How to overcome a mourning, the expert’s advice

How to overcome a mourning, the expert’s advice

About 34,000 deaths from coronaviruses in Italy and, regardless of the pandemic, some of us lose a loved one every day. A legitimate question in these cases is: how to overcome a mourning? Let’s talk about mourning with healthy or pathological variations.

Contents hide 1 Mourning as psychological decompensation 2 Mourning processing 3 Complicated mourning 4 How to overcome mourning 4.1 Give meaning to pain 4.2 How to overcome mourning when avoiding pain (isolation, anger and injustice suffered)

Mourning as a psychological decompensation

L ‘ processing of mourning  is a very complex process that requires its time. Freud himself, consulted by a lady who complained of depressed mood following the death of her husband, said: “Madam, you do not have a neurosis, you have only suffered a misfortune.”

In speaking of depression , the same Diagnostic and Statistical Manual of Mental Disorders (DSM V) takes into consideration the existence of a non-pathological “depression”, linked to losses and failures. In other words, suffering from the loss of a loved one is completely natural. When does suffering become pathological?

When the depressive reaction exceeds certain limits in terms of intensity and duration, we speak of  pathological mourning . In case of pathological mourning, in addition to wondering how to overcome a mourning, it would be advisable to resort to the help of a psychotherapist.

mourning can represent a decompensation  that can undermine the normal “psychological functioning” inducing the appearance of mental disorders such as:

  • Depression
  • Post traumatic stress disorder
  • Panic disorder
  • Suicidal ideation
  • Hypochondria

Mourning processing

Many authors divide the mourning process  into several stages. Regardless of the theoretical approach, the goal of mourning  is to  reorganize the self , its values, its affects and its entire existence.

A “healthy mind”, with excellent emotional resources, well inserted in its social environment and surrounded by affections, following a loss, can process it through a  painful process  that comes to the acceptance of compromised purposes  (of the lost person) and reinvestment in other purposes (or affects). Mourning is a painful process because the lost person is often perceived as “irreplaceable” and the damage suffered “irreparable”. It is natural to go through a depressive phase.

The more the lost good has value for the person, the more the process of elaboration becomes intense and painful. 

Depression is linked to the awareness that any effort will not serve to get the lost person back. From desperation we can move on to a new reorganization: to  overcome mourning  , acceptance of the definitive loss is deemed necessary . It is from acceptance that the person can reinvest in other purposes / affects.

In DSM V we talk about complicated mourning disorder. The normal symptoms encountered in every mourning are: anger, agitation, confusion, disorientation, moments of guilt, disinterest in pleasant activities and in the future. When it comes to “complicated mourning”, the central aspect for diagnosis is the duration of symptoms.

The complicated mourning

Failure to process mourning can be very dangerous: in the first place it can return a depressive response that could become chronic.

When we go from mourning to full-blown depression, probably those who are experiencing mourning already had underlying fragility or a previous depressive history. The most fragile people have greater difficulty in elaborating a mourning.

In the failure to process mourning, there is an arrest in the depressive phase due to which the person is unable to accept the loss and the compromised purposes. The reason for the failure to elaborate the mourning should be sought in one’s personal history and in characteristics such as:

  • tendency to brood,
  • strong critical sense (self-critical),
  • tendency to confuse internal states with external ones,
  • scarce emotional resources,
  • low resilience,
  • self-image compromised by loss,
  • low self-worth,
  • difficulty investing in other purposes,
  • following the mourning, the person does not resume the activities that he carried out before the loss.

The time factor plays a crucial role in mourning . The great majority of people who face the loss of a loved one, within about 12 months , have a return to levels of psychological functioning comparable to those of pre-mourning. In this period of time we speak of “normal mourning”: over time we notice several mental states (anger, resignation, desperation, sub-tone mood) that follow one another and a progressive decrease in the intensity of the depressive reaction that tends to resolve itself.

In  pathological mourning there is the crystallization  of the acute mourning reaction that can last for years and invalidate the life of those who suffer from it. A 2017 meta-analysis (Lundorff and collaborators) estimates a prevalence of 9.8% of complicated mourning  among adults who lose a loved one.

How to overcome a mourning

Clinicians use terms such as: unresolved mourning, inhibited mourning, unprocessed mourning, traumatic mourning, or non-acceptance of loss to indicate complicated mourning . The term “non-acceptance of loss” can be very emblematic. To overcome a mourning, in fact, it is necessary to work on the beliefs that inhibit the ability to accept loss .

For a parent, accepting a reality that says “my son is dead and will never return” is a difficult step. Similarly, for a child, accepting the idea “my mother is dead and I will never see her again” sets up a dramatic picture (in fact, unacceptable ). Working out a mourning, regardless of the degree of kinship of the lost person, means totally accepting the inevitability of death. We paradoxically move away from this acceptance in order “not to lose the lost person further”.

To aggravate the mourning process there is the self-critical role of those who suffered it. If the person criticizes himself for his mourning reactions, the prognosis worsens. During the mourning period it is completely normal to have work difficulties and low productivity, however, some people tend to condemn themselves and criticize their emotional difficulties.

To allow for the elaboration of mourning, it is appropriate to examine which coping symptoms and “strategies” make the subject more  vulnerable  to complicated mourning.

Fully elaborate the concept: “I have lost a loved one forever and this kind of loss is a fact of normal life” can activate  functional reactions  and, progressively, reduce contact with suffering.

Give meaning to pain

Giving meaning to the pain you are experiencing and making sense of the loss can help you overcome a mourning . The gap is generated when we experience death as an intolerable  idea  and not as a natural stage in life.

“I don’t even want to imagine it”, “I don’t even want to hear about it …” – They are typical phrases that we pronounce when we talk about death. The problem is that to escape the idea of ​​death (obtaining a momentary relief) we invest a lot of energy and detach ourselves from it so much that over time we assume beliefs that prevent us from reaching the acceptance of this occurrence.

We do everything to escape the full representation of the event  and when it strikes us closely, everything becomes more difficult especially because death represents the arrest of one’s existence or “something” that takes away a loved one.

The pain associated with this representation crystallizes due to the lack of acceptance of reality. The integration of a loss  into one’s system of meanings correlates with a good  mourning process .

This explains why several studies show a correlation between  successfully overcoming a mourning  and the ability to give a religious (or spiritual) sense to loss. Spirituality educates to the acceptance of death as a natural part of life. Religion educates to resilience and trust in the future.

Taking note that death is something painful but natural, it can be understood that  smiling and trying to distract oneself is not more or less right than crying or mulling over lost affection , however, are actions to be promoted to continue honoring life.

Every day of our existence we should try to live respecting ourselves, and this means trying to go on even when the pain seems insurmountable.

“I have lost a loved one and this is a fact of normal life, I can accept it and I will always keep a place in my heart for her”. 

One is confrontation with reality, surrounding oneself with affections, trying to distract oneself, encouraging new positive experiences … they are all attitudes that help to overcome mourning.

How to overcome mourning when avoiding pain (isolation, anger and injustice)

“Nobody can understand me” or “My loss is too unfair to accept it”, are classic phrases that conceal, once again, the refusal of loss: we return to the theme of non-acceptance. In this case, an avoidance is put in place to move away from the mourning process . By focusing on the injustice suffered, one does not focus on the intense emotional pain of loss . Paradoxically, you are feeling bad for not taking the risk of getting worse.

Other forms of “mourning avoidance” consist of social withdrawal or systematically avoiding any place or activity that can be linked to the deceased. Isolating yourself in order not to face life “without your loved one” has the effect of increasing the severity of the loss.

Also in this case what has been said above is valid: every day we have an obligation towards ourselves to respect ourselves. This implies an obligation to take care of yourself and reassure yourself . In the presence of vulnerability factors or if you cannot understand how to overcome a mourning , contact your trusted psychotherapist.