GRIEF AND THE TRAUMATICALLY HEAD‐INJURED ADULT*

Traumatic head injury can lead to serious emotional upheaval for the head-trauma patient and family (Lezak, 1978; Romano, 1974; Rosin, 1977). One emotional reaction that receives little attention is grief. This article addresses the experiences of grief such as when a traumatically head-injured adult has lost a close relative or friend. There are no specific statistics indicating the incidence of death of significant others for head-trauma patients, yet it does happen. Motor vehicle accidents cause many traumatic head injuries (Jennett & Teasdale, 1981) and may kill other passengers who are family or friends of the head-injured adult. Inpatient rehabilitation can be lengthy, during which time natural deaths of friends or relatives can also occur. It is essential that professional staff learn to recognize, understand, and effectively to handle a grieving head-trauma patient. The grief reaction of the head-trauma patient differs markedly from the normal or commonly expected reaction. In presenting this point, a normal grief process will be briefly reviewed, followed by a case history illustrating grief reaction in a head-trauma adult. Specific cognitive and environmental constraints that may explain the head-trauma patient’s idiosyncratic grief reaction will then be covered. Treatment recommendations with the concepts of death and grief incorporated into a rehabilitation program will be discussed. Freud, in “Mourning and Melancholia” (Strachey, 1957) discussed the normal process of grief and mourning. He stated that mourning requires an understanding and acceptance of the finality of death. The individual withdraws energy that was invested in a dead relative or friend and reapplies it elsewhere. The individual may reminisce, feel lonely, or experience longing for the dead person. He or she may become quiet, tearful, or show disrupted eating and sleeping habits. A positive outcome of normal mourning is to become more social and return to previous activities. In comparison to this normal grief process, the grief reaction in headtrauma patients differs. Paul R. Sachs, PhD