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The Medicalization of Grief

The Medicalization of Grief
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by Amy Cavanaugh

I love going to Goodwill to buy books. I notice that there are always a good number of books on wellness and spirituality, and I never know if the person who donated the book did so because they had healed themselves by reading it or merely gave up. Either way, it has been a goldmine for me, allowing me to buy books to write-in, rip out pages or share with friends. One time, I was so excited by a find that I actually bought my own book back.

Among this week’s books was On Death and Dying by Dr. Elizabeth Kubler Ross. The original retail price of the paperback copy was $1.95. This should give you an idea of how long ago Dr. Ross set the stage for a long overdue candid conversation on death and dying in America (1969). In her groundbreaking book that remains the definitive source on the topic, Dr. Ross warned that our culture has isolated and insulated itself from death and that, even 40 years ago, religion had transformed from something sacred to something social, rendering us woefully unprepared to deal with death, be it our own or that of a loved one.

I did not become interested in death and dying on a whim, rather, after the extended illness and death of a loved one, I became obsessed with raising awareness about this taboo subject. I equate dying to how we treated the topic of sex in the 1950’s. Sex was something everyone did, but no one talked about. Dying is something each of us will do, but no one wants to talk about it. I have spent the past year and a half navigating my way through my grief. Sadly, I found the available resources and support to be well intentioned but not especially helpful. I also noticed that my friends and co-workers grew tired of my grief long before I had processed it. As my friend, widow and comedian, Kelly Lynn says in her blog, RIP The Life I Knew, grief lasts longer than the sympathy.

I was disappointed in the support and services I found when processing my grief. Always an outside of the box type of thinker, I sought out support any place I could find a safe place to heal. I have since become an advocate for the grieving, and a hospice volunteer. I continue to seek out new modalities for treatment and demand that death and dying be discussed with the sacredness and candor it deserves. Dr. Melvin Morse said a mouthful when he said that “mediums and psychics have become the modern age grief counselors”.

Sadly, despite the well intentioned, the well educated and my fellow outside the box thinkers, more and more bereaved are turning to pharmaceuticals to restore themselves to “normal” after a loss. There are some instances when loss can trigger a chemical imbalance and medical intervention is appropriate. While I am not a doctor, based on my own experience with grieving and with depression, I believe that we have once again taken a normal but uncomfortable reaction to life and made into a disease.

“Grief is not a disorder, a disease or a sign of weakness. It is an emotional, physical and spiritual necessity, the price you pay for love. The only cure for grief is to grieve.”                         –Earl Grollman

Grief is a normal and natural reaction to loss. It can cause, but is not of itself, an illness or chemical imbalance. The word “grieve” is a verb, meaning that grieving requires the bereaved to take action. To grieve successfully, the bereaved must make changes, and change is generally preceded by discomfort. Our culture loathes discomfort even though the Bible and other spiritual works have spoken of the spiritual growth that is borne of suffering. We will do anything not to suffer, including denying ourselves the opportunity to grieve the loss of a loved one.

Dr. Ross pointed out over 40 years ago, that our society had little time or patience for grief. If that was the case then, it is even more so today. Our jobs, economic pressures, and other responsibilities tend to take precedence over taking time to mourn the loss of a loved one. Sympathies are short lived and the bereaved often receive friends and family via Facebook messages, rather than at a wake or funeral. Traditional sources of comfort and support for the bereaved such as families and churches are not relied upon as they once were, thus leaving the bereaved isolated and confused. Our culture does not respect grief, rather, we treat grief like a disability and we treat the bereaved as if they were victims of a crime. Grieving makes family, friends, and co-workers sad and uncomfortable, which tends to isolate the bereaved. As a result, more and more of the bereaved are turning to medical doctors and mental health professionals. Many are given a mental illness diagnosis and then encouraged to rely upon pharmaceutical treatment. In short, we have done to grief what we have done to so many other difficult social problems—we have made it a disease and we treat the symptoms of grief as if they are unnatural.

In response to this trend, the American Psychiatric Association (APA) is in the process of revising their Diagnostic and Statistical Manual of Mental Disorders (DSM). In DSM-V, scheduled for release in 2013, grief lasting any longer than two weeks can be classified as a psychiatric disorder. In the current version, DSM-IV, bereavement is a noted exception to the diagnosis of “major depression.” While many of the emotions associated with loss such as lack of energy and confusion are also symptoms of clinical depression, unlike depression, these symptoms are a normal and natural reaction to loss. Actually, not reacting to loss with these emotions would seem to indicate some sort of emotional disorder. Nonetheless, the APA saw fit to transform a normal reaction to a universal experience into a form of mental illness.

This should not come as a shock. We as a culture are as much to blame as the APA and the pharmaceutical industry. We have become conditioned to view pain and discomfort as unacceptable and often demand immediate relief. Sadly, by doing so, we sacrifice our right to the spiritual growth and transformation that follow the successful navigation of difficult experiences.

I am not a doctor, and I am not attempting to provide medical advice or give the impression that medication is never appropriate. It is just that there are times when someone should feel depressed, such as when a loved one dies. Anti-depressants may treat the symptoms of grief and make it easier to work or maintain a normal lifestyle but it will not facilitate the processing of grief. Pain and discomfort, whether emotional or physical, are indications of the need for change. A successful griever will gradually respond with new thoughts and behaviors to the various emotions associated with their loss, which, in turn, will cause pain and discomfort to diminish.

People grieving a loss say they want to feel “normal” again, but what they mean is they want their old life back. We tend to allow the bereaved to operate under special rules and make excuses for them, but provide few tools for empowering them. Many grievers complain that grief support groups just serve to reinforce their loss. Author and medical intuitive, Caroline Myss, calls this “woundology,” referring to our culture’s obsession with defining ourselves by what happens to us. We are quick to identify victims, and then attempt to rescue them, but rarely do we invest in or commit to victims. Think of how our culture responds to people who face other types of tragedies such as natural disasters. We make them victims and provide short-term relief. This mindset makes it apparent why our culture would see the introduction of pharmacology as the obvious solution to bereavement. It is quick, profitable and involves little commitment.

Instead of breaking down the individual emotions associated with a loss into individual problems, we tend to couch the loss as a predicament. Myss says that problems have solutions but predicaments do not. She is quick to point out that life is supposed to be, at times, painful but that our culture has turned to pharmaceuticals because we cannot endure the pain of life. While we eliminate much of the discomfort, we pay a high price in that we do not evolve emotionally. For many, the inability to process grief is not depression but rather a deep-rooted resistance to change. For others, it results from the fact that the loss has triggered old traumas. While uncomfortable emotions are intended to fuel change and growth, the introduction of anti-depressants tends to shut down the motivation to change.

There are many alternatives to medication with respect to processing grief. Following the death of a loved one, the grieving are often referred to generic grief support groups. Commonly, the bereaved are offered clichés such as “time heals,” “life goes on,” or “he/she is in a better place” and, as a consequence, report leaving more depressed then when they came in. The bereaved need a tool chest, not a medicine chest, and they need candor and honesty, not meaningless happy thoughts. Despite our best intentions, America is not the melting pot we would like to think it is. Because traditions surrounding death and mourning are largely religious and cultural, we have diluted or abandoned them in an effort to become a homogenous society.

Grief is not the only area where lapses in culturally based beliefs and traditions have morphed into opportunities to medicate. Teenage coming of age, women going through menopause, and even obesity, are just a few examples where rites of passage or changes in the way that we live have been deemed diseases that warrant medical treatment. This is not to say that it is not appropriate to seek medical treatment in conjunction with grief (or any other problem). Grief’s symptoms are physical, emotional, and spiritual and, when left unprocessed, can cause illness. This is a wake-up call for each of us with respect to what we deem to be normal. It is normal to grieve. It is good to grieve. To introduce medication to treat physical and emotional behaviors that are normal given a particular circumstance is not good medicine.

Resources:
 – Dr. Melvin Morse. Spiritual Scientific: The Institute for the Scientific Study of Consciousnessspiritualscientific.blogspot.com

– Kelly Lynn’s Blog: RIP The Life I Knew. www.ripthelifeiknew.com

Amy Cavanaugh is an old soul, Reiki practitioner, and mermaid living in Jacksonville Beach, Florida. Her Facebook page is called Awakening Claire. Much of her work surrounds assuring that death is a dignified, peaceful, and sacred experience. She teaches that survivors can heal and develop meaningful ongoing relations with the departed through training intended to focus and sharpen the intuition.

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All content contained herein represents the opinion of Dr. Malerba and should not be construed as medical advice. This information is not intended as a substitute for consultation with a qualified health care professional. All readers are encouraged to seek appropriate care as needed.

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