MEN, WOMEN AND GRIEF – DR MARK TAUBERT

MEN, WOMEN AND GRIEF – DR MARK TAUBERT

On Friday the 26th May 2017, the 30th Hay Festival drew a spotlight on men and how they deal with grief, with George Brinley Evans, broadcaster Phil Steele and Dr Mark Taubert drawing on personal experience to discuss why in our society men still often suffer silently.

Dr Mark Taubert is a palliative care consultant at Velindre Cancer Centre in Cardiff and Hywel Francis and chair of the Byw Nawr end of life care coalition in Wales. For the Hay Festival blog, Mark shares his thoughts on whether gender differences in grief experience are in fact as pronounced as many think or whether there are other factors at play…

Grief does not fit into easily labelled drawers. There is nothing inherently wrong or pathological with most types of grieving. But often, it ‘feels’ very wrong and we’d like to be able to switch it off. Healthcare colleagues often tell me that a patient hasn’t accepted their loss or their diagnosis, that they are ‘in denial’, or that they are insufficiently expressing their true feelings. Some even feel that grievers must be made to cry openly, before the real healing process can fully commence. This assumes that only one type of grieving is ‘correct’.

Most will have heard of the Kuebler-Ross’ stages of grieving, but in recent years, psychologists like Doka and Martin have categorized types as well: these are intuitive and instrumental grief.

Intuitive grief, on one end of a ‘grief continuum’, can be associated with our cultural generalizations and clichés on how women grieve:

- An emotional style of expressing grief
- Expressions that mirror feelings ( ‘he/she was like an open book’)
- Moving forward involves exploring and expressing feelings, progressing through the pain in order to heal.

Instrumental grief, on the other end of the continuum, can be associated with the perceived masculine way of grieving:

- More thinking than feeling (an inward, quiet process, less expression of emotions)
- More cognitive and action-oriented
- Being physical, expressing grief through doing something (busying yourself with work, spending more time in the shed)

Psychologists suggest that there is a constellation of more than forty social, physical and psychological factors that form a complex network for each unique grieving episode. An individual’s grief process is seen in expert circles as so unique, as though it were a finger-print. And the immediate environment will form part of this process.

Whilst the gender connection with grief is one of many of these factors, it is not everything. The learning point for me over years of practice has been that grief is influenced by gender, but is not determined by it.

My five key take home messages are:

  1. Many men and women will experience a form of blended grief. They will be somewhere on the continuum between instrumental and intuitive grief.
  2. Some people will oscillate between the two ends of the spectrum. This may be influenced, for instance, by how safe they feel to express their vulnerability. It is also influenced by factors such as context and additional life stressors.
  3. Men are not always instrumental grievers and women aren’t always intuitive grievers. Always fitting men/women into one pattern may deprive them of the approach towards grief that may fit best.
  4. There is still a presiding culture in healthcare that nudges grievers towards intuitive grief management. This is well-intended, but may be unhelpful or harmful for a more instrumental leaning griever.
  5. Instrumental grievers may feel guilt if they perceive that people around them are assuming that they are not ‘grieving properly’.

“Why does he never cry?” and “She should not be going on holiday so soon after her husband’s death!”, are examples of unhelpful commentary that I have heard.

If you are a friend, colleague, relative or acquaintance of someone who is grieving, male or female, the most important thing is presence, a completely non-judgemental approach and some affirming, reassuring words:  “I am here for you, don’t hold back if you want to chat” and “I’m going to cook a meal for you next week, pick the day!”

A bit of knowledge about grief and bereavement and what to expect can also be very helpful. Recognising a pattern on grief that fits with one’s own, makes it clearer to people that they are not alone in the way they are feeling. Literature and the arts can be a very therapeutic step towards pattern-recognition of others’ lived experience of grief.

Here is are some of the books I might prescribe to those looking for help and answers. There are many more.

  • The Guardians: An Elegy by Sarah Manguso
  • A Very Easy Death by Simone de Beauvoir
  • Quicksand by Henning Mankell

Dr Mark Taubert is Clinical Director and Consultant Physician in Palliative Care at Velindre NHS Trust, Cardiff