Grief is a normal part of life for most of us. It is not usually considered a mental disorder. Some grief does reach the level of a mental disorder, complicating the daily life of the mourner. A July 2005 study published in the Journal of the American Medical Association found that a specialized "complicated grief therapy" is particularly effective in treating this severe form of grief.
Elizabeth Kubler-Ross first described the five stages of grief: denial, anger, bargaining, depression, and acceptance. Grief does not always follow these stages, but these ingredients are usually present to some extent. The study's authors looked at subjects with complicated grief that includes:
- a sense of disbelief regarding the death
- anger and bitterness over the death
- recurrent pangs of painful emotions, with intense yearning and longing for the deceased
- preoccupation with thoughts of the loved one, often including distressing intrusive thoughts related to the death. (Shear, et.al., 2005)
Complicated grief is more common when a young person dies; or when a death is sudden, unexpected, or violent. It can also occur when someone is angry at the person before they died, or has unresolved emotional issues with the person who died.
Interpersonal Thearpy with a New Twist
Interpersonal therapy is an approach that is commonly used to help people through grief. The therapist helps the client explore their relationship with the deceased to assist them in moving through the stages or tasks of grief. The JAMA study compared interpersonal therapy with a new variant that adds a cognitive-behavioral component that helps the person focus on adjusting to daily life after the death. There is an element of directly confronting the death that is not present in traditional interpersonal therapy.
The researchers found that 66% of participants using the new technique had a very good response, compared with 32% of those who received traditional interpersonal therapy. The new approach was especially helpful for people mourning a violent death. If you or a loved one is having a particularly difficult time mourning a loss, this new approach may be especially helpful.
Sources: Shear, Katherine; Frank, Ellen; Houck, Patricia; Reynolds, Charles. Treatment of Complicated Grief: A Randomized Controlled Trial JAMA 2005 293: 2601-2608.; Treating Complicated Grief, Harvard Mental Health Letter, February 2006.
