childhood Education Journal 29, no. 4 (2002): 221-226.

Kübler-Ross, Elisabeth, and Ira Byock. On Death & Dying: What the Dying Have to Teach Doctors, Nurses, Clergy & Their Own Families. New York: Scribner, a Division of Simon & Schuster, 2014.

Andrews, Catherine R., and Sylvia A. Marotta. “Spirituality and Coping Among Grieving Children: A Preliminary Study.Counseling and Values50, no. 1 (2005): 38-50.

Seccareccia, Dori, and Andrea Warnick. “When a Parent Is Dying -Helping Parents Explain Death to Their Children.” Palliative Care Files 54 (2008).

Moules, Nancy. (2009). Following in Behind Grief: An Interview with the Reverend Bob Glasgow on his Practice of Grief Work. Illness, Crisis, & Loss. 17. 51-69.

Pictures:

“Visitation Dreams.” J.M. DeBord Dream Interpretation. March 27, 2018. Accessed April 08, 2019. https://dreams123.net/dream-interpretation-contact-with-a-deceased-parent-is-it-real/.

McKinley. “There Is Nothing You Can Say to Heal Someone Else’s Grief.” The Mighty. April 08, 2019. Accessed April 08, 2019. https://themighty.com/2016/12/what-to-say-to-someone-whos-grieving/.

“Is Your Child Acting Out?” Psychology Everywhere. September 06, 2017. Accessed April 08, 2019. https://psychologyeverywhere.com/article/is-your-child-acting-out.html.

“Gran Celebración del Día de Muertos en la Ciudad de Mexico.” Oct. 27, 2018. Accessed April 08, 2019. https://www.marca.com/claro-mx/trending/2018/10/27/5bd4026822601d18598b464f.html

Juliano, Michael. “Day of the Dead 2013 at Hollywood Forever.” Sept. 25, 2018. Accessed April 08, 2019. https://www.timeout.com/los-angeles/things-to-do/amazing-things-happening-in-la-this-october

Menkedick, Sarah. “How to manage machismo on the road.” March 13, 2009. Accessed April 08, 2019. https://matadornetwork.com/bnt/hey-baby-how-to-manage-machismo-on-the-road/

T., Buddy. “Parental Alcoholism Affects Children.” 27 October 2018. Accessed April 08, 2019. https://www.verywellmind.com/what-to-tell-children-about-a-parents-addiction-66633

 

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