Abstract
Although the incidence of pathological grief does not appear to be high, the morbidity and mortality of sufferers is significant. Because of attitudes about grieving and the reluctance to experience grief, patients may avoid sharing grief with the family physician, who may then fail to recognize pathological grief. This article discusses clinical manifestations and situations which can lead to pathological grief. The types of pathological grief—chronic, inhibited, delayed, and atypical—are also discussed, along with personality variables which predispose some people to difficult grieving. Failure to grieve may also lead to a higher incidence of physical disease and various forms of mental illness. In order to manage grief, the physician must encourage the patient to express all his feelings of sadness, anger, and guilt; reassure him that his anger and guilt are a normal reaction to loss; and later, give him permission to stop grieving.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Clayton P., Desmarais L., Winokur G. A study of normal bereavement. Am J Psychiatry. 1968 Aug;125(2):168–178. doi: 10.1176/ajp.125.2.168. [DOI] [PubMed] [Google Scholar]
- DeVaul R. A., Zisook S., Faschingbauer T. R. Clinical aspects of grief and bereavement. Prim Care. 1979 Jun;6(2):391–402. [PubMed] [Google Scholar]
- Kitson G. C., Lopata H. Z., Holmes W. M., Meyering S. M. Divorcees and widows: similarities and differences. Am J Orthopsychiatry. 1980 Apr;50(2):291–301. doi: 10.1111/j.1939-0025.1980.tb03291.x. [DOI] [PubMed] [Google Scholar]
- Krein N. Sudden infant death syndrome. Acute loss and grief reactions. Clin Pediatr (Phila) 1979 Jul;18(7):414–423. doi: 10.1177/000992287901800706. [DOI] [PubMed] [Google Scholar]
- LEHRMAN S. R. Reactions to untimely death. Psychiatr Q. 1956 Oct;30(4):564–578. doi: 10.1007/BF01564370. [DOI] [PubMed] [Google Scholar]
- Lewis E., Page A. Failure to mourn a stillbirth: an overlooked catastrophe. Br J Med Psychol. 1978 Sep;51(3):237–241. doi: 10.1111/j.2044-8341.1978.tb02468.x. [DOI] [PubMed] [Google Scholar]
- Melges F. T., DeMaso D. R. Grief-resolution therapy: reliving, revising, and revisiting. Am J Psychother. 1980 Jan;34(1):51–61. doi: 10.1176/appi.psychotherapy.1980.34.1.51. [DOI] [PubMed] [Google Scholar]
- PARKES C. M. BEREAVEMENT AND MENTAL ILLNESS. 1. A CLINICAL STUDY OF THE GRIEF OF BEREAVED PSYCHIATRIC PATIENTS. Br J Med Psychol. 1965 Mar;38:1–12. doi: 10.1111/j.2044-8341.1965.tb00956.x. [DOI] [PubMed] [Google Scholar]
- PARKES C. M. BEREAVEMENT AND MENTAL ILLNESS. 2. A CLASSIFICATION OF BEREAVEMENT REACTIONS. Br J Med Psychol. 1965 Mar;38:13–26. doi: 10.1111/j.2044-8341.1965.tb00957.x. [DOI] [PubMed] [Google Scholar]
- Parkes C. M. Bereavement counselling: does it work? Br Med J. 1980 Jul 5;281(6232):3–6. doi: 10.1136/bmj.281.6232.3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Parkes C. M. The first year of bereavement. A longitudinal study of the reaction of London widows to the death of their husbands. Psychiatry. 1970 Nov;33(4):444–467. doi: 10.1080/00332747.1970.11023644. [DOI] [PubMed] [Google Scholar]
- STERN K., WILLIAMS G. M., PRADOS M. Grief reactions in later life. Am J Psychiatry. 1951 Oct;108(4):289–294. doi: 10.1176/ajp.108.4.289. [DOI] [PubMed] [Google Scholar]
- Skolnick V. The addictions as pathological mourning: an attempt at restitution of early losses. Am J Psychother. 1979 Apr;33(2):281–290. doi: 10.1176/appi.psychotherapy.1979.33.2.281. [DOI] [PubMed] [Google Scholar]
- Stack J. M. Spontaneous abortion and grieving. Am Fam Physician. 1980 May;21(5):99–102. [PubMed] [Google Scholar]
- Volkan V. Typical findings in pathological grief. Psychiatr Q. 1970;44(2):231–250. doi: 10.1007/BF01562971. [DOI] [PubMed] [Google Scholar]
- Wise M. J. The aftermath of divorce. Am J Psychoanal. 1980 Summer;40(2):149–148. doi: 10.1007/BF01254807. [DOI] [PubMed] [Google Scholar]
- Wolfenstein M. How is mourning possible? Psychoanal Study Child. 1966;21:93–123. doi: 10.1080/00797308.1966.11823254. [DOI] [PubMed] [Google Scholar]