Psychotherapy of pathologic grief. Revisions and limitations.
A significant minority (14 per cent) of a nonpatient bereaved population may be presumed to develop intense and enduring pathologic grief responses. The promise of recovery with short-term, focused intervention appears to be misleading, as a sizable proportion of patients with pathologic grief will be unresponsive to treatment. Prospective studies have demonstrated a positive correlation of dependent attachment, conflicted attachment, and unexpected loss with specific pathologic grief syndromes; preliminary reports suggest that these specific grief syndromes require specific interventions. The presentation of a nonresponsive case illustrates the clinical application and limitation of a revised strategy of treatment. The development and maintenance of formative imagery and symbols is of crucial support to the patient and therapist.
Section of Psychiatry, Virginia Mason Clinic.
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Rynearson
D003220:Conflict, Psychological; D003419:Crisis Intervention; D003858:Dependency, Psychological; D004213:Dissociative Disorders / Q000523:psychology; D005260:Female; D006117:Grief; D006801:Humans; D007092:Imagination; D008960:Models, Psychological; D009769:Object Attachment; D011613:Psychotherapy / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D014956:Writing