Complicated duel or traumatic duel

The grieving process appears after the loss of a loved one, It affects at the cognitive, emotional, behavioral, physical and spiritual level, the duration is usually limited, although it can vary according to many characteristics.

"TOturn on to contact the silence within yourself, and know that everything in life has a purpose. There are no errors, or coincidences, all events They are blessings given to us to learn." Elisabeth Kübler-Poss

Content

• Latest investigations
• Duel process
• Tasks that allow to elaborate the duel
• Challenges to make the duel
• Elements that can avoid complicated or traumatic duel.
  • References

Latest investigations

In this last decade, it has been investigated on the individuals of protection and risk with respect to the possible complications of the natural process of the duel, which can be derived in complicated or traumatic duel, With the primary objective of increasing the understanding of this multifactorial fact. Certain risk characteristics related to age related to the age of the person suffering from duel, the type of relationship, circumstances of death, poor social support or unresolved previous duels. Unexpected deaths or in adverse (traumatic, suicidal, missing people), frequently have more difficulty in making duel. Access to aid and social support resources are essential to benefit the elaboration of the fact and reduce its complexity.

Duel process

The duel is considered by the majority of the authors as a process that needs to be crossed after the death of a loved one, however, the strength of emotions, the duration of the process and the resolution of the duel will depend on many characteristics. According to Ramón Bayés, “it depends on the degree of the appreciation made by the person of the threats and deficiencies that create the loss, and on their own possibilities, circumstances and psychosocial support that you have to cross it, this will be the evolution of the process, it will be Always an individual process".

Although it is also a universal process (all people go through several losses throughout life), it is usually extremely painful and disabling, at least transitory. The duel can mean a deep setback in which people consider themselves as useless, improper, inhabile, immature or brittle (Horowitz et al., 1980). However, the duel process is usually solved without great complications, although it is relevant Duel people are more likely to suffer physical and psychological disorders, even more suicide probability.

Tasks that allow to elaborate the duel

For Worden, W. The duel in addition to the loss, involves an active process of four basic tasks that allow the loss. These tasks do not need to express a defined order although a certain provision of tasks, as indicated below:

• Task 1: Accept the situation of loss. At the beginning, a sensation of unreality, distancing and disbelief that frequently although it is not always solved in a short time is experienced in a short time.
• Task 2: Prepare emotions and pain of loss. It is essential to recognize the feelings that are active and not try to avoid them, feel the pain, learn to regulate emotions and be aware of it, allowing them to transform and cross them.
• Task 3: Adapt to the absence of the loved one who has died. Wraps different characteristics of the loss.
• Task 4: Manage and structure the emotions you feel before the person who has lost and adapt it to life. In a pleasant way, although there is a transformation and change in relations with others, it is necessary that these feelings face and express.

Challenges to make the duel

Neimeyer states that the active process duel, reformulates the "tasks" for "challenges", adds some factors in this new formula. These challenges that the person has to cross, will solve it thanks to the resources of the type of loss, are not resolved in a certain order as indicated below:

1. Explore the reality of loss.
2. Face pain.
3. Review our nature of meanings. After a significant loss, it may not only change our life at the practical level, in addition the need for a transpersonal change, beliefs, rethinking not only of beliefs but also of values ​​that had been part of the loss of our life can be rethink.
4. Rebuild the relationship with what has been lost.
5. Rebuild ourselves.
6. One of the primary factors of the companion, psychologist or advisor, It is to be able to tolerate feelings sadness or longing, be present and allow the person who lives the loss face and express.

Elements that can avoid complicated or traumatic duel.

They highlight certain general elements that can help the resolution of the duel preventing it from changing to be a complicated or traumatic duel. According to Worden, these can be avoided through the following points:

1. Help assume the reality of loss.
2. Help identify and talk about emotions.
   • Anger.
   • The blame
   • Anxiety and impotence
   • The sadness.
3. Help live with loss, without the loved one. Adapt to a new way of life.
4. Provide resources to adapt emotions to the resources of the loved one.
5. Give time to make the duel.
6. Understand and accept behaviors and emotions as necessary, valuable and universal (They experience all human beings at some point in their lives). Help know what is inside to experience this process.
7. Recognize individual differences. The way of elaborating the duel is individual and different in each person, it depends on many characteristics (relationship with the person who has lost, age, previous duels, etc.) It is essential to understand and respect individual differences in the way of feeling and proceeding.
8. Keep support 
9. Analyze defenses and ways of coping.

“Only people capable of loving intensely can suffer great pain, but this same need to love serves to counteract their duels and heals them." Leo Tolstoy

References

• Bayés, r. Facing life, waiting for death. Madrid: Editorial Alianza S.TO., 2006.
• García-Viniegras, c. R. V., And Pérez Cernuda, C. (2013). Duel before death from suicide. Havana Magazine of Medical Sciences, 12 (2), 265-274.
• Horowitz, m.J., Siegel, b., Holen, a., Bonano, g.TO., MILBRATH, c., Stinson, c.H. Diagnostic Criteria for Complicated Grief Disorder. The American Journal of Psychiatry, 1997; 154: 904-10.
• Neimeyer, r.TO. (2002). Learn from loss. A guide to face the duel. Barcelona: Paidós Ibérica editions, S.TO.
• Parkes, c.M. Berevement. In: Doyle, D., Hanks, g.W.C., Macdonald, n.(1993).  Eds. Oxford Textbook of Palliative Medicine, Oxford: Oxford University Press.
• Vedia, v. (2016). Digital Magazine of Psychosomatic Medicine and Psychotherapy, 6- (2) Nu
• Worden, J.W. (1997). Duel treatment: psychological advice and therapy. Barcelona: Paidós.
• Photo: photo of Engin Akyurt in Pexels