Traumatic Grief Part I
By Dr. Michael Basso
The normal bereavement process can be tough on most of us. However, when bereavement becomes excessive for extended periods of time traumatic grief syndrome may be indicated.
The clinical and social consequences of traumatic grief are significant and diverse. Beyond the characteristic pattern of numbness, depression and recovery following normal bereavement,there arepeople who suffer from traumatic grief (TG) syndrome for extended periods of time; sometimes lasting for several years. During this period of TG, there is increased mortality in the bereaved due to many clinical problems including, but not limited to; cardiovascular disease, cancer, substance dependence and abuse, numbness, apathy, irritability and insomnia.
Stress hormones, including cortisol, catechlamines and histamine, are particularly important factors in the development of the psychosomatic aspects of TG.
In addition to a biological predisposition towards TG there may be significant environmental developmental factors, which may predispose someone to the TG syndrome later in life. These factors may include death of or separation from a parent or significant other.
In Japan, Furukawa et al (1998) found a significance correlation between alcohol dependence and loss of a parent, through death or separation, before the age of 16. In a 1982 Swedish study, Mellstrom et al found significant increases in a variety of illnesses, including cancer, cardiovascular disease and cirrhosis of the liver as well as accidents and suicides. There is also evidence that cognitive patterns based on interpersonal relationships, such as unresolved marital conflicts (Blankfield 1989), may also predispose someone to TG.
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It has been proposed that traumatic grief syndrome is a subset of diseases which can be classified under the umbrella of post traumatic stress disorder (Prigerson et al 2000). The disease also shares characteristics with separation anxiety, or perhaps separation adjustment might be an appropriate classification category. In any event, the disease has characteristics of both PTSD and separation anxiety.
It may be useful to consider biological subtypes of TG, based on occurrence and intensity of outward symptoms and individual differences.
A proposed ‘TG - obsessive type’ may have the biological tendency for excessive rumination (repeating thoughts over and over), inclusive of intrusive thoughts of the deceased and compulsive searching for things that remind one of the dead person. This subtype may very well share biological predisposition with the obsessive-compulsive personality type; more so than other TG sufferers.
‘TG addictive type’ may share underlying biology with non-TG sufferers who also abuse, or are dependant on, addictive substances. The underlying biological predisposition may be manifested primarily as substance abuse or dependence as well as excessively long or intense numbing and associated withdrawal-type symptoms after the numbing period.
The ‘TG suicidal-depressive type’ may have similar biological markers with those suffering from major depression without TG, while having features which are unique to TG.
The TG sufferer may also suffer from a variety of diseases associated with reduced immunity.
Next time we will briefly discuss ways to deal with traumatic grief.
The topic is discussed more thoroughly in my new book entitled Spiritual Medicine: A Guide for Clinicians, Educators, and Researchers. Readers may also enjoy the companion book, The 13th Step: The Secret of becoming a Coworker with the Higher Power of GOD.
Dr. Basso has a Ph.D. in Professional Psychology and Biomedical Systems and an MBA in executive leadership. Michael is president of the CT Holistic Health Association, is an adjunct faculty member at UCONN and is a research affiliate at the Yale School of Medicine.
