The Crafting of Grief

Constructing Aesthetic Responses to Loss

Lorraine Hedtke, John Winslade

• Publisher: Routledge
• Year: 2016
• Print ISBN: 9781138916876
• eBook ISBN: 9781317416234
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Many books on grief lay out a model to be followed, either for bereaved persons to live through or for professionals to practice, and usually follow some familiar prescriptions for what people should do to reach an accommodation with loss. The Crafting of Grief is different: it focuses on conversations that help people chart their own path through grief. Authors Hedtke and Winslade argue convincingly that therapists and counselors can support people more by helping them craft their own responses to bereavement rather than trying to squeeze experiences into a model. In the pages of this book, readers will learn how to develop lines of inquiry based on the concept of continuing bonds, and they'll discover ways to use these ideas to help the bereaved craft stories that remember loved ones' lives.

CHAPTER 1

Seeking Beauty in Grief

In 2009, Waka Matsushita¹ and her family were “living happily” in Japan when they were suddenly “thrown into an abyss” when her mother was diagnosed with cancer. Waka tells the story of what followed.

From the outset, the doctors assured us they could remove the renal cancer and that she would be just fine. However, during the initial surgery, the doctor found many cancer tumors and said that he could not continue. Her diagnosis was changed from renal cancer to metastatic cancer of the abdomen, which meant that her cancer had worsened to level four, the worst possible condition. This meant surgery was no longer an option and the doctor recommended chemotherapy.

His next words were crushing. Should the chemotherapy be unsuccessful, he told us, our dear mother would only have two more years to live. Then, he told us not to lose hope, with a hopeless expression on his face.

Worried, yet determined, we looked everywhere for answers and discovered one doctor who had seen great success with the same type of cancer. This doctor was famous in Japan. He had featured on TV as the doctor “with God’s hands”. We insisted on seeing him at whatever cost, and booked his next available appointment after a two-month wait.

During the examination, the doctor showed us diagrams and illustrations that boasted a post-surgery survival rate of five years for fifty percent of his patients. To us, these odds seemed far too low for our dear mother who we hoped would be with us for another forty years. The doctor did his best in an eight-hour operation; however, even the one “with God’s hands” could only remove ninety percent of mom’s cancer.

After the surgery, placing his hand on mom’s swollen belly, he said, “Let’s see what chemotherapy can do for the remaining cancer.”

We had no idea what that meant. He told us to go to the chemotherapy room and our appointment ended.

Thus far, this story of cancer’s intrusion into the life of a person and of a family might be typical of what happens many times over in different contexts. In what follows, however, Waka starts to tell a story of how, slowly and steadily, her mother and then her family began to craft their response to the shadow that death was casting over their lives.

Despite her condition, my mother showed that she did not fear death. On one particular day, a nurse asked me quietly, “Your mom doesn’t know anything about her condition, right? Does she even know she has cancer?”

I replied, “Oh no, she knows everything. I mean everything.”

“Are you serious?” the nurse replied. “Then, why does she look so calm and happy? Why do I hear laughing when you guys visit her?”

I just smiled and said in my heart, “That’s my mom. That’s us, my family.”

The chemotherapy was tough. She experienced every side effect imaginable. We were at a loss to know how to best care for her, when a private practitioner in our neighborhood, Dr. Mishima, offered to make house calls. He was a kind man we had known since we were children. When mom couldn’t eat, he gave her an IV. When she felt pain, he offered her relief. As mom’s illness progressed, so did his visits, from once a week to twice and then three times.

Dr. Mishima was never far away. Whenever she suffered, he would rush to her side – often late at night. One night, when mom was in severe pain, we tried everything to help her, until finally, at around six in the morning, we called Dr. Mishima.

He immediately came and said, “Why didn’t you call me sooner? I told you to call me any time.”

These words filled our hearts with gratitude. He knelt beside her and gently took her hand and whispered, “You did an amazing job. I will take the pain from you now.”

In early summer, Dr. Mishima produced a plastic bottle in which he had placed a small twig from a tree. As I looked closer, I could see tiny fireflies resting on the branch. In Japan, we gather by a river to watch the tiny fireflies (called hotaru), to celebrate the beauty of an early summer.

Mother could not leave the house to enjoy such pleasures, so Dr. Mishima found a way to bring summer to her. This made her smile and brought tears to our eyes. I felt joy to see my mother’s smiling face, as she watched the glow of the tiny fireflies fluttering in rhythm with her own breath.

As winter arrived, Dr. Mishima’s visits became more frequent. One day he brought a beautiful Christmas wreath. Mom was always so stylish and loved to decorate her house. She insisted that the wreath be hung in our entrance, so that every visitor could enjoy its beauty.

She discontinued her visits to the other doctor, and requested Dr. Mishima as her official practitioner. As her illness got worse, she did her best to fight back. I watched her suffer every day, but not once did I hear her complain. Never did she speak of self-pity. She would express gratitude for all the goodness in her life and of how blessed she was to be surrounded by caring loved ones.

As I listened to mom’s request to change doctors, I realized that mom received hope to live not from the doctor with “God’s hands”, but from Dr. Mishima. His daily visits offered much more than medicine – he also brought sincerity, care, and hope.

It is worth pausing to notice some important aspects of professional practice here that go beyond what can be mapped onto charts and diagrams. Dr. Mishima makes no claim to have “God’s hands”, but he weaves into his care for Waka’s mom and her family simple pieces of personal kindness. He respects the family’s wishes, rather than imposing modern scientific knowledge onto them. And he draws from local cultural knowledge resources that help everyone find a moment of beauty through these events – the branch with fireflies above and the cherry blossom below. In these little ways, he invites the family to craft their own responses to the situation they find themselves in.

The Hardest Decisions

As winter drew to an end, Dr. Mishima spoke to us in private. He leaned forward and said quietly, “Do you want to care for her at home?”

It was his way of telling us to prepare; mom’s final day was near. We all knew this moment would come but did not want to accept it. Our reply was instant: “We want to be at mom’s side when she goes to heaven.”

He said, “OK! Let’s make it happen together!”

When cherry blossom trees were in full bloom, Dr. Mishima brought mom a beautiful cherry blossom branch. Cherry blossom viewing is a favorite tradition in Japan. Friends and family gather together to celebrate the coming of spring and to express gratitude and appreciation for being Japanese. It’s a time to celebrate peace, health, and happiness.

Late April, my cell phone rang. My aunt had come to take care of mom for the day.

“Dr. Mishima said that she has only a week.”

I asked my boss for the week off and headed home. For the next week we never left mom’s side. My family came from far and wide, and we all slept on the floor next to mom’s bed, so that not a second would be wasted.

Mom suffered excruciating pain and violent vomiting, but still she never complained. She was weak, and lacked the physical strength to even turn in bed. There were moments of delusion, and the ability to speak waned. It was obvious that she knew her end was near. Still, she remained fearless.

One day, mom said, “Bring me all the scraps of lace in the house.”

We looked at her, wondering why she would need such a thing.

“I want to choose a piece for my funeral. When I’m laid to rest, I want you to place it on my head. Let’s have a rehearsal, so that I look beautiful at my own funeral.”

Our mom had always wanted to be fashionable. We brought all the lace we could find, and in turn placed each piece upon her head. Looking in a mirror, she chose the piece she liked and proceeded to give precise instruction on how it should be placed. We even had a rehearsal, which made us all, including mom, burst into uncontrollable laughter.

Mother then asked if we’d prepared our mourning dresses for her funeral. She instructed us to get ready. In fact, I hadn’t prepared my dress, because, deep inside, I felt that such preparation meant accepting that my mother would die. But, despite my hopes and prayers, it was time to accept the unacceptable. I found a dress on the internet and ordered it right away. When it arrived, I put it on and went to show my mom.

“How do I look?” I twirled for my mom in my new mourning dress, just like I would when going on an outing or a date.

Mom smiled.

My aunt, watching from the other room, became cross and gestured for me to stop.

My mom said, “I love that! It’s a great choice. I’m relieved that you are good to go now. Have it ready on hand along with your accessories, so that you can go to the funeral at any time.”

A few days later, watching the wedding of Prince William and Kate Middleton on TV, mom said, “Oh no! She stole my lace? I need it!”

Maybe she was a little delirious, or maybe she was joking. Either way, we just laughed and laughed. Mom was laughing too.

I said, “Mom, promise me you will stay by me, even after you are gone.”

“Yes. Yes. I will always be with you. Don’t worry. I will be always floating right above you.” Then we laughed, imagining how funny it would be to see mom floating.

One day, mom spoke to each of us. “I’ve been really happy; I’ve had such a great life. Please forgive me for going to a better place first.”

Then she took my brother, my sister, and me, in turn, by the hand, and gave us each a personal message of encouragement and blessing for our own lives.

After a short pause, mom cried out to dad who was being cared for in another setting, “Papa, I’m sorry for passing away before you. I always loved you so much and will love you forever.”

We all burst into tears. Mom then closed her eyes and went to sleep. We did not know when, or if, she would wake again.

Many hours later, she awoke. She stared at us dazedly, opened her eyes wide, and said, “What! Am I still alive? Do I have to go through that all over again? I have already said everything I wanted to say.”

After a second of silence, we all burst out laughing. Her calm attitude toward death saved us from falling apart.

One day before she passed, my sister and I told mom that we were going to see dad at his hospital. She was always pleased when we told her this and in the past, hurried us away. But on this day, she asked us not to go. She said, “I’m sorry. I don’t want you to go – please forgive me – just this once – I want you to stay with me.”

On May 2nd, at 6:00 am, my family and I, accompanied by close friends and our pastor, gathered around mom’s bedside. We sang her favorite hymns and fought back tears. Her eyes were closed as she lay there hushed, barely breathing. Hugging one another and sobbing, we watched her chest moving up and down with each gasping breath.

At exactly 6:30 am, mom opened her eyes for the last time. Her eyes darted around the room in search of my brother, sister, and me. With her gaze fixed on her three children, a single tear trickled down her face. She didn’t say a word, but, in that one instant, I felt a lifetime of love. Then she closed her eyes, and went to heaven.

At her funeral, we put the lace on her head just as she had wanted. She looked so restful and beautiful. I could imagine her saying to me, “Good job. Thank you . . . and wasn’t the rehearsal hilarious?”

There are elements of Waka’s story that many families will recognize. But there are also elements that are quite unique. These moments are not only sad and exceptionally hard, but are moments filled with love, strength, and even humor. They are the glimpses of what is unique to Waka’s family and to those who are helping them. These are the moments when Waka’s family crafts their responses to death. These are the moments when the presence of death in their lives requires that they put their own stamp on the event. Crafting these responses requires having an aesthetic sense of what is apt, and even beautiful, rather than just adherence to the right or the normal path.

There are also key moments, when Waka and her mother take up agency. They happen in the choice of the doctor who best suits the journey. They happen in the rehearsal for the funeral. They are there in the relational exchanges that are special to just this family. They pervade the moments of laughter, as well as the tears. They happen in the sorting of pieces of lace and through the link to a contemporary event, like the British royal wedding. We see them, too, in the physician’s honoring of cultural traditions, like the bringing of cherry blossoms or the branch with the fireflies on it. They permeate the messages Waka’s mom left as little legacies for each of her children.

The whole family, it seems, was left with a sense that they had done this well. It was painful and sad, but they had crafted a pathway that helped them through. Focusing on an aesthetic sense of death allows Waka’s mom to play a significant role in this event, even though many who are dying are often left out of such conversations. Waka’s mom had invited them to be with her in her dying, but she had also helped shape how they would live on with her memory, how the vibrancy of life would not be defeated by death, and how grief might be lived in consciousness of this sense of life. The moments of laughter were still powerful. The sense of family connection and relationship was still strong. The reality of death was not treated as more powerful than laughter, memory, cultural resonance, and personal relationship. Is this realistic? Perhaps not. But perhaps using creativity to craft a way through difficult events is more important than realism. It helps people fashion moments of beauty in among the pain. That is what this book will explore.

Focus of This Book

How might we respond to the presence of death in our own lives and in the lives of others? That is the focus of this book. Responding to this question includes, but is not restricted to, what is usually referred to as grieving. It also includes a focus on the experience of individuals and their loved ones who are approaching imminent death. We are most interested in how to work therapeutically with people in the circumstances of life that Waka and her family were encountering. We will explore how to create conversations that use the sweet moments, as well as the tough moments, to foster agency in the face of the unthinkable.

The concept of working therapeutically, however, should not be restricted to those who claim to be doing therapy. We use the term in a broader sense to refer to the kinds of conversation that people might experience as helpful, comforting, encouraging, and invigorating, whether they are holding such conversations with therapists, nurses, doctors, social workers, family members, or trusted friends.

To be therapeutic, an activity should help people make sense out of situations, overcome problems or difficulties, and find a pathway forward in life. It may involve the cure of what the ancient Greeks called “diseases of the soul”. It may help a person find the wherewithal to put one foot in front of the other and carry on living through a challenging situation. It may help identify places of comfort that sustain a person through the less comfortable and more challenging moments that accompany death when it visits.

Not everything that may be called therapeutic fits within the boundaries of what is usually called therapy. For instance, going for a walk, listening to music, or looking at some cherry blossom may each be therapeutic but are not, in themselves, therapy. In the same way, we do not restrict helpful conversation with a person who is grieving to the formal therapy hour. Sometimes it may just be one question from a visitor that soothes, or opens up a new pathway for living. Many people can give comfort or help a grieving person to “know how to go on” (Wittgenstein, 1953, p. 151) in conversations of various kinds. Our interest is in the working assumptions that might govern such a helpful conversation or in the range of topics that might achieve this purpose. We shall refer in subsequent chapters to examples drawn from some counseling contexts, as well as from other kinds of conversations, but in no way do we intend to restrict the relevance of these ideas to formal counseling.

This book is driven by the idea that people can be invited into an active response to the challenges that death brings, much as Waka and her family sought to do. To be active in response means to be an agent in the construction of one’s own life. Our assumption is that taking up such an active position in response to a significant life challenge is therapeutic in...

Table of contents

• Cover Page
• Endorsement
• The Crafting of Grief
• The Series In Death, Dying, And Bereavement
• Title
• Copyright
• Contents
• Preface
• Series Editor’s Foreword
• Other Titles by the Authors
• 1 Seeking Beauty in Grief
• 2 Reality Gains the Day
• 3 Re-membering
• 4 Becoming Bereaved
• 5 Rescuing Implicit Meanings
• 6 The Politics of Death
• 7 Elastic Time
• 8 Embracing Fragility: The Gift of Damocles
• 9 Reinvigorating Hope
• References
• Index