Holly Prigerson recalls the moments in which she started investigating prolonged grief disorder. She recalls being “a social scientist [Holly] in room a full of psychiatrists,” who recognized a diagnostic gap in people experiencing profound and potentially harmful grief far after the death of a loved one. This led her on a remarkable journey. Holly has accumulated mountains of evidence for the diagnosis of prolonged grief disorder as a specific condition primarily notable for a yearning over a year after the death. Prolonged grief is associated with increased risk of suicide and other negative health outcomes. This accumulation of data over her career led ultimately to the inclusion of Prolonged Grief Disorder first in the ICD, then in the DSM-V.

And yet, despite mountains of evidence, Holly has taken a tremendous amount of heat for this work. “Everyone has experienced grief, which makes everyone the expert.” Today we offer Holly a chance to answer her critics, including assertions that:

Grief is love; how can love be wrong?
Pathologizing grief leads to overmedicalization of a natural condition
Prolonged grief disorder is a tool made for the pharmaceutical industry
Prolonged grief disorder does not account for cultural variation in mourning practices

Along the way we talk about other related studies Holly has conducted, including a validation of DABDA - Elizabeth Kubler Ross’s famous stages of grief.

And a song choice from the great lyricist Tom Waits.

Enjoy!

-@AlexSmithMD

Prolonged Grief Disorder: Holly Prigerson

GeriPal - A Geriatrics and Palliative Medicine Podcast