The New Grief: The Transformation of Death and Dying

Guest Author: Dr. Joseph Nowinski

My maternal grandfather died suddenly when I was in high school. He was in his late fifties and died, I only later learned, from emphysema—a condition had its origins in his youthful work in Pennsylvania coal mines. My grandmother, in contrast, lived to the age of 100, but suffered a long, slow decline. She was, it turns out, a harbinger of what modern medical technology is able to do, which is to stave off death for longer and longer periods of time.

A colleague, Dr. Barbara Okun, lost her husband to cancer after a prolonged struggle. His story, too, was emblematic of modern medicine. It’s a story we’ve all come to know well, either from personal experience or by reading about the struggles of well-known people like Steve Jobs and Elizabeth Edwards.

A mutual acquaintance of Barbara and myself—an editor at Harvard who herself is a cancer survivor—came up with the idea of getting us together to see if we might be able to write something about this “New Grief” that is the result of medical advances. It is, in a sense, the dark side of these advances, which is a long and protracted crisis that ensnares not only the person who receives a terminal diagnosis, but his or her entire family.

What Barbara and I discovered, through informal conversations with other colleagues and friends, was that virtually everyone we knew could personally relate to this process that is the new grief. It is remarkably different from the grief a person typically experiences when a loved one dies suddenly, as was once much more common than it is today. We also learned that this new grief was akin to what several people described as an “emotional roller-coaster” that had the potential to wear down even the most devoted caretaker, the most loving spouse or child. The challenge we faced, however, was to see if there was any way to make sense of this process, or, to put it differently, to see if there was any way we could construct a sort of “road map” that others could use when they find themselves in this situation—as they surely will.

The method that Barbara and I chose was to seek permission from several major cancer and medical treatment centers to recruit and confidentially interview both patients and family members, either as they struggled with terminal illness, or afterward as they looked back on the experience. What we found, somewhat to our surprise, that there was in fact a great deal of commonality across the stories we heard. Though each story was of course unique, we were nevertheless able to discern clear patterns, and even “stages” in the new grief, the first of which we simply named crisis, because a terminal diagnosis immediately throws both the patient and the family into a crisis.

The book that emerged from our work, Saying Goodbye: A Guide to Coping with A Loved One’s Terminal Illness, presents the collected wisdom we were able to distill from those who generously shared their experiences. Our hope was that it will in turn be a source of information, comfort, and sound advice to others as they enter into the new grief.

 Author Bio:

Joseph Nowinski, Ph.D. is a clinical psychologist. He has held positions as Assistant Professor of Psychiatry at the University of California San Francisco,  Associate Adjunct Professor of Psychology at the University of Connecticut, and Supervising Psychologist, University of Connecticut Health Center. Dr. Nowinski currently has a private practice and does consulting.

Dr. Nowinski is the author of numerous books, both for professionals and the general readership, as well as articles and book chapters. He is the principal author of Twelve Step Facilitation Therapy which is listed in the National Registry of Evidence-based Programs and Practices.

Dr. Nowinski’s most recent books include Saying Goodbye: A Guide to Coping with a Loved One’s terminal Illness, and Almost Alcoholic: Is Your (Or Your Loved One’s) Drinking a Problem? For additional information visit

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