Therapy For Pathological Grief: How To Say “goodbye “

Losing a loved one is extremely difficult. It affects us all at some point, but not all people have the same resources or tools to deal with it. Sometimes this process becomes a chronic, serious problem – pathological grief.

Researchers estimate that this type of chronic problem occurs in 10-20% of cases when a person mourns. For these cases, there are different techniques, supported by different studies, that can help us break free.

Among them, we will talk about directed grief. Before we begin, however, we must distinguish between normal grief and pathological grief. This is our question: to what extent is suffering normal?

Grief is a set of reactions that occur on a physical, emotional and social level. They are triggered by a great loss, in our case the death of a close relative. The symptoms can vary in intensity and duration, and in some cases last a lifetime. In any case, remember that it is an adaptive (good) reaction.

Sadness, sadness and anxiety are the most common emotions, in that order. Fear of being alone is also common. We can also feel guilty and become uninterested in our surroundings.

These symptoms are normal, but they should go away within six months to a year.

When the emotional reactions are much stronger, they can make life difficult. And if they last for over a year, you may suffer from pathological grief.

In these cases, unusual symptoms of grief appear, such as hallucinations and suicidal thoughts. Pathological grief is often complicated and can give rise to other behaviors, including social isolation, personal neglect or substance abuse. That is when we should consider grief therapy and professional help.

Experts use both individual therapy and group therapy to treat pathological grief. In some cases, it is effective to use both. The treatment is about giving people tools while offering them social support to end the isolation.

The main goal of grief therapy is not to forget the deceased, but to transform the grief process so that the memory of the person does not create a blockage. Therefore, the fundamental goals of this therapy are:

• Enables the expression of feelings and experiences in connection with the deceased. Usually the person has not put into words how he feels or thinks. This makes it difficult to recover from the loss.
• Discuss the circumstances that led to the death. Depending on the type of death that has occurred (suicide, sudden accident, terrorist attack, etc.) the grief can be more painful. Talk about promoting assimilation and acceptance.

• Center the therapy around solving daily problems and adapting to daily life. Small daily steps can have great results.
• Project the patient into the future and include gradually fulfilling activities in his routine. This will make the patient feel that things are good after all.

Psychologists use this type of therapy with people who experience pathological grief as well as avoidant behavior, emotional blockages, nightmares or intrusive thoughts.

In these cases, targeted grief may work. It consists of exposing the person to memories associated with the deceased, especially shared experiences.

For example, therapists often instruct their patients to read old letters or look at photo albums. No matter how it goes, the goal is to break this disturbing, emotional inhibition.

The underlying mechanism that makes this type of therapy work is the weakening of the shaped emotional response (grief) through repeated presentation of the stimuli that generate this response. We thus repeatedly expose the patient to what generates the grief, whereupon the feeling weakens.

Repeated exposure can also be done with behaviors that the patient used to like, but no longer because they lead to memories of the deceased.

For example: going to the cinema, traveling, eating out, etc. In these cases, the satisfaction from the activities will serve as an underlying mechanism for the therapy.

How do we know that the therapy has worked? What behaviors establish that we have recovered from pathological grief? Here is a series of indicators or signals of recovery:

• The person has regained normal biological aspects, such as appetite and sleep.
• Verbal expressions of emotion, such as smiles and hugs, reappear.
• The person has started doing enjoyable things again, resumes his social life and even participates in volunteer activities to help others.
• The memory of the deceased is already integrated as part of the individual’s personal history. It no longer triggers strong negative emotions. The person remembers the positive experiences he shared with the deceased.
• The person enjoys daily life and sets goals for the future.

In short, grief is a normal process that requires personal growth, and which is not always easy to get through. However, knowing what pathological grief is and knowing its treatment methods can help us identify and confront the last goodbye.

Furthermore, it can help motivate us to seek professional help when we need it.