Grief in a Family Context -- HPER F460/F560
As we mature, we realize that people perceive the world differently. No two eyewitnesses to a crime scene describe it identically. Moreover, with the present knowledge and mensuration of neuroscience, we can’t assume that “green” looks the same to others as it does to us. Therefore, it should not be surprising that experiences in grief also are driven by differing perceptions. In this unit, we discuss two possible explanations that could help explain the unique variations; gender and personality. While we may assume a certain confidence in approaching these topics, a closer examination will show that gender and personality influence how we are viewed by others during normal and stressful times, and the options we see ourselves as having during family bereavement. When completed, this unit should provide new insights into your personal coping resources, and provide new understanding and compassion for families caught in the whirlpool of grief.
McGoldrick, M. (2004). Gender and mourning. In F. Walsh & M. McGoldrick, (Eds.) Living beyond loss: Death in the family (pp. 99-118). New York: W. W. Norton & Co.
Thomas, P. (1996). Big boys don't cry? Mental health and the politics of gender, Journal of Mental Health, 5, 107-110.
Tagliaferre, L. and Harbaugh, G.L. (2002) Recovery From Loss. CAPT. (pp.31-54)
Quenk, Naomi (1996) “In the Grip...Our Hidden Personality.” Consulting Psychologists Press.
MenWeb: Men's Issues -- Men and Grief -- many of the links here are to Tom Golden's website. This explores the complexity of what has, for a long time, been a hidden or misinterpreted phenomenon, the grief experience of men
www.personalitytype.com– includes a short form of self assessment that could lead to further personal exploration.
www.capt.org - offers books and related research, including bibliography of reports relating personality types to stress and trauma reactions.
Although the increased interest is encouraging, drawbacks do exist. There are only two genders and this fact easily leads us to dichotomize our view and to think in terms of "women's grief" and "men's grief." This view of two extremes may present us with a comfortable, "balanced" picture of two distinctly different groups. It rarely reflects the reality in which people live. More realistically, what exists is gender-based tendencies. So, rather than referring to "men's grief" and "women's grief," a more accurate statement would be that "Men, in generally, tend to be more.... while women tend, in general, to be more..."It's important to keep that in mind while you work on this unit.
Peppers and Knapp (1980) found a great deal of similarity in the intensity of mothers' acute grief after the death of a child in pregnancy or infancy, regardless of the type of loss. Alternatively, paternal grieving (as reported by their wives), was very specific and individualized. One suggestion they made to explain the difference was that mothers bond with the child during the pregnancy while the father only bonds after the child's birth. Peppers and Knapp also coined the term incongruent grieving to describe the sense expressed by the women that they and their husband responded with forms of grief that were "out of synch" with each other.
I would like to urge caution in considering their findings, however, as Peppers and Knapp interviewed only the women and asked them about their own and their husband's grief. My (KG) own interviews with bereaved marital partners suggest that there is a surprisingly large degree of conflict between the intent of one spouse's behavior and the interpretation of that behavior by the other. It is possible that the differences in perceived grieving were more a function of the contrast between expectations and observation on the part of the wives than of actual behavior on the part of the husbands. Others and I have seen much support for their idea that incongruent grieving is the norm among couples. In addition, this concept is one that many couples find very useful to them in understanding their relational struggles after the death of their child.
General patterns have emerged to differentiate the grief of men and women:
Men have been seen as more likely to avoid going through the grieving (i.e., emotional) process than women (Frantz, 1984), to be less willing to talk about the loss of a child(DeFrain, 1991) and to experience a less intense grief that is resolved more quickly than mother's grief (Osterweis, Solomon and Green, 1984). The grief of fathers is seen as less intense and resolved much sooner than the mother's (Osterweis, Solomon & Green, 1984, Benefield, Lieb & Vollman, 1978).
Men are more likely to take on a managerial role, intellectualize their emotions, increase their involvement outside the home and express a strong desire for future children (Mandell, McAnulty and Reece, 1980). Women are seen to express more sorrow, depression (DeFrain, 1991), and guilt (Peppers & Knapp, 1980) while men indicate that they feel more anger, fear and loss of control (DeFrain, 1991).
Men control their emotions (Schwab, 1992), suppress their feelings (Hughes-Page & Lieberman), and use denial more than women (Bohannon, 1990-1991; Smart, 1992). Men limit their show of grief to a greater extent than women, feeling that they need to be strong for their wives (Benefield, Lieb & Vollman, 1978). Interestingly, their stoicism may not be seen by their wives as strength; rather, it may be seen as coldness and evidence that he did not truly love the child (Gilbert & Smart, 1992) and women report anger at the father's lack of expression (Schwab, 1992).
Women express their feelings early after loss (Dygrove & Mattheisen, 1987; Stinson, Lasker, Lohmann & Toedtler, 1992), , and reach out for social support (Dygrove & Mattheisen, 1987, Stinson; Lasker, Lohmann & Toedtler, 1992; Feely & Gottlieb, 1988) , seeking help from their social group, friends, or family (Smart, 1992; Smith & Borgers, 1988-1989). Bereaved mothers are seen as having a closer relationship with their deceased child, confront a daily world without their child, and visualize or feel a strong presence of their child. Fathers, on the other hand, manage others' grief as well as their own and restrict their grief to times when they are alone (Cook, 1983)
Husbands and wives have exhibited different interpretations of appropriate gender role behavior in grieving, with men more likely to speak of performing their role as “man of the family,” to engage in avoidant coping behaviors, to focus on and feel overburdened by their wife's needs, and to speak of their lack of a male support system. Women have been more likely to perceive their grief as their right, and to look for ways to support their husband's limited emotional expression (Gilbert & Smart, 1992).
A recent study (Carroll and Shaefer, 1994) was consistent in agreeing that men are less expressive than women, but suggested that this is not denial as traditionally thought. They argue that men feel grief, they simply just are not public about it. Because of their more private role, men then become dependent on their partner for information about the loss and about the nature of grief. If the loss is of their partner, they can feel isolated and abandoned in a world totally foreign to their experience. It can seem as though the law of gravity has been repealed.
An important issue for marital partners is that both partners have the need for intimacy, but each may be unable to see it in the other if it is suppressed or unexpressed. Essentially, men and women are different in this regard and this difference is difficult to see and recognize. Lang and Gottlieb (1993) explored the intimacy needs of spouses coping with sudden infant death syndrome (SIDS) and found that, for women, intimacy means having opportunities to talk about events and share ideas with their partner. For men, on the other hand, intimacy is emotional and social, sexual and recreational. A particularly complicated issue is sexual intimacy. Sexual intimacy is associated with yearning for comfort by women while men find comfort in sexual intimacy. They also express a sense of being stigmatized by their wife for wanting sexual intimacy, and by society for wanting sex after loss of their wives. The researchers suggested that the men may also feel “less of a man” because of their inability to fulfill the role of husband (i.e., protector), leading to their feeling less adequate sexually too, which can further complicate their reactions to grief.
These patterns of gender differences are consistent cross-culturally, with women generally more expressive of their emotions and men more restrained, within the context of their culture (Haig, 1990; McGoldrick, Almeida, Hines, Rosen, Garcia-Presto & Lee, 1991). By that, I mean that regardless of how expressive a society is, women tend, within the context of the culture, to be more expressive than the men.
Now that you've read this summary of research on gender differences, do you see a change taking place over time (look at the dates of the studies--do you see any trend?).
At the same time, just as we recognize that there is diversity in the grief of males and females, we need to maintain the same sense of vigilance with regard to the range of possibilities in gender-based grief among and within different cultural groups.
So, when trying to come up with an explanation for gender differences observed in research, it is important to consider what might lead to these differences. For example, we might ask, "What is the effect of being 'programmed' genetically and socially, to behave in a certain way?" What if we are told from very young childhood that, in order to accurately reflect our gender, we should behave in a particular way? What if we are told, at a time of great confusion and emotional stress, that our normal way of behaving is not "right" and, in fact, reflects badly on our ability to engage in intimate relationships? This is particularly an issue for men, since, as I indicated earlier in the course, our understanding of grief was normed on the grief of women. It may be that the differences we see between men and women in their grief is not a reflection of men's lower involvement in relationships and women's greater investment in them. It may be that what we see is more of reflection of the fact that men and women are not the same.
Interestingly, as I was developing this unit, I had a conversation about gender differences with a close male friend of mine. He told me, "For a man, expressing your emotions gets socialized out of you. You don't like it, but there it is. 'Cause, if you show your emotions, you lose your edge. If you lose your edge, you can't win. If you don't win, you're not a man. It's as simple as that."
Although it was not the case for all of the men in her study, Cook found that the men tended to evidence a more solitary, cognitive form of grief than the normative, "women's" model. What she referred to as "male grief" was found to include: efforts to manage and control the emotions of grief; the use of reason and reflection to work through their emotions; the use of involvement in other activities, including work, as distractions; self-isolation during periods of intense unhappiness; and the helping of others as a means of managing their grief. Overall, their need to isolate themselves and use rationality to control and manage emotions caused their grief to sharply contrast with the affective, social grief considered to be normal and healthy.
Although I believe Cook's study was ground breaking, particularly in that it took a men's studies perspective, divorcing her view of the men's grief from preconceived ideas of "good" and "bad" grief. I'm uncomfortable in referring to these two classes of grief as "men's and "women's" grief, particularly after applying her categories to the parents from whom I have collected data. What I found was a significant minority of women who "grieved like men" and men who "grieved like women." As a result, I prefer to think of these two types of grief as cognitive and solitary and social and emotional. More recently, Ken Doka and Terry Martinhave written of a model of grief that differentiated between two general approaches to grief: an intuitive form, seen more often in women and characterized by emotional expression; and in instrumental form, seen more often in men and characterized by a cognitive and behavioral grief process.
Interestingly, I have noticed in the interviews I have done, that men who were more emotional in their grieving (and, in some cases, more emotional than some of the more cognitive women) still expressed a need to spend time alone (something rarely expressed as a need by any of the women). Women who had a more cognitive grief style also were more social than the men, although women used their social network as tool for confirming the reality of their loss ("I made them look at those ultrasounds. I wanted them to know that baby in there was real."). I also noted that no one was purely cognitive and solitary or social and emotional. Rather, each person evidenced a tendency toward on type of grief or the other and, across time, shifted between the two and that, overall, men tended toward cognitive and solitary grief and women tended toward social and emotional.
Another thing I have found to be interesting is that the men show a greater need for regaining control, especially of their emotions. They talk about their need to regain a structure, and evaluate their wife's attempts to meet this need for structure in a positive light. Men seem to focus on order rather than "making sense of the chaos." They might establish a set time to think about the loss or to emphasize the need "to think about the good things, let the good things shine," rather than dwelling on what they see as non-productive negative emotions. Women, on the other hand, show a greater need to confirm the reality of their loss through conversation about their loss with others and to validate the legitimacy of their emotions through social contact. In addition, women are more likely to attend support groups (with or without their spouse), to keep a journal or to write a chronology or poetry as ways of working through their grief. The essential difference seemed to be that men seemed to focus more on regaining control while women focused on a more detailed understanding. The question below, about oil painting and pencil sketching relates to this idea of detailed images vs. the minimalist approach. Yet, is it really accurate, or are we unfairly falling into the stereotype of men as taking a more simplistic approach to things emotional?
The word "control" often is seen in a negative light and the need bereaved men seem to have for control often is looked on as wrong-headed. We all have a need for control and predictability -- I need to know that, when I go to pick my foot up, it will lift off the floor and when I put my foot down on the floor, the floor will be there. This is a need for control and predictability at a very basic level, but is on the same continuum as the need felt by bereaved men. Also, if you look at the typical gender role of men, as a strong, quiet, take-charge problem solver, the desire to create order in their lives by exerting control makes perfect sense.
At the same time, the need for women to develop a fuller understanding of the situation, with all of the nuances and fine details, facilitates her ability to carry out her typical role of social manager, listener, caregiver and nurturer. In this context, the need to talk her view through with others allows her to confirm that their view is consistent with hers and, then, allows her to determine who she can turn to for assistance in working through the loss and for her to determine who might need her help.
As indicated above, concern has been expressed by various people working in the area of grief about the institutionalization of a single way to grief being seen as the "healthy way" to grieve. Now, with our increased interest in grief, concern has been expressed about the "institutionalization of gender differences." Do we run the risk of simply shifting one narrow view of healthy or appropriate grief to another that simply splits the population in half and ascribing one set of acceptable behaviors for one half while another set of acceptable behaviors applies to the other half? How do we avoid this? Should we avoid it? This presents us with an interesting dilemma, and is not a suggestion that we ignore differences, but that we look for alternative explanations. One such resource may be found in personality factors.
Attempts to explain human behavior in terms of personality find their genesis among ancient Greeks who identified what they called “The Four Temperments” of the Choleric, Sanguine, Phlegmatic and Melancholic natures of the Human Being. Even older were attempts by astrologers to link human behaviors to the constellations of the stars which produced the twelve “Signs of the Zodiac.” Astrology is still practiced by many today who regularly check their horoscope for entertainment or more serious consultations. One astrologer even suggested that the twelve apostles were chosen very carefully by Jesus to represent each of the twelve signs. Among religious groups, perhaps the Muslim Sufi branch is best known for its origination of a personality model known as the Enneagram that produces nine different types with several subtypes.
However, a model of personality offered by Swiss psychiatrist, Carl Gustav Jung (1875-1962) has found popular usage among psychological practitioners for many applications including learning styles, team building, communications, intimate relationships, and spiritual practices. His theoretical work published in Psychological Types (1920) was expanded and translated by Isabel Briggs Myers and adopted by the Consulting Psychologists Press, Inc. (CPP) in 1975. Since then, the Myers-Briggs Type Indicator (MBTI) has been validated by numerous approaches among professional members of the Association for Psychological Type (APT). (MBTI is a registered trade mark of CPP). This model of personality results in 16 different four-letter type descriptions. As noted in the referenced reading from Tagliaferre (2002), “None of the psychological types is ‘better’ or ‘worse’ than any other. Each type has something very valuable to offer to the world.” (pp.31) Since Jung noted that genetic traits of personality drive much of our human relations in groups, organizations, schools, and families, it would seem logical that understanding his theory could be useful in understanding grief better too.
Unfortunately, little research has been documented to support this notion. The Handbook of Bereavement: Consequences, Coping, and Care by Stroebe, Stroebe, Hansson and Schut (American Psychological Association, 2001) documents hundreds of studies but none of them relates grief specifically to personality factors. The Center for Applications of Psychological Type lists 103 reports relating type to stress, and six reports relating type to trauma, but none specifically related to grief. The work referenced by Tagliaferre and Harbaugh (2002) in Recovery From Loss is the most relevant for our purposes. Therefore, reading the designated text (pp31-54) will be necessary in order to process what follows. It also will be useful to visit the referenced web site and complete the questionnaire to determine your personal type, if you have not done so previously. Note: Recognize this and other unofficial forms are unvalidated and do not replace administration of the CPP authorized version by competent counsel.
Jung said the human personality had two functions, perceiving and judging and there were two forms of each. People use both sensing and intuition for perceiving, but they usually prefer one more than the other. People use both thinking and feeling for judging, but they usually prefer one more than the other. Further, they prefer to implement these functions either internally (introversion) or externally (extraversion.) Fully understanding of what these combinations means requires more explanation than presented here, so your further investigation is encouraged. Refer to Consulting Psychologists Press and the Center for Applications of Psychological Type.
The MBTI model of personality employs a questionnaire that enables identification of preferred forms of perception, either sensing (S) or intuition (I) and preferred forms of judging, either thinking (T) or feeling (F). Further, Jungian theory suggests these “functions” are ranked by preference uniquely in each type and are either extraverted (E) or introverted (I) in social relations where people exhibit their perceiving (P) and judging functions (J). Thus, a four letter combination results from four scales: E or I scale, S or N scale, T or F scale, and J or P scale.
Much of the foregoing discussion of gender issues in grief might be explained by variances in the MBTI types. For example, it has been reported that a national sample among women produced 25 percent who preferred thinking and 75 percent who preferred feeling in decision making. A national sample of men produced 56 percent who preferred thinking and 44 percent who preferred feeling. (Tables 7.14, 15 pp. 157-158, MBTI Manual, Third Edition 1998). This finding easily could explain the “men who grieve like women” (F) and the “women who grieve like men.” (T) Consider the observable differences between Hillary Clinton (T, assumed) and Laura Bush (F, assumed). Also, the common conflicts and intolerance between genders could be ascribed to combinations of “thinkers and feelers” who do not understand or accept each other. Differences on the other MBTI scales offer similar significance in bereavement among family members independent of gender.
Using this model as their basis Tagliaferre and Harbaugh described twenty “steps of grief” each related to one of the four functions relabeled as Physical/sensing, Intellectual/thinking, Emotional/feeling, and Spiritual/intuition. (table, pp.28) From their personal and clinical experience respectively, they propose that the model can help clinicians lead a client through the process of recovery by focusing on the tasks of acknowledge, feel, substitute, detach, and reconstruct using the coping skills that are most relevant to their type. Although presented linearly in a book, the authors emphasize that the tasks occur randomly and often in unexpected patterns. As with gender, they point out that grief reactions cannot be generalized, but possibly they can be related to personality-based tendencies. Having the model related to personality helps one to “go with the flow” so to speak during bereavement. For example, a man or woman who prefers introverted feelings may show reluctance to share them in a support group or to cry in front of the family. In extremes, they may “drown”his sorrow in drink or unhealthy avoidant behavior. Similarly, a woman or man who prefers extraverted sensing may be encouraged to pursue the desire to mitigate grief by traveling to new venues or actively participating in social events, art galleries, concerts and such. Both individuals can be seen to exhibit normal grieving for their type independent of gender.
Clinical observations reported by Naomi Quenk (1996) suggest that a traumatic experience accompanied by loss of control may momentarily disable one’s preferred functions, and so force them to rely on a backup personality mode, similar to putting in the second string quarterback when the star is disabled in football. For example, a person normally exhibiting S-T would shift more toward N-F or a normal N-T might shift to S-F. Unfortunately, the backup mode may not be well developed and could present childish or primitive behavior. Needed things may still get done, but possibly not as effectively, and some needed things could be overlooked. This could help explain changes in behavior expressed thusly, “What is the matter with (widow)...She is not acting like herself.” Support during this phase of grief can help one to avoid social complications, such as relocating, remarrying prematurely, inadvisable sexual encounters, or investing inappropriately, until normal functions return. This could take months or even years. When you are distressed, there is great comfort in feeling that someone understands what you are going through.
Some validation of this approach was reported by Tagliaferre, using the Coping Resources Inventory constructed by Alan Hammer (Table 2.2, pp.52). (Out of print.) It is seen that the ENFP type, which prefers extraverted intuition with introverted feeling, scored highest on coping resources in terms of cognitive, social, emotional, spiritual, and physical strategies. The INTP type, which prefers introverted thinking with extraverted intuition, scored lowest. It is useful to note that Tagliaferre reports his type preference as INTP. This is the type reported least equipped to deal with grief, with the highest need to seek replacement of structure and control in his life after loss. Hence, his need to develop the model for 20 Steps of Grief after untimely death of his wife.
Understanding the Tagliaferre-Harbaugh model of grief work might help families deal with the inevitable storm of conflicts that emerge in grief and provide counselors with tools for shaping their treatment to fit the person. It might also help to prevent suicide if the bereaved is totally overcome in extreme situations. One reviewing widower noted, “How can you review a book which had no small part in saving your life? I lost my 36 year old, vibrant and beautiful wife to a hit and run (she was a pedestrian) and read dozens of books as part of my healing process. Many had to do with “grief work.” If I had to point out one book which had the most positive influence on me in the healing process and was the most comforting, it would have to be Recovery from Loss. The pain and grief shared by Mr. T (sic) after the loss of his own wife after 32 years of marriage was so heartrending and relevant to what I was going through, it felt at times as if he read my mind. There is grief work, spirituality, the communion of man and the pain of a man in just the right proportions.” (Amazon.com)
Much additional work is needed to validate these assumptions, but this material does show at least how some personalty factors may be both exhibited in grief and used to help facilitate recovery, as well as to help explain some reported gender implications.
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