Gire, J. T. (2002). How death imitates life: Cultural influences on conceptions of death and dying. In W. J. Lonner, D. L. Dinnel, S. A. Hayes, & D. N. Sattler (Eds.), Online Readings in Psychology and Culture (Unit 14, Chapter 2), Center for Cross-Cultural Research, Western Washington University, Bellingham, Washington USA.

This material is copyrighted by the author(s), who have kindly extended to the Center the right to use the material as described in the Introduction to this collection and the form entitled "Agreement to Extend License to Use Work."

UNIT 14, CHAPTER 2

HOW DEATH IMITATES LIFE: CULTURAL INFLUENCES ON CONCEPTIONS OF DEATH AND DYING

James T. Gire
Virginia Military Institute
USA

ABSTRACT

Although the final outcome of death is the same for all humans, cultures vary in how they conceptualize death and what happens when a person dies. In some cultures, death is conceived to involve different conditions, including sleep, illness, and reaching a certain age. In other cultures, death is said to occur only when there is a total cessation of life. In a similar manner, certain cultural traditions view death as a transition to other forms of existence; others propose a continuous interaction between the dead and the living; some cultures conceive a circular pattern of multiple deaths and rebirths; and yet others view death as the final end, with nothing occurring after death. These different conceptions have a noticeable influence on people's lifestyles, their readiness to die for a cause, the degree to which they fear death, their expressions of grief and mourning, and the nature of funeral rituals. A relatively global conceptualization of death issues would have to incorporate these various cultural variations.

INTRODUCTION

Two of the attributes that all humans share are the experiences of being born and the fact that everyone would eventually die. Although we are excited about discussions concerning birth, people in all cultures discuss death with extreme reluctance. However, even though we may use the same words to describe death, the actual meaning and conceptualization of death differs widely across cultures. The tendency for vast differences to occur in conceptions about issues or events that, on the surface, seem very obvious is a major reason why a cultural examination and analysis of every behavioral phenomenon should almost be mandated. For example, eating is a behavior engaged in by most human several times a day. Yet, cultural variations in eating are enormous. Cultures vary in what they eat, how they eat, when they eat and with whom. Even when cultures agree on what should be eaten, differences arise in how it is prepared, who is expected to eat the given item, and at what stage in time and age.

Kagawa-Singer (1998) provides a very fitting analogy of cultural diversity using weaving as an example. Although weaving is a universal technique, the patterns that result from this process are culturally unique and identifiable. Thus, even when they use the same materials, patterns used in Navajo, Chinese, Persian, Japanese and French tapestries are recognizable not only in terms of colors, but also of patterns and textures. This range of diversity applies to issues about death and dying. In this respect, then, issues of death imitate those of life. This reading explores some of the cultural variations in death and dying, and discusses how these differences at once derive from a given culture's world view as well as influences members of that culture's approach to death. These are manifested in conceptions about death, death anxiety, bereavement, and burial rituals.

Conceptions of Death

The difficulty of having a unitary view of death or the death experience can be better appreciated when we realize that it is problematic to even define what we mean by death. The first definition of death in Webster's Encyclopedic Unabridged Dictionary is that it is "the act of dying; the end of life; the total and permanent cessation of all the vital functions of an animal or plant." (1989, p.372). This appears quite straightforward enough, until we realize that it represents a largely Western conception of death. According to Counts and Counts (1985), some South Pacific cultures believe that life, as is generally construed, departs the body of a person in different situations, such as when one is ill or asleep. Thus conceptualized, people can be said to "die" several times before the final death. This also means that a person can be defined as dead without meeting many of the criteria listed in the above definition or definitions found in the social and medical literature. Similarly, the Truskese of Micronesia believe that life ends at 40 years of age, and when you reach 40, you are, in effect, dead. Given the physically demanding activities engaged in by people in this society, there seems to be a noticeable decline in the ability of the Truskese to perform their socially assigned roles at acceptable standards at this age. Sensing that the end must be coming, the individual begins to prepare for death and is viewed as being dead even before he or she transitions to that point as viewed from the Western perspective.

The differences in conceptions about death extend to what exactly happens when one is dead, however defined. Some cultures, such as the Hindu, envision a circular pattern of life and death where a person is thought to die and is reborn with a new identity. This exit and reentry into life can occur multiple times. This contrasts with the Christian view where death is believed to occur only once. However, Christians do not believe that everything ceases at death. The person sheds his or her bodily form but continues on in spirit where there are consequences: the faithful - believers who kept the faith - are rewarded with eternal joy in heaven, and sinners proceed to hell where there is endless pain and suffering. Among some Native American tribes and certain segments of Buddhism, the dead and the living coexist, and the dead can influence the well-being of the living. If the dead (ancestral spirits) are properly propitiated, the likely outcome is a benevolent spirit that protects the interests of the living. If not accorded the appropriate treatment, the result is an unhappy spirit that may ignore the well-being of the living, leading to misery. There are, of course, some cultures in which death signals an abrupt and permanent disengagement. In some instances, people are prohibited from even mentioning the names of the deceased in the fear that doing so may actually endanger the lives of the living or prevent the ghost from leaving this earth and attaining peace.

Irrespective of how death is defined, each culture has notions of how death ought to occur. Kellahear (1990) makes a distinction between an "acceptable death" and a "good death" for the person who is dying. An acceptable death is said to be non-dramatic, disciplined, and with very little emotion. This is the atmosphere that seems to exist in structured settings such as hospitals in the West where most people die. On the other hand, a good death is said to be one that allows for social adjustments and personal preparation by the dying person and his or her family. This is a time when the dying person attempts to complete unfinished tasks, to say farewells, and for the family to begin to prepare for life without the dying. Van Gennep (1960) considers a good death as the funeral that the dying give to the living so as to enable the family disengage from the dying person as an active part of the family's life.

It is important to examine these cultural variations in conceptions of death and dying because they have significant implications on how people act in life, how they approach death, whether or not they fear death, and on their funeral and bereavement practices. An obvious implication of how notions about death and dying influence actions is the phenomenon of suicide bombings. This is a fairly recent phenomenon, believed to have started in the early 1980's by Lebanon's Shi'ite extremist Muslim group, Hizballah, which was influenced by the way Iran used humans as minesweepers in their war against Iraq. By 1994, two Palestinian groups, Hamas and Islamic Jihad took up the practice. Initially, only a few people joined the suicide squads, and even then, with little enthusiasm. They had to be subjected to several months of training in what appeared to be extreme indoctrination. Today, people willingly compete for the privilege of being selected into the suicide squads. The major change from the initial reluctance and the current enthusiasm seems to be the modification in their conception of death and what awaits them after death.

According to some Islamic teachings, the great Prophet Mohamed stated that the sins of a shahid or martyr (as the suicide bombers are called by their compatriots) will be forgiven when he sheds his first drop of blood. In addition, he can admit 70 relatives to paradise and will personally be married to 72 beautiful virgins upon his arrival in paradise (Van Biema, 2001). Although this approach to death is said to be associated with the Islamic faith, this represents a clear case of how religion interacts with other aspects of culture. This is because the practice of suicide bombings seems to be localized to the Middle East and is almost nonexistent among millions of practicing Muslims in other parts of the world. The other implications of the varying conceptions of death and dying are discussed in greater detail in the next few sections.

Death Anxiety: The Fear of Death

Most humans do not willingly welcome the idea of their own or their loved ones' death. In fact, the most common reaction to the thought of dying is fear. Becker (1973) is among the many theorists who believe that the fear of death is a major motivator of all behavior. When the fear of death is channeled properly, it can be a motivating force to propel individuals into phenomenal achievements with the goal that those achievements would transcend their physical mortality. This is perhaps why every president of the United States tries to make an enduring contribution that would be recorded as a legacy of his administration. Another way in which death anxiety can be a positive force is that people who are afraid of dying tend to do whatever it takes to ensure that they stay alive. Staying alive, in turn, contributes to the continuity and socialization of the species because people so driven are more likely to want to have children and to raise them according to their society's acceptable standards. However, the same death anxiety, if not properly handled, can become a destructive force and could even result in both physical and mental problems. According to Fortner and Neimeyer (1999), high levels of death anxiety in older adults are associated with lower ego integrity, more physical and psychological problems relative to individuals with low death anxiety.

Death anxiety is a multifaceted construct that is not easy to define but has been conceptualized to include: fear of death of oneself, fear of death of others, fear of dying of self, and fear of the dying of others. Fear of death of oneself has to do with the fear of the event of death and comprises such things as what happens to the individual after the experience of death. To some, it could be fear about judgment - whether one would go to heaven or hell, fear of cremation, earth burial, the donation of one's body to science, and what might happen to people and possessions that one may leave behind, including one's spouse, children, and businesses.

Fear of death of others encompasses the apprehension by an individual of death occurring to significant others in one's life, especially family members and friends. Fear of dying of one's self differs from fear of death of one's self in the sense that the former refers to the process of dying while the latter involves the event of death. A good number of people are not afraid of death itself, but are extremely anxious about how they will die. Anxieties here revolve around the notions of wasting away, the possible deterioration in one's physical appearance, and the pain that may be associated with dying. It is not uncommon for some to also worry about the possibility of being a burden to others, both in terms of time and financial costs. Fear of dying of others is similar to the fear of dying of self, the only difference being that the person in question may have anxieties about the process of dying of significant others in his or her life.

In addition, each of the above components can be examined at the public, private, and nonconscious levels. Thus, the fears about death that we may relay publicly may differ from what we may believe and express privately, which may be different from the fears that we may not, ourselves, be consciously aware that we are exhibiting. The complexity of this construct suggests that death anxiety is likely to manifest itself in various ways. One of the most obvious ways in which we display death anxiety is through avoidance (e.g., Kastenbaum, 1999). Avoidance may involve a public as well as a conscious manifestation of death anxiety. Some people consciously refuse to attend to funerals or visit friends and loved ones who are dying because it makes them uneasy or uncomfortable. Unconsciously, the person may avoid doing so because he or she is too busy to attend to these obligations. Other people may display death anxiety by engaging in activities that seem to confront or defy death (Kalish, 1984). These people may repeatedly engage in risky activities such as bungy jumping, skydiving, rock climbing and becoming soldiers of fortune. Death anxiety can also manifest itself through changes in lifestyles, use of humor, or getting involved in jobs that deal with death such as funeral parlors or retirement facilities for the very old. 

Death anxiety is not prevalent to the same degree across cultures. One of the cultural variables that has received extensive examination with respect to death anxiety is religiosity. In a survey of 674 older adults, Duff and Hong (1995) found that death anxiety was significantly associated with the frequency of attending religious services. This factor was particularly related to the belief in life after death. For example, Alvarado, Templer, Bresler, and Thomson-Dobson (1995) found a strong negative correlation between death anxiety and belief in afterlife. That is, as the degree of certainty in afterlife increased, levels of death anxiety decreased.

This belief in afterlife factor was explored more extensively by Parsuram and Sharma (1992) who compared people of three different religions in India: Hindus, Muslims, and Christians. They found that Hindus (who had the greatest belief in life after death) also tested lowest in death anxiety, followed by the Muslims, while the Christians showed the highest death anxiety. In a more recent study, Roshdieh, Templer, Cannon, and Canfield (1999) studied death anxiety and death depression among 1,176 Iranian Muslims who had war-related exposure during the Iran-Iraq war. They found that those who showed the higher death anxiety were those who also had weaker religious beliefs, did not belief in life after death, and did not assert that the most important aspect of religion is life after death.

Although not many studies have empirically made comparisons between cultural groups on variables other than religion, we can extrapolate from these findings that death anxiety will be relatively lower among death affirming societies than among death-denying or death-defying cultures. The United States, and probably most of the societies in the West, is a death-denying/defying society where even the idiom of expression is that of resistance. People vow not to go gently into the good night (Blake, 1988) or conjure images of fighting illness, or fighting the enemy, death (Kalish & Reynolds, 1981). On the other hand, other societies appear to be more accepting of death. The Truskese of Micronesia are an example of a death-affirming society where people start preparing for death at age 40. This acceptance ought to manifest itself in lower death anxiety levels. Since this aspect has not been systematically explored in research, it presents an attractive item on the research agenda to add to the pool of the existing variables that influence the death anxiety.

Having a certain degree of death anxiety may be appropriate in the sense that it may propel the individual to some productive pursuits as well as refrain from certain risky life choices. However, if death anxiety becomes too powerful, it may interfere with one's normal daily routines. There are several ways to help people deal with their fear of death. One way, suggested by Kalish (1984, 1987) is to live life to its fullest. The rationale here is that even if the person were to die, he or she would not have a sense of having being cheated out of life, and therefore have few regrets. Another way of reducing death anxiety is through death education. There are several of these programs and they differ in the nature of topics covered, but tend to focus around such topics as religion, philosophy, ethics, psychology, and medicine. They also discuss issues involving the death process, grief and bereavement. Death education helps mainly by increasing people's awareness of the range of emotions experienced by the people dying and their families. Research evaluating the experiences of those who have undergone training in these experiential workshops suggests that they are effective in lowering death anxiety (Abengozar, Bueno, & Vega, 1999).

Grief and Bereavement

Events leading to death such as terminal illness do not end with the death of the dying person. In fact, all humans, including the dying, experience grief as a response to impeding or resultant death. Worden (1991) defines grief as the personal emotional reactions (e.g., sadness, anger, and guilt) that follow a loss. Bereavement refers to the experiences that follow the death of a loved one, while mourning is the process through which grief is expressed. Mourning thus represents the culturally accepted expression of the personal feelings that follow the death of a loved one. There is a wide variation across cultures in how people behave after a death and how they are expected to behave. In some cultures, close relatives are expected to shave their heads, wear either white or black clothing, and express grief for a specified minimum period of time. In other cultures, mourning involves a lot of drinking, dancing, and in some cases, a person within a certain kinship position is expected to marry the spouse of the deceased. In yet other cultures, the requirements for dealing with a major loss are played out over the balance of the lifetime of the survivor. This could be in form of rituals, what is worn, how one is to be addressed by others, and one's rights and obligations to participate in various activities within the community (Rosenblatt, 1997).

Despite these differences, there are also some similarities. For example, grief reactions expressed in the form of crying, fear and anger are so common as to be deemed universal. Also, most cultures provide sanction for the expression of these emotions in rites of mourning that follow bereavement (Parkes, Laungani, & Young, 1997). This has led to the suggestion that grief or mourning may involve a specific sequence. Some theorists have found it convenient to view grieving as a process that consists of stages or phases, and most theorists have divided grief into three phases (e.g., Parkes, 1972).

The most common feelings people are thought to express in the first phase are shock, disbelief, and numbness. These feelings are actually believed to be adaptive in the sense that they protect the person from the severe pain of bereavement. Then the person gets into the second phase where he or she realizes that the deceased is gone, never to return. Three behaviors characterize this phase: thinking a lot about the deceased, which is often followed by feelings of guilt, trying to find a reason why the deceased died, and finally, a tremendous longing for the deceased, manifested in such ways as dreaming about the deceased, or even speaking to him or her. When these feelings diminish, the bereaved is ready to move into the final phase - recovery. Recovery comes about due to conscious and concerted efforts by the bereaved, who realizes that there is no sense in dwelling on the loss, and that he or she has a lot of other responsibilities to take care of. Mourners at this stage may now enthusiastically seek out the company of others and socialize actively. There is no specific time frame within which a person should stay in one stage or across stages; it depends on a number of factors, including the age at which the deceased died, the closeness of the relationship between the deceased and the bereaved, and the availability of social support. However, experts believe that it takes at least a year, perhaps more, to progress through the first phase through to recovery.

Despite the appealing concept of phases of grieving, Worden (1991) prefers to view the grieving process in terms of tasks, not stages or phases, because of the implied passivity on the part of mourners embedded in these two terms. The implication is that the mourner has no choice but to pass through these stages. In contrast, tasks imply some action on the part of the mourner and suggest that the grieving process can be subject to external intervention. This tends to provide some hope that there is something the bereaved can actively do about the situation. Worden (1991) proposes four tasks of mourning. Task 1: Accept the reality of the loss. This can be enhanced by viewing the corpse, attending memorial services, and funerals. Task 2: Work through the pain of grief. Trying to avoid pain can actually prolong the course of mourning and may lead to abnormal grief. Task 3: Adjust to an environment in which the deceased is missing. This task principally involves cognitive readjustment. Task 4: Emotionally relocate the deceased and move on. This does not really call for a complete disengagement from the deceased, but rather, to find a more suitable place for the deceased in the life of the survivor so as to enable the survivor live an effective life (Shuchter & Zissok, 1986).

While the organization of the grieving process into stages or tasks has provided a much needed structure in the way in which we can study the process, it also appears to prescribe what might be deemed an acceptable way of mourning. This notion has led to terms such as normal and abnormal grief or complicated and uncomplicated grief. Given the cultural diversity in the expression of grief and bereavement, such terms should be applied globally only after they have been found to encompass practices involving these concepts across cultures

Normal Versus Abnormal Grief Reactions

Worden (1991) identified four main categories under which a broad range of grief reactions can be classified - feelings, physical sensations, cognitions and behaviors. Feelings include reactions of shock and numbness, sadness, anger and anxiety. Physical sensations can include shortness of breath, tightness in the chest, and, in some cases, even feelings of depersonalization. Common cognitions are disbelief, preoccupation with thoughts of the deceased and hallucinations (these last two are usually transient). Behaviors include sleep disturbance, eating difficulties and absentmindedness.

Abnormal or pathological grief reactions are said to occur when people display actions that are not statistically common or express common grief reactions but for an extended period of time. Based on the criteria listed by Worden (1991), grief that is never expressed, grief that is expressed but is intense and goes on for too long, and grief that involves self-injury, may be considered abnormal. However, while the concept of grief is universal, the specific way in which grief is expressed can vary widely across cultures. A mother in Egypt who is immersed in deep grief for seven years over the death of a child may not be behaving pathologically if judged by the standards of her culture (Wikan, 1980). In contrast, overt expressions of sorrow are severely proscribed among the Bali. Thus, a bereaved Balinese who appears to laugh off a death is also behaving appropriately, based on the standards of her culture (Wikan, 1990). In yet another society, a person who is possessed by the spirits of the dead may be within the limits of what is quite appropriate and common in bereavement in his or her own culture (Rosenblatt, 1997). Thus, issues of normal and abnormal grief reactions will make sense only when they are viewed within the cultural framework of the people being evaluated.

Funeral and Burial Rituals

Transitions, along with their accompanying rites of passage, occur throughout the life cycle. These transitions require discarding one set of behaviors, beliefs, and identities, and taking on a new set that makes up a new identity. Death is the final life transition. The funeral can thus be viewed as a celebration of a rite of passage for both the deceased and the living. Societies tend to surround death with specific rituals that are aimed at assisting the bereaved through this final life transition. Funeral rites are believed to serve three closely intertwined functions (Palgi, & Abramovitch, 1984; Rawski, 1988). When a member of a society dies, there arises a need to realign the relationships among the survivors. The first function of the funeral is to explain, justify, and regulate the new social relationships that are created by the death. The second function served by a funeral is that it is part of a longer ritual that takes the dead safely out of this world and into the next. After the funeral rituals are concluded, the immediate family may practice other rituals that enhance the safe passage of the deceased into the next world. Finally, funerals provide an avenue through which the bereaved deal with grief and guilt. Thus, funerals can provide a set of psychologically healthy mourning practices for the bereaved, enabling them to act out their grief in the presence of a support group (Martinson, 1998).

The nature of the rituals is sometimes related to the nature or age of the deceased. When people die after having attained old age, the activities represent a celebration of the person's life and can be very festive. Almost no elaborate rituals accompany the death of a child. Among most groups in Taiwan and Korea, a child is buried only a few days after his or her death, and with very limited funeral rituals. In one example of the death of an 8-year old boy, his cremation took place only two days after his death, with very few people in attendance. The mourners did not wear any mourning clothes.

Just like the other aspects of life and death, funeral and burial rites vary widely across cultures, and are influenced by each culture's conceptions of death and dying. The rituals change the identity of the person from living to dead. That new identity may be as a spirit of an ancestor who remains with the family, or a soul that returns to its maker. Funeral rituals usually mark the beginning of the adoption of new identities - as a widow, widower, a son who is now the head of the family, or the mother as matriarch. This transformation takes time, often lasting for years. Even though the survivors may start acting the new identities after the funeral, the transformation itself is a process that begins as soon as it is evident that the sick family member is likely going to die. The family immediately begins to prepare for the imminent loss, and once it occurs, public support is provided throughout the transition through its mourning rituals.

In many cultures, particularly in the developing world, the old identities of the bereaved do not die with the deceased but are resurrected with every commemorative service of the loved one. Thus, these identities are renewed and grief is openly expressed on a recurring basis (Kagawa-Singer, 1998). In some cultures, survivors in certain kinship standing take over the spouse of the deceased. However, any children that may come out of this union still answer the name of the deceased. In whatever form they may take within a given culture, funeral and burial rituals are ways that each society tries to help the bereaved with the death of a loved one.

As the preceding discussion has shown, even though all humans may experience death, conceptions about death and how we respond to issues of death and dying vary widely across cultures. As the world is increasingly shrinking due to the extensive interaction of people from cultures across the world, it is important to understand the complexities that surround the issues of death, just as we do the issues of life. This will better prepare us to respect and understand people from other cultures, and respond to them in ways that are meaningful to them and ourselves so that their lives and ours may be enriched in the process.

About the Author

James T. Gire received a doctorate degree in experimental psychology from McMaster University, Hamilton, Ontario, Canada. He is currently an Associate Professor of Psychology (Lieutenant Colonel) in the Department of Psychology and Philosophy at the Virginia Military Institute. His research interests are in the areas of aging and adult development, cross-cultural social psychology, substance use and misuse, especially alcohol and tobacco. He has published in more than half a dozen peer-review journals, including Psychology of Addictive Behaviors, Journal of Social Psychology, Substance Use and Misuse, and the Canadian Journal of Behavioural Science. He also has a book in press (Frank Eyetsemitan, co-author) on adult development and aging in the developing world with Greenwood Press. Electronic mail: girejt@mail.vmi.edu.

References

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Discussion Questions

1. What are the various cultural conceptions of death?
2. What impact do conceptions of death have on behavior, including life and death decisions?
3. What is the distinction between a good death and a bad death? Why is such a distinction important?
4. Define death anxiety and describe the different ways in which it is manifested.
5. What factors influence death anxiety? How do people learn to deal with death anxiety?
6. What are the cultural differences in grief and mourning?
7. Describe the different stages or phases of grief/mourning. How long does grief usually last?
8. Describe the tasks of mourning and how they differ (especially conceptually) from the phases or stages of grief/mourning.
9. Distinguish between normal and abnormal grief. What are the dangers in uncritically labeling certain types of grief as abnormal?
10. What are the major functions of funerals? How does the type of loss affect funerals?

Related Web Sites

1. www.choices/org
2. www.compassionnatefriends.org
3. www.hospicefoundation.org

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