Bereavement Narratives

Continuing bonds in the twenty-first century

Christine Valentine

• Publisher: Routledge
• Year: 2008
• Print ISBN: 9780415457293
• eBook ISBN: 9781134049035
• Edition: 1
• Topic: Social Sciences
• Subtopic: Health Care Delivery
• Index: Social Sciences

Bereavement is often treated as a psychological condition of the individual with both healthy and pathological forms. However, this empirically-grounded study argues that this is not always the best or only way to help the bereaved. In a radical departure, it emphasises normality and social and cultural diversity in grieving.

Exploring the significance of the dying person's final moments for those who are left behind, this book sheds new light on the variety of ways in which bereaved people maintain their relationship with dead loved ones and how the dead retain a significant social presence in the lives of the living. It draws practical conclusions for professionals in relation to the complex and social nature of grief and the value placed on the right to grieve in one's own way – supporting and encouraging the bereaved person to articulate their own experience and find their own methods of coping.

Based on new empirical research, Bereavement Narratives is an innovative and invaluable read for all students and researchers of death, dying and bereavement.

Part One
Preserving and affirming personhood

I have identified how academic discourses of bereavement have taken a more social turn and how this has highlighted the extent to which the dead may remain an integral part of the lives of the living, thus obscuring the boundary between the living and the dead. This perspective has been reflected in the use of more qualitative, intersubjective approaches to researching death and bereavement. I have drawn attention to the implications of taking a more informal and engaged stance in terms of capturing a fuller picture of bereavement as it interacts with other agendas and priorities in people’s lives to form part of their day-to-day social world. Thus the scientific, rationalist model in which the researcher remains separate from the field of study has been replaced with a more ‘humanised’ approach to researching social life. This approach recognises that the researcher cannot remain separate but rather forms an integral part of the picture. The following three chapters reveal how such shared humanity and intersubjectivity is also reflected in the narrative reconstructions of 25 bereaved individuals of the way their loved ones’ died. These dying narratives offer crucial insight into the impact of the circumstances surrounding a loved one’s dying on the bereavement experience.

By attending to my own part in the narratives that emerged from these interview conversations, I began to register the way the characters of those who had died seemed to impress themselves on me in a very poignant way. This was conveyed through very intimate, personalised details, which were touching in the way that, far from being idealised, they evoked the deceased person’s humanity and therefore mortality. The impact on me was to hold my attention and invite my further inquiry in a way that created a feeling of that person’s presence between us. At the end of an interview I was often left with a vivid impression of the deceased person, almost as if he or she had been present with us in the room. Thus the process of constructing a narrative around the death of a loved one served to recreate and perpetuate that person’s identity or personhood.

The presence of the dead has been identified in relation to the reported experiences of bereaved people (Bennett and Bennett, 2000) and the bereavement counselling situation (Klass, 1997). My own experience has revealed how such presence may extend to the interview encounter to form part of the relationship between researcher and researched and therefore contribute to the research endeavour and its findings. As such, it represents a further obscuring of the boundary between the living and the dead to reveal how the dead may become integrated in the lives of the living to the extent of finding a place and a voice in the life of a stranger.

This process of ‘recovering’ and integrating dead loved ones into bereaved peoples’ ongoing lives included reconstructing the experience of the way they died. Such reconstruction was characterised by an emphasis on the dying person’s unique identity and personhood and the social nature of dying. The dying experience was evaluated in terms of the extent to which it reflected the dying person’s characteristic selfhood and continuing agency, as well as affirming the relationship between the dying person and the narrator. Where such continuing personhood and relatedness had to some extent been achieved, this served to redeem what in most cases was a difficult, unpredictable and uncertain process for both parties.

The importance and urgency of preserving and affirming personhood was powerfully conveyed in those cases where the dying process had called this into question. Thus the narrator would still be able to recall how a deceased loved one had taken charge of some aspect of his or her dying and/or the narrator had taken great pains to ensure that any rituals of disposal bore the deceased person’s unique stamp. Indeed, making up for a death that had not been sufficiently characteristic of the dying person took precedence over what the bereaved person might have wanted. In some cases, the narrator’s sense of having maintained his or her relationship with the deceased person during the dying process provided a further source of consolation.

Chapter 1 draws attention to and examines the key discourses that structured people’s ‘dying narratives’, highlighting how narrators negotiated these to personalise and humanise their loved one’s dying by emphasising his or her unique personhood and the relationship between them. By focusing on the relationship between individual and collective resources, it places the narratives in the wider social context of contemporary British society. Chapter 2 explores the significance of personhood and relatedness in relation to the way narrators sought to achieve a good death for their loved ones. It reveals the way that the social presence of dying people could be both sustained and lost in the face of the dying experience, and the implications of this for our understanding of the nature of personhood and agency in contemporary society. It considers the relationship of personhood to the experience of embodiment and to the larger social structure. Chapter 3 introduces and explores the significance of the ‘moment of death’ in a contemporary medical setting for those left behind. With reference to the historical Ars Moriendi, it examines the deathbed account that formed part of some of my participants’ dying narratives. These accounts revealed how a loved one’s final moments could be experienced as profound, special and memorable occasions in which the dying person took his or her leave by demonstrating enhanced presence and aliveness.

1 Humanising a loved one’s dying

In sharing their experiences of bereavement with me, narrators conveyed how, in trying to reconcile themselves to the death of a loved one, they needed to recall and reconstruct the way he or she died. These narratives of dying entailed a process of evaluating and negotiating such experience in terms of ‘how things should be’ as they attempted to make sense of their loved one’s dying. In relation to an experience, such as bereavement, which has a profound impact on one’s taken-for-granted reality or assumptive world (Berger and Luckmann, 1967; Parkes, 1972), including one’s sense of identity, this process becomes all the more urgent and poignant. How, and the extent to which, it is achieved depends on the cultural and individual resources by means of which such experience is shaped. In this chapter I identify and examine these resources at a discursive level in relation to the ways in which 25 bereaved individuals talked about and tried to make sense of the experience of witnessing a loved one’s dying in contemporary British society.

The role of discourse

Discourse has been identified as both reflective and constitutive of the social order and the interaction of individuals with society (Jaworski and Coupland, 1999: 3). Its language and imagery reflect deep-seated and largely invisible attitudes and ideologies. Discourse therefore has far-reaching implications, for example, discourses about death have an impact on what we do with the dead and how we treat those who suffer bereavement. Thus, if any change is to occur it can only happen at this fundamental level. Yet, as well-demonstrated by the power of modernist rationalist discourses, the promotion of change is far from easy or straightforward. Dominant cultural scripts produce certain versions of reality and inhibit others, producing blindspots or a tendency to become caught up in our socially constructed version of reality (Crossley, 2000). The task of the researcher of social life is to constantly test one’s own assumptions against participants’ actual utterances to avoid becoming caught up in one’s own version of reality. Rather the aim is to discover the strange in the familiar and gain an appreciation of how ‘commonsense’ experiences are not as self-evident as they may seem, but rather reflect cultural meaning systems.

Foucault (1972) has drawn attention to the way discursive activity may contain hidden repressions and be used to perpetuate existing power relations. Some studies have drawn attention to the blind spots that result from the way dominant discourses produce certain versions of reality and inhibit others, especially in relation to goals that appear laudable and desirable (Crossley, 2000). The hospice movement’s ideological goal of enabling patients ‘to live until they die’ glosses over the non-negotiable effects of the physical degeneration of their bodies on their sense of self (Lawton, 2000). The choices of dying people may be constrained by hospice constructions of the ‘good death’ in terms of the ideals of dying with dignity, peace-fulness, preparedness, awareness, adjustment and acceptance (Hart et al., 1998). The ‘open disclosure’ and ‘shared awareness’ of dying promoted by Glaser and Strauss’s findings (1965) and by the hospice movement itself, does not take into account the uncertainties of prognoses and that some cultures and individuals value ‘shielding’ over ‘sharing’ (McIntosh, 1977; Littlewood, 1993; Seale, 1998: 178; McNamara, 2001; Lock, 2002).

A discursive perspective has revealed the limitations of a positivist paradigm in reflecting the complex and reflexive relationship between subjective experience and social practice and the diversity of bereavement experience within contemporary British society. It has allowed a closer examination of how people experience their bodies, minds and social relationships and create meanings from such experiences that can act as a resource for shaping their world. This approach has drawn attention to the way competing discourses co-exist. For example, when talking about sensing the presence of dead loved ones, Bennett and Bennett (2000) found that bereaved individuals would shift between a rationalist scepticism and a more supernaturalist validation of such experiences. They may modify or even reject predominant discourses, such as those offered by medicine, psychotherapy and religion, which position the individual in a subordinate relationship to the expert. Such discursive activity has produced alternative discourses, such as the ‘natural good death’, in which individuals may characterise a sudden death as ‘good’ due to it being both painless and free of medical intervention (Bradbury, 1996, 1999).

Studies of the ‘good death’ have highlighted the way individuals may weave together normative and individual understandings of the world (Bradbury, 1996; Masson, 2002; Young and Cullen, 1996). These highlight the multifaceted and changing nature of such concepts and the way individuals negotiate these to serve differing needs and purposes. Thus, in bereavement, people have been shown to demonstrate a ‘flexible realism’ in taking account of the limitations and contingencies of real life (Masson, 2002). Their narratives reveal how they attempt to negotiate the ideal within the context of their lived situation. Though professionals may try to impose a dominant medical discourse on patients and their families, this has been found to be only temporary and bereaved individuals still manage to come to their own conclusions (Bradbury, 1996).

Discursive activity represents a valuable resource for adjusting to the social world and making sense of experience, particularly at vulnerable times, such as during bereavement (Crossley, 2000). Thus, in attempting to deconstruct cultural assumptions, it is important to take into account the way that such scripts may offer people a life-line when their taken for granted reality, including their sense of self-identity feels under threat (2000: 179). In such circumstances people inevitably seek guidelines for managing and affirming their experience. Where there is a mismatch between conventional wisdom and individual experience this may produce guilt for ‘not doing it right’. It may also give rise to questioning and negotiating the conventional line to produce alternative discourses.

Indeed, discourse is far from static and has been defined as ‘an open, unstable and negotiable conception of how cultural notions influence and can be employed by groups and individuals’ (Reimars, 2003: 326). Social norms are neither stable nor consistent, since they emerge from a process of negotiation between cultural resources in the form of available discourses and more personal resources that shape these according to individual circumstances, purposes and idiosyncrasies. Such negotiation includes contested representations of reality, both within as well as between individuals (Hockey, 1996b). This perspective offers a concept of social reality as complex, open-ended and contingent, emerging from the tension between such contested representations.

The narratives of those I interviewed well demonstrated how the discursive process is a complex, open-ended, fluid and contingent one in which discourses interweave, overlap, compete and evolve (Hockey, 1996b; Reimars, 2003: 326). In this chapter the key discourses that informed people’s dying narratives are explored in relation to the wider social context in which dying occurs today, as well as the individualised and personalised dimension. This exploration draws attention to the way people shifted between discourses, and negotiated paradox and ambiguity to produce highly individual accounts that are characterised by ambivalence and contingency.

This chapter highlights and illustrates the relationship between individual and cultural perspectives in terms of the individual’s reflexive reworking of events in which memories are subject to an ongoing process of interpretative reconstruction (Giddens, 1991). For in the process of reconstructing their loved ones’ dying, narrators demonstrated a high degree of reflexivity. Not only were they trying to remember, recapture and convey to me the quality of their experience at the time, but also to reassess it in the light of the present. This involved moving backwards and forwards between the past and the present, as well as attempting to appreciate other people’s viewpoints. Though a single interview is limited in conveying such fluctuation and change over time, an in-depth, open-ended, conversational approach to interviewing to some extent allows this to be captured.

In recounting their experiences narrators drew on the broad discursive frameworks of medicalisation, individualism, relationship, religion and death’s timing. They negotiated these, in some cases, potentially competing frames of reference, by means of a humanising, person-centred perspective. This perspective provided a unifying thread of meaning in the face of the uncertainties and paradoxes that...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Acknowledgements
• Introduction
• PART ONE Preserving and affirming personhood
• PART TWO Absence and presence
• Bibliography
• Appendix Participants’ personal profiles