Unit 2 -- The Family Context

Grief in a Family Context --HPER F460/F560

This unit underwent a major revision in 2001.

Goals for this Unit

As we saw with the grief of individuals, grief in the family context is approached from a variety of perspectives. The intent of this unit is to address several of these, providing you with the opportunity to consider and apply these perspectives. We also continue to explore cultural diversity, here in relation to the way in which grief is played out in the family context.

Preliminaries

Some things to think about as you work on this unit:

Readings

Anthology

Gilbert, K. R. (1995). Family loss and grief. In R. D. Day, K. R. Gilbert, B. H. Settles, & W. R. Burr, (Eds.), Research and theory in family science (pp. 304-318), Pacific Grove, CA: Brooks/Cole Pub. Co.

Gilbert, K. R. (1996). 'We've had the same loss, why don't we have the same grief?' Loss and differential grief in families. Death Studies, 20, 269-283.

Lipton, S. T. (June 30, 1995). The mourning gradient. Ethnic News Watch, 60-.

Web Resources

Bereavement and Grief Advice for Family and Friends who Mourn a Loss and Death -- http://www.finalarrangementsnetwork.com/free_help/grief_help.htm

"Lecture"

For the most part, our understanding of grief concentrates on the grieving individual. In general, the family is seen as a supportive resources for bereaved family members. This has provided a limited sense of how family members deal with multiple roles and varied pressures in the grieving process.

Grief in families is a complicated thing, because each person must deal with his or her own grief while also coping with that of others in the family. When the loss affects all family members, the expectation may be that others in our family will be supportive and understanding. After all, they have experienced the same loss, haven't they? In the case of the loss directly affecting only one (or few) family member, do others grieve too, and what exactly is it that they are grieving over? How far does this "secondary" grief extend beyond the primary griever(s)?

Loss in families can be tremendously painful and can contribute to the breakdown of the family system. It can also serve as a catalyst for positive change. These positive effects can be facilitated in a number of ways and these will be addressed throughout the course.

The Effects of Loss on the Family System

With the loss of a family member, the family system will change. Family structure is modified as a result of the loss and the family system must be reorganized to adapt to that change. If the person who is now gone had played a central role in the functioning of the family and the family is relatively rigid in identifying that specific individual in that role, adaptation to the loss will be made more difficult. If they are more flexible, adaptation will be made easier.

Much work in this area focuses on the mutual loss of a family member, but families also are indirectly affected by the loss experience of individual or few family members. Impacts of the loss may spread through multiple generations in the family and may not be restricted to the generations that directly experience the loss. Grief has an effect across multiple generations and within the extended family culture. Although these familial effects are often thought of as negative, they need not be. For example, previous successful experience with a loss can provide families with shared coping resources as well as perceptions of family competence.

Before I go on to describe a variety of aspects of family systems, I'd like to define what a system is: A system is an ordered composition of elements in a unified whole and the whole is more than the sum of its parts (Simon, Stierlin & Wynne, 1985). A systems perspective, in looking at grief, considers the way relationships within the family and among family members as well as the relationship between the family and other elements of the social environment influence individual and family bereavement. 

Considering The Family as a System

I would like to address some important concepts from family systems theory before I go on to other aspects of the family context of loss. These concepts have particular relevance to grief and family systems. I would like to point out that there are many other conceptions of families as systems, and variation in how these concepts, listed below, are defined. Feel free to contact me for suggestions on other approaches to systems. But, for a starting point in our discussion, we will use these concepts, defined as follow:

As a system, the family exists in paradox. It needs stability so that family members know their roles and can carry them out with the security that they are "doing it right." Stability provides continuity over time. At the same time, the system needs to be able to adapt to the changes in and among family members. The result is a balancing act. If there is too much change, the system breaks down; if too much stability the system atrophies and dies away.

Family systems theory has been useful as a tool for creating explanations for patterns of behavior seen in families. It has come under increasing criticism, primarily because of its neglect of the individual in the family. In addition to the possible loss of the individual in family systems, suggested by others, Rosenblatt (1994) has critiqued metaphors used in family systems theory while suggesting creative ways of reconceptualizing these metaphors. I strongly recommend his book.

Family as a Context for Creating and Maintaining Meaning

Grief takes place within a social context and in order to reconstruct the assumptive world and create a view of a stable reality which can be trusted, one must compare his/her perception of reality against the views of others. This social construction of their changing view of reality appears to be an essential element of the grief process.

The family is an important resource in this social construction after loss. In fact, people are embedded in an ongoing process of definition within the context of the family. On a daily basis, family members validate each others' view of reality, often without awareness that this is going on. As they encounter new information, they compare and attempt to confirm beliefs, opinions, hunches, and theories. If family members confirm one another's subjective views of each other and the situation, these subjective views are then given objective reality. By that I mean that what they perceive comes to be seen as real because significant others also see it that way; if not, they question their own or the other's perceptions and formation of an objective reality is made more difficult.

As you will recall from Unit 1, the need to create a new, trustworthy view of the world is a driving force after a loss. Ambiguity is uncomfortable, even frightening, and the urge to find certainty and to have it confirmed by others we trust is quite strong. Where a loss has occurred, if the family is able to develop a shared view, ambiguity about who and/or what has been lost is reduced. Family members who can do this have a better sense of how they are to cope with that loss and how they are to move forward with their lives. Shared meaning also facilitates positive communication, provides structure and meaning to their interactions, and serves as the basis for family coping.

An important point to remember here, as we address "shared" views, is that families do not actually hold beliefs; families are a collection of individuals held together by, among other things, a sense among its members of commitment, history and the promise of a future. So when we talk about "shared views" in families, we are demonstrating the need for a socially confirmed reality. As members of a family, we assume that others see things as we do based on our observation of and interaction with other family members. We may, in fact, be inaccurate, but as long as our belief in a shared view is not confronted by contrary information, that belief continues to be held. I found in separate interviews with marital partners that they frequently made assumptions about shared beliefs that were not held by the other partner. You may have already noted this, but this is the central idea I present in the article "We've had the same loss, why don't we have the same grief?"

At the same time they feel a need for a shared view, family members may all find themselves overwhelmed by the loss. Each has unique issues to address as they grieve and this diminishes their ability to verify each others' view of the loss. Thus, paradoxically, family members actually may be more likely, at first, to recognize differences, rather than the similarity they desire. One possible explanation for this awareness of differences actually may be the drive to find a shared view. The difference between what they expect and what they encounter may exaggerate the differences.

As I have indicated above, one consistency in clinical and scholarly literature is that the drive for a shared family view is powerful and a lack of one is painful for family members. Logically, the push should be for consistency. Yet, trying to establish a single view may be counterproductive. Consistent with Shapiro's view on family communication, it may be best to recognize that there are aspects of the loss that are open to discussion and confirmation within the family and others that are not. Figley (1989), in proposing the "family healing theory" as a single, unifying healing theory, also recognizes that family members may agree to disagree about certain aspects of the loss.

Family Development and Grief

Shapiro (1994, 1996) Takes a social developmental approach that is also sensitive to cultural variation to how families develop. Family development addresses the process of change in the family system. It takes place interactively with development and change of family members. As individuals develop, they find themselves torn between the connections of their family and a need to focus on their own, individual needs. In a sense, they need to be a part of the family while also being apart from it. This fits with the forces in the family system that simultaneously pull between stability and change, mentioned above in the section on family systems.

Some changes in families are considered normative events because can be anticipated and planned for (e.g., marriage, births, retirement). Others, non-normative events, can not be anticipated, are unusual and result in unexpected change. These are more likely to be experienced as crises and are more likely to result in the family life course being changed (e.g., divorce, death of a child). Some events that could be considered as normative at one age (e.g., the natural death of a parent when s/he is 85 years old and in ill health) might be experienced as untimely or out of sequence at another time (e.g., the accidental death of a parent when s/he is 30 years old and in good health).

A variety of models of normative change have been suggested, the most commonly mentioned of which is the "family life-cycle" which moves from dating, through the rearing of children, to the death of one spouse. Unfortunately, the number of families that meet this "normal" model is extremely small, reducing the utility of this model. The complexity of family life within the context of a wide variety of family forms suggests that it would be best to think of development as a process of change and adaptation rather than a set of "normal" elements.

Because grief reconciliation is a long-term (some say never-ending) process, normal development in the family may act as a complicating factor. This is due to the fact that, even as the family members must cope with the loss, they also are going through developmental changes as individuals and as a family. Various developmental tasks are tied to one's individual stage of development as well as the stage of family development. Individuals will have different developmental tasks to complete, as well (This will be addressed in greater detail when we discuss developmental issues in the next few units.).

Families at different points in their evolution will have different strengths and weaknesses. A newly married couple, for example, will have very different resources to draw on than a couple who have been married for over 25 years.

Development of the family may be affected by a loss far into the future. Later life transitions or other stressors may bring family members back to the pain and memories of earlier losses. Often I have spoken with family members who talked about "supposed to" times or "should have been's"-- These are characterized by statements like "When the next Christmas came, it killed me. We were supposed to be together at Christmas," or "I woke up in the morning, ready to go to Luci's graduation with such mixed feelings. John wasn't there and he'd never be there. He was such a good dad. He should have been there."

A loss can affect family development into future generations. Transgenerational effects of loss have been explored by Bowen (1991), who found through his practice of therapy that unresolved loss can have long-term implications for the family. His contention is that loss disrupts normal family process and this can extend into future generations if it is not resolved. The experiences of Holocaust survivors and their descendants are well-documented examples of transgenerational effects.

The Family as a Resource after Loss

In addition to viewing the impacts of loss on families and family functioning, we can also look at the family as it acts as a resource for individual family members. The family often is seen as the first source of social support, and, in fact, people are most likely to turn to their families for support when in crisis. Not all families are equally capable of providing this support. If social support is available and accepted, it can reduce stress on the bereaved while simultaneously allowing the helper to feel useful and more capable. Thus, if each family member is able to communicate his/her need for support while, also indicating his/her availability to provide it, family members can give each other that support as well as share in the collective coping experience.

Although the family often serves as the primary source of support during times of great stress, the reality is that providing such support is difficult, at best. More often than not, the ideal picture of the family is tempered by pressures on the family and its members. Support frequently does not come easily, it may be positive or negative in its impact, or it may not come at all. This is because family members, in broad context, are coping with their own loss issues as well as the loss issues of others in the family. Later in this course, when we cover roles and relationships, we will address the nature of support in families and why family members actually may be the least capable of providing support.

Family Tasks of Grieving

Walsh and McGoldrick (1991) have proposed that, in order to successfully adapt to a loss, the family must to achieve these tasks:

According to Walsh and McGoldrick, open communication is essential to completion of these tasks. This process may be slow, as each family member has strong needs and limited resources after a loss. Family members, who are already more emotional, may not recognize each other's different grief styles as legitimate. Rituals (e.g., funerals, religious rites, family holiday rituals) can be used to facilitate the process of recognition, reorganization, and reinvestment in the family. At the end of this course, we will address the use of ritual and ceremony in greater detail.

General Conclusions

We have several ways of looking at families as they grieve, all of which have strengths and weaknesses. The systems view allows us to look at broader patterns in the family than we could see if we considered only the perspective of each family as an individual, without taking into account the broader family context within which they live. At the same time, we must retain our awareness of the individual, particularly when we consider the attribution of meaning as an element of the grief process.

Development, both of individuals and family systems, is one of the more important and overlooked aspects of family grief. This may be related to the tendency among most family systems theories to concentrate on the "here and now," rather than to think in historical terms. Yet, grief extends far beyond the weeks, months, or even years, that it was traditionally seen to last and people do not enter a developmental vacuums as they work through their grief. Both interact to influence each other.

In looking at the tasks of grief described by Walsh and McGoldrick, one thing that strikes me is how important it is to have a stable, supportive family system in order to resolve the grief of the family members. Yet I know that pressures on the family system are tremendous after a loss. Family members must contend with outside as well as inside pressures and may feel that, somehow, there is a sense that they "deserve" their loss. They may even feel this way themselves, adding to their stress.

Finally, the readings for this unit listed a number of factors that contribute to the complexity of grief in families. We will be using the remainder of this course to address several of these contributing factors.

Questions for Discussion

Post your response to the following questions on the Class Discussion

  1. Walsh and McGoldrick recommend open communication for successful completion of the family tasks of grieving (listed above). The communication style in some cultures, though, is one of veiled communication and limited direct sharing of emotions (e.g., Asian cultures). Do you see this "task" focused model of grieving to be appropriate in families from these cultures? How so?
  2. After reading and considering the readings and the lecture, respond to this statements: "Families don't feel. Families don't think. Families don't grieve. Only individuals do these things."
  3. Starting in this unit, I'd like you to go back at the end of the week and identify at least one "take away" message you took from the readings, lecture and class discussion.

Sources

Boss, P. (1999). Ambiguous loss: Learning to live with unresolved grief. Cambridge, MA: Harvard University Press.

Bowen, M. (1991). Family reaction to death. In F. Walsh & M. McGoldrick, (Eds.), Living beyond loss: Death in the family (78-92). New York: W. W. Norton & Co.

Bowlby-West, L. (1983). The impact of death on the family system. Journal of Family Therapy, 5, 279-294.

Burr, W. R., Day, R. D., & Bahr, K. S. (1993). Family science. Pacific Groves: CA: Brooks/Cole.

Chubb, H. (1990). Looking at systems as process. Family Process, 29, 169_175.

Cook, A. S., & Oltjenbruns, K. A. (1989). Dying & grieving: Lifespan & family perspective. New York: Holt, Rinehart and Winston, Inc.

DeFrain, J. D., & Ernst, L. (1978). The psychological effects of Sudden Infant Death Syndrome on surviving family members. The Journal of Family Practice, 6, 985-989.

Figley, C. R. (1989). Post-traumatic family therapy. In F. Ocher (Ed.), Post-traumatic therapy (pp. 83_109). New York: Brunner/Mazel.

Fowlkes, M. R. (1991). The morality of loss: The social construction of mourning and melancholia. Contemporary Psychoanalysis, 27, 529_551.

Gilbert, K. R. (1996). 'We've had the same loss, why don't we have the same grief?' Loss and differential grief in families. Death Studies, 20, 269_283.

Imber-Black, E., & Roberts, J. (1992). Rituals for our times: Celebrating, healing, and changing our lives and our relationships. New York: Harper Collins.

Krauss, M. W., & Jacobs, F. (1990). Family assessment: Purposes and techniques. In Meisels, S. J. & Shonkoff, J. P., (Eds.). Handbook of early childhood intervention. (pp. 303_325). New York, NY: Cambridge University Press.

McCubbin, H. I., McCubbin, M. A., Thompson, A. I., Han, S. Y. & Allen, C. T. (1997). Families Under Stress: What Makes Them Resilient. [Available on-line: http://www.cyfernet.org/research/resilient.html].

McCubbin, H. I., & Figley, C. R. (1983). Bridging normative and catastrophic family stress. In H. I. McCubbin & C. R. Figley (Eds.), Stress and the family: Volume I: Coping with normative stress (pp. 221_228). New York: Brunner/Mazel.

McGoldrick, M., Almeida, R., Hines, P. M., Rosen, E., Garcia-Preto, N., & Lee, E. (1991). Mourning in different cultures. In F. Walsh & M. McGoldrick, (Eds.), Living beyond loss: Death in the family (pp. 176-206). New York: W. W. Norton & Co.

Minuchin, S. (1974).Families and family therapy. Cambridge, MA: Harvard University Press.

Peppers, L. G., & Knapp, R. J. (1980). Motherhood and mourning: Perinatal death. New York: Praeger.

Rosenblatt, P. C. (1994) Metaphors of family systems theory: Toward new constructions. New York: The Guilford Press.

Rosenblatt, P. C., Spoentgen, P., Karis, T. A., Dahl, C., Kaiser, T., & Elde, C. (1991). Difficulties in supporting the bereaved. Omega, 23, 119_128.

Satir, V. (1988). The new peoplemaking. Mountain View, CA: Science and Behavior Books, Inc.

Shapiro, E. R. (1994). Grief as a family process: A developmental approach to clinical practice. New York, NY: Guilford Press.

Shapiro, E. R. (1996). Family bereavement and cultural diversity: A social developmental perspective. Family Process, 35, 313_332.

Simon, F. G., Stierlin, H., & Wynne, L.C. (1985). The language of family therapy: A systemic vocabulary and sourcebook. New York: Family Process Press.

Stierlin, H. (1973). Group fantasies and group myths–Some theoretical and practical aspects. Family Process, 12, 111-125.

Walsh, F. & McGoldrick, M. (Eds.) (1991). Living beyond loss: Death in the family. New York: W. W. Norton & Co.

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