7 FAM 200 APPENDIX B
GRIEF, BEREAVEMENT, MOURNING, FUNERAL CUSTOMS, CULTURAL CONSIDERATIONS
(CT:CON-905; 04-22-2021)
(Office of Origin: CA/OCS)
7 FAM 210 APPENDIX B Summary
(CT:CON-905; 04-22-2021)
a. Consistent with 22 U.S.C. 5505 regarding consultation with death and bereavement counselors in expanding training programs for consular officers, PC 124 (School of Professional and Area Studies/Consular Training), Assisting Victims of Crime, PC 535 American Citizens Services, and PC 122 Workshop for Senior American Citizens Services LE staff (Locally Employed Staff) address various aspects of the subject of assisting grieving U.S. nationals. In addition, Consular Affairs/Overseas Citizen Services (CA/OCS) encourages participation in non-Department of State training about the subjects raised in this subchapter. L/CA stands ready to provide posts with additional guidance on these subjects available from our inter-agency sources. CA/OCS/ACS is available to provide guidance to posts on a case-by-case basis and CA/OCS Victim Assistance Specialists are available to help CA/OCS/ACS and post consular sections with reference and resource information as appropriate.
b. If the family includes dual nationals or host country nationals, consular officers should consult Locally Employed Staff for cultural insights about local mourning customs.
7 FAM 220 APPENDIX B WORKING WITH STRESSED AND BEREAVED CITIZENS
(CT:CON-156; 02-07-2007)
a. Understanding the stages of grief may help you better understand anger or hostility you may receive from families.
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STAGES OF GRIEF |
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Overview |
In your personal and professional life you may meet people who are grieving as a result of a traumatic incident. Or, you may experience the loss of a loved one. Because you may face death and loss, it is important to understand the grieving process. |
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Reminder |
The stages of grief do not occur in a specific order and may repeat. Grieving people are likely to experience all the stages in a way that is unique to them. Also, cultural differences may affect how each stage is expressed. |
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Shock/Denial |
Immediately after learning of a traumatic incident, one may feel an emotional numbing. The traumatic reality is likely to be absorbed very slowly. Feelings of disbelief may be articulated in expressions such as: “This can’t be true!” “It must be a bad dream!” |
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Anger |
Once the realization of loss begins to set in, the feeling of anger may be overwhelming, particularly if death was unexpected or sudden. It may be unfocused and an individual may find himself/herself verbally lashing out at anyone. Strong desires to blame someone for the loss are not uncommon. |
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Depression/Sadness |
Emotions displayed during this stage include agony, depression, anguish, grief and despair. Performing normal, everyday tasks suddenly becomes difficult and even unbearable. One may have a preoccupation with learning every detail of the incident. |
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Guilt |
When one begins to have a full awareness and understanding of the loss, he/she may have strong feelings of guilt. These feelings may be expressed as: “If only I had gotten home earlier, maybe this wouldn’t have happened,” or “I should have told her more often that I loved her.” Feelings of guilt usually subside with time. Individuals begin to acknowledge their loss and to accept that they did the best they could to let loved ones know they cared. |
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Integration |
At this stage, individuals are able to remember the good times, look at photographs, and talk about loved ones without a feeling of overwhelming pain. Being able to integrate the loss into one's life so that there are more good days than bad will allow one to move forward. |
b. The Medical Director's (M/MED) Casualty Assistance Intranet page includes links to guidance about the stages of grief.
c. Conversations with victims and their families:
(1) Show Compassion: First and foremost it is important to keep in mind that in the initial aftermath of a death, callers or citizens you may be assisting in person are likely to be extremely distressed. By showing compassion you will demonstrate to families that you are working on their behalf. If authorized to communicate with the family by e-mail, you should also take this guidance into account.
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Do … |
Don’t |
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Convey sympathy Say “I can only imagine/I understand how distressing this is for you”, and Refer to the victim by name or as “your son/daughter”, etc. Offer your assistance and a listening ear if they have not asked for help Reassure them they are safe Tell them that you are sorry such an event has occurred and you want to understand and assist them |
Share personal experiences Say–“I know how you feel.” Be cold or distant Be too clinical Use terms such as “deceased”, “the late”, “remains” etc. Tell them they are lucky it wasn’t worse or that the deceased is better off – traumatized people are not consoled by those statements |
(2) Remain Composed: As victims and family members may be uncertain of their loved one’s condition, or their onward transportation options, some of their frustration or anger may be directed towards you. They may also express personal beliefs that you may not agree with.
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Do… |
Don’t … |
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Remain composed |
Argue, NEVER argue |
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Act professional |
Be defensive |
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Respect religious or personal beliefs |
Question the personal or religious beliefs of others |
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Take the person’s anger personally |
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Listen |
Give advice on how to handle bereavement |
(3) Take Your Time: Always bear in mind the extreme pressure the person is under:
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Do |
Don’t |
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Show your understanding or appreciation for the extreme pressure the person is under |
Convey impatience or time constraints to get off the phone Only in the most urgent scenarios (i.e., the body will be cremated tomorrow unless you say otherwise today) should the citizens be given time constraints In most scenarios, consular officials should consider the deadlines to be for themselves rather than for the mourners and should raise items that need timely decisions in a timely fashion (and perhaps repeatedly) rather than giving the citizens the added (and often paralyzing) pressure of a deadline |
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Assist the family to make necessary decisions |
Show impatience to move on to the next call or case. Don’t Expect immediate decisions from the family |
(4) Communicate Clearly: Inquirers may feel very confused and not quite understand the impact of the situation.
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Do |
Don’t |
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Repeat information Reiterate all principal points discussed verbally in writing (e.g. standard notification/sympathy correspondence and correspondence describing burial options) Conversations may not be fully absorbed by someone under stress, whereas information in writing can be referred to and absorbed gradually
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Convey bureaucratic obstacles
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Speak slowly Use short sentences Try to respond to specific questions |
Use abbreviations or acronyms |
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If you don’t have the answers to the questions raised, advise the person that you will do your best to get the answer, and then be sure to follow up |
Give your opinions
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Stress the positive actions you can take Give bad news in a compassionate and straightforward way |
Give false hopes or pass on unconfirmed rumors regarding a person's well-being, although you may convey preliminary reports from local authorities, citing the source Avoid or sugar-coat the bad news once it is confirmed |
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Set a time when you will call again and do it. |
Make promises and not follow through |
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Note: This is most easily done when you have the resources to use a case-worker approach (where one consular officer is the sole point of contact for the family) and ensure that a victim/family becomes used to and comfortable with a particular member of your staff |
d. Pay attention to the needs of your colleagues who are doing very difficult work. Debrief colleagues at the end of your shift both to keep them informed and decompress about what you had to handle in the last few hours. See 7 FAM 1800 Appendix A Managing Stress and the Consular Crisis Worker.
e. Other Sources of information about stress and grieving:
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Medline Plus Bereavement National Center for Post Traumatic Stress Disorder – Managing Grief After Disaster Yale Hospital – Common Reactions to Grief and Bereavement |
7 fam 230 appendix B reference and resources
(CT:CON-156; 02-07-2007)
a. Reference Books
(1) International Handbook of Funeral Customs, (1998), ISBN: 0-313-30443-2
(2) Funeral Customs The World Over, Habenstein and Lamers, 4th edition (1994)
b. U.S. Government Reference Materials
(1) U.S. Department of Justice, Office of Juvenile Justice and Delinquency Programs (OJJDP), Working With Grieving Children After Violent Death, Appendix VIII, Giving Sorrow Words, Funeral and Mourning Customs
(2) Federal Bureau of Investigation (FBI) Information for Families About Autopsies
c. National Funeral Directors Association (NFDA)
(1) NFDA Death of United States Citizens Abroad
(2) NFDA New Cargo Inspection and Security Rules Adopted by Customs and TSA
(3) State Department Help When Americans Die Overseas, The Director, May 1998.
d. Museum of Funeral Customs
e. PBS, POV, Death Customs (Public Broadcasting System, Point of View)