Factors Influencing Grief Response
Factors Further Individuating1 the Grieving Process
Grief is shaped by many social factors,2 and as discussed in previous chapters, today women (and we suggest men as well) often experience both inner turmoil and social dissonance due to their search for self-identity through their choice of role in a constantly changing society. Some women live within a traditional role orientation; others, within a transitional or modern/postmodern framework. Women may not identify with any one role exclusively. As well, outsiders may interpret a woman’s role very differently from the one she identifies with. What is important is the woman’s self-perception, for it is this perception that will most affect her grieving process.
Traditional, transitional, and modern women are each potentially vulnerable to the effects of bereavement because of society’s respective standards, norms, and pressures embedded within each role orientation. Such feelings as guilt, self-blame, and anger are strong for anyone who has experienced a loss. A woman who struggles with role orientation is at risk of stagnating in her guilt and self-blame, but she can also choose to find an inner stability clarifying her own identity and fit in her world that is changed through loss.
Some of the key factors that have a significant influence on a woman’s grief include the value of her lost relationship, her age, personality, ethnicity, educational level, and financial status. The sum of these determinants, along with her choice of social role (traditional, transitional, modern/ postmodern), call forth a very individualized and complex “grief response”3 (Attig, 2011). And although each woman experiences her grief individually, societies and cultures establish mourning practices that provide stabilizing expectations of behaviors during times that women often experience as confusing and chaotic (Noel and Blair, 2008). When the loss of a close relationship occurs during a transitional woman’s reevaluation of her role, for example, the emotions of grief and the entire grieving process are intensified. What is more, these factors typically do not occur in isolation, but rather in some combination to shape a woman’s grief response, and unacknowledged, or misunderstood, they may put women at risk of developing problems dealing with their grief. An individual’s maturity; tolerance for frustration and inner conflict; capacity for adaptation, substitution, and sublimation; as well as intelligence, education, and life experience, all affect her capacity to resolve grief (Doka and Martin, 2010).
Value of the Lost Relationship
In any individual’s life, not all relationships have the same value or intensity. The greater the value of the lost relationship for the woman, that is, the degree of its closeness and uniqueness to her, the greater will be its influence on her response to grief (Lofland, 1985). “The more the deceased is interwoven into the tapestry of our lives, the greater our vulnerability to having to reweave the fabric” (Attig, 2011, p. 77).
According to many, the death of a spouse is considered to be the most stressful loss (Holmes and Rahe, 1967; Norris and Murrell, 1990). Others feel the death of a child has a greater impact on the bereaved parent due to the significance of children representing the parent’s hopes and dreams for the future (Deits, 2009; Klass, 2005; Rando, 1993). To the elderly, the death of a brother or sister is significant because that lost sibling may have been the only person left from the bereaved person’s past (Shah and Meeks, 2012). Memories, no longer shared by siblings, serve to further isolate the elderly, who often in American society already tend to live a lonely, segregated existence. Although the elderly are generally more accustomed to the idea of death than younger people, the value of the lost sibling relationship tends to be very high.
For the bereaved woman, if the relationship was deemed a positive one, whether with a spouse, child, or sibling, successful completion of the grieving process is less difficult. Similarly, if the relationship involved conflict, the survivor is no longer able to resolve the conflict with the lost person. She may anguish over unfinished business (Doka, 1989) and become even more vulnerable. The accompanying grief is then more difficult to work through, and this may result in the woman experiencing a “complicated grief.”
A number of factors determine grief and whether it is uncomplicated or complicated. In an uncomplicated grief process, loss is typically accepted, assimilated, accommodated, and transformed. In complicated grief, the bereaved experience significant functional impairment longer than six months, and they suffer psychiatric comorbidities such as depression, anxiety disorder, and/or PTSD. However, to make that determination, a number of factors must be considered (Love, 2007). Predisposing factors may include previous loss, conflict with the deceased person, dependency of ambivalence in the relationship, and beliefs about death. Protective factors may include personal resilience, adequate social support, opportunities to redefine and create relationships. Precipitating factors may include traumatic loss following accident, other significant attachments, and whether the death is associated with stigma or shame. And finally, perpetuating factors may include inadequate social support, conflict with the deceased person, dependency, or ambivalence in the relationship. All of these factors have to be assessed and considered with respect to the depth of bereavement the woman is experiencing.
Social Role
A woman’s social role also affects her response to grief. A young adult woman, for example, with a traditional upbringing, could initiate an intense grief reaction to feelings of insecurity through the loss of a parent (possibly a dependent relationship). On the other hand, the loss could initiate a sense of freedom and new possibility for the woman. To an older woman in a traditional marriage, loss of her husband could mean the loss of her perceived purpose in life because she had functioned primarily as her husband’s caretaker. For older women who have adopted a transitional or modern role, again the loss of a husband could produce an intensified grief reaction if the woman feels that she has somehow let the deceased down by deviating from a traditional role, or she could feel a strong sense of liberation if her husband had been restrictive in accepting and supporting a more modern role for his wife.
Social Class
Grief is dealt with privately, but also publicly. The social class with which the woman identifies has a definite impact on her experience of grief.
Generally speaking, the working class publicly displays a greater commitment to the deceased through their overt expressions of grief. The middle class in the United States recognizes grief as an accepted consequence of a significant loss, but the bereaved individual is expected to “snap out of it” and get on with life rather quickly. For the upper class, stoicism in public is insisted upon, for grief is considered a private affair. The public image of strength and being in control in times of trouble must be maintained. The private life, including its sorrow, must be protected and withheld. But rules of proper behavior do no more than complicate the woman’s experience of loss, and what is considered proper deportment actually sets up barriers to successful grief resolution.
Age and Life Circumstances
It is generally believed that the young who experience loss of a significant other have intense grief to resolve (Christ, Siegel, and Christ, 2002; Rask, Kaunonen, and Paunon-Illomonen, 2002; Worden, 2009). This includes young adults (Balk, Walker, and Baker, 2010). Societal attitudes give the impression that death is not possible in youth, and its occurrence is likely to be shocking to a young person who has little exposure to death (Lench and Chang, 2007). The reckless lifestyles that many younger people live (drinking and driving, speeding in cars or motorcycles without wearing seat belts or helmets) reflect an attitude and perhaps belief of infallibility and immortality. When death is visited on a young person, there is a sobering and frightening effect on youth (Arnett, 2007). Death by suicide (and therefore choice) makes it especially difficult for youth to grieve, particularly when the suicide victim is another young person. In American society, where death is a subject that is generally avoided or covered up, young women are likely to be hit very hard by the death of someone they know.4
There is little research conducted on the impact on young women who experience the loss of a spouse. However, to a young widow in a traditional relationship, the loss will likely be greater than if she were in a transitional or a modern relationship. She may be feeling abandoned by her husband, left to raise young children alone (if she has children), having to become the sole income provider and financial manager, and possibly having to learn new skills for employment as well. And when she is told, “Don’t worry, you’ll find someone else,” she is torn between feeling that her friends and family believe her husband is easily replaced, and/or that she cannot function or manage on her own.
There is some research to indicate that loss of a partner for a young woman results in peer discomfort because they too are unfamiliar with loss. However, young women can also experience a kind of “rebirth” after losing a spouse (Walter, 2003). When the young woman continues bonds with the deceased and actively incorporates the death into her new life, she is likely to suffer a less complicated grief (Neimeyer, Baldwin, and Gillies, 2006). Technology too has an influence on a woman’s grief response. The Internet allows her to connect with others with similar experiences, and moving forward through online dating sites, for example, can help her connect to a possible new mate. At the same time, these experiences can conflict a young widow in feeling that she is somehow betraying her deceased spouse (Walter, 2003).
Loss to a woman in middle age has different impacts. A decreased social life becomes even more important to a widow who has already lost her primary companion. Often, when a middle-aged woman becomes a widow (or is divorced), her married friends eventually drop her from their guest list because she is no longer part of a couple. Friends might become uncomfortable, assuming she’s “on the prowl,” looking for a new partner. One recently divorced woman explained:
One of the nicest things that happened to me eight months after my divorce was being invited out to dinner by a couple who were old friends of my ex-husband and me. I felt awkward and crushed when the waiter looked at the three of us and inquired if we wanted a table for four saying, “Is there another gentleman coming?” Keith turned and winked at Jennie, and I immediately requested a table for six, giving the waiter fictitious names of three additional women, adding, “I’m expecting my other dates soon.” The look on the waiter’s face was priceless. The ice of uneasiness was broken; we were given a table for six, I relaxed, and the three of us enjoyed the evening. A lot of the hurt is knowing how other people view you. You can see them fitting you into a mold when actually you’re just trying to figure out who you really are. No one seems to understand that.
For someone who has fit comfortably into a social structure only to be displaced because of the loss of a significant other (through death, divorce, or loss of other kind of relationship), being marginalized is painful. On the other hand, the loss experience can also be an opportunity for personal growth. Society, though, generally fails to recognize this and instead stigmatizes displaced individuals.
Women at midlife also experience other types of loss and grief, resulting, for example, from the death of one parent while having to shoulder emotional, caregiving, and possibly financial responsibility for a surviving parent. This may require the woman to juggle multiple role orientations simultaneously—that expected by the surviving parent as well as the one she chooses as an independent individual. At the same time, the woman may also be in a parent role if her own children (regardless of their age or life circumstance) still live in the family home. The fact is that many women in midlife experience a whole range of losses from which grief can arise: loss of a spouse, a partner, siblings, parents, relatives, jobs, and health. (Some of these are covered in subsequent chapters.)
For the elderly, coping with loss may be less difficult because they have more exposure to, and are more accustomed to, the idea of death itself. Research indicates that older women report less fear and anxiety about dying than do men, but that losing an adult child can be as devastating as losing a spouse (Hooyman and Kiyak, 2007). For an elderly woman who lived her life primarily in a traditional role, redefining herself after the death of her spouse is typically very difficult. Having other supportive relationships and continuing active involvement in the companionship of leisure activities with friends help her to develop new positive self-concepts (Montpetit and Bergeman, 2010). More than with any other age group, death is accepted as a fact among the elderly since more friends and acquaintances are dying of old age. Death is regarded as “normal” and if the bereaved’s own life has been rewarding, it is easier to accept than when life has been fraught with hostility and conflict.
Education Level
Usually, the higher a woman’s educational background, the better able she is to take control of her life and handle responsibility for life experiences. This is very important in determining the outcome of her grief. A college education, for example, typically means exposure to various ideologies, and this encourages the individual to actively participate in forming personal values rather than merely accepting or conforming to traditional ones. An education also typically encourages a more mature and broader approach to problem solving. These skills are relevant and important with respect to loss and grief in that with them comes the need for personal examination, redirection, and adaptation to life without a significant other (a spouse, a partner, a child, a parent, and so on). A higher education level eases some of the burden of redefining one’s life in the face of loss, especially, for example, for the widow who becomes the primary income provider. Employment opportunities are greater with a college education, and when education is coupled with some past experience, maintaining a position or reentering the labor force is less difficult.
By comparison, a low level of education means a more difficult path toward personal and economic independence. Research indicates that many aged widows experience a decline in their standard of living upon widowhood, a pattern that is pronounced among those with limited education (Weaver, 2010). Replacing external pressures of tradition with individual freedom might not be customary, as the tendency is for women with less education to lead more traditional lives. Recovering from loss in this instance would be a slow process that involves guidance, counseling, and further education.
Financial Status
Grief is a difficult experience in itself, but when compounded by financial problems, it can be disorienting and overwhelming. People who experience financial decline following their partner’s death are at greater risk of poor psychological health—women more so than men, and for longer periods of time (Cordon and Hirst, 2013).
For the young traditional widow, loss of a husband means the immediate burden of becoming the major breadwinner. (This is exacerbated if there are major outstanding medical bills.) If the traditional woman has a profession (or had one prior to being married), getting back into the workforce may be challenging as she attempts to deal with her loss on an emotional level. Concentration is a problem during bereavement, and this may also create problems at work as the following widow’s experience indicates:
As soon as I sold my home in the country, I took a trip to the town I planned to move to. With my résumé and past experience, I was able to secure a position the second day I looked. Everything was happening so fast, and l felt I was a robot who was saying all the right things. I heard words coming in and bouncing off, but I had trouble remembering what was said. During my new job orientation, I was shown several forms and what to do with them, but I couldn’t remember any of it. I found myself having to look things up in the procedure manual—something I had never had difficulty with before. I found myself listening to conversations, but not participating in them. When I finally tuned in, I realized that I had been thinking about what had happened to me in my life and wondered what I was doing in this strange place anyway.
Disorientation after loss is common, as is a reduced ability to reason and concentrate on duties that once seemed trivial. Without the grounding force that the lost relationship provided, it may seem very difficult, if not impossible, to recenter and focus oneself on new tasks. If the young widow in the story above, for example, had been at home caring for children, the added costs, frustration, and fears of leaving the children with friends, relatives, or at a day care center would add further stress to the chaos she already feels. The necessity of making decisions at a time of also attempting to resolve grief can hinder the grief process and significantly disrupt life. For a woman in this situation, both support from friends and family, and possibly counseling as well, is probably a necessity to help ease the enormity of her burden and to help her put things into perspective. As well, the immediate necessity to solve economic problems and find employment puts her at high risk for developing problems in grief resolution. If older children are at home, she also might feel she is a failure because she is financially unable to assist them in their educational pursuits as previously planned. This is complicated by the fact that she has difficulty providing her children with the stable emotional support they need during their experience with the loss of a father.
For the middle-aged widow, financial problems are also a significant factor in assessing the outcome of her bereavement. One study indicated that widowed individuals in 2011, especially women, reported fewer social and financial difficulties than their counterparts in 1979. However, the effect of widowhood on depressive symptoms and psychological difficulties did not differ significantly across these points in time. The authors concluded that social changes in the late 20th century may be protective for older adults’ physical, social, and financial well-being in the face of spousal loss, yet these changes do not alleviate widow(er)s’ psychological distress (Perrig-Chiello et al., 2016).
In the United States, data indicate that almost half of older women (46%) age 75+ live alone. Over 48 percent of the poor elderly are widows, even though widowed women account for only 26 percent of all persons age 65 and older. Compared to the slightly more than 4 percent of couples age 65 and older who are poor, about 20 percent of widowed women are poor. This poverty rate is considerably lower than the 50 percent of widows who were poor in 1970. However, on average, married women in the United States experience a decline in income when their husbands die. Although widowers are somewhat more likely to be poor than are married couples, data that follow couples over time do not show a decline in average economic well-being for men when wives die. The median income of older persons in 2013 was $29,327 for males and $16,301 for females. Older men were much more likely to be married than older women—72 percent of men, 46 percent of women. In 2014, 35 percent of older women were widows.5
In Canada, the story is not much different. Statistics Canada reported that in 2001, Canada had just over 1.2 million widowed men and women aged 65 and over, a 6.4 percent increase from 1996, according to census data. Senior widows outnumbered senior widowers four to one. In fact, widows accounted for 45 percent of all women aged 65 and over. Because of widowhood, more senior women were entering low-income status over the years. Five years after the death of their spouse, the proportion of widows entering low-income status exceeded the proportion of their still married counterparts by two to one.
Financial security does not guarantee successful grief resolution, but the threat of financial insecurity can be further disorienting and may make it seem that there is just too much for the widow to handle. In short, death of a spouse often still means the loss of the main source of financial support for a woman and a drastic lowering of her standard of living. (Unfortunately, divorce can have a similar result.)
Resilience: The Capacity to Cope with and Recover from Loss
Although an array of social and personal variables influences an individual’s coping ability, there is little agreement on which factors have the most influence. However, the most predictive factors have been found to be positive self-esteem and personal competencies of the bereaved in managing the tasks of daily living (Doka and Martin, 2010). These two characteristics are similar to what Bonanno (2004) calls “resilience.” In his studies of widows, Bonanno found that although personality does play a small role, resilience (the ability to maintain relatively stable, healthy levels of psychological and physical functioning following the death of a spouse) is not a personality trait, but rather healthy adjustment to loss. Bonanno found that laughing and smiling are more helpful in adjusting to loss, along with the repression of negative emotions (Bonanno, Ray, and Gross, 2007; Keltner and Bonanno, 1997). This is quite contrary to the emphasis grief culture has placed on tears or anger as healthy expressions of grief. According to Bonanno, resilience reflects the ability to maintain equilibrium and healthy levels of stable psychological and physical functioning as well as capacity for generative experiences and positive emotions, even in the face of trauma.
Other research supports those results. For example, widows who remained connected, rather than isolated, felt that their grief was manageable and under control; and those who embraced and learned from new experiences, rather than avoiding or feeling threatened by them, were better able to bounce back from widowhood (Rossi, Bisconti, and Bergman, 2007). Having appropriate social support and minimizing other sources of stress, such as financial stress, were also helpful.
Resilience, as an important factor in recovery from loss and grief, is gaining increased prominence throughout the literature. Bonanno and his colleagues have found that mourners with more robust self-narratives that assimilate traumatic loss seem to respond with resilience and resourcefulness, maintaining continuing bonds with the deceased when the loss makes sense spiritually, existentially, or in practical terms (Bonanno, 2004). One of the practical meaning-making strategies of maintaining continuing bonds and assimilating loss is through narrative (also referred to as “therapeutic journaling”). (This is also supported by other grief researchers [Attig, 2011; Deits, 2009; Lichtenthal and Cruess, 2010; Nagel and Clark, 2012; Neimeyer, 2014; Noel and Blair, 2008; Pannebaker, 1997) as well as other researchers throughout the social sciences.)
Thomas Attig (2011) expresses his view on resilience this way:
[O]ur resilience resides in what is not broken.… our daily lives are shattered, our life stories disrupted, our connections to larger wholes threatened or undermined, and our ego’s illusions undone. Yet, much in the tattered web of our life remains intact.… [n]either the soul nor spirit is broken. The home-seeking and meaning-seeking drives that animate our lives, though shaken, can and do address our brokenness and overcome our sorrow. Resilient souls find sustenance in familiar surroundings; draw from roots in family, community, history, and tradition; care and love deeply, and find grounding in the great scheme of things. Resilient spirits find hope, faith, and courage to rise above suffering; stretch into the new and unknown; change and grow; seek understanding; and open to joy again. And the love that still pulses in our soul and spirit can cherish precious memories and lasting legacies, revive connections with fellow survivors, and open to new relationships. As our unbroken and resilient soul and spirit do these things we relearn how to be our selves again in life in separation from our loved one. (p. xlix)
Although “grief work” may be helpful to those bereaved individuals experiencing significant distress (Neimeyer, 2000; Stroebe and Stroebe, 1991), there is a lack of evidence to substantiate its positive effects over time (Wortman and Silver, 1989). In some cases, grief work has actually been shown to have harmful effects (Bonanno and Kaltman, 2001), leading seminal grief researchers to support building resilience as key to overcoming grief.
Ethnicity and Culture: Their Influence on Grief and Its Expression
Cultural norms and traditions significantly influence bereavement. They become “shaping agents” of grief that reinforce both women’s (and men’s) roles in the grieving process (Doka and Martin, 2010). Culture has also been said to “colonize” a person’s public identity and private self-concept (Neimeyer et al., 2006). In short, societies “police” bereavement practices through the culture(s) they support and sustain.
Cultures have rules for expression of grief and for managing continuing bonds with the deceased (Walter, 1999). Grieving too much (prolonged or chronic grief), or at the wrong time (delayed grief), or not at all (absent grief), all are examples of contemporary psychotherapeutic culture where aberrant grief is considered pathological (Neimeyer et al., 2014). Knowing how a particular ethnic group views death, then, is important in understanding how a woman is expected to express her grief, and how members of her ethnic community will judge the appropriateness of her response.
Sometimes, the influence of the cultural group to which the woman belongs has an enormous and lifelong impact on her, as the following vignette illustrates.
My grandfather died in 1950 in an accident at sea. My grandmother, an independent woman from the Madeira Islands, owned a fresh fish market and restaurant in New England. When my grandfather died, her in-laws no longer felt it proper for her to be a business woman, and they strongly suggested that she not shame her dead husband by working in public. My grandmother then sold her business and supported herself by selling her Madeira embroidery creations that she made and sold from her home. From the time of my grandfather’s death, my grandmother dressed completely in black until she died 33 years later at the age of 96.
Although the woman described above was considered fairly modern for the 1950s, the pressures that traditional family members placed on her after her husband’s death plagued her with the guilt of possibly shaming her deceased husband. To reconcile her personal loss and grief, she succumbed to family pressure and lived out her days in a fashion “acceptable” to her ethnicity. She gave up the business she enjoyed and withdrew from the outside world. For a woman who in some ways had experienced movement from a traditional to transitional role in her early life, cultural moirés dictated her reversion to the very traditional lifestyle she had begun to transition out of.
Cultural traditions that dictate, or at least direct, the role of women in their expressions of grief are deeply embedded historically. In the Bible, for example, when Mary Magdalene mourns the death of Jesus and bends to look inside the empty tomb, and is asked by the stoic disciples, “Woman, why are you weeping?” Mary replies, “Because they have taken away My Lord and I don’t know where they have laid him.” (John 20: 10–13). By tradition, it would have been disgraceful for the disciples to display emotion or grief. Mary, on the other hand, as a woman, fulfilled the traditional requirements of her role by crying. Traditional gender roles see women as more openly expressive of their grief and more invested in familial relationship than men, based on their reaction to grief and because women generally may pay more attention to their own and others’ emotional states than men (Doka and Martin, 2010).6 The Women’s Movement itself was a significant factor in allowing for a more feminine expression of grief in the public sphere (Doka and Martin, 2010).
In some cultures such as the Far East, India, the Middle East and in many smaller societies, death affects the immediate family but also the community of which the family is part. Grief is openly expressed by everyone through crying, weeping, sobbing, and wailing. In many North American societies, particularly Britain, America, and the Scandinavian countries, death is largely private and dignified, and limited to the immediate family. Although open expression is not discouraged, neither is it encouraged. Funeral services proceed with restraint and quiet dignity (Parkes, 2015).
Some ethnically diverse examples that illustrate women’s roles in grief and mourning include the following:
There are many other examples from around the world that illustrate women’s traditional mourning practices. Although some practices may seem very foreign to American culture, others may be more relevant given the influx of immigrants and refugees into America. Women who have been exposed to, if not raised according to, diverse cultural beliefs and traditions, experience loss and grief in ways unlike our own. The degree to which women assimilate their diverse ethnic practices into American culture influences not only how a woman responds to her grief but also the extent to which her movement through grief is considered appropriate both by the new ethnic group into which she is trying to assimilate, as well as by the group from which she originates. Not only women but also families, communities, and cultures construct meaning by integrating the experience of grief into their larger cultural and religious narratives. In multicultural societies, the question arises as to which culture controls meaning. Neimeyer, Klass, and Dennis (2014) contend that when power arrangements (political, religious) change, continuing bonds with ancestors also change to reflect those power arrangements. In short, “[P]ublic voicing and performance of grief and its associated rituals are functionally scripted … to support broader social systems and those who wield power within them” (p. 496).
Crying as Expression of Grief
The loss of a close relationship calls forth some form of emotionality in almost all bereaved individuals, whether female or male. The manifestation of that emotionality is typically crying. Indeed, an enduring visual associated with grief over time and across cultures, and through various art and linguistic forms, is that of a woman weeping.
According to Paul Rosenblatt (Rosenblatt, Walsh, and Jackson, 1976) in his book Grief and Mourning in Cross-Cultural Perspective, expression of emotion is exhibited in the form of crying, anger, and fear.
Rosenblatt conducted studies measuring the frequency of crying in both females and males after experiencing a significant loss. Of the 28 societies he studied, women were found to cry more frequently than men (Rosenblatt et al., 1976). Why has this role of ritual griever been assigned to women? According to Rosenblatt, there are several explanations, all of which stem from the traditional role expectation of women.
Due to traditional socialization practices, women may experience losses more strongly than men if they have been trained to perceive themselves only in relation to others, that is, as caregiver/caretaker. Loss of this identity would be more upsetting to someone whose self-esteem is bound up in her relation to others rather than being focused solely on herself as an independent personality. The focus on relationships may cause women to form more extensive emotional attachments if they have been taught that their personal value lies in functioning as a wife or mother.
Rosenblatt also theorized that differences in frequency of crying among females and males stems from the socialization of women to express aggression in a nonaggressive or self-directed manner. Ritual grieving, such as that performed by women at funerals, may have been one of the few acceptable outlets available to women who were indoctrinated to be “seen and not heard.” Indeed, in classical Athens, religious events, along with funerals, furnished women with the only opportunity to participate in the public life of the community. Trained to subvert aggression in every way, the wailing tradition, which seems to be a part of so many societies grieving practices, may have functioned as a nonaggressive way of channeling grief and its accompanying anger and frustration.
As well, Rosenblatt concluded that women may express emotional distress because they feel societal pressure to do so. Traditionally, women have been seen as being of lower status in society, and their role has been to serve as males’ emotion-expressing or respect-expressing surrogates. In short, women may not experience a death more strongly; they may only be used as the persons who symbolize it publicly (sometimes in burdensome or self-injuring ways) (Rosenblatt et al., 1976).
A woman weeping, then, is one of the most prominent of the traditional gender roles of women. According to traditional lore, women are considered the more emotional sex (Walter, 2003), but Doka and Martin (2010), in examining the assumptive roots, highlighted three predominant movements with respect to expression of grief: the feminization of grief, which reflected a counselor bias toward emotional disclosure; distinctive male patterns that emphasized biological differences between genders; and emphasis on grief as a continuum from intuitive to instrumental. The terms intuitive and instrumental carry less baggage than masculine or feminine styles of grieving, derived from Jungian psychology, which regards both masculine and feminine traits on one continuum and existing within each individual. Intuitive grievers naturally gravitate toward exploration and expression of turbulent emotions following loss, whereas instrumental grievers respond in an intellectual or action-oriented manner. Doka suggested that women are predominantly “right-brain,” or intuitive, whereas men are predominantly “left-brain,” or analytical (Doka and Martin, 2010). So, despite the pathology of grief expression being associated with stereotypical feminine behavior (Klass, Silverman, and Nickman, 1996), Doka contends that people with the widest range of response to grief (intuitive to instrumental) and who integrate all aspects of self seem to have the greatest capacity to respond to grief. Doka also reminds that the cross-cultural designation of women as emotional outlets for the male, or for the group as a whole, carries with it ideological implications related to the universal subordination of women and the devaluation of the feminine. A healthy expression of grief is an individual process that occurs independent of ritualization and within each individual’s personal experience, which is not only influenced by socialization practices but by basic inborn temperament or preferences for emotion regulation.
In some countries, the influence of global communication has affected historical grieving patterns. In her chapter entitled “Grief for Export,” Konigsberg (2011) points out that even Australian ways of grieving are not outcomes of local experience, but rather “socially constructed ways of understanding inherited from a variety of dominant foreign influences” (p. 182). Japan and Hong Kong reflect similar patterns of the influence of the Western world on their Asian grieving practices. Still, grief expert Rosenblatt concluded that no feeling, meaning, or understanding of grief is universal across cultures or even within a single culture (Konigsberg, 2011).
Expressions of Anger and Fear
The experience of losing a loved one is chaotic enough, and when combined with the accompanying consequences of the loss, can produce feelings of anger or betrayal by deceased. Feelings like “I have to start all over now. Why did you leave me now when we seemed to be putting our lives together?” or “It’s not fair. Why do l have to raise our child alone?” These emotions are not unusual for the bereaved (Bowlby, 1998). However, when anger is directed inward, as it frequently is during the grieving process, the potential for suicidal thoughts and behavioral problems greatly increases (Worden, 2009). Prolonged anger, especially the self-deprecating kind, must be recognized as a risk factor and treated as such.
Fear is expressed through anxiety. There is a restless feeling of panic that engulfs the bereaved, but it is not something that is always identifiable or tangible, further increasing the confusion the bereaved experience. One cannot run from it like fleeing a stranger in the dark or turn it off like a horror movie on television.
What follows is one woman’s expression of her experience of anxiety.
Is it normal to be so restless? I can’t explain it, but I just want to keep running. Am I trying to run away? I just moved again for the third time. I thought it was the small apartment, so I moved to a larger one. I love it because there’s room to jump rope and dance and exercise. I made a special effort to decorate it with things that say, “This is me!” But there are still times when I feel like running away again. It’s not the place, is it? A friend told me that I can’t run away because it goes with you. Just what is “it”? How can you fight off something you can’t understand?
I don’t know what comes over me sometimes. I have to leave the house. Sometimes I run until I can’t run anymore. Once I jumped in the car and kept driving down the freeway with no destination in mind. It was late at night, and I remember finally coming to a town, and I didn’t realize I’d driven all the way to Nogales and was blinded by the bright white lights at the port of entry. I’d never been there before, and as I drove around, the activity and intermingling of cultures consumed my thoughts. I noticed I began to feel exhausted and sleepy. The fear disappeared, although as I think about it now, being alone there at night was certainly not very safe. My body was relaxed, and I was exhausted, and I had to drink coffee to stay awake for the long drive back home.
Later my friend described to me the fear he experienced after the death of his wife. “No one ever told me that grief was feeling afraid, but the sensation is a fluttering in the stomach. I don’t like being afraid.”
Fear, manifested through anxiety, is a common experience of grief. It is often bewildering to the one who experiences it, and it is difficult to pinpoint its source. Fortunately, over time, it subsides.
Risks of Nonexpression and Gender Assumptions
One of the most devastating consequences of relegating the expression of grief to women is that emotions are a fundamentally human characteristic that knows no gender bias or boundaries. Although some studies have shown an increased expression of grief by women, indeed in many cultures, and as already discussed, denial of emotion can have harsh and devastating results. Vulnerability to loss transcends the social construction of grief, which packages emotion as unmasculine or weak.
In the vignette below, a woman describes the grief experience of her husband following the death of their child.
My husband was a victim. Here was a man, a father, who watched his child being buried and, according to convention, was asked by society to “keep a stiff upper lip.” In the months that followed the funeral, my husband discovered that the demands on him were very unfair. He was the one who went to the funeral home to make burial arrangements. At no time was I asked to participate in any of the macabre arrangements the living make for the dead. The atmosphere around us was one of comfort for me, but for my husband, it was a matter of facing things head on. As time went by, instead of coming out of his grieving, he sank deeper and deeper into his sorrow. Finally, he reached a point where we both knew he needed psychiatric help. He does not remember getting much help or guidance, but, and maybe this is what it was all about, he spent many sessions crying. Just crying. (Schiff, 1977)
The need to express grief through crying is present in both sexes but is generally ascribed mostly to women. Seen as a sign of an inherently weaker nature, it is obvious why men would prefer not to display emotion. It contradicts the image society wishes to bestow on men. But if expressing emotion is no longer so consistently derided and devalued, both men and women could escape the burden of the traditional role when it comes to grief reaction and response. If the feminine becomes more universally accepted, then the interchange of male/female roles should produce a corresponding change in the ability of individuals to express emotion, which would be healthier and more conducive to the successful completion of the grieving process in both women and men.
As it stands now, with vestiges of the feminine still experiencing devaluation, only women who plan no career past marriage and accept the traditional role seem to feel comfortable with emotional expression. Among female acquaintances who are career oriented and who plan to be financially independent following college, very few overtly express their emotions. Many have adopted a more masculine approach to work and life.
Acceptance of the “feminine” characteristic of expressiveness would be much healthier for all individuals who have experienced loss. As Konigsberg (2011) emphasized, “The attempt to ‘gender’ grief—just as marshaling it into stages—does it a disservice.… Whether someone is a man or a woman has little predictive power about how he or she will adjust to bereavement” (p. 180).
One Cultural Approach to Grief
Cultural traditions have a significant influence on one’s grief. Knowing how a particular culture views death is important in understanding a woman’s experience in mourning. For some cultures, death is accepted as a natural part of the process of life, but for many, death is hidden and denied. When a society denies death, pressures are placed on the bereaved to conform to societal denial of death. The bereaved are expected to get on with their lives as quickly as possible and not let the loss affect them—an expectation that is virtually impossible to fulfill.
Although much has been done in recent years to “naturalize” death in American culture, the majority of people continue to deny it. They see death as a failure, and they shield themselves from the sight of it. In some cases, practices persist where the dying are prematurely buried in isolation in rooms at the end of sterile hospital wards, away from family, friends, and the familiar surroundings of home. Because these individuals are tainted with death, they must forfeit their right to continue to live among the living.
Burial rituals also indicate denial of death. Mortuary practices in body preparations or viewing ceremonies are based on unreality, with the goal of trying to make the deceased appear to be “just resting” or looking as lifelike as possible. The family is led away from the viewing room before the coffin is closed and before cemetery workers lower the coffin into the grave and shovel dirt onto the casket. These events constantly give the message that death is to be avoided and denied.
Unlike the Anglo culture, the Jewish recognize death as a natural part of the life process. Throughout the Jewish funeral ritual, time limits help to structure mourning. There is a sense of community associated with these rituals that provides opportunities for the bereaved to progress through grief with social support. In The Psychological Wisdom of the Law (1974), Audrey Gordon documented the rituals of Judaism that work to assist the survivor of loss, and these aspects are instructive to avoid many of the negative impacts of grief.
Although we do not suggest universal adoption of the Jewish view of mourning or as a prescription of how to handle grief, the Jewish model (acknowledging multiple customs within the Jewish faith) (Parkes et al., 2015) could well be used as a starting point for bereavement counseling and intervention. The open expression of grief and individual progression through the grief process promotes healthy grief resolution with less opportunity for stressful or negative impact on the bereaved individual, regardless of their role orientation.
1. Individuation is derived from Jungian psychology. In Hollis’s terms (2005), individuation refers to recovering our own personal story among provisional stories wrapped up in familial limitations and constraints of tribal claims on us.
2. Doka and Martin (2010) identify a number of factors that affect the grieving styles of individuals, including culture, gender, socialization experiences, birth order, and temperament, among others. Rando (1988) categories factors affecting grief as psychological, social, and physical.
3. Attig (2011) distinguishes grief reaction as a specific reaction to grief emotion, whereas grief response refers to the full range of experiences of emotional, psychological, physical, behavioral, social, cognitive, and spiritual impacts of bereavement. Mourning refers to both grief reaction and response. Grieving response is unpredictable and shaped by an individual’s character and their choices.
4. Losses experienced by youth of varying ages are comprehensively covered in McCoyd and Walter (2016).
5. “Administration on aging (AoA),” Administration for Community Living, http://www.aoa.acl.gov/aging_statistics/profile/2014/2.aspx. Note that the site reflects principal sources of data for the Profile are the U.S. Census Bureau, the National Center for Health Statistics, and the Bureau of Labor Statistics. The Profile incorporates the latest data available, but not all items are updated on an annual basis. http://www.aoa.acl.gov/aging_statistics/profile/2014/docs/2014-profile.pdf.
6. Note that Mark Mercer (2012) suggests that women do not understand male grief and that men grieve as “hard” as women; they just typically don’t show it as openly as women do (“What Women Should Know About Male Grief,” http://thegrieftoolbox.com/article/what-women-should-know-about-male-grief).