Coping with bereavement: A research review for clinicians

Abstract

This article provides a broad overview of empirical research on bereavement. We draw on existing research to address three major clinical issues. First, how do people typically respond to major losses? We argue that many reactions assumed to be abnormal, such as the failure to exhibit intense distress following a loss, are more common than believed and are not necessarily indicative of pathology. We maintain that a broader definition of “normal grieving” would benefit the bereaved. It is true, however, that as many as 40% of the bereaved may develop full-blown clinical complications following a major loss. We offer clues for identifying and treating such clients. Second, we review those factors that have been shown to enhance vulnerability to the effects of loss. Special emphasis is placed on the unique symptomology of sudden, traumatic deaths, which are the leading cause of death of people under the age of 44. Third, we discuss the efficacy of various treatments. Available evidence suggests that individual psychotherapy is an effective intervention, particularly among those categorized as high risk. There is also evidence to suggest that antidepressant and antianxiety drugs can be very useful as an adjunct to therapy. This article concludes with a discussion of the unique difficulties in working with the bereaved, including the possibility of emotional numbing, demoralization, and ultimately, burnout. Fortunately, the work is also rich in rewards; sharing and helping to transform another's suffering is at the heart of what it means to be human. © 1996 John Wiley & Sons, Inc.