The Grief Period and Its Application to Counseling

An understanding of the nature and duration of grief is a good counseling tool.

ROBERT L. MARSH, M.D., Glendale, California

GRIEF might be defined as an emotional-psychological readjustment occurring after any of a variety of major losses to the wholeness of the personality. The feeling of security has been unbalanced.

The commonest cause of grief is the loss of a significant, usually loved person by death, rejection, or hopeless separation. The greater the attachment, the deeper the grief, for a larger part of the personality has been involved. It can also occur after significant physical loss, such as health, ap­pearance, a limb, an eye or vision, a breast, facial features, and sometimes the gonads. Yet what happens within the psyche is so often much more important than what happens to us.

An understanding of the nature and duration of grief can be a very useful coun­seling tool.

The psychologic aberrations of a griev­ing person may include emotional instabil­ity, nervous tension, and a yearning preoc­cupation with the separatee, the lost part, object, or person.

Manifested physical symptoms are most commonly related to respiration and di­gestion, and include tightness in the throat, sighing, "shortness of breath," weakness, dry mouth, empty feeling in the stomach.

Normal grief may be a four-stage proc­ess:

  1. Recognition and acceptance of the loss with feelings of loneliness.
  2. Recall of the lost object's positive as­pects with feelings of love, respect, de­pendence, et cetera.
  3. Recall of the negative aspects with feelings of resentment, anger, et cet­era, and their physical equivalents.
  4. A working through of associated guilt feelings, particularly to number 5, and in reaction to the anger aroused by the frustration of the whole proc­ess.

DURATION: Normally after the loss of a significant loved person, grief persists for six to twelve months approximately. This seems to be roughly the predictable built-in time schedule in our society. Grief is increased in intensity and duration if associated with remorse. Its duration is de­creased by "grief work," which is basically the psychologic exercise of running through the emotional reactions, freely dis­cussing and understanding all the aspects of the loss, both positive and negative sides. Guilty feelings may actually come out as "if only" statements of hostility against others close to the situation.

ABNORMAL GRIEF: Normally the griev­ing person anticipates recovery from the tribulation. Thus, grief is dissimilar from depression, wherein the diagnostic hall­mark is hopelessness and inability to see any end or improvement in the future. In grief, the world seems empty; in melan­cholia or depression, the person feels empty.

Pathological depression is an extension or arrest of any of the aforementioned states. It is chronic and exaggerated in na­ture as compared to grief. Patients have particular difficulty with stages 3 and 4. Depression may be seen as the turning of the negative feelings toward oneself con­sciously or unconsciously, instead of "work­ing it through." The counselor should be able to suspect excessive reaction or dura­tion and seek consultation.

OTHER GRIEFLIKE STATES: Loss of self-respect by guilt after violation of one's own conscience can cause very painful loss of ego and may result in consuming anxiety. A grieffike state may develop in a person expecting to lose his or her own life. The grief period can also occur after the loss of money, treasure, or security. It even occurs by loss of something that the person is bet­ter oil without, such as dependency upon dominating persons, rejection of an uncon­scionable relationship, or loss of a bad habit, such as alcoholism. In the latter cases, of course, the person is actually achieving freedom from the bad situation rather than a true loss. An individual may go through a period of grief from the loss of a situation that temptation has taught him to regard as desirable—and yet a situ­ation that he would be better off without.

Such persons should be encouraged that they are actually achieving a new freedom and that they must maintain the new sta­tus until the "grief-time" period has elapsed (six to twenty-four months, de­pending on many individual factors). By that time it might be likely that the per­sonality has achieved some equilibrium in the new state that is less emotionally labile. The person will not be recurringly preoc­cupied with yearning thoughts about the "lost desire."

A MESSAGE OF HOPE: One of the major themes of the Scriptures is that men can change, i.e., be converted. A review of many of the Biblical stories of changed lives reveals that the change occurred during what might be termed a period of grief over guilt. It follows, therefore, that major changes in a person's life (i.e., "conver­sion") occur usually after conviction of sin, a guilt period, and "grief" over loss of self-esteem.

CONCLUSION: To a counselor, the under­standing and application of the grief-time­period principle from any causes should be recognized as useful. During this period of readjustment and restabilizing of the per­sonality, a "growing edge" is raw, sensitive, and more malleable. There is opportunity for improvement if the individual can res­olutely make decisions to establish new pat­terns of thought, conduct, and habits. Dur­ing this time, therefore, there may occur golden opportunities for change that are less available when the personality is in a state of more equilibrium. Counselors may find these principles useful in cases of guilt, and of marital discord, as well as in be­reavement.

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ROBERT L. MARSH, M.D., Glendale, California

December 1967

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