How Much Pain is Necessary in the midst of True Grief?

Posted by Kendall Harmon

Earlier this year, the American Psychiatric Association released a rough draft of its new Diagnostic and Statistical Manual of Mental Disorders, or DSM. It's a big book that lists all the mental disorders doctors can use to diagnose mental illness. One of the changes they're proposing is causing controversy.

Traditionally, the manual has warned doctors away from diagnosing major depression in people who have just lost a loved one in what's called "bereavement exclusion." The idea was that feelings of intense pain were normal, so they shouldn't be labeled as a mental disorder.

But the new DSM changes this....

Dr. Kenneth Kendler, who is on the committee that decided to make this change, says it's not that the committee feels everyone who has a loss should immediately be diagnosed with depression. For Kendler, there is a clear, bright line between normal grief and clinical depression. Grief is OK — depression is not. Depression, by definition, is dangerous and should be treated. Grief is normal and should not.

I caught this by podcast this morning on my run--it is a very thought provoking piece. Do take the time to listen to it all if you can (just under 9 minutes). If not, read the whole thing.

Filed under: * Christian Life / Church Life • Parish Ministry • Death / Burial / Funerals • Pastoral Care • * Culture-Watch • Health & Medicine • Psychology • * Theology • Pastoral Theology

3 Comments
Posted August 3, 2010 at 5:39 pm [Printer Friendly] [Print w/ comments]



1. Teatime2 wrote:

I didn’t see counseling mentioned—only medication. And that’s what it’s come down to for our society, isn’t it? Take a pill to avoid unpleasantness.

Those who are grieving can benefit from grief counseling and grief support groups. Counseling helps in depression, too, of course. But, to me, this reads like a new protocol to permit the drugging of those who are grieving. What happens if the grieving refuse anti-depressants? I suppose they’ll be told they’re “in denial” and, thus, mentally impaired? Sigh…

Having lost both of my parents, I can say that substantive symptoms of grief last longer than the “two weeks” this doctor determined is “normal.” A lot depends on whether the death was sudden or expected, was relatively quick or encompassed weeks of suffering, and the relationship between the survivors and the deceased. I think it’s terribly unfair to put a blanket timetable on it and call people who don’t fit that timetable “clinically depressed.”

August 3, 6:01 pm | [comment link]
2. Theophilus wrote:

How does one deal with the grief caused by the decline of our beloved church?  There is no medication or counseling available to mitigate this extraordinary sense of loss.

August 3, 6:46 pm | [comment link]
3. Larry Morse wrote:

There is something about the quantification of grief that infuriates me. Grief in private is a pain and sorrow mankind needs to know and suffer. What has become of “in private?” For the grief stricken, there is only left the comfort of real friends, who support but do not invade. Grief is knowledge we cannot and should not avoid. Some people grieve their entire lives from an irreparable loss; and there are such losses. They get on with their lives, but grief is like a permanent color, the fabric is altered permanently. The tears of an old grief, coming back again without warning, water the spirit as a fine autumn rain leaves the ground ready for the cold to come.
  How does one deal with grief? Have friends and family. Do you have none? Go to church and offer up your tears. You will find a friend and family.  Ann Rice will learn of this, sooner or later. What will she do then?  Larry

August 4, 8:18 am | [comment link]
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