Rethinking Grief

Grief

Grief, say researchers, deserves a second look.

While we commonly associate the condition with obvious losses, the course of grief does not always follow a pattern or predictable timeline, as we might think.

Sometimes grief is complicated, and sometimes it is prolonged. For this reason, the diagnosis of persistent complex bereavement disorder (PCBD), was recently added as a condition for further study in the Diagnostic Statistical Manual of Mental Disorders, fifth edition (DSM-5).

Also referred to as prolonged grief disorder or complicated grief, PCBD is associated with long-term intense distress and suffering. It affects about seven to 15 percent of those grieving the loss of a loved one, and is typically diagnosed when persistent and severe grief continues beyond twelve months after the death of a loved one, resulting in functional impairment.

In looking to assess these criteria, Dr. Stephen Cozza and his team examined responses of study participants from USU’s National Military Family Bereavement Study, which is examining the impact of military service member death on family members. Participants included surviving family members of military members who died, by any cause, since Sept. 11, 2001.

What the researchers found should have us all reconsidering grief: even with the proposed DSM-5 criteria for PCBD, the individual’s actual experiences of clinically impairing grief were not accurately captured (Cozza et al., 2016).

What Dr. Cozza suggests is that when assessing grief, and a diagnosis of PCBD, symptoms such as prolonged distress and disability associated with the death of a loved one, persistent yearning or sorrow, and preoccupation with the deceased should be considered.

However, where a diagnosis of PCBD requires that six of twelve additional symptom criteria be required as currently proposed by DSM-5, we should be requiring a much less stringent criteria – such as meeting only one criteria. Further, the researchers encourage clinicians to remain vigilant to suicidal thinking, which is prevalent in those with persistent and impairing grief.

“It is imperative for clinicians to have reliable criteria to accurately identify and diagnose those individuals suffering from prolonged and impairing grief,” notes Dr. Cozza.

Related Online Continuing Education (CE) Courses:

Grief: The Reaction to LossGrief: The Reaction to Loss is a 2-hour online continuing education (CE/CEU) course that teaches healthcare professionals how to recognize and respond to grief.

Grief is the reaction to loss, and any kind of loss can trigger grief. People grieve for the loss of someone they love, but they also grieve for the loss of independence, usefulness, cognitive functioning, and physical abilities. Grief is also a lifelong process: a journey rather than a disease that is cured. It changes over time to deal with different kinds of losses. It is an experience that is intellectual, physical, spiritual, and emotional. It is affected by the person’s culture, support system, religious beliefs, and a host of other factors.

Grief is often not recognized by healthcare professionals, in patients or themselves. This course will teach healthcare professionals to recognize grief, as well as how to respond appropriately to the grieving person. The progression of aging and dying will be discussed in order to normalize the process, one of the most important aspects of working with a grieving person. Screening guidelines for depression, suicide risk, and grief are included, as are treatment strategies for anticipatory and complicated grief. A final section on compassion fatigue, burnout, and secondary stress includes strategies for professional self-care. Course #21-25 | 2018 | 35 pages | 15 posttest questions

Caregiver Help: Depression and GriefCaregiver Help: Depression and Grief is a 2-hour online video-based continuing education (CE/CEU) course that addresses caregiver depression and grief and provides strategies to help the caregiver cope.

The emotional stress of caring for persons who are aging, chronically ill or disabled can be debilitating for family members as well as professional caregivers. This course addresses caregiver depression and grief and provides a three-step process that can help develop an attitude of creative indifference toward the people, situations and events that cause emotional stress. It offers suggestions for dealing with preparatory grief, an experience shared by families and professionals as they cope with the stress of caring for someone who will never get well. In the process, it also explains the differences between reactionary depression and clinical depression. By gaining insights into the process of losing someone over an extended period of time, the mental health professional will be in a better position to understand the caregiver’s experience with depression and grief and provide both empathy and strategies for implementing a self-care plan. This course includes downloadable worksheets that you can use (on a limited basis) in your clinical practice. The course video is split into 3 segments for your convenience. Closeout course #20-92 | 2014 | 20 posttest questions

The Grieving SelfThe Grieving Self is a 3-hour online continuing education (CE) course that looks at stories of the bereaved to determine the major issues to address to reconnect those who grieve to a stable sense of self.
The annual number of deaths reported in the United States in the early part of this century was 2.4 million, about four per minute. This course looks at the stories of a few of those who are recently bereaved to determine the major issues for those who grieve: aloneness, loss of self, social connections, anniversaries and holidays, self and others’ expectations, the need to continue living, ambivalence of recovery, grief dreams, medical problems. Studies are reviewed which indicate some researchers’ conclusions as to: 1) Gender differences between men and women who grieve; there are important questions regarding the recruitment of subjects and the data gathering process for gender differences research. 2) And, who among the grief survivors are best served by counseling and psychotherapy. This author, while agreeing with much of the research, challenges the belief that the emotional loneliness suffered by the bereaved is the single, major dynamic of the bereaved, and can only be alleviated through passage of time. It is felt that an effort to reconnect those who grieve to a stable sense of self can help the bereaved regain better function and reduce the length of the time they are consigned to painfully distressing lives. Course #30-49 | 2010 | 34 pages | 20 posttest questions

Course Directions

Our online courses provide instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Grief Work: What Do I Say?

Grief

If you have not been trained in grief work, it can be intimidating to have a client expressing grief by crying, being upset, or angrily responding to you. You may not have easy access to a social worker, psychologist, or other mental health professional. The primary ideas to remember are these:

It is not about you. Grief is not a problem to be solved. It is a process to live through.

Talking to someone who is grieving stirs up your own feelings. This can trigger inappropriate responses to the grieving person. Think about what you are about to say, and why. If you start to talk about yourself, stop. This is not about you. It is about the grieving person.

If you are a problem-solver, you may be tempted to find a solution for the person’s grief. It may be appropriate to refer the person to a mental health professional, but you will not solve the problem and make the person feel better today, tomorrow, or even a month from now. Grief must take its course, and the course will be different for everyone. Your best response is to listen supportively, without judgment and without giving advice (Devine, 2017).

Use these basic ideas to respond to a grieving person:

  • Say, “I can’t imagine how you are feeling.” Do not tell the person you know how they feel. Their grief is unique to them. You may have a similar experience, but it will not be the same.
  • Ask, “What can I do to help right now?” The person may not know what you can do to help, but asking provides the person a small amount of control in a situation that feels wildly out of control.
  • Say “It sounds as if you loved her/him very much. Would you like to tell me what made him/her so special?”
  • Be silent with the person and wait. Offer a tissue if needed.
  • Say, “I am not sure what to say to comfort you, but please know I care” (What’s Your Grief, 2014).

Course excerpt from:

Grief: The Reaction to LossGrief: The Reaction to Loss is a 2-hour online continuing education (CE/CEU) course that teaches healthcare professionals how to recognize and respond to grief.

Grief is the reaction to loss, and any kind of loss can trigger grief. People grieve for the loss of someone they love, but they also grieve for the loss of independence, usefulness, cognitive functioning, and physical abilities. Grief is also a lifelong process: a journey rather than a disease that is cured. It changes over time to deal with different kinds of losses. It is an experience that is intellectual, physical, spiritual, and emotional. It is affected by the person’s culture, support system, religious beliefs, and a host of other factors.

Grief is often not recognized by healthcare professionals, in patients or themselves. This course will teach healthcare professionals to recognize grief, as well as how to respond appropriately to the grieving person. The progression of aging and dying will be discussed in order to normalize the process, one of the most important aspects of working with a grieving person. Screening guidelines for depression, suicide risk, and grief are included, as are treatment strategies for anticipatory and complicated grief. A final section on compassion fatigue, burnout, and secondary stress includes strategies for professional self-care. Course #21-25 | 2018 | 35 pages | 15 posttest questions

Click here to learn more.

Related Online Continuing Education (CE) Courses:

The Grieving SelfThe Grieving Self is a 3-hour online continuing education (CE) course that looks at stories of the bereaved to determine the major issues to address to reconnect those who grieve to a stable sense of self. The annual number of deaths reported in the United States in the early part of this century was 2.4 million, about four per minute. This course looks at the stories of a few of those who are recently bereaved to determine the major issues for those who grieve: aloneness, loss of self, social connections, anniversaries and holidays, self and others’ expectations, the need to continue living, ambivalence of recovery, grief dreams, medical problems. Studies are reviewed which indicate some researchers’ conclusions as to: 1) Gender differences between men and women who grieve; there are important questions regarding the recruitment of subjects and the data gathering process for gender differences research. 2) And, who among the grief survivors are best served by counseling and psychotherapy. This author, while agreeing with much of the research, challenges the belief that the emotional loneliness suffered by the bereaved is the single, major dynamic of the bereaved, and can only be alleviated through passage of time. It is felt that an effort to reconnect those who grieve to a stable sense of self can help the bereaved regain better function and reduce the length of the time they are consigned to painfully distressing lives. Course #30-49 | 2010 | 34 pages | 20 posttest questions
Suicide PreventionSuicide Prevention: Evidence-Based Strategies is a 3-hour online continuing education (CE) course that reviews evidence-based research and offers strategies for screening, assessment, treatment, and prevention of suicide in both adolescents and adults. Suicide is one of the leading causes of death in the United States. In 2015, 44,193 people killed themselves. The Centers for Disease Control and Prevention (CDC) notes, “Suicide is a serious but preventable public health problem that can have lasting harmful effects on individuals, families, and communities.” People who attempt suicide but do not die face potentially serious injury or disability, depending on the method used in the attempt. Depression and other mental health issues follow the suicide attempt. Family, friends, and coworkers are negatively affected by suicide. Shock, anger, guilt, and depression arise in the wake of this violent event. Even the community as a whole is affected by the loss of a productive member of society, lost wages not spent at local businesses, and medical costs. The CDC estimates that suicides result in over 44 billion dollars in work loss and medical costs. Prevention is key: reducing risk factors and promoting resilience. This course will provide a review of evidence-based studies so that healthcare professionals are informed on this complex subject. Information from the suicide prevention technical package from the Centers for Disease Control and Prevention will be provided. Included also are strategies for screening and assessment, prevention considerations, methods of treatment, and resources for choosing evidence-based suicide prevention programs. Course #30-97 | 2017 | 60 pages | 20 posttest questions
Overcoming the Stigma of Mental IllnessOvercoming the Stigma of Mental Illness is a 2-hour online continuing education (CE/CEU) course that explores the stigmas around mental illness and provides effective strategies to overcome them. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines mental illness stigma as “a range of negative attitudes, beliefs, and behaviors about mental and substance use disorders.” Mental health and substance use disorders are prevalent and among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. This course will explore the stigmas surrounding mental illness and provide effective strategies clinicians can use to create a therapeutic environment where clients can evaluate their attitudes, beliefs, and fears about mental illness, and ultimately find ways to overcome them. We will explore the ways in which mental illness stigmas shape our beliefs, decisions, and lives. We will then look at specific stigmas about mental illness, from the fear of being seen as crazy to the fear of losing cognitive function and the ways in which we seek to avoid these fears. We will then look at targeted strategies that, you, the clinician, can use to create a therapeutic alliance where change and healing can overcome the client’s fears. Lastly, we will look at the specific exercises you can use in session with your clients to help them address and overcome their biases and stigmas about mental illness. Course #21-24 | 2018 | 35 pages | 15 posttest questions
Course Directions
Our online courses provide instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!—

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Grief: The Reaction to Loss

New Online Continuing Education (CE/CEU) Course @pdresources.org

Grief: The Reaction to LossGrief: The Reaction to Loss is a new 2-hour online continuing education (CE/CEU) course that teaches healthcare professionals how to recognize and respond to grief.

Grief is the reaction to loss, and any kind of loss can trigger grief. People grieve for the loss of someone they love, but they also grieve for the loss of independence, usefulness, cognitive functioning, and physical abilities. Grief is also a lifelong process: a journey rather than a disease that is cured. It changes over time to deal with different kinds of losses. It is an experience that is intellectual, physical, spiritual, and emotional. It is affected by the person’s culture, support system, religious beliefs, and a host of other factors.

Grief is often not recognized by healthcare professionals, in patients or themselves. This course will teach healthcare professionals to recognize grief, as well as how to respond appropriately to the grieving person. The progression of aging and dying will be discussed in order to normalize the process, one of the most important aspects of working with a grieving person. Screening guidelines for depression, suicide risk, and grief are included, as are treatment strategies for anticipatory and complicated grief. A final section on compassion fatigue, burnout, and secondary stress includes strategies for professional self-care. Course #21-25 | 2018 | 35 pages | 15 posttest questions

Course Directions

Our online courses provide instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Grief – More Than Just Loneliness

Grief

A common belief among those who work with the bereaved is that coping with the loneliness of the loss of a loved one is the single most challenging factor of grief. The thought is that if a grieving person can be quickly reconnected to family and friends the loss will be much easier to overcome, and life can resume a sense of normalcy.

Yet coping with grief is much more than the loss of another person. In many ways, it is the loss of a sense of self. We know ourselves through our relationships, and develop a sense of self based upon how we fit amongst our circle of family and friends. This includes the roles we take on, the responsibilities we feel, and the value we derive from functioning as part of a system that is much larger than us.

However, when this system is disrupted, we often feel disrupted. The loss of a loved one can throw off the very homeostasis that helped us determine our sense of self. Often, we struggle to know ourselves without the reference of our closest relationships.

Filling the hole that loss leaves with other relationships may help us feel less alone, but there is much more to grief than that. We have to re-learn who we are. We have to redefine ourselves. In many ways, we have to find ourselves again.

Re-connecting with a stable sense of self lies at the core of grieving because loss interrupts much more than our relationships. It interrupts who we are. In many ways, we don’t only have to grieve the loss of another person, we also have to grieve a loss of self.

But how do we grieve a loss of self? How do we regain a stable sense of self? What steps do we take, and how do we make sure that we aren’t simply trying to fill a void in our lives and, in the process, overlooking the very work that will truly help us relieve our pain?

Professional Development Resources continuing education course, The Grieving Self answers all of these questions and many more. Helping therapists identify common reactions experienced by those who lose a loved one, differentiate between the characteristics of grief’s first and second stages, help clients understand the grieving process and develop strategies to cope better and avoid chronic grief, the course moves beyond simply over-viewing the stages of grief to provide a solid set of skills therapists can use to help clients reclaim an operational self after the loss of a loved one. Click here to learn more.

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Growing Through Loss: A Grief Well Met

By Dr. Cara Baker

Growing Through Loss: A Grief Well MetThere’s nothing like loss to cancel your to-do list and plans. There’s nothing like grief to erase what you thought was top priority. In the wake of what was, we must lay aside the demands of the world, attending to what’s “in your face.”

Sometimes loss is literal: the death of someone you love. Sometimes the grief involves what I have come to call a “living loss.” Living losses include, but are not limited to: lost dreams, profound disappointments or betrayals, untoward changes in health, work, relationships, or abandonments, that feel like a “hit and run.” Sometimes the loss comes when someone dear suddenly turns away from you abruptly, with a hardened heart.

While grief may be thought of as a noun, anyone experiencing it knows full well that grief is an altered raw state, a dynamic at work that affects not only the one who grieves. Deepest grief comes in waves. In the throes, we are confronted with unpolished and un-manicured scary parts of ourselves. When the ground of what we thought once was slips away, this is an earthquake no one else can measure. Historical identity flies out the door. Self-created illusions of certainty predictability vanish. When the loss is big enough, we are left impotent to fix it. No wonder many opt out through anything that will numb the pain and anxiety. But when our favorite method of self-medication/excess fails to work long term, making matters worse, we are left to face the inevitable. We live in an ever-changing universe. What is present today will not last forever. Nothing alters this fact.

The 11 Essentials to a Grief Well Met

Herein comes the challenge. We must accept there is nothing to fix. As my friend Linda puts it: “There is nothing to do or undo.” All we can hope for is that out of the present darkness something unexpected will flower beautifully in the garden of our heart. This is possible. In fact, it is highly probable to the degree we are willing to roll up our sleeves and meet our loss with authenticity and sincere intention to find growth where it seems least likely. Following are 11 aspects to consider:

  1. “Harden not my heart.” While tough times can bring out the best in people, it can also bring out the worst. Our words can turn nasty, our temper impatient, our desire for retaliation inflamed. Reacting, rather than quietly responding, hardens the heart. When this happens, may we meet our grief with self-compassion. When the worst in me flares, my practice is to send forth a request to that which lives deepest in and through me that goes like this: “Harden not my heart.”
  2. When our disposition turns sour, may we press the pause button and seek what restores our Spirit in the natural world. Leaving the phone behind, simply going for a walk in a beautiful spot in nature, while practicing deep breathing can bring back perspective and ease in the system.
  3. Find evidence of new life before you. One method is to wear your watch on your opposite wrist, reminding you, every time you check the time to take time to notice something new or fresh. Breathe deeply. Life is here.
  4. Collect these demonstrations daily. Record them in a demonstration journal, a reference for the future when you need a reminder, that “spring” will come again.
  5. Recall we have choice. Life is fragile, fleeting. We have the capacity for mean-spiritedness or warmth, depending on what we choose. A sharp look, a mean word, a thoughtless gesture with those we encounter, might be our last communication. Is this the legacy we wish to leave behind?
  6. Always, there is an opportunity to clean up our mess. Where I have caused injury, I can do my best to make things right. There is no guarantee, however, that this will change the situation. The only guarantee is that expanding the way we treat ourselves, and others, in the fire of pain, will surely open our own heart.
  7. Facing the most difficult with self-compassion and kindness brings forward the possibility for what Chogyam Trungpa called an “enlightened society.” Not only we, but our children’s children are the beneficiaries of our intention.
  8. Grief can give way to grace. I’d heard the word “grace,” before my son was killed 21 years ago this March 21. But it was not until afterward, sitting in my wingback chair, when I simply could not hold the pain any longer by myself, did I experience grace. One minute, from the bottom of my heart, everything in me silently screamed, beseeched that presence beyond my understanding: “Help me, I cannot do alone.” From some inexplicable place, a deep and abiding calm washed through me so profoundly that I’ve never been the same since. The burden had been lifted. Now, I’m not saying that my bereavement was over. I am saying, however, that this altered my relationship to it and to my life. In an instant, I knew the meaning of these words:

    “Help us to be always hopeful Gardeners of the spirit Who know that without darkness Nothing comes to birth. As without light, Nothing flowers.” — Kali “A Grain of Mustard Seed”

  9. Grief well met affords us the opportunity to untangle ourselves from what no longer serves life well lived. Resisting experience lessens the joy of living. Experience need not be pleasant to find joy. Joy comes from leaning into and “giving over” the burden, trusting that who we are is much, much more.
  10. Welcoming whatever comes sets us free to welcome life in all its forms, without attachment or resistance, and with connection to all who have known this experience in the universe. One day, as I was untangling myself from feelings of self-pity that bereavement can bring, I saw a robin feeding her newly-hatched in apple tree outside my window. Suddenly, one of her babies over-reached and fell out of the nest, hitting the ground dead. As I witnessed mama bird fly to the side of her fallen, I became aware of all creatures who birth and know loss. We were One. I could send her compassion, and it returned ten-fold.
  11. Let the “whole” find you from the “hole.” There is no instant fix to suffering. Whenever I am asked “can you get over it?” by the bereaved, I respond as follows. “The real issue is are you willing to grow through your loss?” A well-met grief teaches there is a presence beyond the personality. What has been hidden behind our self-constructed personality shows itself as new expansions of who we’ve believed we are as they begin to shine and bloom. Become faithful to what can flower, even if you cannot see or name it yet. Hold the space, for the yet to emerge. It will come if you choose.

More on “living losses,” in weeks to come. Today’s piece is in memory of you, Matt. So many thanks for the love that remains.

And now, A Love Letter to the One Who Grieves:

Days like today are bitter reminders that life is neither fair nor easy. There are no words for times like this. Neither pretty nor profound words can ease your pain, take away the source of what you suffer. Every loss is different. I would not presume that what I experienced when I lost my son is what is so for you.

What I can tell you is that I know you are out there, doing the best you can. As I think of you, I remember to breathe more deeply for the two of us. As I think of you, I thank life for who you are, for your sincere heart, even in times like these. When I meet a stranger on the street, I think of you, that this might be you. Of course, I do not know, but, I act “as if,” just in case.

May I wish you ease in the system? May you be free from careless remarks or unwanted advice. May this day and evening bring you comfort. May you be reminded that spring will come again, even in the hardest winter of the soul. May you be reminded in infinite ways that you are not alone.

For more by Dr. Cara Barker, click here.

For more on death and dying, click here.

Follow Dr. Cara Barker on Twitter: www.twitter.com/DrCaraBarker

Source: http://www.huffingtonpost.com/dr-cara-barker/grieving-process_b_1364903.html

Grief is a Mental Illness…Really?

By LAUREN PAXMAN

A controversial decision to reclassify grief as a mental illness has been criticised by medical experts.

Should grief be treated like depression?The change in classification was intended to add flexibility to how early people can be treated for depression following the death of a loved one. But it has led to worries that bereaved people will be treated with pills rather than empathy.

An editorial in influential medical journal, The Lancet, argues that grief does not require psychiatrists and that ‘legitimizing’ the treatment of grief with antidepressants ‘is not only dangerously simplistic, but also flawed.’

The unsigned lead editorial reads: ‘Grief is not an illness; it is more usefully thought of as part of being human and a normal response to the death of a loved one.’

The Lancet’s comments follow the American Psychiatric Association’s decision to add grief reactions to their list of mental illnesses in their fifth edition of the psychiatry ‘bible’, Diagnostic and Statistical Manual of Mental Disorders, (DSM-5), which is due out in 2013.

But The Lancet, along with many psychiatrists and psychologists have called for the changes to be halted – saying they would lead to a ‘tick box’ system that did not consider the wider needs of patients but labelled them as ‘mentally ill’.

They agree that in rare cases, bereavement will develop into prolonged grief or major depression that may merit medical treatment. However, they suggested that for the majority of the bereaved, ‘doctors would do better to offer time, compassion, remembrance and empathy, than pills.’

The DSM-5 proposal – which has been opposed by The Lancet’s editorial writers – would eliminate the so-called ‘grief exclusion.’

This ‘exclusion’ means that anyone who has experienced bereavement cannot be diagnosed as depressed for a certain period of time.

In a previous edition, DSM-III, that period of time was set at one year.

The DSM-IV reduced that period to two months and DSM-5 plans to reduce the period to just two weeks.

Although the proposed changes to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) would not directly affect clinical practice here, where doctors tend to use different international guidelines, experts say it would eventually influence research and thinking in the field.

Defending the change in timeframe, Dr. Kenneth S. Kendler, a member of the DSM-5 Mood Disorder Working Group, said it would allow for an earlier diagnosis but would by no means force it.

Simon Wessely, of the Institute of Psychiatry, King’s College, London, said ‘We need to be very careful before further broadening the boundaries of illness and disorder.’

‘Back in 1840 the Census of the United States included just one category for mental disorder.

‘By 1917 the American Psychiatric Association recognised 59, rising to 128 in 1959, 227 in 1980, and 347 in the last revision. Do we really need all these labels? Probably not. And there is a real danger that shyness will become social phobia, bookish kids labelled as Asperger’s and so on.’

Whereas people who are bereaved are currently given help where necessary, in future they might find themselves labelled as having a depressive disorder if their symptoms lasted longer than a certain period of time, he added.

Peter Kinderman, Professor of Clinical Psychology and Head of Institute of Psychology, University of Liverpool, said ‘It will exacerbate the problems that result from trying to fit a medical, diagnostic, system to problems that just don’t fit nicely into those boxes.

‘Perhaps most seriously, it will pathologise a wide range of problems which should never be thought of as mental illnesses. Many people who are shy, bereaved, eccentric, or have unconventional romantic lives will suddenly find themselves labelled as ‘mentally ill’.

Dr. Arthur Kleinman, a Harvard psychiatrist, social anthropologist and global health expert, says that the main problem is the lack of ‘conclusive scientific evidence to show what a normal length of bereavement is.’

According to the Lancet writers, ‘it is often not until 6 months, or the first anniversary of the death, that grieving can move into a less intense phase.’

They added that grieving is individual, shaped by age, gender, religious beliefs and the strength of the relationship with the lost loved one.

Source: http://www.dailymail.co.uk/health/article-2102618/Lancet-urges-doctors-treat-grief-empathy-pills.html#ixzz1mfIHkK3A

Should grief be treated like depression?

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Facts About Grief


Facts about Grief

Facts about Grief

When my wife died in 2004, I looked for books to help me understand grief and deal with it. Most of what I found was useless, based on highly subjective speculations and anecdotal evidence, although I did find one helpful resource: Therese Rando’s How to Go on Living When Someone You Love Dies. I found it lamentable that so little of the popular advice on grief was based on scientific evidence. So I was pleased to encounter in my local Wordsworth bookstore a new, evidence-based but highly readable review that corrects many widespread misconceptions about bereavement, Ruth Davis Konigsberg’s The Truth about Grief. Here are some of the facts about grief I learned from this book.

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