Good on the DSM-5. This book to be published in 2013 has defined a type of grief that is a mental disorder or perhaps could be called neurotic.
They have put a time limit on normal grief. Somewhat of a courageous thing to do and one that I have been advocating for some time. People who are grieving excessively after a year are considered to be neurotic or have a mental disorder as they say.
This could bring some criticism as it is not a politically correct thing to do. Bereavement counsellors tell us that people grieve in their own time and way. I agree with this to some extent but it is also a view promoted by grief counsellors that in my view has lead to massive over servicing of such clients in a billion dollar a year industry.
Some will see it as being too harsh on the bereaved. They will say to tell someone that their grieving should be somewhat complete after a year is a mean thing to do and not kind to a person who has suffered a great loss.
In my view, and this is supported by psychological research, after a year a significant amount of the grief should have passed. With a close loved one, one would expect there to be some more grief after that time but it will tend to be intermittent and not usually of a intense nature. It probably takes about 4 years for a person to fully psychologically readjust after the loss of a very close loved one. But the actual grief and crying should mostly be gone after 12 month period if the grief is allowed to proceed normally.
Some will argue that such a statement in the DSM-5 does not take into account cultural differences. I have also discussed this before. There are many wide and varied cultural differences in funerals and grief rituals. However underneath the rituals the same psychological processes apply no matter what culture one is from. The process cited in the paragraph above applies if you live in Australia, Egypt, Siberia, China or where ever. That same basic psychological process applies to all humans whilst the burial rituals do vary considerably between cultures. The actual burial or formal ceremony for the dead is only one very small part of any psychological grief response for the loved ones who remain.
The problem with bereavement is that it is so prone to secondary gains. A secondary gain is when a psychological problem starts to be used to the advantage of the sufferer. A woman who starts to be agoraphobic learns over time that this allows her to control her husband more. She cannot leave the house so she can ring him at any time to do tasks for her. A mother who develops depression may learn over time that her children start to feel sorry for her and visit more. These are what are known as secondary gains.
When you suffer the loss of a closed loved one what happens. People all of a sudden become kind and nurturing to you. They cook you casseroles, drop in to see how you are going and mow the front lawn for you. When you start to get over the grief that all stops and things go back to how they were before. For socially isolated and emotionally deprived people this can be very attractive and they will be reluctant to end the grief.
Finally it should be noted that the development of a secondary gain is an unconscious process developed by an individual who is struggling with life. If it is a conscious thought out plan it stops being a secondary gain and becomes manipulation.
Good on the DSM-5 for doing this and it may come in for some criticism when the book is published.
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Tuesday, August 2, 2011
Bereavement neurosis
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