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Understanding Pathological Grief

Kathryn Patricelli, MA, edited by Mark Dombeck, Ph.D. Updated: Mar 2nd 2016

The normal grief process can be considered to be a mild form of traumatic stress injury. More severe forms of tramatic stress injury are possible, and may occur. Two serious psychiatric disorders that occur in the wake of tramatic stress experiences are Acute Stress Disorder, and Posttraumatic Stress Disorder (otherwise known as PTSD). Such disorders may occur after exposure to serious abuse, violent death, combat experience, rape or other life-threatening experiences, and can be disabling. Please refer to our PTSD Topic Center for more information about PTSD.

grieving womanThough most grief is a mild sort of injury compared to how bad such injuries can get, some griefs are experienced as more traumatic, and can become difficult to resolve. The term "Pathological Grief" is sometimes applied to people who are unable to work through their grief despite the passage of time. It can take most people up to several years to get past a serious loss. A pathological grief reaction may be diagnosed after a long time (one or more years) have passed and the grieving person is not improving. By labeling someone's grief as pathological, a doctor is indicating that the grieving process resolution is delayed for some reason and that professional help is needed. No disrespect is intended toward the patient in using this term.

There is no absolute time frame within which grief is considered pathological, although there are cultural norms that serve as guidelines. In Western cultures, a person might be judged as being "stuck" if they are still actively grieving 18 to 24 months after their loss. An unremitting 'overly intense' grief process of shorter duration might also be labeled as pathological. Keeping these guidelines in mind, know that it is very much appropriate to encourage people who appear to be stuck in their grief process to seek professional grief counseling.


Reader Comments
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Pathological Grief - reply - - Jul 1st 2009

An interesting article that i felt I wanted to comment on.

I know that the mental health profession has trouble with all the different "griefs" and whether to elevate some types of grief to a status of mental illness.

I understand the difficulty of this - In my personal situation, after having suffered a parental bereavement at the age of 4 I find myself now mid thirties, with a wife and children and a bereavement of 30+ years ago is threatening to define who I am (or rather my inability or unwillingness to move on). I find myself exceptionally angry and resentful and sad that actually I am poorly prepared to be a loving and nurturing father and husband, brought about by many, many years of avoidant thoughts and behaviour, very concerned that I don't have the resilience or skills to develop, but still very self-centred - not a good mix.

Through my involvement with an organisation who help young people who have suffered a bereavement, I now understand that what I have been doing all this time is about distraction, pre-occupation not allowing myself to srcatch beneath the surface because of fear.

If a bereaved child is unable / or unwilling to engage in the grieving process that can develop into avoidant thinking and behaviour (aswell as others) over time is this pathological grief ? or when it develops into a personality disorder do you classify it as something else - maybe the answer in this should be related to what is needed to achieve a positive outcome - which I believe is only possible by addressing the grief, expressing the often complicated and conflicting emotions associated with this condition and not just trying to treat the displayed symptoms, ranging from the avoidant to the depressive.

Addressing the child-ego state and the emotions involved is neccessary before being allowed to develop further.

Would be interesting to see if there are any forums for adults who have been bereaved as a child - bet there are thousands and thousands of people out there of all ages who feel isolated to a degree because they either didn't understand that actually they are different or that they were too busy trying to show that they weren't.

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