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Complicated grief - how common is it?

I recently wrote a blog post "Grief is our natural human response to bereavementwhere I said that mourning may well involve powerful feelings of yearning, disbelief, anger & depression.  When we have lost someone who has been very important to us, we gradually need to learn to live without them. Reconfiguring our inner emotional lives and our outer activities can be such a challenge.  Mostly though people manage.  It may be hard, but like the body healing after injury, emotional pain also resolves as we hold our loved ones in our hearts but engage more fully again in our lives.  Sometimes though after physical injury, wounds don't heal adequately.  Maybe there is infection or non-union of fractures.  In these situations the healing process may need help.

Grief is our natural human response to bereavement

When we're badly physically injured, there may be horrible pain and loss of ability to function normally. Then though there is typically a gradual recovery.  Scars may be left; there may be some persisting vulnerability, but basically our bodies are wonderful at self-healing.  There are parallels between wounds due to physical injury and wounds due to emotional injury.  For example, when we are bereaved, there may be horrible pain and loss of ability to function normally.  Gradually, over time, our minds & hearts can heal.  Of course, if we have lost someone important to us, we will never be quite the same.  We may always miss them, and remember them with sadness, gratitude and love.  The grief resolves though and we can move on with our lives, even though we continue to carry our loved ones in our hearts ... and this resolution is what they would have wanted for us.

Warwick BABCP conference: 1st morning - trauma memories & a master presentation on four decades of outcome research (2nd post)

Yesterday I blogged about the pre-conference workshop I attended on "Anger dysregulation". Today was the first full day of the conference proper.  Breakfast illustrated the kind of helpful, fun conversation that can emerge at this kind of event.  I talked to Fiona McFarlene & Tara Murphy who were going on to run a skills class on "Exposure and response prevention: adapting skills you already have to the treatment of tics".

If you see a therapist, how many sessions are you likely to need?

Is this one question or many?  If you see a therapist, how many treatment sessions are you likely to need?  Sometimes that's a little like asking "If I go on a journey, how long should I travel for?"  Happily though, we do now have enough research evidence to be able to respond fairly helpfully to this "how many treatment sessions?" question.  To give useful answers though, it’s probably sensible to break the very general “how many sessions?” query into a number of more targeted sub-questions.

Recent research: two studies on relationships, two on body to mind effects, and two on mindfulness

Here are details of half a dozen recent research papers - two on relationships, two on body to mind effects, and two on mindfulness.  Fuller details, links and abstracts of all the studies mentioned are given further down this post.

Recent research: 3 studies on internet-delivered therapy, 2 on speed of antidepressant response, and 1 on therapy effectiveness

Here are three studies (for all abstracts & links see below) highlighting the increasingly encouraging results being reported for internet-delivered psychological interventions.  Van't Hof, Cuijpers et al report on " ... a systematic review of meta-analyses on the efficacy of self-help interventions, including internet-guided therapy, for depression and anxiety disorders". They conclude that the 13 meta-analyses indicate "self-help methods are effective in a range of different disorders, including depression and anxiety disorders. Most meta-analyses found relatively large effect sizes for self-help treatments, independent of the type of self-help, and comparable to effect sizes for face-to-face treatments" (see below for abstracts and links to the six research papers mentioned).  Riper, Kramer et al describe how an experimental internet-delivered self-help alcohol reduction intervention transferred well to being made more generally available.  The authors conclude that " ...

The Ben Lui group (second post): how to know when to change direction on a walk or in treatment for psychological difficulties!

A couple of lines from the Bruce Springsteen song "Hungry heart" kept going through my head - "Like a river that don't know where it's flowing, I took a wrong turn and I just kept going."  Something was wrong.  I couldn't work out where I'd got to on my map.  The line of pylons shouldn't have been where they were - and certainly not where they were in relation to the stream and rough track I could see across the valley. 

I'd started walking fine in the morning.  I left Edinburgh early and before 9.00am was heading out from Dalrigh on the long walk up the valley to Ben Lui.  Two hours walking saw me at the bottom of the hill.  Then a steady tramp up and into the low lying cloud. 

Walking up into the mist on Ben Lui

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