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The treatment of complicated bereavement poses specific management problems. This paper describes a patient who was treated with hypnosis for pathological bereavement following the number of her husband. Hypnosis proved successful after months of conventional therapy did not bring out any symptom relief.
Grief is a pervasive highly individualized dynamic process (Cowles and Rogers, 1991). There is general agreement in the literature that mourning can be conceptualized as a movement through predefined, predictable phases. These phases need not be sequential and not all persons experience the same degree or intensity of emotions. Different names are given but essentially the phases consist of denial, a feeling of numbness, depression and re cover (Conroy, 1997; Clayton, 1990; Parking 1981).
The patient may experience a wide range of symptoms. There are feelings of guilt and hopelessness, decedent anger, fear, feelings of resentment towards intact families and a variety of somatic symptoms. Changes in the financial status, possible changes in residence and different roles are added stressors (Shelton and Sanders, 1973; Sauna 1983; Conroy, 1997; Clayton 1990; Eisenbruch, 1991). The most commonly reported symptom is depression. A distinction can be made between persons suffering depression as part of an affective illness and depression following a loss through death. The affective disorder patients report more depressive symptoms that do the bereaved patients (Clayton, Hispanic, Murphy and Woodruff, 1974).
The survivor may in addition complain of anxiety, a same of unrelated, isolation and inner emptiness (Willis, 1998; Provost, 1989; Hovey and Berkram, 1990). Largely neglected in the literature is the physiological response to grief. Reports of infections and neoclassic shortly after bereavement seem to suggest a relationship between grief as a stress mechanism depressing the immune responses via the pituitary-adrenal axis(Vachon, 1976; Fedrick, 1977). Grief is therefore a multidimensional reaction to a loss through death (Vargas, Loya and Hodde-Vargas, 1989).
The Treatment of Grief:
The aim of any treatment intervention is to help the individual to come to terms with the loss. The person must further "work" through and come to terms with feelings of guilt and decedent directed anger. Treatment within a group setting provides the emotional and social support necessary when strong emotions are expressed (Flatt, 1988; Kawaz, Roesch and Friesen, 1990; De Boer and van der Wal,...