Tuesday, 9 November 2010

Funerals and grieving - facts and fallacies

Over on impactED nurse,an excellent blog ( http://www.impactednurse.com/?p=2431) Ian Miller sums up some research for us under the heading "Grief: fact and fallacy." It seems to me very important for those of us who ponder how best to help grieving people to create the best possible funeral.

Nurse and psychologist Alice E Holman looked at 23 textbooks routinely given to student nurses and found in each of them at least one unsupported assertion about the nature of grieving.

"The study found that most textbooks included more than one myth, and on balance, there was very little exploration or discussion based on current evidence. She compared this to some of the actual evidence based findings surrounding the process of grieving," writes Ian, and quotes these summary points:

  1. There are stages or a predictable course of grief that individuals should or typically will experience
  2. There is a specific timeline for when grieving processes will occur
  3. Negative emotions such as distress, depression, sadness, disorganization, loss of functioning, anger, guilt, fear or emotional pain ARE INEVITABLE following a loss
  4. Emotions need to be ‘‘processed’’: expressed, worked through, acknowledged, dealt with, experienced, attended to, focused on, made sense of
  5. Lack of experiencing or expression of emotions (e.g., denial, absent grief, delayed grief, inhibited grief) indicates pathology or negative consequences
  6. Recovery, acceptance, reorganization or resolution should be reached in ‘‘normal’’ grief
  7. Failure to find resolution indicates unhealthy, dysfunctional, pathological, or complicated grief

Evidence-based Findings

  1. Not all people experience grief in the same way
  2. Some grieving people do not report feeling distressed or depressed
  3. Some people experience high levels of distress for the rest of their lives without pathology
  4. Repressive coping may promote resilience in some people
  5. Resilience, growth, and/or positive emotions may be associated with loss."
Any half-competent FD or celbster would support finding 1. But all of them suggest to me that there should be no such thing as an orthodoxy about funerals, whether it's traditional reserved British religion sans, or emotionally expressive and uninhibited new-minted ritual. No. 4 might support a stiff upper lip sort of funeral, no. 5 a particular kind of "New Age" ritual, to put it crudely.

Why does it matter? Because effective funerals respond to particular people in particular contexts. Ways of grieving are part of that context. It seems more and more important to me that celebrants outside established faith systems are transparent; we need to respond sensitively and quickly to who s/he was and what the family are like, and help them to find the ceremony that suits. How they grieve needs to be part of the construction work - what is said and done, how it is said and done. Our beliefs about what funerals should be like are best kept out of the way, other than to suggest appropriate things they may not have thought of (like "why have the funeral at that horrible old crem anyway?")

A woman said to me some months ago "you won't see me crying at the funeral; I just don't." She showed no evident signs of unhappiness. Yet she went to a lot of trouble to work up the ceremony that she thought was right, for the man she so clearly had loved, anyone could see that. See 2, 4 and 5 above.

Spike Milligan was asked in later life if he missed Peter Sellars, who died in middle age. He said instantly "Every day," and his eyes filled with tears. See 3 above. (No, it wasn't his grief for Sellars that was part of his bipolar problems, no pathology there.)

All of this might seem obvious, but those of us who theorise about "effective funerals" and who ride a high horse sometimes risk sounding as though there are "good" funerals and "bad" funerals, the latter being the status quo. How about this for a formula?

Life and character of dead person + beliefs, attitudes and context of family + nature of their grieving = mooring points for the funeral that fits.

Fits them not us - whether it's a hippy riot or a sombre restrained affair, that's their business even though it's my job.


  1. Interesting as always, Gloria.

    But there is also the problem, within this, or "who do we serve?". I remember a tragic circumstance once of a young woman (30s), who had known a lot of ill health, but who had kept it from many friends (still going clubbing, etc). When I met her family they were, of course, upset, but they wanted very much the upbeat "celebration of life" type funeral, with funny stories of drunkenness etc. I was there to provide.

    The crem was packed, probably with a lot of people at their first funeral. This means that they'd only seen funerals on TV, and were expecting a vicar, "abide with me", and a generally sombre atmosphere.

    So I did the funeral that the family wanted, and only the family laughed at the jokes. As well as the "first funeral" syndrome above, I got a very strong sense that somehow the family members were "further ahead" in their grieving than everyone else. To me, it was job done, my duty was to the parents and sisters of this young woman, but I had a niggle that I'd somehow let everyone else down.

  2. Yes, yes, yes! How very cogent this is. I particularly like the equation at the end (it is an equation, isn't it?)

    How poor old E Kubler Ross has been misused by so many folk looking for patterns and universally applicable best practices. But Death is a wily old bastard who wriggles away from anyone who tries to pin him/her down.

    Not only is grief an individual matter, it's also true, possibly, to say that families have their own culture, their own rituals and traditions, and they resist analysis by grief anthropologists and categorisers and best practitioners.

    Those evidence based findings are terrific. Human nature really is as rich and varied as that. Hooray!

  3. Interesting "case" XP, thanks (and thanks for the burst of comments, which I'll get to in due course!)I can see why you were concerned, but it doesn't sound to me as though you let anyone down, in any sense. The non-family attenders may have been challenged, but a) what's wrong with that? to put it rather coldly and b)people at a funeral have to accept that what happens, happens, it's not always like a night at the ballet with well-understood conventions and comforting familiarities (if you like that sort of thing.)To risk landing up in a version of Pseud's Corner, it's an existential event, a one-off. My own preferences would have caused me to worry about the nature of the celebration they wanted - but as I have droned on about more than once, it's only about what they want.

  4. Family cultures is exactly it Charles, and that's what we are privileged to sit on the edge of for a short but important time, whilst we tune in to it, waggle our antennae and work up what they want.