Psychology of complicated grief

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In clinical practice complicated grief, an ongoing problem in coming to terms with loss, is a familiar issue.

Clinical indicators of complicated mourning

Theresa A. Rando in Treatment of Complicated Mourning outlined the following features:

• A pattern of vulnerability to, or over-reaction to, experiences entailing loss and separation. *Psychological and behavioural restlessness, over-sensitivity, arousal, overreactivity, along with the need always to be occupied, as if cessation of movement would allow the surfacing of anxiety-provoking repressed or suppressed memories.
• Unusually high death anxiety focusing on the self or loved ones.
• Excessive and persistent over-idealisation of the deceased and/or unrealistically positive recollections of the relationship.
• Rigid, compulsive or ritualistic behaviour sufficient to impinge on the mourners freedom and well being.
• Persistent and obsessive thoughts and preoccupation with the deceased and elements of the loss.
• Inability to experience the various emotional reactions to loss typically found in the bereaved and/or uncharacteristically constricted affect.
• Inability to articulate existing feelings and thoughts about the deceased and the loss.
• Relationships with others marked by fear of intimacy and other indicators of avoidance of future loss.
• A pattern of self-destructive relationships commencing or escalating subsequent toithe death, including compulsive care-giving and replacement relationships.
• The commwicement or escalation after the death of self-defeating, self-destructive or acting-out behaviour including substance dependence or abuse.
• Chronic experiences of numbness, alienation, depersonalisation or other emotions that,isolate the mourner from him/herself and others.
• Chronic anger or some variation thereof (eg annoyance) or a combination of anger and depression (eg irritability, belligerence, intolerance).

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See also

• Guided mourning
• Grief therapy
• Grief counselling

Key texts

Books

• [[Rando, T.A. (1993)Treatment of Complicated Mourning. Research Press ISBN-10: 0878223290

• Worden, J.W. (2001)Grief Counseling and Grief Therapy: A Handbook for the Mental Health Professional. Springer. ISBN-10: 0826141625

Additional material

Papers

• Google Scholar