2 results
3 - Pathological grief reactions
- Edited by Margaret S. Stroebe, Universiteit Utrecht, The Netherlands, Wolfgang Stroebe, Universiteit Utrecht, The Netherlands, Robert O. Hansson, Universiteit Utrecht, The Netherlands
-
- Book:
- Handbook of Bereavement
- Published online:
- 04 May 2010
- Print publication:
- 26 March 1993, pp 44-61
-
- Chapter
- Export citation
-
Summary
In many areas of medicine it is difficult to distinguish normal and abnormal, nonpathological and pathological, or health and disease. The study of bereavement shares this difficulty. This chapter focuses on major theoretical perspectives that might aid in defining or understanding pathological grief. A historical overview is provided, and questions are raised regarding the overlap between grief and defined disorder. In particular, discussion focuses on the problem that research to date has not clearly identified areas of psychopathology that are grief-specific. This reflects in part a lack of operationalized criteria for pathological grief.
Defining pathological grief
The field is still struggling to validate and operationalize the construct of “normal” grief (cf. Shuchter & Zisook, this volume). When the focus is then extended to include a range of “abnormal” forms of grief, the difficulties are compounded. Where grief for a particular individual, in a particular culture, appears to deviate from the expected course in such a way that it is associated with excessive or prolonged psychological or physical morbidity, it may be labeled as pathological. Such classification may be descriptive or it may imply a theoretical construct. Furthermore, often it is not clear as to whether the term grief is intended to pertain simply to the affective reaction to loss, as a commonly accepted meaning, or to refer to all aspects of the bereavement reaction and a range of other states.
28 - Counseling and therapy of the bereaved
- Edited by Margaret S. Stroebe, Universiteit Utrecht, The Netherlands, Wolfgang Stroebe, Universiteit Utrecht, The Netherlands, Robert O. Hansson, Universiteit Utrecht, The Netherlands
-
- Book:
- Handbook of Bereavement
- Published online:
- 04 May 2010
- Print publication:
- 26 March 1993, pp 427-454
-
- Chapter
- Export citation
-
Summary
Caring for bereaved people involves a wide range of interventions, from the compassionate and empathic communication of a terminal illness diagnosis through the in-depth psychiatric management of bereaved people whose grief may or may not have contributed to their illness. There is also a powerful social movement of care that has evolved, particularly in the last three decades, recognizing the needs of, and supporting, bereaved people. Associated with this has been the development of self-help organizations that have contributed to the care and counseling of the bereaved. There are now many studies describing the effects of bereavement on health and wellbeing and the interventions that may be provided to prevent or deal with pathological outcomes. Still, there is much to be learned.
The models that have been used for counseling the bereaved have arisen for the most part from psychotherapeutic approaches and have traditionally applied to the one-to-one situation, with some extension to family and group treatments. Horowitz has been a significant contributor in defining the psychotherapeutic approach for grief (Horowitz et al., 1984a), dealing with bereavement in the context of stress response syndromes; other workers (Lindemann, 1944; Raphael, 1977, 1983) have utilized psychodynamic understanding for crisis intervention formats. Behavioral therapies have also been utilized, and descriptions have ranged from the broad model of Ramsay (1979), to the specifics of guided mourning (Mawson et al., 1981), to a more recent conceptualization that is cognitively oriented (Kavanagh, 1990).