Review of Grief Counseling and Grief Therapy by J. William Worden

Summary

In Grief Counseling and Grief Therapy: A Handbook for the Mental Health Practitioner (4th ed.), J. William Worden provides an introduction to bereavement/loss, grief, mourning, and providing grief counseling or therapy. Worden defines grief to be the experience one goes through during a loss (and specifically for the purpose of this book, the loss of a loved one due to death). Mourning indicates the process one undergoes as he or she endeavors to adapt to a loss. And bereavement may be understood as referring to the specific loss to which the mourning individual is trying to adapt.[1]

Worden begins by addressing the concept of attachment. According to Worden, grief is rather incomprehensible or unexplainable a part from attachment. Attachment—“the tendency in human beings to create strong affectional bonds”— to someone (or something) is what makes the loss of that something (or someone) something that needs to be grieved.[2]

Worden distinguishes between normal (or uncomplicated) and abnormal (or complicated) grief. Normal grief may entail or be accompanied by a large variety of emotions, thoughts, and behaviors such as sadness, anger, guilt, depression-like symptoms, shock, preoccupation, various somatic sensations and distresses, insomnia, etc.[3] Worden stresses the importance of recognizing this broad range of experiences (including those that may seem rather odd or abnormal according to everyday experience) “so that they [counselors] do not pathologize behavior that should be recognized as normal.”[4] What makes abnormal grief abnormal, according to Worden, is not the presence of experiences that may seem bizarre compared to regular functional existence, but the intensity and duration of otherwise normal grief-reactions.[5] Thus, abnormal grief includes the following expressions: chronic grief—grief that is excessive in length or lacks resolution; delayed grief—postponed, inhibited, or suppressed grief reactions; exaggerated grief, which involves excessive intensification of the grief experience resulting in maladaptive behavior or feelings of being overwhelmed; and masked grief, where grief reactions are expressed in covert forms.

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