Disenfranchised Grief: Recognizing Hidden Sorrow · Disenfranchised Grief: Recognizing Hidden...
Transcript of Disenfranchised Grief: Recognizing Hidden Sorrow · Disenfranchised Grief: Recognizing Hidden...
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Disenfranchised Grief: Disenfranchised Grief: Recognizing Hidden SorrowRecognizing Hidden Sorrow
Kenneth J. Doka, PhDProfessor, The College of New
RochelleSenior Consultant, The Hospice
Foundation of America
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Beyond Feeling RulesBeyond Feeling Rules
It is acceptable to grieve the deaths of family members
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Not all Losses Are Death Not all Losses Are Death RelatedRelated
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A recognition that grief A recognition that grief reactions do not necessarily reactions do not necessarily
entail deathentail death
Secondary LossesAnticipatory Grief
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Transitions inevitably entail Transitions inevitably entail lossloss
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Worden’s Formulation
Change = Loss = Grief
Disenfranchised GriefDisenfranchised Grief
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Disenfranchised GriefDisenfranchised Grief
A loss that cannot be socially sanctioned, openly acknowledged or
publicly mourned
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Disenfranchised GriefDisenfranchised Grief
The Right to Grief
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The Dimensions of The Dimensions of Disenfranchised GriefDisenfranchised Grief
Sociological
Intrapsychic (Kauffman)
Political (Attig)
Interactional– Neimeyer & Jordan “Empathic Failure”
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SocioSocio--Political Dimension of Political Dimension of Disenfranchised GriefDisenfranchised Grief
Cultural feeling rules assign sympathy to victims considered “above reproach”. This process is influenced by class, race, and ethnicity. (Martin, 2005)
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Contexts of Disenfranchised Contexts of Disenfranchised GriefGrief
Relationship is not recognized
Loss is not acknowledged
Griever is not recognized
Disenfranchised deaths
Ways individuals grieve
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Relationship is not recognizedRelationship is not recognized
Friend
Ex-spouse
Lover/partner
Co-Worker
Therapist/patient
Caregiver
Teacher/coach
Celebrity
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Disenfranchised GriefDisenfranchised Grief
We can grieve persons we did not even know
Example – Grieving a sibling one never knew (Kempson & Murdock, 2010)
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Disenfranchised GriefDisenfranchised Grief Sensitivity to Online RelationshipsSensitivity to Online Relationships
Online Relationships
Chat Room Relationships
Participants in massively multiplayer online role- playing game (MMORPG)
The funeral of Toxik/Chris
(Hensley, 2009)
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Loss is not acknowledged Loss is not acknowledged
Perinatal loss
Elective abortion
Incarceration
Job loss
Infertility
Family abandonment or alienation
Broken relationships - divorce
Loss of an animal companion
Relocation
Psychosocial loss
Illness and anticipatory grief
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Developmental LossesDevelopmental Losses
As we age, we may experience a range of losses as we transition to another developmental period
These losses can be profound as we move to later life but can even be significant as we give up childhood activities and toys to embrace the responsibilities of adolescence and emerging adulthood
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Griever is not recognizedGriever is not recognized
Persons with developmental disabilities
Persons with mental illness or dementia
The very young
The very old
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Grief in PrisonGrief in Prison
Place as disenfranchising
Grief can be highly disenfranchised in prison
Inability or limits for participation in care or rituals
Cost of emotional vulnerability
Likelihood of complicated relationships
Prison relationships
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Disenfranchising deathsDisenfranchising deaths
Homicide
Executions and Martyrdom
Suicide (including Assisted Suicide)
HIV/AIDS
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““DevaluedDevalued”” DeathsDeaths
The very old
Persons with disabilities
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Ways individuals grieveWays individuals grieve
Cultural aspects
Styles of grieving
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Intuitive vs. InstrumentalIntuitive vs. Instrumental
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Grieving Styles Exist along a Grieving Styles Exist along a ContinuumContinuum
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Disenfranchisement and Disenfranchisement and Grieving StylesGrieving Styles
Male Intuitive Grievers
Female Instrumental Grievers
Instrumental Grievers (early)
Intuitive Grievers (late)
Counselor’s Disenfranchisement of Instrumental Grievers
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These contexts are neither These contexts are neither exclusive nor exhaustiveexclusive nor exhaustive
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Disenfranchised Grief in the Disenfranchised Grief in the LifecycleLifecycle
Example - Siblings
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CautionCaution
Selected sub-cultures may enfranchise
Disenfranchisement may vary across time
Disenfranchisement may vary between cultures or classes
Eyesemitian
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Culture and Disenfranchised Culture and Disenfranchised GriefGrief
Certain sub-cultures may recognize certain losses as important even if these are not always acknowledged within the larger society
African-Americans and fictive kin
Hispanics/Latinos and godparents/godchildren
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The Degree of The Degree of DisenfranchisementDisenfranchisement
Assessing levels and sources of support
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All grief becomes All grief becomes disenfranchised over timedisenfranchised over time
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The Evidentiary Basis of The Evidentiary Basis of Disenfranchised GriefDisenfranchised Grief
A number of studies have identified disenfranchised grief in a number of populations including adult children of dysfunctional families, carriers of Huntington’s disease, persons with genetic abnormalities, migrants leaving or re-entering, parents of children with disabilities, gay partners, families with AIDS deaths, Nursing Assistants, Families of Death Row inmates
Verity and Gwyn (2008) found deleterious effects on psycho-social health for disenfranchised grievers
Thupayagale-Tshwenaegae (2008) and Sobel & Cowen (2003) found heightened depression scores in populations experiencing disenfranchised grief
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Possible Complications of Possible Complications of Disenfranchised GriefDisenfranchised Grief
Often intensified reactions
Lack of social support
Inability to participate in dying process
Problem of ritual
Concurrent crises
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The Paradox of The Paradox of Disenfranchised GriefDisenfranchised Grief
Grief is intensified but the usual social supports are missing
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How Can We Help?How Can We Help?
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Sensitivity to LossSensitivity to Loss
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ValidationValidation
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The Power of NamingThe Power of Naming
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The Role of Education and The Role of Education and SelfSelf--AdvocacyAdvocacy
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Analyze Empathic FailureAnalyze Empathic Failure
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Counter Empathic FailureCounter Empathic Failure
Counseling
Support Groups
Therapeutic Ritual
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Grief is manifested in many Grief is manifested in many waysways
Physically
Emotionally (including positive emotions)
Cognitively
Behaviorally
Spiritually
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The Grief ProcessThe Grief Process A Roller Coaster of ReactionsA Roller Coaster of Reactions
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Grief is not a time bound Grief is not a time bound process that ends in process that ends in
detachmentdetachment
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Amelioration of GriefAmelioration of Grief
Over time the intensity of grief reactions lessen
Persons function at similar (or sometimes better levels) than prior to the loss
Yet, grief still has a developmental aspect
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The Tasks of GriefThe Tasks of Grief
Acknowledge the loss
Express manifest and latent emotion
Adjust to a changed life
Relocate the loss
Reconstitute faith and philosophical systems challenged by the loss
Worden (Modified)
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Remember!Remember!
Disenfranchised Grief Is Grief
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CaseCaseMartha is a 43 year-old divorced, white female. She has been divorced for 7 years
after being married for l3 years. She has custody of her 14 year-old soon and her 18 year-old daughter. The divorce was very bitter, the result of her husband’s extra-marital affair with her close friend. Her relationship with her late ex-husband was tenuous, but he did share weekend custody of her son. Her daughter, on the other hand, refused to visit.
Her husband had been sick for 2 years. She had visited him once in the hospital, but felt the visit uncomfortable and tense. After much soul searching, she did attend the funeral with her son. She found the experience “horrible,” resenting the new wife’s warmth, the interaction between that wife and her son, and the funeral homily where her ex-spouse was praised as “a loving family man” and the wife as “a courageous caregiver”. She says she needs to talk with someone before “she goes crazy.” She is upset with her children resenting both her son’s grief and her daughter’s indifferences. She also feels her friends do not understand and she doesn’t feel comfortable in talking with her new boyfriend.
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The Challenge of Grief The Challenge of Grief GroupsGroups
The limits of heterogeneous groups
The value of need assessment
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Utilizing Rituals Utilizing Rituals
Widening the circle
The mandate of noninterference – respectful of other mourners
Creating therapeutic rituals
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Value of Concept of Value of Concept of ““Disenfranchised GriefDisenfranchised Grief””
Increased sensitivity to dimensions of loss
A sociological perspective to loss that challenges a solely intrapsychic perspective
New therapeutic approaches (Neimeyer & Jordan – analyze empathic failure)
Heuristic Value
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Heuristic ValueHeuristic Value Related ConceptsRelated Concepts
Ambiguous Loss (Boss)
Chronic Sorrow (Roos)
Nonfinite Loss (Bruce & Schultz)
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Chronic SorrowChronic Sorrow
A set of pervasive, profound, continuing, and reoccurring grief responses resulting from a significant loss, or the absence or crucial aspects of self or another to whom there is deep attachment” (Roos)
The role of fantasy – “What might have been”
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Criticisms of Concept of Criticisms of Concept of ““Disenfranchised GriefDisenfranchised Grief””
The cost of enfranchisement (Kamerman)
The risk of trivializing the definition of grief (Cable)
Hierarchies of Grief (Robson & Walter)
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The Charge of The Charge of Disenfranchised GriefDisenfranchised Grief
Enfranchising the disenfranchised