Grieving isn't as easy as 1-2-3

When Philadelphia Managing Director Camille Cates Barnett recently announced her June 30th resignation, she said it was in part due to unresolved grief over the untimely death of her husband a year ago. Implied in the news article was the sense that the grief issue was an excuse for problems about the job itself.

While there may have been issues about her responsibilities and chains of command, there was still the lingering sense that her grief work should have been done by now. A year, after all, is time enough.

Except, it isn’t. Death ends only the life of the departed; the loss is ours for the rest of our lives.

It’s as if grief could be programmed and packaged and then discarded. In 1969, a Swiss-born psychiatrist, Elizabeth Kubler-Ross, wrote the bestseller, On Death and Dying, claiming that there five stages for terminally ill patients, as well as for their survivors.

By now, virtually everyone knows they are denial, anger, bargaining, depression, and acceptance. But, as is true with any hierarchical typology, it sounds better in print than in actual life. Whether we look at Piaget’s stages of moral reasoning in children or Erik Erikson’s Eight Ages of Man, we see that people do not all develop at the same pace, in the same order, nor do we completely finish one stage, never to return, before we move to the next one.

Grief comes in waves. We are often prepared for the firsts – the first birthday, anniversary, or holiday without the presence of our loved one. But the second, and sometimes, the ninth, hits us like a brick wall. It can come out of the blue or when we hear a song, smell a familiar fragrance, visit a favored location. Death itself is such a difficult concept to comprehend – the presence and then the complete absence of a person important to us. Our efforts to suggest grief can be compartmentalized can offer us, at best, an illusory sense of control over what is inevitably the most out of our control.

For any of us who have lost someone close to us, particularly if it’s happened more than once, we know that grief is different for each loss; it can depend on the relationship we had with the person who died and the sense of ourselves at the time of the loss.

Expressions of death are also specific to time, place, and culture. Every religion and ethnic group has rituals for the end of life; they include not only the disposal of the body but a way for the community to wrap itself around the mourners. When a loved one dies, there is a rip in the social fabric. The ceremonies are a way for the community to regroup and comfort the survivors, a way to say “We’re still here.” It takes time for those left behind to be able to accept the finality of absence, the sense that a person so present in our lives will be gone forever.

In earlier centuries, the public grieving was very formulaic and circumscribed. During the Civil War, as described in great detail by historian Drew Gilpin Faust, now the President of Harvard, in her 2008 book, This Republic of Suffering, costumes were so elaborately proscribed that prominent retail stores, including New York City’s Lord & Taylor’s, opened Departments for Mourning Clothes in the 1860s. Black was for the first year of full mourning, lavender and grey were for the subsequent year of half-mourning.

The stages of grief, as defined by the Civil War-era clergy, were divided into only three steps. The first was to remember the patriotism and the sacrifice of the departed; the pride in their contribution to the cause (whether for the North or the South) was meant to be comforting. Second, was to rely on the sympathy of others, as “shared mourning was easier mourning.” Last, was the belief in the hereafter, when the families would be reunited for all eternity.

Today, in the post-Freudian world, we expect catharsis, a brief outpouring of sorrow. But in DSM-IV, the diagnostic manual of the American Psychiatric Association, grief is normal but bereavement is not; if the symptoms of sadness persist for more than two months, they are classified as Major Depressive Disturbances.