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For Your Library

Beyond Kübler-Ross: New Perspectives on Death, Dying and Grief edited by Kenneth J. Doka and Amy S. Tucci, Hospice Foundation of America, 2011.

Elizabeth Kübler-Ross' five stages of grief-denial, anger, bargaining, depression, and acceptance-found in her book, On Death and Dying, published in 1969 have had remarkable staying power. Although these stages came from her clinical observations and were never validated by her or anyone else's research, this five-stage approach to understanding grief continues to be taught and understood as the standard approach for many still today. Fortunately we have learned a lot about grief and mourning since 1969 and this book does a very effective job of summarizing many of the important insights gained about our response to loss in the past forty plus years while giving credit to Kübler-Ross for being the pioneer that she was. In the nine chapters of the book, stage and task models of grieving are compared and contrasted, ideas of post-loss growth are explored and cross-cultural perspectives of grief are considered. In the very useful concluding section on "implications for practice," contemporary conflicts in the current "grief world" are discussed regarding the diagnosis of "complicated grief" proposed for the coming DSM-5 and whether or not grief counseling is helpful, harmful or of little use. Robert Neimeyer's closing chapter, From Stage Follower to Stage Manager: Contemporary Directions in Bereavement Care will be appreciated by counselors and therapists looking for ways to apply some of the newer insights in their work with grieving people. This is a brief book-only 152 pages-but it covers a great deal of needed ground for those wanting to take advantage of the grief insights gained since Kübler-Ross gratefully brought the discussion of death, dying and grieving front and center. We owe her a great debt for her pioneering work, and yet as Ken Doka remarks in his introduction to the first section of the book, "would a cancer patient wish to be treated by an oncologist steeped in the approaches offered in 1969?"

The Other Side of Sadness: What the New Science Tells Us About Life After Loss by George A. Bonanno, Basic Books, 2009.

One of the paradoxes when thinking about the grief that comes in response to death is that while many of those who have written about it, both professionally and personally, describe an overwhelming experience and struggle with finding a way to live it death's aftermath, most people find ways to cope and live well without needing the assistance of professionals, support groups, medication, etc. The death of an important person in our lives is undoubtedly a significant and challenging event but most of us find a way through to living well on the other side. George Bonanno has been intrigued by this puzzle and spent his professional life researching the experience of grief, especially in the Western world. What he has found and written about in this very accessible book is that many of the concepts that have often been taken for granted as true-concepts like "grief work", stages of grief, the need to fully explore a loss in order to detach from the person who died-do not hold up to objective scrutiny when researched. What he has found is that most people are resilient and that humans are wired to grieve and cope in adaptive ways. This doesn't mean, he asserts, that there are not those who struggle mightily and chronically and deserve special assistance. Most of us find a way with the internal and external resources we possess when the death occurs but this is not the story that is usually told. In his exploration of our responses to death, Bonanno brings a researcher's perspective to experiences of relief and laughter, enduring connections with the dead and the possible influence of underlying death anxiety in our society. As a scientist and researcher, he is skeptical about concepts of an afterlife but writes about the different ways that cultures consider an afterlife and an ongoing relationship with the dead and how these different approaches may affect grief experiences. Along the way he explores Chinese bereavement rituals which he describes from the outside and also the inside as he meaningfully participates in a ritual in honor of his deceased father. Bonanno's work and writing are and have been an important contribution to our understanding of grief and his writing style is engaging and thoughtful.

Two quotes are especially worth repeating-one from Bonanno in his first chapter and one from a mother whose adult daughter died and whose experience is referenced throughout the book (along with other case examples):

If we understand the different ways people react to loss, we understand something about what it means to be human, something about the way we experience life and death, love and meaning, sadness and joy. (Bonanno)

It's a bit like a fading light. It grows dim but it never goes out, never, not completely anyway. I find that enormously reassuring. I used to worry that someday the light would disappear-that I would forget, and then I would have really lost Claire. I know, now, that doesn't happen. It can't. There is always a little flicker there. It is a bit like the small glowing embers you see after a fire dies down. I carry that around with me, that little ember, and if I need to, if I want to have Claire next to me, I blow on it, ever so gently, and it glows bright again. (a mother's response to the question of what bereavement feels like years after the death of her daughter)

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