"Psychosomatics", Depression And Other Pathognomic Signs Of Complicated Grief

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

As noted in the previous post, grief is a natural reaction to a loss, experiencing which a person needs, in the main, the support of family and friends and their participation in recovery. However, the loss of a significant loved one is a particularly difficult experience that can take on the character of pathology. If this course is not corrected, then the result can be psychopathology, somatoform disorders and / or suicide. At the same time, timely recognition of complicated grief and the help of a specialist help transform them into normal reactions that find their resolution.

I'll start my description with reasons why grief can take a complicated path. Different situations have their own specific nuances, but more often the following ones draw attention to themselves:

1. Quarrels and conflicts with a loved one before his death.

2. Inability to say goodbye, attend a funeral, etc.

3. Broken promises to the deceased.

4. Taboo on the topic of death, a ban on grieving, hiding feelings, etc., especially often this contributes to the development of pathological reactions in children.

5. "The Unburied Dead" - missing persons, as well as loved ones who were not seen dead (for example, during a funeral with a closed coffin, or when the body cannot be identified).

6. Certain circumstances of death close (death from illness, violent death, the so-called "stupid death", etc.).

7. Suicide (along with the so-called "social bullying" when guilt is imposed directly or indirectly on loved ones; when the church makes it impossible to work through grief according to Orthodox rituals, etc.).

8. Depth psychotherapy (with an incorrect assessment of the state and incorrectly chosen tactics of psychotherapy, old psychotraumas come to the surface, and the mentally exhausted by grief cannot cope).

The more factors noted are superimposed and combined with each other, the higher the likelihood that mourning will go in a complicated or pathological way. In order to understand that this is happening, you need to pay attention to the following pathognomic (distinguishing pathology from the norm) signs:

1. Delaying the reaction … If a bereavement catches a person while solving some very important problems or if it is necessary for moral support of others, he may hardly or not at all discover his grief for a week or even much longer. Sometimes this delay can last for years, as evidenced by cases of recent bereavement patients grieving over people who died many years ago.

2. Hostility, changing relationships with others. The person is annoyed, does not want to be bothered, avoids the previous communication (social isolation arises), fears that he may cause the hostility of his friends with his critical attitude and loss of interest in them. It may be the case particularly violent hostility against certain persons, it is often referred to a doctor, judge, etc. Many patients, realizing that the feeling of hostility that has developed in them after the loss of a loved one is completely meaningless and greatly spoils their character, vigorously fight against this feeling and hide it as much as possible. For some of them, who managed to hide their hostility, feelings become as if "numb", and behavior - formal, which resembles a picture of schizophrenia.

3. Absorption in the image of the deceased. When the latent stage comes (after 1, 5-2 months), and the grieving person continues to talk only about the deceased, constantly visits the grave, builds everyday relationships with the photograph of the deceased (constantly communicates, consults, etc.). When the grieving person unconsciously begins to copy the departed (he dresses similarly or begins to do the things that the deceased was engaged in, and the grieving person himself had nothing to do with it, etc.). Also, when a person has died of some kind of illness, the grieving person may unknowingly display his last symptoms (psychosomatic conversion disorders).

4. Psychosomatic disorders and diseases. In the first time after the funeral, immunity decreases, the body weakens and new diseases that have arisen or exacerbated chronic ones are a normal reaction of the body to such a complex stress. However, in the later stages of mourning (after 3 months), psychosomatic illnesses indicate more that the experience is suppressed or repressed, not accepted and not worked through. As grief can be delayed, psychosomatic diseases associated with complicated grief can occur after half a year, one and a half, or even two years later. Very often, clients who apply for complex somatic diseases, diabetes mellitus, oncology, cardiovascular diseases, etc., have a history of complicated grief.

5. Depression … As noted, depression is not the norm for mourning. It can take different forms, the most common of which are:

- agitated depression … When a person is active, however, most of his actions are detrimental to his own economic and social status. Such people give away their property with inappropriate generosity, easily embark on rash financial adventures, commit a series of stupid things and end up without family, friends, social status or money as a result. This extended self-punishment does not seem to be associated with any particular sense of guilt. Eventually, it leads to a grief reaction that takes the form of agitated depression with tension, excitement, insomnia, feelings of inferiority, harsh self-accusations and a clear need for punishment. Such patients may attempt suicide. But even if they are not suicidal, they may have a strong desire for painful experiences.

- hypochondriacal depression. When the experience of grief begins to be accompanied by the certainty that the grieving person himself has gotten sick with something serious. He listens in the body to any unpleasant sensations and interprets them as a symptom. Looking for diseases with similar manifestations in reference books, the grieving person begins to "attack" various specialists, who, in turn, do not detect any diseases. In psychotherapeutic practice, widows are more often susceptible to such a case, who thus draw the attention of children or other relatives to the fact that "they are not in order", not in the somatic, but in the psychological sense, and vice versa. This is not a whim, as is commonly believed in society, but a psychosomatic disorder, which can be aggravated without timely correction.

- melancholic depression … When decisiveness and initiative are lost, and only joint activity is available to the grieving person, he alone cannot act. Nothing, as it seems to him, promises satisfaction, joy, rewards, only ordinary daily affairs are done, moreover, routinely and literally in steps, each of which requires great efforts from the grieving person and is devoid of any interest whatsoever for him. Physical weakness, excessive fatigue, and indifference to the future soon develop. Almost always, such people feel melancholy in their body, in the chest and abdomen, and express it with the phrases “melancholy presses,” “soul hurts,” “tears the soul apart from melancholy,” etc. A severe degree can be considered a situation when delirium, hallucinations appear.

- « anxious "depression … As a result of such conditions, the grieving person may become obsessed with "predicting and preventing" the death of someone close to him or his own. May refer to bad feelings, signs, bad dreams, etc. This type of depression is also considered suicidal, often leading to the development of various phobias, panic attacks, obsessive-compulsive disorders, etc.

6. Feelings of guilt. Both rational and irrational (illogical, unjustified) feelings of guilt have no therapeutic benefit. Even if the grieving person could in any way influence the outcome of the situation, the feeling of guilt interferes with the normal work of grief, and it should be worked out with a specialist. This is especially true when a person blames himself for the death of a loved one unfairly.

7. Mummification … One of the pathological forms of the emergence of the denial of death was called mummification by the English author Gorer. In such cases, the person keeps everything as it was with the deceased, ready at any time for his return. For example, parents keep the rooms of deceased children. This is normal, if it does not last long, this is the creation of a kind of "buffer" that should soften the most difficult stage of the experience and adaptation to the loss, but if this behavior stretches for months and even more years, the grief reaction stops and the person refuses to accept the changes that happened in his life, "keeping everything as it was" and not moving in his mourning.

The opposite pathological condition of mummification is manifested when people hastily remove all the personal belongings of the deceased, everything that can remind of him. Then the grieving person denies the significance of the loss. In this case, he says something like “we were not close”, “he was a bad father,” “I don’t miss him,” etc., or shows “selective forgetting”, losing something significant in his memory. concerning the deceased. Thus, the survivors protect themselves from facing the reality of loss and get stuck.

8. Spiritualism, occultism … Another pathognomic sign of avoiding the awareness of loss is the denial of the irreversibility of death. A variation of this behavior is passion for spiritualism. The irrational hope of reuniting with the deceased is normal in the first weeks after the loss, when the behavior is aimed at restoring the connection, but if it becomes chronic it is not normal.

The manifestation of all these signs after +/- 3 months after the loss attracts special attention.

All of these signs can be noted by people who are around the person experiencing loss.

If the reader himself is grieving, then it makes sense for you to seek advice from a psychologist-psychotherapist if:

• you have new somatic diseases or feelings that something is wrong with your body;
• your intense feelings or bodily sensations continue to overwhelm you;
• your feelings are unusual or even frightening to you;
• memories, dreams and images of the traumatic event continue to be forcibly embedded in your consciousness, making you feel frightened and deprived of peace;
• you cannot find relief for your stress, confusion, feeling of emptiness or exhaustion;
• your attitude to work has changed;
• you must restrain your activity to avoid a hard feeling;
• you have nightmares or insomnia;
• you cannot control your anger;
• you have problems with appetite (you are eating too much or too little);
• you do not have a person or group with whom you could share and open your feelings, others do not allow you to cry and all the time they say “stop suffering, you have to live on”, “pull yourself together”, etc.;
• your relationship has deteriorated greatly, or the people around you say that you have changed;
• you find that you are more likely to experience accidents;
• you find that your usual habits have changed for the worse;
• you noticed that you began to take more medicines, alcohol, smoke more cigarettes;
• you cannot accept the fact of loss, you do not understand how it is to “let go” of the deceased;
• life has lost all meaning and all prospects seem far-fetched and stupid;
• you have fears, obsessive thoughts, it often seems to you that you have seen or heard the deceased;
• you constantly ask yourself questions that you cannot find answers to, you do not understand what is normal in your feelings and behavior, and what is not.