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February 11 - February 14, 2024
disordered grieving has developed a few different names, including complicated grief and prolonged grief disorder.
traumatic grief has come to mean the grief after a traumatic death; the term traumatic focuses the emphasis on surviving a death that is sudden or violent.
Characteristic symptoms include intense yearning, or preoccupying thoughts of the deceased, on a daily basis. Among other symptoms, there is intense emotional pain, a feeling of disbelief or an inability to accept the loss, difficulty engaging in activities or making plans, and a feeling that part of oneself has been lost.
anyone’s life is forever changed because of loss, even when they have adjusted well.
severe, prolonged experience that results from complications in grieving after a death.
many bereaved people complain of difficulty concentrating.
bereavement alone does not affect cognitive capacity.
Those with complicated grief had slightly lower overall cognitive functioning and poorer information processing speed.
loss is a normal life event to which the majority of people adjust without lasting deficits.
for older adults, people with mild cognitive impairments are more likely to have more severe grief reactions when their loved ones die. This mild cognitive impairment makes them more vulnerable to suffering from complicated grief.
Even if mild cognitive deficits are a risk factor for complicated grief, the decline over time is very likely to be an interaction of the aging brain and the stressful bereavement event.
If the prolonged grief remits, then the cognitive difficulties may resolve as well.
many people feel that being stuck in grief is their own fault.
“I think he loved me too much to die while I was in the hospital room,”
murky boundary between disordered grieving and the universal human pain of loss,
grieving does take time, and restoring a meaningful life takes time, in the most normal and natural cases.
the extraordinary stress of grieving feels particularly awful because they are facing it without the one person they would usually turn to in difficult times.
people are at increased risk of early death if they are socially isolated.
We would describe hunger and thirst as motivational states that cause us to seek out food and water, but we would never say that someone is addicted to water.
Encoding someone means that yearning is the inevitable result of separation from them. Our brain is doing everything in its power to keep us united with the ones we love.
Depression is a more global experience, a hopeless and helpless feeling that attaches itself to everything that is happening and has ever happened and ever will happen.
intrusive thoughts are both common and disruptive in the early weeks and months after the event. Part of what is so upsetting about them is that they feel involuntary.
intrusive thoughts are normal, and almost always decline over time,
Although the involuntary memories are more upsetting, they are not actually more frequent than voluntary ones. Recalling memories of both types is more common after a stressful life event than when life is smooth sailing.
Most of the time, and especially in acute grief, intrusive thoughts are simply what the brain does naturally, in order to learn from these important, emotional events.
your brain is bringing them up in order to try to understand what happened, in the same way that you may share memories and stories with friends to talk them through and gain a deeper understanding.
Our brain is constantly generating reminders. It is an organ built to manufacture thoughts the way the pancreas manufactures insulin.
You get reminders because these people are important to us. That does not change right away because the person has died. Your brain has to catch up.
At its most basic, yearning is wanting the person to be here again now.
healthy grieving includes many different responses, appropriate in different situations, at different times, and to achieve different goals.
What is important is the benefit of having many ways of responding to yearning that fit the situation and forward your goals, both at that moment and in the longer picture of adaptation.
The frequency and intensity of people’s feelings typically increase after a loss, like turning up the volume dial.
The most reliable predictor of good mental health is having a large toolkit of strategies to deal with one’s emotions and deploying the right strategy at the right time.
Distraction and denial have their usefulness.
For those of us suffering from complicated grief, it can be more challenging to moderate the expression of our feelings than for those people who are adapting more resiliently.
flexibility in our approach and openness to dealing with feelings as they arise give us the best opportunity to regulate our emotions in a way that allows us to live a vibrant and meaningful life.
Ironically, engaging in activities that typically raise positive emotions, such as going to a party or watching some form of entertainment, are actually more effective at reducing sadness and grief.
Positive emotions broaden people’s attention, encourage creative thinking,
Although engaging in activities that usually lift our mood is effective, bereaved people are often reluctant to engage in them.
humans are pretty bad forecasters of how they will feel in future situations.
Psychologists call our thoughts about what could have happened counterfactual thinking. Counterfactual thinking often involves our real or imagined role in contributing to the death or the suffering of our loved one.
Rumination focuses on things that have happened in the past, like ruminating over something we did wrong, or about how someone treated us. Worry focuses on events in the future, our anxious thoughts about worst-case scenarios.
Reflection is an intentional turning inward, engaging in problem solving in order to alleviate your feelings.
Brooding is finding yourself thinking about your mood even though you did not set out to think about it, and persisting in these thoughts even when you try to stop thinking about it.
women tend to ruminate more than men, and women also have higher levels of depression.
Seeking an answer might precede solving a problem, but feeling better usually requires getting to the solving part.
Feeling better requires stopping the seeking, or ruminating, or worrying, at some point.
I learned that I was most successful at helping her feel better, at least momentarily, when I would say whatever she needed to hear or do what she wanted me to. This often meant I had to ignore what I thought or needed. The pattern of believing I should help her feel better at any cost became a well-worn groove.
The mind ruminates when it cannot resolve the discrepancy between its current state, such as feeling down, and its desired state, such as feeling happy or content.
Rumination predicts depression, and grief-related rumination predicts complicated grief.
