1 BOTTLED TEARS: THE PATHOLOGIZATION, PSYCHOLOGIZATION, AND PRIVATIZATION OF GRIEF LEEAT GRANEK A DISSERTATION SUBMITTED TO THE FACULTY OF GRADUATE STUDIES IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY GRADUATE PROGRAM IN PSYCHOLOGY YORK UNIVERSITY, TORONTO, ONTARIO OCTOBER 2008 Library and Archives Bibliotheque et Canada Archives Canada Published Heritage Direction du Branch Patrimoine de I'edition 395 Wellington Street 395, rue Wellington Ottawa ON K1A0N4 Ottawa ON K1A 0N4 Canada Canada Your file Votre reference ISBN: 978-0-494-90378-0 Our file Notre reference ISBN: 978-0-494-90378-0 NOTICE: AVIS: The author has granted a non­ L'auteur a accorde une licence non exclusive exclusive license allowing Library and permettant a la Bibliotheque et Archives Archives Canada to reproduce, Canada de reproduire, publier, archiver, publish, archive, preserve, conserve, sauvegarder, conserver, transmettre au public communicate to the public by par telecommunication ou par I'lnternet, preter, telecommunication or on the Internet, distribuer et vendre des theses partout dans le loan, distrbute and sell theses monde, a des fins commerciales ou autres, sur worldwide, for commercial or non­ support microforme, papier, electronique et/ou commercial purposes, in microform, autres formats. paper, electronic and/or any other formats. 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Canada iv Abstract I examine how grief has become constructed by the psy-disciplines as a pathology, and the impact this approach to viewing grief has had on contemporary grievers. I argue that the psy-disciplines have constructed grief as a disorder so as to claim a role in professionally treating grief. Further, I argue that the construction of grief by mainstream psychology has influenced North American norms in the modern world. I show how these grief norms are reiterated in medical/psychological discourses, in mainstream media, and in public policy. By tracing the development of grief theory, originally conceived by Freud within a psychoanalytic framework, to the current conceptualization of grief within the disease model, I show how grief theory has evolved within the discipline of psychology to become a) an object worthy of scientific study within the discipline and subsequently, b) a pathology to be privatized specialized, and treated by mental health professionals. Subsequent chapters examine the impact of psychological classifications on people's experiences of grieving. I argue that the power of the psy-disciplines to construct categories of human experience actively constructs new ways of being, thinking, and feeling when it comes to the expression and experience of grief. Using examples of mainstream media such as film, television, newspapers, magazines, self-help books, and memoirs, I show how the psy-construction of grief becomes thoroughly looped into people's consciousness so that the notion of pathological grief becomes the norm for people. I also examine three intertwined cultural discourses that support and enforce the psy-construction of pathological grief including fear of the body and emotions, the denial of death, and subsequently the denial of grief, and the contemporary progress narrative that does not allow for expressions of prolonged sadness. I show that a significant outcome of all three of these discourses that support the construction of pathological grief is a sense of shame and embarrassment for the mourner. The last chapter examines how modern grieving trends can be interpreted as new forms of rituals that have arisen in response to a culture that does not tolerate grieving, and offers no protocol on how to mourn one's losses. vi For Irit Granek (1953-2005), a dedicated, loving mother, and a loyal and passionate friend. vii Acknowledgments A wise child once told me that when someone you love dies, your heart hurts so much it stretches and then there is room for more love after the pain goes away. One of the things that happened after my mother died is that I gained a new appreciation and overwhelming sense of gratitude for those around me. A result, I believe, of my stretched heart. There aren't enough pages for me to include all the people to whom I am thankful for. With that caveat in mind, here are a few out of the many that I wish to acknowledge. I thank my supervisory committee, Dr. Thomas Teo, Dr. Stephen Fleming, and Dr. Alexandra Rutherford for their editorial input and continual enthusiasm for my project. To Alexandra Rutherford, a committed, and supportive mentor, I am particularly grateful. Thank you for the advice, the collaborative work, the encouragement, your caring, your generosity with time and resources, and the delicious baked goods that kept me going all these years. To Naomi Wolf, I owe heart-felt thanks. Thank you for supporting my wish to live ethically and spiritually, for being a shining example of courage, bravery, and passion, for generously including me in your family and inviting me into your home and for supporting and encouraging and getting excited about this project, even when, especially when it was the most depressing. To Maria Varnvalis, I owe my gratitude for coming up with the ingenious title of this project. To Beth Dewitt, I am thankful for carefully editing the entire dissertation and catching all the little errors along the way. I thank one of my best friends, Ran Levine, for always making me laugh, for reading, and editing my work with verve and style, and for listening to me talk for hours on end about nothing and everything. I thank Yonatan (age 5), Stav (age 10 months), Noah (age 4 months), Mara (age 7 months) and Keshet (age 1), for bringing so much joy and laughter into my life at a time where I thought I would never smile again. To all the glorious women who have supported and sustained me through the hardest years of my life, Orna Megides, Naomi Valin, Dr. Sharonie Valin, Leemor Valin, Maya Nahman, Dr. Michal Nahman, Lila Beijer, Dr. Ellen Warner, Seagal Eben-Ezra, Dr. Tobi Lubinsky, Dr. Giselle Vincett, Danya Lantz, Dr. Kayli Balaban, Lauren Epton, Dr. Ann Yeoman, Doriann Shapiro, Rabbi Yael Splansky, Dr. Karen Fergus, Wende Jager- Hyman and the Woodhull Institute and all the women of the monthly women's gathering group, I thank you. I thank my best friend, and cousin, Tom Megides, for listening, for being there, and for existing. Without you I could not have survived the last decade of my life. You are the sister I dreamed of my whole life. To my older brother, Jamie and younger brother, Elran with whom I am convinced I share a heart, I owe my gratitude. My world is a safer place because you defend it on both sides. Thank you for laughing with me, crying with me, and grounding me in reality every Shabbat dinner for the last 28 years of my life. You make every experience, every accomplishment, every moment infinitely better because it's shared with you. To Kalman Granek, my father, I am thoroughly grateful. Thank you for telling me you love me every time we talk, for reminding me to drive safely, and cross the street with caution. Thank you for helping me change the oil in my car, teaching me about how to invest money and hanging up every shelf in my house on multiple occasions. Thank you for believing that I could accomplish anything. I am grateful also to the four women who were inspirations for this project that died in 2005. For my aunt, Chaya Itzchaki, my professor, Cynthia Chataway and for my mother's friends, Louise Sahar and Gail, known simply as the 'chemo partner', I thank you wherever you are. May your memories continue to be a blessing to all who had the privilege to know you. And finally, to my mother, Irit Granek (1953- 2005) who was my best friend and to whom this project is dedicated, I am beyond gratitude. There are simply no words to describe or to express appreciation for the value of unconditional love. It is akin to trying to explain the importance of air for survival. May we be blessed to have mothers like these, and may we strive towards becoming such parents ourselves. ix Table of Contents Abstract iv Dedication vi Acknowledgments viii Table of Contents ix Preface xi Horizon of Understanding xiii Introduction 1 Theoretical foundation 1 Overview 9 Chapter One: Problematization 13 Human vs. Natural Kinds: The Development of the Psychological Concept of Grief 13 Psychoanalytic Conceptualizations of Grief 19 Psychiatric Conceptualizations of Grief 31 Grief Studies in the United Kingdom 46 The Synergy of Psychology and Psychiatry 42 Chapter Two: Pathologization 51 The Abnormality Paradigm 51 Psychiatry and Classification 59 The Expansion of Psychology and the Construction of Pathology 65 The Pathologization