Loss In Social Work

Working with grief, loss and the issues that surround it could be said to be one of the core skills of social work practice. As social work professionals, we are expected to intervene usually at times of crisis. Consequently, Loss has often been identified as one of the key stressors at the root of many given crises. This could be the loss of employment, a home, the breakdown of a relationship, the loss of one’s health through debilitating illness or through the death of a loved one or friend. These are all examples of losses that can have a profound effect on an individual’s life and well-being, It is, however, the latter of these forms of loss that is of central importance to this essay.
Death and the loss of a loved one is something many

of us have experienced on a personal level, yet, despite it been a problem that will affect us all at one time or another, it continues to raise profound social and cultural issues of denial or avoidance, consequently, making it an issue we would rather not speak about (Littlewood 1992). This is especially true if the way in which an individual died is seen as unnatural, unexpected or untimely, for instance, death by suicide. Again, losing a loved one or friend to suicide is something many people can draw personal experience from. In 2013, a total 6233 suicides were registered in the UK (Samaritans 2015) , at a rate of one death every two hours (Mental Health Foundation 2015), a figure that has been predicted to have risen dramatically in the last three years. It is often seen as a solitary act, however, family and friends are almost always left behind to grieve (Cerel et al 2008). It has been claimed that around six people are significantly affected by the loss of an individual to suicide (Hawton & Simkin 2003, in Bell et al 2012), this, therefore, suggests that a figure of around 40,000 people in the UK are affected by the suicide of a loved one per year.
From drawing on the work of Durkheim this essay aims to show that suicide, whilst been a highly personal act it is also a social one, whereby not only is the act of suicide itself is socially driven, but also the way in which one expected to grieve. By employing the theoretical framework of Doka’s “disenfranchised grief” alongside Goffman’s theory of stigma and symbolic interactionism it aims to explore if suicide is, by definition a disenfranchised form of grief. If so, does this disenfranchised grief lie at a wider societal macro level whereby survivors are not given the ‘right to grieve’ (Doka 2002) or is it individually entrenched in the survivor at a micro level, consequently influencing the way in which they choose to grieve.
Doka formulated The concept of disenfranchised grief after a class he was teaching on the subject of grieving widows when one student spoke up and said “if you think widows have it tough, you want to see what happens when your ex-spouse dies….no one understood my grief” (2013).

What this student raised here is a strong example of the difficulty people can have to understand, not only the grief of an ex-spouse, but indeed, of any form of grief that could be said to sit outside of societies norms for example, perinatal deaths can be said to cause strong grief reactions, yet society views them as minor. The loss of a pet also can cause a tremendous sense of loss for some individuals, Yet, many find themselves grieving in isolation, to express their grief would likely be met with insensitivity (Janssen 2015). Dependent on the person that died and the grievers relationship to the deceased can also have an effect on the way in which ones expected to grieve, for example, the deceased could have been a criminal, therefore, their death could be seen as a positive. In some cultures, it could also be argued that the loss of a partner in a same-sex relationship is not seen to be as worthy of grief or bereavement. Therefore, for grief to constitute as disenfranchised, an individual experiences grief, however, that grief is not acknowledged, socially validated or publicly observed by their given culture or immediate environment (Doka

2002).
This highlights the importance of the social aspect of grief, whereby the reaction to grief can be multifaceted. The feeling of loss to the individual may be not be understood by others or by society at large, consequently the individual grieves, yet others do not acknowledge it. They are not offered the rights of the grieving role that would lay claim to social sympathy and support. Hochschild (1979) highlighted the importance of the social reaction to grief and how these norms are culturally governed. He uses examples of things that an individual is expected to say such as ‘I know I should not feel guilty’ (1979:152) and ‘I know I have every right to feel angry’ (1979:152). These statements are based on a shared societal understanding of what one is expected to feel in a given situation. They govern what losses one is expected to grieve, how they go about their grieving process, whilst also influencing those around them to respond and give support accordingly. It can, therefore, be said that, if the act of grieving is socially determined then so then is the death itself.
Suicide more than any other death is seen as an individual act, mainly because the individual chooses to take their lives themselves, and very often without warning. To completely discredit the influence of an individual’s social environment is, however, impossible. This argument can be traced all the back to Durkheim (1897) and his study of “anomic suicide”. Durkheim’s main argument was that suicide is not an individual act and that suicide is a social fact that is indeed tied to social structures. He defined suicide as a social fact because it was something that happened driven by social causes, however, hidden they were (Spaulding & Simpson 1951). Durkheim's work surrounding suicide has been contested to some degree, but his hypothesis that suicide is tied to social structure is very much held in high regard. Despite this, however, it could be said that within many western cultures there still lies an unspoken belief that suicide is still a rather individual act, and if the wider social context is taking into considerations it very rarely reaches beyond the micro-social realms of the victim’s immediate family. This very often leads to assumptions been made about the victim and the grieving survivors, for example “that family has always had problems” or “they were having marriage problems”. It could even be suggested that the survivors label themselves with these assumptions, simply because they believe that others will do so, very much like the aforementioned culturally governed expectations that. Hochschild (1979) highlighted, thus they may begin to ask themselves “are we not strong enough as a family” or “could I have been a better wife/husband”. It is with this notion that it could be said the experience of suicide survivors is often different to that of survivors of more natural death (Jordan 2001), for no other kind of death would lead to these kinds of guilt and responsibility-inducing questions to be placed on the survivors either by society, or on themselves. However, in response to whether this makes it disenfranchised, would need further analysis.
Various researchers have suggested that suicide survivor’s grief does not differ all that much to that suffered by individuals undergoing other types of mourning.

Cleiren and Diekstra (1995) believe that the symptoms of problematic adaption in suicide bereavement are not unlike those from any other kind of bereavement (Jordon 2011) for them a survivor of suicide will pass through the usual five stages of grief, which according to Kubler-Ross & Kessler (2005) are denial, anger, bargaining, depression and acceptance. However, in an analysis of Kubler-Ross & Kessler’s work it is clear that them themselves believed that the five stages of change are unlikely to be so linear when the grief involves the loss through suicide, as they state “Grief over a loved one’s suicide is its own type of grief, there is the added sense of guilt and anger, but also shame. Families are left with an enormous stigma around the suicide” (2005:183). As we will discuss shortly, it is likely that it is this sense of guilt and the stigma surrounding suicide that sets it apart from any other form of

grief.
Jordon (2011) insists that despite little quantitative data, the experience of suicide survivors is still inherently different to that of survivors of more natural deaths (Bell et al 2012). And through the analysis of qualitative research, we can hear first-hand how survivors experienced their loss. Stanley, Mallon, Bell & Manthorpe (2006) underwent a UK study of completed student suicides. The research aimed to draw together a range of accounts of the death and its impact on survivors (Bell et al 2012). They found that almost all family members and loved ones of the student that had committed the suicidal act, showed a strong sense of examining their own responsibility in relation to the act, with guilt been the most thematically pervasive outcome. Many of the typical responses were things such as “I blamed myself” “I beat myself up” and “did I do anything wrong?” (Bell et al 2012). They were also deep questions asked regarding their own responsibility for the death with statements such as “what could we have done” (Bell et al 2012). This act of self-questioning and the themes of these questions could ring true to that hypothesized earlier in this essay, that the survivors label themselves with these culturally governed expectations and assumptions, therefore, they are asking such questions of themselves simply because they believe that outsiders would do so. So although these feeling of guilt are internalized in the self, they are also a by-product of ones given culture and the way in which their environment expects one to grieve their loss. unfortunately, in many western cultures, the bereavement of loss through suicide is one laden with stigma. It is through this stigmatization that guilt and responsibility are placed on the survivor, thus making the grieving process of suicide unlike any other and by Doka’s definition, a form of disenfranchised grief.
As Doka (2002) states, there is no such thing as a shared grief experience “How one dies can radically affect the level of support survivors receive. Some deaths are clearly stigmatized…shaming survivors to seek out support” (2002:323). As we have learned, stigmatization is a fundamental problem in regards to suicide survivors. The core aspect of Goffman’s (1963) work on stigma, is in regards to the stigma that influences social interaction, this, however, can be broadened to include individuals who have committed suicide. As Doka (2002) states, the cause of death has acted in discrediting survivors, by affecting and influencing their own personal identity. What is important to consider here, however, is how are people stigmatized. it could be said with little argument that the act of suicide in itself is in fact stigmatized, as ultimately it goes against the very nature of human instinct. However, the extent in which survivors of suicide are stigmatized could be laid into question. according to the basic theme of Goffman’s Stigma a stigmatized individual is a “persons who society does not consider “normal.” Stigmatized people are those that do not have full social acceptance and are constantly striving to adjust their social identities” (Crossman 2014:2). In reference to the statistics shown earlier a figure of around 40,000 people could be affected by the suicide of a loved one per year. Whilst the existence of stigmatization towards suicide survivors cannot be discounted, it is difficult to argue that such a high amount of people are not given any social support, refused full societal acceptance, and, therefore, ostracized in their communities.