Do Patients With Psychosis Experience Loss and Grief As a Result of Their Illness?

BACKGROUND: Depression and suicidality are frequently reported in patients with psychosis and schizophrenia, but the grief process that may be associated with this illness has not been systematically studied. In this study, we examined whether patients diagnosed with psychosis identify, grieve, and mourn losses engendered by the illness. METHOD: 24 patients diagnosed with psychosis in the past five years were surveyed to indicate whether their illness led to losses, and to describe their responses to the losses. Psychosis-related perceived losses were surveyed using three subscales of a loss and grief questionnaire (loss of self, self-care, and roles). Their relationship with beliefs about the illness, symptomatology, coping style, and self-efficacy and insight was studied. RESULTS: 23 (96%) patients named specific losses, and 16 patients (67%) reported feelings associated with grief and mourning. More than half reported loss of self-esteem at the onset of illness and only half saw themselves as having improved in the past month. Patients reported more loss within the past month than at the onset of illness. In the past month, patients with an intact sense of self experienced greater self-efficacy (r = .568, p < .004) while those with loss of self reported feelings of shame (r = ?.582, p < .003). Only patients with insight associated the onset of illness with loss. In the past month, most patients saw themselves as experiencing loss. DISCUSSION: The study results suggest that at some distance from diagnosis, patients still experience themselves as having much loss due to their illness. These unresolved feelings may indicate complicated mourning. Insight appears to be associated with the ability to look back at the onset of the illness and recognize that it engendered losses. Further study of the process of and barriers to grief and mourning is recommended. In clinical practice, the assessment of grief as a part of post-psychotic recovery could lead to providing more appropriate treatment and lead to a positive outcome.     

Working in the Midst of Unfolding Trauma and Traumatic Loss

Abstract

Training developed for New York City social workers in the evolving aftermath of September 11, 2001 is introduced, offering a conceptual framework for clinical practice in the midst of unfolding trauma and traumatic loss. A focus is placed on the shared, collective process of learning and discussion among colleagues, as an effort parallel to work with clients, progressing together to establish meaning and hope through relationships. Professional training framing this catastrophe within trauma and traumatic loss perspectives, and addressing its impact on clinician, client, work, and treatment relationship, is needed. Also providing on-going support, a process of continuity, and a context of community, this training becomes a collective response to the profound impact and complex, evolving needs of this time.     

The Clinical Advantage of the Death Instinct

Abstract

The death instinct has been debated, devalued, criticized, and ignored by various analysts and analytic schools. Nevertheless, it remains a viable part of Kleinian theory. This paper explores the advantages of the concept from both a clinical and theoretical perspective. Due to their self-destructive ways, certain patients seem to create difficult and destructive transference-countertransference patterns. Clinically, they need a period of intrapsychic and interpersonal containment, followed by analysis of the death instinct in its clinical manifestations, followed by the working through of primitive states of paranoid-schizoid loss and persecution. Case material, focusing on the analysis of the death instinct, is used for illustration.     

Co-story-ing

Abstract

This article offers a guide for using collaborative story writing (co-story-ing), an assessment technique as well as a therapeutic intervention for children who demonstrate fears, extreme shyness and difficulty in establishing relationships. Co-story-ing draws from Gardner's Mutual Story Telling Technique. Co-story-ing guides clients as they develop a wider repertoire of strategies and explore the consequences of employing new strategies in a safe context, the story.     

通货膨胀知觉的认知机制和影响因素

通货膨胀知觉是个体对通货膨胀的主观体验.通货膨胀知觉的认知机制主要体现在体验阶段和整合阶段.体验阶段主要涉及到个体对物价的感受性和记忆,整合阶段主要涉及到个体利用可得性启发式以及锚定和调整启发式完成对通货膨胀的最终估计.通货膨胀知觉的影响因素主要包括通货膨胀预期、框架效应、对价格公平性的认知、社会放大效应以及货币改革等.未来可以从通货膨胀知觉的信息加工方式、认知神经机制、跨文化研究以及具有较高生态效度的测量指标等方面进一步探讨.     

Reproductive loss: toward a theology of bodies

ABSTRACT

Reproductive loss—the loss of a pregnancy before 24 weeks—is estimated to occur in 20-50% of all pregnancies. It is a common human experience. However, it is an experience that is shrouded in silence and mystery. Not only is reproductive loss culturally taboo but given the marked absence of theological reflection on the experience, it would seem to be theologically taboo as well. The experience of reproductive loss raises profound theological questions about what it means to be (a gendered) human, issues of suffering, the providence of God, and eschatology. This research considers some of the reasons for this theological silence and begins to examine the experience of reproductive loss with the aim of taking the embodied experience of the miscarrying woman seriously as a site for theological reflection.     

Relationship between church attendance and mental health among Mormons and non-Mormons in Utah

A prevention model was applied to assess the protective effect of religion and church attendance against mental illness among respondents to the 1996 Utah Health Status Survey. Compared to Mormons that attend church weekly (active), less active Mormons, less active non-Mormons, and those with no religious preference, because of emotional problems, are at increased risk of accomplishing less than desired (model 1); having trouble doing work or other activities as carefully as desired (model 2); and seeking professional help (model 3). After adjusting for alcohol and tobacco use, education, income, physical activity, general health status, employment, body mass index, gender and age, only less active Mormons and those with no religious preference remained at significantly increased risk in model 3. Self-reported health status was the strongest predictor of mental health in each model. Active Mormons reported having the best health status and, consequently, the lowest levels of mental illness.     

Bereavement anxieties and health amongst the Australian-Italian Catholic community

This article is based on survey of 269 households in the state of Victoria, Australia. It elicits some useful guidelines for professional caregivers in relation to eight cultural/religious groups including Australian-born Christians and Arab-born Muslims. The focus here is upon the relationships between the Australian Italian community and personal health outcomes during bereavement. The following sub-strata are examined: community differences in relation to grief and loss practices and traditions; the value of religious communal support and counseling; symptomatological differences from psychosocial and educational perspectives; psychopathological/psychiatric symptoms and beliefs and practice concerning the afterlife. Significant differences were revealed between the sexes on such matters as health problems, grief expressions, psychosomatic manifestations, communication with the dead, beliefs in the afterlife and interpretation of the meaning of loss. Differences in these findings will assist professional caregivers who deal with families experiencing personal death loss to broaden their own perspectives on bereavement, offering specific counselling strategies and care-giving interventions.     

Images of God and the imaginary in the face of loss: a quantitative research on Vietnamese immigrants living in Canada

ABSTRACT

This study examines the relationships between images of God, the imaginary and experiences of loss among Vietnamese immigrants living in Canada. One hundred twenty-nine participants completed four sets of questionnaires: a demographic questionnaire, a Questionnaire on God Image, the Brief Symptom Inventory, the Davidson Trauma Scale. In the second phase, 32 participants were administered the AT.9 test (an archetypal test with nine elements). In this test, participants are asked to draw, using nine symbolic elements, and then write a story based on their drawing. Results showed that a positive perception of God negatively correlated with somatisation, anxiety and hostility, whereas negative God image was significantly related to high levels of emotional distress. Results also showed that the synthetic categories of the imaginary were associated with a positive perception of God; and were negatively associated with somatisation, intrusion and hyper-vigilance. Further discussions on the main findings will address cultural implications in the fields of Mental Health, Religion and Culture.