Death and Bereavement Across Cultures

Second edition

Colin Murray Parkes, Pittu Laungani, William Young, Colin Murray Parkes, Pittu Laungani, William Young

• Publisher: Routledge
• Year: 2015
• Print ISBN: 9780415522366
• eBook ISBN: 9781317520924
• Edition: 2
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

All societies have their own customs and beliefs surrounding death. In the West, traditional ways of mourning are disappearing, and although Western science has had a major impact on how people die, it has taught us little about the way to die or to grieve. Many whose work brings them into contact with the dying and the bereaved from Western and other cultures are at a loss to know how to offer appropriate and sensitive support.

Death and Bereavement Across Cultures 2nd Edition is a handbook which meets the needs of doctors, nurses, social workers, hospital chaplains, counsellors and volunteers caring for patients with life-threatening illness and their families before and after bereavement. It is a practical guide explaining the religious and other differences commonly met with in multi-cultural societies when someone is dying or bereaved. In doing so readers may be surprised to find how much we can learn from other cultures about our own attitudes and assumptions about death. Written by international experts in the field the book:

• Describes the rituals and beliefs of major world religions
• Explains their psychological and historical context
• Shows how customs are changed by contact with the West
• Considers the implications for the future

The second edition includes new chapters that: explore how members of the health care professions perform roles formerly conducted by priests and shamans can cross the cultural gaps between different cultures and religions; consider the relevance of attitudes and assumptions about death for our understanding of religious and nationalist extremism and its consequences; discuss the Buddhist, Islamic and Christian ways of death.

Death raises questions which science cannot answer. Whatever our personal beliefs we can all gain from learning how others view these ultimate problems. This book explores the richness of mourning traditions around the world with the aim of increasing the sensitivity and understanding which we all bring to the issue of death and bereavement.

Part 1 A conceptual framework

Historical and cultural themes

Chapter 1 Introduction

DOI: 10.4324/9781315721088-1

Colin Murray Parkes, Pittu Laungani and Bill Young

The last 100 years have seen major changes across the world. Many of these changes are beneficial. Improvements in medical care and nutrition have enabled most people in industrial countries to survive to old age. Improvements in agriculture and the distribution of food have enabled large numbers to escape from the physical toil of working the land. Improvements in mobility enable us to travel the globe and, for those who stay home, the mass media of communication and the internet bring information and entertainment to fill the leisure hours that have been freed up by relief from drudgery.

Government and the rule of law have replaced the family and the neighbour-hood as our main source of security and made it safe for people to leave the homes where they were born and travel to distant cities for their work. Instead of following our parents and relying on them for knowledge, Westerners are sent away from home to be educated. Self-reliance and independence are predominant virtues and the older traditions of obedience and respect for elders have faded in a world in which the knowledge of the elders is soon obsolete. Instead we have a cult of youth which overvalues the attributes of sex appeal and expects the old to emulate the young. And just as old people are out of date, so the traditions, customs and beliefs that previous generations held to are assumed to be irrelevant to the world today. Dietary laws which protected people from harm in the days before refrigerators, methods of healing which have been superseded by modern medicine, and the worship of tribal gods when the tribe has been absorbed into a larger society – all are seen as irrelevant in the modern world. And if they are, we may be tempted to junk the lot.

On the other hand all traditional beliefs and rituals must exist for a reason and many of those reasons may still apply. It is a peculiarly twentieth century attitude to assume that because something is old it can't be true, good or useful. In times gone by its very antiquity was taken as evidence of its value.

It is easy to dismiss the beliefs of other people as ‘myths’, as if myths were unnecessary illusions. Yet myths are the means by which, from time immemorial, people have attempted to make sense out of the mysteries that surround us. This is nowhere more obvious than it is in an area of human experience about which science has taught us very little – death. Despite all the advances of modern science 100 per cent of people still die. Ivan Illich has termed this ‘The ultimate form of consumer resistance’ (Illich, 1975).

Science may delay death but it can neither prevent it nor can it tell us anything about what, if anything, lies beyond death or what we can do to prepare for that transition. This does not prevent people from behaving as if, even now, scientific medicine could provide a solution to the problem of death. Doctors and nurses tend to collude with this and most Westerners still go to a hospital to die, many of them in the naive belief that scientific medicine will prevail over death. When the first edition of this book was published, in 1997, we wrote, ‘Once in hospital nobody mentions the possibility that the disease may prove fatal, death is treated as a guilty secret. As one patient put it to a cheerful doctor, “I'm glad I'm not dying of anything serious!”’ It seemed that modern society had created a new myth and new priests and acolytes (the doctors and nurses) to maintain the illusion that we could live forever. Today this is less often the case: as we shall see in Chapter 11, health care practitioners are still predominant, but improvements in palliative care for the dying (see pp. 169–70) are now enabling more people to stay home and are setting a good example of open communication about prognosis as people approach the end of their lives. Even so, many people prefer not to ask questions about their prospects and doctors still collude with the family in maintaining the pretence of immortality.

Our attempts to sweep death under the carpet also gave rise to a counter-culture, what Geoffrey Gorer termed the ‘Pornography of Death’, which, like other taboo subjects, made it the subject of jokes and fascination (Gorer, 1965). The horror film is an example of a genre which enables us both to approach and to distance ourselves from this area of experience by distorting and fictionalising it.

Along with a decline in our ability to face death comes a decline in trust in the rituals that accompany and follow death. Traditional mourning customs have been largely abandoned and the rituals of cremation or burial of the dead have lost much of the emotional significance which, in the past, often made them a source of support for the bereaved rather than an ordeal. At least, so it is claimed by the psychiatrists and counsellors who are called upon to give help to bereaved people and who are themselves attempting to apply scientific methods to the solution of the problems created by science.

This does not mean that science is wrong and should be abandoned, but that there are still areas of human experience to which science has little to contribute. These include some of the most important and challenging aspects of life. How each of us approaches the prospect of our own death and the deaths of those we love remains a tremendous question which each generation must tackle afresh. Each generation and each society has come up with its own solutions to the problem of death and has enshrined them in a complex web of beliefs and customs which, at first glance, seem so diverse as to be impossible to digest. Yet there are common themes that run through all of them and even the differences become easier to understand when they are considered in the light of the historical context in which they have arisen.

Our enquiries, which will be developed in more detail in this book, lead us to conclude that all societies see death as a transition for the person who dies. How people prepare themselves for this transition and how the survivors feel and behave after a death has occurred varies a great deal but even here there are common themes. Rosenblatt, Walsh and Jackson, in their important book Grief and Mourning in Cross-cultural Perspective (1976) compared the accounts given by anthropologists of grief and mourning in seventy-eight different societies (selected as representative from a pool of 186 world cultures). Crying, fear and anger are so common as to be virtually ubiquitous and most cultures provide social sanction for the expression of these emotions in the funeral rites and customs of mourning which follow bereavement. In this respect Western cultures, which tend to discourage the overt expression of emotion at funerals, are deviant. They differ from most other societies and from our own society as it was before World War I.

The fact that we are deviant does not necessarily make us wrong. Maybe mourning is a waste of time and energy and the best thing is to pull up our socks and get on with our lives. Maybe we are right to ignore death. If there is nothing we can do about it perhaps we should treat it as if it doesn't exist. When somebody dies we should get rid of the body as quickly as possible and carry on as if nothing had happened.

This is the logical view. It accords well with a pragmatic view of life which seeks practical solutions to practical problems. It is very different from the superstitions of religion, the pretensions of art and poetry and the complex theories of psychiatrists and psychologists.

And yet, and yet, there are few of us who are prepared to discount altogether those aspects of life which are concerned with spirit rather than mind, feeling rather than doing, and emotion rather than thought. We continue to prize the art, poetry, literature and music of bygone times and we particularly prize those that treat death. Indeed there are many who prefer these traditional art forms to the arts of today. Mozart's Requiem and Michelangelo's Pieta are enduring sources of inspiration and enlightenment despite, or perhaps, because of their concern with death.

‘The heart has its reasons which the reason knows not’ (Pascal, 1670: IV. 277) and one does not have to be a Mogul to appreciate the beauty of the Taj Mahal or an Elizabethan to enjoy Shakespeare's tragedies. Having said that it does help to have some understanding of the ‘languages’ of architecture and English.

If art can transcend generational and national boundaries the same cannot be said of religion. Despite current attempts at ecumenicity between the many sects of the Christian church, the rites and beliefs of other people seem alien or, at best, quaint. We allow licence to poets but no such licence is allowed to priests. Those who hold most passionately to the truths of their own religion often deride the beliefs of others. Accusations of ‘Mumbo Jumbo’ are made and ‘Holy Wars’ may even result.

One reason for this is the logical incompatibility of many belief systems. If human beings go to heaven or hell when they die they cannot also be reincarnated. If God is a man he cannot also be a woman, or a sun or a red kangaroo. Faced with these inconsistencies we either cling to our own ‘true’ faith and denigrate the rest, or we lose faith in all religions.

Most students of Comparative Religion take a different view. They see each faith as comprehensible in the time and place in which it has arisen. The search for meaning in life and death must take place within a particular historical and geographical context. It would be surprising if the context did not influence the form of our thinking. But there may still be fundamental consistencies, themes and truths that appear and reappear in one culture after another. Jung spoke of these as ‘archetypes’ and related them to his idea of a ‘Collective Unconscious’ (Jung, 1969). The editors of this book are, perhaps, more prosaic than Jung and prefer to leave open the underlying nature of these phenomena. We shall treat them in much the same way that we treat dreams and poetry, as having meanings that we can glimpse but not pin down. The better we understand the cultural context the more evident that meaning.

Psychology, because it deals with much that is subjective and unmeasurable yet tries to be systematic and logical, occupies an uncomfortable hinterland between art and science. Psychologists themselves vary in their commitment to one or other ‘camp’. At one end of the spectrum are the behaviourists who concern themselves only with behaviour which they can measure; at the other extreme are those who distrust measurement and rely on intuition and empathy as their source of knowledge. The editors of this book take no such extreme position. We recognise both the value and the limitations of the science of the mind and we also recognise that intuition, common sense and subjectivity, with all their inherent fallibility, add much to our understanding of those realms of humanity that cannot be understood by any other means. We prefer to be inclusive rather than exclusive, eclectic rather than narrowly focused and soft- rather than hard-nosed scientists.

It could be argued that we are stepping outside our own areas of expertise in studying cross-cultural issues at all; surely this is the province of the anthropologist and the sociologist? While recognising the validity of this we believe that we can justify ourselves. As editors we see it as our role to ensure that our distinguished contributors, who each bring their own special expertise to the book, have taken full account of the current knowledge of the psychology of death and bereavement and will write in a way that is useful to those who are working with the dying and the bereaved. The two current editors are medical practitioners and psychiatrists: one (Parkes) has long experience of helping dying and bereaved adults and the other (Young) specialises in the care of children and their families. In the first edition of this book we had the invaluable assistance of a third editor and contributor, Pittu Laungani. Sadly, he has died and we are grateful for the assistance of his widow, Ann, who has checked and updated his contribution. Pittu was an experienced psychologist and an immigrant to Britain, whose experience of crossing the cultural divide between Hindu India and Christian Britain ensured that our cultural biases would be kept in check. We are in his debt.

Between us we have attempted to make sure that the contributions of our distinguished authors are comprehensible to non-specialists, well informed about the ‘heart’ and its reasons, and useful to those whose role it is to bring comfort and support to the dying and the bereaved of all nations.

We are not so arrogant as to imagine that doctors and nurses are always giving care and patients and their families receiving it. Caring is always a two-way traffic and, in the end, all benefit. Life being an incurable disease which always ends fatally, the main difference between us and our patients is the likelihood that they will die before we do. One is reminded of the old rhyme:

1. Doctor, Doctor shall I die?
2. Yes, my child, and so shall I.

We are all in the same situation and need to learn from each other all we can in order to make sense of it. Serving dying and bereaved people from other races and creeds provides us with the privilege of learning from them. We should not assume that our expertise is greater than theirs, but that does not mean that there is nothing we can do to help them. Times of death and bereavement are times when people need people and the mere presence of another person who cares is important. If, in addition, we have sufficient knowledge of and sympathy for the other person's culture to be able to understand what they need from us we shall have a great deal to offer. At least we can prevent some of the painful and unnecessary suffering that can follow when members of the caring professions impose their own cultural norms on others at times when they are extremely vulnerable. For instance, Perry (1993) relates how authorities in an American hospital called the police who sent a Riot Squad to arrest a group of African American mourners who were ‘crying loudly and wailing’ outside the hospital to which a mortally wounded teenager had been admitted. A community leader subsequently complained ‘The hospital doesn't understand how black people grieve’. At best, by showing positive cultural appreciation we may contribute to make death a transcendent event for those who die and those who survive.

Summary

• The last 100 years has seen major changes across the world.
• Government and the rule of law have replaced the family and the neighbour-hood as our main source of security.
• The traditions, customs and beliefs that previous generations held to are assumed to be irrelevant to the world today.
• Myths are the means by which people have attempted to make sense out of the mysteries that surround us. This is nowhere more obvious than it is in an area of human experience about which science has taught us very little – death.
• Modern society has created a new myth and new priests and acolytes (the doctors and nurses) to maintain the illusion that we can live forever.
• Improvements in palliative care for the dying are setting a good example of open communication about prognosis as people approach the end of their lives. But doctors still collude with the family in maintaining the pretence of immortality.
• All societies see death as a transition for the person who dies. How people prepare themselves for this transition and how the survivors feel and behave after a death has occurred varies a great deal.
• Crying, fear and anger are so common as to be virtually ubiquitous and most cultures provide social sanction for the expression of these emotions in the funeral rites and customs of mourning.
• Western cultures, which tend to discourage the overt expression of emotion at funerals, are deviant.
• The search for meaning in life and death must take place within a particular historical and geographical context… But there may still be fundamental consistencies, themes and truths that appear and reappear in one culture after another.
• We shall treat cultural differences in much the same way that we treat dreams and poetry, as having meanings that we can glimpse but not pin down. The better we understand the cultural context the more evident that meaning.
• Our aim is to be useful to those whose role it is to bring comfort and support to the dying and the bereaved of all nations.
• Times of death and bereavement are times when people need people… If we have sufficient knowledge of and sympathy for the other person's culture to be able to understand what they need from us we shall have a great deal to offer.
• By showing positive cultural appreciation we may contribute to make death a transcendent event for those who die and those who survive.

Chapter 2 Culture and religion

DOI: 10.4324/9781315721088-2

Colin Murray Parkes, Pittu Laungani and Bill Young

The word ‘Religion’ derives from the Latin religare which means ‘to bind’ and, traditionally, it is that body of ideas which binds a society together. More recently it has come to ...

Table of contents

• Cover Page
• Half-Title Page
• Title Page
• Copyright Page
• Dedication
• Table Of Contents
• Contributors
• PART I A conceptual framework: historical and cultural themes
• PART II Major world systems of belief and ritual
• PART III Practical implications and conclusions
• References
• Index