Death of a Spouse or Partner: A Widow’s Grief
Introduction
Losing a spouse is considered the most stressful of all life events (Holmes and Rahe, 1967). In fact, research has shown that people can (and do) die of broken hearts at twice the rate of nonbereaved people matched for age and other demographics (Carey et al., 2014). Widowhood is no small matter.
This chapter presents women’s experiences of spousal death: first, as loss arising from an anticipated death due to terminal illness; second, as a sudden, unplanned death as the result of a workplace accident; and third, as a result of suicide. The chapter examines women’s experiences of loss and their ability to progress through grief within the context of their relationships to their husbands,1 and the roles arising from the nature of those relationships.
Spousal Relationship and Its Influence on a Woman’s Role
In marriage, wife and husband are partners. In a good marriage, this is a loving relationship. The relationship can have defined boundaries (loosely or rigidly), which also define the woman’s role and her relationship to her spouse. In a traditional sense (as described in Chapter 1) the wife’s role is primarily that of caregiver, while the husband’s role is primarily that of protector and provider. Historically, this configuration resulted in women being perceived as dependent since the material aspects of the marriage were given higher value than the emotional or personal. It is not uncommon that older women in today’s society have lived traditional marriages, but this can describe a contemporary marriage relationship as well, although certainly less common.
In a transitional or modern/postmodern role configuration, boundaries in a marriage relationship are generally more flexible with spouses sharing roles and responsibilities. Today’s marriage relationships more typically fall into this categorization where it is common to see a strong element of interdependency between husband and wife, with this dependency leaning more toward one partner or the other, depending on the individuals involved and their individual needs at the time. In these contemporary relationships, equality replaces dependency in the financial realm, and domestic responsibilities are shared. There is a partnership, but individuality thrives and nurtures the relationship. A loving relationship grows with each partner’s experiences being shared by the couple. Within the context of such a relationship, a husband is not only his wife’s partner but her lover and best friend, and she his. When death of the husband ends the relationship, which statistically occurs far more frequently than the death of the wife, the wife has lost a very important aspect of her life.
Widows’ Bereavement
Most women react to death of a spouse in a manner similar to that described by Dr. Erich Lindemann in 1942. A woman’s grief reaction typically includes a period of numbness and disbelief accompanied by a tendency to deny reality. This may last a few hours to several weeks. There is usually a display of strong emotions, such as crying, along with various other physical symptoms related to mental distress. A state of panic may arise as survivors find they are unable to stop thinking about their loss. Overwhelming feelings of guilt and preoccupation with the deceased may surface, including hostile reactions of having been abandoned by the deceased spouse/partner. Anger and jealousy toward those who are left alive may occur, as may hostility toward the medical establishment, which may be blamed for the death. Customary daily routines are disrupted, and incapacitating feelings of sadness or loneliness may persist for several months.
In their study of over 100 widowed persons, Clayton, Halikes, and Maurice (1971) noted that during the first month of bereavement, the most common symptoms included crying, depressed feelings, difficulty sleeping and concentrating, poor memory, lack of appetite or weight loss, and heavy reliance on sleeping pills or tranquilizers. More recent research (Walter, 2003) indicates that the bereaved woman may experience anger, loneliness, and isolation. Her grief is intensified because of losing the partner she mourns, the relationship she lost, and her identity embedded in that partnership. Essentially, her world shifts from “we” to “I.”
Age and Its Influence on a Woman’s Bereavement
Widowed in Young Adulthood
When a woman loses her spouse when she is young, the loss is out of sync with her stage of life. Her peers may experience discomfort with her loss because they have little or no experience of the death of a spouse. They do not know what to say or what to do to help the widow (Shaffer, 1993). However, because of the age of the widow, starting over (e.g., changing a career) reflects a forward-looking response to moving on from death (Young and Caplan, 2010).2 When young widows are intentional about engaging in new activities to define who they are, research indicates that they generally experience less stress and fewer symptoms of complicated grief (Neimeyer, Baldwin, and Gillies, 2006).
Widowed in Midlife
At midlife, the most common death women experience, next to the death of their parent(s), is that of a spouse. Like the woman who is widowed at a young age, people often do not know what to say or do, isolating the woman in her grief (regardless of whether she has adopted a traditional, transitional, or modern/postmodern role). Unfortunately, those women who do become widows in midlife, and never remarry, experience the greatest depressive symptoms (Sasson and Umberson, 2009) that can endure into old age (Hughes and Waite, 2009). This includes greater incidence of chronic disease and lack of mobility. For those women who are partnered, but not married, research indicates that they receive less emotional support from friends and community (Doka, 2002), prolonging the grieving and healing process.
Widowed in Older Age
The majority of widows and widowers are 65 years old and older. The loss of a partner/spouse in later adulthood can result in increased mortality, disease, depression, and sleep disruption (van den Berg, Lindeboom, and Portrait, 2011). At the same time that spousal relationships become even more significant for the elderly, widowhood emphasizes decreased social networks, reduced number of family and friends available to offer support, and reduced numbers of social circles in which the widow can participate (Moss, Moss, and Hansson, 2001)—all this occurring at a time that the elderly woman herself may be experiencing chronic health problems, disability, or reduced mobility and physical stamina (Hansson and Stroebe, 2007). Preoccupation with the image of the deceased partner, lost interaction with him, and the quality of the feelings aroused by his image usually diminishes over time as the widow accepts the fact of her widowhood and begins reorganizing her life.
Factors Complicating a Widow’s Grieving Process
Changed Financial Status
As discussed earlier in this book, the change in standard of living created by loss of a spouse often complicates a widow’s grieving process. This was particularly true in the last century. Fortunately, changing sex roles in society are helping somewhat, for now most women are not completely dependent on their husbands for financial support and many, if not most, have careers of their own.
Reduced Engagement in Social Roles/Relations
In addition to financial adjustment, changes in social roles due to the death of a spouse can also negatively affect the widow. Although this is dated information, some of the precepts set up in Lopata’s 1973 study of the social involvement of American widows are still applicable today. The study reported the degree of change in the type and level of engagement in social roles the widow performed. Three degrees were reported: medium to high levels of interaction, similar to those in the widow’s life before the death of her husband and dependent upon the availability of social groups that do not require the husband’s presence (including kin, longtime friends, neighbors, work associates and voluntary associations); interaction in new types of social roles; and relative isolation. A study by Williams and Loeb (1956) indicated that at that time many American widows had minimal levels of interaction. Many widows were found to be only minimally involved in social relations even previous to their husband’s death. The death of their husbands caused a further drop in social activity. Lopata reported that about one-half of the widows she studied felt a strain in couple-based social activities, saying that they often felt like a “fifth wheel.” Lopata went on to argue that American widows are largely restricted in both the availability of social roles and in their ability to actually become involved in new social role patterns. Lack of education, training, and skills limited the widow’s choice of occupational or voluntary experiences. Insecurity, inexperience, and poor motivation often prevented her from even thinking about new activities, let alone risking trying something new.
So, although American society boasts that many social roles are now open to the new widow, in reality, the choices are restricted to the woman’s level of financial security, education, health, and motivation. This is particularly true for the older widow. As well, current awareness and tolerance of the single person has eased the fifth-wheel awkwardness somewhat, as living either singly or in relationships other than marriages is occurring more frequently, which may also reflect changing sex roles.
Impact of a Death-Denying Society
In a society in which death is considered unnatural, almost taboo, and something to be avoided or covered up, other people are often not helpful to the bereaved. According to Parkes (1972), every widow discovers that people who were previously friendly and approachable become embarrassed and strained in her presence. Expressions of sympathy often ring hollow, and it is as if the widow has become “tainted with death.”
The bereaved themselves have described their experiences in a similar manner. They find that people do not want to talk about the husband’s death, nor do they understand the widow’s pain—not even close family members, and sometimes not professionals either.
When confronted with a woman who has suffered a major loss, the behavior of others can make progression through the grieving process much more difficult for the widow. A society which requires survivors to “keep a stiff upper lip” and “get on with it” isolates the widow, not so much as a result of her own withdrawal, but as a result of the behaviors of others and their inability to deal with death. Further, when a death-denying society prevents the adequate expression of mourning, a widow is likely to feel intense preoccupation with her own physical health, sometimes even conjuring up images of her own terminal illness and death. A widow is likely to become preoccupied with fears of being physically or emotionally alone when having to face this illness. Unless a widow is encouraged to express her feelings and talk out her fears, the fears may be repressed without being resolved, thus enhancing a widow’s risks of mental and physical breakdown. Talking about her loss helps a widow to accept it.
Women’s Experiences of Spousal Grief
Three case studies follow. The first is a woman’s experience of her husband’s terminal illness (an anticipated grief). The second deals with a widow who experiences her husband’s accidental death (a sudden grief). The third is also about surviving the sudden death of a spouse—this time through her husband’s suicide. In each case, note the influence of the age and role of the woman, and any complicating factors delaying her grieving process.
A Woman’s Experience of a Husband’s Terminal Illness
Nancy is a 44-year-old woman who was 37 when her husband died of cancer. He was 45 at the time of his death. Nancy is a professional health care provider and now has her own business. She is financially stable and a single parent who lives with three of her five children. She is comfortable in new relationships, both professional and personal, and seems to have resolved her grief without complication. Nancy has lived both a traditional first marriage, and in her second transitioned into a modern/postmodern role where she is/was an equal partner with her husband John.
A man’s dying is more the survivors’ affair than his own. My husband’s tumor was a cylindroma—a rare form prevalent in the Philippines. He had been a fighter pilot there. That was the only connection we could find. The tumor was initially discovered in his left lung in 1972. At that time, he had surgery. His left lung was removed, and he was started on radiation therapy with no growth noted after years. That’s when I met him. He and I dated for a while, and we lived together. We discussed whether or not we should marry, considering the fact that the tumor could reoccur. We had each endured long difficult marriages that became unbearable before we met. We were both divorced, loved and enjoyed each other very much. We decided no tumor was going to frighten us away from sharing our lives together as man and wife, no matter how much time we would have together. We had been married 19 months when John died.
About six months into our marriage, John started having difficulty swallowing. We were in a restaurant, and he almost choked. Like always, John made light of the incident, but the difficulty swallowing began to happen more often. John saw his doctor in Tucson. A fiber-optic bronchoscopy was done; no tumor was found, and the X-ray of his right lung was fine. We were relieved, but the difficulty in swallowing continued, and further X-rays showed a narrowing of his esophagus. A CAT scan was performed, and a tumor was discovered surrounding the esophagus. I thought, “Simple enough, they’ll just remove it by surgery like the last time.” But no. The news was that, due to its position, the cylindroma was now inoperable. I was angry. John and I had finally found happiness with each other. I was angry with God too.
Several procedures were done throughout the course of his illness to alleviate pain and discomfort in eating. But the effect only lasted a couple weeks at a time. John was getting tired. The tumor was growing and causing more constriction of his esophagus. We joked about our new liquid gourmet meals, but even they became difficult to swallow. Amazingly, John had maintained his weight.
Our next trip to the University of Arizona Medical Center brought strong recommendations of chemotherapy because of the rapidly growing tumor. John was getting more uncomfortable, so he reluctantly agreed to chemotherapy. From September to December 1978, he did well, but the side effects of chemotherapy caused him to lose 60 pounds and tire easily. He was miserable. At Christmastime John said, “Enough of this.” He had been told this time it was terminal, and he refused to continue chemotherapy. I felt helpless. Everyone felt helpless.
I begged him to try something, and late in January we went to a clinic in Mexico. John was on Laetrile for six weeks. Again I almost lost him due to choking. I decided to keep an oxygen machine in the house, which I used two times.
Sometime before Christmas and Mexico, John started talking about death. I tried to change the subject, but he kept encouraging me to talk about it. Do you believe that guy? Here he was dying, and he was preparing me for his death. John taught me how to be an independent person. To my first husband, I was a possession, and I felt like a baby factory. (He wanted a big family, and we had four children in the first five years of our marriage and then another one after that.)
John encouraged me to do what I wanted to do with the rest of my life. It was a new freedom that I enjoyed, and now he was teaching me to be free and how to live independently without him. I remember one weekend we went to the coast. We had a copy of Elisabeth Kübler-Ross’s book Death and Dying. We read it together, and we spent time walking along the beach, talking and crying together. John was having some problems with his oldest son (from his first marriage), and one day he said, “I can understand why people commit suicide—not because of illness, but because of rejection by your children.”
He continually encouraged me to make decisions on my own about the children, financial matters, returning to work (which I did part time), even calling a tow truck when the car stalled (he sat on the curb watching and laughing as I raised the hood of the car, pretending to know what all those parts were supposed to do). He showed me that these little problems were nothing to be upset about.
About three weeks before Easter, John agreed to another procedure to ease his difficulty in swallowing and the accompanying pain. It did provide relief. He was home for six weeks. I was already back to work as an operating room nurse, and I received a phone call from my mother, who stayed with us and helped with the children. She said John had been out jogging as he usually did (he kept active because he said he didn’t fear death as much as he feared being an invalid before dying), and he’d started to vomit blood and was in the emergency room where I worked. My coworkers at the hospital were my support system too. They were aware of John’s terminal illness and adjusted my schedule or provided backup help for me whenever I needed to be away.
I found John in the emergency wing, and he said, “Hi, babe, I don’t feel so good.” He looked so pale and tired, and still he smiled. I said, “John, damn you, don’t you go and die on me now.” He laughed and then we both laughed. The doctors were pumping blood into him and had stabilized him enough to move him to intensive care. There was talk of surgery, X-rays, etc., but John wanted none of it. His surgeon took me aside and told me that John did not want to be revived if his heart stopped. I said that John and I had agreed to this already but when the surgeon told the ICU nurses, they objected and questioned his decision. This was my first outburst of anger. I said, “How dare you nurses hit on the dying and his decision. Why mutilate him?”
The surgeon reviewed John’s blood count report with me. John continued to bleed, but they couldn’t tell from where. The doctor said he didn’t think John would live through this crisis. I knew he wouldn’t and John knew he wouldn’t. The nurses let me stay with John constantly (which is unusual in ICU). John dozed off and we talked a little when he woke. He said, “I think this is it.” I left his side long enough to call his oldest son. I explained what was happening, and John’s son said he’d pick up the other children and come right away. John had tried to prepare his son for his death too.
John cried when he saw his children. They all talked with him. I sat there holding his hand, and somehow we both seemed to feel a peacefulness as his children all said goodbye.
Shortly before he died, John thanked me for the time he spent with his children, and I kissed him goodbye.
Nancy’s stopped her story at this point. She recalled choosing a song for her husband’s funeral because of a line that talked about those who die young but have lived, and about those who are alive but choose not to live. John (Nancy’s husband) had told her when they started to talk about death and life, “Nancy, you have to each be your own planet. You can’t be a planet and a satellite.” Nancy said, “John helped me to be that before he died. That’s how I handled my grief.”
Anticipatory Grief
Preparing for the loss of a loved one can lessen the potential for extreme grief reaction. The duration and nature of the illness, particularly with respect to changes in the spouse brought about by his illness, also appear to affect the widow’s grief reaction and her later adjustment to his death.
When a husband has a terminal illness, the grief process of the wife begins when the news of the illness is received. That news affords a couple the opportunity to acknowledge and try to enjoy what remains of their relationship. With the support of each other and the understanding and caring of family, friends, and health care professionals and volunteers, the widow is better able to complete the part of her life that she has lived with her husband.
When deciding how this last phase should be lived out, it is important to note that in a hospital, which is an institution that emphasizes curative care, a person with a terminal illness can be shunned as an embarrassing failure on the part of the medical community. One nurse who recently was assigned to the surgical ward in a community hospital noted how little time was even spent discussing a cancer patient at the shift report: “When it came to me to discuss Mr. J. (a man with terminal lung cancer), all that was reported was that ‘He’s still here.’ It was like being here meant nothing, and to see his family standing around in a daze was uncomfortable for the staff, who were caught up in their busy work of monitors, tubes, drains, catheters, and superficial chatter. In contrast, the palliative care setting with its hospice concept accepts where this couple is in their lives and encourages the dying man and his wife to express their feelings about death and their grief. Staff associated with this setting support the widow and other family members through the death and the grief process. Cicely Saunders of the St. Christopher’s Hospice in England sums up the hospice concept of the palliative care setting this way: “You matter because you are you. You matter to the last moment of your life, and we will do all we can not only to help you die peacefully but to help you live until you die” (Buckingham, 1983).
This coming together in the final phase of a couple’s relationship is accomplished by providing a comfortable, familiar environment in their own home or a palliative care setting. This, together with symptom and pain control for the dying, a relaxed atmosphere, and a caring multidisciplinary team and bereavement counseling program, provide the wife with a sensitive transition from being a wife to becoming a widow and then an independent individual.
The Experience of Sudden Death
Sarah’s Story
Sarah is a 32-year-old woman who experienced the sudden death of her husband. She was 26 years old at the time of his death. He died in a workplace accident. Sarah was a college student at the time of the accident. Following the death of her husband, she completed her teacher’s training and is now moderately financially secure. She values religion in her life but has a more modern approach to living with religion than the traditional, strict believer.
Evan was on call at work that evening. He came home for dinner at 6:00 p.m. but said he had one more call in Newburgh to make and then he’d be home—except that he never did make it back home.
At 11:00 p.m. that night a “representative” (who I later learned was actually the coroner) came to our home and said there had been an accident at work and that he would like me to call someone to come over. My parents lived two blocks away. I called them and they said they were on the way. The representative would not say what had happened, just that there had been an accident.
It seemed like it took my parents hours to arrive. I was very anxious to go to the hospital. I assumed that Evan was badly hurt and that he was in the hospital. The representative said nothing. As we waited for my parents, I started thinking and talking incessantly.
I tried hard to remember everything Evan had told me before he left the house at 7:00 p.m. He had one more stop to make in Newburgh to work on the big machine. The “representative” just sat there as I rattled on and on. “You know Evan always said he didn’t like to work on that damn machine; it was too dangerous. There is no safety switch at the bottom where they have to check its operation. He said that if anything ever happened to him there, he would be a dead man.”
There was a long silence.
It was like I had slapped myself in the face with what I had been avoiding all along. “Oh, my God! He’s dead isn’t he?” I asked. The representative said, “I’m sorry, Mrs. Roberts. I’m sorry.”
Those words kept ringing in my ears as I felt my blood drain from my head and down through all my body. I started running around the house. But every time I came to the living room, the representative was still there. Then I began to fill my head with what I would tell my parents, how I would tell his parents, how I would tell his brother and sisters, and how I would tell our son. My parents arrived and we sat together and cried. My son was still asleep in his bedroom.
I remember a feeling of emptiness, terrible thoughts of the agony Evan must have endured, trying to imagine what he’d felt. For some reason I felt the need to know every last detail of his last moments, and when I asked the coroner, he said I shouldn’t think about that. It’s strange; it frightened me, but I needed to know.
My thoughts shifted to birth—of labor and delivery, and how Evan and I shared that together and how after the discomfort of labor, there was beauty—peace after the struggle. I found some peace in believing that Evan found peace after his struggle, but I wish I could have been there to support him.
The coroner had opened his briefcase, and he removed a manila envelope from it. Inside was the concrete proof of his big announcement. The wedding ring I’d given Evan, his watch, his wallet, some change, and his keys. That was all—things that I saw every day and hardly noticed, but now I was clinging to them.
I heard the coroner tell my Dad that he needed someone to identify the body. I said, “I don’t want to see him.” More thoughts of Evan’s torn, bruised body lying in the morgue. I repeated, “No! I don’t want to see him.”
My Dad called our families, and I sat in the kitchen with my mother, remembering that I’d eaten an orange about 8:00 p.m. That was close to when he’d died. How could I have not sensed something was wrong? I’d been eating food while Evan was dying! (I find food repulsive now.) I won’t be able to smell him anymore. I smell his ring and his watch. They are still dirty from him working on the machine. I put them on. It comforts me. I wore them for a month, every day, smelling them in private and crying.
I remember he changed his shirt this evening. I went to the hamper and smelled his shirt. It smelled like Evan! I got a Ziploc plastic bag from the kitchen and put his dirty shirt in it and put it in a bedroom drawer. I kept it for a year. I’d go to it, smell it, and cry.
I had been trying to find a teaching position before Evan’s death and was offered one two weeks after he was buried. It was good for me, although I was still numb about his death. Working helped me make decisions and got my mind off how things used to be. I decided it was better for my son and I to live our lives enriched by the time we spent with Evan rather than clinging to things which only made the hurt worse. One by one, I put the ring and watch in a chest to give to my son when he was older. And finally, one day when I was ready, I put the shirt in the garbage.
Jocelyn’s Story
Jocelyn was 34 years old when her husband took his life. She was left with three small children, ages 2, 4, and 7. The following is her account of life with her husband before his suicide and how the stigma of suicide affected her grief after his death. Jocelyn remains very active in the Catholic Church. She had held a position in the health field prior to marrying her husband, but left her career shortly after marrying to devote herself full-time to the role of wife and mother.
It was not uncommon that I would not know if Tom would make it home for dinner. I would make dinner for the family, waiting, and then usually deciding that Tom must have stopped for more cigarettes and beer. Life was too difficult for him to cope with, and he had become an alcoholic.
I loved Tom, and our three children loved him too, but the situation was becoming unbearable. One night as I prepared dinner, I remember hearing sirens and finding myself hoping that Tom had been killed in an accident. I discussed my conflicting feelings of loving and disliking Tom with our pastor, as I began seeing similar conflicted reactions to Tom from our children. I knew that I had to make a decision about our lives.
Our pastor helped me by suggesting that I look at our family life and individual lives and ask myself questions such as, ‘Who is benefitting from this situation? Was anyone? How could I change our lives? Would a change benefit anyone in our family? Would it benefit everyone?’
I wrestled with these questions and some of my own for some time, and one day after Tom and I had had yet another argument, I told him that I felt we needed to be separated until he could figure out how to deal with his life without alcohol, because our being together under these circumstances was killing our relationship and hurting our children. Tom moved out.
The months that followed brought his games of manipulation and denial of his drinking problem. He refused to seek help through counseling because he did not believe that he had a problem. Financially, life was difficult for me. I could not work because Patty, our youngest child, was in and out of the hospital for surgery to correct a congenital orthopedic problem, and she required a great deal of follow-up home care. When our pastor suggested that I apply for food stamps, I was devastated. However, seeing no other alternative, I did attempt to apply, but we did not qualify because Tom and I were still married. Following that, Catholic Social Service was very helpful to me, and to our children.
Eight months passed in the same futile manner until Tom finally agreed to counseling. I attended some of the sessions with him. He seemed to be handling life better. He took a more active interest in the children, and our relationship improved. Christmastime came, and I planned a traditional family brunch. All of our relatives were happy, and Tom and I spoke of getting back together. We were on good terms.
Three weeks later, Tom sat in his apartment alone, pointed a gun into his mouth, and pulled the trigger.
I remember the day vividly and always will. The phone rang and a man identified himself as a police detective. He asked me many questions. Was I Jocelyn F.? Was I Jocelyn Mary F.? Was I Mrs. Thomas F.? I asked him what was going on and if something had happened to Tom. He would not answer me but said he would come to the house shortly.
The next half hour was a chilling and frightening time. I did not know if Tom was drunk, in jail, injured, or dead. The uncertainty of what had happened was coiling up inside of me, and when the doorbell finally rang, I ran and opened it and yelled, “Is Tom dead?”
I didn’t realize it, but that question immediately made me a prime suspect in a possible homicide because Tom was dead, and no one had yet informed me. None of my questions were answered, and the next hour brought even more painful questions about our relationship. After I was ruled out as a suspect, I was told of Tom’s death and the circumstances surrounding it.
What was I feeling? It’s strange, but I wasn’t hysterical. I felt a huge abyss—a big black hole deep inside of me. I couldn’t articulate anything. I wasn’t afraid of material concerns. I just felt a black emptiness, a sadness that is indescribable.
My feelings shifted from sadness to anger as I recalled how the children begged Tom to spend time with them during our separation, but his excuse was that he couldn’t bear to leave them each time he had to go. Why had he been so selfish again in choosing death?
I was crying. Then I heard our children in their bedroom, innocently playing and laughing. My concern immediately turned to how I would communicate this tragedy to them without causing any further trauma in their young lives. I knew that they could not cope with the fact that there was an element of choice which led to their father’s death. They would see this as abandonment. And I knew they could not cope with all the details that were too grotesque for children to live with.
In explaining their father’s death to the children, I felt that gentle truth was important. I wanted to be able to build on that truth as they grew older, so I went to their bedroom door and announced that I had something really sad to tell them. Tom and I had always saved that introduction for serious matters, so they knew something was very wrong. I sat on the bed with our children and told them that their Daddy had had an accident with his hunting gun and that he had died. We cried. We hugged. And we prayed. I felt like I had a ton of bricks on top of me.
I was glad I had decided to tell the children of Tom’s death right away, because we had our own quiet time together before the demands of the funeral arrangements took over.
The detective stayed with me and the children until Tom’s brother, Jim, arrived. Jim was very supportive of me and understanding of my previous decisions about the separation. He would visit often, and he saw how Tom and I had been living. Frequently, Uncle Jim would stop by, see our refrigerator near empty, and take us all home to have dinner with his family. To ease my pain, he would joke about how his wife, Susan, always cooked twice as much spaghetti than what was needed for his own family. But other people were cruel.
The night before the funeral, I received what I thought was another one of many phone calls of condolence from Tom’s coworkers. The caller coldly told me, “I don’t like what’s happened, Jocelyn.” He said that I did not know him, but that he knew me, and that he would be at the services the next day. I was frightened and hung up. To this day, I shudder when I hear an unfamiliar voice on the phone.
That call was the first of a series of incidents involving comments, repeated rumors, and strange looks toward me by friends, relatives, and even strangers.
The funeral was short, simple, yet comforting. Our pastor had known Tom and me for years, and his talk brought some peace by helping us recall the husband, father, brother, and son we loved. It diminished the dramatic, awful last moments preceding his death.
The women from our parish prepared a lovely dinner, but l couldn’t eat, and it was at this time that I began to feel the coldness and rage of Tom’s sisters who had flown from back East. This was so horrible for me because even though they lived far away, I’d always felt I had a close relationship with them, sharing much through phone calls and letters. But the day of the funeral, they were cold as if they were saying, “What has she done to our brother?” I felt like I was being judged. At one point that afternoon, as I looked around the room, everyone seemed to be looking down at me. It reminded me of a television commercial where a young bride invites her mother-in-law over for lunch for the first time, and when the mother-in-law enters the room you see a woman with sharp, ugly features. She scans the room, unable to find anything amiss, but comments on the lingering food odors anyway. That’s how I felt Tom’s sisters were looking at me. I felt inadequate, and to me, they looked ugly and distorted.
The following week Jim moved Tom’s chair back to the house from the apartment Tom had been renting. It was the chair I had bought for him for Father’s Day two years earlier. Mary Ann, our eldest child, wanted to put the chair in the family room. The children liked having Daddy’s chair there. It was special to them, and they took turns sitting in it. It was as if that was as close to Tom as they could get, and the chair gave them comfort. But I couldn’t look at the chair without thinking of Tom’s life in the apartment and his suicide. I’d look at the chair and start defending my actions regarding the decision to separate all over again. Had my suggestion of counseling been too strong? Had I been unfair? Had I caused Tom to commit suicide? When I looked at Tom’s chair, I saw 10 months of loneliness that had led to despair.
It took me five years to work through the guilt and what I saw as my part in Tom’s death. Because of Tom’s increasing amount of alcohol consumption, financial insecurity had been a big problem before his death. After his death, the children and I had financial security. We had his veteran’s benefits, social security, and retirement benefits. It took a long time for me to admit that I was relieved by this, even though it meant that Tom was gone. I had enough money now to pay bills and buy food and clothing, and even enough to drive the children to California for a week the following year. It felt good to enjoy life with them for a change. But along with financial security came the burden of decisions. This was frightening at first because there was no one to share this responsibility with—especially when it came to signing a consent form for one of Patty’s serious operations. If it was unsuccessful, it would mean the amputation of her left leg. I felt so alone.
The most difficult part of having your love commit suicide is getting over the guilt you put on yourself. Working through it was hard, but when a friend invited me to attend a workshop on self-esteem, we went through some exercises on self-forgiving. Figuratively, I placed Tom in a chair and was able to see him in an entirely different perspective. I forgave him for dying, then sat myself in the chair and was able to forgive myself for any contribution I felt I had made in Tom’s death. Being an “impartial observer” to our relationship, and to Tom’s suicide, helped me accept Tom’s decision about death and my decision about life.
I attended several more workshops and widow groups that helped me cut the ties of guilt and to finally let go. I remember my first dream about Tom after his death. I went to him and we hugged, and it was a truly good feeling. I woke up feeling like we had finally kissed goodbye.
Sometime during the five-year period following Tom’s death, two people asked me why I never wore dresses. That really startled me. Pantsuits were in style at the time, that’s all. I had never thought of myself as masculine—maybe neutral, but not masculine. It took me six years to feel comfortable in developing relationships with other men, and I have noticed that dresses have replaced many of the pantsuits in my closet. Today I am happy in my life with my present husband and our children, and I find peace in knowing that I am who I am today because Tom was a part of my life yesterday.
Making Sense of Sudden Death
J. William Worden (1982) outlined significant features of sudden death that make grief more difficult for the survivor, and some of these both Sarah and Jocelyn had experienced: for example, a sense of unreality about the loss, a need to fully understand the circumstances surrounding the death, exacerbation of guilt feelings (“if only …”), a need to blame someone (even God), a sense of helplessness that can turn to anger and rage, agitation and extreme depression (“flight or fight” response), and regret over unfinished business for things not said or done with the deceased.
Sudden death of a husband robs the widow of the opportunity to say goodbye. Unlike Nancy, who had some time to prepare for her husband’s death and even to discuss what life would be like after Tom’s death, Sarah and Jocelyn did not have this opportunity. Sarah used articles (her husband’s shirt, his wedding ring) to help her maintain some kind of contact with her husband while she came to terms with her loss. In some ways, Tom’s chair also provided that linkage to the deceased for Jocelyn, and especially for her children. Sarah’s and Jocelyn’s behaviors were not abnormal or destructive, but rather emotionally constructive in overcoming feelings of devastation, disconnection, and emptiness.
In the case of terminal illness of a husband, such as in Nancy’s, anticipatory grief is possible and can provide for earlier acceptance of death when it occurs. The influence of an appropriate care setting and compassionate health care providers are particularly important. Such care can encourage the expression of anticipatory grief by the widow, which assists her in progressing through the grief process. In the instance of sudden death as in heart attack, accident, or even suicide, coping mechanisms play an especially important part in the initial impact of widow’s grief. It is important to look at the special case of suicide.
The Special Case of Suicide
Prevalence. In 2014, suicide was the 10th leading cause of death in the United States (homicide ranked 17th), and the second leading cause of death among 15- to 24-year-olds. Every day approximately 105 Americans die by suicide, that is, one death approximately every 12 minutes. (The rate reported in Canada in 2014 was slightly lower at 11.3 per 100,000 population compared to 13.4 per 100,000 people in the United States, the highest recorded rate in 28 years.) Across the world, there is one death by suicide every 40 seconds (World Health Organization [WHO], 2014).3
Completed suicides are more likely to be men over age 45 who are depressed or alcoholic. The ratio of attempted to completed suicides is likely 10:1.4 Suicide among males is four times higher than for females, with male deaths representing 79 percent of all U.S. suicides. Females attempt suicide three times as often as males. Male deaths occur most frequently by firearms; female deaths, by poisoning. Suicide rates for females are highest for those aged 45–54; and for males, aged 75 and older. Twenty percent of the population and 40 percent of suicide victims are over age 60. After age 75, the rate is three times higher than average, and among white men over 80, six times higher than average. Rates among the elderly are highest for those who are divorced or widowed.
The untold story is that these rates may, in reality, be much higher. Many suicides go unreported because they are listed as accidental deaths, violence, or poisonings. And, although the media dramatizes suicide, particularly among the rich and famous, for a family, suicide is a dreaded word. In our society, suicide is a taboo subject—one that stigmatizes the victim, but also the survivor.
Before the 1900s, Durkheim’s Le Suicide, published in 1897, pioneered efforts to understand suicide. He tied the incidence of self-destruction to the environment in which people lived. Briefly, Durkheim’s theory included three types of suicide: egoistic (the individual had few ties to family, religion, social controls, or community); anomie (the individual failed to adjust to social change); and altruistic (the individual loses his own personal identity and wishes to sacrifice his life for another cause). About a century later, the Suicide Prevention Center of Los Angeles devised three psychological classifications for suicidal death: an unintentional death (one in which the individual had no real or active role in the decision of his death); the intentional (one in which the victim actually deliberated and caused his own death); and sub-intentional (the victim unconsciously caused his own self-destruction). These classifications point to the complexity of suicide, and the multitudes of factors that influence the choice to take one’s life.
Some common precipitating factors that appear to coincide with suicide include: depression (30% to 70% of suicide victims suffer from major depression or bipolar (manic-depressive) disorder);5 a long and painful illness (many people take their lives, leaving behind memories of themselves as they were—hearty and vigorous), economic distress, or the death of someone close.
Women who are survivors of suicide (typically of their spouses) may have teens under their care, so it is important to recognize the signs and address teens’ feelings about it, as the period following the death of a loved one is an especially trying time for teens (Manor, Vincent, and Tyano, 2004). Among teens, suicide ideation peaks between ages 14 and 17. Males with decreasing suicide ideation are more likely to attempt suicide, whereas female teens with increasing suicide ideation are more likely to attempt suicide (Rueter et al., 2008).
However, suicide may also surface in situations of divorce.
When a person dies, at least there can be some sort of explanation, for example, “He had cancer.” With divorce, the practical explanations and questions are harder to understand, especially when children are involved. The feelings of guilt and failure affect both the parents and the children. Studies have revealed that many people who kill themselves are either products of a broken home or have recently gone through a divorce. These specific stressful situations—illness, economic distress, death, and divorce—can often overwhelm a person’s defenses. Despair and helplessness often cause a person to panic and resort to suicide. Older adults who are less resilient and overcome by their losses may also decide to end their lives. Men over age 75, for example, have one of the highest suicide rates (Dombrovski et al., 2008; Sisask, Kolves, and Varnik, 2009). Various meaning-making interventions seem to help older adults and depressed veterans (for example) avoid suicide. (Veterans are reported to be at higher risk of suicide than nonveterans in the United States (Braden et al., 2015).)
In many cultures, suicide is seen as forbidden (e.g., Muslim) and spiritually extremely harmful to the deceased. Some cultures and religions regard suicide as shameful or sinful, which prevents families from grieving openly and receiving social support (Catholics, Orthodox Christians, Protestants, and Jews) (Parkes, Laungaini, and Young, 2015). Perceptions and views on suicide may be less radical under sociopolitical or economic pressures, weakness, or madness, or as an honorable act serving a higher cause (witness the increase in suicide bombers in Europe and the Middle East).
Loneliness, disbelief, heartache, torment. With self-inflicted death, add to these guilt, shame, and self-blame. “Why?” “What could I have done to prevent it?” These are often the most common questions survivors ask.
In our death-denying society, we are ill prepared to handle the loss of a loved one, especially when there is no illness preparing us to accept the ultimate outcome. When a person kills him- or herself, life is over. But for the family, the real tragedy is just beginning. Unfortunately, the stigma associated with suicide is attached not only to the individual who committed suicide but also to the family and friends connected to that person. For the widow, suicide may intensify feelings of abandonment, alienation, guilt, shame, anger, depression, and meaninglessness. “The suicidal person places his psychological skeleton in the survivor’s closet” (Grollman, 1971).
Unnatural, sudden death puts the bereaved at a higher risk of complications in their grief process (de Groot, de Keijser, and Neeleman, 2006). Survivors themselves can become victims of physical, emotional, or behavioral disorders. Acute bereavement brings about symptoms of distress such as preoccupation with the image of the deceased, vivid memories of the circumstances of the death (many people repress this thought because it is so painful), hostile reactions, loss of acceptable social behavior, and a tendency to push away from friends and relatives. All this emotional turmoil decreases the surviving family’s ability to cope with consequences of the death. Practical problems of finances and settling the estate can be very difficult for the survivor. Even attending church, which is traditionally a comfort to the bereaved, may feel alien or awkward (Cain, 1972). Family members may even turn against one another, and in their attempts to explain the event, they may blame one another. For the family, the suicidal person may have been difficult to live with over a period of years. The husband may have been mentally ill or may have been an alcoholic or abusive (or both) to his family. The feelings of finally being rid of the abuse can doubly intensify feelings of guilt of the survivor(s) (Wolman, 1976). The widow may also blame her husband for leaving her to cope on her own. Most widows have children, and the effects on them must be handled delicately so they do not grow up hating the father who “deserted” them. Many women are faced with the problems of having to move to a smaller, less expensive home in a new neighborhood because of financial problems. This alone can cause and increase the feelings of disorientation and change. As well, many widows constantly seek answers for the cause, which may have sparked the suicide in the first place. There is always the lurking thought: “What did I do wrong?” But sometimes the spouse may deprecate her husband by saying that he was weak, cruel, or no good, however consciously or unconsciously, as a way to minimize her sense of loss. This rather wicked smorgasbord of psychological and emotional turmoil causes considerable angst in the life of a widow that may prolong the grief process.
Coming to Terms with Suicide
The funeral offers an important opportunity to comfort mourners: it is the rite of separation. Elisabeth Kübler-Ross stresses in her book Questions and Answers on Death and Dying (1974) that when a family is faced with a sudden death, it is important that they not be prevented from viewing the body, even though it may be mutilated. It is important for the family to be able to identify with the deceased in order to face the reality of the death. The presence of the body can transform the process of denial into one of accepting reality. During the funeral, the clergyman/woman should avoid any reference to “sin” or “crime.” The man who took his own life was still a man, with strengths as well as weaknesses. The positive and negative aspects of his life should be mentioned so that people can recall the happy times with him and the many ways in which life was enriched by his presence. The funeral must bring about the feeling that the total years of this person should be remembered, not just the isolated moment of his death (Kübler-Ross, 1974).
One of the key areas in helping the woman grieve is helping her face the fact that she is now a widow. Cain, in his Survivors of Suicide (1972), characterizes grief as a process with three stages. He refers to these stages as impact, recoil, and recovery. During the impact period, the widow seems to be dazed, almost unaware of what has happened. She is in a zombie-like state, goes through the motions of the funeral, and deals with the immediate needs of her family. It is during recoil that her awareness of what has happened reawakens, and she begins to understand that she is a widow. This is a time of great pining, of trying to recapture the lost husband, weeping, and sleeplessness; of being very angry with him and herself; and general disarray. This is a very important time for intervention in order to avoid a situation where the widow feels stuck in the past. Recovery marks the acceptance of widowhood and a willingness to look for new relationships.
Suicide, as a special kind of death, must be taken into account. Friends should be neither judgmental nor prejudiced of the actions of the deceased or of the survivors. Conversation should be natural, and interest in the survivor should be sincere. One should not try too hard to assist the widow, as over-solicitation may induce further guilt reactions. The most important method of encouraging grief is by listening. It is of no help to say, “Don’t talk about it.” The bereaved widow is going through an intense emotional crisis, and she needs to talk about it. Especially in a case of suicide, the bereaved needs to pour her heart out. What Sigmund Freud called “dissolution” is the sharing with the survivor of both pleasant and unpleasant memories of the deceased. When each pain is felt, the widow slowly begins to dissolve herself of the emotional ties to her dead husband. A gradual working over of such old thoughts and feelings is necessary to ensure completion of the mourning process and the acceptance of the reality of her husband’ s suicide.
Survivors of suicide carry the stigma for life. Years afterward, a woman is still remembered as “the one whose husband shot himself.” Suicide is never completely forgiven or forgotten by society. But someone has died and must be buried, so no matter how difficult the situation, the grieving must be faced (Wolman, 1976). For some widows, their grief feels disenfranchised (Doka, 2002), that it is not acknowledged or condoned, much less supported. After all, there must have been a reason, and unless there was a note clearly stating the reasons, who knows? The stigma of blame, including self-blame, makes the widow vulnerable to disenfranchised grieving, and others may not acknowledge the grief as legitimate, or they may stigmatize it.
The question of suicide means breaking taboos. The law labels it “criminal,” and religion calls it a sin. But whatever the label society places on suicide, it is still a way of death that many people choose. The survivors who bear the burden of guilt and the stigma of having had a loved one who has willfully taken his or her life are the “living victims” whom friends and health professionals must support.
Healthy Adjustment to Loss of a Spouse
Living through loss and grief is difficult for anyone. If a woman’s whole life has been centered on her husband (as in a traditional role), without an independent existence of her own, adjustment can be especially difficult (Lopata, 1973). Parkes, in his 1964 study of widows, found a sharp rise in the number of widows’ psychiatric complaints in the first six months following the death of their spouse, but a return to normal after that. Another study conducted in the late 1960s and early 1970s in the United States (Silverman, 1986) indicated that widowhood was difficult because a woman’s identity is so tied to a relationship with her spouse, including the roles associated with it (again, the traditional role of women). However, women outside the study (the nontraditional women) were doing just fine. The “husband sanctification” (a term coined by Lopata in the early 1970s) served to elevate the widow’s own self-worth and at the same time allowed her to regard her deceased husband in a benevolent way. Both Silverman and Lopata admitted that viewing widowhood as a prolonged state from which recovery was nearly impossible was likely more a reflection of “social convention than psychological reality” (Konigsberg, 2011, p. 59).6
Other research (Boerner, Workman, and Bonanno, 2005) has confirmed that although loss is forever, acute grief is not. When a widow suffers prolonged grief disorder, it is likely due to her being dependent on the deceased for a sense of role in life or identity (again, a traditional role). Unfortunately, when the traditional widow does attempt to restart her life or transition to a different role, she may be seen as unfaithful in keeping the memory of her deceased husband if she dates too early, cohabitates, or remarries too soon. The widow is somehow seen as suspect in the trueness of the love she had for her husband, or as cold, unfeeling, or even in denial of the death itself (Konigsberg, 2011). Konigsberg cites research to indicate that, as an American population, although we have become more aware of the diversity of romantic relationships and relaxed in our attitudes about interracial dating, cohabitation, divorce, homosexuality, and gay marriage, “[W]e have actually grown more conservative about remarriage after spousal loss” (p. 39).
Contrary to these negative views, Boerner, Wortman, and Bonanno (2005) found no significant differences in distress between widows who recovered from their grief quickly (e.g., within six months) and those who took much longer (2–4 years). Over time, symptoms of distress just declined. The authors concluded that resilient grievers appear better equipped to accept death as a fact of life, and tend to have a more positive worldview, whereas chronic grievers seem less confident about their ability to cope and are more dependent on their relationship to the deceased. A study of Canadian widows and widowers reflected similar results, indicating that the securely attached were less angry, less socially isolated, and less prone to guilt, despair, and depression following spousal loss than were insecurely attached persons (Waskowic and Chartier, 2003).
Both Silverman and Lopata acknowledged that some widows enjoy their new independence and financial security (collecting Social Security benefits) following spousal loss. Others (e.g., De Giulio, 1989) point out that widowhood is temporary and can be an opportunity for self-expression and self-discovery. And finally, Konigsberg (2011) reminds us of the paradox that the prevailing “grief culture” supports widowhood as being a punitive event in a woman’s life. After all, pain is good and it is the only way out of grief. But, many widows, she contends, find the subtle message of grief culture very sad and discouraging—and refuse to abide by it.
So, for a widow—and acknowledging that adjustment can be complicated by emotional challenges, financial insecurity,7 social isolation, and lack of meaningful life purpose—the development of new roles, relationships, and activities are critical to help her transition out of grief and into a new life. Adjustment of this kind involves finding meaning in her own life (Coleman and Neimeyer, 2010)—a kind of individual reconstruction of a more meaningful and purposeful identity (Klass, Silverman, and Nickman, 1996). In particular, an older widow’s self-concept may undergo a kind of structural reorganization following spousal loss (Montpetit and Bergeman, 2010), and this may include revisiting positive memories, having conversations with the deceased, sensing the deceased’s presence, or sustaining activities once enjoyed together—something Carr (2010) referred to as restoration-oriented coping, which is also reflective of the Dual Process Model (Stroebe and Schut, 1999). For the widow, activities may involve replacing some familiar activities with new ones such as painting, reading, writing, or playing an instrument. These may divert or wean the widow (especially the traditional widow) from craving the relationship previously provided by her spouse.
Nancy’s, Sarah’s, and Jocelyn’s journeys through grief involved first becoming a widow, then an individual woman. In coming to terms with being a widow, all three showed a healthy “feminine” capacity for grief, and a “masculine” sense of themselves as independent and valuable individuals who are important in and of themselves and not just in relation to their families or primary relationships. Individuating their grief, according to their own life circumstances and proclivities for enriching their own interests and lives, helped them to recreate a life shaped by, but not defined by, their deceased spouses.
As society begins to recognize and address the special needs of the widow who has been socialized according to traditional doctrines and traditional sex-role boundaries, greater understanding of and support for the widow’s grief experience is required to encourage women to develop identities that are not completely limited to the role of familial caretaker and caregiver. The modern widow is more likely to have a better education, more occupational skills, and a wider repertoire of individual and social functions,8 which allow her to make the transition into and out of widowhood with less difficulty than the traditional widow. Social support and healthy social networks (Jackson, 2013), and the degree to which the grieving spouse finds those supports helpful, is critical to healthy recovery and positive aging (Hill, 2005).
Notes
1. Note that this chapter generally refers to male/female spousal relationships, with full acknowledgment of variations of spousal relationships involving LGBT (lesbian, gay, bisexual and transgender) individuals. Note also that relationship, as used in this text, refers to several configurations of relationships, including those that have been sanctified through a religious or civil ceremony and those recognized as common-law.
2. However, even though the economic well-being of widows has shifted from widespread hardship to being reported just above the poverty line (Weaver, 2010), it remains pronounced among those with limited education.
3. World Health Organization (2014) “Preventing suicide: A global imperative,” (http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/).
4. Mental Health America (n.d.) (http://www.mentalhealthamerica.net/suicide).
5. Ibid.
6. Incidentally, in the instance where a woman is not legally married to her partner with whom she cohabitates, she generally experiences less support both at the time of the death and following the loss (Walter, 2003). In these cases, the woman experiences additional stresses either from lack of support or from the lack of predictability of the support that does come her way (Bent and Magilvy, 2006; Walter, 2003).
7. Interestingly, although financial status is perceived to decline for widows, a 2004 study from the Institute for Research on Poverty in the United States found that women widowed less than three years and more than seven years did not report being less satisfied with their finances. (Note that earlier findings in this book indicate evidence contrary to this finding.)
8. For widows, generally, technology (e.g., online dating sites) affords a sense of safety in her anonymity and her privacy, as well as insulation from judgment of others, some control over her relationships, and her ability to search possible new relationships with individuals who have had similar life experiences (i.e., loss of a spouse) (Gilbert and Horsley, 2011).