Virtually all of us experience the loss of a loved one at some point in our life. So it is surprising that the serious study of grief is not much more than 30 years old. Yet in that time, we have made significant discoveries that have deepened our understanding of this phenomenon—and challenged widely held assumptions.

In this column, we confront two common misconceptions about grief. The first is that the bereaved inevitably experience intense symptoms of distress and depression. The second is that unless those who have experienced the death of a loved one “work through” their feelings about the loss, they will surely experience delayed grief reactions, in which strong emotions may be triggered by events unrelated to the loss, even long after it occurred. As we will show, neither belief holds up well to scientific scrutiny.

Bouncing Back
Most people believe that distress and depression almost always follow the death of someone close, according to psychologists Camille B. Wortman of Stony Brook University and Kathrin Boerner of Mount Sinai School of Medicine. Symptoms of distress include yearning for the deceased, feeling that life has lost its meaning, having anxiety about the future and experiencing shock at the loss. Depression involves feeling sad and self-critical, having suicidal thoughts, lacking energy, and undergoing disturbed appetite and sleep.

To examine this belief, several groups of investigators tracked bereaved people, mostly widows and widowers, for up to five years. Results revealed that between 26 and 65 percent had no significant symptoms in the initial years after their loss; only 9 to 41 percent did. (The variability results partly from differences in how the symptoms were measured.) And the depression of some may be chronic rather than a reaction to the death.

Psychologist George A. Bonanno of Columbia University and his colleagues examined this possibility and other questions in a prospective study published in 2002. They followed about 1,500 elderly married individuals over several years. During that time 205 subjects lost a spouse, after which the investigators continued to track them for 18 months. Surprisingly, about half of the bereaved spouses experienced no significant depression either before or after the loss. Nor did they display serious distress, although some did feel sad for a short time. Eight percent of the participants were depressed before losing his or her partner—and stayed that way. For about 10 percent—individuals who had reported being very unhappy in their marriage—the death actually brought relief from preexisting depression.

The spouse’s death did precipitate depression in 27 percent. Of these individuals, a substantial proportion (about 11 percent of the total) started improving after six months and became symptom-free within 18 months. The rest of that subgroup did not get better—but even so, more than 70 percent of the study’s participants neither developed depression nor became more depressed as a result of their spouse’s demise. (The small number of remaining subjects fit various other patterns.) These results tell a clear story, at least where an elderly partner is concerned: most people are resilient and do not become seriously depressed or distressed when someone close to them dies.

Working It Out
In her 1980 book The Courage to Grieve, social worker Judy Tatelbaum wrote that after the death of a loved one “we must thoroughly experience all the feelings evoked by our loss,” and if we don’t “problems and symptoms of unsuccessful grief” will occur. The idea that people need to work through grief originated with Sigmund Freud and is still pervasive. It usually includes expressing feelings about the loss, reviewing memories about the deceased and finding meaning in the loss. According to this view, those who do not explore their emotions will suffer the consequences later.

8 Comments

1. 1. Pema1 12:24 PM 1/5/12

   The people studied were probably so brainwashed by their broken medical system, numbed by watching tv, undernourished by eating cheap gmo food, and confused by breathing toxic air and drinking toxic water that they can’t feel anything anymore. Now they read in your science magazine that it may not even be necessary to grieve the loss of a loved one. Please do more research before subjecting the world to your totally subjective, biased, and spiritually bankrupt views. It’s hard enough for the next generation to live in this world without ‘science’ telling them it may not be necessary to grieve.

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2. 2. GabrielB in reply to Pema1 12:35 PM 1/5/12

   Do not attempt to lambast an article which is based on scientific research with a collection of wildly inaccurate and opinionated statements based on nothing but personal opinions, before accusing it of bias and subjectivity. If you read the article, it concludes that different people may cope with the deaths of loved ones differently, and a logical decision based on the article would be to grieve anyway, just in case. Please, if you wish to comment, attempt to spark intellectual discussion, rather than simply rant.

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3. 3. sillofthedoor 04:42 PM 1/5/12

   The caveat mentioned is an important one, while I have counciled several people who have suppressed feelings of grief, I have also met people who do not suffer such problems and I am not about to tell them they should or even less find people to tell them they should!
   
   In my experience as councilor, most of these problems come from something that is unresolved, about the relationship to the person, or about death itself perhaps, and that inhibits the proper moving on other people experience.
   
   But as a councilor I would say it is a necessary prerequisite of emotional health to be willing to feel the feelings that are there. Its just that different people feel different things and should be free to feel what they do, not pressured to live up to other people's expectations, which in the case of expecting tears and sadness depression is just another form of suppressing the persons true and actual feelings.
   
   I would also say that many older people have time to face the inevitability of death and come to terms with it before it actually occurs, again of course not everyone. Certainly not all but at least the opportunity is there!

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4. 4. JuliatheMouser 11:18 AM 1/15/12

   Maybe the people who didn't show signs of depression or distress didn't love their spouses. Maybe it's not that these people weren't "coping with death in disparate ways" -- maybe they simply weren't grieving.
   
   This study seems to say more about marriage than about grieving.

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5. 5. Michael M 03:56 PM 1/15/12

   Concerning Freud's insights:
   We should remember the statistical skew occurring within a clinician's experience. Freud wrote and developed his hypotheses in response to people who came to him and others as patients. Random samples, quantitative analysis, and other tools now used to overcome basic human psychological biases were unavailable to that physician.
   Before we comment on proximate hypotheses, we might well consider
   1: The authors did speculate for further study, upon the issues commentors redundantly bring up.
   2:A simple basic belief/cognition (albeit one not prevalent in the culture they studied) like, "the deceased had lived fully in their time, and this was valid and beautiful and complete", or another such as was brought up by Freud's pupil Fritz Perls: "I am responsible for my life, and cannot be responsible for another free living being" (yes, he phrased it differently and more succinctly to some minds), can reduce survivor's guilt, which can directly lead to severe grief response.
   
   In short, there are many cognitive avenues other than preexisting unhappiness, which the authors explored, available to help explain grief and lack thereof.

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6. 6. Michael M 04:00 PM 1/15/12

   For assessment of validity of comments:
   
   The spelling of a psychological profession is counselor.

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7. 7. rambansal 04:25 PM 1/15/12

   Grief on the loss of a dear one is temporal for our basic reason that the death is an inevitable outcome of birth. But griefs for other reasons, such as inability to marry the beloved, or her betrayal, etc. are felt far and wide throughout the lifespans, for the reason that such losses are not inevitable and could be avoided.

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8. 8. d3mocritus 10:08 AM 2/17/12

   I think the caveats mentioned in this article, are so significant, that taken with the spread in detected reactions, the headlines hugely overstates the case.
   
   There appears to be many obvious variables not accounted for in the article and data, as other commentators have already noted.
   
   Among them,
   
   (I) It seems to be based on (mostly) elderly people. Dying from "natural" causes.
   
   (II) No mention of any analysis of how deep the affection actual was between the spouses, prior to the loss. (Which from my personal observation can vary considerable, and for which I would like to see scientific data, to be able to compare back with the results.)
   
   And, if you have lived a full life, and your partner is suffering from Alzheimer's, cancer or another crippling decease, you have both have had a long time to prepare yourself mentally, and you may also feel relived that the fight is finally over.
   
   It is a natural event, something we all know will happen.
   
   But how about a sudden, non natural event, natural catastrophes, involving young people, whole families with a single survivor, 20, 30years old, deeply in love, deaths of a young child, in events that are "unnatural", and/or could have been avoided...
   
   Then we can begin to really evaluate the propositions in the headline in earnest.

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