Therapeutic death:

...thanatology...

...Management is the goal of these experts, so it is no surprise that the final stage of the process is always "acceptance...

...In the Book of Revelation, "there was silence in heaven for about a half an hour" when the Lamb broke open the seventh seal...

...And since this splitting of the self into two -- the grieving or dying self and the transcendent solicitous self watching over the process -- is no mean trick, we need the help of experts who alone can show us how to get it fight...

...Such an attitude would resist the temptation to reduce the strange to the familiar, the dreadful to the manageable, the careful to the ordinary...

...refusing to submit to the normal procedures by which ordinary, profane, secular man handles his life...

...Like its predecessor, the death and dying revolution attempts to liberate us from the irrational fears and repressive anxieties that surround the experience of death...

...But liberation, however exhilarating, can involve needless violation and garish light thrown in dark places can overexpose -- rather than reveal -- reality...

...So when we lose someone who is important to us, it's like a piece of ourselves taken away...

...Death is or ought to be a continual, albeit painful, reminder of that...

...The death of the other as an-other is repressed and, Commonweal: 110 ironically, the very devil which the movement sought to expel returns with a vengeance...

...Yet, not unlike the sexologists who teach their clients how to manipulate their pleasures, the new thanatologists teach us how to get on top of and master our grief and dying...

...Curiously enough, the death and dying movement seems to have little quarrel with an affirmation of the fragility of human existence...

...Articles, like the July 1982 Harper's "Canoodling wit Death," have aimed at a previously sacrosanct figure like Kiibler-Ross...

...Get in touch with your feelings" seems to be a prime imperative for death care practitioners as well as for the dying themselves...

...indeed, such an understanding is often utilized in their battles against the medical profession's often frenetic attempts to keep a patient alive at all costs...

...But even then our speech would be the language of indirection, a poem (of the nightingale) a song (about the blues) or a story (from the Bible...

...Grief, like any significant human experience, does have its pathological expression, but a criticism of that pathology would lie on grounds other than failure to "work it through...

...Yet one can only violate what was first held to be sacred...

...Besides establishing a new battlefield for narcissistic self-enrichment (I will get to that later), such an attitude denies a fundamental truth about ourselves -- that life exists not as a problem that needs solution but a mystery that continually thwarts our attempts even at understanding much less controlling it...

...In his study of contemporary culture, Christopher Lasch nicely expresses the identity of the will-tocontrol and narcissism: The manager's view of the world . . . is that of the narcissist who sees the world as a mirror of himself and has no interest in external events except as they throw back a reflection of his own image (The Culture of Narcissism, p. 96...

...Perhaps because it is a newer phenomenon, such serious scrutiny of the thanatology movement has not occurred, although it has started...

...Rather than harmful inhibitions, the covert and surreptitious glances that often accompany the viewing of obscene matters might well be indices of shame, recognizing that some things ought not be viewed -- not at least without the sheltering commitment of love or, in the case of death, grief...

...Lattanzi expresses it quite well: Basically...

...Nonetheless, there is a hint in the new practice of thanatology of a much more subtle but no less real effort at controlling death...

...T HE ARGUMENT of this essay has, by now, I trust, come into sharper focus...

...but rather death, my own death, reveals that at the very heart of existence I am not in control...

...Properly corrected, our attitude toward death will lose its obscene character and, like our sexual comportment, bask in open and liberated expression...

...And, like all disciplines seeking respectability, it coined its own nomenclature...

...The death of the unique and irreplaceable other becomes a fissure in ourselves that needs to be therapeutically repaired...

...One poem in particular, the "Ode to a Nightingale," is wrenched from his experience of ministering to his dying brother...

...Indeed, what makes "grief management" itself almost pathological is its failure to suffer it through...

...But it is an acceptance cheaply purchased whose chief end seems to be the transformation of the patient into a tractable subject...

...But the leap from the "good" orgasm to the "'good" death is not all that hard, as David Guttman has observed...

...A cardinal sin of the movement is not to verbalize how you feel about your dying...

...That debate -- defined and, for the most part, won by the thanatology movement i t s e l f - has pitted the professional technicians and their interventionist assaults on death against the proponents o f " death with dignity" and their more liberated and humanistic approach...

...We spend our lives getting close to people, and certain people reflect dimensions or parts of ourselves as we'd like to see ourselves...

...First of all, publicness could hardly be the remedy for the obscene since it is the public display of intimate acts that fuels our voyeuristic intents...

...What is mind-boggling in this statement (in which the personal and possessive pronoun is repeated twelve times) is the complete forgetfulness of what occasioned the grief, the death of the other...

...Ironically, even some believers, whether wittingly or not, are not immune from such reductionistic tendencies...

...Instead the grief-stricken ones are now urged to "master" and "control" their grief, to "work through" the grieving process -- the very words betraying a resolute if not desperate attempt to overcome our vulnerability...

...Infantilization" is the term Rosenbaum uses and he tightly notes it amounts to a subtle form of behavior control...

...What that revolution promised was a liberation from the repressive Victorian taboos and inhibitions that surrounded sexual activity...

...Yet, on a deeper level, there seems to be a lack of i'ealization that in the face of such an awesome event as death silence may well be the only appropriate response...

...NO SENIOR CITIZEN" An afternoon with an elderly respondent HARINE BYRNE "Most elderly respondents report that the sequential experiences of their day-to-day existence are basically satisfying, especially as these relate to the achievement of an equitable resolution to earlier familial and cultural conflicts...

...death and dying courses and films, death and dying nurses, therapists, and specialists...

...Eros and now thanatos have been liberated from the last bastions of Victorian prudery and opened to the managerial expertise of the therapist...

...Such a ludicrous advertisement could easily be dismissed or become grist for the comedian's mill -- except that the attitude it betrays is so pervasive and its theoretical underpinnings cut deeper than it first appears...

...Death encroaches on us and compels us to admit our own finitude...

...FOUND THIS ponderous quotation in a report of a seminar on aging, a subject which, if not yet close to my heart, is already knocking at my arteries...

...Yet of such frailty the thanatology movement wants no reminder...

...Just listen to this...

...The young movement has learned its lesson well from its parent, the sexual awareness movement...

...It confounds the efforts of the practical man to control it and the contemplative man to know it...

...When one considers how ill-tempered, acrimonious, and feisty the rest of us are, it is good to hear that the elderly, in their wisdom~ have attained a I I I KATHARINE B YRNE, formerly associated with the Psychometric Laboratory at the University of Chicago, was also Director of Continuing Education at Mundelein College...

...Yet it is probably more the case that by making it public we have, like children insisting on their night light, simply repressed for a while the very real darkness that hovers over our beds...

...Undoubtedly, some of this new enlightenment has been and continues to be beneficial...

...The narcissist, Lasch pointed out, "cannot live without an admiring audience" and so it is hardly surprising that the urge to self-display would be found here even though one might hope a sense of dignity and shame (now, perhaps, outdated) would inhibit the performance...

...One of the most pernicious effects of the sexual revolution has been the complete blurring of the distinction between public and private...

...That truth is in danger of being misunderstood or trivialized unless it is recognized that death is not just one event among others peculiar only in that, unlike most, it stands impervious to ot:r efforts at control...

...Yet, one need not deny the importance of feelings -- though one wonders in today's world why we need be admonished to get in touch with them -- without making the equally important point that "pure" feelings do not even exist and, even if they did, they certainly would be inarticulate without a consciousness that mediates and gives them meaning...

...Such exhibitionism has now crept into the dying process so that the privacy of the bedroom where one loved and died has been totally violated...

...One day last fall I heard Cora's insistent telephone voice giving me a directive...

...As Homer long ago reminded us -- "any sorrow can be borne if it is told in a story...

...Thanatology trainees spend a good deal of their time learning how to elicit the appropriate responses...

...Transforming obstinate adults into docile, childlike patients certainly eases the burden of one's case load...

...Such an attitude which let death be death would ultimately redound to those who remain and then, perhaps, life might truly be life...

...In short, it has been secularized...

...Yet, in one of the few perceptive articles on death and dying (in Social Research for Autumn, 1972), William May hammers home the distinction of the sacred from the profane and its implication for our will to control...

...Still, Ron Rosenbaum's critique in that article goes after the more obvious absurdities of the movement and leaves somewhat unchalFRANCIS KANE, a new contributor to Commonweal, is an associate professor and chairman ~J'the philosophy department at Salisbury State College in Maryland...

...Death has lost its power and its sting, not because of the transcendent mystery that is faith, but because it has been stripped of its terror and transformed into an ordinary event subject to our will to control...

...I do...

...What is it, then, that strikes us when ~ve think what we do even when that doing, in the case of dying, is our own 24 February 1984:109 un-doing...

...state of equilibrium, accommodation, and generosity that their children and their children's children fail to achieve...

...Instead, we need to stand humble before this humbling event, suffer its indignity, and perhaps reverence what may lay beyond it...

...Contemporary culture seems heU-bent on liberating us from any sense of violation and thereby eliminating altogether the category of the obscene...

...Indeed, one fear, perhaps not all that remote or silly, is that these same professionals will soon seek to determine who is "qualified" enough to "deal with" the dying...

...Pop psychologists have reduced their productions of books on achieving the good orgasm...

...instead, they are now telling us how to compose an aesthetic decomposition -- the graceful death...

...Such therapeutic surgery is nothing more than an intellectual lobotomy that cuts us off from the terrifying experience of what lies beyond our control...

...You can only "sing the blues" -- and that is not a technique for dealing with troubles but a way of suffering through them...

...Following on its heels has come another similar revolution -- this one in the area of death, dying, and grief...

...Yet certain questions do need to be posed, especially the age-old queries of any liberation -- in whose name and for what end...

...Here is the real world of dying, the "fever and the f r e t . . , where youth grows pale, and spectre-thin and dies...

...people are mirrors in our fives...

...Secondly, it is not in the name of the sacred (as one might expect) that the obscenity of death is attacked but a rather more mundane effort to level the experience to more manageable 24 February 1984: I 11 proportions...

...We are, each of us, beings who have been thrust unwittingly into a world and who must quit that world whether we wish it or not...

...When they call death the "last obscenity" they seem to have in mind the refusal to speak about it and deal openly with it...

...Given the finality of death, however, it might seem that the thanatology and self-fulfillment movements would make strange bedfellows...

...The attitude of the will-to-control leading, as it does, to the "infantilization" of death offers us a transition to the next presupposition of the movement -- its narcissism or gospel of self-fulfillment...

...The sacred is distinguished from ordinary profane power in that it does not appear as something that man can fully master and use toward his own appointed ends...

...Yet I hesitate to convey this information to you without also telling you something about the only elderly respondent I have ever actually known, my neighbor Cord Weatherby...

...Serious questions and challenges (not just from conservatives) have been put to the aims, intention, goals, and motives of the sexual movement...

...in Feifel, New Meanings of Death...

...To undergo grief, to let death be death -- in its utter finality -- would strike terror in our hearts, leaving us helpless and vulnerable...

...Such self.conscious manipulation -- this feverish anxiety by which we monitor our progress through the various stages -- is but an ingenious device for distancing ourselves from the very reality we seek to confront...

...And she read me a letter asking her "cooperation in a study of the attitudes of mature members of our community...

...In one metropolitan hospital, the social workers were insisting that they be called imp: mediately upon the death of the patient and, despite innocent intentions, one could not help but see one more professional cadre crowding arounding the bedside to get a piece of the action...

...What redeems such agony is not the faddish gimmicks of the thanatology movement but men and women of virtue who with humility and courage suffer the shame of death rather than manage it away...

...If these words mean what I think they mean, they are reassuring...

...Again, in May's words, it would simply "let death be death...

...It is an almost commonplace truth nowadays to assert that death is an event which we cannot control...

...Kathern, you got to come over tomorrow at two o'clock...

...E ARLY ON IN this reflection I quoted Hannah Arendt's injunction that we "think what we do...

...Curiously, though perhaps not surprisingly, the violation often finds the dying victim cooperating, even inviting the display of his or her own demise...

...Tkere is nothing to be done toward the sacred," writes William May, "except to let it be what it is, permit it to run its course, and let one's own life be caught up in its force...

...Some researcher at the University must have got Cora's name from the Nutrition Site where she eats lunch twice a week, complaining about the soy beans in the meat loaf and those old people "full of aches and pains and dying to tell you about them...

...Obscenity is the sacred's counterimage...

...A particularly striking example of this new "will-tocontrol" is the activity usually described in the literature as "grief management...

...He refers to a recent example, the book Coming to Terms with Death, and quotes from the publisher's blurb: "A do it yourself book on how to die gracefully . . . the perfect gift for Morn...

...Certainly, infantilization implies narcissism for the will-to-control, which aims at self-mastery, easily fixates on the self...

...Film seems to be the medium of choice, and we are now inundated with Cinima Vdritd analysis of the last dying gasp of the cancer-ridden, the elderly, and even the suicidal...

...DON'T c'ALL My...

...The thanatology movement -- at least in some quarters -- has succeeded in sentimentalizing, trivializing, and leveling down death until it has become but one more overexposed event in the life of "homo dominator...

...Such was the traditional wisdom, but in today's world death has become public and perhaps lost its awe-full character...

...Love -- which includes the intimate feelings, desires, and acts of lovers -- has been exposed, even flaunted, under the garish light of the leering public eye...

...This notion, made popular by one of the guiding lights of the American Hospice movement, Marcia Lattanzi, certainly belies the old Shakespearean maxim: "Everyone can master a grief but he that has it...

...If cinema is the more dramatic expression of this "publicization" of the private, a less dramatic though more universal example is the almost continual and incessant stream of chatter about dying that the movement has fostered...

...Rather, what we may well nee~ to be admonished about is "to think what we are doing" -- to use Hannah Arendt's insightful phrase -- if for no other reason than it might eliminate a great deal of gut level flatulence...

...Thoughtful reservations about interventions and techniques of death and dying care are often met with a patient, benign, and paternalistic pat on the head that goes something like this: "Ah, but you're rationalizing again...

...One need not be "religious" to sense that when every human event becomes so leveled down and equalized -- grist for the managerial mill -- then, as Bob Dylan put it, "there's nothing really sacred...

...Such naive leveling underestimates the power of the obscene to shock and violate...

...It is in this area of underlying presuppositions (five in all) that I wish to bring to bear my analysis and, in so doing, I hope to shift the grounds of the argument...

...Again, much like the sexual liberation that led to sexual education, the death and dying movement has spawned its own paidea...

...The terror and the shame have been therapeutically excised from death, as evidenced in the droning boredom of films like Joan Robinson: One Woman's Story or the silly saccharine placebos of the spiritualist in Poltergeist or finally, the trendy proclamation by Kiibler-Ross that we should no longer speak of death, only another "transition...

...I should like to close in a similar chord by invoking the memory of the poet John Keats whose verse represents an authentic encounter with death as death...

...By denying love the dark and sheltering intimacy it needs, we have transformed it into something else, a mere exhibition complete with self-glorified exhibitors and an array of voyeuristic spectators...

...An instructive contrast to these misplaced and hence ineffectual techniques of control might be the old blues singers who at least had the good sense to know that you cannot master, avoid, or dismiss life's troubles...

...While impressed by the word "gerontological," which she sounded-out carefully, she was also suspicious of Commonweal: 112...

...One of the methodological assumptions of the thanatology movement which would preempt any reflective critique is what might be termed its "emotivism" or anti-theoretical bias...

...Yet in a world where nothing is obscene, nothing can be saved...

...Death has been brought out of doors, chronicled, discussed, even experimented with and, above all (to use Philip Rieff's phrase) therapeutically managed...

...Their muddled attack on the "obscenity of death" is particularly instructive...

...Granting the relative superiority of the latter's position could, unfortunately, forestall any further questions about it...

...lenged its basic operative assumptions...

...To return to our example of grief management, what is so striking is the total fixation on the self...

...It is full of surprises and therefore it insists upon its own unfolding...

...To lose the sense of the sacred, what transcends us, overwhelms us, measures us, is to lose the sense of ourselves, our vulnerability, our shame, our finitude...

...He even speaks of the temptation to be "half in love with easeful Death" but resolutely bids it "adieu" realizing "the fancy cannot cheat so well as she is famed to do...

...Like Arendt, Keats knew full well our task --- only in a world of suffering and death it is a melancholy one -- here "where but to think is to be full of sorrow and leaden-eyed despairs...

...In such a crucible, what Keats called the "vale of soul making," and only in such a crucible might we then become emboldened to speak...

...The upshot of this progressive "publicization" of death is that it has given the movement professionals a rationalization for some highly intrusive methods...

...As one person, active in the movement, said about his own grief in tones of obvious selfcongratulatory relish: "I was surprised how quickly I worked through it...

...On a certain superficial level it's all a bit tiresome, reminding one of the old vaudeville routine where the "corpse" keeps rising out of the coffin for one last admonition to the harried family until finally, out of exasperation, they just close the lid...

...The confusion here is two-fold...

...It is but a short step, then, to deny one's own death, to view it as illusion, or merely (in K iiblerRoss's quaintly reassuring phrase) "A transition...

...What for, Cora...

...Now the raising of so-called "gut level" feelings to sacrosanct heights is hardly new or surprising and bears little consideration--except that, practically speaking, it is so often effectively utilized by experts in the field who wish to deflect any possible criticism...

...After all, how could this marvelously self-managed and self-developed person ever face a real break in its existence...

...And so no longer exposed to the obscenity of death, we axe now treated (by the new thanatology experts) to its utter banality...

...And the way we have seen ourselves is no longer the way we a r e now...