thinking about positivity and death

The New Year is typically a time when people think about making positive changes in their lives. It is a time for resolutions, resets, fresh starts. It is also the time of year when the death rate is at its highest…

For some time, Tia has been reading and writing about the relationship between being positive and being well. Across a range of disciplines, the research suggests that positivity – including the ability to find meaning and coherence in otherwise potentially random life events – is health promoting. Staying positive releases the body’s natural ‘feelgood’ chemicals – endorphins and opioids while it suppresses cortisol, the ‘stress’ hormone closely associated with chronic inflammation and thus a range of health conditions such as arthritis, cancer, colitis, heart disease, and diabetes. 

But what about positivity in situations where health promotion is no longer on the table – is it still ‘good’ to stay ‘positive’? What exactly might positivity mean in different circumstances, in extremis? And might there not be circumstances when the ‘wrong’ kind of positivity might actually be bad for us? 

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Taking the last question first, some commentators have suggested that, in the face of life-limiting illnesses, ‘trying to stay positive’ can be abused. As already discussed (in a related essay in this project blog), at times, encouraging people to ‘look on the bright side’ is belied by the statistical probabilities and realities of individuals’ health situations. Which leads back to the first two questions as posed above. Is it possible to be positive about one’s, or a loved one’s, imminent demise? And if so, what kind of positivity might be of benefit in the face of life’s close?

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In recent years, the “Positive Death Movement” has grown and received attention from the media. The movement, which encompasses news, literature, YouTube videos, cafés, courses, advocates and educators, is about facing death with courage. Last month (December 9, 2022), the New York Times published a piece chronicling the last life phase of one of that movement’s leading lights, Shatzi Weisberger. Diagnosed with pancreatic cancer at age 92, Weisberger, who had worked as a nurse for 47 years, phoned the NYT to invite the paper to follow her end of life journey. What she wanted, she said, was, to, “experience my dying…to share that experience with anyone who’s interested.” 

Weisberger tried, she said, to look forward rather than backward, to see her death as her final life event. She planned for that event and its aftermath. She planned her funeral. She invited friends to help. She engaged a music thanatologist. She even specified in advance a list of which friends she wished to prepare her body for burial when the time came. 

Weisberger also did not want pain killers and wanted to die at home….But the local hospice organisations were over-stretched. There were labour shortages and a two-week waiting list. And even when, finally, hospice care was arranged, there were challenges. Friends came to help in between hospice visits. Private care was mostly not affordable. Her pain intensified. Two documentary film crews arrived at her home (Weisberger is featured in the pilot episode, Doing Death Differently). She said she did not feel fear but acknowledged that she might at some point.

Then in her final two weeks, Weisberger began to experience severe pain. She retreated from social interaction. The lights in her apartment were dimmed. She accepted pain killers. And she began to need a great deal of support. Her friends later agreed the situation would probably have been unsustainable had it continued for longer than it did (two weeks).

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In 1967, the sociologist Harold Garfinkel described a social-psychological experiment in which subjects (students) tried out a new form of ‘counselling’. The subjects could ask only yes/no questions. The ‘counsellor’ would reply only with, “my answer is yes” or, “my answer is no.” Unbeknownst to the experimental subjects, the ‘counsellor’s’ answers were randomly determined. The subjects were asked to think out loud after each answer from the ‘counsellor’ about the reasoning that might lie behind the yes, or the no. 

Garfinkel’s aim was to follow the careful, logical, sense-making procedures exhibited by these experimental subjects as they attempted to figure out the ‘logic’ behind each piece of advice. He described how these subjects maintained a fundamental assumption, namely, that there was a logic to find. And he described how, out of those sense-making procedures, these subjects found meaning – and actually found the ‘advice’ they received to be of help. Today such an ‘experiment’ would not be done; it would, rightly, be deemed unethical. In fact, however, we enact features of Garfinkel’s experiment repeatedly in the course of a day as we make (provisional) sense of the often contrary, often surprising things we encounter in our daily lives. Our sense-making skill is also a tremendous resource: It is our everyday way to reason positively, to form coherence out of what otherwise might lend itself to incoherence and, perhaps, anxiety.

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So, in the face of what might seem like the ‘worst’ of obdurate realities – death – the lessons drawn from Garfinkel’s ‘counselling’ study seem somehow apt. And Weisberger’s efforts to make and sustain meaning, her planning and her engagement, help us to reflect on the value of creative action, understood as agency and (partial) control in end of life situations. 

Not everyone will remain able, or want, to plan and act in the ways that Weisberger did, but the opportunity to be active in the process of arranging how we die and/or how we are commemorated, can be of importance also for those who love us and care for us. Thought about in this way, it seems possible to approach the negative situation of dying with a kind of – realistic – positivity.

Further Reading:

Antonovsky, A. (1987). Unraveling the mystery of health: How people manage stress and stay well. San Francisco, CA: Jossey-Bass Publishers. 

Berlant, L. (2011) Cruel Optimism. Durham, North Carolina: Duke University Press.

DeNora, T. 2021. Hope: The dream we carry. London: Palgrave Macmillan. 

Ehrenreich, B. (2009). Bright Sided: How the Relentless Promotion of Positive Thinking Has Undermined America. New York: Metropolitan Books.

Garfinkel, H. (1999 [1967]). Studies in Ethnomethodology. Cambridge: Polity Press. 

Groopman J (2006) The Anatomy of Hope: How People Prevail in the Face of Illness. New York: Random House.

Leland, J. (2022) She Preached Death Without Fear. Could She Practice It? New York Times (December 9). https://www.nytimes.com/2022/12/09/nyregion/shatzi-weisberger-death.html

Peterson, A. (2015) Hope in Health: The socio-politics of optimism. Basingstoke: Palgrave Macmillan. 

Rau, R. (2007) Seasonality in Human Mortality: A Demographic Approach. Berlin, Heidelberg, New York: Springer. 

Ruud, E. 2021. Toward a Sociology of Music Therapy: Musicking as a Cultural Immunogen. Dallas TX: Barcelona Publishers.