Grief in Many Disguises

December 2, 2016

A neighbor, Linda, called the other day, asking if I had time to talk. We are friendly and wave to each other on the road, but are not close. I invited her over for iced tea but she declared it was too hot to venture outside; she then proceeded to launch into a tearful tale about her primary physician announcing his retirement.* She said she'd been crying for two days and was feeling a real loss since she had gone to this physician for many years.

As it happened, I am facing the same situation, so it seems we share the same physician - which I told her. The thought of "breaking in" a new doctor after 30 years with the current one is not pleasant for me, either. But I silently marveled at the almost personal nature of her feeling abandoned and the magnitude of her emotions. She continued to talk about losing her doctor and was obviously crying as she talked.

Then I remembered that I'd played a role in her life about 15 years ago. Coming home from work early because of chronic pain from a previous ankle injury, I saw cars pulled over on my rural road and a group of people standing around a woman doing 1-person CPR on a man supine on the road. As a nurse, I carry a pocket mask and gloves in my car and approached the woman, asking if I could help. We promptly started two-person CPR, a much easier endeavor.

The outcome was not positive: Linda's husband had gone out to run and had sudden death on the road not far from their house. The arrival of the automated external defibrillator (AED) from the fire station did not help; there was no shockable rhythm. And when the rescue squad arrived from town, all their efforts failed.

I'd almost forgotten about this incident but, surprised at the intensity of Linda's grief over losing her doctor, I was reminded that, rather than abating, sometimes grief and mourning can take on a life of its own. This phenomenon is known as “complicated grief”. Other terms used are “prolonged grief disorder”, or “traumatic grief".

Factors that may increase the risk of developing complicated grief include:

  • An unexpected or violent death, such as death from a car accident, or the murder or suicide of a loved one

  • Death of a child

  • Close or dependent relationship to the deceased person

  • Lack of a support system or friendships

  • Past history of depression or other mental health issues

  • Traumatic childhood experiences, such as abuse or neglect

  • Lack of resilience or adaptability to life change.

Not knowing this woman well, I had no idea if any or many of these factors applied except for suddenly losing her husband in a traumatic incident. As we talked, she calmed down and we discussed finding other doctors. She mentioned that she had already had an appointment with a different doctor a few months before, when her current doctor was on vacation, and she liked him very much. I could hear the resolve in her voice as she said she would make an appointment with this doctor. The intense emotions had blocked her rational use of her own experience to move forward until she had had an opportunity to express her feelings.

She was also receptive when I suggested she might benefit from seeing a mental health therapist since this seemed to represent another big loss for her; she wrote down the names I gave her and said she'd heard of one of them and would call.

We in the mental health field never know when we will be called upon to help - either being seen as a person who can be turned to by someone going through a crisis or being called upon to perform CPR.

Have you had an experience like this?

*Since this is not a patient and we are not in a patient/therapist relationship, I don't feel the need to obscure details.

Leslie Durr, PhD, RN, PMHCNS-BC is an advanced practice psychiatric-mental health nurse with a private psychotherapy practice in Charlottesville, Virginia.

The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors. 

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