Friday, March 1, 2013

Hospice, grief and bereavement: how families heal

This is a press release from the agency for whom I work. I am a volunteer, as are about 85 people in my region. It is best to contact your local hospice for free assistance in your region.

BEREAVEMENT:  HOW FAMILIES HEAL                                                                                                                                                                                                                                            February 2013
By Hospice Volunteer, Barbara Carroll

In bereavement, the primary focus is on individual grief and healing but grief is also a family process, and just as individuals need to heal, so the family as a unit needs to heal. Families are systems that have their own life, over and above the individuals they contain. Family systems are governed by principles such as: anything that affects individuals in the family affects the family as a whole; families work to keep themselves in a state of equilibrium that allow them to function smoothly; and, whenever an element is either added or taken away from the family it becomes unbalanced.  Then the family works toward restoring a new and effective steady state.

The family unit is defined by the roles family members play and the relationships defined by those roles. To understand how families heal after the loss of a family member we need to look at what happens to family roles at such a time.  When a family member dies a major element is missing from the family system. The death means that all the roles that person played in the family are now vacant and need to be filled before a family heals and returns to a new way of functioning effectively. This process is called role reorganization.  At a family level, the impact of a member’s death is therefore directly related to the number and type of roles that person played.

When we think of the roles a person plays in a family, we think first of the most obvious, the task related roles such as:  cooking, yard maintenance, laundry, taking care of younger siblings, managing the investments, picking up children from day care, or organizing family social events.  Less obvious are the emotional roles such as: Emotional Stabilizer, Humorist, Peace Keeper, or Rebel. These roles are crucial because they allow families to function smoothly despite the inevitable family problems.  An example might be an emotional stabilizer who works to contain the extreme levels of anxiety in an emotionally unstable spouse.

Some roles that are lost after a family death are relatively easy to fill.  These include many of the functional roles described above.   After the death of a father who drove his son to hockey practice, for instance, the boy’s mother may assume the task.   Even this example may not be trivial, however.   For the son, the father’s role may have been to drive to hockey.  For the mother it may have been the only time she had to herself during the week.  Following the death of his father, the son may be looking for someone to drive him to hockey and the mother may be looking for someone to assume a role that will give her a little time to herself.

Other functional roles are harder to fill and these are typically roles that involve specialized skills that are beyond the capacity of other family members.  These may include roles such as managing the family investments, using a tractor to mow a large lawn, or getting groceries when there is now no driver in the family. These difficulties will be magnified in families dealing with factors such as disabilities, major health issues, or poverty.

Perhaps the most problematic roles to fill are those emotional roles that help a family function despite their family problems.   To return to the example of the emotional stabilizer above, it may not be easy for children of any age to take on the role of containing Mom’s anxiety when her emotional instability may have left them with a need to protect themselves from that anxiety. 

As families struggle to reorganize family roles their first attempts may not be ideal.  Role reorganization is a process that occurs over time.   It requires that surviving family members cooperate and compromise, and this is by no means straightforward as members move through their own individual grief processes.  A new family balance comes little by little.   As roles are reorganized, initially, the new family system may seem second best.  Over time, however, it comes to be treasured as the new normal, the new way in which the family functions smoothly to get everything done and meet members’ emotional needs.   Most families do complete this healing process, each in their own way and in their own time.   They do so by drawing on the bonds of mutual love, support, caring, and comfort, and because it is what family’s do – they survive.  When they are destabilized by death, they work to move towards a role reorganization that works for them.

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