Death and Bereavement: The Psychological Viewpoint

When people think of death they may simply think of it as the cessation of life, in which a person or persons body shuts down and life ceases to continue. However, by rules of psychology these things are far more complex and there is now a 'development of the dying' research area within psychology, which is where I now focus this article. Of course the topic is depressing, however it covers also the acceptance of loss and the stages of both bereavement and grieving and the emotions of those who are dying. Consequently however dark, the area is indeed one of interest.

Death, in official terms, is not even as simple as that, for there are three types of death one may fall into. Clinical death, in which one may stand a chance of being saved by the process of resuscitation and although the person may have experienced death and the body has shut down, when the heart has restarted the person can go on to live, however this may cause problems for the person. Then comes brain dead, when the brain stops its function and the person is legally dead and cannot be revived by course of resuscitation and then social death, when the person is considered dead or treated as dead, this is often the point when the death is confirmed by death certificate and/or funeral.

There are in the western world many different attitudes to death, for example many people are scared or nervous and dislike hospital like settings for they feel that hospital and such institutions are directly linked to death in that they are where people go to de – thus many young children believe that in going to hospital, they will themselves die. Of course, Kubler-Ross would emphasise the importance of dignity in death, in which a person should be allowed to die as they wish and in a happy and respectful environment, however according to Renz, Mao, Bueche, Cerny and Strasser (2013) such is not always possible as the dying patient often goes through phases of emotional change and reminiscence. The interesting thing also shown in their study was other research which suggested that the dying are more closely linked to their younger self, in fact in many developmental forms are closely linked to a foetus in that that have similar perception - can tell differences between sounds and have a higher sensitivity to music, and further research suggesting that in death one sees bright lights, this is classed as being linked closely to feelings of intense stress as well as the patient experiencing joy and intense peace. This could then be linked the shutting down of neurological circuits which also cause reminiscence of past times and thus explains why dying patients feel intense feelings of 'oscillating time and timelessness.'

The human understanding of death varies, at different ages we each understand different meanings of death. Under six or seven years old children often fail to have a concept of death at all, however by the ages of seven plus children demonstrate a warped understanding of death in that they feel both that it is irreversible and lacks permanency, also that it is their fault directly. 'I said something bad and so grandpa will die... if I do something nice grandpa will not,' which of course is utterly incorrect. By teenage years, a higher understanding of death is found, in that they understand the concept of death but feel immune to such and do not value their mortality, this has been suggested to be because they have often rarely or seldom experienced death and those who have rarely see their age dying and thus feel immune – it will never happen to them. However by mid adulthood, we see an increase in anxiety about dying. This could be due to the death of friends or parents, as death usually occurs according to ages and this age group often have children/partners for whom they wish to provide, it is then suggested that it is at this age that they feel an increased worry about death. By late adulthood this is something far more accepted and even actively prepared for (for instance by the making of wills).

Kubler-Ross described 5 simple reactions to death and terminal illness, she called these stages, however this would seem slightly flawed for an explanation for although these reactions do seem to be prominent in these situations, it would seem that the use of the word 'stages' is incorrect because that would suggest a one way trajectory through these emotions in which people could not have conflicting nor changing emotions of their mortality. These emotions however are as followed, and Kubler-Ross would suggest that they are indeed experienced in this order. These are: denial, anger, bargaining, depression and acceptance.

Of course, psychologists must be critical of this and question many areas, for instance is there a difference between ages? Kubler-Ross failed to explain this and did not confirm if there was a difference in ages about dying. This stage theory would suggest that other feelings cannot appear, however they do, and will reappear through stages, a common one of these of course is anxiety and worry – what will happen after death both to the individual and those they leave behind, thus it would seem that preradiation was a good idea and may indeed explain why people so readily prepare for death.

We are aware that the process of dying does not stop after the individual is dead, much like the effects of dying and the emotional reaction on all those after death is huge. Thus research has also been done of the processes of grieving and bereavement. Of course, the process of grieving is different between cultures and different people see dying in different ways, this then alters the grieving process. For example, in those cultures where the belief is firm that when one dies they return to their maker or are reincarnated, the process of grieving, whilst still observable may be less intense or shorter. It has also often – historically – been accepted that women are more sensitive to grieving than men and will have more intense and prolonged periods of grieving than will men. This does not necessarily prove true and may have much to do with the fact that men often die before women do – does this then give less opportunity for researchers to look at men’s grieving? This observation can be much harder than one would think however as it is often the case that soon after one partner has died, the other is quick to join them.

Bereavement then refers to the time of as such social isolation in which the person left alive can begin to recover from their feelings of grief after the death of a loved one. This is something questioned, for many people after the death of a loved one – particularly husbands – do not want want to socialise. Bereavement does tend to happen however as socially, many people do not know what to say upon a persons death, so they will leave the remaining partner in isolation, this does not necessarily help the person and often leaves them in a position where they are deprived of contact and lose their places in social circles, it can even lead to alteration in status which can further affect the person emotionally.

Many theories have been applied to death and grieving, one of the more popular ones is attachment theory created by Bowlby which would suggest that it is feelings of numbness, yearning and disorganisation which lead to such intense feelings of grief before the recovery and reorganisation can be begin.

However, in some cases, bereavement can last longer, although this usually true in cases of troublesome or untimely death - such as those of children. This can be caused by the making public of a usually private process. Grieving is known for being a process in which the persons whom have lost the individual can recover, more commonly and especially for children or young peoples deaths parents in particular (but sometimes friends and other relations) there is the creation of 'online memorials' in which the person is in text and image immortalised, thus allowing for the grieving individuals to reminisce, however this can cause problems in that it can create a more permanent reminder and thus cause extra and high level grieving. (Mitchell, Stephenson, Cadell & Macdonald, 2012)

References:

Mitchell, L. M., Stephenson, P. H., Cadell, S. & Macdonald, M. E. (2012). Death and grief on-line: Virtual memorialization and changing concepts of childhood death and parental bereavement on the internet. Health Sociology Review. 21(4). 413 -431 .

Renz, M. Mao, M. S., Bueche, D., Cerny, T & Strasser, F. (2013). Dying is a Transition. American Journal of Hospice and Palliative Medicine. 30(3). 283-290