Mourning and Grief as Healing Processes in Psychotherapy

Abstract

The argument developed in this paper can be outlined as follows: relationships are vital for growth, for adults and especially for children; to ensure that we work to maintain relationships, evolution provided for pain on separation, which stimulates behaviours designed to restore the relationship. If the separation is permanent, it is necessary to form other relationships. This requires modifying the attachment to the lost object, a process which involves unlearning of emotional bonds and then learning new bonds to new objects. The process of mourning and the affective state of grief, I believe, assist in this unlearning and new learning. The stages of mourning involve cognitive learning of the reality of the loss; behaviours associated with mourning, such as searching, embody unlearning by extinction; finally, physiological concomitants of grief may influence unlearning by direct effects on neurotransmitters or neurohormones, such as cortisol, ACTH, or norepinephrine. Besides losses occasioned by bereavement, life and normal development include many other kinds of losses. Mourning for these losses is as necessary as mourning after a death. Failure to adequately mourn can result in psychopathology or psychosomatic illness. In comparison, appropriate mourning is adaptive, and parallels can be drawn between it and healing in psychotherapy. The psychoanalytic and psychotherapeutic literature supports the notion that mourning and grief in therapy act to heal. Given that there may be a biological basis for this healing through the effects of mourning on learning, psychotherapists might actively seek to encourage identification of losses and their adequate mourning in therapy. Various approaches are discussed. Two case reports of mourning occurring in psychotherapy are given, followed by suggestions for research.

Grieving, Mourning, and Healing Following Youth Suicide: A Focus on Health and Well Being in Families

“…Interestingly, a connection between grieving, mourning, and healing has been documented in the literature. Grieving and mourning have been viewed as healing and adaptive processes integral to psychotherapy (Olders, 1989).…”

No such thing as 'uncomplicated bereavement' for patients in rehabilitation

“…2, 13, 24, 25, 31 ± 33, 36, 45, 94 For example, eOE ects on the bereaved person' s immune system 2,5,8,25,26,31 may render them more vulnerable to illness. Physiological changes during grieving may have direct eOE ects on neurotransmitters or neurohormones such as cortisol, ACTH and norepinephrine which, on a positive note, also in¯uence learning and thus may facilitate improvement of functioning after losses.…”

“…Shukla 49,50 and, subsequently, Parkes 14 observed that patients undergoing amputations experienced symptoms and phases similar to those observed with widowers and widows. Olders 26 believes that losses other than those through death, losses such as those experienced during the normal course of life and development, must also be mourned to maintain mental health. In the area of rehabilitation counselling, several theorists 20, 51, 52 purport that working through stages, similar to those set forth in bereavement models, is essential for facilitation of adjustment to disability and thus to overall successful rehabilitation eOE orts.…”

“…Physiological changes during grieving may have direct eOE ects on neurotransmitters or neurohormones such as cortisol, ACTH and norepinephrine which, on a positive note, also in¯uence learning and thus may facilitate improvement of functioning after losses. 26 Elderly men, in particular, have been observed by providers who help bereaved individuals to increase their use and abuse of substances following the death of a signi® cant other. 35,36,94 Approximately 10% of bereaved individuals have been noted to eventually develop a full clinical depression.…”

What Do You Say Before You Say Good-Bye? The Psychotherapy of Grief

“…The literature on the psychotherapy of grief, mourning, and bereavement is replete with articles that address various stages of grieving (Axelrod, 2006; Friedman, 2009; Kübler-Ross, 1969), complications in the natural process of grieving (Bowlby, 1980; Wetherell, 2012), the treatment of despair and anger (Greenwald, 2013), grieving as an attachment disruption (Parkes, 1972), how grieving may potentiate other mental health issues (Greenwald, 2013), various treatment models (A. Clark, 2004; Hensley, 2006), and the need for supportive relationships in the family and community and in therapy (Olders, 1989). In general, authors have tended to focus the treatment of grief on accepting the loss, understanding the necessity for supportive and caring relationships, providing a suitable amount of time for healing from the loss, and developing new interests and activities (Wetherell, 2012).…”