Ester Holte Kofod

Grief as a border diagnosis

Grief is sometimes poetically described as the price of love: An inescapable existential condition of human life. However, throughout the 20th century, grief has increasingly come to be understood as a pathological condition that requires psychological and/or medical intervention. With the release of Diagnostic and Statistical Manual of Mental Disorders (5th ed., DSM-5; American Psychiatric Association, 2013), grief came close to being included as a separate mental disorder. However, the diagnostic revisions concerning bereavement have been met with criticism of medicalizing grief and of exceeding the territory of psychiatry beyond its legitimate borders. On this basis, I argue that grief is currently a border diagnosis, that is, a condition whose meanings are informed in heterogeneous ways by medical, psychiatric, and psychological understandings yet constantly challenged by alternative, nonmedicalizing discourses. Drawing on empirical findings from an ongoing interview study with bereaved parents after infant loss, I analyze and discuss 4 different accounts concerning the question of diagnosing grief: (a) diagnosis as a legitimating and normalizing practice, (b) diagnosis as a demarcation practice, (c) diagnosis as pathologization, and (d) diagnosis as a normative ideal. Through the examples, I attempt to demonstrate how bereaved individuals do not merely passively adopt but reflectively use these kinds of understandings to deal with their grief.

From morality to pathology: A brief historization of contemporary Western grief practices and understandings

Abstract In this paper, I present three ideal typical grief articulations drawn from three historical periods: (1) grief as a moral practice in Ancient Greek virtue ethics, (2) grief as an expression of an inner, authentic morality in the Romantic era, and (3) grief as a psychologized and increasingly pathologized phenomenon in modern psychology up to the present attempts to include separate diagnoses for pathological grief in the diagnostic manuals for mental disorders (American Psychiatric Association, 2013; World Health Organization, 2016). The purpose of this presentation is to shed light on current taken-for-granted notions of grief, and, by providing some historical background, challenge prevailing understandings that depict grief as an ahistorical, universal, intra-psychological and (potentially) medical condition that is analytically separate from historical, social, cultural, and religious practices. Informed by a cultural psychological outlook (Brinkmann, 2016; Valsiner, 2014), I argue that the relationship between grieving individuals and their cultures is dialectical, mutually constituting and inherently normative, and hence, that the diagnostic approach to grief as an individual, causal reaction to loss is flawed. On this background, I argue that an acknowledgment of the inherent normativity of grief (as presented by the historical accounts) can potentially inform and enrich contemporary understandings and practices related to bereavement, ultimately to the benefit of people who suffer from grief.AbstractIn this paper, I present three ideal typical grief articulations drawn from three historical periods: (1) grief as a moral practice in Ancient Greek virtue ethics, (2) grief as an expression of an inner, authentic morality in the Romantic era, and (3) grief as a psychologized and increasingly pathologized phenomenon in modern psychology up to the present attempts to include separate diagnoses for pathological grief in the diagnostic manuals for mental disorders (American Psychiatric Association, 2013; World Health Organization, 2016). The purpose of this presentation is to shed light on current taken-for-granted notions of grief, and, by providing some historical background, challenge prevailing understandings that depict grief as an ahistorical, universal, intra-psychological and (potentially) medical condition that is analytically separate from historical, social, cultural, and religious practices. Informed by a cultural psychological outlook (Brinkmann, 2016; Valsiner, 2014), I argue that the r...

Grief as a normative phenomenon: The diffuse and ambivalent normativity of infant loss and parental grieving in contemporary Western culture

Grief is often conceived in causal or reactive terms, as something that simply strikes people after a loss. But, on closer scrutiny, there are good reasons to think of grief as a normative phenomenon, which is done or enacted by people, relative to cultural norms. To substantiate the claim that grief should be thought of as normative, we draw upon empirical examples from a qualitative interview study with bereaved parents following infant loss, and analyze how grieving the loss of a small child in our culture is experienced, interpreted, and enacted within a diffuse and ambivalent, yet inescapable, moral framework. Further, we discuss some of the possible consequences for bereaved individuals when navigating the normative landscape of grieving in contemporary Western cultures: A landscape in which suffering is increasingly dealt with in psychiatric and medical terms and understood as an adverse and unnecessary condition to be overcome in order to maximize personal health, happiness, and well-being.

The Presence of Grief: Research-Based Art and Arts-Based Research on Grief:

The authors involved in the creation of this text collaborate on a research project called The Culture of Grief, which explores the current conditions and implications of grief. The authors mostly employ conventional forms of qualitative inquiry, but the present text represents an attempt to reach a level of understanding not easily obtained through conventional methods. The group of authors participated as members of the audience in an avant-garde theatrical performance about grief, created by a group called CoreAct. The artists of CoreAct create their art through systematic research, in this case on grief, and we as researchers decided to study both the development of the play and its performance, and to report our impressions in fragments in a way that hopefully represents the nature of grief as an experienced phenomenon. We use Hans Ulrich Gumbrecht’s concept of presence to look for understanding beyond meaning in grief and its theatrical enactment.

Grief as an extended emotion

In recent years, human scientists have generalized the so-called hypothesis of the extended mind to human emotional life. The extended mind hypothesis states that objects within the environment function as a part of the mind and are centrally involved in cognition. Some emotion researchers have argued along these lines that there are bodily extended emotions, and (more controversially) environmentally extended emotions. In this article, we will first briefly introduce the idea of the extended mind and extended emotions before applying it to the emotion of grief specifically. We explain by introducing the notion of a cultural affective niche within which grief is scaffolded and enacted. An affective niche couples the person and the environment and enables the realization of affective states.