The Foundations of Psychiatry

By Silvano Arieti | Go to book overview

CHAPTER 33

GRIEF AND BEREAVEMENT

Alberta B. Szalita

I follow'd rest; rest fled and soon forsook me;
I ran from grief; grief ran and overtook me.

—QUARLES, Emblems (1635)

THE SHADOW OF DEATH haunts man even when he does not think about it. With the expansion of consciousness characteristic of our age of awareness,46,56 the transience of our existence is brought home with greater force, particularly since the survival of the race has become an ever present concern. Yet man manages to deny this ultimate reality—his mortality—with illusions of perpetual youth, reliance on advances in technology, and naive belief in magical solutions.

Only the giants of our globe, according to Gorki, are able to live as if death did not exist while living in fear of it. The average human being has the task of finding a midpoint between denial of death and obsessive fear of it. It is noteworthy that the greatest intellects as well as the mentally ill show a marked preoccupation with death. The former transform their obsession58 into a creative quest for immortality; the latter suffer the anguish to the point of incapacitation. On the other hand, helping professionals, as well as average men, keep themselves busy avoiding confrontations with such questions as the impermanence of our existence.

Modern man does not place easy trust in religious systems to aid him in this dilemma; rarely does he believe in life in the hereafter. Grief, sorrow, and bereavement are inseparable companions of the human condition.

The health professions have recently addressed themselves more vigorously to the emotional impact of death and severe illness. Assistance to the dying patient and his family, as well as the rehabilitation of the physically injured or handicapped and those maimed by war or accidents, have finally emerged as central issues in modern psychiatric practice. And with good reason. Every patient soliciting help has many grounds for deep grief.

Bereavement has been defined as the "loss of a loved one and separation from others on whom we depend for sustenance, comfort, and security" (Erich Lindemann).29 The data on bereavement are staggeringly abundant

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