Book Review
General Psychiatry
Retelling Violent Death. Edward K Rynearson, Philadelphia: Brunner-Routledge; 2001. 164 p. CAN$32.95.
Reviewer
rating*: Excellent
Review by Michael F Myers, MD
Vancouver, British Columbia
This slim volume holds the reader’s attention from the prologue to the epilogue. Dr Rynearson, a psychiatrist at the Virginia Mason Medical Centre in Seattle, Washington, is a published authority in the field of bereavement associated with violent death. His work is particularly evocative because he merges his own story—his wife Julie’s death by suicide—and his clinical research with patients who have lost loved ones suddenly and violently. His premise is simple: individuals are changed forever by the violent death of a loved one, whether they die by accident, suicide, or homicide. There are no discrete stages, no precise answers, and no “substituting a bright fantasy of recovery for the dark reality of death” (p xv). Dr Rynearson argues that the search for coherence in violent death is futile and that repeated questioning is exhausting and empty. What he offers is restorative retelling.
In the first few pages, we are told about Julie’s severe postpartum depression, magnified by the sudden death of their new baby from a brain hemorrhage. Overcome by guilt and unrelenting self-blame, Julie dies by drowning (leaping from a ferry on the way to a visit with her psychiatrist). Her body is never found. Dr Rynearson is left a widower with 2 young children. We are left emotionally shaken and transfixed by this young psychiatrist’s pain.
Retelling Violent Death is divided into two sections: “Coherent Retelling” and “Clinical Intervention.” This form works well. In Part 1, we learn much more about Julie’s life and death and about the author’s journey of healing. Restorative retelling cannot begin until distancing from the chaos is in place and resilience is regained. One of the chapters nicely illustrates and explains the challenges to coherent retelling: narrative, social, biological, and psychological. Other chapters include several stories from Dr Rynearson’s practice and the unique experiences of children and adolescents, with guidance for parents and caregivers. Part 2 is clinically rich. We are given a model for restorative retelling, strategies of intervention, risk factors, family assessment, treatment goals, and approaches with individuals and with groups. This section also reviews the work of the “greats”: Janet, Freud, Adler, Lindemann (the 1942 Cocoanut Grove fire in Boston), Frankl, Lipton, and others. The remaining chapters address violence as a major public health problem in our society, the author’s thoughts about the popular term “closure,” and wise recommendations about prevention.
This book is reader-friendly, with short chapters, bold headings, a comprehensive list of references, a useful appendix with screening tools and intervention agendas, and a reasonable price. Clinicians eager to enhance their empathic understanding of violent bereavement and to improve their diagnostic and therapeutic skills will gain much from this fine book.
*Reviewer
Rating Scale/ Échelle d’évaluation du réviseur
Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé
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