Faces of Death [April 08 2017]

My grandfather died last year. He was 88. He'd been dying for months before he passed away. When I visited him and I was standing next to him I felt like stepping into another dimension. He could not speak clearly and participate in the verbal interactions we visitors tried to maintain. After a time turning, looking, eye contact, touching, pressing, stroking, wiping, massaging, feeding and facial expressions were the only tools for the connection. Gradually he was disappearing into an unknown place. This world way beyond words frightened me and amazed me at the same time. Words lost their meanings but everything was present in a look. I had mixed feelings and I perceived the past, the present and the future during those heavy moments on his side.

There is no doubt about that nonverbal communication plays a significant role when being with or caring for a dying person (be it a loved one or a patient). In this post I will bring different approaches closer to you related to the context of dying; when death is near. I do believe we can improve both our verbal and nonverbal communication skills in this context with the dying person, with the hospital staff or with the family members present in the same room - and even weeks or months later. (I am thinking of facial expressions of contempt or disgust from people who think we should show sadness or the overdoing empathy gestures as if the bereaved person had no resources they could use and with this tossing them into the Victim position.)

Other times you can decode certain messages coming from young boys and girls who might be depressed and thinking about committing suicide. I know books could or should be written about this topic. My goal right now is only to introduce some topics, approaches, studies and questions around this area. As the first step I will bring you some paintings. Please observe the people, their positions, the proxemics, the appropriateness of what they are doing, their postures, gestures and facial expressions. What do they signal? What messages do they send with what they are doing? Who do you think they are? Why?

Source: http://1.bp.blogspot.com/_cpToIwY89Rc/SwRAxaGpk4I/AAAAAAAAB3Q/1XT4XBDJT5w/s1600/765px-IngresDeathOfDaVinci.jpg

Here is another painting:

Source: https://static1.squarespace.com/static/55463e35e4b04bf77e438ac0/t/557b54b2e4b014e8c750d6b9/1434145977526/anointing.jpg?format=1500w

And one more:.

Source: https://media.licdn.com/mpr/mpr/AAEAAQAAAAAAAAaeAAAAJGU0MzIxNDExLWI0MDktNDY0ZS1hMGE0LTRiMzczYzM5ZGU5ZQ.png

Some years ago Andrew George, American photographer, spent two years in hospitals taking pictures of people who are terminally ill. He asked them to share anecdotes from their lives, their regrets and what life advice they would give to others. You can see his pictures he took and some messages from those people by clicking here.

Source: http://www.dailymail.co.uk/health/article-2983069/Staring-death-face-Poignant-images-capture-terminally-ill-people-reflect-lives-regrets-final-moments.html

I am quoting Daily Mail:

Sara said being loved makes people offer love to others. She said: "I think growing up with love makes people give love back. And you have to give love to receive love, you have to be good without expecting anything in return. You do it because it comes from within you to do it. I've always fought to improve myself and risen to the occasion. It's what I was taught growing up and was very ingrained in me. I think that's what I'll be remembered for when I pass on".

Have a look at the picture below. What do these faces tell you? What might be the context here?

Source: http://www.godvine.com/read/dying-89-year-old-woman-moved-in-neighbor-1550.html

To read the story, please click here.

Look at this picture now. What do you think? Guess before you check the source given below.

Source: http://www.mirror.co.uk/news/real-life-stories/begged-judge-end-sick-daughters-4509235

To read the story, please click here.

Now I am bringing two examples from the world of WORDS and BELIEFS.

The first one is a research. Last year scientists from Cambridge University interviewed a group of over-95s, to find out what they think about death and dying. They did that because more people will be dying in very old age, but little is known about the preferences of the "oldest old" regarding their care at the end of life. What do you think about the context in which an old person is dying? Are old people ready to die? What are their main concerns? Are they worried about death? What death is their ideal? How do they approach life-saving treatments?

Source: https://www.buzzfeed.com/tomchivers/the-only-thing-im-worried-about-is-my-sister?utm_term=.skP4QYYMr#.afa5bggea

Here is what they found. Most were ready to die, reflecting their concerns regarding quality of life, being a nuisance, having nothing to live for and having lived long enough. Contrasting views were rare exceptions but voiced firmly. Most were not worried about death itself, but concerned more about the dying process and impacts on those left behind; a peaceful and pain-free death was a common ideal. Attitudes ranged from not wanting to think about death, through accepting its inevitable approach to longing for its release. Preferring to be made comfortable rather than have life-saving treatment if seriously ill, and wishing to avoid hospital, were commonly expressed views. There was little or no future planning, some consciously choosing not to. Uncertainty hampered end-of-life planning even when death was expected soon. Some stressed circumstances, such as severe dependency and others' likely decision-making roles, would influence choices. Carers found these issues harder to raise but felt they would know their older relatives' preferences.

Source: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0150686

Source: http://img02.deviantart.net/04b4/i/2009/300/3/6/failed_suicide_note_by_alahay.jpg

The second example I am bringing from the world of WORDS is the suicide note. Sadly it can be followed by the act of suicide. The modern version of the suicide note is when the person shares an online video about it. I was shocked when I learned from the 12 year old girl, Katelym Nicole Davis, from Georgia, USA who followed this path. She hanged herself in her front yard, and livestreamed her death. Previously she posted on her blog about what had happened to her.

To read more about the story, please click here.

As I do believe we can do about to prevent cases like this by being more sensitive to the signs, overt and covert messages of a suicidal person and actively take steps to help or get the necessary help, I will summarize some key points where we can start.

These are the potential suicide warning signs:

Source: https://y8ro61guopdy92fn3a9bof1d-wpengine.netdna-ssl.com/wp-content/uploads/2016/09/Suicide-and-suicide-prevention-3.jpg

WORDS - the verbal messages they send

The person might be talking about suicide, dying or self-harm. Example: "I wish I hadn't been born" "I'd be better off dead" "I'll kill myself" The covert message is "HELP ME". It is an invitation from them to LISTEN TO THEM.

Source: https://paradigmmalibu.com/wp-content/uploads/2014/07/iStock_000057026562_Small.jpg

They may say good-bye, have unusual or unexpected visits or calls to family and friends.

They may express feelings of helplessness, hopelessness, being cornered or trapped. "There is no way out" "Life sucks" "I hate it all" "Things will never change" "It won't get any better".

Source: http://80c2c58297745c19d00b-3ef697e5597e4211b9a782820054083a.r58.cf2.rackcdn.com/503B933C-6114-41D3-82E8-036E4126A7A0.jpg

PROXEMICS - the distance they keep

Withdrawing from friends and family. Avoiding friends or social activities. This includes the loss of interest or pleasure in activities the person previously enjoyed. Increasing social isolation. Desire to be left alone.

Source: https://tribkswb.files.wordpress.com/2014/08/depression.gif

CONTEXT - circumstances and history of the situation

A major life crises might trigger a suicide attempt. You can think of things like the death of a loved one (or even a pet), divorce or break-up of a relationship, diagnosis of a major illness, loss of a job, or serious financial problems. You can observe them making out a will. Giving away prized possessions or favorite objects and so on.

Source: http://assets4.bigthink.com/system/idea_thumbnails/55510/size_1024/unemployed.jpg?1403230105

MOOD, EMOTIONS - how the person is feeling

Long-lasting sadness, mood swings, and unexpected rage. Feeling a deep sense of hopelessness about the future, with little expectation that circumstances can improve. They can be so stressed out that they cannot sleep at night (insonmia). There is one more important sign here: when suddenly they are becoming calm after a period of depression or moodiness. It can be a sign that the person has made a decision to end his or her life. Feelings of worthlessness, guilt, shame, and self-hatred can be strong. Feeling like a burden ("Everyone would be better off without me").

Source: http://www.thechildren.com/sites/default/files/articles/488_photo.jpg

UNUSUAL BEHAVIOR - self-harmful, dangerous or suspicious actions

Potentially dangerous behavior, such as reckless driving, engaging in unsafe sex, and increased use of drugs and/or alcohol might indicate that the person no longer values his or her life. Often, a person considering suicide will begin to put his or her personal business in order. This might include visiting friends and family members, giving away personal possessions, making a will, and cleaning up his or her room or home. Some people will write a note before committing suicide. Some will buy a firearm or other means like poison. Seeking access to guns, pills, knives, or other objects that could be used in a suicide attempt. A person who is considering suicide might exhibit a change in attitude or behavior, such as speaking or moving with unusual speed or slowness. In addition, the person might suddenly become less concerned about his or her personal appearance. Unusual focus on death, dying, or violence. Writing poems or stories about death.

Source: http://st.depositphotos.com/1039548/4547/v/450/depositphotos_45473085-stock-video-happy-and-carefree-group-of.jpg

THIS IS WHAT YOU CAN DO

Don't be afraid to ask if he or she is depressed or thinking about suicide.

Ask if he or she is seeing a therapist or taking medication.

Rather than trying to talk the person out of suicide, let him or her know that depression is temporary and treatable.

In some cases, the person just needs to know that someone cares and is looking for the chance to talk about his or her feelings. You can then encourage the person to seek professional help.

Do not leave the person alone. If possible, ask for help from friends or other family members.

Ask the person to give you any weapons he or she might have. Take away or remove sharp objects or anything else that the person could use to hurt himself or herself.

If the person is already in psychiatric treatment, help him or her to contact the doctor or therapist for guidance and help.

Try to keep the person as calm as possible.

Call your local emergency number or take the person to an emergency room.

NONVERBAL COMMUNICATION OF THE BEREAVED

I am closing this post with some pictures and stories of bereaved people in which body language can be analyzed. Some of them are very telling, others are culture specific and there are some where you need trained eyes to decode the hidden messages.

Have a look at this scene first.

Source: http://p6.qhimg.com/t01752c683dd8ab74d9.jpg

In the picture below British Soldiers carry the casket of a World War I soldier during the re-burial ceremony in Bois-Grenier in 2014. The body language in this context is strictly regulated by traditional rules.

Source: http://i.dailymail.co.uk/i/pix/2014/10/22/1413988268508_wps_1_British_Soldiers_carry_th.jpg

Look at this illustration of a peasant funeral from Ireland. If you compare this context with the previous one, what differences can you spot in the light of appropriateness, display rules, proxemics, gestures, postures?

Source: https://upload.wikimedia.org/wikipedia/commons/7/78/Peasant_Funeral.jpg

Look at this picture. What do these bones tell you? In 2012 archaeologists revealed an incredible discovery in a village in the Novosibirsk region of Siberia where scientists were studying some 600 Bronze Age tombs - dozens of them contained the skeletal remains of couples clutching onto each other in loving embrace.

Source: http://www.ancient-origins.net/sites/default/files/styles/large/public/field/image/skeletonsembrace.jpg?itok=at_yJ9Sg

What do these bones tell you? Theye were found in the rock shelter of Lapa do Santo (an archaeological site located in the Lagoa Santa karst in east-central Brazil) in 2007. Based on the positions and conditions of the bones of the body, archeologists suggest that it was a ritualized decapitation testifying for the sophistication of mortuary rituals among hunter-gatherers in the Americas during the early Archaic period. In the apparent absence of wealth goods or elaborated architecture, Lapa do Santo's inhabitants seemed to use the human body to express their cosmological principles regarding death.

Source: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0137456

Now let us see another case. What does this picture tell you? It shows Lynda Bellingham's "final show": On an emotional day her husband and three children fulfilled her final wish for people to smile and enjoy her funeral. What is your view or belief? Is it appropriate to be happy or smile when you are grieving? What social rules must be followed or mustn't be violated when grieving? Is it allowed to cry? When? Where? For how long? What should your face show? How are you expected to be walking, dressed or communicating? How about getting closer to others, touching them or living sexual life? What are your answers?

Source: http://www.dailymail.co.uk/news/article-2818478/Lynda-Bellingham-s-family-friends-vow-actress-one-final-prepare-sad-day-funeral-service.html

Firemen, ambulance crew and policemen need to deal with death and dead bodies. Sometimes all they have is a dead body. Its position, the surrounding objects, the context help them find out what might have happened. Crime scene investigators conduct a systematic examination to uncover the physical evidence to help identify what happened and who was involved.

Source: http://www.forensicsciencesimplified.org/csi/img/iStock_000013576959Small.jpg

And now I am showing some examples related to people in grief. I am starting with the case of Sandy Hook school massacre where a gunman walked into an elementary school in Newtown, Connecticut and opened fire, killing 20 first-graders and six educators before turning the gun on himself in December, 2012.

Source: http://people.com/crime/sandy-hook-shooting-anniversary-parents-plans/

If you have a look at this picture, what do you think the child is experiencing inside? What are you experiencing inside when observing this context? According to statistics a child loses a parent through death every 20 minutes, and most 16-year-olds will have experienced losing someone close.

Source: https://expertbeacon.com/sites/default/files/from_helpless_to_helpful-_parents_can_assist_their_grieving_kids.jpg

Is this girl only sad or is she grieving? How can we tell the difference when being with a child? Children express their grief in a variety of ways. Different feelings may emerge at different times and the intense sadness and crying associated with grief may be quite intermittent, interspersed with times of play and hilarity. This can mean that people around bereaved children sometimes don't recognise that they are grieving, or think that they are behaving inappropriately. Bereaved children have been described as 'forgotten mourners'.

Source: http://iowacityhospice.org/wp-content/uploads/2014/12/Dollarphotoclub_69193246.jpg

Look at these fingers. What is your impression? How do you interpret what you see? In some cultures amputation is a form of mourning. This was especially true of the Dani tribe from Papua, Indonesia. The members of this tribe cut off their fingers as a way of displaying their grief at funeral ceremonies. Along with amputation, they also smeared their faces with ashes and clay, as an expression of sorrow.

Source: http://www.odditycentral.com/pics/tribe-practices-finger-cutting-as-a-means-of-grieving.html

I am closing the blog with a picture from North America. It shows that American author Harry Behn smokes a ceremonial pipe, a common ritual within Native American culture. Did someone die? Well, smoking pipe can be part of their funeral rituals. Other death rituals include painting a dead person's face red, the colour of life, or washing the body with yucca before burial. Sometimes feathers are tied around the head of the dead tribe member as a form of prayer. Other common rituals such as smudging (the burning of special herbs such as sage) and smoking a special ceremonial pipe may be incorporated into funeral rituals, led by the tribe's medicine man or spiritual leader.

Source: http://content.funeralzone.co.uk/storage/app/media/native-american/native-american-ritual.jpg

If you have any questions, comments or stories, share them with me via email. We can publish them here.

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by Bali Polyanki

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