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Grief Perspectives
Research that Matters
Professional Bookshelf


Beverley Raphael
An Influence from "Down Under"

By William G. Hoy

Editor’s Note: During his 30th year of practice, Bill Hoy is profiling some of the people who have had a significant impact on his work. This is the third in that occasional series.
 
Not too many years after publication in 1983, I discovered Beverley Raphael’s fine volume, Anatomy of Bereavement. Through her books, papers and conference addresses, this Australian psychiatrist has had a seminal influence on my work for most of my career. Today, Dr. Raphael serves as Professor Emeritus in the medical school at University of Western Sydney.
 
As most readers of this newsletter know, my fascination for most of my career has been the role viewing of the body has in grief outcomes. It was likely Beverley Raphael who first suggested this connection to me. In Anatomy of Bereavement, she referenced a study she and Bruce Singh had completed after the 1977 Sydney rail disaster. Among several other findings, they noted that those who had viewed the bodies of their mostly young adult dead fared better long-term than those who did not (Singh & Raphael, 1981).
 
The emphasis of much of my early training had pointed in exactly the opposite direction. In a 1979 conference I attended, I was first introduced to the idea of separating the body from the ceremonies surrounding death. This influential leader of my faith denomination suggested that we should bury or cremate the body first and then hold a memorial service so that people could focus on their worship of God, a refrain I have heard about a million times in the last 35 years! Raphael provided data to counteract this religious leader’s opinion. I was hooked.
 
In addition to seeing the body, Raphael along with her colleague, Bruce Singh reached the data-informed conclusion that perceiving one’s social network as supportive was also predictive of a good bereavement outcome. Certainly, Raphael was not the first clinical scholar to suggest social support as a significant factor in grief but for me, she was the first who got my attention. Perhaps we are most attracted to the people whose conclusions confirm our own!
 
Beverley Raphael’s professional life has long been dedicated to understanding and helping people bereaved by traumatic circumstances. Even though much of her vocabulary and even some of her concepts (such as “stages of grief”) are now dated and no longer in lockstep with today’s standards of practice, her contribution to our field—and to my professional life—have been invaluable.

Reference:
Singh, B. & Raphael, B. (1981). Postdisaster morbidity of the bereaved: A possible role for preventive psychiatry? Journal of Nervous and Mental Disease, 169 (4), 203-212.

Author:
William G. (Bill) Hoy is an educator, counselor and author who has specialized in end-of-life and bereavement care for nearly 30 years. Dr. Hoy’s passion is equipping the next generation of physicians and other healthcare professionals through his research, writing and teaching responsibilities on the clinical faculty in Medical Humanities at Baylor University. His newest book is Do Funerals Matter? The Purposes and Practices of Death Rituals in Global Perspective (Routledge, 2013).

Harrington, C. & Sprowl, B. (2011-2012). Family members’ experience with viewing in the wake of sudden death. Omega: Journal of Death and Dying, 64 (1), 65-82.
 
Hamilton, Ontario social workers Christina Harrington and Bethany Sprowl conducted in-depth interviews with 16 individuals bereaved by the sudden death of a loved one to discover the salutary effects of viewing of the body. All but one of their participants expressed an “instinctual need or drive to view” (p. 75) and the sometimes poor condition of the body was not significant in the mourners’ choices. Participants seemed most appreciative of multiple opportunities to view the remains, including at the scene (when possible), in the hospital, and in the funeral home.
           
One interesting element in this study was the sense on the part of many informants that they needed to “take care” of their loved one during the early hours of transition from death to life. One mother described her regret at not holding her son at the accident scene, in spite of information that he died instantly. “Maybe he was still there inside…waiting for me, waiting for his mother to just come by and hold him” (p. 76).
 
This finding parallels the principle of liminality described by early 20th century anthropologist Arnold van Gennep. Liminal refers to the notion of a threshold, being “neither here nor there” but rather, in an in-between state. According to van Gennep, during the early days after a death, mourners have difficulty describing the actual location of the dead. In other words, people are not sure whether to describe them as dead or alive, and in fact, during this period, they are psychologically “both and neither.” An example most caregiving professionals have witnessed is that widowed people generally cannot see themselves as either married or single in the early hours or days after a spouse’s death, and almost never describe themselves in this early period as “widowed.”
           
Harrington & Sprowl concluded that evidence from their interviews reaffirmed the importance of viewing the body for families after sudden death, regardless of the condition of the remains. Acknowledging that some religious and cultural groups (traditional Judaism and Islam among them) do not view the body, these two social workers make a valid case for why the opportunity must be given and the potential benefit such viewing can have for family members of the deceased.
 
Research based on in-depth interviews belongs to the larger genre of “qualitative research.” As such its results are sometimes seen as less “scientific” because the pool of informants is small. The reason qualitative methods are often used in social science research, however, is because of the nuances of experience that appear in the “story” of the respondent; many of these details would never become apparent in the questions asked on any survey, even when conducted under the most exacting of scientific conditions with hundreds (or thousands) or research participants.
 
Members of the Association for Death Education & Counseling members can read this article for free as a member benefit in the “Members Only” section of the ADEC website at www.adec.org.

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Hoy, W.G. (2013). Do Funerals mMatter? The Purposes and Practices of Death Rituals in Global Perspective. New York & London: Routledge.
 
Editor’s Note. This month GriefPerspectives welcomes the book review contribution of Kevin O’Neill. Dr. O’Neill is professor emeritus of philosophy at California’s University of Redlands.
 
Bill Hoy’s remarkable book combines elements that one would not expect to find coexisting happily within a single set of covers. First, this book will introduce the layperson to the concept of how to perform proper grief rituals by offering a five-part template that could prove extraordinarily useful if one is faced with the sad responsibility of dealing with the death of a loved one or close family member. In any case the template can help us to a much richer understanding of funerals, and a way to assess how they work. In addition, this template will prove useful to funeral and other death professionals, as well as to grief counselors, when they are helping people through the complex process of saying proper farewells to the dead.
 
Hoy discusses the various aspects of a proper disposition of the dead, covering the need for community involvement, a respect for historical traditions and heritage, the introduction of meaningful ritual actions and symbols, and a respect for the personal integrity of the deceased, who is in transition from one state of being to another. His remarks are especially useful because of the sophisticated and open-minded cross-cultural perspective that he brings to the issues he discusses—Hmong who settled in southern California after the Vietnam War, Luo tribes people of Kenya, North American Roman Catholics, and especially sensitive and detailed descriptions of Jewish rituals and customs. His own Southern Baptist upbringing and his work in the field of grief counseling also make him sensitive to the needs and feelings of North American Protestants. People from many traditions will feel comfortable with Hoy’s understanding of death and its rituals; grief professionals cannot help but benefit from his suggestions about how to honor cultural differences.
 
But his book is more than even this. Remarkably, his later chapters extend his study beyond the five-part template to include knowledgeable and well-argued discussions of controversial aspects of American funeral practice. His chapter on cremation is a revelation to the non-specialist. Hoy effortlessly details the technical, financial, and social complexities of American cremation into a way that makes the entire question clear and intellectually manageable. He follows that with a brilliant chapter in which he takes up the question of whether American funeral directors and cemetery managers are the venal charlatans portrayed by Jessica Mitford. Hoy is not an uncritical proponent for the American funeral industry but he makes a complex and plausible case that this industry offers a reasonable and socially beneficial set of services at a reasonable if not low price. In this chapter his voice shifts from anthropological analysis and/or discussion of cremation practices to a voice that is comfortable with the discussion of profit margins and capital investment.
 
Hoy follows this with a chapter filled with advice for grief professionals, making an excellent case that proper ritual disposal of the body has an important role to play in a healthy relationship to the process of grieving.
 
It is, as I said earlier, remarkable to find so many topics covered with such proficiency and competence in a single volume. As a philosopher and death theorist, I would obviously prefer the earlier chapters—especially Chapter 6 which discusses how corpses are represented in culture—but I found the later chapters very useful in giving me a more balanced understanding of funeral customs. I therefore recommend this book without a single reservation.


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