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Conceptualisations of grief have transformed significantly in recent decades, from an experience accepted and expressed in community spaces to a diagnosable clinical phenomenon. Narratives of this transformation tend to focus on grief’s relationship to major depression, or on recent nosological changes. This paper examines the possibility of a new narrative for medicalisation by grounding in the networks of language and power created around ‘grief’ through a critical discourse analysis of psy‐discipline articles (n = 70) published between 1975 and 1995. Focusing on shifts in definitions of, methods used to approach, and rationales motivating study of the experience, it posits that the psy‐disciplines exerted exclusive expertise over grief decades before its creation as a diagnosis. By reconceptualising grief in the terms of psy‐specific symptoms and functional performance and by approaching it with the decontextualising and interventionist methods of an increasingly scientific psy‐discipline, the psy‐community medicalised grief between 1975 and 1995. Identifying neoliberal and other cultural influences shaping this process of medical construction and reconsidering narratives of grief’s history mindful of the powers exerted in medicalisation, this paper establishes that these moments played a critical role in the development of the present’s grief.
Conceptualisations of grief have transformed significantly in recent decades, from an experience accepted and expressed in community spaces to a diagnosable clinical phenomenon. Narratives of this transformation tend to focus on grief’s relationship to major depression, or on recent nosological changes. This paper examines the possibility of a new narrative for medicalisation by grounding in the networks of language and power created around ‘grief’ through a critical discourse analysis of psy‐discipline articles (n = 70) published between 1975 and 1995. Focusing on shifts in definitions of, methods used to approach, and rationales motivating study of the experience, it posits that the psy‐disciplines exerted exclusive expertise over grief decades before its creation as a diagnosis. By reconceptualising grief in the terms of psy‐specific symptoms and functional performance and by approaching it with the decontextualising and interventionist methods of an increasingly scientific psy‐discipline, the psy‐community medicalised grief between 1975 and 1995. Identifying neoliberal and other cultural influences shaping this process of medical construction and reconsidering narratives of grief’s history mindful of the powers exerted in medicalisation, this paper establishes that these moments played a critical role in the development of the present’s grief.
Objective: Synthesize research findings and provide insight into firsthand experiences of complicated grief. Methods: We systematically searched qualitative studies in English in four databases (PsycInfo, PubMed, CINAHL and Web of Science). We included 5 studies and applied meta-ethnography to identify and translate across studies. Results: This review illuminates the firsthand experiences of complicated grief. Three key themes were identified: ‘ambivalence’, ‘misrecognition’, and ‘self-sacrifice’. These concepts reflect the synthesis of available qualitative research on the experience of complicated grief. The findings suggest that complicated grief is experienced as intrusive and unhelpful, providing a distressful state with lack of recognition from the perspective of the bereaved. Conclusions: The synthesis provides an empirically founded interpretation and contribution to the challenge of distinguishing between normal, complicated, and pathological grief reactions. As bereavement increasingly becomes a clinical concern, these findings highlight the necessity for further phenomenological research and the detailed profiling of disordered grief.
Emerging theories of grief over the last 30 years have represented a shift from the healing of pathology to a focus on the adaptation to loss. Recently, however, there has been an alarming resurgence for a medicalized model of grief, most saliently evident in the removal of the bereavement exclusion from the diagnosis of major depressive disorder in theDiagnostic and Statistical Manual of Mental Disorders(5th ed.;DSM-V; American Psychiatric Association [APA], 2013) and the inclusion of prolonged grief disorder in theDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision(DSM-V-TR; APA, 2022). These have predictably opened up opportunities for the pursuit of pharmacological treatment including antidepressants and medication usually offered for recovery from alcohol and drug addiction. A pathologizing approach to grief can have a significant and detrimental impact on individuals and compromises the core humanistic values that underpin my professional identity as a counselling psychologist. I propose that we need a radically different lens, and the power–threat–meaning framework (PTMF), an alternative to psychiatric diagnosis developed by psychologists in the United Kingdom, offers us such an opportunity. Consideration is given to how the PTMF may be applied to grief therapy where it can embrace the uniqueness of grief responses and reframe it as an entirely understandable response to trauma and loss.
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