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Grief is a depressive reaction to significant loss which usually resolves after a period of four to six weeks. Significant losses in life can take the form of the death of a loved one, separation or divorce, loss of a valued possession (especially the home), severe illness, a change in job, financial loss, or loss of status or prestige. Grief becomes pathological (abnormal) if it extends much beyond this period of time or is accompanied by severe psychosomatic (physical) symptoms such as weight loss.
Emotional support is very helpful in managing the grieving client whose grief reaction seems to be pathological. The grieving person must be allowed to ventilate his or her feelings of loss in a supportive atmosphere; be assisted in identifying and performing essential tasks (in the case of the loss of a loved one, arranging the funeral, attending to the will and so on); be linked up with relatives, friends or appropriate carers; be occupied with and supervised in satisfying essential needs (meals, household tasks, sleep); and be assessed or observed for suicide risk.
Occasionally, medication may be necessary in this situation. With adequate psychotherapeutic support, most clients will satisfactorily negotiate the necessary stages in resolving their grief.
Tim is 41 years old and hasn't been seen around for a week, but now surfaces and is tearful and upset. He tells you that his mother died some time ago. Last night he imagined he had seen her in his room and talked to her for some time.
Help Tim discuss his feelings about the death. If this was recent then the presence of a depressed mood and constant thoughts of, or even visions of, the dead person, are all part of the normal grieving reaction. Numbness, denial and anger are common in the acute stages of loss or bereavement. These are often swiftly followed by intense unhappiness. Normal grieving can be helped by encouraging the person to talk about what the loss means to them, thus allowing their emotions to be fully expressed. This can mean talking about the dead person, the nature of the relationship, its ups and downs, and the good and bad feelings that people sometimes have about the deceased. It normally takes some months to fully accept the loss.
If the death was some time ago, this could be pathological grief, a case of depression, or a sign of a psychotic illness. In this case, seek an immediate referral to a doctor or psychiatrist. Referral is also essential for any person fantasising about dying and rejoining their loved one in heaven, as this is a significant indication of the potential for suicide.