Ever since Sigmund Freud proposed the idea of "grief work" in 1917, it has been generally accepted that it is healthy for the bereaved to confront and express their feelings and reactions. Many popular forms of bereavement counselling involve the therapist challenging the bereaved patient's "resistance" to mourning, compelling them to express sadness.
But Wolfgang Stroebe, Henk Schut and Margaret Stroebe, all leading authorities on bereavement research, say that the benefit of emotional disclosure following loss is not proven scientifically.
The authors carried out a study at Utrecht University in the Netherlands which assessed 128 recently bereaved people four times in the two years following their loss. They found that none of the links between disclosure and subsequent reduced distress approached statistical significance.
One common method of treating the bereaved involves a counsellor asking them to write either about a recent traumatic loss or about a trivial topic. Those who write about trauma are asked to set down their "very deepest thoughts and feelings". Psychotherapeutic theory suggests that writing about such events should be beneficial because it forces the subject to confront threatening thoughts. The assumption is that inhibition is unhealthy. But the researchers in Utrecht studied 61 randomly selected examples of this kind of disclosure, which they say raise serious doubts about its effectiveness in improving mental health generally; when they looked at the efficacy of bereavement disclosure in particular, the results were mostly negative.
The authors argue that "grief work" is ineffective because the most common problem for the bereaved is loneliness, as the term "loss" suggests: they miss the deceased and feel utterly alone, even when they're with friends and family. It is possible, the authors argue, that this only abates with time.
Wolfgang Stroebe cautions, however, that the research does not mean that a small group suffering from severe psychological problems following a death, or those who experience a traumatic loss through a sudden or horrific accident, for example, might not benefit from professional intervention.
Dr Raj Persaud is Gresham professor for public understanding of psychiatry, and director of the Centre for Public Engagement, King's College London.
His latest book is The Motivated Mind (Bantam Press). Email: firstname.lastname@example.org