Grief: A cognitive-behavioral analysis

Abstract

Traditional views of grief are briefly examined, and a cognitive-behavioral analysis is offered. Particular attention is given to the role of social reinforcement and the possible consequences of the common "conspiracy of silence" which often follows the loss of a loved one. In this latter pattern, family and friends may withhold information about the death, avoid discussing the dead person, and remove all signs of the deceased from a patient's environment. The prolonged grief reactions which sometimes follow this type of reaction are likened to the Napalkov phenomenon and Eysenck's hypothesis about incubation of distress. To explore the implications of this analysis, four cases of pathological grief were treated with prolonged exposure to the stimuli producing grief and a rescheduling of social reinforcement. Remarkable success was observed in all cases despite their chronic nature, and suggestions are made for more controlled evaluation of this treatment strategy. © 1977 Plenum Publishing Corp.