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RE: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

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  • Roger Lass
    For some people, according to some definitions, drinking (or doing anything else) to adjust your moods may mean you have a ‘problem’. But if you don’t
    Message 1 of 20 , Feb 26, 2013

      For some people, according to some definitions, drinking (or doing anything else) to adjust your moods may mean you have a ‘problem’. But if you don’t mind the dependency that goes along with it, it’s not a true problem but a merely definitional one, in that the professional literature has decided to define such behaviour as problematic. There are two kinds of problems: professionally defined ones, and problems in the ordinary language sense, i.e. behaviours that disturb the person exhibiting them. If I get good results, and furthermore hugely enjoy the taste of good whisky, then I don’t have a problem as far as I’m concerned.

       

      As far as simply calling the treatment of natural grief stupidity, that is not a terribly intelligent form of characterisation. It might be an idea to say what you mean by stupid and why. Because it’s ‘natural’? So is osteoarthritis in older people. I think you’re being dualist here, and separating ‘mental’ phenomena out from ‘physical’ ones.

       

       

      From: psychiatry-research@yahoogroups.com [mailto:psychiatry-research@yahoogroups.com] On Behalf Of rajan_radhakrishnan Radhakrishnan
      Sent: 26 February 2013 04:49 PM
      To: psychiatry-research@yahoogroups.com
      Subject: Re: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

       

      If you drink regularly to adjust your mood or to change your cognitive or psychological states, you have a problem and you need to be treated. But treating natural grief is stupidity.

      RK

       

      From: Roger Lass <lass@...>
      To: psychiatry-research@yahoogroups.com
      Sent: Tuesday, February 26, 2013 12:03 AM
      Subject: RE: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

       

      I see we have two primary disagreements here, and there is no way of solving them. First, I don’t  have any concerns, as is clear, with using chemicals for cognitive and psychological or whatever problems. Or for adjusting mood. That’s one of the reasons I drink. As to the second issue, not being a dualist I cannot see that grief is not a biological problem, as it is produced by the brain/mind, which are as much part of biology as the oesophagus.

      RL

       

      From: psychiatry-research@yahoogroups.com [mailto:psychiatry-research@yahoogroups.com] On Behalf Of Gaither, George
      Sent: 25 February 2013 04:23 PM
      To: psychiatry-research@yahoogroups.com
      Subject: RE: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

       



      I have some grave concerns about medicalizing anything that we don’t like.  We already have a V code in the DSM for bereavement, so not sure why we need to make it an actual disorder.  We have done the same thing with attention problems in that we now have lots of college students thinking that they need medications to help them study because college is hard.  I have been doing ADD screenings at my university and am floored by the number of students who said that they never had to study in high school and now are struggling in college.  Instead of going to the Learning Center, a tutor, or the course instructor, they schedule an appointment with an MD to try to get on Adderall.  It is natural for people who lack skills to struggle, but I don’t think we should give them pills for it just because they don’t like it.  They will not learn to study anymore with pills than without, just like I don’t believe that people will grieve any less with pills b/c the pills do not get at the root of the problem which is NOT biological in nature.  Reflux is biological in nature so, yes, it does make sense to treat it with pills, but that is completely different IMHO.

       

      George

       

      From: psychiatry-research@yahoogroups.com [mailto:psychiatry-research@yahoogroups.com] On Behalf Of Roger Lass
      Sent: Monday, February 25, 2013 2:43 AM
      To: psychiatry-research@yahoogroups.com
      Subject: RE: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

       

       

      Yes I have, and I do not think this is the same thing at all. Soma as I recall was designed to make people happy so they would be docile; my strategy discussed here is a way of getting through a bad time and then getting back to something like the old self. A deliberate temporary clouding of consciousness is not what Huxley meant, as far as I remember. Could be wrong, haven’t read that book in 40 years.

      RL

       

      From: psychiatry-research@yahoogroups.com [mailto:psychiatry-research@yahoogroups.com] On Behalf Of Johan G
      Sent: 25 February 2013 01:27 AM
      To: psychiatry-research@yahoogroups.com
      Subject: Re: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

       



      Roger,

      Have you read Aldous Huxley's text about "soma"?

      JH

      2013/2/24 Roger Lass <lass@...>

       

      Cat among pigeons time. This may seem a bit outlandish but it’s serious.

       

      My central claim: Just because major depression while grieving is normal does not mean it should be tolerated. Reflux disease is normal too, in the sense that it’s something that it happens to some of us in the course of natural life. Yet we treat it, and those of us who have it bless Pharma every day for inventing proton-pump inhibitors. On this analogy, in particular from the perspective of an already depressed person (semi-controlled bipolar II with MD episodes) who went through an extended grieving experience (the loss of my wife of nearly 50 years), during which my depression got worse, why shouldn’t that have been treated? Painful and conducing to dysfunction = something proper to treat. I do not think that there is anything particularly valuable or good in grief, and if depression during grief looks like a disease and quacks like a disease, it is a disease. So why not treat it so as to get rid of the symptoms that are causing pain and making the sufferer dysfunctional? (And why discuss the issue endlessly in terms of Talmudical number-mysticism in the DSM tradition, two weeks, no four weeks, two signs from the Chinese restaurant menu, no three: what if you’re a day short or a sign short, do you not then have the numbered disorder?)

       

      I do not understand what is meant by grief being ‘healing’; mine, which is now in its 8th year, though with only my ‘normal’ partly remitted background mood disorder, has been nothing of the kind. (‘Grief fills the room up of my absent child’ as Shakespeare immortally says in King John.) What ‘heals’ if anything is carrying grief for years and learning that it’s part of life and won’t go away, so you get tougher; but the depression associated with it can be made better. I was already on maximum safe dose of antidepressant, so as soon as my wife died I started self-medicating with alcohol in huge quantity and high doses of benzodiazepines. This of course did not treat the depression, but it at least dulled the feelings of grief and made it less possible to feel anything at all and not notice my depression so much because my consciousness was compromised. After a few weeks of this my mood was much better, and I had avoided or evaded much of the ‘deeper’ experience of grief. (And I went back to normal drinking and benzodiazepine dosage, no trouble.) In fact the drugs could be said to have made my experience of grief somewhat more superficial, and three cheers for that. It’s just what my wife would have done in the same position. When in doubt, reach for the ethanol. Much of whatever grief is supposed to be for had gone on behind the scenes, if at all. I cannot see this as anything but good. Maybe this is a peculiarity of mine. As I said at the beginning, just because something is ‘natural’ does not make it good: so is menopause, but that doesn’t mean HRT is bad. To equate the natural with the good is a famous philosophical fallacy, in one formulation ‘turning an is into an ought’.

       

      How about this for a motto: if you don’t like something and can develop a medicine for it, then the intelligent, distinctively human and morally good thing to do is medicalise it. In the immortal words of the Duponts, Better Living Through Chemistry.

       

      RL

       

      From: psychiatry-research@yahoogroups.com [mailto:psychiatry-research@yahoogroups.com] On Behalf Of Robert Karl Stonjek
      Sent: 24 February 2013 02:21 AM
      To: Cognitive NeuroScience; Mind and Brain; Psychiatry-Research
      Subject: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

       

       

      Psychiatrists to brand grief lasting longer than two weeks a mental illness

      • Clifford Fram, AAP National Medical Writer
      • AAP
      • February 22, 2013 2:28PM

      SadPsychiatrists want to brand grief lasting longer than two weeks a mental illness. picture: Thinkstock

      THE grieving process is in danger of being branded a medical condition if a mourner feels sad for more than two weeks and consults a GP, according to an international authority on death and dying.

      At present, mourners can feel sad for two months before being told they have a mental disorder, says Professor Dale Larson. Decades ago, a diagnosis could be made after a year.

      In a keynote address at an Australian Psychological Society conference in Melbourne on Saturday, Prof Larson will express his anger about the American Psychiatric Association's new diagnostic manual, DSM 5, which is used in many countries including Australia and New Zealand.

      The manual, to be published in May, allows a diagnosis of depression after two weeks of grieving.

      According to Prof Larson, the manual undermines the legitimate feelings of the mourner and the help available from family, support groups, clerics and professional counsellors.

      "We are essentially labelling grief a disorder. Now it becomes a target for drug development."

      Prof Larson, head of Counselling Psychology at Santa Clara University in the US, is concerned GPs will be dishing out prescriptions for anti-depressants.

      "Almost all bereaved people believe they are depressed. But grief is a normal healing process and it resolves itself in most cases.

      "Bereavement-related depression is different from other kinds of depression," he told AAP on Friday.

      "Medication, not psychotherapy, will be the major treatment because most people see their GP when they have an issue."

      He acknowledged support in Australia might be more focused on the needs of the mourner, who could take advantage of a Medicare benefit and consult a psychologist.

      He said the focus should be on "helping the mourner figure out grief's questions: 'What's happening to me and how long will it last?'

      "It's a bonanza for the pharmaceutical industry. The GP prescribes anti-depressants and the bereaved feel better, largely because of placebo effects. The truth is people are resilient and they would have got better on their own.

      "If they do struggle, and many do, talk therapy should be the first line of support."

      Prof Larson said the authors of the new guidelines had a genuine desire to help people. "People do have complicated grief. That's a reality. One option would be to include a diagnosis for prolonged grief disorder.

      "I personally think a year is the minimum amount of time before a disorder should be diagnosed, if we do medicalise this universal human experience."

       

      Posted by
      Robert Karl Stonjek

       




       



    • Dr. Chittaranjan Andrade
      Some thoughts in support of Roger s views: 1. Why should bereavement grief be treated as different from other stressors just because it is so common and
      Message 2 of 20 , Feb 26, 2013
        Some thoughts in support of Roger's views:
        1. Why should bereavement grief be treated as different from other stressors just because it is so common and because it happens to almost everybody?
        2. If a grieving person is suffering and is emotionally, functionally, and otherwise impaired because of his grief, and if he wants help, why is it wrong to offer the help?
        CA

        On Wed, Feb 27, 2013 at 12:39 PM, Roger Lass <lass@...> wrote:
         

        For some people, according to some definitions, drinking (or doing anything else) to adjust your moods may mean you have a ‘problem’. But if you don’t mind the dependency that goes along with it, it’s not a true problem but a merely definitional one, in that the professional literature has decided to define such behaviour as problematic. There are two kinds of problems: professionally defined ones, and problems in the ordinary language sense, i.e. behaviours that disturb the person exhibiting them. If I get good results, and furthermore hugely enjoy the taste of good whisky, then I don’t have a problem as far as I’m concerned.

         

        As far as simply calling the treatment of natural grief stupidity, that is not a terribly intelligent form of characterisation. It might be an idea to say what you mean by stupid and why. Because it’s ‘natural’? So is osteoarthritis in older people. I think you’re being dualist here, and separating ‘mental’ phenomena out from ‘physical’ ones.

         



      • Robert Karl Stonjek
        ... From: Dr. Chittaranjan Andrade To: psychiatry-research@yahoogroups.com Sent: Wednesday, February 27, 2013 6:37 PM Subject: Re: [psychiatry-research] News:
        Message 3 of 20 , Feb 27, 2013
          ----- Original Message -----
          Sent: Wednesday, February 27, 2013 6:37 PM
          Subject: Re: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

          Some thoughts in support of Roger's views:
          1. Why should bereavement grief be treated as different from other stressors just because it is so common and because it happens to almost everybody?
          2. If a grieving person is suffering and is emotionally, functionally, and otherwise impaired because of his grief, and if he wants help, why is it wrong to offer the help?
          CA
          RKS:
          I think it is reasonable to compare emotional scars to physical scars, at least by analogue.
           
          If you get a cut on your knee then sure, the body is a brilliant self healer and can heal the wound all by itself.
           
          But would that stop you cleaning the wound, putting disinfectant around it and maybe a curative salve on the wound to aid healing?  If the wound is going to be vulnerable if exposed then you put a bandaid over it so that healing can proceed naturally under this protective umbrella.
           
          Now when it comes to traumatic experiences, even those that are going to heal naturally by themselves, it still pays to 'clean the wound' which in the case of traumatic experience involves talking through the event and the emotions that have been disturbed by it.  Some positive reinforcement from a friend or clinician provides that curative salve and if the emotions are to be further exposed in the normal course of that person's life then a protective medication umbrella might be called for so the emotions can heal without further insult from their environment.
           
          Do people scratch the itchy wound and make it worse?  Do they pull off the scab and rub the wound, delaying recovery and possibly causing infection?  You bet they do, and we council them against it.  But if we can't see the wound or the 'scratching' that people inadvertently are compelled to do then we tend to ignore it.  Clinicians, however, should be able to recognise this process and be able to guide the client away from that behaviour.  The technical term is 'reconsolidation'.  It is a normal process of reviewing memories and strengthening those that are important but the process is vulnerable to corruption when a distressing memory is repeatedly recalled and further strengthened each time, thus raising the likelihood of that recollection being recalled again and again.
           
          Hence we could think of the emotional wound like the physical wound that heals naturally.  But like the physical wound, natural recovery does not mean that the wound is left entirely unattended.  And just like that itchy cut, we may be tempted to scratch away at an emotional wound, making it worse and worse and ever more 'itchy'.
           
          Robert
        • Dr. Chittaranjan Andrade
          Nice metaphors and sensible arguments, RKS. Appreciatively, CA On Wed, Feb 27, 2013 at 2:07 PM, Robert Karl Stonjek
          Message 4 of 20 , Feb 27, 2013
            Nice metaphors and sensible arguments, RKS.
            Appreciatively,
            CA

            On Wed, Feb 27, 2013 at 2:07 PM, Robert Karl Stonjek <stonjek@...> wrote:
             

            ----- Original Message -----
            Sent: Wednesday, February 27, 2013 6:37 PM
            Subject: Re: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

            Some thoughts in support of Roger's views:
            1. Why should bereavement grief be treated as different from other stressors just because it is so common and because it happens to almost everybody?
            2. If a grieving person is suffering and is emotionally, functionally, and otherwise impaired because of his grief, and if he wants help, why is it wrong to offer the help?
            CA
            RKS:
            I think it is reasonable to compare emotional scars to physical scars, at least by analogue.
             
            If you get a cut on your knee then sure, the body is a brilliant self healer and can heal the wound all by itself.
             
            But would that stop you cleaning the wound, putting disinfectant around it and maybe a curative salve on the wound to aid healing?  If the wound is going to be vulnerable if exposed then you put a bandaid over it so that healing can proceed naturally under this protective umbrella.
             
            Now when it comes to traumatic experiences, even those that are going to heal naturally by themselves, it still pays to 'clean the wound' which in the case of traumatic experience involves talking through the event and the emotions that have been disturbed by it.  Some positive reinforcement from a friend or clinician provides that curative salve and if the emotions are to be further exposed in the normal course of that person's life then a protective medication umbrella might be called for so the emotions can heal without further insult from their environment.
             
            Do people scratch the itchy wound and make it worse?  Do they pull off the scab and rub the wound, delaying recovery and possibly causing infection?  You bet they do, and we council them against it.  But if we can't see the wound or the 'scratching' that people inadvertently are compelled to do then we tend to ignore it.  Clinicians, however, should be able to recognise this process and be able to guide the client away from that behaviour.  The technical term is 'reconsolidation'.  It is a normal process of reviewing memories and strengthening those that are important but the process is vulnerable to corruption when a distressing memory is repeatedly recalled and further strengthened each time, thus raising the likelihood of that recollection being recalled again and again.
             
            Hence we could think of the emotional wound like the physical wound that heals naturally.  But like the physical wound, natural recovery does not mean that the wound is left entirely unattended.  And just like that itchy cut, we may be tempted to scratch away at an emotional wound, making it worse and worse and ever more 'itchy'.
             
            Robert


          • Roger Lass
            Thanks to both of you for not thinking I m mad. I appreciate this sensible support from professionals I respect. R From: psychiatry-research@yahoogroups.com
            Message 5 of 20 , Feb 28, 2013

              Thanks to both of you for not thinking I’m mad. I appreciate this sensible support from professionals I respect.

              R

               

              From: psychiatry-research@yahoogroups.com [mailto:psychiatry-research@yahoogroups.com] On Behalf Of Dr. Chittaranjan Andrade
              Sent: 27 February 2013 10:47 AM
              To: psychiatry-research@yahoogroups.com
              Subject: Re: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

               



              Nice metaphors and sensible arguments, RKS.
              Appreciatively,
              CA

              On Wed, Feb 27, 2013 at 2:07 PM, Robert Karl Stonjek <stonjek@...> wrote:

               

              ----- Original Message -----

              Sent: Wednesday, February 27, 2013 6:37 PM

              Subject: Re: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

              Some thoughts in support of Roger's views:
              1. Why should bereavement grief be treated as different from other stressors just because it is so common and because it happens to almost everybody?
              2. If a grieving person is suffering and is emotionally, functionally, and otherwise impaired because of his grief, and if he wants help, why is it wrong to offer the help?
              CA

              RKS:
              I think it is reasonable to compare emotional scars to physical scars, at least by analogue.

               

              If you get a cut on your knee then sure, the body is a brilliant self healer and can heal the wound all by itself.

               

              But would that stop you cleaning the wound, putting disinfectant around it and maybe a curative salve on the wound to aid healing?  If the wound is going to be vulnerable if exposed then you put a bandaid over it so that healing can proceed naturally under this protective umbrella.

               

              Now when it comes to traumatic experiences, even those that are going to heal naturally by themselves, it still pays to 'clean the wound' which in the case of traumatic experience involves talking through the event and the emotions that have been disturbed by it.  Some positive reinforcement from a friend or clinician provides that curative salve and if the emotions are to be further exposed in the normal course of that person's life then a protective medication umbrella might be called for so the emotions can heal without further insult from their environment.

               

              Do people scratch the itchy wound and make it worse?  Do they pull off the scab and rub the wound, delaying recovery and possibly causing infection?  You bet they do, and we council them against it.  But if we can't see the wound or the 'scratching' that people inadvertently are compelled to do then we tend to ignore it.  Clinicians, however, should be able to recognise this process and be able to guide the client away from that behaviour.  The technical term is 'reconsolidation'.  It is a normal process of reviewing memories and strengthening those that are important but the process is vulnerable to corruption when a distressing memory is repeatedly recalled and further strengthened each time, thus raising the likelihood of that recollection being recalled again and again.

               

              Hence we could think of the emotional wound like the physical wound that heals naturally.  But like the physical wound, natural recovery does not mean that the wound is left entirely unattended.  And just like that itchy cut, we may be tempted to scratch away at an emotional wound, making it worse and worse and ever more 'itchy'.

               

              Robert





            • Glynn Owens
              Not sure I fit into the respected category :-) but for what it s worth, I too think your argument is splendid and perfectly coherent - unfortunately it clashes
              Message 6 of 20 , Feb 28, 2013

                Not sure I fit into the respected category :-) but for what it's worth, I too think your argument is splendid and perfectly coherent - unfortunately it clashes with too many people's sacred cows, I suspect, to end up being widely accepted....

                 

                cheers,

                 

                Glynn


                From: psychiatry-research@yahoogroups.com [psychiatry-research@yahoogroups.com] on behalf of Roger Lass [lass@...]
                Sent: Friday, 1 March 2013 3:25 a.m.
                To: psychiatry-research@yahoogroups.com
                Subject: RE: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

                 

                Thanks to both of you for not thinking I’m mad. I appreciate this sensible support from professionals I respect.

                R

                 

                From: psychiatry-research@yahoogroups.com [mailto:psychiatry-research@yahoogroups.com] On Behalf Of Dr. Chittaranjan Andrade
                Sent: 27 February 2013 10:47 AM
                To: psychiatry-research@yahoogroups.com
                Subject: Re: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

                 



                Nice metaphors and sensible arguments, RKS.
                Appreciatively,
                CA

                On Wed, Feb 27, 2013 at 2:07 PM, Robert Karl Stonjek <stonjek@...> wrote:

                ----- Original Message -----

                Sent: Wednesday, February 27, 2013 6:37 PM

                Subject: Re: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

                Some thoughts in support of Roger's views:
                1. Why should bereavement grief be treated as different from other stressors just because it is so common and because it happens to almost everybody?
                2. If a grieving person is suffering and is emotionally, functionally, and otherwise impaired because of his grief, and if he wants help, why is it wrong to offer the help?
                CA

                RKS:
                I think it is reasonable to compare emotional scars to physical scars, at least by analogue.

                 

                If you get a cut on your knee then sure, the body is a brilliant self healer and can heal the wound all by itself.

                 

                But would that stop you cleaning the wound, putting disinfectant around it and maybe a curative salve on the wound to aid healing?  If the wound is going to be vulnerable if exposed then you put a bandaid over it so that healing can proceed naturally under this protective umbrella.

                 

                Now when it comes to traumatic experiences, even those that are going to heal naturally by themselves, it still pays to 'clean the wound' which in the case of traumatic experience involves talking through the event and the emotions that have been disturbed by it.  Some positive reinforcement from a friend or clinician provides that curative salve and if the emotions are to be further exposed in the normal course of that person's life then a protective medication umbrella might be called for so the emotions can heal without further insult from their environment.

                 

                Do people scratch the itchy wound and make it worse?  Do they pull off the scab and rub the wound, delaying recovery and possibly causing infection?  You bet they do, and we council them against it.  But if we can't see the wound or the 'scratching' that people inadvertently are compelled to do then we tend to ignore it.  Clinicians, however, should be able to recognise this process and be able to guide the client away from that behaviour.  The technical term is 'reconsolidation'.  It is a normal process of reviewing memories and strengthening those that are important but the process is vulnerable to corruption when a distressing memory is repeatedly recalled and further strengthened each time, thus raising the likelihood of that recollection being recalled again and again.

                 

                Hence we could think of the emotional wound like the physical wound that heals naturally.  But like the physical wound, natural recovery does not mean that the wound is left entirely unattended.  And just like that itchy cut, we may be tempted to scratch away at an emotional wound, making it worse and worse and ever more 'itchy'.

                 

                Robert





              • Johan G
                Almost nobody objects to simple pills against head ache. With anxiety there will be more objections. For problems with insomnia still more objections. A common
                Message 7 of 20 , Feb 28, 2013
                  Almost nobody objects to simple pills against head ache.

                  With anxiety there will be more objections.

                  For problems with insomnia still more objections.

                  A common denominator is fear of dependency.

                  Another denominator is physical side effects

                  and so on.

                  So far I haven't even touched on the Big Pharma complexity and the problem of trust connected with greed.

                  JG


                  2013/3/1 Glynn Owens <g.owens@...>
                   

                  Not sure I fit into the respected category :-) but for what it's worth, I too think your argument is splendid and perfectly coherent - unfortunately it clashes with too many people's sacred cows, I suspect, to end up being widely accepted....

                   

                  cheers,

                   

                  Glynn


                  From: psychiatry-research@yahoogroups.com [psychiatry-research@yahoogroups.com] on behalf of Roger Lass [lass@...]
                  Sent: Friday, 1 March 2013 3:25 a.m.
                  To: psychiatry-research@yahoogroups.com
                  Subject: RE: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

                   

                  Thanks to both of you for not thinking I’m mad. I appreciate this sensible support from professionals I respect.

                  R

                   

                  From: psychiatry-research@yahoogroups.com [mailto:psychiatry-research@yahoogroups.com] On Behalf Of Dr. Chittaranjan Andrade
                  Sent: 27 February 2013 10:47 AM
                  To: psychiatry-research@yahoogroups.com
                  Subject: Re: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

                   



                  Nice metaphors and sensible arguments, RKS.
                  Appreciatively,
                  CA

                  On Wed, Feb 27, 2013 at 2:07 PM, Robert Karl Stonjek <stonjek@...> wrote:

                  ----- Original Message -----

                  Sent: Wednesday, February 27, 2013 6:37 PM

                  Subject: Re: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

                  Some thoughts in support of Roger's views:
                  1. Why should bereavement grief be treated as different from other stressors just because it is so common and because it happens to almost everybody?
                  2. If a grieving person is suffering and is emotionally, functionally, and otherwise impaired because of his grief, and if he wants help, why is it wrong to offer the help?
                  CA

                  RKS:
                  I think it is reasonable to compare emotional scars to physical scars, at least by analogue.

                   

                  If you get a cut on your knee then sure, the body is a brilliant self healer and can heal the wound all by itself.

                   

                  But would that stop you cleaning the wound, putting disinfectant around it and maybe a curative salve on the wound to aid healing?  If the wound is going to be vulnerable if exposed then you put a bandaid over it so that healing can proceed naturally under this protective umbrella.

                   

                  Now when it comes to traumatic experiences, even those that are going to heal naturally by themselves, it still pays to 'clean the wound' which in the case of traumatic experience involves talking through the event and the emotions that have been disturbed by it.  Some positive reinforcement from a friend or clinician provides that curative salve and if the emotions are to be further exposed in the normal course of that person's life then a protective medication umbrella might be called for so the emotions can heal without further insult from their environment.

                   

                  Do people scratch the itchy wound and make it worse?  Do they pull off the scab and rub the wound, delaying recovery and possibly causing infection?  You bet they do, and we council them against it.  But if we can't see the wound or the 'scratching' that people inadvertently are compelled to do then we tend to ignore it.  Clinicians, however, should be able to recognise this process and be able to guide the client away from that behaviour.  The technical term is 'reconsolidation'.  It is a normal process of reviewing memories and strengthening those that are important but the process is vulnerable to corruption when a distressing memory is repeatedly recalled and further strengthened each time, thus raising the likelihood of that recollection being recalled again and again.

                   

                  Hence we could think of the emotional wound like the physical wound that heals naturally.  But like the physical wound, natural recovery does not mean that the wound is left entirely unattended.  And just like that itchy cut, we may be tempted to scratch away at an emotional wound, making it worse and worse and ever more 'itchy'.

                   

                  Robert






                • Roger Lass
                  Well if you want to be modest, note that I only said people I respect, and we all have our own idiosyncrasies. There s a whole barn full of sacred cows here.
                  Message 8 of 20 , Feb 28, 2013

                    Well if you want to be modest, note that I only said people I respect, and we all have our own idiosyncrasies. There’s a whole barn full of sacred cows here.

                    RL

                     

                    From: psychiatry-research@yahoogroups.com [mailto:psychiatry-research@yahoogroups.com] On Behalf Of Glynn Owens
                    Sent: 01 March 2013 01:35 AM
                    To: psychiatry-research@yahoogroups.com
                    Subject: RE: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

                     




                    Not sure I fit into the respected category :-) but for what it's worth, I too think your argument is splendid and perfectly coherent - unfortunately it clashes with too many people's sacred cows, I suspect, to end up being widely accepted....

                     

                    cheers,

                     

                    Glynn


                    From: psychiatry-research@yahoogroups.com [psychiatry-research@yahoogroups.com] on behalf of Roger Lass [lass@...]
                    Sent: Friday, 1 March 2013 3:25 a.m.
                    To: psychiatry-research@yahoogroups.com
                    Subject: RE: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

                     

                    Thanks to both of you for not thinking I’m mad. I appreciate this sensible support from professionals I respect.

                    R

                     

                    From: psychiatry-research@yahoogroups.com [mailto:psychiatry-research@yahoogroups.com] On Behalf Of Dr. Chittaranjan Andrade
                    Sent: 27 February 2013 10:47 AM
                    To: psychiatry-research@yahoogroups.com
                    Subject: Re: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

                     



                    Nice metaphors and sensible arguments, RKS.
                    Appreciatively,
                    CA

                    On Wed, Feb 27, 2013 at 2:07 PM, Robert Karl Stonjek <stonjek@...> wrote:

                    ----- Original Message -----

                    Sent: Wednesday, February 27, 2013 6:37 PM

                    Subject: Re: [psychiatry-research] News: Psychiatrists to brand grief lasting longer than two weeks a mental illness

                    Some thoughts in support of Roger's views:
                    1. Why should bereavement grief be treated as different from other stressors just because it is so common and because it happens to almost everybody?
                    2. If a grieving person is suffering and is emotionally, functionally, and otherwise impaired because of his grief, and if he wants help, why is it wrong to offer the help?
                    CA

                    RKS:
                    I think it is reasonable to compare emotional scars to physical scars, at least by analogue.

                     

                    If you get a cut on your knee then sure, the body is a brilliant self healer and can heal the wound all by itself.

                     

                    But would that stop you cleaning the wound, putting disinfectant around it and maybe a curative salve on the wound to aid healing?  If the wound is going to be vulnerable if exposed then you put a bandaid over it so that healing can proceed naturally under this protective umbrella.

                     

                    Now when it comes to traumatic experiences, even those that are going to heal naturally by themselves, it still pays to 'clean the wound' which in the case of traumatic experience involves talking through the event and the emotions that have been disturbed by it.  Some positive reinforcement from a friend or clinician provides that curative salve and if the emotions are to be further exposed in the normal course of that person's life then a protective medication umbrella might be called for so the emotions can heal without further insult from their environment.

                     

                    Do people scratch the itchy wound and make it worse?  Do they pull off the scab and rub the wound, delaying recovery and possibly causing infection?  You bet they do, and we council them against it.  But if we can't see the wound or the 'scratching' that people inadvertently are compelled to do then we tend to ignore it.  Clinicians, however, should be able to recognise this process and be able to guide the client away from that behaviour.  The technical term is 'reconsolidation'.  It is a normal process of reviewing memories and strengthening those that are important but the process is vulnerable to corruption when a distressing memory is repeatedly recalled and further strengthened each time, thus raising the likelihood of that recollection being recalled again and again.

                     

                    Hence we could think of the emotional wound like the physical wound that heals naturally.  But like the physical wound, natural recovery does not mean that the wound is left entirely unattended.  And just like that itchy cut, we may be tempted to scratch away at an emotional wound, making it worse and worse and ever more 'itchy'.

                     

                    Robert







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