Book Review: Ethnic Variations in Dying, Death and Grief: Diversity in Universality

Ethnic Variations in Dying, Death and Grief: Diversity in Universitality by Donald Irish, Kathleen Lundquist and Vivian Jenkins Nelsen (Eds), Taylor and Francis Ltd. Washington, London (1993).

Death, dying and grieving are important issues for all psychotherapists and counsellors. As existential practitioners we often assume that we know more about these topics than more traditional colleagues. After all the work of our authors of reference is often centered around the notion of death and we may consider ourselves some sort of experts on the subject. In our therapeutic work however we get challenged by our clients diverse views on death and dying and this may remind us of the importance of enquiring into the manifold variations upon the theme of death interpretation that exist across the range of human culture.

This book is specifically geared to extending helping professionals' insights into the different customs and perceptions that exist on this score in our multi ethnic societies. It is based in North-American culture and deals with the views of African Americans, Mexicans, Hmong, Judaism, Buddhism, Islam, Native Americans and Quakers. In this sense it is culture specific and omits many of the views that are particularly relevant to therapists in Britain and Europe. It does, however, in the more general chapters refer to a broad spectrum of cultural givens and greatly expands one's perception of a wide range of customs, making one reflect upon one's own and putting a different perspective to one's therapeutic work.

Take for example the huge difference between the Balinese and the Egyptian views. The Balinese attitude to death is to stay calm in the face of it for fear of offending the gods, so that humour and laughter are in order, treating death lightly and even as desirable. The Egyptians on the other hand expect death to be followed by years of constant suffering on the part of the bereaved. Or think of the potential clash between the Kaluli and the Chinese customs. The Kaluli, of New Guinea, require death to be avenged, even if natural or accidental, so that they respond to death with anger and a search for the source of death in order to redress the wrong done by death. The Chinese, at the other end of the spectrum, respond by turning inwards rather than outwards and they frequently express bereavement through somatization, settling their grief on a symptom in their own body.

Of course there is heterogeneity of expression of all these differing habits even within cultures, through class, gender, subculture and individual variations. The object of the book is not to determine which beliefs belong where, but rather to demonstrate the range of the human relationship to death. Reading the book makes you aware of what each custom reveals about the overall challenges of existence and our ways of dealing with them. You will recognize elements of your own and your clients' beliefs in many of the stories.

It is clear that looking at death, dying and grief involves looking at religious beliefs, for these underpin and determine how a person responds in the face of death. Throughout the book one's attention is implicitly drawn to the way in which the western scientific attitude is tantamount to another belief system, which dictates certain rituals and routines like any other religion. The clashes between the scientific need for a postmortem and the magical attitude on the part of some groups that makes the cutting up of the body taboo are particularly revealing. It is important to pay attention to this clash and enquire into what each of these extreme attitudes can teach us, rather than to take sides and merely observe or reject other peoples's customs as alien and curious.

The book drives home forcefully how some attitudes and behaviours are easily dismissed as pathological in western society, whilst other cultures uphold them as central and essential. I was particularly struck by the story about a deceased western teacher, who had been buried by her family with a class photograph of her beloved Hmong pupils in her coffin. When the parents of the Hmong children discovered that this was the case a major panic ensued until finally the coffin was exhumed. The Hmong believe that burial of someone's picture endangers them, as their spirit is lost in the process. Animism may seem unscientific, but it reveals a deeply seated human tendency to attach significance to symbols, objects and rituals, which we would do well to ponder on. Where matters of life and death are concerned many of us are similarly captured by our imagination rather than by hard physical facts. Who is to say that this is right or wrong? What harm might we do ourselves by trying to be civilized, rational and deny such a different reality?

This book is to be commended for opening up an important debate and should be read by any counsellor or therapist who is willing to look beyond their current ken. In fact it should be particularly read by those who are not willing to do so. Emmy van Deurzen-Smith

Emmy van Deurzen-Smith