Sometimes, life is just really sad

Barbara Kay, National Post · Apr. 27, 2011 | Last Updated: Apr. 27, 2011 4:07 AM ET

Grief over the loss of a loved one is a universal phenomenon. But grief's expression and attendant rituals vary greatly according to individual circumstances and cultural tradition. The stiff upper lip and discrete silent tear is the norm amongst my WASP friends, while a West Indian acquaintance of mine took comfort from the histrionic style; with obvious admiration, she once recalled for me the moment when a wailing cousin had to be restrained from jumping into her mother's grave.

Mourning is a more complex matter. Some people recover quickly from bereavement, or make a point of pretending to, and get on with their lives; others not so much. Queen Victoria never stopped mourning the death of her beloved Prince Albert. Considering their loving union, the perfection of their working partnership, the loneliness of solitary reign and the culture of her era, her emotional withdrawal seems understandable to me. But according to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of psychiatrists everywhere, Victoria was suffering from a mental disorder.

The fifth version of the DSM (DSM-5) is due out in 2013. In DSM-4, grief used to occupy a special category: One could suffer depression from grief longer than from other stressors and still be considered "normal." But in DSM-5, grief is likely to be lumped in with other triggers for depression, such as job loss, divorce or any other life stressor.

In other words, whether your child dies of leukemia or Walmart laid you off: They're both just "stressors." So if after two weeks, for either reason, you feel sad, can't sleep well, find your appetite diminished and experience low energy, you'll have a DSM-stamped "disorder." And lo, official disorders rather conveniently require the services of those tasked with identifying them.

This pathologization of grief, according to Dr. Allen Francis, the U.S. psychiatrist who chaired the task force for DSM-4, is a "disaster," which "ignores the inescapable fact that grief is the necessary price we pay for our mammalian capacity to love."

He's right, of course, but he's spitting into the zeistgeist. Our era isn't governed by common sense and respect for universal human nature, but by therapism -a kind of emotional correctness that confuses aspects of the human condition with disease. Anyone subject to a "stressor" may henceforth claim to be a passive victim. His negative mood or behaviour is seen as beyond his free will or moral agency to overcome.

The DSM-5 could end up making Person A feel there is something medically wrong with her if she mourns the passing of her mate of 50 years longer than Person B mourns that of his beloved dog. Meanwhile, Person C's obnoxious child will just be a victim of "temper dysregulaton disorder with dysphoria"; and hey, Person D is not promiscuous, she merely has a "sex addiction." Not your fault. Here, have a pill. Big Pharma must be doing the chicken dance in anticipation.

After 9/11, the greatest "stressor" of our times, 9,000 counsellors and therapists descended on New York City. Turns out their services were in little demand. Apparently the bereaved were coping quite adequately with their losses by drawing on support from family and friends, not to mention their own inner fortitude. Just as the bereaved have done from time immemorial before psychiatry came along.

I am no Scientologist. And so I know that mental illness is a reality. But bona fide mental illnesses and disorders demonstrate invariable somatic characteristics discovered through methodical scientific observation. That's not the case with grief and mourning. It is not possible to set down a "science" of human identity and behaviour for life passages. Psychological states of mind like "anxious" and "unhappy" cannot be quantified or standardized, even though they can be chemically anesthetized. Freely chosen talk or chemical therapy may give welcome relief to those who can't cope in other ways. But those who choose to embrace bereavement as a natural process, even if it takes a while longer than psychiatrists like, do not deserve to be labelled disordered.

There are many bereaved people with "issues" they failed to resolve with the living, and maybe their guiltridden mourning is therefore especially stressful (and maybe deserved as well). Let them seek counselling and pills if they must. But let them take ownership of the reasons for their issues. Let them be responsible adults, not infantilized victims.

This paternalistic mania for the medical branding of people's emotions and behaviour must cease. It's a short step from pathologizing individual emotional expression to pathologizing individual opinions. In the Soviet Union, those who exhibited contempt for communism were labelled mentally ill and shut up in hospital prisons. 'Nuff said.

bkay@videotron. ca