Disenfranchised Grief

Ken Doka (1989) described the phenomena of disenfranchised grief. While a person is experiencing a loss, the grief is not openly acknowledged, socially validated or publically observed. It brings to mind some of the work I have done with adolescent females who have not had the support they needed. This has sometimes resulted in a complicated greiving which is manifested in the increase or commencement of substance use, depressive episodes and behavioral manifestations such as self harm. I recall working with an adolescent who witnessed the murder of her best friend at a drug deal that went bad. In this case the grief of the friend was not acknowledged and went unnoticed. In fact, stigma was attached to the friend because of her association with drugs.

In some cases the adolescent, themselves, may contribute to their own disenfranchisement as a result of repressing the grief reactions and then turning to drugs for medication. One young adult lost her father at 15. She spent the next three years putting all her energy into school and extracurricular activities. By her own report she ceased thinking about her father alltogether. Three years late, she was dropped off at college by her mother. Within a week, she withdrew after having a depressive episode. Shortly after returning home, she began using heroin.

In situations like these, the grief has been prolonged, traumatic and complicated. It requires treatment in which the clientt is provided with a safe environment and a therapeutic alliance is created with the therapist. Clients need to tell the story of the loss. There is power in the narration. Written exercises, unsent letters, guided imagery and symbolic dialoguing with the deceased have been useful in my work with grievers. Assessing for co-morbid issues like depression. PTSD and substance use are a necessity. My goal is not to end the grieving process because that is unrealistic. Rather, I like to assist the client in accomodating to the loss and developing a holistic view of the deceased that is not centered on the tragedy alone. In future blogs, I will comment on other aspects of grief and loss as well as other topics.

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