Aspects of Pathological Grief and Mourning

There is a peculiarly painful and despairing quality of feeling both in grief and mourning: what has been loved seems to be irretrievably lost, and the mourner, as if responsible, reproaches himself, literally or symbolically rending his garments. These self-reproaches have their obverse for there is a plaint, an accusation against the dead person for having left and deserted the mourner. 'For what have you left me?' the peasant moans accusingly to his friends in his ritualized and cathartic lamentations. With more lonely individuals there is no such group catharsis and the loss must be gradually and painfully surmounted before harmony can be restored to the inner world.

Most painful of all, is the fusion of grief with depression, signal anxiety fear and triumph, a phenomenon which most of us have encountered in the course of our clinical work during the past few years, so full of loss. There are many people, especially in these recent years, who still have every cause to be sad, but are really not so; instead they are anxious, despairing and assailed by nightmares in which they are confronted with the images of dead, injured and avenging objects. The post-war scene is studded with innumerable Hamlets unable to live in peace without those they have lost, nor yet able to live in peace with the memories and images they carry within. It is among the most severe instances of chronic neurosis that there will be found those who are suffering from the extremities of morbid grief, so persistent and intense in its nature that those who exhibit it give the appearance of suffering from an acute, rather than a chronic, mental illness. Such people are usually very tense and restless; they are anxious and fearful and afraid to sleep for fear of encountering in their dreams, internal persecutors; often enough they give the impression that their neurosis is but the cover for deeper and psychotic mechanisms.

The classical studies of Freud and Abraham and the recent contributi