In 1969, Elizabeth Kubler-Ross published On Death and Dying and provided her five-stage model for dealing with death and grief. Kubler-Ross carried out groundbreaking research by breaking the taboo and actually speaking with dying volunteers. Her work has since become a classic in its field and has provided a guide for those coping with death.
With current advances in medicine, the survival time of many illnesses has been dramatically increased. Kubler-Ross made her study for On Death and Dying in a world where terminal illnesses were usually discovered in the late stages and a sudden, unexpected death was much more common. In Saying Goodbye: How Families Can Find Renewal Through Loss, Barbara Okun, Ph.D. and Joseph Nowinski, Ph.D, continue along Kubler-Ross’s path. They base their work upon interviews of the often long-term terminally ill patients, their friends and loved ones. Okun and Nowinski write in their conclusion of Saying Goodbye, “Our hope is that this book – and especially the stories that others have so generously shared – will be both a source of useful information and a source of comfort to the families as they navigate their way through the new grief.”
The many stories and guides that the authors share from those undergoing the process of extended terminal illness offer a wealth of excellent suggestions to those who confront this new landscape of grieving.
Okun and Nowinski introduce the concept of “contemporary grief” or a “new grief,” which is the grief experienced by those involved in an extended terminal illness. (“Traditional grief” involves the grief resulting from a sudden death.) They present a new five-stage model for coping with family grief, based upon their many case studies and accompanying detailed interviews of those moving through this new grief.
The authors share not only the stories of the terminally ill or those close to them, but also information they wish they had known in dealing with saying goodbye to a loved one: from coping with their loss, to talking about mortality or determining last wishes. By providing many valuable resources, Okun and Nowinski satisfy the hope for their book. They provide us with both a source of useful information and a source of comfort as a pragmatic guide for grieving families.
The structure of the book is straightforward. Following the introduction, Okun and Nowinski share their own stories in Chapter One, “Grief as a Family Matter.” In the second chapter, “The Five Stages of Family Grief,” Okun and Nowinski give their proposal for a five-stage model for family grief that takes into account the changing demands of contemporary grief. The rest of the book is divided into Okun and Nowinskiʼs stages of grief in this model – crisis, unity, upheaval, resolution, and renewal – within which interviews, insights, and templates for dealing with the difficulties that typically arise during these particular stages of grief are presented.
The five stages of contemporary grief, given by Okun and Nowinski, may be summarized as:
- Crisis. Family grief begins when the family learns that a loved one has a terminal disease. Feelings of anxiety, anger, confusion, and fear may arise. The equilibrium of the family has been disrupted.
- Unity. The reality of impending death forces family members to put even longstanding resentments or grudges on hold to pull together to care for the dying loved one.
- Upheaval. In a protracted illness, the unity experienced starts to fade, and issues put off to deal with later eventually rear their head, with guilt, anger, and resentment starting to emerge. It is most important, at this stage, that members of the family communicate effectively with each other and with other loved ones.
- Resolution. Upheaval created by the illness subsides. The protracted nature of contemporary grief presents families now with an opportunity to resolve any long-standing issues and to redefine each person’s role in the family.
- Renewal. The final stage of grief begins at the funeral and expresses itself through the celebration of the life of the now-deceased family member. The interconnected system of individuals that make up the family, through acceptance of change, rather than its resistance, is given the opportunity to become stronger, more resilient and thus find its new equilibrium.
Saying Goodbye is written for the layperson in readily understood terms, yet it effectively and forthrightly handles many complex issues that may arise during this process. By beginning with the stories of the grieving or insights they may have, Okun and Nowinski begin a respectful dialogue with the terminally ill or grieving, adding depth to their own suggestions. Saying Goodbye, through the hope it brings and detailed information it provides, is very successful in satisfying the goal Okun and Nowinski hope their book will provide.
Saying Goodbye: How Families Can Find Renewal Through Loss
By Barbara Okun, Ph.D. and Joseph Nowinski, Ph.D.
Berkley Hardcover: January 4, 2011
Hardcover, 336 pages
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Stoeckel, M. (2012). Saying Goodbye: How Families Can Find Renewal Through Loss. Psych Central. Retrieved on August 21, 2014, from http://psychcentral.com/lib/saying-goodbye-how-families-can-find-renewal-through-loss-2/00011375
Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
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