Duluth, Minnesota (OpEdNews) July 6, 2012: If you wonder what happens to a child who does not learn how to mourn in a healthy way, there is one well known example of such a child: former President George W. Bush.
In his perceptive book BUSH ON THE COUCH: INSIDE THE MIND OF THE PRESIDENT (rev. ed. 2007), Justin A. Frank, M.D., a psychiatrist and psychoanalyst, examines the life of George W. Bush with empathy. Dr. Frank carefully discusses the death of young Robin Bush, young George's little sister. Her death was a traumatic loss for young George, not an occasion when he might have learned how to mourn in a healthy way. In the spirit of empathy, Dr. Franks suggests that seven-year-old George was probably "understandably frightened by all sorts of things -- from concerns about the power of his own negative feelings toward his sister, to fears of getting leukemia himself, to guilt about being angry at his mother for being away so much during Robin's illness. . . . But the situation called for a response that acknowledged young George's pain and helped him process it, rather than one that swept all signs of pain under the rug" as "his grieving mother decided to put on a brave face so her seven-year-old son wouldn't have to worry about her" (all quotes from page 187).
It is probably impossible for us to understand the full impact of this traumatic loss in George W. Bush's life. However, young George's loss of his little sister did not have to be as traumatic as it evidently was for him, because, as Dr. Frank points out, the situation could have been handled in a different way. In any event, it is probably fair to say that this traumatic childhood event contributed to the adult George W. Bush's limited capacity for empathy. In other words, when we do not learn as children how to mourn losses in a healthy way, we are as a result probably going to have a limited capacity for empathy as adults, but that will probably not be the only result.
When we do not learn as children how to mourn losses in a healthy way, we remain locked into an unhealthy way to mourn losses for the rest of our lives -- unless and until we are somehow able to learn how to mourn our losses in a healthy way, perhaps with the help of a psychotherapist. Because we are locked into our childhood way of mourning losses in an unhealthy way, we can use the conceptual construct of the Child Within (also known as the Inner Child) to imagine how our childhood traumatization still influences us long after our childhood.
For years now, Alice Miller, John Bradshaw, and others have been using the conceptual construct of the Child Within (also known as the Inner Child) to refer to our childhood traumatization. As a result of childhood traumatization, we remain psychologically children who still need to mourn in a healthy way. In other words, each trauma that the child experiences represents a loss that the child needs to mourn in a healthy way. But the child needs the help of adults to learn this. But the adults first need to recognize when the child has indeed experienced a loss, and then comfort and console the child.
At the present time, psychiatrists are considering the possibility of listing complicated grief (also known as complicated bereavement and complicated mourning) in the psychiatrists' Bible known as the DIAGNOSTIC AND STATISTICAL MANUAL, or the DSM, for short. Healthy bereavement should not be listed in the DSM, because it basically is not unhealthy. Thus the real trick for psychiatrists and other users of the DSM will be to figure out when healthy bereavement turns into unhealthy bereavement (or complicated bereavement). To be sure, complicated bereavement is real, and it is not healthy. From my own experience, I have no doubt that my persistent complicated bereavement involves unhealthy mourning. But here's the catch: Did my bereavement somehow move from being healthy mourning to becoming unhealthy mourning? Or was my bereavement from the onset unhealthy mourning? Regardless of how we may operationally define complicated bereavement, we also have to face the troubling issue of how psychotherapists should proceed to help someone who is clearly experiencing complicated bereavement. In plain English, how can a psychotherapist help someone who is experiencing unhealthy mourning? Do we understand healthy mourning well enough that we can identify when someone is experiencing unhealthy mourning? For example, over the years I consulted five different professional counselors, each of whom asked me to discuss my childhood. No doubt all of our experiences in life resonate against our childhood traumatization. But I was mourning somebody's death who had not been part of my childhood. In any event, I derived no benefit from discussing my childhood. Discussing my childhood did not somehow prompt the really deep stuff in my psyche involving childhood traumatization to surface, so that I might be able to work through it. And discussing my childhood did not bring me relief from any of the symptoms of bereavement.
Here's how I would describe the main symptoms of bereavement that I have experienced over the last eight years or so since late in 2003: acute sadness; preoccupation with feeling sad; walking around in a daze (a kind of detachment from and numbing out of immediate experience); limited disposable energy; extraordinary procrastination; extreme lethargy; focus on the deceased and reminders of the deceased; intense pining about the deceased; difficulty concentrating; irritability; reclusiveness. Since the onset of my bereavement, I have also been oversleeping, and I have gained a lot of weight. Now, to gain a measure of relief from the powerful symptoms of complicated bereavement, some people may take an antidepressant, if they can find one that works for them. But I have not been able to find an antidepressant that works for me.
Among the symptoms of bereavement that came into my life, acute sadness was by far the most dominant symptom. However, after several years of acute sadness, I took St. John's Wort, an over-the-counter product that is categorized as a supplement. But I had to take it for more than 60 days before I got any results. But taking it stopped the acute sadness, and after I stopped taking it several months later, the acute sadness did not come back. However, the other initial symptoms have not yet gone away, as I would prefer for them to.
I read Joan Didion's book about her experience of bereavement after the sudden death of her husband, THE YEAR OF MAGICAL THINKING (2005). Among other things, she reported that in connection with her own experience of mourning, she had read Freud's essay "Mourning and Melancholia" and other professional literature about mourning. So I decided to read Freud's famous essay and other professional literature about mourning. I quickly concluded that I was experiencing what Freud refers to as melancholia. But this term is no longer widely used in the professional literature about mourning. Instead, the terms complicated bereavement, complicated grief, and complicated mourning are used today. The word "complicated" is apt. By contrast, uncomplicated mourning is referred to as healthy mourning. By implication, the complicated versions are unhealthy. But what do the healthy versions of mourning look like? And can we specify what exactly makes the unhealthy versions occur?
In general terms, there are two basic kinds of mourning: (1) mourning somebody's death (also known as bereavement) and (2) mourning nondeath losses. Mourning is an involuntary response to loss. When this involuntary response begins, the initial processes of mourning proceed apace. However, when the processes of mourning are not completed, the result is uncompleted mourning (also known as unresolved mourning), which remains in our psyches to be completed at some later time. When we are children growing up, we need to learn from our parents and other adults in our lives how to mourn our nondeath losses in a healthy and how to mourn somebody's death in a healthy way. I am reasonably certain that my mother had herself never learned to mourn in a healthy way, and I suspect that my father also had not. When we do not learn as children to mourn in a healthy way, then we remain psychologically children who still need to learn how to mourn in a healthy way.
Over the years after my bereavement started late in 2003, I at times had PTSD flashes of extreme anger out of the blue that were not accompanied by any visual or audio cues that might enable me to associate the extreme anger with certain events in my life. By extreme anger, I do not mean extreme anger like Achilles' understandable anger at Agamemnon, but something more like King Lear's raging on the heath. But I was puzzled about how such extreme anger in me might be connected with the deceased, if it was connected. However, if it was not directly connected with the deceased, was it connected indirectly somehow, and if so, how and to what was it connected?
Eventually, the symptoms of my persistent complicated bereavement were too much of a drain on me, so I decided to retire at the end of May 2009. A few months after I had retired, I felt a strong resurgence of the PTSD flashes of extreme anger out of the blue. I began experiencing them more frequently than I had before I retired, and they seemed stronger. Even though I had not yet connected them with any particular events in my life, I happened to start writing op-ed editorials and getting them published online. Oftentimes, but not always, the pieces I published online did express my anger about one thing or another. Thus I was expressing my anger about certain issues in public discourse, but not about any particular persons or events in my life. For this reason, my op-ed editorials seemed like a kind of sublimation of the extreme anger I had experienced in PTSD flashes. However, I was at least expressing my anger about something, which seemed preferable to just sitting around absorbing the PTSD flash of extreme anger out of the blue.
Psychotherapists like to repeat the mantra advising us to feel the feelings. But when I experienced a PTSD flash of extreme anger out of the blue, there really was not anything else that I could do but feel the anger. The anger was so strong that I could not have paid attention to anything else as long as I was experiencing it. Psychotherapists also like to repeat the mantra advising us to work through the feelings. By writing op-ed editorials, I was working through some anger by expressing my anger in writing about certain issues in public discourse. Indeed, I was expressing anger about certain issues after a lifetime of internalizing anger others expressed toward me, starting in my childhood with my mother and father. Eventually, I reached the conclusion that the PTSD flashes of extreme anger out of the blue were in effect prompts prompting me, as it were, to recognize how I had internalized anger others had directed toward me. When I recognized this, the certain pieces of the puzzle began to fall in place. I began to understand how my internalized anger about certain events in my life were connected indirectly with the deceased. As I say, I began to understand how certain pieces of the puzzle were interconnected with one another.
As I was thinking about the puzzling things that were happening to me, I read Susan Anderson's book THE JOURNEY FROM ABANDONMENT TO HEALING (2000). I was able to connect the waves of anger that I had likened to King Lear on the heath raging away with her discussion of rage as a late stage in the process of mourning nondeath loss. In her book she repeatedly stresses that the process of mourning that she is describing is similar to but also different from mourning somebody's death. Then I read her essay about mourning somebody's death: "Suffer the Death of a Loved One" (2006), which is available online at http://www.abandonment.net. In her account of mourning somebody's death, there is no late stage of rage comparable to the late stage of rage in the process of mourning nondeath loss. From this difference I concluded that I was experiencing two different kinds of mourning processes concurrently: (1) mourning somebody's death and (2) mourning nondeath loss(es). No wonder my bereavement is complicated bereavement. I had not mourned certain losses in my life in the 1980s in a healthy way. As a result, my experience of mourning somebody's death that started late in 2003 prompted my unresolved mourning of losses in the 1980s to be reactivated, because the losses in my life in the 1980s were connected in a way with the deceased person.
In summary, I started this essay by discussing young George W. Bush's loss of his little sister. But many Americans did not lose a younger sibling when they were young children. However, many Americans probably did not learn how to mourn a loss in a healthy way when they were young children, just as young George W. Bush did not learn how to mourn his sister's death in a healthy way. As odd as this may sound, complicated bereavement may be a blessing in disguise, provided the person who experiences it can work through it to a healthy conclusion. For in effect, complicated bereavement is an invitation to finish some unfinished business -- to resolve some unresolved mourning from the past that is probably connected in a way to the deceased person whose death prompted the involuntary response of bereavement. Of course resolving some unresolved mourning from the past does not necessarily mean resolving all unresolved mourning from the past, including one's childhood.
The really deep stuff in our psyches involves our childhood. Alice Miller and John Bradshaw and others have urged us to work on the really deep stuff involving our childhood. But our experience of bereavement due to the death of an adult-onset attachment may not signal the resurfacing of unresolved mourning from our childhood, but the reactivation of unresolved mourning from our adult lives that was connected in a way with the deceased person.