Up until the time my father died when I was 17 years old, I had witnessed tears in his eyes on only two occasions. The second was during a time of life-threat to one of our family members. It reflected the well-known dynamics that operate when one confronts the possibility of the death of a dearly beloved other with whom a deep and personally meaningful and reciprocal attachment has been sustained, and when that loss specifically threatens the very structure, stability, and continued existence of one’s intimate family group. Countless publications have been devoted to the analysis of this experience, informing the wider mental health community in general and the disciplines of thanatology and traumatology specifically. There have been many concepts and terms to describe what my father underwent.
In contrast, the first occurrence manifested a phenomenon that heretofore has not received even the smallest fraction of the attention accorded to individual responses to threatened and actual loss. It was in reaction to the death of someone my father did not personally know, yet experienced by him as a significant enough event to generate the type of public sorrowful behavior that I was to observe only once more in his lifetime. This initial incident was the funeral of the assassinated President John F. Kennedy in 1963. My father’s response was, I now know in retrospect, the first and, for me, one of the most potent examples of group survivorship. Up until now, there has been insufficient conceptualization and an absent lexicon to describe what I observed with him. The process simply has not been the subject of concerted investigation and in-depth examination. Thanks to Ellen Zinner and Mary Beth Williams, this oversight has been corrected with When A Community Weeps: Case Studies in Group Survivorship.
The phenomenon of group survivorship involves a fascinating interplay of factors specific to the individual and to his/her community, which operate as the individual contends with the death of one or more members of the group. Given the requisite experience of death loss, concepts of trauma are necessarily relevant in group survivorship. This is true even following deaths that are not unexpected, violent, horrific, preventable, or that personally expose one to life threat or grotesquerie. This is because postdeath acute grief, even that which is relatively benign, can be legitimately viewed as a form of traumatic stress reaction (Rando, In press). Arguments for this revolve around each of these two processes having inherent involvement with loss, being significantly associated with anxiety, and sharing six broad areas of similarity. For both acute grief and traumatic stress— whether or not criteria are met for diagnosis of posttraumatic stress disorder, acute stress disorder, or any other mental disorder recognized in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV, 1994)—two tasks are presented to the affected individual: trauma mastery and loss accommodation (i.e., healthy mourning).
For both individuals and groups (construed herein, as in systems theory, to be more than merely the sum of the members), a trauma can be considered to be any experience generating intense anxiety too powerful to be assimilated or dealt with in typical fashion, overwhelming the individual or group and engendering feelings of loss of control, helplessness, and other flooding affects. Frequently, it is accompanied by the shattering of fundamental assumptions on which life has been predicated (Janoff-Bulman, 1992). In instances of traumatic bereavement, these coincide with other violations of the mourner’s assumptive world pertaining either to specific assumptions about the deceased or to global assumptions about the self, others, life, or the world in general (Rando, 1993). Such violated assumptions comprise some of the many psychosocial “secondary losses” (Rando, 1984) that develop consequent to a death and create additional loss and trauma for the mourner.
It is fair to say, theretofore, that in all trauma there is loss, and that in most loss there are at least some dimensions of trauma. This means that group survivorship inherently incorporates both experiences of loss and traumatization. These experiences—and their ensuant grief/mourning and traumatic stress— depend upon the unique constellation of dozens of specific factors operating to influence the situation, the individuals, and the group. It may also involve the experience of vicarious bereavement, which alone or in combination with other processes adds to the interesting complexion of group survivorship.
As a social phenomenon, one of the ways in which group survivorship can be analyzed is according to whether or not the deceased member(s) was personally known by the surviving members. Elsewhere I have written about the concept of vicarious bereavement (Rando, 1997). I address it here because of its strong relevance in many cases of group survivorship. As I had conceptualized it, vicarious bereavement refers to the experience of loss and consequent grief and mourning that occur following the deaths of others not personally known by the mourner. The three psychological processes necessary for its development are empathy, sympathy, and identification.
Two types of vicarious bereavement exist. In Type I, losses to the mourner are exclusively vicarious, and are mildly to moderately identified with what is being experienced by the actual mourner (e.g., the vicarious mourner feels that this is what it must be like to be in the actual mourner’s position). In Type II, in addition to the vicarious losses being identified with, there are personally experienced losses. These develop as a consequence of (a) relatively intense reactions to the actual mourner’s loss (e.g., the vicarious mourner feels quite personally shocked, shaken, and adversely impacted in response to the actual mourner’s experiencing the traumatic death of a loved one), and/or (b) any assumptive world violations sustained by the vicarious mourner. These violations may occur either because of heightened identification with the actual mourner (e.g., the vicarious mourner so identifies with the actual mourner that he/she experiences a shattering of his/her own sense of parental control when the actual mourner’s child is killed) and/or traumatization of the vicarious mourner secondary to the circumstances of the death under which the actual mourner had lost the loved one (e.g., the vicarious mourner becomes traumatized by the violent and mutilating death of the actual mourner’s loved one, and consequently experiences personal assumptive world violations, such as a loss of security). Although the term vicarious bereavement may seem a little bit of a misnomer because personal bereavement is stimulated in this case, it is retained because it is useful in focusing attention on the fact that bereavement initially can be stimulated by losses not personally experienced.
In those situations where the death of the group member has not severed a reciprocal personal relationship, vicarious bereavement probably partially explains some group survivors’ responses. There may be at least two additional factors. First, a variation of vicarious bereavement might be stimulated in an individual who survives a traumatic event that takes the lives of others. Although these others may be personally unknown, the experience of being in the same event that took their lives may be sufficient to create a sense of communality or identification with the victims, or enough survivor guilt, to bring grief over their deaths. As well, heightened senses of empathy and sympathy for, and identification with, the victims’ survivors can create vicarious bereavement as described above.
An additional factor, and one particularly evidenced in the wake of Princess Diana’s tragic death in 1997, may be the mourner’s getting caught up in the responses of others. In other words, the group survivor’s responses are not just to the actual death and the loss it signifies, but as well are a response to others’ responses. In this regard, witnessing the grieving behaviors of other survivors (e.g., seeing others overwhelmed, crying, and leaving flowers in reaction to Princess Diana’s car crash) can catalyze grief responses in that witness. Depending upon the person and circumstances, this can be the result of the observed reactions of others: (1) inviting imitation, (2) disinhibiting one’s grief, (3) providing implicit legitimization of certain feelings and/or permission to engage in particular behaviors, (4) stimulating unfinished business about other losses or important issues in one’s past or present life, (5) eliciting a contagion response, or (6) creating a sense of community via commonly shared experiences. It is in this last course of action that one can see how a kinship can be specifically formed with others via one’s responses to trauma, death, and loss.
Survivor groups can be created prior to the event (e.g., family, local community), during it (e.g., emergency services workers, crisis interveners), or after it concludes (e.g., mental health professionals, loved ones of the victims). They may be strongly, narrowly, or rigidly defined. Group membership may be formally designated or self-assigned. Among other traits, survivor groups may be transitory or permanent, naturally developed or officially created, inclusive or exclusionary, facilitative of or inhibitory to healthy mourning and adaptation. The point so well made by this book is that there is a unique constellation of influencing variables, along with personal and psychosocial contextual issues, that go into the creation of these survivor groups. In turn, the groups both affect and are affected by the individual member’s responses to the loss and trauma experienced. Effective interventions on either the individual or group level requires being appropriately informed about both, and realizing that questions about the meanings and impacts of losses of people not personally known must be asked.
While people have been experiencing group survivorship since the dawn of time, it appears there are a number of changes that have intensified the group survivorship phenomenon in recent years. Among other changes, two prominent ones need to be mentioned here. The first is that there is a greater probability of death today to be sudden and unexpected, and associated with traumatic circumstances. This is because technological advances have decreased the proportion of natural death and increased the proportion of unnatural death (i.e., accidents, suicide, and homicide). While biomedical technology helps people survive illnesses that previously would have killed them, it leaves them alive longer to be susceptible to unnatural death, through greater exposure to potentially dangerous technology such as motor vehicles, mass-transport vehicles (e.g., airplanes, ferries, trains) that can take the lives of a larger number of people if there is mishap, weapons of mass destruction, and toxic chemicals. To add to the increased chance of sudden, traumatic death, recent sociocultural trends have culminated in significant increases in political and societal violence, acts of terrorism, and homicide rates.
Thus, human-induced mass disasters and terrorist actions are particularly relevant to the creation of survivor groups, especially those that are significantly traumatized due to the nature of these types of deaths. They tend to embody a number of high-risk factors identified to make any death circumstance traumatic. As adapted from Rando (1994), these include: (1) suddenness and lack of anticipation; (2) violence, mutilation, and destruction, (3) preventability and/or randomness; (4) loss of a child; (5) multiple death; and (6) the mourner’s personal encounter with death secondary to either (a) a significant threat to survival, or (b) a massive and/or shocking confrontation with the death and mutilation of others. Certainly, one readily can see how these factors are present as well in natural disasters, and are vividly exemplified in the case examples within this volume.
The second critical change intensifying the experience of group survivorship is the role of the media. Here is found an example of the “double-edged sword” effect par excellence. On the one hand, as illustrated so well in the majority of these chapters, the media can be a positive, therapeutic agent. It can disseminate necessary and accurate information about the event. It can provide acknowledgment of precisely what has happened, and be the vehicle by which healing can be promoted, even early on, if it is effectively utilized by leaders who convey messages that enable and provide direction for healthy grief. It can illustrate the fact that others are impacted too, and that there are concerned individuals, communities, and nations that care about the survivor’s losses and traumatization and share the survivor’s sorrow and the often accompanying feelings, such as shock, confusion, outrage, and so forth. Media can be the conduit for telling one’s story, connecting individuals to others, and reducing disenfranchisement (see Doka, 1989). Media can help—through the repetitious recounting of events, presentation of images, and the analysis provided by experts—to facilitate the beginning of cognitively grasping what has occurred, and therefore enable the beginnings of mourning and, ultimately, the composition of the narrative of the event. These processes can also be a way of coping with the emotions that have been generated, and they can implicitly and explicitly provide the legitimization and permission to appropriately engage in grief and self-care after trauma. The psychoeducational information media transmits can eliminate or ameliorate problems, as can its encouraging self-referral to professionals if necessary.
However, the other side of the double-edged sword slices. In this case, it can increase the suffering of actual mourners, and actually create vicarious mourners, by the confrontation of the public with graphic images of and horrifying information about traumatic events and the responses of others to them. These can perpetuate one’s already-existing traumatization, or can create it through the arousal of great anxiety, an internal sense of terror and helplessness, frightening perceptions, and other traumatic sequelae. Secondary traumatic stress (Figley, 1995) is spawned. Additional problems occur when secondary victimization (Remer & Elliot, 1988a, 1988b) takes place because of the media’s insensitivity or intrusion, or when it is perceived to fail to acknowledge certain realities about given individuals or groups.
Perhaps there has been no other agent that has been as valued and as vilified in contemporary events creating group survivorship, and in impacting upon so many of the dynamics of that very survivorship, as the media.
Although thanatologists and traumatologists have long noted that death and trauma occur in a social context, this book, moreso than any other, clarifies and explores this reality to which so many authors have merely given lip-service in their inclusion of the dimension among lists of factors identified to influence response. Like it or not, the human being is embedded in a sociocultural fabric that is an important determinant of one’s personal reactions and that, in itself, becomes colored by those reactions. Social “ripples” after death have been mentioned, but their clinical impacts upon survivor groups have never been this carefully probed. Zinner and Williams have orchestrated a resource that has clearly identified a phenomenon, richly illustrated it with cases that give it life, delineated critical therapeutic conclusions that are, in many cases, generalizable to numerous other situations, and, in lucid, practical terms, provided the specifics for effective intervention with survivors on the individual and group levels.
Whether one is interested in group survivorship from an individual, group, systems, ethnocultural, national, or international perspective; regardless if he/she is concerned about policy, planning, or intervention; and irrespective of focus upon directly affected family members, communities, or emergency services personnel, or upon vicarious mourners of any kind, When A Community Weeps: Case Studies in Group Survivorship addresses relevant concerns. In the Introduction, Williams, Zinner, and Ellis put forth the conceptual integration of grief and trauma, concluding with a series of questions to assist the reader in examining how actual communities responded to the problem of coping with nodal traumatic events that took the lives of one or more members, and offering some preliminary thoughts as to how communities begin to heal. In the Summary, Zinner and Williams delineate a reference frame for community recovery and restoration. This, one of the highlights of the book, should be in the armamentarium of every thanatologist, traumatologist, sociologist, and community and disaster planner, along with those having anything to do with such areas.
In between these two chapters are ten that examine specific traumas resulting from the death of one or more community members. Each is remarkable in its own right, poignantly portraying one or more grieving survivor groups and identifying concrete strategies for coping with the trauma and the death, loss, and traumatic stress encountered. There are gems to be found in all. While space prevents me from synopsizing the chapters, let me identify one of the nuggets from each.
In Zinner’s discussion of the Challenger disaster (Chapter 2), the reader finds an excellent specification of the four levels of survivor groups and an enumeration of the social rights and obligations of these groups. In Chapter 3, a discussion of the Estonia disaster, Nurmi provides a candid and critical look at what to do and, more importantly, what not to do with rescue workers and other emergency services personnel. In their discussion of an Australian bus crash in Chapter 4, Watts and Wilson present quite interesting information about the long-term effects of rescue work and its impact, not only among those who were at the scene, but upon those subsequently hired to the disaster-response team years after the event.
Analyzing the community response to the earthquake in Armenia (Chapter 5), Kalayjian asserts that concepts of logotherapy, or existential analysis, are especially helpful in enabling survivors to cope with disaster—given that when all else has been taken away by trauma the individual is left with the “ultimate freedom” to choose one’s attitude in even the worst circumstances. Williams, Baker, and Williams, in their examination of the Kobe, Japan earthquake (Chapter 6), address how, unfortunately, a country’s cultural mandates can prohibit acceptance of greatly needed assistance and interfere with emotional self-care in the survivors.
Turning to the topic of the loss of leaders and heroes, Witztum and Malkinson address the assassination of Israeli Prime Minister Yitzhak Rabin (Chapter 7). The authors compare and contrast individual bereavement with that of social-collective grief, observing that differing needs at differing times can lead to responses that serve one group at the expense of the other. In Chapter 8, exploring the legacy of Mickey Mantle following the death of the newly reborn hero, Harnell demonstrates that groups can recover in part by taking action to restore balance after a loss, turning their grief into positive undertakings.
Sitterle and Gurwitch offer detailed and extremely useful information regarding mental health operations after disasters based upon their work after the Oklahoma City terrorist bombing (Chapter 9). Another bombing, this time in Enniskillen, Northern Ireland (Chapter 10), is the focus for Bolton’s compelling analysis of the impacts upon and interventions required for community belonging and communality that is attacked by terrorism springing from decades of political conflict. In Chapter 11, Lieblich beautifully weaves together the three developmental processes—covering the personal, social, and national levels— that both influence and are influenced by the unexpected death of a 30-year-old member of an Israeli kibbutz, as the community struggles with the confusion and uncertainty of its continued existence.
While I have intuitively “known” for many years the issues about my father’s grief over the death of John F. Kennedy, I very much appreciate Ellen Zinner and Mary Beth Williams for providing me with the conceptual framework, the language, and the clinical information enabling me to understand, speak about, and appreciate these issues so much more today.
Therese A. Rando, Ph.D.
The Institute for the Study and Treatment of Loss
Warwick, Rhode Island
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