Complicated Mourning

Accommodation to a loss by death unfolds in expectable stages when complications do not interfere. The aim of this paper is to familiarize the professional whose work brings him in contact with the bereaved with these stages and to help him assess signs of complication, whether they appear in the acute or the chronic stage of mourning. Complications in the latter culminate psychodynamically in one of two pathologies—(reactive) depression or established pathological mourning. The emphasis here will be on a definition of the metapsychology and the clinical picture of the latter and the description of a brief, but intensive form of psychotherapy especially effective for patients suffering established pathological mourning. I have termed this form of treatment “re-grief therapy.” The psychoanalysis of persons with complicated mourning is also explored.

Investigators studying the sequential behavior patterns of persons who had just suffered the loss of a “psychologically important other” by death have synthesized these patterns into schemata. Significantly, in spite of certain theoretical differences, I find all of these schemata to be generally similar from a phenomenological point of view. Pollock (1961), for example, describes the mourner's reactions as occurring in two states—the acute and the chronic. He holds further that the first stage includes three sequential steps of its own in which the mourner successively experiences shock, accompanied