Living With Grief

After Sudden Loss Suicide, Homicide, Accident, Heart Attack, Stroke

Kenneth J. Doka, Kenneth J. Doka

• Publisher: Taylor & Francis
• Year: 2014
• ISBN:
  9781317705888
• Edition: 1
• Topic: Psicologia
• Subtopic: Salute mentale in psicologia

First published in 1996. This book was produced as a companion to the Hospice Foundation of America's third annual teleconference. The Foundation, begun in 1982, is a nonprofit organization dedicated to providing leadership in the development of hospice and its philosophy of care for terminally ill people. The Foundation conducts educational programs related to hospice, sponsors research on ethical questions as well as the economics of health care at the end-of-life, and serves as a philanthropic presence within the national hospice community. Close to 90 percent of hospices in the United States reach beyond their own patients and families to become, in a variety of ways, a community resource on grief and bereavement That is part of the hospice mission and an important service which the Hospice Foundation of America encourages and tries to support Our annual teleconference is a major part of our effort and it, like all of our projects, is largely underwritten by contributions from individuals. The Hospice Foundation of America is a member of the Combined Federal Campaign through Health Charities of Americas. The Hospice Foundation of America is a member of the Combined Federal Campaign through Health Charities of America.

1.	Journey of a Young Window: The Bowling of Pan Am 103
	VICTORIA CUMMOCK

On December 21, 1988, when John Cummock was murdered, with 269 other people, on Pan Am 103, I lost not only my husband, but my best friend and the father of my three children, Christopher, 6, Matthew, 4, and Ashley, 3. It was on that day that my world was totally shattered. Not only had I lost John, but everything about my life from that point on changed forever. I lost a little bit of my country on that day because, I realized, the terrorists were going after the American flag on the tail of the plane and not anyone specifically on that flight–a fact unacknowledged for months by my country–the State Department and the U.S. Congress.

I lost the economic security provided by a two-income household, a wonderful marriage, the possibility of raising our small children with John and of growing old together. The journey of healing in the past seven years has been, for each member of my family, an individual and ongoing complex journey.

MY REACTION

The process of waiting for official information after a disaster is complicated by a range of emotions including disbelief, growing anguish and deep grief itself. No one is ever prepared to deal with news that someone they love has been brutally murdered, but, in the case of the Pan Am 103 families, we never even received any official information or notification. Like the rest of the world, the only information we gleaned was from television! This compounded our disbelief. When malice is involved, the process of connecting the horror of such an unthinkable act to the loved one is kept at bay for various reasons.

First and most important are the issues of hope and loyalty. It is natural to hope against all hope that somehow a loved one has been spared the cruel fate of a violent murder. It is not uncommon for families to hold out hope for their loved one’s survival for days or even weeks as the effects of shock alter the perception of time to that of endless minutes, rather than hours or days. Holding out hope is driven by a deep sense of loyalty to the victim. To give up this hope is to abandon one’s family during the time of its greatest need. Thus, a strong sense of denial is maintained at all cost and remains in effect until official notification of death is received and/or a body is recovered. It is at this juncture that families can and must let go of life as they have known it and accept the reality of death with the horror and anguish that it brings. It was with the return of John’s body, two weeks after the explosion, that I accepted his death and began to let go of hope, thus beginning my grieving process.

Searing anguish typified every day, compounded by total mental fragmentation. I thought I had gone insane. I had no idea whether it was day or night. If I looked at my watch and it said three o’clock, I’d have to go look out a window to see if it was daytime or nighttime. I didn’t feel hunger until somewhere in May of the year after. Initially, coping meant trying to get through minute by minute, then expanding it to hour by hour, and after a time I could manage a morning or a day.

For my part, when people did not acknowledge what truly happened, but minimized the atrocity of John’s death by calling it an accident, I felt as though my feelings of anguish didn’t correspond to such a passive event as an “accident.” I kept wondering how much John and his fellow passengers had known and had suffered as the plane exploded at 31,000 feet. By not calling a spade a spade, I was pushed further into despair and isolation because I wasn’t given permission to feel my feelings or ask my questions.

The events that exacerbated my anger, my grief and my loss were unanticipated. Because Americans feel that we are an invincible young country, terrorism is not something that our society often has to think about or live with. Hence, people always try to make nice of everything, including murder. It’s our way of coping.

Nobody wants to dwell on something that’s morbid. When people said “I’m sorry your husband passed away,” I found no consolation. Instead, my anger was piqued. I would respond by saying, “I guess he passed away like the Jews passed away under Hitler.” It seemed that most people chose not to recognize John’s murder nor the enormity of the bombing of Pan Am 103.

My isolation and that of other Pan Am family widows was increased with remarks such as “You’re young. You’ll find another husband.” I didn’t want to hear that. I had just lost my husband, and I wanted him back. Such words of hope often pushed me further into my grief and a greater sense of loss. I felt no one understood my feelings, and I became more stuck in my anger and confusion.

Another coping tool that people tried to impose on me, in order to avoid being confronted by my active grief and anguish, was to offer me jobs in order to keep me busy. But, immediately after such profound trauma, it is not the time to forget. It is the time to grieve, to find consolation and comfort.

I found consolation and comfort from the advice of my therapist who encouraged me to feel my feelings, to accept that grieving is hard work and, lastly, to realize that there is no timetable for the healing process. I had to accept that each of us in my family and in the Pan Am 103 family would cope in different ways and at different rates. I had to decide either to be a victim or a survivor, and decide what effect this tragic event would have on my life and that of my three children. I didn’t have a choice about what happened to John, but I did have a choice about how it would impact me and his legacy. The terrorists were not going to be victorious by ruining four more lives from the Cummock family.

THE CHILDREN’S REACTION

For my children, coping was a very different process. Because of their ages (ranging from 3 to 6 years), they thought death was a temporary state like going to work or traveling. For example, Ashley would ask me, “Mommy, when Daddy finishes dying, is he going to come home and tuck me in?” The permanence of death was a very difficult concept for me. I had to explain to them that dying is a time when your energy or your soul goes to God. I explained, “You know when Christopher’s battery-operated car stops because there’s no more energy in the battery? That’s what’s happened with your dad. His energy, or his soul, has gone out of his body; he is no longer with us. He’s with God.”

When John’s body came home and they saw him, they wanted to bring him home. They remembered the movie E.T. and that E.T. had hidden in the closet with the stuffed animals. Perhaps daddy could stay in the closet too, even if he wasn’t very energetic. Then they could visit him whenever they wanted to.

The children expressed missing their father in many surprising ways. For example, one day we were walking out of a parking lot and one of the boys darted out in front of a car. I said, “Honey, you can’t do that. A car could not see you and you could be killed.” My son answered, “Well, that’s all right because I could be with Dad.” Recognizing their altered value system, I said, “I’m glad you don’t have a fear of dying, but we need you here. Even worse, you could be crippled for the rest of your life.” Over the years, depending on their ages and ability to cope with the enormity of death, each of them at different times “searched” for their dad. And, often, their bafflement with death and their dad’s absence gave way to anxiety in varying degrees. As they entered different stages of awareness developmentally, their loss or anxiety would peak, requiring therapy. At age three, Ashley would cheerfully and as a matter of fact tell you, “My daddy was murdered.” At age six she found out what murder was and was devastated. All three children, particularly Ashley, suffered from nightmares and other post-traumatic stress disorder (PTSD) symptoms for a very long time, requiring therapy for years, as issues developed.

PAN AM 103 FAMILIES

Being involved in the formation and leadership of the Pan Am 103 Families group, I have seen how 270 families have journeyed through the grieving process. Some chose to utilize different resources to help and support themselves. When faced with a highly complex emotional event such as murder, those who didn’t get professional mental health counseling have had a very long and tough struggle dealing with their issues of grief and, especially, anger. Seven years later, many are still stuck in the different stages of the process and, regrettably, have not been able to move on in their lives.

THE ROLE OF THE MENTAL HEALTH PROVIDERS

Most mental health professionals are aware of the different stages of the grieving process: the initial shock, denial, sadness, anger, guilt, loneliness and despair and gradual acceptance. But when the loss of a loved one is complicated by a sudden, violent and intentional act, such as murder, the reactions of survivors are also sudden and violent in their own way–intense, severe and extremely profound. Recovery becomes a multifaceted process. Although there are common variables affecting survivors’ bereavement reactions to any loss or trauma (i.e., previous traumas and history of preexisting mental illness, coping skills for stress and/or conflict resolution, level of support), there are marked differences that can compound the recovery process for homicide survivors. This includes the length of time awaiting official notification and the return of remains, the degree of intrusive outside influences (e.g., media/public involvement). The role of the mental health provider can result in a markedly different or compounded post-traumatic environment.

Unlike most losses in which there is a time to mentally prepare and say good-bye to one’s loved one, the sudden and violent nature of murder leaves the surviving families with an immense burden, a burden further weighted by the survivors’ “unfinished business” with the victim. Unresolved issues related to earlier resentments or conflicts, to hopes and dreams and to unfulfilled promises require attention. Survivors and those who support them particularly benefit from learning that the depth and duration of the healing process is prolonged, and that the state of acute grief may last longer than a year. Learning that each person grieves separately, differently and at his or her own pace can be of great comfort to the bereaved. In short, educating the bereaved to the many stages of the grieving process helps to normalize and validate the range of intense and often contradictory emotions. The mental health provider serves to give the bereaved the confidence to continue through the grieving process and avoid getting “stuck” in any one reaction.

Helping the bereaved to understand their own state of mind, as well as to interpret the range of emotions of others around them, is an important tool in preventing isolation and fragmentation. Remaining close relationships can become unraveled when others choose a variety of coping mechanisms, which are unexpected by the bereaved, such as minimization or various degrees of denial.

The recovery process is further complicated as families of homicide victims contend with the criminal justice system. The enormous challenge of learning how this system works and its untimely demands amplify the already distressing states of disorientation and disorganization. Mental health providers can normalize the emotional highs and lows that the next-of-kin frequently experience as they seek to find closure through the attainment of justice. For many, justice will never be served, and it is vital to help the bereaved avoid the demoralizing effects of alienation. Referrals to long-term therapy or participation in support and/or advocacy groups is recommended as a means to give the bereaved ongoing support, a sense of belonging, a sense of purpose and encouragement.

Other intrusive influences such as mass media or expansive public involvement, at the outset of a murder, can greatly complicate the grieving process. Families are on an emotional overload leaving them disoriented, vulnerable and defenseless. In trying to identify and connect with the range and intensity of their feelings, it is important to provide a supportive environment that allows private time to be introspective and minimizes additional unnecessary external variables.

Repeated media images of the carnage, devastation and destruction further intensify the shock, keeping survivors confused and isolated. The families’ need for truth and official information must be protected and held as a priority. Based on their acute emotional state, it is imperative that families be given firsthand official information about their loved ones, thus allowing them a private time to cope with the facts prior to public consumption. Again it becomes an issue of loyalty to the deceased in that the families want to respect, honor and protect them. Once the deceased becomes a public persona entering the public domain, families have lost yet another part of that person during a time that they have not learned how to cope with their initial loss.

Since the nature of news is what is “new,” the pace in which the press intrudes in the victims’ families is uncaring and often quite relentless. The media often tries to sensationalize tragedy when the truth and facts alone are hard enough for the families to cope with. It is important to honor the needs of the families to privacy and minimize unnecessary outside influences to avoid compounding and adding yet another dimension to their loss. The addition of the media, attorneys and the judicial system into the lives of homicide survivors is so overwhelming and confusing that it prevents families from regaining a sense of balance and control in their lives. Often it prevents or postpones their grief work as it relates to the loss of the victim, but also around the loss of their own life as they have known it.

OKLAHOMA CITY–OBSERVATIONS OF THE VICTIMS’ FAMILIES

The personal hell I went through after the bombing of Pan Am 103 echoed across thousands of miles to me when I heard of the Oklahoma City bombing. I immediately sent a letter expressing our sympathy, love and prayers to the victims’ families with a floral wreath in the shape of an American Flag. I needed to make sure that this country expressed solidarity and support at all levels for these families. I then sent a fax to senior White House aide Bruce Lindsey stressing the extreme necessity for the President to acknowledge their tragic loss and offer them words of hope and a promise to pursue justice. The President quoted from my letter in his speech at the Oklahoma City memorial service. This communication led to my involvement and consoling efforts for eight days in Oklahoma City. Under the sponsorship of the American Red Cross, I spent 12 to 14 hours daily working with many of the 168 victims’ families still waiting to hear about their loved ones trapped in the Murrah Federal Building. For weeks they gathered at the First Christian Church, (a center set up by the Red Cross exclusively for next-of-kin), to await official information or death notification. Much of what I have observed over the last seven years about traumatic loss and the grieving process of survivors of homicide was confirmed.

For the families of the 116 victims left trapped in the Federal Building ten days after the bombing, the parallel process of holding vigil and awaiting notification was striking. Initially, the conversations were of hope for survival. Many spoke of the physical strength, stamina and endurance of their loved one and his or her ability to overcome ex...