Layers of Dying and Death

Citation preview

Edited by

Kate Woodthorpe

Layers of Dying and Death

Papers Presented at the Fourth Global Conference: Making Sense Of Dying and Death Wednesday 12th July – Friday 14th July 2006 Mansfield College, Oxford

Edited by Kate Woodthorpe

Oxford, United Kingdom

Dr Robert Fisher Series Editor

Advisory Board Professor Margaret Chatterjee Dr Wayne Cristaudo Dr Phil Fitzsimmons Dr Jones Irwin Professor Asa Kasher Revd Stephen Morris

Professor John Parry Dr David Seth Preston Professor Peter Twohig Professor S Ram Vemuri Professor Bernie Warren Revd Dr Kenneth Wilson, O.B.E

Volume 40 A volume in the Probing the Boundaries project >Making Sense Of: Dying and Death=

Published by the Inter-Disciplinary Press Oxford, United Kingdom

First Edition 2007

8 Inter-Disciplinary Press 2007

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

ISBN: 978-1-904710-39-5 EAN: 9781904710395

Contents Introduction ................................................................................................ 3 Family-Assisted Suicide in the British Media Daphna Birenbaum-Carmeli ............................................................ 5 Death and Dying: Making Sense of Life in Post-Soviet Cinemas Irina Novikova ............................................................................... 13 The Living Dead as Cinematic Images of Death Outi Hakola.................................................................................... 23 Complicated Grief Sandra Jones .................................................................................. 31 Britain’s ‘Punk’ Mourning Culture Gerri Excell.................................................................................... 45 The Making of ‘Good’ Memorialisation Kate Woodthorpe........................................................................... 55 Institutional Loss: Dialectical Tensions in Coping with Major Loss Melanie K. Finney ....................................................................... 667 Traumatic Bereavement and Coping: Implications for a Contextual Approach Karola Dillenburger, Montse Fargas, Grace Kelly and Rym Akhonzada ..................................................................................... 75 Can the Dying Mourn? Kate Powis ..................................................................................... 87 The Death of Innocents: Noncombatant Immunity vs. the Divine Foetus Lloyd Steffen ................................................................................. 97 Do We Have Moral Obligations to the Dead? Liz McKinnell.............................................................................. 107 Don’t Fear the Reaper: An Epicurean Answer to Puzzles about Death and Injustice Simon Cushing............................................................................. 117

Tele-visions of the Dying: Ghost-Seeing in the Society for Psychical Research in the 1880s Shane McCorristine ..................................................................... 129 “Of Death I Try to Think like This”: Emily Dickinson’s ‘Play’ with Death Lucia Aiello ................................................................................. 139 Coming to Grips with Death: Explained and Explored in a Children’s Picture Book Phil Fitzsimmons ......................................................................... 149 Older People’s Preferences at the End-of-Life: a Review of the Literature Eileen Sutton and Joanna Coast ................................................... 157 The Wholeness of a Broken Heart Leeat Granek................................................................................ 177 Religion and Medicine in the Process of Managing Death and Dying: The Case of Hospice Circle in Poland Malgorzata Zawila ....................................................................... 185 Convenient Arrangements with Death Florence Ollivier .......................................................................... 193 Death and Funerals in Sunni Communities of Turkey Reyhan Varli Görk....................................................................... 203 The Body of Necessities in Finnish Discourse on Euthanasia Leila Jylhänkangas....................................................................... 217 Images Of Death, Images Of Society: The Case Of Poland and Polish Community Emilie Jaworski ........................................................................... 229 Attachment Trauma, Sudden Death and Anticipatory Grief: the Chamorro Sample Stephen W. Kane and Vera de Oro .............................................. 237 Environmental Grief®: Hope and Healing Kriss A. Kevorkian ...................................................................... 249

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Introduction This collection of papers originates from the fourth annual Making Sense of: Dying and Death conference held in July 2006 at the University of Oxford, and forms part of the on-going Interdisciplinary.net catalogue of international multi-disciplinary dialogue into topical subject matter. The intention of this volume is to create a snapshot of the conference, thus the papers are presented in the form they were delivered, providing an overview of the diversity and dynamism of both the topic and the conference itself. Importantly, the international flavour of the papers in this volume illustrates the universality of experiences of dying and death. As one of the ‘universal truths’ 1 of human existence, the diversity of the papers in this volume points to the relevance of practices and issues surrounding dying and death to all of us, regardless of our origins or culture. As mortal beings we cannot escape our corporeal condition, thus every society indeed, every individual - has to deal with dying and death at some point. The varied manner in which this is constructed, practiced and interpreted is illustrated by the rich accounts in this multi-disciplinary volume. Making a contribution to a wide range of disciplinary fields of study on dying and death, this collection is an extremely evocative example of the dynamism and complexity of this most human of topics. The papers in this volume are a unique mix of, amongst other things, social research (such as Jones), philosophical debate (McKinnell), historical description (McCorristine), death imagery (Hakola), personal accounts (Granek), literature (Aeillo) and cultural analysis (Jaworski). They have been arranged to demonstrate the multiplicity of issues that are touched by death, and the global scope of the Making Sense of: Dying and Death Conference. Each paper therefore needs to be understood as a particular disciplinary and cultural account of dying and death, yet read as a contribution to a wider international inter-disciplinary dialogue on death and dying. I sincerely hope that this valuable and constructive exchange of ideas, and the productive sharing of knowledge into this most complex and emotive of subjects, will continue long into the future. Thank you to all those who have contributed to this e-book, and I hope that you enjoy the volume. Kate Woodthorpe, October 2006.

Notes 1

Zygmunt Bauman, Mortality, Immortality and other life strategies (Cambridge, Polity Press, 1992).

Family Assisted Suicide in the British Media Daphna Birenbaum-Carmeli Abstract The paper tackles the subject of family assisted suicide through its presentation in the British press during the 1990s. Looking for basic characteristics of the coverage, the paper reveals a consistently supportive stance towards family assisted suicide that is produced by depictions of the dying persons and the perpetrators as autonomous and conscientious individuals; by idyllic portrayals of family relations; and by praising judges for their lenient verdicts. Presentations of the law as a dated State system, as well as marginalization of opposing voices, further enhanced the supportive message. The argument of the paper is that this presentation may carry implicit political implications: in commending actors’ selfreliance and in calling for decreased State interference in personal affairs, the press augments the neo-liberal spirit that has come into prominence in Britain since the 1980s. Within this context, we raise some ethical questions regarding the broader political significance of such media representations. Key words: euthanasia, family, assisted suicide, Britain, press, neoliberalism. Biomedicine’s commitment to preserve lives has found one of its powerful expressions in extending the lives of terminally ill persons. Whereas some patients are greatly assisted by such options, others may find the resulting life conditions hard to accept. In this paper, we probe a particular type of suicide: one that is facilitated by a close family relative. Our interest is in the ways in which such cases and the dilemmas that they invoke are constructed in the daily British press, and in the political implications of these media constructions may carry. The mass media plays a crucial role in the emergence and unfolding of public debates. 1 It mediates the experience and the dissemination of ideas. It influences what issues will be considered worthy of attention; who should be held accountable and whose opinion can be dismissed; and it suggests where potential solutions lie. Especially susceptible to the media's influence are issues with which the audience has little direct experience. 2 Assisted suicide is a case in point. Assisting someone’s suicide is illegal in Britain, subjecting the ‘assistant’ to imprisonment for up to 14 years. However, studies reveal substantial professional and lay approval of this practice, which co-exist alongside passionate opposing views.

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___________________________________________________________ 1.

Article themes Within this general framework, I now turn to a content analysis of the press presentations of 3 cases of Family Assisted Suicide (FAS) that had taken place in Britain during the 1990s. In all these cases, the sick person had been reported to have repeatedly requested the relative to help them die. All the prosecuted individuals had pleaded guilty and all had eventually walked free out of court. Beyond the difference in circumstances, journalists constructed the reported cases in very similar ways. I will illustrate the essence of these leitmotifs. A. The deceased person Articles conveyed the deceased person’s age, marital status (all single), previous occupation and ailment. Character descriptions typically suggested strong-willed and independent individuals, courageous throughout their lives as well in the face of death: Jim Brady “fought like a demon against the illness”, Janet Pitman had been “a strong-minded, determined woman”. Annie Wilks used to be a “dignified,” “strong,” “self-reliant,” “vibrant career woman,” “the most loving person in the world … had a magic way with children… optimistic and happy. She loved to …go for drives to the seaside. She also liked Shirley Bassey and poetry”. However, now, being bedridden, Jim “could do nothing for himself. His family dressed his skeletal frame, took him to the lavatory, minced his food and held his baby beaker to his lips.” Mrs. Pitman was depicted as “crippled” and “pain-racked” and Mrs. Wilks emerged as “seeing double… [she] could scarcely walk,” she became “frail,” “distressed”, “confused, forgetful and started to suffer from hallucinations”. As common in FAS reports, the finer details come from the perpetrators themselves. Mrs. Wilks’ daughter thus described: Mum went all aggressive with the nurses. She threw a jug of water over one of them and head-butted a window. It was so unlike her - I’d never heard my mum swear or raise her voice before. It is significant that the description was not validated by external sources, nor was it used to question Mrs. Wilks’ mental capacity to request euthanasia. One device to sustain this accord was to show that Mrs. Wilks still retained some of her old ‘authentic’ self, e.g. her sense of humour and refraining from complaints.

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___________________________________________________________ We regard the stark contrast that journalists constructed between the autonomous healthy person and the dependent dying patient as suggesting a drastic transformation rather than gradual degeneration. This binary imagery of mind/body and health/disease constituted suicide as a release, freeing one’s ‘trapped’ self from a failing body. B. Perpetrators and their acts The perpetrators were positioned as the event’s key figures, portrayed as dignified individuals caught in unfortunate circumstances. Factual evidence established their moral decency, e.g. their honesty in confessing to their crime, their respectable professions, and the devoted care that they had provided to their relatives. Fully relying on the perpetrator's own declarations, the descriptions of the loyalty to the deceased relative presumably removed any doubt concerning the motivation for the act. Within this framing, assisting in suicide was construed as “an act of mercy”; “a gift”; “the ultimate show of … love”. Thus, Paul Brady was depicted as having “the courage to save [his brother] from his suffering”, and Jennison was given space to portray herself as a loving, devoted daughter: [E]ven if I had got a life sentence, and that’s what I was expecting, I’m glad I did what I did…I loved my mum so very much. She wanted to die, what else could I do? The image of moral integrity and the purity of motive was given official validation through quotes from judges’ parallel evaluations: “the circumstances … showed plainly that she was a caring and loving daughter.” The prosecution’s sharing of this positive evaluation provided still further evidence. Formative in the justification of the perpetrators’ actions was the explicit absence of any hesitation or regret: “I [Jennison] don't regret what I have done. I'd never have forgiven myself for letting her be in this living death.” The law makes Paul [Brady] a guilty man, but the family’s only regret is that they let Jim suffer for so long. The brief, scarce allusions almost trivialised the moral debate surrounding FAS. Indeed, the marginalisation of the case against FAS was consistent, with criticism relegated to one or two sentences at the end of the piece that were not followed by any engagement with the arguments: The Voluntary Euthanasia Society welcomed the decision [to free Brady] and called for the law to be changed. But a spokesman for the Roman Catholic

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___________________________________________________________ Church in Scotland voiced concern at the case. Through such fleeting comments journalists bestowed a ‘balanced’ appearance on their reports while virtually silencing the debate and enhancing the framing of FAS as an act of familial compassion. C. Families Family dynamic was virtually written off by the press. Through ‘normalised’ descriptions, family relations were made to appear as purely loving and harmonious, suggesting a lifelong closeness. Jim Brady’s death was located in a family Christmas gathering. Mrs. Wilks’ end was framed within a cosy weekend scene: [She] spent Friday afternoon with Gillian, her brother Colin and his wife. They had a few drinks and talked about old times… we had a lovely evening. Mum always liked a tipple, she enjoyed a sweet Martini. So even though the doctors had told her to stop drinking, she looked so serene that I thought, ‘Sod this’ and gave her a glass of sherry. These scenes of warmth paved the way for the act that was about to follow, which could then be framed as the culmination of harmonious family togetherness: In each other’s arms they lay, the loving daughter and her suicidal mother, talking about old times. Annie swallowed her pills - two at a time - sipped her sherry and slipped slowly into the big sleep. The consensual impression was affirmed through reports of relatives’ support of the prosecuted member as they made their way through the trial: “As he left the court, Brady was hugged by his tearful family, who had supported his actions and appeared on television to argue his case.” D. The State system: Law and judges From the press, the judicial system emerged as an oppressive apparatus that failed terminally ill citizens and tormented anguished relatives. In some articles, especially the few that did touch upon the broader ethico-political aspects of euthanasia, journalists would occasionally opt for even stronger language, implying that the existing law

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___________________________________________________________ was heartless to the point of absurdity (“Even sitting in the same room as someone who kills themselves … is considered to be aiding or abetting a suicide”). The disapproving message was reinforced by the favourable images of the judges, as compassionate, open-minded individuals, rising above bureaucratic rigidity. An article on Brady’s verdict praised judges, prosecutors and juries “[who were] prepared to perform legal sleight-ofhand to reflect society’s compassion - by dropping charges, accepting a lesser plea or passing a lenient sentence.” Through such positioning of the judges alongside the ‘offenders’, as individuals who were forced to grapple with an inadequate State system in order to respond to human suffering, journalists were isolating the State not only from its rank and file citizens but also from its own arbitrators. A main vehicle for bridging this law/judges gap was the exceptionality claim that journalists had repeatedly cited from the verdicts. This notion served to justify judges’ leniency while allowing to avoid an open discontent with existing law. Lord McFadyen’s comment on Paul Brady’s verdict was typical, explicating that owing to the exceptional circumstances of this case, the disposal must not be taken as reflecting any general view on the part of the courts, but simply the sentence I regard as appropriate in the individual circumstances of this case. Journalists, too, presented each case as unique, and have never referred to any of the preceding cases. We understand the media endorsement of the exceptionality claim as part of its preference for episodic framing, in which a heroic narrative and a human drama enhance the emotional draw of the article. It also relieved readers’ own fears and sidestepped related ethical debate. 2.

Discussion The one-sided, supportive coverage that we identified relied heavily on the notion of the ‘normal’ family. Suggesting similarity of actors’ sentiments across the cases, this narrative replaced the idiosyncrasy and complexity that one would expect in a real life consideration of FAS with descriptions of wholesome harmony. As such, the articles advanced a moral discourse on living and dying, effectively “reducing the traumatic event to a set of standardized narratives… turning it from a frightening and uncontrollable event into a contained and predictable narrative.” 3 From this perspective, the normal family discourse helped deny the very trauma by toning down complexity and anxiety, and emphasising individual heroism and beatific acts. Another constituent of the one-sided supportive coverage was the episodic framing of FAS, namely, reading the problem at a micro level, as

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___________________________________________________________ a difficult decision made between two individuals. As the arguments against euthanasia address broader socio-ethical issues, they are harder to contain within an episodic framework. The concept of dignity can illustrate the difference. Opposition to euthanasia revolves around a form of dignity that is neither negotiable nor reducible. 4 In contrast, arguments in favour of euthanasia turn on a concept of dignity that is personal and can be diminished or lost. 5 Episodic framing, with its focus on the individual, ultimately privileges personal conceptions of dignity and is therefore structurally biased against the major claims of euthanasia opponents. Located in the context of late 1990s Britain, the courageous individual narrative dove-tailed with a neo-liberal discourse of autonomy, and a move towards a State withdrawal from caring labour. Since the 1980s, the neo-liberal rationalities that came into prominence in Britain accorded a vital value to a self that is to aspire to autonomy, it is to strive for personal fulfilment in its earthly life, it is to interpret its reality and destiny as a matter of individual responsibility, it is to find meaning in existence by shaping its life through acts of choice. 6 The decisions made by the deceased and the perpetrators could be said to ally with this notion of the individual, as suicide became an act of self-determination. The emphasis on self-reliance and the near glorification of suicide further reinforced the neo-liberal accent on individualism and, possibly, the justification of cuts in State services. During the 1990s, neo-liberal reforms had legitimated the shrinking of health services, reducing the number of nurses, and hospitals as well as long term care facilities. While we are not suggesting that journalists were intentionally promoting a neo-liberal agenda, we suggest that the British press of the late 1990s constituted FAS in accordance with this vision. By framing particular types of suicide within a self-assured harmonious family narrative, family-assisted suicide emerged as commensurate with neo-liberal ideals in terms of care, family and societal morality at large. If our analysis is acceptable, then it raises several questions: How do such media presentations impact on circulating views regarding FAS? What do they imply regarding the role of relatives and the State in caring for the terminally ill? Is the coverage in fact advancing the privatization of death? More generally, could the glorifying of one's courage to die, in the sensitive context of FAS, contribute - if inadvertently - to a social climate in which people would be encouraged to ‘courageously’ end their lives? Further enquiries into this emerging territory would hopefully help elucidate these issues.

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___________________________________________________________ 3.

Epilogue On January 14, 2005, the BBC featured on its front website newspage the story of Brian Blackburn, a 62 year old policeman who pleaded guilty to manslaughter after having killed his wife who was dying of cancer. The journalist quoted the husband citing his deceased wife saying that this was the “last loving thing you could do for [me].” The judge was quoted stating that Blackburn “had acted as a ‘loving husband’,” and then, noting that the circumstances were exceptional, gave him a suspended nine month sentence. The couple’s two sons emerged from the piece as fully supportive, pledging for mercy. A description of Blackburn being “greeted by friends and family as he left the court” sealed the report. No opposing voices were included.

Notes 1

S.D. Reese, O.H. Gandy, & A.E. Grant (eds.). Framing public life: Perspectives on media and our understanding of the social world. (Mahwah, NJ: Lawrence Erlbaum, 2001). 2 M. Baum, Sex lies and war: How soft news brings foreign policy to the inattentive public. American Political Science Review, 96 (2002), 91-109. 3 K. Tal, Worlds of hurt. (Cambridge: Cambridge University Press, 1996). 4 L. Gormally, Euthanasia and assisted suicide: Seven reasons why they should not be legalized (1997). 5 D. Pullman, Death, dignity, and moral nonsense. Journal of Palliative Care, 20 (2004), 171-78. 6 N. Rose, Inventing ourselves: psychology, power, and personhood. (Cambridge: Cambridge University Press, 1988). Daphna Birenbaum-Carmeli is a medical anthropologist at the University of Haifa, Israel. Her main interest is in the social and political implication of medical technologies. Within this domain, she has focussed on the subjects of reproductive medicine and genetic testing.

Death and Dying: Making Sense of Life in Post-Soviet Cinemas Irina Novikova Abstract The article focuses on how death and dying as an insistent discursive and emotional agenda of ‘post-Soviet-Hamlets’ have been represented in the post-Soviet Russian films of the 1990s-early 2000s. Post-Soviet cinematic ‘hauntology’ was marked by an emancipatory inventiveness to unsettle and re-imagine future uncertainties beyond the spectres of the past. Gendered imageries of death and dying plotted mainly in the father-son relationship have been central to the ‘real’ of the visual and political re-imagination of the nation, history, borders, and boundaries of post socialist ‘rebirth’. For my argument I will address particular instances of filmed death in the cine-texts by Russian ‘necrorealism’, Pavel Chukhrai, Sergei Bodrov, Aleksandr Sokurov, Andrei Zvyagintsev. Key words: death, dying, mask, ghost, body, metanarrative, film narrative, gender, masculinity, trauma. The death of a hero has been among the most favourite plot elements in cinematic storylines as it Determines a proponent role of the beginnings and the ends, especially the latter. Usually, the process of thinking about reality is subjected to its discrete partitioning, in particular, the literary plots inextricably related to the concept of the end and the beginning.… Just as the concept of art is connected to reality, the understanding of a ‘text - border of the text’ is inseparably interfaced with the ‘life - death.’ 1 The Soviet imaginary as a metanarrative that had its beginning and its end was related to the ‘ontologization of the spectre’, the eternal repetition of one and the same to relinquish “any hope of transcendental transformation,” 2 and the Soviet teleology of death “turned the mausoleum into museum.” 3 Jacques Derrida brilliantly discusses in Specters of Marx the effect of “an ontological treatment of the spectrality of the ghost... leading to the terrifying failure and totalitarian perversions to which it gave rise.” 4 The ‘ontologization of the specter’ was left to the perpetuated rituals of its mourning integrated in the Soviet cinematic vernacular.

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___________________________________________________________ After the break-up of the USSR in 1991, post-Soviet cinematic “hauntology” 5 was marked by an emancipatory inventiveness to unsettle and re-imagine future uncertainties beyond the collapsing spectres of the past. Although earlier, the Soviet filmmakers of the perestroika period (1984-1991) committed themselves to what was beyond the permitted themes and plots in the Soviet period, in particular, sexual and necromantic. Theirs was the “necropolis” time when the deaths of the Soviet leaders Brezhnev, Andropov, and Cherrnenko embodied the dying of the socialist route in the metanarrative of modernity. 6 The obsession with death and dying was central to necrorealism. 7 Evgeni Jufit, made Hospital Attendants-Werewolves (1985), a manifesto of necrorealist aesthetics, and his first feature length film, Daddy, Father Christmas Is Dead (1991). Necrorealism has been interpreted as “a barely allegorical manifestation of total social collapse and anomie, of the hypercharged atmosphere of cynicism and doubleness” 8 diagnosed by Berkeley anthropologist Alexei Yurchak among members of “the last Soviet generation.” 9 In the 1990s a number of the filmmakers revolted against their fathers’ cinematic legacy. The treatment of the phantomatic in these films challenges the absolute privilege granted to Derrida’s patrimony of the idol, both political and patriarchal.. One of the most recognized films of the early 1990s, the Oscar-nominated Thief (1997) by Pavel Chukhrai, was made as a tragic parody of his father Grigorii Chukhrai’s famous epic Ballad of a Soldier (1959). Apart from its outstanding cinematic qualities, the epic narrative of Ballad of a Soldier about a death of a Russian soldier as the symbolic/Christological sacrifice for the world’s liberation from Nazism became a medium of collective psychotherapy for millions and millions of its Soviet female spectators, very much within the emotional space of hope in the 1950s. The film of his son, Pavel Chukhrai is, on the contrary, based on a singular and banal plot, subaltern to the totalizing narratives of war heroes central to the Soviet metanarrative of Russian hegemonic nation building and its historiography after the World War Two. A thief Tol’an who pretends to be a military officer and a war veteran involves a young woman Kat’a and her small son San’ka into his plots of robbing communal flats. 10 Kat’a meets Tol’an on a train, falls in love with a handsome and brave hero of the war. She dreams - like many other young women of the post-war time - to become a wife of a Soviet military officer. When she finds out that Tol’an is a thief, she still trusts his promise to stop robbing soon for the sake of the family. However, the family travels from town to town, rents a room in a communal flat. His military uniform is the most valid and unquestionable ‘pass’ and evidence of his reliability among people who agree to rent the family a room. Later

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___________________________________________________________ he robs ruthlessly the inhabitants of a communal flat of whatever could be of any value to be sold by Kat’a in black market. Tol’an is detained and arrested by militia accidentally, Kat’a dies of a failed illegal abortion, and San’ka is placed into an orphanage. He dreams that his ‘daddy’ will return and adopt him to start a family. He runs into Tol’an several years later and decides to kill him to revenge on Tol’an for the honour of his dead mother. As a parallel plot, the ghost of San’ka’s dead father-soldier, semantically central in the lexicon of the Soviet ideologue and its spectres, emerges in some crucial episodes. The only fact that the son knows about his true father is his mother’s story of his death because of wounds soon after returning from the war battles the mystical character of the specter, as a para-religious experience for San’ka, is accompanied with the pedagogy of his adopting father, thief Tol’an of what it means to become a real man. Tol’an becomes San’ka’s model of masculinity - violent and aggressive. So, the boy is lost between his commitment to the memory of his idealized dead father and enchantment with his ‘daddy’, very masculine and brutal, at the same time, charismatic and trying to love both Kat’a and her son. San’ka is lost between a mask that ‘mimes the living’ and the ghost that should be mimed by the living. The effect upon San’ka’s subjectivity is born of this relation, ‘as double relation, one should say as double social bond’. Both - the specter and the mask - are the invincible forces and the original powers in San’ka’s subject-formation as the double ‘ghost’ effect. The Oedipus-Hamlet mythological convolution that plots the psychologically complex relations between San’ka, his mother Kat’a, and his stepfather, does not finish with the scene, when after many years of an orphanage San’ka accidentally finds and kills Tol’an. Neither the boy nor the spectators know whether Tol’an is really dead, or he mimics his own death (as he was a mask all his life) on the floor of a cargo-car in a speeding-up train, taking away his body - dead or alive - away from San’ka. The very act of San’ka’s shooting at his ‘daddy’, a thief, a mask, has a subversive meaning. Killing a mask as revenge becomes a terrible loss to the boy. San’ka is attached to Tol’an, seeing himself as his son, however, the annihilation of the mask discloses emptiness behind it, nothingness, and absence of a real body to be buried and mourned. ‘Daddy’ can be annihilated only on condition of annihilating oneself, as a ‘daddy’ body has become inalienable part of the life of his son, his norms, behaviour, choices, actions and body. The third and final part of the film shows San’ka as a colonel somewhere on the southern borders of the collapsing Soviet Union. His childhood dream ‘like father, like son’ came true - he became a military like his father, the ghost in the film narrative and the sacralized figure in

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___________________________________________________________ the paternalist metanarrative of the Soviet ideological and political order. However, San’ka’s gendered perception of masculinity was modelled by the Word and Law of Tol’an. Army and prison are two allegedly opposite forms of collective construction, control and organization of normative (army) or deviant (prison) masculinity. However, both institutions perpetuate Tol’an’s principle of violence and aggression. This gendered principle of modern masculinity is central to the Oedipal father-son plot in the complex ‘ghost’ space of Soviet history - Lenin (eternally alive), Stalin (symbolic father), father-soldier (legend, myth, ghost), stepfatherthief (thief) and their lost sons. The phanthomatic presence of Stalin (father of every Soviet child) in the filmic narrative, the regular emergence of father-legend in San’ka’s fantasies and finally, Tol’an’s ‘death’ - are ghostly presences in the protagonist’s quest to understand himself and the meaning/value of his life. Only in the final episode, the agonizing death of an old alcoholic stranger whom the colonel mistakes for Tol’an (the same tattoo of Stalin’s profile on the left side of the drunkard’s chest) becomes the ghastly symbol of the dying political order and its narrative of hegemonic masculinity. 11 Similarly to Pavel Chukhrai, Vladimir Khotinenko addresses the major institutions of forming modern normative/deviant masculinities in his famous film Muslim (1995), focusing on a dramatic story of a mother and her two sons in a post-Soviet Russian village. The elder brother spent time in prison; the younger took part in the Afghanistan war and spent some time in captivity with mojaheds. Both institutions and experiences remain beyond the film narrative when the two brothers meet again in the house in which their father had committed suicide by hanging himself on the hook in the ceiling. The very beauty of typical Russian landscape -pastoral panorama of green fields, distant churches around a quiet village, the heart and soul of the Russian nationalist discourse since the 19th century - invites the film’s spectators into the ideal chronotope of the missionary Russian idea, genealogically central to the discourses and practices of Soviet Orientalism. However, death, or its expectation, is woven effortlessly into a loose fabric of cinematic incidents and images in Muslim. Khotinenko brilliantly examines and deconstructs the ‘idiocy’ of village life, symptomatic not only of the collapse of the Soviet system and its values, but of the dying Russian Idea, a historical and nationalist metanarrative, central to the very mechanism of Russian xenophobia. Nikolai, an Afghanistan war hero, comes home after having been officially declared missing in a military action for years. His arrival causes a shock in the village community - during his captivity years he had converted into Islam. The villagers openly hate the Muslim, Nikolai

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___________________________________________________________ Ivanov or Abdullah, for being different, though one of their own, for reminding them with his very presence, work and behaviour of their own corruption. Villagers, including his own mother, want Nikolai-Abdullah to leave as they do not want to learn and know how to deal with Otherness not on the ‘margins’ but inside the Russian ‘pastoral’ world of today. Nikolai’s death that he accepts with relief does not bring redemption and hope in the end of the film. In the film Captive of the Mountains (1996) by Sergei Bodrov a Chechen father tries to break off the chain of deaths permeating the distant world of his Chechen village in the mountains and the town where a Russian army garrison stays. In the last episode of the film the father takes a Russian young soldier, his captive, to an execution to revenge for his son, killed by a Russian soldier during his attempt to run away from prison. The old Chechen man releases his captive but his attempt to disrupt the chain reaction of men’s deaths on both sides of the conflict is futile. The final episode directly alludes to the episode of a sanguinary bombing of a Vietnamese village accompanied with Wagner’s music Valkiria Riding in the legendary film Apocalypse by Francis Ford Koppola. In Koppola’s film, the magnificent symphonic orchestration of the politics of the sublime annihilates its objects/abjects into the gaze of his spectatorship frozen with horror and anger. In Bodrov’s film, only several Russian military choppers modestly emerge out of the mountains. They fly over the head of the soldier to bomb the village. Unlike Koppola, Bodrov does not show the bombing of the village and death of its inhabitants. Instead, he lets his spectators enjoy the exotic and wild beauty of a still untouched oriental landscape with a tiny village, vis-à-vis the approaching choppers - the image on the screen before it becomes an offscreen destroyed reality off the screen. The final sentence of the narrator who is the former captive in the village does not leave us any hope for a happy-end fantasy. A spectator is as helpless as the former captive soldier, in the role of a visitor to another ‘museum’ of war and its natures mortes. The situation of how a son perceives the death of his father becomes the plot and narrative in Aleksandr Sokurov’s film The Second Circle (1990). 12 The perception/recognition of father’s death by his son, the protagonist of the film, occurs in a direct visual and tactile contact of the son with the body of the deceased. Having lost its intentionality, the dead father’s body is leaving life and demanding the shelter/haven in nonbeing. The spontaneity, rigidity, granularity of the contact between father’s non-being and his son’s being is an emphasized and focused process in the film narrative. This allows Mikhail Yampolsky to argue that Alexander Sokurov's film has introduced death in its metaphysical

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___________________________________________________________ dimension into the modern Russian cinematic tradition. Sokurov introduces a missing part in the Russian cinematic tradition - the directly visualized work of death, the process of dying, the chronicle of necrotransformations therefore his cinematic world finds completeness and loses the language, thus, waiting for a new language, the son’s language, to be imagined. In the film The Return (2003) by Andrei Zvyagintsev the narrative plot focuses on the return of the father to the family of mother, grandmother and two adolescent sons Ivan and Andrei. An old photo of a happy young family is both the imagination of a lost paradise for both boys, and the suppression of images of the missing father in their imagination. Will the return of the real father resurrect the lost completeness of life? A tower, a phallogocentric 13 metaphor of the ascension, death and rebirth, appears in the beginning and in the end of the cinematic narrative. The first tower is the place where the boys have to prove their manly courage and jump into the water. The second tower on an abandoned island is the place from which the father tries to save Ivan, accidentally falls and is broken.

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___________________________________________________________ The image of the tower strongly implies a rigid discourse of masculinity, or ‘a gender corset’, meant to discipline a boyish body and consciousness in compliance with certain schemata of man’s behaviour. Most likely, the father in his childhood passed rituals of becoming a man, but we never find out about his past, and what had happened to him. However, he does not know how to become the father to his sons. His latent traumatic experience eventually tells itself in the aggression against his adolescent sons. He is a son of the certain social and gender order, which had trained him in the certain system of coordinates and norms of masculinity. He is theatrical in his hyperimperous behaviour at the dinner table, he is obnoxious when trying to give categorical orders to his sons (the Law of the Father), and he is violent when the boys disobey his orders. During the years of separation, Ivan and Andrei have subconsciously waited for the return of their father. Three of them spend some days on an uninhabited island, in a mutual return to each other; let it have a tragic end. Rescuing Ivan, father perishes, and the sons have to sit next to the body of their father in the boat while returning from the island. Here the reality of the death of the father, the pain of the loss reveal the changes in the boys, particularly, the rigidity and resoluteness which come to his elder son Andrei, testifying that, at least, for him the return of the father is real. The Sokurov-Zv’agintsev cinematic space of death and dying is intriguing as it focuses visualization of death in an image of a dead body of the father. In their films the figure of the father goes on a trajectory from deconstructing the metanarrative (Chukhrai, Khotinenko) to absolute silence. His death as absolute silence designates a situation of a voice transfer, igniting the reciprocal speech of the son. In other words, father demands in his death for the similar and articulated repetition of his words, action, narrations, as it happens with Andrei in Zvyagintsev’s Return. All his questions to his son (or sons) become one question – the question of his/their commitments to him as a past reality, not a returning ghost. The direct observation of a dead body of the father is at the same time a metamorphosis occurring to his son/sons. Looking at the face of the late father, the son/sons try to see, and, hence, to understand and seize, i.e. to take advantage of mechanisms of sight and to understand, and, thus, to connect the fact of father’s death with speech – “in time to start talking.” The dead body of father becomes the object, which breaks the habits of sight and looking. It becomes a chasm that demands to be sealed off, or in other words, re-signified into certain narratives of future reality.

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Death and Dying: Making Sense of Life in Post-Soviet Cinemas

___________________________________________________________ Death of a male body and the spectacle of a male body dying, mainly represented in the father-son relationship, prevailed in the postSoviet Russian films of the 1990s, interrelating the themes of history, masculinity and nation, but not more than diagnostically. The shift from a metanarrative to a metanarrative has been represented mostly in the tragic film genres, focusing on the ‘masculinity crisis’ as effected by the historical trauma of the late 1980s. The historical traumas are thus translated into the historical consciousness of the transitional period into capitalist modernity, demanding for the reconstruction of ‘authentic’, ‘lost’, ‘destroyed’ masculinity, thus, for the revival/return of the nation. This Zeitgeist of revival/return includes the very crisis of masculinity as an indicator of its overcoming. At the same time, the very masculine subjectivity has been considered self-sufficient and metaphysically selfreproductive by distancing its ‘essence’ from the former abjected iconographies of hegemonic masculinity in the lavish objectifying and dissecting representations of the deaths of former icons in the post-Soviet Russian cinema of the 1990s.

Notes 1

Felicitas Becker, Knowing the Limits. Kinoeye. New Perspectives on European Film, 10 November 2003, (5 May 2006). < http://www.kinoeye.org/03/13/becker13.php>. 2 Boris Groys, Utopiia i obmen. (Tr. Utopia and Exchange). (Moskva: Znak, 1993), 354. 3 Ibid., 64. 4 Jacques Derrida, The Specters of Marx. Tr. Peggy Kamuf. New York: Routledge, 1994, 91, 97. 5 Ibid., 10. 6 Metanarrative “is a global or totalizing cultural narrative schema which orders and explains knowledge and experience”. In John Stephens. Retelling Stories, Framing Culture: Traditional Story and Metanarratives in Children's Literature (1998) 7 Christina Stojanova, The New Russian Cinema, Fall 1998, (9 May 2006). . 8 Thomas H. Campbell, The Bioeasthetics of Evgenii Jufit, 26 January 2006, (16 May 2006). . 9 Alexei Yurchak, The Politics of Indistinction. Bioaesthetic utopias at the end of Soviet history, 5 April, (2 June 2006).

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___________________________________________________________ . 10 A Soviet communal flat was inhabited by several tenant families sharing a kitchen, toilet and bathroom. 11 R.W Connell, Masculinities. (Berkeley: University of California Press, 1995). 12 The title of the film refers to the second circle of hell depicted in The Divine Comedy, Volume I: Inferno by Dante Alighieri. 13 Phallogocentrism, by Jacques Derrida, refers to locating the centre of text/discourse within the logos and the phallus and privileging of the signified over the signifier. Irina Novikova is Professor of the Department of Culture and Literature, Director of the Centre for Gender Studies, at the University of Latvia, Riga. Her current research is on gender and genre in literature and cinema.

The Living Dead as Cinematic Images of Death Outi Hakola Abstract Death is an open area for beliefs, fears and fictions. The cinematic living dead, as vampires, mummies and zombies, represent and visualize death in a corporeal way. These creatures are familiar from the horror genre where they threat humanity because of physical and mental transformation through death. The living dead are uncanny other and they create abjection. They highlight the fear of death and otherness, unknown existence and marginal phenomena. In the living dead film the undead characters symbolize contradictions of race, class, sexuality or nationality. In my presentation I will consider the nature of the living dead character between life and death and those fears and imaginative possibilities these creatures open to us. At the same time I will consider the narrative tradition of these films and how the narration marks these creatures as monsters. I use as an example Francis Ford Coppola’s film Bram Stoker’s Dracula. In this film the un-dead character is both evil and empathetic and victims are both sinful and innocent at the same. In this film love and sexuality become the driving forces for the unnatural extension of life beyond death. Key words: living dead, horror movies, abjection, otherness, narration. The ‘living dead’ is a term for such fictive creatures as vampires, mummies and zombies. In this paper I discuss the themes of death and dying in the living dead films. As an example I use a vampire film - Bram Stoker’s Dracula (released in 1992) - that was directed by Francis Ford Coppola nearly 15 years ago. I start with an image of the love scene between Dracula and Mina. Dracula, who sees in Mina his former beloved, has taken the form of a young aristocrat and has seduced Mina. The scene starts when Dracula enters Mina’s bedroom and Mina demands to know, what he actually is. Dracula responds: “I am nothing. Lifeless. Soulless. Hated and feared. I am dead to all the world. I am the monster that breathing men would kill. I am Dracula.” This is moment when Mina realizes that this man of her dreams has murdered her best friend, Lucy. Even then Mina can not deny her love or desire to be what Dracula is. Dracula tells her the means to become a vampire: “To walk with me, you must die from this life and be reborn to mine. Then I give you life eternal, everlasting love. The power of the storm and the beasts of the earth. Walk with me to be my loving wife forever”.

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___________________________________________________________ But when Mina is about to drink Dracula’s blood the monster shows his empathetic side. He stops being seducer and the love towards Mina forces him to tell the terms of transformation as well. “I cannot let this be. You will be cursed to walk in the shadow of death for all eternity. I love you too much to condemn you.” But Mina has already made her mind. With Dracula she sees her life in a different light. She sees the obstacles and barriers that limit her decisions. With Dracula she sees the possibilities to make different choices, to have extreme and denied experiences. She says: “Take me away from all this death” and starts her transformation process into a vampire. This love scene between Dracula and Mina is beautiful and essential part of the Coppola’s film and in this scene the important themes of my paper come apparent. This scene reveals the living dead as immortal, powerful and seductive as well as murderer, nonhuman and unclean. In Coppola’s film death is main narrative turning point. On the one hand, death is feared and avoided because it transforms you to something creepy. In this case into a monster who has the narrative task to destroy on physical, moral and / or psychological levels. 1 But on the other hand death is a doorway to a new life. As for Mina the vampirism reveals her feeling that she is not always living life to the full. She wants to bypass the limiting social or moral barriers. 1.

The living dead as Otherness The living dead are undead bodies and death is their main and unifying feature. They are visualized images of death. As dead and alive at the same time, they are placed outside the natural order and they represent otherness and unknown. The living dead, such as Dracula, visualize death in a very corporeal way. A living dead is primarily a corpse, a physical and moving body even though it is pronounced dead. As American horror film historian Gregory Waller says, the living dead betray their origins. They stay recognizable human beings, even though their physical appearance may change or they may achieve supernatural powers or other special characteristics. 2 The threat caused by the living dead arises from this transformation and from their unnatural relationship to death. As corpses these undead bodies start to fall apart and to be able to stop the decomposing process, the living dead exploit the living. They need blood, flesh, bodies and even souls of the living to survive. Therefore the otherness is underlined by physical danger. Drinking of blood is a key to vampirism and it is a symbol for extreme egoism that shows no respect to other’s lives. Harto Hänninen

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___________________________________________________________ and Marko Latvanen see the bleeding as the crossing point between life and death. The vampire does not have its own blood production and therefore it seeks the blood of others. The vampire’s bite causes immortality but makes the victims lose both blood/life and their human identity. 3 Dying separates a person from the society, as well as it separates him/her from social behaviour. In a moment of death both conscious and consciousness as a moral figure are lost. The drives and immediate fulfilment of desires surface instead. The drives, deeply buried into the subconscious according to Freud’s psychoanalysis, represent the darker side of humanity. Death brings these suppressed elements of the human being into the open. The living dead are a nightmare what a mankind could be and perhaps already are. The monstrousness is in the human being, it is not something exterior. 2.

The living dead as admired creatures Because we can recognize ourselves in the image of the living dead, we can identify to the surfaced desires and feelings as well. Vesa Sisättö considers that even though the vampires stand for death and darkness, they stand for the ideal of freedom at the same time. For example, the vampires are powerful creatures, they have conquered death, they shamelessly fulfil their desires and they express their sexuality openly. 4 They dare to do what we dare not. One essential suppressed and desired element is sexuality. Where as death and immortality stand for the outreaching the natural limits, sexuality stands for the transgressing the limits of society. As Andrew Tudor remarks, in horror fiction sexuality is a threat to the social order. 5 Especially in Coppola’s film sexuality and control are important themes. Dracula is an erotic creature and its victims participate willingly in the seduction. Andrew Tudor emphasizes that Dracula’s threat arises out of our own weaknesses. The strongest obstacle for a vampire is a strong will, not any physical object. The vampire uses our suppressed sexuality and desire for excitement. 6 In the Bram Stoker’s Dracula the vampires bite one man and two women. The man is able to resist his own lust and sexual seduction and escapes. The two women willingly give in for the experience of lust. However the film does not state that women are easy victims. Instead, as Bonnie Zimmerman argues, Coppola’s version is a story of attempts to free oneself from the restrictions that cultural codes have enforced people to act out. 7 The story is situated to the 19th century and is based on the sexual restrictions women confronted while men seem to have more space

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The Living Dead as Cinematic Images of Death

___________________________________________________________ to express their sexuality. Dracula merely gives to women a chance to explore their sexual drives openly. 3.

Narration of dying As figures of death the living dead can be feared and admired at the same time. They image the post-mortem to be both rewarding and punitive experience. Their unnatural corpses are appalling, but their freedom from social limitations is envied. However the narration of the horror films puts these monsters in their places. For horror fiction, as Yvonne Leffler states, the antagonist is a central narrative and structural element. 8 The narrative structure with beginning, middle and end brings forward a narrative progress were a monster is born, then its existence is accepted and finally the monster is destroyed and the order regained. In this progress the beginning is the introduction of the main antagonist, Dracula. Then the threat is materialized with human victims, like Lucy. The victim is contaminated and he/she returns as a representative of the undead. The body is alive, but the personality has replaced with monstrousness. In the end, both main antagonist and other reborn monsters must be destroyed. The narration does not only picture a transformation process into a monster, but also describes beautifully and horrifyingly the processes of loss, grieve and rejection. One needs to accept the death of a loved one in order to survive. These films make a viewer to concentrate more on the cultural and personal meanings of death than on the medical definitions of it. 4.

First death: death of a person The birth of a monster is important narrative turn. In the living dead films a death is not the end. Instead it is a new beginning. David Skal has remarkably interpreted that all monsters can be seen as an expression of birth, whether it is weird or unnatural. 9 In the living dead films, I call these narrative turning points as first deaths, deaths of a person, because at the moment of death the personality of individual victim dies. The essence of person is lost and this essence appears to be the soul. Soul marks the humanity, the body marks the animality. Dualistic separation brings the body and bodily instincts, such as hunger and sexuality, the dominant forces. The loss of soul is internal transformation, but as Roger Dadoun emphasizes, in the rebirth process the inner state of monstrousness becomes outer and concrete reality. 10 In horror fiction the outer appearance reflects otherness and inner existence.

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___________________________________________________________ In Bram Stoker’s Dracula the fate of Lucy is a good example of the described process of dying. She is a lively and passionate girl and easily seduced by Dracula. The first marks for forthcoming transformation can be seen even before the first death. The external changes work as warning signs. The bodily marks are bite marks in the neck, paleness and growing fangs. Personality starts to change as well, and Lucy becomes openly lustily and aggressive. The first death finishes the transformation process and makes the changes irreversible. 5.

Social death: grieving Transformation from human into monster is difficult situation to handle. Norbert Elias has remarked that death is a problem to the living, not to the dead. The living have to find means to deal with death, loss and the anxiety they arouse. 11 Those who are left behind have to accept this change in order to destroy the monster. After being buried Lucy keeps rising from her grave and eats little children. The normal transition and grieving rites fail their task and death needs to be faced directly. Michael Mulkay talks of biological and social deaths. The biological death is the death of an organism, whereas the social death is the death of a person’s social influence. 12 The living dead films describe the same processes. The first death has started a process where a person has to be declared to be both biologically and socially dead. In the living dead films, death is a state of emergency and a challenge to the society and individuals. The exclusion process of death stands as a symbol for social death. In the horror narratives the importance of social death is often described with Julia Kristeva’s concept of abject. Abject has been a part of a human being, but after separation from the subject it creates a threat to the identity and therefore it needs to be cut loose. 13 Jonathan Lake Crane sees a corpse as a typical source of an abject in the horror. The corpse reminds of life and subject and denies them at the same. The corpse becomes a source of mayhem and it must be excluded, often with violence. Before exclusion can take place, the protagonist and other characters need to accept the transformation of diseased. They must negotiate between their memories and abject. 14 If characters are unable to deal with loss and grief they become easy victims for a newborn monster. When men come to destroy Lucy’s undead body, they do not want to believe that the transformation has actually taken place. They wish to see Lucy, but in the end they do realize that the blood-sucking creature is not Lucy, but something else and they cut her head off.

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___________________________________________________________ 6.

Second death: end of existence The second death is end of exclusion process and end of existence. The extermination is a physical act. Because the vampire is not born naturally, it cannot be killed naturally. For example, ever since the days of folk tradition the vampire could be pierced with a wooden stick, burned or the head might be cut off. 15 In the second death the monstrous body is destroyed. In Coppola’s film Dracula returns to his former, human body and rests in peace. At the same moment both his and his victims’ souls are set free. Death has been replaced under societal control and separated from the normal life. 7.

Death as a threat to body, identity and society As a conclusion I claim that the living dead create a threat at least on three different levels. Firstly, they threaten the body, because they cause the bodies to transform into something unnatural. Secondly, they threaten the human identity because they replace sense with drives and instincts. They make a human to recognize his / hers own monstrousness, which is the biggest threat to the identity according to Yvonne Leffler. 16 Thirdly they threaten society, because they stand for egoistic desires that break up the social order. On the one hand the narratives on these fascinating creatures criticize the social structure, limitations and humanity; on the other hand these narratives highlight the importance of status quo and social order. As Michael Pickering sees, the living dead may serve as ritualistic and symbolic process of exclusion of otherness. 17 This otherness is marked by death, and these narratives tell as much about the fear of death than the process of dying. These films picture death as nightmarish and celebrate the living.

Notes Yvonne Leffler, Horror as Pleasure (Stockholm: Almqvist & Wiksell International, 2000), 156. 2 Gregory A. Waller, The Living and the Undead. From Stoker´s Dracula to Romero’s Dawn of the Dead (Urbana, Chicago: University of Illinois Press, 1986), 16. 3 Harto Hänninen, and Marko Latvanen, Verikekkerit. Kauhun käsikirja (Helsinki: Otava, 1992), 58-59. 4 Vesa Sisättö, ’Hirviö on tuhottava! Vampyyrimagian rajoituksista ja kehityksestä’, in Kirjallisuus, tunteet ja keskipäivän demoni. 1

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___________________________________________________________ Kirjallisuudentutkijain Seuran vuosikirja 51, osa II, ed. Outi Alanko (Helsinki: Suomalaisen kirjallisuuden seura, 1998), 76-77. 5 Andrew Tudor, Monsters and Mad Scientist. A Cultural History of the Horror Movie (Oxford: Basil Blackwell, 1989), 167-172. 6 Ibid, 165. 7 Bonnie Zimmerman, ‘Daughters of Darkness. The Lesbian Vampire on Film’, in The Dread of Difference. Gender and Horror Film, ed. Barry Keith Grant (Austin: University of Texas Press, 1996), 397-398. 8 Leffler, 137. 9 David J. Skal, The Monster Show. A Cultural History of Horror (London: Plexus, 1993), 287. 10 Roger Dadoun, ‘Fetishism in the Horror Film’, in Fantasy and the Cinema, ed. James Donald (London: British Film Institute, 1989), 49. 11 Norbert Elias, Kuolevien yksinäisyys (Tampere: Gaudeamus, 1993), 3-6. 12 Michael Mulkay, ‘Social Death in Britain’, in The Sociology of Death, ed. David Clark (Oxford: Blackwell Publishers, 1993), 32-34. 13 Julia Kristeva, Powers of Horror. An Essay on Abjection (New York: Columbia University Press, 1982), 1-12. 14 Jonathan Lake Crane, Terror and Everyday Life (Thousand Oaks: Sage Publications, 1994), 30-34. 15 Hänninen, Latvanen, 21. 16 Leffler, 153. 17 Michael Pickering, Stereotyping. The Politics of Representation (Basingstoke, New York: Palgrave, 2001), 2-5, 47-50. Outi Hakola is Ph.D. student from the Department of Media Studies, University of Turku, Finland.

Complicated Grief Faced by the Families of Death Row Inmates: Obstacles to Effective Grief Therapy Sandra Jones Abstract The families of death row inmates experience unique grief and loss issues that have largely been neglected by scholars and clinicians alike. This study uncovers the meaning that lies within the specific forms of grief and loss experienced by family members who currently have a loved one on death row or have already lost their loved one to an execution. The concepts of disenfranchised grief 1 and non-finite loss 2 are utilized to bring attention to the ways in which the circumstances surrounding an execution complicate the grieving process for the family members of those condemned to death. Obstacles to effective grief therapy for these family members are further examined and addressed within this study. Qualitative interviews were conducted with 50 family members of Delaware death row inmates. The reactions of family members to having a loved one on death row are varied and complex, yet they include the following common responses: social isolation; loss of the assumptive world; intensified family conflict; diminished self-esteem; fragmented sense of security, trust, and meaning; guilt and shame; and a chronic state of despair. These symptoms create numerous barriers to these family members receiving effective grief therapy. Key words: complicated grief, death penalty, disenfranchised grief, nonfinite loss, grief therapy, death row inmates, execution. 1.

Introduction Anyone who has experienced the death of a loved one is likely to feel that their life has been complicated by their loss. Even under the best conditions, grieving is a complex and an individual process, yet there are particular types of deaths that make the grieving process even more complicated due to the circumstances surrounding the death. 3 Research aimed at determining the prevalence of complicated grief has led to an estimation that 14-30% of grieving people develop some form of complicated grief. 4 Although the mental health profession lacks a formal diagnostic category for complicated grief, a significant amount of literature has emerged in recent years aimed at defining and treating those who suffer from this intensified form of grief. 5 Examples of particular types of deaths that are likely to lead to complicated grief among the survivors of the deceased include those that carry a social stigma and those that occur through violent means.6 The sources of stigmatized deaths are many, yet perhaps no greater stigma

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___________________________________________________________ exists than that which accompanies the death of a loved one due to execution. While much of society may not see an execution as a violent death, the family members of death row inmates certainly view it as violent.7 While much has been written about the effects of incarceration on family members of the offender8 and there is an important body of literature on grief and bereavement,9 there has been little research into the grieving process associated with a death sentence and execution. This paper explores the effects of a death sentence and execution on family members of the accused, and their unique bereavement. The obstacles that interfere with these family members receiving effective grief therapy are further examined. This article not only provides insight into the complicated grief experienced by this population, but it also yields information that should prove crucial to mental health professionals who strive to address the clinical needs of these families. 2.

Overview of the population In an effort to justify sentencing someone to death row, the prosecution and media must make the capital defendant appear subhuman and monstrous. Therefore, it can be difficult for the general public to realize that there are people who love the accused. To the extent that attention is even given to the family members of death row inmates, they are typically criminalized along with their loved one, rather than viewed as the productive members of society that they tend to be. The pain of having a loved one on death row, and sometimes having to survive their execution, is excruciating. Several authors have conducted research with family members of death row inmates and have found among them high levels of social isolation, stigmatization, depression, and chronic grief. 10 It is against this backdrop that death row families experience the grieving process. Moving closer to understanding their bereavement is the work of John Smykla, Margaret Vandiver, and Susan Sharp. Smykla11 interviewed forty family members of eight death row inmates and found strong prolonged grief reactions among them that were distorted to the point that they significantly altered their personalities and lives. Vandiver12 suggested that the family members experience something that she called “chronic dread,” which comes from the anticipatory grief associated with executions. Sharp13 analyzed their grief process using the approach of stage theory, made famous by Elizabeth Kübler-Ross. Sharp describes the stages of grief facing the families of the accused as BADD (bargaining, activity, disillusionment, and desperation). Unlike the stages of grief described by Kübler-Ross, which eventually reach a point of resolution, the grieving process brought by the BADD cycle is particularly

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___________________________________________________________ destructive because it typically contains multiple repetitions of the stages, pushing eventual resolution farther out of reach.14 3.

Methods The primary source of data collection was qualitative interviews conducted with the family members of capital offenders. The family members participated in a 45-minute to several hour interview, which included questions that explored the nature of their grief as they have moved from the time of the arrest of their loved one throughout the various stages of the death penalty process. Topics that were explored include their relationship with the accused, changes in their family structure, and their interactions with the criminal justice system, the media, and their community. Their mental health status was assessed as they were asked to discuss whether or not they have sought any mental health services to assist them through the grieving process. When they indicated that they have received mental heath services were asked to evaluate the effectiveness of such services. More often than not, the family members indicated that they have not received such services, thus these family members were asked a series of questions to assess the obstacles that prevented them from receiving mental health treatment. Participation observation served as a secondary source of data collection, as I visited the prison on numerous occasions to meet with the men on death row. The time I spent in the prison visiting area provided me with opportunities to observe the grief of the families. The moments leading up to, during, and immediately after the time that the families spend with their loved one on death row allowed me to observe the ways in which they cope with the realization of their loss and the intensity of their response 4.

Sample The state of Delaware has a very small death row population, yet when the small size of the state is taken into account, the rate of executions is alarming. For nearly a decade following the first execution in 1992, after the death penalty was re-enacted within this state in 1974, Delaware held the distinction of executing more people per capita than any other state in the United States.15 The current Delaware death row population includes 16 men and 14 others have been executed over the last 14 years since the death penalty was reinstated. My sample includes 37 family members who are related to eleven of the sixteen men currently sitting on death row and 13 family members who are related to four of the fourteen men who have been executed since Delaware resumed executions in 1992.

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___________________________________________________________ 5.

Non-finite loss The theory of non-finite loss contributes to our understanding of the ways in which factors associated with particular types of deaths complicate the grieving process. Non-finite loss refers to those situations in which losses are slowly manifested over time, and often do not have an impending ending. It is loss that is continuous, and exacerbated by such things as milestones, which are not met by the affected individual. The continuous nature of the loss eludes the family member’s ability to go through the stages of grief to a point of recovery.16 Authors Bruce and Schultz, who coined the term, state that the grieving person is lost between two worlds, one that is known and one that is dreaded. There are three conditions for non-finite loss. The first is that the loss must be continuous and often follows a major event. The second involves developmental expectations that cannot be met. This is well illustrated by examining the grief felt by parents of developmentally or physically disabled individuals. These parents grieve when their children reach an age that carries significant milestones that cannot be obtained. The last condition described by Bruce and Shultz is the loss of one’s own hopes and ideals. Those who experience a non-finite loss question who they could/should/might have been. An examination of these conditions that must be met in order for a loss to be considered ‘non-finite’ suggests that such a loss is very likely to lead to complicated grief on the part of those who are grief-stricken. Many of the factors associated with the specific deaths that complicate the grieving process of the mourners can also be found with non-finite losses. These factors include death from an overly lengthy illness, the unique nature of the loss, the mourner’s perception of the deceased’s fulfilment in life, the secondary losses that come with such loss, and the anticipatory grief that accompanies such a loss. 6.

Disenfranchised grief The theory of disenfranchised grief contributes to our understanding of the ways in which particular antecedent and subsequent variables complicate the grieving process. Disenfranchised grief is a term that was developed by Kenneth Doka,17 and refers to instances when the bereaved are denied the ‘right to grieve’ by the larger society. Disenfranchised grief occurs when a loss cannot be openly acknowledged, publicly mourned, or socially supported. Doka and others have found that when disenfranchised grief occurs, the emotions of the bereaved are intensified and healing becomes more difficult. In addition, the bereaved often experience high levels of distress, disorganization, and prolonged grieving. The concept of disenfranchised grief becomes more profound

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___________________________________________________________ when it is combined with Romanoff’s finding18 that grief is most effectively addressed when there is community support for the bereaved, and the relationship between the dead and his or her mourners is acknowledged. The mourner who is disenfranchised from his or her grief is likely to face many of the same antecedent and subsequent variables that have been noted to occur with complicated grief. These variables include anger, ambivalence, or marked dependence directed toward the deceased, ‘mourner liabilities’ such as prior or concurrent unaccommodated losses or mental health problems, and the mourner’s perceived lack of social support.19 The most obvious variable operating prior to, during, and after the death of their loved one for those mourners whose grief is both ‘complicated’ and ‘disenfranchised’ is a lack of social support within the community. As a result of the social isolation that typically ensues from their loss, it is not uncommon for disenfranchised mourners to feel anger or ambivalence toward their deceased loved one. Their grief is further complicated by the assaults waged against their notion of the “assumptive world,”20 as they are often disillusioned by the lack of social support that they receive from others during their time of sorrow. Other antecedent and subsequent variables that complicate grief, including mental health problems and such social factors as the mourner’s educational, economic, occupational, or legal status, are frequently found to occur among disenfranchised grievers. 7. Findings A. Non-finite loss When the grief experienced by those families directly affected by the death penalty is examined, it becomes apparent that many aspects of their mourning are indicative of a ‘non-finite loss’. In all cases, the pain started after a specific event, the crime and subsequent arrest. Rebecca’s description of her family’s reaction to her husband’s arrest was typical among the families interviewed. I think it was just shock… I think it hit everyone like a ton of bricks because it’s unexpected. There was a lot of grief. I just really can’t put it into words, what you feel. I guess its anguish, like your world has been snatched away. The sudden event then spawns what might be considered the most overarching experience for family members, which is the continuous nature of the loss. With each new phase of their loss, including the arrest,

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___________________________________________________________ conviction, sentencing, death warrants, numerous failed appeals, and, in some cases, eventual execution of their loved one, family members feel as if they are experiencing the loss for the first time. In terms of sheer years, the time between arrest and execution is often 10 years or more. Throughout the years, hearings and appeals occur frequently. For most families, appeals only confirm the death sentence, and most said that when that occurred, they felt like they were reliving the worst days since the arrest. However, even a good outcome can bring its own set of fears. Margaret is the mother of a man who was sentenced to death row over eight years ago. Her family is one of the ‘lucky’ ones because her son won an appeal for a new sentencing hearing four years ago. Margaret and her family have been experiencing ‘anticipatory grief’ as they wait for the new sentencing hearing to begin, a hearing that has been scheduled and postponed several times. The various themes that tend to cycle with a nonfinite loss surfaced in Margaret’s comments as she spoke of her fear that a new sentencing hearing may very well land her son back on death row. Just when she manages to put aside thoughts of her son’s pending hearing, a court date is set again and she finds herself isolating from everyone and entering a state of despair. The constant threat looming over this mother’s head rings loudly in Margaret’s words when she asks rhetorically, “Everyday you wonder, is this going to be the day when somebody else besides God says it’s time to end your child’s life?” The second condition for non-finite loss is the inability to meet developmental expectations. The example of having a developmentally or physically disabled child is aptly compared to the experience of having a child on death row. Of the family members who were interviewed for my research, Bonnie’s story provides the clearest understanding of family members’ experience with developmental expectations. She is the mother of two sons, one who is developmentally disabled and one on death row. When Bonnie’s son was sentenced to death row, it suddenly hit her that both of her two children are likely to die before her. Having already survived three near death experiences with her disabled son, she had long ago accepted the possibility that he would die prematurely, but now she struggles with the realization that her other son’s death sentence may too lead him to an early grave. The milestones Bonnie will never see, such as weddings and grandchildren have been exchanged for a different and devastating event: the death of a child. In addition to the continuous nature of a non-finite loss, Bruce and Shultz note that a common characteristic of such mourning is the loss of one’s own hopes and ideals. This aspect of non-finite loss was readily apparent in the remarks of the family members interviewed. The most overarching loss of ideal was the families’ loss of what their government

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___________________________________________________________ means to them. Prior to their loved one’s conviction, many of these individuals saw the state as their protector. After their experiences with the state, they were left feeling quite jaded and betrayed, and were forced to reconcile this earlier notion with their current view of the state as being no less than a premeditated murderer. This ambivalent view of the state and, by extension, the criminal justice system, serves as an example of the effect of complicated grief upon mourners who have their notion of the ‘assumptive world’ challenged. B. Disenfranchised grief The concept of ‘disenfranchised grief’ sheds light on another dimension of the unique grieving process experienced by the families of death row inmates. The stigma associated with having a loved one on death row is so enormous that the families who were interviewed for this research frequently indicated that they do not feel comfortable acknowledging their loss with anyone outside of their family. Stated by one mother of a death row inmate, “I don’t tell anybody. They will never know it from me.” Of course, it is not so easy to keep this information from people within the community, due to the high level of publicity that typically surrounds the case of their loved one. When people within the community note the associations that family members have with death row inmates, the reaction is typically negative. As a result, the families of these men on death row are essentially disenfranchised from their grief. Elizabeth is the mother of a man who was executed for the murder of four people, including three children. She recalled the harsh treatment that she received by strangers in her community during the early period of her son’s incarceration, when she entered public places like grocery stores and heard people yell out “There’s the mother of the baby killer!” The taunting that Elizabeth was exposed to throughout her son’s death row sentence continued through to his execution. She insisted on being a witness to her son’s execution, yet was not prepared for the taunts that she would hear from the victim’s family in the execution chamber as she watched her son being put to death. The families of death row inmates are further disenfranchised from their grief in that their loss is never acknowledged. Even if their relationship with an inmate were to be recognized as a legitimate and significant one, many people would not consider the unfortunate experience of having a loved one on death row to be a real ‘loss.’ To the extent that the feelings of the family members are even taken into consideration, it is not usual for outsiders to dismiss any thoughts that families are suffering a loss because they are considered to be better off without a murderer in their family.

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___________________________________________________________ Perhaps the time when the families of death row inmates are most often left feeling as though their loss is not recognized occurs soon after their loved one is arrested and convicted, when the community’s memory of the horrific murder is still fresh. Several family members who were interviewed recalled exchanges that they had early on with the family members of the murder victim or others who were intimately familiar with the case against their loved one. These exchanges often left the death row families feeling not only as though their loss had gone unrecognized, but also that they were being scoffed at for the mere suggestion that they might be in pain. Particularly when the loss suffered by the family of the murder victim was contrasted to their loss, the families of death row inmates were made to feel as though they did not have a right to their grief. They received remarks like “at least you can still see your son; mine is dead.” 8.

Obstacles to effective grief therapy The vast majority of the family members in my sample indicated that they have not sought mental health services to help them deal with the pain of having a loved one on death row. This was not the case for the children in my sample. Fourteen of the eighteen children I interviewed indicated that they have received some form of counselling after their father was incarcerated. Most of these children currently have a father on death row, yet three of them have also survived the execution of their fathers. Family members provide a variety of reasons for their reluctance to receive mental health services. Many of them indicated that they were reluctant to seek therapy even before their loved one was charged with murder. They reported that they were not inclined to seek counselling either for cultural reasons or because they viewed such services as reserved for those who are “crazy” or “weak.” Even those family members who would ordinarily seek counselling to address problems throughout their life, however, were unlikely to seek such services to assist them through their grief. The reason most often given for their reluctance to seek counselling is that the stigma attached to having a loved one on death row has left them feeling very mistrustful of strangers. These family members invest a great deal of energy into shutting themselves down to outsiders who are not in their immediate support network. They work hard to protect themselves from the ostracism that they face all too often once people at their jobs, school, or community find out that their loved one is on death row for murder. In order to talk to a therapist, therefore, they must be willing to make themselves vulnerable enough to reopen the wounds caused by their grief. Many of the family members I interviewed

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___________________________________________________________ are simply not willing to risk opening these wounds with someone who they fear may judge them and stigmatize them as so many others within the community have done. When it comes to the children of the men on death row, however, family members are much more willing to seek counselling for them to help them deal with the complications that arise from having a father on death row. These children typically display emotional and behavioural problems at home and in school that their mothers, grandmothers, or other adults in the family worry are manifestations of the anxiety that comes with their father’s looming execution. Several of the children in my sample who received counselling had survived having a father on death row for many years by the time I met with them. Now young adults, they reflected back on the early years of their father’s death row sentence and shared how helpful they found counselling to be for them during that time. Caroline, the 22-year-old daughter of man who had been incarcerated for nearly ten years at the time of our interview, stated that she was taken to a couple of different counsellors as a preadolescent. Her mother sought such services in an attempt to help her daughter deal with the effects of having a father tried for capital murder in a highly publicized case. Caroline said that she did not find counselling at all helpful to her. Her father’s case was in the local and national news so frequently that she felt suspicious of counsellors who asked too many questions, wary that they were only interested in hearing about her father’s famous case. Even when they were impressed with the demeanour of the counsellor they visited, the majority of the children of death row inmates I interviewed indicated that they simply found that they did not want to talk about their feelings around their father’s death sentence. This was certainly the case with 21-year-old Bobby. When his father was executed, Bobby was 14 years old. He was sent to numerous counsellors to address the “anger problems” he and his paternal grandmother said that he has had over the years that have transpired from the time that his father killed his mother, was sentenced to death row, and eventually executed. Many times such counselling was court-ordered due to numerous assault charges that he has received since his father’s execution. Bobby said that the counsellors that he was court-ordered to see were usually very nice to him, but he just didn’t like to talk about how he felt about having a father on death row. This was a common sentiment expressed by many of the children. In order to assist the families as they deal with the non-finite nature of their loss of their loved one to death row, it is important for the grief counsellor to address the loss of ideals and the challenges toward the mourner’s assumptive world that come with this type of loss. Before it is

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___________________________________________________________ possible to do so, however, the loss experienced by the family member of a death row inmate must be legitimized and the magnitude of the loss must also be recognized. It is important, therefore, for the grief counsellor to first enfranchise the grief of the family member in order to address the non-finite characteristics of the loss. If a grief counsellor hopes to legitimize the status of death row families as mourners, however, he or she must first have an awareness of the secondary losses that come with the disenfranchisement of these families. 9.

Discussion Given the current discussion taking place in the United States about whether the death penalty should continue to occupy a place within our criminal justice system, it is crucial to consider the impact of this form of punishment on the family members of the accused. These family members have often said they feel like they have been given a death sentence along with their loved one. The unique experience of having a loved one sentenced to death row has set them upon a long, complicated grieving process. Their grief has been made complicated by the interaction of two circumstances associated with their grief: non-finite loss and disenfranchised grief. They grieve what may have become of their loved one before he was accused of murder. They grieve numerous other secondary losses, including the loss of their assumptive world, the loss of community support, and for some, and the loss of their own identity. The mental health needs of this population are great. A majority of the family members in my sample suffer from some form of a depressive and/or anxiety disorder. Symptoms of post-traumatic stress in particular are prevalent among these families at points throughout their grieving process. This is most often the case among those family members I interviewed who have survived the execution of their loved one, such as the mother who witnessed the execution of her son on her birthday. Unfortunately, the social isolation and stigmatization that is associated with having a loved one on death row makes it extremely difficult for these families to feel comfortable enough to reach out for help from a stranger. They frequently worry that a prospective counsellor may support the death penalty and, if so; many confided in me that they could not possibly bear their grief to someone who supports the institution that is likely to lead to the death of their loved one. Some of them commented that their loved one had received mental health treatment at numerous facilities before they committed the crime that landed them on death row. These family members remarked that they are not inclined to seek counselling because they are disillusioned by the mental health community that they see as having failed their loved one.

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___________________________________________________________ The pain of having a loved one on death row becomes so great, however, that some family members eventually find their way into a mental health facility. Their entry into treatment is not typically via the traditional route of mourners who seek grief counselling. They are more often compelled to seek treatment by the complications arising from their grief, such as drug addiction, legal problems, or parenting concerns. When mental health professionals find an occasion to work with the family members of death row inmates, there are several implications from my research that they can use to assist them toward their aim of effective treatment outcomes for these individuals. They need to have an understanding of the complexities related to a capital crime. Therapists also need to be willing to disclose their position toward the death penalty in order to determine if it is an obstacle for their client. Therapists must work toward enfranchising the family members by validating their grief. The secondary losses of the family members must also be identified and addressed.

Notes 1

Kenneth Doka ed., Disenfranchised Grief: New Directions, Challenges, and Strategies for Practice. (Illinois: Research Press, 2002). 2 Elizabeth Bruce & Cynthia Schultz, Nonfinite Loss and Grief: A Psychoeducational Approach. (Baltimore, Md.: Brookes Publishing Co., 2001). 3 John Bowlby, Attachment and Loss, Vol. III. (New York: Basic Books, 1980); Colin Murray Parkes. Bereavement: Studies of Grief in Adult Life. (New York: International University Press, 1972); P. Marris, Loss and Change, 2nd ed. (London: Routledge & Kegan Paul, 1986). 4 Linda Schupp, Grief: Normal, Complicated, Traumatic. (Eau Claire, WI: PESI Healthcare, 2004). 5 It has been identified with different terms, such as ‘traumatic grief’ by Selby Jacobs, Traumatic Grief: Diagnosis, Treatment, and Prevention. (Castleton, N.Y.: Hamilton Printing Co., 1999); ‘pathological grief’ by John Bowlby ‘Pathological mourning and childhood mourning’, Journal of the American Psycholoanalytic Association, 11 (1963), 500-541; or ‘unresolved grief’ by A. Lazare, ‘Unresolved Grief’ in Outpatient Psychiatry: Diagnosis and Treatment, ed. A. Lazare (Baltimore: Williams & Wilkins, 1979); S. Zisook, & L. Lyons, ‘Bereavement and Unresolved Grief in Psychiatric Patients’, Omega, 20 (1988-1989), 43-58. Regardless of the terminology utilized, increasingly more attention has been given to complicated grief in an effort to equip clinicians with the diagnostic tools

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___________________________________________________________ and treatment strategies that will allow them to respond in the most effective manner possible to those suffering from this form of grief. 6 Edward Rynearson, Retelling Violent Death. (Philadelphia, Pa.: BrunnerRoutledge, 2001); E.K. Rynearson, & J.M. McCreery, ‘Bereavement after Homicide: A Synergism of Trauma and Loss’, American Journal of Psychiatry, 150 (1993), 258-261. 7 Susan Sharp, Hidden Victims: The Effects of the Death Penalty on Families of the Accused. (New Brunswick: Rutgers University Press, 2005); Recent research indicates that the process of lethal injection may be far more brutal than it appears. Research suggests that some individuals may feel enormous pain from the lethal injection, yet are unable to express it, as the protocol requires three injections and the second one is a paralyzing agent. L. Konaris, T. Zimmers, D. Lubarsky, & J. Sheldon, ‘Inadequate Anaesthesia in Lethal Injection in Lethal Injection for Execution’, Lancet 365 (2005), 1412-1414. Professional medical groups, such as the American Medical Association, have deemed it unethical for their members to participate in executions. As a result, numerous lawsuits have recently been filed in the U.S., challenging the constitutionality of lethal injection as a mode of execution, and a recent U.S. Supreme Court ruling has made it easier for death row inmates to file such a claim. Death Penalty Information Center (DPIC) 8 Donald Braman, Doing Time on the Outside. (Ann Arbor: University of Michigan Press, 2004); Katherine Gabel & Denise Johnston, Children of Incarcerated Parents. (Lanham, Md.: Lexington Books, 1995); Jeremy Travis & Michelle Waul, eds. Prisoners Once Removed: The Impact of Incarceration and Re-entry on Children, Families, and Communities. (Washington, D.C.: The Urban Institute Press, 2003). 9 John Bowlby, 1980; Colin Murray Parkes, Bereavement: Studies of Grief in Adult Life. (New York: International University Press, 1972); T.A Rando, Grief, Dying, and Death: Clinical Interventions for Caregivers. (Champaign, Il.: Research Press, 1984); W. Worden, Grief Counseling and Grief Therapy, 2nd. ed. (New York: Springer, 1991). 10 E. Beck, S. Britto, and A. Andrews, In the Shadow of Death: Restorative Justice and Capital Offenders’ Family Members. (New York: Oxford University Press, forthcoming); E. Beck, B. Sims-Blackwell, P. Leonard, & M. Mears, ‘Seeking Sanctuary: Interviews with Family Members of Capital Defendants’, The Cornell Law Review, 88 (2003), 382-418; R. King & K. Norgard, ‘What about our Families? Using Impact on Death Row Defendants’ Family Members as a Mitigating Factor in Death Penalty Sentencing Hearings’. Florida State University Law Review, 26 (2003), 119-1174.

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___________________________________________________________ 11

J.O. Smykla, ‘The Human Impact of Capital Punishment: Interviews with Families of Persons on Death Row’, Journal of Criminal Justice, 15 (1987), 331-347. 12 Margaret Vandiver, ‘The Impact of the Death Penalty on Families of Homicide Victims and of Condemned Prisoners’, p. 477-505 in America’s Experiment with Capital Punishment: Reflections on the Past, Present and Future of the Ultimate Penal Sanction, eds. by James R. Acker, Robert M. Bohn, and Charles S. Lanier. Durham, (N.C.: Carolina Academic Press, 1998). 13 Susan Sharp, Hidden Victims: The Effects of the Death Penalty on Families of the Accused. (New Brunswick: Rutgers University Press, 2005). 14 Ibid. 15 Oklahoma recently rose to the position of the state that executes more people per capita than any other state in the country, bumping Delaware to second in line for this dubious distinction Death Penalty Information Center (DPIC) 16 Bruce & Schultz, 2001. 17 Doka, 2002. 18 B.D.Romanoff & M. Terenzio, ‘Rituals and the grieving process’, Death Studies, 22, 697-711. 19 T.A. Rando, Treatment of Complicated Mourning. (Champaign, Il.: Research Press, 1993). 20 Colin Murray Parkes, ‘Bereavement as a psychosocial transition: Processes of adaptation to change’, Journal of Social Issues, 44, 3, 53-65.

Britain’s ‘Punk’ Mourning Culture Gerri Excell Abstract In 1977 the British music industry was rocked when the Sex Pistols catapulted into the music world with their anti establishment assault on the industry. Now it’s the turn of the British mourning culture, out with established rules of mourning and, in with the new anti establishment mourning culture of the roadside memorial. There are no prescribed rules of what constitutes a roadside memorial and, this is exactly the characteristic that appeals to the bereft, the personalisation of a memorial site. A content analysis of 50 roadside memorials in the UK reveals that it is the individuality of the symbolism that is important for those bereft in today’s society. The roadside is a public space and is the perfect space to incorporate a memorial that can draw attention to the end of a life; the roadside can be used as a place to celebrate the life whilst at the same time protest the untimely death. Religious iconography does not focus heavily in the roadside memorial culture of the UK, is this because the roadside is not perceived as the place for a religious icon? Could it be that the death itself has questioned their faith? This paper will chronicle the development of the roadside memorial in the UK and, discuss how the proliferation of memorials is challenging established rules of mourning. The new ‘punk’ movement of mourning will not go away but may possibly evolve as policy is fashioned and attempts are made at standardising the memorials. However, more can be learnt from the individualised memorials; what are societal values today? What makes a statement about this life, and maybe more importantly what might have been missed about this life if a memorial had not been placed? The roadside memorial provides a voice for a life that may only have a brief eulogy in a crematorium by an officiant who never knew that individual, this voice encourages freedom of speech. Key words: mourning, punk music, roadside memorials, spontaneous memorials. 1.

Introduction In this world nothing can be said to be certain except death and taxes Benjamin Franklin, 1 death is the greatest leveller for all, besides being born death is the only other certainty we have. However, how our deaths are memorialised remains one of the great uncertainties, unless of course plans have been made in this age of the buy now die later prepayment funerals. The mode of your death, however, may have a qualifying effect on how you are memorialised. Since the 1980s there has

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___________________________________________________________ been a substantial growth in the number of spontaneous and roadside memorials in the UK. 2 This paper will examine the phenomenon of the roadside memorial and compare their emergence on British mourning culture to that of the onslaught of punk music on the British music scene of the 1970s. I will argue that Britain’s mourning culture has been subject to the same processes that the music industry suffered at the hands of the punk music genre. What was once a bottom up movement moves into the mainstream. Whilst at first being feared by the established music world and society, punk music quickly became part of the mainstream and lost some of its original power. The same argument will be levied at the roadside memorial phenomenon, what once courted controversy, has once again joined the mainstream. This paper draws heavily on a previous research project carried out in 2004 as part of my Masters degree. The focus was roadside memorials in the UK, in which interviews were conducted with those who have placed and maintained memorials at the roadside. 2.

Roadside memorials in the UK Over a period of four years I have photographed roadside and spontaneous memorials, collecting visual evidence of this form of memorialisation I decided to research the phenomenon of roadside memorials for my Masters dissertation; I interviewed individuals who had been bereaved through road traffic accidents. I wanted to find out why they chose this form of memorialisation and what meanings they had attached to the memorial. The findings revealed that the mode of their loved ones death, sudden, violent often lonely death was the determining factor in their decision to place a spontaneous memorial. The British have a stoic reputation when it comes to grief, with the British stiff upper lip and a lack of demonstrative public acts. Geoffrey Gorer famously stating in his book on mourning that in the UK death was “pornographic.” 3 However this historically stoic British reputation was in jeopardy of being dismissed as a myth when Diana Princess of Wales died in 1997, the Australian sociologist Peter Griffiths 4 , claiming that in England there was a new “Mediterreanisation” of emotional expression. However, public acts of remembrance and memorialisation have always been a part of the British way of mourning. According to George Monger 5 there has always been a tradition of placing wayside flowers in the British Isles. Yet, it was not until the 1980s that the numbers of spontaneous memorials grew and became part of the British way of mourning. The 1980s saw a host of tragic events, Hillsborough, Lockerbie and The Kings Cross Fire for example, each subjected to spontaneous memorialisation-

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___________________________________________________________ both formal and informal. 6 The mass media played an important part in the dissemination and mass exposure of this organic form of memorialisation. Today, with the advent of 24-hour news television and the Internet, news editors depend on the image of the spontaneous memorial as a poignant backdrop to the news story they are reporting on. In the course of my earlier research I was helped by the UK charity RoadPeace, an organisation founded by Brigitte Chaudhry following the death of her only son in a road traffic accident in 1995. RoadPeace offer advocacy to the families of those bereft through road traffic accidents and offer an online memorial site and a permanent plaque that can be placed at the scene of the fatality. These plastic A4 plaques feature a bleeding anemone and a space where the bereaved can write the name of the person who died, to date RoadPeace report that over 3000 of these plaques are in place. 7 Although RoadPeace claim that over 3000 of their “Remember Me” plaques are in use, it is the individualised, stylised roadside memorial that is commonplace in the UK. 3.

The study Having previously established the rationale for the placing of a spontaneous memorial in an earlier research project 8 , focus was placed on the material culture of the roadside memorials. Cataloguing over 100 memorials from the UK, 50 random memorials were selected and their material culture recorded. Cataloguing the unique features of each memorial in the sample revealed some fascinating insights into our memorial culture of the UK. Drawing from previous published research into roadside memorials from the USA and Australia 9 , it was evident that the UK was unique in its spontaneous memorial culture. Most noticeable was the dearth of “crosses” in our roadside memorials, In Australia Clark & Cheshire 10 report that 80% of the memorials in their sample had a small white cross in the material culture. Similarly in the USA white crosses are the most common form of memorialisation in the roadside memorial culture, many states in the US provide formal white crosses to be placed on the roadside, and only these official white crosses may be placed. 11 The top ten totems found in British roadside memorials were (1) Flowers; (2) Names; (3) Footballing items (flags, shirts, tickets); (4) Candles; (5) Messages; (6) Photographs; (7) Soft toys; (8) Alcohol; (9) Clothing; and (10) Automobile wreckage. 12 This post-modern mourning culture surrounds itself in personal representations of the individual, the individual is the focus, what football team they supported, who they have left behind and what their loss means to society. The study supported the assumption that roadside/spontaneous

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___________________________________________________________ memorialisation is a bottom up movement, where there are no rules of what makes a good memorial it is entirely personal and organic. 4.

The connection with ‘punk’ The early 1970s were dominated by bands that wore more make up, sequins and glitter than the amassed crowds of female fans. Music became light, almost comical, the art school college bands and Oxbridge educated bands like Pink Floyd were edged out by the pop bands such as Sweet, Glitter Band and T Rex. Throughout the twentieth century music styles and cultures had clashed, big band sounds versus rock & roll, Mods Vs Rockers, soon, all music styles encountered their nemesis in the Punk Rockers. Early punk rock was an underground movement that attracted those disillusioned by the grandiose ostentation of the glam rock scene. The Sex Pistols were a band that epitomised the punk movement young men with little or no futures and marginally less musical ability, but with a Machiavellian mentor one Malcolm Maclaren. Keen to make as much money as he could Maclaren was the mastermind behind the Sex Pistols. The rationale behind the Punk movement was borne from that of the Situationalists 13 a social movement active in France in the early part of the nineteenth century. The punk movement was a kick against the established music, clothing and way of live. The seminal Sex Pistols album ‘Never Mind the Bollocks’ contained such ground-breaking songs such as Anarchy in the UK, God Save the Queen and Pretty Vacant. The Sex Pistols were hailed as the voice of the youth, Johnny Rotten, infamous for his angry nihilism; was renowned for his bitterly sarcastic attacks on pretentious affectation and the very foundations of British society. Once again British society was debating the birth of yet, another subculture. Sarah Thornton describes a subculture as Subcultures are groups of people that have something in common with each other …which distinguished them in a significant way from the members of other social groups. 14 This explanation of a subculture exemplifies the punk rock and spontaneous memorial activists in that they are distinguishable from other members of society one by their outlandish appearance and the other with their fervent desire to express their grief so publicly. Thornton goes further in her dissection of a subculture and reveals that subcultures have been studied whilst in a state of transience. This is also true of those who participate in acts of spontaneous memorialisation; they are in a liminal state, a state transition-the mourning phase. Subcultures are often feared

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___________________________________________________________ and misunderstood Stanley Cohen’s seminal work on subcultures 15 laid the foundations for sociological investigations into societal reactions to deviant behaviour. Punk Rock was feared, the very physical appearance of the punk rockers with their safety pin piercings, Mohawk hairstyles and ripped clothing striking fear into the hearts of society. Television programmes discussed the impending dangers of the punk rockers and their influence on impressionable teens. Bill Grundy, the late veteran TV presenter was partly responsible for the Sex Pistols notoriety; the group disrupted a live television interview with their swearing and apparent disregard for the presenter. 16 This behaviour had never been seen on television before in the UK and the nation was in uproar, but the bubble was soon to burst. 5.

The diminishing return Punk rock was a shock, an underground movement, grass roots and anti establishment. However this was all soon to change, the music rapidly became the norm the music charts groaned under the weight of pseudo punk rock bands. High street fashion shops stocked mass-market chain street punk fashions; punk was the norm anyone who had the money could buy into the punk lifestyle. Where once questions were asked in Parliament, now punk was seen in soap operas, daytime television and glossy fashion magazines. The power that punk had was diminishing. The phenomenon of the roadside memorial crept into the British mourning culture by stealth; nobody was interested in the increasing numbers of memorials on busy roads or country lanes. Yet, just as punk burst onto the music scene, now came the dawn of the spontaneous mass memorial. Throughout the decade of tragedy, the 1980s, nightly images, via the news channels, were beamed into our homes, haunting images of the lost lives on the pitch at Hillsborough, or in the sleepy Scottish village of Lockerbie. Once a mass audience had seen the footage the act was absorbed by the viewing public and adopted as a format for memorializing a sudden death, a death that is tragic, and an untimely death. The fascination with this form of memorialisation is that it is spontaneous, what is placed is instantaneous and provides a snapshot of that raw grief at the very moment it was felt. With accidental death agencies of control taking over - the Ambulance, Police and Coroner - the bereft lose control of the situation. The mourning period then resembles what Goffman 17 termed front and back stage behaviour, what goes on front stage the controlled stoical face of ‘bearing up’ has no relation to what is going on behind the scenes The spontaneous memorial allows an outlet for this grief, outrage and protest. The scene of the death, where those bereft lives changed forever can be regained and controlled and personalised within

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___________________________________________________________ hours of the death occurring. No waiting for the undertaker to plan the service and show you the body in its newly purchased coffin, the bereft can act right away to protest and memorialise the death. This is where the danger and fear of the memorial began to materialise, the very fact that the memorials could be used as a protest, a very visual protest. Just as punk rockers were feared because of the questions they asked of society so do roadside memorials their existence poses questions of society and this can be dangerous. Local authorities began to outlaw the practice on the grounds of road safety; others had their own agenda one local authority councillor publicly stating “We don’t need this European mumbo jumbo here in the UK.” 18 As with the punk music phenomenon, there was good and bad press. The freedom of expression in memorialising was good for all, especially with the restrictions imposed by cemeteries with regard to memorial content. However, roadside memorials were considered a contentious issue and the subject of debate in the press and radio, many voicing concerns that the memorials were really litter. The spontaneous memorial made society notice deaths that were sometimes ‘hidden’ for example the numbers of road deaths, the numbers of deaths due to gun crimes and fatal stabbings. The media inflamed these debates by using the memorial sites in their news bulletins and so increasing the numbers of ‘mourning tourists’ those individual’s who choose to visit memorial sites purely out of curiosity. It is almost de rigueur that a spontaneous memorial is placed at the site of a fatal accident. Memorials have developed into, whatever you can do I can do better situation. In economics there is a theory of diminishing returns, for example when you go to the pub the first drink you have you savour, it quenches your thirst, you relish the experience, however, any second or third drinks may be equally enjoyable but, never the same as the first. The same can be said of the roadside memorial, whenever you come across your first roadside memorial you can be saddened, curious angry or disturbed. Yet, it is possible to become desensitized to the memorials and just drive or walk passed with just a glance at yet, another memorial. 6.

Inclusive mourning British mourning culture has embraced this new form of memorialisation and added it to the repertoire and acknowledged that this form of memorialisation encompasses disenfranchised grievers into the fold. The sample of fifty UK spontaneous memorials used in this study revealed that the usually absent group of young individuals 16-25 19 are heavily involved in this form of memorialisation. Youth culture has embraced a way in which they can actively participate in the

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___________________________________________________________ memorialisation process and infuse their own values and beliefs into this practice. Although, this form of memorialisation has allowed a more inclusive mourning practice here in the UK it is sad to see that what was once a powerful individualistic way of expressing private grief publicly has been diluted by its very popularity. 7.

Conclusion The premise for this paper was that Britain’s memorial culture has been transformed by the same processes and sub cultural undercurrents that transformed the music world in the late 1970s. In the USA purpose made memorial crosses and plaques can be purchased from websites eager entrepreneurs finding a lucrative business. The spontaneous memorial has become the ‘darling’ of the mass media, poignant images of a spontaneous memorial site being used as the backdrop of the new report of the incident. The once spontaneously hastily placed bunch of flowers in its supermarket cellophane wrapping with attached price tag, has become a stage-managed prop. Recently on British television a favourite character was ‘killed off’, the character was stabbed and died in the street. The next episode began with a panoramic shot of the gates of the square decked with floral tributes to the dead character 20 . Most of this episode focused on the memorial and characters central to the show were seen placing their tributes and talking about who actually had the right to place tributes there. This can be cited as evidence of how the spontaneous memorial has become part of the norm when it comes to memorialising a tragic death. The soap opera in question claims to represent modern living in London and by using a spontaneous memorial it is enforcing what would be expected to happen in that locality in real life .Real life is reflected in the totems found at these post modern memorial sites . Each memorial is unique, previous research 21 has highlighted the importance to the bereft of the site of death itself a site that is made sacred by the bereft and a place in which reflections of a lost individual can be used in a way to regain control of the tragic circumstances surrounding the death. Cemeteries throughout the UK have introduced wide ranging rules and regulations regarding the decorations and adornments allowed on the graves. Not surprisingly then that the bereft may attempt to find another avenue for displaying their grief. The roadside provides this freedom, the freedom of expression, and the spontaneous memorial is valuable as it is spontaneous. It provides society with an immediate response ho the death, whether this response is an angry protest or a touching human personal response to the death providing a valuable resource for researchers into death, bereavement and post modern

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___________________________________________________________ mourning practices. In the formalized memorial world it may take weeks often months before a permanent memorial is in place, in the events of homicide it may be months of bureaucratic demands before the bodies are released for cremation or burial. Post war British memorial culture has been dominated by the denial of death paradigm, Tony Walter 22 has written extensively on the ‘revival of death’ and a Modernist approach to the rationalization of death; however this rationalization of death only serves to distance death once again from the bereaved. The spontaneous memorial provides a new fresh avenue for active involvement in memorial practices, and holistic approach that was inclusive for all. Lessons can be learnt from the eclectic array of totems so representative of a post – modern world I fear that the once innovative spontaneous memorial has lost some of its initial power and influence on society as a whole. Evidence has been provided where the cultural image of a spontaneous memorial has become part of the TV and music video repertoire, this is a double edges sword it may bring the genre to the masses but, some how reduces the whole aspect and meaning of a memorial of this type. The law of diminishing returns, where once a powerful icon of sudden death now the return has lessened and will we see familiarity breeding contempt?

Notes 1

Benjamin Franklin, Letter to Jean Baptiste Le Roy (1789) US author diplomat, inventor, physicist, politician & printer (1706-1790). 2 Gerri Excell, Roadside Memorials in the UK: Private Grief made Public. Unpublished MA thesis, The University of Reading, UK (2004). 3 Geoffrey Gorer, Death, grief and mourning in contemporary Britain (London: Cresset, 1965), 41. 4 Peter Griffiths, ‘Words cannot say what she is’, in Planet Diana Cultural studies and Global Mourning, ed. Public (Kingswood: University of Western Australia, 1997), 47-48. 5 George Monger, ‘Modern Wayside shrines’, Folklore 108 (1997), 113114. 6 Anne Eyre, ‘Post-Disaster Rituals’, in Grief, Mourning and Death Rituals, ed. Jenny Hockey, Jeanne Katz & Neil Small (Buckingham: Open University Press, 2001), 104-111. 7 RoadPeace actively campaign in the UK for the rights of road crash victims to ensure the trauma they suffer is acknowledged. Since 31st August 2003, over 3,000 A4 plaques have been placed nationally, resulting in over 400 articles in local and national press.

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Excell, 2004, 68. Roadside memorials have been subjected to academic debate in the USA and Australia for some years. The first International symposium on Roadside Memorials was held in Australia in 2004. 10 Jennifer Clark and Ashley Cheshire. ‘RIP by the roadside: A comparative Study of roadside memorials in New South Wales, Australia and Texas, United States’, Omega 48 (2004), 229-248. 11 MADD, Mothers against Drunk Drivers in the USA have campaigned since the 1980s and are a tour de force in the US. MADD sanctioned the White Crosses to be placed at the scene of a fatality where alcohol was involved. 12 Gerri Excell, ‘Contemporary deathscapes’ paper given at 7th Annual International Conference on Death, Dying & Disposal, The University of Bath, September 15th-18th (2005). 13 Situationist International (SI) a political movement formed in 1957 in Italy. It grew out of a number of avant-garde artistic and political movements. Its main aim was to challenge conformity and overthrow capitalism. 14 Sarah Thornton, ‘General introduction’, in The Subcultures Reader, ed. Ken Gelder and Sarah Thornton (London: Routledge, 1997), 1. 15 Stanley Cohen, Folk Devils and Moral Panics: The creation of Mods and Rockers (London: Mac Gibbon & Kee, 1972), 57. 16 Bill Grundy presented the Thames Television news show ‘Today’ the show was aired only in the London area. On December 1st 1976 the Sex Pistols were a last minute stand in the band Queen who cancelled at the last minute. The band were all intoxicated and were goaded and patronised by Grundy throughout the interview. Grundy succeeded in getting the band to swear live on air, the next day the tabloids were outraged, Grundy was sacked from the show and ‘Today’ was taken off the air for two months. 17 Erving Goffman, The Presentation of Self in Everyday Life (Harmondsworth: Penguin, 1971), 70. 18 Sophie Kummer. ‘Road Fatality Signs are Morbid and Un-English’, Edgware Times, sec3, p.4., 12 July (2003). 19 In my local neighborhood a sixteen year old boy tragically drowned. His peer group held nightly vigils until his funeral. T-shirts were produced by the group and worn throughout the period prior to his funeral and at the funeral. Walls were ‘tagged’ with RIP Tyson and signs defaced with text speak messages. The group received press coverage throughout the mourning period those interviewed were in the age range was 14-25. 9

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___________________________________________________________ 20

Eastenders is a BBC 1 soap opera shown three times a week in the UK, first aired in 1985 it portrays the fictional London town of Walford. The episode in question was shown over the Christmas/New Year period 2005. 21 Excell, 2004, 40. 22 Tony Walter, The Revival of Death (London: Routledge, 1994), 51.

Bibliography Hartig, Katie & Kevin Dunn. ‘Roadside Memorials: Interpreting New Deathscapes in Newcastle, New South Wales’. Australian Geographical Studies 36 (1998), 5-20. RoadPeace, ‘About RoadPeace’ Available online at [accessed 17 August 2006]. Based at the University of Reading, Gerri Excell has researched the phenomenon of roadside memorials for the last four years. Her current research examines the spontaneous memorials following terrorist attacks in the UK.

The Making of ‘Good’ Memorialisation Kate Woodthorpe Abstract Studying death is by no means a new adventure in sociology. However, making connections between the different areas of research that largely follow the chronological pattern of dying, moment of death, and after death practices, have to date not been systematically made. Thus, this paper is going to make some preliminary associations between pre-death and post-death literature, via the concept of the ‘good death’. Specifically, it will use Bradbury’s 1 conceptualisation of the good death in order to make sense of how practice in the cemetery is becoming increasingly subjected to norms of behaviour, and constructions of what conforms to/is defined as ‘good’ mourning practice. Using this valuable concept I wish to suggest that, similar to the arguments proposed by Field and James 2 whereby the hospice is becoming increasingly institutionalised - that the contemporary cemetery could now be understood as an institution that dictates memorialisation behaviour and activity, creating powerful norms of ‘good’ memorialisation that in turn are utilised to signify how individuals are ‘coping’ with their bereavement. Key words: cemeteries, memorialisation, good death, institutions, bereavement. 1.

Introduction Social research into death and dying is by no means a recent endeavour. However, the sociality of death and dying remains on the periphery of sociology, with a lot of the literature being produced in this area coming from more anthropological perspectives. The origins of these anthropological perspectives owe much to Hertz, 3 who is commonly regarded as one of the first, and most significant, anthropologists exploring the social meaning of death rituals. In terms of Western death practices, sociological interpretation has tended to reflect the growth of the death work industry, which recently has been dominated by the monumental developments in health care. The 1960s can lay claim to being one of the most progressive decades in the development of a ‘death movement’, with the establishment of the Hospice Movement by Dame Cicely Saunders, and the publication of Jessica Mitford’s ‘American Way of Death.’ 4 Importantly however, whilst these two isolated occurrences reflect the progress of intellectual endeavours on death and dying, whereby they did not act to establish a link between the periods before and after death. This separation between work on before and after death has prevailed since then, with a huge

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___________________________________________________________ growth in dying and palliative care study, and less attention paid to issues surrounding disposal and after-death practices. Evidence for the current state of affairs in England today includes many academic departments devoted specifically to researching hospices. Cemeteries, on the other hand, remain on the periphery of academics’ remits, although there have been important developments with the establishment of the Cemetery Research Group at the University of York and the Death Centre at the University of Bath within the last decade. In addition, whilst there have been individual academic authors who have attempted to bridge the gap between dying and death 5, 6 , 7 these works have not fully entered the contemporary cemetery landscape, tending to focus on exploring wider ritual activity and frameworks of understanding. This paper therefore intends to expand on these tentative bridges between disciplines, and incorporate ‘dying’ literature into an ethnographic study of the contemporary cemetery and memorialisation practice, underpinned by “a dawning realisation that contemporary attitudes to death and dying are unsatisfactory and that society has somehow lost touch with the meaning of life.” 8 As sites of remembrance, cemeteries have a lot to offer us in terms of how people understand and remember the dead, both individually and collectively, locating the activity of bereaved people in the social world; something which, to date, has been neglected in the positivist climate of bereavement research. 9 Thus, I wish to create a dialogue between accounts of those experiences of dying and contemporary mourning behaviour, using the model of the good death 10 to describe and suggest there is scope for utilising concepts from the dying experience when exploring post-death experience, specifically memorialisation. This will then be extended to suggest that there are similarities between the institutionalisation of hospice activity 11 and an institutionalisation of ‘good’ memorialisation activity. The data for this paper comes from an ESRC funded ethnographic study of the contemporary cemetery landscape, co-funded by the City of London and Institute of Cemetery and Crematorium Management. All fieldwork took placed at the City of London Cemetery and Crematorium in Newham, East London. This 220-acre site is celebrating its 150 year anniversary this year. It is run by the Corporation of London, employs approximately 90 staff, and is in the process of establishing itself as a ‘Centre of Excellence for Best Practice’. In addition the cemetery prides itself in offering a range of choices for the burial of dead individuals, including lawn burial, traditional burial and woodland burial. In this vein, the cemetery attempts to cater for everyone, placing accessibility and individuality at its core. The purpose of this project has

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___________________________________________________________ been to explore conservation and how different groups of people (visitors, staff and the local community) perceive this dynamic and complex landscape. In turn, this has developed into a wider exploration of meanings and values attributed to the dead and conceptualisations of life, as “the issue of death throws into relief the most important cultural values by which people live their lives and evaluate their experiences.” 12 2.

The ‘good’ and ‘bad’ death The beginning of the conceptualisation of the ‘good death’ can be attributed to Glaser and Strauss’ 13 ideal dying typologies, whereby the dying person has varying degrees of awareness of their situation. The notion of an ‘ideal’ way to die was further expanded upon by Ariès 14 who compared contemporary dying with a romantic model of the ‘tame’ death from the nineteenth century. Bloch and Parry 15 developed this typology of death, with several of the papers in their edited collection pointing to a ‘good’ death being closely linked with ideas of rebirth. 16,17 A good death is largely characterised as one where there is an absence of pain and an awareness of dying, “while a ‘bad death’ may mean weeks, months, or even years of slow agony.” 18 These conceptual tools of a ‘good’ and ‘bad’ death can be contested for being overly romantic 19 and too narrow in their scope 20 , yet the ‘intellectual structure’ that they can provide 21 is nevertheless a useful mechanism through which to explore experiences of death. In particular, how the good death has been constructed gives us great insight into how we, individually and collectively, can understand ‘life’ and ‘death’, as Sociological contributions to our understandings of the good death [that] have provided descriptions of the social management of dying and death, and expositions of cultural reactions to death and their consequent shaping of the lives of dying people. 22 Specifically, this paper focuses on Bradbury’s 23 understandings of the good death to suggest that there are real parallels between activity within institutions that the dying and dead inhabit. In addition there are further similarities in tensions that arise between these ‘ideal’ types of dying/post-death practice and the increasing bureaucratisation and routinisation of these settings. 24 3. Good death typologies and cemetery memorialisation A. Sacred good death

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___________________________________________________________ For Bradbury a sacred good death involves the notion of ‘moving’ on to a better place and the concept of rebirth. It is therefore spiritual in that there are larger belief systems about life and death being incorporated into the death experience, in order to make sense of it. Pain and agony can be present, but in this death they are acceptable, as they are part of the process of moving from life into death. In this typology death is a social event, with death bed farewells commonly occurring. Thus, the death bed scene is central to this type of death, with the dying surrounding themselves with things that represent ‘life’. 25 B. Sacred good memorialisation Using the death bed model, we can understand sacred memorialisation as activity that takes place beside the (bed) grave, as my data has suggested: visiting the grave is a social event, where family members and friends can be reunited with the deceased or other family members/friends who may visit. It was not uncommon for visitors to locate their dead in the cemetery, but still as part of their social networks of friends and family to visit, exemplified by one visitor who told me: “I always talk to people I come to, tell them different things. I see loved ones as being here.” Survivors’ new identities also reflect wider beliefs about their relationship with the dead. As one participant told me: “I think for some people it’s not just to do this, lay the flowers and that sort of thing. They find comfort, they do, they talk to them, say things, they ask their advice.” Thus, for this person the dead continue to have a continuing social presence in their life, taking on a special - a sacred - capacity in that they have to be visited specifically in the cemetery. C. Medical (modern) good death Control is central to this type of death. The locus of this control is medical intervention that can be applied and manipulated to orchestrate the death. Death is the responsibility of experts, whose technical knowledge means they are the privileged holders of knowledge and their control over the process can be equivalent to, if not greater than, the dying person themselves. In this type of death, location and timing are everything, and is most evident in the hospice or hospital setting, where symptom control is vital. This can further lead to an increasing medicalisation of the dying process and a resulting institutionalisation of practice. 26 D. Modern memorialisation As in the case of modern dying, this type of memorialisation is about control and limitations placed upon visitors by ‘the experts’ - who in

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___________________________________________________________ this instance are the cemetery staff. Emphasis is placed on controlling of expressions of grief through particular forms of memorialisation, and a practical regulation of any expressions that breach the limits of acceptability constructed by the cemetery management and enacted through the cemetery regulations. For example, the City of London Cemetery and Crematorium Regulation 27 number 86 states that: ‘We do not allow curbs, posts or vases in the lawn section’. Regulation 94 further states: ‘We do not allow crosses made of wood, bell glasses, shells, grass wreaths or other moveable or fragile items in the cemetery.’ Thus memorialisation activity is perceived as either abiding by or breaking those rules. The wider meaning or purpose behind it is implied by the enforcement of memorial directives and the need to maintain a controlled landscape overall. Much like Lawton’s 28 assertion that patients were sedated or moved due to the collective nature of wards in the hospice and the distress dying could cause for others, cemetery staff clear graves of prohibited memorialisation in order to ensure that the collective space fulfils their ideal of good memorialisation practice, based on their reading of the public’s reaction – and then incorporated into the regulations. E. Natural good death For Bradbury, the natural good death has a dual meaning: firstly, a sense of death taking place ‘in’ nature, and secondly of it being ‘natural.’ 29 A death may have only one of these elements or both, but it is the notion of acceptance of death that permeates both of these meanings. Primarily, the main focus of this category is the break from, or lack of, intervention and control in death. Whilst this type of dying may incorporate elements of the sacred death, in that rituals and concepts of regeneration may be present, the emphasis is on the individual rather than wider belief systems. F. Natural memorialisation Similar to the ambiguous nature of other items within Bradbury’s typology, this form of memorialisation can simultaneously be seen as about being ‘in’ nature and/or being ‘natural’. Burial could take place in a woodland area or a more conventional municipal lawn section; importantly, the focus is not where the body is buried, but rather it is this theme of intervention that is key here. In natural memorialisation there is an emphasis on the normality of death, an acceptance, and a sentiment towards the individuality of the person, rather than expert technical knowledge. Thus, there may be elements of the sacred and modern in this type of memorialisation, but the focus is on the individual rather than wider frameworks of shared beliefs and values. In this way, it is the

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___________________________________________________________ ultimate late modern act of memorialisation, ‘done my way.’ 30 Inevitably, in a collective landscape, this individuality can cause conflict, as one staff member told me: They still don’t understand that people, you’re not going to never stop people putting things on the grave, what they want on the grave. You can give them rules and regulations, what you can have and what you can’t have, but people don’t want to listen to that. That’s their little memory to that person isn’t it? They want to put on it what they want. Thus, through all these conceptualisations of memorialisation practice, visitors and staff members alike are characterising activity, relating it to their shared and individual understandings of death and bereavement, and constructing wider notions of what is ‘good’ and ‘bad’ practice. Similar to the hospice and the good death however, this has led to a routinisation of practice, which has a profound impact upon those individuals who do not conform to ‘good’ behaviour. Similar to how the good death has been constructed in a dichotomous relationship to the aforementioned ‘bad’ death the sacred, modern and natural types of memorialisation practice can be utilised to understand perceptions of ‘bad’ activity within the cemetery. Throughout my data, ‘abandoned’ graves were frequently referred to as ‘being left behind’ or ‘forgotten’, implying that there is judgement being made about what is being done by/left on a grave in terms of ‘bad’ behaviour. This was exemplified by one woman who told me: I don’t like [it] when I see graves looking… I know it sounds silly, but I don’t like them when they’re half falling down and really badly taken care of. I don’t like that. I wouldn’t like to see my Mother’s grave in a big mess, I wouldn’t like that. I think it does matter, if it’s all overgrown. I mean, I know they’re dead already but to see it look in a big mess like that, it needs to be neater and tidy, and taken care of. Like someone’s almost caring for them. In addition, similar to the ideal good deaths constructed by health professionals who see dying on a daily basis, 31 staff at the cemetery construct their own typology of ‘good’ and ‘bad’ memorialisation (independent of the regulations) based on what they perceive to be either

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___________________________________________________________ valuable or unattractive. One staff member was particularly vocal about current memorialisation practices: I can only use one word to describe my feelings [towards memorialisation], tacky. I think the modern ones are often tacky. Colours, lack of imagination in the design of the memorial, strange lines, over polished, the lettering, machine cut, what more can I say? As we can see, staff and visitor perceptions of memorialisation practice around the cemetery are mediated by broad conceptualisations of good and bad practices, which relate closely to Bradbury’s typologies of the good death. These in turn are ‘read’ as indicators of the strength of relationships with the dead, and of how individuals are coping with their bereavement. Unfortunately there is not the scope of entering into this final point in greater detail here, suffice to say, one of the principal suggestions of this paper is that embodied material activity in the cemetery is being associated closely with ‘clinical lore’ 32 conceptualisations of what constitutes ‘normal’ and ‘healthy’ grieving behaviour. 4.

Conflict in the cemetery However, tensions arise as these ideal types of memorialisation sometimes simply do not fit with the actual reality of what happens (similar to Lawton’s experiences of dying not fitting the ideal type in the hospice). This tension manifests itself in the clearing of mementoes from graves if they are deemed inappropriate or dangerous by the cemetery regulations, causing visitors to complain. This conflict has grown to the extent that I was told by visitors to the graves that there were ‘miniHitler’s’ in the cemetery office. On another occasion one woman told me: I don’t know quite how to describe why I think this, but I do sometimes get the impression that someone in control, the manager or somebody, would prefer to have only the people who’ve died and not the people who are living at all. That they’re a nuisance in some way. There a distinct parallels here with Lawton’s data that suggests dying patients feel they are a nuisance or a burden upon their families and the health authority. This perception, particularly in terms of relationships between the professionals and the patient/cemetery visitor is troubling, as it indicates the ideological underpinning of ‘choice’ and ‘individuality’ is not being successfully negotiated in either the hospice or the cemetery. In

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___________________________________________________________ the hospice, this issue is highlighted by the heavy sedation of patients to fit the ‘good death’ model; in the cemetery this is the removal of items from the grave to fit a ‘good’ landscape aesthetic. Concurrently, individuals who do not correspond with the ideal types of dying and cemetery activity are pathologised: excessive noise/smell/pain are discouraged in the hospice; excessive memorialisation is also viewed as disproportionate and actively controlled in the cemetery by removal of what is deemed ‘inappropriate’. Essentially, it is the controlling function of the institutional nature of the hospice and cemetery that is key here, as they impose norms of ‘good’ behaviour and practice upon their residents and visitors that is further internalised by visitors and adopted as the ‘ideal’ way to ‘do’ memorialisation and bereavement practice. Williams 33 has argued that at an institutional level, all societies need to control death. However, this abstract statement needs to move beyond the realm of theory into the lived reality of the two spaces considered in this paper, where we can see that behaviour is frequently mediated and regulated to meet institutionalised (collective) standards of practice and behaviour 34 . McNamara et al 35 believe the institutionalisation of practice in the hospice is particularly problematic, as it undermines the ideological foundation of the hospice: that of patient autonomy, holistic practice and quality of life. 36 To meet the demands of a growing population however, the hospice has had to become increasingly routinised to ensure that it functions efficiently and effectively. 37 This in turn has led to a return to hierarchies of expertise in the hospice 38 and the aforementioned manipulation of dying experiences to ‘fit’ the ideology. 39 Furthermore, this institutionalisation of death practice is not limited to the hospice, as research in other organizations suggests there are similar ideologies being tested. 40 Through transposing the good death typologies onto memorialisation activity within the cemetery, we can see comparable institutionalisation of behaviour in the cemetery landscape, evidenced particularly by the regulations which state what is allowed. By doing this, these regulations are constructing ‘appropriate’ collective memorialisation practices that manipulate behaviour and artefacts left in the cemetery to ‘fit’ the good mourning practice aesthetic. 5.

The cemetery in society Hart et al 41 have expressed a concern over the dominance of the good death ideology in the hospice; my data suggests that this concern is applicable also to the contemporary cemetery. Whilst the ideology of the good death was created in response to the increasing medicalisation of death, it has now become a possible tool through which control over the dying experience can be exercised by experts. Similarly, memorialisation

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___________________________________________________________ in the cemetery is now regulated to conform to a collective ideal – which in reality is problematic and contested. For the dying patient, the routinisation of the good death experience can be accused of pushing the patient to the periphery and enabling the ‘experts’ to dominate the dying experience. Similarly, ideal types of memorialisation behaviour are creating a routinisation and idealisation of bereavement practices, enforced by regulations. So, what does this mean for the contemporary cemetery landscape? It is the principle argument of this paper that due to the constructions of ‘appropriate’ memorialisation practice, the cemetery is as revealing as the hospice in terms of the institutionalisation of death. This institutionalisation rhetoric does not rest easily with typologies of good death/memorialisation, and thus, the cemetery needs to be assessed as under threat from this routinisation of practice as the hospice has been. Practitioners, policy makers and academics alike need to recognise the significance of the controlling of memorialisation practice, and what this actually reflects in terms of wider (late) modernist understandings of life and death. In addition, we need to expand perceptions the cemetery landscape in order to understand its institutionalised role in society and address how this role could change in the future 42 . By doing this, the cemetery landscape could be much more closely linked into the process of living and dying, and accordingly attract more attention from local communities, stakeholders, fundraisers and policy makers. 6.

Conclusion Through exploring these conceptualisations of good memorialisation practice, I have shown how the cemetery shapes mourning behaviour and practice, similar to ways in which activity is shaped within a hospice. There is much scope for a greater integration of the cemetery into local communities, in the way that hospices have been, yet they continue to remain on the periphery of local communities and policy makers’ agendas. This low status has been reflected in research into death-related spaces, with only a few notable exceptions in recent years 43, 44 . However, it is my hope that this will begin to change, as interdisciplinary conferences such as Making Sense of: Dying and Death promote a dialogue between the different researchers and audiences working with death and dying. If we - as individuals, academics, policy markers and practitioners - can begin to develop a constructive acrossdiscipline conversation about our understandings of how people deal with dying, death and disposal, there is a greater potential for providing the best

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___________________________________________________________ and most appropriate space, landscape and service for the dying, the dead, and the bereaved, both now and in the future.

Notes 1

Mary Bradbury, Representations of death: a social psychological perspective (London: Routledge, 1999). 2 David Field, & Neil James, ‘Where and how people die’, in D. Clark, (ed) The Future for Palliative Care: Issues of Policy and Practice (Buckingham: Open University Press, 1993), 6-29. 3 Robert Hertz, Death and the Right Hand, Tr. R. and C. Needham (London: Cohen West, 1960 [1907]). 4 Richard Huntington & Peter Metcalf, Celebrations of Death: the anthropology of mortuary ritual, 2nd ed. (Cambridge: Cambridge University Press, 1991). 5 Tony Walter, The Revival of Death (London: Routledge, 1994). 6 Jenny Hockey ‘Encountering the ‘reality of death’ through professional discourses: the matter of materiality’, Mortality, 1, 1 (1996), 45-60. 7 S.M. O’Gorman ‘Death and Dying in contemporary society: an evaluation of current attitudes and the rituals associated with death and dying and their relevance to recent understandings of health and healing’, Journal of Advanced Nursing, 27 (1998), 1127-1135. 8 Ibid, 1133. 9 Christine Valentine, ‘Academic constructions of bereavement’, Mortality, 11, 1 (2006), 57-78. 10 Maurice Bloch & Jonathan Parry (ed.s) Death and the Regeneration of Life (Cambridge: Cambridge University Press, 1982). 11 Field and James. 12 Huntington and Metcalf, 25. 13 Barney Glaser & Anselm Strauss, Awareness of Dying (New York: Aldine, 1965). 14 Phillipe Ariès, Western Attitudes towards death: from the middle ages to the present, tr. P.R. Ranum (London: John Hopkins University Press, 1974). 15 Bloch and Parry. 16 Jonathan Parry, ‘Sacrificial death and the necrophagous ascetic’, in Death and the Regeneration of Life, ed. M. Bloch and J. Parry (Cambridge: Cambridge University Press, 1982), 74-110. 17 J. Watson, ‘Of flesh and bones: the management of death pollution in Cantonese Society’, in Death and the Regeneration of Life, ed. M. Bloch and J. Parry (Cambridge: Cambridge University Press, 1982), 155-186.

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Maria Càtedra, ‘Kinds of Death and the House’, in Death, Mourning, and Burial: a cross-cultural reader, ed A.C.G.M. Robben (Oxford: Blackwell Publishing, 2004), 77. 19 Norbert Elias, The Loneliness of the Dying, tr. E. Jephcott (Oxford: Blackwell, 1985). 20 B. Hart, P. Sainsbury. & S. Short ‘Whose dying? A sociological critique of the ‘good death’’, Mortality, 3, 1 (1998), 65-77. 21 Beverley McNamara, C. Waddell & M. Colvin, ‘Threats to the good death: the cultural context of stress and coping among hospice workers’, Sociology of Health and Illness, 17, 2 (1995) 222-244, 237. 22 Hart et al, 65. 23 Bradbury. 24 Beverley McNamara, C. Waddell, & M. Colvin, ‘The Institutionalization of the Good Death’, Social Science and Medicine, 39, 11 (1994), 1501-1508. 25 Julia Lawton, The Dying Process: patients’ experiences of palliative care (London: Routledge, 2000). 26 McNamara et al, 1994. 27 City of London Cemetery Regulations, 2000 (30th May 2006) . 28 Lawton. 29 Bradbury, 152. 30 Walter, 1994. 31 Beverley McNamara, Fragile Lives: death, dying and care (Buckingham: Open University Press, 2001). 32 Tony Walter, On Bereavement: the culture of grief (Buckingham: Open University Press, 1999). 33 Simon Williams, Medicine and the Body (London: Sage, 2003). 34 see E.K. Abel, ‘The Hospice Movement: institutionalizing innovation’, International Journal of Health Services, 16, 1 (1986). 35 McNamara et al, 1994. 36 Hart et al. 37 Field and James. 38 McNamara et al, 1995. 39 Lawton. 40 see Carol Komaromy, ‘The performance of the hour of death’, in Palliative Care for Older People in Care Homes, ed J. Hockley and D. Clark (Buckingham: Open University Press, 2002), 138-150. 41 Hart et al.

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Ian Hussein, Paper given at Memorial Awareness Board session, Houses of Parliament, (3rd May 2006). 43 Phillip Bachelor Sorrow and Solace: the social world of the cemetery (Amityville, NY: Baywood Publishers, 2004). 44 Doris Francis, Leonie Kellaher, & Georgina Neophytou, The Secret Cemetery (Oxford: Berg, 2005). Kate Woodthorpe is completing her Ph.D. thesis on Cemetery Conservation in the Department of Sociological Studies at the University of Sheffield, under the principal supervision of Professor Jenny Hockey. Her other interests include Cultural Sociology and the Sociology of Health and Illness, particularly chronic illness and embodiment. This project has been funded by the Economic and Social Research Council, the City of London, and the Institute of Cemetery and Crematorium Management.

Institutional Loss: Dialectical Tensions in Coping with Major Loss Melanie K. Finney Abstract Multiple deaths occurring at academic institutions present interesting challenges for those trying to help others adjust and cope with such losses. This article addresses the characteristics of higher educational institutions that make them vulnerable to extreme forms of grieving, and that may complicate coping with major traumas. In particular, these factors serve to emphasize the dialectical tensions involved in coping with major loss that are present when multiple deaths occur in university communities. Drawing on the dialogism of social theorist Bahktin, five particular dialectical tensions are outlined: (1) tensions between individuals’ needs to remember and institutions' need to move on; (2) tensions regarding the demonstration of private grief and public mourning; (3) tensions between performance of public and private rituals; (4) tensions as individuals move between roles as mourners and consolers; and (5) tensions as individuals struggle to accept pain and move towards growth. This essay considers how institutions must be aware of, and address, the frequently competing needs of the various parties as they encounter these types of losses. Key words: dialectical tensions, grief, institutional loss, mourning, rituals, university communities. As seemingly safe, protected institutions, colleges and universities face special challenges in helping members of their communities make sense of, and come to terms with, emotionally devastating events. This essay first examines the characteristics that distinguish academic institutions from other types of organizations, especially in terms of how traumatic events may affect its members. Additionally, because of these characteristics, administrators may struggle as they consider the needs of the various groups that are affected by major losses. In response to these challenges, I outline five dialectical tensions that may be present as university communities’ grapple with how best to address institutional tragedies. 1.

Universities as distinctive institutions American academic institutions are generally perceived as safe havens, where problems are solved through discourse and debate, not through aggression or violence. Stereotypically, these ‘ivory towers’ are places where the highly educated have chosen to pursue the life of the

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___________________________________________________________ mind, rather than engage in the vagaries of life. Faculty frequently function as observers or critics of social practices, rather than actively ‘getting their hands dirty’ with politics, capitalism, or social disputes. Because university communities are generally perceived as bastions of liberty, democracy, and locations that promote the free exchange of ideas, there is a presumption of safety and isolation from the ‘real world’. Historically, universities have served in some capacity in locus parentis, as parents entrust their nearly grown children into the care of others. Generally speaking, bad things are not supposed to happen on college campuses. Students and faculty should be immune from tragedy or crime. Additionally, colleges and universities are unique types of institutions because of their largely transitory population. Typically, students, who are the largest peer/cohort group in the overall institution, are enrolled only until they meet their degree requirements, generally in the range of four to six years. This is the nature of the institution: students enter, receive training/education, and then leave. While there is less movement on the part of faculty and administrators, some turnover on the part of the employees in educational institutions is also expected. In addition to the transitory nature of colleges, students are a particularly vulnerable population in terms of their ability to cope with traumatic or stressful events due in part to the developmental stage of most students at undergraduate institutions. Young people frequently lack experience in dealing with loss and haven’t yet adopted behavioural scripts about how to cope with traumatic events. 1 Specifically, age itself, especially for those under age 25, is a predictor of complicated or postponed grief. Additionally, as Janoff-Bulman notes, young people frequently have a distorted view of their invulnerability. 2 To co-opt the title of a previously published book, young people generally don’t believe or understand that “bad things happen to good people.” 3 Most college undergraduates are not cognitively or emotionally ready to deal with tragedy, especially when it happens to individuals in their social networks. Thus, when tragedies occur within an academic institution, those most affected are unprepared to confront such losses. A final characteristic of college life concerns the types of bonds that are formed during the college years. Because most young college students are living independently for the first time, they seek out and develop relationships with others. During this developmental stage, many students become strongly identified with their academic community, which frequently continues long past graduation. As students are socialized into their academic institutions, they become loyal fans and supporters, which is one way that universities keep alumni connected. For example, supporting varsity athletics is a major contributing factor in

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___________________________________________________________ creating a sense of belonging and unity for current and former students. Alumni come to define themselves in part by their institutions. For example, students who graduate from Texas A & M University in College Station, Texas are not simply ‘alums’ of TAMU; they are and forever will be “Fightin’ Texas Aggies.” This strong identification with an alma mater explains why, in some cases, people continue to be affected by the events on a campus even after they have left the university. Thus, the collective group of people that are affiliated or identified with a particular institution is very large. University communities are much more than the currently enrolled student body. Clearly then, because of their transitory, young adult populations, coupled with the presumption, or perhaps illusion, that universities are safe havens and places that are above the fray of violent crime or heinous behaviour, as well as the fiercely held loyalties to one’s alma mater, academic institutions consist of multiple audiences and present many challenges for the study of how individuals and communities cope with tragedies resulting from multiple or violent deaths. Addressing those who have suffered a major loss, however, is complicated since not only the support needs of the bereaved change over time 4 but frequently, multiple communities or audiences exist. When dealing with major public tragedies, especially those that involve multiple loss of life, the needs of many and varied audiences become even more intricate. For example, in addition to the profound grief experienced by families and loved ones of the victims, those who may have witnessed the tragedy and survived may struggle with feelings of helplessness or guilt. Thus multiple messages, to multiple audiences, whether in the form of public address, ritual, or memorial construction, require careful attention and development in order to satisfy individual and social needs successfully. The next section more fully considers, from a dialectical perspective, the frequently competing needs of those whose lives have been touched by tragedy. 2.

Dialectical tensions in institutional grief and loss A dialectical perspective is useful for examining the complications inherent in coping with major loss. Based originally on the dialogic work of Mikhail Bakhtin 5 and further developed by Baxter and Montgomery, 6 dialectics explain the contradictions inherent in the study of various social relationships. I later expand this approach to apply as well to issues of grief and loss, and subsequent sense-making, coping, and moving on. In general, however, the theory of relational dialectics concerns the ongoing experience and management of tensions in personal relationships. According to Baxter and Montgomery, there are four

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___________________________________________________________ dimensions of dialectics present in relationships: contradiction, change, praxis, and totality. Contradiction involves the “dynamic interplay of unified oppositions” in relationships, 7 and describes how simultaneous, competing needs require careful management. For example, individuals in personal relationships may have needs for both personal autonomy and concurrently, emotional connection with a partner. The dimension of change indicates awareness of these competing tensions as a means for promoting change and modification to the relationship. Praxis refers to the idea that individuals are simultaneously subjects and objects, both acting and being acted upon, so that actions and reactions are perpetually ongoing. Finally, totality suggests that multiple contradictions or tensions occur together and are not isolated. It is possible, therefore, for several different tensions to be present at any one time, further complicating the desire to respond in a way that helps maintain balance. Overall, this dialectical perspective recognizes that individuals have competing needs that require skilful management, at both the personal and the social level. In a different article, I argue that these same four dimensions of contradiction, change, praxis, and totality are also evident in how individuals and institutions adjust to various dialectical tensions concerning grief and loss. 8 In a grief-related context, Stroebe, Schut, and Stroebe discuss how bereaved people may oscillate between a loss-orientation and a restoration-orientation, and emphasize the need for a ‘dual process model’ for coping with loss. They define these two orientations in the following way: By loss-orientation we mean that a person is concentrating on, dealing with, and processing some aspect of the loss experience. Grief work falls within this dimension, as do rumination and yearning for the deceased, just thinking or talking about him or her, looking at photos, and imagining how he or she would react. Facing up to the loss or crying over the death would also be part of this process. 9 By contrast, the process less familiar, and certainly less explicit, in bereavement research and counselling, is that of restoration orientation. When a loved one dies, not only do we grieve for him or her, we also have to adjust to substantial changes that are secondary consequences of loss. … It incorporates learning to do things alone learning to go places as a single person, not as part of a

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___________________________________________________________ couple and this, perhaps more than anything, may force confrontation again with the fact of loss.) It means establishing new routines, fulfilling new roles, developing a new identity, and adjusting to an environment without the deceased. 10 Thus, when confronted with major loss, bereaved individuals have both a need to ruminate, remember, and grieve the loss, as well as to create a new life and identity without the loved one. While not describing this dual-process model in terms of dialectical theory, clearly this conflicting pull between these two orientations is a type of dialectical tension. Considering the previously outlined complexities within the university context, I suggest that there are at least five dialectical tensions concerning grief and loss that must be managed in these types of institutions: (1) the tension between individuals’ needs to remember and institutions' needs to move on (similar to Stroebe, et al’s dual process model); (2) tensions regarding the demonstration (or not) of private grief and public mourning; (3) the tension between performance of public and private rituals; (4) the tension as individuals move between being mourners and consolers; and (5) tensions as people struggle to accept pain and move towards growth. The first tension is the most significant and potentially longest lasting, as individuals and institutions struggle with the desire to hold on to the past and the memory of the deceased. Socio-cultural assumptions suggest that the more we love(d) an individual, the more difficult it is to ‘let that person go.’ By staying in a prolonged grieving period, some individuals may feel they are showing more honour and respect to the deceased than if they were to begin to ‘move on.’ Frequently heard expressions relating to this dialectic tension include ‘we will remember’ or ‘we’ll never forget.’ On the other hand, people and institutions cannot effectively exist in a perpetual state of limbo. Given the cyclical nature of life in the academy especially, it is imperative that classes continue to meet, students continue to work on meeting degree requirements, faculty continue to teach and conduct research, and administrators continue to oversee both day-to-day and long-term operations. While students frequently get breaks from classes and faculty members earn sabbaticals, it is impossible for an academic institution to simply put its obligations on hold. Life must continue on and institutions must be forward-looking. Thus, there is a strong dialectical tension between needing to remember and needing to move on. This tension is probably most strongly evident

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___________________________________________________________ when the needs of grieving individuals and the needs of the institution are in conflict with one another. Second, especially in western culture, there is a strong dialectical tension between the demonstrations of emotion in public versus private settings. Publicly, individuals must grapple with what and how much emotion to display. In some cases, individuals may feel torn between needing to be strong or stoic and experiencing and wanting to express deep pain and loss. In many western cultures, for example, it is generally considered appropriate for women and children to publicly display intense grief, especially during the initial stages of loss. For men, however, and more notably for professional men, emotional displays are considered a weakness. According to Martin and Doka, gendered stereotypes continue to exist about the proper ways for men and women to grieve and adapt to loss. 11 They note that the issue is not so much whether men and women grieve differently as it is that people have different ways of coping with grief, and that “different” does not imply inferior. Nonetheless, the presumptions in many cultures are that weak individuals display emotion publicly and that strong, professional people should present a stoic front and grieve in private. Additionally, there are socially constructed views about the appropriate ways that the deceased may be remembered publicly, but there are fewer restrictions about social appropriateness in small, private settings. For example, privately, it may be appropriate to share personal and humorous stories of the deceased, but one would never do so in a formal tribute. There are clear, albeit frequently unspoken, social rules about how one can celebrate the life of, or eulogize, deceased members of a community in a public setting. Oftentimes, the tension between balancing the public and private demonstration of grief and mourning creates intrapersonal, as well as interpersonal and social conflict. The third dialectical tension is similar in that it concerns the performance of public and private rituals. In some communities, there are precise rituals that must be enacted, regardless of whether the individual participants wish to do so. For example, when a head of state dies, there are certain public rituals, i.e., calling for a day of mourning, having an escorted funeral procession, or a body lying in state, that must be enacted for the benefit of the larger community, regardless of the wishes of the immediate family. Conversely, there may be very personal, private rituals that some may feel need to be performed, yet these rituals may not be understood by others in the community. For example, one of my family traditions is that burial clothes for the deceased should be night or bed clothes, and as such, a family member was buried in a smoking jacket, rather than a formal suit and tie. This private, personalized tradition may

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___________________________________________________________ conflict with norms for appropriate public behaviour. These contradictions can create difficulties for all parties involved, as an institutional loss is in some ways private, as well as public. A fourth dialectical tension exists in the roles individuals must assume following the death of a community member. While many individuals may be affected either directly or indirectly, their needs for offering consolation or requiring comfort may shift back and forth. It is relatively easy to note those needing assistance or comfort: family members of the deceased, those who directly worked with or under the one who has died, those whose lives were personally touched by the individual. However, grief and loss does not simply affect one individual at a time, especially in an institution with diverse populations. Put simply: who comforts the comforters? People may simultaneously be both grievers and comforters. For example, some hospice workers assume a great deal of the responsibility for providing assistance and comfort to a terminally ill patient’s family, yet when the patient dies, they may also experience a profound sense of loss and require comfort as well. This dialectical tension concerns how people balance the desire to comfort others and yet be able to receive or ask for comfort when necessary. Finally, there is a strong dialectical tension as people struggle to accept and embrace pain and move towards growth. In John Harvey’s book, Give Sorrow Words, he approaches dealing with major loss in a way that “loss becomes gain as we heal and particularly as we use our losses and what we learn from them to contribute to others who also suffer.” 12 Pain resulting from major loss is not simply something that is experienced and remains forever so by one person. Pain can bring growth and development as surely as growth begets additional pain. As prior bereavement work suggests, acceptance of loss is a necessary precursor for healing, but individuals may cycle through various phases of pain and healing throughout one’s life. Thus, moving through pain could be recast as potential growth. Simultaneously, producing new growth, especially as the bereaved reach out to others, may necessitate enduring additional pain as well. For example, life-saving surgeries may be quite painful, recoveries prolonged and difficult. Similarly, as those who have suffered a major loss engage with, and help support or care for others, the growth that results may be inexplicably linked with pain and heartache. Thus, major tragedies in academic institutions necessitate balancing many and varied competing needs, notably for many and varied competing audiences. The five dialectical tensions outlined emphasize the need for careful and well co-ordinated communication at multiple levels when tragedy strikes the academy. Pain and suffering resulting from extensive grief and loss may eventually give way to healing and growth,

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___________________________________________________________ but these on-going, intrinsically linked processes require conscientious forethought and action.

Notes 1

Melanie K. Barnes, et al., ‘The Relativity of Grief: Differential Adaptation Reactions of Younger and Older Persons’, Journal of Personal and Interpersonal Loss, 1 (1998), 375-392. 2 Ronnie Janoff-Bulman & Michael Berg, ‘Disillusionment and the Creation of Values: From Traumatic Losses to Existential Gains’, in Perspectives on Loss: A Sourcebook, ed. John H. Harvey (Philadelphia: Brunner Mazel, 1998), 35-47. 3 Harold S. Kushner, When Bad Things Happen to Good People. (New York: Avon Books, 1981). 4 Melanie K. Barnes, ‘A case study approach to support needs following the death of a loved one’, Journal of Personal and Interpersonal Loss, 1 (1996), 275-298. 5 Mikhail M. Bakhtin, The Dialogic Imagination: Four Essays by M. M. Bakhtin, ed. Michael Holquist, trans. Caryl Emerson & Michael Holquist (Austin: University of Texas Press, 1981). 6 Leslie A. Baxter & Barbara M. Montgomery, Relating: Dialogues and Dialectics (New York: Guilford, 1996). 7 Ibid, 9. 8 Melanie K. Finney, ‘Accommodating Dialectical Tensions in Academic Institutions Following Traumatic Events’ (in prep). 9 Margaret Strobes, Hank Schut, & Wolfgang Stroebe, ‘Trauma and Grief: A Comparative Analysis’, in Perspectives on Loss: A Sourcebook, ed. John H. Harvey, (Philadelphia: Brunner Mazel, 1998), 91. 10 Ibid, 92. 11 Terry L. Martin & Kenneth J. Doka, Men Don’t Cry… Women Do: Transcending Gender Stereotypes of Grief (Philadelphia: Brunner Mazel, 1999). 12 John H. Harvey, Give Sorrow Words: Perspectives on Loss and Trauma (Philadelphia: Brunner Mazel, 2000), 208. Melanie K. Finney received her Ph.D. from The University of Iowa and is Associate Professor of Communication and Theatre at DePauw University, Greencastle, Indiana, United States.

Traumatic Bereavement and Coping: Implications for a Contextual Approach Karola Dillenburger, Montse Fargas, Grace Kelly and Rym Akhonzada Abstract Bereavement responses and outcomes depend on multiple factors, such as circumstances of the death, the relationship with the deceased, individual characteristics, social context, and cultural factors. Responses to natural death differ from those following traumatic death. Death of a child or spouse is most difficult, while age mitigates coping. Social support is important and cultural differences affect funeral rites and coping patterns. Using Northern Ireland as a case in point, this paper explores implications of violent death over time. Northern Ireland lived in civil unrest and political violence, commonly known as the Troubles, since 1969. Over 3,600 people have been killed as a result. In 1994/05, ceasefires were negotiated and since then, violent incidents have decreased dramatically, although they have not completely stopped. In the early years of the Troubles, the impact of the violence on people’s mental health was underestimated and there was a lack of structured support. Since the ceasefires, more attention has been paid to those affected and community support groups have grown rapidly. In this paper, we report data from pre-ceasefire studies and contrast these with newly emerging post- ceasefire research in regard to psychological health, depression, and PTSD in individuals who experienced traumatic bereavement. Quantitative as well as qualitative data will be reported and implications for a contextual analysis outlined. Key words: traumatic bereavement, victims’ groups, Northern Ireland, D.I.S.C analysis, GHQ, BDI, PDS. 1.

Introduction Bereavement is an inevitable and universal experience, although how each individual reacts to the death of a loved one depends on multiple factors. Dillenburger and Keenan 1 suggested that bereavement outcomes and coping are shaped by at least four different yet intertwined contexts: (1) the Death itself, including the circumstances surrounding the death, and how the death was communicated; (2) Individual factors, such as age, gender, relationship with the deceased, and health prior to bereavement; (3) Social circumstances, such as the extent of social support and quality of social network; and (4) Cultural context, including cultural norms and rites, historical circumstances and political situations. In this paper, we use

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___________________________________________________________ their D.I.S.C model to look at traumatic bereavement and, we compare data of the PAVE Project (People Affected by Violence) 2 with data of the first study on violent bereavement in Northern Ireland in the mideighties. 3 Bereavement caused by violence is clearly more traumatic than other types of bereavement. 4 Since 1969, over 3,600 people were killed as a direct result of violent conflict in Northern Ireland. This means that thousands have lost immediate family members, relatives, and close friends in shootings, beatings and bombings. Mass violence is not unique to Northern Ireland, and there are many other examples where people have suffered mass-scale bereavement through war, genocide or natural disasters. The question is, how do people cope in the long-term? Ten years after the ceasefires, one could expect that people have learned to live with their loss, however, recent research shows that many are still suffering twenty, thirty or even thirty-five years after their loss 5 , “for many, the hurt of thirty years ago is just as strong as it was then and remains undiminished by the passage of time.” 6 In 1985/6, a violently bereaved widow said: [my grown up children] say I have to forget him and they think I should be over it after all these years. But I will never forget. 7 Twenty years later, these widows cannot stop thinking about their loss: I know its thirty odd years ago but it seems like yesterday and I still have not got over it and I will never get over it. 8 To me, I would say, inside deeply, I still haven’t snapped out, you know, the death of my husband, I would say it’s still there but, as I say, it will be there until the day I die. It does not go away. It won’t go away. And I have learned to accept that. 9 2.

Impact of traumatic bereavement on psychological wellbeing The impact of conflict in general and violent bereavement in particular is subject of some controversy in Northern Ireland. In the early years, psychiatrists 10 and some researchers 11 believed that most people reacted with astonishing denial or resilience to the continuing violence. Reports that presented a different picture 12 were all but ignored. Support was scant. 13 However, with the beginning of the Peace Process in the mid-

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___________________________________________________________ 1990s, and particularly since the Belfast Agreement in 1998, more research was carried out that confirmed significant long-term psychological suffering. 14 The Government paid increasing attention to victims’ issues, and voluntary support groups experienced a rapid growth. In this paper, we draw findings from the PAVE project, which explores the effectiveness of voluntary services offered to people affected by the Troubles. To-date, 71 individuals, of which 59 were violently bereaved, completed a set of psychological standardised questionnaires (General Health Questionnaire, GHQ-30 15 ; the Beck Depression Inventory, BDIII 16 ; and the Posttraumatic Stress Diagnostic Scale, PDS 17 ). Findings show poor psychological health, high levels of depression, and severe PTSD symptomatology (Table 1). N

GHQ mean (SD) 10.46 (9.8)

BDI mean (SD) 19.70 (13.9)

PDS mean (SD) 25.36 (15.4)

All participants 71 Violently 59 10.05 (9.6) 19.57 (13.7) 24.77 (14.7) bereaved Table 1: GHQ, BDI and PDS means of PAVE Project participants

These data are similar to findings from the mid 1980s when the GHQ-30 mean score for violently bereaved widows was 10.69 (SD 9.4). 18 3.

The death It is widely believed that the circumstances of the death are one of the crucial factors that affect bereavement outcome. Certain circumstances, such as sudden death and lack of anticipation, violence, or multiple deaths, are more likely to lead to more problematic bereavement or to so-called ‘complicated grief’. 19 For example, Kaltman and Bonnano 20 found that bereavement following violent death (accidental death, suicide or homicide) is likely to result in PTSD symptoms and enduring depression. In Northern Ireland, a widow in 1985/6 revealed how her husband was killed and how his violent death affected her: The gunmen had shot him straight into the face. His face was so bad that they just put a plastic bag over it. All I can see when I close my eyes now is that white plastic bag. I cannot even remember his face. 21

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___________________________________________________________ In 2006, a widow explains how seventeen years after the violent death of her husband, the way he was killed still has an impact on her: If there was a door here, we were sitting, I would have to go over and open the door. I can’t bare the door closed. Probably because of the way they came in through my back door and murdered my husband. 22 Another important factor is the way in which the death is communicated 23 . While twenty years ago widows who witnessed the death of their husband scored significantly lower on the GHQ-30 than those who were told by somebody else 24 , today those who were present when their loved one was killed scored higher than those who were told by a third party (Table 2). N GHQ mean BDI mean (SD) PDS mean 28 8.43 (9.1) 17.39(13.7) 20.39(13.2) 8 8.50 (5.9) 13.13 (8.1) 20.71(10.7) 2 5.50 (6.4) 6.50 (4.9) 10.00(14.1) By a doctor 23 13.30 (10.8) 25.45(13.6) 32.55(12.8) Witnessed Table 2: GHQ, BDI & PDS by how the death was communicated By a By the

4.

The individual context Individual factors, such as age and the relationship with the deceased, have an effect on how the bereaved are coping. 25 Some PAVE project participants were children when they lost a parent and this obviously had and still has a huge impact on them: I suppose for a long time we didn’t even talk about the death of my mother, how it happened or how it affected us. I suppose we all just thought you have to get on with it… it was more really as I got older, got into my teens, that would affected me more so, ‘cause I had to listen to my friends saying, ‘oh, I’m off into town with my mammy’ and I thought I can’t do that… or your first boyfriend. I had no mother to discuss it with… and probably to an extent I still resent that. Erm… it’s something you just can’t let go of, I’d like to, but I can’t, you know. 26

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___________________________________________________________ The loss of a sibling can also have detrimental effects on bereavement outcomes, particularly if the bond with the deceased had weaken over the years, as illustrated below: my other brother… sort of way had drifted from [name of deceased] and the bond wasn’t quite as strong.… He said to me, ‘I can’t get him back now. He’s dead. And I don’t have any chance to get him back’. He thought with time, things would change… things can improve… But he was dead and buried. So, I had to carry him for 18 months, as well. 27 Parental and spousal bereavement are particularly difficult. Twenty years ago, a widow explained how she felt: I feel most under stress in the morning when I wake. I cannot help feeling for my husband when I look at his photo. If he was here I could cope better. My son had an accident. I felt so useless. When I see other women with their husbands I feel I have to keep going for my son’s sake. 28 The bereaved widows in the PAVE Project felt no different: I thought I can’t live, and then you look at your daughter… well, what is she going to do? What about that child? There’s a child here! And I think that is the only thing that kept me alive… was… had my daughter there. 29 5.

Social context The social context, in particular the level of social support, is an important factor in terms of bereavement outcome. Twenty years ago, bereaved widows relied almost exclusively on support from family and friends, as very little structured support was available: Friends of my husband helped me. Two in particular… They kept encouraging me. My mother, my sister, my brother and my husband's niece helped me by looking after the children and by

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___________________________________________________________ loving and caring for me and in other ways I cannot find words to express. 30 Today, the memories are still raw: There was no help whatsoever, no help for me and my daughter. And… the last… person we seen coming down the road, it was my husband in a box and the door was shut. There’s… nobody ever comes to say… how are you coping? Can I help? Nothing whatsoever. 31 Most bereaved PAVE project participants (40 out of 59) had received some support from support groups (n=19), family (n=14), and friends (n=5). Being able to talk clearly mitigates poor psychological health, depression, and PTSD (Table 3). GHQ BDI mean PDS mean mean (SD) (SD) (SD) Able to talk with 41 8.24 (8.5) 16.75 (12.6) 21.49 (14.9) Not able to talk with 16 15.69 (10) 28.44 (13.2) 33.44 (10.1) Table 3: Questionnaires score means by being able to talk with family N

Today, voluntary support groups are considered a fundamental part of the recovery process: I would have been lost if I hadn’t have had here, when I had the second daughter… But it’s sort of funny coming up here like at this time, because you are thinking, ‘Survivors… Oh, my God! What does that mean? And I’m not one of them’ or whatever. And then, when you do come in, and you do start talking to people and like… we are all in the same boat, you know. Maybe some haven’t had it as bad as others, or maybe they have a completely different reason why they are here, but everybody… it’s the same stuff muddle on through together, you know what I mean. 32 However, some of the services offered by the groups seemed to be more helpful than others. Those who were availing of indirect services (such as courses or advocacy), counselling, storytelling, yoga, aromatherapy, massage and advice and information tended to score lower

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___________________________________________________________ in all three psychological measures than those availing of psychotherapy, reflexology, support groups and respite care, although most of the differences were not statistically significant. Participants explained which services found most helpful. Many highlighted the importance of trust, getting out of the house, and being amongst people who had similar experiences. I think that this was great to get away together, talk about it, and… chatting and doing things like that. So, it grew from there on, then, the… pantomimes and shopping trips, weekends away… And everyone in the group really, really, really enjoyed it. And still does. 33 There’s a girl in here, G, and she does like… reiki, and aromatherapy and all this stuff, and she does this other thing, sounds or something… but like I found maybe six weeks I did it for, the difference was unbelievable. And I never would have said like, I had a problem or I find it harder, until I done that with G… And when I came out of that, I says, ‘G, my face is sore’. And she says, ‘Why?’ and I says, ‘Because I never really must smile’. All I did was smile the whole day after I came out of it. 34 The financial situation of the bereaved is another factor that can affect or complicate their grieving process. In Northern Ireland, a large proportion of the deaths of the Troubles occurred in socially deprived areas 35 . This means that many bereaved individuals and families, apart from having to cope with their loss, had to live in a context of extreme financial hardship. We found that those participants who had worries about money (n=32) scored higher in all three psychological measures than those who did not have such worries (n=25). 6.

Cultural context The effect of cultural and political contexts on the bereavement process is difficult to assess. Because of dramatic political changes over recent years, Northern Ireland supplies an intriguing example. During the early phase of the Troubles, shootings and bombings were nearly daily occurrences. The effect on people’s coping is reflected in this quote from a widow:

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___________________________________________________________ Whenever I listen to the television and another terrorist attack happened I feel most under stress. I switch the television off. I just cannot stand any more murders. 36 In the late-1990s, remarkable political changes occurred and violent death decreased dramatically, while awareness of victims’ issues increased. The effect of these contextual changes meant that those still violently bereaved were more isolated, as a bereaved brother explains: But this is after the Good Friday Agreement, after the ceasefires were on, you know, when everybody said ‘The war’s over. We are finished with it’. And everybody sort of said, ‘We don’t have to look over our shoulder every five seconds’. And basically people were walking in the street thinking that this would never happen. 37 Intriguingly, however, when pre-ceasefire and post-ceasefire data are compared, psychological health did not improve. Violently bereaved widows in Dillenburger’s pre-ceasefire study scored well above the threshold for psychological health with a GHQ-12 mean score of 4.6 (SD 3.9), whereas post-ceasefire bereaved PAVE project participants scored about the same, 4.61 (SD 4.1). These scores are similar to those of people affected by Bloody Sunday 38 (GHQ-12 mean score of 4.9 (SD 4.27)), twenty-five years after the event. Many are concerned about the changes that the Peace Process has brought, including early prisoner releases, and feel that justice has still not been done. These feelings of injustice, frustration, and powerlessness have obviously an impact on bereavement outcomes, as illustrated below: I think… the innocent victims should be looked after better by the Government. So, there’s another hurt there that you are getting from the Government… and they were never caught the ones that murdered my husband… No one was ever brought to justice. 39 There is one thing that… would be a big burden off my shoulders. It is to see the ones that murdered my husband in a courthouse, and be punished for what they did… The Government keeps them people… They chose to go out and murder my husband, and they should be made pay for their crime. It’s not fair on me

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___________________________________________________________ that they can walk about ten foot high, laughing, and I have suffered over them. 40

7.

Summary Traumatic bereavement amalgamates the effects of trauma and grief. 41 Data reported here opens an extensive range of questions for trauma and bereavement researchers and practitioners. How do those who have lost a loved one in violent circumstances cope over the years? What needs to happen for them to move on? Why do some people cope better than others do? Why do some bereaved individuals still suffer twenty or thirty years after their loss? In this paper, we argue that a holistic approach is needed in order to address these questions. Coping with traumatic bereavement does not happen in isolation and we explored Death-related, Individual, Social, and Cultural (D.I.S.C.) contexts in order to illustrate this process.

Notes 1

Karola Dillenburger and Mickey Keenan, ‘Bereavement: A D.I.S.C Analysis’, Behavior and Social Issues, 14 (2005), 92-112. 2 Karola Dillenburger et al., ‘The PAVE Project’, Victims and Survivors Newsletter 2nd Edition, (Belfast: Victims Unit, OFMDFM, 2005). 3 Karola Dillenburger, Violent Bereavement: Widows in Northern Ireland (Aldershot: Avebury, 1992). 4 See: Janice L. Genevro, Report on Bereavement and Grief Research [report on line] (Washington DC: Center for the Advancement of Health, 2003, accessed 15 July 2005); available from the Center for the Advancement of Health: http://www.cfah.org/pdfs/griefreport.pdf/; and Colleen Murray et al, ‘Death, Dying, and Grief in Families’, in Families and Change. Coping with Stressful Events and Transitions, ed. Patrick C. McKenry and Sharon J. Price (Thousand Oaks, CA: Sage Publications, 2005, 3rd Ed.), 75-102. 5 see Karola Dillenburger, 1992; Peter S. Curran et al., ‘Psychological Consequences of the Enniskillen Bombing’, The British Journal of Psychiatry 156 (1990), 479-482; Patrick Hayes and Jim Campbell, ‘Dealing with Post-Traumatic Stress Disorder: The Psychological Sequel of Bloody Sunday and the Response of State Services’, Research on Social Work Practice 10, 6 (2000), 705-721; Dermot O’Reilly and Mike Stevenson, ‘Mental health in Northern Ireland: have “the Troubles” made it worse?’, Journal of Epidemiology and Community Health, 57 (2003),

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___________________________________________________________ 488-492; Ed Cairns and John Mallet, Who are the Victims? Self-assessed Victimhood and the Northern Irish Conflict; NIO Research and Statistical Series, Report No.7 (Belfast: NIO Statistics and Research Branch, June 2003); and PAVE Project, 2005/6. 6 Michael Potter, In Their Own Words: A Research Report into the Victims Sector in Northern Ireland (Belfast: Training for Women Network, April 2004), 4. 7 Widow in Dillenburger, p. 91. 8 A., widow, January 06. PAVE project. 9 M., widow, February 06. PAVE project. 10 Morris Fraser, Children in conflict (Norwich: Norfolk Pelican Book, 1973). 11 Alf McCreary, Survivors (Belfast: Century Books, 1976); and Ed Cairns and Ronnie Wilson, ‘The impact of political violence on mild psychiatric morbidity in Northern Ireland’, The British Journal of Psychiatry 145 (1984), 631-635. 12 Curran et al., 479; and Dillenburger, 1992. 13 John Darby and Arthur Williamson, eds, Violence and the Social Services in Northern Ireland (London: Heinemann, 1978). 14 see Marie Therese Fay et al , The Cost of the Troubles Study. Report on the Northern Ireland Survey: the experience and impact of the Troubles (Belfast: INCORE, 1999); Hayes & Campbell, 705; Karola Dillenburger and Mickey Keenan, ‘Islands of Pain in a Sea of Change: Behavior Analysis and Bereavement’, European Journal of Behaviour Analysis 2 (2001), 187-207; Cairns and Mallet, Who are the Victims?; O’Reilly and Stevenson, 488. 15 David Goldberg, Manual of the General Health Questionnaire (Windsor: NFER-Nelson, 1978). 16 Aaron T. Beck et al., ‘Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation’, Clinical Psychology Review 8, 1 (1988), 77-100. 17 Edna B. Foa et al., ‘The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale’, Psychological Assessment 9, 4 (1997), 445–451. 18 Dillenburger, 1992. 19 Therese A. Rando, The treatment of complicated mourning (Champaign, IL: Research Press, 1993). 20 Stacey Kaltman and George A. Bonnano, ‘Trauma and bereavement: Examining the impact of sudden and violent deaths’, Journal of Anxiety Disorders 17, 2 (2003), 131-147. 21 Widows in Dillenburger, pp.91-92.

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M., widow, February 06. PAVE Project. E. Kirschner, ‘Data on bereavement and rehabilitation of war widows’, Series in Clinical & Community Psychology: Stress & Anxiety, 8 (1982), 219-224. 24 Karola Dillenburger and Mickey Keenan, Some suggestions for a behaviour analysis of bereavement and loss. Behaviour Analysis in Ireland, 25 years Anniversary Conference, Maynooth, Ireland, 5 May (2002). 25 Dillenburger and Keenan, 92. 26 C., bereaved daughter, March 06. PAVE Project. 27 D., bereaved brother, March 06. PAVE Project. 28 Widow in Dillenburger, p. 71. 29 M., widow, February 06. PAVE Project. 30 Widows in Dillenburger, p. 89. 31 M., widow, February 06. PAVE Project.. 32 S., bereaved daughter, March 06. PAVE Project. 33 M., widow. February 06. PAVE Project. 34 S., bereaved daughter, March 06. PAVE Project.. 35 Paddy Hillyard et al., Bare Necessities: Poverty and Social Exclusion in Northern Ireland (Belfast, Democratic Dialogue, 2003). 36 Widow in Dillenburger, p. 71. 37 D., bereaved brother, March 06. PAVE Project. 38 Hayes and Campbell, 705. 39 A., bereaved widow, February 06. PAVE Project. 40 M., bereaved widow, January 06. PAVE Project. 41 Kaltman and Bonnano, 131. 23

Can the Dying Mourn? Kate Powis Abstract Seale, in identifying the late modern patient-centred ‘scripts’ adopted by the hospice movement, has declared that the dying themselves can now play the role of chief mourner. For the aware dying, it is proposed that some of their grief is anticipatory and the manner in which they mourn their prospective death will offer guidance and even hope to those who will have to negotiate their own bereavement after the death of their loved one. This paper will examine the psychoanalytic roots of mourning theories to be found in Freud’s ‘Mourning and Melancholia’ in order to determine how appropriate it might be to apply psychological models of bereavement to the dying. While there can be no doubt loss is a major feature in the experiences of the dying, meaning that elements of such models may have relevance, I will propose that a key feature of Freud’s foundational theory cannot be available to the aware dying, thereby rendering the notion that the dying can ‘successfully’ mourn untenable. I go on to suggest an alternative account of what may be intermingled with the experiences of loss for the dying: the fear of annihilation. Key words: mourning, aware dying, psychoanalysis, narcissistic satisfaction, annihilation, powerlessness, nothingness, meaninglessness. 1.

Introduction Constructivist theorists studying this topic have proposed that the ‘aware dying’ have recourse to social scripts that allow them to negotiate their way through the dying trajectory. One such script has been transplanted from psychological theories of bereavement and mourning. Such accounts have been developed into stage theories, identifying a path through the mourning process, and in turn allowing those accompanying the bereaved, and indeed the bereaved themselves, to assess how successful they are in working through this process. The efficacy of these theories in the area of bereavement, based as they are on profound psychoanalytic insights and an understanding of infant experiences of loss and separation, has meant that attempts have been made to transpose the model to the dying themselves; the most well-known, indeed some would say notorious, being that of Kübler Ross. The purpose of this paper however is not to launch yet another broadside against Kübler-Ross’s ‘Five Stages’, 1 or propose an alternative modelling for the dying process. Instead I will examine the psychoanalytic roots of mourning theories to be found in Freud’s ‘Mourning and

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___________________________________________________________ Melancholia’ 2 in order to determine how appropriate it might be to apply psychological models of bereavement to the dying in the first place. While there can be no doubt loss is a major feature in the experiences of the dying, meaning that elements of such models may have relevance, I will propose that a key feature of Freud’s foundational theory cannot be available to the ‘aware dying’, thereby rendering the notion that the dying can ‘successfully’ mourn untenable. I go on to suggest an alternative account of what may be intermingled with the experiences of loss for the dying drawn from the work of Freud again, and two contemporary psychoanalysts: Hurvich and Grotstein and their analysis of trauma and the fear of annihilation and the trinity of powerlessness, meaninglessness and nothingness. 2.

Seale and the dying ‘expert’ Clive Seale identifies late modern ‘scripts’ adopted by the hospice movement that draw on medical and therapeutic discourses of ‘patient-centred’ treatments. The development of these, he claims, has led to the construction of “dying and grief as orderly experiences, guided by a knowing expertise.” 3 The “knowing expert” in this case is the dying themselves, who are acknowledged within such scripts to be experiencing an anticipatory grief, that is to say they are grieving their own death in advance of the actual event. In such a role, Seale claims, they have become the chief mourner and can offer guidance and even hope for the grieving processes of those around them. 4 The conceptualising of a ‘journey’ of grieving in the dying, with the dying person acting as trail blazer for those who will be their bereaved, draws on psychological literature that describes the unfolding of an inner process. Drawing on psychological analyses of mourning, such as Freud’s ‘Mourning and Melancholia’, and Bowlby’s attachment theory, 5 psychosociological treatments of mourning present mourning as a process with a purpose. Versions of these accounts, often over-simplified, have become central to what Wortman and Silver have termed ‘clinical lore’ in bereavement counselling. 6 The purpose of mourning, according to Walter, is presented by such texts to be the reconfiguration of an autonomous individual, one who has managed to detach themselves from the deceased and is now able to form new relationships. 7 This end is sought by a process which involves a ‘working through’ of a gamut of emotions, often represented as ‘stages’ in order to come to terms with the loss and ‘move on’. As already acknowledged, the doyenne of such theorising as it might be applied to the dying themselves is Kübler-Ross. Although in her own writing she admits that the reality will be far more complex than a

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___________________________________________________________ matter of simply moving through each stage as though on a step-by-step programme, her model of five stages: denial and isolation, anger, bargaining, depression, acceptance, 8 in some cases has been adapted to clinical practice where the dying may be ‘diagnosed’ as being ‘stuck’ at a certain stage, say anger or bargaining, and need to be helped to move on and through the subsequent stages. When examining classic texts on bereavement such as Freud and Bowlby however, one can discern a richer depiction of the complexities of mourning, one that might admit to the need for the bereaved to form a deeper understanding of the deceased in order to re-negotiate a continuing and meaningful presence of the lost loved one in their lives. This is a more complex understanding of the processes of mourning than the idea of simply ‘letting go’ of the dead in order for the living to go forward in their own lives. Seale acknowledges this but realises that: Stage theories have inspired professionals working with dying and grieving people…because they offer a classificatory system with which to organise disturbing experiences… They offer professionals - and sufferers too - a sense of direction and purpose as well as a job to do in the face of threats to basic security. 9 I believe that such classificatory systems offer not just a means for action and purpose in negotiating the mourning processes in dying, but a distraction from the ultimate source of that ontological threat, both to the aware dying and indeed those accompanying them. However, before we examine what this threat might be, the reality of losses that the dying face should first be acknowledged. 3.

Dying and bereaved Sociological and psychoanalytic literature that broaches the subject of mourning tends to focus on the normal conception of bereavement: the permanent separation from oneself of a loved object. These bereaved, however, will survive the loss and mourning can be the process that helps them make that survival more than just a survival; helping them find a new way of living with that loss. The term ‘bereavement’ has however been used by one Jungian psychoanalyst, Joy Schaverien, in reference to the losses undergone by the dying: In the psychotherapy literature on bereavement the focus is usually with the bereaved relatives. Far less attention has been paid to the bereavement

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___________________________________________________________ experienced by those facing death. This is odd because a person who is dying is on the verge of losing everything. 10 ‘Aware’ dying involves confronting the reality of one’s own death: the loss of a future, the loss of witnessing the futures of loved ones, the loss of health, the loss of autonomy, the loss of friends, the loss of work, the loss of social status. Unlike the bereaved relative, the dying do not survive the loss because ultimately all these losses amount to the end of their life. If they were to mourn these losses where would their mourning be oriented? Can they re-negotiate a continuing and meaningful presence of these losses in their lives, in the same way that those who have lost an external presence may be able to use the processes of mourning to re-formulate that presence into an internal one? How appropriate is it to transpose concepts derived from those grieving the loss of someone other than the bereaved person to what might be experienced by the dying themselves? To return to Schaverien’s appropriation of the term bereavement for the experience of loss in the dying themselves, it strikes me that this highlights a certain dissonance in the comparison between the two forms of experience here. Although I welcome her acknowledgement of the paucity of psychotherapeutic literature around the losses experienced by the dying, using the term ‘bereavement’ and thereby importing the literature surrounding that topic does not, I feel, seem to answer the problem at hand for the dying’s experience of loss. In order to explore my misgivings about the theorising around this topic I will examine the seminal psychoanalytic text on mourning. 4.

The ‘engine’ of mourning Freud’s paper ‘Mourning and Melancholia’ has formed the most influential psychoanalytical account of mourning, which he seeks to differentiate from a condition that he sees has some associations with it, melancholia. For Freud, mourning can be understood as “the reaction to the loss of a loved person, or to the loss of some abstraction which has taken the place of one”. 11 The phenomenon of mourning shares with melancholia the distinguishing features of “painful dejection…cessation of interest…loss of capacity to love…inhibition of all activity” but melancholia has the unique addition of “a lowering of self-regard”. 12 Thus Freud can distinguish between the two by declaring that for those in mourning “the world has become poor” by the removal of a cherished object, whereas for the melancholic “the ego is impoverished” 13 because it is deemed uncherishable. Another central distinguishing feature of

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___________________________________________________________ mourning is that it is a conscious process – the loss is focused on consciously, whereas in melancholia the lost object is lost even to consciousness, but nevertheless this unconscious experiencing of loss presents somatic as well as psychological features. The purpose or, as Freud has it, the work of mourning is again to test reality: to come to an acknowledgement that the loved one no longer exists, thereby allowing the libido to withdraw its attachment to the lost object. This work is done in the face of intense opposition from the libido that seeks to turn away from the reality of the loss of the loved object, clinging to it through “a hallucinatory wishful psychosis”. 14 Each memory and association with the lost object has to become the focus of a hypercathexis, an extremely painful and time-consuming process. With each step of this reality testing the ego is “confronted…with the question [of] whether it shall share this fate [i.e. the fate of the lost object].” 15 It is only through this process that the ego can be persuaded via “the sum of narcissistic satisfactions it derives from being alive” 16 to sever the attachment to the lost object. It is as though each moment of “narcissistic satisfaction” provides a little bit more momentum through the process of mourning, hence the appellation I have given this feature of Freud’s theory: the engine of mourning. Freud’s recognition of the source of energy provided for a painful and time consuming process must raise the question of how can the dying successfully and viably go through such a process entailing ‘narcissistic satisfactions’ that cannot be open to the aware dying? 5.

An example of narcissistic satisfaction: The Death of Ivan Ilyich Leo Tolstoy presented evidence of this mechanism at work even before Freud himself identified it. In ‘The Death of Ivan Ilyich’ 17 the story opens with colleagues of Ivan Ilyich discussing the news of the death of their associate. On hearing this, each one present considers the advantages that might accrue to them in the form of promotions or transfers. In these discussions, Tolstoy notes, “the mere fact of the death of an intimate associate aroused… in all who heard of it a complacent feeling that ‘it is he who is dead, and not I’.” 18 When they observe custom and visit the grieving family, two of them exchange glances as though to say “Ivan Ilyich has made a mess of things – not like you and me.” 19 However for one, Piotr Ivanovich, the sight of the dead body shakes him: “There was reproach…and a reminder to the living. This reminder seemed out of place to Piotr Ivanovich, or at least to have nothing to do with him. It gave him an unpleasant

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___________________________________________________________ feeling…” 20 and this unpleasant feeling intensifies when he listens to the widow’s account of the final days of her husband: ‘Three days and nights of awful suffering and then death. Why it might happen to me, all of a sudden, at any moment,’ he thought and for an instant he was terrified. But immediately he could not have explained how, there came to his support the old reflection that this thing had befallen Ivan Ilyich, and not him, and that it ought not and could not happen to him… 21 Admittedly Tolstoy is interested in exploring the hypocrisy of complacent Russian bourgeoisies but nevertheless I believe that here he has exposed the workings of certain defence mechanisms that we are all prone to when facing a particular death. And what precisely is it that Ivanovich is terrified of when he hears of the terrible suffering at the end of his friend’s life? If it was simply the obvious fear of undergoing the same form of suffering then perhaps empathy and compassion would figure more here. But what if there is a stronger and more primal source of that fear that calls forth the defensive manoeuvres in Ilyich’s friends, and indeed family? 6.

Trauma, danger and annihilation And now we return to Freud, and this time to his analysis of anxiety. 22, 23 He believed that anxiety could be traced to two sources: the direct experience of a traumatic situation, and the anticipation of such an experience. 24, 25 A traumatic situation for Freud consists of overwhelming stimulation, either internal or external, that cannot be discharged or in any other way processed. The experience, therefore, is one of absolute helplessness. Freud postulates that birth is the prototype for the traumatic situation and therefore it is one of the primary functions of the human organism to avoid any over-stimulation, as it threatens to overwhelm. Anxiety therefore recreates the sense of mortal danger that originates in the associations of extreme and unpleasurable bodily sensations during birth. The second source of anxiety is the anticipation of being in a traumatic situation which Freud called a danger situation. He sees it as a “recognised, remembered, expected situation of helplessness.” 26 I believe that it is this that terrified Piotr Ivanovich: the anticipation of such overwhelming suffering in the face of death and the accompanying helplessness that his friend Ivan Ilyich had undergone.

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___________________________________________________________ For Freud, a danger situation may be triggered, for example, by fears of loss of a loved object, or the actual loss of love. However, in his discussion of Freud’s analysis of these phenomena, Hurvich believes that neither the prospect of the loss of a loved object, nor the loss of love itself can be constituted as the source of either state of anxiety. Rather it is the fear of being overwhelmed, annihilated, that is best understood as the basic danger. The trauma triggered by loss refers back to the prototypical situation of annihilation anxiety: the overwhelming over-stimulation of birth. In this model the primary and secondary, anticipatory form of anxiety constitute two poles of “a series of potential responses”. 27 At one pole there exists an unprocessed organismic panic, while at the other pole thought-like processes are possible, reducing the affective element of the experience. It then becomes obvious that at the primary end of this scale of anxiety there can be no recourse to a conscious analysis as the experience harks back to the preverbal condition. Unable to explain the ‘reason’ for the terror, to ourselves or to others can only increase the panic and the sense of being utterly overwhelmed. However I would tentatively suggest that this model of a spectrum of responses between primary and secondary sources of anxiety offers the hope of a shift from panic to the capacity to process the trauma induced anxiety. What is necessary though is for others around the sufferer to at first acknowledge and stay with, or to use Bion’s term ‘contain’, 28 the panic and the sense of powerlessness - of both the sufferer and those accompanying them. 7.

Power and powerlessness Thinking again about Clive Seale’s realisation that mourning scripts offer ways to classify disturbing experiences, I think that the nature of the ontological threat constituting these experiences has become clearer. We are driven to find something ‘to do’ to fend off the panic of this primal anxiety. But, as we have seen they are based on Freud’s concept of the process of mourning which posits ‘narcissistic satisfaction’ as the source of power in working through this process. Without access to this the dying are without the necessary power - indeed are ultimately powerless in the face of their losses. What role might powerlessness, as the dialectic of power, play here? James Grotstein identifies the cultural debt that Freud owed to the German Romantics’ celebration of the potency of Nature on the one hand and the power of science and logic on the other, the combination of which gave birth to psychoanalysis and its emphasis on the power of the instinctive. 29 However, in a later article, a seminal influence in certain areas of current psychoanalytic theory, Grotstein goes on to introduce powerlessness, twinned with meaninglessness, in just such a dialectic role.

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For him, powerlessness in this case must be understood not as mere “static emptiness but as an implosive, centripetal pull into the void” 31 , analogous to the black hole of astrophysics. Close kin to powerlessness is meaninglessness; that is content either without meaning or deprived of meaning. The Kleinian analyst Bion had identified the “beta prime elements” of the “container” of meaninglessness: “nameless dread”. 32 Grotstein offers a further distinction in his conceptualisation of meaninglessness, identifying primary and secondary forms. The primary form takes place before experience - and here he refers to the “Darkness of the Deep” in Genesis. It consists of a ‘primal’ void that anticipates content and realisation via experience. The secondary condition emanates from a turning away from experience and a return to emptiness, but this time it is not the immaculate void, but rather a “black hole” that evacuates meaning. 33 Alongside powerlessness and meaninglessness is a third phenomenon: nothingness. Indeed, for Grotstein psychic trauma “ultimately consists of meaninglessness… in an atmosphere of nothingness”. 34 Nothingness here can also be identified as primary and secondary conditions. The first is the Sartrean notion of an emptiness, a base condition that must be undergone in order to create meaning, while the second consists of the negation of being: the no-thing. There is a link here to the secondary form of meaninglessness, with secondary nothingness as the “black-hole” breaking down and sucking out meaning, leaving only the Bionian “beta elements” and the “nameless dread” 35 - a dread of being stripped of our thingness, of nothingness overwhelming our existence. At bottom, this is the fear of our annihilation. 8.

Conclusion My starting point in this paper has been a doubt around the efficacy of a wholesale transposition of mourning theories to the predicament of the aware dying, albeit that this inevitably involves a range of losses. With this doubt came a suspicion that what prompted us to rely on these theories was an unwillingness to examine the ultimate source of anxiety in dying, the fear of annihilation. This may be seen as defensiveness on both an individual and a social and cultural scale. Even psychoanalysts have recognised that their discipline may be prey to this; Hurvich acknowledges that it is a relatively undeveloped concept in the literature, with no comprehensive definition. 36 He cites Langs who suggests “classical psychoanalytic theory and technique has been designed to some extent as a defence against such primitive anxieties.” 37 I believe that Grotstein’s discussion of powerlessness as the dialectic of power offers one answer as to why this might be. In a culture that is driven to

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___________________________________________________________ holding and maintaining power on an individual, social and global scale, the ultimate relinquishing of it that all humans must face is a terrible threat indeed. And finally, to return to Ivan Ilyich: I wish that there had been time and space to do more justice to this work, but I will end with a brief glimpse of the predicament of Ivan himself. He faces terrible despair that racks up the pain and suffering he must endure as he realises that all he has valued in his life is meaningless. His powerfully connected friends, status hungry wife and self-regarding doctor can offer him no way out of his agony. The only person who can bring temporary ease is his serf who cheerfully stays with him and supports his legs to make him more comfortable. Finally, an hour before his death, Ilyich is shrieking desperately. His young son comes to him and kisses his hand and bursts into tears. It as at this point that Ilyich finds relief, can turn away from bitterness and looks with compassion on his family, and at last relinquishes fear. The two least powerful figures in the story are finally the ones to help.

Notes 1

Elisabeth Kübler-Ross, On Death and Dying (London and New York: Routledge, 1973). 2 Sigmund Freud, ‘Mourning and Melancholia’ (1917) from On Metapsychology: The Theory of Psychoanalysis, Volume 11 of The Penguin Freud Library, Standard Edition edited by James Strachey, present volume compiled and edited by Angela Richards (London, Penguin, 1984), 251-268. 3 Clive Seale, Constructing Death (Cambridge: Cambridge University Press, 1998), 118. 4 Seale, 118 -119. 5 John Bowlby, Attachment and Loss. Vol. III: Loss: Sadness and Depression (London: Penguin, 1980). 6 C.B. Wortman and R.C. Silver, ‘The myths of coping with loss’, Journal of Consulting and Clinical Psychology: 57, 3 (1989) 349-57. 7 Tony Walter, ‘A new model of grief: bereavement and biography’, Mortality 1, 1 (1996), 7-25. 8 Kübler-Ross, 34-121. 9 Seale, 107. 10 Joy Schaverien. The Dying Patient in Psychotherapy: Desire, Dreams and Individuation (Basingstoke: Palgrave, 2002), 125. 11 Freud, 1917, 252.

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Ibid. Ibid., 254. 14 Ibid., 253. 15 Ibid., 265. 16 Ibid. 17 Leo Tolstoy, The Death of Ivan Ilyich, tr. Rosemary Edmonds (London: Penguin [1886]1960). 18 Ibid., 102. 19 Ibid., 103. 20 Ibid., 104. 21 Ibid., 107. 22 Sigmund Freud (1926) ‘Inhibitions, symptoms and anxieties’ from The Standard Edition 20, edited by James Strachey (London: Hogarth, 1959), 77 -175. 23 Sigmund Freud (1933) ‘Anxiety and instinctual life’ from New introductory lectures on psychoanalysis (Lecture 32), Standard Edition 22 edited by James Strachey (London: Hogarth, 1933), 81-111. 24 Freud, 1926, 162. 25 Freud, 1933, 94 -95. 26 Freud, 1926, 166. 27 Hurvich, 312. 28 Wilfred Bion Learning form Experience (London: Karnac, 1984). 29 James Grotstein, ‘The psychology of powerlessness: Disorders of selfregulation and interactional regulation as a newer paradigm for psychopathology’, Psychoanalytic Inquiry, 6 (1986) 93 -118. 30 James Grotstein, ‘Nothingness, Meaninglessness, Chaos, and the ‘Black Hole’’, Contemporary Psychoanalysis, 26 (1990), 257- 290. 31 Grotstein, 1990, 257. 32 Bion, 1962b. 33 Grotstein, 1990, 267. 34 Ibid., 264. 35 Bion, 1962b. 36 Hurvich, 1989. 37 Langs, 1981, cited by Hurvich, 1989, 318. 13

Kate Powis is a Ph.D. student in the Department of Sociology, at the University of Essex, UK. This paper was presented with the financial support of the departmental Small Grants Fund. She is also a consultant lecturer on a part time basis at St Helena Hospice, Myland Hall Education Centre.

The Death of Innocents: Noncombatant Immunity vs. the Divine Foetus Lloyd Steffen Abstract This paper argues that one of the reasons the abortion issue is so intractable is that a metaphysical notion of ‘innocence’ has attached to the foetus, thus subverting our ordinary, morally framed understanding of how and why abortion can be justified. Attention is focused on the refusal of some anti-abortion advocates, including the moral teaching of the Roman Catholic Church, to accept that a pregnant woman can justifiably abort a foetus if that foetus poses a threat to her life or health. The just war notion of ‘non-combatant immunity’ is offered as a non-absolutist point of contrast with absolutized notions of innocence that would value the foetus over the pregnant woman. Key Words: abortion, just abortion, just war theory, religious innocence, non-combatant immunity, foetal death. 1.

Introduction Why has the abortion debate been so intractable? I suggest in this paper that the reason may involve people talking past one another over issues that have not been fully presented for reflection and critique. One such issue is that of foetal innocence My argument is that invocations of foetal innocence have elevated the foetus to a peculiar metaphysical status even beyond the moral category of person; and to expose this development I shall contrast this metaphysical claim with more accessible moral notions of innocence as they arise in non-sectarian moral thinking. The just war idea of ‘noncombatant’ immunity will serve to expose this moral notion of innocence. The contrast between metaphysical and moral ideas of innocence will illumine the meaning of foetal death as it arises in the debate over abortion. 2.

Moral innocence In our ordinary moral discourse, we make reference to ‘innocent’ persons. We acknowledge in the moral life the threat to innocent lives posed by a terrorist or armed bank robber who may be panicking; and what we mean innocence in such situations is that persons so threatened, all of whom possess a right to life, have been positioned by unwanted life circumstances, to be in harms way. These persons are agents and capable of action; their right to life is protected by their inclusion in the moral category of personhood; and it would be morally wrong to intentionally

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___________________________________________________________ kill one of these innocent persons. The duty to protect them may lead others, say, the police, to use deadly force to protect them. This idea of protecting innocent persons because they are persons and possessed of a right to life which it is a moral duty to protect has been enshrined in what we know as just war theory. Just war has always made appeal to the idea of restraint of force, and underwriting just war as a policy tool is a moral framework - a structure for moral thinking - that is, I believe, enormously practical and helpful for thinking through moral issues and dilemmas. Just war, as a moral perspective, presumes reasonably that force ordinarily ought not to be used to settle conflicts, then imposes various tests of justice that must be satisfied if that presumption against using force is to be lifted so that a use of force then could make a reasonable claim to being morally justified. The tests of justice - he jus ad bellum criteria so familiar to us - deal with such matters as competent authority, just cause, announcement of intention, last resort and so on; and in the classic jus in bello requirements for the actual use of force once a use of force has been justified and is underway, two other constraints, a proportionality requirement that the use of force must be proportionate to the end of peace (this deals with weapons that are disproportionate and ought not be used); and a ‘non-combatant immunity’ provision. What this provision says is that the actual use of force requires that persons not engaged in the conflict must be protected - they are not to be directly attacked. Non-combatant immunity makes reference to what we typically call ‘innocent persons.’ What do we mean by this? Combatant and non-combatants are all persons and all possess a right to life; but non-combatants are immune from the use of force and it is presumptively wrong to directly use force, especially lethal force, against them. They are innocent. They are bystanders in the bank that is being robbed, they are in the line of fire when warring parties unleash urban mop-up operations; they are in office buildings and subways when terrorists strike. Directly intending to harm and kill non-combatants, those not party to a conflict where lethal force is being used, is, according to just war ethics, morally wrong. Targeting civilians to achieve some end is wrong; using terrorist tactics, which by definition are directed at civilian non-combatants, at innocent persons, is wrong; and every effort must be made, just war wants to say, to prevent harming these ‘innocent persons.’ The only thing that would make the killing of an innocent person permissible is if every conceivable effort was made to prevent such killing and when such killing did take place it happened as a regrettable and foreseen - but always unintended consequence of a morally legitimized use of force. The doctrine of double-effect has been devised in the natural law tradition to take note of the messiness

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___________________________________________________________ of moral life and the possibility that even innocent persons may be put in harm’s way and killed as an unwanted and regretted consequence of a conflict where force is being used. I suggest that immunity from harm identifies a reasonable notion of innocence. The use of force always poses some threat of harm, even non-violent force. Martin Luther King used to worry enormously about starting non-violent boycotts, because they would harm innocent persons not directly involved in the conflict. King, like Gandhi, understood nonviolent force to be a use of force and followed a non-combatant immunity provision by seeking to avoid inflicting harm on innocent persons in conflict situations where even the force of non-violent resistance was to be used. In summary: In the moral life, we acknowledge that persons not party to a conflict should be immune from direct action that would cause them harm. No mantle of absolute protection can be thrown over the innocent bystander or innocent civilian, however, and in the application of justified uses of force the death of an ‘innocent’ may be ‘justifiable’ if every reasonable effort has been made to avoid inflicting such harm. In the moral life, then, the idea of innocence is attached a duty that falls on the parties in conflict to respect the lives and well-being of non-combatant, innocent persons. The innocence is not absolute and can even be rendered justifiable, even if always regrettably so. 3.

Abortion and the innocent foetus Having examined the idea of non-combatant immunity as a presumptive protection of person that is not an absolute protection, I want now to turn to the abortion issue and consider the matter of foetal innocence. If we were to use the model of ‘non-combatant immunity’ from the just war ethic, we could say that a foetus is deserving of protection as a developing form of human life. But even if one should go so far as to regard the foetus as a person, that status does not provide an absolute immunity or prevent the killing of the foetus under any and all circumstances, if, in fact, a conflict of values leads to the conclusions that this immunity can be overridden and justifiably so. In the abortion debate, people who defend abortion rights would argue that because the foetus is not a person-the argument could be that the foetus does not possess the attributes of recognized members of the moral community, self-awareness, ability to use language or whatever criteria for personhood one would present - the foetus does not enjoy the protections afforded persons and can be aborted, killed, without that killing amounting to a moral offence. (This is Mary Ann Warren’s classic

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___________________________________________________________ argument 1 ). Pro-life persons, who are not absolutists but who acknowledge foetal person-hood, would reasonably acknowledge certain cases where abortion could be justified, those situation typically being incest, rape, and ‘to save a woman’s life.’ Since rape and incest have been losing support from pro-life supporters, my focus will be turned to ‘save the pregnant woman’s life.’ This ‘exception’ arises even for reasonable pro-life supporters as they acknowledge that pregnancy is a medical condition that can itself pose dangers to a woman. The foetal ‘person’ can present itself to a pregnant woman as a material aggressor that cannot form intentions and is not an agent. In the moral life, a woman facing such a threat has a right; others would actually claim a duty, to protect herself from this threat even if it cost the life of the ‘innocent’ foetus. Whatever ‘innocent’ means for those who ascribe innocence to the foetus-as-person, reasonable persons would allow innocence is not absolute, that foetal innocence can be overridden by other values, such as the life of the pregnant woman; and that a foetus could be aborted and justifiably so for just cause, say, for reasons of self-defence. It is beyond this point that things get interesting. What about those who hold that abortion is never permissible - absolutely impermissible - and invoke foetal innocence as the reason for this claim? My case is that in the moral life, this move cannot really be made rationally and coherently, for conflicts in value, even conflicts involving the value of life, are possible, and life cannot reasonably be thought of as an absolute value that will always and in every situation trump other values when life as a biological reality becomes party to a conflict, else we would be morally obligated, for example, never to terminate life support so long as we can keep life going regardless of the patient’s condition. Reason and morality would assert that foetal life ought to be valued but not in an absolute sense that it would trump a woman’s life when her pregnancy was threatening her life; and this would hold I think even for those committed to the view that the foetus is a person and itself possesses a right to life. I make this case even by appealing to a tradition of thought in the Roman Catholic moral tradition, which has ironically preserved and developed through the centuries just war theory and non-combatant immunity provision that is a non-absolutist idea of innocence. Roman Catholic moral teaching, however, has absolutized the value of the foetus, even though that same tradition has over the centuries tried to avoid absolutism and create, if I may as an outsider describe this feature of the Roman Catholic tradition, loopholes in the interests of justice and in recognition of the impossibility of acting purely or being god-like in our

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___________________________________________________________ moral knowledge or moral action. Just war theory itself is a model of such hesitation in the face of absolute certainty. The Roman Catholic tradition has addressed the idea of foetal innocence in different ways, and just as there has been change underway in movement toward absolutizing the foetus in, say, the Republican Platform of 2004 where ‘rape, incest and to save a mother’s life’ were for the first time dropped out of the anti-abortion plank, the Roman Catholic position has similarly changed. Consider how American jurist and moral philosopher, John Noonan, rehearses the history of the Catholic moral tradition in its non-absolutism: In Catholic moral theology, as it developed, life even of the innocent was not taken as absolute. Judgments on acts affecting life issued from a process or weighing.... Even with the foetus weighed as human [as ‘person’ in the moral sense I have been using, LHS], one interest could be weighed as equal or superior: that of the mother in her own life. The casuists between 1450 and 1895 were willing to weigh this interest as superior. Since 1895, that interest was given decisive weight only in the two special cases of the cancerous uterus and the ectopic pregnancy. In both of these cases the foetus itself had little chance of survival even if the abortion were not performed. 2 This understanding of the moral tradition asserted a strict protection for the foetus but not an absolute protection. Contrast this with a statement from Pope John Paul II: The moral gravity of procured abortion is apparent in all its truth if we recognize that we are dealing with murder and, in particular, when we consider the specific elements involved. The one eliminated is a human being at the very beginning of life. No one more absolutely innocent could be imagined. In no way could this human being ever be considered an aggressor, much less an unjust aggressor! Then quoting from ‘Instruction on the Respect for Human Life’, John Paul continues:

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___________________________________________________________ The human being is to be respected and treated as a person from the moment of conception; and therefore from that same moment his rights as a person must be recognized, among which in the first place is the inviolable right of every innocent human being to life.... 3 The papal statement regards abortion as murder and the justifying notion for that characterization of the abortion killing is that the human being is innocent - absolutely innocent, the Pope emphasizes. Recognizing the foetus as an absolutely innocent is designed to remove the foetus from a moral framework where even an innocent foetus regarded as a person could conceivably be killed in the face of a conflict where some other value might trump that of the foetus right to life as a person. Noonan identifies one such situation - only one - in which the pregnant mother’s right to life supersedes that of the foetus. The Roman Catholic moral teaching denies that a mother has any right to directly intend the killing of the foetus; and even to save her own life such a direct killing cannot be sanctioned. Noonan calls in his article for the Church to reassert the mother’s right to save her life if threatened by medical complications in pregnancy, and does so against the papal statement. In John Paul’s statement, abortion is always murder, and the life of the foetus always trumps the mother. And that is the normative Roman Catholic moral teaching. 4.

Absolute innocence: the metaphysical trump I have been contemplating these questions for some time, and the insight I am going to offer came to me when I was a visitor in Japan. When I visited the ancient capital of Nara, Japan a couple of years ago, my guide informed me that deer are sacred in Nara. He then proceeded to tell me that in recent memory, a driver had accidentally hit a deer and killed it. The accident was particularly nasty, for the driver was himself killed. Despite the tragic loss of a human life, the state intervened to sue the survivors of the now deceased driver. With the law reflecting a Shinto valuing of sacred being, in this case the kami of sacred deer, the family of the dead driver confronted both religion and law: killing a sacred deer is a terrible offence, a religious violation that it carries with it a stiff, legally imposed fine. Taken to court in metaphysical absentia, the driver was tried for killing a sacred deer, found guilty, and his survivors were required to pay the fine. This situation was created by the way the deer was valued, and be clear: the deer was recognized as spirit-filled, and protected because it was divine. Any injury to it was a religious offence apart from

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___________________________________________________________ being a legal offence. The dead deer was enshrined with a religiously conceived, numinous sense of innocence so profound that even if it had caused the death of a person, any injury to the deer - however that injury might have actually occurred - always imputed guilt to the one who caused the injury. Moral meaning folds in the face of religious valuation, though it is somewhat rare to find in the modern world the law of a nation bend to religious propriety and the metaphysics of the deer’s status this way. Japanese law required that the violation of the sacred must be addressed and requited even when the deer was responsible for creating harm to a human being, even when that harm was so serious as to be the loss of a human life. Clearly the religious point of view trumped the moral point of view: the deer was worth more than the human being, and its loss imposed a debt beyond rational moral proprieties Here’s the connection. What the pope has done in absolutizing the foetus is not at all unlike what the Shinto inspired legal proceeding did to the family of the deer-killer: it has identified an offence wherein the object of the offence is sacralized, regarded as sacred or holy - even divinized. I use the Shinto example because it is easier for those not Shinto to see this kind of elevated sacralizing divinizing valuation in another culture than in one’s own. Were we able to step outside our Western framework and see what is happening with the ascribing of absolute innocence to the foetus, we would, I suggest, draw a similar conclusion about the papal view of what cannot be anything but a divine foetus. Lest this conclusion seem outrageous or implausible, let me ask a question about absolute innocence as part of the Christian, and especially the Roman Catholic, faith tradition: where do we find absolute innocence? Who is to be regarded as absolutely innocent? The answer: for Christians it is God the Father, Jesus Christ, and the Holy Spirit, and for many Christians, Mary, Mother of God. These are all absolutely innocent, and in the religious context, metaphysical innocence when absolutized identifies sinlessness. To assure Jesus of such metaphysical innocence, a Roman Catholic doctrine pronounced ex cathedra regarding Mary’s own Immaculate Conception guaranteed that Jesus would not contract the condition of original sin not only in utero but also post utero. Whatever the specifics of theological understanding, it is clear that the foetus not only cannot act but cannot sin, so that its status is metaphysically pure. The foetus trumps the pregnant woman when the medical condition of pregnancy is posing a threat to the mother’s life either because the mother is not a person and the foetus is; or because the pregnant woman is a person, and the foetus is something higher - god-like, God. That is what absolute innocence means - that the foetus is God. No

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___________________________________________________________ wonder the foetus cannot be a material aggressor: it is innocent – it is divine. It is akin to the deer in Nara - a religious, sectarian valuation has removed it from the rational constraints of the moral life and reframed the meaning of its status outside the rational framework of moderate moral thinking and evaluation. The abortion debate becomes divisively intractable at the point where moral argumentation is engaged with a sectarian religious position, where moral issues are simply superseded. The divine foetus trumps even the life of the pregnant woman, a position that poses enormous difficulties for practical reason and the moral point of view. The moral point of view does of course allow that the foetus should be valued, but not so much as the mother who is a fully endowed member of the moral community; and even if regarded as a person that foetus cannot be protected absolutely against every and all possible challenges, not from the moral point of view. Religion deals with ultimate power and absolutes, and ‘pro-life’ religion that deems the foetus inviolate confers absolute value on the foetus, rendering it sacred, holy, and numinous - outside the categories of moral thought and discrimination. This is a suppressed dimension of the abortion debate, but identifies the source of the passion some people have that seeks to protect the foetus even at the expense of the pregnant woman’s life. Granting the foetus power to trump a fully endowed member of the moral community in every situation for the sectarian reason that its metaphysical status is superior to the woman’s moral status as person renders the foetus divine - at least that is how the moral point of view would interpret this shift from moral to some kind of extra or supramoral valuation. Killing the foetus is abhorrent because it is akin to killing God. If absolutely innocent, a foetal death killing can never be justified. At this point, the debate about abortion is not a moral debate, but a religious proclamation about the foetus against which the moral point of view can exercise little if any influence. 5.

Conclusion Invoking a sectarian notion of foetal innocence is socially dangerous especially in a pluralistic society where different religious views are held about such matters as abortion rights and no one religious view should receive official sanction as privileged and commanding and authoritative over all. Furthermore, to hold that the foetus is absolutely innocent is to create a divine foetus that is also, for purposes of religious valuation, also interpretable as an idol, and idol making for some religious people violates clear prohibitions on such activity. The injection of a sectarian metaphysics has the effect of devaluing the pregnant woman as agent and decision–maker because the god within her subverts her

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___________________________________________________________ autonomy as person, as agent, as decider. She is the Nara family member who must pay a terrible fine for killing a divine deer. The meaning of that killing reaches beyond moral meaning and is superseded by religion. The abortion debate is intractable because the terms of the debate are not commensurate - it is a debate over moral apples and theological oranges. . The debate over abortion ought to be a moral debate conducted by reasonable people respectful of women as persons, as fully endowed members of the moral community. The problem is that a sectarian viewpoint, represented by the idea of ‘absolute innocence’ has skewed the terms of the debate and made rational conversation difficult and in some contexts impossible. Those who want to affirm an absolutely innocent foetus should be free to do so. The moral community situated in a pluralistic society condones this absolutizing tendency to its peril. The moral point of view centres on the imperfections of existence and the conflicts that arise over goods and values. It advances the view that even life itself ought not be considered ‘an absolute good’ that trumps every other value. Such a viewpoint reflects a commitment to a religious purity the moral life cannot sustain and ought not to accept as normative; for the religious viewpoint is powerful and dangerous enough to create moral chaos.

Notes 1

Mary Anne Warren, ‘On the Moral and Legal Status of Abortion’, The Monist, 57, 1 (1973). 2 John T. Noonan, Jr., ‘An Almost Absolute Value in History’, reprinted in Christina Sommers & Fred Sommers, eds., Vice and Virtue in Everyday Life, 7th edition, (Belmont, CA: Wadsworth, 2006), 391. 3 John Paul II, ‘The Unspeakable Crime of Abortion’, from Evangelium Vitae, March 25, 1995; reprinted in Thomas Mappes and David DeGrazia, Biomedical Ethics, 6th Edition (New York: McGraw-Hill, 2006), 458. Lloyd Steffen is Professor and Chair of Religion Studies, and University Chaplain, at Lehigh University in Bethlehem, PA. Among his books is Abortion: A Reader and Life/Choice: The Theory of Just Abortion.

Do We Have Moral Obligations to the Dead? Liz McKinnell Abstract Much has been written about moral obligations to future people. 1 In this piece I look at the related area of our obligations to past people (the dead). Past people have some morally relevant similarities to future people. Neither group of people exists at the present time. There are also some interesting differences: We can do things that affect the identities of future people, not with dead people; and we can do things which affect the experiences of future people; but again this is not the case with the dead. I address the question of whether there can be a wrong done against someone when we cannot affect his experiences. I conclude that this does not present us with a major obstacle to having obligations to the dead, and identify the biggest problem as lying in the fact (if it is a fact) that the dead do not presently exist, and therefore do not meet the ‘existence condition’ for harm. 2 After exploring a number of responses to this, I conclude that we can wrong the dead, but by a process of ‘backward signification’ (distinct from backward causation) we wrong them while they are alive. Key words: death, ethics, existence, identity. 1.

Introduction The intuition that we have obligations to the dead is at once a very strong one and a very old one. There have always been moral beliefs about what we owe to our ancestors, just as there always have been about what we owe to our descendents. Our culture’s respect for these traditions is no exception. For example, institutions such as wills are held as very important, and on a more personal level, we often feel we owe something to those who are no longer around. However, as we shall see, the notion of having an obligation to someone who has died can be metaphysically puzzling. 2.

Are past people like future people? For me, the question of what we owe to people who no longer exist arose out of research that I have done on future people. Discussions of intergenerational justice inevitably encompass past people as well as future people. It might be appealing to think that there is symmetry between our moral relationship with the dead and our moral relationship with the not-yet-living. In both cases there is no presently existing person who we can affect or have obligations to. This is the main root of the

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___________________________________________________________ problems concerning the moral status of future people and indeed of the dead. However, when we compare past people with future people the asymmetries are more interesting than the symmetries. One of these asymmetries is that we can affect the conscious experiences of future people, but we cannot affect the experiences of the dead. When I talk about my obligations to my great great grandchildren, I am probably talking about things that I can do that will affect their lives, such as preserving the environment or refusing to sell the family silver. When I talk about my obligations to my great great grandparents I cannot mean the same kind of thing, since their experience of life has already been played out and determined before I even appear on the scene. This is a difficulty with obligations to the dead that does not arise with future people, whereas the other major asymmetry between past and future people poses a problem for obligations to future people, but not to the dead. This relates to Derek Parfit’s ‘Non-identity problem’. 3 The crux of the non-identity problem is that by making decisions about the future, we affect which individuals will come to exist. This, Parfit suggests, means that making a choice in order to benefit future people is essentially self-defeating, because we cannot identify anyone who has been benefited or harmed. This problem does not apply to the dead. Winston Churchill, although dead, was a specific person. We can refer to him and be referring to a particular individual, and (unless we believe in bizarre science fiction scenarios) we cannot do something that prevents him from having existed. So the idea that past people have moral status has one advantage and one disadvantage over the view that future people are morally significant. The ‘advantage’ that the dead have over the not-yet-living stems from the fact that their identities have been determined and cannot be affected by what we do now. Their ‘disadvantage’ is that their conscious experiences, likewise, have been determined and cannot be affected by what we do now. 3.

Conscious experiences and harms You may now (quite rightly) accuse me of neglecting the idea of an afterlife. If conscious experience continues beyond life on earth, then it is at least theoretically possible to affect the conscious experiences of ‘the dead’, but by at least some views that accept the idea of an afterlife the difficulty might remain. It could be theologically difficult to claim that the torment of hell can be assuaged or the joys of heaven diminished by what a mortal does on earth, since it would give us the ability to moderate divine justice. It might also be claimed that any afterlife is simply ‘beyond this world’ and that events that happen here and now are simply

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___________________________________________________________ insignificant to it. So the argument that we cannot have obligations to the dead because we cannot affect their experiences is by no means confined to the realms of the atheist. If the main problem with obligations to the dead is that we cannot affect their conscious experiences, this means that there must be a problem with labelling anything wrong if it does not affect the conscious experiences of the person who is said to be wronged. This view would not just pose a problem for wronging the dead, this is the notion of wrong which in many people’s understanding underpins the badness of sexual infidelity, lying and cheating. Of course, we have all heard the adage ‘the crime is getting found out’ and we might argue that it is the possibility of discovery that makes unexperienced wrongs wrong nonetheless. Perhaps it is wrong for us to commit an act of deception because there is always at least a remote chance that the deceived individual will discover the deception and be distressed. Of course, if this is what is wrong with deception, then we can argue that the dead cannot be harmed in the same way. Not only do dead people not know what we do or say about them, it is in fact impossible for them to know about it. This would mean that, while we can accept that there are some wrong actions that do not affect the conscious experience of the one who is wronged, there can be no wrong without some risk of discovery. However, there are a couple of reasons why I think this isn’t the case. Firstly, if it is a risk of being caught that makes a deception bad, then presumably the smaller the risk, the less serious the wrong. It would be strange to have a moral theory that relied on risk in this way without taking account of the fact that some risks are greater than others. This would make the coldly skilful adulterer’s actions less bad than those of the honest husband who cannot hide his terrible lapse from his wife. If the possibility of getting found out is what makes the action bad, then we seemingly lessen our crimes by becoming adept at disguising them. A second point arises when we examine why the wronged person’s feelings are hurt if they discover the wrong. When someone discovers that they have been deceived, ridiculed or lied to, they are not upset because they have discovered that this has happened, they are upset because it has happened. The adulterer’s wife does not cry because she has found out about her husband’s adultery, she cries because he committed adultery. Given these points, we should not reject the notion of obligations to the dead on the grounds that we cannot affect their conscious experiences. Whether their experiences have already been played out from

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___________________________________________________________ start to finish, or whether they dwell in an afterlife beyond the reach of our actions, we cannot use this as a reason to deny our obligations to them. 4.

Is there a problem of non-existence? Any problem that uniquely affects obligations to the dead must relate to the fact that their lives are confined to the past. A simple, but perhaps very serious point that can be made is that if dead people no longer exist, then there is nobody to whom we have an obligation. At the heart of this problem is something that Fred Feldman terms the “Existence Condition.” 4 This condition states that something can only be good or bad for a subject s at time t if s exists at t. This condition would only pose a problem for those who do not believe in an afterlife. If a person’s consciousness continues after death, he continues to exist, and there remains an individual who can be the subject of good and bad events, and to whom we can owe an obligation. This is the case even if a person in the afterlife cannot be consciously affected by what goes on in the world. What is important is that they meet Feldman’s existence condition. If a subject s has eternal life, then for any time t after his birth s exists at t. Those who do not believe in an afterlife must have a response to this argument if they wish to defend the intuition that we have obligations to the dead. How can we have obligations toward them when they do not exist? This relates to a wider metaphysical worry which David-Hillel Ruben terms a “puzzle about posthumous predication”: In order for something to happen to an object it must acquire or lose a property; and to do that it must exist… A suitable slogan might be: No properties can be had or acquired by things at times at which the thing in question is not there to have or acquire a property. That is, (4) If, at t, x has the property P, then x exists at t.

5

It is clear how this problem relates to the ‘existence condition’ which states that something can only be good or bad for a subject s at time t if s exists at t. Ruben’s ‘puzzle’, similarly, states that something can only be a property of a subject s at time t if s exists at t. In fact, if ‘being wronged’ is a property, then the existence condition is arguably very similar to the puzzle of posthumous predication. I will assume here that ‘being wronged’ is a property, although there probably are good grounds to question this.

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___________________________________________________________ There are several ways that we can attempt to avoid this problem. We can try to show that the dead do, in some sense exist to be wronged at the time that they are wronged, and that therefore there is no puzzle in the first place. Alternatively we can challenge the assertion “(4) If, at t, x has the property P, then x exists at t”. A final answer might be to argue that the property in question (being wronged) is one that is instantiated by the person before they died, and that time t when the property P was instantiated was in fact a time when s existed. 5.

Do dead people exist? It is important to note that the believers in an afterlife who want to believe in obligations to the dead have already got their way. The problem of affecting conscious experiences, in as much as it faces those who believe in an afterlife, has been dealt with. The problem that we now face (that dead people do not exist to be wronged) is not one that concerns the believer, since he believes that the dead do exist. But what if the nonbeliever can employ a similar line of defence? Can a person who does not believe in the conventional concept of life after death still argue that the dead do exist in the present? There are various linguistic devices, which seem to imply that a person does not cease to exist at the moment of death. We talk about a person being ‘immortalised’ through his work. It can be responded that these turns of phrase are just that. It seems reasonable to say that a human life ends at the point of death, and that the language of ‘immortality through our work’ is employed metaphorically. The sense that ‘immortality’ in this context is not real immortality is nicely summed up by Woody Allen, who said, “I don’t want to achieve immortality through my work… I want to achieve it through not dying”. 6 But does this mean that we need to dismiss the idea of ‘living on’ through one’s work, projects or relationships as insignificant to our topic? Not necessarily. It is true to a greater or lesser extent that a person is defined in terms of their most closely held projects, relationships, goals and beliefs. These things are not simply external factors, they are intimately entangled with who and what we are. Since we are so entangled in these projects, and they are so involved in our personal identity, then it might be arguable that, even after our biological life has come to an end, some of the constituents of our identity carry on in the form of our projects and relationships. If this is true, then perhaps there is no puzzle of posthumous predication when we talk about the property of ‘being wronged’ in one who has died. I am going to leave this idea as a mere suggestion, since it would require an entire theory of personal identity. So for now we should simply

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___________________________________________________________ note that, as with the idea of a conventional afterlife, if we can hold a theory of personal identity that allows people (in an unconventional, nonconscious sense) to exist after their deaths, then we can escape the puzzle. 6.

Must someone exist to be wronged? Let us recap. Faced with the thought that dead people no longer exist, we encounter a difficulty in accounting for how they can be wronged. Dead people being wronged (if being wronged is a property) is a specific example of Ruben’s ‘puzzle of posthumous predication’: (4) If, at t, x has the property P, then x exists at t. But do we have to accept this ‘puzzle’? It is true that, in the case of most properties that we ascribe, it is nonsense to speak of something having that property if that something does not exist. This is what is wrong with sentences like ‘The current King of France is bald’. There is no current King of France, so we cannot say that it is true that he is bald. So in terms of ‘normal’ properties like being bald it is true that a nonexistent person cannot instantiate them. However, it can be argued that being wronged is not like ‘being bald’. Ruben suggests that, while we cannot ascribe properties in the everyday sense to things that no longer exist, we can say that they are the subject of ‘Cambridge changes’. Cambridge changes are relational changes that, while they may be a real change in the one of the relata, are not a real change in another one of the relata. To put this a little more clearly, when my first nephew was born in 1998, I underwent a Cambridge change. No real change occurred in me, and yet I became an aunt. Ruben argues that this kind of change can occur in the dead. I am inclined to agree. Joe’s grandmother Ethel died before he was born, even though, while she was alive, Ethel was not his grandmother. If this perfectly sensible assertion is true, then there must have been a point (Joe’s birth) when Ethel underwent the change of becoming Joe’s grandmother, even though at that point Ethel no longer existed. Ruben also points out that: To predicate a Cambridge change of an object may be to predicate of it a phoney change, but notice that it is to predicate of the object a perfectly good property. To say of some person that he has acquired a new cousin upon the birth of a child to his aunt or uncle, is to ascribe a perfectly genuine property to that person, but it is not to ascribe to him a perfectly genuine change. 7

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___________________________________________________________ This would also seem to apply to Ethel, who becomes a grandmother posthumously. However, the problem here would be to see why a ‘phoney change’ like this can have any real moral significance for the person who ‘is wronged’. If they no longer exist to be the subject of a real change, it seems that they no longer exist when they come to instantiate the property ‘is wronged’. After all, we might accept that a fictional character can have certain properties, but their non-existence would make it difficult to claim that we can have obligations toward them. Cambridge changes seem to lack the moral force that obligations to the dead would require. 7.

When is a dead person wronged? Until now we have assumed that the time at which the dead person instantiates the property ‘is wronged’ is after his death. It is certainly true that if I defame Winston Churchill in July 2006, I am wronging Churchill after Churchill has died and (we shall assume) no longer exists. However, it may be the case that my act of wronging Winston Churchill is not identical with his instantiation of the property ‘is wronged’. If this can be possible, then perhaps the time t at which x instantiates the property of ‘is wronged’ is in fact during x’s lifetime, and so it is undeniable that x exists at this point. I do not think that there is any particular problem with someone’s wronging of x and x instantiating the property of ‘is wronged’ occurring at different times. We might compare this with me shooting at someone and that someone being shot. I shoot at them the moment I pull the trigger, but they do not instantiate the property ‘being shot’ until the bullet hits them. This analogy makes it clear how, by separating the wronging from the property ‘is wronged’, we can make sense of the two events happening at different times. This certainly makes sense of how we can wrong future generations. Remember that (as with the dead) they do not exist at the present time, so they would also be subject to something rather like the puzzle of posthumous predication (a puzzle of prenatal predication?). If I wrong someone at a particular time, and then at some other time they are wronged, this might make sense of how I can wrong future generations before they come into existence, and when my life does not overlap with theirs. I can exist to wrong them, and they can exist to be wronged at a different time. This is entirely consistent with Ruben’s formulation of the ‘puzzle’: (4) If, at t, x has the property P, then x exists at t.

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___________________________________________________________ However, this solution is rather more counterintuitive when it comes to the notion of wronging the dead. This is because, if the dead person is wronged during his lifetime, I actually wrong him after he is wronged. This starts to look rather worryingly like backward causation, a concept that all but the bravest philosophers are keen to avoid. However, the relationship between wronging someone and their being wronged is not necessarily causal. It has been suggested that what goes on when the dead are wronged is not backward causation, but rather backward signification. Geoffrey Scarre writes “While a person cannot be pleased or pained by what he never knows, occurrences after his death can cast a backward light or shadow over his life”. 8 It is this notion of ‘casting a shadow’, not an instance of efficient causation that is meant by backward signification. Pitcher has a beautiful example: If the world should be blasted to smithereens during the next presidency after Ronald Reagan’s, this would make it true (be responsible for the fact) that even now, during Reagan’s term, he is the penultimate president of the United States. 9 If signification, not causation is what connects the act of wronging with the instantiation of the property ‘is wronged’ then it becomes possible for it to be made true, after a person’s death, that they instantiate that property during their lifetime. This means that they do exist at the time that they are wronged, giving the act of signification (wronging them) genuine moral importance. This notion needs more work, but if it can be supported, backward signification may well open the door to obligations to the dead.

Notes 1

The prime example being Derek Parfit, Reasons and Persons (Oxford: Clarendon, 1984). 2 Fred Feldman. ‘Some Puzzles about the Evil of Death’, The Philosophical Review (1991), 205-227. 3 Parfit 351-381. 4 Feldman, 205. 5 Ruben, David-Hillel. ‘A Puzzle about Posthumous Predication’, The Philosophical Review (1988), 213. 6 Oxford Dictionary of Quotations 4th ed., (1996). 7 Ruben, 224.

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Geoffrey Scarre. ‘On Caring about One’s Posthumous Reputation’, American Philosophical Quarterly (2001). 9 George Pitcher. ‘The Misfortunes of the Dead’, American Philosophical Quarterly (1984), 188. Liz McKinnell is studying for a philosophy Ph.D. at Durham University.

Don’t Fear the Reaper: An Epicurean Answer to Puzzles about Death and Injustice Simon Cushing Abstract I begin by sketching the Epicurean position on death - that it cannot be bad for the one who dies because she no longer exists - which has struck many people as specious. However, alternative views must specify who is wronged by death (the dead person?), what is the harm (suffering?), and when does the harm take place (before death, when you’re not dead yet, or after death, when you’re not around any more?). In the second section I outline the most sophisticated anti-Epicurean view, the deprivation account, according to which someone who dies is harmed to the extent that the death has deprived her of goods she would otherwise have had. In the third section I argue that deprivation accounts that use the philosophical tool of possible worlds have the counterintuitive implication that we are harmed in the actual world because counterfactual versions of us lead fantastic lives in other possible worlds. In the final section I outline a neo-Epicurean position that explains how one can be wronged by being killed without being harmed by death and how it is possible to defend intuitions about injustice without problematic appeal to possible worlds. Key words: death, deprivation, possible worlds, Epicurus, Nagel, Silverstein, Feldman, McMahan. 1.

Introduction First, let me clarify that when I talk about death in this paper, I mean the state of being dead. None of what I say should be taken to apply to dying (which Epicureans can certainly concede to be harmful) or death as a moment, whereby one can debate whose death is better, Joan of Arc’s or Elvis’s (Joan of Arc’s was painful but heroic, while Elvis’s was quick, but, all things being equal, one wants to avoid any chance of the phrase “straining at stool” appearing on one’s death certificate). Next, a disclaimer: I am not an Epicurus scholar. When I talk about the Epicurean position, I will not attempt to argue that this is precisely what Epicurus said or even what he meant. With that in mind, as I take it, the Epicurean position on death is essentially as follows: 1. 2. 3.

The only way one can be harmed is if one experiences suffering. It is impossible to experience suffering when one does not exist. When one becomes dead, one ceases to exist.

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Therefore, one is not harmed by being dead.

To put it succinctly: death won’t be bad for me because I won’t be around. As Epicurus’s follower Lucretius pointed out, we don’t lament the time of our non-existence before our births, so we should no more fear the time of our non-existence after our deaths. That is not, of course, to say that Epicureans deny that my death will be bad for other people. It is my fervent hope that upon my death the wailing and gnashing of teeth of my surviving great great great grandchildren will be heard across the land. (Of course, this hope in itself is probably as irrational as a fear of death, but even philosophers should be allowed occasional lapses.) I find this Epicurean reasoning about death very compelling, but I must concede that it has counterintuitive implications, not least of which is that it appears to suggest that attempted murder is worse for the victim than successful murder. If only Caesar hadn’t had time to say “et tu, Brute” he would’ve been fine. However, even if the Epicurean view has these implications, they are not sufficient to constitute a reductio of the position if the argument for it cannot be faulted. And, as we shall see, it is not clear that alternative views fare any better in the strange consequences department. The Epicurean position has been met with much snorting and sputtering. As Steven Luper-Foy writes: Epicurus’s famous argument…is about as absurd as any I have seen…The self-deception of people like Epicurus is not conscious; we cannot relieve our anxiety by swallowing beliefs of whose inanity we are aware. But deception is nonetheless at work. 1 One is reminded of David Lewis’s comment about criticisms of his views, that it is hard to argue with an incredulous stare. Of course, the critics offer alternatives, most of which fall under what Harry Silverstein has called ‘the standard argument’ 2 or what Fred Feldman calls ‘the deprivation approach.’ 3 In what follows I will consider some of the betterknown versions of this approach and explain why I think each is unsatisfactory. I shall conclude by attempting to explain away the more counterintuitive implications of the Epicurean position. 2.

The deprivation approach Let us make clear the common ground between the Epicureans and the anti-Epicureans. First, we will assume, as writers on this subject typically do, that death marks the end of all experience. That is not to rule

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___________________________________________________________ out by fiat the possibility of a so-called afterlife, just to deny that it happens during death. Better to say that those who believe in an afterlife in fact believe in immortality and deny that death happens. (They needn’t deny the death of the body, just that the person dies along with it). With that understanding of death, very few people deny the third Epicurean premise, which Fred Feldman dubs the termination thesis, that we cease to exist at death. Feldman himself is one who does deny it, but not in a way that gives much solace to those approaching death. Although he calls himself a “survivalist” to distinguish himself from so-called “terminators” who accept the claim, Feldman’s position is a mixed bag. I quote: The good news is that most of us will survive death. Most of us will continue to exist after we die. The bad news is that though we will survive death, and will continue to exist after we die, each of us will then be dead… We will just be corpses. 4 In something of an understatement he concedes, “such survival may be of very little value.” Feldman’s position follows from his view that we are our bodies, and while that view has some advantages (for example, it makes sense of statements like “we’re burying Aunt Ethel today”), it does not really capture what we care about. So I will assume the termination thesis in what follows. Even if one did not, however, one would still be forced to accept premise 2, which is as uncontroversial as any claim in philosophy can be. That leaves premise 1 as the only weak spot in the Epicurean argument, and it is indeed on this that the critics focus. Of Epicurus’s contemporary critics, undoubtedly the most well known is Thomas Nagel, who points out its implications: It means that even if a man is betrayed by his friends, ridiculed behind his back, and despised by people who treat him politely to his face, none of it can be counted as a misfortune for him so long as he does not suffer as a result. 5 Nagel implies the plausible claim that being ridiculed against one’s knowledge is an example of harm without suffering. Although I will not challenge this claim here I am not sure I find it fully convincing. I am inclined to say that those who ridicule or betray their friends wrong them even if they do not harm them. I shall return to this below, but notice that Nagel’s examples of harm are all inflicted by other persons – that is,

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___________________________________________________________ exactly the kind of beings that can inflict wrongs. But death itself (that is, the state of being dead, not the titular Grim Reaper) cannot betray or ridicule one, 6 so Nagel’s analogy is flawed. It remains to specify exactly what the harm of being dead consists in. Nagel’s answer is what gives the deprivation approach its name: one can be harmed by being deprived of something, even if this does not cause suffering. In the case of death, what one is being deprived of is everything. Nagel offers the following as an example of harm (without suffering) by deprivation: Suppose an intelligent person receives a brain injury that reduces him to the mental condition of a contented infant, and that such desires as remain to him can be satisfied by a custodian, so that he is free from care. Such a development would be widely regarded as a severe misfortune, not only for his friends and relations, or for society, but also, and primarily, for the person himself. 7 3.

The Epicurean strikes back Nagel’s case reinforces what we already knew: the idea of death being a loss seems perfectly intuitive. However, the Epicurean is used to fighting uphill against received wisdom, and has hard questions to ask. These centrally include: Who is harmed? When is this person harmed? And what exactly is the harm? The candidates for the subject of harm are suggested by Nagel’s parallel case of deprivation. In that case, we can say either that the preinjury, intelligent person, or the post-injury person is harmed by his current brain-damaged state. George Pitcher dubs the parallel “before and after” persons in the case of death the ante-mortem person and the postmortem person. 8 As noted, in Nagel’s brain-injury case we are inclined to say that the before-and-after are the same person, but in the case of death, since we have accepted the termination thesis, not only can they not be the same, there is no post-mortem person. How can a non-existent individual be harmed, and why should one care? So that leaves the ante-mortem person as the only remotely plausible subject of the harm of death. But in what way has the living Aunt Ethel been harmed by her death? 9 She isn’t dead yet, and so has not been deprived. Hence the second Epicurean challenge, specifying when one is harmed by death. Again, if the antemortem person is harmed after her death, then why should she care? And is it even possible for there to be a connection between a person and a harm committed after she has ceased to be?

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___________________________________________________________ Harry Silverstein argues that it is, and responds to this second Epicurean challenge by denying the “temporality assumption” which requires that a harm to a person “must have a temporal location or extent at least part of which” is prior to her death. 10 Expanding on a remark by Nagel that “for certain purposes it is possible to regard time as just another type of distance,” 11 Silverstein argues that events in the future exist just as much as events far away exist, and that thus A’s death coexists with A (“in an eternal or timeless sense of the word” [Quine]), and is therefore a possible object of A’s suffering, and is therefore an intelligible Arelative evil. 12 What is interesting about Silverstein’s approach is that he, unlike Nagel, accepts a variant of the first Epicurean premise that harm must in some sense be connectable with suffering, or, more generally, what he calls the “Values Connect with Feelings” view. 13 His variant, however, allows that a particular event x can be viewed as a harm for person A even if it does not actually cause suffering for her: x can intelligibly be said to have a certain A-relative value provided merely that it be possible, or possible under certain conditions, for A to have the appropriate feelings as a result of x. 14 Thus, on this view, the ante-mortem Aunt Ethel can be harmed by post-mortem event x because they coexist with each other in a timeless sense and x is therefore a possible object of suffering for Aunt Ethel. But it still remains for this view to explain the harm of death itself, rather than particular events after Aunt Ethel’s death. Besides the problems of such a strange entity as one’s state of being dead being an object of suffering, 15 we need to know what about it would cause suffering. Silverstein’s response is as follows: [T]he reason one fears death, of course, is that it shortens the duration of one’s life; if A contracts terminal cancer…his approaching death would typically be the object of negative feelings precisely because of his awareness of the brevity of his life as a whole, and the consequent sparsity of its content, in comparison with alternative imaginable lives. In short, it is the “four-dimensional” ability to understand life in

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___________________________________________________________ durational terms, to view one’s life as a temporal whole and to make evaluative comparisons between it and alternative possible life-wholes which ultimately accounts for the fact that statements of the form “A’s death is an evil for A” are commonly regarded as not merely intelligible, but true. 16 That is, Aunt Ethel’s being dead is a harm to her while alive because she is potentially aware of the comparative brevity of her life in comparison to “alternative possible life-wholes” in which she lives longer. It seems we are to picture Aunt Ethel as a disembodied self in something like Rawls’s Original Position (minus the veil of ignorance) asked to choose which among the various possible lives she would prefer. If there is one that is better (which, for now, simply means longer) than the actual one, then her death is a misfortune for her. However, what exactly are we to understand by alternative ‘possible life-wholes’ (henceforth PLWs)? The most philosophically familiar way to spell out this idea is using possible worlds, as Fred Feldman (among others) makes explicit. Assuming, purely for the sake of engaging Epicurus on common ground, a crude form of hedonic calculus, Feldman suggests the following analysis to explain the harm of dying in a ‘plane crash: Suppose I am thinking of taking an airplane trip to Europe.… consider the nearest possible word in which I… die en route to Europe on this trip… Let us suppose that that world is worth +500 to me… Next…consider the nearest world in which I do not die en route to Europe on this trip… Let us suppose my welfare level at that world is +1,100. [This account] implies that my death on this trip would have a value of -600 for me. It would be a terrible misfortune. 17 There are all sorts of potential pitfalls with possible worlds, though. For one thing, there is the problem of establishing transworld identity: in what sense are all these people, some who die, some who live, Fred Feldman? This question is contentious, and the subject of high-level metaphysical debate. It seems odd that the harm of death, supposedly so intuitively obvious as to make the Epicurean position absurd, should hang on such abstract philosophizing. According to the view popularized by Saul Kripke, Fred Feldman could possibly be just about any being in any circumstances at any time. There is a possible world in which I, sitting

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___________________________________________________________ here named Simon Cushing, am in fact Fred Feldman. If there are such a wide range of possible lives for me, then it seems that the actual me, sitting here alive, is harmed by more than my actual death. If the harm of being dead is that I am thusly deprived things of value I have in some other possible world, then presumably I am currently being harmed because in some alternative possible world I live the life of an immortal philosopher-king. What is more, this is exactly the same kind of harm that constitutes the harm of being dead, and, on Feldman’s calculus, potentially far greater. This seems to me either a reductio of the possible-worlds deprivation account, or the biggest excuse for whining ever. Can the anti-Epicurean avoid these unpalatable implications by restricting the range of possible mess? Feldman has this in mind when he refers specifically to the nearest possible worlds. Jeff McMahan spells out this idea in more detail: Let t be the time at which some person died. Our overall, objective evaluation of how bad or good his death was for him will be based on a counterfactual claim about what would have happened to him if he had not died at t. Let the antecedent of the relevant counterfactual be “if the entire transitive cause of his death had not occurred….” To complete the counterfactual, we consult the possible world in which the antecedent is realized which is closest to the actual world up to t. 18 McMahan thinks that this view both encapsulates and develops the intuitive idea that “death is bad for a person…at any point in his life, provided that the life that is thereby lost would on balance have been worth living,” 19 where the “life lost” is the life that is had by the person on the possible world that is identical to the actual world except for the key causal factor that brought about the death of the actual person. Does McMahan’s account remove the counterintuitive implications of PLW views? I do not think so. McMahan’s focus is on establishing the harm of a person’s actual death. This is how he can justify comparing the actual world to just one closest possible world, where the closeness includes as much as possible an identical life up to the point of death. However, my complaint against the PLW school is that if you are going to allow that a person is harmed because of the existence of an alternative, better life on another possible world, then there are a lot more harms than just death, and again, these can be much more extensive. McMahan thinks focusing

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___________________________________________________________ on someone’s actual death removes the relevance of other possible worlds. But why not focus on someone’s actual non-buying-of-a-winning lottery ticket? Or even one’s actual absence of genius because the potential genius combination of sperm-and-egg got pipped to the post by fasterswimming but duller sperm. All of these are harms as real as the harm of death on accounts like these. 20 In sum, McMahan has not successfully delimited the number of PLWs that one should compare oneself with to find out how much one is being harmed, and thus his view, as much as any of the PLW views subjects actual people to potentially infinite harms in its attempt to make being dead a harm to the living. 4.

Accounting for injustice That’s all very well, the anti-Epicurean can respond, but the Epicurean position has far worse implications, most notably that you do not harm a person by killing her. Not only that, but eschewing possibleworlds talk deprives the Epicurean of the apparatus to explain all kinds of harms, including, in particular, injustice. Earlier I compared Silverstein’s PLWs to the possible worlds a party in Rawls’s Original Position contemplates, and it certainly seems that views like his make use of counterfactuals to explain the injustice of actual institutional arrangements or distributions. If I am disallowing comparisons across possible worlds, can I no longer account for actual people suffering injustice? Here is my suggestion: one does not suffer injustice because there is a possible world in which one is better off (in justice-relevant ways). One suffers injustice because one is not better off in this one. This is an incredibly crude characterization, and I cannot hope to do justice to the topic of justice in such a short space, but let me explain what I mean. There are two ways in which injustice might be taken to be comparative. One way is that I suffer injustice if things could have gone better (in the relevant justice-relative ways) for me in another possible world. Here the possible world would have to be relatively near: if it is one where I am some amalgam of FDR, John Lennon and Pele, the injustice seems trivial. But that leaves the possibility that, in fact, although I suffer in the actual world, there is no near-enough possible world that both preserves my identity sufficiently and in which I am better off. On this account of injustice, I do not suffer it. Positively Panglossian. The alternative suggestion for the relevant comparison is to some ideal of justice that perhaps is impossible to attain amongst humans. This would allow that the best of all actually possible human worlds would still exhibit injustice. I am inclined to think this is the correct view.

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___________________________________________________________ In these foregoing remarks I have been discussing justice in a purely distributive sense. There is also another, more personal, sense of injustice, the kind that more closely fits a Nozickian model than a Rawlsian one. Here I am done an injustice if somebody deprives me of something (however abstract) that is rightfully mine. But this kind of injustice concerns wrongs, not harms, and, moreover, does not require possible worlds to account for it. In fact, possible worlds talk might have counter-intuitive results. Consider the argument against restitution to the descendents of slaves, that in fact they are better off than they would have been had they stayed in Africa. That, even if true (and of course it does not apply to the non-descendents of the people who died childless in the crossing) is surely beside the point: it was wrong to enslave people, even if they fared better than their possible non-enslaved counterparts. That one can be wronged even if one is not harmed by death: if I murder someone, I wrong him because he has the right of selfdetermination that my action robs of its essential basis. I have no right to embark on the course of action that causes that right to be annulled. That is the sense in which I wrong the living person before he dies. There is no mystery as to when this wrong occurs – it occurs as I act intentionally, and thus the victim of the wrong is the ante-mortem person, wronged simultaneous to my act. As I mentioned earlier, I take this to be parallel to the case of a person being wronged by a betrayal of which he is oblivious. I am fairly certain Epicurus would not be happy with my suggestion that there are some wrongs that can be done with no accompanying harm. And he is probably not alone. Am I just turning this into a squabble over words? Well, not really. I deny that one is wronged or harmed by being dead, but further deny that this undercuts the wrongness of killing. More broadly, I deny that one is harmed by being deprived of something, while allowing that the person who deprives me of it may thereby wrong me. In sum: I do not believe that the Epicurean challenge has been met by the various writers who have attempted it. In particular, possibleworld deprivation accounts are in the unenviable position of claiming that the living suffer the deprivation of being dead, and the use of possible worlds to characterize actual harms opens the door to horrendously implausible claims about the harms we suffer because of our myriad possible selves. 21

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Notes 1

Steven Luper-Foy, ‘Annihilation’, in The Metaphysics of Death, ed. J. M. Fischer, (Stanford: Stanford University Press, 1993), 270. Interestingly, it is the now simply Steven Luper who writes the entry in the Stanford Encyclopedia on Death (see note 20). For somebody so scornful of the Epicurean argument, he has certainly devoted enough time to it. 2 Harry Silverstein, ‘The Evil of Death’, in ed. Fischer, 98. 3 Fred Feldman, Confrontations with the Reaper (New York: Oxford University Press, 1992), 236. 4 Ibid., 105. 5 Thomas Nagel, Death, in ed. Fischer, 64. 6 Of course, the dead being betrayed by the living is a common fictional theme (at least, in the films I like to watch), but the stories inevitably have to resort to the device of the betrayed party either returning from the grave or at least reaching across to the land of the living to exact revenge. That is, the stories cheat by allowing an existing party to experience the betrayal. 7 Nagel, 64. 8 George Pitcher ‘The Misfortunes of the Dead’, in ed. Fischer, 161. 9 Presumably this is different from jumping up and down on a long-buried person’s grave: supposing, contrary to what I believe, a harm is committed to a person by this disrespectful act, it surely must be (contrary to the termination thesis) to the post-mortem person. Disrespect to the dead is not disrespect to the living. 10 Silverstein, 106. 11 Nagel, 66. 12 Silverstein, 112. 13 Silverstein, 107. 14 Silverstein, 107. 15 While one might view the moment of death as an event, it seems odd to view the potential infinity of time one spends being dead as a single discrete event. Moreover, even if it were legitimately seen as such, is it possible for one to have an infinitely long event as the subject of feelings? 16 Silverstein, 116. While I have lumped Silverstein in with proponents of the so-called standard argument, Silverstein is adamant in distancing his position from the standard anti-Epicurean view, because that approach makes the fatal mistake of suggesting that death is a loss to the nonexistent dead person. His view, he insists, entails a coherent ‘life-life’ comparison instead of an incoherent ‘life-death’ comparison. However, in

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___________________________________________________________ my opinion his view is just a more respectable fleshing out of the deprivation idea. 17 Feldman, ‘Puzzles about the Evil of Death’, in ed. Fischer, 316-317. 18 Jeff McMahan, ‘Death and the Value of Life’, Ethics, 99 (October 1988), 48. 19 McMahan, 58. 20 Steven Luper suggests a terminological loophole for PLW views as follows: “An explanation of why it is awkward to speak of harm when certain good possibilities, such as enjoying God-like powers, are not actualized, is that we tend to use the term ‘harm’ to refer to misfortune, and often it is not a misfortune for us when good possibilities fail to be actualized (since the failure does not bear on our having essential goods),” “Death”, The Stanford Encyclopedia of Philosophy, (Spring 2006). The suggestion is that we are only harmed by not having ‘essential goods,’ but if not having something can constitute a harm, then I think most people would feel it a harm if they missed out on $1M (say, because they lost a lottery ticket) even if they were otherwise comfortable. 21 Harry Silverstein insists that his account is different from the “standard” deprivation accounts, specifically because future events (on his view) can be the objects of the feelings that constitute a harm to the living (and, recall, this is so even if in fact one experiences no actual adverse feelings). He attempts to support this case in “The Evil of Death Revisited,” Midwest Studies in Philosophy, XXIV (2000), with a case where a husband finds out the truth, that his wife is having an affair with his best friend, by a report from another friend who mistakenly thought he overheard something to that effect (123-4). This is a case where, claims Silverstein, the affair is the object of the husband’s misery without actually being the cause of it. That is, he holds a de re view of the objects of feelings. I find this simply implausible; while I might allow that my statement “the alien with thirty arms somewhere in the universe” might have as its object that actual being, my feelings cannot be “about” that being without some causal connection. My feelings are about my conception of that being. And so with my death: I cannot have feelings about my actual death (or state of being dead), just my imagination of it, and thus on his VCF view, I cannot be harmed by it.

Tele-visions of the Dying: Ghost-Seeing in the Society for Psychical Research in the 1880s 1 Shane McCorristine Abstract The spread of spiritualism in the second half of the nineteenth century led to the establishment of the Society for Psychical Research (SPR) in London in 1882 as a scientific society dedicated to investigating the phenomena emanating from the spiritualist séances. In the landmark quasi-sociological study, ‘Phantasms of the Living’ (1886), the SPR published some 700 cases which pointed away from the traditional concept of the ghost as a disembodied spirit, in favour of a new theory based upon the telepathic awareness of (living) loved ones in a state of crisis, or in a dying situation – in essence a percipience of an embodied ghost, a ‘phantasm of the living’. The SPR reformatted the popular ghost story through the language of psychical research by positing a modernist death-ritual that invested the bodies of both the agent and percipient in the ghost story with a telepathic apparatus that extensively mirrored the developments in contemporary tele-technologies. With the telepathic hypothesis entrenched in interpretations of ghost-seeing, psychical research suggested a salient feature of modernity – the idea that the spectres of the self expressed a disturbing psychical reality more marvellous by far than the sensational accounts of ghosts so prevalent in Victorian and Edwardian fiction. Key words: ghost-seeing, spiritualism, telepathy, hallucination, death, psychical research, mourning, technology. In the dumb agony which seizes the soul when some loved one is taken from us, in the awful sense of separation which paralyses us as we gaze upon the lifeless form, there comes the unutterable yearning for some voice, some sign from beyond; and if in answer to our imploring cry for an assurance that our faith is not in vain, that our dear one is living still, a smile were to overspread the features of the dead, or its lips to move, or even its fingers to be lifted, should we deem any action a paltry thing that assures us death has not yet ended life, and still more that death will not end all? 2 This was written by Sir William F. Barrett, Professor of Physics at the Royal College of Science, Dublin, and founding member of the Society for Psychical Research, a scientific group set up to investigate claims of

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paranormal phenomena which had emerged toward the end of the nineteenth century. This quote serves to encapsulate the sheer utopian yearnings that were invested in the figure of the post-mortem body during this period. Following the rapid spread of the modern spiritualist faith in America and Britain in the 1850s and 1860s, rationalist groups and circles of friends with an investigative urge and pretensions to the ‘scientific method’ had sprung up chiefly interested in exploring the validity of the unexplained phenomena emanating from the new spiritualist séances. Spiritualism was an anti-materialist faith with a varied set of beliefs centred upon the tenet that the spiritual world could and does manifest itself through so-called ‘supernatural’ occurrences in the physical world such as ghosts, materialisations, and extra-terrestrial communications via mediums. The establishment of the Society for Psychical Research (SPR) in London in 1882 was the consequence of the efforts of a number of spiritualists and Cambridge scholars to place their beliefs upon a sounder, unprejudiced, and more scientific footing. This would lead to the establishment of ‘psychical research’ and the examination of ghost-seeing, as profoundly influential cultural constants in late-Victorian and Edwardian society. Ghost-seeing is as old as the human nervous system, yet for the agnostic generation of the 1860s there was the feeling that the issue of apparitions had reached a crisis-point, with the validity of spiritualistic phenomena being fiercely debated in the public sphere, and blended into religious discourses on one hand and psychiatric discourses on the other. Seeking to find a way out of this extremism, the members of the SPR sought to usurp and replace what William James called the ‘will to believe’, with the “will to investigate” - an avowedly scientific approach which sought to finally solve paranormal issues through the setting up of objective fact-finding committees, with a sceptical bias it must be said. The most productive of these committees was lead by Professor William Barrett who, after conducting experiments into ‘thought-reading’ in Co. Westmeath and London in the late 1870s and early 1880s, believed that the SPR would profit most by investigating the area of supernormal communications, where it seemed there was a huge amount of evidence above the rate of chance which could be gathered within an objective and scientific environment. The theory of thought-reading, or ‘thought-transference’ - that A could consciously know what B was thinking of – allowed for new ways of approaching the ultimate questions of psychical research, ways which could be packaged as both experimentally valid and scientifically

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___________________________________________________________ pioneering. Yet the thought-transference hypothesis was most fully and fruitfully integrated into theories regarding hallucinations, apparitions, ‘phantasms’, and the alleged hauntings of the dead, for the role of thoughttransference was seen as crucial in determining the difference between delusive and veridical hallucinations, and this differentiation opened up the genre of supernatural hallucinations to scientific explanation and exposition. The increased speculations about thought-transference, and its wider implications for theories of hallucinations and apparitions led to its second name-change in the space of a year with Frederic W.H. Myers coining the word ‘telepathy’ from the Greek ‘tele’ (distant) and ‘patheia’ (feeling). Despite the seeming prevalence of ghosts, wraiths, and spirits in everyday life, the SPR Committee on Haunted Houses and Apparitions seemed to encounter a reluctance on the part of their prey, for as it remarked upon the activity of ghost-hunting, ghosts “like aerolites, seem to be no respecters of persons; and no amount of scientific watchfulness will make them come to order”. 3 It was undoubtedly the acute lack of sensational eyewitness experience on the part of SPR investigators which led to them toward a more sociological approach, toward the more pedestrian methods of collecting and collating masses of material, and issuing circular requests for data to friends of the Society and the major newspapers and journals. It prioritised a personal interview with the percipient - as they called the ghost-seer - and expressed the wish to “hear his story told in a manner which pledges his honour to its truth”. 4 It was at this point that testimony from people the SPR considered hysterical, hypochondriacal, or uneducated would be discounted, for it is evident that notions of tellability and its hierarchical requirements played a key role in the scientific discourse on ghosts and apparitions at the time. This is further demonstrated by a footnote to the above quote which notes that if the case concerns the testimony of an illiterate person, the narrative is accepted as authentic only on the authority of the local clergyman. 5 Clearly, then the SPR developed an a priori notion of an accredited ghost story which relied upon the non-sensational account of a literate and respectable member of the public willing to communicate with, and be interviewed by, the SPR. However, if the primary requirement of personal acquaintance with the person who experienced the occurrence were not possible, then cross-examination by letter would be a necessary procedure, an avenue which proved to be the primary method of verification for the SPR in the 1880s; some 10,000 letters were sent to correspondents by the SPR Literary Committee in 1883 alone. 6 In this heavily regulated sociology of the ghost story, exaggerated, embellished, and ‘readerly’ accounts of the supernatural were

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to be mistrusted, and the Society was proud of the fact that the ghost stories they reported were “far more likely to provoke sleep in the course of perusal than to banish it afterwards.” 7 This quantitative, rather than qualitative methodology of reducing ghosts to statistics was certainly a novel approach to the area, an approach that was in tune with the new sociological trends of the period, and which aimed to develop a critical mass of evidence from witnesses whom they considered of a high character. In short the SPR developed a montage-approach to ghosthunting with a view to synthesising recurring themes within an experimentally valid framework. They sought to counter beliefs that they were only engaged in cold theorisation and snobbishly experimenting within their chosen circle, and assured percipients that statistics in this matter were everything: “The achievement which we claim for our Society is not a theory of cases but a colligation of facts.” 8 They went even further and outlined the direct role that the public could play in supporting and constructing the work of the SPR: The public are for the first time being made participators in scientific work: for the first time they appear as the sources of evidence, as the actual material (so to speak) of the experiments, which the novel nature of recent inquiries demands. 9 While this does point to a conscious development in the democratisation of scientific work, it may be more accurate to conceive of a chosen ‘community of sensation’ within the SPR’s ghost-seeing investigations. Thus from the outset, the success or failure of the SPR theory of apparitions depended to a large extent upon public participation in their investigative enterprise, upon offering up cases of ghost-seeing for the project, based as it was upon a liberal epistemology and middle-brow marketing. 10 By far the most common type of ghost being described by the correspondents of the SPR in the 1880s was the ‘crisis apparition’: this involved cases where A, or the agent, entered a critical or traumatic state, usually a dying situation, and supernaturally appeared to B, or the percipient, in the form of a hallucination of the senses, possibly due to a pre-existing personal rapport with the percipient or a strong psychical connection with the locality of the occurrence. This type of ghost-seeing experience was usually a decidedly family affair, with, for example dying husbands appearing to their wives, or was an acute awareness of the loss

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___________________________________________________________ of a close relation, and thus could be verified in death records as to the factual reality of the claims made. Building upon this veridical nature of apparitions, the SPR began to use the term ‘phantasm’ to refer to the paranormal apprehension of a crisis apparition. Thus, by describing them as mental phenomena with no physical reality, by dealing with a person who was dying, i.e. still technically alive, and by linking the topic to what they believed was scientifically proven - telepathy - the SPR sought to modernise the ghost story as an empirical narrative within the precepts of scientific naturalism. The classic representation of this exploration remains ‘Phantasms of the Living’. 11 This two-volume work is a huge compendium of some 700 tales of ghosts from Britain and Ireland of many different hues with speculative comments interspersed by the SPR psychologists Edmund Gurney, and Frederic W.H. Myers, who were aided by Frank Podmore, a postal official and co-founder of the Fabian Society. ‘Phantasms of the Living’ included many stories which resembled cases of experimental thought-transference in the extreme banality of the impression received. Non-lethal telepathic hallucinations included the case of a woman who felt she was struck on the lip at the very moment her husband was elsewhere, a clergyman who intuitively ‘knew’ when his daughter had arrived safely in India, and a father who had a feeling that his child had fallen out of bed many miles away. 12 However the themes in ‘Phantasms of the Living’ quickly took on a darker tone, for it is primarily a book drenched in death and dying: about half the cases included deal with an attested occasion when a percipient’s ghostseeing experience either coincided with, or shortly followed, the death of a loved one. The problem that the SPR now faced was how to distinguish between the ghost of a dying person and the ghost of a dead person, how to distinguish between the cessation of life and the cessation of its psychical affects. The creation of this distinction was crucial in proposing theories of ghost-seeing which could be propounded as naturalistic and scientific, without the taints of theology, spiritualism, or the occult. As a result the SPR implemented a temporal limit of 12 hours from the moment of the agent’s death during which the ghost-seeing experience of the percipient, the appearance of the phantasm, would remain within the boundaries of scientific naturalism and remain a phantasm of the living and not a phantom of the dead. By compartmentalising and allotting arbitrary time-frames to the moment of death and the moment of ghostseeing based upon neo-Schopenhauerian theories of vitality and the latency of psychical forces, the SPR sought to break up the supernaturalism of the traditional ghost story and reformat it as a phenomenological event within a temporal culture. The intervention of the

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SPR into theories of ghost-seeing, and its influence in paranormally translating late-Victorian attitudes on death and dying would link its interest in the cultures of intimacy surrounding telepathy with the more precarious and quasi-spiritual theories clustered around the moment of death and the possibility of survival. 13 Thus, after a few years of research the SPR had forcefully begun to advance the rather surprising thesis that it was ‘phantasms of the living’ and not the ghosts of the dead which held the most evidential, experimental, and ultimately speculative value for society. The arena for this modern prophesising, or pre-emptive grief, was firmly within the normality of everyday life, and the manifestation situation of ghost-seeing reflected a passive state of mind on the part of the percipient – about as far away from the agent’s crisis as was possible. Indeed, most ghosts, like accidents, happened within the security of the home, and many of the cases recorded in ‘Phantasms’ were reported to have taken place in the bedroom where such an encounter with the unheimlich would resonate most fully. An example of this would be the case of a woman waking up after dreaming of her own death to find her husband sobbing beside her, saying that he had dreamt the exact same thing. 14 When the case relied upon visual sightings, the apparition was usually distinctly recognised by the ghost-seer. The apparition was described most commonly as being anthropomorphic, pale, misty, and of a melancholy demeanour. Notably the figure of the hallucination rarely induced horror or fear in the percipient. Rather, profoundly existentialist themes of dread, anxiety, and Weltschmerz feature prominently in many of the cases recorded in ‘Phantasms’, and indeed premonitions and the physical reactions to such forebodings were a common trope of popular ghost stories. However, in the 1880s these premonitions of the death of the other appear to resemble the simulated death of the self. One example serves to illustrate the type of language (and rationalisations) used in these cases: Case No. 68: Mrs Powys reports: About 3 months ago as I was sitting, quietly thinking, between 5 and 7 p.m., I experienced a very curious sensation. I can only describe it as like a cloud of calamity gradually wrapping me round. It was almost a physical feeling, so strong was it; and I seemed to be certain, in some inexplicable way, of disaster to some one of my relations or friends, though I could not

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___________________________________________________________ in the least fix upon anybody in particular, and there was no one about whom I was anxious at the time…on Monday I got a letter from my sister…in which she told me she had received a telegram…informing her of the dangerous illness of her brother-in-law, at which she was greatly upset. This appeared to be a very probable explanation of my extraordinary presentiment, and I wrote and told her all about it at once. 15 The psychoanalyst Nicolas Abraham has theorised the phantom as representing a gap within the mind of the percipient, as a secret hidden and buried in a crypt constructed by the psyche. 16 In the cases recorded by the SPR, the phantasm of the dying person can be interpreted as using the emotional apparatus of the percipient to express the secret of the death of the other/self, to fill the gap left by the pre-empted loss of a loved one. That this gap is usually confirmed by the swift arrival of a black-bordered telegram, which confirms the death of the other and affirms the ghostseeing of the self, suggests how bodies in crisis can act as both the medium and the message. It can be seen quite clearly how the essentially nunciative function of the telepathic apparition can be linked to contemporary innovations in tele-technologies such as telephones, telegraphs, phonographs, x-rays, spectroscopes, and photographs. 17 With many cases involving the phantasmic appearance of loved one’s residing throughout the British Empire, it can be seen that ghost-seeing functioned as a form of magical thinking and magic linking which to some extent reflects developments in instant communication in late-Victorian science and culture. Furthermore, the psychological impact of the new magical technologies can be traced in the large amount of cases involving auditory hallucinations, or the hearing of the voices of loved one’s in one’s own head. For this forms a direct link both with the experience of receiving a telephone call from the other side of the world, and with the appearance of new dissociative mental disorders at the end of the nineteenth century, such as Multiple Personality Disorder. Through its committed investigation of ghost-seeing and the phantasmic death of loved ones, the SPR inspired experimental psychologists such as Charles Richet, Pierre Janet, Frederic Myers, Theodor Flournoy, Carl Jung, and Sigmund Freud to deal with the dark phenomena of unconscious desires, fears, and projections that came to characterise the birth of modernity. To conclude, in the 1880s we have the concerted attempt to normalise, scientise, and collectivise ghostly experiences by withdrawing investigations from religious and psychiatric discourses of faith and diagnosis and attempting to place them within a ‘psychical’ context which

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utilised and influenced the emerging disciplines experimental psychology, sociology, and probability theory. 18 With the telepathic hypothesis entrenched in interpretations of ghost-seeing, psychical research suggested a salient feature of modernity - the idea that the spectres of the self expressed a rich and disturbing psychical reality more marvellous by far than the sensational accounts of ghosts and ghouls so prevalent in Victorian and Edwardian fiction. Ghosts, spirits, and ‘phantasms of the dead’ as phenomena embedded within popular literary-oral and spiritualist culture were to be either pushed aside as unsubstantiated superstitions or else examined through the medium of the scientific and experimental standards which the SPR championed, standards which held an increasingly ambiguous status in the mainstream spiritualist movement. As a Society which was at the crossroads between a spiritualist group based upon belief and a scientific society based upon fact, the SPR provided a unique arena of ‘as-if-ness’ 19 where ghost-seeing and its implications could be expressed with the tools of empiricism, sociology, and abnormal psychology. With ghosts, phantasms, and spirits trapped between traditional modes of religious belief or supernatural expressionism on one hand, and modern scientific trends of public demonstration, explication and cultural investigation on the other, the huge level of ghost-seeing in the 1880s is not surprising at all.

Notes 1

The author wishes to acknowledge the funding and support provided to him by the Humanities Institute of Ireland. 2 William F. Barrett, On the Threshold of the Unseen: An Examination of the Phenomena of Spiritualism and the Evidence for Survival after Death (London and New York: Kegan Paul, Trench, Trübner &Co, 1917), 197198. 3 William F. Barrett, A.P. Percival Keep, Charles C. Massey, Hensleigh Wedgwood, Frank Podmore, and E.R. Pease, ‘First Report of the Committee on Haunted Houses’, PSPR, Vol. I (1882-1883), 101-115. 4 Barrett et al, ‘Literary Committee’, 117. 5 Ibid, ff. 6 William F. Barrett, Charles C. Massey, Stainton Moses, Frank Podmore, Edmund Gurney, and Frederic W. H. Myers, ‘Second Report of the Literary Committee’, PSPR, Vol. II (1884), 43-55. 7 Barrett et al, ‘Haunted Houses’, 117-118.

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William F. Barrett, Charles C. Massey, Stainton Moses, Frank Podmore, Edmund Gurney, and Frederic W. H. Myers, ‘Third Report of the Literary Committee’, PSPR, Vol. II (1884), 109-136. 9 Ibid, 112. 10 See John Peregrine Williams, The Making of Victorian Psychical Research: an Intellectual Elite’s Approach to the Spiritual World, unpublished Ph.D. Thesis, (University of Cambridge, 1984). 11 Edmund Gurney et al, Phantasms of the Living, 2 vols. (Gainesville, Florida: Scholars’ Facsims & Reprints, 1970). 12 Ibid, 188, 192, 196-198. 13 See Frederic W.H. Myers, Human Personality and Its Survival of Bodily Death (New York: Longmans Green, 1909). 14 Gurney et al, 316. 15 Ibid, 271. 16 Nicolas Abraham, ‘Notes on the Phantom: A Complement to Freud’s Metapsychology’, Critical Inquiry, vol.13, no.2, (Winter, 1987), 287-292. 17 See for instance Steven Connor, “Voice, Technology and the Victorian Ear”, Roger Luckhurst and Josephine MacDonagh eds, Transactions and Encounters: Science and Culture in the Nineteenth Century (Manchester: Manchester University Press, 2002), 16-29. 18 On the influence that psychical research had upon probability theory see Ian Hacking, ‘Telepathy: Origins of Randomization in Experimental Design’, Isis, Vol.79, no.3, (September, 1988), 427-451. 1919 See Hans Vaihinger, The Philosophy of ‘As If’: A System of the Theoretical, Practical and Religious Fictions of Mankind. tr. C.K. Ogden (London: Routledge & Kegan Paul, 1965).

Bibliography Brandon, Ruth. The Spiritualists: the Passion for the Occult in the Nineteenth and Twentieth Centuries. (London: Weidenfeld and Nicolson, 1983). Cerullo, John J. The Secularization of the Soul: Psychical Research in Modern Britain. (Philadelphia: Institute for the Study of Human Issues, 1982). Gauld, Alan. The Founders of Psychical Research. (London: Routledge & Kegan Paul, 1968). Haynes, Renée. The Society for Psychical Research 1882-1982: A History. (London and Sydney: MacDonald & Co, 1982).

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James, William. The Will to Believe: and Other Essays in Popular Psychology. (New York: Longmans Green & Co, 1898). Luckhurst, Roger. The Invention of Telepathy: 1870-1901. (Oxford: Oxford University Press, 2002). Oppenheim, Janet. The Other World: Spiritualism and Psychical Research in England, 1850-1914. (Cambridge: Cambridge University Press, 1985). Ronell, Avital. The Telephone Book: Technology, Schizophrenia, Electric Speech. (Lincoln, Nebraska: University of Nebraska Press, 1989). Thurschwell, Pamela. Literature, Technology and Magical Thinking, 1880-1920. (Cambridge: Cambridge University Press, 2001). Shane McCorristine received his BA in History and MA in Cultural History from University College Dublin. He is currently a Doctoral Scholar in the Humanities Institute of Ireland.

“Of Death I Try to Think like This”: Emily Dickinson’s ‘Play’ with Death 1 Lucia Aiello Abstract This paper explains Emily Dickinson’s use of the concept of ‘Death’. The paper argues that in her poetry Dickinson divests death of traditional metaphysical connotations and turns it into a signifier shedding light on the composite nature of human experience. Within her poetry the concept of death is divested of its intimidating power, without falling into the cliché of becoming replete with ‘positive’ meaning. ‘Death’ in Dickinson is a figure of the poetic form that, together with other figures such as ‘Life’, ‘Poet’, ‘I’, ‘Immortality’, ‘Grief’, etc., assumes a conceptual dignity beyond the role allocated to it by traditional semantic definitions. New combinations become workable, innovative associations emerge as a result of the expansion of perception and prefigure possibilities of new meanings. The paper explores some of these possibilities using Dickinson’s poems as examples. The paper concludes by advancing the hypothesis that Dickinson’s playful engagement with death at the level of the conceptual covers in fact a deeper ontological need, namely the need to make sense, not of death, but of human experience as a whole. The paper argues that a fear of a loss of sense is an anxiety concerned with the ineffable, the unspeakable, and therefore the meaningless. Key words: Dickinson, death in poetry, Heidegger, Adorno, poetry of experience. 1.

Kenosis In poem 1052, Emily Dickinson writes: I never saw a Moor I never saw the Sea Yet know I how the Heather looks And what a Billow be I never spoke with God Nor visited in Heaven Yet certain am I of the spot As if the Checks were given -

For Dickinson, experience does not define existence. A Moor, the Sea, God and Heaven, are all available concepts, the existential reality of which is not legitimated by direct experience. This dispels possible doubts

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___________________________________________________________ about Dickinson misunderstanding the nature of the poetic as the unmediated expression of experienced reality. Dickinson’s poetry is consciously not poetry of experience. It is a universe made of words arranged through the poetic form into a different order of experience - one perhaps could call it aesthetic, but this might be reductive - an order, however, not less significant in existential terms. In this universe, words such as God, Life, Immortality, I, Love, etc., assume a conceptual dignity which is augmented, not diminished, by the fact that they are not tied to the experiential moment. Value hierarchies and traditional roles are revised and an expanded concept of existence emerges from Dickinson’s poetry. ‘Death’ in Dickinson is not exempt from such treatment. In fact, the impossibility for the living to experience the facticity of their own death is reworked in her poetry as the trace of an experience, a test, an experiment, which the poetic word bears witness of, thus preserving the memory of a desire for fullness of experience. In the well known poems I felt a funeral in my brain and I heard a fly buzz - when I died, 2 death is represented as the recollection of a series of sensory perceptions that, once organised in the artistic form, give a sense of what experience might be. These poems reveal as illusory the image that the poetry of experience pretends to convey, that is of a time when the word might have expressed with confidence the fullness of experience. In Dickinson’s poetry there is always an obstacle to absolute unity and immediate expression: in poem 465, such obstacle is ironically represented by a fly, interposed between “the light and me” and “I could not see to see”; in poem 280, “a plank in Reason broke”, and “I finished knowing then.” The moment of selfconsciousness, however, does not precede the poetic composition in order to be subsequently transferred onto its content. It is accomplished in and through the poem itself. The only possibility of a return to experience, however differently it might be conceived, is given only if the poet renounces the idea that the word carries the essence of that which it represents, while retaining the trace of a desire to transcend its semantic boundaries. I will return to this point later. Briefly, Dickinson’s treatment of death can be said to consist of three main strands. One such strand concerns the recorded experience of the death of others; another one assumes the death of the poet herself, who, imagining being a corpse, comments at her curious new condition. The third larger component takes the form of a complex elaboration on the conception of death. This paper will deal mainly with the latter, although the implications stemming from it inevitably affect the other two. In dealing with death, Dickinson makes a double effort in order first to divest the concept of death of its traditional metaphysical connotations and

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___________________________________________________________ second to let this concept interact with other concepts and thus create new combinations. Such double movement is not sequential but occurs simultaneously, thus increasing the gap between the initial effect of disorientation that her poetry engenders and the playful composure of her poetic lines. “Of Death I try to think like this,” states the first line of poem 1558, meaning that death is intelligible to us. In Dickinson’s poetry, death, far from representing the mysterious beyond of life, carries as a concept an existential weight that goes beyond the experiential moment traditionally associated with the end of life. This, however, does not imply a transposition into a transcendental sphere, as critics have often inferred. In metaphysical terms, death can say very little to the living. As the final stanza of poem 432 clearly states: I need no further Argue That statement of the Lord Is not a controvertible He told me, Death was dead Death, “the Old Imperator,” 3 is dead, or, to put it in other terms, it is not, or not any longer, the unintelligibility of death that constitutes a problem for the living, as the fact that death is now intelligible to us and is an available tool for the poetic form. To think of death through the poetic form means to mediate the facticity of death and to explore the prismatic nature of a word through which the living try to “distil sense” (Dickinson’s expression) of what is lacking to them. For Dickinson, death is “but our rapt attention to Immortality,” 4 or “an ecstasy of parting denominated ‘Death’.” 5 “Life is but Life! And Death but Death!” 6 Death is indifferent (“the quiet nonchalance of death” 7 ), but for “Us” (capital letter often used by Dickinson) is the “most profound experiment/Appointed unto Men-.” 8 Although death is still a fact of existence, “potential to that Man who dies,” 9 little can be known about it. As the first two stanzas of poem 153 state: Dust is the only Secret Death, the only One You cannot find out all about In his “native town.” Nobody knew “his Father” Never was a Boy Hadn’t any playmates,

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___________________________________________________________ Or “Early history” If death’s history cannot be known, certainly the significance of the word “death” unfolds itself in history and not outside history. This historical “presence” constitutes and legitimizes the existential conception of Death. The most well known exponent of the existential encounter with death is of course Martin Heidegger. In ‘Being and Time’, Heidegger is at pains to explain how one does not “experience” death, in any other way as “Dasein’s potentiality-for-Being,” as an anxiety, not “in the face of one’s demise,” but as an impending possibility of Being. 10 However to give a “full existential-ontological conception of death,” in Heidegger’s terms, 11 is not the main aim of Dickinson’s poetry. Unlike Heidegger’s disregard for the historicity of Being, Dickinson confronts History by addressing the constitutive historicity of the word as the mark of the detachment from the essence it purports to represent. 2.

The experiment Interestingly, when Heidegger seeks to give an ontological definition of Dasein, it is to the German lyric poet Friedrich Hölderlin that he turns. Heidegger’s interest in Hollering has been commented upon both by Theodor Adorno and by Paul de Man. In ‘Parataxis’, one of the most remarkable essays of his ‘Notes to Literature’, Adorno thus comments on Hölderlin’s use of ‘abstractions’ in his late hymns: “In his poetic usage they [the abstractions] acknowledge themselves as something historical rather than pictorial representations of something beyond history.” 12 One could hardly find a better and more appropriate definition of the non-metaphysical use of names in Dickinson’s poetry. Dickinson’s poetic universe is made of a ‘constellation of abstractions’, stemming from a self-reflective consciousness, aware of the illusory character of the correspondence between name and meaning. Perhaps the fact that originally Adorno refers this comment to Hölderlin gives us an insight into unexplored affiliations of Dickinson with the poetic continental tradition including poets such as Hölderlin, Rainer Maria Rilke, and Paul Celan, the translator of Dickinson into German. All these poets’ works, and Dickinson’s with them, address the question of the impossibility of the subject to speak for itself. In this sense their poetry stands in contrast with the poetry of experience. As Adorno writes: “Only by virtue of the fact that the abstractions put an end to the illusion that they can be reconciled with the pure concrete entity are they granted this second life.” 13 This ‘second life’, in which the concept is abstracted into and mediated via the poetic form, does not turn words into “living organisms,” as some critics have inferred in regard to Dickinson, 14

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___________________________________________________________ but into simulacra through which the whole of human experience is rethought in completely different terms. Heidegger’s rhetoric of the presence of Being, which he sees enacted in Hölderlin’s poetic language, neglects what Adorno calls “the agency of form” and turns concrete experience into an ultimately inward circuit of Being. 15 Heidegger places Being-towards-death right at the core of Dasein’s Being and accredits Hölderlin’s poetic language with a foundational quality that, as Paul De Man demonstrates, language simply does not have. In a crucial passage of his essay called ‘Heidegger’s Exegeses of Hölderlin’, Paul De Man writes: In its moment of highest achievement, language manages to mediate between the two dimensions we distinguish in Being. It does it by attempting to name them and by seeking to grasp and arbitrate their difference and their opposition. But it cannot reunite them. Their unity is ineffable and cannot be said, because it is language itself that introduces the distinction. Propelled by the appeal of parousia, it seeks to establish the absolute presence of immediate Being but can do no more than struggle, never found. 16 If poetic language undertakes the task to reflect critically on the nature of such distinction, then it becomes decisive to point out that in Dickinson such reflection does not lead to nostalgia. Although loss has penetrated the concept to its core, the ‘second life’, which Adorno makes reference to, should not be mistaken for a possible transformation of the impossibility of the poetry of experience into the possibility of the poetry of consolation. “Death sets a Thing significant,” states the first line of poem 360. One might ask: significant to what? Does this mean that Dickinson invests death with a ‘positive’ meaning? A further analysis into the context in which she uses the word death seems to disprove this suggestion. If on the one hand the human condition of ‘finiteness’ is a ‘privilege’ 17 and death a ‘need’, 18 on the other hand, the possible outcome of a close encounter with death is manifold and unpredictable. Dickinson’s use of death is certainly not designed to reconcile us with the anxiety we experience in the face of our own demise. In her constellation of abstractions, a demythologised version of death is granted a ‘second life’ and connected to other apparently remote abstractions. Thus, in poem 234, death is characterised in commercial terms: “'Tis just the price of Breath /With but the ‘Discount’ of the Grave -/Termed by the Brokers -‘Death!’” In poem 614, Death is associated with Grace: “Many Things - are fruitless

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___________________________________________________________ -/'Tis a Baffling Earth -/But there is no Gratitude/Like the Grace - of Death-.” Death and Life are juxtaposed in many of Dickinson’s poems. For example, the short poem 816 states: “A Death blow is a Life blow, to Some/Who till they died, did not alive become/Who had they lived had died, but when/They died, Vitality begun.” Dickinson is at ease in the territory of literary language. Amongst all abstractions, death allows for a more sophisticated play with equivocations and ironic language games. The ambiguity lies at the core of a word that designates that which by definition cannot be concretely experienced but it is constitutive of Dasein as an impending possibility. Heidegger, by placing the ontological characterization of ending and totality at the centre of Being, resolves this ambiguity by making Hölderlin’s poetic word coincide with essence, absolute presence of Being. Instead, in Dickinson’s play with death such ambivalence is wilfully maintained; the essence of poetry is to mediate for the living the impossibility of an authentic unmediated Being. Not only death is demythologised in her poetry, but even the semantic coordinates within which the word “death” occurs are destabilised and destabilising. Thanks to the use of the “syntactic doubling” - namely, as Cristanne Miller explains, “the use of a single word or phrase to cover two nonparallel syntactic contexts” 19 - the destabilising effect permeates the structure of the poems even down to its minimal components. In poem 539, the play is between the words Death, Defeat, and Despair: The Province of the Saved Should be the Art - To Save Through Skill obtained in Themselves The Science of the Grave No Man can understand But He that hath endured The Dissolution - in Himself That Man - be qualified To qualify Despair To Those who failing new Mistake Defeat for Death - Each time Till acclimated - to Again, the question one might ask is: “acclimated” to what? To death? To defeat? Or despair? And in any case, “that man” that is qualified “to qualify despair”, what kind of dissolution has he endured? The dissolution of death or of defeat?

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___________________________________________________________ In poem 510, the ambiguity is played both at the level of content and form: “It was not Death, for I stood up, / And all the Dead, lie down-” Thus the poem begins. It is and it is not death. Another line states: “The Figures I have seen/Set orderly, for Burial, /Reminded me, of mine-.” In this poem, the “experience” of death is nothing other than a trace in our memory, stimulated by sensory perceptions - sight, sound, smell, taste, and touch are all involved. A feeble ‘as’ separates the remembrance of a semblance of death - what would be a paradox in a non poetic context from a ‘shaven life’, ‘fitted to a frame’: ‘as if my life were shaven/And fitted to a frame,/And could not breathe without a key […].’ Such reference to ‘life’, however, is not reassuring. The poetic form does not romantically authenticate experience, nor does it impart a coherent meaning to fragments of existence. Dickinson’s poetry reflects thematically the impossibility of fulfilling its original promise to achieve and elaborate meaning on the sole basis of its own strength, and ultimately it therefore prompts the question as to whether or not there is concrete meaning. In existential terms, Dickinson’s ironic and playful engagement with death at the level of the conceptual administers to a much deeper ontological need, namely the need to “distil sense,” making sense, not of death, but of experience as a whole, in its contradictory forms. In poem 883, Dickinson reflects on the limits inherent in the position of the poet vis-à-vis the production of meaning: The Poets light but Lamps Themselves - go out The Wicks they stimulate If vital Light Inhere as do the Suns Each Age a Lens Disseminating their Circumference Poets go out, “disseminating their circumference”. It is not a fall into meaninglessness or, worse, a renunciation of the stimulating light of poetry, and neither, however, is it mystical transcendentalism, as it has often been imputed to Dickinson, but poetry as the refracting lens through which new understandings of experience, death included, are historically unfolded. The poet is not the dispenser of pre-established meanings but the distiller of sense. As the first stanza of poem 448 states:

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___________________________________________________________ This was a Poet It is That Distils amazing sense From Ordinary Meanings Sense is the word that here identifies the beyond which Dickinson’s abstractions point at, in a dialectical movement that distils meaning from the multiplicity of a fragmented experience and returns it to us as poetry.

Notes 1

The poems are numbered according Thomas Johnson’s arrangement in The Complete Poems of Emily Dickinson, ed. Thomas Johnson (Little, Brown and Company, 1957), which reproduces the 1955 Harvard edition but gives only one version of each poem. “Of Death I try to think like this” is the first line of poem J 1558. 2 Respectively poem J280 and J465. 3 Poem J 455. 4 Poem J 7. 5 Poem J 71. 6 Poem J 172. 7 Poem J 194. 8 Poem J 822. 9 Poem J 548. 10 Martin Heidegger, Being and Time, trans. John Macquarrie and Edward Robinson (Oxford: Blackwell Publishing, 1962), 295. 11 Heidegger, 303. 12 Theodor W. Adorno, ‘Parataxis’, in Notes to Literature Volume Two, trans. Shierry Weber Nicholsen (New York: Columbia University Press, 1974), 124. 13 Adorno, 125. 14 See Joseph Raab, ‘The Metapoetic Element in Dickinson’, in The Emily Dickinson Handbook, ed. Gudrun Grabher, Roland Hegenbüchle and Cristanne Miller (Amherst and Boston: University of Massachusetts Press, 1998), 273-295. 15 Adorno, 114. 16 Paul de Man, ‘Heidegger’s Exegeses of Hölderlin’, in Blindness and Insight: Essays in the Rhetoric of Contemporary Criticism, 2nd ed. (London: Routledge, 1989), 259. 17 Poem J907.

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Poem J1112. Cristanne Miller, ‘Dickinson’s Experiments in Language’, in The Emily Dickinson Handbook, 249. 19

Lucia Aiello is a Lecturer in Literature and Philosophy at John Cabot University, Rome, Italy. Currently she is working on a monograph on Emily Dickinson’s poetry and the idea of a feminist poetics.

Coming to Grips with Death: Explained and Explored in a Children’s Picture Book Phil Fitzsimmons Abstract This paper details how Jenny Wagner’s best selling children’s picture book ‘John Brown, Rose and the Midnight Cat’, explores the onset of death and coping with death. Although this text was the Australian picture book of the year in 1978 and has continued to be a children’s favourite for almost three decades, the description of the book on the Healthy Books website as “a strange little fable, but quite beautiful in both words and pictures” 1 reveals just how widely misinterpreted and misunderstood this text continues to be. An overlay of archetypal analysis discloses a deeper subtext where the concept of death becomes a para-textual sliding signifier revealing the current First World’s fear of death. Key words: children’s’ literature, death, fear of dying. 1.

Introduction: from the personal to the public Overall this paper represents a thirty-year reflective culmination of trying to understand how one of Australia’s best selling children’s picture books could have been bypassed by academics and to some degree educators for over a generation. How could a text such as ‘John Brown, Rose and the Midnight Cat’ reach classic status amongst parents and children and been research dormant for this period of time? Conversely, why do parents still by this book for their children? In regard to the first question, the answer could simply be that this book has slipped through the methodological cracks of academe because the overwhelming debate amongst educational researchers during this period has been on how children learn to read and not on what they are reading. However, as I see it this period of debate, a euphemism for what has been termed the ‘literacy wars’, is also symptomatic of an even longer socio-cultural disavowal, a period and perspective that Rose has termed “the difficulties and contradictions of childhood.” 2 In the field of children’s literature these contradictions include the continuing impact of Rousseauian philosophy on publishers of children’s books, the sexuality of the child and the concept of death. This cultural denial has in turn lead to the almost exclusive use of ‘puritan’ images and imagery of children and childhood in First World publishing houses that attempts to completely deny or completely ignore the existence of these facets.

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___________________________________________________________ This leads to the second question, why do parents still by this book for their children? It has been my experience that parents have no idea about the true nature of this text. It would appear that they have become so imbued with the typical feel good sentimentalism of children’s texts they have, in the Antipodes at least, fallen into a form of Freudian deception. That is children’s literature just like the fictional nature of language itself has built up a façade, in this case one of denying reality. In general, the background condition of an interpretative community in the reading process can be so pervasive that it can be hard to see that it is there. 3 On the surface this text is a typical, albeit quirky, children’s picture book. Its drawings are rounded and soft. The text, although a little bizarre, involves a grandmother figure and animals, forms and figures that children are supposedly attracted to because of their “psychological and cognitive appropriateness, and their ability to stimulate youthful imaginations.” 4 I want to argue that the visual appearance and simple story line in this narrative is a complete smokescreen and a form of literary epithelization, a fictional veneer that overlays an ongoing context of culture in denial. 2.

Children, death and the context of culture ‘John Brown, Rose and the Midnight Cat’ arose out of the cultural milieux of the late 1970’s that in some degree gave it literary birth, a time characterised by “a lack of mythology in our society.” 5 Of course, this context of situation was the product of a much larger chain of historical events. In the area of child growth and development, it is generally accepted that there are three historical periods of death as it relates to the more industrial societies. From 1600 to 1830, children lived in an overwhelmingly agrarian culture and within an extended family. Because of its proximity and constant exposure death in the family and death of the livestock that supported the family was a natural part of life. The second period extending from 1830 to 1945 is viewed as the ‘dying of death’. With increased urbanisation and the Victorian tendency to pigeon hole its worldview; death and life became separated as constructs. As well, the extended family began to disintegrate and death was gradually relegated to the retirement home. Death also became professionalised with the mortician now undertaking the formalities that

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___________________________________________________________ the family used to perform. The rituals of death and its preparations became an ‘out of sight out of mind’ concept. The first explosions of the atomic bomb in 1945 ushered in the third phase of death and dying. With the possibility of universal annihilation at the push of an anonymous button, mortality became more focussed in the collective psyche of ‘first world’ peoples. There was a supposed reawakening of death. However, with this resurrection of death, there was a corresponding universal movement to protect and shield children from it. Thus a social phenomenon commenced in the 1830’s that sought to “restrict children from accessing taboo topics.” 6 Children’s literature became the bastion of all pure thoughts and reality was kept at arms length. However, I believe that this last period has evolved into another phase. The overwhelming cultural belief of the Allies following the end of the Second World War was one of trust in science, economics and the existential view that “God is on our side.” 7 To a large degree these world-views came to a crashing halt with the end of the Vietnam War and the ensuing ‘blood guilt’ of those countries that participated in this war. With the failure of the American intervention in Vietnam, I would argue that this personal “repression of death” 8 was further hardened into a period of increased collective repression and a period of nihilism and further denial was ushered in. In the world of children’s literature, the effect on publishers was to further enforce the collective shield that grew out of the post 1945 period. While death in the early 1970’s had been a clearly manifested in the daily news reports on the body bags gathering in Vietnam, with only a few exceptions children’s books in Australia generally reflected and reinforced wholesome images. John Brown, Rose and the Midnight Cat was one of these exceptions, and while it gained critical acclaim its content has never received critical scrutiny. 3. Peeling back the pages and scrutinising the layers A. A summary of the narrative This twenty-five paged book opens with a single frame that depicts an old woman patting a large dog, underpinned by the sentences; Rose’s husband died a long time ago. Now she lived with her dog. His name was John Brown. With the notion of death at the fore, this text then moves into a continuing pattern of illustrations above the text. However, despite the simple and often single sentence descriptions, the notion of death is

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___________________________________________________________ subtly carried forward in nearly every illustration or linked illustrations. However, one has to look beyond the text, as this text is deceptive because of its elegance. As copyright and limited editorial space does not allow me to reproduce the book in tact, the following summary is provided so that you the reader can begin to understand the paratextual interplay in this narrative. Rose and John Brown live alone in a small farmhouse. The are seemingly comfortable in their existence, feeding the animals and sitting reading under a tree until Rose, looks out the window one night and thinks she sees a cat. Refusing to accept she sees a cat, John Brown in subsequent frames refuses to even look in the direction that Rose is gazing, stating that he doesn’t see any cat. It is in the next frame that a pivotal confrontation occurs. In one of the two most focussed pages in the entire book, John Brown is seen aggressively facing the cat as it quietly sits: But that night when Rose was safe in bed, John Brown went outside. He drew a line around the house… and told the midnight cat to stay away. “We don’t need you, cat,” he said. “We are alright, Rose and I.” 9 In the following pages Rose is seen again peering out the window and winding back her clock as she debates with John Brown about being able to see the cat. John Brown moves into total denial, finally closing his eyes. In the next six pages there is an ebb and flow of denial and acceptance of the cat. Rose puts out milk for the cat, John Brown tips it out and is shown facing in the opposite direction to Rose. The last page of this section, the two are facing each other and John Brown exclaims, You don’t need a cat. You’ve got me. 10 It is at this point that the midnight cat appears at the window, and Rose wants to let him in but John Brown again refuses. Rose then goes to bed. John Brown waits for his breakfast but nothing happens. When he visits Rose in her room she states that she is staying in bed; All day, and for ever. 11 In one the last of the two largest and most focussed frames, John Brown thinks things through, and after waking Rose asks if letting the cat in would make her better. “Yes”, she replies. “That’s just what I

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___________________________________________________________ want.” The cat is let in and Rose gets out of bed to join her animals companions, and the book ends with the cat purring. B. Understanding the subtext The text that I have highlighted gives insight into Booth’s notion that even the simplest of narratives “can only be spoken of in figures and metaphors.” 12 The critical metaphorical point of course is where John Brown draws a circle around the house and attempts to stare down the midnight cat. It is this double paged instance a critical mythical symbol surfaces, and creates the chiastic hinge which allows the reader to see the more clearly the metaphoric symbols before and after this sequence. The circle in mythic terms represents the dividing line that “illuminates the balance between life and death.” 13 The circle is actually a simpler form of the labyrinth, an outline that represents the alignment between life and death, a path that “… joins the visible to the invisible, just as the axis joins and separates two inverse and symmetrical parts of a single pattern.” 14 The encounter between John Brown and the midnight cat with the circle acting as the dividing line is also a long held mythic tool of analysis. Two contrasting animals typically represent the ultimate asymmetrical psychical tension common to all human kind that is the contrast and lack of understanding between the two interconnected worlds of human kind’s faulty appreciation and the realities existing in the larger cosmos. In this instance, this tension is further highlighted by the dog being personified and the cat being named but not with capital letters. Thus, the now generalised midnight cat, often seen as being representative of death, darkness and whose name has connotation of the darkest hour, is in this context a typical inversion metaphor that often occurs in tropological literature. Lying as it does at the heart of the metaphoric labyrinth, a point in which both sides of the one element of theme confront each other, and by a subtle shift of perception and transformation reveal their interconnectedness. Hence in this text the dog represents those who resist “the fact that death is the destiny of life” 15 , and the cat the actual destiny: Awareness of mortality is the alpha and omega of all that we do. 16 While cast as being happy in these opening two pages, Rose does not smile again in this text until the final frame. This is a carefully constructed signal because despite the appearance of contentment, Rose does not look directly John Brown again until he allows the midnight cat

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___________________________________________________________ into the house. While the text tends to indicate otherwise, the pictures reveal that Rose is living an inauthentic life. With the written narrative purporting an apparently comfortable existence within the four walls of her house with her pet as her only companion her downcast face gives off the sense that she is otherwise absorbed. Her house is in fact her prison. Typically, the house is emblematic of the universe and its inhabitants with the points of architecture representing the intervention of light into darkness. However, in this case instead of a microcosm of transcendence, Rose’s immediate world is the opposite in focus and direction. With her eyes down cast or peering outside, she is both physically and symbolically unable to see the truth that is all around her. The initial symbolism of the brevity of summer quickly passing into winter in conjunction with her gaze gives metaphoric voice to her ignoring of the passing of time. In tandem with this the blazing fire in the opening scenes is seen to die down in subsequent frames. With the chimney presenting the universal passageway from this world to another, in the very opening scenes the text may frame a life of ease, the visual elements reveal a life in denial. In harmony with the symbols of transformation and change, Rose is also framed by archetypal elements representing a further series of polarities. The wallpaper in her house is a patterned with roses. In mythic terms, and a corresponding “life as art view” 17 this flower is a more modern version of the lotus, representing both spiritual direction and universality. In this text the central character’s name and immediate surroundings reveal her need but her actions, reveal that Rose’s existential view was becoming “…hardened,… fixed,… and irreparable.” 18 That is until she sees the midnight cat and realises that the life she has been living in denial. Life without death is role-playing one’s entire existence, and having accepted this she is then seen at doors and windows, the universal symbols of the gateway to the genuine soul. 4.

The ultimate narrative: A question of life and death ‘John Brown, Rose and the Midnight Cat’ is a metaphorical microcosm revealing that the first world has not only “lost the symbol system of death” 19 but that by and large is in a state of “denying their final destiny.” 20 This book offers no answers to what happens after death, but seeks to highlight the greatest dilemma that lies at the deepest stratum of psyche; “… our fear of death. That which we carry secure in our heart, but this is our authentic heart, our authentic self.” 21

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___________________________________________________________ Just as Rose faced the existential choice of whether to let the cat in and accept death or remain suspended in ‘inauthenticity’, so too we too do not have to be “boxed in by a fiction of permanence.” 22 To let the cat in is to live.

Notes 1

Healthy Books, ‘On-line sales’ 3 June 2005, (14 February 2006). . 2 Jacqueline Rose, The Case of Peter Pan or the Impossibility of Children’s Fiction. (Philadelphia: University of Philadelphia Press, 1984), 15. 3 Carol F. Feldman, ‘The Construction of Mind in an Interpretive Community’. In Literacy, Narrative and Culture, edited by Jens Brockmeier, Min Wing and David R Olson, 52-66. (Surrey: Curzen Press, 2002), 58. 4 Michael Hilton, Potent Fictions. Children’s literature and the challenge of popular culture. (London: Routledge, 1996), 25. 5 Steven .A. Galipeau, The Journey of Luke Skywalker: An analysis of modern myth and symbol. (Chicago: Open Court, 2001), 3. 6 Maire Messenger-Davies, ‘The Child Audience - Pre-School Programming’. In The Television Genre Book, edited by Glen Creeber, 97102 (London: British Film Institute, 2002), 99. 7 Susan Wallis, Portents of the Real: A primer for post 9/11 America. (New York: Verso, 2006), xiv. 8 James Park, Our Existential Predicament: Loneliness, Depression, Anxiety and Death, 5th Edition. (New York: Existential Books, 2000), 183 9 Jenny Wagner and Ron Brooks. John Brown, Rose and the Midnight Cat. (Camberwell: Puffin), 1. 10 Wagner and Brooks, 5. 11 Wagner and Brooks, 15. 12 Wagner and Brooks, 31. 13 Wayne C. Booth, The Rhetoric of Fiction. (Chicago: University of Chicago Press, 1961), 24. 14 Patrick Conty, The Genesis and Geometry of the Labyrinth: Architecture, Hidden Language, Myths and Rituals. (Rochester, Vermont: Inner Traditions, 2002), 53. 15 Conty, 53. 16 Alfred Adler, Problems of Neurosis. (New York: Harper), 145.

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Jeffrey Kaufman, ‘Disassociative Functions in the Normal Mourning Process’. Omega, 28, (1994), 31-38, 38. 18 Richard Rorty, Contingency, Irony and Solidarity. (Cambridge: Cambridge University Press, 1989), 45. 19 Charles Pierce, ‘The Fixation of Belief’, in Buchler, J. (ed.), Philosophical Writings of Charles Sanders Pierce. (New York: Dover Press, 1955), 12. 20 Ernest Becker, The Denial of Death. (New York: Free Press, 1997), xiii 21 Becker, viii. 22 Fritz Perls, Gestalt Theory Verbatim. (Lafeytette, Cal.: Real People Press, 1969), 260. Phil Fitzsimmons currently lectures in language education at the University of Wollongong, Australia. His research interests focus on critical literacy, visual literacy and children’s literature.

Older People’s Preferences at the End-of-Life: a Review of the Literature Eileen Sutton and Joanna Coast Abstract This paper presents evidence from a review of 60 studies looking at older people’s preferences at the end of life published between 1995 and 2005, and highlights the potential for future research in this area. The review revealed three main areas of focus: treatment decisions, place of care/death and good death. However, there is some evidence of a cultural variation in research focus. Whilst much of the research on treatment preferences originates from the US, where advanced care statements are more popular, research on place of care mostly originates from the UK. Studies present conflicting evidence on the impact of socio-demographic variables such as age, gender, religiosity and ethnicity on treatment preferences and preferred place of care/death, and there are indications that patient choice may be service-led and tempered by personal circumstances such as the availability of informal care, the existence of local service provision, and awareness of this provision. Although it is difficult to disentangle the relationship between age, health status and the dying experience, it would appear that there may be certain features of a good death that remain constant. Key words: older people, death and dying, end-of-life, end of life, preferences. 1.

Introduction The proportion of older people in the United Kingdom population is growing. In 1961, just 0.7% of the population were aged 85 and over, but by 2002 this rose to 1.9%. Projections for 2031 indicate that this will rise to 3.8%. 1 This growing ageing population has implications for health and social care service provision. The UK National Health Service already spends around 40% of its total budget on people over the age of 65, and approximately 50% of Social Services expenditure is also allocated to this age group. The Government has declared its commitment to providing high quality person-centred care for older people, as well as dignity in care at the end-of-life 2 and it is important that resources are carefully targeted to meet older people’s needs. Death is now most likely to occur at the end of a long life 3 and the recent growth in hospice and palliative care services has drawn attention to the importance of quality of death and dying, in addition to quality of life, in old age. However, research has found that the modern way of death does not always meet people’s hopes and desires. 4 Questions around how to separate, or measure quality of death, rather than

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___________________________________________________________ quality of life, have been raised. Is there a particular point in time when people can be regarded as being “actively dying”, 5 and is this dependent upon the “dying trajectory” 6 or perceived course of a particular disease or condition? Organizations such as the Help the Aged and Age Concern have produced guidelines or definitions and principles of a good death, 7, 8 but we do not know if goals to improve the dying experience of older people are being achieved in practice. Some evidence exists that their choices concerning place of death are not being met, with the majority still dying in hospital, despite saying they would prefer to die at home. 9, 10 However, whilst statistics are available on life expectancy, mortality and cause and place of death, we still know relatively little about older people’s personal experience of the dying process.9 This review, therefore, aims to examine the existing literature on older people’s preferences for care at the end-of-life and indicate areas for future research. 2.

Main findings of the literature review The majority of studies included in this review originated from the United States (64%), with literature from the UK providing 19% (11 papers), and Israel 9%. There were also three papers from Canada, one from the Netherlands, and one joint paper from the US and Japan. The main focus of studies was treatment decisions – including advance care directives/planning, living wills, and life sustaining treatments. The next most popular theme was a good death (quality of care/dying). These papers tended to focus on older people’s perspectives of what constitutes good quality care at the end-of-life and during the dying process. The remaining papers were specifically concerned with place of care at the end-of-life or place of death. Studies employed a range of methodologies from reviews of literature to surveys and qualitative interviewing. 3.

Treatment decisions These studies focus on advanced care statements/planning, living wills, health care power of attorney and medical decision-making (issues around life-sustaining or prolonging treatments/technologies and their continuation or withdrawal). Several papers seek respondent’s preferences for life-sustaining treatments (LST’s) in various illness/disability scenarios presented. Studies looking at the stability of people’s preferences and gender and cultural variations in end-of-life decision-making are also included. Eight studies present data on the number of respondents with some type of advanced care directive, or living will, although it should be noted that the terminology is used somewhat interchangeably. Four of the papers originate from the US, but interestingly, the study from the

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___________________________________________________________ Netherlands, where euthanasia was legalised in 2001, revealed the lowest numbers of written advance directives. 11 Figures range widely from 9% 12 to 64%. 13 Schiff et al’s 14 UK study found that 82% of participants hadn’t heard of a living will, advance directives or advanced care statements, and of those who had, only four could describe them correctly, most believing they were concerned with financial arrangements. Some studies also present figures for those who have a designated power of attorney or surrogate decision-maker, ranging from 27% 15 to 49%. 16 Three studies report that the majority of respondents had discussed end-of-life treatments with either doctors or relatives, 17, 18 but conversely Matsumura et al 19 found that few had discussed these issues with a doctor, but many would like to do so. Gender differences may be apparent, with more women than men in one study possessing a living will (28% compared to 19%). 20 Hawkins et al 21 report that 55% of older people in their study felt that it is “definitely necessary” to record patients’ wishes in an advance directive, although the study does not give figures for the number of people who had executed such a document. Qualitative research from the UK emphasises the interdependency between dying people and their families and concludes that advanced care statements can be helpful with the burden of decision-making at the end-of-life, but that this process should involve ongoing discussion and review, to take account of changing preferences. 22, 23 , 24 A substantial number of papers are concerned with the expressed preferences of older people for treatment, or its withdrawal, in various illness/disability scenarios. There is some evidence that people value cognitive ability more than physical functioning 25,26 with advanced dementia the most feared condition in one study, becoming even more unacceptable when combined with other disabilities. 27 Some studies 28, 29 look at the effect of treatment outcomes on people’s preferences, with varying conclusions. In a study by Fried et al 30 almost all participants preferred a low-burden therapy that would restore their current health status, if the alternative without treatment was death, but if the low-burden therapy resulted in an outcome of severe cognitive impairment almost 90% would not choose to receive the therapy. In contrast, other studies found that in illness scenarios presented there were many instances when participants rated the outcomes of treatments as a heath state worse than death, but still wanted treatment 31 or rejected a recommendation for palliative care, requesting active treatments. 32 A study of bereaved relatives has shown that patients’ preferences are often ignored, revealing that 56% of patients had received at least one LST in the last three days of life, despite requesting “comfort only” care. 33 Other studies, however, show that doctors and caregivers have varying perceptions of the patient’s

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___________________________________________________________ preferred type of treatment 34, 35 , 36 , 37 with one revealing that 50% of patient-caregiver pairings disagreed concerning mechanical ventilation. 38 A further study reporting on patient’s chosen surrogate decision-maker’s lack of knowledge of end-of-life treatment preferences found that 91% of patients were, nevertheless, willing to let these surrogates have some leeway to override their written decisions. 39 Results from studies are, in some cases, further analysed for the impact of personal and socio-demographic characteristics, including religiosity, gender, and ethnicity. Five papers look specifically at the attitudes and preferences of different ethnic groups to end-of-life care 40, 41 , 42 , 43 , 44 and ethnicity is one of the variables noted in many of the other papers reviewed, although much of the research reported here involves white respondents. African-Americans were found more likely than European-Americans, Korean-Americans and Mexican-Americans to want to be kept alive on life support in one study 45 and similarly AfricanAmerican patients with terminal cancer desired the use of LSTs more than their white counterparts in both their current health state, and in a neardeath condition. 46 African-Americans were found to be less likely than whites to have executed advanced care statements, 47 but there is some evidence that attitudes towards end-of-life care change with acculturation, with increasingly positive attitudes towards foregoing care and advance care statements. 48 Significant gender differences in treatment preferences are reported in some studies 49,50 with men reporting a stronger preference overall for LSTs. 51 However, the significance of gender on treatment preferences is disputed by other authors. 52, 53 The impact of marital status appears to be less contested, with unmarried individuals more likely to have discussed their preferences with others 54 or present an “activist” position towards end-of-life decision-making. 55 In this study “activists” were seen to prefer a voice in the decision-making process, in contrast to “delegators” who prefer to delegate decision-making to their doctors, to God or to fate. “Activists” were more likely to be better educated, held more professional and managerial jobs and tended to be middle class. 56 Age may also be a relevant consideration, with some participants in a study by Rosenfeld et al believing that at an advanced age they had lived a natural life span placing more importance on maintaining function, rather than living on, and being less willing to tolerate the risks of pain and uncertain outcomes of some treatment options. 57 The impact of age on preferences, however, is disputed in another study. 58 The literature presents conflicting information on the impact of religiosity on older people’s treatment preferences, with Cicirelli et al 59

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___________________________________________________________ reporting that respondents with a greater preference for refusing treatment and in favour of assisted suicide were less religious, this conclusion is supported by Klinkenberg et al 60 who found that more religious people were less likely to have expressed preferences in advance. However, other studies found no significant association between religiosity and treatment preferences 61 and only small differences in position on control of dying. 62 A study of male veterans found that, for treatment preferences, only tube feeding showed a significant relationship with religious affiliation, with Catholics less willing to undergo this type of treatment than other Christians. 63 Two studies, one from the US and the other from Israel, report specifically on the stability of older people’s treatment preferences over time. In one US study, preferences were reported as moderately stable over a two-year period, with those concerning the most invasive treatments showing the greatest stability. 64 The second study found that preferences were relatively alike and quite stable over a similar time period, with around 70% of respondents showing no change in preferences, but with a slightly stronger trend towards wanting less treatment. 65 Declining health status could also impact on preferences over time. A study examining the relationship between worsening physical function and depression and preferences for LST in older doctors found that those who experienced clinically significant physical functioning decline were more likely to prefer high-burden treatment options rather than no treatment, thus posing a challenge to written advance care statements which do not take account of declining health status. 66 4.

Good death (quality of care/dying) Authors recognise the difficulties in distinguishing between the quality of the dying experience and quality of life. Differentiation between some of the main components of a good death can also be problematic, because of the co-dependence between these components. For example, psychological well-being is closely connected to spiritual/whole person concerns. Nevertheless the most frequently cited features of a good death are detailed below. It should be noted that much of the research in this section involves data from both older and younger participants, and those with, or without, terminal illness. Consequently, it is more difficult to determine the impact of age and health status upon preferences in this area than in previous sections, although results will be differentiated where possible.

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___________________________________________________________ A. Family/carers The most common theme, which occurs in the majority of papers, is the significance of family and caregivers to the quality of the experience of the dying person, regardless of their age and socio-economic status. This theme has two main strands, firstly social, and secondly caring perspectives. The importance of spending time with friends and family 67 68 is emphasised, as is valuing friends and family 69 and feeling loved and cared for. 70 Social relations and support, 71 and social functioning and well-being 72 are also highlighted. Dying may also facilitate reunion with relatives 73 and a strengthening of relationships with loved ones, 74 with the majority of older people preferring family and friends to be present at some stage during the dying experience. 75 Williams highlights the importance of being cared for by the right people 76 and family members are often vital to the care of older people, 77 thus enabling their preferences to be met. Family members are frequently involved in the decision-making process regarding treatment options 78 and place of care. There is evidence, however, that older people’s preferences in this area are tempered by concerns around the potential caring burden on family or other caregivers and the availability of informal care. 79, 80 , 81 , 82 , 83 , 84 B. Symptoms/physical care Many of the papers mention the physical symptoms of terminal illness and their treatment, and in particular pain control, 85, 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 with broad agreement that patients should have access to appropriate medication and therapies. Nevertheless, research by Steinhauser et al with terminally ill patients, bereaved family members, doctors and other care providers, found that the most highly ranked attribute by all groups was being kept clean. 96 Interestingly, although freedom from pain was universally highly rated in this study, patients themselves judged this attribute to be slightly less important than did the three other groups. Being able to participate in activities of daily living such as eating, sleeping, and walking was also rated as significant by respondents in some studies, 97, 98 , 99 and this is closely connected to the theme of independence and control (discussed below). C. Spiritual/whole person concerns This theme was quite complex, with threads relating to religious faith 100, 101 , 102 and being at peace with God, 103,104 spiritual and existential beliefs, 105, 106 , 107 as well as feelings of worth. 108 Care at the-end-of-life should be culturally sensitive 109 and take the whole person into consideration, with the dying person able to access desired spiritual and

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___________________________________________________________ emotional support, 110 which might include visits from a religious leader or clergy member. 111 Older people participating in an Israeli study felt that a good and meaningful life was a prerequisite for a good death 112 and similarly in a UK study 74% of patients felt that it was important to remember personal accomplishments, although this attribute of a good death was ranked more highly by care providers, relatives and doctors than patients themselves. 113 D. Psychological well-being Closely linked to the above are issues surrounding the psychological well-being of older people. Authors report the need to be treated with dignity and respect 114,115 and to receive emotional support from both professional and family caregivers 116 to help alleviate feelings of fear, anxiety and depression, which are often experienced at the end-oflife. 117 Older people’s fears included being a burden, loss of dignity or “being a vegetable” 118 and having a doctor with whom one could discuss fears was regarded as significant by 90% of patients in Steinhauser’s 119 study. Similarly, discussing fears was integral to affective communication in Gautier’s model of end-of-life care. 120 E. Time/place of death Uncertainty around the dying trajectory of individual diseases and conditions means that it is difficult to establish at what point people can be defined as “actively dying.” 121 Some authors viewed death as a sequential process occurring over a prolonged period of time and extending beyond the moment of death, to take account of the impact of death on loved ones. 122 Contradictions existed between some study respondents’ descriptions of a good death, which envisaged dying quickly, quietly, unconsciously, in a desired location and free of pain, avoiding inappropriately prolonged dying, 123, 124 , 125 , 126 with a desire to complete preparations and having time to say goodbye, possibly surrounded by family and friends. 127, 128 Age of death was noted as having an impact in one UK study, which found that in practice older people experienced better deaths than their younger counterparts. This may have been partly due to older people feeling that they had lived a full life, that some of their closest companions had already died and that they might possibly be reunited with them, if they believed in an afterlife. 129 F. Preparation Being prepared for death was recorded as an important attribute of a good death by several authors, this theme covering personal, medical, practical and financial preparations. As previously mentioned, having the

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___________________________________________________________ opportunity to say goodbye to loved ones, and resolving unfinished business or achieving a sense of closure 130, 131 were all viewed as significant. Other concerns such as having funeral arrangements in place 132 and making appropriate financial preparations, including those concerning care costs, were also regarded as important. 133 Appointing surrogate decision-makers and deciding on treatment preferences, or writing advanced care directives, were other aspects of preparation. 134, 135 , 136 Much of the motivation for making preparations in these areas was to remove burden from loved ones. 137 G. Independence/control Several authors mentioned the significance of allowing dying people to retain some control over their care. 138, 139 , 140 , 141 This might involve participating in everyday activities for as long as possible, or permitting them to feel that, even at this time, they had something to contribute to others. 142 Young and Cullen described the way some study participants with terminal illness attempted to exercise control by taking less than their prescribed dose of pain medication, perhaps to reassure themselves that death was not imminent, as pain and death were closely associated for some respondents, so managing without pain relief signalled progress. 143 H. Policy/service provision The need for co-ordinated health care and related services which are focused on the requirements and values of the dying, including specific provision for those suffering from dementia, is highlighted throughout the studies. 144, 145 , 146 A lack of hospice care provision within some areas in the UK has resulted in unmet need. 147 The UK Debate of the Age Heath and Care Study Group recommend that palliative and terminal care services should be based on the principles of a good death presented within their report, in order to ensure that older people can achieve maximum individual autonomy and control over their deaths. 148 5.

Place of care/death Preferences for place of death vary across studies, with figures for home as preferred place of death ranging from 43% 149 to 94%. 150 There is conflicting evidence on the impact of health status upon preference, as in one study recently hospitalized patients were more likely to opt for hospital care, 151 whereas in other studies, respondents with life limiting or terminal illness preferred either home or hospice care. 152,153

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___________________________________________________________ Age and gender may both impact upon choice, with preference for home care falling, and hospice care rising, with advancing age. More women than men opt for hospice care 154 and also express more practical concerns over care in the home. 155 However, other authors dispute the impact of gender. 156, 157 There is some evidence that unmarried people are less likely to opt for home care, 158 this being related to the availability of informal carers potentially restricting their choice. Dependency when dying 159 and fears of being a burden to relatives 160 are also important factors which need to be understood when analysing patient preferences. Only one of the studies considers the impact of ethnicity upon preferences and this revealed that a higher number of deceased black Caribbean than native-born white patients living in the UK had expressed a preference for location of death, and that, of those patients that had, slightly more of the former group wanted to die at home. 161 However, the study also shows that only just over half had this preference met, with similar figures for both groups. Similarly, only one study published results by employment status, revealing that those from a professional and management background were more likely to opt for hospice care and those from semi-skilled backgrounds had the highest preference for care at home. 162 One study conducted in a deprived area of London comments on the potential impact of social disadvantage in shaping patient choice. 163 Two studies mention the impact of religion, with contradictory results, being either influential 164 or insignificant. 165 6.

Conclusions A review of the literature on older people’s preferences for care at the end-of-life has revealed three main areas of focus: treatment decisions, place of care/death and good death (quality of care/dying). The majority of studies originate from the US and there is some evidence of a cultural variation in focus. Whilst much of the research on treatment preferences originates from the US, where advanced care statements are more popular, research on place of care tends to have been carried out in the UK, so further research in other geographical areas would be useful to help to establish the existence of cultural differences in these preferences. Although many of the studies in this review involve research with white respondents, there is some evidence that ethnicity has an impact on preferences for care at end-of-life. Studies present conflicting evidence on the impact of socio-demographic variables such as age, gender and religiosity on treatment preferences, but there are indications that patient choice may be service-led, with older people’s preferences tempered by personal circumstances such as the availability of informal care, the existence of local service provision, and awareness of this provision.

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___________________________________________________________ Although some evidence exists on the impact of health status, further research involving direct comparisons between healthy older people’s preferences with those of older people with terminal illness, would be helpful to inform health care commissioners targeting end-of-life service provision and to improve patient choice. The second section of the review attempted to elaborate on the many and complex components of a good death. Although it is difficult to disentangle the relationship between age, health status and the dying experience, it would appear that there might be certain features that are constant, such as the importance of family and friends, and the adequacy of symptom relief and physical care. Other important issues noted included those surrounding holistic, culturally sensitive care; psychological well-being; preparation; and retention of independence/control. As previously observed, much of the research in this section originated in the US. Further research investigating the relationship between health status and preferences, which takes account of different cultural perspectives, would be helpful to inform future policy provision within the UK. Studies on preferred place of death/care reveal that older people have a range of preferences for care at the end-of-life, but, in general there is a strong preference for home death/care, and that this preference remains fairly constant across national boundaries, although it should be noted that the majority of studies in this section of the review originated from the UK. There is also some evidence of the impact of socioeconomic factors, personal circumstances, health status, age, gender, religiosity and ethnicity upon choice, although the extent or importance of such factors remains a matter for debate and requires further clarification. However, there is evidence to suggest that preference for place of death is influenced by patients’ knowledge of available services and variances of service provision, such as hospice care, in different geographical areas. Further qualitative work investigating older peoples’ preferences at different stages on the dying trajectory, possibly comparing the preferences of healthy older people, those living in residential care and those receiving palliative care in a contemporary UK setting, would also be useful to establish the relative importance of different attributes of care at the end-of-life and aid the targeting of resources.

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Notes 1

National Statistics, Focus on Older People, (19 July 2005).

2 Department of Health, National Service Framework for Older People. (London: The Stationery Office, 2001). 3 Clive Seale, ‘Demographic change and the experience of dying’, in Death, Dying and Bereavement, ed. D Dickenson, M Johnson, and J Samson Katz (London: Sage, 2000), 35-43. 4 Liz Lloyd, ‘Dying in old age: promoting well-being at the end of life’, Mortality 5, 2 (2000), 171-188. 5 Anita L Stewart, Joan Teno, Donald L Patrick and Joanne Lynn, ‘The Concept of Quality of Life of Dying Persons in the Context of Health Care’, Journal of Pain and Symptom Management, 17, 2 (1999), 93-108. 6 Anselm L Strauss and Barney G Glaser, Anguish: the case history of a dying trajectory (San Francisco: Sociology Press, 1977). 7 Help the Aged, End-of-Life: making decisions around the end-of-life, (20 July 2005).

8 Melanie Henwood and Debate of the Age Health and Care Study Group, The future of health and care of older people: the best is yet to come. (London, Age Concern. The Millennium Papers, 1999). 9 Richard Smith, ‘A good death’. British Medical Journal, 320, 129 (2000), 130. 10 Irene J. Higginson, Priorities and Preferences for end of life care in England, Wales and Scotland. (London, National Council for Hospice and Specialist Palliative Care Services, 2003). 11 Marianne Klinkenberg, Dick L. Willems, Bregje D. OnwuteakaPhilipsen, Dorly J.H. Deeg and Gerrit van der Wal, ‘Preferences in Endof-Life Care of Older Persons: After-Death Interviews With Proxy Respondents’, Social Science & Medicine 59, 12 (2004), 2467-2477. 12 Klinkenberg et al. 13 Joseph J. Gallo, Joseph B. Stratton, Michael J. Klag, Lucy A. Meoni, Daniel P. Sulmasy, Nae-yuh Y. Wang and Daniel E. Ford., ‘LifeSustaining Treatments: What Do Physicians Want and Do They Express Their Wishes to Others?’, Journal of the American Geriatrics Society 51, 7 (2003), 961-969.

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Rebekah Schiff, Chakravarthi Rajkumar, and Christopher Bulpitt, ‘Views of Elderly People on Living Wills: Interview Study’, BMJ, 320, 7250, (2000), 1640-1641. 15 Klinkenberg et al. 16 Kathryn L. Braun, Alvin T. Onaka, and Brian Y. Horiuchi, ‘Advance Directive Completion Rates and End-of-Life Preferences in Hawaii’, Journal of the American Geriatrics Society, 49, 12 (2001), 1708-1713. 17 Etienne Phipps, Gala True, Diana Harris, Umi Chong, William Tester, Stephen I. Chavin, and Leonard E. Braitman, ‘Approaching the End of Life: Attitudes, Preferences, and Behaviors of African-American and White Patients and Their Family Caregivers’, Journal of Clinical Oncology 21, 3 (2003), 549-554. 18 Boaz Kahana, Amy Dan, Eva Kahana, and Kyle Kercher, ‘The Personal and Social Context of Planning for End-of-Life Care’, Journal of the American Geriatrics Society 52, 7 (2004), 1163-1167. 19 Shinji Matsumura, Seiji Bito, Honghu Lui, Katherine Kahn, Shunichi Fukuhara, Marjorie Kagawa-Singer and Neil Wenger, ‘Acculturation of Attitudes Toward End-of-Life Care: a Cross-Cultural Survey of Japanese Americans and Japanese’, Journal of General Internal Medicine 17, 7 (2002), 531-539. 20 Phipps et al. 21 Nikki A. Hawkins, Peter H. Ditto, Joseph H. Danks and William D. Smucker, ‘Micromanaging Death: Process Preferences, Values, and Goals in End-of-Life Medical Decision Making’, Gerontologist, 45, 1 (2005), 107-117. 22 Jane Seymour, Gary Bellamy, Merryn Gott, Sam H. Ahmedzai and David Clark, ‘Good Deaths, Bad Deaths: Older People's Assessments of the Risks and Benefits of Morphine and Terminal Sedation in End-of- Life Care’, Health Risk & Society, 4, 3 (2002), 287-303. 23 Jane Seymour, ‘Technology and Natural Death: A Study of Older People’, Z Gerontol Geriat, 36, 5 (2003), 339-346. 24 Jane Seymour, Merryn Gott, Gary Bellamy, Sam H. Ahmedzai and David Clark, ‘Planning for the End of Life: the Views of Older People about Advance Care Statements’, Social Science & Medicine 59, 1 (2004), 57-68. 25 Kenneth E. Rosenfeld, Neil S. Wenger, and Marjorie Kagawa-Singer, ‘End-of-Life Decision Making - A Qualitative Study of Elderly Individuals’, Journal of General Internal Medicine 15, 9 (2000), 620-625. 26 Terri R. Fried, Elizabeth H. Bradley, Virginia R. Towle and Heather Allore, ‘Understanding the Treatment Preferences of Seriously Ill

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___________________________________________________________ Patients’, The New England Journal of Medicine, 346, 14 (2002), 10611066. 27 Schiff et al. 28 Rosenfeld et al. 29 Terri R. Fried and Elizabeth H. Bradley, ‘What Matters to Seriously Ill Older Persons Making End-of-Life Treatment Decisions?: A Qualitative Study’, Journal of Palliative Medicine 6, 2 (2003), 237-244. 30 Terri R. Fried et al, 2002. 31 Donald L. Patrick, Robert A. Pearlman, Helene E. Starks, Kevin C. Cain, William G. Cole and Richard F. Ulman, ‘Validation of Preferences for Life-Sustaining Treatment: Implications for Advance Care Planning’, Annals of Internal Medicine 127, 7 (1997), 509-517. 32 Rudoph M. Navari, Carol B. Stocking, and Mark Siegler, ‘Preferences of Patients with Advanced Cancer for Hospice Care’, JAMA: The Journal of the American Medical Association, 284, 19 (2000), 2449. 33 Joanne Lynn, Joan M. Teno, Russell S. Phillips, Albert W. Wu, Norman Desbiens, Joan Harrold, Michael T. Classens, Neil Wenger, Barbara Kreling and Alfred F Connors Jr., ‘Perceptions by Family Members of the Dying Experience of Older and Seriously Ill Patients. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments’, Annals of Internal Medicine 126, 2 (1997), 97-106. 34 Phipps et al. 35 Hawkins et al. 36 Gregory P. Gramelspacher, Xiao-Hua Zhou, Mark P. Hanna and William M. Tierney ‘Preferences of Physicians and Their Patients for End-of-Life Care’, Journal of General Internal Medicine, 12, 6 (1997), 346-351. 37 Sara Carmel, ‘Life-Sustaining Treatments: What Doctors Do, What They Want for Themselves and What Elderly Persons Want’, Social Science and Medicine 49, 10 (1999), 1401-1408. 38 Phipps et al. 39 Hawkins et al. 40 Phipps et al. 41 Kahana et al. 42 Matsumura et al. 43 Leslie J. Blackhall, Gelya Frank, Sheila T. Murphy, Vicki Michel, Joycelynne M. Palmer and Stanley P. Azen, ‘Ethnicity and Attitudes Towards Life Sustaining Technology’, Social Science & Medicine 48, 12 (1999), 1779-1789.

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A.M. Fairrow, T.J. McCallum and B.J. Messinger-Rapport, ‘Preferences of Older African-Americans for Long-Term Tube Feeding at the End of Life’, Aging & Mental Health 8, 6 (2004), 530-534. 45 Blackhall et al. 46 Phipps et al. 47 Kahana et al. 48 Matsumura et al. 49 Blackhall et al. 50 Jamila Bookwala, Kirsten M. Coppola, Angela Fagerlin, Peter H. Ditto, Joseph H. Danks and William D. Smucker, ‘Gender Differences in Older Adults' Preferences for Life-Sustaining Medical Treatments and End-ofLife Values’, Death Studies . 25, 2 (2001), 127-149. 51 Bookwala et al. 52 Gramelspacher et al. 53 Merrijoy Kelner, ‘Activists and Delegators: Elderly Patients' Preferences about Control at the End of Life’, Social Science & Medicine 41, 4 (1995), 537-545. 54 Kahana et al. 55 Kelner et al. 56 Kelner, 1995. 57 Rosenfeld et al. 58 Kelner, 1995. 59 Victor G. Cicirelli, Peter MacLean, and Lisa S. Cox, ‘Hastening Death: A Comparison of Two End-of-Life Decisions’, Death Studies 24, 5 (2000), 401-419. 60 Klinkenberg et al. 61 Gramelspacher et al. 62 Kelner et al, 1995. 63 Oscar Heeren, A. Srikumar Menon, Allen Raskin and Paul Ruskin, ‘Religion and End of Life Treatment Preferences among Geriatric Patients’, International Journal of Geriatric Psychiatry 16, 2 (2001), 203208. 64 Peter H. Ditto, Joseph H. Danks, Renate M. Houts, Kristen M. Coppola, William D. Smucker, Jill A. Jacobson, Angela Fagerlin and R. Mitchell Gready, ‘Stability of Older Adults' Preferences for Life-Sustaining Medical Treatment’, Health Psychology 22, 6 (2003), 605-615. 65 Sara Carmel and Elizabeth J. Mutran, ‘Stability of Elderly Persons’ Expressed Preferences Regarding the Use of Life-Sustaining Treatments’, Social Science & Medicine 49, 3 (1999), 303-311.

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Joseph B. Straton, Nae-Yuh Wang, Lucy A. Meoni, Daniel E. Ford, Michael J. Klag, David Casarett and Joseph J. Gallo, ‘Physical Functioning, Depression, and Preferences for Treatment at the End of Life: the Johns Hopkins Precursors Study’, Journal of the American Geriatrics Society 52, 4 (2004), 577-582. 67 Donald L. Patrick, Ruth A. Engelberg, and J. Randall Curtis, ‘Evaluating the Quality of Dying and Death’, Journal of Pain and Symptom Management 22, 3 (2001), 717-726. 68 Karen E. Steinhauser, Nicholas A. Christakis, Elizabeth C. Clipp, Maya McNeilly, Lauren McIntyre and James A. Tulsky, ‘Factors Considered Important at the End of Life by Patients, Family, Physicians, and Other Care Providers’, JAMA 284, 19 (2000), 2476-2482. 69 Elizabeth K. Vig and Robert A. Pearlman, ‘Quality of Life While Dying: a Qualitative Study of Terminally Ill Older Men’, Journal of the American Geriatrics Society, 51 (2003), 1595-1601. 70 Elizabeth K. Vig and Robert A. Pearlman, ‘Good Deaths, Bad Deaths, and Preferences for the End of Life: A Qualitative Study of Geriatric Outpatients’, Journal of the American Geriatrics Society 50, 9 (2002), 1541-1548. 71 Ezekiel J. Emanuel and Linda L. Emanuel, ‘The Promise of a Good Death’, The Lancet, 351, 1002 (1998), SII21-SII29. 72 Stewart et al. 73 Rory Williams, A Protestant Legacy: attitudes to death and illness among older Aberdonians (Oxford: Clarendon Press, 1990). 74 Singer et al. 75 Vig and Pearlman. 76 Williams. 77 Emanuel and Emanuel. 78 Donna M Gauthier and Robin D. Froman, ‘Preferences for Care near the End of Life: Scale Development and Validation’, Research in Nursing & Health 24, 4 (2001), 298-306. 79 Patrick et al. 80 Vig and Pearlman. 81 Williams. 82 Singer et al. 83 Michael Young and Lesley Cullen, A Good Death: conversations with East Londoners (London: Routledge, 1996). 84 Ronald D. Leichtentritt and Kathryn D. Rettig, ‘Meanings and Attitudes toward End-of-Life Preferences in Israel’, Death Studies 23, 4 (1999), 323-358.

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Karen E. Steinhauser, Nicholas A. Christakis, Elizabeth C. Clipp, Maya McNeilly, Lauren McIntyre and James A. Tulsky, ‘Factors Considered Important at the End of Life by Patients, Family, Physicians, and Other Care Providers’, JAMA 284, 19 (2000), 2476-2482. 86 Vig and Pearlman. 87 Elizabeth K. Vig and Robert A. Pearlman, ‘Good Deaths, Bad Deaths, and Preferences for the End of Life: A Qualitative Study of Geriatric Outpatients’, Journal of the American Geriatrics Society 50, 9 (2002), 1541-1548. 88 Williams. 89 Singer et al. 90 Young and Cullen. 91 Steinhauser et al, 2001. 92 Patrick et al. 93 Robin Yurk, David Morgan, Steve Franey, Jennifer Burk Stebner and David Lansky. Understanding the Continuum of Palliative Care for Patients and Their Caregivers 94 J. Randall Curtis, Donald L. Patrick, Ruth A. Engelberg, Kaye Norris, Charles Asp and Ira Byock, ‘A Measure of the Quality of Dying and Death. Initial Validation Using After-Death Interviews With Family Members’, Journal of Pain & Symptom Management 24, 1 (2002), 17-31. 95 Joan M. Teno, ‘Patient-Focused, Family-Centered End-of-Life Medical Care: Views of the Guidelines and Bereaved Family Members’, Journal of Pain and Symptom Management 22, 3 (2001), 738-751. 96 Karen E. Steinhauser, Nicholas A. Christakis, Elizabeth C. Clipp, Maya McNeilly, Lauren McIntyre and James A. Tulsky, ‘Factors Considered Important at the End of Life by Patients, Family, Physicians, and Other Care Providers’, JAMA 284, 19 (2000), 2476-2482. 97 Vig and Pearlman. 98 Patrick et al. 99 Yurk et al. 100 Patrick et al. 101 Steinhauser et al, 2000. 102 Leichtentritt and Rettig. 103 Stewart et al. 104 Steinhauser et al, 2000. 105 Emanuel and Emanuel. 106 Gauthier and Froman. 107 Yurk et al. 108 Leichtentritt and Rettig.

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Ann C. Hurley, Ladislav Volicer, and Zuzka V. Blasi, ‘End-of-Life Care for Patients with Advanced Dementia’, JAMA: The Journal of the American Medical Association 284, 19 (2000), 2449-244a. 110 Melanie Henwood and Debate of the Age Health and Care Study Group, The future of health and care of older people: the best is yet to come. (London, Age Concern. The Millennium Papers, 1999). 111 Patrick et al. 112 Leichtentritt and Rettig. 113 Steinhauser et al, 2001. 114 Stewart et al. 115 Teno et al. 116 Henwood. 117 Stewart et al. 118 Williams. 119 Steinhauser et al, 2000. 120 Gauthier and Froman. 121 Matsumura et al. 122 Leichtentritt and Rettig. 123 Henwood. 124 Patrick et al. 125 Singer et al. 126 Curtis et al. 127 Patrick et al. 128 Steinhauser et al, 2001. 129 Young and Cullen. 130 Patrick et al. 131 Steinhauser et al, 2000. 132 Steinhauser et al, 2001. 133 Yurk et al. 134 Henwood. 135 Williams. 136 Yurk et al. 137 Steinhauser et al, 2001. 138 Stewart et al. 139 Henwood. 140 Singer et al. 141 Young and Cullen. 142 Steinhauser et al, 2000. 143 Young and Cullen. 144 Henwood. 145 Yurk et al.

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Hurley et al. Williams. 148 Henwood. 149 Terri R. Fried, John R O'Leary and Margaret A. Drickamer ‘Older Persons' Preferences for Site of Terminal Care’, Annals of Internal Medicine 131, 2 (1999), 109-112. 150 Donna M. Wilson, ‘End-of-Life Care Preferences of Canadian Senior Citizens With Caregiving Experience’, Journal of Advanced Nursing 31, 6 (2000), 1416-1421. 151 Fried et al, 1999. 152 C. Thomas, S.M. Morris and D. Clark, ‘Place of Death: Preferences Among Cancer Patients and Their Carers’, Social Science & Medicine 58, 12 (2004), 2431-2444. 153 Edward Ratner, Linda Norlander, and Kerstin McSteen, ‘Death at Home Following a Targeted Advance-Care Planning Process at Home: the Kitchen Table Discussion’, Journal of the American Geriatrics Society 49, 6 (2001), 778-781. 154 Irene J. Higginson, Priorities and Preferences for end of life care in England, Wales and Scotland. (London, National Council for Hospice and Specialist Palliative Care Services, 2003). 155 Merryn Gott, Jane Seymour, Gary Bellamy, David Clark and Sam Ahmedzai. ‘Older People's Views about Home as a Place of Care at the End of Life’, Palliative Medicine 18 (2004), 460-467. 156 Fried et al, 1999. 157 Judith C. Hays, Anthony N. Galanos, Tahira A. Palmer, Douglas R. McQuoid and Elisabeth P. Flint, ‘Preference for Place of Death in a Continuing Care Retirement Community’, Gerontologist 41, 1 (2001), 123-128. 158 Wilson. 159 Wilson. 160 Thomas et al. 161 Jonathan Koffman and Irene J. Higginson, ‘Dying to Be Home? Preferred Location of Death of First-Generation Black Caribbean and Native-Born White Patients in the United Kingdom’, Journal of Palliative Medicine 7, 5 (2004), 628-636. 162 Higginson. 163 Koffman and Higginson. 164 Thomas et al. 165 Hays et al. 147

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___________________________________________________________ Eileen Sutton is a Research Associate at the Medical Research Council, Health Services Research Collaboration. Joanna Coast is Professor of Health Economics at the University of Birmingham.

The Wholeness of a Broken Heart Leeat Granek Abstract Contemporary western psychology teaches that an ‘autonomous’ ontology is the only healthy kind. This view holds that ‘normal’, ‘healthy’ development is towards separation, most especially from the mother in childhood and adolescence, growing towards individuation, or the total separation of one’s being from others in adulthood. This ontological view of humanity, with it’s assumptions of essential separate selves leads quite naturally into the Western understanding of mourning when there is a loss. The idea is that when someone you love dies, you grieve for them for a prescribed period and then you ‘move on’ with your life, perhaps a little sadder then you were before, but mostly intact. Mourning my mother has taught me otherwise; this has not been my experience. Whereas Holub writes of mourning as the process in which we ‘heal and repair the bond between our bodies and souls’, I contend that grieving is not about mending or repairing, but about learning how to live with the painful split. Whereas western psychology and the culture in which its housed insists on putting the pieces together’ in order ‘move on’ and ‘move forward’ as quickly as possible, I believe that mourning is a process in which we must stand still in the chaos of our shattered pieces and feel the pain of our brokenness in order to truly heal. Key words: mourning, mothers and daughters. 1.

Introduction To create is to reveal the parts from the whole. To repair takes a greater wisdom. It is to discover the whole from the shattered parts. 1

My mother’s death was not a surprise. Despite 17 years of her relative psychological and physical health while she lived with metastatic breast cancer, the last year of her life was a violent struggle against the disease that aggressively invaded her body. I am by training a Psychologist. I know all about the stages of grief. My mother fought her death until the last moment. One day we were shopping, eating lunch, we were united, arm in arm, solid and content in our togetherness, and the next day she was in the hospital, attached to tubes, to wires and to pain pumps. Suddenly her face was swollen, suddenly she was confused, suddenly she was no longer my mother, but a body withering in pain, uncomprehending in her terrible, terrible suffering. Within three days of

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___________________________________________________________ being admitted, she died. I thought I would be prepared for her death. I wasn’t. I agree with Didion 2 who has written recently, “Grief, when it comes, is nothing we expect it to be.” Holub writes: How can we tell where one person ends and another begins? The material finitude of our bodies is evident, but the borders of the soul are less definite…Love blurs the boundaries between one soul and another… When the tenuous coupling of a person’s body and soul is undone by death, the bond of body and soul within each person who has been close to the met/metah [dead person] is also weakened... And so it is that a survivor must mourn, to heal and repair the bond between his or her own body and soul - literally, in some measure, to stay alive. 3 In Jewish theory, there is a concept called Tikkun Olam, which roughly translated, means ‘mending of the world’. It is taught that G-d created the world by forming vessels to hold the Divine Light. But as G-d poured the Light into the vessels, they shattered, tumbling toward the realm of matter. Thus, our world consists of countless shards of the original vessels entrapping sparks of the Divine Light. Humanity’s task involves helping G-d by reuniting and mending together the scattered Light that is found in the shards, raising the sparks back to Divinity and restoring the broken world. Mourning my mother has taught me that people are reflections of the cosmic broken vessel and that I am a broken vessel too. People who are grieving often say that they feel like they are shattered into a million pieces. Mourning is the slow, painful process of stitching together the pieces of ourselves including the body and the soul that was split with the death of our loves, to become a new kind of scarred and sacred vessel that holds a different light than before. This is not a traditionally academic paper. What I mean by that is my ‘data’, which in this case are my observations about mourning do not come out of books or out of analysis of interviews or from statistics, they come out of me, out of my own pain and my suffering and my own struggle to accept an unacceptable loss. I intend to stay true to this process. I have thus decided to draw on excerpts of writing I did before my mother died and shortly after she died as an introduction to my thesis on the phenomenology of mourning. The first except was written three months before my mother died when she began to get sick to the degree that for the first time in her life, she was physically impaired.

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July 2005 My mother has been a cancer patient for as long as I can remember. I was nine when she was first diagnosed. I don’t remember much before that. I remember the matching dresses we used to wear, a visible sign of our unity; I remember the comfortable weight of being embraced, nestled contentedly in the concave of her curled body. I remember the weight of her scent that used to envelope me when I came back from school each day, familiar and intoxicating. I remember that this weight used to feel different than it does now. Sometimes it thrilled when it took the shape of her proud gaze and sometimes it burdened when it chained me with guilt and kept me from straying too far. Today the weight is not comfortable, it is heavy. It fills my nights pressing hard on my chest making it impossible to breathe. It is in my head during the day- heaviness that hurts- a vice squeezing from the inside out. It is in my legs- this weight. Walking is slow, painful; it is dragging stones through wet sand, stiff and effortful and tiring. It is in my hands making them feel thick and calloused and clumsy as they brush over the dishes, my lover’s face, the keyboard, the pages in a book. But for the most part this weight hovers around my heart. It seems a cliché to talk about a broken heart, a painful heart, a bleeding heart. But here it is again, another metaphor that persists even though my critically trained mind recognizes its kitsch, balks at its obviousness, its mundaneness. The intellect is nothing in matters of the heart. It is the heart that bears this burden. In my writings I have often reflected on the meaning of embodiment. Never did I imagine that grief and fear and pain could be so tangibly located in the body- could be the body. There is a constant, chronic dull pain that begins around my left shoulder blade and branches out up my neck and down my left arm. My shiatsu therapist says it’s the heart meridian that is overworked and out of balance. I look at him suspiciously trying to remember if I told him about my mother. My yoga teacher says my heart chakra is ‘working overtime’ and I need to breathe through this, let it go. Am I this transparent? I wonder, feeling shellshocked and dazed. I stop going to shiatsu and stop going to yoga and sit instead in the steam room wrapped in white towels at the Jewish Community Center near my house. I am comforted by the sounds of old Jewish women talking. Their Yiddish intonation, their loudness makes me feel safe, like those brief and rare occasions that I would sit at my grandmothers table in Israel and listen to her laughing with her own daughters. Those moments felt like eternity, like they could go on forever. That was pre-cancer. Those moments no longer exist. I wonder if my mother will live to be an old woman. Having lived so far from my grandmother, I always imagined

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___________________________________________________________ that when I would have my own children, we would live close to my mother so that I could be whole and they could have the grandmother that I have been missing all of my life. I have spent sixteen of my twenty six years on this earth in the shadow of a disease. Cancer. A dirty word - the dirtiest I can think of - has held me captive to its insatiable grip on my mother’s life. No matter how many times her tired body has been blasted with poison, no matter how many times her flesh has been brutally cut, forced to heal and heal again, this angry, persistent disease comes back to mock her. I am so angry I can barely breathe. I want so badly to be free - to be released from these chains of anxiety, terror, rage. I am twenty five, I think, feeling the lingering hysteria, the panic that always resides just beneath (what I imagine to be) my calm exterior threatening the surface. I am twenty five. I should be travelling the world; I should be wandering through shoe stores instead of doctor’s offices, choosing a husband instead of choosing a palliative care specialist. I feel so old. There is a haunted quality in my reflection that I do not recognize. Pounds that I have struggled with for years shed themselves without effort. And laughter - my oxygen - has evaporated leaving me constantly heaving for breath. What is it like to be a daughter of cancer? It is odd to phrase it this way, but it is true. Cancer demands more then its immediate victim, it is not satisfied until it has swallowed the spirit of all that surround the ‘patient’ struggling for their lives. I feel guilty for indulging in my own struggle to come to terms with my mother’s ill health. The West demands autonomy, demands individuals define themselves sharply, demands isolation and clear boundaries between people. I cannot carve this clean, bloodless line. For me it is still like when I was four in our matching dresses, when it was still ok to be an extension of my mother or at the very least to indulge in the illusion that we defined each other by our very presence, by the very act of witnessing the existence of the other. We are blurred, my mother and I. The psychologist in me jumps out, protective; Winnicott would say that I have never fully individuated from my mother and that this is a pathology. The academic voice is stern and unfeeling and it is asking me, demanding from me to retract my conclusion, to show myself in a better, more psychologically healthy light. But I am too tired to heed this voice which has lorded over me for the last eight years of my academic life and which will be certain to follow me into the next thirty as I become a professor myself. I am too tired not to tell the truth. And the truth is that my mother and I are connected by the invisible umbilical cord that was never really fully cut. And that with each day of her dying, Which is torturously slow and tortuously painful, I am dying too.

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___________________________________________________________ 3.

October 2005 My mother is dead. It’s been less than a month since she died. I sit and sit and sit and sit, pondering these words. It is raining outside as it has been for the last three days. I haven’t left my apartment in what feels like weeks. I sit all day, I stare out the window, grateful for the rain, grateful for the permission it affords me to hibernate indoors. There is nothing to say, but I think I might die in this silence, so I make the attempt to think through this unforgiving fog, to produce something, anything that will crack the vice around my head. Mourning is nothing like people describe. There are no cycles, there are no ‘phases’, there are no rituals that help. It is a bloody war, it’s painful. And not painful like ‘emotionally painful’, or ‘mentally painful’, not painful like the clean, neat category of what pain is described as in my solid compendium of mental disorders that sits on my bookshelf. I mean painful. Gut wrenching - physically excruciating - ‘wish you could crawl into a hole and die’- painful. My breath stops a hundred times a day. I fall to the floor and curl into a ball trying to ease the crushing weight pressing into my stomach. This grief has literally brought me to my knees; I attempt with caution to stretch out one limb and then the other to see if the pain has passed. My mother’s death is breaking me. And it comes at the most unexpected times. There is no ‘bereavement phase’ when all you do is think about the deceased. What a lie! Death is trauma. And trauma is devious. It will follow no order, there are no rules, it comes and goes and I flail in its grip. A broken, vulnerable, weakened woman unhinged. 4.

August 2006 That’s how I felt just after she died, since then, ten months have passed. The physical pain I describe in this last excerpt is no longer a daily occurrence but still grips me often and always at unexpected times. While I was writing this paper, I experienced a wave of such grief that I decided I needed help. I sent the abstract for this paper to a colleague asking for some direction with readings on the subject. She sent me back a short note with a question instead of an answer. She asked, “Do you really want to theorize your own grief?” This is a good question. After much reflection on it, I realized that yes, indeed I did want to theorize, or at the very least think about my grief. I have learned more about life from this year of mourning than I have from all of my other life experiences combined. And if I am able to learn, then maybe I am also able to say something meaningful about death, about dying and about mourning that other people might be able to relate too. Out of all these lessons, the one alluded to in the introduction about brokenness and mending is the one I’m most interested in. I quoted

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___________________________________________________________ Holub who said that when a person dies, their body and soul separate and that each person who has been close to that person also experiences a break or a weakening of the bond between their own body and soul. Mourning and grieving, according to Holub, is what happens when we try to mend that split. The interesting part of this idea for me is not that we break, but why we break when another dies? Contemporary western psychology teaches that an ‘autonomous’ ontology is the only healthy kind. This view holds that ‘normal’, ‘healthy’ development is towards separation, most especially from the mother in childhood and adolescence, growing towards individuation, or the total separation of one’s being from others in adulthood. This ontological view of humanity, with it’s assumptions of essential separate selves leads quite naturally into the Western understanding of mourning when there is a loss. The idea is that when someone you love dies, you grieve for them for a prescribed period - no longer than three months according to the DSM or it becomes pathological! - and then you ‘move on’ with your life, perhaps a little sadder then you were before, but mostly intact. Mourning my mother has taught me otherwise; this has not been my experience. Adrienne Rich has written, “The loss of the daughter to the mother, the mother to the daughter, is the essential female tragedy.” 4 And it’s true. Losing my mother was a tragedy of epic proportions. More painful, more shattering, more devastating than I could have ever imagined. Losing her is about more than love; it’s about more than missing the familiarity and comfort that only a mother can bring; it is about more than mourning these terrible incomprehensible losses, it is about mourning my own death with her passing. It is about mourning the person that I used to be that died when she died. It is about recognizing that contrary to the Western insistence on individuation, I was indeed, undoubtedly part of her and she of me. Our boundaries were blurred, fluid, osmotic. We are all closer to each other than we think, fluidly connected, dependant on one another to exist. I recognize that my mother and I were unusual in our closeness. She was my best friend, we could intuit each others’ thoughts, we spoke several times a day and could always make each other laugh. Because I recognized the finitude of this relationship in my life from a very young age, I also knew it had to be an accelerated one. There was a time urgency, we had to live out what should have been a life long mother-daughter trajectory in just two and a half decades. This awareness of her mortality intensified our bond to a degree of closeness in my youth that many people never experience in their entire lifetimes. It is from this place that I present these observations on mourning and it is ALSO from this place that I recognize their limitations; they cannot be generalized to everyone.

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___________________________________________________________ While recognizing that the intensity of mourning my mother comes out of the symbiotic relationship I had with her, I also assert that the deaths of those we love change us irreparably. Whereas Holub writes of mourning as the process in which we ‘heal and repair the bond between our bodies and souls’, I contend that grieving is not about mending or repairing, but about learning how to live with the painful split. Whereas western psychology and the culture in which its housed insists on ‘putting the pieces together’ in order ‘move on’ and ‘move forward’ as quickly as possible, I believe that mourning is a process in which we must stand still in the chaos of our shattered pieces and feel the pain of our brokenness in order to truly heal. In a culture that insists on the total separation of human beings, this is a radical prescription for mourning. It acknowledges that in addition to grieving for the person who has died, we are also mourning the loss of our selves that will never be entirely whole or unscarred again. In Judaism there are two kinds of prayers for health; the first is a prayer for ‘re’fuat haguf’, translated to mean the ‘healing of the body’. The second kind is called ‘re’fuat h’nepshesh’, which calls for the healing of the whole human being - this includes the body, the mind, psyche, the soul and every other aspect that makes up each individual person. Healing in turn comes form the word ‘wholeness’ and has been associated with ‘holiness’. I believe that healing from grief comes when we sit with our brokenness and acknowledge the fissures as part of ourselves. It is as the Rabbi I quoted in the introduction says, to heal is to ‘discover the whole from the shattered parts’.

Notes 1

Org Chabad. A Daily Dose of Wisdom from the Rebbe. (words and condensation by Tzvi Freeman). Retrieved in an email, April 10, 2006. 2 Joan Didion. The year of magical thinking. (New York: Knof, 2005), 26. 3 Margaret Holub. ‘A cosmology of mourning’, in, Lifecycles: Jewish women on life passages and personal milestones, ed. Deborah Orenstein (Woodstock, Vermont: Jewish Lights Publishing, 1994), 341-351. 4 Adrienne Rich. Of woman born: Motherhood as experience and institution. (New York: Norton, 1986), 237. Leeat Granek is a doctoral student in the History and Theory of Psychology Program at York University in Toronto, Canada. Her research interests are in feminist, critical psychology and take an interdisciplinary approach drawing from psychology, anthropology, sociology, women’s studies and neuroscience. This is her first article on grieving.

Religion and Medicine in the Process of Managing Death and Dying: The Case of Hospice Circle in Poland Malgorzata Zawila Abstract Religion and medicine are both very meaningful phenomena when considering death and dying. They can be understood as important elements constructing social attitudes toward death and dying as well as factors helpful in the process of managing the individual with death and dying. The question of place and role of religion and medicine in the context of attitudes toward death and dying is important especially in the conditions of medicalization and secularization on one hand and the New Age movement and growth of spirituality on the other. In the context of the processes mentioned above (medicalization, secularization) religion and medicine are often understood as opposite to each other. According to some sociologists and historians in the twentieth century the place and role of religion in handling the death and dying takes medicine. In my opinion it is worth to raise the question of this process once more nowadays, in the twenty first century. The paper focuses mainly on the results of the research conducted, in three Polish hospices, on the patients, their relatives and the staff. The main research goal was to study attitudes toward death and dying among the hospice circle. The method chosen for analysis was Grounded Theory. Initial analysis of the empirical material gathered during the research allows treating medicine and religion as complementary and not opposite to each other, when attitudes toward death and dying are considered. Key words: death, dying, religion, medicine, hospice, trajectory, coping, Grounded Theory, secularization, medicalization. 1.

Introduction Over the centuries many social institutions were involved in peoples’ managing with death and dying on an individual and a social level as well. Magic, religion, medicine and family all are the phenomena, to some extent, concerning the problem of death and the process of dying. They all influence social attitudes toward death and dying and help people to cope with death of their own and grief. There are many different views on the changes in using those factors like religion, medicine and family in handling with death and dying on macro and micro level as well. In this paper I am looking at some ways of understanding of the changes in the culture of death, as we may call all the human acts, attitudes, and works concerning the subject of death. I’m focusing especially on the changing role of religion and medicine in the historical context of death and dying.

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In the first part of the paper there are some theoretical considerations on changes, which took place on a macro scale. In the second part, there is a presentation of a research project that was run in three Polish hospices, which shows using religion and medicine in coping with death and dying on a micro level. 2.

Medicalization and secularisation processes: history, presence or future? In the literature on death and dying for last few decades there has been a wide discussion on such processes as medicalization of death and dying and secularisation of death rituals and attitudes. We will discuss these both processes in one part of the article because they seem related to each other; what’s more they are inseparable. Secularisation - a term considered mostly by sociologists of religion, defining: “the process by which sectors of society and culture are removed from the domination of religious institutions and symbols.” 1 According to Peter Berger secularisation is a process that can be observed on two levels: social-structural level and a subjective one as a secularisation of consciousness. 2 There are many various origins of secularisation found, but two of them are especially interesting when speaking about medicalization of death and dying, these are the processes of fragmentation of society and specialization. The process of modernization of society was accompanied by formation of more and more specialized spheres of social life. From one total universe embracing existence of each individual creating community social reality has changed into many, different, fragmented realities. This process can be easily observed in the case of religion, which used to be inseparable and non-questionable part of everyone’s life and with the process of modernization it no longer played such an important role. Religion was separated from such social spheres as: education, politics, economy, law and also from medicine and morality. The place of religion in these spheres took science, state and other secular phenomena. Even if there are religious schools, hospitals and laws they are not obligatory to everyone, they are a matter of every person’s choice but not fate anymore. When people’s health, illness, death and dying are considered, magic and religion became replaced by medicine. This process is called medicalization. The role of shaman and then the priest taking care of the seriously ill and the dying is taken over by nurses and physicians. The responsibility for and control over the dying lies in hands of professionals, who are usually secular ones, using their education and scientific knowledge to do their job. In this case, the scientific experiences and

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___________________________________________________________ knowledge is the source of healing power and the control over the patient and not the supernatural power or God, like it is with religion. The place, when the medical care and also the dying process takes place, is usually not home anymore, but the hospital, hospice or other highly specialized institution. Philippe Aries in his ‘Western Attitudes toward Death’ writes: Death in the hospital is no longer the occasion of a ritual ceremony, over which the dying person presides amidst his assembled relatives and friends. Death is a technical phenomenon obtained by cessation of care, a cessation determined in a more or less avowed way by a decision of the doctor and the hospital team. 3 When speaking about medicalization we need to remember that Aries wrote these words in the 1970s and at that time this process was especially apparent. The discussion on medicalization was raised in the 1970s and continued for next decades but not without any critics. Particularly in the 1990s, there started to be noticed opposite processes to the mentioned above; they are de-secularisation and de-medicalization of death and dying. There are many examples of de-secularisation and demedicalization processes in western societies, which I just want to mention: like the growing role of physicians and other medical staff in their professional settings, what was described by Steven S. Miles in his article on ‘The Role of the Physician in Sacred End-of-life Rituals in the ICU’, the whole idea of hospice care in which religion and spirituality plays quite important role. 4 Those are only the most discussed ones, not to mention all the New Age ideas and spirituality that are used in our popular culture very often. 3.

The research project In the research presented here forty eight people closely connected to three Polish hospices took part. It was a group of patients, relatives and/or friends of patients and stuff which were volunteers and medical staffs like: physicians, nurses and physiotherapists. The reason for choosing a hospice circle as I called the research group was the fact of its closeness to the phenomena of death and experience of dying. For those people death and dying are not a hypothetical experience but real and a tangible one. The research project was based on a combination of elements of visual sociology and Grounded Theory. Visual sociology was used on the level of the research technique and Grounded Theory on the level of

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analysis of the data. All interviewees were given the same set of twelve illustrations and were asked a set of questions to each. Firstly they were asked to describe the illustration, next to describe the feelings of people in the illustration and then to describe their own feelings. Later on they were asked to say what are the needs of people in the illustrations and eventually to say what may happen after the situation illustrated. At the end of each interview interviewees were asked how he did/she thinks, what happens with human after death. Only this question was not accompanied by an illustration so not to suggest in any way the answer. In the research I treated illustrations (photographs and pictures) as an interview device making speaking about such an intimate problem as death, as natural and open as possible. In visual sociology such a technique, as used in presented research is called ‘photo-elicitation’ and is more and more commonly used for exploring people’s values, beliefs, attitudes and meanings. 5 A method chosen for analysis of empirical material gained from interviews is Grounded Theory, which gives an opportunity to build a theory on the basis of the gathered data. Grounded Theory method gives clear set of procedures, techniques (tools) for analyzing data, which were used for analyzing interviews about death and dying. As a result of the process of open coding, which is a part of GT method of analysis, a set of categories were defined and developed out of the data. During the process of axial coding, categories were related to their subcategories on the basis of their properties and dimensions. In the process of selective coding a core or central category has been chosen and a coding for process helped to achieve continuous, changeable and moving picture of the data. 4.

Research results This diagram shows a part of the result of first three mentioned processes of coding. Central category:

Death & Dying COPING

Subcategories: RELIGION MEDICINE RELATIVES Dimensions: - ritual - treatment - psych. help - priest/nun - medicines - physical help - God/higher power - medic. equipment - being/assisting - Faith - staff - family - Afterlife - medical org. - friends Diagram 1: Coding process results

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___________________________________________________________ To avoid reducing this presentation to a research report I will focus now on the most important categories which have influenced the most the process of building the grounded theory in this case. These are two categories: religion and medicine. They are both in some way social institutions, helping the individual to cope (each one in other ways) with the phenomena of death and the process of dying. But before that I’d like to show some sample ways of understanding death among group researched. Death: • • • •

•

•

“Then, the new life starts, about which we don’t know much.” (P5) “I don’t know, for me person comes into another stage of life and that is normal, that someday body will be dust.” (S2) “After the death? Soul will go somewhere and body will stay in a grave.” (P4) “According to what everybody says, what I read in this book about life after death, that’s exactly what I imagine. Meeting a lightning creature, first there is a tunnel and then the light and you go into a different life.” (S5) “I think, well I don’t know how to call it; spirit or human conscious or some kind of energy. I think it comes back to the source, which is God’s energy, God’s mind, some kind of wisdom, something like this. It unites. Body is physically changed.” (S9) “I don’t know, I don’t know. If I had known, I’d have easier in my life. That is a puzzle.” (F1)

As we see the category of death is closely related to the category of religion, understood in a quite wide way. In some cases it’s hard to say about religion, sometimes more convenient term than religion would be spirituality. Those examples do not show the wide range of possibilities, but they are the most frequent. Let’s see now some sample answers categorized in the category of religion/ritual: Prayer: • • •

“It can be that grandma suffers a lot, he will thank God that He took her with Him. Because it will relieve her pain.” (P4) “A prayer for peace and averting wars and conflicts.” (F1) “He will pray a lot and through it, he will join her.” (S8)

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In the category of religion another very meaningful subcategory is God or higher power. And as the analysis showed it’s also very important and connected with death, and here are examples of understanding God and its role in death and dying: God: • • •

“Grief he may feel or that they didn’t care for him and hence their child is dying, or that God punished him.” (P5) “Blaming God for taking his child.” (S5) "He has already agreed with God’s will.” (F1)

As it is shown in these examples God/supernatural power is usually understood in the context of death as its source, Master who punishes people with death, and who can be blamed of someone’s death. By showing examples in these two categories death and religion I wanted to indicate close connection between them. Nevertheless, religion is not the only one factor helping people to handle the death and dying process. The other one, equally important is medicine. The analysis showed that both religion and medicine are complementary factors in coping process. However, they are used together at the same time in the dying trajectory very rarely. Institution used for all the time of dying process is a family (relatives/friends). When understanding the process of dying as a trajectory, started at the point of having an awareness of being seriously ill (diagnosis) and finished with death, then we may notice a turning point in defining ones own situation (role) by the patient. MED.DIAGNOSIS patient

REDEFINING OF SITUATION

DEATH

dying person

MEDICINE RELIGION RELATIVES /FAMILY /FRIENDS Diagram 2: Dying trajectory and coping factors used in Polish hospices. In the first stage of the process of dying; started with the diagnosis, patients’ major role in coping with the disease is a medicine accompanied by family, then in the second stage (after the redefining the situation) in

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___________________________________________________________ the place of medicine – religion is being used. Here are some sample citations taken from interviews: •

• • • • •

“I don’t know, maybe its grandma and grandson, that’s what I thought, didn’t I? She’s praying there, maybe she has the last stadium of disease, or they are aware that there’s not much time left.” (S1) “Here you can’t help, here only a prayer will help, nothing more.” (P11) “If they’re dressed, standing over the grave only a prayer will help.” (P5) “Here nothing can help. Nothing. Even a prayer won’t.” (P13) “Only this Holy Communion can…improve her health…well and can, can…a miracle may happen.” (P6) “Surely they’re taking care of her, well spiritual sphere, she’s getting Communion. Obviously, they’re praying. They feel that she is ill, probably she’ll die, so to help her in a spiritual way rather. And she’s thinking more about these matters related with God, more than about herself in a physical way. “ (S15)

The turning point in the trajectory of dying is the redefinition of the individual’s situation and the role, which is based on the effectiveness of the factor used in coping process. The patient understands that medicine with its prescriptions, equipment and highly specialized staff is no longer effective in his or her case and turns to other institution which is religion and which is estimated as more helpful in his/her present situation. This point in the dying trajectory Anselm Strauss and Barney Glaser called “nothing more to do” situation 6 . It is the situation when there is nothing more to do for the medical professionals, there is no hope for the healing and for good diagnosis for the patient or rather we would say for the dying. 5.

Conclusion On the basis of the analysis of the data some general conclusions may have been drawn. First of all, religion and medicine are complementary factors in the individual process of coping death and dying - that is on a micro level. Then - medicine and religion are equally important in the process of coping with death and dying for the researched hospice circle. Another conclusion is that individuals use medicine/religion according to their subjective estimation of the situation and the estimation of the effectiveness of used factor. And the last is that using the specific factor is related with the redefining of the person's role

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(from the patient to the dying), that includes the expectations, the plans, the goals and the estimated perspective, relations and ways of communicating with others.

Notes 1

Peter Berger, The Sacred Canopy, (Anchor Books, New York, 1967), 107. 2 Ibid, 108. 3 Philippe Aries, Western Attitudes toward Death. From the Middle Ages to the Present, (London: The John's Hopkins University Press, 1975), 88. 4 Steven Miles, ‘The Role of the Physician in Sacred End-of-life Rituals in the ICU’, in Managing Death in the ICU, ed. J. Randall Curtis, Gordon D. Rubenfeld (Oxford: Oxford University Press, 2001), 207-211. 5 Jon Prosser and Donna Schwartz, ‘Photographs within the sociological research process’, in Image Based Research: a Sourcebook for Qualitative Researchers, ed. Jon Posser (Falmer Press, 1998), 123. 6 Barney G. Glaser and Anselm L. Strauss, Awareness of Dying, (London: Aldine Transaction, 1965), 204.

Bibliography Posser, J. Image Based Research: a Sourcebook for Qualitative Researchers, (Falmer Press, 1998). Randall, J.C. and Rubenfeld G. D, Managing Death in the ICU (Oxford University Press: Oxford, 2001). Malgorzata Zawila is a Ph.D. student at the Institute for Scientific Studies of Religions, Jagiellonian University in Krakow, Poland, and is interested in sociological aspects of death, especially in social attitudes toward death and dying and its religious elements. Her other subject of interest is sociology of religion and contemporary religious changes including privatization of religion and secularization.

Convenient Arrangements with Death Florence Ollivier Abstract How does (or does not) a doctor accept to bring death to a patient? How is the medical staff confronted with this moral problem? We have studied these questions from the angle of deviance, in order to understand how a doctor could practice ‘euthanasia’ even if there is an absence of law, traditional medical ethics, or a request from a patient. This paper is the result of a sociological study based on interviews with twenty French doctors. Our study has focused on the attitudes of doctors confronted with difficult decisions in the context of the end-of-life. In our choice, we have tried to vary doctor’s specialities in order to obtain a multiple context of the end-of-life situation (urban environment, rural environment, hospital/ home). We have examined how the question of ‘euthanasia’ is understood in accordance with the speciality of doctors. We have defined three stereotypes of doctor’s attitudes towards the end-of-life situation, which are more or less well appreciated. A distinction is obvious by the use of the drug treatment. Our results demonstrate that euthanasia is practiced as much in hospital as at home, but with different drugs and in different situations. These practices are revealed to young doctors during their hospital training. However it is quite perceived as a negative point for both doctors and the medical profession, or it is tolerated as an extreme response to a limit of life. To minimize deviance, doctors are brought to produce an arrangement with this ‘secret’ practice within the medical staff. This practice is tolerated in silence, by all in the profession. Furthermore, doctors are led to a second arrangement that is a linguistic strategy. Doctors rename deviant practices under a neutral label. The last arrangement is the request of a consensus between all actors. Families rarely denounce euthanasia, because it is often a result of consensus. A denunciation of euthanasia is more likely to arise from a conflictual situation within the medical staff. Key words: medicine, decision making, deviance, practice of euthanasia, France, consensus. 1.

Introduction In 2003, we were witnesses to the prosecution of a nurse who was found guilty of killing six patients, and on the opposite side, Vincent Humbert, 1 a 21-year-old man, was announcing his death to the Public. A few months later, a couple of caregivers were arrested for having stopped

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___________________________________________________________ a patient’s life in a hospice. Death was coming into the open through the media. A public sphere was created to speak about death in our society: movies, prosecution and debates in media 2 were promoting these questions of end-of-life 3 acts. For this reason, my present request to speak about euthanasia with the doctors I had solicited was less of a surprise. 4 On the contrary, some of them were very talkative on this question of legalisation. They were less forthcoming in revealing their practice in the end-of-life. Our questions were how a doctor accepts (or does not) to put a patient to death and how the medical staff is confronted with this moral problem. We have studied these questions from the angle of deviance, in order to understand how a doctor could practice ‘euthanasia’ even if there is an absence of law, traditional medical ethics, or a request from a patient. As society knows deviance and tends to stigmatize this kind of attitude to reaffirm the order of society. 5 Deviance is related to an interactive relation. According to Becker’s approach, “We must see deviance as a consequence of a process of interaction between people, some of whom in the service of their own interests make and enforce rules which catch others who, in the service of their own interests, have committed acts which are labelled deviant.” 6 This paper is the result of a sociological study based on interviews with twenty French doctors. Our study has focused on the attitudes of doctors confronted with difficult decisions in the end-of-life context. In our choice, we have tried to vary doctor’s specialities 7 in order to obtain a multiple context of the end-of-life situation (urban environment, rural environment, hospital/ home). We have examined how the question of ‘euthanasia’ is understood in accordance with the speciality of doctors. This study presents a double interest. Firstly, there is still a lack of knowledge on the medical practice of euthanasia and its conditions in France. Secondly, studies on deviance in sociology are often about minorities 8 . It is rare to have qualitative surveys on deviants’ attitudes in entire professions (and in the dominant class). Therefore, our starting question is about how a doctor is brought to put a patient to death in spite of the law and official medical ethics? 2. Practice of euthanasia: a deviant practice or deviant doctors? A. Forms of ‘euthanasia’ In the 1980s death was redefined by prioritizing brain activity over cardiac activity. This new definition of death was legitimised in order to remove organs. In this way, stopping machines of resuscitation for a person with deficient brain activity is no longer described as a murder.

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___________________________________________________________ This form of ‘euthanasia’ is especially done in intensive care units when doctors are confronted with the limit of life. The Law has recently allowed this practice after consulting each member of the medical staff 9 . This change has contributed to legitimise this practice and to create a new label ‘stopping care’, but also goes on denigrating other practices, which put an end to a patient’s life. Doctors tend to rename their own practice to avoid being labelled as a deviant. For those ‘falsely accused’, the distinction of label between ‘stopping care’ and ‘euthanasia’ is crucial. It especially concerns hospital practitioners. Their strategy is to demonstrate that their decision is tolerated by all of the medical staff and that it conforms to ethical positions. Euthanasia is a brutal act... It is for this reason that is experienced as a poisoning, a murder... but a decision made with the staff... because we have some patients with no solution to save them. It is not euthanasia... we have done our best but as for this patient, we are not able to save him. [Dr. A., women, in emergency room] The more euthanasia is practiced in the quiet, with a distant reflection and with ‘soft’ drugs, the more the practice is marked as ‘worthy’. The more a doctor is experienced in end-of-life decisions, the more he will use a ‘soft’ method to practice euthanasia, or the more he will feel he is acting in a ‘good’ way. Doctors make distinctions between the dirty practice and the clean practice in end-of-life, according to their own representations: a dirty practice is close to ‘providing deliberate death’, and a clean practice is closer to ‘stopping care’, or ‘to relieve a suffering patient’. However as Mary Douglas has shown, the perception of what is dirty is correlated to the position of observer. This distinction pure/impure is also found through a classification of drugs used for euthanasia. Drugs are more or less labelled as dangerous for the patient (even if all drugs lead to death). The first group of drugs labelled as ‘soft’ drugs are hypnotics, Valium. They bring patients into a deep sleep, and so patients do not feel themselves dying. The second group is an analgesic group, they ‘released patient suffering’. The use of morphine for an act of euthanasia is more tolerated, because the effect is slow and less brutal for survivors. The third labelled negatively label is Chl. Its action is ‘brutal’ and ‘too speedy’. This last drug is perceived as ‘impure’ for those initiated in the practice, because it is also used for criminal execution in capital punishment. We have noticed that the more a drug used in ‘euthanasia’ is tolerated, the more the act is

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___________________________________________________________ labelled under another name more neutral than ‘euthanasia’: ‘accompaniment’, ‘stopping care’, ‘care in end-of-life’, ‘helping to die’, ‘sedation’, or ‘IVV’. 10 B. A Deviant’s Career Becker‘s analysis helps us to understand social conditions for pursuing a deviant activity. Becker demonstrates that a deviant practice is not the result of a deviant actor, but an actor who is brought to practice a deviant act. During his ‘career’, the deviant will develop a ‘culture’ coherent to his attitude. According to this theory, a doctor will continue to practice euthanasia on the condition that he has translated his attitude into a belief, which brings coherence to his attitude. However, the system of justification, or the ideology could be different to other deviant doctors. Thus, deviant actors do not share the same value, or the same beliefs. To neutralize the bad label (i.e. to consider euthanasia as a murder), the doctor will use an ideology, or a system of auto-justification and pass out his deviant position to qualify others as deviant. He stops feeling guilty after having constructed a meaning of his activity. His ideology gives him a ‘good’ reason to pursue. Some of deviants keep their beliefs and no longer trust the official conventions. Good reasons are supported by the feeling of satisfaction. It could come from the family. 11 Often, this group of doctors is far from the official organization called Conseil de l’Ordre des médecins. 3. Doctor’s socialisation to death A. It is known but it is not revealed Euthanasia does exist in the hospital, 12 but it is never denounced outside of the institution. The secret is shared by professional caregivers. To terminate a patient’s life is ‘bad work’ for a senior doctor. This ‘bad’ task is generally delegated to the technician who could be the most experienced nurse, a voluntary nurse, or also a doctor demonstrating for a young graduate student. This act is a severe test for caregivers, 13 until they give a reason to themselves. These practices are often revealed to young doctors during their hospital training. Usually, the senior doctor prescribes or has his staff understand that a patient should die, because he can no longer be saved. This kind of decision, made after a ‘consensus’ decision has been reached, is followed by an implicit message, which any care-givers who are in on the secret know the meaning. It could be written with an acronym, or it could be suggested by some looks or words. A nurse explained that:

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___________________________________________________________ Doctors speak to nurses, or caregivers, he knows well. Everyone knows, but no one speaks honestly. He looks at you, starts to say: ‘Well, he is not well. We should start a drip.’ And you reply ‘ok’. Then we do it, and that’s enough. Doctors do not say more, nurses seem to understand the implicit message. They have also learned to locate and translate ‘the death cocktail’, or ‘D.L.P.’ prescription. All share in this experience, but rarely do people speak about it. This practice is tolerated: known and shared by all in the profession. As the anthropologist, Jean Jamin, said: “the knowledge of secrets supposes or implies knowing how to keep quiet which defines a power-to-say.” 14 Doctors and nurses internalize this norm of secrecy for their socialization. Revealing the secret is to break the frontier between being initiated and non-initiated. 15 B. Role of hospital Death is not taught at school, or even officially at the university. More than death, it is the dying process which is taboo in our society. I mean that death is less hidden than the process of dying. The moment of death is hidden as an impure moment or as a ‘private’ moment for the individual. Scientists know the birth process, and even teenagers learn this in detail at school. They even learn how humans reproduce. It is not the same for the dying process. That means that dying is still a mysterious event for people and they more lack knowledge about it, especially since death is professionalized. 16 Further, our contemporaries have lost their popular knowledge of the signs of death. They no longer know how to detect signs of approaching death, as they did when people died at home. They have become dependant on professional’s experience and expertise. It is quite the last “knowledge” resistant to the disillusion of the world 17 , and so, it leaves a place for other interpretations and beliefs around this ‘natural’ event. In this way, even some GPs don’t know how people die, or how to practice euthanasia. This group of GPs comes more from urban areas. Anaesthetists are known to be experts in the dosage of neuroleptics. This medical figure controls techniques in order to put patients to sleep, to resuscitate and also has the power to save or kill them with their chemical drugs. In addition, this speciality dominates others specialities in the medical hierarchy. They should be well placed to give an advice on the procedures to perform euthanasia. For instance, Dr. M., a

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___________________________________________________________ GP in Belgium, had never been socialized to euthanasia in hospital, and she had never been involved in it before the law allowed it. I had to ask about the meaning of a death cocktail... in general, it is asked to anaesthetists. [Dr. M., women, GP in town] C. Strategy for providing the necessary drugs We could think that the status of being a doctor is enough to obtain the drugs in order to perform euthanasia, but it is not so easy. Paradoxically, these drugs are frequently used in intensive care units in order to resuscitate patients. Therefore, hospital chemists can only provide them. This implies that doctors, who conduct euthanasia with ‘soft’ drugs, should be in contact with the hospital, or else they have to use so-called ‘bad’ drugs. In fact, the GP’s means are reduced to basic analgesic drugs. As we have said, this group of drugs is less effective for practicing ‘soft’ euthanasia. Therefore, either the GP sends the patient to a hospital, he uses ‘bad’ drugs, or he is included in the hospital networks and obtains drugs from an accommodating colleague. To perform euthanasia or to give death to a patient, especially for a GP, is not easy. As one doctor says: As doctors, we learn to save lives, but not to give death... I once used Valium, and as I was a novice, I thought everything would well... and then I realized it was taking too long. I thought she was weaker. I put myself in an awkward situation. I thought it will go on fast with Valium. I used that because I had nothing handy. It would work because it did not take time, it wasn’t painful for her. She was sleeping deeply. But if I had to do it again, I wouldn’t do it like that. [Dr. M., man, country GP] One GP takes advice from another GP who is said in the professional circles to practice euthanasia: I receive regularly a ring from doctors who ask me what I do, what kind of drugs I use. [Dr. H., man, country GP]

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___________________________________________________________ 4. Consensus is required A. The lack of social control Stories of doctor’s prosecution for euthanasia in newspapers contribute to social control. Doctors increase their vigilance; those who are occasional deviants, and those who experiment with euthanasia know that the social control is weak. While euthanasia is forbidden in France, there should be more controls on death in hospitals, or more autopsies. But an investigation has shown that the number of autopsies has decreased. 18 Moreover, chemists should control the reason for prescriptions, but there seems to be connivance between professionals. 19 Moreover, we may see a compassionate view from judges in most cases of the murders of disabled persons, or of the sick. They are rarely convicted or if convicted, they are released due to the benefit of tolerance. The murder is considered to be committed in a moment of distress. 20 Either a parent could not take sole responsibility for a disabled child or a spouse who is extremely ill. This brings to mind Memmi’s analysis on the evolution of the decline of penal control on the regulation of the body. Individuals seem to be free to consume their own reproductive or disease-bodies without strong outward control. B. A triangle of dependence around death Despite a lack of penal control, doctors tend to convince all caregivers, and also family members that their act is ‘good’, with regard to the situation. For a decision concerning end-of-life, the favourable opinion of all persons involved (family, nurse) is necessary, because there is a risk of denunciation. Doctors are constrained to listen and take into account all opinions, and try to reach a ‘consensus’. But when everyone agrees, there are no more problems! [Dr. A., women, in emergency room] In a recent case, a doctor and a nurse were accused of killing a patient, but the reasons were that they had done it alone, without asking the medical staff. Beyond the form of euthanasia, deviance concerns the way of doing it. Furthermore, in this case, the denunciation arose from colleagues and not from the family. A denunciation of euthanasia is more likely to arise from a conflictual situation within the medical staff, under a conflict of value. The patient’s death is the source of a power conflict where the survivors try to bring forth their values and their needs.

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___________________________________________________________ Even if last wishes are pronounced, they could be changed in regards to a family agreement. That means families take a part in decisionmaking. An end-of-life negotiated by the patient could only take place in the case where all the family and doctor agree with his or her decision. In this way, the patient is dependant on survivors. 5.

Conclusion So what are convenient arrangements with death in an end-of-life situation? Firstly, doctors make an arrangement “between themselves” and with nurses to keep this practice secret. This practice is tolerated in silence by all in the profession. Secondly, there is a convenient arrangement around a linguistic strategy. Doctors tend to avoid a practice being labelled as a deviant one by renaming it with a neutral label. Thirdly, consensus seems to be required as a magic solution to a deviant practice in medicine. Further studies can explain more fully how consensus comes up in the triangle of dependence around the dying patient. ‘Consensus’ is beginning to be a new obligation for professional caregivers, even if they had already been constrained to have it before the law was passed. However, by consulting families and patient’s wishes, it remains to be seen what doctors will hear, or what families and patients could say.

Notes 1

After a car injury, Vincent Humbert became quadriplegic, blind and dumb for four years in a hospital. He was the co-author of Je demande le droit de mourir, (Paris: Michel Lafon, 2004). 2 Between the end of 2003 and 2004, there was a surge of debates on euthanasia and palliative care which opposed Marie Humbert and Dr. Chaussoy to medical ethics, added to journalistic comments, a series of movies (C’est la vie, J-P. Ameris, 2002; The Barbarian invasions, D. Arcand, 2003 ; Mar adentro, A. Amenabar, 2004; Million dollars baby, C. Eastwood, 2005) came out the same year. It was public incitement to a ‘reflection’ on end-of-life with a normative background. 3 In this article, we will use the concept of end-of-life in a large meaning. This concept will include all situations in that patients are, conscious or not, suffering from a chronic disease or suddenly dying. For instance, few patients are rapidly confronted with death in case of bleeding.(throat cancer, patient with an insufficient heart condition.) or in instability cardiac condition.

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___________________________________________________________ 4

This paper is the result of an investigation led between 2003 and 2004 in France. 5 Marc Augé, Le sens des Autres. Actualité de l’anthropologie. (Paris: Fayard, 1994), 95. 6 Howard Saul Becker, Outsiders: Studies in the Sociology of Deviance. (New York: The Free Press, 1973), 163. 7 Our sample is composed of eight country GPs, five anaesthetists in intensive care units, three doctors in emergency rooms, two doctors in palliative care, one cardiologist, and one doctor in geriatrics. 8 H.S. Becker’s studies were focused on marijuana smokers, and the community of jazz musicians. 9 See Law 22 April 2005 ‘Loi relative aux droits des malades et à la fin de vie’. 10 Interruption volontaire de la vie (termination of life). This acronym is deliberately close to IVG (abortion, termination of pregnancy). 11 Care-giver could be thanked, or receive flowers. 12 See E. Ferrand. ‘Withholding and withdrawal of life support in intensive-care units in France: a prospective survey’, Lancet, 357, (2001) 9249. According to this study, 88% of ‘stopping care’ results from a unique medical decision. 13 See A. Paillet, ‘Consciences professionnelles, approches sociologiques de la morale au travail à partir des cas des décisions d’arrêt ou de poursuite en réanimation néo-natale’, thèse de doctorat de sociologie à l’EHESS ss dir. Cl. Herzlich, 2003. 14 Jean Jamin, Les lois du silence, essai sur la fonction sociale du secret. (Paris: Maspéro, Dossiers africains, 1977), 43. 15 Although the interviews were anonymous, only a half of sample declared to me that they have been personally confronted to euthanasia by having performed it. That characterizes the importance of secret around this practice in end-of-life. 16 Annick Barrau, Humaniser la mort: est-ce ainsi que les hommes meurent? (Paris: L’Harmattan, logiques sociales, 1993), 9. 17 Max Weber, Le savant et le politique. (Paris: 10/18), 63. 18 Claude Got, Les autopsies remis au secrétaire d’Etat à la santé et à la sécurité sociale, (Sicom, 1997), 68. 19 Laure Patrick, Caroline Binsinger, Les médicaments détournés. (Paris: Masson, 2003), 111. 20 1996: accused J-M. Préfaut to have poisoned her autistic-girl, a twoyear suspended sentence. 1998: Dr. Duffault is released

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___________________________________________________________ 1998: A. Pasquiou on her boy, a three-year suspended sentence 2004: E. Bendayan on his Alzheimer-wife, a two-year suspended sentence 2006: M. Humbert and Dr. Chaussoy, discharged from lack of evidence

Bibliography Arborio, Anny-Marie, Un personnel invisible : les aides-soignantes à l’hôpital. (Paris: Anthropos, 2001). Baudry, Patrick, ‘De la mort à la disparition’, in Savoir mourir , ed. Christiane Montandon-Binet (Paris: L’Harmattan, Nouvelles études anthropologiques, 1993), 211- 217. Douglas, Mary, De la souillure. Essai sur les notions de pollution et de tabou. (Paris: La découverte et Syros, 2001). Memmi, Dominique, Faire vivre et laisser mourir. Gouvernement contemporain de la naissance et de la mort. (Paris: La découverte, Textes à l’appui, Politique et sociétés, 2003). Florence Ollivier is a Ph.D. student in Sociology at Ecole des Hautes Etudes en Sciences Sociales in Paris. She receives a grant from Institut National du Cancer in order to achieve her study on thanato-politics in Europe.

Death and Funerals in Sunni Communities of Turkey Reyhan Varli Görk Abstract This study discusses the perception of death and funerals in Sunni Moslem communities of Turkey whilst evaluating Islamic culture and urbanised society. The main theme is to understand the attitudes of the urbanised Islamic Sunni society toward the death phenomenon in metropolitan cities provincial towns particularly in Ankara and Marmaris. Emphasis is placed on changes in attitudes over time, in the light of comparisons between Ottoman and modern Turkish culture. Graves, tombs, tombstones, epitaphs and cemeteries are also discussed from the viewpoint of Islamic culture. With these objectives, the study begins with the analysis of the concept of death. In order to carry out the study, a method approaching the subject from four disparate points has been employed. First, literature was surveyed to gain an understanding of the meaning of death in present-day society. Second, the Islamic canon was reviewed with regard to the death phenomenon. Third, reflexive narratives originating from personal observations as a participant in the funerals of my family members’ were employed in this study. The fourth and last field of research includes field observations and photographs from Karşıyaka Cemetery in Ankara, and copies of photographs from several other sources in order to identify the divergence of the modern from traditional. The major verdict of this study is that in modern Islamic culture, in contrast to its earlier traditional evaluation, death is sequestrated from social communal life and assigned to the status of an institutional event. Key words: death, funerals, cemetery, tombstone, Islam, modernism, urbanised society. 1.

Introduction The aim of this study is to analyse the perception of death, and the actions performed for the deceased in urban communities considering themselves Sunni Moslems living in Ankara and Marmaris. Through visits to the Karşıyaka Cemetery, affiliated with the Ankara Metropolitan Municipality, I have attempted to observe attitudes of members of the present-day Turkish urban community regarding death, the procedures followed death, burial procedures, graves and gravestones. As interview with the relatives of the deceased might be deemed offensive, frequent use of participant observation has made use of. In a manner not common in academic literature, my personal experiences of the decease and funerals of parents and brother are inevitably reflected in

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___________________________________________________________ this study. In addition, perception of death in hospitals and death at home will be included in this study. 2.

The Perception of Death Death ends human life, and no one can experience death without his/her own death. This may account for why death is frequently perceived as a phenomenon befalling others. Death is the only ‘absolute nothingness’ defiance and revolt against life, therefore all living people endeavour to find immortality in modern medical sciences. If death comes to an old aged person because of an illness, people are somewhat able to console themselves. Visitors to the patient do not refrain from saying ‘may God give one of two goods” to the relatives of the patient or even to the patient. This phrase means; if there is no way of recovering from an illness, death is a salvation from continual suffering. Here, there is a reference to divine might. In traditional and Islamic discourses, death and life are not opposites but complements of one another. In an article of Department of Religious Affairs, 1 death is described as: … the most effective advice and the biggest warning. It is impossible to escape death ... People who are in bond with the Great Creator, see death as an instance of reunite. Death turns to be ‘şeb-i arus/ night of wedding as Mevlana 2 proposes.

As it evokes death, the thought of being a tiny spot in the universe is unbearable to man. 3 At this moment, the meaning of the world constructed within daily life is abolished. The orderly relationship with things and people is disintegrated. 4 I remember my grandmother at the end of her life at eighty-one she reflected the disintegration between her self and material objects in sentences such as: I want to buy a new cardigan but I lived enough, I don’t want to cause needless expense. But I don’t die either! 3.

Death at home and death in hospital When death takes place at home, it is almost exhibited; separated in small parts and stages. It is not possible to know exactly when - with the loss of consciousness or with the last breath - death occurs. 5 Five hours before the decease of my mother, just after her loss of consciousness, my grandmother visited us. During this visit, my grandmother stood behind the head of my mother, whose bed has been

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___________________________________________________________ positioned facing Kıble (the direction of Mecca) ten days ago, and read passages from Qur’an and dampened lips of my mother with Zemzem holy water from Mecca. I emphasize the position of my grandmother as it relates to her religious and traditional beliefs. Accordingly, a mother does not stand in front of her child who is about to die; this is to defy God and equivalent with demanding a return of the ‘helal’ - canonically lawfulmilk she has provided to her child. As the illness of my mother become more serious, there was an increase in the number of people who visited us to express their wish “get well soon”, but actually, they were all there for ‘helalleşmek’; to forgive and be forgiven by the soon to be deceased.. Even rarely met people visited us to express their best wishes for health and good appetite. In urban part of Turkey, although the occurrence of death in hospital is getting more common, hospital authorities inform the relatives about the impending death of patients. Doctors of the state university hospital in İzmir told us that my mother’s life expectancy was around fifteen days and we, her family, were allowed to take her back home if we deemed it appropriate for her to die at home. In such circumstances, families face a dilemma: taking the patient to the home to let all the relatives say their farewell but at the same time impeding her stay in the hospital and annulling the chance of living for a longer period of time. My entire wish during the journey back to Marmaris was to get her home while she was still alive. Similar to my mother’s death, in spite of his exhausted body following a one and half year cancer cure program, my father was released from a state hospital in Ankara. Since I was working and it was not possible to take care of him properly at home, I decided to take him to a private hospital. It was interesting that despite his diagnosis, operations and all the cure programs, the authorities of this private hospital claimed “the patient’s health is in very good condition, but feels ill psychologically and is well enough to self-sustain him and even go shopping”, and released my father. Despite these claims, one day later my father passed away in sleep at night. Some time afterwards I was informed by a healthcare authority that both state and private hospitals are very careful about not to accept critically ill patients and this was mainly because of their motivation to reduce the rate of ‘ex’ or ‘dead’. According to this view, “the reason of decease is the unsuccessful cure program of the hospitals.” 6 After a death at home, one of the elderly members of the household ties the chin and toes before the body cools. The necessity of this act is explained by keeping the joints together and prevention of drooping of the chin. The corpse is laid down facing upward; the arms are joined on the belly and covered with a sheet in a way such that all the

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___________________________________________________________ body including the face is under the cover. A steel knife is laid lengthwise on the corpse and metal coins are put on the eye lids as it is traditionally done in many places across Anatolia. This knife is believed to prevent the body from swelling up and the coins keep the eyes shut. If the burial is to take place in the day following the decease, relatives and friends do not leave the corpse alone, but stay with the corpse and keep the lights open. 7 If the decease takes place at home, washing of the dead body, the first step of the funeral may also be done at home. For this purpose, a wooden couch is placed either in the garden or balcony and the sides of this couch is covered with sheets or curtains to limit visual access. Nowadays, there are ready packages sold by funeral companies, which include the necessary materials for funeral procedures. In these packages, there are soap, washcloth, two towels for body and head, a bowl, a piece of cotton and shroud for winding. After the water is heated, the corpse is laid down on this couch with the sheet on it. The procedure continues as follows: The corpse is washed by someone who is a relative or is experienced about washing. The washer expresses the statement of intention (niyet) and begins washing. However, there is no need to wash children who are not adolescent according to Islamic definitions. Men wash men and women wash women. A woman may wash her husband, but according to Hanifi doctrine a man shall not wash his wife. 8 During the washing of my mother, the washerwomen did not take the cover off throughout performing the washing with their hands under the cover. Thus, they prevented corpse to be seen by both themselves and the others and ensured that they were in line with the principle of Islam, which states that the corpse should be secluded during the wash. After the washing, the dried and covered corpse is laid out over shroud cloth. The washers invite the same-gender friends or relatives of the deceased to join in the shrouding procedure. I, as the only daughter, was persuaded to participate in this procedure. The only thing I remember is that the participants lined on both sides of my mother holding one piece of the shroud with both hands also before covering with the shroud, participants holding a piece of shroud in their hands pretending to cover three times, before finally covering the body. The essential thing was that I should not cry, since it was said that even one drop of tear on the shroud would torment the soul of my mother. Mourning has become something to be

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___________________________________________________________ ashamed not because it means to resist the fate in Sunni communities but also means madness in modern societies. After washing and shrouding, the burial process is started with the application to the municipality with the “death certificate.” The municipality funeral vehicle or ambulances from private funeral companies carry the corpse to the mosque for the funeral praying in a coffin. When my mother was taken from home to vehicle, I was told to be silent. Why? Because her soul would feel hurt! In those years, in towns, women did not generally go to the mosque or attend the burial. After a few hours, I felt a pain in my chest. The reason for this pain was a cord tied very tightly just below the chest called “nerving belt.” This was supposed to help me to preserve my fortitude. I did not mourn loudly in response to this experience at twentythree, either because of the shock or because I was so persuaded. However, four years later at the funeral of my elder brother who passed away due to a heart attack fifteen days after the decease of my father, I lost all fortitude. I was told later that everybody thought I had gone mad. Shouting and braying in the middle of cemetery, “There is no God! If there were, all this could not happen!” could not be attributed to anything but madness. After death started to occur in hospitals, it ceased to be something of spectacle. In fact, to die in a hospital setting has also become an indicator of status and level of consumption. In a recent funeral I attended, a relative of my friend who had lost his father, was remarking: “Thanks to the money his son provided, he lived up to now, otherwise he would have died a long time ago.” On the other hand, the son of the deceased, my friend was remarking: “I am at peace with my self. Everything that could be done was done until the last moment. This is my only consolation.” 4.

The funeral and the funeral prayer As is known, in Islam every prayer is performed upon a call for particular azan (Moslem call to prayer). A funeral prayer performed in accordance with this purpose is described below: A Muslim child, when born, is taken in to arms of a man with ablution, who turns towards the direction of Mecca with the baby’s head to his right, and whilst standing calls the azan of this new Moslem life. Taking the head of the child to his left, calls Kamet (an azan peculiar to funerals), and names the child... When this child dies, only Moslem men perform the funeral prayer of this call, standing and as a group. 9

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___________________________________________________________ For the last five years, in Turkey women attending funerals may also be observed performing the funeral prayer. There is no criticism or aggression about the participation of women to funeral prayer, neither at individual nor institutional level. The matter of debate is essentially about the place occupied by women relative to men in the funeral prayers. Indeed, a woman performing the funeral prayer in front of a man is held responsible for undoing the prayer of that man. 10 According to Islam, some preconditions exist for the dead person to be eligible to a funeral prayer. The most important precondition is that the dead person be a Moslem. To perform a funeral prayer for people who are non-Moslem, is deemed as disrespect to their memory. After the funeral pray, accompanied by the relatives and friends of the deceased, the coffin is taken to the cemetery for burial by the funeral vehicle or ambulance. Generally, silence prevails among this group, but if the deceased is someone with a political persona or the cause of death is murder committed under suspicious circumstances, the participants chant slogans from time to time. Even though these kinds of rituals are not found strange by urban society, religious authorities emphasize that these rituals are not in harmony with Islamic practices. In urban societies where people are increasingly alienated to each other, funerals are announced to relatives and friends by obituaries published in newspapers rather than the ‘Sela’ - an announcement made by the masque about the death of the deceased. It’s not surprised to see ‘lively’ relatives acting as the host of the funeral going around the courtyard of mosque introducing people to each other, then moving on to the next group of people after a chit chat of a few sentences to host the others. A. The burial of the corpse The corpse, which is carried to cemetery after the funeral ceremony and prayer in the mosque, “is carried to the place of burial in the coffin which is a wooden chest with four handles on the shoulders of those close to the deceased,” 11 then the corpse is taken out of the coffin to be placed in the hole dug in the ground. In these burial ceremonies, laying the corpse inside or outside of the coffin in a position of sleep has become a tradition. According to Islamic practices, the corpse is laid down on his/her right side facing the direction of Mecca/Kıble. It’s an old tradition for those participating in the burial to shovel at least one spade of soil on the gravel, to give money to the poor nearby and to cook halva (either by flour or semolina) in the evening for distribution in the neighbourhood. Traditionally, a religious relative of the deceased or an imam reads passages from Qur’an. After the burial, the participants express their

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___________________________________________________________ condolences to and wish fortitude for the relatives of the deceased. They express wishes such as “May your life be spared” or “God give long lives to the remaining”. After the burial, no further time is spent in the cemetery, those close to the deceased mostly go leave for the home of the deceased. B. Rituals after the burial of the corpse Either after having the burial of the corpse, halva made with flour or semolina is prepared for those who come back to home of the deceased. People other than the first-degree relatives assume this responsibility to spare them the commotion. It is generally the bride who cooks and serves the halva. Grooms go after any necessary shopping errands. Nowadays, major restaurants prepare special menus for funerals. The family of the deceased eats and drinks together with those who came for condolences. During the meal, some proclaim “may it touch the soul of the deceased/rahmetlinin ruhuna değsin.” Afterwards, a religious attendant reads passages from the Qur’an. As most of the women are unprepared they hurriedly cover their heads. One of the women of the home of the deceased distributes headscarves. After reading passages from Qur’an, people start to pray, pronouncing the deceased’s name and pleading for forgiveness for his/her sin. The name of the deceased’s mother is pronounced with emphasis as only the mother can be known with certainty in early ages. On the evening of the burial, and the seven days following, the deceased is commemorated with similar rituals. People pray and especially read passages from Qur’an; sometimes ‘mevlit’ is also read. Lemonade which is a sugary drink and Turkish delight and sugar candies in the packaging of well-known patisseries - in past times wrapped in paper cones - are served. The aim is the symbolic exorcising of the bitterness of death through their sweetness. ‘Mevlit’ 12 is generally read on the fifty-second day of the decease is read on the fortieth and fifty-second days after the burial. In Western Anatolia, especially in Marmaris, on the fortieth day a dessert with honey or sherbet (lokma tatlısı) is served. In Mevlit ceremonies, women and men sit in different places- if it takes place in the home of the deceased, in different rooms. Mevlit ceremonies which may be organized at any time of the year and especially after burials are read by an imam or by a religious volunteer. 13 The home of the deceased continues to be visited in the days following the burial. Neighbours and relatives bring meals for the family of the deceased for ten to fifteen days. During these visits of consolation, especially in western Anatolia, the guests bring granulated or lump sugar to symbolically help to family disperse their bitter sorrow. In rural areas, if

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___________________________________________________________ the guest owning cattle will also bring fresh milk. In my opinion, the “clean-whiteness” of the milk and its being the first foodstuff of life is a symbolical invitation to a life after darkness of death. 5.

Cemeteries as a space In Ottoman cemeteries, until the nineteenth century, practices similar to western practices of graves and cemeteries may be observed. The shift in the cemetery culture of Ottoman Empire took place after the nineteenth century. In the present day, cemeteries are situated far from cities either because of economical necessities or ‘city planning’ principles. But in big cities like Ankara, or even in small towns like Marmaris, cemeteries, which were initially intended to be far outside the city are again becoming situated inside cities because of the haphazard and rapid growth of these cities. As is the case with almost all municipally-owned cemeteries, in Ankara Karşıyaka Cemetery there are wash rooms, mosques or ‘mescit’s, a large area for funeral praying, and ‘musalla taşı' - a stone used as a table on which the coffin is temporarily placed - kept ready for the funeral prayer. A. Graves and Gravestones Even before Islam, in Turkish culture corpses were buried in ‘taşhöyük’ graves which are round hillocks of six to seven meter diameter with holes opened up at the ground level. 14 Unlike Islamic practice, in these graves, “corpses were positioned in east-to-west direction, not facing the Kıble, direction of Mecca” 15 , instead the “head is positioned either to the east or to the north.” 16 The first Moslems and religious men “strictly opposed to the building of gravestones to prevent idolatry, but tolerated stones to be put on graves to protect the corpses from wild animals. More moderate ones, allowed within limits the use of simple gravestones made with non kiln-dried bricks.” 17 Later on, especially after tenth century, “along with the building of mausoleums of important by people for themselves, graves which are not in line with Islamic tradition re-appeared.” 18 Because of this change in grave culture in Moslem societies, it is not possible to talk about a singletype Islamic grave culture. Instead, “there arises the necessity of introducing distinctive Egyptian, Persian or Turkish grave cultures resulting from interaction between Islamic practices and local traditions.” 19 Accepting the interpretation of Ottoman gravestones as abstract symbols of man, it may be asserted that this tradition stems from Central Asian Turkish Shaman practices. 20 In Ottoman grave culture male grave

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___________________________________________________________ stones are more dominant. It is also possible to identify gravestones as belonging to men or women from the stonework. 21 On present day gravestones such a distinction is not easily made without reading the names on the gravestones. It may be observed in Karşıyaka Cemetery that all the graves are similar to each other. Most of the graves seem like to have been made by the same worker or as copies of each other. The primary work of marble workers situated on the ways both inside and outside the cemeteries is to make graves and gravestones. For urgent orders, they have pre-made stones of standard dimensions, everything including the writing of “Ruhuna Fatiha/Pray for the Soul” is ready except for the name and the birth and death date of the deceased. ‘Head and foot stones’, the basic constituents of Ottoman graves, are sometimes not erected separately on the cover stone but, “like a sarcophagus placed on the stones covering the grave so as to form a unity.” 22 Modern graves as seen in Turkey have solely a ‘headstone’. The rest of the grave has evolved in to rectangular boxes, usually made out of marble, with centres filled with soil, serving as flowerpots. These rectangular boxes remind us the traditional garden of the Persians which was a sacred space that was supposed to unite four separate parts within its rectangle, representing the four parts of the world. 23 The garden is the smallest fragment of the world and, at the same time represents its totality. This fragment, eventually to be owned by each person, also has an economical value. The price of a plot, according to the January 2006 tariffs of Ankara Metropolitan Municipality is 275YTL/137€/£93. However, the purchase price of plots bought in advance by people with the apprehension of having no one to bury them after their death and to be buried in a ‘cemetery for people with no one’ or as a family burial place is 6600YTL/3300€/£2237 . As a tradition, still, only one person is buried per grave. Von den Driesh, ambassador of Vermondt to the Ottoman Empire during 1719-20, expressed his surprise that “there are extraordinary number graves in the courtyards of the mosques, because of their tradition of separate graves per one dead.” 24 As an exception, a women and her child may be buried into the same grave according to Islamic traditions. Laquer 25 points out a gravestone which belongs to a women who died during giving birth, and thus deemed a martyr is buried in the same grave as her child who died with her. Even for couples who have deeply loved each other and whish to be buried in the same grave; it is against Islam. According to Islam, the reason for this prohibition is that the religious wedlock between spouses ceases with death. Thus, couples may not be buried together as they become ‘namahrem’ (i.e. a woman and man not of first degree relationship or

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___________________________________________________________ married to each other and therefore not allowed to share the private sphere of life). B. Cemetery visits Before visiting the cemeteries Sunni Moslems still have a wash ‘boy abdesti/ablution’ according to Islamic practices and women cover their heads with headscarves. Cemeteries may be visited on any day of the year, but in Islam, it is especially day before the religious bairams. People take flowers, or as in Marmaris branches of myrtle, believed to be holy, to put in the vases at the foot of graves. It is also common to take flowers to funerals. Wreaths prepared for this purpose are readily available in flower shops, or indeed may be ordered online. The aim of cemetery visits before bairams is to symbolically celebrate the bairam with those who have passed away to the ‘other world’. Due to the sacredness of the day, people read either the prayer of their ‘hatim’- a previous complete read of Qur’anor the Sura of Yasin from the Qur’an. Also in compliance with the request written on the gravestones ‘RUHUNA FATİHA/FATIHA FOR THE SOUL’, they read the Sura of Fatiha. Writings on gravestones requesting for a prayer reflect a tradition extending back to Ottoman grave culture. 26 Traditionally, it is suggested that one should not walk or stand on the graves and complete the visit standing-up. Nowadays, children are not seen in burial rituals and even at cemetery visits. In 1970s, during my childhood, children were taken on cemetery visits at least on the day before bairams. Particularly my grandmother used to take all her grandchildren to the cemetery to help her in cleaning and watering of the graves. In complete silence, somewhat bored, but excited by doing something different and happy that, according to my grandmother, we had gained some ‘sevap’—credit awarded by God for good deeds—we would complete the visit. 6.

Conclusion To make an interpretation on how Sunni Moslem society especially those who live in cities view death and the subsequent funeral arrangements in today’s Turkey; it may be stated that there change has occurred since Ottoman Times. Some people, despite their lessening faith ensure a religious funeral for their relatives and friends. Perhaps the refrain from funeral rites outside those sanctioned by the Islamic tradition to preserve the esteem their nearest are held in, on their final journey. Even people without faith, are left in a position of being the organizer of an ‘Islamic Funeral Ritual’ as their deceased relative is a Moslem and would want to be buried in accordance with the Islamic tradition.

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___________________________________________________________ To conclude; it seems true to say that these changes point to an accelerating trend in the social institutionalization of death. Through this transformation, both death itself and funeral rituals are producing a services sector within organizations and establishments. In view of all this, it may be observed that funerals, the last social rituals in which people participate, will evolve into mechanistic, ever-rationalized and commercialized procedures participating in the societal division of labour.

Notes 1

‘Cenaze İle İlgili Bazı Uygulamalar’ (Some Practices about Funerals), 22 September 2000, (03 June 2002).

2 (06.06.2006), “Mevlana who is also known as Rumi, was a philosopher and mystic of Islam, but not a Muslim of the orthodox type. His doctrine advocates unlimited tolerance, positive reasoning, goodness, charity and awareness through love. To him and to his disciples all religions are more or less truth. Looking with the same eye on Muslim, Jew and Christian alike, his peaceful and tolerant teaching has appealed to men of all sects and creeds.” 3 Yaşar Çubuklu, ‘Ölüm Üzerine Spekülatif Düşünceler’, Defter, 1, 2 (1987), 72-77, 75. 4 Çubuklu, 76. 5 Phlippe Ariés, ‘Yasak Ölüm’, Defter, 1,2 (1987), 78-94. p. 80. [‘Yasak Ölüm’ The last chapter of ‘Batı'nın Ölüm Karşısındaki Tutumları’ by Philippe Ariés, Western Attitudes Toward Death (London, Baltimore: The John Hopkins University Press, 1974)]. 6 Ariés, 80. 7 According to traditions burial should not be left after mid afternoon time. 8 Ana Britannica, Volume 7, s.v. ‘cenaze yıkama’ (İstanbul: Ana Yayıncılık A.Ş., 1994) p. 377. 9 Münif Çelebi, Kuran Dili ve Alfabesi ve Okuma Kaideleri, Tecvit ve Namaz, (Ankara: Balkanoğlu Matbaacılık Ltd. 1974), 57. 10 Diyanet İşleri Başkanlığı, (Religous Affairs) 03 June 2002, "... Be it Friday, Religious Festival or funeral prayer, if women are going to participate in the group of prayers, they should be situated in a suitable place separated from that of men. Indeed, Prophet Mohammed organized the prayer group as the men standing in the front part followed my boys and then women.

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___________________________________________________________ Otherwise for Hanefi (a Moslem sect), if men is situated behind women during a prayer, the prayer of the man is undone and the women responsible for that is deemed to commit a sin.” 11 Ana Britannica, Volume 24, s.v. ‘cenaze töreni’ (İstanbul: Ana Yayıncılık A.Ş. 1994) p. 303. 12 “… a work in Turkish and Arabic Literature composed of 730 verses in ‘mesnevi’ style narrating the birth and life of the Prophet Mohammed with praise and written by Süleyman Çelebi in the years between 1409 and 1410 with title Vesid. letü’n Necat” Ana Britannica, 22nd volume (İstanbul: Ana Yayıncılık A.Ş., 1994) s. 341. 13 Nancy Tapper, Richard Tapper, ‘The Birth of the Prophet: Ritual and Gender in Turkish Islam’, Man (N.S), 22 (1987), 69-92. 14 Necibe Saracoğlu, ‘Türk Mezarlarına Dair Araştırma’ II. Bina Bilgisi Kürsüsü, 3.1.1947 tarihli Yeterlik Çalışması, İ.T.Ü. (İstanbul: İstanbul Matbaacılık, 1950) p. 8. (Ph.D. Thesis, University Publishing) 15 Saracoğlu, 28. 16 Saracoğlu, 8. 17 Hans-Peter Laqueur, Hüve'l-Baki: İstanbul’da Osmanlı Mezarlıkları ve Mezar Taşları, çev. Selahattin Dilidüzgün, (İstanbul: Tarih Vakfı Yurt Yayınları 46, 1993), 1. 18 Mez, Adam., Die Renaissance des Islams, (Heidelberg, 1922), 371, quoted in Hans-Peter Laqueur, Hüve'l-Baki: İstanbul’da Osmanlı Mezarlıkları ve Mezar Taşları, çev. Selahattin Dilidüzgün, (İstanbul: Tarih Vakfı Yurt Yayınları 46, 1993), 2. 19 Adam, 2. 20 Laqueur. 21 Laqueur. 22 Laqueur, 131. 23 Michel Foucault, ‘Of Other Spaces: Utopias and Heterotopias’ in Rethinking Architecture ed. Neil Leach, (London and New York: Routledge, 1997), 350-356. 24 Gerardo Cornelio Drischio, Historia magnae legationis caesaaarae..., I, (Viennae, Austriae, 1721), s. 246. German translation: Historische Nachricht von der Röm. Kayserl.Gross-Botschaft nach Constantinopel... (Nürnberg: 1723), 113. quoted in Hans-Peter Laqueur, Hüve'l-Baki: İstanbul’da Osmanlı Mezarlıkları ve Mezar Taşları, çev. Selahattin Dilidüzgün, (İstanbul: Tarih Vakfı Yurt Yayınları 46, 1993), 107. 25 Laqueur, 108. 26 Laqueur, 92. "This part of the gravestone consists of the request of praying for the deceased. … Although Fatiha is read for someone particular, reading Fatiha means the requesting God to forgive all the evil

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___________________________________________________________ deeds of the all living and deceased. This is why a religious Moslem, when enters a cemetery, reads Fatiha not for someone particular, but for all deceased to be forgiven by God.” Reyhan Varli Görk is a Research Assistant in the Faculty of Fine Arts, Akdeniz University, Antalya and a Ph.D. Candidate in the Department of Sociology, Middle East Technical University, Ankara, Turkey.

The Body of Necessities in Finnish Discourse on Euthanasia Leila Jylhänkangas Abstract The purpose of this study is to examine the different ways in which people discuss euthanasia in contemporary Finnish society. The data in this study consist of letters in which ordinary Finns discuss euthanasia. Arguments today often focus on the question of whether a terminally ill individual should be allowed to die with active death assistance. Although active euthanasia has not been legalised in Finland, the issue occasionally arises in the Finnish media. Unsurprisingly, the data reflect people’s interest in discussing euthanasia. Representations of suffering, pain and despair often arise in arguments supporting euthanasia. Considering this, it is interesting to note that psychological distress (especially depression) is one of the main factors behind requests for euthanasia. In Finnish euthanasia discourse, however, the fear of pain, and the possibility of falling into the care of other people in particular, are the principal motivators. The data compel one to pose the following questions: What kinds of cultural representations do people construct concerning dying and suffering in end-of-life situations? How are representations of euthanasia related to them? Key words: euthanasia, death and dying, cultural categories, human body. 1.

Introduction The purpose of this study is to examine some of the different ways in which people discuss euthanasia 1 in contemporary Finnish society as well as to shed light on representations of a dying human body in euthanasia discourse. The data in this paper consist of letters 2 in which ordinary Finns discuss euthanasia. Arguments today often focus on the question of whether a terminally ill individual should be allowed to die with active death assistance. In euthanasia letters, images of the last stages of one’s life are often associated with despair and worry about pain. Cultural constructions of the body serve to sustain views of social relations. Human beings relate to each other through their visible body, a body that sees and can be seen. Euthanasia discourse represents different kinds of bodies. One of them is the body of necessities, a human body dependent on the help of other people to maintain basic, necessary vital functions and everyday hygiene 3 . I define the body of necessities as something that is crucially related to dying, the last stages of human life. The body of necessities is a construct closely and concretely related to data, in this case Finnish euthanasia discourse, on pain and suffering

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___________________________________________________________ related to dying. In euthanasia discourse, dying is considered an unwelcome intrusion into the midst of a happy life. Representations of suffering, pain and despair often arise in arguments supporting euthanasia. Considering this, it is interesting to note that psychological distress (especially depression) is one of the main factors behind requests for euthanasia 4 . In this paper I’ll also examine hopelessness and rejection. Hopelessness at the end of life is not simply ‘the absence of hope’, but attachment to a kind of hope that is lost 5 . Rejections, on the other hand, are consequences of hopelessness. Rejection of medical technology toward the end of life is one example of this. In this study, the analysis of the data will include categorytheoretical orientations which presume that cultural categories play a significant role in euthanasia discourse. Following Mark Johnson, I consider reasoning and experience to be closely linked to one’s understanding of the human body. 6 Also, the ideas of Mary Douglas are useful in the analysis of euthanasia discourse, for according to Douglas, the body is a model standing for any bounded system 7 . We can see in the body a symbol of society, for the powers and dangers credited to social structure are manifested on a smaller scale to the human body 8 . Consequently, the social and cultural categories of the human body are considered strong influencers of euthanasia discourse. The body is also central to the construction of metaphors 9 concerning the body of necessities. 2.

When life holds no greater worth than death The issue of competence frequently arises in the treatment of the elderly and dying 10 . In treatment situations, the fear of losing individual autonomy and control seems to worry patients when they contemplate the end of life. The following writer ‘would not want to live with a respirator’ because it would not be a ‘natural’ way to live: My opinion is based on the fact that modern medicine can artificially support human life so well that in this matter we are already playing God... Birth, life and death are part of being a human. I would not want to live with a respirator. If I cannot live ‘naturally’, I want to die. (KE 42) What happens at death is, of course, understood differently across various cultural and religious groups. Death and euthanasia are also related to how life is conceived and illness is treated. As a kind of mental or ‘imagined ritual’, 11 euthanasia has a certain effect on social continuity:

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___________________________________________________________ it can be seen as a threat or as a relief. The following writer talks about ‘a living corpse who is kept alive with the assistance of machines’. The writer defines such life-sustaining treatment as ‘ill-treatment of the worst kind’. Even if a person is already a living corpse, he is kept alive with the assistance of machines, poisonous medicines are fed to him and injections are given in order to keep this person alive. It is harsh – and illtreatment of the worst kind. (KE 109) Perhaps more than ever before, modern dying is prolonged and shaped by human choice. According to Mark D. Sullivan, this is the reason for the current situation in which hope and hopelessness play an active role in the dying process 12 . Sullivan also points out that hopelessness and depression share much common ground, both considered classic symptoms of melancholia 13 . In euthanasia discourse, images of uncleanliness and the unpleasant sights surrounding death are often categorised as intolerable. Hence, images of the last stages of one’s life are often associated with fear and despair. The following writer fears the possibility of ‘falling into the care of other people’: I’m not so much afraid of death. What scares me is the possibility of falling into the care of other people. It would be so safe to look at my life one day at a time and to know that I could leave when I don’t enjoy my life anymore, don’t have the energy to live. Physicians should have the right to help people to obtain a beautiful and dignified death. (KE 61) A dying person may consider death the only way to escape from dying and the concrete physical pain and emotional distress. For example, the following writers are worried about the pain and suffering various incurable illnesses cause. The latter person writes about such suffering ‘that only death can end’. Nowadays people live long and experience all kinds of illnesses. When there’s pain and suffering, it comes to one’s mind that a person should be helped to escape from the pain. (KE 128)

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___________________________________________________________ In the last stages of lung cancer, a person experiences terrible pain. There is a lot of suffering that only death can end. (KE 65) The previous writer is worried about the pain in cancer and notes that ‘in the last stages of lung cancer, a person experiences terrible pain’. People want to escape the pain cancer causes, and very often death is considered the only way to end the pain. Considering this, it is worth noting that cancer is a risk factor for suicide, and the risk increases with disease severity 14 . According to Émile Durkheim, melancholia and depression have ‘a long history’ in the individual who commits suicide. Although an individual may be driven to suicide by what appears to be an immediate cause, no such sudden stimulus alone would result in such selfmurder 15 . This notion is analogous to the notion according to which cancer is a risk factor for suicide (or any other life-threatening illness). There is a sufficient ‘time to be anxious and depressed’ before death comes. The following excerpt comes from a letter belonging to a 40-yearold woman who describes the serious illness and suffering of her own husband. Her husband had attempted suicide twice: My husband has an incurable muscle illness called dystrophia myotonica... He has said that he is not afraid of death. In his illness, the body and muscles decay but the mind is left untouched... My husband has been depressed for a long time... My husband tried to commit suicide twice. (KE 65) In Finnish discourse on euthanasia, people seem to have a tendency to fear situations in which scientific medicine eventually fails to ease the patient’s pain and physical discomfort. In such circumstances, (active) euthanasia is considered a welcome option. However, these circumstances vary. Hence the body of necessities has different kinds of dimensions. One is a human body in terrible pain. Another important dimension concerns a situation in which a dying person is losing her or his personality. For example, a hospitalised person may not always be called by her or his name, but by her or his illness, as in ‘that lymph follicle cancer in compartment six’. 16 In such a situation the patient becomes depersonalised. He or she is no longer referred to as a person. People may also associate the weakness of the human body with mental incapacitation. Such a state illustrates the idea that one’s inability to control oneself in one area causes the inability to control one’s behaviour in other areas. 17 In the following excerpts, the body of

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___________________________________________________________ necessities appears as ‘an idiot who has lost his personality’ and as ‘a halfdead person’. The writers feel that to deny euthanasia to the physically weak is unfair (‘an additional punishment’ and ‘torture of a human being’). They demand and stress the right to assisted death, especially for situations in which a dying person is brain-dead and dependant upon machines, or is already ‘half-dead’. If a healthy person has the right and the ability to kill himself, why is this right robbed from those in such bad condition that they cannot kill themselves anymore? Why such an additional punishment? This is simply cruel and unfair. Euthanasia is justified in a situation in which a mentally healthy person expresses his will for not wishing to live brain-dead and dependant upon machines…I have already told my friends for many years that I do not wish to live brain-dead, dependant upon machines, or as ‘an idiot’ who has lost his personality. (KE 36) It is the torture of a human being, a waste of drugs, I’d like to say it is hate, envy, cruelty to try to keep a halfdead person alive on this earth. There are drugs for mercy killing. (KE 63) 3.

Rejecting medical technology I have told my spouse that I’m never going to be connected to any life support machine. If I would be injured, for instance in an accident, and there would be a choice between dying and living connected to life support machines then I would definitely choose death. (KE 41)

Technological advances over the past decades are vast, and they have enabled us to overcome many diseases and have extended life. At times, however, the result has been an unfortunate prolongation of the dying process. 18 Due to technological advances made during the past decades, death has changed radically, having passed largely from the home to the hospital. According to Ariès, “the hospital is the only place where death is sure of escaping a visibility - or what remains of it - that is hereafter regarded as suitable and morbid”. 19 When death has been

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___________________________________________________________ removed from the home and taken to the hospital, it has been rendered invisible. David W. Meyers writes that “the natural tendency of many doctors has been to use any available technology, in the hope it may improve the patient’s condition or extend his life, even if the patient is suffering from a terminal and incurable malady.” 20 The following writers are worried about a situation in which an unconscious person is ‘connected to machines’: A person is connected to machines and is unconscious. At some point, the relatives are asked if the machines could be turned off because the person cannot breathe. This is euthanasia, right? It just happens with another label. I think this is the case. We all have the right to die with dignity. That’s why euthanasia should be accepted and the word euthanasia in particular should be used, without any pretexts. (KE 81) When a person is already outside all consciousness, it should be obvious that he should be released from the machines. This idea should also be applied to children and youngsters, not just to the elderly. (KE 120) Euthanasia discourse is constructed with body-based metaphors. A good example of this is the vegetable metaphor, which describes a human body that has lost all capacity to live independently and is totally dependent upon machines and the care of other people. The vegetable metaphor appears in arguments that accept euthanasia, as the following example illustrates: Euthanasia should be used when a brain injury makes a child or a young person ‘a vegetable’…when a patient is incurable, you hope the law would permit an end to the suffering. (KE 120) Mark Johnson has argued that metaphors are more than just ‘isolated beliefs’. For example, for a physician whose understanding of a human body is structured by the ‘body as machine’ metaphor, representations such as ‘breakdowns occur at specific point of injuries in the mechanism’, influence his or her perception, diagnosis, treatment, theorising and other practices. Such representations constitute the physician’s grasp of medical situations. 21 In the same way, the ‘body as a

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___________________________________________________________ vegetable’ metaphor is a kind of ‘chief metaphor’ that systematically structures the dying process in a very definite manner. It seems easier to give up and let a person die when he or she is no longer considered a human, but rather a vegetable. In this study, not all of the writers supporting euthanasia use strong metaphors such as ‘a vegetable’ or ‘a living corpse’. As already mentioned, some writers worry about ‘the intense physical pain’ and life being ‘all but distress’. In such a worry, euthanasia can be represented as ‘a salvation’, and as a means ‘to end the suffering’ justifiably, ‘especially when the physical pain is intense’: I think that every human being deserves the right to make the decision of his own life and death, especially when the physical pain is intense. When a person sees that his life is all but distress and can no longer be healed, the physician should have the right to help him to end the suffering, meaning to help him to have a quick and painless death. It’s not killing; it’s a salvation. (KE 54) The following writer stresses the value of human life. This excerpt compels us to remember that death can also be ‘dignified’: Life is always dignified; one cannot deny that. However, we should also remember that death can be dignified too, even more dignified than life. (KE 42) It is not the concern here how fortunate or unfortunate the entire life of a dying person has been, but more importantly, the concrete suffering that the human body (of necessities) experiences towards the end of life. Euthanasia is accepted on the basis of the possibility that a dying person will live ‘outside all consciousness’, and that continued life will involve the endurance of great suffering. At the same time, the ideas of autonomy, self-determination and control are actively defended in arguments supporting euthanasia, as the following example illustrates: I have thought about it [the possibility of falling seriously ill] and have also told my children that I wouldn’t want to live as ‘a vegetable’, dependant upon machines. And if I could think and understand everything, but couldn’t ever move by myself or take care of myself, I guess I’d like to end such a life; it

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___________________________________________________________ wouldn’t be worth living. In addition, in such a condition, I’d cause trouble for and distress to my friends. (KE 38) An interesting point concerning the body of necessities stems from the idea that every human being has the right to determine what shall be done to his own body. As in the previous examples, the following writer is also concerned about falling into ‘unconsciousness’ and ‘helplessness’, and worries about being dependant upon machines: I definitely support euthanasia. I’d like to be euthanised when I’m already helpless and connected to a machine…it is not worth nursing brain-dead and unconscious living corpses. (KE 89) According to Hazel Biggs, medically assisted suicide is usually contemplated because life and medicine have nothing left to offer but a prolongation of the dying process 22 . Such circumstances are inevitably characterized by dependence and loss. 4.

Rejecting the prolonged torture I definitely support active euthanasia. I’ve heard from many sources that cancer is very painful and distressing in its late stages; it is all but prolonged torture for the dying person. I don’t store a broken radio forever; useless and old property is thrown away. Why would I keep my useless mortal clay when I don’t have a use for it anymore! (KE 35)

Sometimes the body of necessities is defined as someone easily forgotten by the social environment. The following voice belongs to a concerned nurse who has observed in her work that the longer the patients remain hospitalised, the more forgotten they become: During the years I nursed ill people, I noticed that the longer the patients remained in hospital, the more forgotten they became…On the basis of these experiences, I’ve become a supporter of euthanasia. (KE 132)

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___________________________________________________________ The following excerpt comes from a letter belonging to a nurse who has worked in a hospital for chronic patients. According to the nurse, many patients were ‘skeletons’ fed with a pap made of chocolate and banana in order to make them gain weight. On the basis of her experiences, the nurse thinks that people who reject euthanasia must be ‘sadists’ who enjoy the suffering of other people. When I was young, I worked in a hospital for chronic patients... There were many skeletons who were fed with a pap made of chocolate and banana in order to make them gain weight. They lay in a foetal position and unable to talk, being nothing more than skin and bone... People who do not accept euthanasia must be sadists who enjoy the suffering of other people. (KE 65) Besides being a collection of anatomical structures and physiological processes, a person is also ‘a socio-emotional being that elicits moral, compassionate responses from others.’ 23 In addition, those individuals who have been seriously ill and begin to recover often feel they must prove to themselves and to others that they are capable of surviving on their own and are not so dependant on the help of other people 24 . The body of necessities (in the case of a very seriously ill and dying person), however, doesn’t encourage such hope for recovery and survival. According to discourse accepting of euthanasia, all one can do in the face of death is to minimise the suffering of a dying person. 5.

Conclusion The theoretical orientation of this paper combines ideas of Mary Douglas, George Lakoff and Mark Johnson. Structures of human understanding have their origin in the body, and human life has always been a concept confined to the body. 25 George Lakoff and Mark Johnson have argued that our conceptions of reality should not be separated from what we experience in our embodied interactions. The movements of our bodies and their placement in space generate knowledge structures and modes of reasoning evident in linguistic usage. 26 The socially constructed world of euthanasia discourse sees the crossing of the line between life and death as a matter of individual autonomy and as a matter for the whole community. More than death, which itself is an experience not easily shared with others, dying is an observable and sometimes lengthy process whose contemplation shapes peoples’ perceptions of their own lives and forthcoming modes of dying.

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___________________________________________________________ In Finnish discourse on euthanasia, people talk about hopelessness and rejection in end-of-life circumstances. Hopelessness arises from situations in which life is considered to hold no greater value than death. Rejections, on the other hand, are consequences of hopelessness. These rejections are directed at lifesustaining treatment (especially machine-based) and a life of all but pain, distress and ‘torture’. The body of necessities appears differently in these situations. In this paper, I have offered examples in which the body of necessities is viewed as a suffering person totally dependant upon machines and the care of others. Finnish discourse on euthanasia represents the culturally constructed dying human body and its treatment in the community. The body is also central to the construction of metaphors concerning the body of necessities.

Notes 1

Definitions of euthanasia are, of course, cultural constructions. Originally, the Greek word euthanasia meant ‘easy death’, but the definition of the word has evolved throughout the years depending on the cultural environment in which it has been defined. In the data of this study, the concept ‘euthanasia’ usually refers to its active form: a doctor intentionally ends the life of a terminally ill patient who is in intense pain and who voluntarily chooses to end his or her own life to stop the prolonged suffering. Hence, in this article, ‘euthanasia’ refers to its active form even though the word ‘active’ does not appear in every context. Passive euthanasia is to allow the patient to die by succumbing to his or her illness. 2 I obtained the 132 letters (coded KE 2-133) by publishing in several Finnish newspapers a request in which I invited people to discuss euthanasia. This article contains excerpts from the data translated from Finnish into English. 3 Silva Tedre, Välttämättömyyksien ruumis vanhusten hoivassa, (The Body of Necessities in Old People’s Care), Naistutkimus 9, 4 (1996), 2-14. 4 Ezekiel J. Emanuel, ‘Depression, Euthanasia, and Improving End-of-Life Care’, Journal of Clinical Oncology, 23, 27 (2005), 6456-6458. 5 Mark D. Sullivan, ‘Hope and Hopelessness at the End of Life’, American Journal of Geriatric Psychiatry, 11 (2003), 393-405. 6 Mark Johnson, The Body in the Mind. The Bodily Basis of Meaning, Imagination, and Reason (Chicago: University of Chicago Press, 1987). 7 Mary Douglas, Purity and Danger. An Analysis of the Concepts of Pollution and Taboo (London and New York: Routledge, [1966] 1996).

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Ibid. According to George Lakoff and Mark Johnson, human thought processes are metaphorical, and metaphors are part of our everyday language. George Lakoff and Mark Johnson, Metaphors We Live By (Chicago and London: The University of Chicago Press, 1981); Mark Johnson, 1987. 10 David W. Meyers, Human Body and the Law (Edinburgh: Edinburgh University Press, 1990); Hazel Biggs, Euthanasia. Death with Dignity and the Law (Oxford: Hart, 2001). 11 Presently, no specific law on euthanasia exists in Finland, and no legislative enactment mentions the concept of euthanasia. Elise Kosunen et al., ‘Finland’, in Euthanasia in Europe. National Laws, Medical Guidelines, Ethical Aspects, eds. Wolfgang Sohn & Michael Zenz (Stuttgart: Schattauer, 2001), 43-57. Consequently, I define euthanasia as an ‘imagined ritual’. 12 Sullivan. 13 Ibid. 14 Erlend Hem et al., ‘Suicide Risk in Cancer Patients from 1960 to 1999’, Journal of Clinical Oncology, 22, 20 (2004): 4209-4216. 15 Émile Durkheim, Suicide. A Study in Sociology (New York: The Free Press, 1966). 16 Terhi Utriainen, Läsnä, riisuttu, puhdas. Uskontoantropologinen tutkimus naisista kuolevan vierellä (“Present, Naked, Pure: Study in the Anthropology of Religion on Women by the Side of the Dying”) (Helsinki: SKS, 1999), 61-63. 17 Tedre, 2-7. 18 David W. Meyers, Human Body and the Law (Edinburgh: Edinburgh University Press, 1990); Philippe Ariès, The Hour of Our Death (New York: Alfred A. Knopf, 1991). 19 Ariès, 571. 20 Meyers, 277. 21 Johnson, 129-130. Susan Greenhalgh has analysed the various ways in which “the ritualised practices of the initial consultation works to turn doctor and patient into subject and object, knower and known, mind and body of medical science”. This is not to suggest, however, that doctors are cynically manipulative or deliberately exploit the patient’s emotional vulnerability. Susan Greenhalgh, Under the Medical Gaze. Facts and Fictions of Chronic Pain (Berkeley: University of California Press, 2001), 77-81. 22 Hazel Biggs, Euthanasia. Death with Dignity and the Law (Oxford: Hart, 2001). 9

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Julia Lawton, ‘Contemporary Hospice Care: the Sequestration of the Unbounded Body and ‘dirty dying’’, Sociology of Health & Illness 20, 2 (1998), 121-143. 24 Janice M. Morse and Joy L. Johnson. ‘Understanding the Illness Experience’, in The Illness Experience. Dimensions of Suffering, eds. J. M Morse and J. L. Johnson, (Newbury Park: Sage, 1991), 1-12 25 Douglas. 26 Lakoff and Johnson. Leila Jylhänkangas is a Ph.D. candidate in Comparative Religion at the Faculty of Arts, University of Helsinki, Finland. She is currently working on her dissertation, which explores cultural representations of euthanasia in contemporary Finnish society.

Images Of Death, Images Of Society: The Case Of Poland and Polish Community Emilie Jaworski Abstract The globalization may be described as the expansion of the capitalist system and its ideals. This phenomenon implies deep structural transformations inside societies and reorganization of worldwide population, because of the intensification of the migratory movements. It is then obvious that each society must redefine all their social and cultural practices, in order to give sense to the new social reality. The mechanism of those reshapenings obviously appears in funeral rituals. Those events, which combine economical, social and cultural dimensions of a society, are interesting to get a better understanding of a population. The part of participators for funeral is to establish the dead among the ancestors - references for the identity of a group - and fix his memory. Then, during this action, they solicit all the values and ideals of the society. So funerals are a total social fact, 1 which can be considered as a mirror of the society. This problematic which involves social change and funerary rituals, can be applied to the case of Poland and polish community in the North of France. Since the fall of communism in 1989, the social and cultural environment of Poland had deeply changed and the population must adapt itself to a new reality. The polish community also had to reconfigure its practices but in a foreign environment. A comparative study of those two common original populations, facing the social change, can help to understand the mechanisms which drive the social and cultural reshapenings. According to this aim, I especially focus on a practice which was common to both of the concerned populations: the post-mortem pictures, consisting in taking pictures of dead relatives in the coffin before the funerary mess. By working on social uses and functions of those pictures and by re-establishing them in the whole of funerary practices, it is possible to understand how works a society and how a population adapt itself to changes. Key words: globalization, cultural re-shaping, funerary rituals, postmortem pictures, Polish community, Poland, Catholicism. 1. The uses and functions of post-mortem pictures A. The post-mortem portraits in the past and in the world The practice of post-mortem pictures seems to be the product of an old tradition of representations of the deceased. Portraits and sculptures were adorning the sepulchres in Egypt between the 2nd and 3rd century and

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___________________________________________________________ in ancient Greece. In Europe, during the Renaissance, the great aristocratic families have built chapels with representations of their dead. During this period also existed a great fashion of recumbent statues on the graves, especially intended to the royal families. In the 16th century, in the Flemish bourgeoisie, painters were requested in order to paint the deceased during his exhibition. Between the 18th and 19th have occurred the tradition of mortuary masks in France, in England, Germany, United States, Italy and Russia. When the photography appeared it permitted the democratization of funeral portraits. Then, the practice of post-mortem pictures was affordable by many people and became famous in all Europe, in United States, and in South America. Briefly, those portraits encountered a great success mainly in Christian countries, including Poland and Polish community. B. Conception and uses of post-mortem pictures The way of making post-mortem pictures in Poland and in Polish community was not determined by strict rules and depended on the wishes of the families. Some of them preferred not to take such pictures at all, some other only take pictures of the mess and the burial or eventually of the grave, some other of the corpse in the coffin and finally some other take pictures of all the funeral. Nevertheless, we can notice that each practice is based on values and needs which correspond to the social and cultural configuration of the society. Mainly, the pictures of a corpse work as pair: there are pictures of the dead surrounded by the closest family and other of the dead alone 2 . The other common point between those pictures concerns the decorum. Generally we can find a lot of flowers and plants not only all around the coffin but also on the feet of the dead. It is usual to see a crucifix and candles on the top or on one side of the coffin. The dead wear in general the most elegant clothes and shoes. It is also usual to see a corpse adorned of catholic icons, with a rosary and sometimes with a prayer book in the hands. The treatment of children is different compared to the adults, and we can distinguish here two kinds of post-mortem portraits: one that shows them in the coffin and surrounded by all the signs of death as the crucifix, the white flowers and clothes, the icons, except the rosary and payer’s book when the child is really young; the other one where the children look sleepy. In general the family does not appear on those pictures. By looking to those pictures, to the way people are dressed, to the decorations, to the colours used we can easily notice that they are an

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___________________________________________________________ expression of the social level, of the degree of integration of the deceased in the community or in the group, of the cultural and social values. Those pictures can be made by a member of the family, or by a photographer. This depended on the wealth of the family. When developed those pictures could be shared between the closest members of the family. If somebody else wanted to have such pictures he could ask the family. In general, this kind of wish is appreciated by the family, because it means that other people miss the dead showing his qualities. In polish families, those pictures are in family albums among pictures of baptisms, communions, weddings and other events which constitute the different steps of life. Then, such albums can be considered as house archives where is written the story of the family in a non-verbal language. In the Polish community the use seems to have been different. I can not know exactly how those pictures have been used by the members of the first generation of immigrants - who arrived in France about 1920 because almost all of them are not alive. Nevertheless, by consulting archives we can realize that many mortuary pictures have been taken. The following generation kept or hided those pictures received or transmitted by the first generation in shoes box or in the very end of a forgotten drawer or something similar. When facing emigration or family separation, those pictures had a precise role. When a member of a family died in France or in Poland the other part of the family could not participate to the funeral. Then, sending such pictures was a way to share this event with the members of the family who lived abroad.

Picture 1: Deceased surrounded (Source: personal)

Picture 2: Same deceased alone (Source: personal)

C. The functions The first function we can attribute to those pictures concerns the required process of creating ancestors. This concept of ancestor refers to all the dead who stay alive in the memory of the family. This means a

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___________________________________________________________ descent is necessary to reach this status. Children, as they are pure according to Catholicism and do not have descent, become angels, if they are baptized of course. So the pictures of adults and children belong to different processes, but actually the most interesting for us is the case of adults. The first element which drives us to this conclusion appears when we consider the post-mortem pictures as a part of a more general practice, which consists in taking pictures of all the great events of a the social life as for example baptisms, weddings and funerals. All those events are finally some rites de passage, which confirm a change of status and of identity. Then post-mortem pictures are an expression of a specific moment of the life’s cycle: the death. For Catholics, this event is not the End, but the beginning of a new way of life. The funeral, according to this point of view, is the first step consisting in raising the soul of the dead and establishing him among the other ancestors. Here the fact that the postmortem pictures work as a pair, which shows the dead alone and with the family, makes sense. This can be interpreted as an expression of the individuality of the dead on one hand, and as the expression of his position in a social network on another hand. In fact, this way of taking pictures would illustrate the rupture between the dead and his relatives, as Sakalavas in Madagascar expresses this rupture by the symbolic cut of a string which fastens the dead husband to his live wife for example. In general, the funeral is the occasion to create a legend about the dead, to create a hagiographic speech which consists in deleting his bad sides and insisting on his good sides and his good actions corresponding to the values of the society. In fact the aim of this process is to create a local hero, which will allow the group and the family to recognize themselves in him and use him as a social and cultural reference. The ultimate step which ends the process of making an ancestor occurs the first birthday of the death. Usually the family celebrates this birthday by cleaning and then adorning the grave of flowers and candles. This birthday is also connected with the setting up of the real grave. In Poland a family can choose between a gróbowiec and a nagróbek. This choice is determined in general by the standard of living of the family. A gróbowiec is made of a vault, when a nagróbek just includes the funeral monument. In this last configuration the dead and its coffin are buried directly in the ground. For this kind of grave the monumental mason must wait one year before installing the definitive grave. According to them one year corresponds to the time necessary to get the ground stable. By setting up this definitive grave starts the ancestor’s cult. The post-mortem pictures, which illustrate parts of the process of making ancestors, can be considered as the support of the memory; so do the graves. They show the last moments of the dead on earth and his

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___________________________________________________________ transformation in ancestor with all its implications. Those pictures will fix this process in the memories and also the values of the society represented by the ancestor. The post-mortem pictures here work as a metonymy of the entire life, and do not only refer to the values implied in a particular moment of the life as weddings for example which are especially focused on fecundity. In Poland in general, and probably in the first generation of Polish immigrants, the family pictures, including post-mortem portraits, are or have been watched during family meetings. Relatives, by watching them together, refresh and strengthen the family history, identity and links. The members of a family recognize themselves in a common ancestor and in the values funding their culture and which belong to different levels of the society - it can be national values like the respect of catholic tradition or patriotism, regional, local, familial and individual values which refer to the specific history and traditions of the region, the village, the family and the individual. Those pictures refer also to the social status of the ancestor. The way the dead is dressed, the quality of the coffin and grave, the kind of flowers exhibited are all signs revealing and fixing it. So by taking such pictures, and watching them in special circumstances, a family reactivates what is meaningful for itself and reaffirms its social position among a group. Globally those pictures can be considered as non-verbal texts, which help a family to perpetuate its indoor cohesion, its outdoor position within a larger group. The comparison between post-mortem pictures and graves can be made. The grave is a monument which is connected to the values, to the identity and the social level of a family thanks to its architecture, its symbols and its quality, but the main difference is that a grave is fixed when a picture can be given or sent and infinitely reproduced. This point is really important in a context of immigration. The families which had been separated can symbolically gather by sending post-mortem pictures to the part who could not attend the ceremony. So the entire family is aware with the family history. But the interest of those pictures is lost without the speech. As they are metonymies of the family history, they have to be supplemented by the oral evocation of the ancestors. So their memory is continuously updated, insuring the perpetuation and cohesion of family identity. Here the post-mortem pictures and the graves have the same purpose: to let a track of the stay of somebody on earth. This track works as a transitional object 3 , which support the psychological process of mourning. It is a kind of compromise which enable the transition between the presence and absence of the deceased and which is a proof of the reality of death. So, post-mortem pictures are also very interesting to help people who could not participate to funeral by showing them the

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___________________________________________________________ indisputable reality of death and allowing them to launch the process of mourning. 2. Disappearing of post-mortem pictures and social changes A. The circumstances of disappearing The disappearing of post-mortem pictures started first in Polish community immediately after the second generation of immigrants. This seems to be a consequence of integration of Polish community in French society where using such pictures did not make sense anymore. Nowadays in Poland we assist to the same phenomenon especially in big cities. As post-mortem pictures worked before as a part of life’s cycle, we can conclude to a disconnection between death and life for those two populations. The progression of the jobs linked with the death sounds like the confirmation of this hypothesis. Before the family and the closest relatives used to care about the corpse whereas today the family let the professionals - in hospitals and funeral firms - assume this responsibility. So the common knowledge concerning the funeral practices have been transferred from ordinary people to specialists and become a sector more and more autonomous. This results in weaker and weaker links between a family and it’s deceased. As death disappeared from the everyday life, the approach of the dead causes more and more troubles and disgusts. The new conception of cemeteries seems to confirm this fact since they are managed by architects or engineers. The cemeteries are no longer areas where ordinary people act directly and where the ordination of graves depends on the free room and the wishes of people. Nowadays they are the product of a professional knowledge and new space management linked with the process of urbanization, which implies that the space is more and more precious. B. The cremation as a new alternative The beginning of cremation in Poland, and its popularity in France and in the Polish community can be interpreted as another consequence of the disconnection between death and everyday life. It seems to be a response to the new rationalization of the societies. Cremation can be considered as a way to save time and space more and more precious in western societies, and to destroy a corpse which disgusts and is cumbersome. But the meanings of cremation are deeper and it responds also to a reconfiguration of social network. The family structure is changing and is more and more centralized around parents and children. In this case, the family graves correspond less and less to the new expectations of the society. People have to leave more and more often the place they born to a city or abroad in order to get a job. So the families are

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___________________________________________________________ spread which makes the common ancestors' cult more and more complicate. The cremation permit not to spend so much money in a grave which is losing its strength and offers a freedom in rituals which corresponds to the actual ways of life and the diversity of situations. 3.

Conclusion Post-mortem pictures were involved in practices which were corresponding to the expectations and the needs of a society and a group. In such case it’s analyze is really interesting to understand the functioning of a population. The disappearing of this element is a witness of deep transformations of a society, which is, in the case of Poland and Polish community, linked with the phenomenon of globalization. The new economical configuration requires a population to change its behaviors and its system of perception of the reality. Here we see clearly how the capitalist rationality works in the two populations studied. The traditional knowledge is transferred to specialists who create a funeral market, and the family is not anymore really concerned by the care of the deceased. So taking a picture of them does not make sense anymore if they belong in another dimension of the society more and more autonomous from its origin, and do not belong anymore in the family surroundings. The same logical is observable in cemeteries, which are areas submitted to the knowledge of urbanists and architects. In this new social configuration the practice of cremation become an alternative which corresponds to the new rationality and social structure of the society. It implies a gain of space and time, and then of money, but also a reinventing of funerary rituals correlatively to the new plurality of lives trajectories and to the individualism. The specialization of the funeral knowledge and the diversity of funeral rituals generally drive people to think the death became a taboo and the funerals are debased. This conclusion is maybe not totally false, but could not we appreciate those evolutions of funerals practices as adaptations which correspond to the new social structures and needs? Are the funerals debased or do we assist to everyday micro-reinventing connected with the new realities, more and more diverse, and the personal needs?

Notes 1. Marcel Mauss, Sociologie et anthropologie (Paris: PUF, 1950). 2. Picture 1 and Picture 2, p.3.

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___________________________________________________________ 4. Donald Woods Winnicott, Jeu et réalité: L’espace potentiel (Paris: Gallimard, 1971).

Bibliography Berger, Laurent. Les Nouvelles Ethnologies: Enjeux et Perspectives. (Paris: Nathan, 2004). Goedefroit, Sophie, and Lombard, Jacques. Andolo: L’Art Funéraire Sakalava au Menabe. (Paris: A. Birot, 2004). Jaworski, Emilie. Usages et Fonctions de la Photographie Post-Mortem dans la Communauté Polonaise du Nord-Pas-de-Calais. (Mémoire de Maîtrise en Anthropologie, USTL, Sous la Direction de Sophie Goedefroit, 2003). Jaworski, Emilie. La Pratique de la Photographie Post-Mortem chez les Catholiques Polonais en Pologne: Vers une Occidentalisation des Pratiques Funéraires? (Mémoire de DEA en Anthropologie, USTL, sous la Direction de Sophie Goedefroit, 2004). Thomas, Louis-Vincent. Anthropologie de la mort (Paris: Payot, 1975). Urbain, Jean-Didier. L’Archipel des Mort: LeSsentiment de la Mort et les Dérives de la Mémoire dans les Cimetières d’Occident. (Paris: Payot, 1989), 65. Emilie Jaworski is a Ph.D. student in social anthropology, at the University of Paris V.

Attachment Trauma, Sudden Death and Anticipatory Grief: the Chamorro Sample Stephen W. Kane and Vera de Oro Abstract Fifty nine female Chamorro subjects in a sample size of sixty six responded to the Family Crisis Scale to determine their emotional and psychological reactions to threatened loss, anticipation of loss and sudden death of a family member. A corollary interest was an inquiry into culture specific mental health interventions which could be recommended for this population. Subject’s responses to the instrument resulted in the development of the Chamorro Family Crisis Scale with two variables ranked more stressful when compared to the western Family Crisis Scale. Further results revealed that twenty five per cent stated there was no emotional difference between situations of threatened loss, anticipated loss and sudden death. Of the twelve subjects who listed a sudden death in the family in the last year, seven likewise reported the occurrence of a divorce. The most frequent attachment traumas in the past year included threat of dissolution of the family, loss of a job and a family member leaves temporarily. And finally, sixty two percent of respondents ranked most stressful more than once to FCS items. These results are discussed within a context of an examination of the Chamorro culture and an application of attachment concepts. Key words: Chamorro, attachment theory, anticipatory grief, sudden death, attachment trauma, family crisis, family therapy, family counselling. 1.

Background of the study An understanding of Pacific Islanders mental health concerns and effective psychotherapy strategies for this population have been dimly studied with little or no island specific recommendations. Monica McGoldrick’s 1 prodigious work focusing on the interactions of ethnic status, cultural peculiarities and cultural specific interventions follows a global application of matching therapy with ethnic status. Her direction of identifying mental health concerns with cultural uniqueness to arrive at the best therapeutic applications comes from a substantial amount of historical, cultural and psychological information as well as, in many cases, psychological studies designed to reveal best fit models of therapy. McGoldrick’s 2 work covers an examination of the following broad groups of peoples: American Indian families, families of African origin, Latino families, Asian families, Asian Indian and Pakistani

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families, Middle Eastern families, families of European origin, Jewish families and Slavic families. Her third edition of Ethnicity and Family Therapy, however addresses Pacific Islanders as only limited to Hawaii, a group comprised mostly of Polynesian heritage. The aim of this paper has been to explore the psychological demography of the Chamorro people who are likewise considered Pacific Islanders, and who populate the Northern Marianas islands. Of particular interest is the Chamorro’s culture and their psychological responses to sudden death, anticipatory grief and attachment traumas. An understanding of attachment traumas, or, losses experienced in the context of the family are advanced by the application of the author’s Family Crisis Scale. The Chamorro Family Crisis Scale will be presented and compared to the western Family Crisis Scale, and a variety of questions designed to explore the Chamorro’s psychological reactions to losses in the family are advanced. An understanding of these variables is broadly hypothesized as the recommended starting point for the derivation of psychological mental health interventions for the Chamorro people and Pacific Island inhabitants of the Marianas Islands. 2.

A brief history of Guam and the Chamorro people Guam lies at the southernmost tip of the Marianas Islands. These islands include Farallon De Pajaros, Asuncion, and Pagan to the north, with Tinian, Saipan, Rota and Guam to the south, and make up an area of the western pacific known as Micronesia. Forty two million years ago volcanic activity, the result of the collision of the Pacific and Philippine plates, resulted in the development of these islands which aligned themselves in an arc according to eruptions at locations at the bottom of the earth’s crust beneath the Marianas Trench. 3 Anthropologic estimates of the beginnings of the Chamorro people who eventually settled on Guam and islands to the north place a diaspora of peoples from Southeast Asia at or around 3,500 B.C. across Indonesia and the Philippines to the Marianas. These peoples who spoke an Austronesian language modified it further upon discovery of the Marianas islands in response to their survival and reactions to a challenging environment. The men were described as tall, muscular, and their families were matrilineal, where women held highest ranks and controlled property. They developed their own religion and believed in the spirits of dead ancestry who inhabited the jungle. These spirits, called tao tao mo’na, were in a position to critically involve themselves for good or ill in the lives of the living if they were pleased or offended. 4

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___________________________________________________________ This early existence of the Chamorros up to the birth of Christ and for another 1500 years thereafter was, according to record, an unremarkable period. While Europeans establishing trade routes first made their appearance to the Chamorros in the 1400s, it was not until the arrival of Magellan, on behalf of the Spanish monarchy in 1521 which initiated an intrusive domination and conflicted presence on the islands of Guam, Rota, Saipan and Tinian for the following 300 years. 5 The Chamorros fought the presence of Spain for two hundred years until the end of the 18th century when it was estimated that there were only 1300 natives remaining, most of whom were women and children. It was at this point that the Spanish were able to take considerable control of the culture and religion, converting the Chamorros to Christianity and marrying into what was left of the matrilineal order. After this longstanding Spanish intrusion the eventual ethnic makeup was characterized as ‘mestizos’, or, a blend of Chamorro, Hispanic, Mexican and Philippino as well as the Carolinian races, as it today. 6 3.

Chamorro spirituality and responses to death The Chamorros have two distinct influences on the development of their spiritual values. One is from their psychological reaction to the island jungles of the Marianas islands circa 3500 B.C. with their reinforcing sense of deceased relatives ‘staying on’ in the form of spirits to inform, instruct and affect the lives of their progeny. The other is Catholicism introduced by the Spaniards. The mediating fulcrum between pre-Christ islanders attempt to attribute sense to death and dying and Catholicism’s ordered arrangement of morality and steps to achieve everlasting salvation appear to be connected by a matrilineal elevation of the spiritual persona of Mary, mother of God. Focus and devotion to the liturgy of the rosary, particularly as it relates to forgiveness, not only to the dying but to the dying member’s kin, is seen in the phrase of the Catholic Hail Mary prayer: “holy Mary, mother of god, pray for us sinners now and at the hour of our death”. These words likewise inspire thoughts of a wish for un-conflicted acceptance and union with mother. This spiritual bond with Mary, mother, is incorporated in the Chamorro ritual of the nine nights of rosary prior to the internment of a family member and the nine nights of rosary after internment. The rosary ritual prior to internment is open for everyone on the island and the nine nights after internment is closed to family members. While practical explanations of the nine nights prior to internment revolve around the temporal contingencies of family members in other parts of the world attempting to return home to a small island in the pacific to pay respects, the spiritual intuitive sense may point to a profound need and respect for

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maternal forgiveness and reconciliation in life and after death. The maternal matrix, for example, represented by the circular band of beads and the group recitation of prayers in the form of the rosary bridges spiritual, matrilineal forgiveness and unconditional acceptance passions within the Catholic context. 4.

The psychological impact of family loss The aim of this paper has been to explore the psychological demography of the Charmorro people in an attempt to gauge their sensitivities and peculiar/unique attributes regarding (1) sudden death and anticipatory grief, and (2) to derive an ethnic sensitive mental health approach to direct counselling and psychotherapeutic interventions for this population. George Vaillant 7 assumed direction of a longitudinal study at Harvard University which was initiated in the nineteen forties. The study focused on the personal development and careers of Harvard graduates over time. It was a sample of males who were followed throughout their lives by the collection of pertinent data about themselves every few years. One important variable was longevity. Age at death was recorded. Circumstances of death were recorded such as types of illnesses and injuries. One further notation was made if the death was ‘sudden’. In those cases of sudden death a further investigation was made in the form of a psychological autopsy. Valliant’s research team was able to discover that a significant proportion of those individuals who died suddenly had experienced a ‘loss’ in the six months prior to death. Furthermore, the loss in question included either an estrangement, divorce, separation or death of an immediate family member. 8 These results reaffirmed the emerging research of the day which focused on stress, change and loss, and their effects on physical and psychological health. The study was also the impetus for the development of the Homes-Rahe Social Readjustment Scale 9 and the author’s Family Crisis Scale 10 . The Holmes-Rahe scale was the pioneering study which linked stressful events to psychological and physical health. The Family Crisis Scale, modelled after the Holmes-Rahe scale lists 9 attachment traumas, or, unavoidable losses occurring in the family and extended family. The Family Crisis Scale was developed to demonstrate the kinds of losses that effect calibrated grief reactions for individuals in their families.

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___________________________________________________________ 5.

A closer look at the Family Crisis Scale The following is the Family Crisis Scale. It has face validity from a western perspective. The nine attachment traumas, or, losses which occur within the perspective of the family are listed in order from (1) least severe to (9) most severe. The list in its entirety is shown below. (1) A geographical move but all family members are included. This is a loss of the familiar. The loss of the familiar can be a profoundly disturbing experience. Object constancy is a clinical term that refers to the healthy individual’s ability to keep an intact identity and secure sense of self despite being geographically and socially uprooted. For some people the fear of losing the familiar and the routine can be so reinforcing as to prevent them from leaving a hurtful or punishing relationship. This loss of the familiar in this case describes the loss of geographical and social familiarity, but not family familiarity, which operates to reduce the stress, because all family members are included. (2) A developmental conflict of a family member. Loss of psychological well being because of a developmental conflict of a family member presents a problem to the entire family as well as to the one suffering. Examples include the parent who acknowledges a developmental delay in a child, or a spouse who has seen the onset of depression in her mate. Problems that one member experiences are usually met with compensation by others in the secure family. Insecure families are burdened by the guilt of the deficiency. (3) A move has occurred but not all family members are included. This category includes losses revolving around agreed upon separations of a family member, for example a spouse who travels to support his family, a child’s stay at a summer camp, or the developmental milestone of an eighteen year old leaving for college or military service. In the latter case when the offspring leaves the stability of the family requires compensation by the others to adjust. (4) Family member experiences a loss of status. Stress is generated at multiple levels when the loss of a job, demotion or financial complications jeopardize the well being and material security of all family members. Depression and further complications from financial setbacks may highlight the guilt generated by the family member’s conflicted confusion of his inability to provide love and protection in a material way. (5) A threatening illness or injury. In this category physical trauma of a family member alters the terrain of the familiar and routine and forces the victim and family members to evaluate the impact of a potential loss of life. While the physical trauma in this category is recoverable the threat of potential loss of a loved one can be as emotionally painful as a loss of loved one over the short term until the loved one is out of danger.

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(6) A terminal illness or injury of a family member. The anticipation of the death of a family member is included in this category where remaining family members are given a period of time to react with grief in advance of the loved one’s passing. Advances in medicine to extend the lives of the terminally ill in many cases from six months to two years has allowed family members to express their feelings and activate closure with loved ones in their final stages of their lives. Typically the first experience of a member dying from a terminal illness is a grand parent. (7) A threatened dissolution of the family. Chronic episodes of tension and chaos characterizes this family’s attempts to remain together with intimidation, threats of violence, ridicule and threats to abandon as the instruments of maintaining an intact unit. Ever present warring factions and literal threats of abandonment, separation and divorce are constantly experienced as a possibility. (8) The loss of the family. The abdication of parental responsibilities by one or both parents because of conflict or incompatibility has a profound psychological impact on the remaining family members. The loss of the unit by divorce or separation is accompanied by shame, psychological and geographical distancing or abandonment, in some cases without any future contact with the divorcing parents. Many family members suffer guilt and depression revolving around feelings of being rejected or not being loved by the perpetrators. (9) Sudden death of a family member. The sudden loss of a loved one is more stressful than a loss preceded by anticipatory grief. A conflicted relationship with the suddenly deceased family member also increases the possibility of conflicted bereavement in the aftermath and depression over the long term. This western version of the Family Crisis Scale, see Appendix A, was administered randomly ordered to a sample of Chamorro subjects to explore their reactions to sudden death, anticipatory grief and related family attachment traumas. Questions for study, procedures and results are considered in next sections. 6.

A look at the subjects and procedures in this study The subjects were adults with ages ranging from 19 to 60. Ninety eight percent of the subjects were Chamorro and two percent represented Philippino, Caucasian and other. There were 59 females and 11 males. These subjects were enrolled at Guam Community College in adult basic education courses. In a regularly scheduled classroom arrangement subjects were presented the Family Crisis Scale randomly-ordered and asked to rank each attachment trauma on a Likert Scale in terms of least

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___________________________________________________________ severe to most severe. They were then instructed to circle all attachment traumas they had experienced in the previous year and to respond to two open ended questions. The questions concerned emotional reactions to three situations: threat of loss, anticipation of loss and sudden loss of a family member. After responding, subjects were encouraged to discuss their personal feelings and reactions to the exercise. 7.

A look at the questions that were asked of respondents in this study The following questions were raised with the help of the Family Crisis Scale to investigate the Chamorro psychological reactions to attachment traumas. The questions are listed below. Question 1: Is there a difference between Chamorro subject’s ranking and western ranking of attachment traumas, or, the experience of loss(es) in the family? Question 2: Is there a difference between a threatening potential loss of a family member and the anticipation of loss of a family member? Question 3: Is there a difference between the anticipation of loss of a family member and the sudden death of a family member? Question 4: Is the occurrence of sudden death related to any of the listed attachment traumas? Question 5: What are the 3 highest ranked frequencies of attachment traumas in the past year? 8.

Results Question 1: Rank of attachment traumas. Chamorro responses to two attachment traumas resulted in their being ranked as more stressful when compared to western perspectives. These included (6), a terminal illness and (2) a developmental conflict in a family member. Further comparisons revealed the ranking of divorce, threat of dissolution of the family, job loss and a move, not all family, as less stressful. Chamorros ranked sudden death, threatening illness and a move, all family, equally with western perspectives. The Chamorro Family Crisis Scale, to be found in appendix B, is portrayed and compared with the western Family Crisis Scale. Questions 2 and 3: What are the differences between threatening, anticipatory and sudden death of a family member? Twenty five percent of respondents indicated there was no emotional difference between the situations of threatening, anticipatory and sudden loss of a family member. Question 4: The occurrence of sudden death. While analysis revealed 12 subjects had experienced a sudden death in the family in the previous year, 7 of the 12 likewise indicated the occurrence of a divorce.

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Question 5: Frequencies of stressors. The three most frequent attachment traumas included threat of dissolution of the family tied with loss of job by a family member. A family member leaves temporarily ranked second in terms of frequency and a move, all family included, was third most frequent. A corollary observation was made to discover that sixty two percent of respondents ranked most stressful more than once to FCS items. An understanding of these results are addressed in the next section of this study. Attachment traumas affect all human beings throughout their lifespans. The ability to cope and handle the stress within a family varies from person to person and family to family. Results from the Family Crisis Scale reveal several thoughts that allow an understanding of the psychological demography of the Chamorro people. An analysis of their responses to the questions generated in this study is presented below. 9.

Value placed on families Families are a traditional core value in Chamorro lives. Actions, decisions and behaviours often affect other family members, and most often stay within the family. In this study Chamorros ranked terminal illness of a family member more seriously when compared to western perspectives. An understanding of the rank for terminal illness for Chamorros lends support to the notion that they may tend to rate/rank all potential threats of loss of life and sudden death equally. A more practical explanation is advanced given the composition of females, fifty nine, in this study. On the island of Guam there is a paucity of services aimed at care-giving for the elderly ill and disabled. Care-giving for an ill, dying family member is typically reserved for and expected of a female offspring or relative of the ailing family member. Ranked number six on the western FCS, for female Chamorros this variable jumped two levels ahead in terms of stress and fell immediately behind the most stressful, sudden death. Likewise, a developmental conflict, for example, an emotional or psychological difficulty experienced by a family member, is seen as more serious for Chamorros. It appears that a developmental conflict might hinder or prevent an individual from supporting the overall family or extended family, which is seen as critical for family well being. Again, the predominantly female sample may be reacting to their sense of their husband’s loss of status, which on Guam, conforms to traditional male, female roles.

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Calibration of emotions A corollary observation indicated that sixty two percent of respondents ranked most stressful to more than one FCS item. Respondents selectively weighted several family losses as all equally stressful. This may demonstrate an instrumental way of cognitive processing in terms of perceiving and coping with stressful situations. An instrumental approach addresses conflicts parsimoniously by reducing reflection to good or bad, or right or wrong, and is indicative of a less cognitively complex process. A complicating variable to add to this understanding is the occurrence of the Iraq war which was in progress during the collection of data. Guam has been historically, since world war two, overrepresented in the successful recruitment and enlistment of substantial numbers of individuals into the armed services. In this study it is quite possible that females, having deployed husbands or other family members in the armed services, are placed in a position to experience a significant increase in the probability of threat of loss, anticipation of loss and sudden loss because of the war. Unavoidable losses occurring within the perspective of the family are stressful by their nature, but raising the expectation of the various threats and exposure to loss may have provoked an overlapping stressful blur of bleak possibilities for these Chamorro females, leading to the sixty two percent response rate. Regarding questions 2 and 3, the question of instrumental ways of thinking is again evident in the Chamorro’s understanding of family losses as represented in the qualitative/open ended questions section. For example, ‘Is there a difference between a threatening potential loss and the anticipation of loss?’ and ‘Is there a difference between anticipation of loss and sudden loss?’ Twenty-five percent of respondents stated that there is no emotional difference to the three situational loss experiences. This raises the question, instrumentally speaking, do some Chamorro’s belief systems contain the internalization that any threat of experience of loss in the family is consequently regarded as equally emotionally devastating and damaging? And indeed, if the Iraq war phenomenon can be applied, perhaps the twenty five percent of subjects were likewise stressfully overlapping and blurring the potential for negative expectations. Regarding question 4, responses to sudden death and its correlation to other attachment traumas reveals a frequency in this study that is in keeping with the results by George Vaillant’s longitudinal study of a cohort of Harvard graduates. He found significant correlations between sudden death of a subject and the occurrence of a break up in the family or an estrangement with a loved one. In this study seven of twelve

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subjects, or over fifty percent, indicated sudden death and a divorce in the family in the same year. Regarding question 5, “What are the most occurring attachment traumas” found in this study within the past year? The three most frequent attachment traumas included threat of dissolution of the family and loss of job, tied, and a family member has to leave temporarily. All of these stressors affect the core value of the family and represent movement away, geographically, emotionally and financially from the strengths contained in the foundation of the family, the extended family and the clan. The notion of movement away is suggested as a threat to the psychological well being generated by living on an island where containment and multi-generational family lines indigenously reinforce well being and contentment. 11.

Conclusion The stress generated losses examined in this study, experienced by subjects within their families/extended family/clan occur in many cases without a calibrated, differentiated pattern of emotional response(s) deemed necessary for coping. It is broadly hypothesized that psychotherapeutic interventions for Chamorros contain emotion based models to process the varying types of unavoidable losses, and supportive cognitive models to enhance cognitive complexity, vis-à-vis, the coordinated calibrated appraisal of conflict management at home, work and at school. Appendix A The Family Crisis Scale 1. A geographical move. All primary kin, however move together. Any move, relocation where family remains intact. 2. A family member experiences a developmental obstacle; anxiety, depression, identity conflict; developmental issues, psychological distress. 3. A move has occurred but not all primary kin members are included. Some temporary form of agreed upon separation. Extended periods of time spent away from family due to work, travel obligations; a college student. 4. A family member experiences some form of loss of status. A change in socio-economic standing; loss of job, demotion, a threat to family well being due to loss of financial stability.

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___________________________________________________________ 5. 6.

7.

8. 9.

A threatening illness, accident or harmful physical threat to life of family member. A loss of anatomical or physiological functioning; a recoverable form of trauma. A terminal illness or accident/injury of primary kin member. Eventual loss is perceived; a state of preparedness for loss, anticipatory grief. Typically the first experience of dying family member dying from terminal illness is grandparent. A threatened dissolution of the family. Individuals perceive a break due to separation or divorce. Also indicates warring factions amongst family members. Inharmonious atmosphere, chronic conflict, aggression, violence. A separation, divorce, abandonment; a break occurs. Separation of family members, geographically and emotionally. Death, sudden death of family member due to illness, injury, accident

Appendix B 1. A geographical move. All primary kin however move together. Any move or relocation where primary kin unit remains intact. 2. A move has occurred, but not all primary kin members are included. Some temporary form of agreed upon separation of family members. Extended periods of time spent away from family due to work, travel obligations; a college student. 3. A family member experiences some form of loss of status. A change in socio-economic standing; loss of job, demotion, a threat to family well being due to loss of financial stability. 4. A family member experiences a developmental obstacle; anxiety, depression, identity conflict, developmental issues, psychological distress. 5. A threatening illness, accident or harmful physical threat to life of family member. A loss of anatomical or physiological functioning; a recoverable form of trauma. 6. A threatened dissolution of the family. Individuals perceive a break due to separation or divorce. Also indicates warring factions amongst family members. Unharmonious atmosphere, chronic conflict, aggression, violence. 7. A separation, divorce, abandonment; a break occurs. Separation of family members, geographically and emotionally. 8. A terminal illness or accident/injury of primary kin member. Eventual loss is perceived; a state of preparedness for loss, anticipatory grief. Typically the first experience of a family member dying from a terminal illness is a grandparent.

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9.

Death, sudden death of family member due to illness, injury, accident.

Notes 1

Monica McGoldrick et al. Ethnicity and Family Therapy, 3rd ed. (The Guilford Press, 2005), 4. 2 Ibid, xv-xix. 3 Don A. Farrell, History of the Northern Marianas Islands, (The Public School System, Commonwealth of the Northern Marianas Islands, 1991), 60. 4 Ibid. 5 Ibid. 6 Ibid. 7 George Vaillant. ‘Natural History of Male Psychological Health’, American Journal of Psychiatry, 145 (1990), 31-37. 8 Vaillant, 35. 99 T. Holmes and R. Rahe. ‘The Social Readjustment Scale’, Journal of Psychosomatic Research, 147 (1967), 215-218. 10 Stephen Kane, ‘Family Crisis: An Attachment Perspective’, The 11th International Conference for Counselling”, Bangkok, Thailand, December 28th -January 2nd 2005/6 Stephen W. Kane, Ph.D. is Assistant Professor of Counsellor Education, University of Guam. He is the author of the Family CHORES model of family therapy published in the American Journal of Family Therapy. Vera de Oro has her Masters degree in Counsellor Education from the University of Guam and is employed as a teacher/counsellor in the Adult Basic Education program at Guam Community College.

Environmental Grief®: Hope and Healing Kriss A. Kevorkian Abstract Earthquakes, hurricanes, tornadoes, landslides, killer storms and a recent tsunami illustrate the awesome power of Mother Nature. We pollute, destroy, and reshape our planet, eliminating animal habitats and ecosystems to fit human needs. People conscious of the plight of these events react to this decline by experiencing environmental grief®, the grief reaction stemming from the environmental loss of ecosystems caused by natural or man-made events. This is a unique form of disenfranchised grief; grief that is not openly accepted or acknowledged in society. The foundation for environmental grief lies in the Gaia Theory, which supports the concept of interconnectedness, and the considerations found in deep ecology and the ecology of grief. Despite what some theorists believe about the plight of our environment, grief issues should and can be acknowledged. Once a name is put to any type of symptom or feeling, people are generally able to move forward and begin the healing process. Key words: environmental grief, grief, loss, coping, validation, healing, disenfranchised grief, Gaia theory, killer whale. 1.

Introduction Grief is the reaction to loss. When we speak of grief, it is usually in regard to the death of a loved one. Grief can also be a reaction to many other losses that occur in life. The losses of a job, a house, or even the experience of having a friend move away are also associated with grief; however, these kinds of losses are not often considered in discussions of grief. Grief is very individual: How one person reacts could be very different from how another might react. Grief manifests itself in many ways, including the following: feelings such as sadness, anger, guilt, anxiety, fatigue, and shock; physical sensations, such as tightness in the throat or chest, dry mouth, lack of energy, and shortness of breath; cognitive responses, such as disbelief, confusion, and sometimes a sense of the presence of the deceased; and behaviours such as disruptions in sleep or appetite, crying, dreaming of the deceased, loss of interest, and social withdrawal. Grief can also express itself in social and spiritual manifestations: problems functioning in an organization or family and difficulties with interpersonal relationships; and spiritual issues, such as searching for meaning, anger, or hostility toward a religious figure. There are many forms of grief, including anticipatory grief - the reaction to losses associated with an impending death, which may include

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___________________________________________________________ past, present, or future losses during the dying process; complicated grief “A significant minority of bereaved persons will experience substantial impairment in their social and occupational functioning for many months following the loss, accompanied by marked symptoms of emotional numbness, disbelief, purposelessness, futility, insecurity, and a sense that a part of the self has died”; 1 uncomplicated grief - a healthy, normal response to loss; and disenfranchised grief - grief that a person experiences for a loss that is not acknowledged by society. 2.

Environmental grief ‘Environmental grief’ is the grief reaction stemming from the environmental loss of ecosystems caused by natural or man-made events. For purposes of this study, we conclude that environmental grief builds on the research of Dr. Ken Doka 2 regarding disenfranchised grief, including the following elements: The relationship is not recognized. In our society, most support is given to people who have lost family members, such as parents or children, people to whom they are closely related. The many losses that occur but are not acknowledged are those in which the relationship to the deceased is that of friend, life partner, or homosexual life partner or lover. The loss is not acknowledged. Perinatal deaths, abortion, or placing a child for adoption are all examples of losses not acknowledged by society. Another loss is pet loss, which is now becoming more recognized as society becomes increasingly aware of the roles that animals can and do play in our lives. Other losses include the loss of a job, which can also contribute to the loss of self-worth, self-esteem, and selfrespect. Doka also mentions infertility as a loss in adulthood causing a sense of loss not only that one’s body has failed but also that dreams of having a child are shattered, which can also lead to the loss of a relationship. The griever is excluded. In some cases, a person may disenfranchise herself or himself from the grief. In these cases, the person is not seen socially as being capable of grief. For example, parents may exclude children from learning about the grieving process or experiencing the grieving process because the parents don’t believe the child capable of grief. Children may then disenfranchise from their own grief because that is what they believe is right, given their role in the family. The circumstance of the death is questionable in some way. If there is a suicide in the family or a death from AIDS, for example, there is often a stigma involved that precludes the survivors from feeling support for their grief. These circumstances influence the very nature of the grief reaction and at times cause the griever to inhibit her or his grief responses. Doka also mentions that many losses might have occurred in the past, such as a divorce or the end of a relationship, but when someone

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___________________________________________________________ learns that an ex-spouse or an ex-friend has died, that loss may still cause a grief reaction because there is now an end to that given relationship. “Even though loss is experienced, society as a whole may not perceive that the loss of a past relationship could or should cause grief reactions” 3 Oftentimes, when an experience is labelled or named, a certain validity is acknowledged. The term disenfranchised grief has brought great validation to people who have felt as though they were ostracized by society for having an abnormal grieving process. Similarly, the guilt and shame many women faced after having an abortion was increased by the lack of support they had from society. The idea of disenfranchised grief offered validation to these women and opened up support groups for people dealing with this type of grief. The term environmental grief was developed to put a name to the grief that many environmentalists and others who are concerned about the plight of our environment are experiencing. Jane Goodall has expressed her feelings eloquently: The emotions triggered by the death of a chimpanzee I have loved are different again from those that overwhelm me whenever I think of the vanishing wildlife of the world, of animals shot by hunters, snared by poachers, starved by the encroachment of farmers into their feeding grounds. I am angered, as well as saddened, when I think how hard it is to help them. The sight of a rhino killed for his horn is terribly distressing. It brings tears to my eyes, but the tears are part rage because we seem unable to stop the slaughter. 4 3.

Gaia theory In 1961, Dr. James Lovelock, a British atmospheric chemist, was invited to be an experimenter with the National Aeronautics and Space Administration on its first lunar instrument mission. At that time, NASA was investigating the possibility of life on Mars. NASA had difficulty finding experts in the field regarding life on Mars, so they had to settle for people who were experts regarding life on Earth. Soon after Lovelock began work on a lunar probe, he was promoted to designing instruments to analyze the surface and atmospheres of planets. In 1972, Lovelock published a paper suggesting that life on a planet would have to use the atmosphere and oceans to produce raw materials for the products of its metabolism. The gases in Earth’s atmosphere are in a persistent state of disequilibrium, but a look at Mars through infrared telescopes revealed that the atmosphere was dominated

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___________________________________________________________ by carbon dioxide and was not far from the state of chemical equilibrium, strongly suggesting that Mars was lifeless. NASA scientists continued to investigate in hopes that they would find life on Mars or on our other neighbour planet, Venus. 5 Lovelock created quite a stir with conclusions that ultimately led to his development of the Gaia hypothesis. 6 Gaia comes from the Greek word meaning earth or Earth Goddess. The Gaia hypothesis states that the Earth is a self-regulating living organism. Lovelock realized that science in the 1960s looked at our world from a reductionist point of view, meaning that it was seen from the bottom up, which did not take into account the chemical compositions of the climate of the earth. When he had the opportunity to view Earth from the top down, he realized that the atmosphere of the Earth was a living part of the whole organism, that Earth itself was a living organism. Looking at the planet from the top down was not a new approach. Lovelock writes that physiologists, engineers, and inventors have investigated from the top down for some time. 7 Lovelock has written extensively regarding the fact that the Gaia theory has not been accepted by all sciences as yet, but it has become more mainstream. 8 Although Lovelock developed the Gaia theory and he found that many environmentalists agreed with it; he did not always agree with the direction environmentalists were taking in regard to protecting the planet. Environmentalists at the time appeared to be more concerned with human rights. “If, in caring for people, we fail to care for other forms of life on Earth then our civilization and we will suffer.” 9 Environmentalists, it seems, have to find a balance between the needs of humans and the need to protect our planet without excluding one from the other. According to Lovelock, once more than 70% to 80% of the tropical forest is destroyed, the remaining forest will no longer sustain its climate, meaning that the whole ecosystem will collapse. 10 If that is the case, and we continue to destroy the tropical forest, it will not be long before the tropical forests vanish and the people in those regions find themselves living in a desert. Lovelock expressed it this way in 1999: It is not enough to be concerned for people; there is no tenure for anyone on this planet, not even for a species. If we do not recognize our responsibility to our planet we may not as a species ever reach our allotted span. So let us be moderate in our ways and aim for a world that is healthy and beautiful and which will remain fit for our grandchildren as well as those of our partners in Gaia. 11

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___________________________________________________________ The Gaia theory introduced an awareness not seen in science previously, an exposure to a relationship more conducive to the health of our natural world. Lovelock had his share of critics, but a number of scientists opened their eyes to a new view of the world and to science as a result of his work. When science views the earth as a living organism, then we can also accept that humans are a part of the interconnectedness of life on a living earth. There is already much information regarding the interconnectedness of the living earth among many indigenous cultures, but science tends to ask too many questions and wants to probe deeply without an awareness of how much damage that probing can cause the earth. At one time in human history, when we were hunter-gatherers, humans lived with nature, not separate from it. We did not think ourselves superior to nature but connected to it. As science advanced, we became observers of nature, rather than being a part of it, seeking out how to make nature work for us. If we can again view our earth as a living organism, then perhaps we will feel more inclined to live with it and not as though the earth was a never-ending faucet of resources for our use. Steven Fenwick put it this way: To view the earth as a complex, self-regulating, living being gives new impetus to the need for ecological protection. If ecosystems are vital parts of the earth organism, in many respects analogous to organism, then the death of these ecosystems may eventually lead to the death of the planet, or at least to the extinction of humans, since humans appear to be the major threat to the rest of planetary life. 12 Through the work of Lovelock, scientists now maintain that the Gaia theory has become serious science. Richard Leakey notes that field biologists traditionally believed that the interactions among species within ecosystems were important in maintaining stability. 13 That belief was based more on intuition before the Gaia theory was developed. Field biologists as well as other scientists are now able to accept what was originally intuition thanks to the emergence of the Gaia theory “that everything has a part to play in the emergence of the whole.” 14 4.

Interconnectedness Rory Spowers, freelance writer and broadcaster, writes that the common thread that unites much of science today is the recognition of the

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___________________________________________________________ interconnectedness in nature of all life. 15 This new paradigm in science “shares the same vision as the ancient mystics, suggesting that there are no boundaries between the individual and the rest of the universe.” 16 Knowing that we are connected to the earth and all its inhabitants, we must now learn to be conscious of our actions toward our environments. Field biologists, ecologists, botanists, and biologists appear to have been conscious of their actions on the planet. Most often, people in the fields of biological sciences are drawn to that field because of a love for the environment. Ecologist Phyllis Windle wrote about her connectedness to nature not only as an ecologist but also on an emotional level.17 In 1990, she read an article regarding the dogwood trees that were dying due to a fungus that had been killing dogwood trees since the 1970s. Dr. Windle did not realize that her reaction to the demise of the dogwoods would be so strong. She related her reactions to those of grief, but added, Our external, as well as our internal worlds, may make environmental losses difficult to grieve. We have almost no social support for expressing this grief. When I sit beside a hospital bed as a chaplain, I expect people to cry about the unwelcome changes they are experiencing…Their tears (and sometimes my own) are a sign of work well done. Honest conversations about grief that come quite naturally at a bedside are far more difficult at a lab bench or conference table. Thus, it is harder for me to speak freely about my grief for dogwoods with ecological colleagues than with fellow chaplains. 18 There is now a name that describes and validates her grief environmental grief. She and her colleagues can share their grief while they continue to educate those who are not aware of the connection to nature. This is the first step toward healing our environment. 5.

Deep ecology Bill Devall and George Sessions credit Arne Naess, a Norwegian philosopher and mountain climber, with coining the terms shallow ecology and deep ecology in the 1970s. 19 Shallow ecology describes the more human-centred version of ecology that was mainstream at the time; it placed the needs of humans over the needs of nonhuman species. Shallow ecology had more to do with economic well-being, with what the environment could do to make humans more comfortable. Deep ecology,

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___________________________________________________________ on the other hand, involves looking out for the welfare of the whole system of life, including nonhuman species. The philosophy behind deep ecology is that it is a long-term process of change for most people, awakening an environmental ethic, a land ethic, taking into account that humans are equal to the rocks and rivers, for example, that we are not better than other species or things on this planet. As Aldo Leopold has written, In short, a land ethic changes the role of Homo sapiens from conqueror of the land-community to plain member and citizen of it. It implies respect for his fellowmembers, and also respect for the community as such. 20 Environmental grief is a part of deep ecology as we awaken to our own understandings of the loss that we as humans are perpetrating on this planet. Humans need to ask themselves deep questions about change in order to preserve life on earth. Deep ecology has a strong foothold in environmental activism, where it is understood that there is also a strong reaction to environmental grief. Some people cannot see that there is any hope in saving this environment. They perhaps believe we have destroyed too much of the earth to heal from our wounds. Deep ecologists are working not only to save our planet but to shift our consciousness to awaken people to the beauty that nature holds for all of us, if we choose to be her equal. 6.

Hope Thankfully, many people believe there is still hope for saving our planet. For example, despite all the destruction that she sees, Dr. Jane Goodall remains hopeful that humans will soon learn that we must nurture nature and no longer continue to destroy it. 21 In this respect, our environmental grief can turn to a state of healing. It is interesting that when people share their grief with one another, it seems to allow others to open up and share as well. In that case, they are also sharing their hope because they have just educated another person about the effects humans are having on our environment. Dr. Jane Goodall began her research of wild chimpanzees on the shore of Lake Tanganyika in 1960. Her study has become the longest field study of any animal species in its natural surroundings. Dr. Goodall has seen firsthand the destruction of our environment as she returns to Gombe National Park where she began all those years ago. Gombe has changed a great deal, yet Dr. Goodall remains hopeful that our world will be preserved:

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___________________________________________________________ There are many signs of hope. Along a lakeshore in Tanzania, for example, villagers are planting trees where all the trees had disappeared. Women are taking more control over their lives, and, once they become better educated, then the birth rate begins to drop. And the children are being taught about the dire effects of habitat destruction. There is the terrible pollution around the world, the balance of nature is disturbed, and we are destroying our beautiful planet…But in spite of all this I do have hope. 22 Scientists with a great deal of experience in the field and in education continue to have hope for our future. It might be more difficult for adults to change their behaviours, so science seems to be relying on the young, in hopes that they will be taught and made aware of the need to protect the environment from the very start. Change is not as easy as some might believe, but it is the only hope for our planet. 7.

Healing As stated earlier, environmental grief is the term that validates all the emotions of despair, hopelessness, and anger. Joanna Macy discusses the “despair work” she has created. It is similar to grief work, but she states that one does not have to accept the loss, given that the loss has not yet occurred and is “hardly to be accepted.” She does write, however, that Despair cannot be banished by injections of optimism or sermons on “positive thinking.” Like grief, it must be acknowledged and worked through. This means it must be named and validated as a healthy, normal human response to the situation we find ourselves in. Faced and experienced, its power can be used, as the frozen defences of the psyche thaw and new energies are released. Something analogous to grief work is in order. 23 In grief work, it is helpful for the bereaved to accept the reality of the loss. Doing grief work doesn’t necessarily mean that one must accept the reality of the loss, but for healthy growth and healing, accepting the loss is helpful when the bereaved is ready to accept.

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___________________________________________________________ 8.

Conclusion In the case of environmental grief, when I first considered the idea, my concern was whether or not I was crazy. Was I the only person in the world who was grieving over the plight of our environment? I coined the term after reacting to the loss of marine mammals, particularly whales. My concerns were validated by the responses and reactions of the coresearchers, particularly when writer/scientist Leigh Calvez stated that she felt she was alone in her thinking. “I think it’s incredibly helpful to give this grief a name. It helps me to hear a term like that. It helps me feel that I’m not crazy, that I’m not alone.” 24 The term environmental grief was never intended as a label to explain to people that they are reacting to grief over loss of the environment. It is intended to validate feelings and, hopefully, to call people to action to make a change in the way they live so that all beings on this planet can live as a whole system. Educating ourselves and those around us is the key to making us conscious of our actions toward the environment. It is important not to judge others who are not as conscious. I do not condone any violence against another person in order to make that person understand what she or he is doing to the environment. We must be peaceful among ourselves if we want to make peace with nature.

Notes 1

Robert Neimeyer and Louis A. Gamino, ‘The Experience of Grief and Bereavement’, In Handbook of Death and Dying, Volume 2, ed. Clifton D. Bryant (Thousand Oaks, CA: Sage, 2003), 849. 2 Ken J. Doka, ed., Disenfranchised Grief: New Directions, Challenges, and Strategies for Practice (Champaign, Illinois: Research Books, 2002). 3 Ibid, 11. 4 Jane Goodall, ‘Digging Up the Roots’, Orion 13 (1994), 21. 5 James E. Lovelock, ‘Gaia as Seen Through the Atmosphere’, Atmospheric Environment, 6 (1972), 579. 6 James E. Lovelock and E. Margulis, ‘Atmospheric Homeostasis by and for the Biosphere: The Gaia Hypothesis’, Tellus, 26 (1973), 2. 7 James E. Lovelock, ‘The Environment Now and the Gaian Perspective’, in The Spirit of Science from Experiment to Experience, ed. D. Lorimer, (New York: Continuum, 1999), 129-148. 8 James E. Lovelock, Homage to Gaia: The Life of an Independent Scientist (Oxford: Oxford University Press, 2000). 9 Ibid, 4.

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___________________________________________________________ 10

Ibid. Lovelock, 1999, 148. 12 Steven Fenwick, The Dreaming Earth: Foundations for a ProcessOriented Approach to Ecopsychology (Ann Arbor, Michigan: UMI, 1998), 88. 13 Richard Leakey and Roger Lewin, The Sixth Extinction: Patterns of Life and the Future of Humankind (New York: Anchor Books, 1995). 14 Ibid, 139. 15 Rory Spowers, Rising tides: A History of the Environmental Revolution and Visions for an Ecological Age (Edinburgh: Canongate Books, 2002). 16 Ibid, 232. 17 Phyllis Windle, ‘The Ecology of Grief’, BioScience, 42 (1992). 18 Ibid, 363, 366. 19 Bill Devall and George Sessions, Deep Ecology: Living as if Nature Mattered (Salt Lake City, Utah: Peregrine Smith Books, 1985). 20 Aldo Leopold, A Sand County Almanac: With Essays on Conservation (New York: Oxford University Press, 1949), 171. 21 Jane Goodall, ‘My Three Reasons for Hope’, 2001 [article available online] (accessed 17 November 2003)

22 Ibid, para. 2. 23 Joanna Macy, World as Lover, World as Self (Berkeley, California: Parallax Press, 1991), 16. 24 Leigh Calvez, in interview with author, October 2002, quoted in Kriss Kevorkian, Environmental Grief: Hope and Healing, Ph.D. diss., Union Institute and University, Cincinatti, Ohio, (2004), 64. 11

Bibliography Devall, Bill and George Sessions. Deep Ecology: Living as if Nature Mattered.( Salt Lake City, Utah: Peregrine Smith Books, 1985). Doka, Ken J., ed. Disenfranchised Grief: New Directions, Challenges, and Strategies for Practice. (Champaign, Illinois: Research Books, 2002). Fenwick, Steven M. The Dreaming Earth: Foundations for a ProcessOriented Approach to Ecopsychology (UMI Microform 9910825). (Ann Arbor, Michigan: UMI, 1998). Goodall, Jane. ‘Digging Up the Roots’, Orion, 13 (1994), 20-21. Goodall, Jane. ‘My Three Reasons for Hope’ [article online] (2001; accessed 17 November 2003); available from http://www.janegoodall.org/jane/essay.html

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___________________________________________________________ Kevorkian, Kriss. ‘Environmental Grief: Hope and Healing’, unpublished Ph.D. dissertation, (Union Institute and University, Cincinatti, Ohio, 2004). Leakey, Richard and Roger Lewin. The Sixth Extinction: Patterns of Life and the Future of Humankind. (New York: Anchor Books, 1995). Leopold, Aldo. A Sand County Almanac: With Essays on Conservation. (New York: Oxford University Press, 1949). Lovelock, James E. ‘Gaia as Seen Through the Atmosphere’. Atmospheric Environment, 6 (1972), 579. Lovelock, James E. ‘The Environment Now and the Gaian Perspective’. In The Spirit of Science from Experiment to Experience, edited by D. Lorimer, 129-148. (New York: Continuum, 1999). Lovelock, James E. Homage to Gaia: The Life of an Independent Scientist. (Oxford: Oxford University Press, 2000). Lovelock, James E. and E. Margulis. ‘Atmospheric Homeostasis by and for the Biosphere: The Gaia Hypothesis’, Tellus, 26 (1973) 2. Macy, Joanna. World as Lover, World as Self. (Berkeley, California: Parallax Press, 1991). Neimeyer, Robert and Louis A. Gamino. ‘The Experience of Grief and Bereavement’, In Handbook of Death and Dying Volume 2, edited by Clifton D. Bryant, 847-854. (Thousand Oaks, California: Sage, 2003). Spowers, Rory. Rising Tides: A History of the Environmental Revolution and Visions for an Ecological Age. (Edinburgh: Canongate Books, 2002). Windle, Phyllis. ‘The Ecology of Grief’. BioScience, 42 (1992), 363-366. Kriss A. Kevorkian, MSW, Ph.D., holds a doctoral degree in thanatology, and is the leading authority on environmental grief®. She is an adjunct professor at Antioch University in Los Angeles, Executive Director of The Center for Conscious Dying and Grieving, and Co-Chair of the Los Angeles County Bar Association.