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After the Death of a Child
BOOK REVIEWS
After the Death of a Child. By Ann K Finkbeiner. New York: The Free Press, 1996, 273 pp., $23.00 (hardcover). Ann K. Finkbeiner is a science journalist whose only child was killed in 1987. It was not until 4 years after her son's death that she noticed she was feeling better and that acting normal was only intermittently difficult. In an attempt to better understand her experience, she reviewed literature on grief and attachment. Little was available regarding loss of a child, and the body of existing research especially did not document long-term effects on the parent. At that point the author said that she "did what writers do: interviewed people and got a contract to write a book." This book was completed 9 years after her child's death and is subtitled Living With
Loss Through the Years. Ms. Finkbeiner's style is warm and personal. She weaves various parents' stories together throughout the book, highlighting specific themes in a poignant and artistic way. The book is not clinical in its descriptions and terminology. It reads more like a novel, and it is experienced personally and emotionally. As a result, it is easy to fall into the trap of attempting to analyze situations and apply diagnostic labels to symptoms, perhaps in an unconscious attempt to keep away from the painful nature of the material. It serves as a good reminder that the physician can easily use the intellect to distance himself or herself from vulnerability and human pain. The work is looselyorganized around various content areas including short-term responses, changes in relationships with others, changes in the internal world, and considerations on the nature of the parent--ehild bond. Throughout the book, vignettes demonstrate individual variation in the grief responses. For the most part, this serves as helpful amplification of a theme. Occasionally, however, this becomes confusing when many different names and stories are involved and interconnected. Certainly the most prominent aspect of the content of this book lies in the parents' stories and words. Their descriptions of feelings for their children and the coping strategies they used when confronted with loss are powerful and inspiring. Certain key concepts are presented as well, providing more of a frame of reference. One such concept is that the child's death creates a "zero point," a time when everything starts over and everything looks different. Changes occur in all arenas: within marriage, with other children, in life priorities, and in one's relationship to God. Guilt in parents is addressed. The author presents an interesting hypothesis that guilt may persist because of a need to make sense of a death that seems so wrong and out
1308
of order. If one attributes the child's death to someone or oneself, it may be less disturbing than facing the next question: "Why did the child die? . . . . Maybe God had a reason." Anger with God is described in many accounts. The inability to make sense of the world results in fear and anxiety. Anxiety manifests in a mistrust of the future, an inability to plan, and, frequently, a need to keep busy or distracted. The effects of a child's death on the other children in the family are addressed. As the author points out, this subject "deserves its own book." The children have not only their own grief to deal with, but also the changes in their parents. Examples of parents who became overprotecting and smothering, and those who "refused to mother," are given. The issuesof survivor's guilt and ongoing difficulty committing to relationships are described. The book serves as an important reminder that early loss of a sibling has tremendous ramifications throughout the life cycle. Ms. Finkbeiner grapples with the nature of the parent--ehild bond. The connection has an element of merger and mystery.The author describes the bond as central to one's own humanness: "If children are part of parents, they are not arms or legs but bones and breath." Children are like "links in a chain" that carry the parent's life forward and beyond. When the chain is broken, parents need to find a way to carry that link forward. Those persons interviewed creatively found ways to maintain the bond by taking on "virtues and character of the child." After the Death of a Child has an important place as a resource for those treating bereaved parents and for the bereaved themselves. The honest account of parents telling their stories certainly could help others struggling with such a loss. Inexperienced therapists can easily fall into the use of "pop recovery jargon" or "foolish words kindly meant." The author refers to such interactions as "horror stories." This book would not provide such clinicians with all of the skills or theoretical background needed to treat bereaved parents. It would certainly, however, give them a broader sense of what that experience may be like. In addition, it has an excellent list of suggested readings, organized by topic. Although the book is painful to read, it is enriching. One is struck by the mysterious power of attachment and love in the parent--ehild bond. When a child dies, the parent creatively carries the momentum of the child's life forward. The child's "trajectory" is carried ahead through the parent so that it "is neither the child's original path nor the parent's; it is somewhere between." Holly Perkins, M.D. Grand Rapids, MI
J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY, 36:9, SEPTEMBER 1997
After the Death of a Child. By Ann K Finkbeiner. New York: The Free Press, 1996, 273 pp., $23.00 (hardcover). Ann K. Finkbeiner is a science journalist whose only child was killed in 1987. It was not until 4 years after her son's death that she noticed she was feeling better and that acting normal was only intermittently difficult. In an attempt to better understand her experience, she reviewed literature on grief and attachment. Little was available regarding loss of a child, and the body of existing research especially did not document long-term effects on the parent. At that point the author said that she "did what writers do: interviewed people and got a contract to write a book." This book was completed 9 years after her child's death and is subtitled Living With
Loss Through the Years. Ms. Finkbeiner's style is warm and personal. She weaves various parents' stories together throughout the book, highlighting specific themes in a poignant and artistic way. The book is not clinical in its descriptions and terminology. It reads more like a novel, and it is experienced personally and emotionally. As a result, it is easy to fall into the trap of attempting to analyze situations and apply diagnostic labels to symptoms, perhaps in an unconscious attempt to keep away from the painful nature of the material. It serves as a good reminder that the physician can easily use the intellect to distance himself or herself from vulnerability and human pain. The work is looselyorganized around various content areas including short-term responses, changes in relationships with others, changes in the internal world, and considerations on the nature of the parent--ehild bond. Throughout the book, vignettes demonstrate individual variation in the grief responses. For the most part, this serves as helpful amplification of a theme. Occasionally, however, this becomes confusing when many different names and stories are involved and interconnected. Certainly the most prominent aspect of the content of this book lies in the parents' stories and words. Their descriptions of feelings for their children and the coping strategies they used when confronted with loss are powerful and inspiring. Certain key concepts are presented as well, providing more of a frame of reference. One such concept is that the child's death creates a "zero point," a time when everything starts over and everything looks different. Changes occur in all arenas: within marriage, with other children, in life priorities, and in one's relationship to God. Guilt in parents is addressed. The author presents an interesting hypothesis that guilt may persist because of a need to make sense of a death that seems so wrong and out
1308
of order. If one attributes the child's death to someone or oneself, it may be less disturbing than facing the next question: "Why did the child die? . . . . Maybe God had a reason." Anger with God is described in many accounts. The inability to make sense of the world results in fear and anxiety. Anxiety manifests in a mistrust of the future, an inability to plan, and, frequently, a need to keep busy or distracted. The effects of a child's death on the other children in the family are addressed. As the author points out, this subject "deserves its own book." The children have not only their own grief to deal with, but also the changes in their parents. Examples of parents who became overprotecting and smothering, and those who "refused to mother," are given. The issuesof survivor's guilt and ongoing difficulty committing to relationships are described. The book serves as an important reminder that early loss of a sibling has tremendous ramifications throughout the life cycle. Ms. Finkbeiner grapples with the nature of the parent--ehild bond. The connection has an element of merger and mystery.The author describes the bond as central to one's own humanness: "If children are part of parents, they are not arms or legs but bones and breath." Children are like "links in a chain" that carry the parent's life forward and beyond. When the chain is broken, parents need to find a way to carry that link forward. Those persons interviewed creatively found ways to maintain the bond by taking on "virtues and character of the child." After the Death of a Child has an important place as a resource for those treating bereaved parents and for the bereaved themselves. The honest account of parents telling their stories certainly could help others struggling with such a loss. Inexperienced therapists can easily fall into the use of "pop recovery jargon" or "foolish words kindly meant." The author refers to such interactions as "horror stories." This book would not provide such clinicians with all of the skills or theoretical background needed to treat bereaved parents. It would certainly, however, give them a broader sense of what that experience may be like. In addition, it has an excellent list of suggested readings, organized by topic. Although the book is painful to read, it is enriching. One is struck by the mysterious power of attachment and love in the parent--ehild bond. When a child dies, the parent creatively carries the momentum of the child's life forward. The child's "trajectory" is carried ahead through the parent so that it "is neither the child's original path nor the parent's; it is somewhere between." Holly Perkins, M.D. Grand Rapids, MI
J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY, 36:9, SEPTEMBER 1997