All of us sooner or later must face bereavement. And one of
the most valuable developments in modern psychiatry is new understanding of the
importance of the grief process, of what it apparently must consist of, and of
the suffering, physical and mental, which may occur if the process is not
properly worked through. In particular, the studies of Harvard on the mourning
process have clearly useful implications for maintaining mental and physical
health.
Dr. Lindemann has established that in adapting to the death of a loved
one, a bereaved person goes through a well-defined process which usually takes
four to six weeks to complete and involves a succession of specific
psychological steps.
His findings indicate that it is essential to work hard
psychologically to adapt to a loss. Starting with studies of mourners for
people lost in a disastrous Boston nightclub fire some years ago, Dr. Lindemann
was able to note that the majority of people do their "grief work"
satisfactorily, on an instinctive basis, and recover their psychological and
physical equilibrium at the end of four to six weeks.
But a significant number
do not, and either immediately or later shows signs, sometimes extreme, of
psychiatric or psychosomatic illness. They are especially likely to develop
depressed mental states and peptic ulcers, ulcerative colitis, or other gastrointestinal
disorders.
Dr. Lindemann has not merely theorized that there is a
causative relationship between failure to go through a normal mourning process
and the later development of such illnesses. He has been able to demonstrate
that sometimes the illnesses can be brought under control by help- ing the
patients revive, months and years later, their bereaved feelings and at that
point do their previously undone grief work.
What constitutes a healthy
mourning reaction? Among the typical manifestations of a healthy reaction are a
temporary loss of interest in the usual daily affairs of life and work;
feelings of loneliness and mental pain; crying; breathing disturbances,
including frequent deep sighs; insomnia; appetite loss; and preoccupation with
many memories about the lost one. It appears that the normally bereaved person
actually loses interest in most phases of daily life in order to concentrate on
remembering how his life was influenced and enriched by the lost one.
It appears, too, that it is necessary for him to suffer
through, detail by detail, his loss, realizing it in terms of the role the lost
one played in various segments of his life. Only after he has gone through this
process can he truly return to emotional stability and normal activity. On the
other hand, unsuccessful mourners who later develop illnesses depart in one or
several ways from this process. Some throw them- selves into more business or
other activity than usual, trying in that fashion to escape the trials of
mourning. They do not cry. Some show a strange cheerfulness; others merely say
that they feel numb or empty.
