The role of psychotherapy and humor for death anxiety, death wishes, and aging

This article is part of a series of humor on social attitudes (Richmen, 1977), humor by the elderly (Richman, 1989), assessment (Richman, 1996a), and psychotherapy (Richman, 1996b). The present study is based on the topics of humor related to death anxiety and wishes, and aging that emerged during psychotherapy with elderly patients. The healing qualities of laughter and humor have been observed since Biblical times to the present, however the applications of humor to professional psychotherapy is still in its infancy. The examples in this study spell out how humor in therapy can bring people together, and help them affirm life and laugh at anxiety, depression, and their problems in living.     

Predictors of children's understandings of death: age, cognitive ability, death experience and maternal communicative competence

A child's age, cognitive ability, and exposure to death in the environment have been documented as major factors affecting the formation of a mature death concept. The present study investigated the relationships between these three factors (age, cognitive ability, and death experience) and children's understandings of death, as well as the relationship between mothers' communicative competence and children's understandings of death. Thirty-seven children (ages 48-96 months) completed three cognitive tasks and answered four dichotomous questions about death. Their mothers (N = 37) responded in writing to 16 questions about death that children are likely to ask. Results showed significant relationships between age and understanding, between seriation ability and understanding, and between death experience and understanding. There was no statistically significant relationship between maternal response competence and children's understandings of death. Implications are discussed.     

Quality insights of university students on dying, death, and death education--a preliminary study in Hong Kong

Death is a subject seldom studied in school and often misunderstood and feared by many people. Children often learn about death from their family and mass media. From the literature review on dying, death, and death education, it may be concluded that people are generally ignorant about the issues of death and dying. There is a need to investigate what young people, such as university students, know about death and dying, and their attitudes toward them. Eight university students were recruited for this study. Most participants have had death experiences. They seldom talked about death and loss. Some of these experiences were quite pleasant but some of them were not. Most participants addressed the need to have "life and death" education in schools at their young age. Such a need is further supported by the incidents of two participants who attempted suicide unsuccessfully when they encountered a life problem which they could not solve.     

Attachment, social support, and responses following the death of a companion animal

This research tested hypotheses concerning attachment, social support, and grief responses to the loss of animal companionship. Participants whose companion cat or dog had recently died (N = 429) completed the Attachment Style Questionnaire, the Inventory of Complicated Grief, and the Multidimensional Health Profile-Psychosocial Functioning questionnaires. Both attachment anxiety and attachment avoidance were found to be positively associated with respondents' grief, depression, anxiety, and somatic symptoms. Social support was found to be negatively associated with these outcomes as well as with attachment anxiety and attachment avoidance. In multiple regression analyses, attachment anxiety incrementally predicted grief, anxiety and somatic symptoms, attachment avoidance incrementally predicted grief and depression, and social support incrementally predicted all outcomes. Interaction effects of attachment and social support in relation to outcomes were not found. The present study's implications and limitations are discussed, as are directions for future research.     

Dispensing death,desiring death: an exploration of medical roles and patient motivation during the period of legalized euthanasia in Australia

A qualitative case study was conducted to explore the clinical decision making processes that underpinned the practice of euthanasia under the Rights of the Terminally Ill (ROTI) Act. The key informant for this research was Philip Nitschke, the general practitioner responsible for the legal cases of euthanasia. His information was supported by extensive document analysis based on the public texts created by patients in the form of letters and documentaries. Further collaborating sources were those texts generated by the media, rights groups, politicians, the coroner's cort, and the literature on euthanasia and assisted suicide. A key study finding was that the ROTI legislation did not adequately provide for the specific medical situation in the Northern Territory, Australia. The medical roles, as proscribed by the legislation, carried many inherent assumptions about the health care context and the availability of appropriately qualified medical staff committed to providing euthanasia. These assumptions translated into difficulties in establishing clinical practices for the provision of euthanasia. A further finding concerned the motivations of those who requested euthanasia. This article addresses the medical roles and the motivations of those seeking euthanasia.     

Personifications of personal and typical death as related to death attitudes

The present article examined differences in personifications of personal and typical death as a function of attitudes about death. Ninety-eight students enrolled in psychology classes were randomly assigned to personify death as a character in a movie depicting either their own deathbed scene or the deathbed scene of the typical person prior to completing the Death Attitude Profile-Revised. The results supported the conceptual distinction between attitudes about personal death and death in general. Participants in the personal death condition personified death more frequently as a gentle-comforting image and less frequently as a cold-remote image than did participants in the typical death condition. The results also further validated the relation between personifications of death and death attitudes. Across both conditions, participants who selected the grim-terrifying image reported more fear of death and death avoidance; whereas, participants who selected the cold-remote or robot-like images reported more neutral acceptance.     

Images of heaven and the spiritual afterlife: Qualitative analysis of children's storybooks about death, dying, grief, and bereavement

Many parents turn to picture books and storybooks to help explain issues surrounding death and dying to their young children. In addition to dealing with topics such as death, funerals, memories, and grief, a number of the books also mention the concept of heaven and what our loved ones might experience after they die. This article uses qualitative research methods to analyze 49 children's storybooks that touch on the existence of heaven or a spiritual afterlife. Results show that heaven is portrayed in a simplistic fashion, as a place high in the sky with bright lights, angels, and clouds. Even as heaven is presented in a relatively simple way, there are also patterned differences in depictions of the spiritual afterlife depending upon whether the decedent in the book was a family pet, a child, a parent, or a grandparent. The article concludes with a discussion of how these depictions of heaven and the afterlife might help young children cope with death-related grief.     

The "moment of death"

The "moment of death," once a dominant concept in preparing for a "good death", has been eclipsed by a focus on the wider concept of the "dying trajectory". However, findings from interviews with 25 bereaved individuals suggest that dying loved ones' final moments may still be experienced as highly significant in their own right. In some accounts the dying individual's final moments did not feature or made little impression, either because the survivor was not present, or there was no obviously definable moment, or because other, usually medical factors, such as whether to resuscitate the person, took precedence. However, in six cases such moments were constructed as profound, special, and memorable occasions. These constructions are explored in relation to achieving a good death, the dying trajectory as a whole, and making sense of the bereavement experience. Their implications for sociological theories of identity and embodiment are also considered.     

The death distress construct and scale

The purpose of this research was to construct a short scale to assess the death distress construct, that is, death anxiety, death depression, and death obsession as derivatives from the already existing scales. A sample of 630 volunteer undergraduates responded to scales of death anxiety, death depression, and death obsession. A Pearson correlation matrix was computed using the 51 individual items of the three scales. A forced three-factor principal components analysis with orthogonal varimax rotation was carried out. Eight items with factor loading > 0.5 on each scale was determined. The eight items with highest factor loadings on Factor I were with "Death obsession," whereas the Factors II and III were labeled: "Death anxiety," and "Death depression." Their alpha reliabilities ranged from 0.83 to 0.93, indicating high internal consistency. One week test retest reliability ranged between 0.76 and 0.91, indicating temporal stability. A single high-loaded factor of death distress was disclosed, demonstrating the discriminant validity of the death distress construct and scale. Women obtained a significantly higher mean scores on all three factors. It was concluded that the aforementioned three factors were sufficiently independent to justify their use in assessing partially distinct sub-constructs as sub-components of the generic high-order factor of death distress, with empirical and clinical implications.     

Avoiding the valley of death in educating strategists

Billions of dollars and hundreds of millions of hours are invested every year in executive education. However, much of this investment dies in a familiar “Valley of Death” (VoD) wherein what is learned in the classroom is not applied when the strategist returns back to work. Based on 30 in-depth interviews and live observation, we investigate the architecture of an executive education program designed to avoid the VoD. In the observed program, senior partners of a strategy consulting firm, and their key strategist clients, are brought together to co-learn strategy associated with scenario planning, and, at the same time, improve their ongoing business relations. We find that adopting a “paired learning structure” and utilizing “live case content” results in “group-level co-learning” (or the co-production of knowledge) that, participants report, avoids the VoD. This research contributes to the scholarship on learning architecture in executive education by establishing linkages to the literature on client-partner relationships, modelling the student, and service co-production in knowledge-intensive organizations, and, in the end, provides a blueprint that professional service firms and business schools, seeking to produce more value for their participants, can jointly emulate.     

Beyond death: inheriting the past and giving to the future, transmitting the legacy of one's self

This study explores the phenomenon of legacy as a component of the aging experience among women. Against a backdrop of prior focus on transmission of material possessions as the primary form of legacy, the concept is critically examined in developing an expanded, theoretically and empirically grounded perspective. In-depth interviews with 38 women, ranging in age from 31 to 94 and representing diverse marital, parental, and health statuses, reveal multiple dimensions of leaving a legacy in terms of content, creation, and transmission. Through the stories of the participants in this study, legacy emerges as a means of passing on the essence of one's self, in particular one's values and beliefs. Legacy is a method of leaving something behind after death and making meaning of the end of life. The desire to leave a legacy is manifest in many different ways dependent on the individual and their culture. While the idea of legacy is often couched in terms of material possessions, it appears that passing on values and beliefs is more important to older adults.     

Parental grief after a child's drug death compared to other death causes: investigating a greatly neglected bereavement population

This comparative survey contrasted 571 parents who lost children to various death causes: 48 to drug-related deaths and overdoses, 462 to suicide, 24 to natural death cases, and 37 to mostly accidental death cases. Groups were compared in terms of grief difficulties, mental health problems, posttraumatic stress, and stigmatization. Results did not show any appreciable differences in these respects between the suicide bereaved parents and those losing children to drug-related deaths. However, when the suicide and drug-related death survivors were specifically contrasted against accidental and natural death loss cases, a consistent pattern emerged showing the former group was consistently more troubled by grief and mental health problems than the latter two sub-groups. These differences remained when controls of time since the loss and gender differences were employed as covariates. These findings suggest that the powerful and intense stigma against drug use and mental illness, shared among the public-at-large, imposes challenges in healing of immense proportion for these parents as they find less compassionate responses from their significant others, following their losses.     

Indicators of family resilience after the death of a child

The aim of this study was to identify and describe resilience qualities in families after losing a child. Questionnaires, including an open-ended question, were utilized to collect data independently from the parents and siblings of the deceased in 89 Belgian families. The results indicate that family strengths in general, and commitment to the family in particular, helped the families' adaptation after the loss. In addition, the adaptation process after the loss was aided if the family members viewed the crisis as a challenge. Both the siblings and the parents indicated that the extent to which a family experienced support from the community was directly related to family adaptation after the loss. Redefining the situation and utilizing social support from friends and family were underlined as effective family coping strategies. The findings could be used in interventions to promote family resilience, thereby affirming the reparative potential of families.