I read an article this morning about a judge who ordered release of a grieving mother, Christina Schumacher, who was held against her will for more than five weeks in a psychiatric ward. When she separated from her husband last year, Ms. Schumacher made a comment to her sister “that she would kill herself if anything happened to her two children.”* The day after her husband killed their son and then hanged himself, the grieving mother’s doctor decided that she “needed to admit herself or be taken into custody.”*
Other people, however, thought differently. Vermont Superior Court Judge Kevin Griffin ruled that, “The court did not find, by clear and convincing evidence, that Respondent was a person in need of treatment at the time of admission or application, nor a patient in need of further treatment at the time of the hearing.”* Ms. Schumacher, said, “I am not ill; I am simply a mother who is grieving the tragic loss of her young son…No mother should ever have to experience this loss.”*
Who has the right to decide whether grieving parents need psychiatric help and/or whether their grief needs medicalizing? When is it appropriate for someone else to decide when grief is too overwhelming or going on too long for a bereaved parent? What non-bereaved parent hasn’t thought, “I don’t know if I could go on living if something should happen to my children”? Should that person’s child die, are his or her previous statements enough to warrant involuntary commitment to a psychiatric ward? If a bereaved parent mentions suicidal type of thoughts while deeply grieving the loss of a child, is that enough for such drastic action as involuntary commitment to a psychiatric ward? What bereaved parent hasn’t struggled with trying to find a reason to go on living when a child has died? (By the way, having suicidal thoughts is not totally uncommon for bereaved parents. Not that those thoughts are necessary acted upon, but they are sometimes thought.) What are the warning flags that a bereaved parent needs help to deal with grief? When is appropriate to pathologize grief? What is “normal” grief? When should grief be considered “abnormal”?
I think these are questions that have been brought to the forefront in the discussion of the inclusion of complicated grief into the DSM-5. I also think that because these questions – and many more – are so difficult to definitively answer is why complicated grief was not included in the DSM-5, but rather indicated for further study and research.
I have no doubt that there are many researchers on the subject of grief and doctors who have the best intentions of helping those who grieve and those who struggle with prolonged or complicated grief. I applaud them for their research and for efforts to deal with this difficult subject. I also think the situation of Ms. Schumacher should also be a cautionary tale for misdirected and over-zealousness in pathologizing grief.
Lately, I have been doing some reading and research on the topic of complicated grief. My main concern with adding complicated grief to the DSM-5 and pathologizing grief is that for every doctor who uses due caution in determining whether or not grief intervention is necessary, there are those who may not. There are medical people who may think they know what they are talking about, but they don’t. They make decisions based on something they’ve read or heard without doing their own adequate research. For every doctor who graduated in the top half of his or her class, there are equal numbers who graduated in the bottom half.
I am very thankful that the discussion of complicated grief and its potential inclusion in the DSM-5 has brought the topic of grief and its many complications to the forefront of discussions. Grief and those who grieve deeply have been swept to the side for too long. We have much understanding to gain from the research, the foremost of which is caution in pathologizing grief.
Are there times when help is needed in processing grief? Without a doubt. But there are also other times when someone else (relative, concerned friend, acquaintance, doctor) determines that a bereaved person needs to be “helped,” instead of trying to understand that grief is not tidy nor simple and that compassion, understanding, a listening ear and adequate time to grieve is what’s needed. When that someone is a reactionary doctor with authority (perceived or otherwise) over the bereaved’s life, that’s when we can run into problems such as Ms. Schumacher encountered.
*Credit for article quotes: http://www.foxnews.com/us/2014/01/25/vermont-woman-held-against-will-in-psych-ward-ordered-released/?intcmp=trending
© 2014 Rebecca R. Carney
Here’s a link to testimony of Ms Schumacher: