Book Review: Beyond Endurance: When a Child Dies by Ronald J. Knapp

I recently checked out from our local library Beyond Endurance: When a Child Dies (1986 edition) by Ronald J. Knapp. (Beyond Endurance was updated in 2005 to include a chapter on internet resources.) Dr. Knapp was a professor of sociology at Clemson University, and also co-authored Motherhood and Mourning: Perinatal Death with Dr. Larry Peppers in 1980, covering losses from miscarriage to postnatal death.

The jacket flap states that this book is “the first book based on empirical [information gained by observation] studies of the death of children.” Dr. Knapp had not lost a child, but based his findings on “an assessment and analysis of in-depth interviews with 155 families…who had suffered the loss of a child ranging in age from 1 to 28…three months to five years prior to the interviews” (xii). In some ways, this book reads like a research paper filled with heart. His goal is “to know better how to respond and how best to offer our help and assistance to families and parents undergoing the agony of losing a child (21).” Beyond Endurance offers suggestions to professionals, to those surrounding grievers, and to grieving parents.

Although an outsider, Dr. Knapp states that he tried to see and feel what the parents went through, eventually becoming a “participant experiencer” as the parents talked about their stories (xiii). The people and stories became real to him as he listened and then took the information he had collected and synthesized it into this book. He does acknowledge that, although he can imagine what it’s like to lose a child, he “can draw away from it and the ‘experience’…[and it] becomes a simple exercise of the mind, a large step away from the real world…But persons who have actually lost a child cannot pull themselves free…They must face this grueling, gut-wrenching reality every hour, every minute, every second of every day. There is no place to run, no place to hide (18).”

Dr. Knapp focuses on three types of child death – from a long illness, sudden death, and murdered children – and devotes a specific chapter to each (including comments on his observations of the differences between the specific types of losses). He also notes common patterns he observed in the bereaved parents, including the fear that memories will fade away and the inability to find a context for understanding the death of a child. It was interesting to read Dr. Knapp’s assessment that “in the case of death after a long illness, parents were more successful in their attempt to describe and work through consequences of their loss.” He found that parents who lost a child after a long illness had already gone through the initial stages of shock and denial, and had experienced an anticipatory mourning; therefore, they were better able to vocalize their experience and feelings in talking about their child’s death. The parents felt they had a chance to prepare, to wrap up loose ends, and to say goodbye.

Dr. Knapp found that parents whose child had died suddenly (including suicide and murder) had “difficulty responding” when asked to describe their emotions and experiences. “It was as if they were forced to relive those scenes again (70).” He found that family members could clearly and accurately describe the reactions of other family members, yet were unable to put into words or sometimes even remember their own reactions immediately following a child’s death (72). “Apparently the mind has a way of protecting the self from too harsh a reality. We all have the ability…to reject something that is too threatening to our system to absorb all at once (71).” Parents whose children were murdered had the additional horror of the crime being intentional.

The chapter on “The Family in Crisis” covers how availability of internal and external resources can help the family…and how lack of them can be a detriment or cause additional stress. The chapter entitled “Some Special Problems” deals with topics such as lack of community support, the child’s empty room, and special days. Both chapters contain good, practical suggestions.

Probably the most helpful chapter in this book is entitled “Coping.” Dr. Knapp defines coping as “allowing ourselves to mourn a loss actively…Grief work cannot be hurried. Each person has a built-in time frame for completing it. However, one must make a determined effort to met it — to face it — head-on, and to accept the pain that realization of the loss will bring (187).” He feels that the parents who are most successful in dealing with the loss face it and actively work on grieving while being supported by family and friends. He states:

“Of course it is easier to do this if one has help and support from the community of friends who surround the individual. This tends to remove feelings of isolation and leaves parents with the impression that the death of their child was an event that mattered in the eyes of others as well.

However, this kind of support, particularly in response to child death, is often terminated too quickly. Family supporters and friends often treat the death of a child as they would any other type of death. They give support and assistance for a few weeks and then expect the grieving to end and the survivors to get on with living as usual. Thus support and understanding are curtailed too soon and the survivors are left on their own to fend for themselves in the wilderness of their intense emotions. This produces a double hardship for parents… (187).”

Dr. Knapp then personalizes the question “How do I respond to this? Can I help? Can you help? Can anyone help? (emphasis his) (187)”, giving excellent suggestions in the chapter to both supporters (external support) and grievers (internal support). He addresses the question of why the family can’t help or give adequate support from each other (“We cannot expect one crippled person to pick up and carry another [crippled person] (191).”) He also addresses the necessity of continued support (“The sharing of grief with other human beings who are there, willingly giving of themselves, has enormous therapeutic value (192).”), and why the lack of support causes grievers to turn inward and feel isolated/alone. Dr. Knapp encourages “participatory grievers” (those most intimate friends) to “break down the walls of resistance that many families throw up to protect themselves from the insensitivities of others…As true helpers, we should be there as their safe havens. And most important, we should be there for as long as it takes, as long as there are needs to be met (192)”. Although it seems to me that “breaking down” walls of resistance might come across as a bit heavy-handed to a grieving parent (perhaps a more gentle and kind approach would work better), there is no doubt in my mind that support makes all the difference in the world.

He finishes up the book with chapters concerning depression, support groups, and one specific chapter dedicated to the group Kinder-Mourn. (Although I don’t doubt the helpfulness and legitimacy of this group – and I am certainly grateful for any group supporting bereaved parents! – it seemed odd to me to include one entire,  specific chapter on Kinder-Mourn. It seemed more like a specific plug for the group, written by one of its board members. Just my opinion.)

Overall, I would recommend this book. I think anyone – professionals, those surrounding grievers, and grieving parents – would find helpful information here. Probably my only wish was that his sample size had been a little larger (although each group leader from which his interviewees were pulled felt like a good/accurate cross-section of participants was represented), and that his research had been from all sections of the country (his interviews of “white, generally middle-class Americans (28)” took place in the southeast). I’m sure time and financial constraints made both of these difficult. However, Dr. Knapp does feel that the group is accurately “representative of the ‘typical’ American family (28).” As always, one must filter out what applies to his or her own specific situation. There is no one shoe that fits all, but it bears mentioning that I made so many notes while reading this book that I bought the updated version to re-read and for reference.

Knapp, Ronald J. Beyond Endurance: When a Child Dies. New York: Schocken Books, 1986.

© 2011 Rebecca R. Carney

4 thoughts on “Book Review: Beyond Endurance: When a Child Dies by Ronald J. Knapp

  1. Thank you for sharing about and providing your opinion on this resource. As grieving parents, we will consider adding Dr. Knapp’s book to our library of helpful resources. We are helped by you sharing your journey through grief.

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