Changing Funerals and Their Effects on Bereavement Grief in Japan

Abstract

Bereavement is an extremely personal feeling, but Japanese society tends to disapprove of displays of negative personal emotion or weakness. For ages, mourning rituals like funerals provided an exception where social permission was given to sharing grief and seeking support. However, the form and significance of Japanese funerals have changed rapidly over the past generation, and especially since the advent of COVID-19 restrictions on assembly and travel. This paper overviews the trajectory of changes and continuities in mourning rituals in Japan, looking at their psychological and social impacts. It goes on to summarize recent Japanese research showing that appropriate funerals are not merely of psychological and social benefit, but may have an important role in reducing or supporting grief that might otherwise require medical and social work intervention.

Background: Japan’s High-Death Society

Japanese language often uses the term high-death (or high-mortality) society these days. Japan became a “super-aged” society ahead of other countries. In 2015, the Cabinet Office estimated that 18 million, or one out of seven people in Japan, would die before 2030. Since 2018, its death-rate has exceeded its birthrate (Ministry of Health Labor and Welfare, 2019), so Japanese encounter death bereavement more than childbirth. Japan’s unusual average longevity and its trend towards nuclear families are two reasons that the younger generation is unlikely to experience the death of someone close, and that people experience death of a parent for the first time in their 60s (Yamada, 2019). Japan continues to have one of the world’s highest suicide rates, and in recent years, many Japanese lost loved ones in sudden deaths to infectious diseases or natural disasters like earthquakes and typhoons as well. Yet here too, life and death tend to be confined to and concealed within the sterility of hospital wards, depriving Japanese of the chance to witness and contemplate the dying process.

Death of a loved one is among the most significant events in our lives. Such loss cannot easily be shared with other people; verbal expression often fails to suffice. Unable to communicate with other people or participate fully in society, many bereaved must still carry on with their daily lives. How can they deal with the pain and grief of permanent separation from loved ones?

The Evolution of Mourning Rituals in Recent Years

The loss of a loved one constitutes a tremendous challenge to survivors’ identity and worldview, significantly impacting their lives thereafter (Setou, 2016). Even (or especially!) in a death-denying and sadness-suppressing society, rites of mourning provide a public way to express that sorrow externally, remembering and paying tribute to the deceased, most frequently through funerals and subsequent memorials. Funerals and Buddhist memorial services are important mourning ceremonies, both to comfort the spirits of the dead, and to enable bereaved families to publicly express their sorrow and find sympathy (Sakaguchi, 2012; Setou & Maeda, 2019). As Ken Doka hypothesized in a widely-cited article 40 years ago (1984), funeral rituals are most important in facilitating grief adjustment in those cases in which death was not expected.

Japan’s “law of mourning” was issued as a Grand Council Proclamation in 1874; it stipulated the length of the mourning period based on the bereaved’s relationship with the deceased. In the century and a half since that time, Japan’s society has changed; today, workplace bereavement leave is often limited to 7 days. Despite Japan’s workaholic image, Japan still gives the death of a family member the highest priority for taking time off work. Most workplaces send not only official condolences but monetary gifts to employees who lose parents or partners.

In hospitals, Japanese doctors will often attempt to maintain the body temperature and artificial ventilation of a terminal patient until the next of kin can arrive to “witness the passing.” In home care, a home doctor or coroner may be summoned to confirm the cause and time of death. Families consider it important to towel-wash the body of the deceased, assemble combustible mementos to be cremated, and break the deceased’s rice-bowl, so that no one may use it again. Such rituals gradually convince them of the finality of the passing and loss.

The mourning process begins by making the death of the deceased public. Traditional funerals in Japan include an overnight wake for visitation and viewing of the deceased, then a Buddhist service the next day, followed by escorting the deceased to the crematorium. While the deceased is being cremated, family and friends partake of a ceremonial banquet. When the hot ashes and remains are removed from the furnace, the closer family members take turns in picking pieces of bone out of the ashes. After all the ashes have been collected into an urn, the family will typically carry them home for a few days or weeks prior to interring them permanently in the family crypt, vault, or gravesite.

Pushing the coffin into the furnace, and then receiving the hot ashes a couple hours later, can constitute psychological challenges for families not yet ready to accept the death of their loved one. The ceremonial banquet, and the words of the priest and crematorium attendants, can significantly impact the impressions and memories that the bereaved carry with them after the funeral.

Socially, funerals provide places where the bereaved family and relatives, past or present colleagues, local residents, friends of the deceased and bereaved family, can gather in one place, regardless of the difference in the strength of social ties (Yamada, 2019). They allow people close to the bereaved family to exchange expressions of concern and sympathy as well as to revere if not revel in the memories of the deceased (Tamagawa, 2018). Funerals link the surviving bereaved not only vertically, with elder and younger generations, and horizontally, with those closer and distant in their community, but also link the extremely internal world of personal feelings toward the deceased with the external emotional support of society.

In addition to this psycho-social dimension, however, funerals can also become an occasion to affirm the status of the deceased and their families. During Japan’s so-called economic bubble of the 1980s, some funerals exhibited extravagant displays of flowers, food, pomp and ceremony. By the 1990s, well-to-do families’ unspoken competition to invite more attendees and host more lavish ceremonies than their neighbors exhausted their nerves if not finances from these burdens of hospitality and attendance (Yamada, 2019).

The 21^st century has seen a major decline in funeral invitations and attendance (Japan Fair Trade Commission, 2017), first from large to smaller funerals, then to “family” funerals, then to “private” funerals, and recently in rare cases to direct cremation. The increase in the number of highly aged people means that more nonagenarians and centenarians are dying than ever before, with fewer friends, classmates, or even relatives to remember them.

Local newspapers typically publish obituaries as a free-of-charge public service. Traditionally, they would announce not only the names of the deceased and survivors, but also the location and phone number of the funeral hall, so that any acquaintance so inclined could contact the funeral hall and pay their respects. In recent decades, however, this practice has shifted from a pre-funeral announcement to a post-funeral posting, conveying the sub-textual message that if you were not invited, you need not feel obliged nor presume yourself connected enough to pay your respects (Takase, 2021).

Covid-19 Accelerates the Privatization of Funerals and Grief

Even in the years before the arrival of Covid-19, one could not listen to daytime TV or radio without encountering ditties, skits, and commercials praising “tiny funerals”; the term “tiny funeral” became a socially acceptable buzzword. The past 20 years had witnessed a shift from open public wakes and funerals to private family wakes and funerals, and ultimately to “direct funerals” with neither wakes nor religious rituals. This trend began in metropolitan Tokyo, but visibly accelerated every month in rural areas after the Japanese government restricted movement and activities due to Covid-19. The tsunami of Covid-19, with its government admonitions to avoid travel, congregating in groups, eating out, and physical touch, created not only a social distance but concomitantly a psychological distance at gatherings, including funerals and memorials (Kanazawa, 2021).

For some, this inability to assemble family and friends felt tragic; for others, Covid provided a legitimate excuse to avoid the intricate details of human relations entailed by a full public funeral. Conversely, for those who still desired public ceremonies, substantial additional costs were imposed by the need for larger halls (for social distance) and sterilization (Kanazawa, 2021). “Direct cremation” too posed a traumatic shock to many families who were never allowed to see the deceased in the hospital nor in a wake or funeral thereafter, but were simply given a bag of ashes several days after their death.

In partial response to Japanese government admonitions against travel and assembly, both funeral homes and temples began improvising. Funeral homes in rural areas arranged “pay-respects drive-ins,” whereby people could “participate” in funerals much as they would at drive-in movies, without leaving the private sanctuary of their cars or violating local rules against assembly. As some celebrities and politicians had already held online funerals to avoid massive crowding, following Covid-19, funeral homes created online programs whereby those who could not physically attend a service could observe and participate virtually from a distance. This was particularly appreciated by those living in uninfected or outlying islands when the cities of the main island were experiencing horrifying infection rates; the fact that celebrities had done so too gave it prima facie legitimation (as had David Bowie’s “direct cremation” in the UK).

Transformation of funeral formats inevitably entails transformation of their underlying functions and meanings. Funerals not only represent local culture and traditional religion, but also reflect the life of the deceased and feelings of the bereaved family (Tamagawa, 2018). Recent transformation of the format of funerals means that “funerals are becoming more for the bereaved family, i.e., for the living, rather than for the souls of the dead” (Shintani, 2009), and more for the individuality of the deceased than for the sociality of the living. Over the course of a single generation, Japanese funerals have transformed from communities mourning the loss of a community member, to families commemorating the life of a family member, to the last personal expressions of the dying persons themselves. As dying persons come to think of their funerals as their last personal expressions, not only funerals but also the mourning process itself transitioned from something shared publicly to something exclusive and extremely personal (Murakami, 2001).

Yet in this context, we need to remember Japanese social strictures against showing negative emotions in public. Traditionally, Japanese people avoid expressing negative emotions publicly, but the period of mourning allowed a notable exception whereby the bereaved were given public permission to release and express their feelings with others (Sakaguchi, et al., 2002). Ironically, the reduction in size, attendants, and visibility of funerals has concomitantly eroded this salutary privilege of talking freely about grief after separation by death; bereaved feel even more constrained not to express their feelings except in limited occasions to intimate people (Miyabayashi & Yamakawa, 2005).

In other words, the abridgement of funerals and abbreviation of public mourning has increased the emotional burden of grief for many bereaved who cannot share their feelings. To respond in part to this issue, the government has begun licensing clinical psychologists and encouraging social workers to pay more attention to bereavement grief. Yet such psycho-social care and welfare assistance fails to locate and assist countless bereaved families in need of support, due to their social withdrawal or interpersonal anxiety. Moreover, as a study on disaster victims indicated, fear of stigma leads many bereaved to resist being labeled as in need of psychological or social support. Since mental care and social workers cannot identify them, they remain isolated and unable to share their deep but solitary grief (Setou & Maeda, 2019).

Socially, funerals used to be times to send off the deceased together, to share feelings about death and grief with the bereaved, and to mark the first step toward a new way of living without the deceased. Abbreviated mourning and funerals do not retain sufficient time and space to remember the deceased. This is partly a result of the breakdown of traditional communities and the distancing of individual lifestyles from the surrogate family of Japanese corporate culture.

Two generations ago, Japanese knew everyone in their neighborhood, and the neighbors would all help out preparing meals and preparations for funerals. A generation ago, when Japanese not only worked with their colleagues, but dined, picnicked, and took their whole families to vacation with their colleagues’ families, their companies would support and their colleagues attend their funerals. In the present century, separation of work and private life have been touted as virtues of individualism; neither communities, nor companies, nor even extended families support the bereaved in an age of abbreviated funerals (Yamada, 2019). Yamada (2019) raised the concern that this transformation of funeral rites will exacerbate issues for the bereaved dealing with the process of mourning.

Buddhist and Funeral Home Responses to Covid Restrictions

For years after each funeral in Japan, elder survivors conduct periodic Buddhist memorial services for their deceased. These rituals are part and parcel of their senior lifestyle; how far the younger generation will continue these rituals remains a subject of continuing interest and debate. Outside of the Tokyo metro area, Buddhist monks typically visit the homes of their parishioners on the day of the month on which a loved one has passed. There they chant sutras or prayers for the repose of the deceased, share condolences, and listen to the complaints or concerns of the bereaved over a cup of tea. Most temple monks continued this important psycho-social ritual even during the more stringent of Covid restrictions; since they could do so individually, they did not violate rules on public assembly, and they could maintain sterility, masks, and social distance while carrying on these valuable rituals (Takase, 2021). In fact, Taniyama’s ground-breaking research suggests that just listening to the priests’ prayers alone reduces the stress of bereavement grief for Japanese (Taniyama et al., 2019).

Another response to the secularization and decline of religious rituals can be seen in the recent education of Buddhist chaplains and “spiritual care workers” to address the unresolved grief of solitary bereaved. Tohoku (National) University (in Sendai where the tsunami hit), Sophia (Jesuit) University, inheriting the legacy of a tragic train crash, and a handful of Buddhist universities which were already training priests, have created programs to educate non-sectarian but religiously sensitive chaplains or “spiritual care workers” with a new licensing program based on the North American CPE program. They sponsor “death cafes,” where bereaved can congregate to share their experiences, especially after insufficient funeral rituals, and promote the “normalization” of discussing matters of death, dying, and bereavement in daily life.

Takase conducted online surveys of the effects of Covid on Buddhist temple priests’ religious activities (Takase, 2021). Since they were answered almost entirely by urban priests under the age of 60, it may not represent the other half of the Buddhist priesthood over the age of 60 and in more devoutly religious rural areas. Nonetheless, Takase’s empirical findings are intriguing. In the first year after Covid hit Japan (2020), he found no increase in direct cremations, a slight 6–7% increase in funerals that were limited to a few participants, and a 12% increase in funerals which abandoned the traditional funeral banquet. The tendencies to abbreviate funeral rituals showed no correlation to sectarian affiliation, but were far more pronounced in the Tokyo area than in other cities of Japan. For those who continued standard funeral and memorial procedures, many attested to changes in methods, procedures, or format to suit the requirements of social distance—but this did not significantly affect the priests’ customary monthly house calls for memorial services (Takase, 2021).

Other periodic memorial services, however, involve family travel and public assembly—notably the quarterly cleaning of the family gravesite near the seasonal solstices and equinoxes. This is an occasion, not merely for cleaning the grave and decorating it with flowers and favorite foods, but also for reporting the past quarter’s activities to the ancestors, and thanking them for looking after us. Most families require hours of public transportation to return to their countryside gravesites, but during the thick of the pandemic, Japanese shunned public transportation as potentially infectious. Similarly, many Japanese considered even gathering at gravesites dangerous because of the proximity to other families also cleaning their gravesites (averaging less than a meter apart).

In response to this decline in family grave pilgrimage/maintenance, some temples and mortuaries created online sites through which a family could pay a cemetery worker to properly clean and adorn their gravesite and show them the process or result online. While traditionalists condemned this as a shirking of personal responsibility, others have approved it as an alternative preferable to completely closing down or neglecting the family gravesites. Many who have not availed themselves of online services have tended to cancel their cemetery-based activities altogether (Takase, 2021).

In short, there can be little doubt that Covid has accelerated latent trends towards smaller private or “direct” funerals and less family attention to gravesites. What remains to be clarified is whether this reduction in caring for the deceased bespeaks a welcome relief from traditional responsibilities, or rather leaves a burden of unaddressed psycho-social symptoms that may later emerge as psychosomatic health issues.

Funerals and Health of the Bereaved

It is easy to understand that funerals and subsequent memorial services can potentially support bereaved families both socially and psychologically. It is less widely understood that this support may make an important difference between being able to function relatively normally in daily work and life, or falling into ill health, drug- or alcohol-dependence, eating and sleeping disorders, psycho-somatic and immune disorders. This research suggests that grief is not merely a personal issue for the bereaved, but a public health issue for any society that takes medical and social support seriously.

As early as the 1990s, studies of bereaved spouses found continuing headaches, breathing difficulty, and drug use even a year after the death of their partner (Paula, 1990). Prigerson et al. (2000) noted that British bereaved visited medical institutions more than other people in the same generation, while Prigerson’s massive research proved that bereaved people who present complex grief tend to show higher blood pressure leading to cardiac episodes and cerebrovascular disease over a period of 2 years after losing loved ones (e.g. Prigerson et al. 2000). With respect to mental disorders contracted by bereaved families, long term depression, compromised immunity, anxiety disorders and insomnia (Byrne & Raphael, 1997; Kreicbergs et al., 2004; Monk et al., 2008), and other cases requiring medical and welfare intervention increase noticeably due to social withdrawal, alcohol dependence, and eating disorders. (Worden, 2003). We need not here review the long debates about including bereavement grief in the DSM-5 and the ICD-11; the very fact that this was hotly debated attests to the facts that (1) grief can resemble other psychological disorders, and (2) pharmaceuticals may reduce its symptoms without relieving its causes.

While the mental health of bereaved Japanese does tend to improve with the passing of time (Sakaguchi & Kashiwagi, 2000), other Japanese studies have shown that complex grief occurs in 25%–30% of bereaved families within one year after separation by death, and 10%–20% in following years (e.g. Tatsuno et al., 2011). Complication of grief and depression due to sudden separation in disasters is also an important issue for mental health (Setou & Maeda, 2019). So grief is not only a normal response to losing loved ones but also constitutes a concern for national medical care and social welfare.

With respect to the influence of funerals on bereavement grief, it is widely reported that positive participation in not only funerals but also commemoration rituals and anniversary events will have a healthy influence (Rando, 1984; Gamino et al., 2000; Wijngaards-De Meij et al., 2008; Hoy, 2013); however, such study is scarce in Japan. In the progress of changes in the social structure and individualization of the mourning process, it is necessary to reconsider the significance of funerals as an important part of mourning.

Since 2018, the authors have been conducting a nationwide Japanese survey on, among other things, the relation between funeral rituals and the health of bereaved families (Grant-in-aid for Scientific Research on Innovative Areas (A) Research Project Number 18H04075). The Kyoto University-based survey of bereaved was completed just as Covid was heating up in Japan, so its insights are not about Covid bereavement per se, but its implications have bearing on the utility and meaning of funeral rituals. The details of data collection and analysis have been reported at length in previously published publicly accessible articles, so we shall not reiterate them. Here we should like to provide a summary and overview of the many facets and conclusions that have emerged from the responses of 1078 chief mourners to nearly a hundred questions about their lives, feelings, and health.

Studies in Germany and Australia have reported productivity decreases by one million yen or more per year per bereaved person as the economic loss to unresolved grief (Van den Berg et al., 2011; McCarthy, 2016). Our first survey in 2018 also showed higher psychological and physical symptoms of grief, and a decline in physical health that adversely affected the work as well as daily lives of the bereaved. While our data did not permit specific calculation of lost productivity, it clearly suggested “presenteeism”—reduced productivity for those continuing to work. We did find, however, that high grievers spent 2.7 times more for medical and pharmaceutical services than non-serious grievers; half of them considered these expenses to be a personal financial burden, while the cost to Japanese government coffers were even higher. (Becker, et al., 2021) Physically, seriously bereaved reported sleeping disorders, eating disorders, increased use of alcohol and drugs, motor and language disorders, showing the same symptoms of sorrow as previous studies. But bereaved families who had held traditional funerals tended to request less medical or counseling support compared to bereaved families who had held “direct” or abbreviated funerals, and their expenditures for pharmaceuticals and counseling was similarly reduced (Becker, et al., 2021).

One out of three of our bereaved sample showed continuing daily symptoms of grief, entailing continued or increasing use of tranquillizers or antidepressants, from 14–24 months after their bereavement. Interestingly, being forced to make sudden decisions about funerals, and/or to pay for a spouse’s funeral, were leading factors implicated in prolonging such elevated grief. This advises discussion of funeral plans with families before the end of life (Becker et al., 2022c).

Further statistical analyses correlated mourners who spent more on medical, pharmaceutical, or social services after bereavement with those who showed greatest dissatisfaction toward their interactions with funeral directors and Buddhist priests. This suggests that if priests’ and funeral directors’ more sensitive and competent interaction could reduce dissatisfaction with funerals, they might contribute to reducing the costs of medical, pharmaceutical, or social services for elderly bereaved Japanese (Becker et al., 2022a).

Textual analysis of hundreds of respondents’ open-ended comments gave further insights into what it was that the bereaved most liked and disliked. Bereaved respondents profoundly appreciated funeral directors’ support, and regretted not having planned better or invited more people to the funeral. Their dissatisfaction derived from issues like unexplained expenses, funeral workers’ mistakes or offenses in conducting the final rites, and regrets at not having invited as many people as they should have to the ceremonies. Such responses reveal the strength of the impressions that funeral directors leave on their clientele, and the importance of fidelity to traditional religious expectations. Conversely, skilled funeral directors can significantly support their clients through early acute grief. Not surprisingly, inviting more celebrants to a full funeral may facilitate subsequent psycho-social support and prevent future regrets. Thus rituals provide memorable means to help survivors deal with grief (Becker et al., 2022b).

In Conclusion

Our overview of mourning and funeral rituals in Japan notes that tendencies to move from elaborate community funerals to smaller nuclear-family rituals was accelerated by restrictions imposed to slow the spread of the COVID-19 pandemic in Japan. In the face of these restrictions, however, Buddhist priests continued to conduct monthly home-visits and services, and new chaplaincy training programs have sprung up. Reduction in funeral size—usually the elimination of a communal meal—was pronounced primarily in the Tokyo area. Quarterly maintenance of family graves, and its concomitant communication with the ancestors, notably declined, sometimes replaced by remote or hired services.

This privatization, reduction, and abbreviation of funerals and mourning rituals should be seen not merely as personal or psycho-social preferences, but also as entailing implications for the bereaved’s dependence upon and expenditures for public medical and social services. Oversimplified, if the bereaved cannot find time, place, or people with whom to share their grief, and their closest friends and family are not acquainted with their loss in a way to support them, then the grief of the bereaved may emerge in disorders of eating, sleeping, and lifestyle, requiring not only psychological but also medical responses. This danger may be greatest—and most amenable to alleviation through post-mortem rituals like funerals—for those who were least expecting or psychologically prepared for the death, as Doka had predicted (Doka, 1985) ^. Thus the changing functions of funerals in Japan—and other rapidly aging societies—become an issue of concern for public health. Ongoing bereavement research in Japan may contain lessons for other rapidly aging and secularizing societies.