Psychology: seven percent of all mourners grieve pathologically

Grief is a complex emotion that is still largely unexplored

I n autumn, hearts become heavy. For many people who have lost someone close to them, grief reawakens during the dark season of the year. This can be healing for the soul, but it does not have to be. Because mourners often fail because of false expectations. They also often get advice from friends and acquaintances that is not very helpful. "You have to allow the pain," he said, or "Now it’s about time to get back to life."

Grief as an important human emotion is not very well researched. The image of this emotion is still based in part on assumptions made by Sigmund Freud some 100 years ago. Scientists are now trying to learn more about grief. They have already been able to show how common pathological grief is and what happens in the brains of those affected by it.

The well-intentioned advice suggests that there is a right and a wrong way to grieve. In doing so, they sometimes even cause feelings of guilt among survivors. "If you don’t know anything about mourning processes, you have no idea of how mourners feel in their world," explains Uta Schmidt of the Bundesverband Trauerbegleitung (Federal Association of Bereavement Support).

After a death, the pressure of suffering of the bereaved is often great, their pain can hardly be described in words. Deep grief and longing, anger, despair, feelings of guilt, bitterness or fear of being alone – all of these can drive them around.

Physical problems as a consequence of grief

Triggers for such feelings lurk everywhere: "The empty bed and the empty chair constantly point to what is not coming back," explains Schmidt, who works as a grief counselor in Linz am Rhein in Rhineland-Palatinate. Some mourners feel the loss so strongly that they feel "as if they had been amputated". In addition, there are often physical problems such as loss of appetite, palpitations or insomnia.

"People who are grieving often come to me because they’re afraid they’re going crazy," Schmidt says. The grief counselor then explains that this feeling is normal. Behind this is often not only their own emotional chaos, but also a strange idea of grief in society.

This goes back significantly to Sigmund Freud. The founder of psychoanalysis wrote almost 100 years ago in his work "Mourning and Melancholy" (1917) that those affected must actively work on themselves by thinking intensively about the deceased as well as the common relationship. You should, Freud advised, consciously seek out and live through the pain.

Those who show little emotion do not necessarily grieve less

The converse of this: Those who do not deal with the loss enough and show too little emotion, repress – and run the risk of being caught up again by the events with greater force. Or the lack of grief reveals that something is wrong with the relationship or the person themselves. Ultimately, Freud believed, only a decisive turning away from the deceased would lead to a return to normality.

"The psychoanalyst himself suspected that his thesis could be wrong after he had to cope with his own losses," says loss researcher Kathrin Boerner of the University of Massachusetts in Boston. The experience of many survivors also shows the opposite: they do not completely detach themselves from the deceased, but even after many years they still think back to him and maintain rituals to feel close to him.

Only the space that this commemoration occupies in relation to everyday life dwindles with time. Grief is not a clearly definable phase that you get over, it has no clear end, says Boerner: "The bond changes, but there is a continuing inner connection that is very important to many people."

Grief is not a pathological process

In fact, many experts now believe that those people whose thoughts constantly revolve around the deceased are more at risk of not finding a way out of their emotional state of emergency. In the worst case the mourning becomes pathological, i.e. pathological. But even though an emotional roller coaster may fuel concerns about one’s mental health, most of the time, grief is not a pathological process at all, but a normal reaction. "It’s the flip side of attachment," explains psychosomatics expert Anette Kersting of Leipzig University Hospital.

But when is the concern for one’s own condition justified?? The decisive factor is that grief still severely restricts a person in everyday life after a long period of time – Kersting speaks of 14 months. According to a study by Kersting, about seven percent of mourners are affected by this pathological form; other estimates speak of ten to 20 percent.

But it is not only the duration that is decisive, believes Boerner: "These people actually grieve differently from the beginning," she emphasizes. Typical for the pathological form is that on the one hand they constantly deal with the grief, but on the other hand they try to avoid the pain. For example, if mourners shun many things they used to do with the deceased – such as going for walks. They wall themselves in with their grief and no longer manage to turn back to life on their own.

Proper processing

Several factors play a role in processing a loss: the circumstances of the death, the nature of the relationship with the deceased, age and gender, and one’s own personality. "There’s one factor in particular that comes into play, and that’s prior psychological difficulties," Boerner notes. People who were already unstable can therefore cope particularly badly with a loss.

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