Grief Work

It is not unusual with a distressed or depressed patient to find that there are grief issues that have not been adequately dealt with.  Usually, there is some pattern of avoidance and/or pre-occupation

(Pre-occupation with some details of the bereavement is consistent with avoiding other issues.  The most common example would be an idealised pre-occupation with a dead spouse when in fact the marital relationship was quite problematic).

Grief work is often productive.  Here again a rehabilitation approach works.  The principal is gradually increasing exposure to what have become feared memories. 

Photographs are a good tool - patients are encouraged to bring photos and look at them together with the doctor.

Typical patient feedback on being exposed to previously avoided memories:

‘that was upsetting but not as bad as I thought it would be. Even the bad feelings were not as bad as the kind of numbness I was experiencing before.’