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Adolescent Unresolved Grief in Response to the Death of a Mother

Author(s): Ann Marie C. Lenhardt and Bernadette McCourt

Source: Professional School Counseling, Vol. 3, No. 3 (February 2000), pp. 189-196
Published by: Sage Publications, Inc.
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Professional School Counseling

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Adolescent Unresolved
Grief in Response to the
Death of a Mother

T ĒĒhe he
grief processes of young children and adults have
mJLm been studied in depth. However, adolescent bereave-
ment, particularly in response to the death of a parent,
is an area of limited research (Clark, Pynoos, & Goebel,
1996; Garber, 1995; Harris, 1991; Kandt, 1994; Meshot &
Leitner, 1993). Elisabeth Kübler-Ross (1969) in her book,
On Death and Dying , referred to adolescent grievers as
the "forgotten ones." Researchers and professionals
alike often group adolescents with children and assume
Ann Marie C. Lenhardt,
that the mourning experiences of adolescents are similar
Ph.D., NCC, is a professor, to those of younger children (Gray, 1987). Similarly,
bereaved adolescents are classified with adults, assum-
Department of Counselor
ing that adolescent grief is merely a less intense form of
Education , School of Education adult grief (Clark et al., 1996; Kandt, 1994). Adolescents
are a distinct group with very specific developmental
and Human Services , Canisius
needs that complicate the normal grieving processes.
College, Williamsville, NY. To further complicate matters, many adolescents
Bernadette McCourt is a
who have experienced the death of a significant other -
whether a friend, sibling, or parent - respond to the loss
doctoral candidate in the by inhibiting their grief (Harris, 1991). Adolescents'
reluctance or inability to grieve expressively often con-
Department of Counseling
tributes to the lack of response by adults to adolescents
Psychology, State University of in the aftermath of a significant loss. Parents, teachers,
and mental health professionals may assume that, since
New York at Buffalo.
adolescents do not appear to be distressed, they are
adjusting to the death without difficulty. However, the
more composed adolescents appear, the greater their
Correspondence may be directed
risk may be to experiencing a complicated grief known
to Dr. Lenhardt, Canisius as unresolved grief.
Unresolved grief occurs "when the grief process is
College, do 4120 Harris Hill Rd .,
prolonged, obstructed, intensified, or delayed" (Meshot
Williamsville, NY 14221. & Leitner, 1993, p. 295). Adolescents who refuse to
engage or are incapable of engaging in the mourning
process may be vulnerable for unresolved grief, which
could interfere with the recovery process. Adolescents,

ASCA • Professional School Counseling • 3:3 February 2000 189

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as a result, may be unable to resume relationships with is not present; the person accepts the loss cognitively but
significant others and may find it difficult to again feel does not express emotion that is congruent with the loss.
pleasure (Meshot & Leitner, 1993). Resolution of grief For adolescents who have suffered the loss of a parent,
occurs when adolescents come to accept their grief and affective denial is common. Halperin (1993), in a study
can move beyond that grief to again enjoy life, work, of adolescents whose parents had died of AIDS, found
friendship, and love. Those who can not resolve their that affective denial was a prime coping mechanism. The
grief may be at risk for depression, physical illness, and author noted that after the parent's death, the adoles-
increased risk of drug and alcohol abuse (Keitel, Kopala cents initially responded with "an outburst of recogniz-
& Robin, 1998; Raphael, 1983; Zisook & DeVaul, 1985). able grief" (Halperin, 1993, p. 254). However, shortly
A loss that has the potential to be traumatic for an after this display of overt grief, he noted that these ado-
adolescent is the loss of a parent, particularly a mother. lescents adopted a stoic and unemotional coping style
This article explores developmental factors and gender (Halperin, 1993). They spoke without affect in a flat,
differences in the grief responses of adolescents who monotone style. The author hypothesized that this way
experience maternal death and presents professional of speaking and acting protected these adolescents from
counselors with factors that place adolescent daughters overwhelming feelings of anxiety and grief over the loss
at increased risk for complicated grief reactions to a of their parents. Self-protection may be one reason why
mother's death. School counselors who are aware of the adolescents deny their grief.
implications of such events can provide bereaved stu- Adolescents deny their grief in response to the
dents with valuable opportunities and services to death of a parent for several reasons. Affective denial
express and explore what may be overwhelming grief may result from pressure to conform to behavior that is
and begin the transition to a healthy adaptation and accepted by their peers. Adolescents who lose a parent
recovery. Recommendations and strategies for school- are deeply ashamed of their loss. Most of their friends
based services are included. have both parents available. Adolescents who lose a
parent therefore feel estranged from their peers. These
Parental Death and Adolescent adolescents will inhibit their grief so that their sorrow
Grief Research will not further differentiate them from their peers
Limited research has been conducted in the area of ado- (Harris, 1991).
lescent grief reactions, particularly to the death of a par- Adolescents are also struggling to assert their inde-
ent (Harris, 1991; Keitel et al., 1998; Meshot & Leitner, pendence and become adults, therefore, they invest
1993). One reason for this is that the process of adoles- much of their energy in appearing unaffected by their
cent mourning is complex; adolescence is inherently a losses (Garber, 1995). Tears and yearning for the lost
time of loss, as adolescents relinquish childhood and parent are perceived by them as child-like reactions.
their idealized conceptions of parents. Researchers often Adolescents do not want to be perceived as regressing
feel unable to differentiate the characteristics of grief to a previous stage of development.
over the death of a significant person from the develop- The surviving parent may also indirectly encourage
mental grief that typically characterizes normal adoles- the adolescent's denial. After the loss of a spouse, the
cent development (Garber, 1995; Keitel et al., 1998). surviving parent relies on the adolescent for help and
Consequently, few researchers attempt to study this support. A grieving adolescent would constitute an
population. Another explanation for the lack of research additional burden to the already overwhelmed surviv-
on adolescent mourning has been the long-held belief ing parent. Therefore, parents may unknowingly
that adolescents are developmentally unable to grieve encourage adolescents to inhibit their grief. Stoic adoles-
(Clark et al., 1996). Some theorists believe that genuine cents are then available to assist the surviving parents in
mourning is not possible until an individual has com- maintaining the home and the family in this time of cri-
pleted the developmental tasks of adolescence (Wolfen- sis. The parent's need for a helpmate may complement
stein, 1966). This belief seems to have deterred many the adolescent's need to demonstrate their adulthood
researchers from even attempting to understand adoles- (Garber, 1995). The combination of these needs provides
cent mourning. strong encouragement for the adolescent to deny and
inhibit personal grief.
Adolescents9 Denial
Typical adolescent responses to the death Response
of a parent areto Maternal
similar to adolescent reactions to other losses: inhibition Death
of affect and denial (Halperine, 1993; Harris, 1991). Statistically, children under the age of 18 are at t
Bowlby (1973) suggested that there are two ways to times the risk to experience the death of a father
deny a loss, cognitively and affectively. Cognitive denial mother (Clark et al., 1996). Although fewer ado
occurs when a person is aware of the details of a loss, yet experience the loss of a mother, they may be at g
views these details with skepticism. Affective denial risk for complicated grief reactions. Given the re
occurs when an appropriate emotional response to a loss infrequency of maternal death, less is known a

190 ASCA • Professional School Counseling • 3:3 February 2000

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adolescents respond to the death of a death on adolescents. The findings of
mother than to the death of a father. this study indicated that daughters
Mental health professionals are also experienced a greater level of mourning
less experienced working with this than did sons. Adult women who suf-
population. Adolescents themselves fered the loss of a parent in adolescence
may be hard-pressed to find supportive were found to cry more and to identify
peers who have experienced the loss of more with the deceased than men who
a mother, whereas those who have lost experienced the loss of a parent in ado-
a father are better able to find peers lescence. Furthermore, women reported
who have suffered this loss. Therefore, more often than men that they felt that
the smaller number of adolescents who the deceased parent "was still with
have experienced the death of a mother them" (Meshot & Leitner, 1993, p. 287).
may be at greater risk for negative out- In addition, Zisook and Lyons (1990), in
comes. In addition, this risk may be their study of psychiatric outpatients,
greatest for adolescent girls. found that women who had experi-
enced the deaths of their mothers were
Gender Factors in the at a higher risk to experience unre-
Grieving Process solved grief than were men who had
The counselor's understanding of the experienced this loss. It was also noted
role that gender plays in the bereave- that unresolved grief was present more
ment process for adolescents is critical often in response to the death of a
to determining adolescents' respective mother than to the death of a father.
styles of coping and the need for support in the adap-
Overall, results indicated that women were at greater
tive process. Adolescent girls and boys will risk
respond dif- unresolved grief in response to a loss
to experience
ferently to the deaths of their mothers, withofadolescent
a significant other and were, consequently, more
daughters traditionally being more negatively
to experience unresolved grief in response to
by the loss than adolescent sons (Meshot & maternal
Leitner,death (Zisook & Lyons, 1990).
1993). There are a number of factors that make the expe-
rience of the mother's death different for adolescent
Separation-individuation Process
girls and boys (Chodorow, 1978; Gray, 1987; Parish
The &
separation-individuation process during adoles-
Hortin, 1983). These factors include: cence is tumultuous and, if a mother should die during
this critical time, particularly daughters would be at
■ Differences in styles of relationship building
great risk for complicated grief reactions (Edelman,
1994; LaSorsa & Fodor, 1990). In adolescence, children
■ The mother-daughter separation-individuation
process experience what Bios (1967) referred to as the second
■ The surviving father's response to maternalindividuation process. This separation prepares adoles-
death /gender differences in the grieving process
cents to differentiate from their parents so that they can
■ The daughters' shift to the maternal role develop relationships with others outside the family.
■ Sons' reluctance to acknowledge their grief In order to achieve this separateness, adolescents
typically need to question and often reject the values of
their parents. This is a part of the process of "de-idealiz-
Differences in Styles of Relationship Building ing" their parents (Steinberg & Silverberg, 1986). Not
Adolescent daughters may be more likely to experience
surprisingly, this typically results in conflict between
unresolved grief after the deaths of their mothers and adolescents. Such conflict can lead to
will adolescent sons. Daughters tend to place greater
intense guilt and regret if parents die in the midst of this
importance on relationships with others (Gilligan,
process. If1982).
it is the mother who dies, this guilt may be
Relationships are more central to a woman's gender
more intense for adolescent daughters than for adoles-
identity than to a man's gender identity (Chodorow,
cent sons because of the more turbulent separation-indi-
viduation process
1978; Gilligan, 1982). Given the central importance of that occurs between mothers and
relationships to a woman's identity, the loss of the rela-
tionship with the mother, in general, causes daughters
Daughters typically expend more energy de-idealiz-
to experience greater levels of grief than sons.
ing their mothers in order to firmly separate. More
Meshot and Leitner (1993) found, for example, that to separate because of the daughter's
effort is required
women who experienced the death of a parent inresemblance
physical ado- to her mother and because of their
greater gender
lescence grieved more intensely and for a longer period identification (Ruebush, 1994). If a
than did sons who experienced this same loss. motherThis
dies during separation, the adolescent daughter
study noted gender differences in the effectsmay of look
back on this crucial time with her mother with

ASCA • Professional School Counseling • 3:3 February 2000 191

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deep regret. As a result, we might expect that daughters Daughters' Shift to the Maternal Role
will experience a greater degree of unresolved grief. After the death of the mother, a daughter may feel com-
pelled by her father to take the mother's place as the
Surviving Fathers' Response / Gender Differences family's caretaker (Edelman, 1994). Consequently,
A third factor that may contribute to adolescent daugh- daughters may feel overwhelmed by stress and respon-
ters' greater level of unresolved grief may be the sup- sibility as they try to replace the mother as the caretaker.
port, or lack of support, that they receive from their This responsibility often falls onto daughters, even if
fathers after the deaths of their mothers. A lack of sup- brothers are present, because daughters are the same
port is a risk factor identified with complicated bereave- sex as the deceased mother and are expected, by the
ment (Worden, 1991). Adolescent daughters may father, to take on a maternal role (Edelman, 1994). These
perceive a lack of support from their fathers because of responsibilities may cause daughters to resent their
gender differences in the grief process. Lister (1991) father and may contribute to feelings of anger toward
noted that men and women grieve differently. Men fre- their deceased mother.
quently take on instrumental roles in response to grief, Parish and Hortin (1983), for instance, found that
while females engage in expressive grief. Avoidance is girls who experienced maternal death and whose
the primary mechanism of instrumental grief. Expres- fathers did not remarry were significantly more nega-
sive behavior is the tendency to reminisce about, and tive in their evaluations of their deceased mothers than
weep for, the deceased. Fathers and sons may be more were daughters whose fathers had remarried. This dif-
likely to grieve instrumentally, while daughters may be ference might reflect the daughters' shouldering of
more likely to grieve expressively. As such, daughters parental responsibilities. Once a father remarries,
may feel a need to grieve overtly, but may find a lack of daughters are probably relieved of their household
support or encouragement from their fathers to do so. responsibilities and allowed to resume their status as
Daughters may particularly need this opportunity to children, reducing their anger toward their deceased
grieve because of the guilt they feel over their conflicted mother and speeding their adjustment process. If the
relationships with their deceased mothers. This lack of father does not remarry, however, daughters may have
opportunity for grief within the family structure could to persist in their roles as caregivers, fueling their anger
contribute to unresolved grief in both adolescent sons toward their deceased mother and impairing their
and daughters, but more so for daughters. recovery. It is important to note that sons who lost a
Clark et al. (1996) found that adolescents cope better mother in childhood or adolescence had just the
after the death of a parent if the surviving parent opposite reaction (Parish & Hortin, 1983). Those sons
encourages them to intermittently reminisce about the whose fathers remarried were more angry toward the
deceased parent, a form of expressive grief. They also deceased mother than those whose fathers did not
reported that surviving mothers more often facilitate remarry. This difference might reflect the interrupted
discussions of the deceased fathers than surviving closeness between the son and father with the introduc-
fathers reminisced about deceased mothers. The father's tion of the stepmother, rekindling feelings of abandon-
reluctance to speak about his deceased wife and grieve ment brought upon by the death of the mother. The
openly may stem from his conviction that he is the pro- son's reaction probably has less to do with
tector of the family and has the obligation to shield his household/ care responsibilities than does the daugh-
children from the pain of their mother's death. Unfortu- ter's reaction.

nately, the father's protective instincts might seriously

impair his children's recovery from their mother's Sons' Reluctance to Acknowledge Their Grief
death, as well as impair his own recovery process. Although it is theorized that adolescent daughters will
Parkes (1988) noted that although young widows exhib- experience greater levels of unresolved grief, this is not
ited more symptoms of emotional disturbance in the to say that adolescent boys will not experience unre-
first year after the death of their spouses, it was the wid- solved grief and find it difficult to adjust to the loss of
ows and not the widowers who returned to emotional their mothers (Clark et al., 1996). Counselors should be
health more quickly. This trend may reflect the widows' aware that adolescent boys may be as grief stricken as
use of a more overt grieving style, which at first renders adolescent girls, but that the boys may be more reluc-
them somewhat vulnerable, but in the end is most ther- tant than adolescent girls to express their grief. Reluc-
apeutic. In contrast, the father's initial inhibition of his tance to openly express grief is a common male
grief may seem more adaptive, but in the long run may response in the face of a death or loss (Lister, 1991). The
son observes his father's stoic response and models his
inhibit recovery for both himself and his children. The
father's lack of expressive grief may be particularly father's behavior. Furthermore, Worden (1991) noted
damaging to daughters who have been socialized to that particularly boys over the age of twelve were told
grieve expressively. The result is that the female adoles- after the funeral of the deceased parent that they had to
cent's grief is not encouraged or supported, resulting in grow up. Such injunctions further enforce the adoles-
a delay in the healing process. cent son's belief that he must conceal his grief.

192 ASCA • Professional School Counseling • 3:3 February 2000

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In a study of college students who bereaved adolescent may not be w
were asked to evaluate descriptions of to even discuss the loss. Counselors
fictional male and female grievers, fic- need to be prepared for resistance that
tional male grievers who grieved more results from denial. The school coun-
expressively were rated more nega- selor can support the bereaved adoles-
tively by the students than were the cent by simply acknowledging the
female grievers who were described as magnitude of the loss and the pain that
grieving expressively (Kubitz, Thorn- such a loss can inflict. This acknowledg-
ton, & Robertson, 1989). These findings ment may then lay the groundwork for
demonstrate that there are strong social future mourning, when the adolescent
prohibitions against a display of matures and feels more capable of con-
expressive grief by men. These prohibi- fronting his or her grief issues (Rosen,
tions may be particularly strong for 1991).
adolescent boys who have a great deal Kandt (1994) and Wolfert (1997)
invested in maintaining a calm offered the following individual coun-
demeanor. However, adolescent boys seling strategies for short-term bereave-
may pay a heavy toll for this control. In ment work in a school setting.
order to maintain their controlled
demeanor, adolescent boys may turn to 1. Acknowledge the pain and grief:
drugs or alcohol as a way to self-med- Assure him or her that it is normal and
icate and to avoid the pain of grieving. give permission to grieve. Provide a
Given these erief reactions, mental supportive and empathetic environ-
health professionals might be more likely to misunder- ment for the adolescent to feel comfortable in experienc-
stand the experiences of the grieving adolescent boy. ing emotions and to understand that reminiscing is
Unresolved male grief may be misinterpreted as delin- essential to healing.
quency or a conduct disorder. Therefore, it is imperative 2. Biotherapy and journaling strategies. Books and sto-
that both adolescent girls and boys who experience the ries pertaining to death and grief issues can be
death of their mothers be given an opportunity to work employed to help the adolescent deal with denial issues
through their grief with a caring professional. in response to losses and get in touch with feelings. In
addition, through journal writing, adolescents can be
Strategies for Working with invited to explore themes related to the grief process. A
Bereaved Adolescents memory book and family tree was recommended by
In reality, school counselors often Kandt
lack (1994).
the The time
family tree,andas a means
spe- of helping the
cialized training to offer extended youth
services in
to evaluate the bereave-
different roles that family mem-
bers played in his or
ment counseling to individual adolescents. her life. The memory book can
students who lose a parent during include
thisphotos, poems, letters,
critical stage and other
of memorabilia
related to the In
development are in need of intervention. deceased.
fact, This provides
provid- concrete objects to
ing services as soon after the loss as the adolescentis
possible to the deceased and encourage
a critical
factor in the recovery process. Unfortunately, an in-
3. Relaxation
depth literature review revealed only techniques. Used
a limited with discretion, progres-
of references that offered models orsive muscle relaxation,
practical deep breathing, and guided
dations for adolescent bereavement imagery can be taught
services to promote feelings of peace and
well-being and serve
for school settings. These few bereavement to alleviate stress.
models pro-
4. Take a for
vided general information on services loss history. This is beneficial in determining
with no systematic evaluations in experiences
objectives that adolescents
measures. have had with grief and
In addition, only one study (Moorepossible unresolved issues.
& Herlihy, 1993)
offered a model that specifically focused on adolescent
loss in response to the death of a parent;In schoolno settings, additional long-term individual
were found that provided strategies support can be gained through
specially related referrals
toto outside agen-
the death of a mother. Following is cies.
a Depending
composite on adolescentofneeds,
themore extensive
few models and strategies that arecounseling
available may be offered,
for both or for more complicated
individual and group counseling. bereavement cases, intense therapy may be required.
Grief counseling is an accepted initial approach for ado-
Individual Strategies lescents who are experiencing an uncomplicated grief
The bereaved adolescents frequently (Worden,
use 1991). Grief counseling
denial as their allows these adoles-
primary coping strategy in responsecents
to totheresolvedeath
unfinishedof matters
a with their deceased
parent. Given this heavy reliance onmothers and to saythe
denial, goodbye.

ASCA • Professional School Counseling • 3:3 February 2000 193

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The school counselor must assess (Cornell & Pack, 1993; Kandt, 1994; Kei-
whether counseling or therapy is more tel et al., 1998; Quarmby, 1993; Wolfert,
appropriate in assisting an adolescent 1997). However, few models exist for
to adjust to a loss. It is important to conducting such groups in a school set-
become familiar with the adolescent's ting. Obviously, grief is a complex
social and emotional history. Determi- process that takes time and energy as
nation of how many earlier deaths or everyone moves through their own
losses the adolescent has experienced pace regarding strategies and issues.
and how those losses were mourned However, two short-term models in
are important factors. If these earlier school settings are summarized below.
losses were not mourned or resolved, Moore and Herlihy (1993) recom-
there is a greater risk for a more com- mended a group model for adolescents
plicated grief reaction with the current who had lost a parent. Their design
loss (Keitel et al., 1998; Valentine, 1996). included a 6- week group of six to eight
It is also important to assess the adoles- members for weekly 60-minute to 90-
cent's mental health history. Adoles- minute sessions. The sessions focused
cents with a history of depression on a discussion of various individual
should be considered at risk for a more experiences in the grieving process.
complicated bereavement (Valentine, They found that adolescents preferred
1996). Finally, it is necessary to assess interaction with peers in the familiar
the amount of support available to the context of the school environment to
individual, both within and outside the individual counseling. Since adoles-
family. If the family system is unable to provide support cents have a more difficult time grieving than adults,
to the adolescent, he or she is at risk for a more difficult
they found that using some structure and themes was
grief reaction (Worden, 1991). beneficial for this age group. The group sessions were
Whether counseling or therapy is undertaken, the very structured and included the following content: (a)
goal is to facilitate the mourning process. Worden (1991) sharing the event, (b) mini-sessions on stages of griev-
enumerated four tasks of mourning, (1) to accept the ing sudi as Kübler-Ross's (1969) stages of grieving, (c)
death of the loved one, (2) to uncover and endure the events after death, (d) special concern of the changing
pain inherent in the grieving process, (3) to adapt to an family, (e) family rituals and holidays, and (f) termina-
environment in which the loved one is absent, and (4) to tion. Although diese groups were short term, Moore
reconnect with the deceased in a way that the mourner and Herlihy (1993) found them to be beneficial to stu-
is able to continue with life. These goals should guide dents and very manageable in a school setting.
any therapeutic interventions undertaken. Similarly, Kandt (1994) presented a short-term sup-
port group for grieving adolescents. Although it was not
Support Groups specifically designed for adolescents grieving the death
One of the central tasks in resolving grief is to maintain of a parent, it does at least provide another school-based
a supportive social network in the grieving process support model. An eight-session bereavement support
(Johansen, 1988; Meager, 1989; Rosenblatt, 1988; Van Der group focused on issues surrounding the loss and pro-
Wal, 1989). Adolescents who experience the loss of a vided opportunities for further exploration. Again, this
parent may be reluctant to express their grief because it group model was highly structured and included the
makes them different from their peers (Garber, 1995). A following content sessions: (a) establish norms and pro-
grief group can serve to normalize adolescents' experi- cedures and have participants share the loss experience,
ences because it would allow them to feel less isolated (b) share keepsakes identified with the deceased, (c)
from their peers. In addition, it would provide them provide adolescents with opportunities to tell their sto-
with a collaborative opportunity to continue the devel- ries while receiving education about death and dying
opmental tasks of mourning (Corr & Balk, 1996). The issues, (d) deal with concerns which often include final
school is an ideal setting for such a group because rites, special occasions, and unfinished business with
school personnel can recruit students who have recently the deceased; (e) summary evaluation and a closure cel-
experienced the death of a parent. In forming the group, ebration; and (f) a final meeting one month after termi-
only children who have suffered the loss of a parent nation to serve as an opportunity to share how they
may be included, or the attendance could be expanded were getting along and decide on any referrals for more
to include students who have endured different types of long-term counseling.
losses such as sibling loss.
A peer support group model used as a resource for Family Counseling
facilitating the mourning process among bereaved ado- Although long-term family counseling is not usually
lescents has been suggested by a number of authors possible in a school setting, benefits can be gained even

194 ASCA • Professional School Counseling • 3:3 February 2000

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from a few family sessions. An understanding of the References
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Gilligan, C. (1982). Woman's place in man's life cycle. Harvard Educa-
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