Family therapy after a death in the traditional Jewish family

Transcription

1 @ The Association for Family Therapy Published by Blackwell Publishers, 108 Cowley Road, Oxford, OX4 ljf, UK and 238 Main Street, Cambridge, MA, USA. Journal of Family Therapy (1995) 17: Family therapy after a death in the traditional Jewish family Vicky Harari and Joel B. Wolowelskyt A family therapist working with a religious family should be aware of its religious dynamics which, as part of the family s overriding belief system, influence coping mechanisms. We discuss here some of the dynamics within a traditional Jewish family following a death, including traditional and specially constructed therapeutic rituals. Introduction Death impacts on both the individuals who suffer the loss of a close relative and their family system as a whole. Unfortunately, there has been little discussion of these reverberations within the family system (Walsh and McGoldrick, 1991a). Moreover, there has been a hesitation among some marriage and family therapists to bring religious discussions into their therapy, feeling that they must separate themselves from nonscientific spiritual constructs, metaphors and rituals (e.g., those of the institutionalized church). In addition, the clergy who were long responsible for addressing the emotional and mental health needs of the people have been categorized by professional helpers as less skilled, knowledgeable, and trained (Prest and Keller, 1993; p. 139). But a family therapist working with a religious family should be aware of its religious dynamics which, as part of its overriding belief system, influence the coping mechanisms available to the bereaved. As Lau (1992) notes, the effectiveness of outside therapists (i.e. those from a culturally alien background) is limited by their unfamiliarity with the religious and cultural details of their clients lives. Clergy generally have the religious knowledge and perspective which the * Private Family Practice, 1459 East 4th Street, Brooklyn, New York 11230, USA. Department of Jewish Philosophy, Yeshivah of Flatbush, Brooklyn, New York, USA.

2 244 Vicky Harari and Joel B. Wolowelsky therapist lacks; they should be viewed as allies rather than competitors in meeting the needs of a family in distress. In discussing therapy with ultra-orthodox Jews (a subgroup of the traditional Jewish community), Wieselberg ( 1992) notes three considerations of which the family therapist should be aware: (1) family members may misuse an interpretation of Halachah, or Jewish law; (2) healthy ritual observance may slip into pathology with loss of self-control; (3) otherwise desirable therapeutic interventions may run counter to all interpretations of Hulachah. Wikler (1982) has dicussed the problem of religious observances or expressions becoming intertwined with the emotional and/or family dysfunction. These caveats also apply to the broader traditional community. With this in mind, we discuss here some of the dynamics following death within traditional Jewish families.* Traditional Jewish mourning customs and potential family conflicts Traditional Judaism has a well-developed system of mourning protocols (Lamm, 1969), some details of which have already been discussed in the context of family therapy (Rosen, 1991). Many of these rituals are designed to give open expression to underlying feelings (Wolowelsky, 1984). For example, the mourners, usually dealing with anger on many levels, must formally rip their jacket or shirt at the start of the formal mourning, and, depressed in spirit, they sit on the floor or on low stools throughout shiuu, the seven-day mourning period. The shiua experience places the, individual within the family organization and also positions the family and its members within the broader Jewish community. Shiva is in many ways a community experience (Wolowelsky, 1974). There is a religious obligation to visit the mourners during shiva; hundreds of community members may pass through the mourners home during the week. Neighbours are obligated to bring the first meal eaten during shiua; the mourners, as part of a caring community, are not expected to eat from their own * While the term traditional is sometimes used interchangeably with Orthodox, we refer to a somewhat broader group which also includes families which maintain a continuous positive involvement with traditional Jewish rituals, even if they might be somewhat inconsistent in their religious 1995 The Association for Family Therapj

3 Family therapy after a death in a Jewish family 245 food when they return from the funeral. A mini-synagogue is usually set up at the shiva home and services are held two or three times each day. Kaddish, the main mourner s prayer, may be recited only in the context of a congregation. A few questions from the therapist on the number of people who paid a shiva visit to each family member, whether services were held in the home, and so on will yield important information on the family s interaction with its community. As the family reconstitutes itself after the death of one of its members, it must realign relationships and redistribute responsibilities. This process is more acute in the traditional family where there is generally a well-defined role-assignment in ritual matters. If, for example, the father was the main authority figure in the house, readustments to his absence can be negotiated over an extended period as situations arise. However, if he was the person who introduced the Friday-night Shabbat (Sabbath) meal with recitation of Kiddush (prayer over wine), the issue must be addressed before the next Friday night meal. A similar problem occurs with deciding who will take on a deceased mother s role of lighting the Shabbat candles. Exploring with the family how it negotiates the reassignment of this ritual allows an entree into the more complicated and potentially threatening question of how more complex roles are redistributed. Complicating the issue is the fact that many of these rituals are traditionally gender-assigned. For example, according to the technical requirements of Jewish law, the mother can say Kiddush and the father light the Shabbat candles. Tradition, however, has assigned the former to the father and the latter to the mother. This can often create the expectation that it is a son, even if he is not the oldest sibling, who should take on saying Kiddush and a daughter who should light the candles. This in turn can create confusion and tension in the reassignment of non-ritual and unstructured responsibilities in the family. The non-egalitarian nature of traditional Judaism can create further tensions and complications in the surviving children s working through of their grief. In many - though not all - traditional synagogues, only males may say Kaddish, the prayer for the dead recited by the mourner during the daily services. A daughter may feel cheated at being deprived of this opportunity, especially if she has been more religiously observant than her brothers. Counselling her to attend an Orthodox synagogue that would allow her to say Kaddish is not always advisable, as her family (and she herself) might view this as a suggestion to reject her family s religious 1995 The Association for Family Therapy

4 246 Vicky Harari and Joel B. Wolowelsky It might therefore be necessary to explore other possibilities for a religious gesture to express mourning. A traditional response - equally applicable to male members of the family - is to undertake the formal study of a particular religious text (such as a book of the Bible or Mishnah), the culmination of which is a siyyum, a presentation of the last section of the text studied in the context of a gathering of friends and/or family, and which includes brief eulogies of the deceased. Other possibilities include undertaking a particular mitsva (good/righteous deed), such as visiting the sick in a hospital for a welldefined period, as a personal living memorial to the deceased. On the other hand, it is important to understand that people raised in a traditional family might see gender differentiation in religious matters as the norm, one that creates no feelings ofjealousy or ill-will. Therapists must therefore be alert to the danger of reading family circumstances through the prism of their own personal values. All mourners observe a thirty-day mourning period, the first seven days of which is the shiva. The mourning term for orphans is extended to a full year. During this period, mourners may not attend parties that include music, a meal and large groups of people. This social restriction can have a very negative impact on adolescent mourners who are suddenly excluded from many social events. Premature grief conflicts with the developmental task of separation/ individuation (Walsh and McGoldrick, b). This developmental conflict can give rise to feelings of anger, resentment and guilt that are not easily verbalized for fear of appearing disioyal to the deceased. A difference of opinion within the family as to which social activities must be excluded can lead to additional family tensions. Sometimes the parent, concerned that the child will be resentful, encourages the child to attend a celebration which the child would rather avoid, placing him or her in a no-win position of being disloyal to either the deceased or the surviving parent. Spouses of orphaned adults may also feel bitter at being forced to curtail their own social activities. Members of the extended family - especially if they are not personally observant - may not be understanding when, months after the burial, the mourners will not attend a family celebration like a wedding or burlbat mitsva. In fact, there is a certain amount of latitude available in defining the social events which must be avoided, and the family s rabbinic authority should be consulted if a problem arises. However, this too can be a potential source of conflict if various family members have different authorities or conflicting views on the binding nature of 1995 The Association for Farnib Therapy

5 Family therapy after a death in a Jewish family 247 respective judgements. Therapists who are not themselves knowledgeable in Halachah (traditional Jewish law and ritual) should have access to a halachist who can offer advice on understanding these issues as they arise. Therapists who are halachically observant must guard against projecting their own understanding of Jewish law onto their clients. Grief trauma may have a negative impact on the sexual relationship between the mourner and spouse (or between two mourners who have lost a child). It is therefore important for the therapist to be aware that marital relations are prohibited during shiva. (In many cases, a stillborn birth or a late miscarriage requires a period of abstinence even though there is no shiva.) In addition, observant Jewish couples are constrained from having sex during part of the wife s menstrual cycle and for some days thereafter. This means that if the wife s menstrual period begins at the end ofshiva, sex might be religiously prohibited to the mourner for a few weeks after the death. This can create additional tensions or offer a welcome period of withdrawal that is impersonally imposed. The existence of an objective prohibition that applies to all mourners gives the therapist an opportunity to raise the issue. Therapeutic rituals Imber-Black ( 1988) discussed the value of creating therapeutic rituals for idiosyncratic life-cycle events when families face a transition that, by virtue of its seemingly unusual nature, may not be marked by normative life-cycle rituals. Generally, traditional mourning rituals help move everyone through the mourning process, and the family might well be relying on these rituals to provide the organizational patterns for coping with the death. This makes such a family all the more vulnerable when the tradition provides no mourning structure, as in the case of a miscarriage, stillbirth, or nefel (a child who dies within thirty days of birth), where there is no funeral or shiva. Accustomed to relying on the tradition for direction, the family may feel unanchored as it tries to cope with the loss. Indeed, such individuals might mistakenly feel that the absence of such traditional rituals is a denial of the legitimacy of their feelings and distress. The theological insistence on differentiating between the loss of potential and actual full human life is often lost on such a family. While there have been attempts in liberal Jewish circles to create new liturgical responses to these moments of loss, the more traditional the The Association for Family Therajy

6 248 Vicky Harari and Joel B. Wolowelsky family, the more difficult it might be for its members to accept them as authentic and comforting. In such cases, the therapist might directly explore the effect of the absence of traditional rituals in dealing with their feelings. Here, too, adapting normative rituals which are performed in a broader context (such as arranging a s~yum or undertaking a particular mitsua) to the situation under consideration might well be productive. However, this is not to suggest that traditional Jewish families are not open to therapeutic rituals, especially if they are presented as designed for the specific family and not as proposed innovative community rituals. Case examfile Abe and Hannah S., aged 30 and 25 respectively, came for therapy presenting the problem of Hannah s rage and resulting inability to parent and love their 4-year-old daughter while finding it natural and easy to parent their 5-year-old son. This problem was painfully obvious in observing the interactions in the therapist s ofice. Hannah completely ignored her daughter s presence while she lavished her son with attention and affection. It soon became apparent that there was intense unresolved grief in their family system. Hannah had given birth to two other babies following the birth of her daughter. The first, a boy, died in the hospital the night before he was to go home with his mother. According to Hannah, he turned blue during the evening, was placed on a respirator, and died the following morning. The doctors said that his heart had failed. Abe and Hannah, an Orthodox couple, refused an autopsy. The time following the death of the boy - as the child was not named before he died, this is what they called him - was a blur in their minds. Since the baby died at age three days, ritual grief or shiua period was not observed. Hannah remembers taking lots of Valium and not wanting to be bothered by her very needy 15-month-old daughter while finding comfort in her adorable 2 Yz-year-old son. In an attempt to heal the wounds of their lost child, they immediately conceived another baby. This unnamed baby girl was taken to the intensive care unit immediately upon birth as a precautionary measure, given the previous family history. The baby was born with multiple genetic deformities. Subsequent genetic testing determined that the couple had a genetic problem related to the fact that they were second cousins. This baby died in the 1995 The Association for Family Therapy

7 Family therapy after a death in a Jewish family 249 at three weeks old and, once again, no shiua or ritualized mourning period was observed. Therapy involved helping the couple realize their need to mourn the loss of their two babies and then developing a ritual compatible with their needs. The couple at first were very resistant to any of the therapist s interventions. They felt that if the Orthodox tradition has not deemed it necessary for them to ritually mourn the loss of their two babies, they should be able to get on with life without any formalized mourning process. Taking this into account, the therapist and the couple developed a ritual that was personal while at the same time religious. Abe and Hannah looked through baby magazines and cut out pictures of babies that most reminded them of their deceased newborns. They then wrote a letter to each of their dead babies, sharing with them what they had hoped and desired for them. They then picked two chapters from Psalms that they felt offered them comfort. With this part of their ritual complete, they searched through documents and located the burial plots of the babies - they were not present at the burial - and then asked their rabbi to accompany them to the cemetery. They read their letters to the babies and the rabbi read the Psalms. This ritual was normative but nevertheless incorporated a religious flavour for the couple which allowed them to move on with the appropriate developmental task of bonding with and learning to love their daughter. A tombstone is unveiled within the first year following the death. This is an informal religious ceremony, sometimes attended by only close or extended family members. There is Halachic leeway here in organizing the ceremony, allowing various family members to read Psalms, deliver a short eulogy, or the like. Often a rabbi is not present, and, if one is officiating, he will usually allow family members to participate, if consulted before the ceremony. This offers an occasion for a ritual closure to the mourning period and an opportunity for family members to discuss among themselves how to respond publicly. A specially constructed therapeutic ritual might allow the same closure in a more private context. Case example B.R. was a 19-year-old woman who was referred by her father, who felt that her sad affect and separation anxiety were related to 1995 The Association for Family Therapy

8 250 Vicky Harari and Joel B. Wolowelsky death of her mother, who had died three years before. At the time, B.R. was residing with her father in an insulated ultra-orthodox community. Her brother and sister were both married with children and lived within the same community in their own households. B.R. s father stated that he did not wish to attend therapy sessions, as he did not have a problem. He insisted that it was his daughter who needed therapy. B.R. herself wished to attend at least the first session alone. B.R. could not recall ever having grieved for her mother s death, although she did observe shiva. She was referred after recovering from a three-week debilitating flu. During the illness she had to care for herself while her father was at work. This period of aloneness forced B.R. to confront her sense of loneliness, neediness, and, ultimately the loss of her mother. Three weeks after therapy began, B.R. s father died suddenly of a massive undiagnosed brain tumour. B.R. had difficulty expressing herself verbally but was a talented and prolific writer. The therapist suggested that B.R. write a eulogy for her father and either deliver it at the funeral from the women s section or, alternatively, ask her brother to read the eulogy from the podium. B.R. responded negatively, offended that such an inappropriate suggestion could be proposed. She viewed such an action as totally outside the norm of modest behaviour. This came as a surprise to the therapist who had unconsciously projected her own Modern Orthodox leanings onto her client s ultra-orthodox form of observance. However, B.R. was able to use her therapist s suggested intervention in a resourceful manner. She adapted the ritual some months later by buying her father a Father s Day card, attaching to it a picture of herself with both her parents along with a eulogy that she had written for them. She placed the card in her desk where it was accessible to be read and reread as needed. B.R. found this ritual helpful in working through her present and unresolved past grief in a manner that was comfortable to her personality and culture. B.R. had come into therapy as the identified patient, but soon after her father s death her siblings were included in the therapy room at the therapist s request. The family had practised conflict avoidance until that time, but eventually learned how to relate and communicate more openly with each other, becoming able to offer each other support and allow for different styles of 1995 The Associationfor Family Therapy

9 Conclusion Family therapy after a death in a Jewish family 25 1 Death has an impact on both the individuals who suffer the loss of a close relative and their family system as a whole. A family therapist working with a religious family should be aware of its religious dynamics which, as part of its overriding belief system, influence the coping mechanisms available to the bereaved. At a time of death, even people distanced from day-to-day ritual observance often turn to religious motifs and modes of expression. Traditional and specially constructed rituals can be important tools for facilitating life-cycle transitions in the family system as the family confronts the death of one of its members. References Imber-Black, E. ( 1988) Idiosyncratic life cycle transitions and therapeutic rituals. In: B. Carter and M. McGoldrick (eds) The Changing Family Lzye Cycle. New York and London: Gardner Press. Lamm, M. (1969) The Jewish Way in Death and Mourning. New York: Jonathan David Publishers. Lau, A. (1992) Commentary on Messent and Wieselberg. Journal of Family Therapy, 14: Prest, L.A. and Keller, J. F. (1993) Spirituality and family therapy: spiritual beliefs, myths, and metaphors. Journal of Marital and Family Therapy, 19: Rosen, E. (1991) Mourning in different cultures: Jewish families. In: F. Walsh and M. McGoldrick (eds) Living beyond Loss: Death in the Family. New York: Norton. Walsh, F. and McGoldrick, M. (1991a) Introduction. In: F. Walsh and M. McGoldrick, (eds) Living beyond Loss: Death in the Family. New York: Norton. Walsh, F. and McGoldrick, M. (1991b) A time to mourn: death and the family life cycle. In: F. Walsh and M. McGoldrick (eds) Living beyond Loss: Death in the Family. New York: Norton. Wieselberg, H. (1992) Family therapy and ultra-orthodox Jewish families: a structural approach. Journal of Family Therapy, 14: Wikler, M. (1982) Another look at the diagnosis and treatment of orthodox Jewish family problems. Journal of Psychology and Judaism, 7(1): Wolowelsky, J. B. (1974) A midrash on Jewish mourning. Judaism, 23(2): Wolowelsky, J. B. (1984) Self-confrontation and the mourning rituals. Judaism, 33(1): The Association for Family Therapy