9 Sep 2022

141

Complicated Grief Disorder: Symptoms, Causes, and Treatment

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Academic level: College

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"Stop all the clocks, cut off the telephone. Prevent the dog from barking with a juicy bone. Silence the pianos and with muffled drum. Bring out the coffin, let the mourners come." Basing on this introduction, the speaker is grieving, which brings with it a variety of feelings. The poem presents the idea that grief is likely to make one feel like their entire life is ended. Wystan Hugh Auden is the author of “ Stop all the clocks,” poem. Auden was a British-American poet, who was known for his political and satirical style. He was born in 1907 and raised in England until 1939 when he moved to the States and became a citizen in 1946. Auden was openly gay and maintained long-term relationships with men. He also married Erica Mann in 1935. “ Stop all the clocks” is Auden’s possibly most famous poem, which is a departure from the usual themes. This second version of the poem was inspired by the loss of a lover in which the first version was written for a play and had a different tone. It is unquestionable that the speaker experiences grief due to the loss of a loved one and this eventually graduates to complicated grief disorder as indicated by various symptoms and maladaptive behavior present in the poem including self-isolation, extreme focus on the remainders of his loved one, and the loss of ability to perceive life after the loss. 

The death of a loved one is one of the greatest stressors that humans face. Although, people are different in how they cope with their losses. NIH (2021) asserts that most of the people experiencing grief are likely to cope well, while a few will undergo severe cases of grieve that may require treatment (p. 1). The factors influencing one’s grieving process include a) relationship with the person that died, b) available support c) financial and social position of the grieving individual. Additionally, d) an individual's religious and cultural background, e) personality, f) mental health history, and g) the coping skills of an individual also affects one's grieving process. 

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Grief refers to the emotional response following the loss of a loved one. According to NIH (2021), common grief reactions that one may go through include, feeling anxious from the distress that comes with separation from the loved one, mourning, emotional numbness, and depression. In the normal type of grief, one reacts immediately after the loss of a loved one, in which he or she moves towards accepting the loss as time progresses (p. 2). In " Stop all the clocks," poem the speaker is suffering from chronic grief. NIH (2021) define chronic grief as the type of grieving in which an individual's common symptoms last a long time compared to the normal grief's symptoms (p. 4). In Auden's poem, the speaker's grieving process continues to intensify as time progresses, presenting an individual who is incapable of getting over the loss of the loved one. 

The prolonged type of grief disorder is different from posttraumatic stress and major depressive disorders. According to Rosner et al. (2018), the prolonged stress disorder's major symptoms include preoccupation with the deceased, intense yearning, and reactive distress symptoms (p. 3). Prolonged stress has many negative factors to an individual including increased suicidality as well as deteriorated health. Rosner et al. (2018) assert that the complicated grief disorder comorbidity occurs with posttraumatic stress disorder and depression (p. 4). In most cases, the secondary symptoms of complicated grief disorder are posttraumatic stress, anxiety, and depression. Therefore, complicated stress disorder ought to be diagnosed to prevent deaths associated with the condition. 

The speaker in “ Stop all the clocks,” poem expresses his grief in different ways. For example, the speaker begins by making demands, "Stop all the clocks, cut off the telephone. Prevent the dog from barking with a juicy bone and silence the piano." The speaker seems frustrated as the world does not stop to grieve with him, as the dog continues to bark, the clock keeps on ticking, as well as the pianos that continue playing. The unchanging nature of the things in the world pinpoints the isolating and the intensely personal nature of grief. The speaker is undergoing a complicated grief disorder as he fails to recognize and accept the isolating nature of grief, which he could accept and proceed with his life normally. 

Symbolism is an aspect that is well used in the poem. For example, stopping all clocks in the poem would mean stopping time itself. Cutting the telephone would mean stopping the flow of information and all the interruptions that come with these means of communication. Request on the piano would mean that the speaker wishes to stop all the celebration and parties from going on to have a moment of silence and peace, which is free from distractions from various noises to allow him to reflect on the loss. By analyzing the speaker's demands it is clear that the world progresses normally even with the grieving of the speaker, which is an indication that there is a disconnect between the speaker and the world, in which all other activities progress normally. 

Factors Influencing the Grief Process of the Speaker 

Complicated grief disorder is likely to increase due to a variety of factors. According to NIH (2021), unexpected deaths are likely to lead to difficult grief compared to the expected cases (p. 4). However, even in the unexpected cases of losses, people in control of their lives as well as with high self-esteem are likely to cope better with grief. Individuals with the belief that life is uncontrollable tend to experience complicated grief following unexpected losses. For example, the speaker in the “Stop all the clocks,” poem seems to have reached a standstill after losing a companion, in various life chores including work, rest, and entertainment periods. The speaker suffers from complicated grief disorder due to the unexpected loss of the spouse, with whom they had made promises to establish a long lasting relationship. Therefore, the speaker was likely to fall into depression, due to his clinging to the things that reminded him of the loss that had occurred. 

The bereaved personality plays a key role in one’s development of depression following a loss. People that tend to be highly dependent on their spouses are highly likely to experience long-lasting depression after the loss of a loved one (NIH, 2021, p. 4). Additionally, people dealing with the loss by thinking about it for a long time are highly likely to fall into depression. Words, “He was my North, my South, my East and West. My working week and my Sunday rest," presents an individual that is highly dependent on the dead spouse, thus highly likely to suffer from depression. As the poem progresses, the speaker request that the stars be dismantled as well as the sun, which presents an individual that has lost hope in life and now believes that everything is impossible and he can no longer be productive. 

The speaker's request in the last paragraph of the poem shows that he is becoming desperate. The words, "pour away the ocean and sweep up the wood," presents an individual who has reached a world of impossibilities. The speaker seems to be despairing by requesting to pour the ocean. The last sentence confirms that the speaker expects nothing good to be achieved after the death of the loved one. Therefore, likening the death of the loved one to the impossibility of pouring the ocean and sweeping the woods, the death of the speaker’s loved one is unlikely to be accepted soon meaning he was falling into a complicated grief disorder. 

Mind Adaptation during Grief 

Avoidant attachment, low social support, and adequacy of the financial situation are among the factors that are associated with great depressive and grief symptoms. However, clinical interventions are incapable of changing these factors that result in great grief symptoms. O'Connor (2019) highlights processes such as deliberate grief avoidance, rumination, cognitive appraisals, emotional expression, and meaning-making as crucial in mediating between the risk factors and mental health results (p. 8). Rumination, which is the obsessive thinking about a certain situation, mediates between various risk factors such as attachment avoidance, gender, the expectedness of the loss, social support, and greater depressive symptoms. Therefore, the individuals experiencing an unexpected death tend to ruminate more than those experiencing the timely death, thus experience high rates of depression symptoms. 

In “ Stop all the clocks,” the speaker tends to be experiencing high rumination, which exacerbates the level of grief and depressive symptoms. Auden’s poem is written in such a manner that the desperation of the speaker increases as the poem proceeds. The sentence, "Bring out the coffin, let the mourners come," in the first paragraph presents an individual, who is in the first stages of mourning. However, the last sentence in the poem, "For nothing now can ever come to any good," presents a person who is fixed on the loss of the loved one who is incapable of moving on. Desperation exists in the last sentence, whereby the speaker has grown hopeless after analyzing the crucial roles the deceased played in their life as well as the impossibility of being together with them again. Therefore, the speaker of the poem through frequent rumination is incapable of perceiving life past the deceased, thus, incapable of adapting to the problem and moving on with life. 

Conclusion 

Stop all the clocks,” by Auden is a clear illustration of the factors responsible for the prolonged grief disorder. The speaker at the start of the poem is a person experiencing the normal type of grief and expects the world to accompany him in the process. However, as the poem progresses, the individual from the constant rumination starts becoming depressed and has lost hope in life, as illustrated in the last sentence of the poem. 

References 

Auden, W. (1936). Stop All the Clocks. Retrieved 28 January 2021, from http://www.davidglensmith.com/lonestar/1302/PDFs/Auden-FuneralBlues.pdf 

National Cancer Institute (NIH). (2021). Grief, Bereavement, and Coping with Loss (PDQ)- Patient Version. 

O'Connor, M. (2019). Grief: A Brief History of Research on How Body, Mind, and Brain Adapt.  Psychosom Med 81 (8), 731-738. https://doi.org/doi:10.1097/PSY.0000000000000717

Rosner, R., Rimane, E., Vogel, A., Rau, J., & Hagl, M. (2018). Treating prolonged grief disorder with prolonged grief-specific cognitive behavioral therapy: study protocol for a randomized controlled trial.  Trials 241 , 1-55. https://doi.org/10.1186/s13063-018-2618-3 

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StudyBounty. (2023, September 16). Complicated Grief Disorder: Symptoms, Causes, and Treatment.
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