Death and Loss

  • Blog
  • 09/09/2015

Avoidance in the face of a family death

Without clear principles for relating to others in the face of a painful loss I would be prone to operate out of my deep family programming – that is to emotionally avoid the gravity of pain.

‘Chief among all taboo subjects is death. A high percentage of people die alone, locked into their own thoughts which they cannot communicate to others.’

—Murray Bowen MD

On a recent work assignment I visited the grounds of the hospital where my dear mother died of breast cancer, aged 54, November 1980. The hospital has changed drastically, with large modern buildings dwarfing the original 1930 dark brick edifices. I paused in front of one of those old buildings, now used for pathology. It seems unsettlingly familiar. I recall entering such a building to visit Mum in her last week of life. While heavily dosed with morphine she managed to gesture an acknowledgement of my presence. I recall buying her a chocolate paddle pop to give her some kind of sensate comfort. She was only just able to muster strength to respond and take a few licks. Some 10 years earlier my parents had done the same for me when I was in hospital after the removal of my tonsils and adenoids – Oh how the caretaking tables had turned at this moment! The Sunday night before Mum died I felt compelled to visit her quite late in the evening after visiting hours. I discovered she had been moved from her hospital bed onto a trolley and into some kind of windowless storage room. It was as if her personhood had already been set aside and the nursing staff were filing her way for the next day’s tasks of dealing with a dead body.

It’s now more than 3 decades on and these confusing and troubling memories have become somewhat hazy. The whole episode of her dying is certainly blurred by our family’s coping style at the time. The modes operandi was to carry on with life and thereby avoid the realities of our loved one’s rapid decline. In a way each of us in the family did what the hospital staff had done in the face of her death – we shifted the painful reality into a closed off windowless room. How mournful I am to think that she died alone in that cupboard of a room some 5 hours after my final visit. My father and siblings struggled to know any better way to manage; especially given our mother had been the family rock who conveyed stability to us all when things were tough.

The following excerpt from my book, “Growing Yourself Up” tells some more of the story of my own family of origin’s reaction to death. It illustrates an example of a family system closing up in the face of loss.

“The most painful time in my life to date was the death of my mother to breast cancer when she was just 54 years old. Her untimely loss was heart wrenching, but alongside her painful death there is another level of sadness for me. This is the layer of how her death was handled in our family. I remember being in denial about her imminent death right up to her last ambulance ride to hospital. None of our family talked about her dying and how we were going to support each other.

My mother kept up a courageous presence and spoke of future plans. My father went on a planned trip to a sporting event with his male friends a fortnight before she died. All of us were using distance to cope with what was too painful to confront. We just shut out the facts and the aching emotions in order to keep moving forward. Well-meaning friends made efforts to talk with me about my mother’s deteriorating condition and the prospect of her death being near but I didn’t want any part in such pessimistic conversation.

Shutting down feelings in order to move on

When I look at the generations of my mother’s and father’s families, I can see that this stoic way of dealing with death goes back a long way. Children were not included in funerals, adults did not show their distress in front of others and normal routines were resumed as soon as the funeral was over. This pattern of moving on without dwelling on loss has helped the family to survive in many ways. When my dad’s father died suddenly at the age of 50 of a heart attack, it was vital for my father to quickly take the reins of the family business to prevent financial ruin for himself and his mother. Having just come through the Great Depression, financial survival took precedence over dealing with personal pain. Similarly, when my mother’s eldest brother died as a young child, the whole society was rebuilding from the loss of a generation of young men in World War I. People had to find a way to move on without falling into despair or having their livelihoods collapse.

Moving so far in the direction of shutting off feelings to survive has had its cost. I regret that I could never talk to my mother about what she was going through. It would have helped to have been able to cry together. The family could have been a supportive resource if individuals were able to balance their efforts to keep going with time to talk with each other about our struggles in the midst of grief. Thirty years later I can still awaken the deep hurt and helplessness that I felt after Mum’s death, hearing my father crying in his bed at night and calling out my mother’s name. I knew how to support him through busily helping with tasks but I had no idea how to talk to him about our shared loss. The shockwave of my mother’s death and the limits to being able to grieve openly were evident in my family for a long while. Some family members went through some significant emotional symptoms and there are still traces of anger and blame from this time.”

I sometimes think about my principles for confronting a family death. Without clear principles for relating to others in the face of a painful loss I would be prone to operate out of my deep family programming – that is to emotionally avoid the gravity of pain. When facing my own diagnosis of breast cancer 5 years ago I immediately pondered how I would handle my own death if I were to receive news of a grave prognosis. I considered how much I would want to speak openly to all family members about what I was going through – what I was feeling, thinking, praying, fearing, hoping in; and how I would want to hear the same from my loved ones. I remember praying with the psalmist: “teach me to number my days”, to not take life for granted, to appreciate that death is an inevitable part of every family’s experience. I reflect on my older sister’s vital profession as a palliative care nurse and on ways the health care system has redressed lack of sensitivity for dying people and their families. Compassionate health care and sustained person hood to all dying people is such a gift in assisting family members to be in genuine contact with their dying loved one. As with all areas of strengthening relationship, the effort is to improve toleration of pronounced discomfort in order to sustain open connection with those who mean the most to us.

Questions for reflection:

  • What do I remember about important deaths in my family?
  • How open were family members about the facts of the illness; and about their experience of the sadness and impending loss?
  • What were the indicators of ways family member shut off from the reality of death? What has been the effect over time of this way of coping?
  • What guiding principles have I developed for relating to a dying family member and for how I would want to relate if I were facing my own death?

Bowen Family System theory and Death and Loss

Reading Bowen’s reflections on how families can best open up their system in the face of death gives food for thought on alternate ways that this generation of my family can strive to manage grief; remembering of course that this is not a simple formula but requires an effort in all of life to manage strong emotions while staying in contact with important others.

*The following Bowen Theory ideas are from an excerpt of a book chapter: Bowen Family Systems and Grief: Thinking about variation in the grief response and recovery:

“Bowen wrote about the role of rituals of grieving, such as funerals, in assisting a grieving family. He stressed the importance of making as much contact with as many people as possible as opposed to the anxious drive to shut down and avoid people as a coping mechanism:

The goal is to bring the entire family system into the closest possible contact with death in the presence of the total friendship system and to lend a helping hand to the anxious people who would rather run than face a funeral.

Bowen thought that funerals could provide an opportunity to resolve emotional attachments and for people to define themselves more openly to other family members by being present and accounted for; To get alongside other family members, even those who may have become estranged, is an opportunity for growth. It enables people to be clear that they choose to be present with others even when emotions are charged, that they have a part to play in the family and that they are not willing to allow themselves to avoid difficult times. In contrast to taking up the opportunity to be in contact with family members after a death, any patterns of relating that serve to deny death can prolong unresolved attachment issues for family members well into the future.

The following is a summary of Bowen’s suggestion using a family systems lens for managing a death of a family member:

  • Visit dying family members as often as possible
  • Include children (children aren’t hurt by exposure to death as much as they are hurt by the anxiety of survivors.)
  • Involve as many extended family members as possible
  • Open caskets in order to provide as much contact between the dead and living as possible.
  • Prompt obituary notices and communication with relatives and friends.

References:

Bowen M., “Family Reaction to Death” in, Family Therapy in Clinical Practice (New York: Aronson, 1978)

Brown, J. “Old Age & Facing Death: denial or honest preparation” in Growing Yourself Up: How to bring your best to all of life’s relationships (Wollombi: Exisle, 2012)

Brown, J. “Bowen Family Systems and Grief. Thinking about variation in the grief response and recovery.” published in “Loss and recovery responding to grief with the compassion of Christ and the skills of all Gods people.” Ed. Wesley M, Mosaic press, 2012.

* Part of this blog appeared in another blog by this author in 2014:

* Bowen Family Systems and Grief

Thinking about variation in the grief response and recovery

Jenny Brown: This article (in this excerpt form) is published as a chapter in “Loss and recovery: responding to grief with the compassion of Christ and the skills of all Gods people.” Ed. Wesley M, Mosaic press, 2012.

Death and Loss

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