Professional Documents
Culture Documents
Tina R. Workman
Bereavement, the loss of someone you care about, is a part of life for everyone. How one
reacts to grief and how they move through the grieving process determines whether additional
support or professional help is needed. People seek support from religious leaders, family and
friends, or other social circles. Everyone who is experiencing grief does not need to attend
counseling although many do. Counseling and support groups can be beneficial in addition to the
people come for medical or psychiatric care unaware of the dynamics of grief, and this requires
that the clinician help make the diagnosis (p. 61). We will explore the diagnostic criteria for
bereavement, take a look at the etiology, discuss symptoms and behaviors of grief, and delve into
Due to the fact that grieving is a natural course of life there is no diagnostic criteria for
grief. Pathology is not attached to grief because it could then be viewed as an illness which it is
not. Sometimes people call the grieving process depression. It is important to understand that
while grief may have some of the same diagnostic criteria as major depressive disorder there are
differences. According to the DSM-V (2013), with grief the predominate affect is feelings of
emptiness, whereas with major depressive disorder a persistent depression with the inability to
Research has shown that traumatic bereavement comes from a sudden death such as
grief) due to the suddenness and manner of death. Persistent complex bereavement can only be
considered in adults if symptoms persist longer than 12 months after the person close to you has
The cause of bereavement is when someone to whom you were close to or loved has
died. Individuals are unique and it would make sense that their grief would be too. Research has
shown there are many symptoms people can display when going through grief. J. William
Worden (1982) said Because the list of normal grief behavior is so extensive and varied, these
behaviors can be described under four general categories: (1) feelings, (2) physical sensations,
(3) cognitions, and (4) behaviors (p. 20). Under the category of feelings symptoms would
include: sadness, anger, guilt, anxiety, loneliness, fatigue, helplessness, shock, yearning,
emancipation, relief, and numbness (Worden, 1982). Somatic sensations can include: hollowness
in the stomach, tightness in the chest or throat, oversensitivity to noise, depersonalization, short
of breath, muscle weakness, dry mouth, and lack of energy (Worden, 1982). Cognitions for grief
are varied. There are some thought patterns that disappear after the early stages of grief and
others that persist longer and trigger sadness and/or anxiety (Worden, 1982). Grief can cause
presence, and hallucinations (Worden, 1982). The range of behaviors that are often associated
with bereavement are varied and vast. Common behaviors displayed are: sleep disturbances,
avoiding reminders of the deceased, searching and calling out for the deceased, restless over
activity, crying, visiting places or carrying objects that remind the survivor of the deceased
(Worden, 1982).
When dealing with traumatic or sudden death, research has shown the grieving process
can become complicated leading to what is known as persistent complex bereavement (DSM-V,
2013). There may be a display of symptoms & manifestations that are outside of the average
bereavement process such as increased anxiety, posttraumatic stress disorder, intense guilt,
GRIEF AND HOMICIDE SURVIORS
auditory or visual hallucinations of the deceased, and preoccupation with the manner in which
According to the Centers for Disease Control National Center for Health Statistics
(2013), homicide is the third leading cause of death in men and the fifth leading cause in women
in the age group twenty-five to thirty-four. When someone has a spouse that has been murdered
they can have trouble moving through the process of grieving. There is no way to prepare for the
loss of a loved one through murder. The sudden and unpreventable nature leaves nothing but
pain and anguish in its wake (Asaro, 2001). Laurence Miller (2009) said, The cruel and
malicious nature of murder compounds the rage, grief, and despair of the survivors [] a deep
and justifiable anger toward the killer alternately smolders and flares as investigations and legal
actions meander along (p. 68). There are other factors outside of grief that homicide survivors
must handle. Media attention can be intrusive to some families compounding the grieving
process. Often, there is a microphone shoved in their faces, trying to elicit a reaction or response
(Asaro, 2001). Very often, in sensationalized cases, family members are subjected to frequent
and in-depth discussions of the case and of their loved ones lifestyle (Asaro, 2001, p. 99). If the
murder happens while the victim is participating in risky behavior sometimes there can be stigma
attached, in which others may think the victim got what they deserve or perhaps blame the
As one can see, though grief is a natural process it is also very complex. Homicide
compounds that grief, and in some cases, leads to more serious mental health issues. Given the
prevalence of homicide in the age group outlined above one can see how a support group for
References
Asaro, M. (2001). Working with adult homicide survivors, part I: impact and sequelae
American Psychiatric Association: Diagnostic and statistical manual of mental disorders, Fifth
Heron, M. (2013). Deaths: leading causes for 2010. National Vital Statics Reports,
Worden, J. (1982). Grief counseling and grief therapy: A handbook for the mental health
Zinzow, H., Rheingold, A., Byczkiewicz, M., Saunders, B., & Kilpatrick, D. (2011).
doi:10.1002/jts.20692