If you suddenly lost your child in an accident, how would you cope? Could you go on?
Of course, such a scenario is virtually unthinkable. The loss of a child is the most intense form of loss that can be experienced (Arnold & Gemma, 1994; Cleiren, 1992; Lehman, Wortman & Williams, 1987; Rando, 1986; Sanders, 1988; Valeriote & Fine, 1987; Wheeler, 1993-1994). When the loss comes from an unexpected accident, it is particularly difficult to cope (Grad & Zavasnik, 1996; Reed & Greenwald, 1991; Lundin 1984; Sanders, 1982-1983; Smith, Range, & Ulmer, 1991-1992).
Nonetheless, this nightmare scenario is more real than you may think. Accidental death is the number one killer of people between the ages of 1 and 44 (Oserweis, Solomon, & Green, 1984). Approximately 150,000 people die from sudden, traumatic deaths every year.
Thus is the premise of Rabbit Hole. The movie begins about a year after Becca (Nicole Kidman) and Howie Corbett's (Aaron Eckhart) 4-year-old son chased his dog into the street, being accidently killed by a teen driver who swerved out of the dog's way and right into the child's path.
I had the pleasure of seeing an advance screening of this movie. I was a bit skeptical going in, because Hollywood has a way of distorting reality in the name of sensationalism and ratings. I was pleasantly surprised.
Some researchers have proposed that the function of fiction is to simulate social experience, allowing the viewer to learn through the experience (Mar & Oatley, 2008). Judging by this standard alone, Rabbit Hole is one of the best examples of fiction I've ever seen. In a Hollywood climate where things always seem to end in a neat and tidy box, this movie offers a refreshingly authentic simulation of unimaginable tragedy and loss.
As a scientist, my metric for authenticity is empirical research. The more a movie with this subject matter is align with how people in the real world deal with such tragedy, the more authentic it is in my view. And in this regard, Rabbit Hole, with its story and remarkable acting from all the cast members, is strikingly authentic.
Peering Through The Rabbit Hole
In Lewis Carroll's Alice's Adventures in Wonderland, the main character Alice falls through a rabbit hole into a an alternative reality, where nothing is what it seems and nothing can be expected.
What Becca and Howie go through after the death of their child is similar to going down that rabbit hole. For them, the world is suddenly surreal. Even the once familiar now seems foreign; they are literally strangers in their own environment.
This is how people in the real world see the world after experiencing intense trauma. Trauma changes perspective. Tedeschi and Calhoun (1995) found that trauma causes changes in self-perception, in addition to changes in interpersonal relationships and changes in a philosophy of life.
In Parks and Weiss (1983), 61% of those who had suddenly lost a spouse agreed with the following statement 2 to 4 years after the incident: "It's not real; I feel that I'll wake up and it won't be true."
Lehman et al. (1987) conducted interviews with 41 parents who had lost a child in a motor vehicle crash 4 to 7 years ago and found that many of the respondents had come to see the world as a hostile place where things can be taken away at any time. 37% reported that they felt as though the death was not real and that they would wake up and it would not be true. As the researchers note,
"When a loss occurs suddenly and without warning, it may be especially likely to shatter a person's assumptions that the world is orderly, rational, and fair (Parkes & Weiss, 1983; Wortman, 1983)."
How does one get out of the rabbit hole? As the tagline for the movie says, "The only way out is through".
Long-Term Effects of Traumatic Loss
Rabbit Hole opens roughly a year after the Corbett's loss. We don't know how they coped in the first few months after the accident, but one thing is clear: they are still far from recovery.
Both Becca and Howie are coping in very different ways. Becca wants to sweep all reminders of her son under the floor, including his toys, clothes, dog, and house. She even left the job she had when her son was alive. Becca also resents her mother's (played by Dianne Wiest) advice to embrace religion, and gets upset whenever her mother makes comparison's between the loss of her son and Becca's loss (which occurred under very different circumstances).
Howie, on the other hand, deals with the loss by clinging to every reminder of his son. He watches videos of his son on his phone, wants the dog around, and desires intimacy from his wife, who is not ready yet for that intimacy. He also imagines his son is still around. In a very poignant scene, he is showing potential buyers around the house when they end up in his son's room. One of the potential buyers asks how old his son is, and he tells them his son was killed in an accident. He proceeds to describe how he still half expects his son to pop out of the bed at any moment and surprise him.
Becca and Howie's different ways of coping puts a strain on their relationship. Howie attemps to move on by establishing a relationship with another women who can identify with his pain, whereas Becca attempts to move on by establishing a relationship with the teenager who accidently struck her child with his car. Yet, they are both bonded by certain similarities. They both are grieving, and simultaneously blame each other and no one in particular for the accident, constantly going over "what if" scenarios ("What if we locked the door that day?", "What if the car wasn't driving by at that precise time?", etc.). Also, both are having great difficulty finding any particular meaning from the incident.
The Corbett's ways of coping is strikingly similar to research on the long-term effects of the traumatic loss of a loved one. In this vein, the movie is to be commended for not sugarcoating the coping process.
In their study, Lehman et al. found that even after 7 years after the accident, parental bereavement was associated with increased depression, an increased mortality rate, a drop in financial status, and a higher divorce rate. Most of their effects held, even after controlling for income and marital status, although they did find that a lower income and/or being separated or divorced was significantly associated with poorer coping.
Additionally, those who had lost their child in a crash were less able to talk about their feelings with relatives, often doing the opposite of what their relatives wanted in order to make them angry. Respondents were also less likely to still be working at the same job they held at the time of their child's death.
Even after 4 to 7 years, most respondents had not achieved a state of resolution. Almost half of the sample had reviewed events leading up to the accident in the month prior to the interview. A majority (59%) were still unable to find any meaning in the loss, had thoughts that the death was unfair, and had painful memories of their spouse or child during the past month. 96% of the parents reported that during the past month memories of the deceased entered their mind, 79% of the parents indicated that they keep going over the events that led up to their son's death, 91% often asked "Why me?" or "Why my child?" and 62% indicated that they often find themselves thinking "If only I had done something differently, my child would still be alive." 41% of the bereaved parents indicated that, even though they realized it was not possible, they at times imagined their child coming back.
Variability in Coping Response
People differ quite dramatically in how they cope with loss. Perhaps Rabbit Hole's greatest strength is that it highlights this important variability.
Becca and Howie don't just differ in their coping styles, but nearly every single character in the movie deals with their own loss in different ways- from the support group member's use of religion and drugs, to the teenager who caused the accident (played by Miles Teller), who copes by drawing comic books of an alternate reality called, fittingly, Rabbitt Hole.
Research bears out this widespread variability. Wortman & Silver (1989) found at least three common patterns of adaptation to loss.
"Some individuals indeed seem to go through the expected pattern, moving from high to low distress over time. But others appear not to show intense distress, either immediately after the loss or at subsequent intervals. Still others seem to continue in a state of high distress for much longer than would be expected."
For some, social support can play an important role in helping people maintain physical and psychological well-being, find meaning, and reduce stress (Lyons, 1991; Reif, Patton, & Gold, 1995; Schwab, 1995-1996; Stylianos & Vachon, 1993; Vachon & Stylianos, 1988; Park, Cohen, & Murch, 1996; Reif et al., 1995).
Indeed, some of the members of the support group Becca and Howie attended were able to use the support group to find meaning. One particular pair drew on religion to find meaning. And research does show that religious participation and importance can play an important role in increased perception of social support and finding greater meaning in the loss of a child, and is indirectly related to greater well-being and less distress among parents 18 months after an infants' death (McIntosh, Silver, & Wortman, 1993).
But religion and social support is not for everyone, and it is not always necessary to find meaning in trauma. This is illustrated well by Becca's reluctance to use religion and social support to help her cope, as well as Becca and Howie's difficulty finding meaning in the trauma they both experienced.
Wright (1983) maintains that society frowns upon open displays of distress and requires cheerfulness, when distress can sometimes be a positive coping mechanism in itself. Research supports this notion. Davis, C.G., Nolen-Hoeksema, S., & Larson, J. (1998) found that making sense of loss was associated with less distress, but only in the 1st year postloss, whereas reports of benefit finding were most strongly associated with adjustment at interviews 13 and 18 months postloss.
These various research findings (importance of social support, importance of benefit finding, etc.) point to the idea that there is no one-size-fits all way of coping. Everyone has to figure out the best way for him or herself.
According to Zisook and Shuchter (1986), at the present time
"there is no prescription for how to grieve properly for a lost spouse, and no research-validated guideposts for what is normal vs. deviant mourning... We are just beginning to realize the full range of what may be considered 'normal grieving (p. 288)."
Gender Differences in Coping Style
Without taking away anything of the authenticity of the movie, there were certain minor aspects I thought could only have made the movie more accurate and stronger.
One area I don't think they explored as much as they could have is gender differences in coping style. They were rather inconsistent in terms of which gender displayed which coping style. Among Becca and Howie, Howie seems to be doing a better job adjusting to the loss, but among other couples in the movie (such as Gaby and her husband in the support group), there is gender reversal in coping style.
Some research does show gender differences in coping style. While Polatinsky & Esprey (2000) found no gender differences in coping strategy after loss of a child in a sample of men and women who were both involved in a social support network, research does show that women in general are more likely than men to seek social support (Littlewood, Cramer, Hoeskstra, & Humphrey, 1991; Rosario, Shinn, Morch, & Huckabee, 1988; Thoits, 1991). In Rabbit Hole, Howie is more likely to seek social support than Becca (although Gaby is more likely to seek social support than her husband).
Research also suggests that women may be more capable than men in learning and benefiting from difficult life experiences (Tedeschi & Calhoun, 1996; Lehman et al., 1993; Park, Cohen, & Murch, 1996), although in Rabbit Hole, it seems as though Howie is the one who is learning more from the experience.
But perhaps this isn't the point. Perhaps the point is that both Howie and Becca are both equally learning, just in different ways. There's no way to know for sure who is learning more from the experience. Also, perhaps the writer David Lindsay-Abaire mixed up gender coping styles to show the variability that can exist even among males and females. This is fine, as there is indeed a lot of variability among males and females, even if there are group differences in general.
Additionally, I don't think they pushed Becca's breakdown far enough. Holbrook, Hoyt, and Anderson (2001) found that women are at risk for markedly worse functional and psychological outcomes after major trauma compared to men, independent of injury severity and mechanism and these differences remain after adjusting for injury severity, mechanism, age, and sociodemographic factors. Additionally, Li et al. (2005) found that bereaved mothers had a higher relative risk of being hospitalized for any psychiatric disorder than bereaved fathers. Among mothers, the relative risk of being hospitalized for any psychiatric disorder was highest during the first year after the death of the child but remained significantly elevated five years or more after the death.
In light of this important research, I think the writer could have pushed a bit more the extent to which Becca loses her mind. I don't think it would have been unreasonable to have her lose her sanity in a dramatic way, perhaps even having severe delusions and distortions of reality, beyond what is already depicted in the movie. Perhaps the writer was afraid of reinforcing gender stereotypes or painting mental illness in a negative light. However, I think the movie could have successfully explored the idea that madness, considering the circumstances of severe distress, can be normality.
As Parkes and Weiss (1983) point out,
"Pathology may be a reasonable response to the unexpected and untimely death of one's spouse... What might be characterized as a psychological difficulty or even psychiatric illness can be an understandable consequence of loss (p. 170)."
Life Goes On
At the end of the day, I thought the movie provided hope that life can go on even after the worst of circumstances.
Research shows that we tend to overestimate the duration of our negative affective reactions to negative events, such as the death of a child (see Gilbert et al., 1998). Studies even show that bereavement and grief can enable personal growth and a deeper appreciation of life (Edmonds & Hooker, 1992; Kessler, 1987; Oltjenbruns, 1991; Polatinsky & Esprey, 2000; Schwartzberg & Janoff-Bulman, 1991; Ulmer, Range & Smith, 1991). Reif et al (1995) concluded that the passage of time plays an important role in the healing process (but see Tedeschi and Calhoun, 1996 for a different conclusion).
By providing an accurate portrayal of the coping process, including the many ways people can differ in their coping processes, Rabit Hole counters common myths and unwarranted assumptions about coping with loss.
Wortman & Silver (1989) dispel 5 common myths about the coping process, and each of these myths are also dispelled in Rabbit Hole:
1. Depression is inevitable following loss.
2. Distress is necessary.
3. Failure to experience distress is indicative of pathology.
4. It is necessary to "work through" or process a loss.
5. Recovery and resolution are to be expected following loss.
Rabit Hole does not have a Hollywood ending (compete recovery), but has a real ending (life gets better and bearable over time). Luckily, Becca and Howie have each other to help get through the pain, which certainly makes it easier. But even those without that kind of support can still cope (Lehman et al., 1987). The message of Rabbit Hole is ultimately uplifting: The tragedy may never be forgotten, but life can go on.
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Scott Barry Kaufman is Scientific Director of The Imagination Institute in the Positive Psychology Center at the University of Pennsylvania.