Pathological Mourning in Short-Term Dynamic Psychotherapy

Abstract

The technique of intensive short-term dynamic psychotherapy (ISTDP) as developed by Davanloo (1978), which provides a direct view of the unconscious, has brought further evidence of the prevalence and toxicity of pathological mourning as a major source of psychiatric morbidity. Davanloo (1986) has further discovered that bypassing such unresolved grief reactions prevents successful resolution of other core neurotic conflicts. To increase the efficacy and shorten the duration of therapy, clinicians must maintain vigilance in detecting unresolved grief reactions. As the pathogenesis for this disorder resides within unconscious dynamic forces and because ISTDP provides a direct view of the unconscious, the diagnosis of pathological mourning (which heretofore has been based on presumptive evidence) can now be made conclusively. Many authors (Akisal & McKinney, 1975; Bowlby, 1963; Davanloo, 1990; Melges & Demaso, 1980; Siggin, 1966) recognized the importance of converting pathological mourning to normal mourning, in order to bring restitution and acceptance of the loss, but it was not until Davanloo developed his technique of ISTDP that a systematic method was available to achieve this goal. The success of ISTDP in the treatment of pathological grief results in part from its efficacy in over-coming the inevitable resistances that arise when attempting to convert pathological to normal mourning.