Grief as expression of love or insanity

Abstract

Grief is considered as a normal and natural response to bereavement. It is also referred as the price we pay for love. The previous diagnostic guidelines in DSM-IV intentionally exclude grief reactions as major psychiatric disorders. Researches in the past few decades consistently found that there is a small group of bereaved persons who struggle with their grief. Thus, the DSM-V published in mid-2013 offers a few major changes in bereavement-related disorders, in particular related to the elimination of bereavementexclusion in depression and adjustment disorder. A new diagnosis, persistent complex bereavement disorder (PCBD), is proposed to the Section III of the Appendix. Yet, the manual emphasises cultural, religious and agerelated factors are taken into account for assessment. In line with the main theme of the conference “Yin and Yang of mental health in Asia”, this presentation will first focus on elaborating the yang: the highlights of the changes in DSM-V. It will then follow by detailing the yin component, which are the observations of bereavement reactions as well as coping among Asia cultures. With reference to the diagnostic criteria of PCBD, possible controversies in assessment arisen from Chinese cultural and religious beliefs will be highlighted. In particular, the grief hallucination, the balance between continuing bond and separation distress as well as that between expression and avoidance of emotions will be emphasised. Terms of complicated grief or prolonged grief had been coined to describe the condition faced by this vulnerable group. These were intended to propose as mental disorders. This presentation is hoped to reflect on this new identity of grief for Asian cultures.