Thursday, July 15, 2010

Thursday's Therapy - Complicated Mourning ~Therese A. Rando, Ph.D. - Part One

Thursday's Therapy

Complicated Mourning

~Therese A. Rando, Ph.D.

Part One

Tommy and I went to a wonderful conference in Chattanooga by Dr. Therese A. Rando, a premiere Death and Trauma expert this weekend. The conference was divided into two full-day sessions. Dr. Rando taught Grief and Mourning Interventions the first day, and on Sudden and Traumatic Death and its subsequent causation of Complicated Mourning the second day. We would like to share with you some of the things we are learning over the coming Thursday's Therapy posts.

High Risk Factors Predisposing a Person to Complicated Mourning

~Adapted from Rando, (1993)

First what is Complicated Mourning? Basically, it is prolonged mourning. "Normal" grief is not able to tackle all of the components with which a bereaved person is grappling, so the grief becomes "prolonged." Such a term can be confusing, for in some cases "Complicated Mourning" is an indicator of pathology. But a loss as tremendous as the Loss of One's Child is ALWAYS followed by "Complicated Mourning" as it has so many facets and dimensions that an otherwise "normal" grief couldn't begin to address.

So what are the "High Risk Factors" that predispose one to "Complicated Mourning"?

A) Risk Factors associated with the Specific Death:

▪ 1) Sudden and Unexpected Death, typically from

⁃ Accidents
⁃ Disasters
⁃ Suicides
⁃ Homicides

especially if the death was

⁃ Traumatic
⁃ Violent,
⁃ Mutilating
⁃ Preventable
(It is due to either Intentional or Negligent Behavior onsomeone's part, which did not have to happen)

Dr. Rando says,
"Whenever one deals with a sudden death, one is in fact dealing with a "Traumatic Death" because the suddenness and lack of warning personally traumatizes the mourner."

She goes on to say,
"Traumatic Bereavement" is the state of having suffered the loss of a loved one when grief and mourning over the death is overpowered by the traumatic stress brought about by its circumstances.

"Sudden Death" and "Traumatic Bereavement" always present the mourner, at least for a period of time, with "Complicated Mourning."

▪ 2) Loss of a Child - Anytime someone loses a child to death, there WILL be "Complicated Mourning." according to Dr. Rando. It is simply too great of a loss to go through in a few months or a few years time.

(My understanding is that the Acute-Grief portion of "Complicated Mourning" is expected by the experts to be at least five to seven years in duration, while the on-going mourning will actually continue throughout one's life.)

▪ 3) Sudden or Unexpected Natural Death ("Natural" in that it is caused due to something going wrong within the deceased person's own body)

B) Factors Associated with Before and After Death Circumstances

▪ 1) Relationship with the deceased was markedly
⁃ Angry, Ambivalent, or Dependent
⁃ Characterized by Insecure Attachments:
⁃ Anxious attached between person and the deceased

⁃ Attachment Bonding was avoided, broken or suspended due to relational problems between the person and the deceased

▪ 2) Prior or Concurrent Issues in the Mourner of

⁃ Unaccommodated losses and/or stresses
⁃ Any Mental Health problems or addictive behaviors untreated

▪ 3) The Mourner's Perception of Lack of Support
⁃ By family
⁃ By one's community
⁃ By needed experts, mental health, doctors, police, courts, etc.

Me, Dr. Rando, and Tommy
July 10, 2010

Thank you so much Dr. Therese Rando for your invaluable contributions to the field of Grief, Loss, Mourning, and Trauma. And we appreciate so much your availing to us of this information that should prove to be so helpful to our walking through our necessarily Complicated Mourning in as healthy a way as possible.

Treatment of Complicated Mourning, Rando, (1993)


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