Missing Pieces

“No more let life divide what death can join together…”

Adonais: An Elegy on the Death of John Keats. By Percy Bysshe Shelley

It did not take long after the publication of Elizabeth Kubler-Ross’ book On Death & Dying for the professional pedants, steeped in the authoritative tradition of teaching to students rather than conversing with students to enshrine the “Stages” into a formulaic dogma, despite pleas to the contrary from Kubler-Ross herself. That few of them had any personal or direct experience with the subject mattered little; they had the received wisdom before them. Proof that no industry can long survive without branching out came in the subsequent development of “stages of grief”, complete with order and even time frames.

As I was involved with direct patient and family care I watched these developments from a distance, half expecting a “stages of weight loss” or “stages of low-cal cooking” manual to sweep the nation next. For nearly two decades before meeting and working with Kubler-Ross I had been immersed in death and dying in one form or another, at times only inches from the eyes which, in that remarkable moment of final change, seemed to hold mine – or perhaps were seeing beyond me to vistas I will, in my due time, look upon.

Even today, the slow rejection of lockstep stages notwithstanding, in the bloom of this formulaic flower there is still the assurance of false comfort in what passes for learned knowledge, which may more correctly be described as control over the uncontrollable. A lingering artifact of this is the conflation of Grief and Bereavement, as if saying the words interchangeably will assure accuracy at least half the time.

Having dealt with each, I draw a distinct separation. I see them as: Grief is acute, sudden, often characterized by confusion and “mental paralysis”; and, Bereavement is chronic, long term, and characterized by the tendency to view the future through the lens of the past.

I have seen individuals and families in acute grief, often so deep that one must reserve a portion of one’s thinking to contingencies for the safety and well being of those caught in this psychic maelstrom.

But despite having been present at many deaths, human and non-human, I have not personally experienced disabling grief. Undoubtedly there are several reasons for this, but emotional distance, ample forewarning, and an understanding of the nature of things each played a role. This is not to say I think I am incapable of grief. From the moment I became a father I sometimes wondered how I would deal with the sudden or even prolonged death of my child, particularly in her pre-adult years; reading Rosshalde, by Hermann Hesse, had me listening outside her room nightly. With a degree of certainty bordering on but not becoming belief I can say I would not be here writing this.

Bereavement, however, is another matter. I most certainly do experience dark, lonely, and even tearful bereavement, for my horses, my several dogs, my cat Rommel, and for one particular person, one “significant other” as the academics would have it. At my age, why just one person, you ask? That’s my business………. and always will be.

From a young age I have observed people in both grief and bereavement, and wondered what was meant when someone’s death was described as a “loss”, as in “I lost my….” Loss? My? Many people use an odd form in referring to someone else. Introduction: “This is my wife (plug name here – Undulata; Orgasma; Vampirella….).” One could as easily say, This is my car. And, I learned “my” was a possessive, “wife” a category. Perhaps it is too much trouble to say, “I would like you to meet the woman who shares much of her life with me.” And then there are those smarmy referential terms of endearment: “better half; little wife; and etc”. I half expect the polyester suited speaker to ask if I want a highball. No, but I’ll remove yours if you are not silent.

How do we lose someone that was never ours? How is that not denying the validity of someone’s path in life, as if they abdicated their appointed role to us or were improperly taken from us? Maybe the “join together” intoned at weddings implies some sort of Lego coupling we wonder if our kid is doing so quietly in his room. I’ve heard it said that the people best qualified to get married don’t need to. Unless, of course, “best qualified” means walking around with a gaping hole in the persona that “needs to be filled” by someone.

How is love “lost”? I smell Wall Street. Is the giving of love an investment to bring a big dividend? Feel cheated if the columns don’t match? Death: a market crash. Lost it all. And what to show for it? Make up I won’t use and clothes I can’t wear.

In the early days of grief counseling there was little to no distinction between grief and bereavement. Even the term counseling was rarely questioned. I always preferred the concept grief facilitation, by which I meant providing the safe venue for people to express their feelings and, most importantly, to talk to themselves. As I’ve said elsewhere, people do not hear what we say; they hear what they tell themselves we’ve said. I have no business insinuating myself into someone else’s life, someone else’s chaos, to tell them how to put it in order and feel better. If careful, I do have an opportunity to listen and, through simple techniques such as saying “I don’t know how I would handle this. How do you handle this?” I give the person the chance to feel as if they are counseling me when in fact they are hearing their own thoughts put into words and played directly to them. Whether they realize it or not, people listen to themselves; I’m only the reflective board for them. At times I may replay what seems to be confused logic or faulty assumptions, asking them if I heard correctly. This enables them to replay their utterance to determine if it is really what they want to say/hear from themselves. I have no basis to pronounce fault, but they will do it quickly for themselves and make the correction if given the opportunity, just as in writing a first draft and re-reading it. I am only the paper they have written upon.

Another term which gained currency, and thankfully is steadily losing it is “closure”. There is no such thing as closure. There is a lessening of pain over time. Closure is a code word used by others to mean they wish you would get over it and shut up.

As awareness of the difference between grief and bereavement grew there were questions regarding timetables. How long is too long? What’s a decent interval before the next hot date? Early wisdom had it that if a person is still socially withdrawn or disabled by 18 months post death of a significant other it is an indication of some deeper unresolved problem. I have seen several instances of this, but timing was not the key indicator; behavior was the indicator. There should be no doubt that the First Year is the Year of Firsts. Every public holiday, every private and timed ritual, every familial birthday, etc will be marked as, “This will be the first (fill in the blank) that Harry isn’t with us”, “This will be our first trip to open the beach house without…..”. All these firsts must and will play themselves out, diminishing in observance fairly rapidly once through that Year of Firsts. Of course, there’s always a cautionary note. I recently heard a man say “Mom would have been 100 today.” His mother had died 12 years earlier. In his case, it was mostly a factual statement with little evidence of unresolved emotional issues. Nonetheless, the occurrence of it in his mind was a reminder once again – there just is no “closure.”

Perhaps for as long as humans have chosen to bond with each other, presumably for life, there have been anecdotes of a spouse (life partner) dying not long after the death of the other partner. The likelihood increases with age, and with the number of years behind the connection. Although one could reasonably argue that years together is a stronger predictor than raw age itself, I know of no studies which have attempted to systematically parse the two. We do know that the interim is shorter when a female precedes a male but we do not have a firm answer why. Females tend to hold out longer, perhaps to get in another shopping trip before blasting off.

Either way, there is often mention from the survivor, sometimes repetitive and detailed, that life has now become a waiting room, an empty present awaiting a fulfilling future reunion with the predeceased partner.

Make no mistake. This is not simple. Platitudes and “get a hobby” suggestions usually do far more harm than good. More than “uncomplicated bereavement”, this presents the threat of a dire loss of self.

A therapeutic approach to this state is to:
Affirm the partner has gone.
Question the presumption that there would not have been a disparity in times of death (the partner versus the survivor).
Ask how the partner would have survived had the order been reversed.
Question the presumption that a reunion would simply be “picking up where we left off.”
Ask the survivor to visualize what the deceased partner would advise were he/she able to do so.
Invest the survivor in the thought that remaining life well lived is what would make the deceased partner happiest, and would honor the memory of that partner more.

But again, this is not just academic prattle off page 33 of a counselor manual. Solitary life can become endangering. Yet, the decision to remarry, or marry, can be fraught with guilt. More surprising to those who are not experienced caregivers or counselors (facilitators) is the ultra-confidentially expressed fear (driven by the greatly enlarged media coverage of these phenomena) that while on the death bed one may see the predeceased loved one and blurt out loving rapture in the presence of the current spouse sitting at bedside. I have met few deathbed fears as great as this, driven by the fear of hurting the surviving partner or spouse. “I don’t want him/her in the room in case it happens” is the common statement. Failure to assure the dying survivor of a previous relationship can mean an agonizing wait for death and a silence that they literally “hope to take to the grave.”

I’ve raised some issues. I might easily say here that I do not have all the answers. But that would presume all the answers are fixed in place out there somewhere, we have only to flip to the right page. Working with the perception of missing pieces, of the self or of someone else, is a process questioning the perception, suggesting adjustments, and, finally, being able to helpfully appreciate the validity of the construction upon which the person himself has settled. Tough call. Tough life. But as we begin to appreciate and incorporate the dynamic processes occurring in ourselves and others we find those pieces weren’t missing after all.

“Grief can’t be shared. Everyone carries it alone, his own burden, his own way.” Anne Morrow Lindbergh, “Theodore,”
Dearly Beloved. 1962