Amalina Aminuddin

0820121000 67

Introduction • What • Phases • Management

Grief • Feelings and associated behavior

accompanying the awareness of irrevocable loss of a loved object

• Close relative, friends, • Material or non – material

• Transient, self – limiting

Phases • Bowlby (1961) : • Protest

(minutes,weeks)• Despair

(weeks,months)• Detachment

(months,years)

• Gurmeet Singh : • Normal grief • Morbid grief

1.Protest • Initial shock, disbelieve and denial• Numbness

• Few hours to 2 weeks

2.Despair • Intermediate period of acute discomfort and social

withdrawal• Somatic distress• Withdrawal• Preoccupation • Anger and guilt• Restless, aimless, lack of motivation• Identification phenomenon

• 4-6 weeks to 6 months

3.Detachment • Restitution and reorganization• Return to work • Resume roles• Reexperience pleasure• Seek companionship and love

Gurmeet Singh Pathological• Exaggeration of >1

symptoms OR• > 6 months without

spontaneous recovery

Complicated • By specific neurotic

/psychotic illness• Subtypes :

• Hysterical• Phobic• Obsessive-compulsive • Manic• Acute psychotic episode

Anticipatory grief

• Before actual death• Slow dying process of a

loved one through injury or illness

Anniversary grief

• Special occasion that trigger acute grief reaction

Treatment • Normal : no• Morbid / Complicated : yes• medication depending on presenting clinical

features

• Support• Widowed to widowed Grief

Support Group• Compassionate friends

• Catharsis • Encourage goal –directed

activities

Role of psychotherapist• Education• Expression– Role playing , writing letters to deceased, look at

pictures• Help come at peace with their new relationship

with deceased• Establish new identity

References • Niraj Ahuja, A Short Textbook Of

Psychiatry, 7th edition, 2011• Kaplan And Sadock, Comprehensive

Textbook Of Psychiatry,