Existential Therapy and Prolonged Grief
“Grief is like the ocean; it comes in waves, ebbing and flowing. Sometimes the water is calm, and sometimes it is overwhelming. All we can do is learn to swim.” This quote by Vicki Harrison illustrates the ever-changing nature of the grief cycle and its stages. While grief is a universal human experience, it can also become debilitating for many individuals. Chronic grief can be associated with developing Prolonged Grief Disorder and death anxiety; however, existential therapy techniques may be key to sustainable treatment and healing.
Prolonged Grief Disorder
Prolonged Grief Disorder was recently added to the Diagnostic and Statistical Manual-5-Text Revision in order to not only improve research outcomes related to grief but also to provide more accessible mental health resources for bereavement. Nevertheless, there are concerns about pathologizing the universal human experience of navigating grief and loss by imposing a timeline on when grief is considered prolonged and introducing stigma to the way grief presents.
Grief is a unique experience, manifesting in a myriad of ways and highlighting a variety of losses. A plethora of factors influence grief including but not limited to sociocultural variables, one’s relationship to the deceased, and one’s past experiences with grief and loss. It is common for bereaved individuals to experience different stages of grief in no particular order such as shock and denial, anger and bargaining, depression, the upward turn, reconstruction and working through, and hope and acceptance as originally developed by Kübler-Ross. While grief doesn’t always result in distress and impairment in physical, social, cognitive, and spiritual functioning, approximately five to ten percent of grief experiences become prolonged and complex.
Prolonged Grief Disorder is characterized by distressing symptoms persisting at least twelve months after loss in adults and six months for children and adolescents. It is defined by intense yearning, interrupting to significant life activities, and at least three of the following symptoms on a daily basis for longer than one month: marked sense of disbelief about the loss, avoidance of reminders about the death, intense feelings or emotion numbness, identity disruption, feeling life is meaningless, and acute loneliness.
Death Anxiety
Death anxiety, also known as thanatophobia, can also show up in relation to grief and loss. Symptoms might include intrusive thoughts surrounding death, avoidance of topics related to death, difficulty concentrating, insomnia, physical symptoms such as sweating and shortness of breath, anxiety, depression, and experiencing other mental health conditions. Death anxiety can stem from personal experiences with death and loss, cultural and religious beliefs, having a trauma history, and even some underlying medical conditions. Existential therapy in addition to
other therapeutic modalities can be utilized when dealing with both prolonged grief disorder and death-related anxiety.
Existential Counseling
Existential counseling focuses on the unique experiences of people navigating challenges related to living, which can be tailored as a treatment modality for prolonged grief. Cultivating meaning and purpose in one’s life in the present is at the root of existential therapy approaches. Four pillars define the existential counseling modality: death, isolation, meaning, and responsibility. Existential therapy aims to reduce anxiety related to these topics, leading to acceptance that death is a part of life, encouragement to take on responsibility for your own choices and how you navigate your unique path in life, and being able to identify values that guide you in leading a fulfilled, meaningful life.
In addition to existential counseling, prolonged grief therapy and bereavement support groups can be beneficial for those navigating loss. If you or someone you know is struggling with grief and loss, consider reaching out to Embrace Therapy for mental health support and resources.
