The total absence of authoritative sources on the subject does not stop the undertakers and their spokesmen from donning the mantle of the psychiatrist when it suits their purposes. As an embalming textbook says, “In his care of each subject the embalmer has a heavy responsibility, for his skill and interest will largely determine the degree of permanent mental trauma to be suffered by all those closely associated with the deceased.”
Lately, the meaning of “grief therapy” has been expanded to cover not only the Beautiful Memory Picture but any number of aspects of the funeral. Within the trade, it has become a catchall phrase, its meaning conveniently elastic enough to provide justification for all of its dealings and procedures. Phrases like “therapy of mourning” and “grief syndrome” trip readily from industry tongues. The most “therapeutic” funeral, it seems, is the one that conforms to their pattern, that is to say, the one arranged under circumstances guaranteeing a maximum profit.
I had a long discussion with Mr. Raether about “grief therapy,” in which I sought to know what medical or psychiatric backing he could produce to substantiate the funeral industry theory that viewing the restored and embalmed body has psychotherapeutic value. He spoke of grief and ceremony; he mentioned some clergymen of his acquaintance who thought viewing the body was a valuable experience; but no qualified psychiatric reference was forthcoming.
Eventually he referred me to an article by Stanford University professor Edmund H. Volkart which had appeared in Explorations in Social Psychiatryand which allegedly supported the proposition that “viewing” was therapeutically valuable to the bereaved. Since Professor Volkart’s article was the only authoritative published work cited by Mr. Raether, it seemed advisable to check with him. Professor Volkart, who was at the time director of Stanford’s program in medicine and the behavioral sciences, wrote to me as follows:
I know of no evidence to support the view that “public” viewing of an embalmed body is somehow “therapeutic” to the bereaved. Certainly there are no statistics known to me comparing the outcomes of such a process in the United States with the outcomes of England where public viewing is seldom done. Indeed, since the public viewing of the corpse is part and parcel of a whole complex of events surrounding funerals, it would be difficult, if not impossible, to ascertain either its therapeutic or contra-therapeutic effect.
The phrase “grief therapy” is not in common usage in psychiatry, so far as I know. That the loss of any loved object frequently leads to depressions and malfunctioning of the organism is, of course, well known; what is not well known or understood are the conditions under which some kind of intervention should be made, or even the nature of the intervention.
My general feeling is that the phenomena of grief and mourning have appeared in human life long before there were “experts” of any kind (psychiatric, clerical, etc.) and somehow most, if not all, of the bereaved managed to survive. The interesting problem to me is why it should be that so many modern Americans seem more incapable of managing loss and/or grief than other peoples, and why we have such reliance upon specialists. My own hunch is that morbid problems of grief arise only when the relevant laypersons (family members, friends, children, etc.) somehow fail to perform their normal therapeutic roles for the bereaved—or may it be that the bereaved often break down because they simply do not know how to behave under the circumstances? Very few of us, I think, would be capable of managing sustained, ambiguous situations.
Demonstrably flimsy and absurd as the justifications for universal embalming and “viewing” may have been, these patently fraudulent claims of undertakers for their product remained immune from government intervention until 1984, when the Federal Trade Commission’s funeral rules were adopted. These provided, among other things, that:
It is a deceptive act or practice for a funeral provider to:
• Represent that state or local law requires that a deceased person be embalmed when such is not the case;
• Fail to disclose that embalming is not required by law except in certain special cases.
The rule went on to provide that prior approval for embalming must be obtained from a family member.
The howls of dismay that greeted these seemingly innocuous rulings were pitiful to behold. They echoed, indeed, the eruption, five years earlier, that followed the introduction of a similar requirement at a meeting of California’s State Board of Funeral Directors and Embalmers. I had special reason to take note of it at the time, because the proposer was my husband, Bob Treuhaft, who had been appointed to the board by then governor Jerry Brown.
The proposed regulation required that a responsible party confirm that he or she understood that:
Arterial embalming requires cutting into an artery and draining the blood, which is replaced by chemical preservatives for the temporary preservation of the body while awaiting interment. I understand that embalming is not required by law.
Bud Noakes, an editor of Mortuary Management, responded emotionally in a leading editorial:
I thought I had reached a time of life at which I do not shock easily, but I realize now I had not fully plumbed the depths to which Mr. Treuhaft is capable of descending. I was shocked that an individual, who is sworn to act in the best interest of California, could be so wholly insensitive to the emotional state of bereaved families.
Anyone who wants to know how embalming is accomplished can easily find out simply by asking funeral directors. But the answer will be given in a tactful and diplomatic manner, and in consideration of the emotional state of the person making the inquiry. For anyone to assume that the same explanation could be given to everyone under any and all circumstances is to confess abysmal ignorance of the tender sensitivities of people in a state of bereavement.
There follows a call to action. There will be a hearing at the state capitol (date and address given) to vote on the proposal. “It is incumbent upon all funeral directors to take immediate action to protect the best interests of the bereaved public we are dedicated to serving.”
So the brethren rallied, and the lobbyists lobbied, and the proposal was defeated. Dead, yes, but destined to be reincarnated five years later in the Federal Trade Commission’s Funeral Rule.
The funeral folk soon had another opportunity to show their tender concern for the feelings of those in bereavement. When, in the early eighties, the outbreak of AIDS became a matter of public anxiety, there was panic on the part of funeral directors and embalmers for their own safety. Most mortuaries refused to accept cases where it was believed that the deceased had been exposed to the HIV virus; those that did accept AIDS victims refused to wash, dress, or embalm the victim.
The New York State Funeral Directors Association (NYSFDA), on June 17, 1983, advised members to institute a moratorium on the embalming of AIDS victims. Reaction was quick.
Peter Slocum, a spokesman for the State Department of Health, said that funeral directors had previously been advised to handle the bodies of victims of AIDS as they handle victims of hepatitis B—that is, to wear latex gloves, a procedure that had already been prescribed to prevent spread of any contagious disease and required for health care workers under all circumstances when working with dead bodies. “We have not seen anything that suggests that there needs to be any precautions beyond that.”
Governor Mario Cuomo introduced a bill in the state legislature which would make funeral directors liable to loss of license if they refused to embalm AIDS victims, saying, “We must not permit AIDS sufferers and their families to be subjected to irrational and unscientific behavior born out of fear, not fact.” One week later, the NYSFDA lifted its moratorium on embalming, and the bill died in committee.