Voices of Bereavement

A Casebook for Grief Counselors

Joan Beder

• Publisher: Routledge
• Year: 2013
• Topic: Psychology
• eBook ISBN:
  9781135940959
• Subtopic: Developmental Psychology
• Index: Psychology

Voices of Bereavement presents counselors with specific, sometimes unusual bereavement situations and their subsequent treatment.

Joan Beder blends theoretical content with suggestions for intervention, helping the reader appreciate how theory informs practice. In addition, a section on counselor struggles focuses on what feelings were provoked in the counselor during each case and how these feelings were managed.

1

Bereavement After the Death of a Workplace Friend

The Case—Ernie

At the water department, Dave (46 years old, Caucasian) and Ernie (48 years old, African American) were always seen together. They had joined the department the same year, had been assigned to similar tasks and routes, and for the past decade had been riding in the same truck together as they did their work. Over the years, each found that he enjoyed the company of the other, felt comfortable talking about work events, and felt even more comfortable talking about personal matters. On several occasions, Ernie, who had been divorced for many years, would join Dave's family for an outing or a summer barbecue. Ernie was a frequent dinner guest at Dave's home and was invited to almost all family parties. When Ernie's father died, Dave was one of the first people Ernie called. When a car hit Dave's son, Ernie was at the hospital with Dave and his family.

On a Thursday afternoon, soon after lunch, Dave complained to Ernie that he was not “feeling right, that he must have eaten something bad.” They continued their work, checking office-building meters for water use, but as the day progressed, Dave felt worse and worse. Ernie became alarmed when Dave mentioned that he had pains running down his left arm; that was when Dave relinquished the wheel of their truck and Ernie drove to the local hospital's emergency room. By then, Dave was pale, was having difficulty breathing, and had terrible chest pain. The doctors felt quite certain that Dave either was in the process of having a heart attack or had had one. Tests were needed to confirm the diagnosis. Ernie called Dave's wife and they sat in the emergency room together awaiting news.

When they heard the call for a code emergency, they did not realize that it was for Dave. Some minutes later, the doctor came out to tell them that Dave had had a massive coronary episode and it was unlikely that he would make it. Ernie and Dave's wife went into the acute care area. Dave was unconscious, hooked to a variety of monitors, and looked dreadful. He died during the night.

Ernie was devastated. His partner at the water company was gone, but the most profound loss was that of Dave's unlimited friendship and caring. Ernie did not know how he would ever “recover from Dave's death.” The funeral was something of a haze to him. He remembered that the funeral home was packed with many familiar faces, people he knew from parties with Dave's family and, of course, the entire water company staff. He said that he felt “funny at the funeral and did not know where to put himself in relation to the family.” He stayed toward the back of the church, and he was almost invisible at the funeral home.

After the funeral, Ernie took a few days off. This was not because he was ill but because he could not face going to work without Dave. He dreaded the empty locker next to his, the assignment of a new partner, and the endless hours without his friend. He could feel himself becoming more and more upset, more than a little depressed, and he even had morbid thoughts. His loneliness—he was divorced and had lived alone for many years—weighed on him. Although others at the job mourned Dave's death, none felt it to the degree that Ernie did.

A week after the funeral, Ernie got up in the morning intending to go to work. He got dressed, had breakfast, and returned to bed. He could not get himself to leave the house. He called his supervisor and asked to take a few more days off, but the time did not ameliorate his despair. The supervisor made the suggestion that he speak to the county employee assistance person, and Ernie agreed because he could not bring himself to return to work. A referral for bereavement counseling was made by the social worker at the employee assistance program.

Relevant History

Ernie was the oldest of four brothers; one was deceased and the others lived out of state. He had grown up in a “poor neighborhood, actually the ghetto.” He had not known his father but had lived with the father of his three brothers for 10 years. He did not get along very well with his stepfather or his stepbrothers and kept to himself a lot. His mother worked two jobs after his stepfather left, and Ernie remembered lean times. He did not graduate from high school, as it was incumbent on him as the oldest to get a job and help out with the money crunch of the household. Ernie was a “good kid, did drugs for a short time but did not do any really bad stuff.” When he quit high school, he got a job at a local market making deliveries. He had one or two friends and a steady girlfriend. He gave most of his money to his mother. He got married when he was 21 years old. Two children were born in quick succession, and Ernie was overwhelmed with commitments and obligations, some of which he was able to manage and some he could not. The marriage lasted 10 years. It dissolved when Ernie's wife decided that he was not responsible enough to have and maintain a wife and family and she left him.

Ernie found his way to the water company when one of his customers at the grocery told him about several openings for meter readers. No civil service test was required and Ernie became a county employee, a job he has held until the present.

Relationally, Ernie was a troubled man. He had difficulty making connections and trusting the intentions of others. Dave had been the first close male friend he had ever had. That he had not known his father, had been estranged from his stepfather, and had had a troubled relationship with his stepbrothers suggests that close male bonding would be difficult for Ernie to maintain. He had lost track of his divorced wife and the two children, who were now adults, and he claimed that he had no interest in trying to find them or connect to them in any way.

Ernie described his life before Dave's death as comfortable: “I had a good job; enough money to keep myself going and I had a good friend in Dave. Sometimes I saw one particular woman but nothing serious.” Of course, that all changed with Dave's death.

Conceptual Issues

“Friendships are a core aspect of our lives” (Fehr, 1996, p. 1). Friendship refers to voluntary, enduring social relationships that involve choice, sharing, valuing, trust, loyalty, companionship, and sometimes love. Friendships are more significant than acquaintances; they involve self-revelation and disclosure, an exchange of confidences, and acceptance (Doka, 1989a). Although friendships vary in intensity, they can create meaning in lives, lend a focus and support in time of need, and play a significant role in the social structure of our existence. “Although the definition of ‘friend’ is highly personal and individualized, there are conceptual meanings attached to this term, which involve choice, sharing, valuing, trust, loyalty, and pleasure. From friendship we derive a sense of self-confirmation—a sense of who we are—self-worth and self-esteem” (Albert, 2001, p. 171).

Workplace Friends

The workplace is a natural venue for the development of friendship. Friendships that develop in the workplace have many benefits. They can provide a source of instrumental and emotional support, buffer job-related stress, and reduce job dissatisfaction; they can make work more enjoyable and increase commitment to the job (Yager, 1997).

Friendships that are work based seem to go through a series of three stages as described by Sias and Cahill (1998). The first stage noted was from acquaintance to friend. Proximity, shared tasks, shared projects, and the beginning of socializing out of work—lunches, drinks after work—promote that initial shift. Communication patterns at this level move from discussion of work to nonwork and personal topics with decreased caution, but not at an intimate level. The second stage is friend to close friend. This stage is driven mostly by problems or events in the personal lives of the friends, life events, and perhaps increased work-related problems. At the close friend level, socializing becomes more intimate with vacations or inclusion in family activities. There is decreased caution and increased intimacy of discussion topics. The transition from close friend to almost best friend is associated with extraorganizational socializing, life events, and work-related problems. Because the trust has been developed between the friends, increased comfort and intimacy are felt and opinions and feelings are more easily shared. At this stage, the friends become an important part of each other's personal and work life. It would be accurate to see Dave and Ernie's friendship as being at the third stage in which each saw the other as his “best friend.” This is a level of connection that is deeply felt and experienced as a source of comfort and belonging. In the event of a workplace friend's death, the level of friendship outside the job usually dictates the level of reaction to the event.

Work friendships can be intense. Sometimes work friends spend almost half of their waking time together, develop an emotional dependence on one another, see each other daily, and provide a support system for each other. When this tie is broken, the remaining employee is left in a vulnerable state, grappling with the emotions of anger, confusion, sadness, and helplessness (Stein & Winokuer, 1989). What makes this type of loss more complex is that workplace norms ask us to separate our work lives from our personal lives. When these two quadrants overlap, there is no organizational recognition or structure for this to be acknowledged. Grief and mourning are not acceptable at the workplace because grief does not belong at work; work is about productivity, quality, and profit and not about emotional caretaking. In recent years, larger corporations have begun to create employee assistance programs to help manage the emotional life of the company (Lattanzi-Licht, 2002). It is reasonable to expect employers to be more sensitive and aware of the impact of a coworker's death on the other employees and adjust leave time accordingly. Employers need to understand that grief takes time and to be more aware of the impact of death on their staff.

When there is a death in the workplace, it is up to company policy whether and for how long colleagues and coworkers are permitted to observe the rituals of dying. Most companies will allow time off for the funeral and a family visit but any more extended time off is not permitted. In most organizational settings, the amount of time allowed depends on the level of kinship connection to the deceased, with much more liberal absence time granted for death of blood kin. This position is understandable but short sighted.

Eyetsemitan (1998) coined the phrase “stifled grief,” which is any recognized grief that has been denied its full course. The workplace is a good example of where such grief is exhibited. Stifled grief has negative implications for workers and workplace productivity (pp. 470–471) and begs a reexamination of corporate policy and personnel practices.

Death of a Close Friend

It is surprising that there are so few studies on the death of a friend even though there are many studies that describe adult friendships, friendship patterns, and the role of friendship in adult lives. The few studies that have been reported used a convenience sample of university students or adolescents as their focus (Archer, 1999). What has emerged from the scant literature is the recognition that the bereavement following the death of a close friend can be as severe and in some cases more severe than that of an immediate family member. In the event of a sudden death of a friend, the opportunity for anticipatory grieving does not exist. The survivors of sudden death may have an intensified need for support as their world has been so abruptly turned upside down (G. Lee, 1994).

Sklar and Hartley (1990) reported on an exploratory study involving a sample of young adults who had a friend die. They used the term “survivor-friend” to denote one who has lost a close friend to death. Their findings indicated parallel bereavement patterns between survivor-friend and family member death. They noted the presence of “…unresolved feelings of despair, guilt (especially for things unsaid), fear for one's own mortality, and a sense of emptiness that had not been resolved since the death” (p. 108). In addition they noted the presence of decreased coping ability, premonitions, anger, feelings of craziness, guilt, anniversary syndrome reactions, and visions. All of these reactions are consistent with emotions and experiences commonly reported by widows, widowers, and other family members.

Weiss (2001) suggested that the grief of the survivor-friend might be severe, especially if there is a deep and long-lasting affiliation but that this loss does not produce the depth of despair and hopelessness that a family-member death can evoke. One reason for this difference (which was not the case for Ernie) is that there is an opportunity for substitutability with friends and none for kin. This assumes two things: that the relationship with the kin was positive and that the relationship with the friend was not especially intense.

The death of a friend may place the survivor-friend in an unusual bereavement position in relation to the immediate family. Society does not seem to tolerate or support in substantial ways the grief experiences of the survivor-friend (Rando, 1995). “Grief is a family affair, at least in American society…” and as such “…the …distraught close friend of someone who dies has virtually no legitimate, public, grief and mourning channels. The close friend is likely to be ignored by the deceased's immediate family and extended family and by others” (Sklar, 1992, p. 109). The survivor-friend may be cast in the difficult position of feeling the need to provide support to the family with limited amount of support going back to him or her. There does not seem to be a place for the survivor-friend in the rituals associated with funerals or the mourning period. As Deck and Folta (1989) observed, “There appears to be a cultural lag between the social definition of rights and responsibilities of family members, and the reality of social relationships” (p. 81). This lack of social definition isolates the survivor-friend from the functions and behaviors the family performs. “The family is expected to behave as mourners, experiencing sadness and crying in amounts deemed appropriate. They are expected to perform a variety of functions such as planning the funeral, greeting guests, dealing with funeral directors or clergy. They are prescribed socially acceptable clothing, places to sit, and things to do. These mourners are released from the usual daily tasks of work and play. Not so the friend” (p. 83).

Besides being marginalized by the mourning rituals of the family, another source of anguish is the loss of the role of a friend. In a sense, when a friend dies, his or her friends lose a part of their identity. Because friendship is such a unique relationship, based on sharing, values, trust, and so on, the sharing that occurred during the friendship is aborted and is not validated easily by another. The loss of that role can negatively affect self-esteem and self-confidence as we strive to replace this type of connection and validation from another.

Suggestions for Intervention

A major underlying belief in this and most bereavement cases is that “…losses not fully mourned shadow our lives, sap our energy and impair our ability to connect. If we are unable to mourn, we stay in the thralls of old issues, out of step with the present, because we are still dancing to tunes from the past” (Albert, 2001, p. 173). Therefore, as a form of disenfranchised grief (Doka, 1989a), one of the first counseling tasks in working with a survivor-friend is to legitimize the loss. The cultural imperatives of being sidelined in this form of death may give the subliminal message to the griever that he or she should not display emotion and thus should not feel any. Sklar and Hartley (1990) spoke of the double burden of grief for the survivor-friend: he or she may experience the social and emotional transformations of bereavement while suffering the lack of institutional outlets that act as support (p. 105). As a marginalized griever, the survivor-friend may even be in denial as to the depth of the loss. This denial points the counseling effort in the direction of having the griever talk openly and freely about the loss and the history of the friendship, being able to describe the depth and breadth of the friendship, the unique aspects of the friend, and what will be most missed about the friend.

“By facilitating respectful recognition of the aspects of the mourner's experience that was originally denied or disallowed, each intervention makes possible the pursuit of various subsidiary goals, such as healing relational fractures, encouraging greater self-acceptance, prompting instrumental changes in one's life to address newly recognized needs, and so on” (Neimeyer & Jordan, 2002, p. 102). The survivor-friend has to feel legitimized in order to move ahead.

Barbant (2002) stated that the tasks for the disenfranchised griever is to cope with, deal with, and grapple with the loss in such a way that the loss is incorporated into one's cognitive life. This is accomplished by keeping the griever focused on the loss to help him or her accept the death and reconstruct his or her day-to-day life in the absence of the friend. This is difficult work for one who is mourning but within the supportive atmosphere of the counseling the counselor may become a transitional figure and facilitate the grief process for the survivor-friend. The counselor's continued interest and presence may be especially needed by the griever, as the sense of abandonment and aloneness can be quite powerful.

For many, the death of a friend is a reminder of one's own death. It is not only that a peer has died but also that the death of the peer destroys the social network in which the individual is a member. As most friendships are dyads, the death of one means the demise of the grouping (Deck & Folta, 1989). Here again, the task is for the counselor to help the griever to look at his or her resources while attempting to empower the griever toward linking with others.

Major Issues in This Case

Ernie was suffering when he first came for counseling. His appearance was careless: he was unshaved, was wearing wrinkled clothes, and was generally not well groomed. He had not been to work for more than a week and did not know when he would be able to return.

Early in the counseling relationship, he was encouraged to speak of Dave and his friendship, how it had started, grown and become such a substantial part of his life. Initially, Ernie was slow to respond to this form of guided questioning, as he seemed uncomfortable talking about Dave and what had happened. In moments such as this, when a mourner seems uncomfortable with early content, it is helpful to acknowledge this resistance and say something along the lines of “Beginning is always hard” or “Everyone seems to struggle when they start talking about feelings.” This puts the griever at ease for two reasons: his or her anxiety is acknowledged as “normal” and the counselor is seen as someone who understands the client.

Ernie said that he had had very few male friends over the years and that he had not been “brought up to think that men would come through for you. You can usually depend on women to be there, but not so with guys.” So when he first met Dave, he was wary and “there was the color thing.” But he really felt that Dave was a “good guy and we started to hang out together a lot. Then they put us on the same route and finally on the same truck so if I didn't like this dude I would have had way too much of him.” Slowly, he said, they began to have some social contacts and the friendship expanded. He related the details of Dave's last day and the experiences in the truck and hospital. He said that he felt guilty that he had not acted sooner when Dave began complaining; he wondered whether acting faster might have saved Dave's life.

In the counseling, it was important to reassure Ernie that his feelings of guilt were normal and that the pain that he was expressing was part of sustaining a loss; we all question what we could have done after someone is gone. It was especially important wit...

Table of contents

• Front Cover
• Half Title
• Title Page
• Copyright
• Dedication
• CONTENTS
• Foreword
• Preface
• Chapter 1 Bereavement After the Death of a Workplace Friend
• Chapter 2 Bereavement After a Grandmother Dies
• Chapter 3 Bereavement After Multiple Losses
• Chapter 4 Bereavement After the Death of a Pet
• Chapter 5 Bereavement After Catastrophe: Deceased Unfound
• Chapter 6 Bereavement After a Plane Crash: A Lesbian Couple
• Chapter 7 Bereavement After Death by Murder: A Mother's Grief
• Chapter 8 Bereavement After Miscarriage: The Man's Experience
• Chapter 9 Bereavement in Wartime
• Chapter 10 Bereavement After the Death of an Identical Twin
• Chapter 11 Bereavement After the Death of a Therapist
• Chapter 12 Bereavement After the Death of a Divorced Spouse: A Double Loss
• Chapter 13 Bereavement After Physician-Assisted Suicide: The Physician Ended the Pain
• Chapter 14 Bereavement After the Death of a Young Grandchild: A Triple Loss
• Chapter 15 Bereavement After the Death of a Disabled Sibling
• Appendix
• References
• Index