Guest Post: An Oncology Nurse’s Thoughts on Thanatology Theories Applied to Faith Transitions
By Maureen Edgerly
Recently I have seen many resources geared towards people experiencing a faith crisis or navigating a path as they leave church activity. One blog stated that many people are experiencing the stages of grief during this process. I have an interest in death, dying and bereavement, so this caught my interest. You might say I am well acquainted with grief both personally and professionally. I am a registered nurse who has worked in the fields of oncology and HIV/AIDS for the past 35 years and have a master’s degree in thanatology (the study of death, dying and bereavement).
Theories exist to explain the experiences of dying people. Other theories explain the experiences of grief. These two processes are often used interchangeably but are actually separate processes. Both are applicable to the loss that a person might feel at various points on the journey of awakening to a more mature or nuanced understanding of their beliefs. My goal here is not to influence anyone towards activity or inactivity, but to explain the processes in the framework of thanatology theory and identify ways to help people who are, at times, suffering and isolated.
First, a few definitions, followed by explanations of the theories, then application.
Grief is the process of experiencing the psychological, behavioral, social and physical reactions to the perception of loss.
Mourning is the cultural and/or public display of grief through one’s behaviors.
Bereavement is the state of having suffered a loss.
Elizabeth Kubler-Ross, MD, published her seminal book, On Death and Dying in 1969 based on the analysis of interviews with dying persons. In it she identified similar stages that a dying person might experience during the months/weeks prior to their death.
These stages are familiar to many of us:
• Denial and Isolation
There are multiple theories to explain the grief process following a death, including those by Freud, Fenichel, Sullivan, Pollack, Bowlby, Engel, Parkes, Worden, Sanders and others. The theories that resonate the most with me are Catherine M. Sanders’ integrative theory of bereavement, in Grief, The Mourning After and William Worden’s tasks of mourning in his book Grief Counseling and Grief Therapy.
Sanders’ theory identities 5 phases of grief:
• Conservation and the need to withdraw
Worden identifies four tasks a person must complete for successful grieving:
• Accept the reality of the loss
• Work through the pain of grief
• Adjust to an environment in which the deceased is missing
• Emotionally relocate the deceased and move on with life
The tasks are actions that fit within the framework of phases.
The following is an application of these theories to active believers:
People encounter new, sometimes troubling information. People have life experiences that are incongruent with current teaching. Some people do not enjoy the temple experience. They might try to talk about it with family, friends, even their Bishop, Temple President or church leader. Responses to questions include: “Where are you getting your information from?” “You have to be careful what you are reading.” “I don’t worry about that stuff, it doesn’t affect me.” “There are no specific answers about the temple. It’s not that we are withholding information; there isn’t a specific answer to your question.” “You have to pray about it.”
Not finding someone to discuss matters with, the person feels isolation. They may question themselves. Often the quest for answers continues, along with more information. Anger may set in when the person realizes the narrative they have been taught, the narrative they themselves have believed and taught others, is not completely true or fully presented. They feel anger at the organization and at themselves.
The person might try to double-down on righteousness by praying more earnestly, studying scriptures, fasting more and longer or becoming a temple-ordinance worker. This is a type of bargaining in a quid pro quo to get more information that will explain it all.
As the months turn into years, depression and further isolation ensue. (Here, I do not pretend to be a psychologist, but use the term depression as description, not a clinical diagnosis.) Others notice the change in affect and begin to question or reach out to this person. If they choose to share their concerns they might be met with further judgement or perhaps with a person who is willing to “go there with them.” Finding such a person is like a life-preserver when adrift. Someone who will listen, without judgement, even when they are not aware of all the concerns, offers support and comfort to the isolated. Being able to sound out, talk through, think aloud and express emotions including anger can be therapeutic.
Alas, when the wrestle is complete, a decision is reached to stay or go. To stay, with eyes open, aware of the complexities and dissonance within yourself; or to go, knowing you have thought and prayed through the wrestle and come to the best decision for yourself. Acceptance of the decision may come quickly or slowly or may not come at all. Some may stay in a state of half in/half out unable to reach a conclusion. The analogy of staying in a marriage after a traumatic destabilizing event is similar—stay and make it work, divorce, or stay and be unhappy.
Let’s now apply the phases and tasks of grief to a person that decides to leave activity, either formally or by no longer attending or participating.
The initial relief of having made a decision may be replaced by shock at the changes the decision brings. The shock can manifest as confusion, disappointment at other’s reactions, preoccupation with church despite no longer being active, regression into oneself, and further isolation. Shock will lead to gradual awareness of the reality of loss of membership or activity. The reality of no longer participating in services and activities with your family and friends; the awkwardness of conversations and interactions with family, friends and ward members. Doubt may creep in or the confirmation that the right decision was made.
The task at this point is to accept the reality of the loss and then experience and work through the pain. All decisions have consequences. Acknowledging what you are experiencing and discussing it with others sometimes helps. Having people that love you no-matter-what helps.
Recent interviews with Sam Young, excommunicated in September, are relevant examples of these initial phases. Although Mr. Young did not leave on his own, his actions led to a church disciplinary action. The resulting emotions and experiences are applicable to this discussion. I’ve listened to several of his post-excommunication interviews and recommend “A Thoughtful Faith” podcast interview by Gina Colvin posted October 10, 2018. The experience of being excommunicated is obviously different than voluntarily leaving the church, but there is something to learn from Mr. Young’s experience that is relevant to this discussion. Because he is a public figure, his story and interviews are accessible.
The next phase is conservation and the need to withdraw.
Once a decision is made, the energy expended in that effort can leave the person fatigued—mentally and/or physically. They may withdraw, for example by having a low profile on social media, or skipping family or social activities. They may have no desire or stamina to talk to people. They may not want to talk about “it” anymore so would rather avoid interactions rather than steer around conversations. This is a protective mechanism for one’s mental health.
At this time, when the person is withdrawn, social support is needed but not always accepted. It is not always offered in a way that is acceptable, without judgement. It is a tender time of transition.
According to Sanders, the person reaches a turning point when a decision can be made. The decision is to move ahead with life, stay stuck in their grief, or give up and die. Keep in mind this is a theory about grief following a death. Regarding a faith transition it applies when a person decides to move on with their life or perhaps stay in a withdrawn state of unhappiness or despair.
The tasks, identified by Worden, are to adjust to the environment in which the deceased is missing and emotionally relocate the deceased. Applying this to faith transition could mean finding other ways to experience spirituality, finding activities for Sunday that fill that time gap if needed, identify other areas of common interest with family and friends. Emotionally relocating the past experiences can be a positive experience. For example, if a person served a mission, the mission plaque, journals, planners and memorabilia can be stored for later perusal. Advancement records, seminary graduation diplomas, Young Women medallions and other such items can be stored as well.
Healing and renewal begins as the person assumes control for their decisions and forms a new identity. New energy and hope emerges. The person may feel less frustration with the past and be focused on the future self. This is observable by others. At this point the person is able to reach out to others, helping others. Their social profile reemerges in a happier, more confident version of themselves.
In grief following death, there are variations in the experience such as complicated grief reactions and disenfranchised grief to name a few. So it is with faith transitions. Each transition is different just as each person is different.
The bottom line is–how do we help people who are in a faith crisis or transition?
• Be a friend, willing to listen without judgement.
• Recognize that the issues that brought on the crisis are real, relevant and problematic.
• Acknowledge the person is struggling and in pain; the decision is not made lightly.
• Consider exploring the issues with them, one at a time.
• Accompany them to meetings with their Bishop or others, if asked.
• Keep their confidence.
• Continue the friendship and support regardless of the decision.
• Don’t be afraid to talk about the past times (like the mission or seminary class or youth activities or meaningful lessons in RS that you shared).
• Remember that faith in Jesus Christ is not measured by activity at church.
• Remember the 11th Article of Faith and allow all people to worship how they may.
I hope this explanation of thanatology theories enhances your personal journey with those experiencing faith crisis or transition. The ideas presented here are my own, based on my observations and personal experiences. I went through it the first time in the ‘80s as an adult convert from Catholicism. Right now I’m bargaining.
Maureen Edgerly lives in Maryland with her husband. She enjoys spending time with her family, knitting, reading, contemplating, and vacationing in Ocean City. She works in adult oncology clinical trials.