Sunday, April 12, 2020

Pandemics and Collective Grief

"Yet what do we see when we unravel the scroll of the twentieth century? Two world wars, the rise and fall of communism, perhaps some of the more spectacular episodes of decolonisation. We do not see the most dramatic event of them all...There are very few cemeteries in the world that, assuming they are older than a century, don't contain a cluster of graves from the autumn of 1918 - when the second and worst wave of the pandemic struck - and people's memories reflect that. But there is no cenotaph, no monument in London, Moscow or Washington DC. The Spanish flu is remembered personally, not collectively. Not as a historical disaster, but as millions of discrete, private tragedies." 

(Laura Spinney, Pale Rider, 2018)

People die all the time. Lots of them. According to recent statistics, about 60 million people die every year across the globe. Right now, lots of people are dying in concentrated waves in different countries as a result of the COVID 19 pandemic. On the day that I started writing this introduction, 919 people died in Italy and 773 died in Spain from the disease caused by the SARS-CoV-2 virus. That comes on top of days of similar figures. That's a lot of death to contend with in a short space of time.

How should we respond to this? Ordinarily we process death through grief. This is something I discussed in my recent conversation with Michael Cholbi about the philosophy of grief. In this post, I want to bring some order to my thoughts on the nature of grief in the time of a pandemic. I'll do this in two parts. First, I will talk about the general nature and value of grief. Second, I will discuss how grief might be impacted by the current pandemic. What I will suggest is that, ordinarily, grief tends to be highly individualised. In the midst of a pandemic, the ordinarily individualised nature of grief can become unavoidably blurred and added to a collectivised form of grief. Maintaining the right balance between respect for the individuals who died and the collective harm is the challenge at a time like this.

1. The Nature and Value of Grief
The popular cliché is that grief is a five-stage process. It starts with denial and ends in acceptance, taking in anger, bargaining and depression along the way. This cliché comes from the work of Elizabeth Kubler-Ross, who was originally writing about the emotions experienced by terminally ill patients coming to terms with their condition and not what was experienced by their bereaved relatives after they died. Although this five-stage process is probably not empirically accurate, it does capture something about the nature of grief.

It captures the sense that grief is not simply one single emotional response to the death of a loved one. It is, rather, a process or series of emotional responses and beliefs that we pass through as we rebuild our lives after the death of a loved one. In his work, Michael Cholbi argues that grief is a process in which we reevaluate the relationship that we had with the deceased party. This relationship was once important to us, perhaps central to our sense of who we are. Their death disrupted that relationship and forced us to reevaluate ourselves. Grief is the process we go through as we work all this out. It is often characterised by a range of emotions -- sadness, depression, anger, joy -- but it is the process itself, and not these specific emotions that characterises grief.

The process of grief is supported by a set of social practices. In most societies there are rituals and practices associated with grieving. There are funerals, wakes, remembrance ceremonies and suchlike. These rituals can provide structure and reassurance for people at this difficult time. They can also function as prompts for triggering certain emotional reactions and expressions. At a funeral, it is okay to cry. Indeed, it might even be expected.

Is grief a good thing or a bad thing? There are differing views on this. Grief often has a negative quality to it: the emotions associated with grieving are painful and it's hard to argue that the death of someone you love is a net positive. Death may have alleviated their suffering and so it may have been welcome at the time, but their loss, on balance, is rarely something we would call 'good'. Furthermore, the negative emotions associated with grief can cascade out of control. We can get trapped in depressive funks for extended periods of time and this can prevent us from living a good life.

Still, there might be some positives to grief. Cholbi argues in his work that grief can, in some circumstances, be a path to self-knowledge and self-understanding. In rebuilding ourselves after the death of someone we loved, we get a chance to reassess our values and figure out what is important to us. This can be painful in the short run, but in the long run there can be advantages to this exercise in self-discovery.

I wrote about all of this two years ago, after the death of my sister. For what it is worth, and with the hindsight of two years, I think I would now say that grief is primarily bad but probably unavoidable. I understand what Cholbi is saying. It is certainly true that in the aftermath of my sister's death I had to reconsider a lot of things in my life. I reassessed my values and my character, and in doing so I revealed some dark and uncomfortable truths about who I am. I can't say that any of this has been, on balance, a good thing. I would have preferred it if she hadn't died. But I probably could not have avoided the process of grief: I couldn't simply have ignored her death and pretended that nothing had happened.

I did also come away from the whole experience with a greater sense of the wisdom of ancient traditions like Buddhism and Stoicism because of their approach to grief. They saw excessive grieving as psychologically destructive (and often selfish) and argued that we needed to attune ourselves to the deeper metaphysical reality of life and death. Once we do this we realise how fragile and transient everything we care about really is.

2. How Does A Pandemic Affect Grief?
Those are just some general reflections on the nature of grief. Does any of this change in the midst of a pandemic? You might argue that it doesn't. Each individual loss of life is still a tragedy to someone and they must go through the same process of grief. But there are perhaps some differences that are worth reflecting on.

First, a pandemic like COVID 19 changes the immediate causes of death and this might impact on the process of grief. I remarked on this in my podcast with Michael Cholbi. I experienced far more grief (i.e. a longer process and cycle of negative emotions) after my sister died than I did when my grandparents died. She was still quite young and her death was, relatively, unexpected. My grandparents were old. In fact they were well into their 90s when they died. I was still saddened by their loss but, in a sense, I had long before 'attuned' myself to the inevitability of their deaths. They were at an age where death was quite likely. It was more gutwrenching -- and equilibrium shattering -- to lose my sister at the age of 43. It just didn't seem to be part of the natural course of events.

Many of the people dying from COVID 19 are in the older age bracket, and in some cases they may well have died anyway in a short period of time (perhaps of cancer or some other chronic illness), but COVID 19 hastened their decline in a way that may have been unexpected. Furthermore, even if you ignore the oldest age bracket and the group of people with terminal conditions, the disease is also taking some people who were not expected to die anytime soon. If my experiences in reaction to my sister's death are anything to go by, this means that many people are experiencing more grief at the loss of their loved ones than might otherwise have been the case. They are seeing the deaths as more tragic and unfair because of the pandemic.

Of course, this analysis is the very thing that Stoics and Buddhists counsel against. They would argue that death can strike at any time: our lives are more fragile than we would like to assume. Indeed, people often remark on the suddenness and unexpectedness of death. Joan Didion, in her grief memoir The Year of Magical Thinking makes this point, observing that it is almost a cliché to say that death came 'out of the blue': every death seems to come like that to someone. There is some truth to this criticism. We would all be wise to attune ourselves to the fragility of life, but I still think there must be something about death from a pandemic infectious disease that is more disruptive than death from other, more typical, causes. The pandemic is like a sustained tragic accident, playing out over several months. It brings death to our doors at a speed and scale that can make the loss of life sharper and more disconcerting.

Another thing that makes grief in the midst of a pandemic more unsettling is how it disrupts the rituals of grief. We have all seen the pictures. Coffins being ferried to the graves by military convoy; caskets being closed for fear of spreading the disease; bodies not being released to families; funerals having to maintain social distancing protocols. This is a particular feature of death from infectious disease,* where there is a strong public health rationale for prevent the spread of the disease, but whatever the cause, this disruption can impact on the process of grief.

The impacts could be varied. On the one hand, as noted above, rituals of grief can help people access and express the emotions they need to process a bereavement. Lacking access to these rituals might lead to greater repression and long-term trauma. On the other hand, rituals of grief can be excessive and impose unwelcome emotional burdens on their participants. Having to adapt to strained circumstances, perhaps by coming up with new rituals of grief, might help some people process death in a way that is better suited to their personalities. Still, I wouldn't overemphasise this possibility.

Finally, another effect of the pandemic on grief is that it might tend to collectivise what is usually a highly individualised phenomenon. What I mean here is not that the experience of grief is usually only felt by individuals -- it can, of course, be felt by groups of people too. What I mean is that grief is usually directed at the loss of specific individuals. Only rarely is it directed at groups of people. I grieved the loss of my sister; I did not grieve the loss of the thousands of other people that died on the same day. It was the loss of my relationship with her that I mourned. There was no equivalent relationship with all those other people to mourn. I suppose if my whole family perished in a car accident I would lose multiple connections at the same time and thus my grief might seem collectivised in that case, but I still think it would be the loss of specific relationships with individual family members that would need to be processed and not the loss of the group.

You might argue that the pandemic won't change any of this. As Laura Spinney suggests in the epigraph that I used to open this article, the 1918 flu pandemic was experienced as millions of discrete tragedies and not as a single collective tragedy. The same may well happen now with COVID 19. But I'm not sure that will be the case this time around. I'm sure we will still grieve the loss of specific individuals: there are many families doing that as we speak. But this pandemic seems different because of the surfeit of data that comes with it. We are now obsessed with the collective numbers involved. We are seeing these numbers being updated in real time: 40,000 newly confirmed cases today; 4,000 more deaths. The individual lives tend to get lost in this noise of data. It is the aggregate figures that seem to hit hardest and matter most.

There is a sense then in which the object of grief, for many of us, will be the loss of these collective groups of people, and not just the individuals. These aggregate losses are having a disruptive impact on all our lives; we are all having to rebuild ourselves and our way of life to accommodate them. Perhaps it is a stretch to call this collective rebuilding "grief" but, at a minimum, it would seem to constitute a kind of collective trauma which necessitates some kind of psychological repair.

This is perhaps the most interesting and disturbing impact of the pandemic on the process of grief. If grief is best understood as an emotional process through which we restore ourselves to some equilibrium after having our relationships with deceased loved ones disrupted, then there is a danger that in the fog of the pandemic, with the bodies mounting in the morgue, and the pleas for us to stay home and maintain our distance, that we don't get the time to think about our relationships with these individual lives. We are too busy trying to minimise the damage to our collective way of life.

* It also, of course, happens during genocidal practices.


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