[Mourning].

Abstract

A PAINFUL EXPERIENCE: Mourning characterizes the grief of a person who has lost a loved one forever. The bereavement that follows is natural and should not be medicated. Mourning is not a disease; it is one of the most painful facts of life. In fact, the more we are attached to someone, the more we will suffer his or her loss. This is unavoidable. The grief expressing our attachment is accompanied by immediate and intense regression with repeated need for consolation. For some people, it can be the means of coming to terms with their own mortality. THE STAGES OF MOURNING: There are several stages of mourning: the living person's ambivalence toward the deceased, the recollection corresponding to the progressive acceptance of the loss, which represents the first phase of the mourning process. During the healing phase, the mourner is gradually capable of recalling the good times during the life of the deceased and then progressively of evacuating the souvenirs and start living and opening up to others again. COMPLICATED MOURNING: Mourning may be passionate and characterized by the refusal to integrate the loss, or delayed, with an apparent lack of grief and sorrow. Chronic depression is a sort of greater degree of severity compared with delayed mourning. A denial mechanism installs: the loved one is not dead and will return. A split in personality can be observed: part of the person will integrate the reality; the other will retreat from it. In this case, recollection will not lead to integration of the loss. Somatization disorders or organic problems can be observed and more rarely grief melancholia, mania, hysteria or obsessional grief. These are the domain of the specialist. GENERAL PRINCIPLES FOR THE PHYSICIAN: Reality is always preferable to imagination. Listening to the patient must precede any medication. In severe cases of grief, sedative antidepressors are preferable and the co-prescription of anxiolytics, particularly benzodiazepines should be avoided. One should not hesitate to seek advice from a specialist.