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Prolonged Grief Is Now An Illness

In a tremendous win for Big PhARMA, the American Psychiatric Association has added “Prolonged Grief Disorder” to its Diagnostic and Statistical Manual of Mental Disorder —a list of conditions for which insurance companies reimburse doctors. To break the news March 19, the NY Times made room on a front-page entirely devoted to the war in Ukraine.

“The decision marks an end to a long debate within the field of mental health, steering researchers and clinicians to view intense grief as a target for medical treatment, at a moment when many Americans are overwhelmed by loss,” wrote Ellen Barry. “Since the 1990s, a number of researchers have argued that intense forms of grief should be classified as a mental illness, saying that society tends to accept the suffering of bereaved people as natural and that it fails to steer them toward treatment that could help. A diagnosis, they hope, will allow clinicians to aid a part of the population that has, throughout history, withdrawn into isolation after terrible losses...”

Dr. Paul S. Applebaum, chair of the steering committee overseeing revisions to the DSM, offered the Times this example of people who need treatment for Prolonged Grief Disorder: “The parents who never got over it, and that was how we talked about them. Colloquially, we would say they never got over the loss of that child.”

Barry also quotes a shrink named Kenneth Kendler saying that the inclusion of Prolonged Grief Disorder in the DSM, “is kind of like the bar mitzvah of diagnoses. It’s sort of an official blessing in the world.” Kendler is a professor of psychiatry at Virginia Commonwealth University who, according to Barry, “has played an important role in the last three editions of the diagnostic manual.”

I flashed on Richard Nixon’s brilliant comment to HR Haldemann, “What the Christ is the matter with the Jews, Bob, what is the matter with them? I suppose it’s because most of them are psychiatrists, you know, there’s so many, all the greatest psychiatrists are Jewish.” 

Barry’s story drew a barrage of eloquent letters from Times readers. Some excerpts follow:

• “It is more than six years since my wife died… With the passage of time, I was able to regain my normal functioning. I was able to work, to socialize with others and to laugh. But beneath the surface I retain feelings of loneliness, sadness and a certain emptiness. I return to an empty house, sleep alone in an empty bed and prepare meals to dine alone at an empty table. These are existential facts, and that I should feel the pain of her absence is not a mental disorder but a reality that will remain with me for the rest of my life. The cliché that everyone grieves in his or her way is assuredly true. That the psychiatric establishment has now pathologized prolonged grief is not only stigmatizing, but also imperious. When they develop a pill that will bring my wife back, I will reconsider my position.” —Joseph Chuman, Hackensack, N.J.

• “Unfortunately, each new DSM diagnosis opens up the floodgates for a new group of suffering people to treatment with psychiatric medications. As an internist/psychiatrist with 30 years of experience treating end-of-life patients and their families, I have witnessed psychiatry reduced to viewing all human suffering as a set of pathologic disorders or diagnoses that must be treated with drugs, fallaciously touted as curing everything. Make no mistake, ‘Medical treatment’ means only one thing — drug treatment... Bereaved beware.” —Charles E. Schwartz, New York

• “Thanks to Ellen Barry, whose fine piece on this latest addition to the American Psychiatric Association manual’s list of ‘disorders’ makes explicit its beneficiaries: psychiatrists and pill makers. I have had grief (longer than a year), have interviewed scores of people in grief, and have written about grief, and what strikes me as abnormal is not grief prolonged beyond the A.P.A.’s one-year prescription, but the degree of chutzpah required, professional training notwithstanding, to presume to set timelines for the normal grief of others, which in fact is as various as the grievers themselves.” —Martha Weinman Lear, New York

6 Comments

  1. Judy April 19, 2022

    I’m wondering if Dr. Paul S. Applebaum has ever experienced the loss of a child. If he had he should know a parent never gets over that loss. They eventually learn to live with the loss but they don’t get over it.
    Two weeks after my son died (at age 33) a friend of mine who has never had children told me to “get over it.” I won’t repeat what I said to him.
    I have found that a lot of people who have never experienced this kind of loss think they have all the answers but in reality…they don’t have a clue.

    • Laura Cooskey April 19, 2022

      Would taking drugs so that, although still not “over” the loss of your child, you felt a lot better about it and seldom thought about it, make you happy? If so, welcome to the brave new world.

  2. Douglas Coulter April 19, 2022

    5 stages of grief are the symptoms of PTSD and yes it creates medical problems. Drugs only mask the symptoms. Peer support and community bonds help far more than drugs but when there is money to be made in science for profit world guess who wins

  3. Betsy Cawn April 19, 2022

    Sorrow and joy are two sides of the same coin. In the post-WWII era of real-time “cold war,” people were told to “adjust” to the new reality, with assistance from “therapists” — and in intractable cases, modified their feelings with various treatments (including electro-shock). Today’s answer to human strife is the modulation of reaction through chemistry, with a huge percentage of the population “self-medicating.” Psycho-social rebellion in the 60s and 70s, rejecting the dictates of social mores and responsibilities in which the cream of that generation’s young men were sent to die in Southeast Asia, followed in the 80s and 90s by equally stewed-up “conflicts” in the Middle East still — in the first two decades of the 21st Century — rely on mental gymnastics by which the sanctity of life is demeaned by the lust for power and profits. To which the maleable mind of indoctrinated citizens responds with “manic” depression or complete withdrawal — and thus becoming a social burden on the long-suffering professionals toiling under bureaucratic strictures for which their paychecks are symbolic compensation.

    Don’t forget that at one time homosexuality was deemed to be a mental illness, and that the entire concept of quantifiable mental conditions was created by one man in collaboration with the John Dewey School of Social Science for conducting “controlled” experiments proving that humans are easily confused and often fooled. Good grief!

  4. Douglas Coulter April 20, 2022

    The DSM-5 was created behind closed doors and was NOT peer reviewed

  5. Douglas Coulter April 20, 2022

    Ira Hays died of prolonged grief. Johnny Cash wrote about one drunk indian. Survivor grief is the hardest trauma to overcome

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