Map of life expectancy at birth from Global Education Project.

Friday, August 12, 2005

The Disease of Grief

Take note the next time something really bad happens. Maybe some high school kids are killed in a car crash on prom night, or a deranged former employee shoots up an office, or a radical Christian terrorist bombs a women's health clinic, or maybe a popular high school athlete collapses and dies on the practice field. What does your local TV news tell you is being done about it, while showing you the growing pile of teddy bears and balloons?

Grief counselors. They're sending in the grief counselors.

Simon Wesseley of King's College, London, writing in the latest NEJM (sorry, subscription only) about the July 7 bombings in London, tells us that:

There have now been more than a dozen controlled trials in which people who have been involved in . . . traumatic events have been randomly assigned to receive or not to receive such counseling. The results have shown conclusively that such immediate psychological debriefing does not work. Those who received it were no better off emotionally than those who did not. Worse, the better studies with the longer follow-up periods showed that receiving such counseling actually increased the likelihood of later psychological problems. In fact, the people who seemed to be harmed by this intervention were those who had been especially upset at the time -- precisely those who one might think ought to be treated.

Well, that ought to put a stop to this nonsense. But try googling "grief counselor" and you will get endless pages of links to programs, sponsored by school boards, cities, universities, etc.; training programs; how-to manuals; advertisements for services; and so on. Hardly a discouraging word.

This is just one example of our cultural compulsion to medicalize every part of the human condition. Menopause, sadness, baldness, shyness, boredom and restlessness in class, road rage, loss of interest in your sex partner, grief -- all diseases, all needing appropriate professional and/or chemical intervention.

When we suffer loss, we grieve. If the loss is sudden and traumatic we may feel shock, numbness, fear, confusion, anger, and then grief comes later. That's what happens. We just need to do it. That's life. Let it be.

And all you grief counselors out there -- learn how to do smoking cessation.

PS: Don't get me wrong: Post traumatic stress disorder (whether the diagnostic label is particularly helpful or not) is for real. People can suffer the aftereffects of trauma for a long time, and the right kind of counseling, at that point, can help. But professional intervention in the process of grieving does not prevent PTSD, it just makes it worse, it seems.

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