Although human beings, along
with other social animals, tend to cry and to search when separated from those
they love, the expression of grief following a permanent loss is very variable
being influenced by learning from early childhood. Hence there is no blueprint
for grief and the concept of "normal grief" needs to be considered
in the light of demographic and cultural variables.
Key points:
Most bereaved people
oscillate between episodes of intense pining for the lost person (loss
orientation) and relatively calm periods during which they can plan
and carry out forward-looking activities (restoration orientation).
Problems arise if either of these activities is carried out to the exclusion
of the other (Stroebe
2001a).
Feelings of anxiety,
tension, anger and self-reproach commonly occur (Parkes
1996). In the course of the first year of bereavement the intensity
of distress usually declines steadily but thereafter any further decline
is much more gradual. It is difficult to estimate time range
of bereavement symptoms because there are so many aspects to grief,
some of which are "permanent"
(e.g. "He lives on in my memory" and others less so. Thus, following
the death of a spouse, the loss of appetite seldom lasts more than a month
and, by the end of the first year, weight gain is more likely to
be a problem than weight loss. The first year is usually the worst
and there are likely to be several "turning points" in
the course of the second, when people realize that new directions are
emerging and they can relish life again.
Most often the experience
of bereavement eventually leaves people more mature, confident and sympathetic
to the suffering of others.
Many bereaved people
cherish their memories of the dead person who is often felt to be near
at hand and may even be perceived as a transient ("hypnagogic")
hallucination or illusion. These phenomena usually provide comfort and
should not be seen as "denial" or indicating a need for psychiatric
help. The hypnagogic hallucinations may persist indefinitely. They are
distinguished from psychotic hallucinations by their transience, they
disappear when people
"wake up".
