Lesson 3 of 7 - evolve a pro-grief family

Beyond depression:
When grief doesn't go away

Doctors hope to get severe
 mental condition
recognized

By the Associated Press,
MSNBC Web news, 6/6/05

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The Web address of this article is http://sfhelp.org/grief/news/incomplete.htm

Updated April 11, 2015

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      This news item supports a basic premise in this Web site - that incomplete grief is one of five epidemic stressors spread by an unseen [wounds + unawareness] cycle that is passing down and weakening our families and  generations. For more perspective, see my comments after the article. 

      Links and hilights in this page are mine.  Before reading further, pause and reflect - why are you reading this? What do you need?   - Peter Gerlach, MSW

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May 31, 2005 - PITTSBURGH - In the months after David Golebiewski’s 19-year-old daughter was killed in a car crash, grief consumed his life. He couldn’t go to the restaurant where his daughter had worked, and he spent five hours a day in Internet chat rooms with other parents who lost children.

Doctors say Golebiewski was suffering from “complicated grief” — a condition some hope will soon be recognized by the American Psychiatric Association.

They say the condition is more severe than grief and different from depression, and affects as many as 1 million people a year.

Dr. Katherine Shear, a psychiatry professor at the University of Pittsburgh School of Medicine, said that with complicated grief, the usual feelings of disbelief, loss and anguish do not go away, and eventually affect every part of a person’s life.

Links to suicide, drug and alcohol abuse

Left untreated, doctors say, complicated grief can lead to depression, suicide, drug and alcohol abuse, even heart disease.

Dr. Holly Prigerson, director of the Dana-Farber Cancer Institute’s Center for Psycho-Oncology and Palliative Care Research and an associate professor of psychiatry at Harvard Medical School, said the term “complicated grief” has been used for about 10 years.

“Unlike a lot of disorders following bereavement, including depression, it tends to persist for years and become a chronic distressed state — a sort of frame of mind,” Prigerson said.

Researchers estimate that 10 percent to 15 percent of the surviving relatives of people who die naturally experience complicated grief, Prigerson said. She said people who lose someone they were emotionally dependent on are at greatest risk.

She is working to get the disorder recognized in the American Psychiatric Association’s next edition of the Diagnostic and Statistical Manual of Mental Disorders. The next DSM-V will be published in 2012.

'There really is something different'

Dr. Michael First, a Columbia University psychiatry professor and member of a committee that will decide what goes into the DSM, said the panel will consider whether complicated grief merits its own designation.

“From what I’ve seen so far, it’s certainly not an off-the-wall suggestion,” First said. He said doctors see patients all the time, especially the elderly, who never get over the death of a loved one.

Dr. Richard Glass, a psychiatry professor at the University of Chicago and deputy editor of the Journal of the American Medical Association, said studies have shown that people suffering from complicated grief do not meet the criteria for depression or post-traumatic stress, although some of the symptoms overlap.

“The evidence so far indicates that there really is something different here,” Glass said.

The most recent study, published Tuesday in JAMA by Shear and her colleagues at the University of Pittsburgh, examined different ways to treat complicated grief.

Researchers found that 51 percent of patients treated with a therapy developed just for the symptoms of complicated grief showed improvement. So did 28 percent of complicated grief sufferers who underwent a treatment commonly used for depression.

Golebiewski, 56, of North Fayette, was given the therapy for complicated grief as part of the study. It included being tape-recorded while he talked about his daughter’s life and death, then listening to those recordings. He said after listening to the tapes repeatedly, he developed ways of dealing with those feelings.

“I was able to visualize her again in life and as happy as she was and the cheerful person that she was,” he said. “I was able to see her there in that context.”

© 2005 The Associated Press. All rights reserved.

Comments

      This report seems to support five basic premises in this nonprofit divorce-prevention site:

  • the normal human grieving response to significant losses (broken bonds) - can be slowed or blocked from running its course;

  • blocked ("complicated") grief can promote serious effects like suicide and addiction (including food). A related symptom is obesity in adults and kids, which is a growing epidemic in America and elsewhere. Some have observed that "every fat cell is an unshed tear."

  • the symptoms of "depression" are similar to those of incomplete grief, inviting misdiagnosis and mistreatment - e.g. inappropriate anti-depression medication;

  • blocked grief has not been recognized yet as an "official" mental-health condition meriting inclusion in the prestigious DSM handbook compiled by the American Psychiatric Association (APA). This suggests that many human-service professionals and lay people are unaware of the condition and its causes, the range and severity of its effects, its symptoms, and what to do about it.

      And I propose that...

  • incomplete grief in adults and kids is one of five major unrecognized stressors in typical troubled (low-nurturance) U.S. families - specially in divorcing biofamilies and average stepfamilies. Few co-parents know the signs of it or what to do about it.

      This report doesn't suggest what causes "complicated grief" in some people. From 36 years' clinical research, I propose that it probably comes from (a) psychological wounds caused by a low-nurturance early-childhood environment, (b) widespread ignorance of healthy- bonding and grieving basics, and (c) a social environment which discourages healthy mourning.  

      A misleading implication in this news article is that treating the symptom of "complicated grief" is justified, rather than diagnosing and reducing the several primary causes of the condition. This risks reducing the local condition (in the best case), and having symptoms of [psychological wounds + unawareness + anti-grief (low-nurturance) environments] reappear - e.g. addictions.

      This article also promotes the harmful illusion that grieving is usually caused by the death of a loved person or pet, rather than the ending of any intense emotional - spiritual bond.

      The report doesn't comment on the requisites for healthy grieving, or what can hinder it. The term "complicated" grief is vague, and distracts from the real issue of incomplete grief.

      The author of this article promotes epidemic unawareness by using the common phrase "dealing with ...feelings."  A similar vague phrase is "processing your feelings." More definitive language is "fully feeling and safely expressing strong emotions until they naturally subside."

      Lesson 1 in this site and the related guidebook offer perspective, concepts, and options for identifying and reducing psychological wounds. Lesson 3 provides similar resources for adults who want to (a) learn "good-grief" basics, (b) assess for and free up any blocked grief, and (c) evolve a pro-grief family environment over time.

      Are you living in a pro-grief family? Are your kids and any grandkids? Do you know someone for whom "grief doesn't go away"?

- Peter K. Gerlach, MSW

      Pause and recall why you read this. Did you get what you needed? If not - what do you need?

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