Grief And Homicide Survivor

Running head: GRIEF AND HOMICIDE SURVIORS

Study of Grief and How It Impacts Homicide Survivors
Tina R. Workman
Hillsborough Community College

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).
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 overactivity, 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, 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 one’s 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.

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/
Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.
Heron, M. 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.
Zinzow, H., Rheingold, A., Byczkiewicz, M., Saunders, B., & Kilpatrick, D. (2011). 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