When Brad’s infant son died, he was surprised and troubled at the extent of his wife’s grief. Every night she disconsolately cried herself to sleep. He was also perplexed at his own lack of tears. “Why am I not grieving?” he constantly asked himself. Yet as he asked this question, he would be alone in his workshop sculpting a memorial stone for his child. “What is wrong with me? Why can’t I feel grief?” he reflected, as he pounded his hammer on a chisel.
Friends often wondered about Alicia. When her husband John died, she used the insurance to finance her graduate education. She thinks of John frequently, taking comfort that her new job has allowed her to continue to support their family. But friends keep questioning her, wondering, as one put it, “if she is doing too well.”
Bob, too, wondered about his grief. When their son, a training pilot, was lost at sea, his wife availed herself of all the counseling the airline provided. All Bob wanted to do was to take his own plane up every afternoon to search for signs of wreckage.
All of these individuals are grieving a significant loss. And all are troubled by what they believe to be inappropriate responses to loss. In fact, each has effective ways to experience and adapt to his or her losses, yet they each reflect a societal understanding that the keys to experiencing grief lie in overtly expressing emotion and consciously seeking support.
Grieving Beyond Gender: Understanding the Ways Men and Women Mourn challenges that presumption. Its basic thesis is that there are many different ways in which individuals experience, express, and adapt to grief. Affectively oriented strategies are one way, but other strategies, building upon activity or cognition, can be equally effective.
This book describes two patterns of grieving. One is an intuitive pattern where individuals experience and express grief in an affective way. In this pattern, grieving individuals will find adaptive strategies that are oriented toward the expression of affect. But there is another pattern as well, one that we label instrumental. Here, grief is experienced physically, such as in a restlessness or cognition. Here the adaptive strategies individuals use tend to be, as the vignettes indicate, cognitive and active as well. These two patterns are seen as end points on a continuum. Many individuals may exhibit more blended patterns that draw from both intuitive and instrumental reactions and responses in the ways that individuals experience, express, and adapt to loss. Other individuals may show inconsistencies between the ways that grief is experienced and expressed. We label such inconsistent patterns as dissonant. Both dissonant and blended patterns are also discussed within the book.
This instrumental pattern is typical of the way many men grieve, due to contemporary patterns of male socialization. Yet as the book emphasizes, while there is a clear relation between gender and grieving patterns, this is not seen as deterministic. Women also may exhibit an instrumental style. And many women and men represent grievers who demonstrate more intuitive patterns. Clearly, patterns are influenced by gender but not determined by it.
This book is written primarily for grief counselors, psychologists, social workers, mental health counselors, pastoral counselors, and other therapists—especially those who work with men and adolescent boys. Although strongly affirming that these grief patterns are influenced but not determined by gender, the book offers a corrective, building on some of the most current research on the psychology of men, to the bias toward affective expression described in the next section. That corrective also may offer a value for academicians in thanatology or areas related to death studies and certainly would provide validation to bereaved individuals who are trying to understand not only their own reactions to loss, but the responses and strategies of others within their intimate networks.
Although instrumental and intuitive patterns exist, are equally effective, and have complementary sets of advantages and disadvantages, instrumental styles are often viewed negatively within counseling, self-help, and grieving literature.
This reflects a general Western bias in counseling that tends to value affective expressiveness as inherently more therapeutic than cognitive or behavioral responses. Sue and Sue (2008), in the groundbreaking work Counseling the Culturally Diverse, criticize the counseling paradigm for overemphasizing affect:
Emotional expressiveness is also valued, as we like individuals to be in touch with their feelings and to be able to realize their emotional reactions. (p. 142)
This bias, Sue and Sue note, can inhibit counseling with other cultural groups that do not place significance on affective disclosure.
This bias is also evident in what has been termed the grief work hypothesis (see Stroebe, 1997; Wortman & Silver, 1989). This hypothesis, or operating set of assumptions within the field of grief counseling, has emphasized that unless one expresses one’s feelings openly, grieving cannot be successfully accomplished. For example, Vail (1982) expressed the sentiment often found in self-help literature about grief:
Of course, those who allow themselves to experience the gamut of emotions are probably the least likely to actually go crazy. It is those of us who attempt to suppress, deny, and displace grief who eventually have real problems coping with the loss. (p. 55)
In fact, there is danger in identifying grief with any affective expression. The danger is that the absence of affect is taken to be an absence of attachment. As Weiss (1998) notes,
There may indeed be people who were attached to someone whom they lost to death, who fully acknowledge that loss, and yet do not grieve. Their absence of grief is not defensive; they simply do not grieve. I cannot, myself, understand how a relationship of attachment is consistent with an absence of separation distress or interruption of that relationship, and absence of grief or loss of the relationship, but perhaps it is. There may, perhaps, be people so fully autonomous that they can experience attachments, and on loss of those attachments, experience brief distress, after which they go on as before; or there may be some other emotional constellation that permits attachment without giving loss to grief. (p. 347)
But perhaps there is an answer to Weiss’s honest query, one that accepts both the attachment and acknowledges the grief. The answer here would be to look beyond affective distress to other expressions of grief.
This affective bias finds its boldest expression in literature about men and grief. It is unsurprising, given the bias toward affective expressiveness, that many clinicians have seen aspects of the male role placing men at a disadvantage in grieving when compared to women. Women are seen as more ready to accept help and express emotion, both of which are viewed as essential to the process of grieving. Since men are perceived as less likely to show emotion or accept help, they are seen as having more difficulty in responding to loss. Recently at a lecture, one counselor suggested that when grieving men use the word fine in answer to how they are doing, it should be viewed as an acronym for “feelings inside, never expressed.” LaGrand (1986), for example, states: “This does not mean men are not grieving; it does indicate that they may not accomplish the task as successfully as women” (See page).
The underlying assumption is that there are limited ways that one can effectively cope with loss. Staudacher (1991) expresses this succinctly:
Simply put, there is only one way to grieve. That way is to go through the core of grief. Only by experiencing the necessary emotional effects of your loved one’s death is it possible for you to eventually resolve the loss. (see page)
While later chapters explore the relationship of gender and grieving patterns, that assumption can be questioned. On the surface, if survivors were to grieve in identical ways, one would also expect analogous expressions of affect, duplicate behavior patterns, and feelings that would be indistinguishable from one another. In fact, there are many ways to cope with loss. To assert that only one pattern is acceptable is empirically ungrounded, at variance with current theory, and clinically unhelpful— points that will be further explored in later chapters.
When this work began, we clearly had an interest in men and grief. It quickly moved beyond that. At the first description of what we called “male grieving patterns,” a female colleague remarked that it had validated her own way of grieving—her pattern of adapting to loss. In fact, she had responded to her own early perinatal losses in two distinct ways. She began to do some of the basic work and research on how to best support survivors of perinatal loss. Then, once that research base was established, she became a pioneering advocate who both challenged and changed the ways hospitals dealt with such losses. Her comments were taken seriously, changing the terminology for this book to masculine grief (see Martin & Doka, 1996).
There was much to recommend the use of the term masculine grief. First, it allowed us to build a clear bridge to Jung on ideas of animus– anima (1920). Like Jung, we saw masculinity–femininity as a continuum that exists within a person as well as between individuals. Even our concept of grieving patterns is that they fall along a continuum. The use of these terms draws from that theoretical base.
Second, we believe that this pattern of adapting to loss is related to gender, at least in North America and many Western cultures, even if it is not determined by it. The use of the term masculine then reaffirms that gender relationship. It seemed foolish to pretend that gender does not play a role, since it influences so many other aspects of life.
Third, we wished to directly challenge the notion, so prevalent in the popular literature, that many men are ineffectual grievers. We asserted that “masculine” patterns of coping with grief are different, but not less effective than, more “conventional” or “feminine” ways of dealing with loss. Thus, there is a practical rationale for the use of the term. Since most popular literature does offer a view of the male as an ineffectual griever, we believed that only by using a gender-related term might our work be available to clinicians interested in or dealing with male or masculine grievers.
Finally, the use of masculine and feminine has great heuristic value that will, we hope, encourage continued discussion and further research.
However, we ultimately decided to eschew gender-related terms for a variety of reasons. First, they caused confusion. Although we identified a pattern of grief that we believe many males use, we also sought to recognize and to validate female grievers who exhibit such a pattern. But for many the term masculine grief had unfortunate baggage. This was most poignantly illustrated by a conversation with such a griever after a presentation. This woman was a pioneering female rabbi, one of the first to be recognized. “All my life,” she said, “I have tried to be perceived as not just one of the guys. You described my grieving pattern. Please, use a language to describe it that does not make me ‘one of the guys’ again.”
It was confusing for other reasons as well. The distinction between masculine and male was often lost on readers who kept identifying one with another. And it made us apologize about using male examples, diverting us from a critical aspect of our work that instrumental styles are, in fact, utilized by a majority of male grievers.
Moreover, the use of gender-related terms created discomfort. To assert that “masculine” modes of coping with loss are cognitive and active seems to perpetuate stereotypes, only partly true, that view such responses as typical of male response to loss, and it implies that “feminine” responses to loss are more emotive.
In addition, the use of gender-related terms creates its own difficulties. If one end of the continuum is labeled masculine, what is the other end, the alternate pattern, called? The use of the term feminine has merit since it seems like the logical complement and is faithful to the theoretical base. On the other hand, the term conventional has merit since it reflects current conventions on grief that have tended to view seeking support and emotional responses as both desirable and normative. In addition, it avoids further stereotyping of emotional responses as feminine. But the use of the term conventional also runs the risk of appearing to place negative value on the term feminine. In short, either term has merit and complementary disadvantages.
And that raised clinical concerns. Some men who do seek support and are comfortable with emotive responses may feel threatened to hear their mode of response described as “feminine.” And women who tend toward solitary, active, and cognitive responses may resent the label of “masculine.”
In the end, use of the terms instrumental and intuitive seemed to carry far less baggage. Although these patterns will be more fully developed in subsequent chapters, it may be helpful to offer a brief description now.
First, the very experience of grief is different. For reasons that will be described later, instrumental grievers tend to have tempered affect to a loss. While intuitive grievers are more likely to experience their grief as waves of affect, instrumental grievers are more likely to describe it in physical or cognitive terms. Whereas intuitive grievers often need to express their feelings and seek the support of others, instrumental grievers are more likely to cognitively process or immerse themselves in activity.
Sam and Jenny shared their disappointment with each other several months after the sudden death of their 17-year-old son. Responding to Jenny’s accusations that he failed to validate their grief, Sam stated, “I couldn’t allow myself to miss (him) until I figured out what this meant to our family.”
This suggests that at least some instrumental grievers attempt to evaluate their experiences cognitively rather than experience them emotionally.
When instrumental grievers do respond behaviorally to a loss, it usually involves immersion in some form of activity. Sometimes this is work, but at other times it may be intimately related to the loss. They may wish to take legal or physical action in response to the loss. For example, one male client whose young daughter died of cancer found it helpful to develop a scholarship fund in her name. Others may take active roles in the funeral. Ryan (1989), while noting concern at his wife’s affective response to loss, expressed his own grief by carving his son’s memorial stone. Instrumental grievers may also focus on the problems caused by the loss, actively trying to find appropriate solutions or engaging in activities related to the loss.
When Jack’s 20-year-old daughter was killed after losing control of the car, he spent several weeks rebuilding a neighbor’s fence damaged in the accident. He later described this activity as crucial to “getting me through those first two months.”
In short, this section draws attention to the fact that grievers may experience, express, and adapt to grief differently. Cognition and activity remain two key adaptive strategies often utilized by instrumental grievers. And these strategies, like any set of adaptive strategies, may be either effective or ineffective, depending upon the particular strategy and circumstances. Subsequent chapters will explore this further.
Corr, Nabe, and Corr (2009), in reviewing the relationship between gender and grief, note three distinct perspectives that parallel the authors’ journeys. The first position, the feminization of grief, stressed that expressing emotion and seeking social support and help from others is critical in effectively coping with loss. This partiality toward affective expression reflected counselor bias toward emotional disclosure (Sue & Sue, 2008). In addition, much of the early work on grief was based on widows—hence, their modes of dealing with loss were oft perceived as a normative standard.
A second perspective proposed that men had their own distinct patterns of grief. These patterns emphasized cognitive and active, problem- solving approaches to grief. In this perspective, men might show more limited and muted emotional responses to loss such as anger or guilt. Men often valued self-reliance and solitude in coping with loss. In this perspective, men had a distinct experience of grief that was different but no less effective in coping with loss. Counseling interventions, then, should not challenge men’s way of coping but rather find ways to deal with loss congruent with masculine inclinations. This perspective of men’s grief as different and distinct often drew from anthropological sources that ritualized gender differences in grief as well as literature that often emphasized biological differences between the genders (Golden, 1996; Lund, 1999).
Our early work (Martin & Doka, 1996, 1998) already began to offer a transition into a perspective less connected to gender. We began, as mentioned earlier, to describe both a masculine and feminine pattern of grief. In the masculine pattern, individuals often exhibit more cognitive and active responses toward grief while in the feminine pattern the experience and expression of grief was more emotive. In describing masculine and feminine patterns, we were already moving away from the notion that grief responses were inevitably distinct by gender.
Later work (Martin & Doka, 2000) completed the evolution to a third perspective that continued to place less emphasis on gender as a critical determinant of how individuals grieve. Here we proposed that there was a continuum of grieving styles from intuitive to instrumental. In doing so we affirmed there were a number of influences that affected the grieving style of individuals including culture, gender, socialization experiences, birth order, temperament, and other factors. The critical point is that gender influences but does not determine grieving styles. In this model, there is a distinct move away from applying gender-based terminology to describe the different ways individuals grieve. This latter perspective fits in well with current perspectives of grief that move from trying to find universal reactions to a more nuanced understanding of the individuals’ pathways of grief.
Since the publication of an earlier book, Men Don’t Cry, Women Do: Transcending Gender Stereotypes of Grief, in 2000, much has happened to merit a significant revision. There has been some work that has sought to test our model, as well as additional studies on gender and grief. It has been gratifying to see the positive reception of these ideas. Humphrey (2009), in a book published for the American Counseling Association, “highly recommended” the approach (see page). Similarly Doughty (2009), in a Delphi study, found widespread acceptance of the model among experts polled.
Moreover, there has been considerable scholarship in the psychology of men that questions some of our earlier assumptions, illuminates dissonant patterns of grieving, and suggests additional therapeutic approaches (see, for example, Englar-Carlson & Stevens, 2006, and Pollack & Levant, 1998). All these advances suggest a need for a review and, in some cases, an expansion of our work.
This book is organized into three major parts. The first defines terms; provides an overview of our thesis, rooting it in contemporary theories of grief; and delineates grieving patterns. The second part speculates on factors that may influence individuals’ patterns of coping with loss. A final part considers implications, including a self-help section and noting therapeutic interventions likely to be effective with different types of grievers.
As stated earlier, this book arises amid a growing challenge as to what is termed the grief work hypothesis (see Stroebe, 1997; Bonanno, 1997; Wortman & Silver, 1989) or the belief that unless one expresses affect, grief is not likely to be successfully resolved. And it builds upon the work of those who have begun to describe a “male” style of relating to loss (e.g., Golden, 1994a, 1994b, 1994c, 1996; Moss, Resch, & Moss, 1997; Moss, Rubinstein, & Moss, 1997). In Golden’s early work (1994a, 1994b, 1994c), he emphasized physical as well as cultural difficulties to account for gender differences in grief. In his later work, Golden (1996) deemphasizes gender differences by placing more emphasis on masculine modes of healing that can be utilized by either gender. This book also builds on our own earlier work on masculine grief (Doka, 1994; Doka & Martin, 1998; Martin & Doka, 1996, 1998).
Throughout this book runs a common thread: There are many different styles of coping with loss. Each has distinct strengths and limitations. There are advantages in expressing affect and seeking support. But there are also complementary strengths in stoically continuing in the face of loss and in seeking amelioration of pain in cognitive and active approaches. In short, people who draw from a broad range of adaptive strategies are, in fact, likely to do better. People with the widest range of responses, who effectively integrate all aspects of self, seem best able to respond to crisis. One can learn from both types of responses because, after all, different modes of adaptation are just that—differences, not deficiencies.