Bittersweet: How Sorrow and Longing Make Us Whole

Cain gives a brief biographical account of Issa, one of the great Japanese haiku experts. She draws attention to one specific haiku, written after Issa lost his daughter to smallpox in the 1800s. Cain deconstructs an ambiguous line at the end of the poem: “But even so” (202). She insists that this line is packed with both melancholy and resistance. Issa was a Buddhist and practiced non-attachment, but after the loss of his daughter, his ability to remain this way was tested. Cain views the line from the poem as a subtle statement that the poet does not accept the hard realities of death. Cain uses the poem as a means of exploring impermanence and the way modern Western culture pushes people into “letting go” and “moving on.” The tendency to not show any manifestations of one’s grief is a valued trait.

Cain tells a story about her own children who, while vacationing, had become attached to a pair of donkeys. When the trip neared its end, the children became sad and cried because they didn’t want to leave the donkeys. Ultimately, Cain says that what consoled them was the truth, that “good-bye is part of life” (205). She briefly touches on the work of psychologist and professor Dr. Laura Carstensen, who found that older people tend to develop a positivity bias, meaning that as people age, they tend to have a much more positive outlook on life. Carstensen attributes this to a more consistent and acute state of poignancy. Older people tend to be more aware of their own impermanence and the inevitability of death. According to Carstensen, this awareness changes the person’s overall demeanor toward the positive and makes them more appreciative of their lives in the present moment. Additionally, as people age, they tend to be more concerned with finding meaning in life in a deeper way than when they were young. Cain explains that Carstensen had been in a devastating car accident at the age of 21. During her recovery, in which she hovered between life and death, she sensed her own growing desire to find meaning in life. Once recovered, she enrolled at the University of Rochester where she studied psychology. Her research reveals that as people age, their social circles grow smaller because there is a greater focus on the existing circle. Carstensen also discovered that while age plays an important role in this process, a true awareness of impermanence has a more significant role. Regardless of age, the more one is aware of their own impermanence, the more likely they are to adopt a grateful approach to life and to appreciate the people and experiences their life offers them.

While Cain expresses a willingness to practice non-attachment, she also realizes that for her, full non-attachment has limitations. She runs through the philosophy of non-attachment and how one should practice it under the worst scenario possible, the loss of one’s child. She interviews a Hindu spiritual leader who explains how non-attachment works with child-rearing, that practitioners do not view their children as theirs. Instead, the child is their own person. By contrast, she interviews a colleague, Stephen Huff, who while respecting the premise also admits that if he ever lost his children, he would be destroyed. She then interviews a third person, Dr. Ami Vaidya, a chief gynecologist. Vaidya describes her belief, as a Hindu, in reincarnation and that this belief sets her at ease somewhat about her own death. However, when Cain poses the problem of losing a child, Vaidya’s demeanor and confidence change. Ultimately, she acknowledges that the pain of such magnitude is not easily reconciled by her belief system. Cain continues to probe the response of a grieving parent, this time in the real-world example of her friends Lois and Murray, and the loss of their adult daughter Wendy who had been diagnosed with ovarian cancer. Throughout the battle with the disease, Lois had steadfastly believed that Wendy would survive, while Murray remained cautious and braced for the worst. When Wendy eventually succumbed to the disease, Lois was entirely devastated while Murray, still crushed by the loss, was able to better deal with his grief. Eventually, with Murray’s support, Lois was able to finally start moving on in her life, realizing that it still needed to be lived. However, she also recognizes that the loss will always remain with her, and that some wounds, like losing a child, never are meant to fully heal.

Cain begins the final chapter chronicling her attendance at a death and bereavement workshop intended primarily for those who work directly with grieving persons. As the conference begins, audience members are invited to discuss their own moments of loss they have experienced in their lives. A woman named Maureen explains the loss of her father when she was younger, and how it was expected of her to absorb the loss without wallowing in it. Cain feels that the loss she experienced in the relationship with her mother is not of the same magnitude, but when it is her turn to speak, she discloses it anyway, and when she does, she cries. The leader of the conference, a psychotherapist named Simcha Raphael, points out that one person’s grief is no more or less than another’s. As Cain speaks, Simcha comments that it appears Cain is at least partially stuck at age 16 when the troubles with her mother began. Cain comes to the realization that it is not just her own grief that she carries with her; she has always been predisposed to feelings of sadness and concludes that this grief is generational and has been passed down to her. She then describes the circumstances of her lineage, specifically that many were killed in the Holocaust. She explains how her grandfather, whom she loved dearly, despite dedicating his life to the service of others as a rabbi, never resolved the guilt that he felt for escaping Nazi Germany while his family stayed behind and were executed.

Cain summarizes part of a podcast she listened to that featured Dr. Rachel Yehuda, a professor of psychiatry and neuroscience. In the podcast, Yehuda discussed the concept of epigenetics. Her research into the ways grief and sorrow could be passed down genetically revealed that it is indeed possible. She studied Holocaust survivors and their children, and she found that there is sufficient evidence to suggest that the trauma experienced by the survivors could be coded in their genes and inherited by their children. Cain discusses more research along the same lines, and then points out that while suffering may be transgenerational, so too may be healing. She then provides examples from people she knows, including an African American woman named Jeri and a woman named Farah from Jordan. In each case, the woman interviewed mentioned how she finds healing by looking into the past at the lives of her ancestors and by helping others as a cathartic exercise.

Cain interviews Dr. William Breitbart, who works as a meaning-centered psychotherapist at a cancer center in New York City. He tells her the story of his first cancer patient, a 65-year-old man who had asked Breitbart to put him out of his misery. He said he had nothing left to live for and wanted to die. This incident, and how to respond to it, became a new calling for Breitbart. When Cain asks him why he has devoted his life to helping ease the experience and pain of patients with terminal illnesses, Breitbart attributes it to his family lineage, which like Cain, involves survival of the Holocaust. In his treatment protocols, Breitbart helps patients discover meaning and make sense out of their lives, and he helps them to redirect remorse into an appreciation for who they really are. As the chapter nears its end, Cain reflects on the nature of inherited grief, and reminds the reader that one should be aware of their ancestor’s stories, and pay them due respect, but should also recognize that their lives are not our own. She urges readers to understand that to move forward, we must allow our ancestors to live through us only to a point. Lastly, Cain describes a visit with her mother that takes place during the writing of Bittersweet. Her mother is 89, and Alzheimer’s is progressing at an ever-increasing rate. Cain feels a renewed sense of appreciation for her mother, while at the same time a feeling of forgiveness for her mother and for herself.

Cain begins the final section of her book with self-reflection. She discusses her prior career as a lawyer, which ended when she was not granted partnership in the law firm she was with. She mentions that in hindsight, the rejection was what enabled her to pursue her writing career. She describes the ensuing time after she left the firm, and that she fell in love with a man named Raul, a lyricist and a musician with whom Cain concedes she was obsessed. She realizes eventually that her obsession with Raul had more to do with the way she associated him with writing, something that she had always wanted to pursue. She introduces her husband, Ken, who had worked with the UN during peacekeeping missions in Rwanda, and who had witnessed the mass-graves of genocide victims. On her second date with Ken, she showed him the poetry she had written, and he was an immediate and ardent supporter of her skills as a writer.

The reflection offered in the Coda continues, this time as a dialogue with the reader. She directly addresses the reader several times and urges them to consider some of the lessons she has learned in the writing of the book. Once again, she returns to the main idea of the book, which is that people should not shun sadness and melancholy; instead, people should embrace it and use it to transform their pain into something beautiful. Lastly, she describes her father’s funeral, and fondly recalls why she loved him so much, and that as she continues to move forward in her life, she will do so with the great lessons that he imparted to her, which, in his own quiet way, were manifestations of transforming pain into beauty.