Wednesday, February 9, 2022

The Psychological Autopsy and the Unvaccinated

Psychological Autopsy is the title of number 4 of a monogram series. Written by Avery Wieseman and Robert Kastenbaum and published in 1963, we are going back a few years. Both are remembered for their work in researching grief. I heard both years ago at grief seminars. 

I was nine years into my experience as a full-time chaplain and I had already begun to train lay people as story listeners in the hospital. We were to find that grief stories in some form provided the main category of stories heard by the Befrienders. We started a grief resource group in January 1975 to study grief in its many aspects. Then in 1976 we started a grief recovery group which went through many different phases before I retired in 1992. Genesis Hospital has since closed the grief recovery program. 


I came across this book in 1971 on a Clinical Pastoral Education sabbatical at the Alcohol Treatment Unit, the University of Iowa, Iowa City, Iowa. This was a very helpful learning experience providing deep insights into the issue of both addiction and idolatry in Scripture. Also how alcohol is used as a pain reliever in handling grief and losses of all kinds in the craving of being better, even perfect. 


The counselors at the Alcohol Treatment Unity talked about fractional suicide. Addictions take their toll on our life expectancy, lowering the years we live. And with Alcohol Addiction, the terminal face is either DT’s or Kidney failure. The terminal phase would be different for others. Smokers often have pulmonary obstructive lung disease and obese often have a diabetic condition with complications. The sources of the health problem are part of the psychological autopsy in answer to the question: when did they start to die.


Sometime after my reading of the Psychological Autopsy I had a situation in the hospital emergency room which was a classic example. A man working at the Rock Island Arsenal had a cardiac arrest. A young medical intern who was assigned to the Arsenal began procedures to resuscitate. He worked during the ambulance ride to the hospital and continued in the emergency room. The wife arrived and I spend some time hearing her side of the story. Her husband removed himself from relating to his family, even his wife, although they lived in the same house, eating and work was his only activity. 


I had a chance to visit with the young doctor after the wife left the hospital. I heard his lament about not being able to save this man’s life. I then shared with him the story I heard from the wife and the monogram on the psychological autopsy. The question was evident, when did this man begin to pull away from life and relationships. I do not have that story. What I have is the story of his dying process which began long before his cardiac arrest. Was his cardiac arrest part of a broken heart experience, loss of purpose and meaning, etc. We have questions without answers other than there is an in-depth way of studying our dying process: the psychological autopsy.


I know about this first hand. When the family farm was lost in 1938 under questionable legal circumstances followed by my father’s inability to get an automatic calf feeder on the market, he began to register a depression that became chronic and next, manifesting itself in a heart attack leading to an early death. There is a parallel in the broken heart syndrome. His unresolved grief did encourage me to facilitate a grief recovery group for 17 years to provide for others what he didn’t have himself. And this week the newspaper carried a large article on the broken heart syndrome listing various causative factors.


Moving fast forward to the pandemic and 2000-2002 with various mutations of the covid virus we have misinformation, excuses for resisting being vaccinate, anti science, no mandates, etc. all potential behaviors that can lead to death from the virus and can be registered under the psychological autopsy. 


An unvaccinated person may carry a hidden weapon, the virus, which can be he the cause of their death or others. And those who distort the best information we have at a given time as we continue learn more, this is a process, they may unintentionally or even intentionally contribute to a persons death. Example: my brother in law had a person he worked with buy into misinformation. He refused to be vaccinated He came down with the virus and went to the hospital where he died. I doubt if misinformation will be found on the death certificate. I doubt if the name of an unvaccinated person who spread the virus will be found on the death certificate. If you ask the question, when did this person start to die as posed by my understanding of the psychological autopsy, you have many contributing factors not identified. The reality of this dynamic requires a serious look in how you define freedom.


There is a forensic psychological autopsy professional for suicide. My niece is giving some consideration to studying for that profession.



Marlin Whitmer


Sunday, February 6, 2022

Correction: No light at the end of the tunnel

 Way back when the expression "light at the end of the tunnel" was actually read in more than one place to describe what was happening we were hopeful the worst was over. Now how long has it been. I have lost track of time in this timeless journey with the pandemic.

I have lost interest in tracking the metaphors. What has taken over as the virus has gone through various mutations is polarized society almost along political lines with other variations. Misinformation has been rampant. Anti-science has even evident. Court fights of mandates, masks, vaccinations, etc. have been evident. 

For myself at 91 years of age the last few years have been a self confinement. I haven't been out to California to see my family for three years and they haven't been here. Because my grandchildren here didn't want to be vaccinated we didn't meet.  Now they have had the virus so that is their excuse for no vaccination. They have all kinds of excuses.  I haven't seen them for some time. Texting and email and phone conversations have replaced face to face. The family did try Zoom a couple of times. I don't feel like much a grandparent when I look back on the relationship I had with my grandparents. 

The pandemic has made the grieving process different. The accumulation of loss and the various losses have generated the biblical laments for naming the pain. This is where metaphors come in now. They name the pain.

Saturday, February 5, 2022

The Emergence of Story Listening

My introduction to story listening came in the summer of 1953 in a Clinical Pastoral Training session at Bellevue Hospital, New York City. Fred Kuether was our supervisor. He gave us the experience of story listening by listening to  our stories and seeking to see how we were staying with the stories we were writing down in the verbatim of remembered conversations, one a week for 11 weeks.  

The dialogical approach was reinforced at the Virginia Theological Seminary where Ruel Howe introduced us to Martin Buber's I Thou approach. He lectured in a dialogical manner as the content of the class was a shared experience between professor and students. He later wrote a book on the Miracle of Dialogue.

After ordination I began practicing story listening in difference parishes. I finished my needed quarter of Clinical Pastoral Education in 1964 at Bellevue in order to be certified as a Hospital Chaplain. A couple summers before that I service as night chaplain at Bellevue to test my calling. 

In 1965 I became a full time chaplain at St. Luke's Hospital in Davenport, Iowa. Story listening was my focus as I made visits with hospital patients and staff.

I came across a book by Chad Sarah, The Samaritans, during those first years. The book is about his beginning a suicide prevention group in London. As they began to see people in emotional distress, the people would gather in the undercroth of the church waiting to visit a counselor. Lay people began serving tea and engaging in conversation. Then the professionals discovered they only needed to see half of those coming. As a result the lay people became a part of the program. Half the book was the story of their beginning and the second half was about the different emotions of the people who came. They were the same emotional dynamics of many of the hospital patients.

With the book as background a person came to my office with a request. Mavoreen said, "The Auxiliary rule is we are not to visit with patients when we take the notions cart around. I think patients want to visit, how can we change the rule." The change didn't happen over night. When I proposed to the Administrator training lay visitors I encounter resistance, "we're only concerned with what takes place within these four walls." Getting involved with folks not part of the medical community was overstepping.  At a later visit as I persisted he made a proposal. I would have to get permission from the Auxiliary, nursing service, and the medical staff. The Auxiliary said yes, nursing service said we will go with the doctors decision, and the medical staff of the doctors took over an hour to decide and then they made a decision not directly related to what we were about to do. The Sisters of Mercy visit patients and they aren't ordained. I know this since the secretary of the meeting told me some time later. After retiring he took the Befriender training.  He said later, "As a doctor I knew what I would say when I entered the room, as a Befriender I would find out."

To be continued.