‘I have never climbed Mt. Everest, but I sometimes think it would be easier than navigating the pathway through grief’ – Professor Katherine Shear.
Many of us will more than likely experience the loss of a loved one or somebody close to us within our lifetime. Losing somebody close to us has been identified as an underlying contributor to prolonged substance misuse in addiction, (Furr, Johnson & Goodall, 2015), this perhaps due to the isolation, intensity, relative unfamiliarity of grief, and confrontation with morality, (Shear, 2015). Losses of people we hold so dear can be some of the most profound moments of our lives which is why it is so important the loss is addressed to successfully begin the process of recovery, (Huggard & Himiona, 2016).
When loss isn’t properly addressed and the grieving process isn’t properly acknowledged, it can manifest into detrimental mental health problems and even addiction. Prolonged grief disorder (PGD) is a mental health condition effecting roughly one out of every ten adults who have experienced a bereavement, (Lundorff, etal, 2017), however other estimates suggest this number to be higher, (Prigerson, eetal, 2009). An individual suffering from PGD feels a heavy sense of rumination, becomes overly focused on the loss to the point where the associated grief becomes incapacitating, (Frances, 2012).
While these symptoms may sound like major depression disorder, PGD differs in a few subtle ways. Whereas in Major depressive disorder, thoughts and emotions tend to be more generalised and less associated with the loss specifically, in PGD they continue to circle around the loss, (Zisook, etal, 2014). Similarly, in Major depressive disorder, individuals tend to feel a general lowered interest in life, whereas in PGD this is instead a persistent and intrusive preoccupation with the bereavement, feelings of intense longing and often sensory experiences that bring them closer to the bereaved, for example, smelling old clothes etc, (Shear, 2015). Depression requires treatment, grief requires support and reassurance.
Traumatic loss, if not dealt with correctly, can have detriment on physical health also. For Example, broken heart syndrome, a condition brought on by stress, leads to a surge in hormonal activity, resulting in abnormal chest and heart movements and in extreme cases, causing heart attack, (Shulman, 2018). Neuroimaging studies have highlighted how the same neural signatures are present for both emotional and physical pain in specific areas of the brain, (Anterior insula and anterior cingulate cortex), (Eisenberger, Lieberman, & Williams, 2003). This therefore goes to show just how pervasive emotional pain and trauma is and the lasting impact it can have physically on our bodies.
Successful mourning is vastly important. From a clinical perspective, mourning involves emotional regulation and a learning process to come to terms with the loss and reorientation into a world without the loved one in it, (Shear, 2015). Successful mourning involves a deep connection to the departed yet the ability to imagine a satisfying future without them. Of course, mourning is subjective, no two people experience it the same way and everyone handles a bereavement differently
Obviously dealing with loss and grief successfully is important for our mental and physical wellbeing and there are a variety of ways to do this. Reconnecting with suppressed memories is hugely important. During traumatic times to allow us to still be able to function sometimes the traumatic memories can be suppressed, as a result they are never truly dealt with and continue to fester, (Shulman, 2018). Strategies that can be employed to reconnect and confront these memories in order to resolve them include, journaling, meditation and seeking counselling. Thus, once we understand the basis of our experience with the trauma, we gain insight and can begin the healthy recovery process.
Eisenberger, N. I., Lieberman, M. D., & Williams, K. D. (2003). Does rejection hurt? An fMRI study of social exclusion. Science, 302(5643), 290-292.
Frances, A. (2012). When Good Grief Goes Bad. The Huffington Post. http://www.huffingtonpost.com/allen-frances/grief-depression_b_1301050.html
Furr, S. R., Johnson, W. D., & Goodall, C. S. (2015). Grief and recovery: The prevalence of grief and loss in substance abuse treatment. Journal of Addictions & Offender Counseling, 36(1), 43-56.
Huggard, P., & Himiona, K. (2016). Interweaving loss, grief, and addiction. New Zealand Journal of Counselling, 36(1).
Lundorff, M., Holmgren, H., Zachariae, R., Farver-Vestergaard, I., & O’Connor, M. (2017). Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis. Journal of Affective Disorders, 212, 138-149.
Prigerson, H. G., Horowitz, M. J., Jacobs, S. C., Parkes, C. M., Aslan, M., Goodkin, K., … & Bonanno, G. (2009). Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS medicine, 6(8), e1000121.
Shear, M. K. (2015). Complicated grief. New England Journal of Medicine, 372(2), 153-160.
Shulman, L. M. (2018). Before and After Loss: A Neurologist’s Perspective on Loss, Grief, and Our Brain. Johns Hopkins University Press.
Zisook, S., Iglewicz, A., Avanzino, J., Maglione, J., Glorioso, D., Zetumer, S., … & Pies, R. (2014). Bereavement: course, consequences, and care. Current psychiatry reports, 16(10), 482.