“The Emotional Shock Wave” of Death

“The Emotional Shock Wave” of Death

“And who by fire, who by water,
Who in the sunshine, who in the night time,
Who by high ordeal, who by common trial,
Who in your merry merry month of may,
Who by very slow decay,
And who shall I say is calling?”
— Leonard Cohen
— Who by Fire

I am going to die. You are going to die. And with apologies to Country Joe And The Fish, We are all going to die. Aging, Sickness and Death in one form or another will get us all. And yet, many of us try mightily to ignore this inevitable and inescapable fact of life.

In India, death is seen as a potential step away from reincarnation and towards Nirvana. In Europe, death is seen as an existential tragedy we all must face. In the U.S., death is seen as optional.

So what makes Americans think that the ultimate final destination might somehow be avoidable? Well the APA (American Psychiatric Association) in its never ceasing to amaze monomaniacal attempts to pathologize all of human behavior has created “persistent complex bereavement disorder” and listed it under “Conditions for Future Study” in DSM-V. Further to this self-serving endeavor a recent article titled, “Bereavement Can Set Stage for Several Mental Illnesses” gleefully posits “the potential for mental problems following the loss of a loved one.” Who knew?

In his 1976 essay, “Family Reaction to Death”, Bowen described the “emotional shock wave” of death as “a network of underground ‘aftershocks’ of serious life events that can occur anywhere in the extended family system in the months or years following serious emotional events in the family.”

Ronald B. Cohen MD of familyfocusedsolutions.com discusses death and dying and its affect on the individual and family.Why is it so difficult to contemplate the loss of the corporeal self? Death brings the loss of the physical presence of the individual, which I think forever changes one’s life experience. Failure to open the conversations around death and bereavement can be detrimental to a family’s future functioning, denying the family the opportunity to share, honor, mourn, comfort, reinvest and move on.

McGoldrick and Walsh identify four tasks that help a family adapt to the profound loss of death:

  1. Shared acknowledgement of the reality of death
  2. Shared experience of loss
  3. Reorganization of the family system
  4. Reinvestment in other relationships and life pursuits

While death may be expected and not a surprise, it is always a shock. Perhaps that is why we engage in euphemisms such as, “He passed away;” “she’s in a better place” … At times of loss and crisis, we all need the opportunity to tell our story, to be heard, validated and seen, to have someone to commune with and witness our pain. Family and friends can comfort and help with meaning making.

Faith and spirituality, as well as religious practices and rituals, provide valuable tools in the task of meaning making. Family rituals express the experiential history of the family over time and set the context in which we develop and change. Therapeutic healing rituals help solidify the shared experience of loss, grief and bereavement.

Life is in essence loss and reinvestment. Living beyond the deaths of loved ones and making meaning of multiple losses requires profound strength, compassion and respect. To differentiate is to provide a platform for maximum growth and personal development for everyone in your circle of influence. The ability to struggle well, to make meaning out of adversity and to make loss matter is fundamental to emotional well-being.

Best of luck on your unfolding journey of a lifetime.

Please share your thoughts and experiences concerning playing chess with Death in the “Leave a Reply” box below. If you found this post helpful, please don’t keep it a secret. You are encouraged to click on the buttons in the second to the right hand column at the bottom of the page and share this article with your own networks. To request more information please click here. Looking forward to continuing the conversation.

Ronald B Cohen, MD, PC www.familyfocusedsolutions.com Ronald B. Cohen, MD
Bowen Family Systems Coach
1 Barstow Road, Suite P-10
Great Neck, NY 11021
(516) 466-7530
RBCohenMD@FamilyFocusedSolutions.com

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6 comments

  1. Hie on November 6, 2014 at 3:36 am said:

    Deep insights that needed to be expressed and shared. I like this very much. My initial reaction is that it is cultural, and the culture helps to dictate the perception. Now the question becomes, what are we afraid of about death, here in America?

    • Ronald B Cohen, MD on November 11, 2014 at 8:37 pm said:

      Hi Hie,

      Thank you for contributing to the discussion. Great question. Death is the ultimate loss, and most, if not all, of our fears and anxieties may stem from its unknowability. The myriad losses of death include those of the physical person, family content, structure, roles, and relationships, and hopes and dreams for the future. The aftershocks of death can result in physical illness, emotional distress, alcoholism, chemical dependence, relationship discord and cut-offs, marital strife, separation, and divorce, and occupational difficulties, among other carnage.

      Following are answers from various LinkedIn discussion groups:

      On the one hand we cannot avoid death and dying. On the other hand – it is the ultimate loss of control – we are no longer available to control other things – realize our goals – corporally be with our loved ones, etc.

      … those that live well, die well. For those who live poorly, well it isn’t pleasant. If only people focused on what they were becoming when alive. Those who know what they are becoming know where they are going. That is all that matters at the hour of death. Did you be-live, what you said you believed?

      Old Southern gospel/bluegrass song: “Everybody wants to go to Heaven but nobody wants to die.”

      Terry McDonald adds:

      1. Concern for the wellbeing of those left behind.
      2. Regrets, mostly about things not done.
      3. Uncertainty no matter what belief is professed.
      4. The existential aloneness of dying.

      Regards,

      — Ron

      The heart of the wise
      is in the house of mourning
      — Kohelet 7:4

  2. Sara Jacobovici on November 7, 2014 at 8:52 am said:

    Ronald, thank for speaking about something that is often difficult to speak about. In your article you write:

    McGoldrick and Walsh identify four tasks that help a family adapt to the profound loss of death:

    1.Shared acknowledgement of the reality of death
    2.Shared experience of loss
    3.Reorganization of the family system
    4.Reinvestment in other relationships and life pursuits

    Where in the process is the need to talk about the individual that has died identified? Regardless of the relationship; close or not, happy or challenging, loving or shameful, there is a distinctive need to give the individual effected by the death an opportunity to be in a dialogue or tell the story about the individual that has died.

    As well, from my work I have been able to see the common threads of issues around control and meaning. To the degree an individual has in experiencing control in his or her life, will influence the response to death. And in terms of meaning, if an individual has a grounded sense of what “it’s” all about; life, death, how I relate to myself, others and the world around me, this too will influence how an individual copes with death.

    Thank you for a thought provoking article.

    • Ronald B Cohen, MD on November 10, 2014 at 9:21 pm said:

      Hi Sara,

      Great question. Thank you for adding to the conversation in a positive and meaningful way. While all family members grieve in their own way, each individual always exists in the context of family relationships. Indeed, if we think deeply about it there is no such thing as doing individual therapy as the individual is inseparable from his/her relationship networks.

      Open family communication is vital to create a climate of trust, empathy and tolerance for multiple, often conflicting responses. Failure to open the conversations around death and bereavement can be detrimental to a family’s future functioning. The ability to struggle well, to make meaning out of adversity and to make loss matter is fundamental to emotional well-being.

      Three days are for weeping;
      Seven days are for grieving;
      Thirty days are for eulogizing;
      Eleven months are memorializing.
      After that, don’t behave as if you have a greater compassion than God.
      (Babylonian Talmud, Mo’ed Katan 27b)

      Regards,

      — Ron

      • Kathy Hardie-Williams,M.Ed, MS, NCC, LPC, LMFT on November 23, 2014 at 8:07 am said:

        Hi Ron………as always, your article is very timely.

        I just got home and received a voice mail from the wife of a client (I’m seeing them as a couple) who shared that her husband’s father died suddenly on Friday, Nov 21st (today is the 22nd). They have an upcoming appointment and she wants to know if he should come to the appointment alone or should she be there to support him? I haven’t spoken to them yet, as it is late and I won’t be able to return the call until tomorrow, so I don’t know if she has asked what his preference would be or not. In addition, I am having difficulty finding words that could possibly address the shock and grief he must be feeling. I think it is especially difficult to process the unexpected shock of the death of a family member. Words of wisdom?

        Take care,

        Kathy

        • Ronald B Cohen, MD on December 1, 2014 at 7:45 pm said:

          Hi Kathy,

          Death present an unexpected transitional crisis that interrupts the family’s developmental tasks leaving no member untouched.

          (1) There is nothing to be said other than some variation of “I’m sorry for your loss”. Grief, loss and bereavement are not illnesses and rarely need professional intervention.
          (2) The question a Bowen therapist would ask you is what has been your experience with severe, potentially life shortening illness, death, loss, grief and bereavement, and how might that impact your ability to not react emotionally to the clinical situation.
          (3) I would see the husband alone as we don’t want his wife to over-function for him in his grief, and we want him to be responsible for processing his own loss and bereavement.
          (4) I would explain to the wife that each of them has a different loss and each needs to integrate it in their own way.
          (5) This is an excellent opportunity for you and the husband to learn as much as possible about his family of origin.
          (6) The wife may need more help than the husband but again I would see her alone to work on her family of origin issues.
          (7) Read Bowen’s essay Family Reaction to Death.

          Hope that helps as a start. Best of luck on this unfolding journey of a lifetime.

          Regards,

          — Ron

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