Is Closure a Myth ?

A Cancer Doctor Says Closure Is a Myth

You will never stop missing a loved one who passed away

There are few among us who have not experienced the loss of a friend or loved one, often without warning, or — like those of us who care for people with cancer — after a lingering illness.

It is a time when emotions run high and deep, and as time passes from the moment of loss, we often hear how important it is for those who have most directly experienced the void to gain closure in order to move on with their own lives. We seek that closure as a way of tidying up, fearing that the memory of that person or a well-meaning comment may provoke unintended pain or undo what time is said to heal.

The reality is, however, that closure is a myth.

My personal and professional experience with those who have lost family and friends, including children, has taught me that going on with life is not the same as gaining closure.

To close the memory does not sustain the healing nor help in proceeding with life. Such echoes from the past are voices in the present.

The wound of loss is indelible and a part of each person’s life forever, punctuated by many moments of recollection. It is sometimes predictably provoked by a date on the calendar and, less predictably, by a sight, sound, aroma, melody or a place that evokes an immediate awareness of that person, long after their physical presence in our lives has ceased. We continue to think about those dear to us, perhaps not every day, nor with the same intensity, but our lives are populated by those whom we know and, sometimes more profoundly, by those whom we remember.

The experience of these personal moments, seemingly forever paused in time, can cause us to feel alone, even while in the presence of others. This aloneness is heightened by a false expectation that these experiences should, and will at some point, be over.

Hanging Onto Memories

No matter how long it has been, we do not stop recalling such people who remain a presence in our lives, these echoes from the past, and they may even help define the very direction we follow as we do go forward in life. To deny such memories or experiences is to deny precious moments of love, of fellowship, of gratitude and inspiration.

Grief changes the experience of loss, but does not close or eliminate it, and is not intended to do so. To close the memory does not sustain the healing nor help in proceeding with life. Such echoes from the past are voices in the present and are sometimes warmly felt.

As humans, we are connected to each other and despite differences in culture, religion or ethnicity, we all yearn to remember. Nearly every culture has its way of preserving memory and we build memorials as perpetuators of collective memory, whether it is the Vietnam Memorial on the Capitol Mall, the Holocaust Museum or the 9/11 Memorial in New York.

Cemeteries offer a communal “safe” space where grief is openly welcomed and expected. Visitation rights to a plot do not suddenly expire six months after a burial, a time marked by some in the medical community as the “normal” grieving period.

In the Jewish tradition, the acknowledgment of the annual Yahrzeit, the anniversary of the death of a family member, is always done in the presence of others, with a name announced, provoking a collective memory of a person, providing a shared memory of a life within our own.

None of these occasions, sometimes formal, but more often spontaneous, are about closure. Rather, they are about the fullness in each of our lives that came from our family, loved ones, friends and those whose lives were touched by that person’s presence in our own lives.

Never Forgotten

In my work as a cancer physician, I often will write to the family of a loved one who was under our care, months after the death, a time when most of the people who were there in the days and weeks after the death have gone back to the busy-ness of their own lives, and the bereaved is left alone with his or her own feeling and thoughts. The letters are a chance to remain connected, but also a way to convey that the life of their loved one is an important memory for us, too.

They remain an important presence in our own lives, and neither they nor their loved ones are forgotten. These letters, words of acknowledgment and memory, are always welcome, reassuring those whose lives have become interwoven with our own, that their loved one is alive within us, as they are in them.

A few months ago, I ran into a woman who many years ago had, at a very young age and early in her marriage, lost her husband to cancer. She had moved away, met another man whom she adored and married, had a family, raised their children together, along with a successful career, and seemingly had found closure from the tragedy of her early life. As we finished talking and she began to walk away, she turned around, and with eyes full, said: “I think of him almost every day.”


Alternatives in DEATH CARE

What’s a Death Midwife? Inside the Alternative Death Care Movement

From funeral cooperatives to green burials, there’s a kinder, gentler, less expensive way to die.

YES! illustration by Jennifer Luxton

Char Barrett walked into a quaint cafe in Seattle with business in mind.

Over the smell of coffee and freshly baked tarts, she was going to advise a client on how best to host a special event at her home, helping coordinate everything from the logistics of the ceremony, to how to dress the guest of honor. People might cry, they might laugh, and all attention would be on the person of the hour—only that person would never see, hear, or enjoy the festivities, because they would be dead.

As 20th century consumerism took hold and people were more likely to die in a hospital than at home, death receded from public consciousness.

“People looked at me like I had two heads when I said, ‘Keep the body at home after the person dies,’” says Barrett, a Seattle-based funeral director and certified “death midwife.” “For families who want it, they should have the right to do it.”

Barrett has been practicing home funerals in the area since 2006 through her business, A Sacred Moment. In a home funeral service, the body is either brought back to the family from the place of death or stays at home if the person died there. The family then washes the body, in part to prepare it for viewing and in part as a ritual.

“It’s really the way we used to do it,” says Barrett.

To Barrett and many other professionals who are offering alternatives to the more status-oriented, profit-driven funeral industry, it’s time to rethink how we handle death. From consumer cooperatives that combat price gouging, to putting the power of choice back in the hands of the family, the city of Seattle has become a hub for alternative death care in the last two years, according to Barrett. The subculture of “deathxperts” want not only to empower their clients, but also potentially phase out their jobs altogether—a sort of death of the funeral director as we know it.

A History of Death

For the majority of human history, families handled arrangements for the deceased, from the time immediately after death, to burial or cremation. Until the advent of modern hospitals and health care at the turn of the last century, it was the norm for the old and sick to die at home surrounded by loved ones.

During the Civil War, embalming as a form of preservation found a foothold when Union soldier casualties needed to be transported from the sweltering South to mourning families in the North. Today, its pragmatic purpose is to temporarily stop decomposition for viewing and final goodbyes. However, the overwhelming majority of contemporary consumers don’t realize that, in most cases, it’s not legally required to bury a body, although special circumstances vary from state to state.

So why has probably every American funeral you’ve been to had an embalmed body in attendance?

As 20th century consumerism took hold and people were more likely to die in a hospital than at home, death receded from public consciousness. If a loved one were to die today, you would probably call and pay a funeral home to pick her up from wherever she took her last breath. They would wash her, embalm her, and dress her to your family’s liking. You would briefly visit her one last time at a mortuary or a chapel before she was either buried or burned. In all likelihood, her last bodily contact before disposition would be with a complete stranger.

In 1963, investigative journalist Jessica Mitford published “The American Way of Death,” an exposé of the country’s funeral-industrial complex, showing how it exploited the emotions of the living so it could up-sell unnecessary services and products, such as premium caskets and premier vaults. Federal Trade Commission regulations and consumer protections now prevent families from being swindled.

“There’s no sales pressure, there’s no up-selling, and we make sure people get what they need.”

Today, the funeral industry has become managed in part by aggregate companies. Mortuary giant Service Corporation International owns a large network of individually operated funeral homes and cemeteries, some of which exist on the same property as combination locations. If you imagine a standard funeral parlor and graveyard, you’re probably picturing an SCI-owned operation. Of the approximately 19,400 funeral homes in America, the publicly traded company owns about 2,300 homes, according to the National Funeral Director’s Association. Families and individuals privately own most of the rest.

“The reality is that if you can’t adapt to compete with SCI, you probably shouldn’t be in the market,” says Jeff Jorgenson, owner of Elemental Cremation and Burial, which prides itself in being Seattle’s “only green funeral home.” “But SCI is one of the best competitors you could ever hope for because they’re slow to change and they’re exceptionally resistant to anything progressive.”

Jorgenson started his business in 2012 with a special focus on carbon-neutral cremations and “green” embalming using eco-friendly preservatives. In every aspect of his operation, he works to be as environmentally minded as possible, an objective he sees lacking in most business models.

As SCI spent the 1960s through 1990s acquiring independent funeral homes to maximize profits, another organization was doing the exact opposite by forming a collective to prioritize consumer rights.

People’s Memorial Association is one of the nation’s only nonprofit organizations that pushes consumer freedom for end-of-life arrangements. Located in Seattle, the consumer membership-based group coordinates with 19 different death care providers across the state to offer fixed-price burial, cremation, and memorial services, as well as education and advocacy to encourage death care alternatives. Almost all of the funeral homes are privately owned and have a uniform price structure for PMA members, who contribute a one-time fee of $35. Barrett’s A Sacred Moment is one of PMA’s partners.

“Too many people go to funeral homes and just want to be told what to do.”

“We negotiate contracts with the funeral homes so members walk in knowing exactly what they’re going to pay, and it’s usually a pretty significant discount from the usual prices,” says Nora Menkin, the managing funeral director of the Co-op Funeral Home. PMA founded it in 2007 when SCI decided to cancel arrangements with several of PMA’s partners. Now, PMA-contract homes offer full-service funerals for 65 percent less than the average local price, according to a 2014 price survey conducted by the PMA Education Fund.

“There’s no sales pressure, there’s no up-selling, and we make sure people get what they need,” says Menkin. “It’s about the consumer telling us what they want.”

Jorgenson’s Elemental Cremation and Burial works outside the umbrella of PMA’s service providers, but he still finds allies in Menkin and the Co-op Funeral Home.

“We’re in it to change an industry,” he says. “Just one of our voices out there is useless. There’s a kinder, gentler, less expensive way, and that’s what we’re all doing. It’s helping families in a new, more collaborative way.”

In Jorgenson’s opinion, you don’t even really need a funeral director.

“A funeral director is a wedding planner on a compressed time scale,” he says. “With the exception of the legality of filing a death certificate, a funeral director does the exact same things a wedding planner does: They make sure that the venue is available, that the flowers are ordered, the chaplain is there for the service, and that the guest of honor, be it the bride or the dead person, is there on time.”

In Washington state, some of the only legal requirements are preservation of the body 24 hours after death by way of embalming or refrigeration, obtaining a signed death certificate, and securing a permit for disposition of the deceased.

If the body will be kept at home for longer than 24 hours, preservation can be achieved by putting the body on dry ice for the duration of the viewing. Once the family has had enough time with the person, he or she will be removed for final disposition, which includes burial, cremation, or scientific donation.

“A funeral director that is truly in earnest with the services they’re providing these families would have the courage to say that,” says Barrett. “A family can do this themselves. They don’t need a licensed funeral director, especially in the 41 states where legally a family is able to sign their own death certificate.”

Even families who still want the guidance of a professional shouldn’t feel powerless.

“Too many people go to funeral homes and just want to be told what to do, because they haven’t been through it or they don’t want to think about it. That gives the funeral homes way more power than they really deserve,” says Menkin.

Ideally, a funeral home should educate consumers and encourage them to make informed decisions, she says, ultimately just acting as an agent to carry out their wishes.

The Process

For almost every modern funeral home preparation procedure, there is a more sustainable alternative. Dry ice can offset the need for embalming for brief viewing or shipping purposes. In instances where some form of embalming is necessary, such as a violently traumatic death, a mix of essential oils can replace the toxic mix of tinted formaldehyde. Even in the case of burial, biodegradable shrouds can eliminate the need for wood and metal caskets built, in theory, to last forever.

The distinctions apply to cemeteries too, which are divided into several camps as outlined by the Green Burial Council, the industry authority on sustainability. It assigns funeral homes, cemeteries, and suppliers a rating based on strict environmental impact standards, which scrutinize everything from embalming practices to casket material.

As consumers become more comfortable with taking charge of their dead, there will be more room to introduce new methods of body disposition.

There are traditional cemeteries with standard graves, monuments, mausoleums, and often water-intensive grass landscaping. The next step up are hybrid cemeteries, which still may have regular plots, but also offer burial options that don’t require concrete vaults, embalming, or standard caskets. Natural burial grounds, the middle rank, prohibit the use of vaults, traditional embalming techniques, and burial containers that aren’t made from natural or plant-derived materials; landscaping must incorporate native plants to harmonize with the local ecosystem, conserve energy, and minimize waste. Premier green burial occurs on conservation burial grounds, which in addition to meeting all of the above requirements, requires partnership with an established conservation organization and be dedicated to long-term environmental stewardship.

Natural and conservation burial grounds must limit the use and visibility of memorials and headstones so as to preserve the native visual landscape as much as possible. Some properties have switched to GPS-based plot markers—visitors wouldn’t know they’re in the middle of a cemetery unless they were looking for it.

As consumers become more comfortable with taking charge of their dead, there will be more room to introduce new methods of body disposition, such as alkaline hydrolodis, a type of liquid cremation, and body composting. Earlier this year, supporters successfully funded a Kickstarter campaign to start research on the Urban Death Project, which aims to turn decomposing bodies into nutrient-rich soil. According to Jorgenson, sustainable burial practices are still part of a boutique market, though that doesn’t change his bottom line.

“Death is difficult. People don’t really want to experiment with mom,” he says. “But I count myself fortunate to be out there as one of the people that offers these alternatives, should someone want them.”

“The co-op movement is bigger in other countries,” says Menkin, who attended the 2014 International Summit of Funeral Cooperatives in Quebec. “Canada has a large network of funeral cooperatives, but it’s a bit more like a traditional funeral industry, just with a different business model. They’re not about alternative forms of disposition or changing the norm. We’re kind of writing the book on this one.”

Eventually, those conversations may become commonplace.

“Now when I mention home funerals to people, they don’t think anything of it,” says Barrett. To her, the time has come for people to think outside the box—literally.

Jennifer Luxton wrote this article for YES! Magazine. Jennifer is an online design intern. She is a journalist by college major, illustrator by minor, graphic designer by profession, and amateur taxidermist by moonlight.

How to Honor the Elders in Your Family

Celebrants bring a special life force to the ceremony;

This is a great article for those who have elders in your family


A mainstay of many ancient cultures is respect for the elders—those who have preceded us in life and whose wisdom gives guidance and comfort. But our modern culture only rarely honors those who have earned elder status. This is a great loss to young and old alike.
Those who are beyond our youth but who don’t think we’ve reached elder status yet can correct this and give a priceless gift to our families. If we create the time and place to gather family to listen to the oldest members’ stories, we preserve the family heritage, create new memories, and foster relationships across generations.
In April 2012, my family was discussing the upcoming 98th birthday of our Aunt Helen. She is the last of “the greatest generation” in our family, having survived the Great Depression and tended the home front while her three brothers fought for our country in World War II. We recalled the passing of others in that generation, and agreed that we shouldn’t wait to honor Helen, but should instead pay tribute to her while she is here to enjoy the moment.
I started calling Helen to listen to her stories. She’d start out by saying that she wasn’t feeling very well, but before long it was hard to keep up with all the memories that poured out of her. By the fall, I had printed a mini-biography that Helen could edit. In listening to her stories, I had also reconnected with a member of the family that I had almost lost touch with.
To prepare for the tribute dinner, I wrote a simple ceremony on the theme of “the family tree.” On Helen’s big night, family gathered at a banquet room near her home. At each table was a small tree on which we hung notes to her. A family member brought a beautiful hand-drawn family tree tracing our heritage back to the 1500’s. Another shared our grandmother’s mealtime grace before the meal. The youngest children brought small gifts to give Helen. Each person was given a card extolling the wisdom of trees: sinking roots and embracing with joy the changing seasons. Good advice for any family.
Before the celebration, to honor those no longer with us, we set a table with photos of family members who had passed away and gave thanks for their presence in our lives. We also named loved ones at home who could not make the journey.
And then the celebration began. My husband gave a funny speech that put Helen’s life in historical context. “Aunt Helen has outlasted almost everything from the Austro-Hungarian Empire to Phyllis Diller.”
Throughout dinner, family members read Helen’s story out loud. In doing so, we recognized this lady had survived some very tough years. There were poignant moments as well as laughter, and frequent remarks of “I never heard that before!” One of the young adults wrote a note saying what an inspiration Helen was.
There is no simpler, more beautiful way to honor someone than to make room for their story to be told. By listening, we affirm the one who lived the story and we protect their story from being lost. The youngest family members observe more than we might know. Their questions and re-tellings later reveal that they’ve kept these family stories in their hearts.
Later that evening, when she heard her favorite big band music, Helen led the dancing. And when she looked around and said, “They all came!”, I knew we had given her a very happy memory and had honored her. We had also given a tremendous gift to the family.

Diane Gansauer is a certified Life-Cycle Celebrant, trained in music performance, dance, theater, and storytelling. As the director of Lyrical Life Ceremonies, she works with individuals, families and communities to create personal, memorable ceremonies marking important milestones and transitions. Information on her work and is available