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Running head: GRIEF AND HOMICIDE SURVIVORS

Study of Grief and How It Impacts Homicide Survivors

Tina R. Workman

Hillsborough Community College


GRIEF AND HOMICIDE SURVIORS

Bereavement, the loss of someone you care about, is a part of life for everyone. How one

reacts to grief and how they move through the grieving process determines whether additional

support or professional help is needed. People seek support from religious leaders, family and

friends, or other social circles. Everyone who is experiencing grief does not need to attend

counseling although many do. Counseling and support groups can be beneficial in addition to the

traditional interventions mentioned. According to J. William Worden (1982), [] many times

people come for medical or psychiatric care unaware of the dynamics of grief, and this requires

that the clinician help make the diagnosis (p. 61). We will explore the diagnostic criteria for

bereavement, take a look at the etiology, discuss symptoms and behaviors of grief, and delve into

the impact of homicide on the grieving process.

Due to the fact that grieving is a natural course of life there is no diagnostic criteria for

grief. Pathology is not attached to grief because it could then be viewed as an illness which it is

not. Sometimes people call the grieving process depression. It is important to understand that

while grief may have some of the same diagnostic criteria as major depressive disorder there are

differences. According to the DSM-V (2013), with grief the predominate affect is feelings of

emptiness, whereas with major depressive disorder a persistent depression with the inability to

anticipate happiness or pleasure is most prevalent.

Research has shown that traumatic bereavement comes from a sudden death such as

homicide or suicide, resulting in what is called persistent complex bereavement (complicated

grief) due to the suddenness and manner of death. Persistent complex bereavement can only be

considered in adults if symptoms persist longer than 12 months after the person close to you has

died and it is more prevalent in females than males (DSM-V, 2013).


GRIEF AND HOMICIDE SURVIORS

The cause of bereavement is when someone to whom you were close to or loved has

died. Individuals are unique and it would make sense that their grief would be too. Research has

shown there are many symptoms people can display when going through grief. J. William

Worden (1982) said Because the list of normal grief behavior is so extensive and varied, these

behaviors can be described under four general categories: (1) feelings, (2) physical sensations,

(3) cognitions, and (4) behaviors (p. 20). Under the category of feelings symptoms would

include: sadness, anger, guilt, anxiety, loneliness, fatigue, helplessness, shock, yearning,

emancipation, relief, and numbness (Worden, 1982). Somatic sensations can include: hollowness

in the stomach, tightness in the chest or throat, oversensitivity to noise, depersonalization, short

of breath, muscle weakness, dry mouth, and lack of energy (Worden, 1982). Cognitions for grief

are varied. There are some thought patterns that disappear after the early stages of grief and

others that persist longer and trigger sadness and/or anxiety (Worden, 1982). Grief can cause

thought patterns such as: disbelief, confusion/trouble concentrating, preoccupation, sense of

presence, and hallucinations (Worden, 1982). The range of behaviors that are often associated

with bereavement are varied and vast. Common behaviors displayed are: sleep disturbances,

appetite disturbances, absent-minded behavior, social withdrawal, dreams of the deceased,

avoiding reminders of the deceased, searching and calling out for the deceased, restless over

activity, crying, visiting places or carrying objects that remind the survivor of the deceased

(Worden, 1982).

When dealing with traumatic or sudden death, research has shown the grieving process

can become complicated leading to what is known as persistent complex bereavement (DSM-V,

2013). There may be a display of symptoms & manifestations that are outside of the average

bereavement process such as increased anxiety, posttraumatic stress disorder, intense guilt,
GRIEF AND HOMICIDE SURVIORS

auditory or visual hallucinations of the deceased, and preoccupation with the manner in which

the person died (DSM-V, 2013).

According to the Centers for Disease Control National Center for Health Statistics

(2013), homicide is the third leading cause of death in men and the fifth leading cause in women

in the age group twenty-five to thirty-four. When someone has a spouse that has been murdered

they can have trouble moving through the process of grieving. There is no way to prepare for the

loss of a loved one through murder. The sudden and unpreventable nature leaves nothing but

pain and anguish in its wake (Asaro, 2001). Laurence Miller (2009) said, The cruel and

malicious nature of murder compounds the rage, grief, and despair of the survivors [] a deep

and justifiable anger toward the killer alternately smolders and flares as investigations and legal

actions meander along (p. 68). There are other factors outside of grief that homicide survivors

must handle. Media attention can be intrusive to some families compounding the grieving

process. Often, there is a microphone shoved in their faces, trying to elicit a reaction or response

(Asaro, 2001). Very often, in sensationalized cases, family members are subjected to frequent

and in-depth discussions of the case and of their loved ones lifestyle (Asaro, 2001, p. 99). If the

murder happens while the victim is participating in risky behavior sometimes there can be stigma

attached, in which others may think the victim got what they deserve or perhaps blame the

family (Asaro, 2001).

As one can see, though grief is a natural process it is also very complex. Homicide

compounds that grief, and in some cases, leads to more serious mental health issues. Given the

prevalence of homicide in the age group outlined above one can see how a support group for

spousal survivors ages twenty-five to forty would be very beneficial to many.


GRIEF AND HOMICIDE SURVIORS

References
Asaro, M. (2001). Working with adult homicide survivors, part I: impact and sequelae

of murder. Perspectives In Psychiatric Care, 37(3), 95-101.

Retrieved from http://www.wiley.com.db11.linccweb.org/WileyCDA/

American Psychiatric Association: Diagnostic and statistical manual of mental disorders, Fifth

Edition. Arlington, VA, American Psychiatric Publishing. 2013.

Heron, M. (2013). Deaths: leading causes for 2010. National Vital Statics Reports,

62(6). Hyattsville, MD: National Center for Health Statistics. 2013.

Retrieved from http://www.cdc.gov/nchs/index.htm

Miller, L. (2009). Family survivors of homicide: I. Symptoms, syndromes, and reaction

patterns. American Journal Of Family Therapy, 37(1), 67-79.

Retrieved from http://www.tandf.co.uk/journals/titles/01926187.asp

Worden, J. (1982). Grief counseling and grief therapy: A handbook for the mental health

practitioner. New York: Springer.

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Examining posttraumatic stress symptoms in a national sample of homicide

survivors: prevalence and comparison to other violence victims. Journal Of

Traumatic Stress, 24(6), 743-746.

doi:10.1002/jts.20692