Grief is not essentially classified medically as a mental illness, however the symptoms are similar to depression. Although there is currently an exemption for bereavement in the diagnostic criteria that allows for such symptoms to persist for up to two months after the death of a loved one, more than two months of persistent and pervasive depressive symptoms maybe diagnosed as a major depressive disorder (MDD) in the context of bereavement. These symptoms may include a depressed mood, anxiety and sadness, lack of interest in re-engaging in the world or of forming new relationships. This exemption acknowledges that while grieving can look and feel virtually identical to depression, it is also recognised that it is not depression, as we know it. The new version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) will remove the bereavement exemption from the diagnostic criteria and the very appropriate reaction to the death of a loved one described above may be diagnosed as MDD. Grief is a natural and emotional response evoked by significant loss, especially when it entails suffering from the loss of a loved one. A grieving client enters therapy with the expectation of finding meaning in and understanding of how to overcome their emotional distress, interpersonal conflicts and the pain they may be experiencing. Different approaches to therapy may angle this task differently, for example, changing self-defeating thinking patterns in cognitive behaviour therapy or interpreting historical mal-adaptive patterns as in transactional therapy. The two approaches I have chosen for the purpose of this assignment are Existential Therapy and Group Therapy. Introduction
To understand loss we need to understand attachment. John Bowlby, the father of the Bowlby Attachment Theory, found that without attachment to a significant other person, usually the parent, a child’s emotional growth will be impaired and he or she may experience severe difficulty in relating to others in a positive way (Bowlby, 1980). In his research, Bowlby studied the impact of separation and the fear and anxiety caused in such a situation. He noted the emotions of mourning that accompanied such loss: sadness, anxiety, protest and grief. In the normal course of events, because she is looked after, the child learns to trust her primary care giver. She then grows to trust and empathise with her siblings and immediate family. This develops to attachment with others such as friends, their partner and, perhaps one-day, her own children. When a primary attachment is ended through separation or death, grieving takes place (Bowlby, 1980). This theory suggests that whether an individual reacts either in a healthy or problematic expression of grief following a separation would depend on the course of development of their attachment system. Grief
The essence of grief is a dynamic and evolving process, the dimensions and intensity of which change over time. It is a natural and expectable reaction in any circumstance that the individual has some emotional investment that has been lost. The process of grief includes psychological, behavioural, social and physical reactions to loss. Grief is attached to all types of loss that may be experienced in life and not necessarily those only related to death (Underwood, 2004). After loss, one goes through various stages while mourning to complete the process and in order for equilibrium to be re-established. Elisabeth Kubler-Ross suggests five distinct phases in bereavement: denial and isolation, anger, bargaining, depression and, finally, acceptance (Kübler-Ross, 1969). These are not necessarily sequential. Normal grief, also known as "uncomplicated grief’" encompasses a range of feelings and behaviours common after loss (William Wordon, 1983). Most people are able to cope with these processes and see grief to its conclusion. The understanding is that each person may have individualised features in their...
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