Why Are Some Deaths Particularly Difficult

Published Date: 02 Nov 2017

In this essay I will be giving an overview of what complicated grief and special deaths are. This will explain as to what makes a death complicated or special. Grief can affect people in many ways and can differ from person to person depending on their race, culture, religion and background and dependent on the relationships that they have with each other. Some deaths are particularly difficult to grieve, especially the death of a child. Their feelings can be of guilt, regret, anger, whereas some may feel the sense of relief and liberation especially if the child has been suffering or had a long term illness. Lastly, I would like to discuss how the death of a child can cause complicated grief and how I am able to help.

Grief is an emotional suffering that an individual feels when they have lost someone or something that they love (Smith, 2012). Grief is familiar to most people and loss varies throughout our lives whether it is at the end of a relationship, ill health or unemployment (America, 2012). Every step of the grieving process is natural and it can only become unhealthy if for a long period of time they can get ‘stuck’. This can become dangerous and destructive. Grieving is not the same for everyone but acceptance of the loss is important to moving forward (McDonald, 1985).

Losing someone you love can be upsetting and everybody will experience grief. Most people will bereave and will have that feeling of numbness, anger and guilt. As the loss becomes accepted, it is then possible to move forward (Complicated Grief, 2011). It is normal to feel distressed and have that feeling of loss resulting through bereavement. Most people show similar patterns of grieving which include distress, anxiety, sadness and yearning. The duration and how the grief is expressed should settle over time and able to move on (Christ et al, 2003). It is normal to suffer these symptoms when you have suffered a loss.

Elizabeth Kubler-Ross summarised the Five Stages of Grief which help people to understand the stages of the grieving process. The five stages identified are;

Denial

Anger

Bargaining

Depression

Acceptance

People do not necessarily go through these five stages in order. Our relationships, life experiences and personal circumstances are all different which means our coping mechanisms will be different in dealing with the death of a loved one (Kubler-Ross & Kessler, 2005).

If the symptoms linger the condition then becomes complicated grief or Prolonged Grief Disorder (PGD). This is when the symptoms of grief become unresolved and continues for months. People who suffer from complicated grief find it difficult to accept the reality and suffer intense emotions regarding the death of the loved one. Your thoughts can be preoccupied by the death which may include intrusive thoughts. Denial of the death and imagining the dead person is still alive, hopelessness, anger and wanting to die are the most characteristics symptoms when suffering complicated grief. People will often avoid situations or activities as this can be a painful reminder of the loss.

Risk factors

By Mayo Clinic staff

While it's not known specifically what causes complicated grief, researchers continue to learn more about the factors that may increase the risk of developing it. These risk factors may include:

An unexpected or violent death

Suicide of a loved one

Lack of a support system or friendships

Traumatic childhood experiences, such as abuse or neglect

Childhood separation anxiety

Close or dependent relationship to the deceased person

Being unprepared for the death

Lack of resilience or adaptability to life changes

Evidence suggests that most bereaved cope well with major loss and are resilient (Bonanno, 2004). It is estimated that between 10 and 20% of bereaved people experience complicated grief and adults who suffer the loss of a spouse or child have a higher risk of complicated grief (Middleton et al, 1996) and their quality of lives are impaired when many experience the grieving process intensely (Bonanno et al, 2004). This then can affect their mental and physical health in the long term (Ott, 2003; Parkes, 1996; Prigerson & Jacobs, 2001).

There has been a proposed change to the DSM-V which will set out a new boundary of the normality of grief or a mental disorder. Many people will be mistakenly mislabelled as having a psychiatric problem, rather than them experiencing what is normal grief. If after losing a child you lose your appetite, can’t sleep, have no energy, and have less interest in doing things, which include not wanting to go to work. The DSM-V criteria suggests that to be diagnosed with prolonged grief disorder, the bereaved person must have the yearning and pining feeling for the deceased and must be persistent throughout. The DSM-V also requires that four of the eight symptoms, which are;

Trouble accepting the death.

The inability to trust others since the death.

Excessive bitterness related to the death.

Feeling uneasy about moving on.

Detachment from formally close others.

Feeling how life is meaningless.

Feeling the future has no prospect for fulfilment without the deceased.

Feeling agitated since the death.

These need to be experienced more than once and needs to be endured by the bereaved person for at least six months. The DSM-V could diagnose your condition as a major depressive disorder (Frances, 2010).

Understanding complicated grief it is important to have an understanding as to how the symptoms will differ from the normal grieving process. The Mayo Clinic states that the feeling of loss is evident in normal grief. However when the feelings become incapacitating and continues as time passes, then this becomes complicated grief. The signs of complicated grief may include feelings, thoughts, responses and their general health. Longing or pining of the deceased, numbness or detachment and problems with accepting the death (Mayo Clinic, 2011). These symptoms become complicated because of the continuum, regardless of the length of time. The symptoms seen in complicated grief, when combined together can be found in the symptoms of separation as well as traumatic distress (Mayo Clinic, 2011).

Referances

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