Loss, Grief, and Bereavement (cont.)
Roxanne Dryden-Edwards, MD
Roxanne Dryden-Edwards, MD
Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
How is grief assessed?
Although practitioners sometimes use paper and pencil tests to determine if a person is suffering from grief, the assessment is usually made by the health-care professional asking questions to assess what symptoms an individual is suffering from, then considering whether he or she is suffering from normal grief, complicated grief, or some other issue. Those questions tend to explore whether there are emotional, physical, and/or social symptoms of grief, and if so, how severe and how long the symptoms have been present. The practitioner may also try to determine what stages of the grief process the person has experienced and what stage currently dominates their feelings at the time of the assessment.
How can people cope with grief?
There remains some controversy about how to best help people survive the loss of a loved one. While many forms of support are available and do help certain individuals, little scientific research has shown clear benefits for any particular approach for grief reactions in general. That is thought to be because each approach to support is so different that it is hard to scientifically compare one to another, intervention procedures are not consistently reported in publications, and the ways these interventions have been studied are flawed. Although there has been some concern that grief counseling for uncomplicated grief sufferers works against bereavement recovery, there is research to the contrary. One approach to treating grief is the dual process model, which endorses the bereavement process as being the dynamic struggle between the pain of the death of the loved one (loss-oriented) and recovery (restoration-oriented). This model of treatment recommends that bereaved individuals alternate between directly working on their loss (confrontation) and taking a break from (avoidance) that process when appropriate. For couples who are grieving the occurrence of a miscarriage, brief professional counseling has been found to be helpful.
Quite valuable tips for journaling as an effective way of managing bereavement rather than just stirring up painful feelings are provided by the Center for Journal Therapy. While encouraging those who choose to write a journal to apply no strict rules to the process, some of the ideas encouraged include limiting the time journaling to 15 minutes per day or less to decrease the likelihood of worsening grief, writing how one imagines his or her life will be a year from the date of the loss, and clearly identifying feelings to allow for easier tracking of the individual's grieving process.
To help children and adolescents cope emotionally with the death of a friend or family member, it is important to ensure they receive consistent caretaking and frequent interaction with supportive adults. For children of school age and older, appropriate participation in school, social, and extracurricular activities is necessary to a successful resolution of grief. For adolescents, maintaining positive relationships with peers becomes important in helping teens figure out how to deal with grief. Depending on the adolescent, they even may find interactions with peers and family more helpful than formal sources of support like their school counselor. All children and teens can benefit from being reassured that they did not cause their loved one to die, and such reassurance can go a long way toward lessening the developmentally appropriate tendency children and adolescents have for blaming themselves and any angry feelings they may have harbored against their lost loved one for the death.
Effective coping tips for grieving are nearly as different and numerous as there are bereaved individuals. The bereaved individual's caring for him/herself through continuing nutritious and regular eating habits, getting extra rest, and communicating with surviving friends and families are some ways for grief sufferers to ease the grief process. The use of supportive structure can also go a long way to helping the aggrieved individual come to terms with their loss. Anything from reciting comforting prayers or affirmations, to returning to established meal and bedtimes, can help grieving individuals regain a sense of normalcy in their lives. As death involves the loss of an imperfect relationship involving imperfect individuals, forgiveness of the faults of the lost loved one can go a long way toward healing for the bereaved. While the painful aspects of dealing with death are clear, bereavement sometimes also leads to enhanced personal development.
Reviewed by Melissa Conrad Stöppler, MD on 8/23/2012