“A Mixed Blessing”: Social Support as a Coping Resource for Parents Who Lost a Child in Terrorist Attacks in Israel

Abstract

This article deals with the issue of perceived social support among 40 bereaved parents who have lost a child in a terrorist attack in Israel. The aim is to gain a better understanding of the nature and quality of the formal and informal support that the parents received. The parents were interviewed using semistructured in-depth interviews. The content analysis revealed that alongside the positive aspects, the parents also emphasized the negative side of the encounter with the social environment. The positive aspects included feeling of appreciation for the assistance in the coping process. The negative aspects included a sense of abandonment and distress. The dialectic nature of the domain, together with a recognition of its importance, points to the need to reconcile between the desire on the part of the social environment to assist the bereaved parent on one hand and ways to implement it on the other hand.

Keywords

bereavement bereaved parents coping resources social support coping with terrorism

Introduction

The suffering inherent in the loss of a child creates a need not only to examine the consequences of the loss on the bereaved parent’s world but also to map and gain a better understanding of the coping resources. This article deals with one such resource—perceived social support under circumstances of terror attacks.

Little has been written on the encounter between the formal and informal social environment and bereaved parents who have lost their child as a result of a terror attack. Apart from an understanding of the parents’ needs from the point of view of the parents themselves, this research can also shed light on the unique features of the traumatic event, thus furthering a social awareness and empathy vis-à-vis the condition of the parents and helping to formulate therapeutic strategies and effective interventions for their benefit. These aspects constitute the empirical rationale underlying the present research.

Parental Bereavement

The loss of a child is one of the most traumatic life experiences (Malkinson & Bar- Tur, 1999). Numerous factors affect the parents’ grief level, such as the age of the child, the nature of the parent–child relationship (Rando, 1983), and the circumstances of the child’s death (Cleiren, 1993; Florian, 1989; Murphy et al., 1998; Rubin, 1990). The bereavement process and its accompanying trauma constitute a powerful force for many years after the death of a child (Lohan & Murphy, 2006; Malkinson & Bar-Tur, 1999; Malkinson & Bar-Tur, 2004–2005; Song, Floyd, Seltzer, Greenberg, & Hong, 2010; Woodgate, 2006). The reaction to such a loss includes cognitive, psycho-physiological, and behavioral elements whose purpose is to enable the bereaved to come to grips with death, deal with the necessity of life continuity, and restore emotional equilibrium (Stroebe & Stroebe, 1987; Witztum, 2004).

There are multiple reasons why the loss of a child is considered especially traumatic. It appears to contradict what is considered “normal,” while undermining the basic assumptions of what is just (Rando, 1983; Vries, Lana, & Falck, 1994). Also, significant emotional energy is invested over the years in creating the unique parent–child relationship (Malkinson & Bar-Tur, 2004–2005; Rando, 1983; Rubin, 1990), and the unique nature of this relationship makes the grieving process a long, life-altering ordeal (Marrone, 1999). Furthermore, parents regard their children as an extension of themselves. Children symbolize their hopes and the ability to gain new insights into life (Edelstein, 1984; Vries et al., 1994).

A study was conducted among parents who had lost a child during his service in Israel’s military (Israel Defence Forces; Malkinson & Bar-Tur, 2004–2005). The topics raised by the parents offer insights into the nature of parental bereavement. The study’s findings demonstrate that the trauma of bereavement remains, even many years later, making the loss an integral part of the parents’ lives. Time does not heal this wound. As the years pass, the parents become weaker and more vulnerable (Malkinson & Bar-Tur, 1999; Znoj, 2014).

Bereaved parents may be more at risk in developing health problems, having difficulty recovering from an injury or illness, and dying of a disease than their peers who have not lost a child (Birenbaum, Stewart, & Phillips, 1996; Lang, Goulet, & Amsel, 2004; Murphy, Clark-Johnson, & Lohan, 2003; Znoj & Keller, 2002). They may also be more at risk of death from unnatural causes (Goodenough, Drew, Higgins, & Trethewie, 2004).

Many researchers claim that the loss of a child also leads to a crisis of meaning. A study conducted on parents of children who were murdered (Stuckless, 1996) found that they were more likely to be angry and vindictive and to perceive their lives as less meaningful. When life assumptions are shattered, bereaved parents struggle to understand the meaning of life and death. As time passes, however, the intensity of their anger and confusion weakens and is replaced by an attempt to reconcile with the reality of the loss (Wheeler, 2001).

Although the loss of a child is devastating under any circumstance, parents who have lost a child in sudden, violent circumstances face a unique set of challenges that prove to be more traumatizing than those resulting from relatively more understandable or acceptable circumstances, such as death due to illness (Murphy, Clarck-Johnson, & Lohan, 2002). The special issues faced by parents of murdered children have been well documented (Dannemiller, 2002; Matthews & Marwit, 2004; Murphy Murphy, Tapper, Clarck Johnson & Lohan, 2003), as have the unique circumstances of those bereaved as a result of accident (Matthews & Marwit, 2004) and suicide (Jordan, 2001; Provini, Everett, & Pfeffer, 2000).

A research conducted by Matthews and Marwit (2004) studying the assumptive world views of parents who have lost a child to accident, homicide, and illness found that bereaved parents following a sudden, violent death demonstrate more negative views on the benevolence of the world than bereaved parents following an illness or homicide. Assumptive world views were highly significant in predicting the intensity of grief.

Families that have lost a child in terrorist attacks deal with additional issues that exacerbate the trauma: searching for the child, learning of the attack from media reports, physical mutilation, the cruel circumstances of the child’s death, and exposure to inhumanity (Baron, 2004; Pivar & Prigerson, 2004; Spungen, 1998). The parents’ complex grief may continue for months, years, or even indefinitely (Malkinson, Rubin, & Witztum, 2005; Rando, 1983, 1993; Stroebe & Schut, 2001). They define a new identity shaped by their grieving and find that living with the loss has transformed reality (Arnold & Gemma, 2008).

The multidimensional nature of the bereavement process has been addressed in other research on bereaved parents who have lost a child in a terrorist attack in Israel (Saka, 2007). That study reveals three central themes with respect to the coping process: trauma, continuation of life, and posttraumatic growth. All the parents suffered significant pain, disruption of continuity in their lives, and desperate longing for their deceased child. Conversely, they described their attempts to navigate this unexpected detour and position the pain such that it would allow life and growth to continue. An important resource throughout the coping process was social support.

Social Support

Social support as a coping resource plays a vital role in coping with, adapting to, and processing the traumatic experience, in mitigating the emotional damage, and even in healing (Thoits, 1995). At the same time, studies reveal the ambivalent findings with respect to the nature of social support (Laakso & Paunonen-Limonen, 2002; Stroebe, Zech, Strobe, & Abakoumkin, 2005). There is therefore a need to continue research on the nature of formal and informal social support in relation to coping with trauma. The role of social support, in particular its complex nature and dialectical aspects, appears to have received insufficient attention in the literature on bereavement (Bonanno, 2009).

Social support is defined as a multidimensional structure, composed of consolation, assistance, and information that a person receives through informal (family, friend, and peer group) and formal (health-care professionals and human service workers) contacts with people or collectives. These contacts could be verbal or nonverbal (Wallston, Alagna, Devellis, & Devellis, 1983). Social support is the functional content of relationships that can be categorized into four broad types of supportive behaviors or acts: emotional support (provision of empathy, love, trust, and caring), instrumental support (provision of tangible aid and services), informational support (provision of advice, suggestions, and information that a person can use to cope with his problems), and appraisal support (provision of constructive feedback and affirmation; Heaney & Israel, 2008).

The support needed by victims of trauma centers around assistance in restoring self-esteem, expressing affection, validating and encouraging the victim to express emotions and beliefs, correcting cognitive distortions in perception of the event, resolving conflicts, and listening and sharing the emotional burden. For the victim, a supportive social environment provides emotional proof of the fact that he is good and esteemed and that the world is a good and meaningful place (Cohen & Wills, 1985; Figely, 1986; Flannery, 1990; Lepore & Revenson, 2006).

Bereavement following violent death in a terror attack takes place in the context of a network of persons and systems who may contribute greatly by providing social support and in helping the bereaved make sense of the loss (Currier, Neimeyer, & Berman, 2008). It has been suggested that in situations of political violence, the larger community can be a healing force as well as a distorting factor in the grief process (Pivar & Prigerson, 2004).

Being with people who are coping with a similar loss also helps to dull the feeling of hopelessness and guilt and assists in acquiring a sense of shared destiny and in restoring self-esteem and self-efficacy. The bereaved’s ability also to express his feelings and thoughts without prejudice can promote self-growth (Hogan & Schmidt, 2002; Schwab, 1995–1996).

A support group composed of other parents who have experienced the loss of a child—particularly a child who has died from a similar cause—may not only validate what might be perceived by others as dysfunctional grief (McCall, 2004) but can also lessen isolation and provide a context in which recovery can begin (Grinyer, 2012).

Although the human helper can offer relief and solace for a brief period of time, he cannot provide answers to complex questions (Saka, 2007)—hence the value of religion in general, and religious people in particular. Religion provides an emotional and cognitive framework rooted in a metaphysical and spiritual rationale (Klaassen, Young, & James, 2014) that helps impart meaning to death.

A research study carried out by Saka (2007) on parents who had lost a child to a terror attack showed that use of religion and belief concepts as transmitted by religious people helped bereaved religious parents make better progress in coping with their loss. Rabbis helped bereaved parents inject meaning into death as a continuation of life. The particular kind of death is also given a religious perspective, a more exalted significance. Bereaved parents ascribed supreme importance to martyrdom in the name of the Lord: In their view, a Jew who is murdered because of his religious-national affiliation with the Jewish people is elevated on dying to the status of a saint or martyr—an exceptional privilege for a person’s soul, bringing significant relief to the parents.

The Negative Side of Social Support

Alongside studies that emphasize the value of social support, there are those that highlight its undesirable aspects. Negative social support—including hostility, revulsion, superiority, alienation, pity, lack of understanding or helpfulness, criticism, apprehensiveness, and pessimism (Janoff-Bulman, 1992)—gives rise to adaptation difficulties (Nolen-Hoeksama, Parket, & Larson, 1994) and pathological symptoms (Janoff-Bulman, 1992; Kenney, 2002; Lyons, 1991; Thoits, 1995) in the victims.

A number of factors account for the limited ability of social support in providing assistance. First, for many reasons, people harbor negative feelings toward the sufferer, possibly causing them to feel threatened. People who have experienced a traumatic event symbolize vulnerability and hopelessness. Personal victimization is evidence of a cruel, arbitrary, and unjust world (Janoff-Bulman, 1992).

When death has occurred, most people do not know how to react or what to say because of a lack of understanding of the grieving process. They also find it difficult to assess the needs of the bereaved. They may for some reason assume that the bereaved have a desire to get better soon after the loss, when in fact they need or want to continue to grieve long after the death of the loved one (Herkert, 2000; Kenney, 2002).

The requirement to resist expressing one’s feelings or to make an early recovery, or on the other hand, overly protective behavior, could arouse feelings of resistance (Thoits, 1995; Vries et al., 1994). Inasmuch as the victim does not exhibit “appropriate responses,” he will need to cope with a sense of “emotional deviance” (Thoits, 1995). The bereaved individual must feel that both the near and distant social networks are cognizant of the seriousness and intensity of his loss; when this does not occur, he eschews social support (Herkert, 2000).

Therefore, the purpose of the present research is to focus on social support as perceived by bereaved parents who have lost a child in a terrorist attack in Israel, with the focus on the way they view the nature and quality of formal and informal support.

Method

Participants

A total of 40 bereaved parents (28 mothers and 12 fathers) were located and interviewed. Family status: 6—widowed, 5—divorced, and 29—married. The parents ranged in age from 29 to 59 years; 12 had an academic education, 23 had post-high school vocational education, and 5 were high school graduates. Their religious orientation was as follows: religious orthodox (10), traditional religious (9), and secular (21). The average age of the children at the time of death was 17.7 years, and the time elapsed since the loss was 2 to 5 years. Most of the children were civilians (not soldiers). All terror attacks took place during the second Intifada. The children were murdered by shooting attacks, suicide bombings, and home intrusions.

Instrument

The study attempts to explore the subjective experience of parents who had lost a child in a terror attack and their perception of social support as part of their coping process. To achieve this goal, a qualitative approach was used emphasizing subjectivity and the ways in which people reconstruct and interpret their emotional world (Denzin, 1995). The search is for a narrative truth, not an objective one (Patton, 1990).

The data collected via in-depth, semistructured interviews helped the researcher understand the subjective perspective of the bereaved parents with regard to social support and its role in their individual grieving processes. The interviews enabled self-expression with minimal guidance from the interviewer.

The interview guidelines comprised several issues and questions, including: Did the formal and informal social environment assist in the coping process? If so, how? What were the typical reactions to the loss on the part of the immediate social environment? Did formal organizations help in the coping process, and if so, how?

Data Collection

The researcher located 17 of the 40 bereaved parents through reports in the written and electronic media and 23 by snowball sampling: The interviewed parents helped the interviewers establish contact with other bereaved families. For reasons of confidentiality, no government or voluntary organization divulged the names of the bereaved parents. The interviewer contacted the parents by telephone; they were informed that the purpose of the study was to examine the experience of parental bereavement, upon which they consented to participate in the study. There was no past acquaintance between the interviewer and the interviewees. Following the initial telephone conversation, 10 parents declined participation due to emotional difficulties in discussing their child’s death. The interviews were conducted in Hebrew.

The participants were informed at the outset that the interviews would be anonymous and confidential and would be used solely for research purposes. They were given pseudonyms to guarantee anonymity.

Prior to commencement of the interviews, the parents gave their consent for the conversation to be recorded. Before and during the interviews, they were given the opportunity to voice disturbing thoughts or to stop the interview at any point if the emotional burden became unbearable. At the end of each interview, the researcher stayed to ensure that the participants were in a stable emotional state.

At the start of each interview, the participants were asked to introduce themselves in any way they saw fit. Most of them began by describing personal details such as name, age, and number of children. This was followed by a description of their experience in dealing with the loss of their child, and the way they perceived the social support they had received. Data were collected in 2006 to 2007 over a period of 18 months. The study was approved by Bar-Ilan University’s Department of Criminology.

Data Analysis

Data collection, analysis, and transcription were conducted by the researcher. Analysis of the discourse was carried out according to “grounded theory” (Strauss & Corbin, 1994), which emphasizes creation of a theory out of collected field data. Grounded theory contains systematic guidelines for collecting and analyzing qualitative data, and through categorical analysis develops constructs which assist in understanding the complexity of human perception.

Following transcription, the content of the interviews was analyzed in several stages according to open, axial, and focused coding. During the first stage, content units composed of statements made by the parents were noted, without changing the wording in any way. In the second stage, statements were grouped together to represent various shared categories, and a title was assigned to each category. An emphasis was placed on consolidating overlapping content and verbally and semantically combining identical content. The final stage consisted of grouping the previously defined subcategories into larger ones. After completing the analysis, two main categories were selected that best demonstrated references to the social support narrative during the coping process. The two categories are as follows: The positive aspects inherent in the encounter with the formal and informal social environment; and the negative aspects inherent in the encounter with the formal and informal social environment.

To ensure reliability, the categories and subcategories were given to two qualitative researchers who specialize in the field of trauma, loss, and qualitative paradigms. These external researchers were given the categorical analysis, including the quotes, and were asked to assess the compatibility between the quotes and the defined categories. This external evaluation process strengthens the study’s internal validity (Merriam, 1998).

Results

The interviews revealed two main dialectical themes that coexist and represent the place assigned to social support in the parents’ personal bereavement experience. The first emphasizes the positive side of formal and informal social support. The second focuses on the negative side.

Positive Aspects Inherent in the Encounter With the Formal and Informal Social Environment

All the bereaved parents described the value of both formal and informal instrumental and emotional social support. Informal support took the form of assistance from family members, neighbors, friends, religious leaders, friends of the deceased child, and peer group members. Formal support referred mainly to assistance from the National Insurance Institute and voluntary nonprofit organizations. The subjects raised by the parents in this respect included a description of the aspects that they perceived as helpful in coping with the many problems that characterized the new reality of bereavement, both in the immediate term and in subsequent years.

Informal Support—Instrumental Aid

The parents noted the importance of instrumental-technical support, especially in the immediate period following the loss, when they are immersed in a state of torment. Following, for example, is the emotional description given by Noga of the appearance of large numbers of people immediately following the loss, and their concern for the existential needs of her and her family:

From the morning we were inundated with people … thousands … it helped greatly … our friends and family and my son’s friends came from all parts of the country, they were of all ages, from different periods … it really was heart-warming.

Yitzhak too described with emotion the instrumental support he received, especially in the initial stages after the loss of his son. From the moment he received notification of his son’s death, Yitzhak, like other parents, needed to cope with a new and chaotic reality. At this point in time, the social-community support—arranging for the funeral service, seeing to all his needs during the 7-day mourning period, and financial help—was indispensable:

When we sat shiva [the seven-day mourning period] … three shifts were being held in turn … we were enveloped with kindness … they brought chairs … they brought water … the family did not have to think or worry about anything … they looked after and embraced us. I recall the giving now with emotion. Someone gave me NIS 10,000 … I told him I didn’t need it, he said to put it in the bank – if you don’t need it return it … Its help until you recover.

The importance of social support is very evident in the talk with Sonia, who immigrated to Israel from the former USSR. The limited family circle together with the difficulties inherent in adapting to a new society, especially following the personal loss, gave rise to a feeling of isolation in her. Her words reflect the power of broad-based social support in minimizing the sense of isolation, absence of belonging, and other difficulties she encountered in Israel:

When I was informed that my daughter had died I did not know what to do, to whom to turn … People from the streets came and helped and friends came and helped. Everyone offered help … I felt I was not alone …

Emotional Support

Apart from the concern for existential needs, all the parents mentioned emotional support. Sergei, an immigrant from the former USSR, described the value of social support for him. The troubling thoughts that gave him no rest, the feeling of isolation, the inherent disbelief regarding the loss of his only daughter, and the emotional difficulties he felt aroused in him a need for a social environment that was supportive and sensitive:

My friends … were with me from the start and helped me in everything I needed … friends have a lot of power to help, even more than psychologists. In order to live through the first few days and after that as well one must have social support. It gives one strength … the thoughts that race through one’s head, especially in the initial period, can kill … I could not believe my daughter was no more.

For Yaron, the feeling of partnership and empathy on the part of the social environment helped him cope with the suffering that accompanied the bereavement. The social support helped him to feel that his loss was not only a personal but also a national one:

The responses were amazing, you feel you are not alone, others are with you … weeping with you … the suffering is mine, but not only mine, it is national, everyone shares this pain. It’s as though he were their son.

Tova describes the importance of social support even with the passage of time, especially in view of her need to fill the void that had formed after the loss of her son. Moreover, coping with the loss of her son put to the test her social contacts, helping her to realize who were her true friends:

It’s rare that I am alone … There are those who come in the morning and those who come in the evening … if I didn’t have this I don’t know what I would have done … a person is not judged in times of joy but in times of sadness, and here is where I see who my real friends are …

Ehud adds his contribution to the steady enveloping social contacts that have helped in defining the personal and social nature of bereavement, in distracting him from the pain, and in giving him the opportunity to express and cope with his loss in a way that would match his needs:

We have a lot of friends and when we go out they refer to him (our son) and this gives us a good feeling. They make it possible to cope with the bereavement in a positive way … without withdrawing into ourselves … if there are lonely people … their anger is greater.

A number of religious parents referred to the support received from religious leaders in coping with their loss. The leaders (rabbis) helped in presenting a religious interpretation of death, providing several parents with answers to questions, consolation, and meaning to their personal suffering:

One of the rabbis came together with his wife to offer their condolences. They related stories from the Gemarah about people who had also experienced such a thing … he said … that those who had been killed were holy … they were privileged in ascending to heaven, God chose only the best … We were all in the bus, why God didn’t take everyone. Because not everyone was worthy … only those who were killed … they strengthen our belief (Sara).

Contact with others in the same situation (peer group) is also viewed by a number of parents as meaningful in their personal coping. The feeling of sharing a similar fate, the ability to express one’s emotions, the exchange of ideas, and empathy with the pain constituted a common thread that bound all the bereaved parents. In the parents’ view, the human ability to understand cognitively and emotionally the nature and intensity of the pain is reserved only for those who have actually experienced a similar loss:

We had a support group and this helped quite a bit … it gave me a sense of proportion about things, firstly in recognizing the fact that there are others who are undergoing this experience like you, and secondly in receiving good advice. Because of our high level of sensitivity, it is very difficult for us to receive advice from every “know-it-all” … (Rachel).

The talk with Ron sheds light on the needs of the grieving parent who comes in contact with the social environment. The need to give vent to the personal pain only in the presence of a peer group that is truly able to identify and understand reappears in the talk with him. The other, different, person is perceived as harboring a sense of fear and having no awareness of the intensity of suffering or sympathy toward the bereaved parent—exactly those emotions that the parent would not appreciate:

When I see a bereaved parent I can talk to him about the pain and know that he will not be shocked … Other people who have not experienced this … don’t know what to say, they are afraid to talk to me … but I meet with bereaved families … I know what they have experienced, and we understand each other.

Some of the parents also referred to the support from friends of the deceased child. Through the course of the friends’ lives, the bereaved parents try to preserve the life and image of their child in order to maintain a sense of continuity. The talk with Sergei, for example, highlights the need for maintaining contact with his daughter’s social group, allowing him to drift in his imagination to realms that speak of a continuity to her life. Despite the pain, this action appears to afford him some relief:

Her friends maintain contact with us and we thank them for it. It is extremely important for us. They come often, especially on the Sabbath. When we see them it’s as though our daughter is still alive. Through them I can see her life … It helps us.

Valerie’s awareness that her son’s social group does not abandon his memory with the passage of the years accords her a measure of solace:

My son’s friends come all the time and ask about me. They arrive for ceremonies. I realize they are busy … but still find the time to come. I find it very touching that nobody has forgotten him.

Formal Social Support

Apart from the informal support, the parents also mentioned support from formal institutional and voluntary agencies, including the National Insurance Institute and nonprofit organizations.

It is a well-known fact that in Israel parents who have lost a child during his service in the military are entitled to extensive formal psychological and financial assistance. The expectation is that parents who have lost a child to terror should be given the same assistance. It is in this context that Reuven refers to the hierarchy of bereavement, heading which is the assistance provided in the event of a national loss, such as an act of terrorism. Injury in such cases entitles the affected persons to the entire gamut of assistance: special rights, public recognition, manifestations of sensitivity with respect to the personal grief, and granting of special favors that could help ease the deeply emotional personal condition:

Sad to say, but if someone must die young in this country it’s better if he die in the army or in a terrorist attack. People who have had someone killed in a road accident … are reduced to poverty, but here in this instance widows and orphans receive everything they need … there is a non-profit organization called One Family, which does good deeds … there are no words to express it.

Against the backdrop of emotional and health difficulties, Ofra also noted the significant contribution of the National Insurance Institute in assisting in the process of rehabilitation, primarily help in consolidating an orientation that would suit the parent’s needs and condition:

As part of the rehabilitation provided by the National Insurance Institute, I work twice a week with the institute, their aim was to get me out of the house, I enjoy it greatly … it makes me do other things as well.

The events arranged by the various voluntary nonprofit organizations, such as parties, excursions, and support groups, especially for families, help to divert one’s attention from the sense of isolation and the difficulty in coping with the personal loss:

The non-profit organizations help … They provide us with amazing vacations. During the religious holidays they organize parties. Anything to inject a bit of joy … everybody knows everybody and we laugh and forget our pain for a bit (Yaron).

A Mixed Blessing: The Negative Side of Bereaved Parents’ Experience

In addition to the positive aspects, the parents also described the negative side of social support. The negative aspects ranged from a sense of abandonment to disappointment, pain, and anger as a result of uncaring statements or conduct on the part of the formal and informal social network.

Sense of Social Abandonment

Lily expressed a feeling of social abandonment and hurt at there being no one with whom to share the existential difficulties and personal pain that accompanied the loss of her daughter. Her statement illustrates the intensity of her hurt:

Today we are altogether alone, we have no friends. People do not know how to talk to us, they have all disappeared and it is very difficult. It all blows up in your face and there is no one to talk to … Why? It is very hurtful … what’s left to live for?

The social environment in this case is perceived by the parents as one that has abandoned them, is disregarding them, and is insensitive to the difficult state in which they find themselves:

I walk down the street and people turn their heads because I have undergone something, people suddenly do not recognize me, is this proper behaviour … ? they do not realize that perhaps closer contact is needed? (Miriam).

Iris pins the blame for social abandonment on the apprehension that people feel about coming face-to-face with the suffering of a grieving parent. According to her, the social environment does not know how to deal with the pain of bereavement, leading to abandonment and disregard:

There are people who cannot look me in the eye. I had a good friend who used to visit me at home, and after the attack he does not so much as look at me, when he sees me he crosses the road. But I am not angry at him, people do not know how to deal with a person’s pain. They do not know how to approach me …

Ron, who lost his daughter, also has an explanation for the lack of social support or inappropriate support. In his view, the distance maintained from him stems from the fear of being infected by the personal suffering or the bad luck of the bereaved person:

In the beginning I had the thought that people were keeping a distance from me and did not wish to talk to me because of my bad luck, because of not wanting the same thing to happen in their family …

How Bereaved Parents Should Cope—Expectations of the Social Environment

From a content analysis, it may be seen that in the parents’ view, the type of social responses demonstrates the difficulty felt by the social environment in receiving an expression of mourning on the part of the bereaved parent. In situations where the grieving parent does not exhibit signs of mourning that are overt or reasonable, he could find himself subjected to hurtful comments. Thus, for example, returning to normalcy, cultivating an outward appearance and participating in joyous social events can be perceived by the social environment as lacking legitimacy. The expectation in such a case is for the bereaved parent to display mourning, pain, and anguish over the loss of his child.

Esther, who lost her son, described social expectations regarding the expression of grief: The parent must play the part of the unfortunate one and wear sackcloth and ashes. As long as he does not act in accordance with this dictate of society, he is subjected to internal and external tension:

When people see bereaved mothers who are well-tended they raise an eyebrow, how do they want to see us, as worn-out and unfortunates … this is not what my son would have wanted … they say this woman who lost her son? … Must I dress in black, must I wear a sack over my head, all these are outward signs, my son is with me here (points to her heart).

There appears to be a contrary expectation as well: Where the bereaved parent is seen to be wallowing in the pool of bereavement, he is expected to find a way out of this morass speedily and get his personal life back on track. Natalia, for example, describes, in anger and in hurt, the inability of the social environment to understand the intensity of her personal pain:

People say, it’s enough already, a long time has passed, you have to get out of it. This really angers and saddens me. They cannot understand how I feel. Once I had an experience with an acquaintance of ours whose mother had passed away, and he invited us to his place, and said look, some time has passed and we are coping, but with you four years have gone by and you are not recovering. Why does he have to say a thing like that? Losing a mother is not like losing a child.

Leah added to this idea and claimed that in the perspective of time, the parent is expected to check the maelstrom of emotions in which he finds himself and resume normalcy:

People feel it’s enough, I should go back to being the Leah I was, happy … I am no longer that way and people expect me to be that again. That I should put on a bit of makeup, wear festive Sabbath clothes … I have a lot of battles with myself, they tell me I have strengths … Every time they say this I have a setback … I want to cope in my own way. I don’t want to be pressured and told how to cope and given infuriating advice …

Social statements indicative of emotional obtuseness also have the power to create hurt in bereaved parents. Maggie described such a case well, while expressing revulsion at the kind of support offered her by religious leaders:

During the shiva religious people came and said that our children had died because they partied on Friday evening and did not observe the Sabbath. Why did they have to say that? At the time there were many attacks and religious people who kept the Sabbath also died. Why do they have to hurt us? Don’t we have enough hardships?

The lack of understanding of the personal pain is demonstrated also in the dialogue with Leah:

Now I am under pressure, I have a wedding and I have a problem with it because I want to go but I find it hard. A friend of mine said I don’t understand you … what’s the problem in dressing up and sitting at a function? … It’s something that makes me cry, raises my blood pressure, causes me fatigue and pains in my entire body … And a few minutes later she tells me that she is under pressure from some end-of-year party for the kids, and I tell her it will all pass, but what I am undergoing will be with me forever.

Iris, who lost her daughter, her partnerm and her son-in-law in an attack that took place on Passover Eve described with cynicism the dialogue she had had on social expectations regarding the appropriate period for the bereaved parent to express his mourning:

Someone at work once said, okay Iris, a year has passed, you must get back to being yourself. So I said, what they (her loved ones) are coming back and didn’t tell me? I didn’t know they were getting back, and if they are getting back, so I too will get back to being myself. they simply do not understand.

Dichotomy Between the Bereaved Parent’s Internal and External World

The aversion to being the object of pity, the social embarrassment, and the severance of social contact give rise to the need in parents to consolidate behavioral norms with respect to encounters with the outside world. The role of these norms is to reduce somewhat the sense of personal injury. The following monologue illustrates the tension that exists between the internal and external world in determining the manner in which to show one’s personal grief:

I want to act normal … I go down the street and feel that I am wearing a badge that sort of I don’t know how to describe it, I don’t want to show people how I feel … the hurting and unfortunate Avishag is at home and outside it’s as though nothing has happened (Avishag).

The negative facets in the interface with the social environment are evident in Hillel’s description too. The following situation created the need on his part to separate the internal world from the external world in order to avoid the bereavement stigma:

Following the shiva … I have workers who left in order not to confront me … they don’t know how to conduct themselves … it makes them feel bad … so I make a special effort in the social world, I want to be an equal amongst equals … I don’t want the stigma of bereavement …

The charged contact with the outside world gives parents the need to forcibly create a schism between the private and public persona, as stated by Ehud:

Outwardly everything is a show … I am the kind of person who does not like others to talk about us, I act as normally as possible outside.

Emotional Burden Vis-à-Vis the Peer Group

Against the backdrop of a destiny shared with another person in the same situation, several parents emphasized the dislike for consolation from the bereaved community. The complexity of the encounter with other bereaved parents clearly intensifies the pain and gives rise to an inability or aversion to contain the pain of the other person like you.

I don’t have the strength to bear more troubles on my shoulders … it hurts that I cannot help them. I would gladly do so but it makes me feel bad … when we met with other bereaved parents … I saw myself in the others. For example, if I saw a bereaved mother it would remind me that I am bereaved and make me feel worse.

Hillel’s words too shed light on the complexity of the contact with bereaved parents. Despite the fact that the peer group serves an emotional function, at times it also creates an emotional load, especially in social encounters which show up the differences in strategies for coping with the personal loss:

We have a woman in the group who lost her son and every time we see her I simply feel sorry for her … the only thing she does is cry. She is constantly trying to understand whether this was meant to happen or not, and if his soul is here or there … I tell her, you are a miserable being … you cannot live this way … she tells me you don’t know what I feel … I do know.

Anger Toward the National Insurance Institute

Parents expressed anger toward formal assistance organizations, stating that their attitude intensified the suffering and the feeling of personal victimization. Most of the parents referred to the actions and approach of the National Insurance Institute, perceived as a public-formal entity responsible for the welfare and rehabilitation of bereaved individuals who knock on its door.

The principal complaints expressed by Iris, for example, toward this agency centered on the feeling of insensitive treatment, imperviousness, and bureaucracy. She describes the encounter with them using militant rhetoric to illustrate the necessity of fighting at every twist and turn:

About National Insurance I have only bad things to say, it’s an insufferable body … It’s a daily war. Obliviousness and bureaucracy and simply abuse … I cannot function, but I have not sued …, I was concerned about my daughter that she should have her degree of disability recognized, there’s an X-ray photo showing a bullet lodged in her knee. They say it could be something else, so we become cynical and say, okay, you are right, she has this habit of shooting herself in the knee just for kicks.

Hillel expressed criticism over the way the welfare worker acted. His words in this connection spoke of a lack of emotional support:

A social worker was here when we were sitting shiva … she said: come to me for anything you may need and since then nothing … then she said, I was here, I saw that you were managing … I said how do you know? … if there is no contact it’s a problem.

The grouse was mainly about the inefficiency, the lack of responsiveness to personal requests, the sense that individual rights were not being disclosed, impatience, disdain, and invasion of personal space. Following is Natalia’s account on her session with the National Insurance Institute:

I don’t have to go and lower myself to the National Insurance people. They give us the feeling that we are beggars. If you don’t know what your rights are you receive nothing, and if you have already heard about some right they don’t give any explanation, they ignore you. If you ask for any help … they immediately start interrogating you about every request.

Discussion

This article presents discourses with bereaved parents on the nature of formal and informal social support received. The findings of the research raised issues that demonstrate the complex and dialectic experience on the part of the parents vis-à-vis the social environment. Some of the parents’ descriptions reinforce findings from other studies that address the value of social support (Figely, 1986; Flannery, 1990; Thoits, 1995). At the same time, the parents elaborated on the negative features that are inherent in this support, causing emotional stress, anger, and disappointment, aspects that could intensify the trauma experienced in coping with the loss of one’s child.

The importance of a meaningful social circle is endorsed in the research and clinical recognition of the fact that the loss of one’s child is a traumatic experience, both in the immediate and long term (Malkinson & Bar-Tur, 1999, 2004–2005). The experience of bereavement brings parents face-to-face with painful, unfamiliar, and chaotic emotional situations.

The extensive literature on the subject clearly illustrates the fact that parents who have lost a child, especially in cruel, violent, or sudden circumstances (Pivar & Prigerson, 2004), belong to a high-risk group that could suffer destructive, prolonged trauma, inherent in which are a loss of life’s meaning (Wheeler, 2001), a breakdown of world assumptions (Matthews & Marwit, 2004), anger, depression, and development of serious health and emotional problems (Lang et al., 2004). Against this backdrop is the increasing importance of the supportive social network, one that understands the complex and fragile world of the bereaved parent. About 30% of the research group were divorced or widowed, and about 20% were new immigrants, facts that intensify the need for a social environment that could fill the void following the loss of the child.

A supportive social environment that provides appropriate instrumental and emotional support helps parents cope with the sense of isolation, pain, and difficulty. The issues that emerged in talks with the parents with regard to the nature of the support included the parents’ need for an available social partnership, for signs of empathy for the personal suffering, for validating emotions, for listening and sharing in the emotional burden, and for help in diverting one’s mind and in filling the void that has been created with the death of the child (Cohen & Wills, 1985; Figely, 1986; Flannery, 1990; Lepore & Revenson, 2006).

A number of parents also noted the support of religious leaders in giving religious significance to the loss of their child as a result of an act of terror—a significance that was a clear source of solace. The humane assistance that religious people provide to religious bereaved parents centers around the meaning they impart to death as an extension of life (Saka, 2007). Harvey (2002) and Neimeyer (2001) claim that reconstruction of meaning in response to a loss becomes a central process in grieving. They maintain that there is no single truth or reality in the grieving process. Rather, that reality and truth are created and invented by both individuals and collectives within a specific context.

Even though the parents referred to the instrumental support of the immediate social environment, such as financial help, an aspect that was viewed with greater appreciation was the knowledge that the social environment was sensitive to the needs of the family in general, and the parents in particular, and that it is doing its utmost to ease their suffering. The loss serves as a test for the strength of the bond with the immediate social system and the extent of its commitment (Ayalon, 1993).

The importance of informal social support is twofold. The loss of a child causes an unprecedented change in the emotional, personal, and functional world of the parents. It disrupts the flow of life. The parents’ emotional and functional reality following the loss of their child is different and harsher (Saka, 2007). The parents are therefore in need of financial and emotional support that will help them adapt to a new reality and cope with their myriad problems.

The death of a child, especially against the backdrop of political-national events, also creates a need in the parents for help in recognizing their condition, in personal rehabilitation, and in meeting their multiple needs. Death in collective-national circumstances generates an anguish that craves social and institutional care of a kind that will formally validate the personal victimization. Collective meaning has enabled bereaved parents to experience coping with the loss of the child as part of the ongoing Jewish struggle for the survival of the Jewish nation and the Jewish state (Possick, Shamai, & Sadeh, 2014). This collective meaning helps in the process of coping (Saka, 2007).

The bereavement is not merely private but collective as well. The national victimization gives rise to fury and frustration in the parents—spurring them to wage the same struggle against the hierarchy of bereavement, announcing to the public that the death of the child in the given circumstances is not without meaning and that the state must assume responsibility for the child’s death and for supporting those left behind, exactly like death in the course of military service (Saka, 2007). The need for social recognition and empathy, the demand for psychological and financial rights, assistance in providing collective or national meaning to death—these are key features in the process of coping by bereaved parents who have lost a child in these circumstances.

Oftentimes the encounter with formal institutions such as National Insurance has been of a militant nature, underlying which is the need to fight at every step of the way in order to receive psychological and financial help. The leniency and empathy shown toward bereavement, expressed through telephonic communication and personal visits, have been part of the needs of bereaved parents in coping with their loss (D’Agostino, Berlin-Romalis, Jovcevska, & Barrera, 2008).

In addition to the positive aspects inherent in formal and informal social support, a large part of the discourse related to the negative facets that characterize the encounter with the social environment. In this context, the parent’s interfacing with the social community appears to be complex and two directional: Bereaved parents have expectations of the social environment in the way of desirable patterns of assistance; however, the social environment too, in the parent’s view, has expectations of the bereaved parent in dealing with his bereavement. From the point of view of the parent, the social environment is at times intimidated by having to rub shoulders with bereaved parents.

Social ineptitude refers to the difficulty a social network encounters in responding to and supporting those bereaved by sudden, traumatic deaths in a manner that is appreciated by the bereaved (Dyregrov, 2003–2004).

The parents referred to statements made and behavioral attitudes that intensified the pain of bereavement, for example, emphasizing the need for them to let go and put the spirit back into their personal lives without a true understanding of the enduring pain or the coping process.

In contrast to religious parents, secular parents cannot derive comfort from the religious world and from statements made by religious people, which only evoke in them feelings of affront and anger. This finding sheds light on the need to match the type of assistance to the religious and cultural world of the bereaved parent.

At times, the social support system also minimizes the implications of the hurt by encouraging the parents to show strength, thus robbing them of the need to vent their emotions. On the other hand, a contrary requirement exists: Where parents show signs of recovery or express their grief, the social environment is quick to point out the need to revert to the model of classic bereavement with its lamentations and torments. As long as the victim does not abide by “normative social standards” with respect to appropriate responses, he will have to deal with a feeling of “emotional deviance” (Thoits, 1995). Ineffective social support, with its overtones of revulsion, pity, lack of understanding, or absence of assistance during a time of crisis, engenders a feeling of secondary victimization (Janoff-Bulman, 1992; Kenney, 2002; Lyons, 1991).

The social requirement of the parents to display linear coping, culminating in a release from the crisis mode, illustrates in the parents’ view the inability of individuals who have not been in a similar condition to understand the circular, dynamic, and dialectic factors involved in dealing with personal loss (Saka, 2007). The existence of this social reality induces in parents a need to consolidate behavioral norms in encountering the outside world. The parent creates a schism between his inner and outer worlds. He retains his grief to himself within a secret emotional core where he is free to express his pain on his loss without fearing that he will be forced to stand trial under the watchful public eye. But in entering the social arena, other norms come to the fore, with clear rules of conduct, whose leitmotif is phoniness and playacting.

As to the social support provided by peers, namely, other bereaved parents, interaction with a counterpart does not always appear to be helpful. This finding is not in line with research studies, which point to the value attached to an encounter with a person who has had a similar experience (Hogan & Schmidt, 2002). At times, the encounter evokes a sense of yet another case of martyrdom, world-weariness, and a reminder of personal loss. This finding too emphasizes the need to match the assistance to the individual.

The existence of this dialectic social ground enhances the need to resolve or at least reduce the tension existing between the attempt on the part of the social-collective space to accord instrumental and emotional support on one hand, and the choice of a path that is nonthreatening to personal suffering on the other hand. The formal and informal social environment must be aware of the degree of hardship, and the emotional and instrumental needs of the bereaved parents. The process of bereavement for a parent is, as stated, complex, chaotic, and strewn with pitfalls; parents therefore need support systems that are there for them, and that show both emotional and cognitive empathy for their condition.

Limitations and Recommendations for Future Research

This research was conducted using the qualitative method on parents who had lost their children in terror attacks in Israel. Thus, it is not possible to generalize the findings and apply them to bereaved parents whose children died under different circumstances. In addition, further research is needed to study other cultures or societies or victims who have come face-to-face with trauma against the background of terror in order to validate what is known and add new knowledge.

With a view to shedding additional light on parental bereavement, research should be conducted that will focus on a comparison between parents who have lost a child as a result of illness, suicide, and road accidents, allowing a more accurate map to be charted regarding the processes of coping, the use of coping resources, and the impact of the loss on their world. Such a comparison would help to achieve a more accurate perception of the unique features of parental bereavement under different circumstances.

Moreover, quantitative research methods can study the complexity of social support and can examine, for example, the correlation between a feeling of social abandonment and posttraumatic stress disorder or complicated grief and also the correlation between positive social support and posttraumatic growth.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biography

Yael Saka (PhD) is a lecturer in criminology at Ashkelon Academic College and also an applied criminologist. The author received PhD in criminology from Bar-Illan University, and doctoral thesis is on trauma construction by parents who bereaved their child in terrorist attacks in Israel. Yael Saka’s research interests include issues in victimization, coping with trauma, bereavement, and qualitative research.

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